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1.
J Appl Oral Sci ; 27: e20180700, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166415

RESUMO

INTRODUCTION: Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. OBJECTIVE: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. METHODOLOGY: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). RESULTS: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). CONCLUSION: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Cárie Dentária/terapia , Forramento da Cavidade Dentária/métodos , Óxidos/uso terapêutico , Silicatos/uso terapêutico , Zircônio/uso terapêutico , Análise de Variância , Criança , Pré-Escolar , Cárie Dentária/diagnóstico por imagem , Cimentos Dentários/uso terapêutico , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/efeitos dos fármacos , Restauração Dentária Permanente/métodos , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Radiografia Dentária , Fatores de Tempo , Dente Decíduo , Resultado do Tratamento
2.
Cochrane Database Syst Rev ; 3: CD010526, 2019 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-30834516

RESUMO

BACKGROUND: Resin-based composite (RBC) is currently accepted as a viable material for the restoration of caries for posterior permanent teeth requiring surgical treatment. Despite the fact that the thermal conductivity of the RBC restorative material closely approximates that of natural tooth structure, postoperative hypersensitivity is sometimes still an issue. Dental cavity liners have historically been used to protect the pulp from the toxic effects of some dental restorative materials and to prevent the pain of thermal conductivity by placing an insulating layer between restorative material and the remaining tooth structure. This is an update of the Cochrane Review first published in 2016. OBJECTIVES: The objective of this review was to assess the effects of using dental cavity liners in the placement of Class I and Class II resin-based composite posterior restorations in permanent teeth in children and adults. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 12 November 2018), the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 10) in the Cochrane Library (searched 12 November 2018), MEDLINE Ovid (1946 to 12 November 2018), Embase Ovid (1980 to 12 November 2018) and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 12 November 2018). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomized controlled trials assessing the effects of the use of liners under Class I and Class II posterior resin-based composite restorations in permanent teeth (in both adults and children). We included both parallel and split-mouth designs. DATA COLLECTION AND ANALYSIS: We utilized standard methodological procedures prescribed by Cochrane for data collection and analysis. Two review authors screened the search results and assessed the eligibility of studies for inclusion against the review inclusion criteria. We conducted risk of bias assessments and data extraction independently and in duplicate. Where information was unclear we contacted study authors for clarification. MAIN RESULTS: Eight studies, recruiting over 700 participants, compared the use of dental cavity liners to no liners for Class I and Class II resin-based composite restorations.Seven studies evaluated postoperative hypersensitivity measured by various methods. All studies were at unclear or high risk of bias. There was inconsistent evidence regarding postoperative hypersensitivity (either measured using cold response or patient-reported), with a benefit shown at some, but not all, time points (low-quality evidence).Four trials measured restoration longevity. Two of the studies were judged to be at high risk and two at unclear risk of bias. No difference in restoration failure rates were shown at 1 year follow-up, with no failures reported in either group for three of the four studies; the fourth study had a risk ratio (RR) 1.00 (95% confidence interval (CI) 0.07 to 15.00) (low-quality evidence). Three studies evaluated restoration longevity at 2 years follow-up and, again, no failures were shown in either group.No adverse events were reported in any of the included studies. AUTHORS' CONCLUSIONS: There is inconsistent, low-quality evidence regarding the difference in postoperative hypersensitivity subsequent to placing a dental cavity liner under Class I and Class II posterior resin-based composite restorations in permanent posterior teeth in adults or children 15 years or older. Furthermore, no evidence was found to demonstrate a difference in the longevity of restorations placed with or without dental cavity liners.


Assuntos
Resinas Compostas , Forramento da Cavidade Dentária/instrumentação , Restauração Dentária Permanente , Sensibilidade da Dentina/prevenção & controle , Dor Pós-Operatória/prevenção & controle , Condutividade Térmica , Adolescente , Adulto , Cárie Dentária/classificação , Cárie Dentária/cirurgia , Falha de Restauração Dentária/estatística & dados numéricos , Restauração Dentária Permanente/efeitos adversos , Restauração Dentária Permanente/classificação , Sensibilidade da Dentina/epidemiologia , Sensibilidade da Dentina/etiologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Clin Oral Investig ; 23(9): 3457-3469, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30552591

