Nanotopography and oral bacterial adhesion on titanium surfaces: in vitro and in vivo studies.

The present study aimed to evaluate the influence of titanium surface nanotopography on the initial bacterial adhesion process by in vivo and in vitro study models. Titanium disks were produced and characterized according to their surface topography: machined (Ti-M), microtopography (Ti-Micro), and nanotopography (Ti-Nano). For the in vivo study, 18 subjects wore oral acrylic splints containing 2 disks from each group for 24 h (n = 36). After this period, the disks were removed from the splints and evaluated by microbial culture method, scanning electron microscopy (SEM), and qPCR for quantification of Streptococcus oralis, Actinomyces naeslundii, Fusobacterium nucleatum, as well as total bacteria. For the in vitro study, adhesion tests were performed with the species S. oralis and A. naeslundii for 24 h. Data were compared by ANOVA, with Tukey's post-test. Regarding the in vivo study, both the total aerobic and total anaerobic bacteria counts were similar among groups (p > 0.05). In qPCR, there was no difference among groups of bacteria adhered to the disks (p > 0.05), except for A. naeslundii, which was found in lower proportions in the Ti-Nano group (p < 0.05). In the SEM analysis, the groups had a similar bacterial distribution, with a predominance of cocci and few bacilli. In the in vitro study, there was no difference in the adhesion profile for S. oralis and A. naeslundii after 24 h of biofilm formation (p > 0.05). Thus, we conclude that micro- and nanotopography do not affect bacterial adhesion, considering an initial period of biofilm formation.

The impact of chitosan in experimental resin with different photoinitiator systems.

OBJECTIVE: to investigate the effect of different concentrations of chitosan added to experimental resins containing either BAPO or camphorquinone (CQ) as photoinitiators, regarding degree of conversion (DC), flexural strength (FS), flexural elastic modulus (E), Knoop microhardness (KHN), cytotoxicity, genotoxicity and antimicrobial activity. METHODS: Experimental resins with polymeric matrix of BisGMA and TEGDMA was added either 0.5 wt% BAPO or 0.5 wt% camphorquinone/0.2% amine along with and chitosan concentrations of 0.5%; 1.0% or 2.0%. Degree of conversion was measured using Fourier transformed infrared spectroscopy. Flexural strength and elastic modulus were obtained through three-point bending test and Knoop microhardness was measured in a microidenter. Direct cytotoxicity was performed in human keratinocytes and genotoxicity test was done in murine macrophages cells. Antimicrobial activity was acessed against Staphylococcus aureus and Streptococcus mutans through the inhibition halo. Data were analyzed using two-way ANOVA and Tukey teste (α = 0.05). RESULTS: The materials containing photoinitiator BAPO showed higher values of DC, FS, E, and KHN compared to resins with CQ. The addition of chitosan did not affect the properties of these materials. However, in resins containing CQ, the addition of chitosan improve these properties compared to control group. For the groups containing BAPO the chitosan reduced cytotoxicity and genotoxicity compared to materials with camphorquinone. The materials with 1.0% and 2.0% chitosan showed increased antibacterial activity in the materials containing BAPO as photoinitiator for both bacteria. SIGNIFICANCE: The alternative photoinitiator BAPO and chitosan can improve physical and biological properties of photoactivated resins when compared with the materials with photoinitiator camphorquinone.

Nanotopography and oral bacterial adhesion on titanium surfaces: in vitro and in vivo studies

Abstract The present study aimed to evaluate the influence of titanium surface nanotopography on the initial bacterial adhesion process by in vivo and in vitro study models. Titanium disks were produced and characterized according to their surface topography: machined (Ti-M), microtopography (Ti-Micro), and nanotopography (Ti-Nano). For the in vivo study, 18 subjects wore oral acrylic splints containing 2 disks from each group for 24 h (n = 36). After this period, the disks were removed from the splints and evaluated by microbial culture method, scanning electron microscopy (SEM), and qPCR for quantification of Streptococcus oralis, Actinomyces naeslundii, Fusobacterium nucleatum, as well as total bacteria. For the in vitro study, adhesion tests were performed with the species S. oralis and A. naeslundii for 24 h. Data were compared by ANOVA, with Tukey's post-test. Regarding the in vivo study, both the total aerobic and total anaerobic bacteria counts were similar among groups (p > 0.05). In qPCR, there was no difference among groups of bacteria adhered to the disks (p > 0.05), except for A. naeslundii, which was found in lower proportions in the Ti-Nano group (p < 0.05). In the SEM analysis, the groups had a similar bacterial distribution, with a predominance of cocci and few bacilli. In the in vitro study, there was no difference in the adhesion profile for S. oralis and A. naeslundii after 24 h of biofilm formation (p > 0.05). Thus, we conclude that micro- and nanotopography do not affect bacterial adhesion, considering an initial period of biofilm formation.

