Microhardness, Color Stability and Microstructural Analysis of Prefabricated Composite Resin Veneers / Estudo da Microdureza, Estabilidade de cor e Microestrutura de Facetas Pré-Fabricadas de Resina Composta

The aim of the work was to determine Knoop microhardness (KH), color stability (ΔE00) and microstructure of prefabricated composite resin veneers (PCRVs). Two PCRVs systems (Componeer Brilliant New Generation, Coltene, Altstätten, Switzerland; and Direct Veneer, Edelweiss, Wolfurt, Austria) were tested. KH was measured at the buccal surface of the PCRVs. Color analyze was evaluated by a spectrophotometer and ΔE00 calculated using CIEDE2000 formula. Microstructure of the PCRVs was characterized using scanning electron microscopy (SEM). Data of KH and ΔE00 were subjected to One-way ANOVA followed by Tukey post hoc test (α=0.05). Componeer (KH = 46) and Edelweiss (KH = 43) presented statistical similar hardness results (p>0.05). Componeer (ΔE00water= 0.1 and ΔE00coffee= 13.4) showed lower ΔE00 than Edelweiss (ΔE00water= 0.5 and ΔE00coffee= 18.7). SEM-images indicated similar microstructures of the PCRVs tested. Although PCRVs present similar microhardness and microstructure, Componeer showed higher color stability and lower extrinsic pigmentation to coffee in comparison to Edelweiss. Direct composite resin veneer treatment might be simplified with PCRVs. However, the high pigmentation observed in the PCRVs could generate aesthetic failures over the time. (AU)

O objetivo do trabalho foi determinar a microdureza Knoop (KH), estabilidade de cor (ΔE00) e a microestrutura de facetas de resina composta pré-fabricadas. Os sistemas de facetas Componeer e Edelweiss foram testados. Para cada sistema, a microdureza foi avaliada na superfície vestibular das facetas. A análise da estabilidade de cor foi feita mediante o emprego de um espectrofotômetro e a alteração de cor foi calculada seguindo a fórmula determinada pelo CIEDE2000. A microestrutura dos sistemas foi observada e caracterizada a partir de um microscópio eletrônico de varredura. Os resultados de microdureza e alteração de cor foram submetidos a análise de variância de um fator complementados pelo teste de Tukey (α=0,05). Os sistemas de facetas pré-fabricadas de resina composta apresentaram valores estatisticamente similares de microdureza (p>0,05). O grupo Componeer apresentou uma alteração de cor inferior em relação ao grupo Edelweiss. Os dois sistemas apresentaram uma elevada pigmentação após imersão em solução com café. A microestrutura dos sistemas se mostrou similar em função da avaliação das imagens em microscopia. Apesar dos sistemas apresentarem microdureza e microestrutura similares, o sistema Componeer gerou menor alteração de cor com menor pigmentação a bebida corante empregada em comparação ao sistema Edelweiss. A técnica de facetas dentárias pode ser simplificada utilizando um sistema de facetas pré-fabricadas de resina composta. Todavia, a elevada pigmentação observada no presente estudo deve ser levada em consideração já que o tratamento com esse tipo faceta tende a ser um procedimento estético com durabilidade elevada. (AU)

A comparative study of bulk-fill composites: degree of conversion, post-gel shrinkage and cytotoxicity.

Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05). All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4%) than that of conventional composites (1.7-2.1%). However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

A comparative study of bulk-fill composites: degree of conversion, post-gel shrinkage and cytotoxicity

Abstract: Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05). All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4%) than that of conventional composites (1.7-2.1%). However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

Reconstrução de dente anterior fraturado com restauração direta associada a pino de fibra de vidro ­ relato de caso / Fractured anterior tooth reconstruction with direct restoration associated with glass fiber pin ­ case report

