Addition of substances to reduce the erosive potential of acidic beverages to tooth enamel: A scoping review.

OBJECTIVE: This scoping review aimed (1) to map, analyse, interpret and synthesize data from in situ studies on which substances were added to acidic beverages to reduce the erosive potential on tooth enamel and (2) to establish the level of evidence of the effectiveness of adding substances to acidic beverages to reduce the erosive potential on tooth enamel. DESIGN: This is a scoping review, according to the methods from the Joanna Briggs Institute and PRISMA-ScR, with high-sensitivity searches in the databases PubMed (MEDLINE), Virtual Health Library, Embase (Elsevier), Scopus (Elsevier), Web of Science and ScienceDirect (Elsevier). In situ studies published in English until December 2022 were included. Studies that did not report a control group were excluded. To map and summarize the results, tables and figures were used. RESULTS: From 895 potentially eligible articles, nine were included. Blackcurrant juices (n = 5) with the addition of calcium (n = 3) or xanthan gum (n = 2) formulations were the most tested in terms of reducing the erosive potential of the beverages on tooth enamel. The profilometer was the equipment of choice (n = 8) for evaluating the loss of enamel structure after the experimental tests. CONCLUSIONS: Calcium and xanthan gum are among the most tested by in situ studies, offering promising results in reducing the erosive potential of fruit juices and carbonated and energy drinks.

Influência do tipo de compósito e tempo de exposição aos raios-x na produção de artefatos radiográficos em modelo de restaurações classe II / Influence of the composite type and exposure time to x-rays on the production of radiographic artifacts in a class II restoration model

Aim: To evaluate the effect of the exposure time and the type of composite in the production of radiographic artifact at the tooth / restorative interface. Materials and Methods: In 20 healthy bovine incisors, cavity preparations and class II restorations were made using composite resins Filtek Bulk Fill One (group 1) and Filtek Z350 (group 2). Then, the teeth were exposed to obtain digital radiographs, varying the exposure time by 0.07, 0.10, 0.14, 0.20 and 0.25s. The images were evaluated for investigation of the presence of artifact through the analysis of the modified number of pixels (QPXD) and the average gray value in class II (MGVR) restorations, using the Image J software (National Health Institute). Results: The presence of artifact was observed in all evaluated samples, regardless of the type of restorative material and the exposure time employed. There was no statistically significant difference in QPXD and MGVR between the resins used (ANOVA 2 factors, p p> 0.05). The MGVR analysis indicated that there were no statistically significant differences between resins or between exposure times (p> 0.05). There was a correlation between QPXD and MGVR (r = 0.29) for Filtek Bulk Fill One resin. Discussion: This study reveals the importance of attention to the region of the tooth-restoration interface by the Surgeon-Dentist, who must combine the radiographic findings diagnosed using digital tools to clinical signs in order to compose a unique therapeutic project with a real need for intervention, if there is such need. Conclusion: The presence of altered pixels on dentin in the region of the tooth-restoration interface was identified in all specimens. The variation in the exposure time as well as the type of the restorative composite did not influence the increase or decrease of QPXD and neither in MGVR. However, there was a correlation between QPXD and MGVR for Filtek Bulk Fill One resin.

Objetivo: Avaliar o efeito do tempo de exposição e do tipo de compósito na produção de artefato radiográfico na interface dente/material restaurador. Materiais e Métodos: Em 20 incisivos bovinos hígidos foram feitos preparos cavitários e restaurações classe II utilizando resinas compostas Filtek Bulk Fill One (grupo 1) e a Filtek Z350 (grupo 2). Em seguida, os dentes foram expostos para obtenção das radiografias digitais, variando o tempo de exposição em 0,07, 0,10, 0,14, 0,20 e 0,25s. As imagens foram avaliadas para investigação da presença de artefato através da análise do número de pixels modificado (QPXD) e do valor médio de cinza nas restaurações de classe II (MGVR), utilizando o software Image J (Instituto Nacional de Saúde, Bethesda, MD, EUA). Resultados: Observou-se a presença de artefato em toda amostra avaliada, independente de tipo de material restaurador e tempo de exposição empregado. Não se observou diferença estatisticamente significativa na QPXD e nos MGVR entre as resinas utilizadas (ANOVA 2 fatores, p p>0,05). A análise do MGVR indicou que não houve diferenças estatisticamente significativas entre as resinas nem entre os tempos de exposição (p>0,05). Observou-se uma correlação entre a QPXD e o MGVR (r=0,29) para a resina Filtek Bulk Fill One. Discussão: Como significado clínico, o presente estudo revela a importância da atenção à região da interface dente-restauração por parte do Cirurgião-Dentista, o qual deve aliar os achados radiográficos diagnosticados com o auxílio de ferramentas digitais aos sinais clínicos, para compor um projeto terapêutico singular com uma real necessidade de intervenção, caso haja. Conclusão: Foi identificado a presença de pixels alterados sobre a dentina na região da interface dente-restauração em todos os corpos de prova. A variação do tempo de exposição como também o tipo do compósito restaurador não influenciou no aumento ou diminuição do QPXD e nem tão pouco no MGVR. Contudo houve correlação entre o QPXD e o MGVR para a resina Filtek Bulk Fill One.

Are polywave light-emitting diodes more effective than monowave ones in the photoactivation of resin-based materials containing alternative photoinitiators? A systematic review.