Marginal discrepancy of lithium disilicate crowns made with digital and conventional technologies.

STATEMENT OF PROBLEM: Digital technologies have brought different workflows to prosthetic rehabilitations, but analyses of the available processes and their influence on the marginal fit of complete crowns are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the marginal discrepancy of lithium disilicate complete crowns made with different workflows. MATERIAL AND METHODS: Fifty lithium disilicate crowns were made with 5 different workflows (n=10): G1-Analog (control): conventional flow/pressed crown; G2-Hybrid: hybrid flow/milled crown; G3-Hybrid: hybrid flow/pressed crown; G4-Hybrid: hybrid flow/printed wax pattern/pressed crown; G5-Digital: digital flow/milled crown. The specimens were analyzed by scanning electron microscopy, and the data were analyzed for normality and submitted to analysis of variance (ANOVA). Multiple comparisons were made by using the Tukey HSD test (α=.05). RESULTS: G4H (18.1 ±6.6 µm) had the lowest mean ±standard deviation marginal discrepancy values, statistically different from G2H (217.9 ±81.4 µm), G5D (236.4 ±89 µm), and G3H (661.8 ±61.9 µm) (P<.05). G3H had the highest marginal discrepancy values and were statistically similar to each other (P>.05). G1A (163.2 ±10.9 µm) had intermediate values, statistically similar to those of other groups (P>.05). CONCLUSIONS: The conventional method showed no statistical differences in marginal discrepancy compared with methods using digital technology (scanner, software, 3D printer, or milling machine).

Physical analysis of an acrylic resin modified by metal and ceramic nanoparticles.

BACKGROUND: Nanoparticles (NPs) have gained significant attention in various fields due to their unique properties and potential applications. Polymethyl methacrylate (PMMA) is an acrylic resin widely used in dentistry and medicine. However, the effect of different types of NP fillers on the physical properties of PMMA-based resins has not been thoroughly explored in the literature. OBJECTIVES: The present study aimed to evaluate the effects of 3 different types of NP fillers on the physical properties of an experimental PMMA-based resin as a function of the NP content and concentration. MATERIAL AND METHODS: Ten groups (n = 10) were designed. The specimens were composed of an acrylic resin, silicon dioxide (SiO2), cerium dioxide (CeO2), and titanium dioxide (TiO2) at the following ratios (wt%): group 1 (G1) - control; group 2 (G2) - 0.5% SiO2; group 3 (G3) - 1% SiO2; group 4 (G4) - 3% SiO2; group 5 (G5) - 0.5% CeO2; group 6 (G6) - 1% CeO2; group 7 (G7) - 3% CeO2; group 8 (G8) - 0.5% TiO2; group 9 (G9) - 1% TiO2; and group 10 (G10) - 3% TiO2. Transmission electron microscopy (TEM) was used to assess the quality of NP dispersion. Thermal stability was assessed with thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The effects of the abovementioned NPs on the properties of the resin were evaluated using the Archimedes principle for density, the Vickers hardness (VH) test and the impact strength (IS) test. Data analysis employed the oneand two-way analysis of variance (ANOVA), followed by Duncan's post hoc test at a significance level of 0.05. RESULTS: Transmission electron microscopy showed partial NP dispersion. All types of NPs enhanced the mechanical properties of the acrylic resin except for IS, which was similar to that of the control group. Among the types of NPs, irrespective of the weight percentage, CeO2 showed higher thermal stability and higher IS for 0.5 wt% and 1 wt% as compared to other groups, as well as the highest values of density at 0.5 wt%, 1 wt% and 3 wt%. Titanium oxide at 1 wt% presented a higher VH as compared to other groups. The fracture pattern was the same for all groups. CONCLUSIONS: Incorporating the tested NPs into the acrylic resin resulted in enhanced physical properties, primarily attributed to a lower NP content.

Microtensile bond strength of resin composite to dentin using different adhesive systems and directions of electric current.

Thisstudy aimed to evaluate the effect of the electric current direction application on the resin composite-dentin bond strength using three adhesive systems. Human molar teeth were distributed according to the adhesive system (two-step self-etch - Clearfil SE Bond, Kuraray [CSE]; one-step self-etch - Single Bond Universal, 3M ESPE [SBU]; and two-step etch-and-rinse - Adper Single Bond 2, 3M ESPE [SB2]), electric current direction (without electric current - control, direct and reverse electric currents - 35µA), and storage time (24h - immediate and 6 months). Resin composite blocks (Filtek Z350XT, 3M ESPE) were bonded to dentin. The teeth/resin composites specimens were stored in distilled water at 37ºC for 24 hours and 6 months for the microtensile bond strength (µTBS) test (n = 10; ~12 sticks for each tooth). Failure patterns were analyzed on a stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive or mixed. Adhesive penetration into dentin and hybrid layer formation were evaluated in a scanning electron microscope (n = 6). Data were submitted to a three-way ANOVA followed by Tukey's post hoc test (α = 0.05). There are no differences in µTBS when the adhesive systems were applied under direct and reverse electric currents, but both electric currents increased the µTBS for all adhesive systems. SBU showed the lowest µTBS values for control groups in both storage times and direct electric current in 6 months of storage. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. Storage for 6 months did not significantly decrease µTBS values. Both directions of electric current (positive and negative charges) at 35µA can increase the µTBS of the adhesive systems tested to dentin.

