Effect of S. mutans biofilm on the hybrid ceramic-resin cement bond strength assessed by different methods

Aim: The purpose of this study was to investigate the biofilm effect on the hybrid ceramic-resin cement bond strength (BS) by comparing two methods. Methods: Teeth were distributed into groups (n=5), according to the resin cement (Maxcem Elite-(MC) or NX3 Nexus-(NX)) and degradation method (24h or 7 days in distilled water; 7 or 30 days incubated with biofilm and 30 days in sterile media). Treated surfaces of Vita Enamic blocks (5x6x7mm) were luted to treated or no treated dentin surfaces and light-cured. After 24h, beams were obtained (1x1x10mm) and stored accordingly. The flexural bond strength (FBS) was assessed by four-point bending test. Additional beams were obtained from new teeth (n=5), stored for 24h or 7 days in distilled water, and submitted to a microtensile bond strength (µTBS) assay. Failure modes were determined by scanning electron microscopy (100X). The flexure strength of the cements (n=10) was assessed by a four-point bending test. Data were analyzed by 1 and 2-ways ANOVA, and Tukey's test (α=0.05). Results: There was no significant difference between the degradation methods for the FBS groups. For the µTBS, the significant difference was as follows: NX 7days > NX 24h > MC 7days = MC 24h. Failure mode was mainly adhesive and mixed, but with an increase of cohesive within cement and pre-failures for the MC groups assessed by µTBS. NX had better performance than MC, regardless of the method. Conclusions: The biofilm had no effect on the materials BS and FBS test was a useful method to evaluate BS of materials with poor performance

Antimicrobial potential of resin matrices loaded with coffee compounds.

This study evaluated the biological behavior of the coffee compounds Trigonelline (T), chlorogenic acid (C), and nicotinic acid (N), correlating with their release from a resin matrix. Minimum inhibitory concentration (MIC) was evaluated against Streptococcus mutans UA159, and cytotoxicity was assessed by methyl tetrazolium salt on OD-21 cells. Resin matrices (bisphenol A-glycidyl-dimethacrylate/triethylene glycol-dimethacrylate 70/30 wt%, camphorquinone/ethyl 4-dimethyl aminobenzoate 0.5/1 wt%) were doped with coffee compounds in different concentrations (10/20/30/40/50 wt%), performing 15 groups (T10-T50, C10-C50, N10-N50), and a control group with no coffee compound. Degree of conversion (DC%) was analyzed by Fourier transform infrared spectroscopy. Antimicrobial properties were evaluated by bioluminescence (Luciferase assay). The release from loaded matrices was analyzed over time (24 hr, 6, 14, 21 and 28 days), using high-performance liquid chromatography (HPLC). Data were submitted to ANOVA/Tukey's test (α = 0.05). MIC for T and C was 6 mg/ml, and 4 mg/ml for N. None of them were cytotoxic. Only T50 and C50 showed lower DC% than control (α < 0.05). Some groups (T30/T40/T50/C40/C50/N50) were strongly antimicrobial, reducing bacterial activity approximately five times compared to control (α < 0.05). For T30, T40, T50, C40, and C50, the HPLC showed a release above or closer to MIC values mainly in 24 hr, but for N50, up to 28 days. In conclusion, the coffee compounds presented antimicrobial activity, depending on their concentration when added in resin matrices, being found a correlation with their release.

Effect of biofilm exposure on marginal integrity of composite restorations.

