Surface treatments of the zirconia-reinforced lithium disilicate ceramic in the adhesion to the resin cement.

This study verified the effect of surface treatments of the zirconia-reinforced lithium disilicate ceramic bonded to resin cement. Ceramic blocks were divided according to treatments (n=10): FA+SRX (Fluoric acid + silane RX), FA+MDP (Fluoric acid + MDP), FA+SCF+MDP (Fluoric acid + silane CF + MDP), FA+MEP (Fluoric acid + MEP), and MEP (Self-etch primer). Resin cement cylinders were made in the ceramic blocks, photoactivated with 1,200 mW/cm² for 40s, stored in water at 37°C for 24h, and evaluated by the microshear strength test, optical failure descriptive analysis (%), surface characterization (SEM) and contact angle (Goniometer). Other samples were submitted to 10,000 thermocycles between 5°C and 55°C. Bond strength data were submitted to two-way ANOVA and Tukey's test. Contact angle to one-way ANOVA and Games-Howell's test (5%). At 24h, MEP showed higher bond strength, and FA+SRX the lower. FA+MDP and FA+SCF+MDP showed similar values and FA+MEP was intermediate. After thermocycling, FA+SCF+MDP, FA+MEP, and MEP showed higher values, and FA+SRX the lower while FA+MDP was intermediate. When the periods were compared, FA+MDP, FA+SCF+MDP, FA+MEP, and MEP showed higher values for 24h while FA+SRX was similar. SEM showed retentive surface and crystal exposure when treated with FA+SCF+MDP. The less retentive surface was obtained with MEP, and the other treatments promoted intermediate irregularities. In conclusion, surface treatment and thermocycling promoted different values of adhesive strength and contact angle in a zirconia-reinforced lithium silicate ceramic. Failures were predominantly adhesive, and the ceramic surface was characterized by different levels of roughness and selective exposure of crystals.

Effect of Ceramic Thickness on the Bond Strength to Resin-Luting Agents before and after Thermal Cycling.

This study investigated microshear bond strength (µSBS) of two (2) dual-cured resin-luting agents (RelyX™ Ultimate and RelyX™ U200) when photoactivated through varying thicknesses of lithium disilicate, with or without thermal cycling. Discs of IPS e.max Press of 0.5, 1.5, and 2 mm in thickness were obtained. Elastomer molds (3.0 mm in thickness) with four cylinder-shaped orifices 1.0 mm in diameter, were placed onto the ceramic surfaces and filled with resin-luting agents. A Mylar strip, glass plate, and load of 250 grams were placed over the filled mold. The load was removed and the resin-luting agents were photoactivated through the ceramics using a single-peak LED (Radii Plus.) All samples were stored in distilled water at 37oC for 24 h. Half of the samples were subjected to thermal cycling (3,000 cycles; 5ºC and 55ºC). All samples were then submitted to µSBS test using a universal testing machine (Instron 4411) at a crosshead speed of 0.5 mm/min. Data were submitted to three-way ANOVA and Tukey post-hoc test (α=0.05). The mean µSBS at 24 h was significantly higher than after thermal cycling (p<0.05). No statistical difference was found between resin-luting agents (p > 0.05). The mean µSBS for groups photoactivated through 0.5 mm ceramic were significantly higher than 1.5 mm and 2.0 mm (p < 0.05). In conclusion, increased ceramic thicknesses reduced the bond strength of tested resin-luting agents to lithium disilicate. No differences were found between resin-luting agents. Thermal cycling reduced the bond strength of both resin-luting agents.

Preheated acid associated with silane and electric current in the adhesion of the resin cement to ceramic.

This study verified the effect of the combination of preheated hydrofluoric acid/silane/electric current in the adhesion of the resin cement to ceramic. IPS E.max Press ceramic discs embedded in PVC rigid tubes were divided into four groups associating preheated hydrofluoric acid and silane applied with electrical current (n=10): Ha+S (Heated acid + silane); Ha+S+Ec (Heated acid + silane + electrical current); A+S (Acid + silane) and A+S+Ec (Acid + silano + electrical current). Resin cement/ceramic samples were stored in water at 37°C for 24h. After storage, they were submitted to the microshear test, fracture analysis, and contact angle at 24h or after thermocycling (10,000 cycles/5-55ºC). Bond strength data were evaluated by two-way ANOVA. For comparison between evaluation times (24h or thermocycling) was applied unpaired t-test. A significance post-hoc test of p=0.05 was assumed for analyses and graphs (GraphPad Prism 9.0 software). At 24h, the microshear strength showed similar values between Ha+S, Ha+S+Ec, and A+S+Ec groups, while A+S showed the lowest value with a statistical difference. After thermocycling, Ha+S and Ha+S+Ec were similar, as well as A+S and A+S+Ec. There was a significant difference in all groups comparing 24h (highest value) with after thermocycling (lowest value). Adhesive fracture was predominant in all groups and evaluation times. Ha+S and A+S groups showed higher contact angle values compared to the Ha+S+Ec and A+S+Ec with lower values. In conclusion, the association of preheated hydrofluoric acid/silane applied or not with electric current promoted different microshear strength values, fracture types, and contact angles in the resin cement/ceramic bond.

