The effect of tooth bleaching using violet LED (405-410 nm) on the properties of resin-based composites.

BACKGROUND: The objective of this study was to evaluate the effect of bleaching techniques, including or not the use of violet light (405-410 nm), on resin-based composites' color, surface roughness, nanohardness, and elastic modulus. METHODS: Ninety-six disk-shaped specimens (12 mm x 2 mm; n = 12) were prepared using Filtek Z350 XT (Z350) and IPS Empress Direct (ED) resin-based composites. After 24 h, specimens were stained in red wine for 28 days. After staining, specimens were divided into four experimental groups: 40 % Hydrogen Peroxide (HP); Violet Light (VL); 40 % Hydrogen Peroxide associated with Violet Light (HP+VL), and a control group - no treatment (NT). Specimens were evaluated at six experimental times: initial (24 h after light curing); after staining and after the 1st, 2nd, 3rd, and 4th bleaching sessions regarding the color change (ΔE00, L*, a*, b*, and WID); roughness (Ra), nanohardness and elastic modulus (GPa). Two-way analysis of variance for repeated measures was performed (α=0.05 %). RESULTS: There was a statistically significant difference between staining and the 1st bleaching session for all ED groups (p<0.05). After the last bleaching session, there were no differences between the experimental and the control groups of both resin-based composites. Bleaching using violet light did not change the roughness, nanohardness and elastic modulus of the tested resin-based composites (p>0.05). CONCLUSIONS: Although hydrogen peroxide and violet light remove pigments from resin-based composites without affecting their surface roughness, nanohardness, and elastic modulus, the color change was similar to the one obtained by immersion in distilled water.

Comparison between a bulk-fill resin-based composite and three luting materials on the cementation of fiberglass-reinforced posts.

Objectives: This study verified the possibility of cementing fiberglass-reinforced posts using a flowable bulk-fill composite (BF), comparing its push-out bond strength and microhardness with these properties of 3 luting materials. Materials and Methods: Sixty endodontically treated bovine roots were used. Posts were cemented using conventional dual-cured cement (CC); self-adhesive cement (SA); dual-cured composite (RC); and BF. Push-out bond strength (n = 10) and microhardness (n = 5) tests were performed after 1 week and 4 months of storage. Two-way repeated measures analysis of variance (ANOVA), 1-way ANOVA, t-test, and Tukey post-hoc tests were applied for the push-out bond strength and microhardness results; and Pearson correlation test was applied to verify the correlation between push-out bond strength and microhardness results (α = 0.05). Results: BF presented higher push-out bond strength than CC and SA in the cervical third before aging (p < 0.01). No differences were found between push-out bond strength before and after aging for all the luting materials (p = 0.84). Regarding hardness, only SA presented higher values measured before than after aging (p < 0.01). RC and BF did not present 80% of the maximum hardness at the apical regions. A strong positive correlation was found between the luting materials' push-out bond strength and microhardness (p < 0.01, R2 = 0.7912). Conclusions: The BF presented comparable or higher push-out bond strength and microhardness than the luting materials, which indicates that it could be used for cementing resin posts in situations where adequate light curing is possible.

Role of non-carious cervical lesions multicausality in the behavior of respective restorations.

