Planning extensive esthetic restorations for anterior teeth: use of waxed-up study casts and composite resin mock-ups.

The aim of this case report is to highlight the importance of appropriate planning protocols when direct composite resin restorations are used to solve extensive esthetic problems. A 30-year-old patient complained about her small maxillary anterior teeth and short upper lip. All teeth were healthy and light colored, and the patient exhibited good oral hygiene. The anterior teeth were relatively short, resulting in a compromised esthetic relationship between height and width. The maxillary and mandibular right central incisors were in an edge-to-edge relationship. After diagnostic casts and waxed-up study casts were obtained, occlusal adjustment and recontouring of the incisal and labial surfaces of the mandibular right central incisor were performed to increase overjet. To increase the volume of the upper lip, composite resin restorations were planned for the maxillary anterior teeth. To confirm that the contours and color of the new smile were acceptable to the patient, composite resin esthetic mock-ups were made directly in the mouth before the definitive procedure. After definitive restoration of the anterior teeth, additional occlusal adjustments were performed. At the 36-month follow-up, no fracturing or severe wear of the restorations was observed. The restored anterior guidance provided excellent function after 3 years of clinical service.

Silanated Surface Treatment: Effects on the Bond Strength to Lithium Disilicate Glass-Ceramic.

The aim of this study was to evaluate the effect of silanization protocols on the bond strength of two resin cements to a lithium disilicate glass-ceramic. Thirty-two ceramic discs were assigned to 2 groups (n=16): G1 - dual-cured resin cement and G2 - light-cured resin cement. Four subgroups were evaluated according to the used silanization protocol. The glass-ceramic was etched with 10% hydrofluoric acid for 20 s and silane was applied for 1 min, as follows: CTL - according to the manufacturer's instructions; HA - dried with hot air; NWA - washed and dried with water and air at room temperature; HWA - washed and dried with hot water and hot air. Thereafter, adhesive was applied and light-cured for 20 s. Silicon molds were used to prepare resin cement cylinders (1x1 mm) on the ceramic surface. The specimens were stored in deionized water at 37 °C for 48 h and subjected to a micro-shear test. The data were submitted to statistical analysis (?#61537;=0.05). Group G1 showed higher bond strengths than G2, except for the CTL and NWA subgroups. Differences as function of the silanization protocol were only observed in G1: HWA (25.13±6.83)≥HA (22.95±7.78)≥CTL(17.44±7.24) ≥NWA(14.63±8.76). For G2 there was no difference among the subgroups. In conclusion, the silanization protocol affected the resin cement/ceramic bond strengths, depending on the material. Washing/drying with hot water and/or hot air increased only the bond strength of the dual-cured resin cement.

Evaluation of Discoloration Removal by Polishing Resin Composites Submitted to Staining in Different Drink Solutions.

The aim of this study was to evaluate the discoloration effects of water, cola-based soft drink, coffee, and wine on resin composites used in restorative dentistry and the possibility of removing the stain with chair side manual polishing. The A2 shade of three materials was tested. Disc specimens were prepared. A spectrophotometer was used to measure the baseline CIE-Lab color parameters of each material (n=10) 24 hours after sample preparation. Samples were then immersed in a cola-based soft drink, coffee, or wine for 1 hour every day, for 30 days. For the remaining hours, the specimens were stored in distilled water. In the control group, the specimens were immersed in water for the whole period. The color differences (ΔE) were calculated after 7 and 30 days of storage, and after polishing with coarse Sof-Lex discs, and analyzed by two-way ANOVA with repeated measures and Tukey's HSD test (α=0.05). Luna presented higher ΔE values (3.41) (a) followed by Durafill (2.82) (b) and Herculite (2.24) (c) . For the drink solutions, ΔE values were higher for wine (4.40) (a) followed by coffee (2.59) (b) and for cola-based soft drink (2.23) (c) and water (2.13) (c) which were statistically similar. For time, ΔE values were higher for 30 days (3.97) (a) and then for 7 days (2.48) (b) and after polishing (2.04) (c) . The results indicate that color stability is material dependent. The types of drinks that patients consume also influence the color stability of restorative materials.

Silanated Surface Treatment: Effects on the Bond Strength to Lithium Disilicate Glass-Ceramic

Abstract: The aim of this study was to evaluate the effect of silanization protocols on the bond strength of two resin cements to a lithium disilicate glass-ceramic. Thirty-two ceramic discs were assigned to 2 groups (n=16): G1 - dual-cured resin cement and G2 - light-cured resin cement. Four subgroups were evaluated according to the used silanization protocol. The glass-ceramic was etched with 10% hydrofluoric acid for 20 s and silane was applied for 1 min, as follows: CTL - according to the manufacturer's instructions; HA - dried with hot air; NWA - washed and dried with water and air at room temperature; HWA - washed and dried with hot water and hot air. Thereafter, adhesive was applied and light-cured for 20 s. Silicon molds were used to prepare resin cement cylinders (1x1 mm) on the ceramic surface. The specimens were stored in deionized water at 37 °C for 48 h and subjected to a micro-shear test. The data were submitted to statistical analysis (?#61537;=0.05). Group G1 showed higher bond strengths than G2, except for the CTL and NWA subgroups. Differences as function of the silanization protocol were only observed in G1: HWA (25.13±6.83)≥HA (22.95±7.78)≥CTL(17.44±7.24) ≥NWA(14.63±8.76). For G2 there was no difference among the subgroups. In conclusion, the silanization protocol affected the resin cement/ceramic bond strengths, depending on the material. Washing/drying with hot water and/or hot air increased only the bond strength of the dual-cured resin cement.

Resumo: O objetivo do estudo foi avaliar o efeito da técnica de silanização na resistência de união de cimentos resinosos a uma vitrocerâmica. Trinta e dois discos de vitrocerâmica foram distribuídos em 2 grupos (n=16) (G1: cimento dual e G2: cimento fotoativado) e subdivididos em 4 grupos de acordo com a técnica de silanização. A vitrocerâmica foi condicionada com ácido fluorídrico a 10% por 20 s e o silano aplicado por 1 min de acordo com os subgrupos: CTL: de acordo com as instruções do fabricante, HA: secagem do silano com ar quente, NWA: lavagem e secagem com água e ar a temperatura ambiente, HWA: lavagem e secagem com água e ar quente. Após, o sistema adesivo foi aplicado e polimerizado por 20 s, e cilindros (1 x 1 mm) foram confeccionados com os cimentos sobre a superfície da cerâmica. Os espécimes foram armazenados em água destilada por 48 h e submetidos ao ensaio de microcisalhamento. Os dados foram submetidos à análise estatística (?#61537;=0,05). O grupo G1 apresentou maiores valores de resistência do que G2, exceto no subgrupo CTL e NWA. Houve diferença na técnica de silanização apenas para G1: HWA (25,13±6,83)≥ HA (22,95±7,78)≥ CTL (17,44±7,24)≥ NWA (14,63±8,76). Para G2 não houve diferença entre os subgrupos. Conclui-se que a técnica de silanização interferiu na resistência de união cimento/cerâmica dependendo do material utilizado. A lavagem e secagem com água e ar aquecidos promoveu maior valor de resistência apenas para o cimento dual.