PURPOSE: To evaluate the effect of bacterial exposure on the marginal integrity of dentin-resin interfaces for composites with and without bioactive glass (BAG). METHODS: Cavity preparations of 5 mm width and 1.5 mm depth were machined into dentin disks by means of a computer controlled milling system. After applying the bonding agent, cavity preparations (n=3-5) were restored by incremental technique with experimental resin composites (50:50 BisGMA/TEGDMA: 72wt% filler) with different filler compositions: control - 67 wt% silanated strontium glass and 5wt% aerosol-silica filler and BAG - 57 wt% silanated strontium glass and 15 wt% BAG-65 wt% silica. Samples were then stored in sterile Todd-Hewitt media or co-incubated with Streptococcus mutans (UA 159), at 37°C, 5% CO2 for 1-2 weeks. For samples co-incubated with a living biofilm, a luciferase assay was performed in order to assess its viability. Surfaces were impressed before and after each storage condition and replicas examined in a scanning electron microscope. Using image analysis software (Image J), the discontinuous margins percentage (%DM) was quantitatively assessed. Data were analyzed using two-way ANOVA followed by Tukey's test (α= 0.05). RESULTS: Gap size ranged between 7-23 µm. The bacterial exposure significantly increased the %DM in both groups predominantly due to the formation of new gap regions. There was no difference between control and BAG composites regarding %DM and the biofilm viability. Bacterial exposure promoted degradation of composite restoration marginal integrity, with no difference between composites with and without BAG. CLINICAL SIGNIFICANCE: The samples incubated with living biofilm had a higher gap percentage in the margins, confirming the negative effect of cariogenic bacteria on margin degradation. The parameters defined for such synergy can help to understand the multi-factorial aspect of marginal discontinuity and therefore, predict the behavior of composite restorations subjected to the challenging oral environment.

Surface Deterioration of Indirect Restorative Materials.

The objective of this work was to evaluate the effects of in vitro and in situ biodegradation on the surface characteristics of two resin cements and a hybrid ceramic system. One hundred and eighty specimens (4X1.5mm) of each material (Maxcem Elite, NX3 Nexus and Vita Enamic) were made and randomly distributed in twelve groups (n=15) according to the material and biodegradation method. The specimens were then submitted to the following challenges: storage in distilled water 37 ºC for 24 h or 7 days, storage for 7 days, at 37 ºC, in stimulated saliva or in situ. The in situ stage corresponded to the preparation of 15 intraoral palatal devices, used for 7 days. Each device presented 3 niches, where a sample of each materials was accommodated. Specimens from both saliva and in situ groups suffered a cariogenic challenge, corresponding to the application of a solution of 20% of sucrose, 10 times throughout each day. After each biodegradation method, the surface roughness (Ra), Vickers hardness (VHN) and scanning electron microscopy (SEM) analyzes were performed. The data collected were evaluated by Levene test, two-way ANOVA and Tukey`s test (α=5%). The in situ challenge promoted the greater biodegradation, regardless of the material. Regarding the materials, the Vita Enamic VHN was negatively affected by all biodegradation methods and the Nexus NX3 presented better performance than the self-adhesive cement tested. Therefore, within the conditions of this work, it was concluded that in situ biodegradation can affect negatively the surface characteristics of indirect restorative materials.

Surface deterioration of indirect restorative materials

Abstract The objective of this work was to evaluate the effects of in vitro and in situ biodegradation on the surface characteristics of two resin cements and a hybrid ceramic system. One hundred and eighty specimens (4X1.5mm) of each material (Maxcem Elite, NX3 Nexus and Vita Enamic) were made and randomly distributed in twelve groups (n=15) according to the material and biodegradation method. The specimens were then submitted to the following challenges: storage in distilled water 37 ºC for 24 h or 7 days, storage for 7 days, at 37 ºC, in stimulated saliva or in situ. The in situ stage corresponded to the preparation of 15 intraoral palatal devices, used for 7 days. Each device presented 3 niches, where a sample of each materials was accommodated. Specimens from both saliva and in situ groups suffered a cariogenic challenge, corresponding to the application of a solution of 20% of sucrose, 10 times throughout each day. After each biodegradation method, the surface roughness (Ra), Vickers hardness (VHN) and scanning electron microscopy (SEM) analyzes were performed. The data collected were evaluated by Levene test, two-way ANOVA and Tukey`s test (α=5%). The in situ challenge promoted the greater biodegradation, regardless of the material. Regarding the materials, the Vita Enamic VHN was negatively affected by all biodegradation methods and the Nexus NX3 presented better performance than the self-adhesive cement tested. Therefore, within the conditions of this work, it was concluded that in situ biodegradation can affect negatively the surface characteristics of indirect restorative materials.