OBJECTIVES: To evaluate biocorrosion and eccentric occlusal loading interplay in marginal quality of cervical restorations. METHODS: Cervical wedge-shaped cavities were prepared in extracted premolars and restored with a composite. Premolars underwent either an erosive challenge (E: 1% citric acid/10 min), eccentric occlusal loading (EOL: 150 N/2.5 Hz/106 cycles), E before EOL (E + EOL), E intermediate to EOL (EOL/E/EOL), E after EOL (EOL + E), or no E or EOL (C: control). Marginal quality was analyzed based on a series of Optical Coherence Tomography images. Each of the margins was assigned a gap score (0, 1, 2, or 3) and measurement (µm). For each margin, scores data were analyzed with Kruskall Wallis and Dunn tests, and µm data, with Kruskall Wallis. Overall and for each group, the different margins were compared using Wilcoxon signed-rank test, and the correlation between scores and µm, Spearman's correlation coefficient (α = 0.05). RESULTS: E and EOL, even if associated, did not influence enamel marginal quality. EOL/E/EOL impaired dentin/cementum marginal quality only in the case of scores and compared to E. E + EOL, EOL + E or EOL and even C, without differences between each other, did not influence results differently from E or EOL/E/EOL. Margins in dentin/cementum always showed lengthier gaps. Except for C, E and EOL + E cervical margin, there was a strong positive correlation between scores and µm. CONCLUSIONS: Eccentric occlusal loading and/or biocorrosion cannot be assumed as causes of marginal failure of cervical restorations in wedge-shaped cavities. A relevant concern may still be the establishment of adhesive interfaces in dentin/cementum. CLINICAL SIGNIFICANCE: Although non-carious cervical lesions are strongly being recognized multifactorial and their respective restorations not always behave as expected, biocorrosion and eccentric occlusal loading interplay cannot serve as an explanation for marginal gaps they often present.

Blinded, parallel and randomized clinical evaluation of in-office dental bleaching with violet LED (405-410nm).

This clinical study evaluated the effect of bleaching performed with violet LED light (405-410 nm), either combined with hydrogen peroxide (HP) gel, or not, on color change, dental sensitivity, participants' satisfaction and impact on their quality of life. A hundred participants were divided into one of the groups (n = 25): G1 - 35% HP (4 sessions, 1x/week); G2 - violet LED (4 sessions, 1x/week); G3 - violet LED (4 sessions, 2x/week); G4 - hybrid technique (violet LED + 35% HP; 4 sessions, 1x/week). Color evaluation was performed with colorimetric tests (objective and subjective), before, 14 days and 3 months after completion. Additionally, satisfaction with treatment, impact on quality of life (OHIP-14) and dental sensitivity were recorded. The data were submitted to statistical analysis, considering a significance level of 5%, with the exception of the data from the questionnaire on satisfaction (descriptive analysis). Two-way ANOVA and Tukey tests showed that there was no difference between color variation resulting from techniques used in G1 and G4; those used in G2 and G3 did not differ and were less effective for bleaching than those of the other groups, in both subjective and objective evaluations. Regarding tooth sensitivity, subjects in G2 and G3 experienced no sensitivity, ​​while those in G4 showed lower sensitivity values than those in G1. With respect to quality of life, only subjects in G1 and G2 showed a significant positive impact. Among the evaluated techniques, the hybrid type seemed to be a good alternative, showing effective bleaching with less tooth sensitivity.

Effect of light curing units on the polymerization of bulk fill resin-based composites.

OBJECTIVE: To determine the potential effect of four different light curing units (LCUs) on the curing profile of two bulk fill resin-based composites (RBCs). METHODS: Four LCUs (Bluephase 20i, Celalux 3, Elipar DeepCure-S and Valo Grand) were used to light cure two RBCs (Filtek Bulk Fill Posterior Restorative and Tetric EvoCeram Bulk Fill). The effective tip diameter, radiant power, radiant emittance, emission spectrum and light beam profile of the LCUs were measured. Knoop microhardness was measured at the top and bottom surfaces of RBC specimens that were 12-mm in diameter and 4-mm deep (n=5). The distribution of the spectral radiant power that was delivered to the surface of the specimen and the light transmission through the 4-mm thick specimens was measured using an integrating sphere. Two-way ANOVA and Tukey tests (α=0.05) were applied. RESULTS: The Valo Grand produced the most homogeneous microhardness across the surfaces of the RBCs (p>0.05). When the Celalux 3, Bluephase 20i and Elipar DeepCure-S lights were used, the center of the specimens achieved greater hardness values compared to their outer regions (p<0.05). Approximately 10% of the radiant power delivered to the top reached the bottom of the specimen, although almost no violet light passed through 4mm of either RBC. A positive correlation was observed between the radiant exposure and microhardness. SIGNIFICANCE: The characteristics of the LCUs influenced the photoactivation of the RBCs. The use of a wide tip with a homogeneous light distribution is preferred when light curing RBCs using a bulk curing technique.

