Impact of simulated toothbrushing on surface properties of chairside CAD-CAM materials: An in vitro study.

STATEMENT OF PROBLEM: Chairside computer-aided design and computer-aided manufacturing (CAD-CAM) materials that do not require any firing steps are a promising option to expedite restoration production; however, little information is available to determine the most suitable material for each clinical situation. PURPOSE: The purpose of this in vitro study was to evaluate the effect of simulated toothbrushing on surface gloss, roughness, and wear of chairside CAD-CAM materials. MATERIAL AND METHODS: Disk-shaped specimens (n=15) were prepared of the following materials: ENA-VITA Enamic; LAV-Lava Ultimate; EMP-IPS Empress CAD; CER-Cerasmart; GRA-Grandio blocs. Gloss (Gloss Unit-GU) and surface roughness (Ra-µm) were evaluated before and after simulated toothbrushing (100 000 strokes). Wear (µm) was assessed by contact profilometry. Additional analyses of microhardness by scanning electron microscopy were also performed. Data were analyzed with 2-way repeated measures ANOVA test for roughness and gloss, and 1-way ANOVA for wear (α=.05). To estimate the correlation between Ra and GU, the Pearson correlation was calculated. RESULTS: Before brushing, CER showed the lowest Ra (P<.001), and GRA the lowest GU values. After brushing, the feldspathic ceramic-based materials (ENA and EMP) presented the highest gloss, whereas the ceramic group (EMP) showed the lowest Ra. Before and after brushing, GRA showed the lowest GU values. Higher wear values were found for the composite resin groups (CER>GRA), with the exception of LAVA, which was similar to ENA, and EMP showing improved wear resistance. A strong negative correlation (-0.925) between GU and Ra values was detected (P<.001). CONCLUSIONS: The materials containing a glass phase (ENA and EMP) presented higher wear resistance, higher gloss, and lower roughness after brushing than the other materials tested. The correlation test showed that the higher the surface roughness, the lower the gloss.

Influence of Preparation Design, Restorative Material and Load Direction on The Stress Distribution of Ceramic Veneer in Upper Central Incisor / Influência do desenho de preparo, material restaurador e direção de carga na distribuição de tensão de laminado cerâmico em incisivo central superior

Objective: Evaluate the effect of four preparation designs, two ceramic materials, and two occlusion contact types on the stress distribution of ceramic veneer in upper central incisor. Material and methods: 3D-models were performed in the modeling software containing enamel, dentin, pulp, periodontal ligament and a base of polyurethane resin. The designs were modeled and exported to the computer aided engineering software to perform the static structural analysis. For the mesh, a total of 155429 tetrahedron elements and 271683 nodes were used, after a 10% convergence test. Two materials, lithium disilicate and feldspathic ceramics, were simulated. A static load of 100 N on 45º was applied on the incisal and middle thirds of the palatal tooth region, guided by the occlusal plane. The base was constrained in all directions. The Maximum Principal Stress was the failure criteria chosen for the analysis. Results:The Finite Element Analysis showed that the most conservative designs presented less stress concentration on the ceramic veneer. However, the highest tensile stress concentrations were observed on lithium disilicate veneer with extend design, on the middle third. The type of occlusal contact presented different stress patterns among the preparation designs; the incisal contact showed higher stress concentration compared to middle third contact regardless the ceramic material. Conclusion: To perform a ceramic veneer in upper central incisor, the feldspathic ceramic presented promising results and should be recommended when the extended design was done. Regarding contact types, the incisal contact is more prone to failure regardless the ceramic and preparation design. (AU).

Objetivo: Avaliar o efeito de quatro desenhos de preparo, dois materiais cerâmicos e dois tipos de contato oclusais na distribuição de tensão de laminado cerâmico em incisivo central superior. Material e métodos: Modelos 3D foram realizados em software de modelagem contendo esmalte, dentina, polpa, simulador de ligamento periodontal e uma base de resina de poliuretano. Os desenhos foram modelados e exportados para o software de engenharia para realizar análise estatística estrutural. Para a malha, foram usados um total de 155429 elementos tetraedros e 271683 nós, após teste de convergência de 10%. Dois materiais, dissilicato de lítio e cerâmica feldspática, foram simulados. Uma carga estática de 100N em 45º foi aplicada no terço incisal e médio na região palatina do dente, guiada pelo plano oclusal e a base foi restringida em todas as direções. A tensão de tração foi o critério de falha escolhido para a análise. Resultados: A análise de elementos finitos mostrou que os desenhos mais conservadores apresentaram menor concentração de tensão no laminado cerâmico. Contudo, as maiores concentrações de tensões foram observadas no laminado de dissilicato de lítio com preparo estendido no terço médio. O tipo de contato oclusal apresentou diferentes padrões de tensões entre os diferentes desenhos, o contato incisal mostrou maior concentração de tensão em relação ao contato do terço médio independentemente do material cerâmico Conclusão: Para a confecção de laminado cerâmico em incisivo central superior, a cerâmica feldspática apresentou resultados promissores e é recomendada quando for feito preparo estendido. Em relação aos tipos de contato, o contato incisal é mais sujeito a falhas independentemente da cerâmica e desenho do preparo. (AU)

Masticatory force and electromyographic activity of the mandibular elevators muscles in different rehabilitation treatments / Força mastigatória e atividade eletromiográfica dos músculos elevadores mandibulares em diferentes tratamentos de reabilitação