OBJECTIVE: This systematic review aimed to analyze if using polywave light-emitting diodes (LED) to photoactivate resin-based materials (resin composites, adhesive systems, and resin cements) containing alternative photoinitiators provide better physicochemical properties than monowave ones. MATERIAL AND METHODS: Inclusion criteria were in vitro studies that evaluated the degree of conversion, microhardness and flexural strength in resin-based materials containing alternative photoinitiators and light-activated with mono and polywave LEDs. Exclusion criteria were studies that evaluated the physicochemical properties of composites through any material interposed between the LED and the resin composite and studies that exclusively compared different modes and/or light activation times. Selection of studies, data extraction, and risk-of-bias analysis was performed. Data from selected studies were qualitatively analyzed. A systematic search was performed in June 2021 using PubMed/Medline, Embase, Scopus, and ISI Web of Science databases and grey literature without language restriction. RESULTS: A total of 18 studies were included in the qualitative analysis. Nine studies used diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide (TPO) as an alternative photoinitiator for resin composite. Polywave LED improved the degree of conversion of resin composite compared to monowave in 9 of the included studies. Polywave LED improved the microhardness of resin composite compared to monowave in 7 of the included studies. Polywave LED improved the degree of conversion for 11 studies and microhardness of resin composite compared to monowave for 7 included studies. No differences in the flexural strength medium between poly and monowave LEDs were observed. The evidence was graded as low quality due to the high risk of bias for 11 studies. CONCLUSION: The existing studies, with their limitations, revealed that the polywave light-emitting diode maximizes activation, resulting in a higher degree of double-bond conversion and microhardness of resin composites containing alternative photoinitiators. However, the flexural strength of these materials is not influenced by the type of light activation device.

Bottom/top hardness ratio and dentin bonding stability of conventional and bulk-fill resin composites

Aim: To evaluate the bottom/top hardness ratio (B/T) and the dentin bonding stability of conventional and bulk-fill resin composites in high c-factor preparations. Methods: Regular conventional (Tetric N-Ceram ­ TNC, and Polofil Supra ­ PFS), regular bulk-fill (Tetric N-Ceram Bulk fill ­ TBF, and Admira Fusion X-tra ­ AFX), and low viscosity bulk-fill resin composites (Tetric N-flow ­ TNF, and X-tra Base ­ XTB) were used to restore 180 dentin conical preparations. The specimens were randomly distributed in 12 groups (n = 15) according to the resin composites and storage time-points (24 h and six months) tested. After 24 h storage, all specimens were subjected to the bottom/top hardness ratio analysis. Then, the push-out bond strength test was performed in half of the specimens and the other half were maintained for six months on water storage before testing. The failure modes were analyzed in a stereomicroscopic. The data were analyzed statistically using one- and two-way ANOVA and Tukey post-test (p <0.05). Results: There were no statistically significant differences for the bottom/top hardness ratio among the resin composites (p>0.05). Regardless of the storage timepoint, regular bulk-fill resin composites showed the highest bond strength values statistically (p<0.05). Only conventional resin composites showed statistically lower bond strength values at six-month storage (p<0.05). Adhesive failures were more predominant for low-viscosity bulk-fill resin composites. Conclusion: Although the DoC was not affected by different materials tested, only bulk-fill resin composites did not present dentin bond strength loss after six-month of water storage

Dual-cured adhesive system improves adhesive properties of dentin cavities restored with a bulk-fill resin composite

Aim: To evaluate the impact of a dual-cured adhesive system on the in situ degree of conversion (DC), bond strength (BS) and failure mode (FM) of adhesive interfaces in dentin cavities restored with a bulk-fill resin composite. Methods: 4-mm-deep dentin cavities with a 3.1 C-factor were created in 68 bovine incisors (n = 17 per group). The lightcured (Scotchbond™ Universal) or the dual-cured (Adper™ Scotchbond™ Multi-purpose Plus) adhesive system was applied to the cavities, which were then restored with a bulkfill resin composite (Filtek™ Bulk Fill). In situ DC analysis was performed by means of micro Raman spectroscopy at the top and bottom interfaces. Push-out BS was measured in a universal testing machine after 24-h or 6-month water storage. FM was determined with a stereomicroscope. Data of in situ DC and BS were analyzed by two-way analysis of variance (ANOVA) and Tukey test (p<0.05), while the FM was analyzed descriptively. Results: The groups that received the dual-cured adhesive system showed statistically higher in situ DC and BS than those that received the light-cured adhesive system. Cohesive failure mode was the most frequent in all conditions. Conclusion: In situ DC and BS were influenced by the curing strategies of the adhesive systems with better performance of the dual-cured material

Direct and semi-direct resin composite restoration in large cavity preparations: analysis of dentin bond strength stability and bottom/top microhardness ratio in a cavity model.

To evaluate the influence of the restorative approach and aging time on dentin bond strength (BS), failure mode (FM), and bottom/top microhardness ratio (B/T) in a large dentin cavity model. A total of 102 bovine incisors were used to produce models of conical dentin cavities (4.0 mm thickness × 4.8 mm top diameter × 2.8 mm bottom diameter), which were restored using semi-direct filling (SDF) (Filtek™ Z250 XT + Scotchbond™ Universal/RelyX™ Ultimate luting system), direct bulk filling (DBF) (Filtek™ One Bulk Fill), and direct incremental filling (DIF) (Filtek™ Z250 XT) techniques. B/T, BS, and FM (n = 17) were analyzed in a microhardness tester, a universal testing machine, and a stereomicroscope, respectively, after 24 h and 6 months of water storage. BS and B/T data were analyzed using two-way ANOVA/Tukey post-hoc test (p < 0.05), while FM data were analyzed descriptively. There was a statistically significant difference in BS between the restorative techniques, and BS was influenced by aging time in the DBF and SDF groups. Mixed failure was predominant for the SDF technique in both aging times. There was no statistically significant difference in B/T among the restorative approaches regardless of the aging time (p > 0.05). Although all restorative approaches provided similar B/T, the semi-direct technique showed better performance on the material bond strength to dentine in large cavities.