Resumo O objetivo deste trabalho foi avaliar os efeitos da biodegradação in vitro e in situ nas características superficiais de dois cimentos resinosos e de um sistema cerâmico híbrido. Cento e oitenta espécimes (4X1,5mm) de cada material (Maxcem Elite, NX3 Nexus e Vita Enamic) foram distribuídos aleatoriamente em doze grupos (n=15) de acordo com o material e o método de biodegradação. Os espécimes foram então submetidos aos seguintes desafios: armazenamento em água destilada 37ºC por 24 horas ou 7 dias, armazenamento por 7 dias, a 37ºC, em saliva estimulada ou in situ. O estágio in situ correspondeu à preparação de 15 dispositivos intra-orais palatinos, utilizados por 7 dias. Cada dispositivo apresentou 3 nichos, onde uma amostra de cada material foi acomodada. As amostras dos grupos saliva e in situ sofreram um desafio cariogênico, correspondendo à aplicação de uma solução de 20% de sacarose, 10 vezes ao longo de cada dia. Após cada método de biodegradação, foram realizadas as análises de rugosidade superficial (Ra), dureza Vickers (VHN) e microscopia eletrônica de varredura (MEV). Os dados coletados foram analisados por meio do teste de Levene, ANOVA two-way e teste de Tukey (α=5%). O desafio in situ promoveu maior degradação, independentemente do material. Em relação aos materiais, a VHN do Vita Enamic foi afetada negativamente por todos os métodos de degradação e o Nexus NX3 apresentou melhor desempenho que o cimento autoadesivo testado. Portanto, dentro das condições deste trabalho, concluiu-se que a biodegradação in situ pode afetar negativamente as características superficiais de materiais restauradores indiretos.

Effect of different bleaching protocols on whitening efficiency and enamel superficial microhardness.

BACKGROUND: Tooth bleaching is a popular aesthetic treatment to modify the color of teeth. Despite the extensive literature concerning the subject, there is still no consensus regarding the application mode of the different bleaching agents and their effect on enamel. Therefore, this study evaluated the influence of different bleaching protocols on whitening efficiency and enamel superficial hardness. MATERIAL AND METHODS: Bovine enamel fragments were embedded in acrylic resin and wet-sanded to obtain a flat buccal surface. The specimens were then randomly divided into 6 groups (n=10), based on the bleaching material [HP Maxx 35% (35% hydrogen peroxide), HP Blue 35% (35% hydrogen peroxide + Ca) and Whiteness Perfect 10% (10% carbamide peroxide)] and application mode (3 applications of 15 min, 1 application of 45 min, 1 application of 1h30 or 1 application of 3h30). The color and superficial hardness were assessed before and after bleaching. The color was assessed by means of a digital spectrophotometer, using CIELab parameters. Vickers hardness was determined using a load of 200g for 10s. Data were statistically analyzed by one-way ANOVA with repeated measures and Tukey's test (α = 0.05). RESULTS: Concerning the color alteration, the groups were similar to each other, except for at-home bleaching protocols, which were statistically different from each other. Similarly, there was a reduction in hardness values comparing the initial and final periods, with lowest final hardness for the at-home bleaching protocol group applied for 3h30. CONCLUSIONS: It can be concluded that the bleaching protocols influenced the final color and enamel surface hardness, evidencing that lower gel concentrations applied for longer periods promoted greater variation in color and lower final hardness. Key words:Tooth bleaching, roughness, microhardness, in-office, at-home bleaching.

Micro-CT Analysis of Y-TZP Copings Made by Different CAD/CAM Systems: Marginal and Internal Fit.

PURPOSE: The aim of the study was to measure the marginal and internal adaptation (MIA) of zirconia copings, made of 4 ceramic systems for CAD/CAM, using microcomputed tomography (micro-CT) technology. MATERIAL AND METHODS: Two identical stainless steel models were used, representing a preparation for full ceramic crown on a lower molar. The master models were then scanned for the production of copings from specific yttrium oxide partially stabilized tetragonal zirconia polycrystal ceramic blocks of each system (n=10): Cerec/inCoris Zi, Sirona; Cercon/Cercon base, Dentsply; Ceramill/Ceramill Zi, Amann Girrbach; and Lava/Lava Frame Zirconia, 3M ESPE. MIA was evaluated measuring 4 points as follows: marginal gap (MG), axial wall gap (AW), axio-occlusal angle gap (AO), and central occlusal area gap (CO). The data were statistically analyzed by ANOVA and Tukey's test (α = 0.05). RESULTS: The ceramic system Lava showed greater internal desadaptation (80.75 ± 22.69 µm) while CEREC presented the lowest values (49.92 ± 11.77 µm). There were significant differences between the measurement points evaluated. CO demonstrated the greater values (77.03 ± 22.61 µm). All marginal and internal adaptation values were considered clinically acceptable. CONCLUSION: It was concluded that there was an influence of the type of ceramic system in marginal and internal adaptation of copings in zirconia.

