Microinvasive esthetic approach for deep enamel white spot lesion.

The white spot lesion on the dental enamel is an optical alteration that compromises the esthetics of smile. It can be caused by many factors, among them, defects in mineralization and formation of tooth enamel. Resin infiltrants are agents that penetrate, by capillarity, through the pores of the demineralized or hypomineralized enamel, altering the refractive index (RI) of the tooth structure and totally or partially masking the appearance of the white spot. The aim of this work was to report the use of resin infiltration to minimize the visualization of white spot lesion, present in an upper central incisor, as a microinvasive approach for the esthetic treatment of deep enamel hypomineralization. A 20-year-old female patient sought care with the esthetic complaint of extensive white spot lesion on the buccal face of her upper right central incisor. The diagnosis established was a deep white stain associated with the incisor molar hypomineralization syndrome, and the treatment of choice for the resolution of the case was the application of the Icon® resin infiltrant (DMG, Hamburg, Germany). To reach the body of the lesion, three cycles of acid erosion, using 15% HCl, were necessary to obtain a satisfactory aspect of masking the white lesion. A camouflage effect of the deep white spot lesion was achieved with the use of the resin infiltration, without the need of additional and irreversible wear of the dental structure.

Effect of ceramic thicknesses and opacities on water sorption and solubility of a light-curing resin cement by different units

Aim: This study evaluated the water sorption and solubility of a light-cured resin cement, under four thicknesses and four opacities of a lithium disilicate ceramic, also considering three light-emitting diode (LED) units. Methods: A total of 288 specimens of a resin cement (AllCem Veneer Trans ­ FGM) were prepared, 96 samples were light-cured by each of the three light curing units (Valo ­ Ultradent / Radii-Cal ­ SDI / Bluephase II ­ Ivoclar Vivadent), divided into 16 experimental conditions, according to the opacities of the ceramic: High Opacity (HO), Medium Opacity (MO), Low Translucency (LT), High Translucency (HT), and thicknesses (0.3, 0.8, 1.5, and 2.0 mm) (n = 6). The specimens were weighed at three different times: Mass M1 (after making the specimens), M2 (after 7 days of storage in water), and M3 (after dissection cycle), for calculating water sorption and solubility. Results: The higher thickness of the ceramic (2.0 mm) significantly increased the values of water sorption (44.0± 4.0) and solubility (7.8±0.6), compared to lower thicknesses. Also, the ceramic of higher opacity (HO) generated the highest values of sorption and solubility when compared to the other opacities, regardless of the thickness tested (ANOVA-3 factors / Tukey's test, α = 0.05). There was no influence of light curing units. Conclusion: Higher thicknesses and opacities of the ceramic increased the water sorption and solubility of the tested light-cured resin cement

Planning and orthodontic preparation for maxillary incisors reshaping.

INTRODUCTION: Having a beautiful smile is the main desire of people seeking dental treatment. To achieve this goal, many variables must be considered. These include tooth alignment, color, shape and size, besides their harmonious relationship with the lips and face. An individualized diagnosis is essential to achieve the best result. Within this context, facial analysis and the characteristics of shape, size and position of maxillary incisors play a key role. METHODS: This paper describes clinical situations in which interdisciplinary treatment was performed to achieve esthetic results in a conservative manner and ensuring greater stability. In most cases requiring reshaping of maxillary incisors for esthetic reasons, prior orthodontic movement is essential. The main focus of this paper is to discuss the many variables involved in these situations. RESULTS AND CONCLUSION: The results of treatments described in this paper were obtained by means of a multidisciplinary approach, involving Orthodontics and Esthetic Dentistry, acting in harmony and recognizing their possibilities and limitations, in order to offer patients the best esthetic solution for their smile. The best treatment option is not always the easiest or fastest. The dentist, as a health professional, should consider the patients' wishes but also perform treatments with minimal intervention, and the best and most predictable esthetic result, also focusing on function and health.

Color stability of an artificially aged nanofilled composite resin post-cured with different techniques.

Background. Post-cured composite resins exhibit improvements in physical and mechanical properties due to additional polymerization conversion. However, the post-curing techniques might influence the color stability of composite resin materials. Thus, this study evaluated the color stability of a nanofilled composite resin (Filtek Z350 XT - 3M ESPE) subjected to different post-curing techniques. Methods. Sixty samples (color A2) were randomly allocated to six experimental groups (n=10): G1: photoactivation (P) (control); G2: P + microwave oven with distilled water; G3: P + microwave oven without distilled water; G4: P + conventional oven; G5: P + dry-heat sterilizer; G6: P + steam autoclave. All the groups were stored in distilled water for 60 days and immersed daily in 5 mL of a coffee solution for 3 minutes. The color readings (CIEL*a*b* system) were performed at two different time intervals, initially and after 60 days, in a reflectance spectrophotometer (UV-2600; Shimadzu). The colorimetric readings were performed using the Color Analysis software (CIEL*a*b* system). Results. Group G6 exhibited significantly low values of total color change (ΔE=13.16). The control (ΔE=15.32) and G5 (ΔE=15.49) groups exhibited intermediate values, with no difference between them. In turn, the groups in which the resin was heated in a microwave (G2 ΔE=18.55 and G3 ΔE=19.45) exhibited the most significant color changes (one-way ANOVA and Tukey test, P ≤0.05). Conclusion. Steam autoclave post-polymerization increased the color stability of the nanofilled resin subjected to artificial aging and coffee immersion.