Preheated acid associated with silane and electric current in the adhesion of the resin cement to ceramic

Abstract This study verified the effect of the combination of preheated hydrofluoric acid/silane/electric current in the adhesion of the resin cement to ceramic. IPS E.max Press ceramic discs embedded in PVC rigid tubes were divided into four groups associating preheated hydrofluoric acid and silane applied with electrical current (n=10): Ha+S (Heated acid + silane); Ha+S+Ec (Heated acid + silane + electrical current); A+S (Acid + silane) and A+S+Ec (Acid + silano + electrical current). Resin cement/ceramic samples were stored in water at 37°C for 24h. After storage, they were submitted to the microshear test, fracture analysis, and contact angle at 24h or after thermocycling (10,000 cycles/5-55ºC). Bond strength data were evaluated by two-way ANOVA. For comparison between evaluation times (24h or thermocycling) was applied unpaired t-test. A significance post-hoc test of p=0.05 was assumed for analyses and graphs (GraphPad Prism 9.0 software). At 24h, the microshear strength showed similar values between Ha+S, Ha+S+Ec, and A+S+Ec groups, while A+S showed the lowest value with a statistical difference. After thermocycling, Ha+S and Ha+S+Ec were similar, as well as A+S and A+S+Ec. There was a significant difference in all groups comparing 24h (highest value) with after thermocycling (lowest value). Adhesive fracture was predominant in all groups and evaluation times. Ha+S and A+S groups showed higher contact angle values compared to the Ha+S+Ec and A+S+Ec with lower values. In conclusion, the association of preheated hydrofluoric acid/silane applied or not with electric current promoted different microshear strength values, fracture types, and contact angles in the resin cement/ceramic bond.

Resumo Este estudo verificou o efeito da combinação ácido fluorídrico pré-aquecido/silano/corrente elétrica na adesão do cimento resinoso à cerâmica. Os discos cerâmicos IPS E.max Press embutidos em tubos rígidos de PVC foram separados em quatro grupos associando ácido fluorídrico pré-aquecido e silano aplicado com corrente elétrica (n=10): Ha+S (ácido aquecido + silano); Ha+S+Ec (Ácido aquecido + silano + corrente elétrica); A+S (Ácido + silano) e A+S+EC (Ácido + silano + corrente elétrica). Amostras de cimento resinoso/cerâmica foram armazenadas em água a 37°C por 24 horas. Após o armazenamento foram submetidas ao ensaio de micro cisalhamento, análise de fratura e ângulo de contato no período de 24 horas ou após termociclagem (10.000 ciclos/5-55ºC). Os dados de resistência de união foram avaliados por ANOVA dois fatores. Para comparação entre os tempos de avaliação (24 horas ou termociclagem) foi aplicado o teste t não pareado. Foi assumida significância de 5% para análises e gráficos (software GraphPad Prism 9.0). Em 24 horas, a resistência ao micro cisalhamento apresentou valores similares entre os grupos Ha+S, Ha+S+Ec e A+S+Ec, enquanto A+S apresentou menor valor com diferença estatística. Após a termociclagem, Ha+S e Ha+S+Ec foram similares, assim como A+S e A+S+Ec. Houve diferença significativa em todos os grupos comparando 24 horas (maior valor) com após termociclagem (menor valor). A fratura adesiva foi predominante em todos os grupos e tempos de avaliação. Os grupos Ha+S e A+S apresentaram maiores valores de ângulos de contato comparados aos grupos Ha+S+Ec e A+S+Ec com valores menores. Em conclusão, a associação ácido fluorídrico pré-aquecido/silano aplicado com corrente elétrica promoveu diferentes valores de resistência ao micro cisalhamento, tipos de fratura e ângulos de contato na adesão do cimento resinoso à cerâmica.

Effect of Ceramic Thickness on the Bond Strength to Resin-Luting Agents before and after Thermal Cycling

Abstract This study investigated microshear bond strength (µSBS) of two (2) dual-cured resin-luting agents (RelyX™ Ultimate and RelyX™ U200) when photoactivated through varying thicknesses of lithium disilicate, with or without thermal cycling. Discs of IPS e.max Press of 0.5, 1.5, and 2 mm in thickness were obtained. Elastomer molds (3.0 mm in thickness) with four cylinder-shaped orifices 1.0 mm in diameter, were placed onto the ceramic surfaces and filled with resin-luting agents. A Mylar strip, glass plate, and load of 250 grams were placed over the filled mold. The load was removed and the resin-luting agents were photoactivated through the ceramics using a single-peak LED (Radii Plus.) All samples were stored in distilled water at 37oC for 24 h. Half of the samples were subjected to thermal cycling (3,000 cycles; 5ºC and 55ºC). All samples were then submitted to µSBS test using a universal testing machine (Instron 4411) at a crosshead speed of 0.5 mm/min. Data were submitted to three-way ANOVA and Tukey post-hoc test (α=0.05). The mean µSBS at 24 h was significantly higher than after thermal cycling (p<0.05). No statistical difference was found between resin-luting agents (p > 0.05). The mean µSBS for groups photoactivated through 0.5 mm ceramic were significantly higher than 1.5 mm and 2.0 mm (p < 0.05). In conclusion, increased ceramic thicknesses reduced the bond strength of tested resin-luting agents to lithium disilicate. No differences were found between resin-luting agents. Thermal cycling reduced the bond strength of both resin-luting agents.

