Crown Material and Occlusal Thickness Affect the Load Stress Dissipation on 3D Molar Crowns: Finite Element Analysis

PURPOSE: To compare the mechanical behavior (stress load dissipation and/or concentration) of posterior crowns made from Lava Ultimate (LU; 3M ESPE) and IPS e.max CAD (LD; Ivoclar Vivadent) using finite element analysis (FEA). MATERIALS AND METHODS: A 3D model of a mandibular first molar was prepared by reducing the occlusal surface by 1 or 2 mm (according to group), the axial walls by 1.5 mm, and using a 0.8-mm-deep shoulder margin as a finish line. A convergence of 6 degrees between opposing walls was set. Subsequently, four 3D crown models were created according to two test groups with two different occlusal thicknesses: (1) LD with 1.0 mm (LD1); (2) LD with 2.0 mm (LD2); (3) LU with 1.0 mm (LU1); and (4) LU with 2.0 mm (LU2). FEA models were constructed using the software Femap (Siemens). A load of 200 N was applied in the axial and oblique (20 degrees) directions for each group, and stress dissipation was viewed using the NEi Nastran software. RESULTS: FEA results demonstrated that the LU crowns dissipated the occlusal load to the tooth structure, whereas the LD material concentrated the load inside the crowns. For the LU material, the lower the occlusal thickness, the higher the stress concentration inside the crown became, and the 2.0-mm occlusal thickness transferred lower stress to the tooth structure. The oblique, rather than the vertical, load caused an increase in the maximum stress concentration at the shoulder margin and axial walls. CONCLUSION: The higher the Young's Modulus mismatch between the crown material and substrate, the higher the load stress concentration inside the material became. The 2-mm occlusal thickness acted by decreasing the load stress to the tooth substrate. Finally, the axial load delivered more favorable stress transmission to the tooth substrate. The crown material and the occlusal thickness appear to be two factors that affect the mechanical behavior of stress dissipation to the tooth structure.

The effectiveness of in-office dental bleaching with and without sonic activation: A randomized, split-mouth, double-blind clinical trial.

OBJECTIVE: This study was aimed at comparing the bleaching efficacy and bleaching sensitivity (BS) of two higher-concentration in-office bleaching gels (37% carbamide peroxide [CP] and 38% hydrogen peroxide [HP]) applied under two conditions: alone or in association with sonic activation. METHODS: Fifty-six volunteers were randomly assigned in the split-mouth design into the following groups: CP, CP with sonic activation (CPS), HP, and HP with sonic activation (HPS). Two in-office bleaching sessions were performed. Color was evaluated using Vita Classical, Vita Bleachedguide, and digital spectrophotometer at baseline and at 30 days post-bleaching. Absolute risk and intensity of BS were recorded using two pain scales. All data were evaluated statistically (color changes [t test], BS [Chi-square and McNemar test], and BS intensity [VAS; t test; NRS; Wilcoxon; α = 0.05]). RESULTS: Significant and higher whitening was observed for HP when compared with CP (p < 0.04). However, higher BS intensity was observed in the former (p < 0.001). No significant difference was observed in whitening effect or BS when the HP or CP bleaching gels were agitated (sonic application) compared with when they were not (p > 0.05). CONCLUSION: The 37% CP gel demonstrated lower bleaching efficacy and lower BS compared with the 38% HP bleaching gel. The whitening effect was not influenced by the use of sonic activation. CLINICAL SIGNIFICANCE: The use of 37% CP gel did not achieve the same whitening effect when compared to 38% HP gel used for in-office bleaching. The use of sonic activation offers no benefit for in-office bleaching.

A new methodology for fluorescence analysis of composite resins used in anterior direct restorations.

The aim of this study was to use a new methodology to evaluate the fluorescence of composite resins for direct restorations. Microhybrid (group 1, Amelogen; group 2, Opallis; group 3, Filtek Z250) and nanohybrid (group 4, Filtek Z350 XT; group 5, Brilliant NG; group 6, Evolu-X) composite resins were analyzed in this study. A prefabricated matrix was used to prepare 60 specimens of 7.0 × 3.0 mm (n = 10 per group); the composite resin discs were prepared in 2 increments (1.5 mm each) and photocured for 20 seconds. To establish a control group of natural teeth, 10 maxillary central incisor crowns were horizontally sectioned to create 10 discs of dentin and enamel tissues with the same dimensions as the composite resin specimens. The specimens were placed in a box with ultraviolet light, and photographs were taken. Aperture 3.0 software was used to quantify the central portion of the image of each specimen in shades of red (R), green (G), and blue (B) of the RGB color space. The brighter the B shade in the evaluated area of the image, the greater the fluorescence shown by the specimen. One-way analysis of variance revealed significant differences between the groups. The fluorescence achieved in group 1 was statistically similar to that of the control group and significantly different from those of the other groups (Bonferroni test). Groups 3 and 4 had the lowest fluorescence values, which were significantly different from those of the other groups. According to the results of this study, neither the size nor the amount of inorganic particles in the evaluated composite resin materials predicts if the material will exhibit good fluorescence.