O relato de caso tem por objetivo descrever as etapas de planejamento e o protocolo restaurador para um caso de reconstrução de dente anterior fraturado por meio de restauração direta com resina composta associada a pino de fibra de vidro, além de discutir os procedimentos necessários para a obtenção de restaurações satisfatórias nessa região. Paciente GLA, leucoderma, 14 anos de idade, vítima de acidente doméstico, com fratura coronária nos dentes 11 e 21. Após anamnese, exame clínico e radiográfico, constatou-se fratura coronária do tipo VI no dente 11, com tratamento endodôntico já realizado, e do tipo III no dente 21. Em virtude da idade do paciente, para o plano de tratamento optou-se pela utilização de um retentor intrarradicular estético, pino de fibra de vidro, associado à restauração direta em resina composta, dada às condições clínicas do remanescente dentário, e para o dente 21, optou-se pela restauração direta em resina composta. Dentes fraturados e submetidos ao tratamento endodôntico devem ser reconstruídos tendo por base um planejamento criterioso. Com a evolução das resinas compostas e dos sistemas adesivos, associados à técnica de condicionamento ácido de esmalte e dentina, tornou-se possível a execução de tratamentos restauradores estéticos mais conservadores (AU).

The objective of this case report was to describe the planning stages and the restorative protocol for a fractured anterior tooth reconstruction by means of direct restoration with composite resin associated with fiberglass pin, in addition to discussing the procedures necessary for obtaining satisfactory restorations in this region. The patient, GLA, leucoderma, 14 years old, was victim of a domestic accident, resulting on a coronary fracture in teeth 11 and 21. After anamnesis, clinical and radiographic examination, a type VI coronary fracture was found in tooth 11 with endodontic treatment and type III in tooth 21. Due to the age of the patient, the treatment plan included the use of an aesthetic intra-radicular retainer, fiberglass pin, associated to direct restoration in composite resin given the clinical conditions of the dental remnant, while the direct restoration in composite resin was chosen for element 21. Fractured teeth as those submitted to endodontic treatment should be reconstructed based on careful planning. With the evolution of composite resins and adhesive systems, associated with the acid etching technique of enamel and dentin, it became possible to perform more conservative esthetic restorative treatments (AU).

Estudo de propriedades de resinas compostas bulk fill / Study of properties of bulk-fill resin composites

Diante da evolução da composição das resinas compostas e do lançamento de compósitos do tipo bulk fill, faz-se necessário o estudo do desempenho dessa nova classe de materiais. Para isso, o presente estudo teve como objetivo avaliar propriedades como grau de conversão (GC) , dureza Knoop (KHN), resistência à flexão (RF) e tenacidade à fratura (KIC) de sete compósitos bulk fill (EverX Posterior, EXP; Filtek Bulk Fill Flow, FBFF; Fill-Up!, FU; SonicFill, SF; Surefil SDR, SDR; Tetric EvoCeram Bulk Fill, TECBF; Venus Bulk Fill, VBF) e um compósito nanohíbrido convencional (Charisma Diamond, CD). De forma complementar, foi realizado tratamento térmico a 170 °C por 10 minutos para melhor compreensão do comportamento desses materiais quanto ao potencial de conversão e à indução de tensões na interface carga/matriz. A avaliação do GC (n=3) foi realizada através de espectroscopia FTIR, a leitura da dureza Knoop foi realizada nas superfícies do topo e da base (n=3), e os ensaios de RF de três pontos (n=10) e KIC (n=10) em máquina de ensaios universais. Os resultados obtidos foram submetidos à analise de variância (complementados pelo teste de Tukey) ou teste Kruskal-Wallis, com nível de significância de 5%. A análise do GC (%) revelou diferença entre os materiais testados, sendo que todas as resinas bulk fill apresentaram valores maiores que a resina convencional: SF (75,7) > VBF (66,7) = EXP (66,4) = SDR (62,8), sendo esta também semelhante a FU (60,0); FU, TECBF (56,6), FBFF (56,6) e CD (54,5) apresentaram conversão semelhante. Os valores de KHN variaram de acordo com o material e com a superfície: apenas SF apresentou KHN semelhante (na superfície do topo) a CD