RESUMO

OBJECTIVES: To assess the biological, antimicrobial, and mechanical effects of the treatment of deep dentin with simvastatin (SV) before application of a glass-ionomer cement (GIC). MATERIALS AND METHODS: Dentin discs were adapted to artificial pulp chambers and SV (2.5 or 1.0 mg/mL) was applied to the occlusal surface, either previously conditioned or not with EDTA (±EDTA). The extracts (culture medium + SV that diffused through dentin) was obtained and then applied to cultured odontoblast-like MDPC-23 cells. Cell viability, alkaline phosphatase (ALP) activity, and mineralization nodule (MN) deposition were evaluated. Untreated discs were used as control. The antibacterial activity of SV (2.5 or 1.0 mg/mL) against Streptococcus mutans and Lactobacillus acidophilus, as well as the bond strength of GIC to dentin in the presence of SV 2.5 mg/mL (±EDTA) were also assessed. The data were analyzed by ANOVA/Tukey tests (α = 5%). RESULTS: EDTA + SV 2.5 mg/mL significantly enhanced the ALP activity and MN deposition in comparison with the control, without changing in the cell viability (p < 0.05). The association EDTA + SV 2.5 mg/mL + GIC determined the highest ALP and MN values (p < 0.05). SV presented intense antimicrobial activity, and the EDTA dentin conditioning followed by SV application increased bond strength values compared with SV treatment alone (p < 0.05). CONCLUSION: SV presents antimicrobial activity and diffuses across conditioned dentin to biostimulate odontoblast-like pulp cells. CLINICAL SIGNIFICANCE: The use of SV as adjuvant agent for indirect pulp capping may biostimulate pulp cells thus preserving vitality and function of the pulp-dentin complex.


Assuntos
Forramento da Cavidade Dentária , Inibidores de Hidroximetilglutaril-CoA Redutases , Sinvastatina , Dentina/efeitos dos fármacos , Dentina/microbiologia , Cimentos de Ionômeros de Vidro , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Odontoblastos , Sinvastatina/uso terapêutico
5.
J Prosthodont ; 28(1): e304-e309, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29323779

RESUMO

PURPOSE: To see whether applying four different liners under short fiber-reinforced composite (SFRC), everX Posterior, compared to conventional composite resin, Z250, affected their strengthening property in premolar MOD cavities. MATERIALS AND METHODS: Mesio-occluso-distal (MOD) cavities were prepared in 120 sound maxillary premolars divided into 10 groups (n = 12) in terms of two composite resin types and 4 liners or no liner. For each composite resin, in 5 groups no liner, resin-modified glass ionomer (RMGI), conventional flowable composite (COFL), self-adhesive flowable composite resin (SAFL), and self-adhesive resin cement (SARC) were applied prior to restoring incrementally. After water storage and thermocycling, static fracture resistance was tested. Data (in Newtons) were analyzed using two-way ANOVA (α = 0.05). RESULTS: Fracture resistance was significantly affected by composite resin type (p = 0.02), but not by the liner (p > 0.05). The interaction of the two factors was not statistically significant (p > 0.05). SFRC exhibited higher fracture strength (1470 ± 200 N) compared to conventional composite resin (1350 ± 290), irrespective of the application of liners. Application of SARC and SAFL liners led to a higher number of restorable fractures for both composite resins. CONCLUSIONS: The four liners can be used without interfering with the higher efficacy of SFRC, compared to conventional composite resins, to improve the fracture strength of premolar MOD cavities.


Assuntos
Dente Pré-Molar/cirurgia , Resinas Compostas/uso terapêutico , Forramento da Cavidade Dentária , Restauração Dentária Permanente , Resinas Compostas/efeitos adversos , Forramento da Cavidade Dentária/efeitos adversos , Falha de Restauração Dentária , Restauração Dentária Permanente/efeitos adversos , Restauração Dentária Permanente/métodos , Análise do Estresse Dentário , Vidro , Humanos , Polímeros/efeitos adversos , Polímeros/uso terapêutico
6.
Acta Odontol Latinoam ; 32(3): 126-132, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32176235

