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

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

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

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

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

Effect of Biosilicate® Addition on Physical-Mechanical and Biological Properties of Dental Glass Ionomer Cements.

This study investigated the influence of incorporating Biosilicate® on the physico-mechanical and biological properties of glass ionomer cement (GIC). This bioactive glass ceramic (23.75% Na2O, 23.75% CaO, 48.5% SiO2, and 4% P2O5) was incorporated by weight (5%, 10%, or 15%) into commercially available GICs (Maxxion R and Fuji IX GP). Surface characterization was made by SEM (n = 3), EDS (n = 3), and FTIR (n = 1). The setting and working (S/W time) times (n = 3) and compressive strength (CS) were analyzed (n = 10) according to ISO 9917-1:2007. The ion release (n = 6) was determined and quantified by ICP OES and by UV-Vis for Ca, Na, Al, Si, P, and F. To verify cell cytotoxicity, stem cells from the apical papilla (SCAP) were exposed to eluates (n = 3, at a ratio of 1.8 cm2/mL) and analyzed 24 h post-exposure. Antimicrobial activity against Streptococcus mutans (ATCC 25175, NCTC 10449) was analyzed by direct contact for 2 h (n = 5). The data were submitted for normality and lognormality testing. One-way ANOVA and Tukey's test were applied for the working and setting time, compressive strength, and ion release data. Data from cytotoxicity and antimicrobial activity were submitted for Kruskal-Wallis' testing and Dunn's post hoc test (α = 0.05). Among all experimental groups, only those with 5% (wt) of Biosilicate® showed better surface quality. Only M5% showed a comparable W/S time to the original material (p = 0.7254 and p = 0.5912). CS was maintained for all Maxxion R groups (p > 0.0001) and declined for Fuji IX experimental groups (p < 0.0001). The Na, Si, P, and F ions released were significantly increased for all Maxxion R and Fuji IX groups (p < 0.0001). Cytotoxicity was increased only for Maxxion R with 5% and 10% of Biosilicate®. A higher inhibition of S. mutans growth was observed for Maxxion R with 5% of Biosilicate® (less than 100 CFU/mL), followed by Maxxion R with 10% of Biosilicate® (p = 0.0053) and Maxxion R without the glass ceramic (p = 0.0093). Maxxion R and Fuji IX presented different behaviors regarding Biosilicate® incorporation. The impacts on physico-mechanical and biological properties were different depending on the GIC, but therapeutic ion release was increased for both materials.

Microtensile bond strength of resin composite to dentin using different adhesive systems and directions of electric current.

Thisstudy aimed to evaluate the effect of the electric current direction application on the resin composite-dentin bond strength using three adhesive systems. Human molar teeth were distributed according to the adhesive system (two-step self-etch - Clearfil SE Bond, Kuraray [CSE]; one-step self-etch - Single Bond Universal, 3M ESPE [SBU]; and two-step etch-and-rinse - Adper Single Bond 2, 3M ESPE [SB2]), electric current direction (without electric current - control, direct and reverse electric currents - 35µA), and storage time (24h - immediate and 6 months). Resin composite blocks (Filtek Z350XT, 3M ESPE) were bonded to dentin. The teeth/resin composites specimens were stored in distilled water at 37ºC for 24 hours and 6 months for the microtensile bond strength (µTBS) test (n = 10; ~12 sticks for each tooth). Failure patterns were analyzed on a stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive or mixed. Adhesive penetration into dentin and hybrid layer formation were evaluated in a scanning electron microscope (n = 6). Data were submitted to a three-way ANOVA followed by Tukey's post hoc test (α = 0.05). There are no differences in µTBS when the adhesive systems were applied under direct and reverse electric currents, but both electric currents increased the µTBS for all adhesive systems. SBU showed the lowest µTBS values for control groups in both storage times and direct electric current in 6 months of storage. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. Storage for 6 months did not significantly decrease µTBS values. Both directions of electric current (positive and negative charges) at 35µA can increase the µTBS of the adhesive systems tested to dentin.