Planning and orthodontic preparation for maxillary incisors reshaping

ABSTRACT Introduction: Having a beautiful smile is the main desire of people seeking dental treatment. To achieve this goal, many variables must be considered. These include tooth alignment, color, shape and size, besides their harmonious relationship with the lips and face. An individualized diagnosis is essential to achieve the best result. Within this context, facial analysis and the characteristics of shape, size and position of maxillary incisors play a key role. Methods: This paper describes clinical situations in which interdisciplinary treatment was performed to achieve esthetic results in a conservative manner and ensuring greater stability. In most cases requiring reshaping of maxillary incisors for esthetic reasons, prior orthodontic movement is essential. The main focus of this paper is to discuss the many variables involved in these situations. Results and Conclusion: The results of treatments described in this paper were obtained by means of a multidisciplinary approach, involving Orthodontics and Esthetic Dentistry, acting in harmony and recognizing their possibilities and limitations, in order to offer patients the best esthetic solution for their smile. The best treatment option is not always the easiest or fastest. The dentist, as a health professional, should consider the patients' wishes but also perform treatments with minimal intervention, and the best and most predictable esthetic result, also focusing on function and health.

RESUMO Introdução: Ter um sorriso bonito é o principal desejo de quem busca um tratamento odontológico. Para se alcançar esse objetivo, muitas variáveis devem ser consideradas. Entre elas, estão alinhamento, cor, forma e tamanho dos dentes, além da sua relação harmoniosa com os lábios e a face. O diagnóstico individualizado é essencial para se alcançar o melhor resultado. Nesse contexto, a análise facial e as características de forma, tamanho e posição dos incisivos superiores têm papel primordial. Métodos: O presente artigo descreve situações clínicas em que o tratamento interdisciplinar foi realizado para alcançar resultados estéticos de modo conservador e garantindo maior estabilidade. Na maioria dos casos em que os incisivos superiores precisam ser reanatomizados por razões estéticas, a movimentação ortodôntica prévia é fundamental. O principal foco desse trabalho é a discussão das muitas variáveis envolvidas nessas situações. Resultados e Conclusão: Os resultados dos tratamentos descritos nesse artigo foram obtidos a partir de um planejamento realizado em equipe - Ortodontia e Dentística, trabalhando em harmonia, reconhecendo as suas possibilidades e limitações, são capazes de oferecer aos pacientes a melhor solução estética para o seu sorriso. A melhor alternativa de tratamento nem sempre é a mais fácil ou a mais rápida. O cirurgião-dentista, como profissional de saúde, deve acolher os desejos dos pacientes, mas realizar tratamentos com intervenção mínima e com o melhor e mais previsível resultado estético, com foco dirigido, também, à função e saúde.

Repair Bond Strength and Leakage of Non-Aged and Aged Bulk-fill Composite.

PURPOSE: This study evaluated repair protocols of a non-aged and aged bulk-fill composite in terms of bond strength and leakage. MATERIALS AND METHODS: Ninety-six bulk-fill resin specimens were constructed; half were submitted to thermocycling. Specimens were divided into six groups (n = 16) according to the repair treatments: CG: no repair (control group); Ad: adhesive; DbAd: abrasion with diamond bur + adhesive; SbAd: sandblasting + adhesive; DbSiAd: abrasion with diamond bur + silane + adhesive; and SbSiAd: sandblasting + silane + adhesive. Resin blocks were bonded to the treated surfaces to simulate repair, and the specimens were submitted to microtensile bond strength testing. The failure area was evaluated under a stereomicroscope (40X magnification), and leakage after specimen immersion in silver nitrate solution for 24 h was evaluated under a microscope (200X magnification). Three-way ANOVA (surface treatment, chemical agent, aging) and Tukey's test were performed. RESULTS: Ad and DbAd groups showed the lowest bond strengths, while Ad was the only group negatively influenced by aging. The other groups were statistically similar to the CG in both conditions. All groups exhibited leakage, but groups without silane presented a greater percentage of leakage, mainly when diamond burs were used. Thermocycling did not influence leakage, nor did surface treatment in groups with silane. CONCLUSION: For composite repair, the use of silane is recommended, mainly when diamond burs are used as a mechanical surface treatment.