Effect of tooth brushing on gloss retention and surface roughness of five bulk-fill resin composites.

OBJECTIVES: To determine the effects of tooth brushing on five bulk-fill resin based composites (RBCs). METHOD: Ten samples of Filtek Supreme Enamel (control), Filtek One Bulk Fill, Tetric EvoCeram Bulk Fill, SonicFill 2, SDR flow+, and Admira Fusion X-tra were light cured for 20 seconds using the Valo Grand curing light. After 24 hours storage in air at 37°C, specimens were brushed in a random order using Colgate OpticWhite dentifrice and a soft toothbrush. Surface gloss was measured prior to brushing, after 5,000, 10,000 and 15,000 back and forth brushing cycles. Surface roughness was measured after 15,000 brushing cycles using atomic force microscopy (AFM) and selected scanning electron microscope (SEM) images were taken. The data was examined using ANOVA and pair-wise comparisons using Scheffe's post-hoc multiple comparison tests (α = 0.05). RESULTS: Surface gloss decreased and the surface roughness increased after brushing. Two-way ANOVA showed that both the RBC and the number of brushing cycles had a significant negative effect on the gloss. One-way ANOVA showed that the RBC had a significant effect on the roughness after 15,000 brushing cycles. For both gloss and roughness, brushing had the least effect on the nano-filled control and nano-filled bulk-fill RBC, and the greatest negative effect on Admira Fusion X-tra. The SEM images provided visual agreement. There was an excellent linear correlation (R2 = 0.98) between the logarithm of the gloss and roughness. CONCLUSION: After brushing, the bulk-fill RBCs were all rougher than the control nano-filled RBC. The nano-filled bulk-fill RBC was the least affected by brushing. CLINICAL SIGNIFICANCE: Bulk-fill RBCs lose their gloss faster and become rougher than the nanofilled conventional RBC, Filtek Supreme Ultra. The nanofilled bulk-fill RBC was the least affected by tooth brushing.

The potential of low-power laser for reducing dental sensitivity after in-office bleaching: a case report.

Postoperative sensitivity is one of the most common side effects of in-office bleaching with hydrogen peroxide. Laser phototherapy (LPT) has been suggested as an adjunctive treatment to prevent or minimize tooth sensitivity. This case report aimed to verify the efficacy of LPT in the reduction of sensitivity after in-office bleaching. Tooth bleaching was performed with 35% hydrogen peroxide activated with a hybrid LED-laser device. Immediately after the bleaching treatment, the patient reported dental sensitivity, as measured with a visual analog scale (VAS). To reduce sensitivity, LPT was applied with a 780-nm laser using the following parameters: 70 mW, exposure time of 10 seconds per point of irradiation (middle region of the buccal surfaces of each compromised tooth) in contact mode, energy of 1 J per point. Immediately after LPT, the patient reported a substantially lower level of pain on the VAS. Twenty-four hours after bleaching, the score on the VAS indicated that sensitivity levels had rebounded, and the patient received additional LPT. After 48 hours, the patient reported no dental sensitivity. The results in this patient indicated that irradiation with an infrared low-power laser substantially reduced dental pain generated by bleaching, suggesting that LPT should be considered as an auxiliary method to reduce postbleaching tooth sensitivity.

Ability of four dental radiometers to measure the light output from nine curing lights.

