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1.
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
2.
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
3.
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
4.
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
5.
J Appl Oral Sci ; 27: e20180678, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596369

RESUMO

OBJECTIVES: Bulk-fill restorative materials such as bulk-fill composite resins and high viscous glass ionomer cements have become very popular materials in operative dentistry because their application is easy and time-saving. The aim of this clinical study was to evaluate the clinical performance of a highly viscous reinforced glass ionomer material, a bulk-fill composite resin and a micro hybrid composite resin in Class II restorations. METHODOLOGY: In total, 109 Class II restorations were performed in 54 patients using three different restorative materials: Charisma Smart Composite (CSC); Filtek Bulk Fill Posterior Restorative (FBF); Equia Forte Fil (EF). Single Bond Universal adhesive (3M ESPE, Germany) was used with composite resin restorations. The restorations were evaluated using modified USPHS 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 Chi-Square, Fischer's and McNemar's tests. RESULTS: At the end of one year, 103 restorations were followed up. No changes were observed during the first 6 months. At the end of one year, there were small changes in composite restorations (FBF and CSC) but no statistically significant difference was observed between the clinical performances of these materials for all criteria (p>0.05). However, there was a statistically significant difference between EF, FBF and CSC groups in all parameters except marginal discoloration, secondary caries and postoperative sensitivity in one-year evaluation (p<0.05). CONCLUSION: Bulk-fill composite resins and conventional composite resins showed more successful clinical performance than highly viscous reinforced glass ionomers in Class II cavities.


Assuntos
Resinas Compostas/uso terapêutico , Restauração Dentária Permanente/métodos , Cimentos de Ionômeros de Vidro/uso terapêutico , Adulto , Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Cárie Dentária/terapia , Adaptação Marginal Dentária , Feminino , Humanos , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Distribuição por Sexo , Resultado do Tratamento , Adulto Jovem
6.
J Appl Oral Sci ; 27: e20180631, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411263

RESUMO

OBJECTIVE: Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost. OBJECTIVE: This study aimed to evaluate the effect of beveling on the fracture resistance and pattern of class II (MOD) restored teeth. METHODOLOGY: Ninety human premolars were randomly assigned into 9 groups: CTR (control/sound); NC (cavity preparation, non-restored); RU (restored, unbeveled); RTB (restored, entire angle beveling); RPB (restored, partial/occlusal beveling); EC (endodontic access/EA, non-restored); EU (EA, unbeveled); ETB (EA, entire angle beveling); EPB (EA, partial/occlusal beveling). Teeth were restored with Esthet X resin composite and stored in distilled water for 24 h before the inclusion in PVC cylinders. The axial loading tests were performed with 500 kgF at 0.5 mm/min crosshead speed until fracture of the specimens. Fracture resistance and pattern were accessed and data were analyzed using one-way ANOVA and Tukey's HSD test (α=0.05). RESULTS: Mean (±SD) failure loads ranged from 136.56 (11.62) to 174.04 (43.5) kgF in the groups tested without endodontic access. For endodontically accessed teeth, fracture resistance ranged from 95.54 (13.05) to 126.51 (19.88) kgF. Beveling of the cavosurface angle promoted the highest fracture resistance values (p<0.05) and prevented catastrophic fractures. CONCLUSIONS: Cavosurface angle beveling is capable of improving fracture resistance and pattern for both endodonticaly accessed and non-accessed teeth.


Assuntos
Dente Pré-Molar , Preparo da Cavidade Dentária/métodos , Restauração Dentária Permanente/métodos , Análise de Variância , Resinas Compostas/uso terapêutico , Humanos , Distribuição Aleatória , Valores de Referência , Reprodutibilidade dos Testes , Fatores de Risco , Fraturas dos Dentes , Dente não Vital , Resultado do Tratamento
7.
BMJ Case Rep ; 12(7)2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31324671

RESUMO

The major challenge in traumatic injuries is the management of subgingival fracture of anterior teeth. Forced orthodontic extrusion is a suitable approach for these teeth as it provides both a sound tissue margin for final restoration and creates a periodontal environment (biological width) which is easy for the patient to maintain. Restoration after orthodontic eruption may present a more conservative treatment choice in young patients compared with the prosthetic restoration after extraction. This paper reports a case of the fractured maxillary anterior tooth at the subgingival level that was managed by forced orthodontic extrusion after endodontic therapy followed by aesthetic rehabilitation, a much-forgotten technique not utilised routinely yet conservative and cost-effective.