O objetivo neste estudo foi avaliar o efeito da direção da corrente elétrica na resistência da união resina composta-dentina usando três sistemas adesivos. Dentes molares humanos foram distribuídos de acordo com o sistema adesivo (dois passos autocondicionante - Clearfil SE Bond, Kuraray [CSE]; e um passo autocondicionante - Single Bond Universal, 3M ESPE [SBU]; e dois passos convencional - Adper Single Bond 2, 3M ESPE [SB2]), a direção da corrente elétrica (sem corrente elétrica - controle, correntes elétricas direta e reversa - 35µA) e tempo de armazenamento (24h - imediato e 6 meses). Blocos de resina composta (Filtek Z350XT, 3M ESPE) foram aderidos à dentina. Amostras de dentina-resina foram produzidas e armazenadas em água destilada a 37ºC por 24 horas e 6 meses para o teste de resistência da união à microtração (µTBS) (n = 10; ~12 palitos por dente). Os padrões de fratura foram analisados ​​em estereomicroscópio e classificados em falhas coesiva na dentina, coesiva na resina, adesiva ou mista. A penetração do adesivo na dentina e a formação da camada híbrida foram avaliadas em microscópio eletrônico de varredura (MEV). Os dados foram submetidos à ANOVA três fatores seguidos pelo teste post hoc de Tukey (α = 0,05). Não houve diferenças na µTBS quando os sistemas adesivos foram aplicados sob as correntes elétricas direta e reversa, mas ambas as correntes elétricas aumentaram a µTBS para todos os sistemas adesivos. SBU apresentou os menores valores de µTBS para o grupo controle em ambos os tempos de armazenamento e para a corrente elétrica direta em 6 meses de armazenamento. Falhas adesivas foram mais frequente em todos os grupos. A corrente elétrica formou longos tags resinosos para todos os sistemas adesivos. O armazenamento por 6 meses não diminuiu significativamente os valores de µTBS. Ambos os sentidos da corrente elétrica (cargas positivas e negativas) a 35µA podem aumentar a µTBS dos sistemas adesivos testados à dentina.

Microtensile bond strength of resin composite to dentin using different adhesive systems and directions of electric current

Resumo O objetivo neste estudo foi avaliar o efeito da direção da corrente elétrica na resistência da união resina composta-dentina usando três sistemas adesivos. Dentes molares humanos foram distribuídos de acordo com o sistema adesivo (dois passos autocondicionante - Clearfil SE Bond, Kuraray [CSE]; e um passo autocondicionante - Single Bond Universal, 3M ESPE [SBU]; e dois passos convencional - Adper Single Bond 2, 3M ESPE [SB2]), a direção da corrente elétrica (sem corrente elétrica - controle, correntes elétricas direta e reversa - 35µA) e tempo de armazenamento (24h - imediato e 6 meses). Blocos de resina composta (Filtek Z350XT, 3M ESPE) foram aderidos à dentina. Amostras de dentina-resina foram produzidas e armazenadas em água destilada a 37ºC por 24 horas e 6 meses para o teste de resistência da união à microtração (µTBS) (n = 10; ~12 palitos por dente). Os padrões de fratura foram analisados ​​em estereomicroscópio e classificados em falhas coesiva na dentina, coesiva na resina, adesiva ou mista. A penetração do adesivo na dentina e a formação da camada híbrida foram avaliadas em microscópio eletrônico de varredura (MEV). Os dados foram submetidos à ANOVA três fatores seguidos pelo teste post hoc de Tukey (α = 0,05). Não houve diferenças na µTBS quando os sistemas adesivos foram aplicados sob as correntes elétricas direta e reversa, mas ambas as correntes elétricas aumentaram a µTBS para todos os sistemas adesivos. SBU apresentou os menores valores de µTBS para o grupo controle em ambos os tempos de armazenamento e para a corrente elétrica direta em 6 meses de armazenamento. Falhas adesivas foram mais frequente em todos os grupos. A corrente elétrica formou longos tags resinosos para todos os sistemas adesivos. O armazenamento por 6 meses não diminuiu significativamente os valores de µTBS. Ambos os sentidos da corrente elétrica (cargas positivas e negativas) a 35µA podem aumentar a µTBS dos sistemas adesivos testados à dentina.

Abstract Thisstudy aimed to evaluate the effect of the electric current direction application on the resin composite-dentin bond strength using three adhesive systems. Human molar teeth were distributed according to the adhesive system (two-step self-etch - Clearfil SE Bond, Kuraray [CSE]; one-step self-etch - Single Bond Universal, 3M ESPE [SBU]; and two-step etch-and-rinse - Adper Single Bond 2, 3M ESPE [SB2]), electric current direction (without electric current - control, direct and reverse electric currents - 35µA), and storage time (24h - immediate and 6 months). Resin composite blocks (Filtek Z350XT, 3M ESPE) were bonded to dentin. The teeth/resin composites specimens were stored in distilled water at 37ºC for 24 hours and 6 months for the microtensile bond strength (µTBS) test (n = 10; ~12 sticks for each tooth). Failure patterns were analyzed on a stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive or mixed. Adhesive penetration into dentin and hybrid layer formation were evaluated in a scanning electron microscope (n = 6). Data were submitted to a three-way ANOVA followed by Tukey's post hoc test (α = 0.05). There are no differences in µTBS when the adhesive systems were applied under direct and reverse electric currents, but both electric currents increased the µTBS for all adhesive systems. SBU showed the lowest µTBS values for control groups in both storage times and direct electric current in 6 months of storage. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. Storage for 6 months did not significantly decrease µTBS values. Both directions of electric current (positive and negative charges) at 35µA can increase the µTBS of the adhesive systems tested to dentin.

