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1.
J Adhes Dent ; 22(1): 107-116, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030381

RESUMO

PURPOSE: This in vitro study evaluated marginal integrity, 2-body wear, and fracture behavior of an array of bonded and nonbonded posterior restorative materials after thermomechanical loading (TML). MATERIALS AND METHODS: Eighty-eight MOD cavities with one proximal box beneath the CEJ were prepared in extracted human third molars according to a well-established protocol. Direct restorations were made using the following materials: amalgam (Dispersalloy), Ketac Molar Quick, Surefil One (with or without light curing), Activa, AdheSE Universal/Heliomolar, Fuji II LC improved, Equia Forte, Scotchbond Universal/Filtek Supreme, Xeno V+/CeramX.mono+, Prime&Bond active/Spectra ST CeramX HV, Prime&Bond elect/Spectra ST CeramX HV. Before and after thermomechanical loading (2500/5000/12,500 thermocycles between 5°C and 55°C + 100,000/ 200,000/500,000 x 50 N), marginal gaps and 2-body wear depths were analyzed on epoxy resin replicas using SEM and CLSM. Fractures were observed under a light microscope (20X). Results were analyzed with Kruskal-Wallis and Mann-Whitney U-tests (p < 0.05). RESULTS: For marginal quality, Surefil One showed promising in vitro behavior close to that of resin composite bonded with a self-etch adhesive (p > 0.05). For wear, amalgam and resin composites with recent filler technology were still superior (p < 0.05), but Surefil One LC outperformed Activa, Ketac Molar Quick, Equia Forte Fil, and Fuji II LC (p < 0.05). When Surefil One was occlusally light cured, no fractures occured, even after 500,000 cycles of TML. CONCLUSION: The novel self-adhesive posterior restorative Surefil One did not exhibit superior outcomes for all evaluated aspects. However, it showed stable fracture behavior, good marginal quality, and acceptable wear resistance in vitro.


Assuntos
Adaptação Marginal Dentária , Restauração Dentária Permanente , Resinas Compostas , Materiais Dentários , Cimentos de Ionômeros de Vidro , Humanos , Teste de Materiais , Cimentos de Resina
3.
Am J Dent ; 33(1): 39-42, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32056414

RESUMO

PURPOSE: This randomized, controlled study evaluated the 2-year clinical performance of two flowable resin composites performed with a universal adhesive in two etching modes for restoring non-carious cervical lesions (NCCLs). METHODS: One hundred NCCLs were restored with two flowable composites ( Charisma Opal Flow and G-aenial Universal Flo) and a universal adhesive (Single Bond Universal) with two etching modes (self-etch and etch&rinse) in a random order. The restorations were evaluated for retention, marginal adaptation, anatomic form, marginal discoloration, surface texture and secondary caries (modified USPHS criteria) at baseline, and after 6, 12 and 24 months. RESULTS: The clinical success for retention, surface texture and secondary caries parameters was scored as 100% for each group after 6, 12 and 24 months. The first acceptable changes (Bravo score) in marginal adaptation, anatomical form and marginal discoloration started to show up after 12 months for all test groups, except for etch&rinse+Charisma Opal Flow. Self-etch+Charisma Opal Flow and self-etch+G-aenial Universal Flo showed progressive marginal discoloration that remained in the clinical acceptability level after 2 years. After 24 months, each resin composite restored with either the etch&rinse mode or the self-etch mode of the universal adhesive showed similar clinical performance. Marginal discoloration was higher in the restorations performed with the self-etch system. Selective-etching can be favorable. CLINICAL SIGNIFICANCE: The clinical performance of flowable composites performed with a universal adhesive in two etching modes was clinically acceptable after 24 months.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Resinas Compostas , Cimentos Dentários , Adaptação Marginal Dentária , Seguimentos , Humanos , Cimentos de Resina , Colo do Dente
4.
Int J Esthet Dent ; 15(1): 16-42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994534

