Color and surface gloss stability of bis-acryl and resin composite after exposure to cigarette smoke / Estabilidade de cor e brilho superficial de resinas compostas e bisacrílicas após exposição por fumaça de cigarro

Objective: To evaluate color and surface gloss stability of bis-acryl resins and resin composites, submitted to artificial staining with cigarette smoke. Material and Methods: Specimens of each material were prepared (n=15). Two resin composites (GrandioSO [RCG], Filtek Supreme [RCZ]) and five bis-acryl resins (Luxatemp Star [BisLUX], Protemp4 [BisPRO], Structor3 [BisSTR], Visalys Temp [BisVIS] and Yprov [BisYPR]) were tested. Initial color was assessed using a spectrophotometer and surface gloss with a glossmeter. Samples were submitted to smoke exposure (10 cigarettes under 8 minutes per cycle). After 3 and 6 cycles, color and gloss were reassessed. Final readings were performed after brush prophylaxis. Data were analyzed using two-way repeated ANOVA and Tukey's test (p<0.05). Results: Differences and interaction of factors (p<0.01) were detected for both color and gloss readings. Resin composites were the least affected by aging, with gloss reduction after prophylaxis. Differences were detected among bis-acryl resins, with better results for BisLUX and BisPRO. BisPRO and BisSTR, showed reduction in gloss after 60 cigarettes, while BisYPR gloss decreased at all evaluated periods. Conclusion: Resin composites are less susceptible to changes after smoke exposure, while bis-acryl resins results are brand-dependent. Prophylaxis negatively influenced the surface gloss of most of the tested materials (AU)

Objetivo: Avaliar a estabilidade de cor e brilho superficial de resinas compostas e bisacrílicas, submetidos ao manchamento artificial por fumaça de cigarro. Material e Métodos: Foram preparados espécimes de cada material (n=15). Duas resinas compostas (GrandioSO [RCG], Filtek Supreme [RCZ]) e cinco resinas bisacrílicas (Luxatemp Star [BisLUX], Protemp4 [BisPRO], Structor3 [BisSTR], Visalys Temp [BisVIS] e Yprov [BisYPR]) foram testados. A cor inicial foi avaliada usando um espectrofotômetro e o brilho de superfície com um medidor de brilho. As amostras foram submetidas à exposição de fumaça de cigarro (10 cigarros com até 8 minutos por ciclo). Após 3 e 6 ciclos, a cor e o brilho foram reavaliados. As leituras finais foram realizadas após a profilaxia escova de robinson. Os dados foram analisados usando de medidas repetidas e teste de Tukey (p<0,05). Resultados: Foram detectadas diferenças e interação de fatores (p<0,01) tanto para leituras de cor quanto para leituras de brilho. As resinas compostas foram as menos afetados pelo envelhecimento, com redução do brilho após a profilaxia. Foram detectadas diferenças entre as resinas bisacrílicas, com melhores resultados para BisLUX e BisPRO. BisPRO e BisSTR, mostraram redução de brilho após 60 cigarros, enquanto que o brilho da BisYPR diminuiu em todos os períodos avaliados. Conclusão: As resinas compostas são as menos suscetíveis a mudanças após a exposição à fumaça, enquanto os resultados das resinas bisacrílicas são dependentes da marca. A profilaxia influenciou negativamente o brilho de superfície da maioria dos materiais testados.(AU)

Effectiveness of Home Bleaching Treatment after Resin Infiltrant Application.

PURPOSE: Resin infiltration may be a barrier for bleaching gels. The aim of this study was to compare dental bleaching effectiveness using low-concentration gels on heavily or mildly stained teeth that were or were not treated with resin infiltration agents. MATERIALS AND METHODS: Forty bovine enamel surfaces were submitted to demineralisation, after which two staining protocols were performed. Twenty specimens were immersed in a staining broth for 24 h (Lab 1) or 7 days (Lab 2). Ten specimens of each group received resin infiltrant application following the manufacturer's recommendation. All specimens were bleached using 15% carbamide peroxide gel for 14 days (8 h daily). Colour measurement was performed using a reflectance spectrophotometer at three time points: baseline, after staining, and after bleaching. Data (CIEDE00) were analysed using Student's t-test (p < 0.05). RESULTS: No statistically significant differences were observed in Lab 1 (p = 0.560). For Lab 2, statistically significant differences were detected (p = 0.031). Once bleaching was achieved to some degree (Lab 2), the resin infiltrant may have behaved as a semipermeable barrier to the carbamide peroxide gels. CONCLUSION: Bleaching treatment was effective on mildly pigmented tooth surfaces. On the other hand, in comparison to the control group, the heavily pigmented surfaces bleached less in the presence of the resin infiltrant, possibly due to the lack of free radicals penetrating into the substrate.