entretanto não foi possível realizar a leitura da superfície da base deste último material; SF, TECBF e FBFF apresentaram valores de KHN diferentes nas superfícies topo e base; EXP, FU, SDR e VBF mantiveram os valores de dureza do topo semelhantes à superfície da base. Para a RF (MPa), os resultados variaram de acordo com o material: EXP (122,54) = SF (101,09) = CD (99,15), sendo estes dois últimos semelhantes a FU (83,86) e TECBF (82,71), os quais não diferiram da resina SDR (65,18); esta última também mostrou comportamento semelhante a FBFF (60,85) e VBF (59,90). Quanto ao KIC (MPa.mm0,5), EXP (3,35) apresentou o maior valor, semelhante a SF (2,42), que por sua vez também foi igual ao compósito convencional CD (2,01); CD apresentou KIC semelhante a SDR (1,74); SDR = VBF (1,59) = TECBF (1,57); TECBF, FU (1,54) e FBFF (1,37) apresentaram valores semelhantes. Na dependência do material, o tratamento térmico aumentou os valores dos parâmetros estudados, apontando limitações da reação de polimerização dos compósitos estudados. Com base nos resultados obtidos, podese concluir que: resinas bulk fill apresentam elevado GC, superior à resina convencional estudada; a nova classe de materiais restauradores é capaz de polimerizar em profundidade e alguns materiais apresentam KHN semelhantes no topo e na base de espécimes de 4 mm de profundidade; RF e KIC variaram de acordo com o material, e o compósito EXP apresentou os maiores valores para ambos os testes.

Facing the evolution of the resin composites and the release of the bulk-fill composite type, it is necessary to study the performance of this new class of materials. For this, the present study aimed to evaluate properties such as degree of conversion (DC), Knoop hardness (KHN), flexural strength (FS) and fracture toughness (KIC) of seven bulk-fill composites (EverX Posterior, EXP; Filtek Bulk Fill Flowable, FBFF; Fill-Up!, FU; SonicFill, SF; Surefil SDR, SDR; Tetric EvoCeram Bulk Fill, TECBF; Venus Bulk Fill, VBF) and a conventional nanohybrid composite (Charisma Diamond, CD). Complementarily, heat treatment was performed at 170 °C for 10 minutes for better understanding the behavior of these materials. Evaluation of DC (n=3) was performed by FTIR spectroscopy, the evaluation of Knoop hardness was made on the top and bottom surfaces (n=3), and three point bending test (n=10) and KIC (n=10) were evaluated on a universal testing machine. The results were submitted to analysis of variance (complemented by Tukey test) or Kruskal-Wallis test with 5% significance level. Analysis of DC (%) revealed differences between tested materials, and all bulk-fill resins had higher values than the conventional resin: SF (75.7) > VBF (66.7) = EXP (66.4) = SDR (62.8), which was also similar to FU (60.0); FU, TECBF (56.6), FBFF (56.6) and CD (54.4) showed similar conversion. KHN values showed variations according to the material and the surface:

only SF showed a similar KHN (on the top surface) to CD, however it was not possible to read the bottom surface of this latter material; SF, TECBF and FBFF presented different KHN values on the top and bottom surfaces; EXP, FU, SDR and VBF maintained top and bottom similar hardness values. For FS (MPa), the results varied according to the material: EXP (122.54) = SF (101.09) = CD (99.15), the latter two being similar to FU (83.86) and TECBF (82.71), which did not differ from SDR resin (65.18); the latter showed similar behavior to FBFF (60.85) and VBF (59.90). As for KIC (MPa.mm0.5), EXP (3.35) had the highest value, similar to SF (2.42), which in turn was also equal to the conventional composite CD (2.01); CD presented KIC similar to SDR (1.74); SDR = VBF (1.59) = TECBF (1.57); TECBF, FU (1.54) and FBFF (1.37) were similar. Depending on the material, heat treatment increased the values of the parameters, pointing limitations of polymerization reaction of the studied composites. Based on these results, it can be concluded that: bulk fill resins have high DC, higher than the conventional resin studied; the new class of restorative materials is capable of polymerizing in...