RESUMO

The aim of this study was to evaluate the effect of flowable composite or glass ionomer liners on the shrinkage stress of a restorative composite resin. Fifteen previously sandblasted metal boxes were attached to a universal mechanical testing machine (INSTRON 1011, Instron Corporation). Five of these boxes were filled with Filtek Z350 XT (FXT) Universal Restorative A2 (3M ESPE) (Group 1 or Control). Two further groups of 5 boxes were prepared by interposing a layer of Vitrebond Light Cure Glass Ionomer 3M ESPE (VGI) (Group 2 or G.I.) or Filtek Z350 XT Flowable Restorative A2 3M ESPE (FFR) (Group 3 or Flowable) between the box and the composite resin, completing with the same volume of composite as in Group 1. Upon activating lightcuring, the filled boxes mounted on the testing machine were videoed for 60 seconds (40 s photoactivation and 20 s postcuring), timed with a digital chronometer. Force values were recorded in newtons and converted into stress according to contact surface. Stress values were recorded every 10 s. Results were analyzed using repeated measures ANOVA. Mean and standard deviation in kPa (stress) recorded for each group were: Control group: 126.2 (30.8); G.I.: 48.4 (18); Flowable: 27.9 (19.5). Statistical analysis showed significant differences between the control group and the rest (p<0.01), with no significant difference between groups with glass ionomer liners and flowable resin liners (G.I. and Flowable). Under the experimental conditions of this study, it can be concluded that polymerization shrinkage stress can be reduced by the presence of a liner between the preparation and the restorative material.


Assuntos
Resinas Acrílicas , Resinas Compostas/química , Infiltração Dentária , Materiais Dentários/química , Restauração Dentária Permanente , Dióxido de Silício , Forramento da Cavidade Dentária/métodos , Preparo da Cavidade Dentária , Cimentos de Ionômeros de Vidro/química , Teste de Materiais , Polimerização
7.
J Contemp Dent Pract ; 19(9): 1065-1071, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30287705

RESUMO

AIM: The aim of the present in vivo study was to compare efficacy of light-cured resin-modified glass ionomer liner, Vitrebond™ (3M ESPE) with Dycal® (Dentsply) on the healing of pulpal tissue in the event of a direct iatrogenic pulpal exposure. MATERIALS AND METHODS: Experimental group consisted of Vitrebond™ (3M ESPE) resin-modified glass ionomer liner, and Vitremer™ (3M ESPE) resin-modified glass ionomer cement (GIC) in comparison with the control group of Dycal® (Dentsply) as liner and Poly F® (Dentsply) dental cement. Class V cavities were prepared in 32 sound premolars that were scheduled for orthodontic extraction, and the exposures were capped according to groups. Five teeth from each group were extracted under local anesthesia after an interval of 24 hours, 35 and 60 days, and evaluated for inflammation, fibrotic changes, formation of reparative dentin and bacterial examination. RESULTS: The present study did not show any statistically significant difference between two groups in terms of inflammation, fibrosis, reparative dentin formation, and bacterial examination. CONCLUSION: This study shows that Vitrebond™ (3M ESPE) light-cured resin-modified glass ionomer liner can be used as an alternative to calcium hydroxide as a direct pulp capping material. CLINICAL SIGNIFICANCE: Light-cured resin-modified glass ionomer liner can be an alternative for the calcium hydroxide-based liner for capping iatrogenic pulp exposures.


Assuntos
Resinas Acrílicas , Hidróxido de Cálcio , Resinas Compostas , Forramento da Cavidade Dentária , Capeamento da Polpa Dentária/métodos , Exposição da Polpa Dentária/terapia , Cimentos de Ionômeros de Vidro , Minerais , Poliuretanos , Agentes de Capeamento da Polpa Dentária e Pulpectomia , Exposição da Polpa Dentária/fisiopatologia , Humanos , Doença Iatrogênica , Cicatrização
8.
Biomed Res Int ; 2018: 9054301, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30186870

RESUMO

The aim of the study was to comparatively evaluate the fracture strength and mode of root canal treated teeth restored with resin composites with and without posts. The lingual cusps of root canal treated first upper premolars (n = 10/group) were removed down to cervical enamel and restored with the following: group A: glass-fiber post (Glassix) followed by a particulate-filled composite resin (PFC, G-aenial posterior, 3 × 2 mm layers); group B: glass-fiber reinforced composite bulk fill liner (EverX posterior, 4 mm layer) with the PFC (2 mm layer). Specimens were immersed in H2O (1 w/37°C), then subjected to load cycling (50 N/0.2 Hz/200k cycles), and fractured under compressive loading. Failure mode was characterized by stereomicroscopy. Statistical analysis was performed by Mann-Whitney (load) and Chi-square (mode) at a = 0.05. No statistically significant differences (p = 0.273) were found in fracture load between median values of groups A (860 N) and B (1059 N). In group A, 60% of the specimens demonstrated catastrophic root fractures and 40% mixed crown fractures (tooth cusp and restoration), whereas in group B, no root fractures were found, and the failure modes were equally distributed between mixed fractures as above and fracture of the buccal cusp. These differences were statistically significant (p = 0.004). The combination of the glass-FRC bulk fill liner with the PFC diminished the catastrophic root fractures induced by FRC posts, at a similar or higher fracture load.