O objetivo neste estudo foi avaliar o efeito da direção da corrente elétrica na resistência da união resina composta-dentina usando três sistemas adesivos. Dentes molares humanos foram distribuídos de acordo com o sistema adesivo (dois passos autocondicionante - Clearfil SE Bond, Kuraray [CSE]; e um passo autocondicionante - Single Bond Universal, 3M ESPE [SBU]; e dois passos convencional - Adper Single Bond 2, 3M ESPE [SB2]), a direção da corrente elétrica (sem corrente elétrica - controle, correntes elétricas direta e reversa - 35µA) e tempo de armazenamento (24h - imediato e 6 meses). Blocos de resina composta (Filtek Z350XT, 3M ESPE) foram aderidos à dentina. Amostras de dentina-resina foram produzidas e armazenadas em água destilada a 37ºC por 24 horas e 6 meses para o teste de resistência da união à microtração (µTBS) (n = 10; ~12 palitos por dente). Os padrões de fratura foram analisados ​​em estereomicroscópio e classificados em falhas coesiva na dentina, coesiva na resina, adesiva ou mista. A penetração do adesivo na dentina e a formação da camada híbrida foram avaliadas em microscópio eletrônico de varredura (MEV). Os dados foram submetidos à ANOVA três fatores seguidos pelo teste post hoc de Tukey (α = 0,05). Não houve diferenças na µTBS quando os sistemas adesivos foram aplicados sob as correntes elétricas direta e reversa, mas ambas as correntes elétricas aumentaram a µTBS para todos os sistemas adesivos. SBU apresentou os menores valores de µTBS para o grupo controle em ambos os tempos de armazenamento e para a corrente elétrica direta em 6 meses de armazenamento. Falhas adesivas foram mais frequente em todos os grupos. A corrente elétrica formou longos tags resinosos para todos os sistemas adesivos. O armazenamento por 6 meses não diminuiu significativamente os valores de µTBS. Ambos os sentidos da corrente elétrica (cargas positivas e negativas) a 35µA podem aumentar a µTBS dos sistemas adesivos testados à dentina.

Microtensile bond strength of resin composite to dentin using different adhesive systems and directions of electric current

Resumo O objetivo neste estudo foi avaliar o efeito da direção da corrente elétrica na resistência da união resina composta-dentina usando três sistemas adesivos. Dentes molares humanos foram distribuídos de acordo com o sistema adesivo (dois passos autocondicionante - Clearfil SE Bond, Kuraray [CSE]; e um passo autocondicionante - Single Bond Universal, 3M ESPE [SBU]; e dois passos convencional - Adper Single Bond 2, 3M ESPE [SB2]), a direção da corrente elétrica (sem corrente elétrica - controle, correntes elétricas direta e reversa - 35µA) e tempo de armazenamento (24h - imediato e 6 meses). Blocos de resina composta (Filtek Z350XT, 3M ESPE) foram aderidos à dentina. Amostras de dentina-resina foram produzidas e armazenadas em água destilada a 37ºC por 24 horas e 6 meses para o teste de resistência da união à microtração (µTBS) (n = 10; ~12 palitos por dente). Os padrões de fratura foram analisados ​​em estereomicroscópio e classificados em falhas coesiva na dentina, coesiva na resina, adesiva ou mista. A penetração do adesivo na dentina e a formação da camada híbrida foram avaliadas em microscópio eletrônico de varredura (MEV). Os dados foram submetidos à ANOVA três fatores seguidos pelo teste post hoc de Tukey (α = 0,05). Não houve diferenças na µTBS quando os sistemas adesivos foram aplicados sob as correntes elétricas direta e reversa, mas ambas as correntes elétricas aumentaram a µTBS para todos os sistemas adesivos. SBU apresentou os menores valores de µTBS para o grupo controle em ambos os tempos de armazenamento e para a corrente elétrica direta em 6 meses de armazenamento. Falhas adesivas foram mais frequente em todos os grupos. A corrente elétrica formou longos tags resinosos para todos os sistemas adesivos. O armazenamento por 6 meses não diminuiu significativamente os valores de µTBS. Ambos os sentidos da corrente elétrica (cargas positivas e negativas) a 35µA podem aumentar a µTBS dos sistemas adesivos testados à dentina.