Can sterilization methods influence surface properties of resin composites? A purpose for previewing bias in laboratory bacterial adhesion tests.

This study aimed to evaluate the influence of sterilization methods on conventional and bulk-fill resin composites' (BFRCs) surface properties in an attempt to preview bias in laboratory bacterial adhesion tests. Two regular viscosity conventional resin composites [Filtek Z350 XT™ (Z350) and IPS Empress Direct™ (ED)] and two regular viscosity BFRCs [Filtek Bulk Fill™ (FILT) and Tetric N-Ceram Bulk Fill IVA™ (TBF)] were used. The materials were characterized by Scanning Electron Microscopy (SEM), surface roughness (SR), and wettability (W) after sterilization with hydrogen peroxide gas plasma (HPGP) and steam sterilization (SS). Nonsterilized samples served as a control group (n = 5). Statistical analysis was performed using two-way analysis of variance (ANOVA) and Tukey post hoc test (p < 0.05). For SR, there were no statistically significant differences among the groups (p > .05). SS method decreased the contact angle for FILT and Z350 (p < .01). The SS promoted more exposition of filler particles, while the HPGP method did not alter the tested materials' morphology. Therefore, sterilization methods affected the resin composites tested selectively. HPGP seems to be the most recommended method to sterilize the tested resin composites before laboratory bacterial adhesion tests.

Incorporation of a polymerization catalyst for improved mechanical behavior and physicochemical characteristics of a light-cured pulp capping material / Incorporação de um catalisador de polimerização para aprimorar propriedades mecânicas e fisíco-químicas de um protetor pulpar fotoativável

Objective: To evaluate the influence of the incorporation of a polymerization catalyst to a light-cured pulp capping material on mechanical behavior and physicochemical characteristics. Material and Methods: Different percentages (2 wt%, and 4 wt%) of diphenyliodonium hexafluorophosphate (DPI) were incorporated into the Ultra-Blend Plus, a resin-modified calcium-based cement. The material without incorporation of DPI (0 wt%) served as control. Degree of Conversion (DC), Flexural Strength (FS), Elastic Modulus (EM), Water Sorption (WSp), Solubility (Sl), and pH of eluate at 24-h, 72-h, and 7-day storage times were measured. One-way ANOVA/Tukey posthoc tests were used to analyze the data (p <0.05). Results: For DC, FS, and EM, materials with different % of DPI showed statistically significant differences, so that 0% provided the lowest values and 2% the highest values. Materials with 0% and 2% of DPI provided statistically the lowest WSp, whilst material with 0% of DPI showed statistically the highest Sl. Conclusion: All materials provided statistically similar pH to eluates regardless of storage time, although only materials with DPI at 2% and 4% maintained pH of eluates statistically similar from 72 h to 7 days storage times.(AU)

Objetivo: avaliar a influência nas propriedades mecânicas e físico-químicas da incorporação de um catalisador de polimerização a um protetor pulpar fotoativável. Material e Métodos: foram adicionadas diferentes porcentagens em massa (2% e 4%) de hexafluorofosfato de difeniliodônio (DPI) ao Ultra-Blend Plus, um cimento à base de hidróxido de cálcio modificado por resina. O material sem a adição do DPI (0%) serviu como controle. Foram avaliados: Grau de Conversão (DC), Resistência Flexural (FS), Módulo de Elasticidade (EM), Sorção (WSp), Solubilidade (SI) e o pH do eluato nos tempos de 24h, 72h e 7 dias de armazenamento. ANOVA 1-way com pós-teste de Tukey (p <0.05). Foi utilizado para avaliar os resultados estatisticamente. Resultados: Os materiais com diferentes % de DPI apresentaram diferenças significativas para os testes de DC, FS e EM. A porcentagem em massa de 0% de DPI mostrou valores inferiores a todos os testados e os materiais com adição 2% apresentaram a melhor performance. Materiais com 0% e 2% de DPI apresentaram valores inferiores de WSp; a porcentagem de 0% proporcionou valores estatisticamente maiores para SI. Conclusão: Todos os materiais testados apresentaram pH semelhante nos eluatos independente do tempo de armazenamento, contudo, apenas os materiais com 2% e 4% mantiveram o pH dos eluatos estatisticamente similares nos tempos de estocagem de 72h a 7 dias.(AU)

Effect of Spondias mombin L. extract on the wettability, roughness, color and morphology of bovine enamel

