Bonding positional accuracy of attachments and marginal adaptation of in-house aligners - A quality improvement laboratory study.

OBJECTIVES: To evaluate the 3D accuracy of attachment positioning and the adaptation of aligners to attachments using in-house templates made with either polyethylene terephthalate glycol (PETG) or ethylene-vinyl acetate (EVA) and either pressure or vacuum thermoforming machines. MATERIALS AND METHODS: Overall, 140 test specimens were resin-printed. Templates for the attachment bonding were made with 1-mm EVA or 0.5-mm PETG laminates. Orthodontic aligners were manufactured with 0.75-mm PETG. The thermoplastification process was carried out using either vacuum or pressure machines. The positional differences between the virtual and bonded attachments were assessed in the X, Y and Z coordinates. The marginal adaptation between the aligners and the attachments was measured. RESULTS: Minor inaccuracies in the positioning of the attachments were observed in all combinations of thermoforming machines and plastic laminates used to fabricate the templates, mainly in the superior-inferior (Z) dimension. PETG performed better than EVA in the anterior region (p < .05). No association was found between thermoplastification machines and the accuracy of the positioning of the attachments (p > .05). While small misadaptations between the aligners and the attachments were observed, the EVA templates performed better than the PETG templates. CONCLUSIONS: The inaccuracy of the attachment positioning and the misadaptation of the aligners to the attachments were slight. The vacuum and pressure thermoplastification machines showed no difference in attachment positioning accuracy. The PETG template was better than the EVA template in the anterior region, but the EVA attachments presented a better adaptation to the aligners than the PETG attachments.

Radiotherapy does not impair dentin adhesive properties in head and neck cancer patients.

OBJECTIVES: This study evaluated the influence of radiotherapy on the dentin bond strength of teeth extracted from patients who had undergone head and neck radiotherapy. MATERIALS AND METHODS: A total of 36 samples were divided into two experimental groups: group I (control group, n = 18) and group II (in vivo irradiated group, n = 18). Groups I and II were further separated into three subgroups (six specimens per subgroup), which were further assigned to the three adhesive system protocols employed: Single Bond 2 (SB) (3M ESPE), Easy Bond (EB) (3M ESPE) and Clearfil SE Bond (CSE) (Kuraray). The adhesive systems were applied to the prepared surface according to the manufacturers' instructions and restored using composite resin (Filtek Supreme, 3M ESPE). After 24 h in deionised water (37(o)C), teeth were horizontally and vertically cut to obtain beam specimens with a cross-section area of 0.8 ± 1.0 mm(2). Specimens were tested in tension using a universal testing machine at a cross-speed of 0.5 mm/min. Fracture patterns were observed under SEM. Data was analysed by two-way analysis of variance (p ≤ 0.05). RESULTS: No statistically significant difference was found between the irradiated (R/SB = 44.66 ± 10.12 MPa; R/EB = 41.48 ± 12.71 MPa; and R/CSE = 46.01 ± 6.98 MPa) and control group (C/SB = 39.12 ± 9.51 MPa; C/EB = 42.40 ± 6.66 MPa; and C/CSE = 36.58 ± 7.06 MPa) for any of the adhesive systems. All groups presented a predominance of mixed fracture modes. CONCLUSION: Head and neck radiotherapy did not affect dentin bond strength for the adhesive materials tested in this study.

Physical, chemical, mechanical, and micromorphological characterization of dental needles.

BACKGROUND: In anesthetic techniques, touching bones can cause needle bending. Theoretically, a needle should support such deflection without fracturing. However, it is possible that a needle may fracture depending on the quality and type of needle used. This study evaluated the physical, chemical, and micromorphological characteristics of long and short dental anesthetic needles, as well as the mechanical properties of flexural load and bending resistance when needles are subjected to different bending angles. METHODS: Long and short needles (30G, Jets, Misawa, Selekto, Terumo, Unoject and 27G, Dencojet, Injex, Jets, Misawa, Procare, Setoject XL, Terumo) were evaluated. Scanning electron microscopy was used to evaluate the needle bevels and energy-dispersive X-ray spectroscopy was used for the chemical analysis of needle compositions. Flexural loading and bending strength assessments were performed using a universal testing machine by bending the needles (n = 5) to angles of 30°, 60°, or 90°, or until fracture occurred. RESULTS: The Injex 27G, Jets 27G, and Septoject XL 27G needles were all less than 30 mm in length. There were small percentage variations in the chemical compositions of the needles. Superior smoothness was observed for the Unoject 30G needle, which exhibited the highest fracture resistance at 60°. The Jets 30G needle exhibited greater resistance to fractures at 90°. The Procare 27G needle exhibited the highest load resistance to bending, followed by the Septoject XL 27G needle, and both needles were tied for the lowest fracture resistance. No needle fractured when bent to 30° or at less than three bends to 60° or 90°. CONCLUSIONS: Greater needle resistance to bending increases the probability of early fracturing. Thinner and shorter needles are more resistant than longer and thicker needles. Performing a single bend does not result in any significant risk of fracture or obliterate the lumen, allowing for the continued passage of anesthetic liquid.