Abstract Thisstudy aimed to evaluate the effect of the electric current direction application on the resin composite-dentin bond strength using three adhesive systems. Human molar teeth were distributed according to the adhesive system (two-step self-etch - Clearfil SE Bond, Kuraray [CSE]; one-step self-etch - Single Bond Universal, 3M ESPE [SBU]; and two-step etch-and-rinse - Adper Single Bond 2, 3M ESPE [SB2]), electric current direction (without electric current - control, direct and reverse electric currents - 35µA), and storage time (24h - immediate and 6 months). Resin composite blocks (Filtek Z350XT, 3M ESPE) were bonded to dentin. The teeth/resin composites specimens were stored in distilled water at 37ºC for 24 hours and 6 months for the microtensile bond strength (µTBS) test (n = 10; ~12 sticks for each tooth). Failure patterns were analyzed on a stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive or mixed. Adhesive penetration into dentin and hybrid layer formation were evaluated in a scanning electron microscope (n = 6). Data were submitted to a three-way ANOVA followed by Tukey's post hoc test (α = 0.05). There are no differences in µTBS when the adhesive systems were applied under direct and reverse electric currents, but both electric currents increased the µTBS for all adhesive systems. SBU showed the lowest µTBS values for control groups in both storage times and direct electric current in 6 months of storage. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. Storage for 6 months did not significantly decrease µTBS values. Both directions of electric current (positive and negative charges) at 35µA can increase the µTBS of the adhesive systems tested to dentin.

Stress distribution in restorations with glass fiber and polyetheretherketone intraradicular posts: An in silico analysis.

This study evaluated stresses generated at maxillary central incisor (21) root restored with lithium disilicate crown (LDC), and glass fiber (GFP) or polyetheretherketone (PEEK) post. 3D models created by computed tomographic image (i-CAT Cone Beam 3D Dental Imaging System) reproduced maxillary central incisor. Each model had prosthetic LDCs (2.0 mm thick) cemented to GFP or PEEK posts with dual resin cement. Different loads were applied to each model (cervical, incisal, axial, middle). At maximum principal stress, PEEK showed higher stress than GFP in all loads, but with qualitative similarity. At minimum principal stress, PEEK and GFP showed qualitative and quantitative similarities, except axial load. Maxillary central incisor restored with GFP or PEEK and LDC presented, in general, similar stress intensity and distribution for main occlusal loads. Only two of sixteen occlusal loads tested (cervical for maximum principal; axial for minimum principal) showed significant quantitative difference.

Bond strength of self-adhesive resin cement to dentin using different adhesion protocols.

BACKGROUND: The treatment of dentin before the use of self-adhesive cements is still a crucial point to achieve the best bond strength values. The objective of this study was to evaluate the bond strength between dentin and composite resin using different adhesion strategies with self-adhesive resin cement. MATERIAL AND METHODS: Forty healthy third human molars were randomly divided into 4 groups (n = 10): CA (control); application of self-adhesive cement (Rely X U200, 3M ESPE), AD + CA: only application of conventional adhesive (Adper Single Bond 2, 3M ESPE) + self-adhesive cement, AC + AD + CA; conditioning with 37% phosphoric acid for 15 seconds + application of conventional adhesive + self-adhesive cement and AC + CA; conditioning with 37% phosphoric acid for 15s + self-adhesive cement. Blocks made of composite resin (Z250 XT, 3M ESPE) were cemented over dentin. The samples were stored for 24h in distilled water at 37ºC and then were sectioned on a metallographic cutter to obtain tooth picks with approximately 1.0 mm2 in cross section. A universal testing machine was used with a speed of 0.5 mm/min to test the microtensile bond strength,. The fracture patterns were classified as adhesive, cohesive and mixed failures. The data (MPa) were analyzed statistically by One-way ANOVA and Holm-Sidak test (α=5%). RESULTS: The AC + AD + CA and AC + CA groups had the highest averages, while the CA and AD + CA groups had the lowest bond strength values. Adhesive failure was prevalent in all groups. CONCLUSIONS: Conditioning with 37% phosphoric acid for 15s increases the adhesion of the self-adhesive resin cement to the dentin, regardless of the use of dental adhesive system. Key words:Resin cement, microtensile bond strength, acid conditioning.

Finite Element Analysis of Stress in Anterior Prosthetic Rehabilitation with Zirconia Implants with and without Cantilever.