OBJECTIVES: To evaluate the accuracy of four dental radiometers when measuring the output from nine light curing units (LCUs). METHODS: The light output from nine light-emitting diode LCUs was measured with a laboratory-grade power meter (PowerMax-Pro 150 HD) and four dental radiometers (Bluephase Meter II, SDI LED Radiometer, Kerr LED Radiometer, and LEDEX CM4000). Ten measurements were made of each LCU with each radiometer. Analysis of variance (ANOVA) followed by Tukey tests (α=0.05) were used to determine if there was a difference between the calculated irradiance values from the power meter and those from the radiometers. Where applicable, the LCUs were ranked according to their power and irradiance values. The emission spectra from the LCUs was measured using an integrating sphere attached to a fiber-optic spectrometer (N=10). The beam profile of the LCUs was measured with a beam profiler camera. RESULTS: Of the dental radiometers, only the Bluephase Meter II could measure power. ANOVA showed no significant difference between power values measured with the laboratory-grade meter and the Bluephase Meter II (p=0.527). The difference between the mean irradiance reported by the various radiometers for the same LCU was up to 479mW/cm2. The ranking of the power values obtained using the laboratory-grade meter was the same for the Bluephase Meter II. CONCLUSION: When compared to the calculated irradiance values from the laboratory-grade power meter, the Bluephase Meter II provided the most accurate data. CLINICAL SIGNIFICANCE: Considering the great variation between the irradiance values provided by radiometers and their overall inaccuracy when compared to a laboratory-grade meter, dentists should not place too much faith in the absolute irradiance value. However, hand-held radiometers can be used to monitor changes in the light output of LCUs over time.

Light output from six battery operated dental curing lights.

Light Curing Units (LCUs) are used daily in almost every dental office to photocure resins, but because the light is so bright, the user is unable to tell visually if there are any differences between different LCUs. This study evaluated the light output from six dental LCUs: Elipar Deep Cure-S (3M ESPE), Bluephase G2 (Ivoclar Vivadent), Translux 2Wave (Heraeus Kulzer), Optilight Prime (Gnatus), Slim Blast (First Medica) and Led.B (Guilin Woodpecker) with a fully charged battery, after 50, and again after 100, 20second light exposures. For each situation, the radiant power was measured 10 times with a laboratory-grade power meter. Then, the emission spectrum was measured using a fiber-optic spectrometer followed by an analysis of the light beam profile. It was found there were significant differences in the LCU power and the irradiance values between the LCUs (p<0.01). The Optilight Prime and Slim Blast LCUs showed a significant reduction in light output after a 50 and 100 exposures, while Bluephase G2 exhibited a significant reduction only after 100 exposures (p<0.01). The Bluephase G2 and Translux 2Wave delivered an emission spectrum that had two distinct wavelength emission peaks. Only the Elipar Deep Cure-S and Bluephase G2 LCUs displayed homogeneous light beam profiles, the other LCUs exhibited highly non-homogeneous light beam profiles. It was concluded that contemporary LCUs could have very different light output characteristics. Both manufacturers and researchers should provide more information about the light output from LCUs.

Five second photoactivation? A microhardness and marginal adaptation in vitro study in composite resin restorations.

INTRODUCTION: Studies defining the characteristics of light curing units and photoactivation methods are necessary to allow the correct choices to be made in daily practice. This study aimed to determine whether different photoactivation protocols for composite resins [periodic level shifting (PLS) - 5 second and soft-start] are able to maintain or enhance the mechanical properties and marginal adaptation of restorations. METHODS: Restorations were placed in bovine teeth using the following photoactivation methods: continuous light for 20 seconds (control group); PLS technology (PLS - 5 second group); and continuous light and a light guide tip distance of 6 mm after which the tip was placed at the surface of the restoration (soft-start group). The teeth were transversely sectioned in the incisal-cervical direction. Thirty halves were randomly selected for Knoop microhardness testing (n = 10). The other 30 halves were subjected to scanning electron microscopy analysis. The images obtained were measured to identify the highest marginal gap, and statistical tests for variance analysis were conducted. RESULTS: Microhardness tests showed no statistically significant difference between the photoactivation methods analysed (P ≥ 0.01). The tests showed a difference among depths (P < 0.01), with the deeper layers being the hardest. In analysing marginal adaptation, no significant difference was identified between the higher marginal gap values in the continuous (mean = 10.36) and PLS - 5 second (mean = 10.62) groups, and the soft-start group (mean = 5.83) presented the lowest values (P < 0.01). CONCLUSIONS: The PLS - 5 second and soft-start protocols did not alter the hardness of the restorations. Moreover, the PLS - 5 second protocol did not alter the marginal adaptation, whereas the soft-start protocol improved marginal adaptation.