Assuntos
Resinas Compostas , Forramento da Cavidade Dentária , Fraturas dos Dentes , Análise do Estresse Dentário , Vidro , Humanos , Teste de Materiais , Dente não Vital
9.
Oper Dent ; 43(6): 656-664, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30142038

RESUMO

This study determined the influence of shrinkage and viscosity of flowable composite liners on the cervical microleakage of Class II restorations using micro-CT. Seven composites of varying viscosities were selected and included five giomers (Shofu Beautifil II [BF], Flow Plus F00 and F03 [F00 and F03], Flow F02 and F10 [F02 and F10]) and 2 nano-filled composites (3M-ESPE Filtek Z350 [Z350] and Filtek Z350 Flowable [Z350F]). Polymerization shrinkage (n=7) was assessed with the Acuvol volumetric shrinkage analyzer while complex viscosity was determined with the advanced rheometric expansion system at 25°C. Standardized Class II restorations incorporating 1-mm horizontal layers of different flowable liners and 3-mm oblique layers of BF or Z350 were subjected to a silver nitrate test for 24 hours and examined using micro-CT. Microleakage was determined at 0.1-mm intervals from the buccal to lingual surfaces providing 30 sites per specimen and scored accordingly. Statistical analysis was performed with the one-way ANOVA, Kruskal-Wallis test, and Spearman's rho correlation at a significance level of p<0.05. Mean volumetric shrinkage ranged from 5.33±0.17% to 2.35±0.02% for F02 to Z350, respectively. The flowable materials had significantly higher shrinkage than did their sculptable counterparts (BF and Z350). Complex viscosities ranged from 9.65 to 4.20 (Z350 and F10, respectively) at a frequency of 10 rad/s and from 8.16 to 3.28 (Z350 and F03, respectively) for 100 rad/s. Giomer restorations had significantly less leakage than did those restored with nano-filled composites. No microleakage was observed with restorations lined with F02 or F10. The use of flowable liners reduced cervical microleakage of Class II restorations. Interfacial integrity of Class II restorations was significantly correlated with liner viscosity, filler volume, and shrinkage.


Assuntos
Resinas Compostas/química , Forramento da Cavidade Dentária/instrumentação , Preparo da Cavidade Dentária/métodos , Infiltração Dentária , Microtomografia por Raio-X , Dente Pré-Molar , Bis-Fenol A-Glicidil Metacrilato , Restauração Dentária Permanente/métodos , Humanos , Técnicas In Vitro , Teste de Materiais , Polimerização , Viscosidade
10.
Int J Periodontics Restorative Dent ; 38(6): 895­901, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30106395

RESUMO

This study investigated the effect of different cavity lining techniques on the marginal sealing of Class II composite restorations. A total of 36 human molar teeth, free of caries and fillings, were each prepared with two proximal Class II boxes mesially and distally. In mesial boxes, cavity liners were applied as follows: in group 1, separately cured flowable composite; in group 2, co-cured flowable composite; and in group 3, resin-modified glass ionomer (RMGI). The remaining cavities were filled incrementally with a universal restorative composite. The distal boxes were filled with no liner as controls. After thermocycling, the specimens were immersed in a silver nitrate solution and the microleakage was evaluated. Analysis of variance showed that the degree of microleakage for group 3 was significantly lower than that of the other groups. Based on the results, it was concluded that the use of RMGI as a cavity liner under composite restorations showed the least microleakage. Flowable composites, whether co-cured or separately cured, had no influence on the marginal sealing.


