Influence of bioceramic sealer residues on the adhesion interface with a universal adhesive in the etch-and-rinse strategy, based on the application protocol and evaluation time.

The aim of this study was to evaluate the effects of the application of universal adhesive in the etch-and-rinse (ER) strategy with a manual brush (MB) or rotary brush (RB) in adhesion to dentin impregnated (WB) or not (NB) with bioceramic sealer, at 24 h and 1 year. Eighty-eight crowns of bovine incisors were divided into four groups (n=22): WB-MB, WB-RB, NB-MB, NB-RB. After the restorative protocol, dentin penetrability was evaluated by confocal microscopy. Bond strength was evaluated by microtensile test. Data were analyzed using one-way ANOVA/Tukey tests (α=0.05). NB-RB and WB-RB exhibited greater extensions of resin tags in dentin. At 24 h, WB-RB and NB-MB showed the highest and lowest values of bond strength, respectively. At 1 year, WB-MB and WB-RB demonstrated the highest bond strength values. The RB increases the formation of resin tags and residues of bioceramic sealer provides higher bond strength in the ER strategy.

Evaluation of bond strength in customizing fiber post using translucent resins photoactivated by different light-emitting diodes.

Aims: The objective of the study was to evaluate two translucent resin composite systems for customizing light-polymerized fiber posts with light-emitting diode (LED) curing units regarding adhesion using conventional cement at 24 h and 6 months. Settings and Design: This was an experimental in vitro study. Methods: Forty roots were prepared and divided into four groups (n = 10): ZV-Z350 resin and LED Valo; ZR-Z350 resin and LED Radii-Cal; OV-Opallis resin and LED Valo; and OR-Opallis resin and LED Radii-Cal. The fiber post was customized and cemented with conventional resin cement and was photoactivated by two different sources. Statistical Analysis Used: The data were subjected to two-way ANOVA and Tukey's post hoc tests (P = 0.05). The data regarding the pattern of adhesive failures were described in terms of the frequency of occurrence in each third of the postspace. Results: Both at 24 h and 6 months, bond strength among groups was similar, regardless of the analyzed postspace 3rd (P > 0.05). Adhesive failure Type 4 was the most frequent in all thirds. Conclusions: Customizing the fiber post with Z350 and Opallis has the same effect on bond strength and adhesive failure pattern, regardless of the LED curing units used for photopolymerization.

Formulations of NaOCl-based in liquid, gel form or with surfactants on dentin deproteinization before fiber post cementation.

The objective of the study was to evaluate the effects of dentin deproteinization protocols for post space using different formulations containing sodium hypochlorite before fiber post cementation with self-adhesive resinous cement. The groups were divided according to the irrigation protocol (DWC, SHS, SHT and SHG). The residue cleanliness, bond strength, adhesive failure pattern, and tag formation at the adhesive interface between the self-adhesive cement and the dentin were evaluated. For this, analysis in scanning electron microscope, push-out test and confocal laser scanning microscopy were performed. The SHT protocol showed the highest residue cleanliness on the dentin surface of the post space (p<0.05). In addition, SHT protocol showed highest bond strength and tag formation in the cervical and middle thirds (p<0.05). Dentin deproteinization with sodium hypochlorite with surfactant provided the best dentin cleaning of residues, bond strength and tag formation after cementation of the fiber post with self-adhesive cement.

Influence of using different translucent composite resins for customizing fiber post on the bond strength of self-adhesive cement to root dentin.

This study evaluated the influence of different translucent resins (Z350 and Opallis) for customizing fiber posts and light-curing the cementation system using different LED equipment (V, Valo or R, Radii-Cal) on the bond strength and adhesive failure pattern at 24 h and 6 months. Eighty roots were prepared and divided into 4 groups (n=20): ZV (Z350 resin and LED Valo), ZR (Z350 resin and LED Radii-Cal), OV (Opallis resin and LED Valo), OR (Opallis resin and LED Radii-Cal). After post space preparation, the fiber post was customized and cemented with self-adhesive cement and light-curing using V or R LED equipment. Bond strength values were submitted to 2-way ANOVA test. ZV and ZR showed higher bond strength values than the other groups at 6 months of evaluation (p<0.05). The Z350 resin has a favorable influence on the bond strength of self-adhesive cement to root dentin, regardless of the LED polymerization equipment used.

Effect of sodium hypochlorite-based formulations on the adhesion interface after fiber post cementation.