Physical properties of two bis-acryl interim materials: color stability, flexural strength and shear bond strength to flowable composite resin as add-on material

Aims: The objective of this study was to evaluate the mechanical properties of two bis-acryl interim resin materials, such as color stability, flexural strength and shear bond strength to flowable composite resin, simulating clinical situations when this material has to be used for repair as add-on. Two shades of two bis-acryl interim resin materials [Structur 2 SC (shades Bleach and A2); Protemp 4 (shades A1 and A2)] were evaluated. Discs (5 x 1 mm) were fabricated and baseline color was determined after 1 h. Ten specimens were immersed at 37oC in solutions of distilled water (control) and cola-based soft drink (Coca-Cola). Color measurements were performed with a spectrophotometer using CIELab parameters. Color readings were again measured after 2 hours, 4 hours, 24 hours and 7 days. Flexural strength was determined using the three-point bending test (10 x 1 x 2 mm) on a universal testing machine (0.5 mm/min) (n = 10). Discs of bis-acryl resin were embedded in acrylic resin, planned and distributed in 2 groups: G1 - Filtek Z350 Flow/Protemp4 and G2 - Grandio SO Flow/Structure 3 (n = 15). Cylinders (3.5 x 2 mm) were made with the flowable composite resins and polymerized for 20 s. The specimens were stored in distilled water at 37oC for 24 h and subjected to shear bond strength test. Data were analyzed using one-way ANOVA and Tukey's test (α = 0.05). ΔE values were higher for Structur Bleach (3.08)a compared with Protemp 4 (shade A1, 2.22)b (shade A2, 2.25)b. There were no significant differences between Structur Bleach and Structur A2 (2.62)ab. Coca-Cola presented higher ΔE values (3.08)a than (2.00)b. Regarding time, ΔE values increased from 1.84a after 2 h to 2.31b after 4 h. The higher values were observed after 24 h and 7 days (2.93c and 3.09d, respectively). No significant differences were observed for the flexural strength of Structur (22.05 MPa)a and Protemp 4 (19.01 MPa)a. The repairs executed with Structur/Grandio flow (9.21 MPa)a were similar to those performed with Protemp 4/Z350XT flow (10.71 MPa)a. It can be concluded that the two bis-acyl resins evaluated showed similar physical and mechanical properties (AU)

Effect of Sonic Vibrations on Bond Strength of Fiberglass Posts Bonded to Root Dentin.

Sonic vibrations may improve the bond strength and durability of fiberglass posts by improving adhesive penetration into dentin as well as the cement flow. The objective of this study was to evaluate the effect of sonic vibrations on the bond strength between fiberglass posts and root dentin using the pull-out test. Bovine roots were endodontically treated and divided randomly into four groups (n=12): Group C - conventional cementation (control); Group SA - sonic vibration (Smart Sonic Device, FGM) of the adhesive system and conventional post accommodation; SP group - conventional adhesive application and sonic vibration of the post during accommodation; and SASP - sonic vibration of the system adhesive and the post during accommodation. The posts were cleaned, treated with a silane and adhesive system (Ambar, FGM), and cemented with a dual-cured resin cement (Allcem Core, FGM). After 24 h, the specimens were subjected to mechanical tests and failure analyses. Representative specimens were analyzed by a scanning electron microscope to observe the cementation line. The results were analyzed using ANOVA and Tukey's test (a=5%). The bond strengths were as follows: SASP (90.9±27.1 N), C (121.4±60.6 N), SA (127.6±31.8 N) and SP (156.4±41.3 N). The use of sonic vibrations during the application of adhesive or post cementation separately did not affect the bond strength but had a negative effect when used for both procedures.

