Two-year clinical evaluation of chlorhexidine incorporation in two-step self-etch adhesive.

OBJECTIVES: The aim of this 24-month double-blind randomized paired-tooth clinical study was to evaluate the 2-year clinical performance of two self-etch adhesives containing or not chlorhexidine digluconate (CHX) in non-carious cervical lesions (NCCLs). METHODS: Twenty-two patients, with at least four NCCLs, participated in this study. After sample size calculation, 126 restorations were assigned to one of the following groups: CSE--Clearfil SE Bond (Kuraray); CSE/CHX--Clearfil SE Bond+CHX; ADS--AdheSE (Ivoclar Vivadent); and ADS/CHX--AdheSE+CHX. The composite resin Filtek Z-250 composite (3M ESPE) was placed incrementally by one expert operator. The restorations were evaluated at baseline and after 2 years using the modified USPHS criteria. Statistical analyses were performed with Friedman repeated measures ANOVA by rank and Fisher exact test for significance in each pair (α=0.05). RESULTS: No significant difference was observed between baseline and 2-year for any criteria when adhesives with and without the addition of CHX were compared (p>0.05). ADS and ADS/CHX resulted in lower retention rates (82% on average) than CSE and CSE/CHX (97%) (p=0.02). CONCLUSIONS: The inclusion of CHX into the primer of both self-etch systems did not add clinical advantages over the 2-year period. Clearfil SE Bond resulted in better retention rate than AdheSE. CLINICAL SIGNIFICANCE: It is more important to choose a gold standard self-etch adhesive, like a Clearfil SE Bond, than to consider the inclusion of CHX in the self-etch adhesives.

Resistência de união de um sistema restaurador à base de silorano ao esmalte bovino / Bond strength of a Silorane-based composite to bovine enamel

O objetivo do presente estudo foi avaliar a resistência de união ao esmalte bovino de um sistema adesivo para compósitos à base de silorano, com e sem condicionamento prévio. Para isso, foram selecionados 12 incisivos bovinos com superfície de esmalte planificada e, então, divididos em dois grupos: Grupo 1 (P90) - realizado um platô em esmalte com o sistema restaurador P90; Grupo 2 (P90A) - realizado um platô com condicionamento ácido prévio à utilização do sistema adesivo, utilizando ácido fosfórico a 37% por 15s. Os espécimes (n=6) foram seccionados nos eixos "x" e "y" para obtenção de palitos para o teste de microtração com velocidade de 0,5mm/min. Os dados obtidos foram submetidos aos testes ANOVA One-way e Tukey. Os testes de microtração mostraram um aumento na resistência de união, quando utilizado o condicionamento ácido prévio ao sistema adesivo adotado no estudo (p<0,05). Concluiu-se que o condicionamento prévio com ácido fosfórico a 37% aumentou a resistência de união do sistema restaurador à base de silorano ao esmalte bovino.

The purpose of this study was to evaluate the bond strength produced by a Silorane-based restorative system to enamel with or without prior acid etching. Twelve bovine incisors were selected. Then, the enamel was planned. The teeth were divided into two groups: Group 1 - a plateau was built in the enamel planned with P90 system (P90); Group 2 - a plateau was built in the enamel with prior etching using 37% phosphoric acid for 15s (P90A). Specimens (n=6) were sectioned in enamel/composite sticks to microtensile testing. The cross-sectional area of the sticks was measured. Beams were pulled until failure and bond strength was calculated. Data were statistically analyzed using ANOVA One-way and Tukey (p=0,05). Microtensile bond strength showed higher values to group 2 (P90A), that used prior etching to the adhesive system tested in the study. In conclusion prior etching with phosphoric acid increased microtensile bond strength values of the Silorane-based composite on bovine enamel.

Resin-dentin bonds of etch-and-rinse adhesives to alcohol-saturated acid-etched dentin.

PURPOSE: To evaluate the effect of the alcohol wet-bonding technique on bond performance of the adhesive interface produced by two-step etch-and-rinse adhesive systems. MATERIALS AND METHODS: Composite buildups were bonded to sectioned human third molars using Adper Single Bond 2 (SB) bonded to acid-etched dentin saturated with water (control) or ethanol, or XP Bond (XP) bonded to acid-etched dentin saturated with water (control) or tert-butanol. A simplified dentin dehydration protocol was performed using 100% ethanol or 99.5% tert-butanol directly applied to dentin for 60 s. Specimens were cut into nontrimming dentin-composite beams that were divided equally in two subgroups: immediately tested and after immersion in 10% NaOCl solution for 1 h. Specimens were tested in tension at a crosshead speed of 1 mm/ min until failure, and the failure mode was evaluated. Data were statistically analyzed with three-way ANOVA and Tukey's test (α = 0.05). Additional dentin disks were bonded using the same groups tested and examined for leakage under light microscopy after immersion in ammoniacal silver nitrate solution. RESULTS: The SB control group showed significantly higher bond strength values than did SB used on ethanol saturated dentin (p < 0.05); this tendency was confirmed by the silver nitrate deposition. The use of tert-butanol did not influence XP bond strength values (p > 0.05) or silver nitrate penetration. NaOCl solution significantly reduced the bond strength of all groups tested (p < 0.05) and also increased the interfacial silver nitrate penetration. CONCLUSION: The simplified alcohol wet-bonding technique used in the present study was not able to improve resin/dentin bond performance for simplified etch-and-rinse adhesive systems.

