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1.
Quintessence Int ; : 2-11, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32901243

RESUMO

OBJECTIVES: This split-mouth study assessed the bleaching sensitivity (risk and intensity) and color change after in-office bleaching using a desensitizing-containing (5% potassium nitrate) and a desensitizing-free 35% hydrogen peroxide gel. The null hypothesis was that there would be no differences between study groups regarding bleaching sensitivity. METHOD AND MATERIALS: Sixty patients participated in this split-mouth study. The subjects received desensitizing-containing hydrogen peroxide in half of the maxillary arch, and the other half received a desensitizing-free hydrogen peroxide, defined by random sequence, in two dental bleaching sessions. The bleaching sensitivity was evaluated during bleaching and from 1 h to 48 h after each bleaching session using a visual analog scale and numeric rating scale; the McNemar test, the Wilcoxon signed-rank test, and the Student-Newman-Keuls test were used for statistical analysis. The color was measured at baseline and 30 days post-bleaching, evaluated with paired t tests (P = .05). RESULTS: Statistically similar risks of bleaching sensitivity were observed (P = 1.000), but the intensity of bleaching sensitivity was lower (P < .011) on average by 1.32 visual analog scale units in the group bleached with the desensitizer-containing gel during up to 24 h assessment times. No statistical difference in color change was observed between groups (P > .321). CONCLUSION: The incorporation of 5% potassium nitrate into in-office bleaching gels does not reduce the risk of bleaching sensitivity, but it reduces its intensity slightly without jeopardizing color change.

2.
Am J Dent ; 33(4): 206-212, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32794396

RESUMO

PURPOSE: This double-blind, randomized clinical trial evaluated the influence of dentin moisture on postoperative sensitivity (POS) in posterior restorations using a simplified etch-and-rinse adhesive, until 12 months of clinical service. METHODS: 90 restorations were inserted in 45 patients to treat carious lesions or to replace existing posterior restorations with a depth ≥ 3 mm. After cavity preparation, the simplified etch-and-rinse adhesive (Adper Single Bond 2) was applied on dry or wet dentin followed by a bulk-fill resin composite (Filtek Bulk Fill) under rubber dam isolation. The patient's spontaneous and stimulated POS was evaluated at baseline and after 7 days, 6 months, and 12 months of clinical evaluation. The secondary parameters (marginal discoloration, marginal adaptation, fracture and recurrence of caries) were evaluated by World Dental Federation (FDI) criteria after 7 days, 6 and 12 months of clinical evaluation. RESULTS: No significant spontaneous and stimulated POS was observed when dry and wet dentin were compared (P> 0.05). A significant and higher risk of spontaneous POS (18.6%; 95% CI 9.7 to 32.6) occurred up to 48 hours after restoration placement for both groups when compared to all evaluation times (P< 0.03). However, the intensity of POS was mild at up to 48 hours with a difference between the dry and wet dentin groups (P> 0.79). When secondary parameters were evaluated, no significant difference between the groups were observed (P> 0.05). CLINICAL SIGNIFICANCE: The moisture level of the dentin substrate in posterior restorations does not influence POS in bulk-fill resin composite posterior restorations when associated with an etch-and-rinse ethanol-based adhesive system.


Assuntos
Cárie Dentária , Sensibilidade da Dentina , Resinas Compostas , Adaptação Marginal Dentária , Restauração Dentária Permanente , Dentina , Adesivos Dentinários , Método Duplo-Cego , Humanos , Cimentos de Resina
3.
Dent Mater ; 36(9): 1151-1160, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32620332

RESUMO

OBJECTIVES: To evaluate the effect of experimental dentin pre-treatment solutions formulated with different flavonoids on microtensile bond strength (µTBS), nanohardness (NH) and ultra-morphological characteristics of artificial caries-affected dentin (CAD) bonded using a universal bonding system. METHODS: A microbiological method was used to create an artificial CAD in 91 human molars. Five experimental pre-treatment solutions were created using the following flavonoids: quercetin (QUE); hesperidin (HES); rutin (RUT); naringin (NAR), or proanthocyanidin (PRO). A placebo solution (PLA) with no flavonoids added was also evaluated. The flavonoids or placebo solutions were applied to the CAD prior to the application and photoactivation of a universal adhesive (Scotchbond Universal, 3M Oral Care). A control group (CON), in which only the bonding agent was applied without any flavonoid solution, was also evaluated. A 3-mm-thick block of resin composite (Opallis, FGM) was built up on the flat bonded CAD surfaces and was light-cured following the manufacturer's instructions. Specimens were sectioned to obtain resin-dentin slices and sticks (cross-sectional area of 0.8 mm2). The µTBS, NH, and confocal ultramorphology analysis of resin-dentin interface was evaluated at 24 h and after thermo-cycling aging (25,000 cycles). The results were analyzed using 2-way ANOVA followed by Bonferroni's post hoc test (pre-set α = 0.05). RESULTS: The specimens from groups QUE, NAR, and RUT presented greater µTBS values than those from CON group (p<0.05). Specimens from some of these experimental groups presented greater nanomechanical properties (p<0.05), and no morphological degradation at the resin-dentin interface after aging. SIGNIFICANCE: The use of exogenous cross-linkers as dentin pre-treatment before bonding procedures may represent a suitable strategy to improve the longevity of universal adhesive systems applied to caries-affected dentin.

