Effect of liners on composite resin microleakage after selective carious lesion removal: an experimental study / Efecto de los recubrimiento en la microfiltración de resina compuesta después de la eliminación selectiva de lesiones cariosas: un estudio experimental

Objetive: To evaluate microleakage of composite resins (CR) placed over different cavitary liners after managing deep caries lesions through selective removal of soft carious tissue to soft dentin (SRCT-S). Material and Methods: Fifty four human teeth were collected for microleakage testing. Each assay comprised ICDAS 5 or ICDAS 6 carious lesions and sound teeth for controls. Sound teeth were prepared with cavities that mirrored the carious teeth cavities, which were prepared with SRCT-S. Sound and carious teeth were further randomly assigned to one of the three experimental groups: Group A: universal adhesive (UA) + CR, Group B: glass ionomer cement liner + UA + CR, and Group C: calcium hydroxide + UA+ CR. Occlusal microleakage (OM) and cervical microleakage (CM) was classified within one of 5 depth categories. ANOVA and Chi-square tests were computed (p<0.05). Results: OM and CM were similarly distributed across subgroups (p>0.05). All Group C samples with carious lesions presented some degree of microleakage. However, no statistically significant differences were observed between groups and within each group (p>0.05). Conclusion: Teeth restored with CR after SRCT-S using calcium hydroxide as a liner material seem to exhibit higher microleakage than those restored using glass ionomer or UA alone. Further clinical research is needed to deepen these findings. Clinical significance: The application of calcium hydroxide as a liner under a composite resin may reduce the longevity of a restoration after performing selective or partial removal of carious tissues. Clinicians should rethink the need of using calcium hydroxide for this application, albeit the lack of clinical evidence.

Objetivo: Evaluar la microfiltración de resinas compuestas (RC) colocadas sobre diferentes liners cavitarios después del manejo de lesiones de caries profundas mediante la remoción selectiva de tejido cariado blando hasta dentina blanda (SRCT-S). Material y Métodos: Se recolectaron 54 dientes humanos para pruebas de microfiltración. Cada ensayo comprendía lesiones cariosas ICDAS 5 o ICDAS 6 y dientes sanos para los controles. Se prepararon dientes sanos con cavidades que reflejaban las cavidades de los dientes cariados, que se prepararon con SRCT-S. Los dientes sanos y cariados se asignaron al azar a uno de los tres grupos experimentales: Grupo A: adhesivo universal (AU) + RC, Grupo B: revestimiento de cemento de ionómero de vidrio + AU + RC, y Grupo C: hidróxido de calcio + AU+ RC. La microfiltración oclusal (MO) y la microfiltración cervical (MC) se clasificaron dentro de una de las 5 categorías de profundidad. Se calcularon las pruebas ANOVA y Chi-cuadrado (p<0,05). Resultados: La MO y MC se distribuyeron de manera similar en los subgrupos (p> 0,05). Todas las muestras del Grupo C con lesiones cariosas presentaron algún grado de microfiltración. Sin embargo, no se observaron diferencias estadísticamente significativas entre grupos y dentro de cada grupo (p>0,05). Conclusión: Los dientes restaurados con RC después de SRCT-S usando hidróxido de calcio como material de revestimiento parecen exhibir una mayor microfiltración que aquellos restaurados usando ionómero de vidrio o AU solo. Se necesita más investigación clínica para profundizar estos hallazgos. Relevancia clínica: la aplicación de hidróxido de calcio como revestimiento debajo de una resina compuesta puede reducir la longevidad de una restauración después de realizar la eliminación selectiva o parcial de los tejidos cariados. Los médicos deberían reconsiderar la necesidad de usar hidróxido de calcio para esta aplicación, aunque no haya evidencia clínica.

Validation of the Spanish version of the oral health impact profile to assess an association between quality of life and oral health of elderly Chileans.

OBJECTIVE: To validate the Spanish version of the OHIP-49 among elderly population. BACKGROUND: Oral health, as a predictor of quality of life, can be evaluated using validated instruments. One of the most commonly used instruments worldwide is the Oral Health Impact Profile-49 (OHIP-49). This instrument has not yet been validated in Chilean older adults. MATERIALS AND METHODS: Interviews and clinical exams were performed in a convenience sample of eighty-five elderly participants aged 60 or more years (mean 69.02 ± 7.82 years). Socio-demographic and clinical variables were analysed: number of teeth, caries, periodontal and prosthetic treatment needs and prosthetic functionality. RESULTS: High internal consistency values were obtained for both the OHIP-49 Sp instrument (0.990) and all of its dimensions (0.875-0.995). The average score of the OHIP-49 Sp was 62.54 ± 43.73. Significantly higher OHIP-49 Sp scores were observed in participants with caries (p = 0.01), in those needing complex periodontal treatment (p = 0.0001) and those in need of dental prostheses (p ≤ 0.0001). CONCLUSION: The OHIP-49 Sp proved to be a valid tool to assess oral health-related quality of life, when tested in Chilean older adults.