Although Spondias mombin L. extract has an excellent antimicrobial effect against oral microorganisms, it should be clarified how it affects enamel surface properties. Aim: To evaluate the color change, wettability/contact angle, surface roughness and morphology of bovine enamel submitted to the Spondias mombin L. extract. Methods: Thirty bovine teeth were distributed into the following groups: 0.12% chlorhexidine digluconate, 1:32 Spondias mombin L. extract and distilled water. Color change (CC) was evaluated after immerging specimens into the solutions for 14 days. Surface roughness (Ra) was measured using a roughness meter; wettability/contact angles (CA) were determined by the sessile drop method, and scanning electron microscopy images were obtained to characterize the morphology (SMA). The pH of the solutions was evaluated using a pHmeter. The Ra, CA, and CC data were parametric (Kolmogorov-Smirnov; p>0.05). Two-way ANOVA (for Ra and CA) and one-way ANOVA (for CC) with Tukey's posthoc tests at a significance level of 5% were used. SMA was analyzed descriptively. Results: The Spondias mombin L. extract revealed an acidic pH, and when in contact with the bovine teeth, it increased the wettability, but it did not cause statistically significant differences in the Ra. Spondias mombin L. extract caused the highest color change. The SEM images showed differences in the specimens' surface submitted to the extract compared to the other groups. Conclusion: Spondias mombin L. extract provided negative effects on bovine enamel's surface, including a high color change and a more wettable substrate

Effects of ionizing radiation on surface properties of current restorative dental materials.

To investigate the impact of radiotherapy on surface properties of restorative dental materials. A conventional resin composite-CRC (Aura Enamel), a bulk-fill resin composite-BFRC (Aura Bulk-fill), a conventional glass ionomer cement-CGIC (Riva self cure), and a resin-modified glass ionomer cement-RMGIC (Riva light cure) were tested. Forty disc-shaped samples from each material (8 mm diameter × 2 mm thickness) (n = 10) were produced according to manufacturer directions and then stored in water distilled for 24 h. Surface wettability (water contact angle), Vickers microhardness, and micromorphology through scanning electron microscopy (SEM) before and after exposition to ionizing radiation (60 Gy) were obtained. The data were statistically evaluated using the two-way ANOVA and Tukey posthoc test (p < 0.05). Baseline and post-radiation values of contact angles were statistically similar for CRC, BFRC, and RMGIC, whilst post-radiation values of contact angles were statistically lower than baseline ones for CGIC. Exposition to ionizing radiation statistically increased the microhardness of CRC, and statistically decreased the microhardness of CGIC. The surface micromorphology of all materials was changed post-radiation. Exposure to ionizing radiation negatively affected the conventional glass ionomer tested, while did not alter or improved surface properties testing of the resin composites and the resin-modified glass ionomer cement tested.

The combined use of systemic analgesic/anti-inflammatory drugs and a bioactive topical desensitizer for reduced in-office bleaching sensitivity without jeopardizing the hydrogen peroxide efficacy: a randomized, triple blinded, split-mouth clinical trial.

OBJECTIVE: To evaluate the effect of combined systemic administration of paracetamol 500 mg/codeine phosphate 30 mg (PACO) and postoperative topical application of a bioactive desensitizer on in-office bleaching sensitivity and tooth color change. MATERIALS AND METHODS: A randomized, triple-blind, split-mouth clinical trial was conducted. Forty volunteers ingested PACO (n = 20) or placebo (PLA) (n = 20). Their left/right hemiarches received topical application of a bioactive desensitizer [Nano-P™(NP)] and prophylactic paste (PAS), generating four treatment approaches: PACO/NP, PACO/PAS, PLA/NP, and PLA/PAS. Two bleaching sessions (35% hydrogen peroxide) were performed, and the PAS/NP were applied after the procedure. Sensitivity was obtained since the first bleaching session up to 7 days post-bleaching. The color change was evaluated using CIEDE2000 and whiteness index parameters up to 7 days post-bleaching. Data were analyzed using one- and two-way ANOVA/Tukey post hoc tests (p < 0.05). RESULTS: The PLA/PAS showed a sensitivity average of at least two times higher than the PACO/NP. The treatment approaches promoted statistically similar bleaching patterns (p > 0.05). CONCLUSION: The combined approach of systemic administration of PACO and postoperative topical application of NP reduced the level of in-office bleaching sensitivity without jeopardizing hydrogen peroxide efficacy. CLINICAL RELEVANCE: Professionals can adopt the combined approach of systemic administration of analgesic/anti-inflammatory drugs and topical application of a bioactive desensitizer for decreased bleaching sensitivity caused by 35% hydrogen peroxide in-office.

Relationship of Porphyromonas gingivalis and Alzheimer's disease: a systematic review of pre-clinical studies.

OBJECTIVES: This study aimed to analyze the following PICO question: Are animals infected with Porphyromonas gingivalis (P. gingivalis) or bacterial lipopolysaccharide (Pg-LPS) more affected by neurodegeneration, similar to the pathogenesis generated by Alzheimer's disease (AD), compared with non-infected animals? METHODS: Databases PubMed, Lilacs, SciELO, Science Direct, Scopus, Web of Science, and Cochrane were searched for pre-clinical in vivo studies in which mice were infected with P. gingivalis or received Pg-LPS, in order to assess the brain tissue and cognitive impairment. No limit for date or publication language was imposed and this study was registered at the International Prospective Register of Systematic Reviews (PROSPERO), with nine articles included. Syrcle's protocol was used to evaluate bias in the selected studies. RESULTS: Nine articles were included. Infection by P. gingivalis or the administration of Pg-LPS increased the production of the inflammatory mediators, TNF-α (tumor necrosis factor-alpha), IL-6 (interleukin-6), and IL-1ß (interleukin-1beta), augmented Aß (amyloid beta) production, and activated the complement system, causing inflammation, brain tissue degeneration, and cognitive impairment, consistent with the damage in AD. CONCLUSIONS: Infection by P. gingivalis and Pg-LPS administration appears to be in relation with the pathogenesis of AD by activating the complement cascade, increasing Aß production and augmenting pro-inflammatory cytokine expression, causing age-dependent brain inflammation, neuroinflammation, and neurodegeneration. CLINICAL RELEVANCE: Taking into account the importance of holistic treatment in the dental office, this study focuses on identifying highly prevalent oral diseases, such as periodontal disease, as risk factors for the aggravation of degenerative diseases in the elderly population.