Color alteration with ceramic veneers according to the tooth type and preparation step: A clinical analysis.

STATEMENT OF PROBLEM: Achieving accurate tooth color is important in esthetic dental treatments; however, clinical studies evaluating how ceramic veneer procedures affect color alterations are lacking. PURPOSE: The purpose of this clinical study was to assess the color alteration during treatment with ceramic veneers and to correlate these changes with the tooth treated and veneer thickness. MATERIAL AND METHODS: Ten patients who underwent esthetic treatment were enrolled as participants. Color analysis with the VITA spectrophotometer was performed at baseline, after tooth preparation, immediately after cementation (Final 1), and after 6 to 12 months of follow-up (Final 2). Data of L∗, a∗, b∗, shade guide unit (SGU), ΔEab, ΔE00, and variation in SGU (ΔSGU) were obtained. Thickness of the veneer was also recorded. Each participant was considered as a statistical block, and the mean results for each tooth (maxillary central incisors, lateral incisors, and canines) were presented. Data were evaluated by the mixed model for repeated measures and Tukey-Kramer post hoc test (L∗, a∗, b∗), generalized linear models (thickness, ΔEab, ΔE00, SGU), Friedman test (ΔSGU), and the Pearson test was used to correlate veneer thickness and color change (ΔEab, ΔE00, ΔSGU) (α=.05). RESULTS: Among the teeth treated, no differences were found in ceramic thicknesses. The mean thickness was 1.03 mm for central incisors, 0.96 for lateral incisors, and 0.89 for canines. The b∗ values increased significantly after preparation and decreased after cementation (P<.001). For ΔEab, ΔE00, and ΔSGU, there was no statistically significant difference between the types of tooth at each respective time of analysis (P>.05). Regardless of the tooth, a decrease in the SGU score was detected after cementation (P=.015). After tooth preparation, there was significant correlation (P<.05) between ceramic thickness and ΔSGU (r=0.36). CONCLUSIONS: Treatment with ceramic veneers resulted in color change, mainly with respect to the b∗ axis (yellow), producing objective differences in the ΔE analysis. Although ceramic thickness correlated with the VITA scale change (ΔSGU) after tooth wear or preparation, ceramic thickness did not differ among tooth types and did not correlate with changes in color parameters after cementation. (P>.05).

Synthesis, characterization, and incorporation of upconverting nanoparticles into a dental adhesive.

The purpose of this study was to describe the synthesis, characterization, and functionalization of b-NaYF4:30%Yb/0.5%Tm upconverting nanocrystals for use as nanofillers in a dental adhesive and microscopically evaluate the interface between the particles and a commercial adhesive. The upconverting nanoparticles were synthesized and purified by thermal decomposition, and their chemical composition determined by energy dispersive X-Ray spectroscopy. The crystalline structure was characterized using X-Ray diffraction and morphology and size were observed with scanning and transmission electron microscopy. Upconverting emission was evaluated by spectrophotometry irradiating the particles with a 975 nm diode laser. Particles were functionalized with polyacrylic acid and the success was confirmed by measurement of Zeta Potential and transmission electron microscopy. The results of X-ray diffraction found a pure hexagonal phase crystalline pattern. Scanning electron microscopy showed uniform dispersion of hexagonal-shaped particles of approximately 150 nm. Upconversion emission was observed in 344 nm, 361 nm, 450 nm, 474nm, 646 nm, 803 nm. Functionalization success was confirmed by formation of a stable aqueous colloid with a Zeta potential of -29.5mV and the absence of voids in the particle-adhesive interface on the transmission electron microscopy images. The reported synthesis and functionalization process produced upconverting nanoparticles emitting photons within the blue spectral region (450 nm and 474 nm).

In vitro efficacy of commercial and experimental proteolytic enzyme-based whitening dentifrices on enamel whitening and superficial roughness.

