The current state of calcium silicate cements in restorative dentistry: a review / Revisión del estado actual de cementos de silicato de calcio en odontología restauradora

ABSTRACT Calcium silicate cements have been used as dental materials for more than twenty years; however, their use in restorative dentistry is more recent. Better mechanical properties and shorter curing times make them suitable for a variety of applications in which they are used as a substitute of dentin, including direct/indirect pulp capping and as cavity base/liner. These materials may also be used to restore enamel temporarily. This article seeks to review the available scientific evidence with a focus on their applications in restorative dentistry. The information was gathered by reviewing original scientific research articles and literature reviews published in journals available in databases such as Medline/Pubmed and Scielo, along with technical information provided by the manufacturers of these cements. This article describes the composition, instructions for use, and curing reaction of calcium silicate cements, as well as the scientific evidence on their applications in restorative dentistry.

RESUMEN Los cementos de silicato de calcio se han aplicado como materiales dentales desde hace más de veinte años; sin embargo, su uso en el área de la odontología restauradora es más reciente. Mejores propiedades mecánicas y menores tiempos de endurecimiento le permiten ser indicados para una variedad de aplicaciones en las que este material se utiliza como sustituto dentinario, entre ellas el recubrimiento pulpar directo/indirecto y como base/liner cavitario. A su vez, también se podría utilizar como material para restaurar esmalte de manera temporal. El presente artículo busca revisar la evidencia científica disponible, enfocándola a sus aplicaciones en odontología restauradora. La información se obtuvo a partir de artículos originales de investigación científica y revisiones de literatura, publicados en revistas disponibles en bases de datos como Medline/Pubmed y Scielo, junto a la información técnica otorgada por los fabricantes de estos cementos. El presente trabajo describe la composición, el modo de empleo, la reacción de fraguado y la evidencia científica sobre las aplicaciones de los cementos de silicato de calcio en odontología restauradora.

Does refurbishing composites lead to short-term effects or long-lasting improvement?

PURPOSE: To evaluate the clinical performance of refurbished resin composite restorations compared to untreated (negative control) restorations over a period of 10 years. METHODS: 26 subjects (having a total of 52 composite restorations) were recruited. All restorations in the refurbished group showed clinical features rated bravo according to modified USPHS criteria. Untreated restorations were those that had been deemed acceptable (alpha or bravo rated); these were used as controls. Two examiners performed assessments at baseline and during the 5th and 10th years after the intervention. Wilcoxon tests were performed for within-group comparisons, Friedman tests were used for multiple within-group comparisons, and Mann Whitney tests were used for between-groups comparisons. Kaplan-Meier survival curves were calculated, and the Mantel-Cox test was used to compare curves. P < 0.05 was considered statistically significant. RESULTS: In both groups, 10-year scores were significantly different from baseline scores in all clinical parameters except secondary caries. There were no statistically significant differences in the survival analysis of groups (log-rank test, P = 0.376). Refurbishing treatment improved the anatomy, roughness, luster, and marginal adaptation of restorations with a short-term effect, with most properties rated acceptable after 10 years of clinical service. The clinical characteristics were similar for all groups at the 10th year.

Is there difference of Streptococcus mutans count and adherence on amalgam and resin occlusal restorations? A blind clinical study

To compare the number of colony forming units CFU and agar adherence of S. mutans on amalgam AM and resin composite RC occlusal restorations. Sixty-five healthy patients older than 18 years with high caries risk who had at least one occlusal AM and RC restorations n=130 were selected. METHODS: The restorations were evaluated according to the alpha Ryge criteria Cohen-Kappa 0.8. For each patient, a biofilm sample was taken using an impression tray technique with previously loaded with solid trypticase yeast extract cysteine sucrose with bacitracin agar placed over the AM restorations and RC restorations in the same patients. The tray was placed inside an oven at 37 °C for 48 h, and the S. mutans count was then performed. Data were analyzed with the test Wilcoxon with a 95% confidence level. RESULTS: RC restorations had statistically significant higher number of CFU of S. mutans than AM restorations p<0.05. CONCLUSIONS: In adult patients with high caries risk, RC occlusal surfaces showed greater agar adherence of S. mutans count than AM restorations...

Indicators of the risk mechanics for Class-I and Class-II amalgam and composite resin restorations

AIM: To determine indicators of prognosis for mechanical risks of amalgam and composite resin restorations in permanent teeth. METHODS: Thirty-nine adult patients with direct clinical, photographic, radiographic and model examinations. A total of 256 restorations were classified as "not satisfactory," with Bravo or Charlie values according to the modified Ryge /USPHS criteria. The total "n" was divided into Bravo and Charlie groups according to the value obtained in the "marginal adaptation" parameter. Each of the groups was sub-divided by the type of material (amalgam and composite resins) and the class: occlusal (O) and proximal (MOD). RESULTS : Comparing the Bravo and Charlie groups, the statistically significant indicators were: the mesiodistal dimension (p=0.037), the distal isthmus (p<0.05), the average of the isthmuses (p<0.05), the distal (p<0.05) cavity depth, and the average depth of the MOD (p<0.05) cavities. It was concluded that the type and the class of the restoration are not indicators for sampling. CONCLUSIONS: With regard to the design of the cavity preparation, the valid mechanical risk indicators include the mesiodistal dimension, the distal isthmus, the average of the isthmuses, the depth of the distal cavity and the average depth of the MOD cavities. A simple clinical assessment does not provide sufficient information to establish the indicators for mechanical failure risk of restorations...

Actividad y efectos de ureasa y arginina deiminasa en saliva y biopelícula oral humana / Activity and effects of urease and arginine deiminase in saliva and oral human biofilm

El objetivo de esta revisión es mostrar los hallazgos emergentes de las potenciales propiedades anticariogénicas de biomoléculas del metabolismo oral relacionados con la producción de amonio. El análisis de la literatura soporta una nueva dimensiónpreventiva en el conocimiento de la enfermedad caries dental al estudiar la evidencia in vitro publicada, en la que el amonio producido desde la urea y la arginina del ambiente oral presentan importantes factores endógenos inhibitorios del desarrollo de lesiones de caries dental. Este hecho apoyaría la hipótesis que la producción de amonio por urealisis y por el sistema de arginina deiminasa, podrían inhibirpotencialmente el desarrollo de la caries dental por la neutralización de ácidos y la estabilización de la microbiota oral, favoreciendo las condiciones para el mantenimiento de la salud oral. Esta revisión presenta estudios de la actividad enzimática oral, que puedeconstituir un prometedor campo para establecer nuevas líneas de investigación en cariología, particularmente in vivo e in situ, destinados a establecer la efectividad y aplicación clínica de estos compuestos en la prevención de caries dental.

The purpose of this review is to present the emerging findings on the potential anti-cariogenic properties of the bioactive molecules of oral metabolism related with ammonia production. The literature analysis supports a new preventive dimension in the knowledge of dental caries disease by studying the published evidence provided by in vitro and clinical studies, in which the ammonia produced from urea and arginine in the oral environment represents an important endogenous inhibitory factor in the development of dental caries lesions. This fact would support the hypothesis that ammonia production by urease and the arginine deiminase system could potentially inhibit the development of dental caries by neutralizing acids and stabilizing the oral microbiota, thus enhancing the conditions for oral healthmaintenance. This review presents studies on the oral enzyme activity which may constitute a promising field in the definition of new lines of research in cariology, particularly in vivo and in situ, aimed at establishing the effectiveness and clinical application of these compounds in the prevention of dental caries.