Adaptación y validación al español del cuestionario de percepción infantil CPQ-Esp11-14 en población comunitaria chilena / Adaptation and validation of the spanish versión of child perception questionnaire CPQ-Spn11-14 in a chilean community population

Fundamentos. Con el fin de medir de forma válida la calidad de vida relacionada con la salud oral en escolares, el objetivo de este trabajo fue adaptar y validar el CPQ11-14 al español y confirmar los cuatro dominios de CPQ-Esp11-14 en su versión completa y abreviada de 16 y 8 ítems. Métodos. El instrumento fue traducido y adaptado al español, posteriormente fue administrado a 288 jóvenes de 12 años que asisten a escuelas públicas. Se realizó un examen bucodental para medir historia de caries con el índice CAOD. Se evaluó la estructura conceptual de las escalas con el análisis factorial y se evaluó la consistencia interna con Alpha de Crombach, estabilidad temporal test-retest con Coeficiente de correlación intraclase y la validez concurrente con la correlación del puntaje del CPQ-Esp11-14 con la historia de caries. Resultados: Las cinco medidas usadas para confirmar la estructura de los factores de la versión de 37 ítems mostraron valores fuera del rango de ajuste del modelo. La versión de 16 y 8 ítems presentó los indicadores dentro de valores que indican ajuste del modelo. La consistencia interna de la escala completa y versiones de 16 y 8 ítems medida con Alpha de Crombach fue mayor a 0,6. Todas las versiones tuvieron coeficiente de correlación intraclase superior a 0,81, excepto en subescala limitaciones funcionales de la versión a de 16 ítems. La correlación Rho de Spearman fue significativa entre CAOD y puntaje del cuestionario, excepto para síntomas orales de la versión total y la versión a y b de la escala de 16 ítems. Conclusiones: la estructura hipotética de los factores fue confirmada por el AFC para las versiones de 16 y 8 ítems. La información que contiene los ítems de las versiones abreviadas permite medir la calidad de vida relativa a la salud en niños chilenos (AU)

Background: In order to validly measure the oral health related quality of life in school age children it is necessary to adapt and validate the CPQ 11-14 for Spanish language. To confirm the four domains of CPQ-Esp 11-14 for the full and abbreviated version of 16 and 8 items. Methods: The instrument was translated into Spanish and culturally adapted. It was administered to 288 12 year-old children attending public schools. Dental caries experience was measure with the DMFT index. The conceptual structure of the scales was assessed by the AFC. It was also evaluated: internal consistency with Cronbach ‘s alpha, test- retest temporal stability with intraclass correlation coeficient, and concurrent validity with correlation of score CPQ-Esp 11-14 with caries experience. Results: The five measures used to confirm the structure of the factors on the version of 37 items showed values outside the range of the model fit. Version 16 and 8 items obtained indicators within values indicating the model fit. The internal consistency of full scale and versions 16 and 8 items were measured with Cronbach Alpha wich was higher than 0.6. All versions had intraclass correlation coefficient above 0.81, except for functional limitations of the subscale version a of 16 items. The Rho Spearman correlation was significant between CAOD and the score the questionnaire, except for oral symptoms and full version b version of 16 items. Conclusions: The hypothetical factor structure was confirmed by the CFA for 16 and 8 items versions. The information contained in abbreviated items allows measuring oral health related quality of life in Chilean children (AU)

[Adaptation and validation of the Spanish version of Child Perception Questionnaire CPQ-Spn11-14 in a Chilean community population]. / Adaptación y validación al español del cuestionario de percepción infantil CPQ-Esp11-14 en población comunitaria chilena.

BACKGROUND: In order to validly measure the oral health related quality of life in school age children it is necessary to adapt and validate the CPQ 11-14 for Spanish language. To confirm the four domains of CPQ-Esp 11-14 for the full and abbreviated version of 16 and 8 items. METHODS: The instrument was translated into Spanish and culturally adapted. It was administered to 288 12 year-old children attending public schools. Dental caries experience was measure with the DMFT index. The conceptual structure of the scales was assessed by the AFC. It was also evaluated: internal consistency with Cronbach 's alpha, test- retest temporal stability with intraclass correlation coeficient, and concurrent validity with correlation of score CPQ-Esp 11-14 with caries experience. RESULTS: The five measures used to confirm the structure of the factors on the version of 37 items showed values outside the range of the model fit. Version 16 and 8 items obtained indicators within values indicating the model fit. The internal consistency of full scale and versions 16 and 8 items were measured with Cronbach Alpha wich was higher than 0.6. All versions had intraclass correlation coefficient above 0.81, except for functional limitations of the subscale version a of 16 items. The Rho Spearman correlation was significant between CAOD and the score the questionnaire, except for oral symptoms and full version b version of 16 items. CONCLUSIONS: The hypothetical factor structure was confirmed by the CFA for 16 and 8 items versions. The information contained in abbreviated items allows measuring oral health related quality of life in Chilean children.

