Direct Resin Composite Restoration in Anterior Tooth: 10 Years of Clinical Follow-Up

The emergence and development of resin-based materials, such as resin composites and adhesive systems, have shifted the restorative treatment of anterior teeth with caries lesions and/or fractures. Thus, based on the disadvantages of indirect restorations, direct esthetic restorations are restorative options even for anterior teeth with exten sive loss of hard tissues. This study aimed to describe and discuss the direct resin composite restoration performed to solve the esthetic and functional impairments of the upper anterior teeth with diastemas. The upper left central incisor received total crown preparation for indirect restoration. Clinical results after 10 years were recorded. Considering the clinical characteris tics of dental restorations, it is possible to conclude that direct resin composite restorations reestablished the esthetic and functional properties satisfactorily, even in a tooth with extensive coronal destruction. The success of the restorative treatm ent was dependent on factors related to the materials´ properties, oral habits of the patient, and mostly the clinical skills of th e dental clinician.

La aparición y el desarrollo de materiales con base de resina, como las resinas compuestas y los sistemas adhesivos, han cambiado el tratamiento restaurador de los dientes anteriores con lesiones de caries y/o fracturas. Por lo tanto, en base a las desventajas de las restauraciones indirectas, las restauraciones estéticas directas son opciones de restauración, incluso para los dientes anteriores con una gran pérdida de tejidos duros. Este estudio tuvo como objetivo describir y discutir la restauración directa con resina compuesta, realizada para solucionar las deficiencias estéticas y funcionales de los dientes anteriores superiores con diastemas. El incisivo central superior izquierdo recibió preparación de corona total para restauración indirecta. Se registraron los resultados clínicos después de 10 años. Considerando las características clínicas de las restauraciones dentales, es posible concluir que las restauraciones directas en resina compuesta restablecieron las propiedades estéticas y funcionales satisfactoriamente, incluso en un diente con destrucción coronal extensa. El éxito del tratamiento restaurador dependió de factores relacionados con las propiedades de los materiales, los hábitos bucales del paciente y, sobre todo, las habilidades clínicas del odontólogo.

Influence of preheating and post-curing on a novel fiber-reinforced composite post material.

The aim of this study was to investigate the influence of preheating and post-curing methods on diametral tensile strength (DTS), flexural strength (FS), knoop microhardness (KHN), and degree of conversion (DC) of an experimental fiber-reinforced composite (FRC). Specimens (30 wt% of 3-mm-short E-glass fiber, 22.5 wt% of methacrylated-based resin and 47.5 wt% of filler particles) were subjected to: P - photocuring at 1500 mW/cm2 for 40 s (control); P/M - photocuring and microwave post-curing (540W/5 minutes); P/A - photocuring and autoclave post-curing (120°C/15 minutes); PH-P - preheating (60°C) and photocuring; PH-P/M - preheating, photocuring and microwave post-curing; and PH-P/A - preheating, photocuring and autoclave post-curing. Specimens for DTS (Ø 3 x 6 mm) and FS (25 x 2 x 2 mm) were tested at Instron 5965. KHN employed a 50g load for 30s. DC was measured using FTIR spectroscopy. Statistical analysis employed: factorial analysis, normality test, one-way ANOVA and Tukey's HSD test, independent T-test and the Dunnett test. Interaction between factors was not significant (P>0.05). Preheating promoted significantly higher values of FS and KHN (p = 0.0001). Post-curing promoted significantly higher values for KHN (p = 0.0001). For DTS (p = 0.066) and DC (p= 0.724) no statistical difference was found between groups. SEM images showed that preheating promoted better interaction between glass fibers and resin matrix. Preheating increased FS, KHN and DTS, and post-curing increased KHN. DC was not affected by both methods. Preheating and post-curing methods can be used to improve some mechanical properties of FRCs' but degree of conversion remains unaffected.

