Influence of fabrication method on the marginal fit of temporary restorations.

Computer-aided manufacturing (CAM) technology allows the use of different manufacturing techniques. This in vitro study aimed to evaluate the marginal fit of temporary restorations manufactured using conventional chairside methods, milling, and three-dimensional printing. Fifteen 3-element temporary restorations specimens were produced and categorized into three groups: non-digital, obtained using the conventional chairside method (GC); milled (GM); and three-dimensionally printed (GP). Marginal fit was assessed using scanning electron microscopy (SEM) performed under two conditions: one with only the central screw tightened, and the other with all three screws tightened. Horizontal misfit values were categorized as over-, equal-, and under-extended and qualitatively analyzed. Statistical analysis was performed using the Tukey-Kramer test (α=0.05). In the vertical assessment, three-dimensionally printed restorations demonstrated greater misfit than restorations obtained by milling and the conventional chairside method (P<0.05). In the horizontal assessment, the misfit in the GP group was significantly higher than that in the GM and GC groups. Restorations obtained using the conventional chairside method and milled provisional restorations showed more favorable results than three-dimensionally printed restorations.

Flexural strength and Vickers hardness of milled and 3D-printed resins for provisional dental restorations

Various forms of temporary resins are offered on the market; however, the properties of temporary resins obtained by milling and 3D printing have not been fully examined. This study aimed to compare the flexural strength and Vickers hardness of milled and 3D-printed resins. Methods: Three resins were tested: Evolux PMMA (milled resin), Cosmos Temp (3D-printed resin), and Structur 2 SC (bis-acrylic resin, group control). Specimens were prepared with rectangular shapes (n = 12) for flexural strength measurements and disc shapes (n = 9) for Vickers hardness tests. Flexural strength tests were performed at a crosshead speed of 0.75 mm/min, and the Vickers hardness was measured under a load of 20 N for 10 s. The obtained data were subjected to the Kruskal­Wallis test. Results: A significant difference (p < 0.05) in flexural strength was observed among the three sample groups: Evolux PMMA (111.76 MPa), Structur 2 SC (87.34 MPa), and Cosmos Temp (56.83 MPa). No significant difference (p < 0.05) was observed between the Vickers hardness values of Structur 2 SC (33.37 VHN) and Evolux PMMA (29.11 VHN); however, both materials were statistically superior to Cosmos Temp (10.90 VHN). Conclusion: While the mechanical properties of the milled resin were superior or similar to those of the bisacrylic resin, the 3D-printed resin was statistically inferior to both the milled and bis-acrylic resins

Factors associated with decision-making for replacing the temporary coronal restoration after endodontic treatment

Aim: This study aimed to evaluate the decision-making by patients to replace temporary restorations with permanent restorations after endodontic treatment and to verify the associated factors and evaluate the quality/integrity of the temporary restorative material within one month. Methods: This is a cross-sectional study using non-probabilistic sampling which analyzed patients after one month of endodontic treatment. The self-administered questionnaire contained sociodemographic, treatment decision-making and endodontic treatment questions. The restoration present in the mouth was evaluated in the clinical oral examination. The Poisson Regression test was used to verify the prevalence ratio. Results: The prevalence failure to perform permanent restorations was 61.1% of patients, and 42.7% reported not having adhered. The reasons are lack of time and not knowing the importance of replacing the restoration with a definitive one. The glass ionomer temporary restorative frequency was higher among those who chose not to replace the temporary restoration with a permanent one (PR=5.19; 95%CI 2.10-12.33). In addition, there was an association between the quality of the restorative material and the type of material, and the best clinical quality of the restoration was statistically associated with glass ionomer and composite resin. Conclusions: The findings show the importance of guidance by the dental surgeon in helping patients decide to replace their temporary restoration

The biotransfer approach: The use of an alveolar cast die for the fabrication of the emergence profile on implant-supported interim restorations.

Maintaining natural-looking soft tissues around dental implants is one of the biggest challenges for the restorative team. To achieve this, the emergence profile of the preexisting teeth in the alveolus can be emulated rather than conditioning the soft tissue architecture arbitrarily. The biotransfer technique uses an interim restoration with a biologically driven emergence profile fabricated before the implant surgery.

Color and surface gloss stability of bis-acryl and resin composite after exposure to cigarette smoke / Estabilidade de cor e brilho superficial de resinas compostas e bisacrílicas após exposição por fumaça de cigarro

Objective: To evaluate color and surface gloss stability of bis-acryl resins and resin composites, submitted to artificial staining with cigarette smoke. Material and Methods: Specimens of each material were prepared (n=15). Two resin composites (GrandioSO [RCG], Filtek Supreme [RCZ]) and five bis-acryl resins (Luxatemp Star [BisLUX], Protemp4 [BisPRO], Structor3 [BisSTR], Visalys Temp [BisVIS] and Yprov [BisYPR]) were tested. Initial color was assessed using a spectrophotometer and surface gloss with a glossmeter. Samples were submitted to smoke exposure (10 cigarettes under 8 minutes per cycle). After 3 and 6 cycles, color and gloss were reassessed. Final readings were performed after brush prophylaxis. Data were analyzed using two-way repeated ANOVA and Tukey's test (p<0.05). Results: Differences and interaction of factors (p<0.01) were detected for both color and gloss readings. Resin composites were the least affected by aging, with gloss reduction after prophylaxis. Differences were detected among bis-acryl resins, with better results for BisLUX and BisPRO. BisPRO and BisSTR, showed reduction in gloss after 60 cigarettes, while BisYPR gloss decreased at all evaluated periods. Conclusion: Resin composites are less susceptible to changes after smoke exposure, while bis-acryl resins results are brand-dependent. Prophylaxis negatively influenced the surface gloss of most of the tested materials (AU)