Influencia del tratamiento de superficie en la resistencia traccional de porcelana feldespática reparada con resina compuesta / Influence of surface treatment on the tensile strength of feldspathic porcelain repaired with composite resin

OBJETIVO Determinar el efecto de distintos tratamientos de superficie en los valores de resistencia traccional en la unión entre porcelana feldespática y resinas compuestas. MATERIALES Y MÉTODOS Se confeccionaron 32 especímenes con forma de «T¼ en porcelana feldespática, distribuidos aleatoriamente en 4 grupos experimentales (n = 8). El extremo de cada espécimen fue sometido a un tratamiento de superficie, previo al acondicionamiento adhesivo y unión con resina. El grupo 1 (control) utilizó fresado, el grupo 2, fresado y arenado, el grupo 3, fresado, arenado y grabado con ácido ortofosfórico, y el grupo 4, fresado, arenado, grabado con ácido ortofosfórico y silanización. Se confeccionó una segunda «T¼ de resina compuesta, adherida a la anterior, que fue introducida en cilindros acrílicos para ser sometida a pruebas de tracción en una máquina Instron. Se registró la fuerza de falla y se analizó la interfase obtenida bajo microscopía óptica 40x. RESULTADOS Se demostró la existencia de diferencias estadísticamente significativas entre los grupos 1 y 2 (p = 0,006), entre los grupos 1 y 3 (p = 0,000), grupos 1 y 4 (p = 0,000), grupos 2 y 3 (p = 0,008) y grupos 2 y 4 (p = 0,000), donde a mayor número de tratamientos de superficie, se observó mayor resistencia traccional. No obstante, entre los grupos 3 y 4, no se encontraron diferencias estadísticamente significativas (p = 0,244). CONCLUSIONES Los resultados del presente estudio in vitro sugieren que para realizar la reparación de la porcelana con resina compuesta, el tratamiento de superficie ideal es el que utiliza como mínimo fresado de la superficie, microabrasión de aire y grabado con ácido ortofosfórico al 37%. La adición de silano, aunque no imprescindible, tiende a generar una mejor unión, lo que se infiere del aumento en la proporción de fallas cohesivas.

OBJECTIVE Determine the effect of different surface treatments on the tensile strength of the bonded interface between feldspathic porcelain and composite resin. MATERIALS AND METHODS Thirty-two "T" shaped specimens were made in feldspathic porcelain, and randomly distributed into four experimental groups (n = 8). The tip of each specimen was subjected to a surface treatment prior to adhesive conditioning and composite resin bonding. Group 1 or control used bur-roughening, group 2 bur-roughening and sandblasting, group 3 bur-roughening, sandblasting and acid etch with orthophosphoric acid, and group 4 bur-roughening, sandblasting, acid etch with orthophosphoric acid and silane treatment. A second "T" was built in composite resin, bonded to the porcelain "T" and immersed in acrylic cylinders to be subjected to tensile testing in an Instrom machine. Ultimate tensile failure strength was obtained and the interphase was analyzed under 40x optic microscopy. RESULTS Statistically significant differences in tensile strength were observed between groups 1 and 2 (p = 0.006), groups 1 and 3 (p = 0.000), groups 1 and 4 (p = 0.000), groups 2 and 3 (p = 0.008) and groups 2 and 4 (p = 0.000), where the more surface treatments, the higher the tensile strength. However, no statistically significant differences were found between groups 3 and 4 (p = 0.244). CONCLUSIONS The results of the present study suggest that porcelain repair with composite resin should be performed at least using bur-roughening, sandblasting, and acid etch with 37% orthophosphoric acid. Silane conditioning, although not essential, tends to generate a better bonding, inferred from the increased proportion of cohesive failures.

Validation of the Spanish version of the Oral Health Impact Profile (OHIP-14Sp) in elderly Chileans.

BACKGROUND: The OHIP-49 is widely used to assess oral health-related quality of life, but its length makes it time-consuming and difficult to use. An abbreviated version of the OHIP-49 with fourteen items has been validated for older adults, but not in Chile. The aim was to develop and validate the Spanish version of the OHIP-14 in an elderly Chilean population. METHODS: Two studies were conducted; a cross sectional to develop and a retrospective study to validate the OHIP-14Sp. The OHIP-49Sp was applied to 490 older adults and the fourteen questions with the higher impact on oral health-related quality of life were selected through linear regression. These items were applied on a retrospective dataset of 85 older adults to test internal consistency (Cronbach's alpha). A discriminative validity analysis was performed along with the assessment of sociodemographic (age and gender, educational level) and clinical variables (number of teeth, caries lesions, CPITN, prosthetic needs and prosthetic functionality). Data were analyzed using Mann-Whitney U, Student's t and one-way ANOVA tests with a 95% confidence level and finally were analyzed by a Multivariate Logistic Regression Model. RESULTS: High internal consistency values were obtained for the OHIP-14Sp instrument (0.91). There was an association between the OHIP-14Sp scores and the presence of caries (p = 0.003), need for complex periodontal treatment (p = 0.002), prosthetic needs (p < 0.0001) and age younger than 70 years-old (p < 0.0001). Subjects with periodontal treatment need were more likely to report reduced oral health-related quality of life (PR = 2.10). CONCLUSIONS: The OHIP-14Sp proved to be a consistent and valid tool to assess oral health-related quality of life when tested in Chilean older adults.