4.
Braz Dent J ; 31(3): 236-243, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32667516

RESUMO

This study aimed to quantify the penetration of hydrogen peroxide, color change evaluation, surface morphology, and composition after application of desensitizing agents before in-office bleaching. Fifty premolars were sectioned, an acetate buffer was placed in the pulp chamber and divided into five groups (n=10). In the positive control group, only the in-office bleaching gel was used, and in the negative control group, no treatment was used. Three different desensitizing agents were applied: Desensibilize KF2%® group; Mi Paste® group, and Desensibilize Nano-P® group. The bleaching procedure was carried out with 35% HP. The absorbance of the resulting solution was determined in a spectrophotometer. Color change was assessed by using a digital spectrophotometer. Four additional premolars were assigned to the same groups above for analysis under scanning electron microscope, as well as to evaluate the elemental composition with X-ray dispersive energy spectrometry. Data were subjected to ANOVA and Tukey's test (α=0.05). All products reduced the penetration of HP in the pulp chamber. Mi Paste and Nano P were the products that yielded the lowest HP penetration, which was similar to the negative control group (p<0.001). No significant difference was detected in color change (p<0.001). Concerning enamel morphology, the groups that were analyzed after bleaching were observed a greater deposition of desensitizing agents on the surface. The use of desensitizing agents before tooth bleaching seems to be an alternative to reduce adverse effects of the tooth.


Assuntos
Clareadores Dentários , Clareamento Dental , Esmalte Dentário , Cavidade Pulpar , Peróxido de Hidrogênio
5.
J Dent ; 99: 103407, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32526348

RESUMO

OBJECTIVE: A systematic review and a meta-analysis were performed to answer the following research question: Are there differences in the color match and surface texture of nanofilled/nanohybrid and hybrid composite in patients with direct posterior restorations? DATA: Randomized clinical trials that compared nanofilled/nanohybrid and hybrid composite in direct restoration in posterior teeth were included. For the analysis of the bias the risk of bias tool (RoB) was used. Meta-analyses of different pairs (nanofilled vs. hybrid and nanohybrid vs. hybrid composite) were conducted for surface texture and color match and other secondary outcomes at different follow-ups, using a random effects model. Heterogeneity was assessed with the Cochran Q test and I2 statistics. GRADE was used to assess the quality of the evidence. SOURCES: A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE, without restrictions. IADR abstracts (2001-2019), unpublished and ongoing trials registries, dissertations and theses were also searched. STUDY SELECTION: 28 studies remained. No study was considered to be at low RoB; four studies were judged to have high RoB, and the remaining were judged to have unclear RoB. RESULTS: For the primary and secondary outcomes variables no significant differences were detected between nanofilled/nanohybrid restorations and hybrid composite restorations in any of the study follow-ups (p > 0.08). The body of evidence for surface texture and color match was classified as moderate or low. CONCLUSION: No evidence of difference was found between nanofilled/nanohybrid and hybrid composite in any of the clinical parameters evaluated.