RESUMO

Noncarious cervical lesions (NCCLs) involve the loss of hard tissue from the cervical areas of teeth through processes unrelated to caries. NCCLs are nowadays a common pathology caused by changes in lifestyle and diet. The prevalence and severity of cervical wear increase with age. It is generally accepted that the lesions are not generated by a single factor but result from a combination of factors. Among the factors proposed to be related to the formation and progression of NCCLs are biocorrosion (erosion), friction (abrasion), and possibly occlusal stress (abfraction). The clinical appearance of NCCLs can vary depending on the type and severity of the etiologic factors involved. Practitioners should follow a checklist to achieve an accurate diagnosis of the etiology of multifactorial NCCLs. The successful prevention and management of NCCLs require an understanding of the etiology and risk factors, including how these change over time in individual patients. The decision to monitor NCCLs rather than intervene should be based on the progression of the lesions and how they compromise tooth vitality, function, and esthetics. Treatment options include techniques to alleviate dentin hypersensitivity and the placement of an adhesive restoration, eventually in combination with a root coverage surgical procedure. An adhesive restoration is considered the last treatment option for NCCLs. Based on their excellent esthetic properties and good clinical performance, there is a general indication to place composite restorations for NCCLs. The clinical performance of these restorations is highly product-dependent, particularly regarding the adhesive system used. The type of composite material seems to have no significant influence on the clinical performance of NCCL restorations in clinical trials. It is much more important that the operator carries out the clinical procedure correctly. Marginal degradation is frequently seen during aging. Yearly maintenance with the eventual repolishing of the restoration margins will lengthen the lifespan of the restorations.


Assuntos
Cárie Dentária , Sensibilidade da Dentina , Cimentos Dentários , Restauração Dentária Permanente , Estética Dentária , Humanos , Colo do Dente
5.
Braz Oral Res ; 33: e124, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994597

RESUMO

This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.


Assuntos
Inquéritos de Saúde Bucal/estatística & dados numéricos , Restauração Dentária Permanente/estatística & dados numéricos , Setor Público/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Brasil/epidemiologia , Criança , Estudos de Coortes , Cárie Dentária/epidemiologia , Cárie Dentária/terapia , Serviços de Saúde Bucal/estatística & dados numéricos , Restauração Dentária Permanente/psicologia , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Análise de Regressão , Fatores Socioeconômicos , Estudantes/psicologia
6.
Braz Oral Res ; 33: e125, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994598

RESUMO

Atraumatic Restorative Treatment (ART) is one of the strategies used to control dental caries; it involves hand instruments for removal of carious tissue, and restorations using high-viscosity Glass Ionomer Cement (GIC). The present controlled clinical trial aimed to evaluate the performance of low-cost GIC indicated for ART in primary teeth, compared with high-viscosity GIC, after one year of follow-up. Two-to six-year-old children with dentin caries lesions on one or two surfaces of anterior and posterior teeth were selected. The children were randomly assigned to 2 groups according to the restorative material used: G1 (control) - Ketac Molar®; G2 (experimental) - Vitro Molar®. Treatments were performed in a school setting, following the guidelines of the ART. A total of 728 restorations were performed in 243 children. Descriptive analysis and Poisson regression were applied, with a significance level of p < 0.05. After 12 months, 559 (76.8%) restorations were re-evaluated. The success rate was evaluated by the prevalence ratio (PR), associated with restorations performed in primary second molars (PR = 1.21; 95%CI = 1.03-1.42), and with small (PR = 1.35; 95%CI = 1.14-1.60) or medium cavities (PR = 1.29; 95%CI = 1.08-1.55), using Ketac Molar® material (PR= 1.07; 95%CI = 1.01-1.15), considering p < 0.05. Small or medium restorations in primary second molars performed with high-viscosity GIC (Ketac Molar®) were more successful than restorations performed with low-cost GIC indicated for ART.