Objetivo: Avaliar a estabilidade de cor e brilho superficial de resinas compostas e bisacrílicas, submetidos ao manchamento artificial por fumaça de cigarro. Material e Métodos: Foram preparados espécimes de cada material (n=15). Duas resinas compostas (GrandioSO [RCG], Filtek Supreme [RCZ]) e cinco resinas bisacrílicas (Luxatemp Star [BisLUX], Protemp4 [BisPRO], Structor3 [BisSTR], Visalys Temp [BisVIS] e Yprov [BisYPR]) foram testados. A cor inicial foi avaliada usando um espectrofotômetro e o brilho de superfície com um medidor de brilho. As amostras foram submetidas à exposição de fumaça de cigarro (10 cigarros com até 8 minutos por ciclo). Após 3 e 6 ciclos, a cor e o brilho foram reavaliados. As leituras finais foram realizadas após a profilaxia escova de robinson. Os dados foram analisados usando de medidas repetidas e teste de Tukey (p<0,05). Resultados: Foram detectadas diferenças e interação de fatores (p<0,01) tanto para leituras de cor quanto para leituras de brilho. As resinas compostas foram as menos afetados pelo envelhecimento, com redução do brilho após a profilaxia. Foram detectadas diferenças entre as resinas bisacrílicas, com melhores resultados para BisLUX e BisPRO. BisPRO e BisSTR, mostraram redução de brilho após 60 cigarros, enquanto que o brilho da BisYPR diminuiu em todos os períodos avaliados. Conclusão: As resinas compostas são as menos suscetíveis a mudanças após a exposição à fumaça, enquanto os resultados das resinas bisacrílicas são dependentes da marca. A profilaxia influenciou negativamente o brilho de superfície da maioria dos materiais testados.(AU)

Influence of different separating mediums applied on the immediate dentin sealing in the tensile strength of temporary restorations / Influência de diferentes agentes isolantes aplicados sobre o selamento dentinário imediato na resistência à tração de restaurações provisórias

Objective: To evaluate the ability of different separating mediums to prevent adhesion between provisional restorations and hybridized dentin surfaces when used with the Immediate Dentin Sealing technique (IDS). Material and Methods: 120 extracted human teeth ­ 40 premolars and 80 molars ­ were selected to integrate acrylics samples separated into 4 different groups (n=10) according to the separating medium used for IDS protection. Forty samples were made of three teeth mounted in a self-cure acrylic resin block (Jet, Classic, São Paulo, Brazil) arranged side by side, simulating the positioning and proximal contacts present in the dental arch between the second premolar, first molar and second molar. A standard dental preparation for ultra-thin occlusal veneer was performed and complete occlusal dentin exposure was achieved by selective removal of the occlusal enamel with a high-speed conical round burr (Code: 1801.4138 FG, KG Sorensen, Medical Burs Ind. e Com. de Pontas e Brocas Cirúrgicas Ltda, São Paulo, Brazil). Dentin hybridization were performed on the control group and 3 different groups of separating mediums (n=10): PC­commercial provisional separating agent (Pro-V Coat, Bisco, Schaumburg, USA); GG­glycerin gel (K-Y Gel; Johnson & Johnson Industry and Commerce LTDA, São Paulo, Brazil); PJ­petroleum jelly (Rioquímica, São Paulo, Brazil). Provisionalization were manufactured on the prepared teeth. After 2 weeks, the tensile test was performed, and the analysis of the failure pattern was performed by 3D laser confocal microscopy and Scanning Electron Microscopy (SEM). The data were analyzed with the 1-way ANOVA and the Tukey test (α = 0.05). Results: Significantly lower tensile strength values were found for the commercial provisional separating agent (30.39 ± 10.01 N) compared to others (p < 0.05). Conclusion: The commercial provisional separating agent showed greater effectiveness on protecting hybridized dentin against the provisional restorations (AU)