6.
Dent Mater ; 36(5): 672-680, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32284197

RESUMO

OBJECTIVE: The present study investigated the ability of a chlorhexidine (CHX)-containing primer (0.2% aqueous solution) to inhibit dentinal enzymes, preserve the hybrid layer (HL) and remain within the HL, after 10 years of aging in artificial saliva at 37°C. METHODS: Non-carious extracted molars were assigned to two groups, cut into slabs exposing middle/deep dentin, etched and bonded with Adper Scotchbond 1XT (SB1XT) with or without 0.2% CHX aqueous solution pretreatment. Composite build-ups were made, and the specimens were cut in 1-mm thick bonded sticks. In situ zymography was performed on freshly prepared specimens (T0) and specimens aged for 10 years (T10-yr) at 37°C in artificial saliva, to investigate endogenous gelatinolytic activity within the HL. At T10-yr, specimens were also decalcified and embedded in epoxy resin for TEM analysis. Micro-Raman spectroscopy was performed at T0 and T10-yr to evaluate the chemical profiles in intertubular dentin and the HL. RESULTS: In situ zymography showed less pronounced enzymatic activity in the CHX-pretreated group (p<0.05) regardless of aging, maintaining a similar level of fluorescence at T0 and T10-yr (p>0.05). TEM results showed that 98% of the HL had been degraded in the control group, while 95% of the HL was intact in the experimental group. Moreover, all the Raman spectra peaks assigned to CHX could be identified only in the CHX-pretreated group (T0 and T10-yr). SIGNIFICANCE: In vitro, CHX remains in the HL after 10 years with its inhibitory effect preserved. This may be the underlying factor for HL preservation after this long aging period.

7.
J Adhes Dent ; 22(2): 161-172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32322837

RESUMO

PURPOSE: To evaluate 1. the microtensile bond strength (µTBS) and in situ degree of conversion (DC) of adhesives applied using two bonding strategies after silver diamine fluoride (diamine) application on carious dentinal lesions, and 2. dentin etching patterns using SEM and energy dispersive x-ray spectroscopy. MATERIALS AND METHODS: Human molars were randomly divided into 12 experimental groups according to: 1. application of a silver diamine fluoride solution (carious dentinal lesion without silver diamine fluoride treatment [control], with 12% silver diamine fluoride [diamine 12%] or 38% silver diamine fluoride [diamine 38%]); 2. adhesives (Clearfil Universal Bond Quick [CUQ] and Scotchbond Universal [SBU]); 3. adhesive strategy (etch-and-rinse [ER] and self-etch [SE]). After restoration, the specimens were sectioned and submitted to µTBS testing. Sticks from each tooth were used for DC evaluation. To examine the changes induced by diamine before and after phosphoric acid treatment, SEM/EDX analysis was performed. Data from the µTBS and DC tests were analyzed using three-way ANOVA and Tukey's test (α = 0.05). RESULTS: Both concentrations of diamine resulted in a statistically significantly higher mean µTBS compared to the control (p < 0.0001). Diamine 38% showed a statistically significantly higher mean µTBS for both adhesives in SE mode compared to diamine 12% (p < 0.0001). The application of diamine to carious dentinal lesions did not significantly influence the mean DC values for either adhesive (p = 0.72). SBU showed a higher mean DC compared to CUQ (p = 0.03). After diamine treatment, there was an increase in the Ca peak intensity and the presence of residual silver ions mainly when diamine 38% was applied along with the SE approach. CONCLUSION: Independent of the adhesive application approach, the use of diamine may be a promising alternative to increase µTBS without jeopardizing the DC of the two adhesives in carious dentinal lesions.


Assuntos
Colagem Dentária , Cimentos Dentários , Dentina , Fluoretos Tópicos , Humanos , Compostos de Amônio Quaternário , Compostos de Prata , Resistência à Tração
8.
J Dent ; 96: 103325, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32205201

RESUMO

OBJECTIVES: This double-blind randomized clinical trial evaluated the influence of pre-treatment with proanthocyanidins (PA) from grape seed extract on the clinical behavior of a simplified etch-and-rinse adhesive placed in non-carious cervical lesions (NCCLs) over 6- and 24-months. MATERIALS AND METHODS: A total of 135 restorations were randomly inserted in 45 subjects. The NCCLs were etched with 37 % phosphoric acid for 15 s and distributed into 3 groups: Control (PA0) - adhesive ExciTE F applied as per the manufacturer's recommendations; PA2 and PA5 groups - 2 wt% and 5 wt% PA solution, respectively, were applied for 60 s and washed for 30 s prior to application of the adhesive. The resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline, 6 months (6 m) and 24 months (24 m) using both the FDI and USPHS criteria. Statistical analyses were carried out using Friedman repeated-measures analysis of variance by rank and the Wilcoxon test (α = 0.05). RESULTS: The retention rates were 98 % (PA0), 98 % (PA2) and 83 % (PA5) after 6 m and 93 % (PA0), 89 % (PA2) and 70 % (PA5) after 24 m. Only PA5 resulted in a significant lower retention rate at 6 m and at 24 m compared with that of baseline (p = 0.03). All groups resulted in a significantly worse marginal adaptation and marginal staining for the FDI criteria when the baseline vs. the 24 m recall data were compared. These differences were considered clinically acceptable under the FDI criteria. CONCLUSIONS: The application of PA as a primer did not result in clinical advantages after 24 m of clinical service, regardless of the concentration used. CLINICAL RELEVANCE: It has been reported that PA, a collagen crosslinking agent, increases the durability of the dentin-resin interface. However, no effects were found clinically after 24 months.