Influência do método de fotoativação na dureza de uma resina composta / Influence of the photoactivation method on the hardness of a composite resin

Objetivo: avaliar a dureza de uma resina composta fotoativada com dois métodos diferentes, contínuo e soft-start, por meio da variação da distância entre a ponta fotoativadora e a resina composta (7 mm e 0 mm). Materiais e métodos: Foram confeccionados 20 corpos-de-prova, nos quais a superfície irradiada e a oposta foram analisadas, totalizando 40 superfícies divididas em quatro grupos (n = 10): Grupo 1, método contínuo superfície irradiada; Grupo 2, método contínuo superfície oposta; Grupo 3, método soft-start superfície irradiada; Grupo 4, método soft-start superfície oposta. Os corpos-de-prova foram confeccionados com o auxílio de matrizes pretas de polipropileno, com 4 mm de diâmetro e 2 mm de espessura, utilizando a resina composta Z350 (3M ESPE) na cor AO3 e o fotoativador Elipar Freelight 2 (3M ESPE). Os corpos-de-prova foram submetidos ao teste de microdureza Vickers, no microdurômetro HMV- 2000 (Shimadzu). Foram realizados cinco entalhes por superfície, com carga de 50 gf por 45 segundos. Para a análise estatística, foram realizados os testes de ANOVA e Tukey. Resultados: Não foi encontrada diferença estatisticamente signifi cante entre os métodos avaliados nas superfícies irradiadas. Entretanto, nas superfícies opostas, houve diferença entre os protocolos, sendo que o soft-start obteve menores valores de dureza. Quando comparadas as diferentes profundidades, houve redução nos valores de dureza para ambos os métodos de fotoativação, de forma que a porcentagem de dureza máxima de 80% não foi atingida na superfície oposta à irradiada. Relevância: O cirurgião-dentista, em sua prátic clínica, deve atentar para o método de fotoativação de suas restaurações, visto que este pode prejudicar a qualidade da polimerização de resinas compostas, especialmente na profundidade de 2 mm em resinas opaca.

Objective: to evaluate the hardness of a composite resin polymerized with two different methods, continuous and soft-start, by varying the distance between the activator tip and the composite resin (7 mm and 0 mm). Materials and Methods: Twenty test specimens were fabricated, in which the irradiated and the opposite surfaces were analyzed, totaling 40 surfaces divided into 4 groups (n = 10): Group 1, continuous method + irradiated surface; Group 2, continuous method + opposite surface; Group 3, soft-start method + irradiated surface; Group 4, soft-start method + opposite surface. The test specimens were prepared using black polypropylene matrices, with a diameter of 4 mm and thickness of 2 mm, Z350 composite resin (3M ESPE), shade AO3, and the Elipar Freelight 2 curing unit (3M ESPE). The test specimens were subjected to nthe Vickers hardness test in an HMV-2000 microhardness tester (Shimadzu). Five indentations were made per surface with a load of 50 gf for 45 seconds. The ANOVA and Tukey tests were used for the statistical analysis. Results: No statistically signifi cant difference between the evaluated methods was found in the irradiated surfaces; however, in the opposite surfaces, there were differences between protocols, in that the soft-start protocol achieved the lowest hardness values. When comparing the different depths, there was a reduction in hardness values for both activation methods, so that the maximum hardness percentage of 80% was not achieved in the opposite surface. Relevance: The dentist should be knowledgeable of the photoactivation method applied to his/her restorations, since it may reduce the polymerization quality, especially in depths of 2 mm when using opaque resins.