Resumo: Este estudo investigou a resistência de união ao microcisalhamento (RUµC) de dois (2) agentes de cimentação de resina dual (RelyX™ Ultimate e RelyX™ U200) quando fotoativados através de diferentes espessuras de dissilicato de lítio, com ou sem ciclagem térmica. Discos do IPS e.max Press de 0,5, 1,5 e 2 mm de espessura foram obtidos. Moldes de elastômero (3,0 mm de espessura) com quatro orifícios cilíndricos de 1,0 mm de diâmetro foram colocados sobre as superfícies cerâmicas e preenchidos com agentes de cimentação de resina. Uma tira Mylar, placa de vidro e carga de 250 gramas foram colocadas sobre o molde preenchido. A carga foi removida e os agentes de cimentação resinosos foram fotoativados através da cerâmica usando um LED de pico-único (Radii Plus). Todas as amostras foram armazenadas em água deionizada a 37oC por 24 h. Metade das amostras foi submetida a ciclagem térmica (3.000 ciclos; 5ºC e 55ºC). Todas as amostras foram então submetidas ao teste de RUµC usando uma máquina de teste universal (Instron 4411) com velocidade de 0,5 mm/min. Os dados foram submetidos à Análise de Variância três fatores e ao teste post-hoc de Tukey (α = 0,05). A média de RUµC em 24 h foi significativamente maior do que após a ciclagem térmica (p < 0,05). Não houve diferença estatística entre os cimentos resinosos (p > 0,05). As médias de RUµC para grupos fotoativados através de cerâmica de 0,5 mm foram significativamente maiores do que 1,5 mm e 2,0 mm (p < 0,05). Em conclusão, o aumento da espessura da cerâmica reduziu a resistência de união dos agentes de cimentação resinosos ao dissilicato de lítio. Não foram encontradas diferenças entre os agentes de cimentação resinosos. A ciclagem térmica reduziu a resistência de união de ambos os agentes de cimentação resinosos.

Surface treatments of the zirconia-reinforced lithium disilicate ceramic in the adhesion to the resin cement

Abstract This study verified the effect of surface treatments of the zirconia-reinforced lithium disilicate ceramic bonded to resin cement. Ceramic blocks were divided according to treatments (n=10): FA+SRX (Fluoric acid + silane RX), FA+MDP (Fluoric acid + MDP), FA+SCF+MDP (Fluoric acid + silane CF + MDP), FA+MEP (Fluoric acid + MEP), and MEP (Self-etch primer). Resin cement cylinders were made in the ceramic blocks, photoactivated with 1,200 mW/cm² for 40s, stored in water at 37°C for 24h, and evaluated by the microshear strength test, optical failure descriptive analysis (%), surface characterization (SEM) and contact angle (Goniometer). Other samples were submitted to 10,000 thermocycles between 5°C and 55°C. Bond strength data were submitted to two-way ANOVA and Tukey's test. Contact angle to one-way ANOVA and Games-Howell's test (5%). At 24h, MEP showed higher bond strength, and FA+SRX the lower. FA+MDP and FA+SCF+MDP showed similar values and FA+MEP was intermediate. After thermocycling, FA+SCF+MDP, FA+MEP, and MEP showed higher values, and FA+SRX the lower while FA+MDP was intermediate. When the periods were compared, FA+MDP, FA+SCF+MDP, FA+MEP, and MEP showed higher values for 24h while FA+SRX was similar. SEM showed retentive surface and crystal exposure when treated with FA+SCF+MDP. The less retentive surface was obtained with MEP, and the other treatments promoted intermediate irregularities. In conclusion, surface treatment and thermocycling promoted different values of adhesive strength and contact angle in a zirconia-reinforced lithium silicate ceramic. Failures were predominantly adhesive, and the ceramic surface was characterized by different levels of roughness and selective exposure of crystals.

Resumo O objetivo neste estudo foi verificar o efeito de tratamentos de superfície da cerâmica de dissilicato de lítio reforçada com zircônia fixada ao cimento resinoso. Os blocos cerâmicos foram separados de acordo com os tratamentos (n=10): AF+SRX (ácido fluorídrico + silano), AF+MDP (ácido fluorídrico + MDP), AF+SCF+MDP (ácido fluorídrico + silano + MDP), AF+MEP (Ácido fluorídrico + MEP) e MEP (Primer auto condicionante). Cilindros de cimento resinoso foram confeccionados em cada bloco cerâmico, foto ativados com 1.200 mW/cm² por 40 segundos, armazenados em água a 37°C por 24 horas e avaliados pelo teste de resistência ao micro cisalhamento, falha por análise descritiva em microscopia óptica (%), caracterização da superfície por imagens MEV e ângulo de contato (Goniômetro). Outras amostras foram submetidas a 10.000 ciclos térmicos (5° e 55°C). Os dados de resistência de união foram submetidos a ANOVA dois fatores e teste de Tukey (5%). Ângulo de contato com ANOVA um fator e teste de Games-Howell (5%). Em 24 horas, MEP apresentou maior resistência de união e AF+S a menor. AF+MDP e AF+SCF+MDP apresentaram valores similares e AF+MEP foi intermediário. Após a ciclagem térmica, AF+SCF+MDP, AF+MEP e MEP apresentaram valores maiores e AF+SRX o menor enquanto AF+MDP foi intermediário. Quando comparados os períodos, AF+MDP, AF+SCF+MDP, AF+MEP e MEP apresentaram valores maiores em 24 horas enquanto AF+SRX foi similar. MEV mostrou superfície mais retentiva e exposição de cristais quando tratada com AF+SCF+MDP. A superfície menos retentiva foi obtida com MEP, e os demais tratamentos promoveram irregularidades de superfície intermediárias. Conclui-se que o tratamento superficial e a termociclagem promoveram diferentes valores de resistência adesiva e ângulo de contato em cerâmica de silicato de lítio reforçada com zircônia. As falhas foram predominantemente adesivas, e a superfície cerâmica foi caracterizada com diferentes níveis de rugosidade e exposição seletiva de cristais.

