Low and high hydrogen peroxide concentrations of in-office dental bleaching associated with violet light: an in vitro study.

OBJECTIVES: This study aims to assess hydrogen peroxide (HP) penetration within the pulp chamber, color change (CC), physical-chemical properties, and temperature using in-office different concentration bleaching gels with or without violet light. MATERIALS AND METHODS: Fifty teeth were divided into five groups (n = 10) based on the HP concentration bleaching gels used (6% and 35%) and the used violet light (with or without). HP penetration within the pulp chamber was measured using UV-Vis. The CC was evaluated with a digital spectrophotometer. Initial and final concentration, and pH were measured through titration, and a Digital pHmeter, respectively. Temperature analyses were measured through a thermocouple. Statistical analysis included two-way ANOVA, Tukey's, and Dunnett's test (α = 0.05). RESULTS: The presence of violet light did not affect the amount of HP within the pulp chamber, or the CC (p > 0.05). Greater penetration of HP was observed within the pulp chamber, as well as CC when using 35% HP (p < 0.05). The final concentration of both gels was lower than the initial concentration, regardless of the use of violet light (p < 0.05). The initial and final pH levels remained neutral and stable (p > 0.05). The pulp temperature increased when the gels were used in conjunction with violet light (p < 0.05). CONCLUSIONS: Using violet light in conjunction with 6% or 35% HP does not alter the physical properties of the bleaching agents, the penetration of HP or enhance color change. However, an increase in temperature was observed when violet light was applied associated with bleaching gels. CLINICAL RELEVANCE: While the simultaneous use of violet light with hydrogen peroxide 6% or 35% does not alter the material's properties, it also does not bring benefits in reducing hydrogen peroxide penetration and improving color change. Furthermore, the use of violet light increases pulp temperature.

The capacity of conservative preparations for lithium disilicate glass-ceramic laminates luted with different resin cements to mask different substrate shades: A minimally invasive esthetic approach.

OBJECTIVE: Demonstrate the ability of 0.5 mm thickness lithium disilicate laminates associated with resin cement to mask different substrate saturations. METHODS: 60 specimens (n = 5) were prepared with CAD/CAM lithium disilicate glass-ceramic IPS e.max CAD, 0.5 mm thick, in three degrees of translucency (HT, MT and LT); cemented by Variolink Esthetic LC Light+ (L) and Neutral (N) on composite resin substrates A1 and A4 shades. Color measurements were performed by a spectrophotometer (CM-3700d -Konica Minolta). The L*, a*, b* parameters of the tri-layer structure (laminate/ resin cement/ substrate) were used to calculate color difference ( ∆ E 00 ) by CIEDE2000 formula and Translucency Parameter ( TP 00 ). This study adopted ∆ E 00 = 0.8, as perceptibility threshold (PT), and ∆ E 00 = 1.8, as acceptability threshold (AT). Statistical analyses were performed by one-way ANOVA and Tukey tests (a = 0.05). RESULTS: Color difference between resin cement shades showed statistical differences (p < 0.0001) and ∆ E 00 > 1.8 for all groups. Color difference between substrates saturations showed a significant statistical difference (p < 0.0001) and ∆ E 00 values above AT for all groups. The TP 00 demonstrated significant statistical differences (p < 0.0001). The LTL combination, the opaquest set, showed the smallest ∆ E 00 values between substrate shades differences, however, above AT. CONCLUSION: The translucency of the lithium disilicate, the substrate saturation and the resin cement opacity influenced final color of restoration. The ceramic translucency impact on final color was reduced by opaque resin cement. Furthermore, the LT lithium disilicate and the Light+ resin cement reduced the translucency of the restoration, contributing to mask saturated substrate. CLINICAL RELEVANCE: This study shows the influence of conservative lithium disilicate laminates with different degrees of translucency associated with resin cement on final color of saturated substrate restorations. A minimally invasive esthetic protocol for masking substrates is demonstrated by associating low translucency ceramic laminates and opaque resin cement.

INitial Steps of Insulin Action in Parotid Glands of Male Wistar Rats.