Effect of Sonic Vibrations on Bond Strength of Fiberglass Posts Bonded to Root Dentin

Abstract Sonic vibrations may improve the bond strength and durability of fiberglass posts by improving adhesive penetration into dentin as well as the cement flow. The objective of this study was to evaluate the effect of sonic vibrations on the bond strength between fiberglass posts and root dentin using the pull-out test. Bovine roots were endodontically treated and divided randomly into four groups (n=12): Group C - conventional cementation (control); Group SA - sonic vibration (Smart Sonic Device, FGM) of the adhesive system and conventional post accommodation; SP group - conventional adhesive application and sonic vibration of the post during accommodation; and SASP - sonic vibration of the system adhesive and the post during accommodation. The posts were cleaned, treated with a silane and adhesive system (Ambar, FGM), and cemented with a dual-cured resin cement (Allcem Core, FGM). After 24 h, the specimens were subjected to mechanical tests and failure analyses. Representative specimens were analyzed by a scanning electron microscope to observe the cementation line. The results were analyzed using ANOVA and Tukey's test (a=5%). The bond strengths were as follows: SASP (90.9±27.1 N), C (121.4±60.6 N), SA (127.6±31.8 N) and SP (156.4±41.3 N). The use of sonic vibrations during the application of adhesive or post cementation separately did not affect the bond strength but had a negative effect when used for both procedures.

Resumo Vibrações sônicas podem melhorar a resistência e a durabilidade da união de pinos de fibra de vidro, melhorando a penetração do sistema adesivo à dentina, bem como o escoamento do cimento. O objetivo deste estudo foi avaliar o efeito da vibração sônica na resistência de união de pinos de fibra de vidro à dentina radicular, através de ensaio pull out. Raízes bovinas tratadas endodonticamente foram preparadas e divididas aleatoriamente em quatro grupos (n=12): Grupo C - cimentação convencional, (controle); Group SA - vibração sônica (Smart Sonic Device(r), FGM) do sistema adesivo e assentamento convencional do pino; grupo SP - aplicação convencional do sistema adesivo e vibração sônica no assentamento do pino; e SASP - vibração sônica do sistema adesivo e no assentamento do pino. Os retentores foram limpos, tratados com silano e sistema adesivo (Ambar, FGM) e cimentados com cimento resinoso dual (Allcem Core, FGM). Após 24 h as amostras foram submetidas ao teste mecânico e análise de falha. Amostras representativas foram avaliadas sob microscópio eletrônico de varredura, para avaliação da linha de cimentação. Os resultados foram analisados por meio de análise de variância e teste de Tukey (a=5%). Os resultados obtidos foram: SASP (90,9±27,1 N, C (121,4±60,6 N), SA (127,6±31,8 N) e SP (156,4±41,3 N). A vibração sônica para aplicação apenas do sistema adesivo ou pino não afetou a resistência de união, entretanto interferiu negativamente quando utilizada para ambos procedimentos.

Effect of Enamel and Dentin Surface Treatment on the Self-Adhesive Resin Cement Bond Strength.

The aim of this study was to evaluate the effect of enamel and dentin surface treatment on the micro-shear bond strength of self-adhesive cement. Seventy-two extracted third molars had their crowns embedded in acrylic resin and worn to obtain a flat enamel or dentin surface. The enamel and dentin specimens were randomly assigned to 8 groups (n=12) that were based on surface treatment (11.5% polyacrylic acid solution or no treatment), substrate condition (wet or dry) and storage period (1 day or 90 days), and treated accordingly. Cylinders (1 × 1 mm) were fabricated using self-adhesive resin cement (RelyX U200) following the manufacturer's instructions. The specimens were stored in distilled water at 37 °C for either 1 day or 90 days and subjected to micro-shear bond strength test (EMIC DL 2000 at 0.5 mm/min). After this, the failure type of the specimens was determined. Data were subjected to statistical analysis (a=0.05). According to the results, the 11.5% polyacrylic acid application decreased the bond strength in both enamel and dentin samples. The moist groups showed higher bond strength than the dry ones, regardless of the substrate and surface treatment. Storage period did not influence bond strength. In conclusion, surface treatment with 11.5% polyacrylic acid and absence of moisture decreased the bond strength of the resin-cement (RelyU200), regardless of the storage period.