Push-out bond strength and marginal adaptation of apical plugs with bioactive endodontic cements in simulated immature teeth.

OBJECTIVES: This study evaluates the bond strength and marginal adaptation of mineral trioxide aggregate (MTA) Repair HP and Biodentine used as apical plugs; MTA was used as reference material for comparison. MATERIALS AND METHODS: A total of 30 single-rooted teeth with standardized, artificially created open apices were randomly divided into 3 groups (n = 10 per group), according to the material used to form 6-mm-thick apical plugs: group 1 (MTA Repair HP); group 2 (Biodentine); and group 3 (white MTA). Subsequently, the specimens were transversely sectioned to obtain 2 (cervical and apical) 2.5-mm-thick slices per root. Epoxy resin replicas were observed under a scanning electron microscope to measure the gap size at the material/dentin interface (the largest and smaller gaps were recorded for each replica). The bond strength of the investigated materials to dentin was determined using the push-out test. The variable bond strengths and gap sizes were evaluated independently at the apical and cervical root dentin slices. Data were analyzed using descriptive and analytic statistics. RESULTS: The comparison between the groups regarding the variables' bond strengths and gap sizes showed no statistical difference (p > 0.05) except for a single difference in the smallest gap at the cervical root dentin slice, which was higher in group 3 than in group 1 (p < 0.05). CONCLUSIONS: The bond strength and marginal adaptation to root canal walls of MTA HP and Biodentine cement were comparable to white MTA.

Bond Strength and Failure Pattern of Orthodontic Tubes Adhered to a Zirconia Surface Submitted to Different Modes of Application of a Ceramic Primer.

The aim of this study was to evaluate the shear bond strength of orthodontic tubes adhered to ceramics with the Transbond™ XT bonding resin (3M, Maplewood, MN, USA) while varying the surface treatment. Then, the adhesive remaining index (ARI) was verified, and the representative fracture patterns were evaluated via scanning electron microscopy. Forty-eight zirconia blocks were divided into three groups, varying the number of layers of the 10-methacryloyloxy-decyl dihydrogen phosphate (MDP) primer: one, two, or three applications. In addition, 16 lithium disilicate IPS E.max ceramic disks (Ivoclar Vivadent, Schaan, Liechtenstein) were conditioned with 10% hydrofluoric acid for 20 s and underwent a single-layer primer application regimen. The four groups were further stratified to undergo bond testing after either 24 h (control) or 5000 cycles in a thermocycling machine. A shear bond strength test was performed (0.5 mm/min), and the MPa values obtained were submitted to a two-way analysis of variance and Tukey's test. There was no statistical difference among the control group ceramics that received the varying surface treatments. After thermocycling, it was verified that both the E.max disks and the zirconia ceramics with three primer applications obtained the highest bond strength values. In the 24 h groups, a total displacement of the resin from the orthodontic tubes was observed (ARI of 1). After thermocycling, the highest prevalence of an ARI of 5 (adhesive failure) was observed among the zirconia ceramics with single-coat primer application, followed by those with triple-coat primer application (mixed failure). Three applications of the MDP-containing ceramic primer achieved the best result in the present study. Zirconia surface should be treated with three coats of MDP primer to achieve a level of bond strength similar to silica-rich phase ceramic.

Long-term Stability of a Camouflage Retreatment of an Asymmetric Class III/Posterior Open Bite Using Sliding Jigs.

This article reports the camouflage retreatment of an adult patient presenting an asymmetric Class III malocclusion and posterior open bite. Sliding jigs (SJs) associated with intermaxillary elastics were used. The long-term stability of the excellent results suggests that the use of SJs to correct asymmetric posterior occlusions may be effective.