Assuntos
Forramento da Cavidade Dentária/métodos , Adaptação Marginal Dentária , Restauração Dentária Permanente/métodos , Resinas Compostas , Infiltração Dentária , Cimentos de Ionômeros de Vidro , Humanos , Teste de Materiais , Cimentos de Resina
11.
J Contemp Dent Pract ; 19(6): 656-661, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29959292

RESUMO

AIM: The purpose of this study was to evaluate and compare the cytotoxicity and genotoxicity of two bioceramic root canal sealers: EndoSequence BC and iRoot SP with zinc oxide eugenol sealers on fibroblast cell line. MATERIALS AND METHODS: The sealers tested were zinc oxide eugenol, EndoSequence BC, and iRoot SP. Each material was mixed according to the manufacturer's instructions and mounted into sterile polyethylene color-coded rings, for cytotoxicity and genotoxicity evaluation. After 48 hours, the set materials were transferred to previously marked wells and cytotoxicity evaluation to L929 murine fibroblast cells was done by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. The percentages of viable cells were then calculated and values were statistically analyzed by Kruskal-Wallis test. The evaluation of genotoxicity of the materials to L929 murine fibroblast cells was carried out by Comet assay. To quantify deoxyribonucleic acid (DNA) damage, the following comet parameters were evaluated in the assay using Comet scoring software: tail length, tail moment, and Olive moment. The values were statistically analyzed using Kruskal-Wallis test with a significance value set to p < 0.05. RESULTS: The results of the study showed that both cytotoxicity and genotoxicity evaluation by MTT assay and Comet assay can be done on L929 murine fibroblast cell line. Among the three tested materials, zinc oxide eugenol showed maximum cytotoxicity to the cells (30.64% viable cells), followed by EndoSequence BC (71.33% viable cells) and iRoot SP (75.11% viable cells). The evaluation of DNA damage by genotoxicity assessment showed iRoot SP to be least genotoxic followed closely by EndoSequence BC. Zinc oxide eugenol was genotoxic and induced more DNA damage on the fibroblast cell line studied. The statistical analyses for both the assays were nonsignificant. CONCLUSION: All the three tested sealers showed varying degrees of cytotoxicity and genotoxicity while using fibro-blast cell line. Zinc oxide eugenol was most toxic in both the assays and iRoot SP showed least toxicity, followed closely by EndoSequence BC.


Assuntos
Fosfatos de Cálcio/toxicidade , Eugenol/toxicidade , Fibroblastos/efeitos dos fármacos , Óxidos/toxicidade , Selantes de Fossas e Fissuras/toxicidade , Materiais Restauradores do Canal Radicular/toxicidade , Silicatos/toxicidade , Óxido de Zinco/toxicidade , Animais , Linhagem Celular , Ensaio Cometa , Forramento da Cavidade Dentária , Combinação de Medicamentos , Técnicas In Vitro , Camundongos , Testes de Mutagenicidade
12.
J Ayub Med Coll Abbottabad ; 30(2): 163-166, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29938411

RESUMO

BACKGROUND: Micro leakage around the margins of a restoration is believed to be one of the main causes of postoperative sensitivity. Dental amalgam is a non-insulating material and has the potential to transfer heat and cold causing irritation of the pulp. Different dentin tubule sealers are used under amalgam restoration to compensate for this post-operative sensitivity. This study was conducted to compare the frequency of sensitivity in amalgam restorations using copal varnish and dentin adhesive liner (dentin bonding agent). METHODS: A total of 60 patients of either gender, aged 18-40 years having class 1 carries in posterior teeth were included. Teeth with restorations, dentinal sensitivity and patients taking analgesic drugs for chronic pain conditions were excluded. The selected patients were placed randomly into Group A (copal varnish) & Group B (dentin adhesive liner), by using computer generated table of random numbers. Restored teeth were evaluated 1-month post operatively for sensitivity. RESULTS: Mean age was 25.63±5.42 years. Out of 60 patients, 68.0% were females and 32.0% were males with a female to male ratio of 2:1. The mean post-operative pain score was 2.83±2.79 in Group A and in Group B, it was 1.43±2.14 with a p-value of 0.03. There was no pain on application of a cold stimulus in 14 (46.7%) patients in Group A (copal varnish) while in Group B (Dentin adhesive), no pain was seen in 23 (76.7%) patients with p-value of 0.02. CONCLUSIONS: This study concluded that dentin adhesive liner (dentin bonding agent) is better than copal varnish in reducing postoperative sensitivity in amalgam restorations.