Técnica minimamente invasiva em lesão branca hipoplásica: relato de caso / Minimally invasive technique in hypoplastic white injury: case report / Técnica minimamente invasiva en lesiónblancahipoplástica: caso clínico

Introdução:As manchas dentárias, dentre elas a hipoplasia do esmalte,corresponde a um dos motivos que fazem com que os pacientes busquem alterações no seu sorriso.O tratamento proposto deve ser sempre o mais conservador possível e buscar devolver a autoestima do paciente. Objetivo:Este trabalho objetivou apresentarum relato de caso clínico de paciente do sexo feminino, 26 anos, insatisfeita com a estética do seu sorriso por apresentar dentes escurecidos e hipoplasia de esmalte na face vestibular, em incisivo superior.Descrição do caso:Ao exame clínico foi observado escurecimento fisiológico e hipoplasia de esmalte no incisivo lateral superior esquerdo (22).O plano de tratamento proposto foi clareamento dental pela técnica associada (técnica de consultório + técnica caseira), remoção da mancha hipoplásica de formaminimamente invasiva e restauração em resina composta direta. Conclusões:Através de um correto diagnóstico, associado a uma técnica e seleção de material adequado, foi possível conseguir excelência estética com preservação de estrutura dentária sadia (AU).

Introduction:Dental stains, including enamel hypoplasia, correspond to one of the reasons that make patients seek changes in their smile. The proposed treatment should always be as conservative as possible and seek to restore the patient's self-esteem.Objective:This study aimedto present a clinical case report of a 26-year-old female patient, dissatisfied with the aesthetics of her smile as she had darkened teeth and enamel hypoplasia on the vestibular face, in anupper incisor. Case description:On clinical examination, physiological darkening and enamel hypoplasia were observedon the left upper lateral incisor (22). The proposed treatment plan was dental bleaching using the associated technique (In-office bleaching+ at-home bleaching), removal of the hypoplastic stain in a minimally invasive manner and restoration in direct composite resin.Conclusions:Through a correct diagnosis, associated with a technique and selection of suitable material, waspossible to achieve aesthetic excellence with preservation of healthy dental structure (AU).

ntroducción: Las manchas dentales, incluida la hipoplasia del esmalte, corresponden a una de lasrazones que hacenquelos pacientes busquencambios em susonrisa. El tratamiento propuestosiempredebe ser lo másconservador posible y tratar de restablecerla autoestima del paciente.Objetivo: Este estudio tuvo como objetivo presentarun informe de caso clínico de una paciente de 26 años de edad, insatisfechacon la estética de susonrisa, ya que habíaoscurecidolosdientes y la hipoplasia del esmalte en lasuperficie vestibular, en el incisivo superior.Descripcióndel caso: Enelexamen clínico, se observó oscurecimiento fisiológico e hipoplasia del esmalte en el incisivo lateral superior izquierdo (22). El plan de tratamiento propuestofueel blanqueamiento dental utilizando la técnica asociada (técnica de consultorio + técnica casera), eliminación de la mancha hipoplásica de maneramínimamente invasiva y restauraciónen resina compuestadirecta. Conclusiones: A través de un diagnóstico correcto, asociado con una técnica y selección de material adecuado, fueposible lograr laexcelencia estética conlapreservación de una estructura dental sana (AU).

Influence of Acid Etching and Universal Adhesives on the Bond Strength to Dentin.

The purpose of this study was to evaluate the influence of the application mode of three universal adhesive systems on interfacial physical properties of indirect composite restorations adhesively cemented to dentin cavities. Seventy-eight bovine lower incisors were selected and a slice of dentin (thickness: 2 mm) between the buccal surface and pulp chamber was obtained for each tooth. Conical cavities were made on this surface. The internal walls of the cavities were then coated with a hydrophilic gel, filled with composite resin and photopolymerized. The dentin/cone sets were divided into 6 groups (n=10) according to type of universal adhesive (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) and acid etching on dentin (A: with acid etching; WA: without acid etching). The acid etching and the adhesive systems were applied to the surface of the dentin. All composite resin cones were sandblasted (Al2O3, 20 s) and silanized. After surface treatment, the cones were cemented (RelyX Ultimate) into the dentin cavity and photopolymerized. After thermocycling (10,000 cycles), samples were submitted to marginal adaptation analysis (using caries detector dye), push-out test (0.5 mm/min), and failure mode analysis. Additional samples were prepared for nanoleakage analysis (SEM). The data (MPa) were analyzed by two-way ANOVA and Tukey's post-test (5%). The groups in which the dentin was acid etched showed significantly lower bond strength values in the push-out test (p<0.01). Dentin acid etching significantly reduced the bond strength between universal adhesive systems and dentin in indirect restorative procedures.