Verificação do grau de severidade estética em perdas dentárias anteriores superiores / Assessment of aesthetic impairment severity in cases of upper front teeth loss

A análise das perdas dentárias tem merecido atenção, visto que não há uniformidade de critérios para aplicação das metodologias vigentes de avaliação. Este trabalho objetiva analisar as diretrizes para a avaliação do dano estético relacionado à perda dentária anterior superior, investigando como os médicos e dentistas a avaliam. Foram investigados o grau de gravidade de perdas dentárias anteriores superiores - um, dois, três, quatro, cinco, seis dentes, dois e três dentes alternados, e a avaliação da gravidade do dano entre as áreas profissionais, Foi realizado levantamento de dados mediante aplicação de um protocolo composto por oito fotografias de um mesmo indivíduo, manipuladas pelo programa Photoshop C53, 2007, que simulam perdas dentárias anteriores superiores de diferentes extensões. A amostra investigada avaliou estes danos de acordo com a escala francesa, que compreende sete graus: muito leve ou insignificante, leve, moderado, médio, suficientemente importante, importante e muito importante, Foram entrevistados 30 médicos e 30 dentistas. Verificou-se que, pela metodologia europeia de avaliação do dano estético, mais da metade do total de atribuições de grau de severidade entre todos os grupos de sequelas odontológicas apresentadas foram situadas entre os graus 6 (250f0) e 7 (530f0) numa escala de sete graus de gravidade crescente. Apesar do conceito de dano estético ter sido semelhante entre as áreas médica e odontológica, foi demonstrada ausência de parâmetros para aplicação da metodologia apresentada, tendo em vista que, para os diferentes prejuízos gerados pelos diferentes danos, a percepção estética foi alta.

The analysis of tooth loss has deserved attention, since there is no uniform criteria for their evaluation. This paper aims to analyze the guidelines for the evaluation of aesthetic damages related to upper front tooth 1055, investigating how doctors and dentists evaluate tooth loss. Therefore, the following aspects were investigated: The degree of severity of upper front tooth loss - one, two, three, four, five, six teeth, two and three alternate teeth- and evaluate the severity of aesthetic damage related to tooth loss between the professional areas. The data collection was conducted by applying a protocol composed of eight photographs of the same individual, handled by the program Photoshop C53, 2007, which simulate upper front tooth loss in different extensions (one, two, three, four, five, six teeth, two and three alternate teeth). The investigated sample evaluated these damages according to the French scale, which comprises seven degrees: very slight or insignificant, mild, moderate, medium, sufficiently important, important and very important. 30 doctors and 30dentists were interviewed. It was found that by the European method for evaluating the aesthetic damage more than half of ali assignments severity among ali groups were situated between 6 (250f0) and 7(530f0) degrees in a scale of seven degrees of increasing severity. Despite the aesthetic damages concept between doctor and dentists are similar, this study demonstrated a lack of criteria considering that for different aesthetics damages generated by the different damages, the aesthetic perception was high.

Comparação in vitro de parâmetros para fotoativação de restaurações em resina composta por meio de microdureza e microscopia eletrônica de varredura / In vitro comparison of parameters for photoactivation of composite resin restorations using hardness and scanning electron microscopy

Este estudo in vitro teve como objetivo a comparação de diferentes protocolos para fotoativação de restaurações em resina composta por meio de teste de microdureza e análise da adaptação marginal com microscopia eletrônica de varredura. Foram confeccionadas restaurações de 2mmx4mmx2mm com a resina composta Premisa (Kerr) em 30 dentes bovinos. Durante o procedimento restaurador, o método de fotoativação teve variação, sendo um grupo ativado com o método contínuo (grupo controle) durante 20 segundos, utilizando o fotoativador Elipar Freelight 2; outro grupo utilizou o mesmo equipamento fotoativador, com variação da distância da ponta ativadora, a fim da promoção de um método soft-start (grupo soft-start), tendo distância inicial de 6mm por 20 segundos, seguido de distância mínima por mais 10 segundos; e um terceiro grupo utilizou a tecnologia PLS (grupo DEMI), fornecida pelo equipamento DEMI, que fornece uma luz pulsada e permite a polimerização adequada de uma resina composta em 5 segundos (segundo o fabricante). Após 24 horas de restaurados, mantidos em estufa a 37ºC, os dentes foram seccionados no sentido inciso cervical resultando em 60 corpos de prova, sendo metade deles utilizados em cada teste (N=10). As metades tiveram as superfícies correspondentes ao corte transversal lixadas até a obteção de superfícies planas e polidas, sendo que 30 delas foram selecionadas aleatoriamente para o tesste de microdureza Knoop em diferentes profundidades e as outras 30 metades foram replicadas em resina epóxica para leitura em microscopia eletrônica de varredura.