The study evaluated the persistence of residues, bond strength and tags formation of a cementation system after post-space irrigation with different sodium hypochlorite-based irrigants. The groups were divided according to the irrigation protocol (DW: distilled water; SHS: sodium hypochlorite solution; SHG: sodium hypochlorite gel; and, SHT: sodium hypochlorite with surfactant). Forty roots (n=10) were used to evaluate the persistence of residues by scanning electron microscopy. Other forty roots were used to the push-out bond strength test, failure mode and tag formation analyses. Non-parametric data were submitted to Kruskal Wallis and Dunn tests, while parametric data were evaluated by one-way ANOVA. No difference was observed in the persistence of residues. DW showed the highest bond strength and tag formation. Type 2 failure mode was the most frequent in the experimental groups. Compared to control, SHT showed the best performance, since less negative effects on adhesive interface was observed.

Surface and intra-pulpal temperature variation during tooth whitening photoactivated with LED/laser.

This study evaluated the variation of surface and intra-pulpal temperature, during bleaching protocol, using LED/laser. The 35% (HP35), 15% (HP15) and 6% (HP6) gels were used associated with LED/laser applied every 1 min for 30 min in a human canine. The evaluation of surface temperature variation (∆Ts) was performed using a pHmeter and the intra-pulpal temperature variation (∆Ti) was performed using a digital thermometer, at times of 1-, 5-, 10- 15- and 30-min. Statistical analysis was performed using the two-way repeated measures ANOVA test and Bonferroni post-hoc test was used at a significance level of 5%. HP35 and HP15 showed greater temperature variation than HP6 up to 10 min of surface evaluation, showing no differences between them. In the intra-pulpal evaluation, no group showed differences throughout the procedure.

Microstructural effect of different concentrations of hydrogen peroxide photoactivated with LED/laser.

BACKGROUND: The use of different concentrations of hydrogen peroxide (HP) photoactivated with LED/laser sources is common however, their influence on tooth structure is not yet fully elucidated. This study aimed to evaluate the pH, microhardness and surface roughness of different bleaching protocols photoactivated with LED/laser. METHODS: Forty bovine incisors were sectioned (7 × 7 × 2 mm) and randomized into four groups for analysis of pH (n = 5), microhardness and roughness (n = 10): HP35, HP6_L, HP15_L, HP35_L. The pH analysis was performed in the initial and final minute of the bleaching protocol. Microhardness and roughness were evaluated before and 7 days after the last bleaching session. Results were obtained from two-way ANOVA for repeated measures and Bonferroni post-test at a significance level of 5%. RESULTS: HP6_L showed higher pH and greater stability between the initial and final evaluations, while the other groups showed similar pH with reduced values in the intragroup evaluation. No differences between groups in microhardness and roughness evaluations were observed. CONCLUSIONS: Although HP6_L showed higher alkalinity and pH stability, none of the protocols reduced the microhardness and surface roughness of bovine enamel.

Violet LED associated with high concentration hydrogen peroxide: Effects on bleaching efficacy, pH, and temperature.

BACKGROUND: This study aimed to evaluate the bleaching efficacy, pH, and temperature of 35% hydrogen peroxide (HP) gel used alone or associated with violet LED. METHODS: Sixty bovine crowns were sectioned (5 × 5 × 2mm). After staining with black tea, the specimens were randomized into four groups (n = 10) according to the bleaching protocol: HP35R: 3 × 15 min 35% HP; HP35: 1 × 45 min 35% HP; HP35VR: 3 × 8min 35% HP + Violet LED; HP35V: 1 × 24 min + Violet LED. Two bleaching sessions were performed for all the groups. Color change was evaluated before, 24h after each session, 7 days and 15 days after the last session. The variables ∆E00 [CIEDE2000] and WID were used for color analysis. The pH variation (initial and final) and the temperature of the gel were recorded (n = 5). ANOVA two-way for repeated measures and Bonferroni post-test was used at a significance level of 5%. RESULTS: HP35VR and HP35V the most noticeable color change(p < 0.05). The final values of pH were lower than the initial ones, but with no difference between the groups (p > 0.05). Groups HP35VR and HP35V showed an increase in temperature in relation to HP35R (p < 0.05). CONCLUSIONS: Violet LED improved the bleaching efficacy of 35% HP in a time-saving manner without negatively affecting the pH and temperature of 35% HP. The renewal of HP did not influence the outcomes.

Effects of tooth bleaching protocols with violet LED and hydrogen peroxide on enamel properties.