Effect of Enamel and Dentin Surface Treatment on the Self-Adhesive Resin Cement Bond Strength

Abstract The aim of this study was to evaluate the effect of enamel and dentin surface treatment on the micro-shear bond strength of self-adhesive cement. Seventy-two extracted third molars had their crowns embedded in acrylic resin and worn to obtain a flat enamel or dentin surface. The enamel and dentin specimens were randomly assigned to 8 groups (n=12) that were based on surface treatment (11.5% polyacrylic acid solution or no treatment), substrate condition (wet or dry) and storage period (1 day or 90 days), and treated accordingly. Cylinders (1 × 1 mm) were fabricated using self-adhesive resin cement (RelyX U200) following the manufacturer's instructions. The specimens were stored in distilled water at 37 °C for either 1 day or 90 days and subjected to micro-shear bond strength test (EMIC DL 2000 at 0.5 mm/min). After this, the failure type of the specimens was determined. Data were subjected to statistical analysis (a=0.05). According to the results, the 11.5% polyacrylic acid application decreased the bond strength in both enamel and dentin samples. The moist groups showed higher bond strength than the dry ones, regardless of the substrate and surface treatment. Storage period did not influence bond strength. In conclusion, surface treatment with 11.5% polyacrylic acid and absence of moisture decreased the bond strength of the resin-cement (RelyU200), regardless of the storage period.

Resumo O objetivo do estudo foi avaliar o efeito de tratamentos de superfície em esmalte e dentina na resistência de união (RU) de um cimento auto-adesivo. As coroas de setenta e dois terceiros-molares foram incluídas em resina acrílica e desgastadas para obtenção de áreas planas em esmalte e dentina. Os espécimes de esmalte e dentina foram aleatoriamente distribuídos em 8 grupos (n=12) de acordo com: tratamento de superfície (sem tratamento ou aplicação de solução de ácido poliacrílico a 11,5%), condição do substrato (seco ou úmido) e período de armazenamento (1 dia ou 90 dias). Após, cilindros (1 x 1 mm) foram confeccionados na superfície dos espécimes utilizando cimento resinoso auto-adesivo (Rely X U200) segundo as instruções do fabricante. Os espécimes foram armazenados em água destilada a 37 oC por 1 dia ou 90 dias e submetidos ao ensaio mecânico de microcisalhamento (EMIC DL 2000 a 0,5 mm/min). O tipo de falha de cada espécime foi determinado após ensaio. Os dados foram submetidos à análise estatística (a=0,05). De acordo com os resultados, a aplicação de ácido poliacrílico a 11,5% diminuiu a RU em ambos substratos, esmalte e dentina. Os grupos mantidos úmidos mostraram maiores valores de RU do que os secos, independentemente do substrato ou tratamento de superfície. O período de armazenamento não influenciou nos valores de RU. Concluiu-se que o tratamento de superfície com ácido poliacrílico a 11,5% e a ausência de umidade no substrato diminuíram os valores de RU para o cimento resinoso auto-adesivo, independentemente do período de armazenamento.

An Indirect Method to Measure Abutment Screw Preload: A Pilot Study Based on Micro-CT Scanning

This study aimed to measure the preload in different implant platform geometries based on micro-CT images. External hexagon (EH) implants and Morse Tapered (MT) implants (n=5) were used for the preload measurement. The abutment screws were scanned in micro-CT to obtain their virtual models, which were used to record their initial length. The abutments were screwed on the implant with a 20 Ncm torque and the set composed by implant, abutment screw and abutment were taken to the micro-CT scanner to obtain virtual slices of the specimens. These slices allowed the measurement of screw lengths after torque application and based on the screw elongation. Preload values were calculated using the Hooke's Law. The preloads of both groups were compared by independent t-test. Removal torque of each specimen was recorded. To evaluate the accuracy of the micro-CT technique, three rods with known lengths were scanned and the length of their virtual model was measured and compared with the original length. One rod was scanned four times to evaluate the measuring method variation. There was no difference between groups for preload (EH = 461.6 N and MT = 477.4 N), but the EH group showed higher removal torque values (13.8±4.7 against 8.2±3.6 Ncm for MT group). The micro-CT technique showed a variability of 0.053% and repeatability showed an error of 0.23 to 0.28%. Within the limitations of this study, there was no difference between external hexagon and Morse taper for preload. The method using micro-CT may be considered for preload calculation.