The parotid gland is the largest salivary gland. It produces watery saliva, rich in proteins (amylase, lysozymes, and antibodies). Due to the gland's morphological cytoarchitecture composed of only serous acini, it contributes almost 50% of total salivary volume upon stimulation. It has been reported that the prevalence of saliva secretion impairments, periodontitis, delayed wound healing, and xerostomia increase in diabetic patients. Herein we evaluated the acute effects of insulin on insulin receptor phosphorylation status and its substrates IRS-1 and IRS-2 in the parotid glands of adult male Wistar rats, using Western blot analyses. We confirmed an acute effect of insulin on IR/IRS/PI3K/Akt and MAPK intracellular pathway activation in the parotid glands of male Wistar rats similar to the classical metabolic targets of the hormone, like the liver.

Microhardness, Color Stability and Microstructural Analysis of Prefabricated Composite Resin Veneers / Estudo da Microdureza, Estabilidade de cor e Microestrutura de Facetas Pré-Fabricadas de Resina Composta

The aim of the work was to determine Knoop microhardness (KH), color stability (ΔE00) and microstructure of prefabricated composite resin veneers (PCRVs). Two PCRVs systems (Componeer Brilliant New Generation, Coltene, Altstätten, Switzerland; and Direct Veneer, Edelweiss, Wolfurt, Austria) were tested. KH was measured at the buccal surface of the PCRVs. Color analyze was evaluated by a spectrophotometer and ΔE00 calculated using CIEDE2000 formula. Microstructure of the PCRVs was characterized using scanning electron microscopy (SEM). Data of KH and ΔE00 were subjected to One-way ANOVA followed by Tukey post hoc test (α=0.05). Componeer (KH = 46) and Edelweiss (KH = 43) presented statistical similar hardness results (p>0.05). Componeer (ΔE00water= 0.1 and ΔE00coffee= 13.4) showed lower ΔE00 than Edelweiss (ΔE00water= 0.5 and ΔE00coffee= 18.7). SEM-images indicated similar microstructures of the PCRVs tested. Although PCRVs present similar microhardness and microstructure, Componeer showed higher color stability and lower extrinsic pigmentation to coffee in comparison to Edelweiss. Direct composite resin veneer treatment might be simplified with PCRVs. However, the high pigmentation observed in the PCRVs could generate aesthetic failures over the time. (AU)

O objetivo do trabalho foi determinar a microdureza Knoop (KH), estabilidade de cor (ΔE00) e a microestrutura de facetas de resina composta pré-fabricadas. Os sistemas de facetas Componeer e Edelweiss foram testados. Para cada sistema, a microdureza foi avaliada na superfície vestibular das facetas. A análise da estabilidade de cor foi feita mediante o emprego de um espectrofotômetro e a alteração de cor foi calculada seguindo a fórmula determinada pelo CIEDE2000. A microestrutura dos sistemas foi observada e caracterizada a partir de um microscópio eletrônico de varredura. Os resultados de microdureza e alteração de cor foram submetidos a análise de variância de um fator complementados pelo teste de Tukey (α=0,05). Os sistemas de facetas pré-fabricadas de resina composta apresentaram valores estatisticamente similares de microdureza (p>0,05). O grupo Componeer apresentou uma alteração de cor inferior em relação ao grupo Edelweiss. Os dois sistemas apresentaram uma elevada pigmentação após imersão em solução com café. A microestrutura dos sistemas se mostrou similar em função da avaliação das imagens em microscopia. Apesar dos sistemas apresentarem microdureza e microestrutura similares, o sistema Componeer gerou menor alteração de cor com menor pigmentação a bebida corante empregada em comparação ao sistema Edelweiss. A técnica de facetas dentárias pode ser simplificada utilizando um sistema de facetas pré-fabricadas de resina composta. Todavia, a elevada pigmentação observada no presente estudo deve ser levada em consideração já que o tratamento com esse tipo faceta tende a ser um procedimento estético com durabilidade elevada. (AU)

Evaluation of Intra Root Canal Er,Cr:YSGG Laser Irradiation on Prosthetic Post Adherence.