Objective: The masticatory function is one of the most complex neuropsychological mechanisms in human motor performance and it depends on several factors, such as bite force, muscle coordination, morphology, and number of teeth in occlusion. To evaluate the influence of different rehabilitation treatments such as complete and partial dentures, masticatory forces, and the dynamics of mandibular elevator muscles. Material and Methods: the maximum bite force (force transducer) and electrical activity (superficial electromyography) associated with the masseter and temporal muscles were quantified. These factors were evaluated at rest position and isometric contraction. The data were subjected to descriptive statistics and compared based on the experimental groups, through ANOVA and Tukey's tests. Results: for bite force, the ANOVA test showed statistical difference between groups and Tukey's test showed that the force measured in the removable partial dentures group was 44.75% lower than that of the control group, while for complete denture wearers, there was a reduction of 74.4% in bite force in relation to the control group. For electromyographic activity, there was no statistical difference between groups. Pearson's correlation test (α = 5%) showed positive correlation between the variables of bite force and electromyographic activity only for the control group. Conclusion: it was concluded that the loss of dental elements and their replacement with either partial or complete dentures has a great influence on bite force and electromyographic activity of the masseter and temporal muscles. (AU)

Objetivo: A função mastigatória é um dos mecanismos neuropsicológicos mais complexos no desempenho motor humano e depende de vários fatores, como força de mordida, coordenação muscular, morfologia e número de dentes na oclusão. Avaliar a influência de diferentes tratamentos de reabilitação, como próteses totais e parciais, forças mastigatórias na dinâmica dos músculos elevadores da mandíbula. Material e Métodos: quantificaramse a força máxima de mordida (transdutor de força) e a atividade elétrica (eletromiografia superficial) associadas aos músculos masseteres e temporais. Esses fatores foram avaliados na posição de repouso e contração isométrica. Os dados foram submetidos à estatística descritiva e comparados com base nos grupos experimentais, através dos testes ANOVA e Tukey. Resultados: para força de mordida, o teste ANOVA mostrou diferença estatística entre os grupos e o teste de Tukey mostrou que a força medida no grupo próteses parciais removíveis foi 44,75% menor que a do grupo controle, enquanto para os usuários de prótese total houve redução 74,4% na força de mordida em relação ao grupo controle. Para a atividade eletromiográfica, não houve diferença estatística entre os grupos. O teste de correlação de Pearson (α = 5%) mostrou correlação positiva entre as variáveis força de mordida e atividade eletromiográfica apenas para o grupo controle. Conclusão: concluiu-se que a perda de elementos dentais e sua substituição por próteses parciais ou totais têm grande influência na força de mordida e na atividade eletromiográfica dos músculos masseteres e temporais. (AU)

Botulinum toxin for modulating the muscle strength of patients rehabilitated with zygomatic implants / Toxina botulínica para modulação da força muscular de pacientes reabilitados por implantes zigomáticos

Objective: To measure the intensity of muscle strength and electrical activity of masseter and anterior temporal muscles based on BTX-A therapy in patients rehabilitated with total prostheses on zygomatic implants. Material and Methods: The object of the study was a sample of 20 individuals subjected to zygomatic implant surgery and rehabilitated with implant-supported prostheses, in order to obtain electromyographic data using an eight-channel module (EMG System do Brasil). The data were collected for three consecutive months: prior to the application (single dose) of BTX-A (30 U/ masseter muscle; 10 U/temporal muscle) and after 30 and 90 days of therapeutic treatment. Result: All muscle groups studied showed reduction of muscle electrical activity during voluntary contraction after 30 days of treatment (around 47%) (p < 0.001), which progressively reverted after 90 days of treatment. The anterior temporal muscles presented similar motor behavior, with activity reduction of 39% (p < 0.05). There was a reduction of 17.68% (p < 0.05) in mandibular force and an increase of 14.22% (p < 0.05) in mouth opening after 30 days of BTX-A administration. Conclusions: The results suggest that BTX-A significantly reduces muscle activity, in either the recruitment of motor units or muscle tone, in the first three months of therapeutic treatment. This therapy may also be useful as a preventive method for the failure of zygomatic implant-supported prostheses. (AU)

Objetivo: Medir a intensidade da força muscular e atividade elétrica dos músculos temporal anterior e masseteres em função da terapia com BTX-A em pacientes reabilitados por próteses totais sobre implantes zigomáticos. Material e Métodos: Uma amostra composta por 20 indivíduos submetidos à cirurgia de implantes zigomáticos e reabilitados com próteses implantossuportadas foi objeto de estudo para obtenção de dados eletromiográficos utilizando um módulo de oito canais (EMG System do Brasil). Os dados foram coletados por três meses consecutivos: antes da aplicação (dose única) de BTX-A (30U / masseter muscular; 10U / temporal), após 30 e 90 dias do tratamento terapêutico. Resultados: Todos os grupos musculares estudados apresentaram redução da atividade elétrica muscular durante a contração voluntária, após 30 dias de tratamento (em torno de 47%) (p < 0,001), e revertidos progressivamente após 90 dias de tratamento. Os temporais anteriores apresentaram comportamento motor semelhante, apresentando redução de atividade de 39% (p < 0,05). Foi observada uma redução de 17,68% (p < 0,05) na força mandibular, assim como um aumento na abertura bucal de 14,22% (p < 0,05) após 30 dias da administração da BTX-A. Conclusões: Os resultados sugerem que a BTX-A reduz significativamente a atividade muscular, seja no recrutamento de unidades motoras ou no tônus muscular, nos primeiros três meses de tratamento terapêutico e pode ser útil como método preventivo de falha de prótese suportada por implantes zigomáticos.(AU)

Influence of drying time of adhesive systems on the bond strength between resin cement and feldspathic ceramic / nfluência do tempo de secagem de sistemas adesivos na resistência de união entre cimento resinoso e cerâmica feldspática