Resumo Este estudo teve como objetivo medir a pré-carga em diferentes conexões implante/pilar baseado em imagens de micro-CT. Implantes de hexágono externo (EH) e Cone Morse (MT) (n = 5) foram utilizados para a medição de pré-carga. Os parafusos de pilares foram digitalizados em um micro-CT de alta resolução para obter seus modelos virtuais, que foram utilizados para registrar o comprimento inicial. Os pilares foram parafusados sobre o implante com um torque de 20 Ncm e, o conjunto composto por implante, parafuso do pilar e pilar foi levado para o micro-CT para obter cortes virtuais dos espécimes. Esses cortes permitiram a medida do comprimento dos parafusos após a aplicação do torque. Assim, com base no alongamento dos parafusos, os valores de pré-carga foram calculados usando a Lei de Hooke. A pré-carga de ambos os grupos foram comparados pelo Test-t independente. O torque de remoção de cada espécime foi registrado. Para avaliar a precisão da técnica de micro-CT, três bastões foram escaneados em micro-CT e o comprimento do seu modelo virtual foi comparado com o comprimento original dos bastões. Um bastão foi digitalizado e mensurado quatro vezes para avaliar a variação do método de medição e a sua repetitividade. Não houve diferença entre os grupos para a pré-carga (EH = 461,6 N e MT = 477,4 N), no entanto o grupo EH apresentou maiores valores de torque de afrouxamento do parafuso (13,8 ± 4,7 contra 8,2 ± 3,6 Ncm para o grupo MT). A técnica de micro-CT mostrou uma variabilidade de 0,053% e a repetitividade apresentou um erro de 0,23 a 0,28%. Dentro das limitações deste estudo, não houve diferença entre Hexágono Externo e Cone Morse para pré-carga. O método baseado em imagens de micro-CT pode ser considerado para mensuração da pré-carga.

Rehabilitation of the dominance of maxillary central incisors with refractory porcelain veneers requiring minimal tooth preparation.

Central dominance is an important element of an esthetic smile. Color, form, and size have been suggested as tools for assessing the dominance of maxillary teeth. A spectrophotometer can be used to determine the value, hue, and chroma. Correct sizing of restorations according to the central incisor dominance principle improves not only esthetics but also aspects of occlusion, such as anterior guidance. Refractory porcelain systems can effectively restore the color, shape, emergence profile, and incisal translucency. This report illustrates the esthetic and occlusal rehabilitation of the dominance of maxillary central incisors using fabricated minimal thickness refractory porcelain veneers.

An Indirect Method to Measure Abutment Screw Preload: A Pilot Study Based on Micro-CT Scanning.

This study aimed to measure the preload in different implant platform geometries based on micro-CT images. External hexagon (EH) implants and Morse Tapered (MT) implants (n=5) were used for the preload measurement. The abutment screws were scanned in micro-CT to obtain their virtual models, which were used to record their initial length. The abutments were screwed on the implant with a 20 Ncm torque and the set composed by implant, abutment screw and abutment were taken to the micro-CT scanner to obtain virtual slices of the specimens. These slices allowed the measurement of screw lengths after torque application and based on the screw elongation. Preload values were calculated using the Hooke's Law. The preloads of both groups were compared by independent t-test. Removal torque of each specimen was recorded. To evaluate the accuracy of the micro-CT technique, three rods with known lengths were scanned and the length of their virtual model was measured and compared with the original length. One rod was scanned four times to evaluate the measuring method variation. There was no difference between groups for preload (EH = 461.6 N and MT = 477.4 N), but the EH group showed higher removal torque values (13.8 ± 4.7 against 8.2 ± 3.6 N cm for MT group). The micro-CT technique showed a variability of 0.053% and repeatability showed an error of 0.23 to 0.28%. Within the limitations of this study, there was no difference between external hexagon and Morse taper for preload. The method using micro-CT may be considered for preload calculation.