Objetivo: Avaliar a capacidade de diferentes agentes isolantes em prevenir a adesão entre as restaurações provisórias e a superfícies de dentina hibridizadas quando usados com a técnica do Selamento Dentinário Imediato (IDS). Material e Métodos: 120 dentes humanos extraídos - 40 pré-molares e 80 molares - foram selecionados para integrar as amostras de acrílico divididas em 4 grupos diferentes (n = 10) de acordo com o meio de separação usado para proteção IDS. Foram confeccionadas 40 amostras de três dentes montados em um bloco de resina acrílica autopolimerizável (Jet, Classic, São Paulo, Brasil) dispostos lado a lado, simulando o posicionamento e os contatos proximais presentes na arcada dentária entre o segundo pré-molar, primeiro molar e segundo molar. Um preparo dentário padrão para laminado oclusal ultrafino foi realizado e a exposição completa da dentina oclusal foi obtida pela remoção seletiva do esmalte oclusal com uma broca cônica arredondada de alta rotação (Código: 1801.4138 FG, KG Sorensen, Medical Burs Ind. E Com. de Pontas e Brocas Cirúrgicas Ltda, São Paulo, Brasil). A hibridização da dentina foi realizada no grupo controle e em 3 grupos diferentes de agentes isolantes (n = 10): PC - agente de separação provisório comercial (Pro-V Coat, Bisco, Schaumburg, EUA); GG ­ gel de glicerina (K-Y Gel; Johnson & Johnson Industry and Commerce LTDA, São Paulo, Brasil); PJ ­ vaselina (Rioquímica, São Paulo, Brasil). As restaurações provisórias foram fabricadas nos dentes preparados. Após 2 semanas, foi realizado o teste de tração, e a análise do padrão de falha foi realizada por microscopia confocal a laser 3D e Microscopia Eletrônica de Varredura (MEV). Os dados foram analisados com a ANOVA de 1 fator e o teste de Tukey (α = 0,05). Resultados: Valores de resistência à tração significativamente menores foram encontrados para o agente separador provisório comercial (30,39 ± 10,01 N) em comparação com os demais (p < 0,05). Conclusão: O agente separador provisório comercial mostrou maior eficácia para a proteção da dentina hibridizada contra as restaurações provisórias (AU)

SAT: Sistematización Adhesiva Temporaria. Integración estético-oclusal predecible en rehabilitación conservadora. Informe de caso y revisión bibliográfica / TAS: Temporary Adhesive Systematization. Predictable aesthetic-occlusal integration in conservative rehabilitation. Case report and bibliographic review

Objetivos: Realizar una revisión de la literatura sobre métodos de rehabilitación mínimamente invasivos, y presentar un caso clínico acerca de un nuevo procedimiento denominado sistematización adhesiva temporaria (SAT), destinado a pacientes que presentan pérdida de sustancia dentaria y que se caracteriza como un abordaje terapéutico predecible para transferir el proyecto rehabilitador (encerado) a la boca del paciente mediante 3 pasos bien definidos y con objetivos específicos. Caso clínico: Un paciente adulto joven de sexo masculino con desgastes severos por bruxismo es rehabilitado temporalmente con resinas compuestas (SAT) para devolver la anatomía perdida en forma adhesiva y conservadora, siguiendo un protocolo de abordaje terapéutico predecible denominado EGOP (estéticamente guiado y oclusalmente protegido). Este procedimiento, que es considerado muchas veces de transición previo a las restauraciones finales, nos permite evaluar la estética, la oclusión y mejorar la comunicación entre el equipo de trabajo para poder realizar el cambio por restauraciones cerámicas en forma gradual. En aquellos pacientes que necesitan rehabilitaciones totales producto del desgaste dentario severo, la SAT puede ser una herramienta que facilite al odontólogo la posibilidad de restablecer los patrones oclusales y estéticos perdidos sin la necesidad de realizar desgastes dentarios y provisionales como se hacía clásicamente (AU)

Aims: To carry out a literature review on minimally-invasive rehabilitation methods and to present a clinical case on a new procedure called Temporary Adhesive Systemization (TAS), intended for patients that show a considerable loss of dental substance, characterized by a predictable therapeutic approach to transfer the rehabilitation diagnosis wax-up through 3 well defined steps and with specific objectives to the patient´s dentition. Clinical case: A young adult male patient with severe wear due to bruxism is temporarily rehabilitated with composite resins (TAS) to return the lost anatomy in a conservative way, following a predictable therapeutic approach protocol called EGOP (aesthetically guided and occlusally protected). This procedure, which is often considered transitional prior to final restorations, allows us to evaluate aesthetics, occlusion, improve communication between the working team and to be able to gradually change for ceramic restorations. In patients that need full rehabilitation due to severe dental erosion, TAS is a predictable procedure that helps the dentist to re-establish the loss of aesthetical and occlusal patterns, without the need of preparing the teeth for the classic provisional restorations (AU)

Effect of Materials For Interim Restoration on Estimation of Working Length Using Electronic Apex Locator: in vitro Study / Efecto de Materiales Para Restauración Intermedia sobre la Estimación de la Longitud de Trabajo Endodóntico Utilizando Localizador Electrónico de Foramen: Estudio in vitro

ABSTRACT: The aim of this in vitro study was to evaluate measurement accordance using an electronic apex locator for estimation of working length in endodontics when different restorative materials for interim crown restoration are utilized. For this study, 13 single-rooted premolars with endodontic occlusal access cavity were prepared. To establish the working length of each tooth, these were mounted in alginate and with the help of an electronic foramen locator and endodontic file K-file # 15, the working length was established. This length was later compared to the estimated working lengths using different intermediate restoration materials. These materials were: Superior Chemfil, Ketac ™ Molar Easymix and Filtek z350 resin. In the electronic measurements, an acceptable tolerance range of variation up to ± 0.5 mm was considered. Highest discrepancies were considered erroneous. For these measurements, central tendency and dispersion were analyzed. The Bland-Altman method was used, and the ANOVA test with a significance level of p <0,05 for statistic difference. Regarding measurements' acceptability and the type of interim restoration material utilized, 7 were acceptable, and 6 were unacceptable for ChemFil Superior, 12 were acceptable and 1 unacceptable for Ketac™ Molar Easymix, and 11 were acceptable and 2 were unacceptable for Filtek Z350 composite resin. The average difference between all electronic measurements was 0.29 (± 0.44). Chemfill Superior showed the most prominent variation between measurements 0.58 (± 0.45). When using an electronic apex locator, measurements showed statistically significant differences depending on the interim restoration material of choice (p<0.05). In conclusion, the measurement accordance using electronic apex locator to estimation the working length is higher, however the electronic estimation of working length can be significatively affected by the material chosen for interim temporary restoration.

