ABSTRACT
OBJECTIVES: To evaluate the clinical performance of a universal adhesive system (Futurabond U, Voco) when applied following different adhesive strategies in non-carious cervical lesions (NCCLs) after 5 years. METHODS: Fifty participants were included. Futurabond U (Voco) was applied in NCCLs using four adhesive strategies (n = 50 each): only self-etch (SE); selective enamel etching + self-etch (SET + SE); etch-and-rinse with dry dentin (ERD); and etch-and-rinse with wet dentin (ERW). All cavities were restored with Admira Fusion composite resin (Voco). Restorations were evaluated after 1, 3, and 5 years using the World Federation criteria (FDI) and the modified United States Public Health Service (USPHS) criteria. RESULTS: After 5 years, retention rates were 81 % (65.8-90.5) for SE, 87 % (73.2-94.4) for SET + SE, 84 % (69.6-92.6) for ERD, and 78 % (63.6-88.9) for ERW (p > 0.05). Thirty-five restorations were considered to have minor discrepancies in marginal adaptation at the 5-year recall (14 for SE, 9 for SET + SE, 6 for ERD, and 6 for ERW; p > 0.05). Sixteen restorations were detected as a minor marginal discoloration (6 for SE, 4 for SET + SE, 1 for ERD, and 5 for ERW; p > 0.05) and one restoration showed a recurrence of caries (1 for ERW; p > 0.05) at the 5-year recall. No restorations showed postoperative sensitivity after 5 years. SIGNIFICANCE: NCCLs restorations using a universal adhesive showed satisfactory clinical performance after 5 years, regardless of the adhesive strategy.
Subject(s)
Dental Bonding , Dental Caries , Humans , Dental Cements , Dentin-Bonding Agents/chemistry , Resin Cements/chemistry , Dental Restoration, Permanent , Dental Marginal Adaptation , Dental Restoration Failure , Composite Resins/chemistry , Dental Caries/therapy , Dental Caries/pathology , Tooth Cervix/pathologyABSTRACT
Objective: The objective of this double-blind, randomized controlled clinical trial was to evaluate the clinical performance of two methacrylate-based flowable composite and ormocer-based flowable composite in non-carious cervical lesions (NCCLs) of adult patients. Material and Methods: 183 restorations were performed on NCCLs using the Futurabond U adhesive system, applied in the selective enamel etching mode in all cavities. After the adhesive application, the cavities were restored with one out of the three evaluated flowable composites (n = 61 per group): ormocer-based flowable composite (Admira Fusion Flow, ORM), low viscosity methacrylate-based composite (GrandioSO Flow, LV) and high viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV). After 12 months of clinical performance, these restorations were evaluated according to FDI and USPHS criteria in the following items: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity and caries recurrence. Results: eight restorations were lost/fractured after 12 months of clinical evaluation (1 in the ORM and 7 in the HV group). The retention rates for 12- months (95% confidence interval) were 98.4% (91.3%-99.7%) for the ORM group, 100% (94.5%-100%) for the LV group and 88.5% (78.1%-94.3%) for the HV group, with no statistical difference identified between any pair of groups (p > 0.05). Five restorations presented small marginal adaptation defects at the 12-months evaluation recall, and all of them were considered clinically acceptable. Conclusion: The clinical performance of the universal adhesive associated to ormocer-based or methacrylate-based flowable composite were found to be promising after 12-month of clinical evaluation (AU)
Objetivo: O objetivo deste estudo clínico duplo-cego randomizado foi comparar as taxas de retenção de um compósito fluido à base de Ormocer versus dois compósitos fluidos à base de metacrilato quando utilizados em lesões cervicais não cariosas (LCNCs) de pacientes adultos. Material e Métodos: 183 restaurações foram realizadas em LCNCs utilizando o sistema adesivo Futurabond U, aplicado no modo de condicionamento seletivo do esmalte em todas as cavidades. Após a aplicação do adesivo, as cavidades foram restauradas com um dos três compósitos fluidos avaliados (n = 61 por grupo): compósito fluido à base de ormocer (Admira Fusion Flow, ORM), compósito à base de metacrilato de baixa viscosidade (GrandioSO Flow, LV) e compósito à base de metacrilato de alta viscosidade (GrandioSO Heavy Flow, HV). Após 12 meses de desempenho clínico, essas restaurações foram avaliadas de acordo com os critérios FDI e USPHS nos seguintes itens: retenção / fratura, adaptação marginal, coloração marginal, sensibilidade pós-operatória e recorrência de cárie. Resultados: oito restaurações foram perdidas / fraturadas após 12 meses de avaliação clínica (1 no grupo ORM e 7 no grupo HV). As taxas de retenção por 12 meses (intervalo de confiança de 95%) foram 98,4% (91,3% -99,7%) para o grupo ORM, 100% (94,5% -100%) para o grupo LV e 88,5% (78,1% -94,3%) para o grupo HV, sem diferença estatística identificada entre nenhum par de grupos (p> 0,05). Cinco restaurações apresentaram pequenos defeitos de adaptação marginais no período de avaliação de 12 meses, e todas foram consideradas clinicamente aceitáveis. Conclusão: O desempenho clínico do adesivo universal associado ao compósito fluido à base de ormocer ou metacrilato mostrou-se promissor após 12 meses de avaliação clínica(AU)