Assuntos
Restauração Dentária Permanente/métodos , Incisivo/lesões , Extrusão Ortodôntica/métodos , Tratamento do Canal Radicular/métodos , Fraturas dos Dentes/terapia , Adolescente , Humanos , Incisivo/cirurgia , Masculino , Maxila , Equipe de Assistência ao Paciente
8.
Niger J Clin Pract ; 22(7): 961-970, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293262

RESUMO

Background: The aim of this study was to evaluate six different glass ionomer cement (GIC)-based restorative materials through comparisons of microleakage and fluoride release. Materials and Methods: For microleakage, 30 teeth were randomly separated into 6 groups of 5: Group 1 (Dyract: compomer), Group 2 (Freedom: compomer), Group 3 (Equia: high-viscosity glass ionomer cements), Group 4 (Fuji IX: resin-modified glass ionomer cement), Group 5 (Ketac Molar: traditional glass ionomer cement [TGIC]) and Group 6 (Voco: TGIC). For fluoride release of six different GIC-based restorative materials, standard samples were prepared of 4 mm thickness and 7 mm diameter. A total of 60 samples were obtained as 10 samples from each group. The analyses were made using a Thermo Orion 720 A+ ionometer with the Orion fluoride electrode. At the end of 24 h, 72 h, 7 days, 14 days, and 30 days, the electrode was placed into the dish containing the sample, distilled water, and TISAB II; a reading was taken; and the value shown on the screen was recorded. Results: For microleakage, a statistically significant difference was determined between the groups in respect of the occlusal variable (P < 0.05), no statistically significant gingival variable (P > 0.05). About fluoride release: According to the repeated measures variance analysis results, the difference between the groups, and between the time-group interaction and according to time, was found to be statistically significant (P < 0.05). Conclusions: In terms of microleakage, it was concluded that all materials could be used in clinical applications. The Equia high-viscosity glass ionomer cements (HVGIC) was determined to be the material with the highest fluoride release value.


Assuntos
Compômeros/química , Infiltração Dentária , Restauração Dentária Permanente/métodos , Fluoretos/química , Cimentos de Ionômeros de Vidro/química , Colagem Dentária , Adesivos Dentinários , Humanos , Teste de Materiais
9.
Rom J Morphol Embryol ; 60(1): 133-138, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31263837

RESUMO

Polymerization stresses in adhesive structure could determine an adhesive or cohesive failure and interfacial gaps forming. Some clinical procedures - as light curing composite resin layering in 2-3 mm increments (especially for dental fills) or using dental reconfiguring clear acetate crowns - are sat up to combat (in some way) the polymerization shrinkage. This study approaches the manner how clinical dental adhesive application could influence the hard dental tissues-composite materials interface. The sample studied consisted of 12 upper bicuspids, extracted for orthodontic reasons. In our study, we chose the adhesion technique in "two steps". We prepared enamel and dentine areas, and then filled them with light-polymerization composite. After that, the teeth were subject of microscopic investigations, at 100× and 200× magnification. As conclusion of our study, we sustain that light curing composite resin applying clinical technique (by layering or with acetate crown) might influence a good dental restoration clinical performance.


Assuntos
Resinas Compostas/química , Cimentos Dentários/química , Restauração Dentária Permanente/métodos , Teste de Materiais/métodos , Humanos
10.
Braz Oral Res ; 33: e052, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31269116

RESUMO

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


Assuntos
Resinas Compostas , Colagem Dentária/métodos , Restauração Dentária Permanente/métodos , Desgaste dos Dentes/terapia , Resinas Compostas/química , Falha de Restauração Dentária , Análise do Estresse Dentário , Dentina/química , Método Duplo-Cego , Etanol , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
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
12.
J Appl Oral Sci ; 27: e20180297, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31166548

RESUMO

INTRODUCTION: Polymer-based composite materials have been proposed as an alternative for single unit restorations, due to their resilient and shock absorbing behavior, in contrast to the brittleness of ceramic materials that could result in failure by fracture. OBJECTIVE: To evaluate the fatigue strength and damage modes of monolithic posterior resin nanoceramic and lithium disilicate glass ceramic crowns. METHODOLOGY: Twenty-six resin nanoceramic (RNC) and lithium disilicate glass ceramic (LD) 2 mm monolithic crowns (n=13) were cemented on composite resin replicas of a prepared tooth and subjected to cyclic load with lithium disilicate indenters for 2 million cycles. Specimens and indenters were inspected every 500,000 cycles and suspended when presenting fractures or debonding. Surviving specimens were embedded in epoxy resin, polished and subsurface damage was analyzed. Specimens presenting fractures or severe subsurface damage were considered as failures. Survival data was subjected to Fisher's exact test; damage modes were subjected to Mann-Whitney test (p<0.05). RESULTS: There were no debonding, cohesive or catastrophic failures. Considering subsurface damage, 53.8% of RNC and 46.2% of LD crowns survived the fatigue test, presenting no statistical difference. Chief damage modes were radial cracks for RNC and inner cone cracks for LD, presenting no statistical difference. CONCLUSIONS: The results suggest that if debonding issues can be resolved, resin nanoceramic figures can be an alternative to posterior crowns. Although distinct, damage modes revealed potential to cause bulk fracture in both glass ceramic and resin nanoceramic crowns.