Effect of the ceramic translucency on the long-term water sorption and solubility of resin cements

Aim: The aim of this study was to evaluate the influence of the translucency of ceramic on water sorption and solubility of resin cements over time. Methods: Lithium disilicate ceramic slides (15x15x1 mm), A1 in color and with different translucencies (high-medium-low) were manufactured; and a glass slide with similar dimension was used as control. Under every slide, 15 specimens (8x0.5 mm) from each resin cement were prepared: light-cured (RelyX Veneer); conventional dual-cured (RelyX ARC); and self-adhesive dual-cured (Rely-X U200). The specimens were then sub-divided according to the period of evaluation (immediately, after 6 and 12 months of storage) (n=5). To evaluate the loss or gain of mass, the specimens were dried until a constant mass was reached. Subsequently, they were divided according to the respective period of storage at 37°C in distilled water and weighed immediately following removal from water. After each period, specimens underwent a new dehydration. Values from water sorption and solubility were calculated and statistically analyzed (Anova 3-way/Tukey test). Results: The lower translucency resulted in greater water sorption and solubility for all cements, regardless of the experimental period. The self-adhesive dual-cured cement showed higher water sorption under all experimental periods and had worse values after 1 year aging. Differences among solubility could only be detected after aging, and the light-cured material had higher values after 6 and 12 months. Conclusions: It could be concluded that the low degree of translucency can negatively influence the passage of light and interfere on the durability of the resin cement. The conventional dual-cured resinous agent seemed to be less affected by such condition

Comparação do efeito de diferentes protocolos de polimento na rugosidade superficial de restaurações de resina composta / Comparison of the effect of different polishing protocols on surface rugosity of composite resin restorations

Objetivo: o objetivo do presente estudo foi comparar a influência de diferentes protocolos de polimento sobre a rugosidade superficial de uma resina composta nanoparticulada. Metodologia: foram confeccionados 30 corpos de prova (1,5 mm espessura e 6 mm diâmetro), divididos em 3 grupos (n=10), de acordo com o tipo de polimento realizado: 1. Grupo controle; 2. Borrachas abrasivas em 3 granulações (grossa, média, fina); 3 Borracha abrasiva de granulação única. Todos os grupos receberam acabamento com lixa d'água, simulando uma ponta diamantada fina, sendo que o grupo controle não recebeu o polimento com borracha, após esse acabamento. Após o polimento dos grupos 2 e 3, a rugosidade superficial de cada corpo de prova, dos três grupos, foi avaliada em 3 medidas, através de rugosímetro, sendo calculada a média aritmética dos 3 valores picos e vales. A análise estatística inferencial foi feita por meio da ANOVA a 1-critério e teste de Tukey, para comparações múltiplas, com nível de significância de 5%. Resultados: observaram-se maiores valores de rugosidade no grupo controle (3,31µm), seguido do polimento de 1 passo (1,53µm) e 3 passos (0,48µm). Conclusão: diante disso, observa-se alta rugosidade superficial no acabamento com pontas diamantadas, simulado pelo grupo controle, e sua redução após o polimento. Entretanto, apenas o sistema de 3 passos foi capaz de produzir uma lisura superficial clinicamente aceitável.

Aim: the aim of the present study was to compare the influence of different polishing protocols on the surface roughness of a nanoparticulate composite resin. Methodology: Thirty specimens (1.5 mm thickness and 6 mm diameter) were made and divided into 3 groups (n = 10), according to the type of polishing performed: 1. Control group; 2. 3 grit abrasive rubs (thick, medium, thin); 3 Single grain abrasive rubber. All groups were finished with sandpaper, simulating a fine diamond tip, and the control group did not receive rubber polishing after this finish. After groups 2 and 3 polishing, the surface roughness of each specimen of the three groups were evaluated in 3 measurements by means of roughness, and the arithmetic mean of the 3 peaks and valleys (Ra) values were calculated. Inferential statistical analysis was performed using one-way ANOVA and Tukey test for multiple comparisons, with a significance level of 5%. Results: higher roughness values were observed in the control group (3.31µm), followed by 1-step (1.53µm) and 3-step (0.48µm) polishing. Conclusion: therefore, it is noticed a high surface roughness in the diamond-tipped finish, simulated by the control group, which was reduced after polishing. However, only the 3-step system was able to produce a clinically acceptable surface smoothness.

Avaliação radiográfica da presença de bolhas em restaurações classe II in vitro utilizando diferentes técnicas restauradoras / Radiographic evaluation of the presence of voids in class II in vitro restaurations using different restorative techiniques

Introdução: a presença de bolhas no interior das restaurações de resina composta pode reduzir suas propriedades biomecânicas, levando ao insucesso do tratamento. Objetivo: avaliar visual e radiograficamente a presença de bolhas em restaurações de resina composta classe II in vitro utilizando diferentes técnicas restauradoras. Metodologia: foram confeccionados 40 corpos de prova em uma matriz metálica bipartida, randomizados em quatro grupos (n=10) de acordo com a técnica de inserção de resina utilizada: Grupo 1 - resina bulk fill flow e resina regular, Grupo 2 ­ resina bulk fill regular e resina regular, Grupo 3 - resina regular pela técnica incremental oblíqua e Grupo 4 ­ resina regular pela técnica incremental horizontal. A avaliação da presença de bolhas foi realizada pelos testes visual e radiográfico. Resultados: o grupo da resina bulk fill flow (G1) foi o que apresentou menor média de bolhas para os dois métodos de avaliação (6,5 para o visual e 2,4 para o radiográfico) e o grupo da técnica incremental horizontal foi o que apresentou maior média de bolhas (24,2 para o teste visual e 4,5 para o radiográfico). Conclusão: a técnica bulk fill apresentou menor formação de bolhas quando comparada à técnica incremental. Desta forma, as resinas bulk fill, principalmente com sua apresentação fluida, parecem ser uma opção viável de material restaurador direto por ser de inserção única, simplificando o procedimento, e evitar a incorporação de bolhas, preservando as propriedades biomecânicas do material.