Objetivo: Este estudo se propôs avaliar o efeito de diferentes tempos de secagem de dois adesivos tipo ‘total-etch & rinse’ e ciclagem térmica na resistência adesiva entre cerâmica feldspatica e cimento resinoso. Material e Métodos: Trinta e dois blocos (12×10×4 mm) de cerâmica feldspática e respectivos blocos (32) de resina composta foram obtidos. A superfície de cimentação de cada bloco cerâmico foicondicionada por ácido fluorídrico (HF), silanizada (S), e recebeu a aplicação de um dos dois sistemas adesivos testados (SB - Single Bond 2, 3M-ESPE; ou PB – Prime & Bond NT, Dentsply). Então a superfície com o adesivo foi seca em diferentes tempos (5, 10 e 15s) antes da cimentação. Após, um cimento resinoso foi aplicado sobre a superfície de cimentação e o bloco correspondente de resina foi cimentado. Os palitos para microtração foram obtidos, sendo que metade deles foram imediatamente testados, enquanto os demais foram submetidos à ciclagem térmica e armazenagem (150 dias). Para os grupos sem envelhecimento, o tempo de secagem mais longo (15s) aumentou a resistência para o adesivo SB, enquanto que reduziu a resistência para o adesivoPB. Resultados: Para os grupos envelhecidos, as resistências adesivas dos diferentes tempos de secagem não foram diferentes estatisticamente, independente do adesivo. A falha predominante foi coesiva do cimento resinoso, seguido pela falha na interface cerâmica cimento. Conclusão: Conclui se que tempos mais longos de secagem podem melhorar a resistência adesiva à cerâmica testada, usando o adesivo SB. Por outro lado, tempos mais curtos podem otimizar a adesão para o adesivo PB. O envelhecimento afetou a adesão somente nos grupos do adesivo SB

Objective: This study evaluated the effect of drying times of two total-etch & rinse adhesives on the resin bond strength to a feldsphatic ceramic, before and after aging. Material and Methods:Feldsphatic-ceramic CAD-CAM bars were cut into blocks (12×10×4 mm) with a cutting machine (N = 32). Impressions were made of each ceramic block with silicone putty material and the negativespace was filled with a composite resin. The bonding ceramic surface was etched with hydrofluoric acid, silanized, and the adhesive system (SB- Single Bond 2, 3M-ESPE; or PB- Prime & Bond NT, Dentsply) was applied. The samples were dried at different times (5, 10 and 15 s) before the cementation. The resin and ceramic blocks were cemented bya dual cure resin cement. All samples were stored in distilled water at 37 °C for 24 h. For the μ-TBS test, the samples were sliced into microbars. Half of the bars of each block was tested after 24 h and, the other bars were submitted to thermocycling (12,000×) and water storage (150 d). For the 24 h groups, the longer drying time increased (p < 0.05) the bond strength of SB (water/alcohol adhesive), while reduced (p < 0.05) for the PB group (acetone based adhesive). Results: For the aged groups, the bond strength for the different drying times had no significant difference, for the both adhesives. Conclusion: Longer drying times increased the bond strength values of SB. Smaller drying times increased the bond strength values of PB. The aging protocol influenced the bond strength of SB groups.

CVD tip or diamond bur: can they influence the bondstrength of a total-etch adhesive to dentin? / Pontas diamantadas e CVD: podem influenciar na força de união de um adesivo convencional à dentina?

Evaluate the microtensile bond strength of a total-etch adhesive to dentin, using a CVD tipor diamond bur for dentin preparation and varying the etching time. Material and Methods: The dentin from the buccal surface of sixty bovine teeth was exposed and prepared using two different methods(n = 30): Group 1 (DB) – a diamond bur on a high-speed hand piece; and Group 2 (CVD) – a CVDtip on an ultrasonic hand piece. Each group used37% phosphoric acid and was divided into three subgroups, according to the etching time (n = 10):Subgroup 5s - 5 seconds; Subgroup 10s - 10 seconds; and Subgroup 15s - 15 seconds. Teeth were restored with Single Bond adhesive and the composite resin Herculite Classic. The specimens were subjected to thermo mechanical wear (mechanical cycling/100.000 cycles, thermal cycling/1.000cycles). Stick-like specimens were obtained and submitted to a microtensile test in a universal testing machine. Data (MPa) were analyzed by two-way ANOVA (Surface treatment X Etching time) andTukey’s test (5%). Results and Conclusion: Surface treatment with CVD tips (27.70 ± 4.04a) produced significantly higher bond strength values compared to diamond burs (23.96 ± 5.83b), and 5 s etching time on dentin produced similar bond strength values when compared to 10 and 15 s etching times...

Objetivo: avaliar a força de união de um adesivo convencional à dentina, usando pontas diamantadas e pontas CVD para preparo dentinário e variando o tempo de condicionamento ácido a dentina. Material e Métodos: A dentina da superfície vestibular de 60 dentes bovinos foi exposta e preparada usando dois diferentes métodos (n=30): Grupo 1 (DB) – ponta diamantada tradicional para alta rotação; e Grupo 2(CVD) – ponta CVD montada em ultrassom. Cada grupo foi dividido em três subgrupos, de acordo com o tempo de condicionamento ácido (n=10): Subgrupo 5s - 5 segundos; Subgrupo 10s - 10 segundos; e Subgrupo 15s- 15 segundos. Os dentes foram restaurados com adesivo convencional Single Bond e resina composta Herculite Classic. As restaurações foram submetidas à ciclagemtermo-mecânica (ciclagem mecânica/100.000 ciclos,ciclagem térmica/1.000 ciclos). Palitos foram obtidos e submetidos ao teste de microtração na máquina de ensaios universal. Os dados (MPa) foram analisados por ANOVA dois-fatores (Tratamento de superfície X condicionamento) e teste de Tukey (5%). Resultado e Conclusão: O tratamento de superfície com pontas CVD (27.70 ± 4.04a) resultaram em valores de adesão significantemente maiores quando comparados com as pontas diamantadas (23.96 ± 5.83b), e 5 segundos de condicionamento ácido sobre a dentina produziu valores similares de adesão quando comparado aos tempos de 10 e 15 segundos de condicionamento...

Effects of Different Polishing Protocols on Lithium Disilicate Ceramics.