9.
Clin Oral Investig ; 24(2): 809-822, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31190231

RESUMO

OBJECTIVES: The aim of this study was to investigate the effects of collagen cross-linking agents on nanomechanical and bonding properties of eroded dentin (ED), 24 h and 2 years after water storage. MATERIALS AND METHODS: Human molar dentin surfaces, eroded by soft drinks or citric acid, were acid-etched and treated with primers containing proanthocyanidin (PA) and riboflavin (RI) or were untreated (control) and tested after 24 h and 2 years. After acid etching and adhesive application (Prime&Bond Elect (PBE); Scotchbond Universal (SBU); Tetric n-bond Universal (TEU)), specimens were sectioned into beams and tested for microtensile bond strength (µTBS) and silver nitrate deposition (NL) after 24 h and 2 years. The beams were used to evaluate the 24-h in situ conversion of degree (DC). Nanohardness (NH) and Young's modulus (YM) were evaluated via resin-bonded dentin slices after 24 h and 2 years. A three-way ANOVA and Tukey's test were used for statistical analysis (5%). RESULTS: For both storage times, ED with citric acid resulted in lower µTBS, NH, and YM and higher NL for each adhesive system than soft drink ED (p < 0.05). After 2 years of water storage, cross-linking primers maintained the µTBS, NH, and YM (p < 0.05) when compared with the control group. Althougth, the NL values decreased for all groups after 2 years of water storage, PA and RI treatments showed NI values lower than control group (p < 0.001). No significant differences were observed between PA and RI treatments (p > 0.05). Cross-linking primers maintain or improve DC (p < 0.03). In general, TEU and SBU yielded higher µTBS, DC, NH, and YM and lower NL than PBE. CONCLUSION: Cross-linking agents improved the results and maintained the resin-ED interface bonding and nanomechanical properties, without jeopardizing adhesive polymerization. CLINICAL RELEVANCE: Cross-linking agents are a viable alternative for improving and maintaining resin-ED interface bonding and nanomechanical properties.


Assuntos
Colagem Dentária , Colágeno , Resinas Compostas , Dentina , Adesivos Dentinários , Humanos , Teste de Materiais , Cimentos de Resina , Resistência à Tração , Água
10.
Braz. dent. sci ; 23(2): 1-8, 2020. tab, ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1096444

RESUMO

Objective: This study's aim was to quantify the hydrogen peroxide (HP) penetration into the pulp chamber of teeth submitted to different protocols of bleaching. Material and Methods: Ninety premolars were randomly divided into nine groups according to the bleaching agent protocol (n = 10): control (no bleaching), carbamide peroxide 10% [10% CP], carbamide peroxide 16% [16% CP], carbamide peroxide 22% [22% CP], hydrogen peroxide 4% [4% HP], hydrogen peroxide 6% [6% HP], hydrogen peroxide 7.5% [7.5% HP], hydrogen peroxide 10% [10% HP] and hydrogen peroxide 35% [35% HP]. The penetration of HP was measured via spectrophotometric analysis of the acetate buffer solution from the pulp chamber. The absorbance of the resulting solution was determined in a spectrophotometer and converted into equivalent concentration of HP (µg/ mL). To analyze the concentration of HP, the titration of bleaching agents with potassium permanganate was used. Data were subjected to ANOVA and Tukey's test for pairwise comparison (α = 0.05). Results: Higher concentration of HP in the pulp chamber was found in the HP 35% group (p < 0.0001). No significant difference between at-home protocols were observed (p = 0.64). Titration values showed that the concentration of the products was similar to that claimed by the manufacturer. Conclusion: It follows that the amount of HP that reaches the pulp chamber is not proportional to the concentration of whitening gels, but depends on the application time recommended by the manufacturers (AU)