OBJECTIVE: To evaluate the whiteness index (WID ) and surface roughness (Ra) of bovine enamel after simulated tooth brushing with different commercial and experimental whitening dentifrices. MATERIALS AND METHODS: Cylindrical enamel bovine specimens were acid etched, stained, and divided in nine groups (n = 8): Colgate® Optic White®, Crest® Baking Soda and Peroxide, Arm and Hammer® Advanced White™ Extreme Whitening, Rembrandt® Deeply White® + Peroxide, Close up® White Attraction Natural Glow, Hinode Prowhite, and experimental dentifrice containing papain (PP), bromelain (PB), or papain and bromelain (PPB). Ra and WID were obtained initially and after 600, 1200, and 3,600 cycles of simulated tooth brushing. Data were analyzed using two-way analysis of variance test (α = 0.05). RESULTS: Ra was significantly influenced by both dentifrice (p = 0.043) and period of tooth-brushing simulation (p < 0.001). Except for PP and PPB, all groups showed a statistically significant increase in Ra after simulated tooth brushing. After staining and brushing, none of the materials tested increased the initial WID . CONCLUSIONS: The effect of commercial whitening dentifrices may be related to their high abrasiveness. Experimental formulations tested provided a similar effect without undesired wear of enamel. Whitening dentifrices only act through an abrasive effect rather than bleaching the tooth structures. When used, special care must be taken for avoid undesired wear of enamel. Experimental dentifrices provided similar removal of extrinsic stains without undesired abrasiveness; however, this effect may be due to the use of less aggressive abrasives in their formulations.

Resin composite adhesion to dentin using different curing lights and adhesive systems applied under electric current.

OBJECTIVES: To evaluate the effect of electric current application on the resin composite-tooth bond strength and hybrid layer of three adhesive systems light-cured by two light-curing units (LCUs). MATERIALS AND METHODS: Human molar teeth were distributed into 12 groups (n=6). Three adhesive systems were used: two-step etch-and-rinse (SB2; Adper Single Bond 2, 3M ESPE); two-step self-etch (CSE; Clearfil SE Bond, Kuraray); and one-step self-etch (SBU; Single Bond Universal, 3M ESPE) applied with (50µA) and without (control; conventional application) electric current, and light-cured with different LCUs. Resin composite blocks (Filtek Z350XT, 3M ESPE) were produced and cut into sticks (~1mm2) for microtensile bond strength (µTBS). Fracture patterns were analyzed on stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive, or mixed. Specimens were prepared for scanning electron microscope observation. The hybrid layer analysis was carried out using a confocal laser scanning microscopy (n=2). Data were submitted to three-way ANOVA followed by Tukey's post hoc test (α=0.05). RESULTS: The electric current increased the µTBS for all adhesive systems light-cured with single-emission peak and multiple-emission peak LCUs. Both LCUs presented similar µTBS values. CSE applied under electric current showed the highest µTBS mean values. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. CONCLUSIONS: The adhesive systems applied under electric current increased the bond strength using single-emission peak and multiple-emission peak LCUs. CLINICAL RELEVANCE: Electric current at 50µA applied throughout the dentin is a safe mode and results in better impregnation of the adhesive systems.

Synthesis, characterization, and incorporation of upconverting nanoparticles into a dental adhesive

Abstract: The purpose of this study was to describe the synthesis, characterization, and functionalization of b-NaYF4:30%Yb/0.5%Tm upconverting nanocrystals for use as nanofillers in a dental adhesive and microscopically evaluate the interface between the particles and a commercial adhesive. The upconverting nanoparticles were synthesized and purified by thermal decomposition, and their chemical composition determined by energy dispersive X-Ray spectroscopy. The crystalline structure was characterized using X-Ray diffraction and morphology and size were observed with scanning and transmission electron microscopy. Upconverting emission was evaluated by spectrophotometry irradiating the particles with a 975 nm diode laser. Particles were functionalized with polyacrylic acid and the success was confirmed by measurement of Zeta Potential and transmission electron microscopy. The results of X-ray diffraction found a pure hexagonal phase crystalline pattern. Scanning electron microscopy showed uniform dispersion of hexagonal-shaped particles of approximately 150 nm. Upconversion emission was observed in 344 nm, 361 nm, 450 nm, 474nm, 646 nm, 803 nm. Functionalization success was confirmed by formation of a stable aqueous colloid with a Zeta potential of −29.5mV and the absence of voids in the particle-adhesive interface on the transmission electron microscopy images. The reported synthesis and functionalization process produced upconverting nanoparticles emitting photons within the blue spectral region (450 nm and 474 nm).

Effect of indirect restorative material and thickness on light transmission at different wavelengths.