RESUMEN: El objetivo de este estudio in vitro, fue evaluar la concordancia de las estimaciones de longitud de trabajo mediante localizador electrónico de foramen, utilizando diferentes materiales de restauración intermedia coronaria. Para tales fines fueron preparados 13 premolares uniradiculares con cavidad de acceso oclusal endodóntico. Para establecer la a longitud de trabajo de cada diente, estos fueron montados en alginato y con la ayuda de un localizador electrónico de foramen y lima de endodoncia K-file #15 fue establecida la longitud de trabajo. Esta longitud fue comparada posteriormente con las longitudes de trabajo estimadas utilizando diferentes materiales de restauración in- termedia. Estos materiales fueron: Chemfil superior, Ketac™ Molar Easymix y resina Filtek z350. En las mediciones electrónicas, se consideró un rango de tolerancia aceptable de variación hasta ± 0,5 mm. Las discrepancias mayores se consideraron erróneas. Se calcularon medidas de tendencia central y la dispersión. Se utilizó el método de Bland- Altman y la prueba ANOVA con un nivel de significancia de p <0,05. Con respecto a la aceptabilidad de las mediciones y el tipo de material de restauración intermedia, 7 fueron aceptables y 6 fueron inaceptables para ChemFil Superior, 12 fueron aceptables y 1 inaceptable para Ketac ™ Molar Easymix, y 11 fueron aceptables y 2 fueron inaceptables para el compuesto Filtek Z350 resina. La diferencia promedio entre todas las mediciones electrónicas fue de 0,29 (± 0,44). Chemfil Superior mostró la mayor variación entre medicio- nes 0,58 (± 0,45). Las mediciones mostraron diferencias estadísticamente significativas dependiendo del material de restauración intermedio elegido (p <0,05). En conclusión, la concordancia en la estimación de la longitud de trabajo usando localizador electrónico de foramen es alta, sin embargo, puede verse afectada significativamente por el material de obturación intermedio.

Percepción de estudiantes respecto al recambio de restauraciones / Students' perception regarding the replacement of restorations

Introducción: El reemplazo de restauraciones defectuosas representa la mayor parte de la práctica del odontólogo, lo que lleva a una perdida mayor del remanente dentario ante cada reemplazo. Objetivo: Determinar si existe variación del criterio clínico en alumnos frente a la decisión de recambio en restauraciones de resina compuesta previo y posterior al reacondicionamiento. Material y Métodos: Estudio analítico transversal. Se contó con una muestra de 40 estudiantes de quinto año de un universo de 72. Se utilizó un set fotográfico, que contaba con restauraciones defectuosas, en uno o más parámetros según los criterios RYGE/USPHS, las cuales posteriormente se reacondicionaron, por lo que se contaba con las fotografías del antes y del después del tratamiento conservador. Se realizó una encuesta a partir de las fotografías mostradas en la cual debían indicar la elección de tratamiento. Resultados: Se observó que hay una gran variación de elección de tratamiento previo a ser reparadas con tratamientos conservadores: 38 por ciento y no conservador de 62 por ciento y frente a la misma restauración de resina posterior a haber sido intervenida la elección de tratamiento conservador fue de 83 por ciento y no conservador 17 por ciento. Mediante el Test de McNemar se obtuvo un p<0.0001 entre elección de tratamiento conservador por sobre el no conservador posterior a haber sido realizada el reacondicionamiento de la restauración. Conclusiones: Existe un cambio en la percepción sobre la indicación de tratamiento de restauraciones defectuosas, a favor de una alternativa conservadora, después de que han sido intervenidas con procedimientos mínimamente invasivos(AU)

Introduction: The replacement of defective restorations, which leads to a greater loss of the dental remnant before each replacement, represents the large majority of the dentist's practice. Objective: To determine if there is any variation in students´ clinical criterion in relation to the decision of replacement of composite resin restorations prior to and following reconditioning. Material and Methods: A cross-sectional analytical study was conducted. The sample was composed of 40 fifth-year students in a universe of 72. A set of photographs showing defective restorations in one or more parameters evaluated according to RYGE / USPHS criteria was used. They were later reconditioned, so there were photographs prior to and following conservative treatment. Based on the photographs shown, a survey in which they had to indicate the choice of treatment was performed. Results: We observed that there is a great variation in the choice of treatment prior to the repair with conservative treatments (38 percent) and non-conservative ones (62 percent), compared to the same resin restoration after the choice of conservative treatment (83 percent) and non-conservative one (17 percent). Using the McNemar Test, p<0.0001 was obtained between the choice of conservative treatment over the non-conservative one after the restoration reconditioning had been performed. Conclusions: There is a change in perception of the indication of treatment to repair defective restorations towards a conservative alternative after they have undergone minimally invasive procedures(AU)

Radiopacidad de Resinas Acrílicas y Bisacrílicas Usadas como Restauraciones Provisionales / Radiopacity of Acrylic and Bisacrylic Resins Used as Provisional Restorations