Protocols to control contamination and strategies to optimize the clinical practice in Restorative Dentistry during the COVID-19 pandemic / Protocolos para controle de contaminação e estratégias para otimizar a prática clínica em Odontologia Restauradora durante a pandemia de COVID-19

The current outbreak of coronavirus 2019 (COVID-19) challenges how professional standards have been defined so far. In Dentistry, biosafety measures already taken by professionals have been intensified, aiming to offer the patient urgent and emergency treatment with safety for both. In this context, Restorative Dentistry is responsible for the care of patients with caries injuries, with or without symptoms and, fractures of teeth and existing restorations. This article guides professionals, during the pandemic period, on the risks involved in adult and pediatric dental care for patients with restorative needs. It also discusses strategies to optimize clinical practice, reducing risks of contamination and virus transmission. (AU)

O atual surto de coronavírus 2019 (COVID-19), fez com que muitos profissionais repensassem sua postura de trabalho. Na Odontologia, medidas de biossegurança já realizadas pelos profissionais, foram intensificadas, com o objetivo de oferecer ao paciente um tratamento de urgência e emergência com segurança para ambos. Neste contexto, a Odontologia Restauradora é responsável pelo atendimento de pacientes com lesões de cárie, com ou sem sintomatologia, e fraturas de dentes e restaurações já existentes. Este trabalho orienta os profissionais quanto aos riscos envolvidos no atendimento odontológico, adulto e pediátrico, de paciente com necessidades restauradoras durante o período de pandemia. O artigo também discute estratégias para otimizar o atendimento, diminuindo riscos de contaminação e transmissão do vírus. (AU)

Six-month performance of restorations produced with the ethanol-wet-bonding technique: a randomized trial.

This double-blind randomized controlled clinical trial evaluated the effectiveness of dentin pretreatment with 100% ethanol (EWBT - ethanol wet bonding technique) and different adhesive protocols in noncarious cervical lesions (NCCL) after 6 months. Patients presenting at least one NCCL were included. NCCLs (n=148) were randomly assigned to 4 groups: NE (Non-EWBT + three-step etch-and-rinse (Scotchbond Multi Purpose, 3M ESPE [MP]), E (EWBT + MP); EB (EWBT + [Bond - third step of MP]), and EU (EWBT + universal adhesive (Single Bond Universal, 3M ESPE). Conventional acid-etching (Condac 37%, FGM) and nanohybrid resin composite (Z350, 3M ESPE) were used. Trained and calibrated examiners (Kappa = 0.61) evaluated the restorations at baseline (7 days) and 6-month recall using the USPHS modified criteria. Data were subjected to Chi square (α = 0.05). Differences in the success rate were found for the treatments (p = 0.003). EB presented the lowest success rate compared with the other groups (p < 0.02). No significant differences were detected among NE, E, and EU (p > 0.49). The survival rates were 97.23%, 97.30%, 78.95%, and 97.30% for NE, E, EB, and EU, respectively. Regarding postoperative sensitivity, a significant reduction was found for groups E (p = 0.027) and EU (p < 0.01) after 6 months. After 6 months, EWBT associated to the hydrophobic adhesive system had the highest failure rate.