Influence of preheating and post-curing on a novel fiber-reinforced composite post material

Abstract The aim of this study was to investigate the influence of preheating and post-curing methods on diametral tensile strength (DTS), flexural strength (FS), knoop microhardness (KHN), and degree of conversion (DC) of an experimental fiber-reinforced composite (FRC). Specimens (30 wt% of 3-mm-short E-glass fiber, 22.5 wt% of methacrylated-based resin and 47.5 wt% of filler particles) were subjected to: P - photocuring at 1500 mW/cm2 for 40 s (control); P/M - photocuring and microwave post-curing (540W/5 minutes); P/A - photocuring and autoclave post-curing (120°C/15 minutes); PH-P - preheating (60°C) and photocuring; PH-P/M - preheating, photocuring and microwave post-curing; and PH-P/A - preheating, photocuring and autoclave post-curing. Specimens for DTS (Ø 3 x 6 mm) and FS (25 x 2 x 2 mm) were tested at Instron 5965. KHN employed a 50g load for 30s. DC was measured using FTIR spectroscopy. Statistical analysis employed: factorial analysis, normality test, one-way ANOVA and Tukey's HSD test, independent T-test and the Dunnett test. Interaction between factors was not significant (P>0.05). Preheating promoted significantly higher values of FS and KHN (p = 0.0001). Post-curing promoted significantly higher values for KHN (p = 0.0001). For DTS (p = 0.066) and DC (p= 0.724) no statistical difference was found between groups. SEM images showed that preheating promoted better interaction between glass fibers and resin matrix. Preheating increased FS, KHN and DTS, and post-curing increased KHN. DC was not affected by both methods. Preheating and post-curing methods can be used to improve some mechanical properties of FRCs' but degree of conversion remains unaffected.

Accuracy in the diagnosis of vertical root fractures, external root resorptions, and root perforations using cone-beam computed tomography with different voxel sizes of acquisition.

AIM: The aim of this study is to assess the accuracy of images acquired with cone-beam computed tomography (CBCT) in the identification of three different root alterations. MATERIALS AND METHODS: Forty human premolars were allocated to four experimental groups (n = 10): sound teeth (control), vertical root fracture (VRF), external root resorption (ERR), and root perforation (RP). After the root alterations had been produced, four teeth were randomly assembled into 10 macerated mandibles and submitted to CBCT. Images were acquired with five voxel sizes (0.125, 0.200, 0.250, 0.300, and 0.400 mm) and assessed by three experienced dental radiologists. Sensitivity, specificity, positive and negative predictive values, and the areas under the receiver operating characteristic curve (accuracy) were calculated. The accuracy of imaging in different voxel sizes was compared with Tukey exact binomial test (α=5%). RESULTS: Accuracy with voxel sizes 0.125, 0.200, and 0.250 mm was significantly higher in the detection of ERRs and VRFs than voxel sizes 0.300 and 0.400 mm. No statistical difference was found in terms of accuracy among any of the studied voxel sizes in the identification of RPs. CONCLUSIONS: Voxel size 0.125 mm produced images with the best resolution without increasing radiation levels to the patient when compared to voxel sizes 0.200 and 0.250 mm. Voxel sizes 0.300 and 0.400 mm should be avoided in the identification of root alterations.

Effect of short glass fiber/filler particle proportion on flexural and diametral tensile strength of a novel fiber-reinforced composite.

PURPOSE: To evaluate the effect of glass fiber/filler particles proportion on flexural strength and diametral tensile strength of an experimental fiber-reinforced composite. METHODS: Four experimental groups (N=10) were created using an experimental short fiber-reinforced composite, having as a factor under study the glass fiber (F) and filler particle (P) proportion: F22.5/P55 with 22.5 wt% of fiber and 55 wt% of filler particles; F25/P52.5 with 25 wt% of fiber and 52.5 wt% of filler particles; F27.5/P50 with 27.5 wt% of fiber and 50 wt% of filler particles; F30/P47.5 with 30 wt% of fiber and 47.5 wt% of filler particles. The experimental composite was made up by a methacrylate-based resin (50% Bis-GMA and 50% TEGDMA). Specimens were prepared for Flexural Strength (FS) (25 mm × 2 mm × 2 mm) and for Diametral Tensile Strength (DTS) (3×6 Ø mm) and tested at 0.5 mm/min in a universal testing machine. RESULTS: The results (in MPa) showed significance (different superscript letters mean statistical significant difference) for FS (p<0.009) and DTS (p<0.001)--FS results: F22.5/P55: 217.24±20.64(B); F25/P52.5: 245.77±26.80(AB); F27.5/P50: 246.88±32.28(AB); F30/P47.5: 259.91±26.01(A). DTS results: F22.5/P55: 21.82±4.42(B); F25/P52.5: 22.00±7.40(B); F27.5/P50: 18.63±4.41(B); F30/P47.5: 31.05±2.97(A). In SEM analysis, areas without fiber reinforcement demonstrated to be more prone to the presence of bubbles and crack development. The group F30/P47.5 showed areas with a great quantity of fibers without empty spaces for crack propagation. CONCLUSION: Increasing fiber content results in higher flexural and diametral tensile strength of an experimental composite reinforced with glass fibers.