Influence of acid etching and universal adhesives on the bond strength to dentin

Abstract The purpose of this study was to evaluate the influence of the application mode of three universal adhesive systems on interfacial physical properties of indirect composite restorations adhesively cemented to dentin cavities. Seventy-eight bovine lower incisors were selected and a slice of dentin (thickness: 2 mm) between the buccal surface and pulp chamber was obtained for each tooth. Conical cavities were made on this surface. The internal walls of the cavities were then coated with a hydrophilic gel, filled with composite resin and photopolymerized. The dentin/cone sets were divided into 6 groups (n=10) according to type of universal adhesive (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) and acid etching on dentin (A: with acid etching; WA: without acid etching). The acid etching and the adhesive systems were applied to the surface of the dentin. All composite resin cones were sandblasted (Al2O3, 20 s) and silanized. After surface treatment, the cones were cemented (RelyX Ultimate) into the dentin cavity and photopolymerized. After thermocycling (10,000 cycles), samples were submitted to marginal adaptation analysis (using caries detector dye), push-out test (0.5 mm/min), and failure mode analysis. Additional samples were prepared for nanoleakage analysis (SEM). The data (MPa) were analyzed by two-way ANOVA and Tukey's post-test (5%). The groups in which the dentin was acid etched showed significantly lower bond strength values in the push-out test (p<0.01). Dentin acid etching significantly reduced the bond strength between universal adhesive systems and dentin in indirect restorative procedures.

Resumo O objetivo deste estudo foi avaliar a influência do modo de aplicação de três sistemas adesivos universais nas propriedades físicas interfaciais de restaurações indiretas de compósito adesivamente cimentadas a cavidades dentinária. Setenta e oito incisivos inferiores bovinos foram selecionados e uma fatia de dentina (espessura: 2 mm) entre a face vestibular e a câmara pulpar foi obtida para cada dente. Cavidades cônicas foram feitas nesta superfície. As paredes internas das cavidades foram então revestidas com um gel hidrofílico, preenchidas com resina composta, e fotopolimerizados. Os conjuntos dentina/cone foram divididos em 6 grupos (n=10) de acordo com o tipo de adesivo universal (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) e ácido na dentina (A: com condicionamento ácido; WA: sem condicionamento ácido). O condicionamento ácido e os sistemas adesivos foram aplicados na superfície da dentina. Todos os cones de resina composta foram jateados (Al2O3, 20 s) e silanizados. Após o tratamento superficial, os cones foram cimentados (RelyX Ultimate) na cavidade dentinária e fotopolimerizados. Após a termociclagem (10.000 ciclos), as amostras foram submetidas a análise de adaptação marginal (usando corante detector de carie), teste push-out (0,5 mm/min) e análise do modo de falha. Amostras adicionais foram preparadas para análise de nanoinfiltração (MEV). Os dados (MPa) foram analisados por ANOVA dois fatores e pós-teste de Tukey (5%). Os grupos em que a dentina foi condicionada por ácido apresentaram valores significativamente menores de resistência de união no teste push-out (p<0,01). O condicionamento ácido da dentina reduziu significativamente a resistência de união entre sistemas adesivos universais e dentina em procedimentos restauradores indiretos.

Influence of exposure to phosphoric and polyacrylic acids on selected microscopic and physical/chemical properties of calcium hydroxide cements.

PURPOSE: This study aimed to evaluate if the contact of calcium hydroxide cements with polyacrylic and phosphoric acids would alter selected microscopic and physical and chemical properties. MATERIALS AND METHODS: Chemically activated (Hydro C and Dycal Advanced Formula II) and resin-modified photoactivated (Ultra-blend Plus) calcium hydroxide cements were examined after exposure to the following different strategies: contact with no substance (control group); rinsing with water and drying; contact with polyacrylic acid, rinsing with water, and drying; and contact with phosphoric acid, rinsing with water, and drying. Surface morphology, determined by scanning electron microscopy (SEM), water sorption and solubility, and the release of hydroxyl ions were evaluated. RESULTS: SEM showed a greater impact of the conditioning acids on the surface of the chemically activated cements. Ultra-blend Plus obtained the highest value of sorption (516.8 µg/mm3) and solubility (381.1 µg/mm3) and Hydro C had the lowest values 251.9 µg/mm3 and 206.3 µg/mm3 respectively. Considering the release of hydroxyl ions in comparison with time, Hydro C and Ultra-blend Plus presented significant statistical difference for polyacrylic and phosphoric acid subgroups. CONCLUSION: Hydro C and Dycal presented intensification of surface irregularities after contact with conditioning acids. The chemically activated materials suffered a decrease in sorption and solubility. The action of the conditioning acids promotes greater increase of the release of hydroxyl ions for Hydro C and Dycal.

Impact of additional polishing method on physical, micromorphological, and microtopographical properties of conventional composites and bulk fill.

The objective of this study was to evaluate the surface roughness (SR), contact angle (CA), depth distribution of the charge particles (DDCP), mapping of chemical elements, 3D microtopography (3DM), and the micromorphology of the composites (MOR) of conventional and bulk fill after additional polishing. The specimens were prepared from Filtek Bulk Fill (FBF), Tetric N-Ceram Bulk Fill (TNCBF), Opus Bulk Fill (OBF), X-tra Fil (XTFL), Filtek Z250 XT (XT), Grandioso (GRA), Tetric N-Ceram (TNC), Vittra APS (VT), according to three additional techniques (n = 10): without finishing and polishing, finishing and polishing with abrasive rubbers (Astropol), finishing and polishing with Astropol plus additional polishing with silicon carbide brush. The SR and CA were measured using a profilometer and adapted goniometer, respectively; 3DM used atomic force microscopy (AFM); the micromorphology and DDCP by scanning electron microscopy (SEM) and the MOR by means of X-ray dispersive energy spectroscopy (EDS). The SR and CA were analyzed by ANOVA-two factors and Tukey test (p < .05); the others data were analyzed descriptively. The DDCP of all the resins had an organic matrix rich surface layer and a particulate rich subsurface layer of smaller dimensions. Additional polishing: reduced SR of FBF, VT, TNCBF, and XTFL resins; increased the CA value of the XTFL and decreased of XT. In the analyzes for 3DM, smoother and more uniform surfaces were observed in all a resins. The elements: carbon (predominant), oxygen, silicon, zirconia, and aluminum were present in all composite resins. Therefore, additional polishing improved the surface properties of the resins studied.