PURPOSE: The aim of this study was to evaluate the influence of indirect restorative material type and thickness on the transmission of different wavelengths from a broad-banded dental curing light. METHODS: Four dental indirect restorative materials for computer-aided design and computer-aided manufacturing (CAD/CAM) were evaluated: [RC] resin/ceramic hybrid material (Lava Ultimate), [FC] feldspathic ceramic (VitaBlocs), and two zirconia-based ceramics ([ZK] Katana; and [ZL] Lava). Total loss of irradiance (TL) was measured for blue (WB, 425-490nm) and violet (WV, 350-425nm) wavelengths. Specimens of 15×15mm with varying thicknesses (0.5, 1.0, 1.5, and 2.0mm) were fabricated (n=5). A plasma-arc dental light-curing unit was used (Arc Light-II). To assess TL as a function of wavelength, a software (Spectra Suite v5.1) connected to a spectroradiometer (USB2000) and an integrating sphere (CTSM-LSM-60-SF) was used. Data was subjected to statistical analysis (two-way ANOVA and post-hoc Tukey test, α=0.05). RESULTS: A 0.5mm interposition resulted in TL from 50.5 to 67.2%, depending on material. Increased thickness resulted in higher TL for all materials. FC showed less TL compared to ZK. In general, WV showed higher TL than did WB, and WV/WB proportion decreased with increasing thickness. CONCLUSIONS: Indirect materials significantly reduced TL, and this effect is greater with increasing thickness. WV showed lower penetration compared to WB.

Addition of phosphates and chlorhexidine to resin-modified MTA materials.

To evaluate the properties of experimental mineral trioxide aggregate (MTA) resin-modified materials for root-end filling procedures, varying their compositions regarding the addition of hydroxiapatite (HA) or dicalcium phosphate dihydrate, with or without chlorhexidine digluconate. White MTA (Angelus, Londrina, Brazil) was used as a reference material. Degree of conversion (DC) was evaluated by Fourier transformed infrared (FTIr) spectroscopy (n = 5). Flowability (n = 3) and radiopacity (n = 3) were evaluated following ISO 6876:2001 methods. For splitting tensile strength analysis, cylindrical samples (n = 10) were subjected to compressive load using a universal testing machine (Instron Corporation, Norwood, MA). Water sorption and solubility tests were performed according to ISO 4049:2009 methods. Calcium ion release and pH analysis (n = 10) were evaluated using a pH meter (Orion, Watsonville, CA). Cytotoxicity (n = 8) of materials extracts was evaluated as cell viability percentage. Statistical analysis was performed using Kolmogorov-Smirnov for normal distribution and data was subjected to one-way ANOVA and Tukey test (α = 0.05). Addition of chlorhexidine digluconate reduced DC mean values for experimental materials (<50%). White MTA demonstrated lower flowability (5.3 mm) and higher radiopacity (9.8 mm Al), splitting tensile strength (9.1 MPa), solubility (8.2 µg/mm3 ), calcium ion release (~26.5 ppm), cytotoxicity (55.2%), and pH mean values (10.8), when compared to experimental materials. All groups demonstrated a decrease in calcium release (<85%) and pH (<13%). Formulation containing HA demonstrated similar pH values after 28 days when compared to white MTA. Evaluated experimental resin-modified MTA based materials without chlorhexidine digluconate showed satisfactory results for all physico-chemical properties tested and cytotoxicity. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2195-2201, 2019.

Effects of ferrule and diameter of parallel cast post and core on fracture resistance / Efeitos da férula e diâmetro de núcleos metálicos paralelos na resistência a fratura

Objective: The aim of this study was to evaluate the effects of using different diameters of parallel cast posts with, or without ferrule, on the overall fracture resistance of Cast Post and Core (CPC). Material and Methods: Forty (40) endodontically treated human maxillary central incisors were divided into four groups (n=10): [F1] 1.0 mm diameter post with ferrule; [NF1] 1.0 mm diameter cast post without ferrule; [F1.5] 1.5 mm diameter cast post with ferrule; [NF1.5] 1.5 mm diameter post without ferrule. For all teeth, the post space (9.0 mm, in depth) was prepared using ParaPostTM drill. CPC using base metal alloy were fabricated and were cemented using resin modified glass ionomer (RMGI) cement along with the Porcelain Fused to Metal (PFM) crowns. A universal testing machine (Instron) was used to apply horizontal force perpendicular to the long axis of the tooth at the center of lingual surface, until catastrophic failure. Data was submitted to two-way ANOVA and Scheffé tests (P<0.05). Results: Both post diameter and ferrule statistically affected the maximum load at fracture (P=0.004 and P=0.013, respectively). The highest mean values were observed for samples with ferrule and wider post size (490N), while the lowest were observed for samples without ferrule and narrower post size (254N). There was no relationship between the presence of a ferrule and post size (P=0.937). Conclusion: For endodontically treated teeth with no ferrule, a wider-diameter cast post increased fracture resistance of a CPC and PFM crown procedure. (AU)