Evaluation of mechanical properties and morphology of miniscrews Ti6Al4V cold worked versus annealed in artificial bones.

PURPOSE: This study aimed to evaluate the influence of different manufacturing procedures (Eli annealed - hot work versus cold worked - cold work) of the raw material under mechanical properties and morphological characteristics of orthodontic miniscrews (MS). MATERIAL AND METHODS: Thirty MS were randomly separated into 3 types (n=10) according to manufacturer and manufacturing process of the raw material: type A - SIN® annealed (control group); type B - Dentfix® annealed; and, type C - Dentfix® cold worked. MI were inserted in artificial bone blocks, through the manufacturer's specific manual key attached to the digital torquemeter stabilized via custom device. Data of fracture's occurrence was performed using Fisher's exact test. Comparisons between the other two types regarding insertion torque and removal torque were performed using the Mann-Whitney test. Data of fracture torque, shear stress, normal stress and torque ratio was submitted to Kruskal Wallis and Dunn tests (α=0.05). Representative images of surface morphology and fractures were selected. RESULTS: Type C showed statistically the lowest fracture torque (N.cm) (26.11±0.41) (P=0.0012) and highest torque ratio (%) (98.74±0.85) (P=0.0007). Type C showed statistically higher calculated shear (MPa) (2,432.73±508.41) and normal stress (MPa) (1,403.86±293.39) than type B and type A, showing that they differed in relation to the mechanical strength of the material with which they were made (P=0.0007). CONCLUSION: Type A fractured completely inside the most apical bone. Type B and type C fractured closer to the transmucosal profile. Cold worked process should be more prone to fractures than those annealed raw manufactured.

Deflection of tandem archwire in a specific self-ligating metal bracket system: an in vitro study.

The aim of this study was to quantify the force exerted by tandem archwires in a specific system of passive self-ligating bracket. Forty-eight thermo-activated nickel-titanium orthodontic archwires were separated into four groups (n = 12): G1 - two .014" + .014" round archwires; G2 - two .014" + .016" round archwires; G3 - .014" x .025" rectangular archwire; and. G4 - .016" x .022" rectangular archwire. Brackets were fixed onto teeth 1.5 to 2.5 using a device that represented the upper teeth, maintaining an interbracket distance of 6.0 mm. The deflection tests were performed using the structure representative of tooth 1.1 as support on the Instron testing machine at a speed of 2.0 mm/min. The archwires were evaluated at deflections of 0.5 mm, 1.0 mm, and 1.5 mm. The data were analyzed by a generalized linear model, considering values at different deflections as repeated measurements in the same experimental unit (α = 0.5%). At 0.5 mm, higher forces were observed in G2 and G3, which did not differ significantly (p > 0.05). The lowest force was observed in G4 (p < 0.05). At 1.0 mm and 1.5 mm, the highest force was observed in G3, followed by G4 and G2 (p < 0.05). The lowest force was observed in G1 (p < 0.05). In general, tandem archwires (same or different calibers) in a specific passive self-ligating bracket exerted lower force when compared with rectangular archwires.

Curing profile and marginal gap formation using a liner containing long-wavelength-absorbing photoinitiator: an in vitro study.

The aim was to evaluate the marginal-gap formation and curing profile of a new restorative technique using a liner with long-wavelength-absorbing photoinitiator (LWAP). Box-shaped preparations (6 mm × 4 mm × 4 mm) were made in third molars. All samples were treated with Clearfill SE Bond and divided into 4 groups (n = 5), according to restorative technique used: (1) incremental technique (INC-Technique); (2) camphorquinone-based liner (CQ-Liner) + bulk-fill resin composite; (3) LWAP-based liner (LWAP-Liner) + bulk-fill resin composite; and (4) bulk-fill technique without liner (BF-Technique). The marginal gaps (%) for all the samples were measured using micro-computed tomography. The restorations were cross-sectioned, and the degree of conversion (DC) and Knoop microhardness were evaluated at different depths (0.3, 1, 2, 3, and 4 mm). INC-Technique, CQ-Liner, and LWAP-Liner groups showed significantly fewer marginal gaps than those from the BF-Technique group. The BF-Technique specimens had the lowest DC and microhardness in depth. All the other techniques presented similar degree of conversion and microhardness at all the depths. The use of liners, regardless of the photoinitiator system, decreased the marginal-gap formation and improved the curing profile of bulk-filling restoration technique.

Chitosan/Xanthan/Hydroxyapatite-graphene oxide porous scaffold associated with mesenchymal stem cells for dentin-pulp complex regeneration.