Subject(s)
Humans , Adult , Clinical Trial , Dentin-Bonding Agents , Dental Marginal Adaptation , Dental Restoration, TemporaryABSTRACT
OBJECTIVES: This study evaluated the effect of the administration of pre-operative dexamethasone on tooth sensitivity stemming from in-office bleaching. MATERIALS AND METHODS: A triple-blind, parallel-design, randomized clinical trial was conducted on 70 volunteers who received dexamethasone or placebo capsules. The drugs were administered in a protocol of three daily 8-mg doses of the drug, starting 48 h before the in-office bleaching treatment. Two bleaching sessions with 37.5% hydrogen peroxide gel were performed with a 1-week interval. Tooth sensitivity (TS) was recorded on visual analog scales (VAS) and numeric rating scales (NRS) in different periods up to 48 h after bleaching. The color evaluations were also performed. The absolute risk of TS and its intensity were evaluated by using Fisher's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney U test and a two-way repeated measures ANOVA and Tukey's test, respectively. RESULTS: In both groups, a high risk of TS (Dexa 80% x Placebo 94%) was detected. No significant difference was observed in terms of TS intensity. A whitening of approximately 3 shade guide units of the VITA Classical was detected in both groups, which were statistically similar. CONCLUSIONS: It was concluded that the administration pre-operatively of dexamethasone, in the proposed protocol, does not reduce the incidence or intensity of bleaching-induced tooth sensitivity. CLINICAL RELEVANCE: The use of dexamethasone drug before in-office bleaching treatment does not reduce incidence or intensity of tooth sensitivity. CLINICAL TRIAL REGISTRATION NUMBER: NCT02956070.
Subject(s)
Dentin Sensitivity/chemically induced , Dentin Sensitivity/prevention & control , Dexamethasone/administration & dosage , Glucocorticoids/administration & dosage , Hydrogen Peroxide/adverse effects , Tooth Bleaching/adverse effects , Adult , Female , Humans , Male , Pain Measurement , Preoperative Care , Treatment OutcomeABSTRACT
Objective: The objective of this study was to evaluate the alteration of the optical properties of bulk fill resin-based composites after two years of simulated toothbrushing. Material and Methods: Three high-viscosity bulk fill resin composites and one conventional sculptable resin composite (control) were analyzed. Five specimens of each resin composite were prepared, and roughness, color, translucency and gloss were evaluated initially and after one and two years of simulated toothbrushing. The specimens were submitted to electric simulated toothbrushing (14600 strokes / 100 g) using a commercially available soft bristle toothbrush and toothpaste slurry in a proportion of 1:2 by weight. The brushing scheme was of 40 cycles per day (2 cycles per second / 280 cycles in a week). The optical properties and the roughness data were analyzed by a multifactor analysis of variance (MANOVA) and a Tukey post hoc test. Results: The baseline and final values of Ra and Sa were submitted to linear regression analyses, all of which were performed at a significance level of 5%. Gloss and roughness presented statistical differences between the resin-time interactions in all composite resins. The gloss (72.5%) and roughness (89.4%) worsened significantly after brushing, but the authors didn't find statistically significant differences when evaluating translucency and color. Conclusion: Based in the results, it could be concluded that the simulated brushing degraded the gloss and roughness of the used high-viscosity bulk fill composites. (AU)