Introduction: the presence of voids within the composite resin restorations can reduce their biomechanical properties, leading to the failure of the treatment. Objetictive: to evaluate visual and radiographically the presence of voids in class II in vitro composite resin restorations using different restorative techniques. Methodology: 40 specimens were made in a bipartite metal matrix, randomized into four groups (n = 10) according to the used resin insertion technique: Group 1 - Bulk Fill Flow Resin and Regular Resin, Group 2 ­Bulk Fill Regular Resin and Regular Resin, Group 3 - Regular Resin by oblique incremental technique and Group 4 ­Regular Resin by incremental horizontal technique. The evaluation of the presence of voids was made by visual and radiographic tests. Results: the Bulk Fill Flow Resin group (G1) was that showed lower average of voids for the two evaluation methods (6,5 for the visual test and 2,4 for the radiographic) and the group of horizontal incremental technique was the one that presented higher average of voids (24,2 for the visual test and 4,5 for the radiographic). Conclusion: the Bulk Fill technique showed lower formation of voids compared to incremental technique. This way, the Bulk Fill resins, mainly with their fluid presentation, appear to be a viable option of direct restorative material for being single insertion, simplifying the procedure and preventing the incorporation of air voids, preserving the properties the biomechanical material.

Mass change of a sodium bicarbonate air-polished nanocomposite exposed to cigarette smoke, coffee, and red wine / Perda de massa de nanocompósito jateado com bicarbonato de sódio e exposto à fumaça de cigarro, café e vinho tinto

Introdução: As resinas compostas estão sujeitas à desafios na cavidade oral relacionados aos hábitos dos pacientes, que podem comprometer a integridade e longevidade das restaurações. As consequências da associação do consumo de bebidas e o uso de cigarros à profilaxia profissional precisam ser estudadas. Objetivo: O objetivo desse estudo foi avaliar como o jateamento com bicarbonato de sódio afeta a mudança de massa (sorção e solubilidade) de uma resina composta exposta à fumaça de cigarro, vinho tinto e café. Material e método: Oitenta corpos-de-prova de resina composta (FiltekZ350 XT - 3M/ESPE) foram preparados e distribuídos em 8 grupos (n=10): G1 (jateamento + água destilada), G2 (jateamento + café), G3 (jateamento + vinho tinto), G4 (jateamento + fumaça de cigarro), G5 (água destilada), G6 (café), G7 (vinho tinto) e G8 (fumaça de cigarro). Os corpos-de-prova de resina composta foram pesados em três tempos diferentes para obter M1 (massa inicial), M2 (massa após 30 dias de armazenamento nas soluções testadas e exposição ao agente) e M3 (após dessecação). Os valores de sorção e solubilidade foram calculados e analisados usando ANOVA 2-fatores e teste Tukey (5%). Resultado: Os grupos experimentais tiveram maior sorção e solubilidade comparado ao grupo controle, independentemente do uso do jateamento. Não houve diferença estatística na sorção para o fator jateamento. Porém, a solubilidade foi maior nos grupos jateados. Conclusão: O jateamento com bicarbonato de sódio foi capaz de intensificar a solubilidade da resina testada, embora não tenha aumentado significativamente os valores de sorção.

Introduction: Composite resins are subject to challenges in the oral cavity that are related to patients' habits, which can compromise the restorations' integrity and longevity. Therefore, it is necessary to study how consuming beverages and smoking cigarettes affects professional prophylaxis. Objective: The aim of this study was to evaluate how the sodium bicarbonate air-polishing affects the mass change (sorption and solubility) of a composite resin exposed to cigarette smoke, red wine, or coffee solution. Material and method: Eighty composite resin samples (FiltekZ350 XT - 3M/ESPE) were prepared and distributed into 8 groups (n=10): G1 (air-polishing + distilled water), G2 (air-polishing + coffee), G3 (air-polishing + red wine), G4 (air-polishing + cigarette smoke), G5 (distilled water), G6 (coffee), G7 (red wine), or G8 (cigarette smoke). The composite resin samples were weighed in triplicate to obtain M1 (initial mass), M2 (mass after 30 days of storage in the tested solutions), and M3 (after desiccation) values. The sorption and solubility values were calculated and analyzed using 2-way ANOVA and Tukey's test (5%). Result: The experimental groups had higher sorption and solubility values than the control groups, regardless of whether air-polishing was used. There was no statistically significant difference in the sorption between the air-polished and non-air-polished groups; however, the solubility was higher in the air-polished groups. Conclusion: Air-polishing using sodium bicarbonate powder was able to intensify the solubility process of the tested resins but did not significantly increase the sorption values.