Alteração de forma dentária com resina direta: relato de caso / Dental form change with direct resin: case report / Cambiode formadental con resina directa: Reporte de un caso

Introdução:A melhoria da qualidade dos materiaisrestauradores odontológicos, sobretudo dasresinascompostas,permitiu a resolução de diversos problemas estéticos de forma conservadora, rápida e satisfatória.Objetivo:Este trabalho objetivou relatar um caso clínico de alteração de forma dos dentes anteriores, solucionado com resina composta pela técnica direta.Descrição do Caso:A paciente apresentava incisivos laterais ovalados e restauração classe IV insatisfatória no incisivo central superior direito.Após exame clínico e seleção de cor, os dentes 12, 12, 21 e 22 foram reanatomizadoscom resina composta direta através da técnica estratificada, além da substituição da restauração classe IV.Para uma perfeita mimetização dos elementos dentários, foram utilizadas resinas translúcidas, opacas e de efeito opalescente, além de resinas para reproduzir as camadas de esmalte e dentina. Conclusões:Uma boa seleção do material e aplicação correta da técnica,permitemrestaurações imperceptíveis,com excelente nível de texturização, acabamento e polimento, devolvendo a harmonia do sorriso (AU).

ntroduction:Theimprovement of the quality of dental restorative materials, especially of composite resins, allowed the resolution of several aesthetic problems in a conservative, fast and satisfactory way.Objective:This study aimed to report a clinical case of alteration of the shape of the anterior teeth, solved with resin composed by the direct technique. Case Description:The patient had oval lateral incisors and an unsatisfactory class IV restoration on the upper right central incisor. After clinical examination and color selection, teeth 12, 12, 21 and 22 were reanatomized with direct composite resin using the stratified technique, in addition to replacing the class IV restoration. For perfect mimicry of dental elements, translucent, opaque and opalescent resins were used, in addition to resins to reproduce the enamel and dentin layers.Conclusions:A good selection of the material and correct application of the technique, allow imperceptible restorations, with an excellent level of texturing, finishing and polishing, returning the harmony of the smile (AU).

Introducción: La mejora de lacalidad de losmateriales de restauración dental, especialmente de las resinas compuestas, permitiólaresolución de varios problemas estéticos de forma conservadora, rápida y satisfactoria. Objetivo: Este estudio tuvo como objetivo informar un caso clínico de alteración de la forma de los dientes anteriores, resuelto con resina compuesta por latécnica directa.Descripcióndel caso: El paciente tenía incisivos laterales ovales y una restauración de clase IV insatisfactoria en el incisivo central superior derecho. Después del examen clínico y la selección del color, los dientes 12, 12, 21 y 22 sereanatomizaron con resina compuesta directa utilizando la técnica estratificada, además de reemplazar la restauración de clase IV. Para una perfecta imitación de los elementos dentales, se utilizaron resinas translúcidas, opacas y opalescentes, además de resinas para reproducir las capas de esmalte y dentina.Conclusiones: Una buena selección del material y la correcta aplicación de la técnica, permiten restauraciones imperceptibles, con un excelente nivel de texturizado, acabado y pulido, devolviendo la armonía de la sonrisa (AU).

Harmonização do sorriso com laminados cerâmicos: relato de caso / Harmonization of smile with ceramic veneers: case report / Armonización de la sonrisa con laminados cerámicos: informe de caso

Introdução: Os padrões de beleza atuais aumentaram o nível de exigência estética e a busca por sorrisos cada vez mais harmônicos. As facetas cerâmicas destacam-se dentre as opções de tratamentos por associarem estética, longevidade e previsibilidade. Objetivo: Este trabalho objetivou apresentar um caso clínico de substituição de facetas diretas de resina composta por facetas indiretas de porcelana. Descrição do caso: A pacienteC.L.M, 25 anos, sexo feminino relatou insatisfação com a estética do seu sorriso, destacando o formato, o tamanho e a cor 1M2dos elementos dentários 11 e 21. Diante da queixa e da situação clínica observada, propôs-se a confecção de laminados cerâmicos de dissilicato de lítio, mediante a realização prévia de gengivoplastia e de clareamento dentário. Conclusões: Conclui-se que o planejamento cuidadoso, o conhecimento da técnica operatória e a execução adequada do protocolo reabilitador permitem que os laminados cerâmicos reestabeleçam o sorriso de forma estética e funcional (AU).

Introduction:The current beauty standards have increased the level of aesthetic demand and the search for more and more harmonious smiles. The ceramicveneers stand out among the treatment options for combining aesthetics, longevity and predictability. Objective:This study aimed to present a clinical case of substitution of direct resin veneers composed of indirect porcelain veneers. Case description:Patient C.L.M, 25 years old, female, reported dissatisfaction with the aesthetics of her smile, highlighting the shape, size and 1M2 colorof dental elements 11 and 21. In view of the complaint and the clinical situation observed, it was proposed to make lithium disilicate ceramic veneers, through previous gingivoplasty and tooth bleaching. Conclusions:It is concluded that the careful planning, the knowledge of the operative technique and the proper execution of the rehabilitation protocol allow the ceramic veneers to reestablish the smile in an aesthetic and functional way (AU).