Avaliação da degradação da força liberada por ligaduras elásticas convencionais e temáticas / Force degradation assessment released by conventional and thematic orthodontic elastic ties

As ligaduras elásticas são consideradas importantes fontes de força na movimentação ortodôntica. No entanto, apresentam a desvantagem de não serem capazes de liberar níveis de forças constantes no meio bucal, por sofrerem alterações em suas propriedades físicas (dimensão, características individuais), prejudicando suas propriedades mecânicas. O objetivo deste trabalho foi avaliar a degradação de força das ligaduras elásticas ortodônticas convencionais e temáticas. Dezoito grupos experimentais foram avaliados (n=10), tendo como fatores em estudo o formato das ligaduras, temática (Orthosource) e convencional (Morelli); o tempo de armazenagem em saliva artificial a 37°C (24 horas e 30 dias) e a cor (vermelho, rosa e azul). Para a determinação da intensidade das forças liberadas, todas as ligaduras elásticas foram distendidas quatro vezes o valor do seu comprimento original (1 mm), em máquina de ensaio universal Instron 5965 à velocidade constante de 5,08 mm/min, sendo a resistência máxima à tração registrada em N. Os dados foram analisados pelos testes Anova e Tukey para comparações entre os grupos (α=0,05). Os resultados demonstraram que a degradação de força após 24 horas foi muito superior nas ligaduras elásticas convencionais (24,09%, 18,90% e 14,45%) do que nas ligaduras temáticas (1,31%, 2,55% e 2,99%) nas cores vermelho, rosa e azul, respectivamente. Após 30 dias, a degradação de força continuou sendo superior nas ligaduras elásticas convencionais (33,20%, 27,23% e 21,87%), embora a degradação nas ligaduras temáticas tenha aumentado drasticamente neste período (11,89%, 15,55% e 18,53%) nas cores vermelho, rosa e azul, respectivamente...

Elastic ties are considered an important source of force for orthodontic movement. However, they present the disadvantage of not being able to release constant force levels overtime in the oral environment due to changes in their physical properties (dimension, individual characteristics) affecting their mechanical properties. The purpose of this study was to evaluate the force degradation of conventional and thematic orthodontic elastic ties. Eighteen experimental groups were evaluated (n=10) having as variables the elastic tie format of two commercial brands, thematic (Orthosource) and conventional (Morelli), the storage time in artificial saliva at 37°C (immediate, 24 hours and 30 days) and color (red, pink and blue). To determine the magnitude of the forces released, all elastic ties were stretched four times their original size (1 mm) in a universal testing machine (Instron 5965) at a constant speed rate of 5.08 mm/min with the tensile strength measured in N. The data were analyzed by Anova and Tukey statistical tests for multiple comparisons among the groups (α=0.05). The results demonstrated that force degradation after 24h was much greater for the conventional (24,09%, 18,90% and 14,45%) than for the thematic elastic ties (1,31%, 2,55% and 2,99%) in red, pink and blue colors, respectively. After 30 days, force degradation continued to be greater with the conventional elastic ties (33,20%, 27,23% and 21,87%) although force degradation with the thematic elastic ties increased dramatically (11,89%, 15,55% and 18,53%) in red, pink and blue colors, respectively...