The aim of this study was to evaluate the effect of different polishing protocols on surface roughness and morphology of lithium disilicate ceramics (IPS e.max CAD). Fifty ceramic bars (2.0x3.0x2.5 mm) were produced and randomly divided into five groups (n=10), according to surface treatments: C: Control; Cer: Ceramaster (60 s); CW: cloth wheel with large-grit diamond (30 s) + cloth wheel with fine-grit diamond paste (30 s); E: grey Exa-Cerapol (20 s) + pink Exa-Cerapol (20 s) + Cerapol Super (20 s); F: Felt wheel with large-grit diamond paste (30 s) + Felt wheel with fine-grit diamond paste (30 s). The samples were evaluated quantitatively for surface roughness (Ra) and qualitatively by SEM, at different moments: initial (prior to roughening), after roughening and after polishing procedures. Ra means were submitted to two-way ANOVA and Tukey test (p<0.05). After the different polishing protocols, no statistically significant differences were observed between the Cer and E groups (p=0.6347), E and CW groups (p=0.1366), and CW and FW groups (p=0.5433). Comparing different stages in the same group, it was possible to observe that CW (p<0.0001) and FW groups (p<0.0001) showed significant differences. SEM analysis revealed that both Cer and E groups exhibited a surface morphological pattern similar to that of control group. All polishing systems were effective in reducing the surface roughness of the studied ceramic type.

Afastamento gengival: técnicas e materiais / Gingival retraction: techniques and materials

Este trabalho teve como objetivo levar o leitor a uma revisão da literatura sobre os diferentes métodos de afastamento gengival, suas técnicas, indicações e contraindicações. Foram abordadas as variações dos métodos e técnicas, a fim de facilitar a escolha mais adequada às diferentes situações clínicas. São feitas considerações sobre as soluções químicas, os fios utilizados para o afastamento gengival, as pastas adstringentes, bem como a combinação entre eles. Foram elaborados quadros comparativos entre os diferentes métodos de afastamento gengival, entre as soluções químicas mais utilizadas e entre as diferentes marcas comerciais existentes.

This paper aims to take the reader on a review of literature about the diff erent methods of gingival retraction, their techniques, indications and contraindications. Variations of the methods and techniques were discussed in order to facilitate the most appropriate choice for diff erent clinical situations. Some considerations were made about the chemical solutions, the gingival retraction cords, as well as their combination. Comparative tables among the diff erent gingival retraction methods, the most used chemical solutions, and the diff erent trademarks were prepared.

Effects of Different Polishing Protocols on Lithium Disilicate Ceramics

Abstract: The aim of this study was to evaluate the effect of different polishing protocols on surface roughness and morphology of lithium disilicate ceramics (IPS e.max CAD). Fifty ceramic bars (2.0x3.0x2.5 mm) were produced and randomly divided into five groups (n=10), according to surface treatments: C: Control; Cer: Ceramaster (60 s); CW: cloth wheel with large-grit diamond (30 s) + cloth wheel with fine-grit diamond paste (30 s); E: grey Exa-Cerapol (20 s) + pink Exa-Cerapol (20 s) + Cerapol Super (20 s); F: Felt wheel with large-grit diamond paste (30 s) + Felt wheel with fine-grit diamond paste (30 s). The samples were evaluated quantitatively for surface roughness (Ra) and qualitatively by SEM, at different moments: initial (prior to roughening), after roughening and after polishing procedures. Ra means were submitted to two-way ANOVA and Tukey test (p<0.05). After the different polishing protocols, no statistically significant differences were observed between the Cer and E groups (p=0.6347), E and CW groups (p=0.1366), and CW and FW groups (p=0.5433). Comparing different stages in the same group, it was possible to observe that CW (p<0.0001) and FW groups (p<0.0001) showed significant differences. SEM analysis revealed that both Cer and E groups exhibited a surface morphological pattern similar to that of control group. All polishing systems were effective in reducing the surface roughness of the studied ceramic type.

Resumo: O objetivo deste estudo foi avaliar o efeito de diferentes protocolos de polimento sobre a rugosidade e morfologia superficial de uma cerâmica à base de dissilicato de lítio (IPS e.max CAD). Foram confeccionadas 50 barras cerâmicas (2,0x3,0x2,5 mm), separadas aleatoriamente em cinco grupos (n=10), conforme os tratamentos de superfície: C: Controle; BC: Borracha Ceramaster (60 s); RP: Roda de pano impregnado granulação grossa (30 s) + Roda de pano impregnado granulação fina (30 s); BE: Borracha Exa-Cerapol cinza (20 s) + Borracha Exa-Cerapol rosa (20 s) + Borracha Cerapol Super (20 s); RF: Roda de feltro com pasta diamantada grossa (30 s) + roda de feltro com pasta diamantada fina (30 s). As amostras foram avaliadas quantitativamente quanto à rugosidade superficial (Ra) e qualitativamente em MEV, em diferentes momentos: inicialmente (antes da asperização), após asperização e após os polimentos. As médias de Ra foram submetidas aos testes estatísticos ANOVA (two-way) e Tukey (p<0,05). Após os diferentes protocolos de polimento, não foi possível observar diferenças significativas entre os grupos BC e BE (p=0,6347), entre BE e RP (p=0,1366) e RP e RF (p=0,5433). Comparando as diferentes etapas de um mesmo grupo foi possível observar que os grupos RP (p<0,0001) e RF (p<0,0001) apresentaram diferenças significativas. Em MEV, os grupos BC e BE apresentam um padrão morfológico superficial semelhante ao grupo controle. Todos os sistemas de polimento foram efetivos na redução da rugosidade de superfície para o mesmo padrão de cerâmica.

The effect of CPP-ACP and Nd:YAG laser on the bond strength of softened dentin.