Assuntos
Forramento da Cavidade Dentária , Cimentos Dentários/efeitos adversos , Restauração Dentária Permanente , Sensibilidade da Dentina/epidemiologia , Resinas Vegetais/efeitos adversos , Adolescente , Adulto , Forramento da Cavidade Dentária/efeitos adversos , Forramento da Cavidade Dentária/métodos , Forramento da Cavidade Dentária/estatística & dados numéricos , Restauração Dentária Permanente/efeitos adversos , Restauração Dentária Permanente/métodos , Restauração Dentária Permanente/estatística & dados numéricos , Feminino , Humanos , Masculino , Adulto Jovem
13.
Dent Mater J ; 37(2): 192-196, 2018 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-29279548

RESUMO

The resin-coating technique is one of the successful bonding techniques used for the indirect restorations. The dentin surfaces exposed after cavity preparation are coated with a thin film of a coating material or a dentin bonding system combined with a flowable composite resin. Resin coating can minimize pulp irritation and improve the bond strength between a resin cement and tooth structures. The technique can also be applied to endodontically treated teeth, resulting in prevention of coronal leakage of the restorations. Application of a resin coating to root surface provides the additional benefit of preventing root caries in elderly patients. Therefore, the coating materials have the potential to reinforce sound tooth ("Super Tooth" formation), leading to preservation of maximum tooth structures.


Assuntos
Resinas Compostas/química , Colagem Dentária/métodos , Forramento da Cavidade Dentária/métodos , Restauração Dentária Permanente/métodos , Adesivos Dentinários/química , Humanos
15.
Gen Dent ; 65(4): 41-47, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28682281

RESUMO

This study investigated the microleakage of Class II composite restorations with composite resin liners. Standardized box cavities were prepared on the mesial and distal surfaces of 84 extracted intact human molars. Proximal margins were located in enamel (occlusal) and 1.0 mm apical to the cementoenamel junction (gingival). The teeth were randomly divided into 6 groups (n = 28 cavities) and restored with Filtek Z350 nanohybrid composite resin (FZ). The test groups were lined with a conventional flowable composite resin, Premise Flowable (PF), or 1 of 2 self-adhesive composites (SACs): Vertise Flow (VF) or Clearfil SA luting cement (CSA) with or without their respective self-etching adhesives: Optibond All-in-One (OB) or Clearfil SE Bond (CSE). The adhesive/lining procedure was performed as follows: OB/FZ (control), OB/PF/FZ, VF/FZ, OB/VF/FZ, CSA/FZ, or CSE/CSA/FZ. Microleakage was evaluated at the occlusal and gingival margins using a dye penetration technique and quantitative assessment. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data at the significance level of α = 0.05. None of the restorative techniques was capable of preventing microleakage completely. The greatest amount of microleakage was detected in the VF/FZ and CSA/FZ groups at both margins (P < 0.02). Among the groups placed with a bonding agent, OB/VF/FZ showed significantly greater values of microleakage at the occlusal margins than did OB/FZ, OB/PF/FZ, and CSE/CSA/FZ (P < 0.05). At the gingival margins, the OB/PF/FZ group exhibited the least leakage compared with the OB/VF/FZ and CSE/CSA/FZ groups (P < 0.001). The results indicated that the additional application of bonding agents improved the marginal sealing of SACs in Class II composite restorations.


Assuntos
Resinas Compostas/efeitos adversos , Infiltração Dentária/etiologia , Restauração Dentária Permanente/efeitos adversos , Resinas Compostas/uso terapêutico , Forramento da Cavidade Dentária/efeitos adversos , Forramento da Cavidade Dentária/métodos , Restauração Dentária Permanente/métodos , Humanos , Técnicas In Vitro , Cimentos de Resina/efeitos adversos , Cimentos de Resina/uso terapêutico
16.
Am J Orthod Dentofacial Orthop ; 151(5): 978-988, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28457276

