Influence of different viscosity and chemical composition of flowable composite resins: A 48-month split-mouth double-blind randomized clinical trial.

OBJECTIVES: To evaluate the clinical performance of two flowable composites based on methacrylate and one based on ormocer in treating non-carious cervical lesions (NCCLs) after 48-month evaluation in a split-mouth double-blind clinical study design. METHODS: A total of 183 restorations were performed on NCCLs using a universal adhesive system (Futurabond U, Voco GmbH) with selective enamel etching on 27 participants: two participants received twelve restorations each, three received nine restorations each, and 22 participants received six restorations each. Three different flowable composites were employed (n = 61): a low-viscosity methacrylate-based composite (GrandioSO Flow, LVM), a high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HVM), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 48 months. Statistical analysis was conducted using Kaplan-Meier Survival analysis and Kruskal-Wallis analysis of variance rank (α = 0.05). RESULTS: After 48 months, 17 restorations were lost: LVM 6, HVM 9, ORM 2. The retention rates (95 % confidence interval) were 89.4 % for LVM, 80.4 % for HVM, and 95.6 % for ORM, with a significant difference between HVM vs. LVM and HVM vs. ORM (p < 0.05). Minor defects were observed in 30 restorations for marginal staining criteria (LVM 12, HVM 10, ORM 8) and in 71 restorations for marginal adaptation criteria (LVM 24, HVM 20, ORM 27) without significant difference between groups (p > 0.05). No restorations showed postoperative sensitivity or recurrence of caries. SIGNIFICANCE: The increased viscosity of flowable composites could reduce the clinical longevity in NCCLs after 48 months. Ormocer-based and low-viscosity methacrylate-based flowable composites showed a successful clinical performance in NCCLs after 48 months.

A 24-month clinical evaluation of composite resins with different viscosity and chemical compositions: a randomized clinical trial.

OBJECTIVES: To evaluate the clinical performance of two methacrylate-based flowable composites and an ormocer-based flowable composite in noncarious cervical lesions (NCCLs) in adult participants. METHOD AND MATERIALS: In total, 183 restorations were performed on NCCLs. All cavities were restored using a universal adhesive system (Futurabond U, Voco) with selective enamel etching and with one of the three evaluated flowable composites (n = 61): low-viscosity methacrylate-based composite (GrandioSO Flow, LV), high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 24 months. Kruskall-Wallis analysis of variance rank (α = .05) was used for statistical analysis. RESULTS: After 24 months of clinical evaluation, 16 restorations were lost (LV = 3, HV = 10, ORM = 3) and the retention rates (95% confidence interval) were 95.0% for LV, 82.2% for HV, and 95.0% for ORM, with statistical differences observed between HV and LV as well as HV and ORM (P < .05). When secondary parameters were evaluated, no significant differences between groups were observed (P > .05). Thirty-three restorations (LV = 8, HV = 13, ORM = 12) showed minor marginal staining, 71 restorations (LV = 26, HV = 20, ORM = 25) presented small marginal adaptation defects, and one restoration for HV presented recurrence of caries. CONCLUSION: The universal adhesive associated with the ormocer-based and methacrylate-based flowable composite showed promising clinical performance after 24 months. However, the heavy-flow restorations showed significantly more failures. (Quintessence Int 2023;54:186-199; doi: 10.3290/j.qi.b3631841).

A universal adhesive containing copper nanoparticles improves the stability of hybrid layer in a cariogenic oral environment: An in situ study.

PURPOSE: To evaluate how incorporating copper nanoparticles (CuNp) into a universal adhesive affects the antimicrobial activity (AMA), bond strength (µTBS), nanoleakage (NL), elastic modulus (EM) and nanohardness (NH) of resin-dentin interfaces, at 24 h (24 h) and after in situ cariogenic challenge (CC). METHODS: CuNp (0% [control] and 0.1 wt%) was added to an adhesive. After enamel removal, the adhesives were applied to dentine surfaces. Each restored tooth was sectioned longitudinally to obtain two hemi-teeth; one of them was evaluated after 24 h, and the other was included in one of the intra-oral palatal devices placed in the mouths of 10 volunteers for 14 days in CC. After that, each hemi-tooth was removed, and any oral biofilm that formed was collected. The AMA was evaluated against Streptococcus mutans. For the 24 h and CC groups, each hemi-tooth was sectioned in the "x" direction to obtain one slice for each EM/NH evaluation. The remains of each hemi-tooth were sectioned in the "x" and "y" directions to obtain resin-dentin beams for µTBS and NL evaluation (24 h and CC). ANOVA and Tukey's test were applied (α = 0.05). RESULTS: The presence of CuNp significantly improved AMA as well as all of the evaluated properties (24 h; p < 0.05). Although the adhesive properties (µTBS/NL) for all groups decreased after CC (p < 0.05), the adhesive containing CuNp showed higher µTBS and lower NL as compared to the copper-free adhesive (p < 0.05). The incorporation of CuNp maintained NH/EM values after CC (p < 0.05). CONCLUSIONS: Adding 0.1% CuNp to an adhesive may provide antimicrobial activity and increase its bonding and mechanical properties, even under a cariogenic challenge. SIGNIFICANCE: This is the first in situ study proving that incorporating CuNp into an adhesive is an achievable alternative to provide antimicrobial properties and improve the integrity of the hybrid layer under in situ cariogenic challenge.