PURPOSE: In clinical prosthetics procedures, including endodontics and post fixation, the presence of a smear layer can reduce the post bond strength. An Er,Cr:YSGG laser, which emits at 2780 nm, can promote a smear-layer-free surface due to the ablation process. Considering these aspects, the purpose of this work was to evaluate the influence of Er,Cr:YSGG laser irradiation using either a radial or an axial fiber tip on the bond strength of three resin cements to the fiber-reinforced composite posts. MATERIALS AND METHODS: Ninety recently extracted single rooted human teeth had their root canal instrumented and were randomly distributed into nine experimental groups, in which three resin cements (total-etching Variolink II, self-etching Panavia F, and self-adhesive RelyX Unicem Aplicap) and three root canal treatments (no treatment, laser irradiation using the radial fiber tip, laser irradiation using the axial fiber tip) were used. Specimens were then sectioned into three sections (cervical, middle, and apical thirds) with two slices on each section. A push-out test was performed on each slice, and the values were recorded as MPa. The push-out data were analyzed by a Ryan-Joiner normality test followed by a two-way ANOVA test and Tukey pairwise comparison. The statistical analysis was performed on each third section separately, with a 5% significance level. RESULTS: Laser irradiation with axial fiber tip significantly increased the post bond strength of RelyX Unicem Aplicap on middle third of specimens (p < 0.001) when compared to other root canal treatments (unlased or irradiated with radial tip). Considering the Panavia resin cement, laser irradiation with either axial or radial tips promoted a significant increase on the post bond strength of middle third when compared to unlased specimens (p < 0.001); however, laser irradiation did not influence the post bond strength of Variolink resin cement. CONCLUSIONS: The use of the Er,Cr:YSGG laser for clinical prosthetics procedures enhances the post bond strength of Panavia and RelyX Unicem Aplicap resin cements, mainly at middle third of roots, and does not interfere with the bond strength of Variolink resin cement. For the RelyX Unicem Aplicap system, the use of axial tip is most advantageous and can be recommended for future clinical application.

Prefabricated resin veneer: A case report of a simplified restorative technique.

Background: the aim of the study was to describe the step-by-step of clinical cases using prefabricated composite resin veneers (PCRVs), manufactured with the composite Brilliant New Generation (Coltene, Altstätten, Switzerland). Direct composite veneers presented some drawback as the difficult of execution and color instability of the composite over the time. The simplified application of the PCRVs presented as an interesting alternative in cases of smile asymmetry, large deficient restorations and discolored tooth. In the present investigation, the complete description of the PCRVs technique can help the dentist during the planning and execution of treatments with the Componeer system. Conclusion: the treatment with Componeer Brilliant NG showed excellent aesthetic results. PCRVs technique is simpler than direct composite veneers. The specific characteristics of the system can promote results with greater aesthetic longevity. It is important to highlight that this procedure does not replace the already established veneer technique with dental ceramics. Clinical implication: PCRVs presented an excellent surface gloss. Their dimensions based on the golden ratio facilitate the technique and turns as an excellent alternative in the aesthetic restorative treatment in the anterior region.

A comparative study of bulk-fill composites: degree of conversion, post-gel shrinkage and cytotoxicity.

Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05). All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4%) than that of conventional composites (1.7-2.1%). However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

Micro-CT and FE-SEM enamel analyses of calcium-based agent application after bleaching.

OBJECTIVES: The objective of the present study is to evaluate the effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on bleached enamel. MATERIALS AND METHODS: A bleaching agent (35% hydrogen peroxide) was applied, 4 × 8 min on premolar teeth (n = 8). A CPP-ACP paste was applied for 7 days. Prior and post-treatment, microtomography images were obtained and 3D regions of interest (ROIs) were selected, from outer enamel, extending to 110.2-µm depth. CT parameters of structure: thickness (St.Th), separation (St.Sp), and fragmentation index (Fr.I.) were calculated for each (ROI). Data was submitted to paired t tests at a 95% confidence level. The samples were evaluated at 3000 to 100,000 magnification. Quantitative analysis of enamel mineral content was also determined by SEM EDX. RESULTS: There was a significant increase in structure thickness and calcium content. The phosphorus content increased after bleaching. There was also a decreased separation and fragmentation index on the outer enamel to a depth of 56.2 µm (p < 0.05). There were no changes at 110.2-µm depth for the bleaching CPP-ACP association. A covering layer and decreased spaces between the hydroxyapatite crystals appeared around the enamel prisms, 7 days after the CPP-ACP application. CONCLUSIONS: The application of a CPP-ACP provides a compact structure on the enamel's outer surface, for 7 days, due to calcium deposition. CT parameters seem to be a useful tool for mineralizing and remineralizing future studies. CLINICAL RELEVANCE: CPP-ACP neutralizes any adverse effects on enamel surface when applied during a week after bleaching and minimizes any side effects of the bleaching treatment due to a more compact structure.