Com as imagens obtidas foram feitas medidas de porcentagem de perímetro de restauração com desadaptação marginal e largura da maior fenda encontrada. Foram aplicados testes estatísticos de análise de variância split plot para os resultados de dureza e one way para a adaptação marginal. Em relação à dureza, os testes mostraram não haver diferença estatisticamente significante entre os grupos avaliados, enquanto houve diferença nas diferentes profundidades (p<0,0001), sendo a dureza na região profunda maior do que na média, que foi maior do que na superficial. Para a adaptação marginal, os testes não mostraram diferença estatisticamente significante para a largura de maior fenda encontrada entre os grupos controle e DEMI, somente o grupo soft-start foi diferente dos outros grupos (p=0,0064), tendo ele os menores valores. Apesar de a porcentagem de perímetro com desadaptação marginal ter apresentado valores com grandes valores de desvio padrão, foi encontrada diferença estatisticamente significante entre os grupos controle e DEMI, mas não entre os grupos DEMI e soft-start. O teste de correlação de Pearson demonstrou correlação linear positiva entre largura da maior fenda encontrada e porcentagem de perímetro com desadaptação marginal. Foi possível a conclusão de que o protocolo de fotoativação soft-start melhorou a adaptação marginal das restaurações em resina composta, sem alterar a dureza do material; o equipamento fotoativador DEMI, com a utilização da tecnologia PLS, teve resultados sem diferença estatisticamente significante na avaliação da adaptação marginal, quando comparados ao grupo controle

This in vitro study aimed to compare different protocols for the photoactivation of composite resin restorations using microhardness test and analysis of marginal adaptation with scanning electron microscopy. Restorations with 2mmx4mmx2mm were made in 30 bovine teeth using the composite resin Premisa (Kerr). During the restorative procedure, the polymerization method had change, being one group activated with the continuous method (control group) for 20 seconds using the curing unit Elipar Freelight 2, another group used the same curing unit equipment, varying the distance from the activator tip in order to promote a soft-start method (soft-start group), with initial distance of 6mm for 20 seconds, followed by minimum distance for 10 seconds, and a third group used technology PLS (DEMI group) supplied from the DEMI, which provides a pulsed light and allows an adequate polymerization of a resin composite in 5 seconds (according to manufacturer). 24 hours after restoration, maintained at 37 ° C, the teeth were sectioned incisocervical towards resulting in 60 specimens, half of them being used in each test (N = 10). The halves were sanded on the transversal section surfaces to obtain flat and polished surfaces, of which 30 were randomly selected for Knoop microhardness testing in 3 different depths and the other 30 halves were replicated in epoxy resin for microscopy scanning electron reading. Measures of percentage of perimeter with marginal desadaptation and width of the largest slot found were made with the obtained images. Split plot analysis of variance tests were applied to hardness results and one way to the marginal adaptation.

Regarding the hardness, tests showed no statistically significant difference among the groups, while there were differences at different depths (p<0,0001), being the hardness of the deep region highest than the medium, which was higher than the superficial. For marginal adaptation, tests showed no statistically significant difference for the width of the largest slot found between the control group and DEMI, only the soft-start group was different from the other groups (p=0,0064), having the lowest values. Despite the large standard deviations shown by the percentage of perimeter with marginal desadaptation, statistically significant difference was found between the control and DEMI, but not between groups DEMI and soft-start. The Pearson correlation test showed positive linear correlation between the width of the largest slot found and the percentage of perimeter with marginal desadaptation. It was possible to conclude that the soft-start photoactivation protocol improved the marginal adaptation of composite resin restorations, without changing the hardness of the material