Assuntos
Tratamento Dentário Restaurador sem Trauma/métodos , Cárie Dentária/terapia , Cimentos de Ionômeros de Vidro/química , Criança , Pré-Escolar , Índice CPO , Falha de Restauração Dentária , Restauração Dentária Permanente/métodos , Feminino , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Masculino , Teste de Materiais , Distribuição de Poisson , Fatores de Tempo , Dente Decíduo , Resultado do Tratamento , Viscosidade
7.
Mymensingh Med J ; 29(1): 228-233, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915363

RESUMO

Reattachment of a fractured fragment to the remaining tooth is challenging but one of the best treatment protocols in regards to aesthetics, function as well as patients acceptance. If the original tooth fragment is retained following fracture, the natural tooth structures can be reattached using adhesive protocols to ensure reliable strength, durability and aesthetics. This case report will discuss a 13 years old boy with a complicated crown-root fracture of maxillary right central incisor tooth. The procedure used to repair the fracture regarding this case including flap surgery with endodontic treatment. The root canal was filled with a root canal sealer and gutta-percha. After root canal obturation, fragment was reattached with an adhesive tooth reattachment technique. After 6 months evaluation, clinical and radiographic examinations showed a stable re-attachment, good aesthetic and healthy periodontium.


Assuntos
Colagem Dentária , Restauração Dentária Permanente/métodos , Incisivo/lesões , Fraturas dos Dentes/terapia , Adolescente , Resinas Compostas , Humanos , Masculino , Maxila , Fraturas dos Dentes/complicações , Resultado do Tratamento
8.
J Prosthet Dent ; 123(1): 61-70, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30982625

RESUMO

STATEMENT OF PROBLEM: Dentists must regularly determine the best adhesive cementation protocol for glass-ceramic restorations on posterior teeth. The authors are aware of few in vivo follow-up studies and no meta-analyses, including clinical trials, regarding this clinically relevant topic, which merits further investigation. PURPOSE: The purpose of this systematic review and meta-analysis was to statistically analyze the clinical performance of glass-ceramic posterior restorations by using a descriptive synthesis based on the integrity of the tooth and restoration under different cementation protocols for self-adhesive or conventional resin cements. MATERIAL AND METHODS: The electronic databases Cochrane, LILACS, PubMed/MEDLINE, SciELO, Scopus, and Web of Science were used to identify relevant clinical trials. Non-peer-reviewed literature searches and hand searching were performed to find additional references. Language, participant's age, or time restrictions were not set. Restoration and tooth integrity were the 2 aspects considered for the meta-analysis. Statistical analyses were performed using a software program in which fixed or random effect models with risk ratios and 95% confidence intervals were applied. RESULTS: Three prospective randomized or quasirandomized clinical trials, published in English from 2012 onward, were selected and statistically analyzed. The integrity of the tooth and restoration was assessed at the baseline and 1 year after the restorative intervention. The statistical analyses did not show any significant differences between the intervention and control groups in terms of the integrity of the tooth and restoration. CONCLUSIONS: This meta-analysis indicated no clinical differences in the ceramic cementation using a self-adhesive or conventional resin cement after the 1-year follow-up period because both resin cements showed adequate properties for tooth and restoration integrity.


Assuntos
Cerâmica , Cimentos de Resina , Adulto , Cimentação , Restauração Dentária Permanente , Humanos , Estudos Prospectivos
9.
Oper Dent ; 45(1): E11-E20, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31794342