A comparative study of bulk-fill composites: degree of conversion, post-gel shrinkage and cytotoxicity

Abstract: Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05). All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4%) than that of conventional composites (1.7-2.1%). However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

In vitro analysis of a local polymeric device as an alternative for systemic antibiotics in Dentistry.

The development of a biodegradable material with antimicrobial properties for local applications is required in the prevention and treatment of infectious diseases. The objective of this study was to produce blends of poly-L-lactide acid (PLLA) synthetic polymer associated with several antimicrobials, as an alternative in the prevention and treatment of infections, as well as to evaluate its cytotoxicity, release of antimicrobials and inhibit bacteria growth. Blends of PLLA added with 20% Amoxicillin, Metronidazole, Clindamycin or Azithromicyn were used to produce Films (F) or Meshs (M) by casting and electrospinning methods, respectively. Standardized discs of the films and meshs were stored in buffer solutions (pH 5 or 7.4) and aliquots were analyzed by high performance chromatography (HPLC) during 168 hours. Cytotoxicity on human gingival fibroblasts was tested after 24, 48 and 72h by MTT reaction. The antimicrobial capacity was determined against P. gingivalis and S. pyogenes. The specimens were weighed after 3 and 6 months of storage for degradation analysis. SEM was performed to control interfaces and degradation. Antimicrobials presented a continuous and exponential drug release. Analysis showed that both M and F were able to inhibit S. pyogenes and P. gingivalis growth, indicating the release of active antimicrobial agents. The products were not toxic to the fibroblasts. Amoxicillin-film showed more degradation than PLLA at both pHs (p < 0.05), whereas Azithromycin-meshes were more degraded than PLLA at pH 7.4 (p < 0.05). PLLA association with antimicrobials is biocompatible and may represent a potential tool for the local delivery of antimicrobials.

Effect of whitening dentifrices on surface roughness of dental nanofiller-based composites. Stereomycroscopyand AFM analysis / Efeito de dentifrícios clareadores na rugosidade superficial de compósitos de nanoparticulados. Estereomicroscopia e AFM

Objective: the aim of this study was to assess the effects of whitening dentifrices on the surface roughness of three commercial nanofiller-based composite. Material and Methods: two optical analyses were performed: stereomicroscopy and atomic force microscopy (AFM). Disks (8.0 diam. x 2.0 mm thick.) of the nanocomposite Z350 (3M ESPE) and two nano-hybrid composites (EsthetXHD, Dentsply and Premisa, Kerr) were submitted to in vitro brushing (1000 cycles) with three whitening dentifrices (Colgate Luminous White, Oral-B 3D White e Close-Up Diamond Attraction) and a control (Colgate Total12). The results were analyzed by stereomicroscopy and rated according to the following criteria: 0 – no observed roughness, 1 – average roughness, 2 – great roughness. Data was submitted to Kruskall-Wallis non-parametric test followed by Tukey test (p = 0.05). Z350 specimens were assessed by AFM. Results: the surface roughness of composites brushed with whitening dentifrices was statistically higher than the roughness found in specimens brushed with conventional dentifrice. AFM analyses showed that, at a submicrometric scale, there was an increase in the number of peaks and irregularities in specimens brushed with whitening dentifrices. Conclusion: Whitening dentifrices may have an impact on the longevity of dental composites by an increase in its roughness. It is strongly recommended that clinicians guide their patients, warning them about the risks and consequences of their use.

