Adhesion in Dentin Prepared with Er,Cr:YSGG Laser: Systematic Review.

BACKGROUND: In dentistry, cavities prepared with Erbium lasers present more advantages, compared to traditional methods, but there is still a lack of investigation about the adhesion in dentin surfaces prepared with Erbium lasers, especially with Erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. AIM: The purpose of this systematic review was to find out which might be "The most adequate adhesive and laser parameters for adhesion in dentin prepared with Er,Cr:YSGG laser." METHODS: An electronic search was performed in the PubMed database. The search was limited to studies between 2009 and 2016. RESULTS: Ten articles were selected to the systematic review according to TRANSPARENT REPORTING of Systematic Reviews and Meta-ANALYSES checklist. CONCLUSIONS: The adhesive that showed the best bond strength results in dentin prepared with Er,Cr:YSGG laser was the self-adhesive Clearfil™ SE (Kuraray), with preconditioning with 40% phosphoric acid. The settings 2 W, 75% water, 60% air, 140 µs pulse duration, and 20 Hz showed the best adhesion outcome.

Influence of solvents and composition of etch-and-rinse and self-etch adhesive systems on the nanoleakage within the hybrid layer.

AIM: The goal of this study was to evaluate nanoleakage within the hybrid layer yielded by etch-and-rinse and self-etch adhesive systems, with different solvents and compositions. MATERIALS AND METHODS: Four adhesives were applied onto 20 human dentin disks: group A: Adper Scotchbond 1XT(™) (3M ESPE), group B: One Coat Bond(®) (Coltène Whaledent), group C: AdheSE(®) (Ivoclar Vivadent) and group D: Xeno-V(®) (Dentsply). The samples were immersed in aqueous ammoniacal silver nitrate for 24 hour, prepared and observed under field-emission scanning electron microscopy with backscattered electrons. Microphotographs were scanned and data were processed. The mean value and standard deviation were calculated. Kruskal- Wallis and Mann-Whitney tests were used (p < 0.05). RESULTS: All the adhesives showed nanoleakage within the hybrid layer: Adper Scotchbond 1XT(™) (218.5 µm ± 52.6 µm), One Coat Bond(®) (139.6 µm ± 79.0 µm), AdheSE(®) (92.7 µm ± 64.8 µm) and Xeno-V(®) (251.0 µm ± 85.2 µm). AdheSE(®) yielded less nanoleakage than Adper Scotchbond-1XT(™) (p = 0.003) and than Xeno-V(®) (p = 0.007). No other statistically significant differences were detected. CONCLUSION: Two-step self-etch adhesive system (AdheSE(®)) might contribute for lower nanoleakage deposition and thus better performance in dentin adhesion. CLINICAL SIGNIFICANCE: The two-step self-etch adhesive system showed the lowest nanoleakage deposition compared with the other adhesive systems evaluated, which seems to indicate a better behavior when a restoration is performed in dentin and possibly can lead to a durable adhesion along time.

Effect of ozone gas on the shear bond strength to enamel.

UNLABELLED: Ozone is an important disinfecting agent, however its influence on enamel adhesion has not yet been clarified. OBJECTIVE: Evaluate the influence of ozone pretreatment on the shear strength of an etch-and-rinse and a self-etch system to enamel and analyze the respective failure modes. MATERIAL AND METHODS: Sixty sound bovine incisors were used. Specimens were randomly assigned to four experimental groups (n=15): Group G1 (Excite® with ozone) and group G3 (AdheSE® with ozone) were prepared with ozone gas from the HealOzone unit (Kavo®) for 20 s prior to adhesion, and groups G2 (Excite®) and G4 (AdheSE®) were used as control. Teeth were bisected and polished to simulate a smear layer just before the application of the adhesive systems. The adhesives were applied according to the manufacturer's instructions to a standardized 3 mm diameter surface, and a composite (Synergy D6, Coltene Whaledent) cylinder with 2 mm increments was build. Specimens were stored in 100% humidity for 24 h at 37°C and then subjected to a thermal cycling regimen of 500 cycles. Shear bond tests were performed with a Watanabe device in a universal testing machine at 5 mm/min. The failure mode was analyzed under scanning electron microscope. Means and standard deviation of shear bond strength (SBS) were calculated and difference between the groups was analyzed using ANOVA, Kolmogorov-Smirnov, Levene and Bonferroni. Chi-squared statistical tests were used to evaluate the failure modes. RESULTS: Mean bond strength values and failure modes were as follows: G1--26.85±6.18 MPa (33.3% of adhesive cohesive failure); G2--27.95±5.58 MPa (53.8% of adhesive failures between enamel and adhesive); G3--15.0±3.84 MPa (77.8% of adhesive failures between enamel and adhesive) and G4--13.1±3.68 MPa (36.4% of adhesive failures between enamel and adhesive). CONCLUSIONS: Shear bond strength values of both adhesives tested on enamel were not influenced by the previous application of ozone gas.

Tratamento em incisivos centrais superiores após traumatismo dental / Treatment of upper central incisors after trauma

Os traumatismos dentários constituem, na atualidade, uma das principais causas da procura pelo cirurgião-dentista. O objetivo deste artigo é apresentar um caso clínico de traumatismo dental, abordando as diferentes reações pulpares dos dentes afetados e uma proposta de tratamento. Foram identificados dois tipos distintos de respostas pulpares ocorridas em dentes que foram sujeitos a um mesmo traumatismo (dente 21 e 11). Após o exame clínico e radiográfico, foi feito o diagnóstico diferencial entre lesão periapical no dente 21 e a imagem radiolúcida do orifício do nervo nasopalatino. Foi diagnosticado necrose pulpar no dente 21, sem lesão periapical e polpa viva no dente 11, apresentando este reabsorção interna e externa da raiz. Foi realizado o planejamento com indicação de tratamento de canal dos dentes 21 e 11, bem como a restauração estética dos mesmos com recurso de técnicas de clareamento interno e externo. O tratamento seleccionado mostrou um ótimo resultado estético com um custo relativamente baixo. O follow-up de dois anos permitiu confirmar o êxito e a longevidade do tratamento proposto.

Presently, dental trauma is one of the main causes for seeking a dental surgeon. The present paper presents a case report of dental trauma, addressing the different pulp reactions of the affected teeth and a treatment plan. The authors identified two distinct types of pulp reactions in teeth (tooth 21 and 11) subject to the same trauma. After clinical and radiographic examination, the differential diagnosis between periapical lesion on tooth 21 and radiolucency of the nasopalatine foramen was performed. Pulpal necrosis, without periapical lesion, was diagnosed in tooth 21, and live pulp in tooth 11, with internal and external root resorption. A treatment plan was designed, which included root canal treatment of teeth 21 and 11, as well as aesthetical restoration of both using internal and external bleaching techniques. This treatment resulted in optimal aesthetic outcome with relatively low cost. The 2-year follow-up confirmed the success and longevity of the treatment.