BACKGROUND: This study evaluated the color change, enamel surface roughness and microhardness after different tooth bleaching protocols, using hydrogen peroxide (HP) and/or violet LED. METHODS: Forty bovine specimens (7 × 7 × 2 mm) were randomly distributed into 4 groups: 35% HP, 6% HP, 6% HP + violet LED and violet LED alone. First, the specimens were stained with black tea and then submitted to two bleaching sessions of 30 min with an interval of 7 days. Color change (∆L*, ∆a*, ∆b* and ∆E00) after 24 h of each session and 1 week after the last session was evaluated. Enamel roughness and microhardness were evaluated immediately before the sessions, 24 h and 1 week after the last session. Data were evaluated by ANOVA for repeated measures and Bonferroni post-test or Kruskall-Wallis and Dunn tests (α = 0.05). Representative specimens from each group were analyzed by scanning electron microscopy. RESULTS: 6% HP + violet LED and 35% HP showed the highest color change, while violet LED alone had the lowest results. Enamel roughness analyses showed that 6% HP + violet LED and 35% HP showed changes after two bleaching sessions. No differences were observed regarding enamel microhardness. CONCLUSIONS: The use of 6% HP + violet LED showed enhanced bleaching efficacy compared to 35% HP. However, violet LED used alone exhibited the lowest color change. 6% HP + violet LED and 35% HP promoted changes on enamel roughness, while no microhardness changes was observed for any group.

Influence of agitation methods of irrigants after methylene blue-mediated PDT on the bonding interface of a fiber post cementation system.

BACKGROUND: This study evaluated the effects of final agitation methods of irrigants to remove methylene blue and sodium hypochlorite residues after PDT-assisted endodontic treatment on the bond strength of fiber posts cemented with etch-and-rinse adhesive and conventional resin cement. METHODS: Ninety bovine teeth were endodontically treated. In sequence, post space preparation followed by methylene blue-mediated PDT and sodium hypochlorite (NaOCl) irrigation were performed. Six final irrigations protocols for dye and NaOCl removal were performed prior to cementation with etch-and-rinse adhesive (Adper Scocthbond Multipurpose) and conventional dual resin cement (RelyX ARC): Conventional endodontic irrigation (CEI), passive ultrasonic irrigation (PUI), mechanical agitation with XP Endo Finisher (XPF), XP Clean (XPC) or Easy Clean (ECL) and distilled water (NCO - control). After fiber post cementation, push-out bond strength test was performed at different thirds of the post space. Failure mode was also analyzed. ANOVA and Tukey's post-hoc test was used for data analysis (α=5%). RESULTS: PUI, XPF e XPC protocols showed the highest bond strength values with no difference among them (p > 0.05), although they were similar to NCO, regardless of the post space third. CEI e ECL showed similar bond strength values, regardless of the third (p > 0.05). Adhesive failure was the most incident for CEI and ECL, while mixed and cohesive failures were predominant in PUI, XPF, XPC and NCO groups. CONCLUSIONS: Mechanical agitation of distilled water with XPF, XPC and PUI after methylene blue-mediated PDT and irrigation with 2.5% sodium hypochlorite promoted bond strength of the resin cementation system in post space dentin comparable to control group.

Management of Tooth Discoloration after Orthognathic Surgery Complications: Report of Two Cases

ABSTRACT: Orthognathic surgery is performed for the correction of craniofacial discrepancies. However, complications, such as tooth discoloration are possible. This case report presents two patients who underwent bilateral sagittal split ramus osteotomy associated with segmental Le Fort I osteotomy and genioplasty. During surgeries, the apical region of anterior teeth was accidentally injured in both cases. After three-week surgery follow-up, the injured teeth showed a change in color to dark pink. In both teeth, the root canal treatment was performed followed by the non vital tooth bleaching. Three sessions were necessary to achieve a significant color change of the teeth. The two-year follow-up showed that both teeth preserved an acceptable color. It was concluded that tooth discoloration after orthognathic surgery is a possible complication, which could be overcome following a conservative approach. Additionally, patients should be informed preoperatively.