The influence of polymerization type and reinforcement method on flexural strength of acrylic resin.

The aim of this study was to evaluate the flexural strength of acrylic resin bars by varying the types of resin polymerization and reinforcement methods. Fourteen groups (N=10) were created by the interaction of factors in study: type of resin (self-cured (SC) or heat-cured (HC)) and reinforcement method (industrialized glass fiber (Ind), unidirectional glass fiber (Uni), short glass fiber (Short), unidirectional and short glass fiber (Uni-Short), thermoplastic resin fiber (Tpl), and steel wire (SW)). Reinforced bars (25×2×2 mm) were tested in flexural strength (0.5 mm/min) and examined by scanning electron microscopy (SEM). Data (MPa) were submitted to factorial analysis, ANOVA, and Tukey and T-student tests (a=5%) showing significant interaction (P=0.008), for SC: Uni (241.71±67.77)a, Uni-Short (221.05±71.97)a, Ind (215.21±46.59)ab, SW (190.51±31.49)abc, Short (156.31±28.76)bcd, Tpl (132.51±20.21)cd, Control SC (101.47±19.79)d and for HC: Ind (268.93±105.65)a, Uni (215.14±67.60)ab, Short (198.44±95.27)abc, Uni-Short (189.56±92.27)abc, Tpl (161.32±62.51)cd, SW (106.69±28.70)cd, and Control HC (93.39±39.61)d. SEM analysis showed better fiber-resin interaction for HC. Nonimpregnated fibers, irrespective of their length, tend to improve fracture strength of acrylics.

Reinforcement of dental methacrylate with glass fiber after heated silane application.

This study evaluated the influence of silane heat treatment and glass fiber fabrication type, industrially treated (I) or pure (P), on flexural and compressive strength of methacrylate resin bars (BISGMA/TEGDMA, 50/50%). Six groups (n = 10) were created: I-sil: I/silanated; P-sil: P-silanated; I-sil/heat: I/silanated heated to 100°; P-sil/heat: P/silanated heated to 100°; (I: I/not silanated; and P: P/not silanated. Specimens were prepared for flexural strength (10 × 2 × 1 mm) and for compressive strength 9.5 × 5.5 × 3 mm) and tested at 0.5 mm/min. Statistical analysis demonstrated the following for flexural strength (P < 0.05): I-sil: 155.89 ± 45.27(BC); P-sil: 155.89 ± 45.27(BC); I-sil/heat: 130.20 ± 22.11(C); P-sil/heat: 169.86 ± 50.29(AB); I: 131.87 ± 15.86(C). For compressive strength, the following are demonstrated: I-sil: 1367.25 ± 188.77(ab); P-sil: 867.61 ± 102.76(d); I-sil/heat: 1162.98 ± 222.07(c); P-sil/heat: 1499.35 ± 339.06(a); and I: 1245.78 ± 211.16(bc). Due to the impossibility of incorporating the stipulated amount of fiber, P group was excluded. Glass fiber treatment with heated silane enhanced flexural and compressive strength of a reinforced dental methacrylate.

Técnica de estratificação e texturização superficial de resinas compostas em dentes anteriores: seis meses de acompanhamento / Layering technique and surface texturization of composite resins in anterior teeth: six month follow-up

Este relato de caso apresenta uma alternativa conservadora para reanatomização de dentes conóides e fechamento de diastemas. O método escolhido foi uma técnica restauradora adesiva direta com resinas compostas, estratificada com diferentes camadas e cores, e posterior texturização superficial durante as fases de acabamento e polimento finais. As restaurações resultaram em dentes reanatomizados, reproduzindo naturalidade de forma, textura e cor, mantidas pelos seis meses em que a paciente foi acompanhada. Com planejamento adequado, enceramento diagnóstico e estratificação-texturização com resinas compostas, foi possível restabelecer o sorriso com proporções, forma e naturalidade satisfatórias.