Objetivo: o objetivo deste estudo foi avaliar os efeitos da abrasão produzida por dentifrícios clareadores sobre as superfícies de três marcas comerciais de resinas compostas contendo partículas nanométricas. Materiais e Métodos: A resina nanoparticulada Z350 (3M ESPE) e as resinas nano-híbridas EsthetXHD (Dentsply) e Premisa (Kerr) foram submetidas à escovação in vitro com três diferentes dentifrícios clareadores (Colgate Luminous White, Oral-B 3D White e Close-Up Diamond Attraction). Os espécimes de resina foram confeccionados com 8mm de diâmetro e 2mm de espessura. Foram produzidos 45 corpos de prova para os grupos experimentais e mais 15 espécimes para o grupo controle (dentifrício Colgate Total12). Após a realização de 1.000 ciclos de escovação, os espécimes foram armazenados em saliva artificial. A análise das superfícies escovadas foi obtida por estereomicroscópio. As rugosidades foram mensuradas segundo os critérios: 0 – sem rugosidade, 1 – média rugosidade e 2 – com muita rugosidade. Os dados obtidos foram analisados estatisticamente por teste não-paramétrico de Kruskall-Wallis seguido pelo teste de Tukey (p < 0,05). Os espécimes confeccionados com Z350 foram avaliados por microscopia de força atômica (AFM). Resultados: A rugosidade superficial dos espécimes de resina composta foi estatisticamente maior quando escovados com os dentifrícios clareadores em relação ao dentifrício controle convencional. Análise por AFM demonstrou, em uma escala submicrométrica, um aumento no número de picos na superfície dos espécimes da resina em que foi realizada a escovação com dentifrícios clareadores em comparação com o grupo controle. Conclusão: Os dentifrícios clareadores aumentaram a rugosidade superficial das resinas compostas podendo, assim, diminuir a sua longevidade.

Afastamento gengival: técnicas e materiais / Gingival retraction: techniques and materials

Este trabalho teve como objetivo levar o leitor a uma revisão da literatura sobre os diferentes métodos de afastamento gengival, suas técnicas, indicações e contraindicações. Foram abordadas as variações dos métodos e técnicas, a fim de facilitar a escolha mais adequada às diferentes situações clínicas. São feitas considerações sobre as soluções químicas, os fios utilizados para o afastamento gengival, as pastas adstringentes, bem como a combinação entre eles. Foram elaborados quadros comparativos entre os diferentes métodos de afastamento gengival, entre as soluções químicas mais utilizadas e entre as diferentes marcas comerciais existentes.

This paper aims to take the reader on a review of literature about the diff erent methods of gingival retraction, their techniques, indications and contraindications. Variations of the methods and techniques were discussed in order to facilitate the most appropriate choice for diff erent clinical situations. Some considerations were made about the chemical solutions, the gingival retraction cords, as well as their combination. Comparative tables among the diff erent gingival retraction methods, the most used chemical solutions, and the diff erent trademarks were prepared.

Polymerization development of "low-shrink" resin composites: Reaction kinetics, polymerization stress and quality of network.

OBJECTIVES: To evaluate "low-shrink" composites in terms of polymerization kinetics, stress development and mechanical properties. METHODS: "Low-shrink" materials (Kalore/KAL, N'Durance/NDUR, and Filtek P90/P90) and one control (Esthet X HD/EHD) were tested. Polymerization stress (PS) was measured using the Instron 5565 tensometer. Volumetric shrinkage (VS) was determined by the ACTA linometer. Elastic modulus (E) and flexural strength (FS) were obtained by a three-point bending test. Degree of conversion (DC) and polymerization rate (Rp) were determined by NIR spectroscopy (6165cm(-1) for dimethacrylates; 4156 and 4071cm(-1) for P90). Photopolymerization was performed at 740mW/cm(2)×27s. Glass transition temperature (Tg), degree of heterogeneity and crosslink density were obtained in a DMA for the fully cured specimens. Analysis of extracts was done by (1)H NMR. Data were analyzed with one-way ANOVA/Tukey's test (α=0.05). RESULTS: The control presented the highest shrinkage and Tg. P90 showed the highest modulus, and NDUR demonstrated the highest conversion. The polymerization rates were comparable for all materials. NDUR and KAL had the highest and the lowest network homogeneity, respectively. The multifunctional P90 had the highest crosslink density, with no difference between other composites. The control had the greatest stress development, similar to NDUR. Crosslinking density and polymer network homogeneity were influenced by degree of conversion and monomer structure. SIGNIFICANCE: Not all "low-shrink" composites reduced polymerization stress. P90 and NDUR had no leachable monomers, which was also a function of high crosslinking (P90) and high conversion (NDUR).