Objetivo: o objetivo deste estudo foi quantificar a penetração do peróxido de hidrogênio (PH) na câmara pulpar dos dentes submetidos a diferentes protocolos de clareamento. Material e Métodos: Noventa pré-molares foram divididos aleatoriamente em nove grupos, de acordo com o protocolo do agente clareador (n = 10): controle (sem clareamento), peróxido de carbamida 10% [PC 10%], peróxido de carbamida 16% [PC 16%], peróxido de carbamida 22% [PC 22%], peróxido de hidrogênio 4% [PH 4%], peróxido de hidrogênio 6% [PH 6%], peróxido de hidrogênio 7,5% [PH 7,5%], peróxido de hidrogênio 10% [PH 10%] e peróxido de hidrogênio 35% [PH 35%]. A penetração de PH foi medida por análise espectrofotométrica da solução de tampão de acetato da câmara pulpar. A absorvância da solução resultante foi determinada em um espectrofotômetro e convertida em concentração equivalente de PH (µg / mL). Para analisar a concentração de PH, foi utilizada a titulação de agentes clareadores com permanganato de potássio. Os dados foram submetidos à ANOVA e teste de Tukey para comparação pareada (α = 0,05). Resultados: Foi encontrada maior concentração de PH na câmara pulpar no grupo PH 35% (p < 0,0001). Não foi observada diferença significativa entre os protocolos domiciliares (p = 0,64). Os valores de titulação mostraram que a concentração dos produtos era semelhante à reivindicada pelo fabricante. Conclusão: Conclui-se que a quantidade de PH que atinge a câmara pulpar não é proporcional à concentração de géis clareadores, porém depende do tempo de aplicação recomendado pelos fabricantes.(AU)


Assuntos
Clareamento Dental , Permeabilidade do Esmalte Dentário , Clareadores , Peróxido de Carbamida , Peróxido de Hidrogênio
11.
J Adhes Dent ; 21(6): 497-508, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31802065

RESUMO

PURPOSE: To compare the retention rates of non-carious cervical restorations (NCCLs) constructed using the sandwich technique (a lining of glass-ionomer cement [GIC] or resin-modified glass-ionomer cement [RMGIC] and composite resin [CR]) with CR-only restorations. MATERIALS AND METHODS: The search was performed in various databases, including the Cochrane Library, PubMed, Scopus, and Web of Science. Gray literature was inspected, as were ongoing and unpublished abstracts from the IADR (1990-2017). Study quality was evaluated using the Cochrane Collaboration bias risk tool. Data from primary and secondary outcomes were meta-analyzed at 1-, 2- and 3-year follow-ups using the random effects model. The quality of the body of evidence was assessed using the GRADE approach. RESULTS: Initially, a total of 3645 articles were selected. After selection by titles, abstracts, and full texts, 6 articles were retrieved, but three were follow-ups of the same RCT. Therefore, a total of four studies remained for analysis. All studies were at unclear risk for bias. Among all outcomes, only loss of retention was lower for the sandwich technique at the 3-year follow-up (risk ratio [RR]: 7.5; 95% CI: 2.1 to 27.2; p = 0.002). CONCLUSIONS: Based on the limited number of available studies, higher retention rates in NCCL restorations were observed with the sandwich technique compared to CR-only restorations at the 3-year follow-up. Secondary outcomes were not influenced by the restorative technique. Except for retention rates, which were of moderate quality, the evidence quality of all secondary outcomes was low.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Resinas Compostas , Falha de Restauração Dentária , Cimentos de Ionômeros de Vidro , Cimentos de Resina
12.
J Adhes Dent ; 21(6): 525-536, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31802068

RESUMO

PURPOSE: To compare the adhesive-enamel microshear bond strength (µSBS), in situ degree of conversion (DC), and the enamel-etching pattern of universal adhesives when applied for a prolonged period in the self-etch vs the etch-and-rinse mode in fluorotic enamel. MATERIALS AND METHODS: Ninety-six human molars (48 with a Thylstrup and Fejerskov index [TFI] score of 0 and 48 with TFI score of 4) were sectioned into four parts and divided into 24 experimental groups based on enamel surface (sound enamel or fluorotic enamel), adhesive (Clearfil Universal Bond, Futurabond U, iBond Universal, or Scotchbond Universal), and enamel treatment/application time (etch-and-rinse mode [ER] or self-etch mode with application times of 20 s [20SE] and 40 s [40SE]). The specimens were stored for 24 h and tested in shear at 1.0 mm/min (µSBS). Adhesive-enamel interfaces were evaluated for DC using micro-Raman spectroscopy. The enamel-etching pattern was evaluated using SEM. For each adhesive, data from µSBS and DC were analyzed separately using two-way ANOVA and Tukey's post-hoc test at α = 0.05. RESULTS: On sound enamel, 40SE usually resulted in statistically similar mean µSBS (p > 0.52) and statistically significantly improved mean DC values (p < 0.001) compared with the ER mode. Moreover, significantly improved mean µSBS and DC values were obtained compared with 20SE (p < 0.01). On fluorotic enamel, there was no statistically significant difference in µSBS between the experimental groups (p > 0.76). However, for each applied adhesive, 40SE resulted in improved mean DC values compared with 20SE or ER (p < 0.001). The deepest enamel-etching pattern was obtained in ER mode, followed by 40SE in sound and fluorotic enamel. CONCLUSION: Compared with ER mode, the prolonged application time of universal adhesives in SE mode in fluorotic enamel increased the DC, enhanced enamel-etching pattern and promoted similar results in terms of adhesive-enamel bond strength.