RESUMO

Orthodontic treatment in adult patients with a skeletal discrepancy can be challenging. In this case report, we achieved both sagittal and vertical control by combining the classic sliding mechanics straight-wire technique with miniscrew anchorage. We treated a 21-year-old Chinese woman with a severe high mandibular plane angle, a retrusive chin, and a gummy smile. Her diagnosis included a skeletal Class II skull base with a mild anterior open bite, a protrusive maxilla, and a backwardly rotated mandible. This case underscores the importance of anchorage control in both the sagittal and vertical directions. First, we used miniscrews in the maxillary and mandibular buccal segments to obtain rigid anchorage. Next, we achieved good anterior and posterior vertical control with miniscrews in the maxillary anterior labial and posterior buccolingual segments. Intrusion of the maxillary molars contributed to deepening of the anterior overbite and counterclockwise rotation of the mandibular plane, which, in turn, improved the facial profile. Intrusion of the maxillary incisors contributed to correction of the gummy smile. After 1 year of retention, the patient had a stable, well-aligned dentition with ideal intercuspation and an improved facial contour. Our results thus suggest that placement of miniscrews in the anterior and posterior regions of the maxilla is effective for camouflaging a high-angle skeletal Class II defect. This technique requires minimal patient compliance and is particularly useful for correction of a high angle in an adult with a gummy smile.


Assuntos
Parafusos Ósseos , Má Oclusão de Angle Classe II/terapia , Procedimentos de Ancoragem Ortodôntica/métodos , Retrognatismo/terapia , Cefalometria , Forramento da Cavidade Dentária , Feminino , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Procedimentos de Ancoragem Ortodôntica/instrumentação , Braquetes Ortodônticos , Radiografia Dentária , Retrognatismo/diagnóstico por imagem , Adulto Jovem
17.
Pediatr Dent ; 39(1): 1-8, 2017 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-28292334

RESUMO

PURPOSE: The purpose of this study was to evaluate macroscopically and ultrastructurally the effect of calcium hydroxide cement (CH) and resin-modified glass ionomer cement (RMGIC) compared with gutta percha (control) as a lining material on carious dentin after partial caries removal and sealing. METHODS: Twenty-seven permanent molars with deep carious lesions underwent partial caries removal with the application of CH, RMGIC, or gutta percha (control) and were then sealed for three months. After a partial caries removal and sealing period, the dentin was macroscopically assessed (for color, consistency, and humidity) and further analyzed by scanning electron microscope to assess the ultrastructural changes in dentin (lumen size, mineralization of tubules, occlusion of tubules by cements, and bacterial ingress). The effect of treatment in each group was statistically analyzed. RESULTS: Dentin darkening and hardening were observed after the sealing period in all groups. However, there was no difference in the color after treatment among the three groups. It was observed that RMGIC showed a significant reduction in the size of the lumen compared to CH and the control. CONCLUSION: Partial caries removal and sealing resulted in dentin hardening, darkening, and dentin remineralization, irrespective of the dentin protection used.


Assuntos
Hidróxido de Cálcio/uso terapêutico , Cárie Dentária/cirurgia , Cimentos de Ionômeros de Vidro/uso terapêutico , Dente Molar/cirurgia , Resinas Sintéticas/uso terapêutico , Adolescente , Criança , Cárie Dentária/diagnóstico por imagem , Forramento da Cavidade Dentária , Dentina/cirurgia , Dentina/ultraestrutura , Método Duplo-Cego , Feminino , Guta-Percha/uso terapêutico , Humanos , Masculino , Microscopia Eletrônica de Varredura , Dente Molar/diagnóstico por imagem , Radiografia Dentária
18.
J Am Dent Assoc ; 148(6): 369-376, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28343596

RESUMO

BACKGROUND: Clinicians often use calcium hydroxide liners during stepwise treatment of advanced caries. In this randomized clinical trial, the authors compared the short-term outcome of stepwise caries removal with and without use of a calcium hydroxide liner in conjunction with provisional resin-modified glass ionomer (RMGI) restorations. METHODS: The authors included in the trial 98 patients aged 15 to 30 years who had a deep carious lesion in a posterior tooth. The authors measured the dentin thickness radiographically and recorded its color, consistency, and moisture, as well as the bacterial count of the lesions. After partial caries removal, the authors assigned patients randomly to have their caries provisionally restored using RMGI with (control group) or without (test group) a calcium hydroxide liner. The primary outcome measure was tooth vitality after 90 days. Secondary outcomes included changes in dentinal, radiographic, and microbiological characteristics of the lesions. RESULTS: The authors found no statistically significant difference between the test and control groups in tooth vitality after 90 days. Irrespective of calcium hydroxide liner use, the authors observed darker, harder, drier, and less contaminated dentin after the provisional restorations, but dentin thickness remained unchanged. CONCLUSIONS: On the basis of this 3-month clinical trial's results, the use of a calcium hydroxide liner during stepwise caries excavation and provisional restoration did not provide any additional benefit. PRACTICAL IMPLICATIONS: After 3 months, using a calcium hydroxide liner does not appear to offer any additional benefit when clinicians use RMGI provisional restorations during stepwise caries removal. Longer studies are needed to confirm these results.