This report presents an alternative, conservative treatment for reshaping conoid teeth and diastema closure. The chosen method was a direct restorative technique with composite resins, stratified with different masses and shades, and subsequent surface texturization during the final stages of finishing and polishing. The final restorations reproduced naturally the form, texture and shade, followed-up for 6 months. After proper planning, diagnostic wax-up and stratification/surface texturization of composite resins reestablished the smile with pleasant proportions, shape and life-like appearance of the smile

Longevidade de clareamento em dente não vital com associação de técnicas: relato de caso / Longevity of nonvital tooth bleaching with a combination of techniques. Case report

O clareamento dentário, por ser um tratamento não invasivo e de baixo custo, representa uma excelente opção de tratamento para dentes com alteração cromática. O propósito desse artigo é relatar um caso clínico com associação de técnicas de clareamento para dentes não vitais e discutir as implicações clínicas imediatas e mediatas. Paciente do sexo masculino, 30 anos de idade, procurou o serviço odontológico da Universidade Estadual de Londrina para tratamento estético do dente 21, diagnosticado com escurecimento após traumatismo e tratamento endodôntico. Diante do exame radiográfco, que não mostrou alterações da normalidade, foi instituído o clareamento dentário intracoronário com pasta clareadora de perborato de sódio e peróxido de hidrogênio a 20% (6 sessões, com intervalo de 7 dias), seguido por clareamento intra- e extracoronário com peróxido de hidrogênio a 35% (3 sessões de 20 minutos ininterruptos, com intervalo de 7 dias). Passados 10 dias da última sessão de clareamento, foi confeccionada restauração da face palatina com resina composta. Também foi feito controle clínico e radiográfco após 18 meses. O resultado obtido demonstrou a longevidade do procedimento realizado. Assim,conclui-se que o clareamento de dentes não vitais é seguro,efcaz e, quando necessário, pode ser realizado com diferentes produtos, aplicados por diferentes técnicas.

Tooth bleaching, as a non-invasive and low cost treatment,provides an excellent option for teeth with color change. The purpose of this study is to report a case with a combination of techniques for nonvital teeth bleaching and discuss the immediate and mediate clinical implications. Male patient,30 year-old, came to the dental service at the State University of Londrina for esthetic treatment of tooth #21, diagnosed with severe darkening after trauma accentuated by endodontic treatment. Radiographic examination showed no alterations of normality. It was established a treatment with intracoronal bleaching techniques, using sodium perborate with 20% hydrogen peroxide (6 sessions every 7 days), followed by intra- and extracoronal bleaching with 35% hydrogen peroxide (3 sessions of 20 minutes every 7 days). Restoration with composite resin for the fnal sealing of the cavity was made 10 days after the end of bleaching. Clinical and radiographic control after 18 months also were performed.The result showed the longevity of the procedure. Therefore it can be conclude that the nonvital bleaching is safe, effective and can be performed with different products, applied by different techniques

Pinos de fibra anatômicos: técnica clínica e benefícios mecânicos — relato de caso

Introdução: o emprego de pinos estéticos compostos por fibra de vidro tem sido cada vez mais estudado e os benefícios biomecânicos, além da possibilidade adesiva,tornam viável seu uso em várias situações clínicas. Estudos mostram que a perfeita adaptação às paredes do canal radicular é importante para melhorar as propriedades do conjunto dente-pino. Objetivo: apresentar a sequência técnica de um reembasamento de pino de fibra de vidro em canal amplo de um incisivo central fraturado coronalmente. Relato do caso: paciente do sexo masculino,12 anos de idade, apresentou-se com fratura oblíqua no dente 11 após acidente, atingindo a câmara pulpar.Após tratamento endodôntico, a obturação do canal radicular foi removida em preparo mecânico, resultando em necessidade de reembasamento do pino de fibra (Exacto#3, Angelus), que foi realizado com resina composta microhíbrida (Natural Look, DFL). O pino foi cimentado com adesivo convencional de três passos quimicamente polimerizado (Fusion Duralink, Angelus) e cimento resinoso autopolimeriável (Cement Post, Angelus), sendo posteriormente reconstruída a restauração da fratura dentária. Resultados: alcançou-se ótima resolução funcional e estética, com previsão de grande durabilidade clínica