RESUMO

PURPOSE: This randomized clinical trial evaluated the influence of the occlusogingival distance (OGD) of noncarious cervical lesions (NCCLs) on the clinical performance of a regular bulk-fill resin composite and a regular nanofilled resin composite. METHODS AND MATERIALS: A total of 140 restorations were randomly placed in 77 participants by one operator. NCCLs were divided into four groups (n=35) according to OGD (1.5 mm±10% or 3 mm±10%) and resin composites (Filtek Bulk Fill Posterior [B] or Filtek Z350 XT [C]) used: 1.5 mm-B, 1.5 mm-C, 3 mm-B, and 3 mm-C. A two-step self-etch adhesive (Clearfil SE Bond) was applied following manufacturer instructions in all restorative procedures. Restorations were polished 1 week after placement. Clinical evaluation was performed at baseline (7 days), 6 months, and 1 year by two calibrated examiners, according to the modified US Public Health Service criteria evaluating fractures/retention, marginal staining, marginal adaptation, recurrence of caries, anatomic form, postoperative sensitivity, and surface texture. The Kruskal-Wallis test was used for intergroup comparison in each follow-up; the Friedman analysis of variance, followed by the least significant difference test (multiple comparisons) was used for intragroup comparison between baseline and follow-up times (α=0.05). RESULTS: Two restorations were lost at 12 months (1 for 1.5 mm-B and 1 for 3 mm-B). The retention rates at 12 months were 100% for 1.5 mm-C, 97% for 1.5 mm-B, 100% for 3 mm-C; and 97% for 3 mm-B, with no statistical difference among the groups (p=0.570). At 12 months, a statistically significant difference was found among the follow-up times for the same group (1.5 mm-B, 1.5 mm-C, and 3 mm-B) regarding the marginal staining criterion; moreover, the 3 mm-C group showed a significant difference from 6 months. No significant difference was found for the other parameters. CONCLUSION: Both resin composites showed acceptable clinical performance, and the OGD of NCCLs did not influence the clinical performance of resin composite restorations after 12 months.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Resinas Compostas , Adaptação Marginal Dentária , Humanos , Cimentos de Resina , Propriedades de Superfície
10.
Oper Dent ; 45(1): E32-E42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31738696

RESUMO

OBJECTIVES: The aim of this clinical study was to evaluate the clinical performance of Class II restorations of a high-viscosity glass ionomer material, of a bulk-fill composite resin, and of a microhybrid composite resin. METHODS AND MATERIALS: One hundred nine Class II restorations were performed in 54 patients using three different restorative materials: Charisma Smart Composite (CSC; a conventional composite resin), Filtek Bulk Fill Posterior Restorative (FBF; a high-viscosity bulk-fill composite), and Equia Forte Fil (EF; a high-viscosity glass ionomer). Single Bond Universal adhesive (3M ESPE, Neuss, Germany) was used for both conventional and bulk-fill composite resin restorations. The restorations were evaluated using modified US Public Health Service criteria in terms of retention, color match, marginal discoloration, anatomic form, contact point, marginal adaptation, secondary caries, postoperative sensitivity, and surface texture. The data were analyzed using the chi-square, Fisher, and McNemar tests. RESULTS: Eighty-four restorations were evaluated at two-year recalls. There were clinically acceptable changes in composite resin restorations (FBF and CSC). In addition, no statistically significant difference was observed between the clinical performances of these materials in terms of all criteria (p>0.05). However, there was a statistically significant difference between the EF group and the FBF and CSC groups in all parameters except for marginal discoloration, secondary caries, and postoperative sensitivity (p<0.05). CONCLUSIONS: The tested bulk-fill and conventional composite resins showed acceptable clinical performance in Class II cavities. However, if EF is to be used for Class II restoration, its use should be carefully considered.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Cor , Resinas Compostas , Adaptação Marginal Dentária , Materiais Dentários , Humanos , Propriedades de Superfície
11.
Int J Paediatr Dent ; 30(1): 4-10, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31593607

RESUMO

AIM: To assess the efficacy of treatment using a minimally invasive approach (selective removal of carious tissue, restoration and preventive strategies) in immature permanent molars with MIH. DESIGN: A total of 281 patients, aged 6-8 years, with carious lesions (ICDAS 5-6), severe MIH, and incomplete root formation (one tooth/patient) were included. After clinical and radiographic examinations, selective carious tissue removal was performed, and the teeth received interim restoration for 6 months and were then restored with composite resin. Clinical and radiographic follow-up was undertaken, 6, 12, 18, and 24 months. A protocol of preventive oral care measures was established and repeated at each follow-up, including diet counselling, oral hygiene instruction, dental plaque control, and topical application of fluoride varnish containing CPP-ACP. All clinical procedures and evaluations were done by a single operator. RESULTS: Clinical and radiographic success was observed 24 months after treatment in 96.8% of the cases. Failures were due to enamel fracture at restoration margins, resulting in pulpitis and absence of apex closure. CONCLUSION: Selective removal of carious tissue, interim, and subsequently definitive restoration, combined with home and professional preventive measures, maintained marginal integrity of restorations in immature permanent molars with severe MIH, confirmed by pulp vitality and occurrence of apexogenesis.