The aim of this paper was to synthesize and characterize polymeric scaffolds of Chitosan/Xanthan/Hydroxyapatite-Graphene Oxide nanocomposite associated with mesenchymal stem cells for regenerative dentistry application. The chitosan-xanthan gum (CX) complex was associated with Hydroxyapatite-Graphene Oxide (HA-GO) nanocomposite with different Graphene Oxides (GO) concentration (0.5 wt%; 1.0 wt%; 1.5 wt%). The scaffolds characterizations were performed by X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Raman spectroscopy, thermogravimetric analysis (TGA), scanning electron microscopy (SEM) and contact angle. The mechanical properties were assessed by compressive strength. The in vitro bioactivity and the in vitro cytotoxicity test (MTT test) were analyzed as well. The data was submitted to the Normality and Homogeneity tests. In vitro Indirect Cytotoxicity assay data was statistically analyzed by ANOVA two-way, followed by Tukey's test (α = 0.05). Compressive strength and contact angle data were statistically analyzed by one-way ANOVA, followed by Tukey's test (α = 0.05). XRD showed the presence of Hydroxyapatite (HA) peaks in the structures CXHA, CXHAGO 0.5%,1.0% and 1.5%. FT-IR showed amino and carboxylic bands characteristic of CX. Raman spectroscopy analysis evidenced a high quality of the GO. In the TGA it was observed the mass loss associated with the CX degradation by depolymerization. SEM analysis showed pores in the scaffolds, in addition to HA incorporated and adhered to the polymer. Contact angle test showed that scaffolds have a hydrophilic characteristic, with the CX group the highest contact angle and CXHA the lowest (p < 0.05). 1.0 wt% GO significantly increased the compressive strength compared to other compositions. In the bioactivity test, the apatite crystals precipitation on the scaffold surface was observed. MTT test showed high cell viability in CXHAGO 1.0% and CXHAGO 1.5% scaffold. CXHAGO scaffolds are promising for regenerative dentistry application because they have morphological characteristics, mechanical and biological properties favorable for the regeneration process.

Delayed light-curing of dual-cure bulk-fill composites on internal adaptation and depth of cure.

OBJECTIVE: To evaluate the effect of delayed light-curing of dual-cure bulk-fill composites on internal adaptation and microhardness (KHN) in depth. MATERIALS AND METHODS: Bulk-fill composites were placed in 35 box-shaped preparations and cured according to the following protocols (n = 5): Filtek Bulk-Fill light-cured immediately after insertion (FBF); Bulk-EZ light-cured immediately after insertion (BEZ-I); Bulk-EZ light-cured 90 s after insertion (BEZ-DP); Bulk-EZ self-cured (BEZ-SC); HyperFIL light-cured immediately after insertion (HF-I); HyperFIL light-cured 90 s after insertion (HF-DP); HyperFIL self-cured (HF-SC). After 24 h, the samples were axially sectioned, and the internal adaptation was evaluated using replicas under a scanning electron microscope. The KHN was evaluated at six depths (0.3 mm, 1 mm, 2 mm, 3 mm, 4 mm, and 5 mm). The statistical analysis was performed using α = 0.05. RESULTS: The KHN significantly decreased with depth, except in self-curing mode, when it was similar at all depths. Delayed light-curing significantly increased the KHN at higher depths. The internal adaptation was material-dependent. Light-curing did not influence the internal adaptation of HyperFIL, whereas delayed light-curing significantly reduced the internal gaps (%) of Bulk-EZ. CONCLUSION: Delayed light-curing improved the depth of cure of dual-cure resin composites. Light-curing did not influence the internal adaptation of HyperFIL, but delayed light-curing improved the internal adaptation of Bulk-EZ. CLINICAL SIGNIFICANCE: Light-curing is fundamental for improving the mechanical properties of dual-cure resin composites. Moreover, depending on the dual-cure resin composite, the delay in light-curing can reduce the internal gaps.

Do cone-beam computed tomography low-dose protocols affect the evaluation of the temporomandibular joint?

BACKGROUND: There is no established acquisition protocol based on scientific evidence for the acquisition of cone-beam computed tomography (CBCT) exams to evaluate the temporomandibular joint (TMJ). OBJECTIVES: To evaluate the influence of acquisition protocols and jaw positioning on the diagnostic accuracy of TMJ condylar morphological alterations (CMA), dimension, position and excursion. METHODS: Thirty-six TMJs on 18 dry skulls were imaged using a CBCT unit (OP300 Maxio, Instrumentarium, Tuusula, Finland) at two exposure settings (4.5 and 6.3 mA), three voxel resolutions (0.085, 0.125 and 0.280 mm), three jaw positions (concentric, anteriorised and posteriorised) and three jaw excursions (normoexcursion, hyperexcursion and hypoexcursion). The macroscopic anatomy examination and high-resolution CBCT images were used as ground truth for CMA. Twenty-five TMJs had at least one CMA with 11 healthy TMJs serving as controls. Three experienced oral and maxillofacial radiologists evaluated the parasagittal images for the presence of CMA, position and excursion and measured dimensions. The area under the ROC curve, sensitivity and specificity were calculated. Weighted Kappa (α = 0.05) was used to determine intra- and interexaminer reliability and comparisons between dependent variables analysed by Analysis of Variance at an a prior level of significance of 0.05. RESULTS: The agreement of the evaluation of the position and excursion with the reference standard was high, independent of the protocol (range, 0.75-0.91). Various combinations of acquisition protocols and jaw position did not influence the CMA evaluation. Erosion was overdiagnosed in protocols with larger voxel sizes and the detection of osteophytes greater in images with smaller voxel sizes. The anteroposterior dimension was greater in the open jaw position (p < .05). CONCLUSION: CBCT protocols using reduced radiation exposure from the CBCT machine evaluated in this study can be used to assess condylar morphology, dimension, position and excursion, without compromising diagnostic performances for these parameters.