Effect of air-polishing on properties of nanocomposite submitted to coffee, red wine and cigarette smoke

AIM: The aim of this study was to evaluate the surface roughness and the color stability of nanocomposite exposed to the sodium bicarbonate air-polishing (SBAP) followed by red wine, coffee and cigarette smoke exposure. MATERIALS AND METHODS: 64 nanocomposite specimens were prepared and allocated in 8 groups: G1 (SBAP + distilled water), G2 (SBAP + coffee), G3 (SBAP + red wine), G4 (SBAP + cigarette smoke), G5 (distilled water), G6 (coffee), G7 (red wine) and G8 (cigarette smoke). The surface roughness was evaluated in three periods: before and after SBAP and after exposuring to agents tested. The color was evaluated according to CIEL*a*b* parameters using reflection spectrophotometer in two moments: initial and 30 days after the exposure to staining agents. Data were subjected to three-way repeated measures ANOVA and Tukey's test (5%). RESULTS: The results showed a higher surface roughness of the nanocomposite submitted only to the SBAP and those exposed to the SBAP followed by exposure to the coffee or wine solution. The previous application of SBAP followed by cigarette smoke exposure did not increase the roughness of nanocomposite. The SBAP procedure just increased the staining for cigarette smoke group. CONCLUSION: The SBAP increases resin surface roughness, which worsens when there is exposure to coffee and red wine solution. In addition, SBAP may also provide increased staining of nanocomposites exposed to cigarette smoke

Avaliação da condição bucal de pacientes portadores de asma-série de casos / Evaluation of the oral condition of patients with asthma ­ serie of cases

Introdução: a relação entre a asma e doenças bucais tem sido avaliada em diversos estudos, tanto pelas características inflamatórias, próprias das patologias, como também pela análise das alterações metabólicas advindas do uso de medicamentos para o controle da asma. Objetivo: este estudo descritivo reúne uma série de casos e tem como objetivo avaliar a condição bucal dos pacientes portadores de asma, assistidos no ambulatório de Pneumologia do Ambulatório Magalhães Neto do Hospital Universitário Professor Edgard Santos. Metodologia: foram avaliados 14 pacientes com diagnóstico clínico de asma. Verificou-se o índice da condição periodontal, a presença de alterações em tecidos moles, o índice de placa corada e sangramento à sondagem. Resultados: o número médio de dentes permanentes cariados, perdidos e obturados foi de 18,14. O Índice de Placa Corada evidenciou, do total avaliado, 3 pacientes com IPC≤ 50% e 11 com IPC > 50 %, sendo que constatou-se uma média do índice equivalente a 65,42. Quanto ao grau de severidade da doença, 3 pacientes apresentaram doença periodontal moderada e 11 doença periodontal severa. Do total avaliado, 14 pacientes foram diagnosticados com periodontite crônica, sendo que, destes, 12 apresentaram distribuição da doença localizada e 2, generalizada. Não foram observadas quaisquer alterações em tecidos moles. Conclusão: o desenvolvimento do presente estudo, juntamente com os estudos realizados até então, ratificam a necessidade de uma melhor investigação a respeito da interferência da atuação dos patógenos periodontais no sistema imune de pacientes com asma, bem como a relação inversa.

Introduction: the relationship between asthma and oral diseases has been evaluated in several studies due to the inflammatory characteristics of the both diseases and by the analysis of the metabolic alterations resulting from the use of medications to control asthma. Objective: this descriptive study is a series of cases and aims to evaluate the oral condition of Asthma patients assisted at the Pulmonology Outpatient Clinic of the Ambulatório Magalhães Neto from Hospital Universitário Professor Edgard Santos. Methodology: 14 patients with clinical diagnosis of Asthma have been evaluated. Both the index of the periodontal condition and the presence of changes in soft tissues as well as the index of stained plaque and bleeding were verified. Results: the average number of decayed, missing and filled permanent teeth was 18.14.The stained plaque index (SPI) showed 3 patients with SPI ≤ 50% and 11 patients with SPI > 50% out of the total evaluated, with an average index equivalent to 65.42. Regarding the degree of disease severity, 3 patients had Moderate Periodontal Disease and 11 Severe Periodontal Disease. Among the total evaluated, 14 patients were diagnosed with chronic periodontitis, 12 of which had localized disease distribution and 2 generalized disease distribution. No changes were observed in soft tissues. Conclusion: the development of the currentstudy, alongside with the studies carried out so far, confirm the need for a better investigation regarding the interference of periodontal pathogens in the immune system of patients with asthma, as well as its inverse relationship.

Alteração de cor em simulação de dente escurecido, utilizando duas resinas compostas de mesma cor com diferentes opacidades / Colour change in a simulation of discolored tooth using two composite resins of the same colour but different opacities

Introdução: o tratamento estético de dentes escurecidos é desafiador, especialmente quando o escurecimento ocorre de maneira pontual. Para alcançar bons resultados, é imprescindível, além do domínio da técnica restauradora, o conhecimento sobre a composição e características ópticas dos materiais restauradores. Objetivo: avaliar a cor resultante da sobreposição de duas resinas compostas, quando utilizadas sobre um substrato escurecido. Metodologia: na confecção dos corpos de prova, foram utilizadas duas matrizes metálicas e as resinas compostas Charisma A2 e OA2 e Opallis DA4 (simulando o substrato escurecido), perfazendo um total de 30 corpos de prova. As mensurações de cor foram realizadas em espectrofotômetro de reflexão (UV-2600; Shimadzu) e as leituras colorimétricas foram realizadas no programa Color Analysis, seguindo os parâmetros do sistema CIEL*a*b*. A análise estatística inferencial foi realizada pela ANOVA 1-critério. Para as comparações múltiplas, utilizou-se o teste Tukey (significância de 5%). Resultados: entre as três variáveis, apenas na variável a* houve diferença estatística (p<0,0001). Conclusão: os resultados permitiram a observação de alteração colorimétrica após o uso de ambas as resinas, porém com melhores resultados para o grupo da resina AO2, quando em comparação com o grupo da A2.