Assuntos
Hipoplasia do Esmalte Dentário , Restauração Dentária Permanente , Criança , Resinas Compostas , Humanos , Estudos Longitudinais , Dente Molar
12.
Oper Dent ; 45(1): 19-29, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31034347

RESUMO

PURPOSE: The aim of this prospective, randomized, split-mouth clinical trial was to evaluate postoperative sensitivity, clinical performance, and interproximal contacts after using different restorative systems. METHODS AND MATERIALS: Fifty-three subjects each received three class II restorations according to the restorative systems: conventional resin composite (PA: Peak Universal+Amelogen Plus, Ultradent), low-shrinkage flowable and nanoparticulate resin composites (ABF: Adper Single Bond 2+Filtek Bulk Fill Flow+Filtek Z350XT, 3M ESPE), and low-shrinkage flowable and microhybrid resin composites (XST: XP Bond+SDR+TPH3, Dentsply). Postoperative sensitivity was assessed at 24 hours, seven days, 90 days, and six months. The clinical performance and interproximal contacts were evaluated at baseline, six months, and one year. Friedman, Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests were used to evaluate postoperative sensitivity and interproximal contacts. The equality test of two proportions and logistic regression analysis were used to assess the clinical performance. RESULTS: No statistically significant differences were observed among groups for postoperative sensitivity. The highest spontaneous sensitivity was reported at 24 hours. ABF was the only group that did not present a reduction in cold sensitivity. Color, marginal discoloration, and superficial staining showed differences among the groups. XST did not show superficial staining after one year. No differences were observed among groups in relation to interproximal contacts. XST resulted in the loss of interproximal contact after one year. CONCLUSIONS: Different types of restorative systems do not influence postoperative sensitivity; however, ABF maintained cold sensitivity over time. Marginal discoloration occurred for all groups but occurred earliest for PA. XST presented a reduction of interproximal contact after one year of evaluation.


Assuntos
Resinas Compostas , Restauração Dentária Permanente , Cor , Estudos Prospectivos
13.
J Appl Oral Sci ; 28: e20190042, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31778443

RESUMO

INTRODUCTION: Gap formation of composite resin restorations is a serious shortcoming in clinical practice. Polymerization shrinkage stress exceeds the tooth-restoration bond strength, and it causes bacterial infiltration within gaps between cavity walls and the restorative material. Thus, an intermediate liner application with a low elastic modulus has been advised to minimize polymerization shrinkage as well as gap formation. OBJECTIVE: The purpose of this in vitro study was to assess gap formation volume in premolars restored with different bulk-fill composites, with and without a resin-modified glass-ionomer cement (RMGIC) liner, using x-ray micro-computed tomography (micro-CT). METHODOLOGY: Sixty extracted human maxillary premolars were divided into six groups according to bucco-palatal dimensions (n=10). Standardized Class II mesio-occluso-distal cavities were prepared. G-Premio Bond (GC Corp., Japan) was applied in the selective-etch mode. Teeth were restored with high-viscosity (Filtek Bulk Fill, 3M ESPE, USA)-FB, sonic-activated (SonicFill 2, Kerr, USA)-SF and low viscosity (Estelite Bulk Fill Flow, Tokuyama, Japan)-EB bulk-fill composites, with and without a liner (Ionoseal, Voco GmbH, Germany)-L. The specimens were subjected to 10,000 thermocycles (5-55°C) and 50,000 simulated chewing cycles (100 N). Gap formation based on the volume of black spaces at the tooth-restoration interface was quantified in mm3 using micro-computed tomography (SkyScan, Belgium), and analyses were performed. Data were analyzed using repeated-measures ANOVA and the Bonferroni correction test (p < 0.05). RESULTS: The gap volume of all tested bulk-fill composites demonstrated that Group SF (1.581±0.773) had significantly higher values than Group EB (0.717±0.679). Regarding the use of a liner, a significant reduction in gap formation volume was observed only in Group SFL (0.927±0.630) compared with Group SF (1.581±0.773). CONCLUSION: It can be concluded that different types of bulk-fill composite resins affected gap formation volume. Low-viscosity bulk-fill composites exhibited better adaptation to cavity walls and less gap formation than did sonic-activated bulk-fill composites. The use of an RMGIC liner produced a significant reduction in gap formation volume for sonic-activated bulk-fill composites.