Lentes de contato: harmonização do sorriso sem desgaste dental / Contact lenses: smile harmonization with non-prep veneers

O presente trabalho apresenta o relato de um caso clínico, no qual foi obtida a harmonia do sorriso a partir de laminados cerâmicos ultrafinos, também conhecidos como “lentes de contato”. Esse tipo de procedimento alia excelência estética ao conceito atual de odontologia minimamente invasiva. As vantagens, desvantagens, indicações e limitações da técnica são brevemente discutidas, a fim de bem informá-las ao clínico e complementar sua capacitação para execução dessa proposta mais conservadora.

This article presentes a case report where the harmony of the smile was obtained using ultra-thin laminate veneers, also known as “contact lenses”. This type of treatment combines the esthetic excellence and the concept of minimally invasive dentistry. The advantages, disadvantages, indications and contraindications are described in order to bring more information to the clinicians about this conservative approach.

Estética: o passo a passo de um novo sorriso / Aesthetics: step by step for a new smile

O presente trabalho apresenta o relato de um caso clínico, no qual foi obtida a harmonia do sorriso a partir de um trabalho de reabilitação estética e funcional da paciente com o uso de restaurações cerâmicas associando laminados e coroas totais. De uma forma simples, o passo a passo de execução de um trabalho reabilitador em cerâmica é descrito, com ênfase na moldagem, nos provisórios e numa cimentação adesiva consciente, tocando principalmente o transcorrer clínico e a interdependência do Cirurgião-Dentista com o técnico em prótese dental.

This paper presents the report of a clinical case, in which was obtained the harmony of the smile from a work of aesthetic and functional rehabilitation of the patient with the use of ceramic restorations involving laminates and crowns. From a sim pie methodology, the step by step implementation of rehabilitation work in ceramics is described, with emphasis on impression, on temporary restorations and on conscious adhesive cementation, focusing primarily on the clinical course and the interdependence of clinician with the dental technician.

Qualitative SEM/EDS analysis of microleakage and apical gap formation of adhesive root-filling materials.

OBJECTIVE: The aim of this study was to compare the correspondence between gap formation and apical microleakage in root canals filled with epoxy resin-based (AH Plus) combined or not with resinous primer or with a dimethacrylate-based root canal sealer (Epiphany). MATERIAL AND METHODS: Thirty-nine lower single-rooted human premolars were filled by the lateral condensation technique (LC) and immersed in a 50-wt% aqueous silver nitrate solution at 37ºC (24 h). After longitudinal sectioning, epoxy resin replicas were made from the tooth specimens. Both the replicas and the specimens were prepared for scanning electron microscopy (SEM). The gaps were observed in the replicas. Apical microleakage was detected in the specimens by SEM/energy dispersive spectroscopy (SEM/EDS). The data were analyzed statistically using an Ordinal Logistic Regression model and Analysis of Correspondence (α=0.05). RESULTS: Epiphany presented more regions containing gaps between dentin and sealer (p<0.05). There was correspondence between the presence of gaps and microleakage (p<0.05). Microleakage was similar among the root-filling materials (p>0.05). CONCLUSIONS: The resinous primer did not improve the sealing ability of AH Plus sealer and the presence of gaps had an effect on apical microleakage for all materials.

Qualitative SEM/EDS analysis of microleakage and apical gap formation of adhesive root-filling materials

OBJECTIVE: The aim of this study was to compare the correspondence between gap formation and apical microleakage in root canals filled with epoxy resin-based (AH Plus) combined or not with resinous primer or with a dimethacrylate-based root canal sealer (Epiphany). MATERIAL AND METHODS: Thirty-nine lower single-rooted human premolars were filled by the lateral condensation technique (LC) and immersed in a 50-wt% aqueous silver nitrate solution at 37ºC (24 h). After longitudinal sectioning, epoxy resin replicas were made from the tooth specimens. Both the replicas and the specimens were prepared for scanning electron microscopy (SEM). The gaps were observed in the replicas. Apical microleakage was detected in the specimens by SEM/energy dispersive spectroscopy (SEM/EDS). The data were analyzed statistically using an Ordinal Logistic Regression model and Analysis of Correspondence (α=0.05). RESULTS: Epiphany presented more regions containing gaps between dentin and sealer (p<0.05). There was correspondence between the presence of gaps and microleakage (p<0.05). Microleakage was similar among the root-filling materials (p>0.05). CONCLUSIONS: The resinous primer did not improve the sealing ability of AH Plus sealer and the presence of gaps had an effect on apical microleakage for all materials.