Avaliação da infiltração marginal em restaurações com compósitos à base de metacrilato e à base de silorano / Evaluation of marginal leakage on restorations of methacrilate and silorane-based composites

Objetivo: O objetivo deste estudo in vitro foi avaliar o nível de infiltração marginal em restaurações realizadas com sistemas restauradores à base de metacrilato e à base de silorano. Materiais e método: Cavidades classe V em forma de caixa (4 x 4 x 2mm) foram preparadas na junção cemento-esmalte nas faces vestibular, lingual, mesial e distal com margens em esmalte e dentina de vinte molares humanos hígidos. Os dentes foram divididos aleatoriamente em dois grupos e restaurados da seguinte forma: Grupo 1 (G1) - Clearfil SE, aplicado se-gundo as instruções do fabricante e restaurado com re-sina composta Filtek Z250, e Grupo 2 (G2) - P90 Bond, aplicado segundo as instruções do fabricante e restau-rado com resina composta Filtek P90. Resina composta foi aplicada em incremento único e fotopolimerizada por 40s. Os espécimes foram imersos em solução de azul de metileno a 2% por 4h e seccionados longitu-dinalmente no centro da restauração. A penetração de corante na interface adesiva foi avaliada usando-se lupa esterioscópica e escores de 0 a 3 foram atribuídos às margens de esmalte e dentina. A significância dos dados foi analisada utilizando-se os testes estatísticos Kruskall Wallis e Student-Newman-Keuls. Resultados: Não houve diferença estatística entre os dois sistemas restauradores testados tanto nas margens de dentina (P = 0,19) quanto nas margens de esmalte (P = 0,97). Conclusão: Não houve diferença na capacidade sela-dora dos materiais restauradores testados.

Restoring esthetics in eroded anterior teeth: a conservative multidisciplinary approach.

Consuming a highly acidic diet can lead to erosion or excessive wear of dental hard tissues, resulting in the need for oral rehabilitation. Previously, a severely eroded dentition could be rehabilitated only by extensive crown and bridge placement or by removable partial dentures. However, developments in adhesive dentistry have made it possible to restore the esthetics and function of eroded teeth in a minimally invasive manner. This case report presents a conservative, multidisciplinary approach to restoring severe wear due to dental erosion using proper techniques and materials.

Resistência de união de pinos de fibra de vidro à dentina em diferentes regiões do canal radicular / Bond strength of glass fiber posts to dentin in different regions of the root canal

OBJETIVO: Avaliar a resistência de união da interface adesiva de pinos de fibra de vidro (Reforpost nº 3 - Angelus) e dentina radicular. MÉTODOS: Vinte e quatro raízes de dentes humanos foram tratadas endodonticamente e desobstruídas até uma profundidade de 9mm e o pino cimentado com um dos três sistemas de fixação descritos a seguir (n = 8): Grupo 1 - sistema Single Bond 2 (3M ESPE, St. Paul, MN, EUA) / RelyX ARC (3M ESPE, St. Paul, MN, EUA); Grupo 2 - sistema ED Primer/Panavia 21 (Kuraray Medical Inc. Kurashiki, Japão); Grupo 3 - cimento RelyX Unicem (3M ESPE/AG. Seefeld, Alemanha). As raízes foram seccionadas em três porções correspondentes aos terços cervical, médio e apical. Os espécimes foram submetidos aos testes de push-out e os valores de resistência de união à análise de variância (ANOVA) e ao teste de Tukey (p< 0,05). RESULTADOS: Somente o Grupo 2 apresentou diferença estatística em relação aos terços, tendo o apical apresentado menor média. Para o terço cervical, o Grupo 3 apresentou maiores valores de resistência de união que o Grupo 2, tendo sido Grupo 1 estatisticamente semelhante aos outros dois materiais. Para os terços médio e apical, Grupo 2 apresentou resistência de união menor que Grupo 1 e Grupo 3, sendo estes estatisticamente iguais entre si. CONCLUSÃO: Os cimentos de presa dual (RelyX ARC, 3M ESPE, St. Paul, MN, EUA e RelyX Unicem, 3M ESPE, St. Paul, MN, EUA) promoveram maior resistência de união entre o pino endodôntico e as paredes do canal radicular do que o cimento quimicamente ativado (Panavia 21, Kuraray Medical Inc., Kurashiki, Japão).

OBJECTIVE: This study assessed the bond strength of the adhesive interface of fiber glass posts (Reforpost nº 3 - Angelus) to root dentin. METHODS: Twenty-four roots of human teeth were treated endodontically and drilled to a depth of 9mm. Posts were cemented using one of the following three systems (n = 8): group 1 (G1) - Single Bond 2 system (3M ESPE, St. Paul, MN, EUA) / RelyX ARC (3M ESPE, St. Paul, MN, EUA); group 2 (G2) ED Primer (Kuraray Medical Inc. Kurashiki, Japan) / Panavia 21 (Kuraray Medical Inc. Kurashiki, Japan) system; and group 3 (G3) RelyX Unicem (3M ESPE/AG. Seefeld, Germany) cement. The roots were sectioned into three parts corresponding to the coronal, middle and apical thirds. The specimens were submitted to the push-out test. Bond strength values were submitted to analysis of variance (ANOVA) and the Tukey's test (p< 0.05). RESULTS: Only G2 presented statistically significant differences among the three regions of the canal with the apical third presenting the lowest mean bond strength. In relation to the coronal third, G3 presented higher bond strengths than G2. G1 was statistically equal to the other two materials. Regarding the middle and apical thirds, the mean bond strength of G2 was significantly lower than those of G2 and G3, these two being statistically equal. CONCLUSION: The dual-cure cements (RelyX ARC, 3M ESPE, St. Paul, MN, EUA and RelyX Unicem, 3M ESPE, St. Paul, MN, EUA) promoted higher bond strengths between the endodontic post and root dentin than the self-cure cement (Panavia 21, Kuraray Medical Inc., Kurashiki, Japan).