Introducción: los estándares de belleza actuales han aumentado el nivel de demanda estética y la búsqueda de sonrisas cada vez más armoniosas. Las facetas cerámicas se destacan entre las opciones de tratamiento para combinar estética, longevidad y previsibilidad. Objetivo: Este estudio tuvo como objetivo presentar un caso clínico de sustitución de carillas de resina directas compuestas de carillas de porcelana indirectas.Descripción del caso: La paciente C.L.M, 25 años, mujer, refirió insatisfacción con la estética de su sonrisa, destacando la forma, tamaño y color 1M2de los elementosdentales 11 y 21. En vista de la queja y la situación clínica observada, se propuso hacer laminados de cerámica disilicato de litio, mediante reparación gingival previa y blanqueamiento dental. Conclusiones: se concluye que la planificación cuidadosa, el conocimiento de la técnica operativa y la ejecución adecuada del protocolo de rehabilitación permiten a los laminados cerámicos restablecer la sonrisa de una manera estética y funcional (AU).

Solução estética multidisciplinar em dentes anteriores: relato de caso / Multidisciplinary aesthetic solution in previous teeth: case report / Solución estética multidisciplinariaem dientes anteriores: caso clínico

ntrodução:Pacientes com dentes curtos e ameias abertas, relatam muita insatisfação com seusorriso.A gengivoplastia, quando bem indicada, permite oaumento no tamanho da coroa dentária de forma a reduzir a necessidade de aumento incisal com resina composta. A reanatomização com resinas compostas para fechamento de ameias e aumentosincisais representa uma alternativa conservadora, pois trata-se de uma técnicaadesiva diretaque pode ser realizada sem nenhum desgaste dentário. Além disso é uma técnica reversível preferível para pacientes jovens. Objetivo:Apresentar um relato de caso clínico de paciente do sexo masculino, 22 anos, insatisfeito com o tamanho, cor e a forma dos seus dentes anteriores. Descrição do Caso:Ao exame clínico foi observado coroa curta, escurecimento fisiológico, espaços interdentais e desalinhamento das bordas incisais. O plano de tratamento proposto foi encaminhar para a gengivoplastia, clareamento dental pela técnica associada e reanatomização estética dos dentes anteriores com resinacomposta diretaestratificada com diferentescamadas e cores, e posterior texturização superficialdurante as fases de acabamento e polimento finais. Conclusões:Com a gengivoplastiae asrestaurações, obtivemos dentes reanatomizados, reproduzindo naturalidadede forma, textura e cor. Com planejamento e técnica adequada, foi possível restabelecer o sorriso comproporções, forma e naturalidade satisfatórias (AU).

Introduction:Patients with short teeth and open battlements, report a lot of dissatisfaction with their smile. Gingivoplasty, when properly indicated, allows for an increase in the size of the dental crown in order to reduce the need for incisal augmentation with composite resin. Resuscitation with composite resins for the closure of niches and incisal increases represents a conservative alternative, as it is a direct adhesive technique that can be performed without any dental wear. Furthermore, it is a preferable reversible technique for young patients.Objective:To present a case report of a 22-year-old male patient, dissatisfied with the size, color and shape of his anterior teeth.Case Description:The clinical examination showed a short crown, physiological darkening, interdental spaces and misalignment of the incisal edges. The proposed treatment plan was to refer to gingivoplasty, tooth whitening by the associated technique and aesthetic reanatomization of the anterior teeth with stratified direct composite resin with different layers and colors, and later surface texturing during the final polishing and finishing phases. Conclusions:With gingivoplastyand restorations, we obtained reanatomized teeth, reproducing natural form, texture and color. With proper planning and technique, it was possible to restore the smile with satisfactory proportions, shape and naturalness (AU).

Introducción: Los pacientes com dientescortos y almenasabiertas, informanmuchainsatisfaccióncom susonrisa. La gingivoplastia, cuando está indicada adecuadamente, permite un aumento em eltamaño de la corona dental para reducirlanecesidad de aumento incisalcon resina compuesta. La rstauración con resinas compuestas para elcierre de nichos y aumentos incisales representa una alternativa conservadora, ya que es una técnica adesiva directa que se puede realizar sinningún tipo de desgaste dental. Además, es una técnica reversiblepreferible para pacientes jóvenes. Objetivo: Presentar un informe de caso de un paciente masculino de 22 años, insatisfechocom eltamaño, el color y la forma de sus dientes anteriores.Descripcióndel caso:El examen clínico mostró una corona corta, oscurecimiento fisiológico, espaciosinterdentales y desalineación de los bordes incisales. El plan de tratamento propuesto era referirse a lagingivoplastia, elblanqueamiento dental mediante la técnica asociada y lareanatización estética de losdientes anteriores con resina compuestadirecta estratificada con diferentes capas y colores, y luego texturizar lasuperficie durante las fases finales de pulido y acabado. Conclusiones: Com lagingivoplasty yrestauracióndental, obtuvimosdientesreanatomizados, reproduciendo forma, textura y color naturales. Con una planificación y técnica adecuadas, fueposible restaurar lasonrisacon proporciones, forma y naturalidade satisfactorias (AU).