Objetivo: O objetivo deste estudo foi avaliar a alteração das propriedades ópticas de resinas compostas do tipo bulk fill após dois anos de escovação simulada. Material e Métodos: Foram analisadas três resinas compostas do tipo bulk fill de alta viscosidade e uma resina composta convencional (controle). Cinco corpos-deprova de cada resina composta foram preparados e a rugosidade, cor, translucidez e brilho foram avaliados inicialmente e após um e dois anos de escovação simulada. Os espécimes foram submetidos a escovação dental simulada (14.600 golpes / 100 g) utilizando-se escova de dentes de cerdas macias comercialmente disponíveis e uma pasta composta de dentifrício e água na proporção de 1:2 em peso. O esquema de escovação foi de 40 ciclos por dia (2 ciclos por segundo / 280 ciclos por semana). As propriedades ópticas e os dados de rugosidade foram analisados por uma análise de variância multifatorial (MANOVA) e um teste post hoc de Tukey. Resultados: Os valores iniciais e finais de Ra e Sa foram submetidos a análises de regressão linear, todas realizadas ao nível de significância de 5%. O brilho e a rugosidade apresentaram diferenças estatísticas entre as interações resina-tempo em todas as resinas compostas. O brilho (72,5%) e a rugosidade (89,4%) pioraram significativamente após a escovação, mas os autores não encontraram diferenças estatisticamente significativas ao avaliar a translucidez e a cor. Conclusão: Com base nos resultados, pôde-se concluir que a escovação simulada degradou o brilho e a rugosidade das resinas compostas do tipo bulk fill avaliadas. (AU)
Subject(s)
Toothbrushing , Analysis of Variance , Composite ResinsABSTRACT
The dental profession is still pursuing the most effective way to treat white-spot lesions in order to produce a sound and esthetically pleasing enamel surface. The aim of the present research was to evaluate in vitro the effects of a dentifrice with nanohydroxyapatite (nano-HAp) on the roughness, color, lightness, and brightness (gloss) of bovine enamel subjected to pH cycling. Twelve enamel discs prepared from bovine incisors were divided into 2 experimental groups: dentifrice with sodium fluoride (Colgate Total 12 Clean Mint) and dentifrice with nanoHAp (Megasonex). For 14 days, the specimens were subjected to 30 cycles of simulated brushing twice a day as well as to a pH cycling model (6 hours of demineralization and 18 hours of remineralization daily). The roughness, color, lightness, and brightness of all specimens were evaluated at baseline (immediately after specimen preparation) and after 7 and 14 days of treatment. A Tukey test demonstrated that there were no statistically significant differences in the effects of the dentifrices on any parameter after 7 days (P > 0.05). After 14 days, however, there was a statistically significant increase in mean roughness in the group brushed with fluoride dentifrice (P < 0.05). Thus, the nanoHAp containing dentifrice promoted less superficial roughness after 14 days, but both dentifrices were similar in relation to color variation, lightness, and brightness.
Subject(s)
Dental Enamel/drug effects , Dentifrices/therapeutic use , Durapatite/therapeutic use , Nanostructures/therapeutic use , Tooth Demineralization/drug therapy , Animals , Cattle , In Vitro Techniques , Incisor/drug effects , Surface Properties , Tooth Discoloration/drug therapy , ToothbrushingABSTRACT
In this in vitro study, 3 experiments were conducted to evaluate the influence of customizing the apical portion on the characteristics of fiber posts. In the first experiment, 4 fiber posts were submitted to different custom adaptations (no customization, industrial shaping tool, diamond bur, or paper disc) and were observed with a scanning electron microscope to evaluate the micromorphologic changes. In the second experiment, 60 posts of different sizes were divided into 6 groups (n = 10): 0 (No. 0.5), 1 (No. 1), 2 (No. 2), 3 (No. 3), 4 (No. 4), and 5 (paper disc-remodeled No. 4). The posts were submitted to a 3-point bending test. In the third experiment, the crowns of 20 extracted, healthy permanent human canines were removed, and the teeth were endodontically treated, embedded in acrylic resin, and divided into 2 groups (n = 10): I (control), No. 4 posts cemented into post spaces prepared with a No. 4 drill; and II (test), remodeled No. 4 posts cemented into root spaces prepared with No. 2 and 4 drills. The posts were cemented with self-adhesive dual resin cement, and the specimens received direct resin crowns. Fracture strength was measured with a universal testing machine at 45 degrees until fracture. Results were submitted to analysis of variance (P ≤ 0.05). Customization of fiber posts with diamond burs or paper discs produced acceptable micromorphologic changes. Custom adaptation of fiber posts reduced their flexural strength, which remained at acceptable values. Teeth restored with customized fiber posts had greater fracture strength than those restored with intact posts. The results of this study indicated that post remodeling is a safe means to facilitate adaptation to root walls and preserve tooth structure.