Assuntos
Resinas Compostas/química , Preparo da Cavidade Dentária/métodos , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Imagem Tridimensional/métodos , Polimerização , Análise do Estresse Dentário , Humanos , Técnicas In Vitro , Teste de Materiais , Cimentos de Resina , Microtomografia por Raio-X
14.
J Prosthet Dent ; 123(1): 71-78, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31202547

RESUMO

STATEMENT OF PROBLEM: Despite the high prevalence of posterior cracked teeth, questions remain regarding the best course of action for managing these teeth. PURPOSE: The purpose of this clinical study was to identify and quantify the characteristics of visible cracks in posterior teeth and their association with treatment recommendations among patients in the National Dental Practice-Based Research Network. MATERIAL AND METHODS: Network dentists enrolled patients with a single, vital posterior tooth with at least 1 observable external crack. Data were collected at the patient, tooth, and crack levels, including the presence and type of pain and treatment recommendations for subject teeth. Frequencies according to treatment recommendation were obtained, and odds ratios (ORs) comparing recommendations for the tooth to be restored versus monitored were calculated. Stepwise regressions were performed using generalized models to adjust for clustering; characteristics with P<.05 were retained. RESULTS: A total of 209 dentists enrolled 2858 patients with a posterior tooth with at least 1 crack. Mean ±standard deviation patient age was 54 ±12 years; 1813 (63%) were female, 2394 (85%) were non-Hispanic white, 2213 (77%) had some dental insurance, and 2432 (86%) had some college education. Overall, 1297 (46%) teeth caused 1 or more of the following types of pain: 1055 sensitivity to cold, 459 biting, and 367 spontaneous. A total of 1040 teeth were recommended for 1 or more treatments: restoration (n=1018; 98%), endodontics (n=29; 3%), endodontic treatment and restoration (n=20; 2%), extraction (n=2; 0.2%), and noninvasive treatment, for example, occlusal device, desensitizing (n=11; 1%). The presence of caries (OR=67.3), biting pain (OR=7.3), and evidence of a crack on radiographs (OR=5.0) were associated with over 5-fold odds of recommending restoration. Spontaneous pain was associated with nearly 3-fold odds; pain to cold, having dental insurance, a crack that was detectable with an explorer or blocked transilluminated light, or connected with a restoration were each weakly associated with increased odds of recommending a restoration (OR<2.0). CONCLUSIONS: Approximately one-third of cracked teeth were recommended for restoration. The presence of caries, biting pain, and evidence of a crack on a radiograph were strong predictors of recommending a restoration, although the evidence of a crack on a radiograph only accounted for a 3% absolute difference (4% recommended treatment versus 1% recommended monitoring).


Assuntos
Síndrome de Dente Quebrado , Cárie Dentária , Restauração Dentária Permanente , Odontólogos , Feminino , Humanos
15.
Oper Dent ; 45(1): 71-79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31226004