Deflection of tandem archwire in a specific self-ligating metal bracket system: an in vitro study

Abstract The aim of this study was to quantify the force exerted by tandem archwires in a specific system of passive self-ligating bracket. Forty-eight thermo-activated nickel-titanium orthodontic archwires were separated into four groups (n = 12): G1 - two .014" + .014" round archwires; G2 - two .014" + .016" round archwires; G3 - .014" x .025" rectangular archwire; and. G4 - .016" x .022" rectangular archwire. Brackets were fixed onto teeth 1.5 to 2.5 using a device that represented the upper teeth, maintaining an interbracket distance of 6.0 mm. The deflection tests were performed using the structure representative of tooth 1.1 as support on the Instron testing machine at a speed of 2.0 mm/min. The archwires were evaluated at deflections of 0.5 mm, 1.0 mm, and 1.5 mm. The data were analyzed by a generalized linear model, considering values at different deflections as repeated measurements in the same experimental unit (α = 0.5%). At 0.5 mm, higher forces were observed in G2 and G3, which did not differ significantly (p > 0.05). The lowest force was observed in G4 (p < 0.05). At 1.0 mm and 1.5 mm, the highest force was observed in G3, followed by G4 and G2 (p < 0.05). The lowest force was observed in G1 (p < 0.05). In general, tandem archwires (same or different calibers) in a specific passive self-ligating bracket exerted lower force when compared with rectangular archwires.

Effect of horizontal slot of maxillary canines' brackets with varying wire angulations - An in vitro study.

A new device was developed to enable the visualization and measurement of canine angulation while at the same time visualizing and measuring the force transmitted to adjacent teeth. This study aimed to evaluate the mesiodistal tilt angle of the upper canine brackets, the wire deflection, and its effects on adjacent teeth with five different slot designs of upper canines. Wires (0.020" and 0.019" x 0.025") were tested on different five bracket types at five different distal angles. The force applied to adjacent teeth was measured as the angle was increased, and its consequences were observed in the posterior and anterior regions as well. The force tension (gf) was measured in a universal testing machine. Data were submitted to a 3-way ANOVA and Tukey's test (α=0.05). For both arches, regardless of the type of tooth and bracket type, the highest means tension mean values were shown by the 20° angle, followed by the 15°,10°, and 5° angles, which differed statistically among themselves. Overall, for 5°, 10°, and 15° angles, conventional and versatile brackets showed significantly higher force values in all teeth, tip-edge and control brackets showed the lowest. The highest force values were observed in central and lateral incisors with conventional and versatile brackets and on first and second premolar teeth with self-ligating passive and control brackets. Conventional brackets presented the highest forces, tip-edge and control brackets showed the lowest. The teeth that suffered the greatest forces were lateral incisors, and those that suffered the least were second premolars.

Chitosan/Xanthan membrane containing hydroxyapatite/Graphene oxide nanocomposite for guided bone regeneration.

OBJECTIVE: To develop a chitosan-xanthan (CX) membrane associated with Hydroxyapatite (HA) and different concentrations of graphene oxide (GO). METHODOLOGY: The CX complex was associated with the hydroxyapatite-graphene oxide (HAGO) nanocomposite in different concentrations. The experimental groups were:1) CX; 2) Chitosan-Xanthan/Hydroxyapatite (CXHA); 3) Chitosan-Xanthan/Hydroxyapatite-Graphene Oxide 0.5% (CXHAGO 0.5%); 4) CXHAGO 1.0%; 5) CXHAGO 1.5%. The membranes characterizations were performed by X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Raman spectroscopy, Scanning Electron Microscopy (SEM), Contact angle, Tensile Strength, in vitro Bioactivity and the in vitro Cell viability (MTT test). The data was submitted to the Normality and Homogeneity tests. In vitro Indirect Cytotoxicity assay data was statistically analyzed by two-way ANOVA and Tukey's test (α = 0.05). Tensile Strength and Contact Angle data were statistically analyzed by one-way ANOVA followed by Tukey's test (α = 0.05). RESULTS: XRD, FTIR and Raman spectroscopy confirmed the characteristic bands of the CX polymeric complex, the phosphate bands related to HA, and the presence of GO. SEM images demonstrated the non-porous and homogeneous surface of membranes. The contact angle test showed the hydrophilic characteristic of all membranes (p > 0.05). CX showed tensile strength significantly higher than other membranes. The apatite deposition was observed in all membranes after performing the bioactivity test. The cell viability of CXHAGO 1.0% and CXHAGO 1.5% was significantly higher than CX. CONCLUSION: The addition of HAGO reduced the mechanical strength of membranes, but improved its cell viability. It demonstrated the potential of CXHAGO membranes to be used in guided bone regeneration therapies.