Subject(s)
Post and Core Technique , Tooth Apex , Crowns , Dental Cements , Dental Materials/chemistry , Dental Restoration Failure , Dental Stress Analysis , Humans , In Vitro Techniques , Materials Testing , Microscopy, Electron, Scanning , Resin Cements/chemistryABSTRACT
Gingival biotype is a clinical term used to describe the thickness of the gingiva. It has been classified as being thick or thin and may be related to the clinical outcome of root coverage procedures. This study evaluated the impact of gingival biotype on the clinical outcome of root coverage procedures following subepithelial connective tissue graft plus coronally positioned flap. A total of 19 patients, 10 with thin and 9 with thick gingival biotype, were treated for localized Miller Class I or II gingival recessions. After 6 months, 14 patients achieved complete root coverage, 7 from each group. The overall mean pooled root coverage rate was 90.93%. The thin biotype cases yielded a reduced mean root coverage of 88.51% compared with 93.63% for patients who had the thick biotype classification. Although the thin gingival biotype may impair the clinical outcome of root coverage procedures, this limitation does not appear to have a strong influence on the success of the root coverage therapy when subepithelial connective tissue graft was associated with the coronal positioning of the flap.
Subject(s)
Gingiva/surgery , Gingival Recession/surgery , Surgical Flaps , Connective Tissue , Follow-Up Studies , Humans , Tooth Root/surgery , Treatment OutcomeABSTRACT
The objective of this study was to evaluate the effect of storage in deionized water at room temperature, for seven days and six months, on the flexural strength of a repaired photocured microhybrid composite resin, using different surface treatments. After each surface treatment, the adhesive interface was analyzed with a surface roughness tester. The flexural strength of samples from each group was determined by three-point bending in a testing machine at a crosshead speed of 0.5 mm/min with a 50 N load cell. Data were analyzed using ANOVA (p=0.0001) and compared with the Newman-Keuls multiple comparison test. It was verified that flexural strength of the unrepaired specimens, after both seven days and six months, was similar (p>0.05) and was in accordance with ISO specifications (minimum of 50 MPa), with values ranging from 52-63 MPa. The authors concluded that the use of an unfilled resin agent is necessary prior to the repair to increase the adhesive strength. Further, the use of a silane agent prior to use of the unfilled resin agent is unnecessary, since it does not increase the adhesive strength.
Subject(s)
Composite Resins/chemistry , Dental Bonding , Dental Materials/chemistry , Dental Prosthesis Repair , Acetone/chemistry , Compressive Strength , Dental Stress Analysis/instrumentation , Diamond/chemistry , Elastic Modulus , Humans , Materials Testing , Phosphoric Acids/chemistry , Photochemical Processes , Pliability , Polymerization , Polymethacrylic Acids/chemistry , Silanes/chemistry , Stress, Mechanical , Surface Properties , Temperature , Time Factors , Water/chemistryABSTRACT
Dentinal surfaces prepared with an Er:YAG laser have distinctly different characteristics compared to those prepared with conventional instruments. The objective of this study was to evaluate the shear bond strength of a total-etch adhesive system and a self-etch adhesive system to dentin, prepared conventionally or with an Er:YAG laser. Specimens that were prepared with a diamond bur and treated with the total-etch adhesive showed the highest mean bond strength, followed by specimens prepared with the laser and treated with the total-etch adhesive, specimens prepared with a diamond bur and treated with the self-etch adhesive, and specimens prepared with the laser and treated with the self-etch adhesive, but there were no differences among the groups (P > 0.05). These data indicate that the tested adhesive systems promote similar shear bond strengths, whether the dentin is prepared with a diamond bur or an Er:YAG laser, and that an Er:YAG laser is a suitable cavity preparation method that promotes an adequate surface for a posterior adhesive procedure.