RESUMO

PURPOSE: This study aimed to characterize and analyze the number of voids and the percentage of void volume within and between the layers of class II composite restorations made using the bulk fill technique or the incremental technique by optical coherence tomography (OCT). METHODS AND MATERIALS: Class II cavities (4×4×2 mm) were prepared in 48 human third molars (n=24 restorations per group, two class II cavities per tooth). Teeth were divided into four groups and restored as follows: group 1 (FOB), bulk filled in a single increment using Filtek One Bulk Fill (3M Oral Care); group 2 (FXT), incrementally filled using four oblique layers of Filtek Z350 XT (3M Oral Care); group 3 (FBF+FXT), bulk filled in a single increment using Filtek Bulk Fill Flowable Restorative (3M Oral Care) covered with two oblique layers of Filtek Z350 XT (3M Oral Care), and group 4 (FF+FXT), incrementally filled using Filtek Z350 XT Flow (3M Oral Care) covered with two oblique layers of Filtek Z350 XT (3M Oral Care). After the restorative procedure, specimens were immersed into distilled water and stored in a hot-air oven at 37°C. Forty-eight hours later, thermal cycling was conducted (5000 cycles, 5°C to 55°C). Afterward, OCT was used to detect the existence of voids and to calculate the number of voids and percentage of voids volume within each restoration. Data were submitted to chi-square and Kruskal-Wallis tests (α=0.05). Comparisons were made using the Dunn method. RESULTS: Voids were detected in all groups, ranging from 0.000002 (FBF+FXT and FF+FXT) to 0.32 mm3 (FBF+FXT). FF + FXT presented voids in all of the restorations and had a significantly higher number of voids per restoration when compared to the other groups (p<0.05), but restorations with the presence of voids were significantly higher only when compared to FXT (p<0.05). FBF + FXT presented a significantly higher percentage of voids volume than that of FXT (p<0.05). When comparing restorations made using high-viscosity resin-based composites (FOB and FXT), no significant differences regarding number of voids or percentage of voids volume were detected (p≥0.05). CONCLUSIONS: The use of flowable resin-based composites can result in an increased number of voids and percentage of voids volume in restorations, and this appears to be more related to voids present inside the syringe of the material than to the use of incremental or bulk fill restorative techniques.


Assuntos
Cárie Dentária , Tomografia de Coerência Óptica , Resinas Compostas , Materiais Dentários , Restauração Dentária Permanente , Humanos , Teste de Materiais
16.
Oper Dent ; 45(1): 62-70, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31373886

RESUMO

AIM: The aim of this study was to quantitatively compare conventional composite removal and composite removal supported by the fluorescence-aided identification technique (FIT) regarding the completeness, selectivity, and duration of the procedure in directly restored permanent posterior teeth. METHODS AND MATERIALS: Two operators removed standardized direct class II composite restorations (n=32 per operator) in human tooth models under simulated clinical conditions. According to a randomized allocation scheme, removal was performed with either the conventional technique (contra-angle handpiece) or supported by FIT. The duration of each removal procedure was recorded. The completeness and selectivity were volumetrically assessed through superimposition of three-dimensional surface scans. Statistical significance was tested by examining the overlap of 95% confidence intervals (CI). Multiple comparison was performed with Tukey tests for each variable. RESULTS: Compared with the conventional technique, composite removal with FIT was faster (329 seconds [95% confidence interval (CI): 268-390 seconds] vs 179 seconds [95% CI: 150-208 seconds]), generated less tooth substance loss (4.53 mm3 [95% CI: 3.77-5.30 mm3] vs 2.77 mm3 [95% CI: 2.11-3.43 mm3]), and left behind less composite residue (1.58 mm3 [95% CI: 1.23-1.94 mm3] vs 0.53 mm3 [95% CI: 0.39-0.67 mm3]). CONCLUSION: Within the limitations of this in vitro study, FIT facilitated the selective and expeditious removal of tooth-colored composites in directly restored posterior teeth.


Assuntos
Resinas Compostas , Restauração Dentária Permanente , Dentição Permanente , Fluorescência , Humanos
17.
Gen Dent ; 68(1): 30-35, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31859659

RESUMO

Occasionally, tooth fractures may demonstrate exaggerated pathologic root migration (PRM), often resulting in tooth loss. The early propagation of the root fracture may not be readily identifiable through clinical inspection and conventional radiographic imaging. Ultimately, increased root separation, isolated deep periodontal probing depth, and characteristic radiolucent changes may facilitate the diagnosis. This article describes 3 patients with unusual presentations of PRM in endodontically treated teeth restored with full-coverage crowns. One case illustrates the use of cone beam computed tomography for restorative assessment following root separation. Although it is efficacious to place crowns on most posterior endodontically treated teeth to maintain structural integrity, patients may remain at risk for catastrophic PRM and tooth loss. Timely extraction of teeth with hopeless PRM may minimize underlying bone resorption and the need for osseous regenerative procedures, ultimately improving the dental implant recipient site.