Objetivo: O objetivo do presente estudo foi avaliar os efeitos de diferentes diâmetros de núcleos metálicos paralelos (com ou sem férula) na resistência a fratura do procedimento restaurador. Material e Métodos: Quarenta (40) incisivos centrais superiores humanos foram tratados endodonticamente e divididos em quarto grupos (n=10): [F1] Diâmetro de 1.0 mm, com férula; [NF1] Diâmetro de 1.0 mm, sem férula; [F1.5] Diâmetro de 1.5 mm, com férula; [NF1.5] Diâmetro de 1.5 mm, sem férula. Para todos os dentes, o espaço foi preparado para o núcleo (9.0 mm, em comprimento) utilizando brocas do ParaPostTM. Os núcleos metálicos e as coroas metalocerâmicas fabricadas foram cimentados utilizando-se cimento de ionômero de vidro modificado por resina. Uma máquina de ensaios universal (Instron) foi utilizada para aplicar uma força horizontal perpendicular ao longo eixo do dente, no centro da face lingual, até falha catastrófica. Os dados foram analisados através de análise de variância de dois fatores e teste de Scheffé (p<0.05). Resultados: O diâmetro do núcleo e a presença (ou ausência) de férula afteram estatiscamente a resistência máxima a fratura do procedimento (P=0.004 e P=0.013, respectivamente). Os maiores valores foram observados para amostras com férula e de maior diâmetro (490N), enquanto os menores valores foram observados para amostras sem férula e de menor diâmetro (254N). Conclusão: Para dentes tratados endodondicamente, com férula, um núcleo de maior diâmetro aumentou a resistência a fratura de procedimentos restauradores envolvendo coroas metalocerâmicas cimentadas sobre núcleos metálicos fundidos. (AU)

Comparison of early treatment outcomes rendered in three different types of malocclusions.

OBJECTIVE: To evaluate the outcome of early treatment in Class I, II, and III malocclusions based on the reduction of weighted Peer Assessment Rating (PAR) scores. MATERIALS AND METHODS: Two hundred thirty subjects (female = 105; male = 125) selected from 400 cases were divided into three groups based on their malocclusions (Class I, II, and III). The PAR index was evaluated prior to early treatment (T0), at the end of phase I (T1), and after completion of phase II therapy (T2). The reliability of overall PAR scores was assessed by Bland-Altman plot and intraclass correlation coefficient. The starting age, total weighted PAR scores and their changes after phase I and II treatments, treatment time, and the percentage of correction in the three different malocclusions were assessed by repeated-measures analysis of variance with post hoc analysis. The level of significance was set at P < .05. RESULTS: More than 30% reduction of the weighted PAR scores and less than 10 points of the remaining weighted PAR scores were observed in all malocclusion groups at T1. The Class III group had the highest percentage of correction during phase I treatment. CONCLUSIONS: Early treatment effectively reduced the complexity of Class I, II, and III malocclusions and accounted for 57%, 64%, and 76% of the total correction, respectively, after phase I treatment, as indicated by an overall reduction in weighted PAR scores. The Class III group responded most favorably to early treatment followed by the Class II group.

Influence of adhesive cementation systems on the bond strength of relined fiber posts to root dentin.

STATEMENT OF PROBLEM: Glass fiber post cementation procedures have undergone significant development. Relining the post with composite resin is a technique that aims to reduce resin cement thickness and consequently problems inherent to polymerization. Evidence is sparse regarding the efficacy of bonding procedures at increasing depths (from cervical to apical) using different adhesive cementation techniques. PURPOSE: The purpose of this in vitro study was to evaluate the push-out bond strength (PBS) of composite resin relined glass fiber posts cemented to bovine root dentin using different adhesive cementation protocols. MATERIAL AND METHODS: Eighteen bovine teeth (n=6) were embedded in polystyrene resin blocks, and the crowns were sectioned leaving a root portion of 20 mm in length. Root canals were prepared using rotary instruments provided by the post manufacturer (Whitepost DC #1), resulting in a uniform root canal preparation. The root canals were lubricated with a water-soluble glycerin gel. Silane (Prosil) was applied and the posts relined with a microhybrid composite resin (Filtek Z100) to conform to the root canal anatomy. Three adhesive cementation protocols were evaluated: a 3-step etch-and-rinse adhesive system (Adper Scotchbond Multi Purpose) in combination with a dual polymerizing resin cement (RelyX ARC); a universal adhesive system (Scotchbond Universal) associated with a dual polymerizing resin cement (RelyX Ultimate); and a self-adhesive dual polymerizing resin cement (RelyX Unicem 2). The roots were sectioned, resulting in four 2-mm segments at 4 different depths (cervical to apical) and evaluated by the PBS test, using a universal testing machine (Instron 4411) at 0.5 mm/min, until failure. Interfaces were evaluated by scanning electron microscopy, and failures were classified as cohesive failure in composite resin, cohesive failure in cement, cohesive failure in root dentin, adhesive failure, or mixed. Data were analyzed by 2-way split-plot ANOVA and the Tukey post hoc test (α=.05). RESULTS: No statistical differences were found for PBS when different cementation systems were compared (P=.253). Increased depths resulted in reduced PBS values for all cementation protocols evaluated (P<.001). CONCLUSIONS: Regardless the cementation system used, the lowest PBS values were at the apical region of resin relined glass fiber posts bonded to root dentin. Furthermore, the highest PBS is observed at the cervical portion of root dentin.