Alargamiento de corona estético previo a rehabilitación protésica. Informe de caso / Aesthetic crown lengthening prior to prosthetic rehabilitation. Case report

RESUMEN: Introducción: Uno de los procedimientos realizados con mayor frecuencia para el restablecimiento de la estética en la zona anterosuperior es el alargamiento de corona, el cual está indicado ante la presencia de una longitud insuficiente de la corona clínica de un diente, cuando existe caries o fracturas subgingivales y para la mejora de la estética en pacientes con margen gingival desigual. Objetivo: El objetivo de este artículo es presentar el alargamiento de corona estético realizado en una paciente que presentaba márgenes discrepantes y pérdida de las papilas en la zona anterosuperior, la cual fue remitida del área de prótesis para poder realizar posterior rehabilitación protésica. Resultados: Mediante el procedimiento quirúrgico se logró la corrección y restablecimiento de los márgenes gingivales. Conclusiones: La zona anterosuperior es el área estéticamente más comprometida, por lo que es indispensable la planeación interdisciplinaria del tratamiento para asegurar el éxito del mismo.

ABSTRACT: Introduction: One of the most frequently performed procedures for aesthetics restoration in the maxillary anterior area is the crown lengthening, which is indicated in the presence of an insufficient length of the clinical crown of a tooth, of cavities or subgingival fractures and for the improvement of aesthetics in patients with uneven gingival margin. Objective: The aim of this article is to present the aesthetic crown lengthening performed in a patient with discrepant margins and loss of the papillae in the maxillary anterior area, referred from the prosthesis department for subsequent prosthetic rehabilitation. Results: Through the surgical procedure, the correction and restoration of the gingival margins were achieved. Conclusions: The maxillary anterior area is the most aesthetically compromised area, which is why the interdisciplinary planning of the treatment is essential to ensure its success.

Hábitos perjudiciales para la salud oral en mujeres gestantes en Ecuador

El embarazo es una etapa donde la futura mamá experimentará cambios físicos y fisiológicos, por lo cual debe cuidar mucho más su salud oral, ya que podrá repercutir en el bebé. El objetivo fue evaluar hábitos perjudiciales para la salud oral en mujeres gestantes que acudieron al centro de salud del barrio "6 de Julio", del norte de Quito - Ecuador. Este estudio se realizó en abril y mayo de 2016 con un universo de 125 embarazadas. La muestra fue de 45, que acudieron a control prenatal en estos meses, se implementó una encuesta con preguntas de selección múltiple, se recolectó información sobre: hábitos alimentarios , de higiene oral y algunos perjudiciales en este período de gestación. Existen prácticas que pueden ser perjudiciales tanto en la salud de la madre como del bebé, en este estudio se obtuvo datos en los cuales un 72,7% de las gestantes ingieren café y 36,3% se muerden las uñas. De acuerdo con los datos recolectados, el 100% refirió algún mal hábito. Con respecto al cepillado, el 20% limpia sus dientes hasta 2 veces al día y el 80% más de dos veces al día, la frecuencia de cambio de cepillo dental el 40% lo realiza en menos de 6 meses y el 60%, más de 6 meses. Hay que hacer hincapié en el cuidado de su cavidad oral como parte integral de organismo y se debe reducir la práctica de hábitos perjudiciales durante la etapa de gestación.

Pregnancy is a stage where expectant mother will feel physical and physiological changes, so she should take care of her oral health because this can affect the baby. The objective was evaluate harmful habits for oral health in pregnant women that were treated at the neighborhood clinic "6 de Julio", north of Quito - Ecuador. This study was made in the months of April and May 2016 with a universe of 125 pregnant women. The simple was 45, who went to prenatal care during these months, was implemented multiple-choice questions at the investigation, and information was collected about: eating habits, oral hygiene habits and harmful habits in this period of gestation. There are habits that can be harmful health by mother and baby, in our study had a 72.7% of pregnant women who drink coffee, and 36.3% bite their nails. According to the data collected 100% reported any bad habits. While to brush teeth 20% brush their teeth twice a day and 80% more than twice a day, the frequency of change of toothbrush 40% was changed in less than 6 months and 60%, more than 6 months. We should do emphasis at the care of oral cavity as an integral part of the body and should reduce bad habits during pregnant period.