The purpose of this study was to investigate the effect of CPP-ACP treatment and Nd:YAG laser on microtensile bond strength (µTBS) of softened dentin. Sixty samples were obtained from thirty sound third molars. All samples were submitted to dentin softening procedure, by the immersion of the specimens in 30 mL of Sprite Zero for 30 min. Afterwards, the samples were randomly divided according to the CPP-ACP treatment: CG-Control group; MP-treated with CPP-ACP paste (MI Paste); MPP-treated with CPP-ACP+900 ppm NaF paste (MI Paste Plus). Each group was further divided according to bonding procedure: NL-No laser; L-Laser irradiation after adhesive application and before polymerization. The laser parameters used were 1.4 W, 10 Hz, 140 mJ/pulse, with an optic fiber of 320 µm, generating energy of 174 J/cm(2) per pulse. All samples were restored with Clearfil SE Bond/Filtek Z350 XT. After 24 h, the restored samples were cut into beams (± 1 mm(2) adhesive interface area) and subjected to a µTBS test. Data were analyzed by two-way ANOVA test and Holm-Sidak post-hoc method (α = 0.05). The treatment with CPP-ACP pastes did not significantly affect softened dentin µTBS (p = 0.070). Statistic revealed significant reduction on µTBS values for CG/L, leading to the rejection of the second null hypothesis (p < 0.001). Both CPP-ACP based pastes did not affect µTBS of softened dentin for the adhesive system utilized. The Nd:YAG laser irradiation after application of adhesive system did affect µTBS values of softened dentin samples untreated with CPP-ACP based pastes.

Bond strength of a self-adhesive resin cement to enamel and dentin.

The purpose of this study was to evaluate the influence of surface treatments and thermocycling on the microtensile bond strength (µTBS) of self-adhesive resin cement to human enamel and dentin. Eighty human third molars were selected. The crowns of 40 teeth were transversally sectioned, exposing the mid-coronal dentin. The buccal surfaces of the other 40 teeth were grinded to obtain a 5 mm2 flat enamel area. Eighty resin blocks were produced and cemented to the dental surfaces with RelyX Unicem, then grouped according to the surface treatment (n=10): UnicemC with no conditioning, UnicemP with 37% phosphoric acid/15 s, and UnicemPA with 37% phosphoric acid/15 s plus adhesive bonding (Single Bond 2). There were two control groups, one for enamel and the other for dentin: VR with 37% phosphoric acid/15 s plus adhesive bonding (Single Bond 2) plus Variolink II. The enamel-dentin resin cement blocks were sectioned to produce non-trimmed bar specimens, which were divided into two storage conditions: dry, µTBS immediately after cutting; TC (5,000 x; 5°C/55°C). The samples were submitted to µTBS, and data were statistically analyzed by ANOVA and Tukey's test. The results showed statistical differences between UnicemC and the others. UnicemPA and VR showed better bond strength to dentin during the period before and after thermocycling, respectively. For the enamel, UnicemP showed better bond strength for both situations. Only for UnicemPA did the thermocycling significantly decrease the bond strength values. Within the limits of this study, it could be concluded that the bond strength is influenced by the surface treatments, and that thermocycling decreases the bond strength of all groups, but significantly only for UnicemPA.

The effect of CPP-ACP and Nd:YAG laser on the bond strength of softened dentin

The purpose of this study was to investigate the effect of CPP-ACP treatment and Nd:YAG laser on microtensile bond strength (µTBS) of softened dentin. Sixty samples were obtained from thirty sound third molars. All samples were submitted to dentin softening procedure, by the immersion of the specimens in 30 mL of Sprite Zero for 30min. Afterwards, the samples were randomly divided according to the CPP-ACP treatment: CG-Control group; MP-treated with CPP-ACP paste (MI Paste); MPP-treated with CPP-ACP+900 ppm NaF paste (MI Paste Plus). Each group was further divided according to bonding procedure: NL-No laser; L–Laser irradiation after adhesive application and before polymerization. The laser parameters used were 1.4 W, 10 Hz, 140 mJ/pulse, with an optic fiber of 320 µm, generating energy of 174 J/cm2 per pulse. All samples were restored with Clearfil SE Bond/Filtek Z350 XT. After 24 h, the restored samples were cut into beams (± 1 mm2adhesive interface area) and subjected to a µTBS test. Data were analyzed by two-way ANOVA test and Holm-Sidak post-hoc method (α = 0.05). The treatment with CPP-ACP pastes did not significantly affect softened dentin µTBS (p = 0.070). Statistic revealed significant reduction on µTBS values for CG/L, leading to the rejection of the second null hypothesis (p < 0.001). Both CPP-ACP based pastes did not affect µTBS of softened dentin for the adhesive system utilized. The Nd:YAG laser irradiation after application of adhesive system did affect µTBS values of softened dentin samples untreated with CPP-ACP based pastes.

Polishing for glass ceramics: which protocol?

PURPOSE: The execution of adjustments on ceramic restorations is sometimes necessary for either correction of occlusion and/or inadequate contours or esthetical improvements. Clinically, the surfaces undergo weariness through fine grinding diamond burs which remove the superficial glazing layer. Several materials for ceramic polishing have been used in an attempt to reach a satisfactory surface smoothness. The aim of this study was to perform a literature review on different polishing protocols of several dental ceramics. STUDY SELECTION: This is a literature review performed through scientific articles published between 2004 and 2012, indexed in MEDLINE, PubMed and Scielo databases. The study selected and analyzed a total of 20 relevant articles that evaluated different types of ceramics, polishing treatment and surface roughness. RESULTS: After an extensive literature review, this study observed: 1 - after the rupture of the glazing layer due to the adjustments of the restorations, the best choice for the polishing of the surface will depend on the type of ceramics used; 2 - glazing procedure provide excellent results regarding to the superficial smoothness; however, if reglazing is impossible, either abrasive rubber cups/points or sandpaper discs followed by the use of diamond polishing pastes results in a satisfactory superficial smoothness; 3 - clinical studies that take into account the behavior of the protocols polishing are scarce and should be encouraged; 4 - the large number of variables influence the final outcome of polishing should be considered. CONCLUSIONS: The necessity in standardization of methodologies to enable a comparison among researches.

Bond strength of adhesive systems with different solvents to dry and wet dentin.