Una adecuada radiopacidad de los materiales para restauraciones provisorias permite su evaluación en el examen radiográfico. Sin embargo, existe gran desconocimiento sobre el cumplimiento de los requerimientos establecidos por la norma ISO 4049. El objetivo del siguiente estudio fue determinar la radiopacidad de los materiales para provisionalización presentes en el mercado nacional y corroborar si estos cumplen con el valor mínimo requerido por la normativa. Se realizó un estudio experimental in vitro, en el cual se prepararon muestras en forma de discos de 10 mm de diámetro y 1 mm de espesor de resinas acrílicas: Acrílico Autocurable (Marché®), Duralay (Reliance), Caulkâ (Dentsply), ALIKE™ (GC) y resinas bisacrílicas: Protemp™4 (3M, 2008), LuxatempStar (DMG), Luxacrown (DMG), Structur Premium (VOCO), ExperTemp™ (Ultradent) y Acrytemp (Zhermack). Las muestras fueron radiografiadas junto a una cuña de aluminio escalonada. Las imágenes fueron analizadas para determinar el valor en escala de grises y su respectivo valor en mm de aluminio. Los datos fueron analizados para verificar si cumplen con la normativa ISO. Se encontraron diferencias estadísticamente significativas. La radiopacidad equivalente de las resinas acrílicas en mm de Al en orden descendente fue de 0,85 ± 0,08 para ALIKE™, 0,72 ± 0,32 para acrílico Marché®, 0,65 ± 0,25 para Caulkâ y 0,56 ± 0,05 para Duralay, siendo todos menores a lo requerido por la norma. La radiopacidad equivalente de las resinas bisacrílicas fue de 1,75 ± 0,2 para Acrytemp, 1,51± 0,27 para Luxacrown, 1,47 ± 0,14 para Structur Premium, 1,43 ± 0,23 para LuxatempStar, 1,02 ± 0,28 para Protemp™4 y 1± 0,1 para ExperTemp™, los cuales son mayores a lo exigido por la norma. En conclusión, las resinas bisacrílicasevaluadas en este estudio cumplen con el requisito de radiopacidad exigido, a diferencia de las acrílicas que no lo cumplen.

An adequate radiopacity of materials for provisionalization allows its proper evaluation on the radiographicexam. However, there is a lack of knowledge about compliance with the requirements established by the ISO 4049 norm. The aim of this study was to determine the radiopacity of provisionalization materials available in the national market and verify if they comply with the minimum requirements of ISO regulations. An in vitro experimental study was carried out, samples of 10 mm in diameter and 1 mm thickness of acrylic resins: Self-Cure Acrylic (Marché®), Duralay (Reliance), Caulkâ (Dentsply), Alike™ (GC) and by sacrilic resins: Protemp™4 (3M), Luxatemp Star (DMG), Luxacrown (DMG), Structur Premium (VOCO), ExperTemp™ (Ultradent), Acrytemp (Zhermack) were prepared. The samples were x-rayed together with a stepped aluminum wedge. The images were analyzed to determine the gray scale value and its equivalent value in mm of Aluminum. The data was analyzed to verify compliance with the ISO standard. Statistically significant differences were found. The equivalent radiopacity of acrylicresins in mm of Al in descending order was 0.85± 0.08 for ALIKE™, 0.72 ± 0.32 for acrylic Marché®, 0.65 ± 0.25 forCaulkâ and 0.56 ± 0.05 forDuralay, all being less than the required by norm. The equivalent radiopacity of by sacrilic resins was 1.75 ± 0.2 for Acrytemp, 1.51± 0.27 for Luxacrown, 1.47 ± 0.14 for Structur Premium, 1.43 ± 0.23 for LuxatempStar, 1.02 ± 0.28 forProtemp™4 and 1± 0.1 forExperTemp™,which are greater than the requirements. In conclusion, the bisacrylic resins evaluated in this study comply with the radiopacity standard, however the acrylic resins evaluated do not comply.

Influence of viscosity and chemical composition of composite resins in non-carious cervical restorations: 12-month randomized clinical trial / Influência da viscosidade e composição química das resina compostas em restaurações de lesões cervicais não-cariosas: resultados de 12 meses de uma pesquisa clínica randomizada

Objective: The objective of this double-blind, randomized controlled clinical trial was to evaluate the clinical performance of two methacrylate-based flowable composite and ormocer-based flowable composite in non-carious cervical lesions (NCCLs) of adult patients. Material and Methods: 183 restorations were performed on NCCLs using the Futurabond U adhesive system, applied in the selective enamel etching mode in all cavities. After the adhesive application, the cavities were restored with one out of the three evaluated flowable composites (n = 61 per group): ormocer-based flowable composite (Admira Fusion Flow, ORM), low viscosity methacrylate-based composite (GrandioSO Flow, LV) and high viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV). After 12 months of clinical performance, these restorations were evaluated according to FDI and USPHS criteria in the following items: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity and caries recurrence. Results: eight restorations were lost/fractured after 12 months of clinical evaluation (1 in the ORM and 7 in the HV group). The retention rates for 12- months (95% confidence interval) were 98.4% (91.3%-99.7%) for the ORM group, 100% (94.5%-100%) for the LV group and 88.5% (78.1%-94.3%) for the HV group, with no statistical difference identified between any pair of groups (p > 0.05). Five restorations presented small marginal adaptation defects at the 12-months evaluation recall, and all of them were considered clinically acceptable. Conclusion: The clinical performance of the universal adhesive associated to ormocer-based or methacrylate-based flowable composite were found to be promising after 12-month of clinical evaluation (AU)