OBJECTIVES: The aim of this study was to evaluate using finite element analysis (FEA), the stress distribution in prostheses (lithium disilicate crowns) on monotype zirconia implants with and without cantilever in the anterior region of the maxilla. MATERIALS AND METHODS: From a virtual reconstruction of bone model of the toothed maxilla from a computed tomography, three models (groups) were created: Zr (11-21)-implants placed in the area of 11 and 21 with cantilever; Zr (12-22)-implants placed in the area of 12 and 22 without cantilever; and Zr (11-22)-implants intercalated placed in the area of 11 and 22. In all models, monotype zirconia implant (4.1 × 12.0 mm) was used in single-body configuration. Lithium disilicate crowns were designed on the implants and pontics for all groups. A 150-N load was applied to the prostheses. The materials used were considered isotropic, homogeneous, and linearly elastic. FEA was performed to evaluate the maximum (tensile) and minimum (compressive) principal stresses in the implant, crowns, and bone tissue. Data were analyzed qualitatively and quantitatively. RESULTS: For all groups, the highest maximum principal stress occurred in the palatal cervical area of the implant, with the high values for the Zr (12-22) group and the low values for the Zr (11-21) group. The maximum principal stress was concentrated in the cervical palatal area of the crown, with the Zr (11-21) group presented the highest values and the Zr (12-22) group showed the lowest values. In the bone tissue all the groups presented similar values of maximum and minimal principal stress, with the palatal (maximum principal) and vestibular (minimum principal) close to the cervical of the implants the area with the highest concentration of stresses. CONCLUSIONS: The position of monotype zirconia implant did not interfere in the bone tissue stress, and the implants placed in the 11-21 present lower stress in implants and higher in the crown. The cantilever does not increase the stress in the implants, crown, and bone tissue.

Influence of the Multiple Layers Application and the Heating of Silane on the Bond Strength between Lithium Disilicate Ceramics and Resinous Cement.

OBJECTIVE: This study aimed to evaluate the bond strength between lithium disilicate ceramic and resinous cement when silane (Prosil, FGM) was applied in different amounts of layers under heating or not. MATERIALS AND METHODS: Sixty IPS E-max CAD ceramic (Ivoclar) was used. They were conditioned with 10% hydrofluoric acid for 20 seconds. The samples were distributed in six groups (n = 10): 1Sil, 1 layer of silane without heating; 1SilAq, 1 layer of silane with heating; 2Sil, 2 layers without heating; 2SilAq, 2 layers with heating; 3Sil, 3 layers without heating; and 3SilAq, 3 layers with heating. After each layer, a jet of cold air was applied for 20 seconds in groups 1Sil, 2Sil, 3Sil, and jet of hot air (50°C) in groups 1SilAq, 2SilAq, and 3SilAq. Subsequently, an adhesive layer was applied, and fourcylinders were made on the ceramic with a resin cement AllCemVeneer and photoactivated for 20 seconds. The samples were stored at 37°C for 24 hours and analyzed to the microshear test at EMIC. STATISTICAL ANALYSIS: Data were submitted to ANOVA and Tukey's test (α = 0.05). RESULTS: The results showed that there was no statistical interaction between the factors studied. The "heating" factor was not statistically significant; however, the "silane layers" factor showed differences between groups. The analysis of the results showed that the use of one (66%) or two layers (67%) of silane regardless of heating, produced higher values of bond strength, when compared with the group of three layers (62%). CONCLUSION: The use of silane with one or two layers provided a greater bond strength between lithium disilicate ceramic and resinous cement and that the heating did not influence the results.

Physical and Mechanical Properties of Resins Blends Containing a Monomethacrylate with Low-polymerization Shrinkage.

OBJECTIVES: The aim of this study was to evaluate the Knoop hardness (KH), cross-link density (CLD), water sorption (WS), water solubility (WSB), and volumetric shrinkage (VS) of experimental resins blends containing a monomethacrylate with low-polymerization shrinkage. MATERIALS AND METHODS: A blend of bisphenol glycidyl methacrylate (BisGMA) as base monomer was formulated with (Bis-GMA)/triethyleneglycol dimethacrylate (TEGDMA), Bis-GMA/isobornyl methacrylate (IBOMA), or Bis-GMA/TEGDMA/IBOMA in different concentrations (40, 50, or 60 wt%). The camphorquinone (CQ)/2-(dimethylamino) ethyl methacrylate (DMAEMA) was used as the photoinitiator system. The KH and CLD were measured at the top surface using an indenter. For WS and WSB, the volume of the samples was calculated in mm3. The samples were transferred to desiccators until a constant mass was obtained (m1) and were subsequently immersed in distilled water until no alteration in mass was detected (m2). The samples were reconditioned to constant mass in desiccators (m3). WS and WSB were determined using the equations m2 - m3/V and m1 - m3/V, respectively. VS results were calculated with the density parameters before and after curing. STATISTICAL ANALYSIS: Data were submitted to ANOVA and Tukey's test (α = 0.05). RESULTS: The resins containing IBOMA showed lower VS results. TEGDMA 40% and TEGDMA/IBOMA 20/20 wt% showed higher KH values. The IBOMA groups showed lower CLD, while TEGDMA groups had higher values of CLD. The BisGMA/TEGDMA resin presented the highest values of WS, and for WSB, all groups showed no significant differences among themselves. CONCLUSION: The monomethacrylate with low-polymerization shrinkage IBOMA used alone or in combination with TEGDMA may decrease VS, WS, and CLD values.