Assuntos
Colagem Dentária , Cimentos Dentários , Adesivos , Resinas Compostas , Esmalte Dentário , Adesivos Dentinários , Humanos , Teste de Materiais , Dente Molar , Cimentos de Resina
13.
J Dent ; 90: 103219, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31629030

RESUMO

OBJECTIVE: This study aimed to evaluate the addition of copper nanoparticles (CuNp) on the clinical performance of a universal adhesive system used as etch-and-rinse (ER) and self-etch (SE). METHODS: 216 restorations were randomly placed in 36 subjects according to the following groups: ERcu = etch-and-rinse with 0.1% CuNp; ERct = etch-and-rinse without CuNp; SEcu = self-etch with 0.1% CuNp; SEct = self-etch without CuNp. Resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline and 6, 12 and 18 months using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α = 0.05). RESULTS: The addition of CuNp did not increase the clinical performance (FDI / USPHS) of the universal adhesive tested after 18-month when applied in the ER mode (p > 0.05). The addition of CuNp in SE restorations increased the retention rate significantly and decreased the marginal discrepancies after 18 months (p < 0.05). CONCLUSION: The clinical performance of universal adhesive was significantly increased when applied in the SE mode with the addition of copper nanoparticles. CLINICAL RELEVANCE: This is the first study that demonstrates a slight improvement in the clinical performance of universal adhesive systems in non-carious cervical lesions when added CuNp in lower concentration.

14.
J Mech Behav Biomed Mater ; 100: 103366, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31422314

RESUMO

This study evaluated the MMP inhibition of the zinc oxide and copper nanoparticles (ZnO/CuNp), and the effects of their addition into adhesives on antimicrobial activity (AMA), ultimate tensile strength (UTS), in vitro degree of conversion (in vitro-DC), as well as, resin-dentin bond strength (µTBS), nanoleakage (NL) and in situ-DC on caries-affected dentin. Anti-MMP activity was evaluated for several MMPs. ZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added into Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. UTS were tested after 24 h and 28d. After induced caries, adhesives and composite were applied to flat dentin surfaces, and specimens were sectioned to obtain resin-dentin sticks. µTBS, NL, in vitro-DC and in situ-DC were evaluated after 24 h. ANOVA and Tukey's test were applied (α = 0.05). ZnO/CuNp demonstrated anti-MMP activity (p < 0.05). The addition of ZnO/CuNp increased AMA and UTS (AMB; p < 0.05). UTS for PBA, in vitro-DC, in situ-DC and µTBS for both adhesives were maintained with ZnO/CuNp (p > 0.05). However, lower NL was observed for ZnO/CuNp groups (p < 0.05). The addition of ZnO/CuNp in adhesives may be an alternative to provide antimicrobial, anti-MMP activities and improves the integrity of the hybrid layer on caries-affected dentin.