AIM: This study evaluates bond strength between dentin and composite using adhesives with different solvents to dry and wet dentin. MATERIALS AND METHODS: Ninety bovine incisors were used; the vestibular surfaces were worn by the exposure of an area with a diameter of 4 mm of dentin. The specimens were divided into 6 groups, according to the type of adhesive used and hydratation stals: Group SB-wet: Single Bond 2 in wet dentin, Group SBdry: Single Bond 2 in dry dentin, Group SL-wet: Solobond M in wet dentin, Group SL-dry: Solobond M in dentin dry. Group XPwet: XP Bond in wet dentin, Group XP-dry: XP Bond in dentin dry. They were cut to obtain specimens in the shape of stick with 1 × 1 mm and subjected to microtensile test in universal testing machine with a cross speed of 1mm/min. The data were analyzed with ANOVA and Tukey's tests (5%). RESULTS: ANOVA showed significant differences for surface treatment and interaction, but no difference was found for adhesive factor. The Tukey's test showed that the samples with wet dentin shown higher values of bond strength. CONCLUSION: The adhesive did not influence in the bond strength. The groups with wet dentin showed higher values of bond strength than groups with dry dentin.

Avaliação da liberação de íon fluoreto de cimentos ionoméricos antes e após a recarga e com proteção da superfície / Fluoride ion release from glass ionomer cements before and after recharge and surface protection

Objetivo: Avaliar a liberação de íon fluoreto de 2 cimentos de ionômerode vidro (CIV) anidro e 2 modificados por resina composta antes e apósrecarga com fluoreto de sódio neutro a 2% por 4min. e após a proteçãoda superfície do CIV Maxxion R com um adesivo odontológico, umverniz cavitário e um esmalte incolor para unhas.Métodos: Com uma matriz de aço inox com 2mm x 6mm,confeccionou-se 5 corpos de prova de cada material, que foramimersos em 5mL de água deionizada, trocada a cada 24h. Foramrealizadas leituras em um potenciômetro nos dias 1, 2, 9 e 17 na 1ª e 2ªetapas, e as amostras foram tamponadas com solução TISAB III. Na 2ªetapa, as amostras foram submetidas à recarga e novamente imersasem 5mL de água deionizada. Na 3ª etapa foi realizada a proteção dasuperfície dos CIVs e feitas leituras nos 5min., 24h, 48h e 72h. Utilizouseos testes estatísticos Post Hoc de Tukey e t Student (p<0,05).Resultados: Observou-se diferença estatisticamente significante aocomparar a 1ª com a 2ª etapas em todos os materiais, exceto no dia 2para o Vidrion R e para o VitroFil LC. Na 3ª etapa observou-se que emtodos os materiais, comparando os primeiros 5 min. com os outrostempos, as diferenças entre as médias da liberação das concentraçõesde íon fluoreto foram estatisticamente significantes. Ao 0comparar osdemais tempos, tanto o verniz quanto o esmalte incolor para unhasapresentou diferença estatisticamente significante entre 24h e 48h,bem como em 24h e 72h.Conclusão: Os CIVs anidros tiveram maior efetividade na liberação deíon fluoreto e na recarga em comparação com os CIVs modificados porresina composta e o Maxxion R apresentou um comportamentohomogêneo e estatisticamente significante nas duas etapas. Todos osmateriais protetores testados foram eficazes, e o esmalte incolor paraunhas apresentou o melhor comportamento...

Objective: To evaluate fluoride ion release from two anhydrous glassionomer cements (GICs) and two resin-modified GICs (RMGICs) before and after recharge with 2% neutral sodium fluoride for 4 min and after surface protection of the Maxxion R GIC with an adhesive system, a cavity varnish and a colorless nail polish. Method: A stainless steel 2x6 mm matrix was used for fabricating 5 specimens of each material, which were immersed in 5 mL of deionized water, renewed every 24 h. Measurements with a potentiometer were performed on days 1, 2, 9 and 17, in the 1st and 2nd phases, and thespecimens were buffered with a TISAB III solution. In the 2nd phase, thespecimens were subjected to recharge and immersed again in 5 mL ofdeionized water. In the 3rd phase, the GIC surfaces were protected andreadings were made at 5 min, 24 h, 48 h and 72 h. TukeyÆs post-hoc and StudentÆs t tests were used for statistical analyses (p<0.05). Results: There was statistically significant difference in the comparison between the 1st and 2nd phases for all materials, except at day 2 for Vidrion R and VitroFil LC. In the 3rd phase, it was observed that for all materials, comparison of the first 5 min with the other times revealedstatistically significant differences among the means of fluoride ionrelease. In the comparison with the other times, both the varnish and the colorless nail polish presented statistically significant differencebetween 24 and 48 h as well as between 24 and 72 h. Conclusion: The anhydrous GICs were more effective in fluoride ion release and recharge compared with the RMGICs. Maxxion R presented a homogeneous and statistically significant behavior in both phases. All materials for surface protection were efficient and the colorless nail polish had the best behavior...

Effect of root perforations on the bond strength of fiberglass post using different adhesive systems and resin cement / Efeito das perfurações radiculares na resistência de união de pinos de fibra de vidro utilizando diferentes sistemas adesivos e cimento resino

Objective: This study evaluated the effect of root perforations on the bond strength of fiberglass posts cemented to the root canal with two adhesive systems and resin cement. Material and Methods: Forty single-rooted human teeth received endodontic treatment and were prepared for the cementation of fiberglass posts (Exacto Mini, Angelus). The teeth were divided into four experimental groups (n = 10) according to the root condition (with or without perforation) and the adhesive system used: G1: without perforation + Adper Single Bond 2 (3M ESPE), G2: without perforation + Clearfil SE Bond (Kuraray), G3: with perforation + Adper Single Bond 2, G4: with perforation + Clearfil SE Bond. The perforation was executed on the root surface with a diamond bur and sealed with white mineral trioxide aggregate (MTA). The specimens were sectioned and a push-out test was carried out (1 mm/min speed and 50 kgf). The data were statistically analyzed by ANOVA and Tukey Test (5%). Results: Adper Single Bond 2 promoted the greatest values of bond strength to the roots without root perforation. The presence of root perforation led to the reduction in bond strength values regardless of the bonding system used (p < 0.05). Conclusion: The root perforations caused a direct effect on the bond strength of the fiberglass posts cemented by reducing the bond strength values to the root dentin regardless of the adhesive system used.