Introduction: the aesthetic treatment of darkened teeth is challenging, especially when darkening occurs in a timely manner. Besides mastering the restorative technique, knowledge about the composition and optical characteristics of restorative materials are essential in order to achieve good results. Objective: to evaluate the colour resulting from the overlapping of two composite resins when used on a darkened substrate. In the preparation of the test specimens, two metal matrices and the Charisma A2 and OA2 and Opallis DA4 composite resins (simulating the darkened substrate) were used, making a total of 30 specimens. The color measurements were performed in a spectrophotometer (UV-2600; Shimadzu) and the colorimetric readings were performed in the Color Analysis program, following the CIEL * a * b * system parameters. Inferential statistical analysis was carried out by ANOVA 1-criterion. The Tukey test (5% significance) was used for the multiple comparisons. Results: among the three variables, only in variable a * there was a statistical difference (p <0.0001). Conclusion: the results allowed the observation of colorimetric alteration after the use of both resins, but with better results for the AO2 resin group in comparison to the A2 group.

Avaliação do efeito da água de piscina sobre a rugosidade superficial de resinas compostas de esmalte / Evaluation of the pool water effect on the surface roughness of enamel composite resins

Introdução: a estabilidade de cor e a durabilidade de uma restauração em resina composta são influenciadas por sua lisura superficial. Características inerentes ao material, procedimentos de acabamento e polimento, dieta e hábitos dos indivíduos podem interferir nas suas propriedades superficiais. Objetivo: avaliar a rugosidade superficial de resinas compostas de esmalte submetidas ao contato com água de piscina clorada e estimar se o uso de uma proteção mecânica limitaria esse contato e seus efeitos. Metodologia: duzentos corpos de prova, de cinco diferentes resinas foram preparados e distribuídos, aleatoriamente, em quatro grupos (n=10), de acordo com o desafio a que foram submetidos: imersão em água destilada sem e com proteção de moldeira de acetato; imersão em água clorada sem e com proteção de moldeira de acetato. Os corpos ficaram imersos por 30 dias, sendo as respectivas águas trocadas diariamente. Para avaliação da rugosidade superficial, utilizou-se um rugosímetro. Procedeu-se à análise estatística inferencial por meio da análise de variância a 3-critérios, avaliando-se a comparação múltipla dessas médias com auxílio do teste de Tukey (nível de significância de 5%). Resultados: observou-se: interação significativa entre os fatores água e condição experimental (p<0,0001) e maior rugosidade superficial para a resina Esthet-X HD, quando exposta à água clorada. O uso da moldeira resultou em maiores valores de rugosidade superficial para todas as resinas testadas quando expostas à água clorada. Conclusão: o efeito da água de piscina foi material dependente. O uso da proteção mecânica pareceu aumentar a rugosidade superficial das resinas compostas expostas à água clorada.

Introduction: the color stability and durability of a composite resin restoration are influenced by its surface smoothness. Characteristics inherent to the material, finishing and polishing procedures, diet and habits of individuals may interfere with their surface properties. Objective: to evaluate the surface roughness of enamel composite resins submitted to contact with chlorinated pool water and to estimate if the use of a mechanical protection would limit this contact and its effects. Methodology: two hundred specimens of five different resins were prepared and randomly distributed into four groups (n = 10), according to the challenge they were subjected to: immersion in distilled water, without and with acetate tray protection; immersion in chlorinated water, without and with acetate tray protection. The bodies were immersed for 30 days, and their waters were changed daily. To evaluate the surface roughness, a rugosimeter was used. Inferential statistical analysis was performed using 3-criteria analysis of variance, and a multiple comparison of these means was evaluated using Tukey's test (significance level of 5%). Results: it was observed a significant interaction between water and experimental conditions (p <0.0001) and greater surface roughness for Esthet-X HD resin when exposed to chlorinated water. The use of the tray resulted in higher surface roughness values for all the resins tested when exposed to chlorinated water. Conclusion: the effect of pool water was dependent material. The use of mechanical protection appeared to increase the surface roughness of composite resins exposed to chlorinated water.