15.
J Adhes Dent ; 21(4): 319-327, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31432046

RESUMO

PURPOSE: To evaluate the effect of different application modes of a recently introduced self-etching ceramic primer on the microshear bond strength (µSBS) and ceramic surface-etching pattern of two glass-ceramic surfaces. MATERIALS AND METHODS: Twenty-two CAD/CAM blocks of lithium disilicate (LD) and feldspathic glass ceramic (VTR) were each cut into 4 rectangular sections (n = 88 for ceramic surface). The LD and VTR specimens were divided into one control group (hydrofluoric acid + silane coupling agent [HF+SII]), and 10 experimental groups using Monobond Etch and Prime (MEP) applied for a combination of scrubbing times (5, 10, 20, 40, and 60 s) and reaction times (20 or 40 s). After each treatment, Tygon matrices (n = 8) were filled with a resin cement and light cured for each ceramic specimen. The specimens were stored in water at 37°C for 24 h and subjected to the µSBS test. The failure pattern and µSBS were statistically evaluated (α = 0.05). In addition, the ceramic surface etching pattern was analyzed using scanning electron microscopy. RESULTS: For the LD groups, the application of MEP 60/40 resulted in a higher mean µSBS compared to HF+SI (p < 0.05). Groups 5/40, 10/40, and 20/40 resulted in mean µSBS similar to that obtained by HF+SI (p > 0.05). For VTR, no significant difference was observed among the groups (p = 0.32). Compared with MEP, HF better promoted the dissolution of glass matrix for both ceramics. However, prolonged MEP scrubbing or reaction caused significant dissolution of the glass matrix for both evaluated ceramics. CONCLUSION: Active and prolonged application of MEP may be a viable alternative to HF+SI for increasing the bond strength to LD.


Assuntos
Colagem Dentária , Cerâmica , Porcelana Dentária , Ácido Fluorídrico , Teste de Materiais , Cimentos de Resina , Silanos , Propriedades de Superfície
16.
Clin Oral Investig ; 23(10): 3673-3689, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31468261

RESUMO

OBJECTIVES: A systematic review and meta-analysis were performed to answer this research question: "Does combined in-office (IO) and at-home (AH) bleaching produce improved color change and lower tooth sensitivity (TS) better than solely AH or IO bleaching in adults?" MATERIAL AND METHODS: Randomized controlled trials in adults that compared combined versus sole application bleaching were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change in shade guide units (∆SGU) and with a spectrophotometer (∆E*), risk, and intensity of TS, using the random effects model. Heterogeneity was assessed with Cochran's Q test and I2 statistics. GRADE assessed the quality of the evidence. PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, IADR abstracts, unpublished, ongoing trial registries, dissertations, and theses were searched on August 28, 2017 (updated on January 29, 2019). RESULTS: Twelve studies remained. Two were considered to have low RoB. For combined vs. IO bleaching, no significant difference for ∆E*, ∆SGU, and risk of TS were observed; data were not available to analyze the intensity of TS. For combined vs. AH bleaching, no significant difference for ∆E*, ∆SGU, but lower TS to risk (RR 1.40, 95% 1.10 to 1.80) and intensity (MD 1.40, 95% CI 0.18 to 2.63) were detected for AH bleaching. Quality of evidence was graded as low or very low in all meta-analyses. CONCLUSION: Lower risk and intensity of TS was observed for the solely AH group without jeopardizing color change. However, more studies are still encouraged due to the low quality of evidence for most of the outcomes. CLINICAL RELEVANCE: If clinicians are to choose between combined or sole AH bleaching, the solely AH may be preferable; combined bleaching may potentiate the risk of TS without benefits in color change. For combined or sole IO bleaching, no important clinical difference in color change and risk of TS were detected; however, intensity of TS could not be compared due to lack of data. Further studies should be conducted due to the low/very low quality of the evidence.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Dente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
J Contemp Dent Pract ; 20(4): 424-427, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31308271

RESUMO

INTRODUCTION: Bleached enamel surfaces may undergo changes and retain more dye, which is a reason to recommend the reduction/suspension of foods with dyes during dental bleaching. AIM: Evaluate the effects of the action of natural and artificial dyes on the bleached enamel of extracted human teeth. MATERIALS AND METHODS: Fifty human premolars were used, which were distributed in 5 groups (n = 10) according to the following staining solutions: GW (distilled water); GB (beet); Gca (caramel); GC (carmine); and GR (red 40). After the removal of the root and pulp section, the teeth were embedded in acrylic resin blocks, stored in artificial saliva, and kept at 37°C. At-home bleaching was performed using 16% carbamide peroxide (CP) for 3 hours daily for 3 weeks. After each daily session of bleaching, the specimens were exposed to the dye solution twice a day for 5 min; one of these exposures was performed immediately after bleaching. The color was recorded using a spectrophotometer according to the CIE Lab system (Δ E) for the following periods: baseline, during bleaching (after 1st, 2nd, and 3rd week) and post-bleaching (after 1 week and 1 month). The color was evaluated by two-way analysis of variance and Tukey's test (α=0.05). RESULTS: There was effective dental bleaching for all groups: GW (18.5 ± 6.1), GB (19.9 ± 4.4), Gca (18.9 ± 6.1), GC (20.2 ± 4.6), and GR (19.3 ± 4.2), p <0.01. No color rebound was observed after 1 week and 1 month (p >0.05). CONCLUSION: The exposure to beet, carmine, caramel, and red 40 dyes did not interfere with the effectiveness of dental bleaching using 16% CP. CLINICAL SIGNIFICANCE: Dyes consumption during bleaching did not affect the effectiveness of dental bleaching.