Utilização da técnica da dentina úmida por etanol na adesão dentinária: influência in vitro da smear layer, avaliação clínica com diferentes protocolos adesivos e revisão sistemática / Use of etanol-wet-bonding technique in dentin adhesion: smear layer in vitro influence, clinical trial with different adhesives protocols and systematic review

Este estudo foi composto por um estudo in vitro, um estudo clínico randomizado, controlado e duplo cego e uma revisão sistemática, com objetivo de compreender e avaliar a aplicabilidade da técnica da dentina úmida por etanol (EWBT) em procedimentos restauradores. Estudo laboratorial: 48 incisivos bovinos foram divididos em 2 grupos, com a utilização ou não de etanol anterior ao sistema adesivo universal (Single Bond Universal) no modo autocondicionante. Em seguida blocos de resina composta (Filtek Z350 xt) foram confeccionados. A interface adesiva foi analisada, antes e após envelhecimento por 6 meses em água, com relação à nanodureza e módulo de elasticidade e em microscopia eletrônica de varredura (MEV) após a realização de nanoinfiltração com nitrato de prata. Os dados de nanodureza e módulo de elasticidade foram analisados estatisticamente com ANOVA e teste de Tukey (α=5%). Houve diferença estatística para as áreas avaliadas (p<0.001) e também para a aplicação do etanol (p<0.001). A dentina apresentou valores maiores de nanodureza quando comparado com a camada híbrida. EWBT foi capaz de manter as propriedades da interface adesiva mesmo após envelhecimento. Estudo clínico randomizado: Os voluntários receberam restaurações em cavidades do tipo classe V, provenientes de lesões cervicais não cariosas, com extensão e profundidade de no mínimo 1 mm. As restaurações foram realizadas aleatoriamente, de acordo com a divisão dos grupos, sendo o grupo controle sem pré-tratamento dentinário (SE) e três grupos com a intervenção, sendo associado com adesivo de 3 passos (E); hidrófobo (EB) ou com adesivo de 2 passos (EU). As restaurações foram avaliadas, por examinadores devidamente calibrados no início do estudo, após 7 dias, 6 e 18 meses, utilizando o critério USPHS modificado. Os dados foram analisados com testes chi-quadrado e KaplanMeier. O grupo com adesivo hidrófobo apresentou maior taxa de falha para retenção quando comparada aos demais grupos, tanto em 6 quanto em 18 meses. Revisão sistemática: Foram pesquisadas as principais bases de dados eletrônicas com a estratégia de busca definida de acordo com a pergunta de pesquisa e estratégia PICO, sendo P: dentes com lesões cervicais não cariosas; I: protocolo adesivo utilizando EWBT; C: protocolo adesivo convencional. Após análise do título e resumo dos artigos pré-selecionados, seguindo a questão PICO, 19 artigos laboratoriais e 3 estudos clínicos relacionados ao tema tiveram os dados extraídos. O risco de viés dos artigos selecionados foi estimado, sendo que para a maioria dos estudos laboratoriais e clínicos foi considerado baixo. Para os estudos laboratoriais houve diferença, sendo que o grupo controle apresentou melhores resultados quando comparado à EWBT. Com relação aos estudos clínicos não houve diferença entre os grupos controle e EWBT(AU)

This study was composed by an in vitro study, a randomized, controlled and double blind clinical trial, and a systematic review, aiming to understand and evaluate the applicability of ethanol-wet-bonding technique (EWBT) in restorative procedures. Laboratory study: 48 bovine incisors were divided into 2 groups, according to EWBT use prior to the universal adhesive system (Single Bond Universal) in the self-etch mode. Blocks of composite resin (Filtek Z350 xt) were made. The adhesive interface was analyzed, on baseline and 6 months of water aging, by scanning electron microscopy (SEM) after nanoleakage with silver nitrate, besides the nanohardness and elastic modulus. The data of nanohardness and elastic modulus were statistically analyzed with ANOVA and Tukey test (α=5%). There was a statistically significant difference for the areas evaluated, in which dentin presented higher values, for nanohardness, than the hybrid layer (p<0.001) and for the use of ethanol (p<0.001). The use of ethanol was able to maintain the properties of the adhesive layer even after aging. Randomized clinical trial: The volunteers received restorations in class V cavities from non-carious cervical lesions (NCCL), with cavity extension and depth of at least 1 mm. The restorations were randomly performed according to group division: no ethanol dentin pretreatment (SE), with ethanol dentin pretreatment in association with 3-step (E) or 2-step (EU) or adhesive, or hydrophobic adhesive (EB). The restorations were evaluated by calibrated examiners at baseline, after 7 days, 6 and 18 months using the modified USPHS criteria. All data were statistically analyzed at Chi square and survival test (α=5%). The hydrophobic adhesive group presented higher failure rate for retention when compared to the other groups, both at 6 and 18 months followup. Systematic review: Main electronic databases were used for search and the strategy was defined according to the research question and PICO strategy, where P: teeth with NCCL; I: adhesive protocol using EWBT; C: conventional adhesive protocol; O: long-term clinical outcome after EWBT. After analyzing the title and abstract of the pre-selected articles, following the PICO question, 19 laboratory studies and 3 clinical trials related to EWBT. The data from selected studies were extracted and then, the risk of bias was estimated. For laboratory studies it was considered high and for clinical trials was considered low risk of bias. After statistical analysis, for laboratory studies the control group presented better results when compared to EWBT. Regarding the clinical studies, there was no difference between control and EWBT groups(AU)