Subject(s)
Dental Bonding , Dentin-Bonding Agents/chemistry , Dentin/radiation effects , Lasers, Solid-State , Acid Etching, Dental/methods , Carbon Compounds, Inorganic/chemistry , Composite Resins/chemistry , Dental Materials/chemistry , Dental Stress Analysis/instrumentation , Diamond/chemistry , Ethanol/chemistry , Humans , Materials Testing , Methacrylates/chemistry , Phosphates/chemistry , Phosphoric Acids/chemistry , Resin Cements/chemistry , Shear Strength , Silicon Compounds/chemistry , Stress, Mechanical , Temperature , Time Factors , Tooth Preparation/instrumentation , Tooth Preparation/methods , Water/chemistryABSTRACT
Dentinal surfaces prepared with air abrasion have considerably different characteristics from those prepared with conventional instruments. Different hybrid layer morphology and thickness occur, which can result in differences in the quality of restorations placed on dentinal surfaces prepared with a diamond bur compared to surfaces prepared using air abrasion. The objective of this study was to compare the hybrid layer thickness and morphology formed utilizing Scotchbond Multi-Purpose Plus (SBMP) on dentin prepared with a diamond bur in a high-speed handpiece and on dentin prepared using air abrasion. Flat dentin surfaces obtained from five human teeth were prepared using each method, then treated with the dentin adhesive system according to manufacturer's instructions. After a layer of composite was applied, specimens were sectioned, flattened, polished, and prepared for scanning electron microscopy. Ten different measurements of hybrid layer thickness were obtained along the bonded surface in each specimen. SBMP produced a 3.43 ± 0.75 µm hybrid layer in dentin prepared with diamond bur. This hybrid layer was regular and found consistently. In the air abrasion group, SBMP produced a 4.94 ± 1.28 µm hybrid layer, which was regular and found consistently. Statistical ANOVA (P = 0.05) indicated that there was a statistically significant difference between the groups. These data indicate that the air abrasion, within the parameters used in this study, provides a thick hybrid layer formation.
Subject(s)
Air Abrasion, Dental/methods , Dental Bonding/methods , Dental Cavity Preparation/methods , Dentin-Bonding Agents/chemistry , Dentin/ultrastructure , Resin Cements/chemistry , Composite Resins/chemistry , Dental Cavity Preparation/instrumentation , Dental High-Speed Equipment , Dental Materials/chemistry , Dental Polishing/methods , Diamond/chemistry , Humans , Materials Testing , Microscopy, Electron, Scanning , Surface PropertiesABSTRACT
This study compared the thickness of the hybrid layer formed using Scotchbond Multi-Purpose Plus, Single Bond 2, Prime & Bond 2.1 and Xeno III on a dentin surface prepared with a diamond bur in a high speed handpiece or prepared with an Er:YAG laser used with two parameters of pulse energy (200 and 400 mJ) and two parameters of frequency (4 and 6 Hz). Flat dentin surfaces obtained from 20 human third molars were treated with the two methods and were then prepared with the dentin adhesive systems according to the manufacturers' instructions. After a layer of composite was applied, the specimens were sectioned, flattened, polished and prepared for Scanning Electronic Microscopy observation. Five different measurements of the hybrid layer thickness were obtained along the bonded surface in each specimen. The results were statistically analyzed using Analysis of Variance and Student-Newman-Keuls tests (p < or = 0.05). When analyzing the hybrid layer thickness and comparing the cavity preparation method, four groups were formed: Group I (diamond bur) > Group II (Laser 200 mJ/4 Hz) = Group III (Laser 200 mJ/6 Hz) > Group IV (Laser 400 mJ/4 Hz) > Group V (Laser 400 mJ/6 Hz). When comparing the dentin adhesive systems, there were no statistically significant differences. These results showed that the four tested dentin adhesive systems produced a 2.90 +/- 1.71 microm hybrid layer in dentin prepared with a diamond bur. This hybrid layer was regular and routinely found. In the laser groups, the dentin adhesive systems produced hybrid layers ranging from 0.41 +/- 1.00 microm to 2.06 +/- 2.49 microm, which were very irregular and not routinely found. It was also concluded that the Er:YAG laser, with the parameters used in this experiment, has a negative influence on the formation of a hybrid layer and cavity preparation methods influence formation of the hybrid layer.