Assuntos
Clareadores Dentários , Clareamento Dental , Corantes , Humanos , Peróxidos , Saliva Artificial , Coloração e Rotulagem , Ureia
18.
J Adhes Dent ; 21(2): 149-158, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949628

RESUMO

PURPOSE: To evaluate the effect of two phosphoric acids containing protease inactivators (chlorhexidine and proanthocyanidin) on the resin/eroded-dentin microtensile bond strength (µTBS), nanoleakage (NL), and in situ degree of conversion (DC) of three universal adhesives applied in the etch-and-rinse mode. MATERIALS AND METHODS: One hundred twenty-six molars were randomly assigned to 18 experimental conditions according to the combination of the independent variables: eroded dentin (soft drink and citric acid), adhesive (Prime&Bond Elect [PBE, Dentsply Sirona], Scotchbond Universal Adhesive [SBU, 3M Oral Care], and Tetric N-Bond Universal [TEU, Ivoclar Vivadent]), and acid pretreatment (conventional phosphoric acid [CP acid]; chlorhexidine acid [CHX acid]; and proanthocyanidin acid [PA acid]). After restorations, specimens were sectioned into resin-dentin sticks (ca 0.8 mm2) that were then tested under tension (crosshead speed: 0.5 mm/min). Selected sticks from each tooth were used to evaluate NL and DC. Data from all tests were subjected to three-way ANOVA and Tukey's test (α=0.05). RESULTS: Dentin eroded with citric acid showed a significant reduction in µTBS for each adhesive in comparison to dentin eroded with the soft drink (p < 0.001). For dentin eroded with CHX acid and PA acid, the µTBS (p > 0.03) significantly improved and NL decreased for all adhesives (p < 0.004); in addition, the DC improved for two of the three adhesives tested (SBU and TEU) (p < 0.03) when CHX acid and PA acid were compared to CP acid. CONCLUSION: The addition of chlorhexidine and proanthocyanidin to phosphoric acid improved the adhesive performance when compared with conventional phosphoric acid, without jeopardizing adhesive polymerization at the resin/eroded-dentin interface.


Assuntos
Colagem Dentária , Infiltração Dentária , Condicionamento Ácido do Dente , Resinas Compostas , Dentina , Adesivos Dentinários , Humanos , Teste de Materiais , Ácidos Fosfóricos , Cimentos de Resina , Resistência à Tração
20.
Braz Dent J ; 30(2): 171-178, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30970061

RESUMO

To evaluate the effect of combining 5% hydrofluoric acid (HF) and silane (SI) with the self-etching ceramic primer on the immediate and after 1-year of water storage on bonding efficacy, conditioning pattern (CP) and chemical interaction (CI) to the lithium disilicate. A total of 16 CAD/CAM blocks of lithium disilicate (LD) were cut into four square sections (n=64). For bonding efficacy evaluation, the LD specimens were divided into 4 groups (n=10): 1) HF+SI; 2) self-etching ceramic primer (MEP); 3) HF+MEP; 4) MEP+SI. After each treatment, an adhesive system was applied and Tygon matrices were filled with a dual-cured resin cement followed by light curing. Cylinder specimens (0.8 mmx0.5mm) were stored in water (37 °C for 24 h or 1-year) and submitted to the µSBS test (2-way ANOVA and Tukey's test; a=0.05). CP and CI were only evaluated qualitatively. No significant difference on the µSBS was observed between groups (p=0.73), but reduced µSBS was observed after 1-year of water storage (p>0.0001). After application of HF+SI and MEP, reduction in a number of siloxane bonds was observed, suggesting the coupling of SI on the LD surface. HF or HF+MEP produced a higher dissolution of the glassy matrix than the use of MEP alone. The MEP can be an alternative to traditional ceramic treatment once the chemical interaction and long-term bond strength were similar between both groups. The association of hydrofluoric acid or silane with a self-etching ceramic primer did not add any benefits in terms of chemical interaction and bonding stability.


Assuntos
Colagem Dentária , Ácido Fluorídrico , Cerâmica , Porcelana Dentária , Análise do Estresse Dentário , Teste de Materiais , Cimentos de Resina , Silanos , Propriedades de Superfície
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