In vitro analysis of morphology of human enamel submitted to excessive use of external bleaching agents / Análisis in vitro de la morfología del esmalte humano sometido a un uso excesivo de agentes blanqueadores externos

The aim of this study was to evaluate the effects of external bleaching agents on morphology of human enamel after excessive homemade dental bleaching. 20 intact human third molars were submitted to mesio-distal crosscut and embedded in polystyrene resin. The specimens were submitted to finish and a half of enamel surface of each specimen was covered with cosmetic varnish, meaning control group (G0). The specimens were randomly divided into four groups (n=10): G1 ­ 1 bleaching session by 16 percent carbamide peroxide; G2 ­ 3 bleaching sessions by 16 percent carbamide peroxide; G3 1 bleaching session by 22 percent carbamide peroxide; G4 3 bleaching sessions by 22 percent carbamide peroxide. Each session lasted 8 hours a day, during two weeks, with 45 days of interval between sessions. In this period, the specimens were kept in artificial saliva at 37°C. The specimens were observed by scanning electron microscopy and the results showed depression areas, irregularities, erosion, and enamel prisms exposition, which was more evident in G4. It can be concluded that the excess of bleaching produced many alterations on enamel surface, mainly when was used carbamide peroxide in higher concentration.

El objetivo de este estudio fue evaluar los efectos en la morfología externa del esmalte humano al utilizar excesivamente agentes blanqueadores dentales de uso casero. Se cortaron 20 intactos terceros molares humanos en sentido mesiodistal, luego fueron sumergidas las porciones radiculares en resina de poliestireno. Las muestras fueron pulidas, cubriendo la mitad de la superficie del esmalte con barniz cosmético, representando así al grupo control (G0). Las muestras fueron distribuidas aleatoriamente en cuatro grupos (n=10): G1-Una sesión de blanqueamiento con peróxido de carbamida al 16 por ciento, G2. Tres sesiones de blanqueamiento con peróxido de carbamida al 16 por ciento, G3-Una sesión de blanqueamiento con peróxido de carbamida al 22 por ciento, G4- Tres sesiones de blanqueamiento con peróxido de carbamida al 22 por ciento. Cada sesión tuvo una duración de 8 horas diarias durante dos semanas con 45 días de intervalo entre sesiones. Durante ese periodo las muestras fueron mantenidas en saliva artificial a 37°C. Las muestras fueron observadas al microscopio electrónico de barrido, mostrando aéreas de depresión, irregularidades, erosiones y exposición de prismas del esmalte. Esto fue más evidente en G4. Se puede concluir que el exceso de blanqueamiento producido muchas alteraciones en la superficie del esmalte, sobre todo cuando se utilizó peróxido de carbamida en alta concentración.

Avaliação da microinfiltração marginal em cavidades classe II restauradas com resina composta auto e fotopolimerizável / Microleakage evaluation in cavity II preparation Restored with autopolymerizing and photopolymerizing composite resins

O objetivo deste trabalho de pesquisa foi avaliar in vitro a microinfiltração marginal em cavidades classe II, com margem gengival em cemento, quando estas são restauradas apenas com resina composta fotopolimerizável ou associando resina composta auto/fotopolimerizável. As cavidades foram confeccionadas em molares humanos recém-extraídos e após os procedimentos de preparo cavitário os espécimes foram divididos em dois grupos, onde um grupo foi restaurado apenas com a resina composta fotopolimerizável Surefil (Dentsply) e o outro grupo com a resina composta autopolimerizável Adaptic (Dentsply) na parede gengival e o restante da cavidade preenchido pela resina composta fotopolimerizável. Em seguida, os corpos-de-prova foram submetidos à ciclagem térmica, imersos em solução corante de nitrato de prata a 50% e seccionados em uma máquina de corte para avaliação da microinfiltração com o auxílio de uma lupa estereoscópica. Os dados obtidos foram tabelados e submetidos à análise estatística pelo teste não-paramétrico de Kruskal-Wallis, observando-se não haver diferença estatisticamente significante entre as duas técnicas restauradoras avaliadas no que diz respeito ao nível de microinfiltração marginal apresentado por elas. Dessa forma, constatou-se desnecessário o uso da resina composta autopolimerizável como incremento gengival em cavidades classe II, já que este material restaurador não foi capaz de impedir a ocorrência de microinfiltração marginal