Objetivo: O objetivo deste estudo foi avaliar o efeito das perfurações radiculares na resistência de união de pinos de fibra de vidro cimentados com dois sistemas adesivos e um cimento resinoso. Material e Métodos: Quarenta dentes humanos unirradiculares receberam tratamento endodôntico e foram preparados para cimentação de pinos de fibra de vidro (Exacto Mini, Angelus). Os dentes foram divididos em quatro grupos experimentais (n = 10) de acordo com a condição radicular (com ou sem perfuração) e o sistema adesivo utilizado: G1: sem perfuração + Adper™ Single Bond 2; G2: sem perfuração + Clearfil SE Bond; G3: com perfuração + Adper™ Single Bond 2; G4: com perfuração + Clearfil SE Bond. A perfuração foi realizada na superfície radicular com uma ponta diamantada e selada com agregado de trióxido mineral branco (MTA). Os espécimes foram seccionados para realização do teste de extrusão por cisalhamento (Push-out) com velocidade de 1 mm/ min e célula de carga de 50 Kgf. Os dados obtidos foram submetidos à Análise de Variância (ANOVA) e Teste de Tukey a 5%. Resultados: O sistema adesivo Adper Single Bond 2 promoveu os maiores valores de resistência de união nas raízes sem perfuração radicular. A presença de perfuração promoveu redução nos valores de resistência de união, independentemente do sistema adesivo utilizado (p < 0,05). Conclusão: As perfurações radiculares causaram efeito direto sobre a resistência de união dos pinos de fibra de vidro, promovendo redução nos valores da resistência de união independentemente do tipo de sistema adesivo utilizado.

Microtensile test in dental research. Controversial aspects in statistical analysis: experimental unit and premature failures / Teste de microtração na pesquisa odontológica. Aspectos controversos na análise estatística: unidade experimental e falhas prematuras

Objetivo: O objetivo dessa pesquisa é apresentar aspectos controversos na condução da análise estatística inferencial quanto à seleção da unidade experimental e quanto ao procedimento adotado diante das falhas pré-teste. Método: Foram avaliadas 87 dissertações e teses na área da odontologia que realizaram ensaio de microtração disponíveis em três universidades públicas do estado de São Paulo: Faculdade de Odontologia da USP (São Paulo, Ribeirão Preto e Bauru), Faculdade de Odontologia da Unesp (Araraquara e São José dos Campos) e Faculdade de Odontologia da Unicamp (Piracicaba e Campinas). Resultados: Quanto à unidade experimental, 34 (39,08%) teses e/ou dissertações utilizaram o “palito” e 53 (60,91%) o “dente/bloco”. Quanto às falhas pré-teste, 9 (10,34%) teses e/ou dissertações atribuíram valor “0”, 6 (6,89%) desconsideraram os palitos, 2 (2,29%) atribuíram o valor mínimo de 2 MPa, 1 (1,14%) atribuiu o valor mínimo de 4 MPa, 1 (1,14%) atribuiu a metade do valor mínimo do grupo e 68 (78,16%) não citaram a ocorrência de falhas pré-testes. Conclusão: Quanto à unidade experimental, atualmente considera-se como unidade experimental o dente (ou o bloco cerâmico) e não o palito. Quanto à ocorrência de falhas pré-teste, considera-se: atribuição de um valor mínimo de resistência adesiva na condição experimental ou grupo considerado; expressar o número e percentual dos casos de falhas em cada condição experimental; qual tipo de falha foi incluído na análise estatística e informar exatamente como os autores procederam em relação ao delineamento experimental (unidade experimental e falhas pré-teste).

Objectives: The aim of this study was to present the controversial aspects in performing inferential statistical analysis with regard to selection of the experimental unit and procedures adopted in the case of pre-test failures. Methods: Eighty-seven dissertations and theses in the field of dentistry were evaluated, for which microtensile testing was made available at three public Universities in the State of São Paulo were performed, namely: School of Dentistry, USP; School of Dentistry, Unesp (Araraquara and São José dos Campos) and the Piracicaba School of Dentistry (Unicamp). Results: Regarding the experimental unit, 34 (39.08%) theses and/or dissertations used the “stick” and 53 (60.91%) the “tooth/block” type. With regard to pretest failures, 9 (10.34%) theses and/or dissertations attributed the value “0”, 6 (6.89%) disregarded the sticks, 2 (2.29%) attributed the minimum value of 2 MPa, 1 (1.14%) the minimum value of 4 MPa, 1 (1.14%) attributed half the minimum value of the group and 68 (78.16%) did not mention the occurrence of pretest failures. Conclusion: At present the experimental unit is considered to be the tooth (or ceramic block) and not the stick. As it relates to pre-test failures, the following are considered: attribution of a minimum bond strength value under experimental condition or in the group considered, an expressed number and percentage of cases of failures under each experimental condition; failures included in the statistical analysis and detailed explantion of how the authors performed with regard experimental designs (experimental unit and premature failures).