Influência da exposição à água de piscina na sorção de água e solubilidade de duas resinas compostas / The infuence of chlorine on sorption and solubility patters of composite resins exposed to pool water

Objetivo: o objetivo deste trabalho foi avaliar o efeito da água de piscina (ozonizada e clorada), na sorção e solubilidade de duas resinas compostas: nanoparticulada Filtek Z350XT e micro-híbrida, Filtek Z250XT. Metodologia: foram confeccionados 80 corpos de prova, utilizando uma matriz de aço inoxidável (7,0 mm diâmetro x 1,0 mm espessura). A resina composta foi inserida em um único incremento, recoberta com tira de poliéster e placa de vidro e fotoativada por 55s. Os corpos de prova foram divididos em quatro grupos (n=10), para cada tipo de material: G1 (controle negativo ­ armazenado em estufa), G2 (controle positivo ­ água destilada), G3 (água ozonizada) e G4 (água clorada). Os corpos de prova foram pesados em balança analítica de precisão para obtenção da massa constante (m1). Posteriormente, foram expostos aos meios líquidos durante 60 dias consecutivos, sendo as águas de armazenamento trocadas diariamente. Após esse período, os corpos de prova foram pesados para obtenção de m2. Após essa etapa, novo ciclo de dessecação e pesagem foi realizado para obtenção de m3. Os valores de sorção de água e de solubilidade foram calculados e analisados estatisticamente ao nível de 5% de significância (ANOVA e teste Tukey). Conclusão: as duas resinas testadas não diferiram quanto à sorção de água, quando expostas à água destilada ou às águas de piscina (clorada ou ozonizada). A resina nanoparticulada apresentou valor de sorção de água estatisticamente superior no controle água destilada e na água ozonizada, já a resina micro-híbrida, apresentou o maior valor de sorção na água clorada. Em relação à solubilidade, ambos os compósitos apresentaram maiores valores quando expostos aos meios líquidos (água destilada, água clorada e água ozonizada), mais do que na condição controle seco. Assim, concluiu-se que a exposição ao meio aquoso aumentou a sorção de água e a solubilidade dos materiais resinosos testados.

Objective: the objective of this work was to evaluate the effect of pool water (ozonized and chlorinated) on the sorption and solubility of two composite resins: Filtek Z350XT nanoparticle and Filtek Z250XT micro-hybrid. Methodology: 80 specimens were prepared using a stainless steel matrix (7.0 mm diameter x 1.0 mm thickness). The composite resin was inserted in a single increment, covered with a polyester strip, a glass plate and was photoactivated for 55s. The specimens were divided into four groups (n = 10) ­ one for each type of material: G1 (negative control ­ stored in greenhouse), G2 (positive control ­ distilled water), G3 (ozonated water) and G4( chlorinated water). The specimens were weighed in a precision analytical balance to obtain the constant mass (m1). Subsequently, they were exposed to the liquid medium for 60 consecutive days. The storage waters were changed daily. After this period, the specimens were weighed in order to obtain m2. After this step, a new desiccation and weighing cycle was performed so as to obtain m3. The values of water sorption and solubility were calculated and analyzed statistically at the 5% level of significance (ANOVA and Tukey test). Conclusion: the two resins which were tested did not differ in sorption from water when exposed to distilled water or pool water (chlorinated or ozonized). The nanoparticulate resin had a statistically higher water sorption value in the distilled water control as well as in the ozonated water, while the micro-hybrid resin had the highest sorption value in the chlorinated water. Regarding solubility, both composites presented higher values when exposed to the liquid medium (distilled water, chlorinated water and ozonated water), rather than in the dry control condition. Thus, it was concluded that exposure to the aqueous medium increased water sorption and solubility of the resin materials tested.

A Conservative Esthetic Approach Using Enamel Recontouring and Composite Resin Restorations.

Conservative clinical solutions, predictable esthetic, and immediate outcomes are important concepts of restorative dentistry. The aim of this case study was to recognize the selective enamel removal as an interesting conservative alternative to achieve optimal esthetic results and discuss the clinical protocol. This clinical report described an alternative esthetic and conservative treatment to transform the long and sharp aspect of the maxillary canines with a slightly aggressive aspect into features of slightly curved teeth with delicate lines. An accurate diagnostic and esthetic analysis of the smile was initially performed. The selective enamel removal was performed, and direct composite restoration was strategically placed. Clinical assessment showed good esthetic outcomes, enabling a smile harmony with an immediate, simple, and lower-cost technique. Practitioners should be exposed to conservative approaches to create esthetic smiles based on the selective enamel removal technique combined with composite resin.

Pigmentação de restaurações de resina composta: uma revisão de literatura / Color alteration of composite resins: a literature review

As resinas compostas são materiais restauradores que reproduzem as características dos tecidos dentais. Contudo, frente aos desafios mecânicos e químicos a que são submetidas na cavidade bucal, sofrem efeitos indesejáveis, como pigmentação e manchamento. O objetivo do presente estudo foi revisar a literatura sobre a etiologia da pigmentação da resina composta e expor alternativas clínicas e domiciliares para reduzir os seus efeitos na alteração de cor deste material odontológico estético. Foi realizado um levantamento bibliográfico na base de dados do Pubmed, no período de agosto de 2009 à agosto de 2014 (5 anos). Os termos utilizados foram: “composite resin and color stability”, “composite resin and pigmentation” e “composite resin and color and pigmentation”. Os critérios de inclusão foram estudos clínicos em humanos e estudos in vitro, na língua inglesa, que avaliaram a estabilidade de cor da resina composta direta e indireta. A pigmentação pode ser atribuída a fatores intrínsecos e extrínsecos. Os fatores intrínsecos se referem à descoloração oriunda de componentes do próprio material, enquanto os fatores extrínsecos estão associados aos hábitos e à dieta do individuo, como o consumo de bebidas e alimentos que possuem corante em sua composição. O profissional pode intervir na prevenção ou redução desses manchamentos através de adequada técnica de confecção das restaurações (polimerização, acabamento e polimento adequados) e, na orientação dos pacientes com relação à higiene oral e aos hábitos que interfiram diretamente na estabilidade de cor do material