Effect of horizontal slot of maxillary canines' brackets with varying wire angulations - An in vitro study

Abstract A new device was developed to enable the visualization and measurement of canine angulation while at the same time visualizing and measuring the force transmitted to adjacent teeth. This study aimed to evaluate the mesiodistal tilt angle of the upper canine brackets, the wire deflection, and its effects on adjacent teeth with five different slot designs of upper canines. Wires (0.020" and 0.019" x 0.025") were tested on different five bracket types at five different distal angles. The force applied to adjacent teeth was measured as the angle was increased, and its consequences were observed in the posterior and anterior regions as well. The force tension (gf) was measured in a universal testing machine. Data were submitted to a 3-way ANOVA and Tukey's test (α=0.05). For both arches, regardless of the type of tooth and bracket type, the highest means tension mean values were shown by the 20° angle, followed by the 15°,10°, and 5° angles, which differed statistically among themselves. Overall, for 5°, 10°, and 15° angles, conventional and versatile brackets showed significantly higher force values in all teeth, tip-edge and control brackets showed the lowest. The highest force values were observed in central and lateral incisors with conventional and versatile brackets and on first and second premolar teeth with self-ligating passive and control brackets. Conventional brackets presented the highest forces, tip-edge and control brackets showed the lowest. The teeth that suffered the greatest forces were lateral incisors, and those that suffered the least were second premolars.

Resumo Foi desenvolvido um novo dispositivo para permitir a visualização e medição da angulação canina ao mesmo tempo que se visualiza e mede a força transmitida aos dentes adjacentes. Este estudo avaliou o ângulo de inclinação mesiodistal dos braquetes caninos superiores, a deflexão do fio, e os seus efeitos nos dentes adjacentes com cinco diferentes desenhos de ranhuras dos caninos superiores. Os fios (0,020" e 0,019" x 0,025") foram testados em cinco diferentes tipos de braquetes e ângulos distais. A força aplicada aos dentes adjacentes foi medida a medida que o ângulo era aumentado, e as suas consequências foram observadas também nas regiões posterior e anterior. A tensão da força (gf) foi medida em uma máquina de ensaio universal (Instron). Os dados foram submetidos ao teste ANOVA 3 fatores e Tukey (α=0,05). Para ambos os arcos, independentemente do tipo de dente e tipo de braquete, os valores médios de tensão mais elevados foram mostrados pelo ângulo de 20°, seguido pelos ângulos de 15°, 10°, e 5°, que diferiram estatisticamente entre si. Em geral, para ângulos de 5°, 10° e 15°, os braquetes convencionais e versáteis apresentaram valores de força significativamente mais elevados em todos os dentes, braquetes tip-edge e controle apresentaram os mais baixos. Os maiores valores de força foram observados nos incisivos centrais e laterais com braquetes convencionais e versáteis e no primeiro e segundo pré-molares com braquetes auto-ligantes passivo e controle. Os braquetes convencionais apresentaram as forças mais elevadas, os braquetes controle e tip-edge apresentaram os valores mais baixos. Os dentes que sofreram as maiores forças foram os incisivos laterais, e os que sofreram menos foram os segundos pré-molares.

Comparison of the shear bond strength between metal brackets and Transbond™ XT, Filtek™ Z250 and Filtek™ Z350 before and after gastroesophageal reflux: An in vitro study.

PURPOSE: To evaluate in vitro the effect of gastroesophageal reflux, before and after bonding of metal brackets on composite resin surface. MATERIALS AND METHODS: Two hundred and ten resin discs were divided into 5 groups (n=42), according to the time and medium of storage: 24h, 7- and -30 days in artificial saliva (AS) and hydrochloric acid (HCL). Twelve samples from each group were submitted to surface roughness analysis (n=60). The other one hundred and fifty samples were divided into 3 groups (n=50) according to the bonding material: Transbond™ XT (TXT), 3M™ Filtek™ Z250 (Z250) and 3M™ Filtek™ Z350 XT (Z350). After bonding, the samples were subdivided, one more time, into 5 groups (n=10) according to the time (24h, 7, and 30 days) and medium storage (AS, HCL). Following, the shear bond strength (SBS) analysis was accomplished. Erosive challenge was performed for 7 or 30 days, before and after bonding of orthodontic brackets, for 1min, 4 times a day. SBS was performed in a universal testing machine (Instron) at 0.5mm/min. SBS data were subjected to two-way ANOVA and Tukey's test (α=0.05). RESULTS: TXT showed higher SBS values in all conditions (AS - 10.9±2.0 (24h); 10.5±4.9 (7 days); 9.4±2.2 (30 days); HCL - 11.5±3.7 (7 days); 8.0±2.1 (30 days)) - (P<0.0001). No statistical difference was detected in SBS between Z250 and Z350 composite resins (Z250 SBS: AS - 7.1±1.9 (24h), 5.2±1.8 (7 days), 4.5±1.5 (30 days); HCL - 5.2±2.3 (7 days), 5.0±2.5 (30 days)) - (P<=0.063)/Z350 SBS: AS - 7.4±1.0 (24h); 3.7±1.7 (7 days); 3.4±1.7 (30 days); HCL - 3.5±3.3 (7 days); 4.4±1.2 (30 days)) - (P<=0.167), respectively). Storage times and media did not statistically influence the SBS of TXT and Z250 composite resins (P>0.05), but did influence the Z350 SBS (P<0.05). CONCLUSION: Regardless of time and storage medium, TXT was the best composite resin for bonding brackets. Furthermore, the erosive challenge did not lead to surface changes in the Z250 resin at 7 and 30 days, unlike the Z350 resin.