Objetivo: O objetivo deste estudo clínico duplo-cego randomizado foi comparar as taxas de retenção de um compósito fluido à base de Ormocer versus dois compósitos fluidos à base de metacrilato quando utilizados em lesões cervicais não cariosas (LCNCs) de pacientes adultos. Material e Métodos: 183 restaurações foram realizadas em LCNCs utilizando o sistema adesivo Futurabond U, aplicado no modo de condicionamento seletivo do esmalte em todas as cavidades. Após a aplicação do adesivo, as cavidades foram restauradas com um dos três compósitos fluidos avaliados (n = 61 por grupo): compósito fluido à base de ormocer (Admira Fusion Flow, ORM), compósito à base de metacrilato de baixa viscosidade (GrandioSO Flow, LV) e compósito à base de metacrilato de alta viscosidade (GrandioSO Heavy Flow, HV). Após 12 meses de desempenho clínico, essas restaurações foram avaliadas de acordo com os critérios FDI e USPHS nos seguintes itens: retenção / fratura, adaptação marginal, coloração marginal, sensibilidade pós-operatória e recorrência de cárie. Resultados: oito restaurações foram perdidas / fraturadas após 12 meses de avaliação clínica (1 no grupo ORM e 7 no grupo HV). As taxas de retenção por 12 meses (intervalo de confiança de 95%) foram 98,4% (91,3% -99,7%) para o grupo ORM, 100% (94,5% -100%) para o grupo LV e 88,5% (78,1% -94,3%) para o grupo HV, sem diferença estatística identificada entre nenhum par de grupos (p> 0,05). Cinco restaurações apresentaram pequenos defeitos de adaptação marginais no período de avaliação de 12 meses, e todas foram consideradas clinicamente aceitáveis. Conclusão: O desempenho clínico do adesivo universal associado ao compósito fluido à base de ormocer ou metacrilato mostrou-se promissor após 12 meses de avaliação clínica(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).

Microfiltración coronal in vitro con cuatro materiales de obturación temporal en cavidades endodoncias / In vitro coronal microfiltration with four temporary filling materials in endodontic cavities

Introducción. Hoy en día el material de obturación provisoria ideal para los dientes tratados endodonticamente parece no existir ya que todos los materiales existentes presentan algún grado de microfiltración marginal. Objetivo. determinar la tasa de éxito medido por el grado de microfiltración coronal de 4 materiales de restauración temporal: Oxido de zinc Eugenol, Villevie, Clip Flow, Cemento de Ionómero de vidrio; en cavidades de acceso en endodoncia a los 15 días, 1 mes y 3 meses, para lo cual se realizó un estudio experimental in vitro donde se utilizaron 120 piezas dentarias extraídas que fueron divididas en 4 grupos de acuerdo al material de obturación. Luego de transcurrido el tiempo las piezas fueron seccionadas y se realizó la observación macroscópica. Se midieron en milímetros la cantidad de colorante filtrado dentro del conducto con la ayuda del programa Imagen J, y en el caso en el que filtró el algodón se consideró que el conducto presentó contaminación y se determinó como fracaso del tratamiento y también fueron clasificados en grados. Resultados. El cemento fue el que mejor se comportó a los 15 días y 1 mes fue el Clip flow, y a los 3 meses ningún cemento fue bueno. Conclusiones. Todos los materiales de obturación provisoria presentaron grado 5 de filtración por lo que se recomienda utilizar las restauraciones por un tiempo específico no mayor a un mes dependiendo del material para evitar la microfiltración.

Introduction. Nowadays, the ideal provisional filling material for teeth treated endodontically does not seem to exist since all the existing materials present some degree of marginal microfiltration. Objective. To determine the success rate measured by the degree of coronal microfiltration of 4 temporary restoration materials: Eugenol zinc oxide, Villevie, Clip Flow, Glass ionomer cement; in access cavities in endodontics in different periods of time, 15 days, 1 month and 3 months, for which an in vitro experimental study was carried out where 120 extracted teeth were used, which were divided into 4 groups according to the filling material. After the time elapsed the pieces were sectioned and the macroscopic observation was made. The amount of dye filtered inside the duct was measured in millimeters with the help of the Image J program, and in the case in which the cotton was filtered, it was considered that the duct showed contamination and was determined as treatment failure and were also classified in degrees. Results. The cement was that behaved better at 15 days and 1 month was the Clip flow, and at 3 months no cement was good. Conclusions. All temporary filling materials presented grade 5 filtration, so it is recommended to use the restorations for a specific time no longer than one month depending on the material to avoid microfiltration.

High-viscosity glass-ionomer vs. composite resin restorations in persons with disability: Five-year follow-up of clinical trial.