Mechanical performance of experimental acrylic resins modified by nanoparticles after chemical and mechanical degradation.

BACKGROUND: Different materials have been incorporated into the polymethylmethacrylate matrix to improve its performance. The aim of this study was to evaluate the degree of conversion (DC), the flexural strength (FS), the elasticity modulus (EM), and the effect of exposure to food-simulating liquids prior to brushing simulation on the gloss loss (GL) of experimental acrylic resins modified by nanoparticles. MATERIAL AND METHODS: Three different types of nanoparticles; silicon oxide (SiO2), cerium oxide (CeO2) and titanium oxide (TiO2) were added to a poly (methylmethacrylate) matrix, in proportions of 0.5wt%, 1wt% and 3wt% each, forming nine experimental groups. The acrylic resin was also tested as a control group. DC was investigated using Fourier transform infrared spectroscopy (FTIR). A three-point bending test was used for FS and EM. GL after chemical degradation and simulated brushing was evaluated using a glossmeter. Data were submitted to one and two-way ANOVA followed by Duncan's post hoc test (α=0.05). RESULTS: All nanoparticle-modified groups showed higher values of DC. Ce1% showed higher values of FS and EM. All other groups showed similar or lower physical-mechanical properties (FS, EM, GL). Regarding type and wt%, CeO2 and TiO2 groups had better performances and were similar to each other. CONCLUSIONS: Incorporating metal nanoparticles, especially CeO2, could improve the physical properties of the dental materials. Key words:Polymethylmetacrylate, degree of conversion, flexural strength, elasticity modulus, gloss loss.

Stress distribution with extra-short implants in an angled frictional system: A finite element analysis study.

STATEMENT OF PROBLEM: Short and extra-short implants with Morse taper connections were developed to avoid grafting procedures. How the stresses around these implants differ with abutments of different angulations is unclear. PURPOSE: The purpose of this finite element study was to analyze the stress distribution in different structures (abutment, implant, and bone) of an extra-short implant with a Morse taper connection to the abutment (Arcsys-FGM-Brazil) (5.0×5.0 mm and 4.3×5.0 mm) when different abutment degrees were used. MATERIAL AND METHODS: Eight 3D models were designed according to each group under analysis: group 5DS (5.0×5.0-mm implants with straight abutment), group 5DA (5.0×5.0-mm implants with 20-degree angled abutments), group 4DS (4.3×5.0-mm implants with straight abutments), and group 4DA (4.3×5.0-mm implants with 20-degree angled abutments). Axial and oblique loads of 150 N were applied on the mandibular molar crowns. RESULTS: The oblique loads and angled abutments had higher stress values in the whole model (implant, abutment, and bone) than the axial loads and straight abutments. Implants with a different diameter had almost the same stress distribution on the implant, abutment, and bone. The yield limit was exceeded in the cortical bone with oblique loads and was also exceeded in implant models when an angled abutment with oblique loads was used. CONCLUSIONS: Extra-short implants with Morse taper connections to the abutment had higher stress concentrations with an angled abutment on oblique loads, and the peri-implant bone was the most damaged structure.

Eficácia polissonográfica de um aparelho intraoral semiflexível em pacientes apneicos resistentes ao CPAP ­ estudo preliminar / Polysomnographic efficacy of a semi-flexible intraoral appliance in CPAPresistant apneic patients ­ preliminary study

INTRODUÇÃO: Os aparelhos intraorais (AIO) possuem indicação para tratamento da Síndrome da Apneia Obstrutiva do Sono (SAOS) inclusive em pacientes com baixa adesão ao CPAP. A polissonografia com o AIO pode confirmar benefício terapêutico. MÉTODOS: Compararam-se os resultados polissonográficos de um AIO semiflexível em pacientes sob uso inadequado do CPAP por meio de estudo-piloto retrospectivo, incluindo 17 pacientes (11 homens e 6 mulheres) com 53,7 +- 7,8 anos, IMC de 27,5 +- 4,1kg/m2 e índice de apneia- -hipopneia basal (IAH) de 35,0 +- 19,8/h. Confirmados o uso inadequado ou recusa do CPAP, os pacientes receberam um aparelho com propulsão semiflexível (A-QUALITY) e, após titulação completa, novas polissonografias foram comparadas aos registros basais e com CPAP. Utilizou-se ANOVA para medidas repetidas e post-hoc Bonferroni (p < 0,05). RESULTADOS: Houve redução semelhante no IAH com AIO (7,7 +- 1,7/h) e CPAP (6,1 +- 1,6/h), ambos comparados ao basal (p < 0,001). O índice de dessaturação de O2 foi reduzido com AIO (2,4 +- 0,6/h) e CPAP (1,3 +- 0,6/h), ambos comparados ao basal (15,7 +- 3,8), (p <0,001). O índice de despertares também foi minimizado com AIO (7,2 +- 1,9/h) e CPAP (4,2 +- 0,7/h), ambos comparados ao basal (18,9 +- 5,3), (p<0,001). A eficiência do sono foi maior com o AIO comparado ao CPAP (87,2 +- 2,1 x 75,6 +- 3,9) (p<0,05). CONCLUSÃO: O tratamento com o aparelho selecionado resultou em melhora nos registros polissonográficos nessa amostra e pode ser indicado como alternativa ao CPAP em pacientes subtratados (AU)