Utilização de novos recursos tecnológicos para o alcance da excelência estética em restaurações diretas / Use of new technology to achieve excellence in esthetic direct restorations

A obtenção da excelência estética em restaurações diretas depende de observação, percepção e registro prévios da situação clínica tanto do dente a ser restaurado quanto de seu análogo, adjacentes e antagonistas. Este artigo apresenta o relato de um caso clínico que envolve uma restauração de classe IV no dente 11, cujo bordo incisal deveria ser restaurado com detalhes e minúcias extremamente marcantes. Para facilitar a confecção da restauração, foi realizado o registro fotográfico inicial do caso, juntamente com o uso de alguns recursos tecnológicos, como a transmissão sem fio de fotos para o computador, a fim de agilizar a visualização do elemento em tamanho grande pelo operador durante o ato operatório, e o software de imagens para análise do formato dental, visando obter a maior simetria possível com o dente 21 no acabamento final.

The achievement of excellence in aesthetic restorations depends on direct observation, perception and previous registration on the clinical situation of both the tooth to be restored and its adjacent and antagonist teeth. This article presents a case report involving a Class IV restoration on tooth 11 whose incisal edge should be restored with details and minutiae extremely remarkable. To facilitate the restoration manufacture, the initial pictures were taken in conjunction with the use of some technological resources, like fast wireless transmission of picture files to computer accelerating the viewing by the operator, and the use of imaging software for analysis the form achieved to obtain the largest possible symmetry with the tooth 21 in the final sculpture.

Os limites da estética / The limits of aesthetic

O artigo discorre sobre a busca pela estética do sorriso e as ferramentas disponíveisatualmente para o clínico corresponder à procura, aliada à ética profissional. Apresenta-se também um caso clínico de devolução de harmonia do sorriso através dos materiais mais atuais disponíveis.

The article presents the concerns about aesthetic demands and the available tools forthe cliniciars to correspond that allied to professional ethics. A clinical report is also presented as an example of the devolution of smile harmony through current materiais.

Microshear bond strength of self-etching systems associated with a hydrophobic resin layer.

PURPOSE: To evaluate in vitro the microshear bond strength of adhesive systems applied to dentin according to manufacturers' instructions, associated or not with a hydrophobic layer of unfilled resin. MATERIALS AND METHODS: Six self-etching adhesives (Clearfil SE Bond, Kuraray Medical; AdheSE, Ivoclar Vivadent; Xeno III, Dentsply; I Bond, Heraeus-Kulzer; Bond Force, Tokuyama; Futurabond DC, Voco) were tested. The labial dentin of sixty bovine incisors was exposed, and the teeth were divided into two groups according to the application or not of an extra hydrophobic resin layer (Scotchbond Multi Purpose Plus, bottle 3). Six composite cylinders (Filtek Z250, 3M ESPE) were built up on each treated surface. Specimens were stored in distilled water at 37ºC for 24 h and then subjected to the microshear bond strength test in a universal testing machine at a crosshead speed of 0.5 mm/min. Microshear bond strength values were analyzed by 2-way ANOVA and Tukey's post-hoc test. Failure mode was determined using a stereomicroscope under 20X magnification. RESULTS: The application of the hydrophobic resin layer did not affect bond strength, except for AdheSE. However, the bond strengths with the hydrophobic layer were similar among the six tested systems (Clearfil: 17.1 ± 7.9; AdheSE: 14.5 ± 7.1; Xeno lll: 12.8 ± 7.7; I Bond: 9.5 ± 5.8; Bond Force: 17.5 ± 4.1; Futurabond: 7.7 ± 2.3). When used as recommended by the manufacturers, Bond Force presented statistically higher bond strength than AdheSE and I Bond (p < 0.05) (Clearfil 10.4 ± 4.9; AdheSE 1.6 ± 1.6; Xeno lll: 9.0 ± 3.8; I Bond: 3.0 ± 1.5; Bond Force: 14 ± 3.9; Futurabond: 8.8 ± 3.8). Failure mode was predominantly adhesive. CONCLUSION: The bond strength of the self-etching systems tested was not significantly affected by the application of a hydrophobic layer, but a significant improvement was observed in AdheSE.