Assuntos
Hidróxido de Cálcio/uso terapêutico , Cárie Dentária/cirurgia , Forramento da Cavidade Dentária/métodos , Restauração Dentária Permanente/métodos , Adolescente , Adulto , Cárie Dentária/diagnóstico por imagem , Feminino , Humanos , Masculino , Radiografia Dentária , Resultado do Tratamento , Adulto Jovem
19.
J Adhes Dent ; 19(1): 77-82, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28195270

RESUMO

PURPOSE: To assess the fracture resistance (FR) and cusp deflection (CD) of lined or non-lined composite (CO) and glass hybrid (GH) restorations over residual demineralized dentin. MATERIALS AND METHODS: In 48 extracted human premolars, artificial residual demineralized dentin was induced on pulpo-axial walls of standardized cavities. Various restorations were placed over this demineralized dentin: an experimental GH, a composite restoration (OptiBond FL+Tetric EvoCeram) without lining, or composite restorations with non-setting (Hypocal) or setting (Dycal) calcium hydroxide lining. After thermomechanical cycling, groups (n = 12) were compared regarding their CD and FR. RESULTS: CD did not differ significantly between groups. FR was significantly lower in teeth restored with GH (median: 238 N; 25th/75th percentiles: 191/287 N) than in those restored with lined or non-lined composites (median range: 517-569 N; p < 0.05/Mann-Whitney), which did not differ significantly from each other (p > 0.05). CONCLUSION: Within the conditions of this in vitro study, CH lining of pulpo-axial walls had only limited impact on CD and FR. GH showed the lowest FR and might not be optimal for restoring deep or extended cavitated lesions.


Assuntos
Sulfato de Bário , Hidróxido de Cálcio , Resinas Compostas , Forramento da Cavidade Dentária , Minerais , Cimentos de Resina , Desmineralização do Dente , Dentina , Combinação de Medicamentos , Vidro , Humanos , Teste de Materiais
20.
Oper Dent ; 42(2): 155-164, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27802124

RESUMO

OBJECTIVES: For deep carious lesions, selective carious tissue removal (leaving soft dentin close to the pulp) is suggested. Afterward, different restoration materials, such as resin composites or glass hybrids (GHs), can be placed. Many dentists also apply setting or non-setting calcium hydroxide liners before restoration. We compared margin integrity and susceptibility for secondary caries in differently restored premolars in vitro. METHODS: In 48 extracted human premolars, artificial residual lesions were induced on pulpo-axial walls of standardized cavities. Teeth were restored using a GH (Equia Forte) or adhesively placed resin composite restoration (OptiBond FL and Tetric EvoCeram) without any liner (RC), resin composite restoration with a non-setting calcium hydroxide liner (RC_NCH), or resin composite restoration with a setting calcium hydroxide liner (RC_SCH). After thermomechanical cycling, groups (n=12) were compared regarding their gingivocervical margin integrity (proportion of irregularities, microgaps, gaps >5 µm, overhangs). Teeth were then submitted to a continuous culture Lactobacillus rhamnosus biofilm model. After 14 days, bacterial numbers in biofilms, along tooth-restoration margins and mineral loss (ΔZ) of secondary lesions, were determined. RESULTS: GH and RC_NCH showed significantly higher proportions of irregularities than RC and RC_SCH (p<0.05/Mann-Whitney). GH also showed significantly more gaps than alternative restorations (p<0.05). Bacterial numbers and ΔZ did not differ significantly between groups (p>0.05). CONCLUSIONS: GH and composites lined with non-setting calcium hydroxide showed reduced margin integrity compared with non-lined composites or composites lined with setting calcium hydroxide. This did not increase susceptibility for secondary caries.


Assuntos
Cárie Dentária/etiologia , Cárie Dentária/terapia , Preparo da Cavidade Dentária/métodos , Dente Pré-Molar , Biofilmes , Hidróxido de Cálcio/uso terapêutico , Resinas Compostas/uso terapêutico , Forramento da Cavidade Dentária , Adaptação Marginal Dentária , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Técnicas In Vitro , Cimentos de Resina
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