The aim of this clinical trial was to compare the 5-year cumulative survival of atraumatic restorative treatment restorations using high-viscosity glass-ionomer restorations (ART/HVGIC) and conventional resin composite restorations (CRT) placed in patients with intellectual and/or physical disability. Patients referred for restorative care to a special care service in Córdoba, Argentina, were recruited. Patients and/or caregivers were provided with written and verbal information regarding treatment options and selected the alternative they preferred. The treatment protocols were ART (hand instruments/HVGIC) in the clinic or CRT (rotary instrumentation/resin composite) in the clinic or under general anaesthesia (GA). Two independent, trained and calibrated examiners evaluated restoration survival using established ART codes after 6, 12, 24, 36 and 60 months. The proportional hazard model with frailty corrections provided survival estimates. Jackknife errors were used to test 5-year results. Sixty-six patients (13.6 ± 7.8 years) with 16 different medical conditions participated. CRT in the clinic proved feasible for five patients (13%), and 14 patients received CRT under GA (21%). ART was provided for 47 patients (71.2%). A total number of 298 dentine carious lesions were restored in primary and permanent teeth (182 ART; 116 CRT). Four patients died between the 3 and 5-year follow up. Percentage survival and jackknife standard error were calculated and were significantly higher for all ART/HVGIC restorations (90.2% ± 2.6) than for all CRT restorations (82.8% ± 5.3), 5 years after placement (p=0.044). These 5-year follow-up results confirm that ART/HVGIC is an effective treatment protocol for patients with disability, equal to that of conventional resin composite restoration. The results of this clinical trial support the use of ART as an evidence-based treatment resource contributing to the reduction of inequalities in access to oral health care among people with disability.

On the understanding of zinc-oxide eugenol cement use prior to etch-rinse bonding strategies.

CONTEXT: Zinc-oxide eugenol (ZOE) is frequently used due to its satisfactory biological response, sedative effect on the pulp, and easy removal. However, literature is very controversial about the influence of the temporary cement-containing eugenol on the bond strength properties. AIMS: This study aims to clarify the literature controversy by evaluating the bond strength of ZOE or ZOE-free applied before bonding procedures and the 7-day resting period after the first session. SETTINGS AND DESIGNS: Twelve recently extracted third molars were randomly divided into three groups: Group 1: Control (without treatment), Group 2: Temp-Bond NE; Group 3: Temp-Bond. SUBJECTS AND METHODS: After temporary restorations, the teeth were immersed in distilled water and stored for 7 days at 37°C. The temporary cement was mechanically removed, and prophylaxis was performed. The adhesive procedures were performed, and a 6-mm-high composite resin block was built. The teeth were immediately stored at 100% relative humidity at 37°C for 24 hours. Specimens with 0.7 (±0.2) mm2 of cross-sectional area were obtained and subjected to a microtensile bond strength (µTBS) test at 1 mm/min until failure. STATISTICAL ANALYSIS USED: Analysis of variance (ANOVA) and Tukey's post hoc test were used for statistical analysis. RESULTS: ZOE or ZOE-free cement did not interfere in the µTBS between resin composite and dentine when used with a two-step-etch-rinse adhesive material, considering 7 days of resting period after the first session, by the ANOVA and Tukey's post hoc test (P < 0.05). CONCLUSIONS: The authors recommend the removal of the temporary cementation at least seven days after the first session and suggest that the clinicians follow-up further studies to use the cement in case its removal is recommended within a longer period.

Effect of Ions Released and pH of Two Glass Ionomer Cements in Human Gingival Fibroblasts / Efecto de la liberación de iones y pH de dos cementos de ionómero de vidrio en fibroblastos gingivales humanos

Abstract 20. Conventional glass ionomer cements are used as dental provisional restorative materials, which present several advantages such as adhesion to the tooth mineral phase among others. On the other hand, the knowledge about biological property of glass ionomers shows various approaches and results. In this work, it was studied the in vitro biological response of human gingival fibroblasts in contact with commercial cements of glass ionomer: Mirafil® and Ionglass® and with their extracts, according to ISO 10993. The extracts of the cements, in which the cells were cultured, were adjusted at different concentrations ranging 0.1% to 100%. The cellular metabolic activity of gingival fibroblasts was measured using the Alamar Blue® reagent. The results showed a significant effect on the cellular metabolic activity correlated with the concentration of liberated ions (Al³+ and Ca²+) for both ionomers, as well as the pH variations of the culture media. This could mean that the cellular metabolic activity is substantially influenced by ions and pH of the cell culture.

Resumen 24. Los cementos de ionómero de vidrio convencionales se utilizan como materiales de restauración provisional para uso dental, los cuales presentan varias ventajas como la adhesión a la fase mineral de los dientes. Por otro lado, las propiedades biológicas de los ionómeros de vidrio muestran diversos enfoques y resultados. En éste trabajo se estudió la respuesta biológica in vitro de fibroblastos gingivales humanos en contacto con cementos comerciales de ionómero de vidrio: Mirafil® e Ionglass® y con sus respectivos extractos según la norma ISO 10993. Los extractos de los cementos en los que se cultivaron las células estaban en diferentes concentraciones: de 0.1% a 100%. La actividad metabólica celular se midió usando el reactivo Alamar Blue®. Los resultados mostraron un efecto significativo sobre la actividad metabólica celular correlacionada con la concentración de iones liberados (Al³+ y Ca²+) para ambos ionómeros, así como las variaciones de pH de los medios de cultivo. Ello podria explicar la influencia por los iones y el pH del cultivo celular en la actividad metabólica celular.

Use of extracted anterior teeth as provisional restorations and surgical guide for immediate multiple implant placement: A clinical case report.

