Minimally Invasive Ceramic Restorations: A Step-by-Step Clinical Approach.

Minimally invasive treatments are a dominant trend in dentistry. Due to the evolution of adhesive materials and ceramics, minimalistic ceramic restorations have been proposed as alternative treatment options to avoid unnecessary tooth reduction. The aim of this article is to show a clinical protocol for the correct diagnosis, treatment planning, and execution of minimally invasive ceramic veneers. Requiring only slight tooth preparation, this conservative technique is well-suited for restoration of teeth that need color and shape modification. The present clinical case demonstrates immediate success in restoring patient esthetics, function, and, in turn, self-esteem. After 2.5 years all veneers were still in exceptional condition and periodontal tissue was healthy. Minimally invasive ceramic restoration is shown to be an excellent option for conservative restorative treatment.

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.

Ceramic veneers with minimum preparation.

The aim of this article is to describe the possibility of improving dental esthetics with low-thickness glass ceramics without major tooth preparation for patients with small to moderate anterior dental wear and little discoloration. For this purpose, a carefully defined treatment planning and a good communication between the clinician and the dental technician helped to maximize enamel preservation, and offered a good treatment option. Moreover, besides restoring esthetics, the restorative treatment also improved the function of the anterior guidance. It can be concluded that the conservative use of minimum thickness ceramic laminate veneers may provide satisfactory esthetic outcomes while preserving the dental structure.

Bond strength of resin cements to Co-Cr and Ni-Cr metal alloys using adhesive primers.

PURPOSE: The aim of this study was to evaluate the effectiveness of adhesive primers (APs) applied to Co-Cr and Ni-Cr metal alloys on the bond strength of resin cements to alloys. MATERIALS AND METHODS: Eight cementing systems were evaluated, consisting of four resin cements (Bistite II DC, LinkMax, Panavia F 2.0, RelyX Unicem) with or without their respective APs (Metaltite, Metal Primer II, Alloy Primer, Ceramic Primer). The two types of dental alloys (Co-Cr, Ni-Cr) were cast in plate specimens (10 x 5 x 1 mm(3)) from resin patterns. After casting, the plates were sandblasted with aluminum oxide (100 microm) and randomly divided into eight groups (n = 6). Each surface to be bonded was treated with one of eight cementing systems. Three resin cement cylinders (0.5 mm high, 0.75 mm diameter) were built on each bonded metal alloy surface, using a Tygon tubing mold. After water storage for 24 hours, specimens were subjected to micro-shear testing. Data were statistically analyzed by two-way ANOVA and Tukey's studentized range test. RESULTS: The application of Metal Primer II resulted in a significantly higher bond strength for LinkMax resin cement when applied in both metal alloys. In general, the cementing systems had higher bond strengths in Co-Cr alloy than in Ni-Cr. CONCLUSIONS: The use of AP between alloy metal surfaces and resin cements did not increase the bond strength for most cementing systems evaluated.

Clinical evaluation of two types of ceramic inlays and onlays after 6 months / Avaliação clínica de inlays e onlays confeccionadas com dois tipos de cerâmica, após 06 meses

Este trabalho se propôs a avaliar a performance clínica de dois tipos de cerâmica: IPS Empress, Ivoclar-Vivadent - IPS e Duceram Plus, Degussa - D. Foram realizadas 86 restaurações por apenas um operador, sendo 44 IPS e 42 D. Vinte e sete pré-molares e 59 molares, num total de 33 onlays e 53 inlays, foram cimentadas em 35 pacientes de ambos os sexos, com idade média de 35 anos. A cimentação das restaurações foi realizada com cimento resinoso dual (Variolink, Ivoclar-Vivadent) sob isolamento absoluto e avaliadas no baseline e após 06 meses, mediante o critério U.S.P.H.S. modificado, quanto à sensibilidade pulpar, reincidência de cárie, fratura, reprodução de cor, descoloração marginal, integridade marginal e textura superficial. Adicionalmente foram realizadas radiografias e fotografias. No baseline foi obtida a classificação Bravo nos itens sensibilidade pulpar - IPS (2,27%); D (7,14%); reprodução de cor - IPS (2,27%); D (2,38%) e textura superficial - IPS (2,27%); D (11,90%). Após 06 meses foram analisadas as 86 restaurações, nas quais foi constatada a classificação Bravo para os itens reprodução de cor - IPS (6,82%); D (2,38%); textura superficial - IPS (2,27%); D (9,52%); descoloração marginal - IPS (6,82%); D (4,76%) e integridade de superfície- IPS (4,55%); D (7,14%). Os resultados obtidos foram submetidos ao Teste Estatístico de Fisher e McNemar. Não houve diferença estatisticamente significante entre as cerâmicas. Pode-se concluir que os dois tipos de cerâmica demonstraram uma performance clínica satisfatória após 06 meses.

Clinical evaluation of two types of ceramic inlays and onlays after 6 months.

The aim of the present study was to evaluate the clinical performance of two types of ceramics: a slurry-powder ceramic (Duceram Plus, Degussa) - D and a hot-pressed leucite-based glass-ceramic (IPS Empress, Ivoclar Vivadent) - IPS. Eighty-six restorations, 44 IPS and 42 D, were made by one operator. A total of 33 onlays and 53 inlays on twenty-seven premolars and 59 molars were cemented in 35 patients of both sexes, mean age 35 years. All restorations were cemented with the dual-resin cement (Variolink, Ivoclar-Vivadent) under rubber dam and were evaluated at the baseline and after six months, using the modified U.S.P.H.S. criteria for postoperative sensitivity, secondary caries, fracture, color match, marginal discoloration, marginal integrity and surface texture. Additionally radiographs and intraoral photographs were carried out. At baseline 86 restorations were analyzed and all of them received Alfa rating, except for the following that received Bravo rating for postoperative sensitivity - IPS (2.27%); D (7.14%); for color match - IPS (2.27%); D (2.38%) and for surface texture - IPS (2.27%); D (11.90%). After 6 months 100% of the restorations were analyzed and the following received Bravo rating: color match - IPS (4.55%) and D (9.52%); surface texture - IPS (2.27%) and D (11.9%); marginal discoloration - IPS (6.82%) and D (4.76%) and marginal integrity - IPS (4.55%) and D (7.14%). The results were submitted to the Fisher and McNemar Statistical Tests. No significant differences were noticed between the two ceramics. Both ceramics demonstrated satisfactory clinical performance after six months.

Reabilitação estética na dentística - uso de pinos não-metalicos e cerâmicas puras / Aesthetic rehabilitation in dentistry - use of non-metallic posts and pure ceramic

Os autores descrevem a aplicação de Pinos de Fibras de Vidro e Cerâmicas para restaurações estréticas anteriores