INTRODUCTION: Intraoral appliances (IOA) are indicated for treatment of Obstructive Sleep Apnea Syndrome (OSAS) even in patients with poor adherence to CPAP. Polysomnography with IOA may confirm therapeutic benefit. METHODS: Polysomnographic results of a semiflexible IOA in patients under inadequate use of CPAP were compared by a retrospective pilot study including 17 patients (11 men and 6 women) aged 53.7 +- 7.8 years, BMI of 27.05 +- 4.1kg/m2 and basal apnea-hypopnea index (AHI) of 35.0 +- 19.8/h. Confirmed the inappropriate use or refusal of CPAP, the patients received a semiflexible propulsion device (AQUALITY) and, after complete titration, new polysomnographies were compared to baseline and CPAP registers. ANOVA was used for repeated and post-hoc Bonferroni measurements (p <0.05). RESULTS: There was a similar reduction in AHI with OA (7.7 +- 1.7/h) and CPAP (6.1 +- 1.6/h), both compared to baseline (p <0.001). The O2 desaturation index was reduced with IOA (2.4 +- 0.6 h) and CPAP (1.3 +- 0.6/h), both compared to baseline (15.7 +- 3.8) (p <0.001). Awakening rates were also minimized with IOA (7.2 +- 1.9/h) and CPAP (4.2 +- 0.7/h), both compared to baseline (18.9 +- 5.3) (p <0.001). Sleep efficiency was higher with IOA compared to CPAP (87,2 +- 2,1 x 75,6 +- 3,9) (p <0.05). CONCLUSION: Treatment with the selected device resulted in improved polysomnographic records in this sample and may be indicated as an alternative to CPAP in undertreated patients. (AU)

Mechanical properties of experimental resin cements containing different photoinitiators and co-initiators.

AIM: The aim of this study was to evaluate the influence of different concentrations of two photoinitiators and one co-initiator on the flexural strength (FS) and elastic modulus (E) of experimental resin cements. MATERIALS AND METHODS: A mixture containing BisGMA, TEGDMA, and barium-aluminum-silicate (BaAlSi) and silanized colloidal silica (SiO2) filler particles was prepared with two photoinitiators, viz. camphorquinone (CQ) and bisacylphosphine oxide (BAPO). Dimethylaminoethyl methacrylate (DMAEMA) was used as co-initiator. Thirty groups (n=10) were formulated with different photoinitiator systems (CQ/DMAEMA and BAPO/DMAEMA) and concentrations (wt%) of photoinitiator and co-initiator. The photoactivation was carried out for 20 s with a light-emitting diode (LED, Bluephase, Ivoclar Vivadent) with irradiance of 1200 mW/cm2. The FS and E were obtained in a three-point bending test on a universal testing machine (0.5 mm/min). Data were subjected to the Kolmogorov-Smirnov normality test, followed by two-way ANOVA and Tukey's test (α=0.05). RESULTS: No polymerization occurred in the CQ groups without DMAEMA (0 wt%). DMAEMA 0.5 %wt and 1 %wt groups showed statistically similar FS and E results for CQ and BAPO, except for CQ 0.3 wt% (FS), CQ 0.9wt% (E) and BAPO 1.76 wt% (FS and E) for DMAEMA 0.5 %wt. No significant difference was found for FS and E values for different concentrations of photoinitiators, except for CQ 0.25 wt% (FS and E) and BAPO 0.25 wt% (E) that showed the lowest values. CONCLUSION: The wt% of the photoinitiators and co-initiator influenced the mechanical properties and the performance of CQ was dependent on the DMAEMA concentration. BAPO can be used as substitute for the conventional CQ/DMAEMA photoinitiator system.

Effect of Glass Fiber Post Adaptation on Push-Out Bond Strength to Root Dentin.