OBJECTIVE: The aim of this article is to describe the use of natural anterior teeth as a surgical guide to implant placement and provisional restoration for a young patient with root resorption of upper central incisors and left-lateral incisor. CLINICAL CONSIDERATIONS: Achieving soft tissue esthetics is quite a challenge in implant dentistry. Here, a case of immediate implant placement using the natural teeth of the patient as an immediate provisional restoration, which achieves satisfactory results in terms of soft tissue architecture. CONCLUSIONS: Post-extraction implant placement in combination with immediate loading of dental implants has been evolving into an appropriate procedure for the treatment of partially edentulous anterior maxilla. Different techniques that include use of the own teeth as provisional implant supported restoration helps to maintain architecture of gingival contour, specially papilla. CLINICAL SIGNIFICANCE: Natural architecture of anterior soft tissue is a big challenge in implant dentistry. Use of natural teeth as a surgical guide and provisional restorations might be helpful to obtain an optimal outcome.

Tendências atuais no tratamento endodôntico por cirurgiões dentistas no Brasil / Current trends in endodontic treatment by dental surgeons in Brazil

Objetivo: conhecer as principais práticas adotadas atualmente por cirurgiões dentistas, clínicos gerais e endodontistas na realização do tratamento endodôntico. Material e Métodos: um questionário contendo 21 perguntas de múltipla escolha foi enviado para os profissionais, nas cinco regiões do país. As perguntas abordaram o tempo de experiência, tipos de técnicas, materiais e recursos auxiliares. Resultados: a maior parte dos respondentes são do Sudeste e Sul, endodontistas há menos de 10 anos. Realizam até 20 tratamentos/mês, utilizam localizador apical, instrumentação manual com limas de aço inoxidável associada a brocas gates glidden/largo, lupa e isolamento absoluto. O hipoclorito de sódio (2,5 a 5%) e o EDTA são os irrigantes mais utilizados juntamente com o ultrassom. O tratamento é feito em sessão única, porém o diagnóstico pulpar pode alterar o número de sessões. Quando é necessário o uso de medicação intracanal, o hidróxido de cálcio associado a outras formulações é a primeira escolha. Para obturação do sistema de canais radiculares é utilizada a técnica de condensação lateral e o cimento à base de óxido de zinco e eugenol. O selamento coronário entre sessões é feito com coltosol e com cimento de ionômero de vidro ao término do tratamento, quando os pacientes são encaminhados a outro profissional para restauração final. Atualizam-se através de artigos científicos e mostram abertura para testar novos produtos. Conclusão: a maioria dos participantes aderem a práticas atuais com uso de novas tecnologias durante o tratamento e se atualizam através da leitura de artigos científicos

Objective: to be aware of the main practices currently adopted by general dentists and endodontists when performing endodontic treatments. Material and methods: a questionnaire containing 21 multiple-choice questions was sent to professionals in the five regions of Brazil. These questions covered experience time, techniques, materials and auxiliary resources. Results: most participants are from the Southeast and South regions of Brazil and have been specialized in endodontic for less than 10 years. They perform up to 20 treatments per month, use apex locator, manual instrumentation with stainless steel files associated with gates-glidden or largo burs, magnifying loupes and absolute isolation. Sodium hypochlorite (2.5 to 5.0%) and EDTA are the most used substances for irrigation associated with ultrasound. The treatment is done in a single visit, but pulp diagnosis might alter the number of visits. When intracanal medication is required, calcium hydroxide associated with other formulations is the first choice. For root canal filling, lateral condensation technique, zinc oxide and eugenol based sealers are used. Coronal sealing between sessions is done with Coltosol® and glass ionomer cement at the end of treatment, when patients are referred to another professional for final restoration. These professionals update their knowledge with scientific articles and show availability to test new products. Conclusion: most participants have been adhering to current practices (new technologies) during treatment and has kept updated by reading scientific articles

Evaluation of the marginal accuracy of provisional restorations made of acrylic resins

Aim: To evaluate the marginal accuracy of provisional crowns made with acrylics resins and to identify the surface(s) with the highest marginal discrepancy. Methods: A direct technique was used to fabricate 96 provisional restorations with 8 materials: Dencrilay, Dencôrlay, Dencôr, Vipicor, Duralay, Resinlay Speed, Refine Bright and Alike (n=12). The provisional crowns were made on a prepared molar-shaped metal die with a vinyl polysiloxane impression as a matrix. Marginal discrepancy of provisional restorations was analyzed at buccal, lingual, mesial and distal surfaces of metal die finish line in a stereomicroscope lupe at 100X. The images obtained were transferred to the Corel Draw X7 program and the distances from the cervical margins of the specimen to the reference lines were measured vertically. Comparisons were made with 1-way analysis of variance and the Tukey test (p <0.05). Results: The Alike resin exhibited the lowest marginal discrepancy (0.018 mm) and was significantly different from the Dencôrlay (0.037 mm), Filter Bright (0.034 mm), Duralay (0.033 mm) and Vipicor (0.032) resins. The buccal surface showed the highest marginal discrepancy (0.040 mm) compared to those of other surfaces (distal 0.029mm, lingual 0.028mm and mesial 0.024mm). Conclusion: The marginal adaptation of all materials and surfaces tested in this study were within a clinical acceptable limit. The Alike resin showed the best performance compared to Dencôrlay, Refine Bright, Duralay, and Vipicor resins. The buccal surface showed the highest marginal discrepancy than those of the other tested surfaces