Effect of light attenuation through veneers on bond strength of adhesives with photoinitiator combinations.

This study aimed to evaluate the effect of light attenuation through ceramic veneers and resin cement on degree of conversion (DC), cohesive strength (CS), and microshear bond strength (µSBS) of experimental adhesive systems. Experimental etch-and-rinse and self-etch adhesives were combined with different ratios of camphorquinone (CQ) and diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) photoinitiators: CQ-only; 3CQ:1TPO; 1CQ:1TPO; 1CQ:3TPO and TPO-only. Square-shaped ceramic veneer (IPS Empress Esthetic, Ivoclar Vivadent) (n = 10; 10mm long x 10mm wide x 0.5mm thick) and resin cement specimens (Variolink Esthetic LC, Ivoclar Vivadent) (n = 10; 10 mm long x 10 mm wide and 0.3 mm thick) were prepared. Light transmittance of a multiple-peak LED (Bluephase G2, Ivoclar Vivadent) was measured through restorative materials using a spectrometer (n = 5). Adhesive specimens were analyzed for DC, CS, and µSBS by light-curing the adhesive with or without (control) ceramic veneer, and with resin cement fixed to output region of the light-curing tip (n = 10). Data were submitted to ANOVA and Tukey's test (α = 0.05). Total light transmittance through the restorative materials was attenuated, and this attenuation was more evident for the violet spectrum. The DC for the TPO groups in ratios up to 1CQ:1TPO was similar to the control. 1CQ:3TPO showed lower values for CS. µSBS was reduced for all groups with light attenuation, but lower values were observed for 1CQ:3TPO and TPO-only. In conclusion, light transmission was reduced with interposed restorative materials. Adhesives combined with CQ and TPO up to 1CQ:1TPO showed greater cure efficiency and mechanical properties compared with a higher amount of TPO.

Comparison of the friction forces delivered by different elastomeric patterns and metal ligature on conventional metal brackets with a NiTi arch wire versus a self-ligating system: An in vitro study.

OBJECTIVES: The aim of this study was to measure the frictional resistance of different types of ligatures used on conventional and self-ligating brackets. MATERIALS AND METHODS: Monoblock (conventional) and Portia (self-ligating) brackets were used and the archwire used was nickel-titanium. On conventional brackets the ligatures tested were the Elastomeric type and steel 0.30 tie-wire. The groups were divided according to the ligature types (n=8): (1) conventional elastomeric ligature; (2) relaxed conventional elastomeric ligature; (3) elastomeric ligature in shape-8; (4) double vertical elastomeric ligatures; (5) double-crossed elastomeric ligatures; (6) crossed ligature; (7) steel wire ligature; and (8) self-ligating ligature (self-ligating bracket). A segment of five brackets, each ligature types, was mounted. The archwire, between the bracket and the ligature, was connected on Instron® Universal test machine to simulate the frictional resistance. The maximum frictional resistance was obtained, and the mean values were submitted to the analysis of variance (ANOVA) and the Tukey's post-hoc test (α=0.05). RESULTS: The elastomeric ligature in shape-8 showed the highest value compared with other groups (P<0.05). Although the crossed elastomeric ligature presented the lowest mean value and it was not statistically different regarding relaxed conventional elastomeric ligature, steel wire ligature and self-ligating (P≥0.05). CONCLUSIONS: The frictional resistance was influenced by ligature types. Elastomeric Ligature in shape-8 showed the highest frictional force. Crossed Elastomeric Ligature had the lowest frictional force value.

Comparison of the physico-chemical impact of chlorhexidine and silver nanoparticles on orthodontic appliances made with laser and silver solder: An in vitro study.

OBJECTIVE: The aim of this study was to evaluate the physical-chemical changes in orthodontic devices made with laser and silver solder after immersion in different antiseptic solutions. METHODS: Wire/band assemblies were fabricated using different types of solders (silver and laser). The devices were immersed in different antimicrobial solutions (chlorhexidine - CHX 0.12% and Silver nanoparticles - NAg 0.12% and 0.18%). Non-immersion in solution and immersion in artificial saliva were used as initial and negative control, respectively (n=12). Surface morphological analysis was performed using Scanning Electron Microscopy (SEM). The quantitative analysis of the chemical elements present after the immersions in the solutions was analysed by Energy Dispersive X-ray Spectroscopy (EDS). The data were subjected to the Kruskal-Wallis test followed by Bonferroni, with a significance level of 5%. RESULTS: Greater amounts of copper, silver and zinc were released from silver soldering, on the other hand, iron, nickel, and chromium ions were the most prevalent metal ions in laser soldering. Regarding mouthwashes, the lowest amounts of metal ions were released in CHX, and the highest amounts of ions were released in the 0.12% NAg and 0.18% NAg solutions. CONCLUSIONS: Laser welding seems to be less susceptible to corrosion. The different antiseptic solutions did not contribute to an increase in ion release.