The aim of this study was to evaluate the effect of different glass fiber posts (GFPs) diameters on the push-out bond strength to dentin. Forty unirradicular human teeth were endodontically treated and used for cementation of GFPs (White Post DC, FGM) with different diameters (n=10): P1 - ø 1.6 mm coronal x 0.85 mm apical; P2 - ø 1.8 mm coronal x 1.05 mm apical; P5 - ø 1.4 mm coronal x 0.65 mm apical; and PC - customized post number 0.5 with composite resin (Tetric Ceram A2, Ivoclair Vivadent). All GFPs were cemented into the root canal using a dual-curing luting composite (Variolink II, Ivoclar Vivadent). One slice (1.7 mm) of each root third of cemented GFP (cervical, middle, and apical) was submitted to push-out testing. Failure modes of all specimens were classified as: adhesive failure between resin cement and post; adhesive failure between dentin and resin cement; cohesive failure within resin cement, post or dentin; and mixed failure. The data were analyzed with two-way ANOVA and Tukey's test (a=0.05). The highest bond strength values were presented for the P2 and PC groups. There was no statistically significant difference between the GFP thirds in each group. The groups P2, P5, and PC showed predominantly adhesive failure. For P1, the most prevalent type of failure was adhesive between resin cement and post. It may be concluded that a glass fiber post that is well adapted to the root canal presents higher bond strength values, regardless of GFP third.

Antibacterial resin-based composite containing chlorhexidine for dental applications.

OBJETICVE: The aim of this study was to develop a composite material with antibacterial activity using MMT loaded with clorhexidine (CHX). For that it was used a BisGMA/TEGDMA matrix and added low concentration of MMT/CHX. The aim was to evaluate the drug release capacity of MMT, and not to provide reinforcement. METHODS: Six experimental composites were made with organic matrix of BisGMA/TEGDMA in equal proportions by weight. The composites received organophlizated montmorillonite with or without CHX. The concentrations were 2,5; 5 or 10% by weight. Degree of conversion (DC) was evaluated using FTIR (peak 6165 cm-1; n=5). Specimens for flexural properties (10×2×1mm) were immediate tested (24h). Elastic modulus(E) and flexural strength (FS) was measured using the three point bending test (n=10). Inibition halo was used to test the antibacterial activity against Staphylococcus aureus, Streptococcus mutans, and Porphyromonas gingivalis (n=5 for each bacteria). The inhibition of biofilm formation (BF) was evaluated by inserting polymerized disc of composite in to a culture media colonized with Streptococcus mutans (n=10). The release of CHX was measured using ultraviolet (255nm) for 10 days (n=5). The data of degree of conversion was analysed using Kruskal-Wallis/ Mann-Whitney, and the other variables using two-way ANOVA/Tukey, always considering a global level of significance of 5%. RESULTS: DC ranged from 71% to 74%. E ranged from 5.7 to 8.1GPa. FS ranged from 61.4 to 74.7MPa. There were no statistical differences among the groups for all the variables. For the three bacteria tested the composites with CHX loaded presented inhibition of growth for all concentration, except for 2,5% that did not inihibited the growth of P. gingivalis. BF was lower for the groups with 10% MMT/CHX, all groups presented BF, even those without CHX loaded. All concentrations presented release off CHX during all the 28 days analyzed. CONCLUSIONS: Within the limitation of this study it can be concluded that: all concentrations tested presented release of CHX and reduced BF. All concentration presented antibacterial activity for the three bacteria tested, except for 2,5% that did not inhibit the growth of P. gingivalis. The presence of MMT with CHX loaded did not interfere in the properties evaluated.

Influence of angulation and height of tooth preparation on the distribution of tensions in prosthetic crowns for upper central incisor: in silico analysis

Aim: it was to use tridimensional finite element analysis (FEA) to analyze the effect of height and angulation of prosthetic preparations on the distribution of stresses for lithium disilicate prosthetic crowns, the underlying resin cement, and the prosthetic preparation of a superior central incisor. Methods: a CAD modeling software, SolidWorks 2013, was used to generate three-dimensional virtual models comprising the dimensions of the preparation parameters. Three angles (6, 12 and 16 degrees) were simulated on the prepared walls and two wall heights were utilized (4 and 5 mm), for a total of six model groups according to the height and angulation of the walls. A vertical line in the Y-axis was used as a reference for determining the degrees of convergence (inclination of the preparations). The chamfer finish and preparation width were standardized for all groups. Results: the 4 mm preparations behaved more appropriately when the axial wall convergence was approximately 6 degrees. The 5 mm preparations required 12 degrees of angulation. In relation to resin cement, there was better stress distribution when the angle of incisal convergence was between 6 and 12 degrees. An increase to 16 degrees led to a considerable increase in peak stress at the preparation margin. Conclusion: it was concluded that the convergence of the axial walls of coronal preparations with 4 and 5 mm heights should be 6 and 12 degrees, respectively, to avoid high tension spikes in the underlying resin cement