Six-month performance of restorations produced with the ethanol-wet-bonding technique: a randomized trial

Abstract This double-blind randomized controlled clinical trial evaluated the effectiveness of dentin pretreatment with 100% ethanol (EWBT - ethanol wet bonding technique) and different adhesive protocols in noncarious cervical lesions (NCCL) after 6 months. Patients presenting at least one NCCL were included. NCCLs (n=148) were randomly assigned to 4 groups: NE (Non-EWBT + three-step etch-and-rinse (Scotchbond Multi Purpose, 3M ESPE [MP]), E (EWBT + MP); EB (EWBT + [Bond - third step of MP]), and EU (EWBT + universal adhesive (Single Bond Universal, 3M ESPE). Conventional acid-etching (Condac 37%, FGM) and nanohybrid resin composite (Z350, 3M ESPE) were used. Trained and calibrated examiners (Kappa = 0.61) evaluated the restorations at baseline (7 days) and 6-month recall using the USPHS modified criteria. Data were subjected to Chi square (α = 0.05). Differences in the success rate were found for the treatments (p = 0.003). EB presented the lowest success rate compared with the other groups (p < 0.02). No significant differences were detected among NE, E, and EU (p > 0.49). The survival rates were 97.23%, 97.30%, 78.95%, and 97.30% for NE, E, EB, and EU, respectively. Regarding postoperative sensitivity, a significant reduction was found for groups E (p = 0.027) and EU (p < 0.01) after 6 months. After 6 months, EWBT associated to the hydrophobic adhesive system had the highest failure rate.

Influence of ethanol-wet dentin, adhesive mode of application, and aging on bond strength of universal adhesive.

The aim of this study was to evaluate the effect of ethanol on the bond longevity of a universal adhesive system to bovine dentin, under different modes of adhesive application and artificial aging. Bovine dentin was exposed, and the smear layer was standardized by sandpaper polishing. Specimens were randomly divided into 2 groups: ethanol (E) and non-ethanol (N). Groups were subdivided according to adhesive mode of application into etch-and-rinse (Er) and self-etching (S). Resin blocks were built onto the treated surface, and the specimens were stored in deionized water at 37°C for 48 h. Half of the specimens (n = 10) were subjected to thermomechanical aging (A for aged and Na for non-aged). Resin/dentin beams were obtained and subjected to microtensile test in a universal testing machine. Data were analyzed using a three-way ANOVA and Tukey's tests (α = 5%). There was interaction among the three factors (p=0.0003). The use of ethanol resulted in higher values, except for the Er and Na groups (E_Er_Na = N_Er_Na). The mode of application was similar, except for the N and A groups (N_S_A > N_Er_A). For the A groups, the values were lower, except in the cases using ethanol, in which the results were not affected. The study concluded that the use of ethanol resulted in higher microtensile bond strength values, even after aging. The mode of adhesive application did not influence the results.