RESUMEN: La cirugía ortognática es comúnmente realizada para corregir las discrepancias cráneo-faciales. Sin embargo, se pueden producir complicaciones tales como la pigmentación dentaria. Este reporte de casos presenta a dos pacientes que fueron sometidos osteotomía sagital bilateral de la rama mandibular asociada a osteotomía segmentaria Le Fort I y genioplastía. Durante la fase quirúrgica, la región apical de dientes anteriores fueron accidentalmente dañados en ambos casos. Después de tres semanas de seguimiento de la cirugía, los dientes afectados mostraron un cambio de color a rosado oscuro. Se realizó el tratamiento de conductos seguido de aclaramiento interno en ambas piezas dentarias. Fueron necesarias tres sesiones para lograr un cambio de color significativo. El seguimiento de dos años mostró que ambos dientess conservaron un color aceptable. En conclusión, la pigmentación dentaria después de la cirugía ortognática es una posible complicación, sin embargo, puede ser tratada por medio de un enfoque conservador. Además, los pacientes deben ser informados antes de la cirugía.

Protocolos de indicação de soluções anestésicas para uso na clínica endodôntica / Anesthetic solution indication protocols for use in the endodontic clinic

A indicação das soluções anestésicas nos tratamentos endodônticos de rotina deve estar fundamentada nos conhecimentos dos possíveis efeitos que essas substâncias podem desencadear no paciente sistemicamente comprometido. Objetivo: O objetivo do presente estudo foi priorizar a indicação e discutir os possíveis efeitos secundários ou adversos passíveis de ocorrência com as substâncias que compõem as soluções anestésicas durante a rotina de tratamento dos canais radiculares (AU).

The indication of anesthetic solutions in routine endodontic treatments must be based on knowledge of the possible effects that these substances can trigger in systemically compromised patients. Aim: The aim of the present study was to prioritize the indication and discuss the possible secondary or adverse effects likely to occur with the use of substances of which anesthetic solutions are composed, during the routine treatment of root canals (AU).

Resistência flexural e adaptação marginal dos materiais restauradores provisórios utilizados em dentes tratados endodonticamente / Flexural strength and marginal adaptation of temporary restorative materials used in endodontically treated teeth

Avaliar a resistência flexural e a adaptação marginal dos materiais restauradores provisórios Clip F (CF),Bifix Temp (BT), Systemp.onlay (SO), Fill Magic Tempo (FT) e Provi Master F (PF), na dentina da coroa dentária de dentes tratados endodonticamente. Métodos: Inicial-mente, foram confeccionados dez espécimes de cada um dos materiais restauradores, que foram individualmente submetidos ao teste de resistência flexural, na máquina de ensaio eletromecânica. Para avaliar a adaptação marginal,a câmara pulpar de cinquenta pré-molares superiores foi restaurada com um dos materiais avaliados (n=10). Após sete dias, a interface entre a dentina e o material restaurador, no terço médio da coroa dentária, foi submetida à análise em microscopia eletrônica de varredura. A extensão de desadaptação dos materiais e os gaps formados com a dentina foram mensurados com o software Image J.Resultados: CF e BT demonstraram o maior e o menor valor de resistência flexural, respectivamente (p<0,05).Os valores demonstrados por SO, FT e PF foram similares entre si (p>0,05). Por outro lado, CF demonstrou a menor extensão de desadaptação marginal (em porcentagem)e extensão de gaps (em µm) (p<0,05) na interface com a dentina. BT apresentou valor intermediário, mas menor do que os dos SO, FT e PF (p<0,05) que, por sua vez, foram similares entre si (p>0,05). Conclusões: O CF demonstrou o maior índice de resistência flexural e menor extensão de desadaptação marginal e gaps, em comparação aos demais materiais restauradores provisórios (AU).

Objectve: This study evaluated the flexural strength and marginal adaptation of Clip F (CF), Bifix Temp (BT), Systemp.onlay (SO), Fill Magic Tempo (FT) and Provi Master F (PF) in endodontically-treated coronal dentin. Methods: Firstly, ten specimens of each restorative material were prepared, and submitted to flexural strength test using eletromechanical testing machine. Then, the pulp chamber of 50 maxillary premolar were restored using one of the provisional restorative materials (n = 10) in order to evaluate the marginal desadaptation extension. After 7 days, the interface between dentin and temporary restorative material, in crown middle third, was subjected to scanning electron microscopy (500X). Marginal desadaptation and gaps extensions in dentin-temporary restorations interface were measured using Image J software. Results: CF and BT presented the highest and the lowest flexural strength values, respectively (p <0.05). SO, FT and PF showed similar values (p> 0.05). In relation to marginal desadaptation (%) and gap extensions (µm), CF presented the lowest marginal desadaptation and gaps incidence values (p < 0.05). BT showed intermediate values, but lower than SO, FT e PF (p < 0.05), which were similar among them (p > 0.05). Conclusion: CF presented the best flexural strength and the lowest marginal desadaptation and gaps extension (AU).