Indirect Restoration Thickness and Time after Light-Activation Effects on Degree of Conversion of Resin Cement.

This study evaluated the effects of indirect restorative materials, curing conditions and time on the degree of conversion (DC) of a dual-cured resin cement using infrared spectroscopy. The resin cement (RelyX Unicem 2, 3M ESPE) was applied to the diamond surface of a horizontal attenuated-total-reflectance unit and activated using one of following conditions: self-cure, direct light exposure, light exposure through indirect restorative materials (resin nano-ceramic: Lava Ultimate, 3M ESPE or feldspathic ceramic: Vita Blocks Mark II, Vita Zahnfabrik). Four thicknesses (0.5, 1.0, 1.5 or 2.0 mm) of each indirect material were analyzed, and the light-activation was performed using a blue LED light. Data (n=5) were analyzed by three-way ANOVA, Tukey's post hoc and Dunnett's tests (α=5%). No significant differences in DC were observed between indirect materials of similar thickness. All groups exhibited higher DC after 10 min than after 5 min. At both times points, the self-cure group exhibited significantly lower DC than all the light exposure groups. Only when the overlying indirect restoration had a thickness of 2 mm did DC decrease significantly. The presence of a thick, indirect restoration can decrease the DC of resin cement. DC after 10 min was higher than after 5 min. The self-cure mode yielded lower DC than the light-activating one.

Indirect Restoration Thickness and Time after Light-Activation Effects on Degree of Conversion of Resin Cement

This study evaluated the effects of indirect restorative materials, curing conditions and time on the degree of conversion (DC) of a dual-cured resin cement using infrared spectroscopy. The resin cement (RelyX Unicem 2, 3M ESPE) was applied to the diamond surface of a horizontal attenuated-total-reflectance unit and activated using one of following conditions: self-cure, direct light exposure, light exposure through indirect restorative materials (resin nano-ceramic: Lava Ultimate, 3M ESPE or feldspathic ceramic: Vita Blocks Mark II, Vita Zahnfabrik). Four thicknesses (0.5, 1.0, 1.5 or 2.0 mm) of each indirect material were analyzed, and the light-activation was performed using a blue LED light. Data (n=5) were analyzed by three-way ANOVA, Tukey's post hoc and Dunnett's tests (α=5%). No significant differences in DC were observed between indirect materials of similar thickness. All groups exhibited higher DC after 10 min than after 5 min. At both times points, the self-cure group exhibited significantly lower DC than all the light exposure groups. Only when the overlying indirect restoration had a thickness of 2 mm did DC decrease significantly. The presence of a thick, indirect restoration can decrease the DC of resin cement. DC after 10 min was higher than after 5 min. The self-cure mode yielded lower DC than the light-activating one.

Este estudo avaliou os efeitos do tipo de material restaurador indireto, da condição de ativação e do tempo no grau de conversão de um cimento resinoso de dupla ativação, utilizando espectroscopia de luz infravermelha. O cemento resinoso (RelyX Unicem 2, 3M ESPE) foi aplicado à superfície do diamante da unidade de reflectância atenuada e ativado segundo as seguintes condições: ativação química, exposição direta da luz e aplicação da luz através de dois materiais protéticos: resina nano-cerâmica (Lava Ultimate, 3M ESPE) ou cerâmica feldspática (Vita Blocks Mark II, Vita Zahnfabrik). Quatro espessuras de cada um desses materiais (0,5; 1,0; 1,5 e 2,0 mm) foram analisadas e a ativação realizada com luz LED. Os dados (n=5) foram analisados pela ANOVA três fatores, testes de Tukey e Dunnett (5%). Nenhuma diferença do grau de conversão foi observada entre os materiais. Todos os grupos mostraram maior grau de conversão após 10 min que após 5 min. Em ambos os tempos, o grupo ativado quimicamente teve menor grau de conversão que todos os grupos fotoativados. O grau de conversão foi reduzido somente quando foi utilizada a peça protética de 2 mm. Espessas peças protéticas podem reduzir o grau de conversão do cemento resinoso. A grau de conversão após 10 min é maior que após 5 min da cimentação. A ativação química produz menor grau de conversão que a fotoativação.