Influence of ethanol-wet dentin, adhesive mode of application, and aging on bond strength of universal adhesive

Abstract The aim of this study was to evaluate the effect of ethanol on the bond longevity of a universal adhesive system to bovine dentin, under different modes of adhesive application and artificial aging. Bovine dentin was exposed, and the smear layer was standardized by sandpaper polishing. Specimens were randomly divided into 2 groups: ethanol (E) and non-ethanol (N). Groups were subdivided according to adhesive mode of application into etch-and-rinse (Er) and self-etching (S). Resin blocks were built onto the treated surface, and the specimens were stored in deionized water at 37°C for 48 h. Half of the specimens (n = 10) were subjected to thermomechanical aging (A for aged and Na for non-aged). Resin/dentin beams were obtained and subjected to microtensile test in a universal testing machine. Data were analyzed using a three-way ANOVA and Tukey's tests (α = 5%). There was interaction among the three factors (p=0.0003). The use of ethanol resulted in higher values, except for the Er and Na groups (E_Er_Na = N_Er_Na). The mode of application was similar, except for the N and A groups (N_S_A > N_Er_A). For the A groups, the values were lower, except in the cases using ethanol, in which the results were not affected. The study concluded that the use of ethanol resulted in higher microtensile bond strength values, even after aging. The mode of adhesive application did not influence the results.

Determination of chemical elements and cross-section hardness of sclerotic darkened human dentin / Determinação de elementos químicos e da microdureza transversal da dentina esclerótica humana

Objetivo: O objetivo deste estudo foi avaliar a quantidade de elementos químicos (Ca, O, C, P, Fe e Mg) e a microdureza superficial da dentina esclerótica escurecida em dentes humanos. Material e Métodos: O estudo foi aprovado pelo Comitê de Ética local e dez dentes extraídos (cinco hígidos e cinco apresentando dentina esclerosada) foram utilizados. Os dentes foram seccionados no sentido mésiodistal e cada metade foi utilizada para cada teste. A quantidade de elementos químicos (%w) foi determinada pela espectroscopia de raio-x por dispersão em energia (EDS) em três áreas dentinárias diferentes (superficial, média ou profunda). Estas mesmas áreas tiveram a microdureza superficial Knoop determinada. Os dados foram analisados por ANOVA dois fatores e teste de comparações múltiplas, com nível de significância de 5%. Resultados: Nenhuma diferença quanto à microdureza foi detectada entre a dentina hígida e esclerótica (p = 0,743) e nem em relação às profundidades (p = 0,837). Menor quantidade de Ca (p = 0,024) e maior quantidade de C (p = 0,015) foram encontradas na dentina esclerótica superficial. O aumento do conteúdo de Mg (p < 0,001) foi detectado na dentina hígida. Conclusão: Pode-se concluir que a dentina esclerótica apresenta microdureza superficial similar à dentina hígida. Os elementos químicos estudados apresentaram-se igualmente para os dois tipos de dentina, exceto para o Mg, o qual estava em maior quantidade na dentina hígida. O cálcio e o fósforo apresentaram quantidades reduzidas na dentina esclerótica superficial.(AU)

Objective: The aim of this study was to assess the amount of chemical elements (Ca, O, C, P, Fe, and Mg) and the cross-section hardness of sclerotic darkened dentin in human teeth. Material and Methods: The study was approved by the local IRB and ten extracted teeth (five sound and five presenting sclerotic darkened dentin) were used. Tooth was sectioned mesiodistally and each half was used for each test. Amount of chemical elements (%w) was determined by energy dispersive X-ray spectroscopy (EDS) in three different dentin areas (shallow, medium, or deep sound or sclerotic dentin). Knoop microhardness was determined at the same EDS areas. Data were analyzed by two-way ANOVA and multiple comparison tests, with significance level at 5%. Results: No difference on microhardness was detected between sound and sclerotic dentin (p = 0.743) and also among dentin depths (p = 0.837). Lower Ca (p = 0.024) and higher C (p = 0.015) amounts were found at superficial sclerotic dentin. Increased Mg content (p < 0.001) was detected in sound dentin. Conclusion: It was concluded darkened sclerotic dentin presents similar cross-section microhardness to sound dentin. The assessed chemical elements were similarly present in sound or sclerotic dentin, except for Mg, which was present higher concentration in sound dentin. Ca and P were lower in superficial sclerotic dentin (AU)