Assuntos
Restauração Dentária Permanente/métodos , Fraturas dos Dentes , Raiz Dentária , Dente não Vital , Tomografia Computadorizada de Feixe Cônico , Coroas , Humanos , Fraturas dos Dentes/reabilitação , Raiz Dentária/patologia , Dente não Vital/reabilitação
18.
Braz Oral Res ; 33: e111, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800863

RESUMO

The aim of the present study was to evaluate the microtensile bond strength and the microleakage of a bulk-fill composite resin compared with a conventional incremental composite resin, in permanent molars and under cariogenic challenge using a Streptococcus mutans model. Permanent human third molars (n = 60) with an occlusal cavity of 5×3×2 mm were randomly allocated into four subgroups of restorative treatments: conventional composite resin with (n = 15) and without (n = 15) cariogenic challenge (Z350-E and Z350-C experimental and control groups, respectively), and bulk-fill composite resin with (n = 15) and without (n = 15) cariogenic challenge (Bulk Fill-E and Bulk Fill-C, respectively). Ten specimens from each subgroup were submitted to microtensile strength, and 5, to microleakage. The cariogenic challenge was conducted using the Streptococcus mutans strain (ATCC) for 7 days. The stickers obtained (1 × 1 × 2 mm) were submitted to a microtensile strength test, followed by classification of the fracture mode. Microleakage was performed using a scoring system. The data were analyzed by Kruskal-Wallis and Mann-Whitney tests (p < 0.05). Filtek Z350 XT resin presented higher microtensile bond strength than Bulk Fill resin without (19.02 ± 4.90 and 8.76 ± 3.94MPa, respectively; p < 0.001) and with cariogenic challenge (22.69 ± 7.86 and 13.31 ± 3.38MPa, respectively; p < 0.02). Z350-C and Bulk Fill-C resins presented a higher prevalence of mixed fractures (23 and 14%, respectively) in the specimens submitted to cariogenic challenge than those of the control groups, whereas microleakage was similar (p = 0.85). The conventional composite resin had higher microtensile bond strength than the bulk-fill resin, but both resin types had similar adhesion quality and microfiltration scores.


Assuntos
Biofilmes/efeitos dos fármacos , Resinas Compostas/química , Colagem Dentária/métodos , Streptococcus mutans/efeitos dos fármacos , Adesividade , Cárie Dentária , Esmalte Dentário/efeitos dos fármacos , Infiltração Dentária , Restauração Dentária Permanente/métodos , Humanos , Teste de Materiais , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Resistência à Tração/efeitos dos fármacos , Fatores de Tempo
19.
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
20.
Anticancer Res ; 39(12): 6931-6938, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810964

RESUMO

BACKGROUND/AIM: Many patients with head-and-neck cancers receive radiotherapy. Treatment planning can be very complex in case of dental fillings or implants that cause metal artefacts. Verification of dose distributions may be performed using specific phantoms. This study aimed to develop a 3D-printed phantom that can be produced easily and cost-effectively. PATIENTS AND METHODS: The phantom was designed to allow fast adaption to a patient's individual situation with a particular focus on metal artefacts due to dental fillings. Bone and soft-tissue shells were 3D-printed and filled with tissue-equivalent materials. RESULTS: Attenuation properties of the tissue-equivalent structures in the phantom corresponded well to the structures of real human anatomy. In magnetic resonance (MR)-imaging, useful signals of the materials in the phantom were obtained. CONCLUSION: The phantom met the requirements including equivalence with human tissues and can be useful for highly individual treatment planning in precision-radiotherapy of head-and-neck cancers. It can be also used for scientific issues related to MR-imaging.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Cabeça/anatomia & histologia , Restauração Dentária Permanente , Restauração Dentária Temporária , Humanos , Imagens de Fantasmas , Impressão Tridimensional , Planejamento da Radioterapia Assistida por Computador/métodos
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