Antibacterial Effect and Physical-Mechanical Properties of Temporary Restorative Material Containing Antibacterial Agents.

Introduction. For the maintenance of the aseptic chain created during the treatment the coronal sealing becomes paramount. Aim. Evaluating the antibacterial effect and the physical-mechanical properties of a temporary restorative material containing different antibacterial agents. Material and Methods. Two antibacterial agents (triclosan and chloramine T) were manually added to a temporary restorative material used as base (Coltosol). The antibacterial action of the material was analyzed using the agar diffusion method, in pure cultures of Escherichia coli (ATCC BAA-2336) and Staphylococcus aureus (ATCC 11632) and mixed culture of saliva collection. The microleakage rate was analyzed using bovine teeth, previously restored with the materials, and submitted to thermocycling, in a solution of 0.5% methylene blue, for a period of 24 hours. The physical and mechanical properties of the materials analyzed were setting time, water sorption, solubility, and compression strength. Results. No marginal leakage was observed for all groups. There was no statistical significant difference in antimicrobial activity, setting time, water sorption, solubility, and compression strength among the materials. Conclusion. The addition of antibacterial agents on a temporary restorative material did not optimize the antibacterial ability of the material and also did not change its physical-mechanical properties.

Aesthetic management of molar-incisor hypomineralization

Introduction: Molar-incisor hypomineralization (MIH) has been challenging for clinical practice. The term refers to an enamel defect that affects permanent molars and often permanent incisors. This defect may result in high sensibility, coronal destruction of the molars, aesthetic problem when incisors are affected, which can jeopardize the child`s emotional and psychological development. Objective: The aim of this paper is to report two cases in which a conservative approach was adopted using new technologies for direct restorative treatment of incisor with MIH opacities. Case report: Patients aged 11 and 12 years-old attended to the clinics of the School of Dentistry (Sao Paulo State University - Unesp) complaining about the appearance of incisors due to the presence of opacities on the labial surface. The cases were diagnosed as MIH, presenting enamel defects on the permanent molars and incisors. Direct restorations were carried out with minimal removal of the opacities using CVD diamond tip (CVDentus, São José dos Campos, São Paulo, Brazil) coupled to an ultrasonic device (CVDentus, São José dos Campos, São Paulo, Brazil) and direct restorations with composite resin. The result of the restorative treatment was satisfactory in both cases, with children showing immediate satisfaction. Conclusion: The incisors affected by MIH should be treated to improve the child`s self-esteem and avoid negative effects on their psychology development. The aesthetic treatment of the incisors should be conservative, since the replacements of restorations are needed throughout life.

Laminados cerâmicos na finalização dos tratamentos clínicos integrados / Laminate veneers and multidisciplinary management

de solucionar. Nestes casos, uma abordagem multidisciplinar éfundamental. Má posição dentária e margem gengival sem umcontorno adequado, normalmente, apresentam problema estético efuncional. Assim, um tratamento ortodôntico e periodontal paraadequação prévia é fundamental para o sucesso do tratamentoreabilitador. Além disso, cuidados e paciência durante todo otratamento são essenciais tanto por parte do profissional como porparte do paciente. Recentemente, os laminados cerâmicos têm sidoamplamente utilizados em dentes anteriores. Adicionalmente, essetratamento tem sido mais conservador quando comparado às coroastotais. Portanto, o presente trabalho demonstra por meio de um casoclínico, a associação da ortodontia, periodontia e dentística norestabelecimento do sorriso com laminados cerâmicos, de formaeficiente, conservadora e com resultados estéticos satisfatórios.

Some clinical cases are more complex. In these situations, amultidisciplinary approach is essential. Malposition dental and gingivalmargin without an adequate contour usually have functional andaesthetic problem. Thus, an integrated orthodontic-periodonticrestorativeapproach may enhance the aesthetic results whenprosthetic therapy itself is not feasible. Additionally, care and patiencethroughout treatment are essential for both the professional and thepatient's part. Recently, ceramic laminate veneers have been widelyused in anterior teeth. Additionally, this treatment has been moreconservative. Therefore, this article presents integrated orthodontics,periodontics and restorative smile solution.