Avaliação da eficácia do etanol na resistência de união à dentina utilizando adesivo convencional e autocondicionante sob envelhecimento / Evaluation of the ethanol effectiveness on bond strength to dentin using etch-and-rinse and self-etching adhesives after aging

O objetivo deste estudo foi avaliar o efeito do etanol na longevidade de união de diferentes modos de aplicação do sistema adesivo ao substrato dentinário bovino, através do teste de microtração. Foram utilizados 80 incisivos bovinos, os quais tiveram a superfície dentinária da face vestibular exposta e a padronização da smear layer. Após a padronização, os espécimes foram divididos aleatoriamente em 2 grupos, Grupo Com Etanol (GE) e Grupo Sem Etanol (GS) e após, subdivididos de acordo com a forma de aplicação do sistema adesivo, Condicionamento Ácido Convencional (GEC, GSC) e Autocondicionante (GEA, GSA). Sobre a superfície tratada foram confeccionados blocos de resina com auxílio de matriz de silicone e armazenados em água deionizada a 37 ºC, por um período de 48 h. Após a cura da resina, metade dos espécimes foi submetida ao envelhecimento termomecânico resultando nos seguintes grupos (n= 10): GEC sem Envelhecimento (GECSE), GEC Envelhecido (GECE), GSC Sem Envelhecimento (GSCSE), GSC Envelhecido (GSCE), GEA Sem Envelhecimento (GEASE), GEA Envelhecido (GEAE), GSA Sem Envelhecimento (GSASE) e GSA Envelhecido (GSAE). Foram obtidos palitos resina/dentina com área adesiva medindo aproximadamente 1x1 mm, e submetidos ao teste de microtração em máquina de ensaios Universal DL- 200MF (EMIC). Os dados foram analisados pelos testes ANOVA a três fatores e Tukey (α = 5%). Houve interação entre os três fatores (p = 0,0003). O modo de aplicação foi semelhante, exceto para o GSAE que foi maior que o GSCE. A utilização do etanol resultou em valores superiores de microtração, exceto para GECSE que foi similar a GSCSE. Para os grupos envelhecidos, os valores foram inferiores, exceto quando da utilização do etanol, no qual os resultados não foram influenciados pelo envelhecimento. Conclui-se que utilização do etanol resultou em valores de microtração superiores, principalmente quando associado ao envelhecimento. O modo de aplicação do adesivo de forma geral não influenciou nos resultados(AU)

The aim of this study was to evaluate the effect of ethanol on the longevity on adhesion by different application ways of adhesive system to bovine dentin substrate, through the microtensile test. Eighty bovine incisors were used, which had buccal dentin exposed and the standardization of smear layer obtained by sandpaper polishing (600 SiC, Fepa-P). After standardization, the specimens were randomly divided into 2 groups, With Ethanol Group (GE) and No Ethanol Group (GS) and further, subdivided according to the application ways into: Conventional Acid conditioning (GEC, GCH) and self-etching (GEA, GSA). Resin blocks were built over the treated surface using a silicon mold and specimens were stored in deionized water at 37ºC for 48 hours. After resin lightcuring, half of the specimens was subjected to thermomechanical aging resulting in the following groups (n = 10): GEC No Aging (GECSE), GEC Aged (GECE), GSC No Aging (GSCSE), GSC Aged (GSCE), GEA No Aged (GEASE), GEA Aged (GEAE), GSA No Aging (GSASE) e GSA Aged (GSAE). Resin/Dentin sticks measuring approximately 1x1 mm were obtained and subjected to microtensile test in universal testing machine Universal DL-200MF (EMIC). Data were analyzed by three-way ANOVA and Tukey tests (α = 5%). There was interaction between the three factors (p = 0.0003). The application way was similar except for GSAE which was highest than GSCE. The use of ethanol resulted in higher values of microtensile except for GECSE which was similar to GSCSE. For the aged group, the values were below, except when the use of ethanol, in which the results were not affected by aging. It is concluded that use of ethanol resulted in higher microtensile bond strength values, especially when associated with aging. The application way of universal adhesive system did not influence the results(AU)