Dentinal Hypersensitivity: pre-hybridization as an alternative treatment / Hipersensibilidade dentinária: pré-hibridização como um tratamento alternativo

A hipersensibilidade dentinária pode ocorrer quando há exposição da dentina após preparos dentários para restaurações indiretas. Para evitar ou minimizar desconfortos pós-operatórios, os adesivos dentinários têm sido utilizados para proteger a dentina exposta. Esta técnica é denominada pré-hibridização. Apesar da utilização clínica, ainda existem controvérsias sobre a eficácia, o material e o protocolo mais adequado para realizá-la. Objetivo: Esta revisão tem como objetivo discutir os conceitos que envolvem a pré-hibridização, baseando-se nos artigos mais relevantes publicados (2002 até a data atual), indexados nas bases de dados da SciELO, MEDLINE e Pubmed. Método: Para a pesquisa foram utilizadas as seguintes palavras-chave: pré-hibridização, hipersensibilidade dental e variáveis (ex.: pré-hibridização dentinária, hipersensibilidade dentinária, tratamento de hipersensibilidade). Foram selecionadas as referências do tipo revisão e artigos de pesquisa originais. Foram feitos esforços para identificar estudos sobre tratamentos clínicos comparativos, controlados e estudos de meta-análise sobre a hipersensibilidade e a pré-hibridização dentinária. Resultado: Baseado na revisão realizada é possível destacar os adesivos autocondicionantes como a primeira escolha para os procedimentos de pré-hibridização. Conclusão: Porém, a literatura ainda não apresenta um protocolo consolidado e as pesquisas clínicas que estudam a eficiência desta técnica são limitadas.

Dentinal hypersensitivity may occur after the dentine exposure because of indirect restoration preparations. Either to avoid or decrease postoperative discomfort, dentinal adhesives have been used to protect the exposed dentine. This technique is called pre-hybridization. Notwithstanding, despite of the clinical use, there still exist controversies on its efficacy and the most adequate material and protocol to execute it. Objective:This review study aimed to discuss the concepts involving the pre-hybridization based on the most important papers published from 2002 to date, indexed at the following databases: SciELO, MEDLINE and Pubmed. Methods: The following keywords were applied in the searching: pre-hybridization, tooth hypersensitivity and their possibilities (e.g.: dentinal pre-hybridization, dentinal hypersensitivity, hypersensitivity treatment). Only review and original research studies were selected. Efforts to identify comparative, controlled clinical studies as well as meta-analysis studies on hypersensitivity and dentinal pre-hybridization were made. Results: Based on the review conducted, it was possible to highlight that the self-conditioning adhesives have been the first choice for pre-hybridization procedures. Conclusion: However, the literature still lacks on determining a consolidated protocol and the clinical effectiveness of this procedure.

Influence of dentin abrasion methods on the bond strength of self-etching adhesive systems / Influência de métodos de abrasão da dentina na resistência de união de sistemas adesivos autocondicionantes

Objective: The aim of this study was to compare the bond strength of two self-etching adhesive systems with different types of dentin abrasion. Methods: Thirty two sound human molars were selected and had the dentin surface exposed and flattened. Tooth were randomly divided into four experimental conditions, according with the adhesive system [Clearfil SE Bond (SE) and One-Up Bond F(ONE)] and the type of dentin abrasion [conventional diamond bur (D) and ultrasound diamond bur (CVD)]. The adhesives were applied following manufactures’ instructions and light cured composite blocks of 4mm height were placed over dentin. After storage in distilled water for 24 h in 37 ºC, serial cuts were made on mesio-distal and buccal-lingual direction, obtaining specimens with stick format, with cross section of 8mm². The microtensile test was performed at a crosshead speed of 0.5 mm/min and load cell of 10kg, until failure. Data were submitted to ANOVA-2-Way followed by Tukey test (5%). Results: The results (MPa) were: D/ SE: 24.06 ± 8.84, D/ONE:15.03 ± 8.61, CVD/SE: 39.90 ± 8.24 and CVD/ONE:15.03 ±8.61. It can be concluded that the adhesive system Clearfil SE Bond showed higher bond strength related with the abrasion with CVD; the type of dentin abrasion interfered on the performance of Clearfil SE Bond but did not influence the One-Up Bond F results

Objetivo: O objetivo desta pesquisa foi comparar a resistência de união de dois sistemas adesivos autocondicionantes com diferentes métodos de preparo da dentina. Métodos: Foram utilizados 32 molares humanos hígidos extraídos, sendo que a superfície dentinária oclusal foi exposta e planificada. Os dentes foram aleatoriamente divididos em quatro diferentes condições experimentais de acordo com o sistema adesivo: Clearfil SE Bond (SE) ou One- Up Bond F (ONE) e com o método de preparo da dentina: ponta diamantada em alta rotação (D) ou ponta diamantada em ultra-som (CVD). Os adesivos foram aplicados de acordo com as recomendações do fabricante e foram confeccionados blocos de 5mm de altura de resina composta fotopolimerizável, pela técnica incremental. Após estocagem em água destilada por 24 h a 37 ºC, foram realizadas secções seriadas no sentido mésio-distal e vestíbulo-lingual, obtendo-se espécimes em forma de palitos, com secção transversal de aproximadamente 0.8 mm2. Os corpos-de-prova foram submetidos ao ensaio de microtração com velocidade de 0.5mm/min e célula de carga de 10kg. Os dados foram submetidos à análise estatística ANOVA e teste de Tukey (5%). Resultados: Os resultados (MPa) foram: D/SE: 24,06 ± 8,84, D/ONE: 15,03 ± 8,61, CVD/SE: 39,90 ± 8,24 e CVD/ONE:15,03 ± 8,61. Concluiu-se que o sistema adesivo Clearfil SE Bond apresentou superioridade significativa de resistência de união em relação ao preparo com ponta CVD; o método de preparo da dentina interferiu no desempenho do Clearfil SE Bond e não influenciou o desempenho do One-Up Bond F

Finite element analysis and fracture resistance testing of a new intraradicular post.

OBJECTIVES: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the São José dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. MATERIAL AND METHODS: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. RESULTS: The fracture test presented the following averages and standard deviation: G1 (45.63 ± 8.77), G2 (49.98 ± 7.08), G3 (43.84 ± 5.52), G4 (47.61 ± 7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. CONCLUSIONS: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008-PA/CEP).