Composite resins are restorative materials that reproduce dental tissue characteristics. However, this material is constantly exposed to chemical and mechanical challenges in the oral cavity, resulting in pigmentation and staining. The aim of this study was to review the literature regarding the composite resin pigmentation etiology and to propose clinical and home alternatives to prevent this undesirable characteristic. A literature review was conducted in Pubmed database, from August 2009 to August 2014 (5 years). The terms used were: “composite resin and color stability”, “composite resin and pigmentation” and “composite resin and color and pigmentation”. The inclusion criteria were clinical and in vitro studies, in English, that evaluated the color stability of direct and indirect composite resins. The pigmentation can be attributed to intrinsic and extrinsic factors. Intrinsic factors refer to discoloration resultant from components of the material itself, while extrinsic factors are associated to the diet and habits, as the consumption of beverages and foods, which have pigment composition. The professional can intervene in preventing or reducing the pigmentation through proper technique of restorations (proper polymerization, finishing and polishing) and in guiding patients regarding oral hygiene and habits that directly interfere on material color stability

Influence of intraoral temperature and relative humidity on the dentin bond strength: an in situ study.

STATEMENT OF THE PROBLEM: The effect of the intraoral environment during adhesive restorative procedures remains a concern, especially in the absence of rubber dam isolation. OBJECTIVE: To evaluate the temperature and relative humidity (RH) at anterior and posterior intraoral sites and their effects on the dentin bond strength of two-step etch-and-rinse adhesive systems. METHODS: Sixty human molars were assigned to six groups according to the adhesive systems (Adper Single Bond Plus and One Step Plus) and intraoral sites (incisor and molar sites). The room condition was used as a control group. Dentin fragments were individually placed in custom-made acetate trays and direct composite restorations were performed. The intraoral temperature and RH were recorded during adhesive procedures. Then, specimens were removed from the acetate trays and sectioned to obtain multiple beams for the microtensile bond strength test. In addition, the adhesive interface morphology was evaluated through scanning electron microscopy. Intraoral conditions were statistically analyzed by paired Students' t-tests and the bond strength data by two-way analysis of variance and Tukey test (α = 0.05). RESULTS: The posterior intraoral site showed a significant increase in the temperature and RH when compared with the anterior site. However, both intraoral sites revealed higher temperatures and RH than the room condition. In regards to the adhesive systems, the intraoral environment did not affect the bond strength, and the One Step Plus system showed the highest bond strength means. CONCLUSION: Despite the fact that remarkable changes in the intraoral conditions were observed for both anterior and posterior sites, the intraoral environment was not able to compromise the immediate dentin bond strength. CLINICAL SIGNIFICANCE: Some conditions of intraoral temperature and relative humidity may not impair the dentin bond strength of two-step etch-and-rinse adhesive systems. Thus, an adequate relative isolation seems to be a good alternative under the specific clinical conditions in which rubber dam isolation is either impossible or very difficult to perform.

Effect of agitation and storage temperature on water sorption and solubility of adhesive systems.

The purpose of this study was to evaluate the influence of storage temperature and flask agitation on the water sorption (WS) and solubility (SL) of simplified adhesive systems. Seventy-two disc-shaped specimens were prepared according to the adhesive system (water/ethanol-based: Adper Single Bond 2; and water-based: One Coat Bond SL) and experimental conditions tested (mechanical agitation and storage temperature). Statistical analysis (3-way ANOVA, alpha=5%) found significantly greater WS and SL means for the water/ethanol-based system when compared to the water-based. Irrespective of factors studied, significant differences in WS and SL were noted between cold and room temperatures, with greater values been obtained at 1°C, and lower ones at 20°C. Agitation provided increased WS for both materials at all temperatures, but did not affect their SL. The mechanical agitation of the flask may negatively affect the dynamics of diffusion of simplified adhesive systems, even at extremely cold or warm temperatures.

Conventional and digital radiographic assessment of tooth enamel de-/remineralization processes: an experimental study.

OBJECTIVE: This study aimed to compare digital techniques for evaluating dental enamel de-/remineralization. MATERIALS AND METHODS: Sixty extracted molars were subjected to a process of de- and remineralization. Radiographs were taken before and after each stage. These radiographs were evaluated by the conventional method and were then scanned and analyzed either with or without the use of image enhancement. Moreover, the gray levels (GLs) of the affected areas were measured. RESULTS: All methods exhibited low sensitivity and identical levels of specificity (99.4%). Analysis of the grayscale levels found statistically significant differences between the initial radiographs (P < 0.05). The mean GL of the carious group was significantly lower than that of the remineralized group. The GL did not differ significantly between the initial and final radiographs of the remineralized group, although the mean of the first group was lower than that of the second, which demonstrated that the remineralization process restored the normal density of the dental enamel. CONCLUSION: Measurement of the mean GL was sufficiently sensitive to detect small alterations in the surface of the enamel.