Efeito de cerâmicas odontológicas na passagem da luz emitida por aparelhos fotoativadores / Effect of dental ceramics on the transmittance of light emitted by curing units

Este estudo avaliou a influência de dois tipos de cerâmicas odontológicas (óxido de zircônio e dissilicato de lítio) na transmitância da luz emitida por diferentes aparelhos fotoativadores. Discos com 1 mm de espessura e 10 mm de diâmetro foram preparados a partir dos materiais restauradores indiretos: IPS e.Max Zircad (lvoclar Vivadent) e IPS e.Max (lvoclar Vivadent). Sobre os materiais protéticos foi aplicada a cerâmica à base de nanofluorapatita (IPS e.Max Ceram, Ivociar vivadent), com 1 mm de espessura. Cinco diferentes aparelhos fotoativadores foram testados: Arc Light 11 (AirTechniques), ColtoLux LED (Colténe Whaledent), Elipar Free Light 2 (3M ESPE), Astralis 10 (lvoclar Vivadent) e Ultralume 5 (Ultradent), sendo esse último utilizado no modo normal, apenas com luz azul ou luz violeta. A irradiância através dos diferentes materiais restauradores foi mensurada com um espectroradiômetro (DAS 2100, Labsphere) associado a um software especifico (Spectra Suite, Ocean Optics). Os dados foram submetidos à analise de variância de 2 fatores e teste de T ukey (p:s;O,05). A luz emitida pelo aparelho arco de plasma (Arc Light 11) mostrou maior passagem através dos materiais indiretos estudados, enquanto a luz violeta emitida pelo aparelho Ultralume 5 foi a mais bloqueada entre os aparelhos. A zircônia permitiu maior passagem de luz quando comparada ao dissilicato de lítio. Os materiais restauradores indiretos estudados apresentaram comportamentos distintos com relação à passagem de luz. O tipo de aparelho fotoativador influenciou a irradiância através dos diferentes materiais restauradores.

This study evaluated the influence of different types of restorative indirect materiais (zirconium oxide and lithium disilicate) in transmittance of light emitted by different types of curing units. Discs with 1 mm thickness and 10 mm dia meter were prepared from the indirect restorative materiais: IPS e.max ZirCAD (Ivoclar Vivadent) and IPS e.max (Ivoclar Vivadent). A nanofluorapatite ceramic (IPS e.max, Ivoclar Vivadent) was applied over theindirect materiais with 1 mm thickness. Five different light curing units were tested: Arc Light II (Air Technologies), ColtoLux LED (Colténe Whaledent), Elipar Free Light 2 (3M ESPE), Astralis 10 (Ivoclar Vivadent) and Ultralume 5 (Ultradent), which was used in regular mode, only light blue and only violet. The Irradiance through different restorative materiais was measured using a spectroradiometer (DAS 2100, Labsphere) associated with a specific software (Spectra Suite, Ocean Optics). Data were analyzed by two-way analysis of variance and Tukey test (p:s;O,05). The plasma are curing unit (Arc Light 11) showed the highest irradiance values through different restorative materiais, while the light source Ultralume 5, violet mode, showed the lowest irradiance values through different restorative materiais. The zirconia allowed higher light intensity passed through it when compared to lithium disilicate. The indirect restorative materiais tested showed distinct properties regarding the transmittance of light. Type of curing unit significantly influenced the Irradiance through different restorative materiais.

Avaliação do efeito da aplicação de primers para metal e do tipo de cimento resinoso na resistência de união à zircônia / Evaluation of the effect of metal primers and type of resin cement on the bond strength to zirconia

Esse estudo avaliou a influência de primers para metal e o tipo de cimento resinoso na resistência de união (RU) à zircônia tetragonal estabilizada por ítrio, após 24 horas e 6 meses de armazenamento em água. Placas de zircônia (13 mm X 5 mm X 1 mm) foram utilizadas em 8 grupos experimentais (n = 10). O ensaio de RU utilizado foi o de microcisalhamento. Os resultados obtidos foram analisados por três fatores Anova (uso de primer, tipo d e cimento resinoso e tempo de armazenamento) e teste de Tukey (α = 0,05). A aplicação do primer não influenciou a RU e o cimento Clearfil SA Cement resultou em maior RUà zircônia. O armazenamento por seis meses reduziu a RU para todos os grupos.

This study evaluated the influence of a metal primer application and the type of resin cement on the bond strength (BS) to yttrium-stabilized tetragonal zirconia, after 24 hours and 6 months of water storage. Zirconia plates (13 mm X 5 mm X 1 mm) were used in 8 experimental groups (n = 10). The micro-shear bond strength test was used in this study. The results were analyzed by three-way Anova (primer application, type of resin cement, storage time) and Tukey test (α = 0.05). The primer application did not influence the BS and the resin cement Clearfil SA Cement resulted in higher BS to zirconia. The storage in water for 6 months reduced the BS for all groups.