Assuntos
Cerâmica/química , Coroas , Porcelana Dentária/química , Cimentos de Resina/química , Projeto Auxiliado por Computador , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Desgaste de Restauração Dentária , Restauração Dentária Permanente/métodos , Análise do Estresse Dentário , Humanos , Teste de Materiais , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Fatores de Tempo
13.
Gen Dent ; 67(3): 47-51, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31199744

RESUMO

Mineral trioxide aggregate (MTA) pulpotomy may be an alternative to root canal therapy, with reported success rates as high as 85%. However, little technique-specific information has been reported regarding MTA placement in 1 visit. The purpose of this study was to evaluate different placement methods for MTA and resin-modified glass ionomer (RMGI) cement before immediate restoration with amalgam. Forty pulpotomized extracted third molars were randomly divided into 4 groups, and moist cotton was used to simulate pulp tissue in all teeth. In group 1, cotton was placed over the entire pulp chamber floor and in each canal orifice, and MTA was placed over the cotton. The procedure for group 2 was the same as that for group 1 except that a layer of RMGI was placed over the MTA. In group 3, cotton was placed in the canal orifices only, a layer of MTA was placed only over the cotton in the orifices, and RMGI was layered over the MTA and pulp chamber floor. The procedure for group 4 was the same as that for group 3 except that RMGI was placed over the MTA but not on the pulpal floor. Each of these procedures was followed by amalgam condensation. After a 7-day setting period, restored teeth were sectioned mesiodistally, photographed, measured, and evaluated for disturbance of the MTA-restoration junction. The study findings showed that the MTA layer was disturbed in 40% of the specimens in group 1, whereas 10%-20% of specimens in groups 2 through 4 demonstrated disturbed MTA. Analysis with a Pearson chi-square test indicated that the difference between group 1 and groups 2 through 4 was statistically significant (P < 0.05), but there was no significant difference (P > 0.05) between groups 2, 3, and 4. Group 3, in which MTA was placed over each canal orifice and RMGI was placed over the entire pulpal floor, performed best--only 10% of specimens exhibited deformed MTA. The findings suggest that RMGI may protect initially placed MTA during amalgam condensation.


Assuntos
Compostos de Alumínio/administração & dosagem , Compostos de Cálcio/administração & dosagem , Restauração Dentária Permanente/métodos , Óxidos/administração & dosagem , Pulpotomia , Materiais Restauradores do Canal Radicular , Silicatos/administração & dosagem , Combinação de Medicamentos , Humanos , Pulpotomia/instrumentação , Pulpotomia/métodos , Resultado do Tratamento
14.
BMC Oral Health ; 19(1): 123, 2019 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226976

RESUMO

BACKGROUND: The paradigm shift obtained with new dental materials permits minimally invasive dentistry, by following a biomimetic approach. Erosion increasingly affects the adult population through dental substance loss by acid attack. Oral rehabilitation is often extensive and requires careful mouth examination and treatments codified in the literature. CASE PRESENTATION: This clinical report proposes a reasoned approach to erosion treatment for a 39-year-old male patient presenting several old fixed prostheses. These old restorations are all of correct quality and are retained. The temporomandibular joint was free from disorder. Only defective reconstructions are remade together with eroded teeth, according to a three-step technical protocol. In the first step, mock-up manufacturing is performed which occlusal vertical dimension increased to 1 mm provoking passive dental overeruption to the second and third molars. In all, one ceramic crown was remade, and two ceramic onlays and a resin composite were integrated on the posterior teeth. The last step consisted of palatal veneers on the maxillary incisor and canine, and an aesthetic resin composite on the incisor edge. After these treatments, regular assessments were carried out at 4 months then at 6 months with visual, photographic and radiographic examinations. CONCLUSION: The present dental care philosophy is to preserve dental tissue as much as possible, even in large erosion cases, and to respond to the aesthetic and functional expectations of the patient. This methodology requires a thorough evaluation phase, compliance with the protocol and regular patient follow-up.


Assuntos
Restauração Dentária Permanente/métodos , Dentição , Estética Dentária , Erosão Dentária/terapia , Adulto , Resinas Compostas , Materiais Dentários , Porcelana Dentária , Facetas Dentárias , Humanos , Masculino , Planejamento de Assistência ao Paciente , Erosão Dentária/etiologia , Resultado do Tratamento
15.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(3): 299-303, 2019 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-31218866

RESUMO

OBJECTIVE: To analyze the effect of ceramic onlay to repair serious defects in young permanent molars. METHODS: Sixty patients with defects in young permanent molars were selected. The patients were randomly divided into two groups. One group was restored with ceramic onlay, and the other used resin composite to direct filling. Follow-up visit was conducted at 3, 6, 12, and 24 months after treatment. Modified USPHS/Ryge criteria were used to evaluate the effect of restoration. The occlusal courses were recorded by the T-Scan Ⅲ system in intercuspal position. Gingival and food impaction were recorded. The effect of the two restorative methods, the recovery of occlusal function, and the gingival and approximal conditions were analyzed. RESULTS: At 12 months after restoration, the marginal fitness in the onlay group was significantly better than that in the resin group (P<0.05). At 12 and 24 months after restoration, the surface smoothness in the onlay group was significantly better than that in the resin composite group (P<0.05). At each follow-up visit, the resin group had significantly lower per-cen-tage of occlusal force than contralateral molar (P<0.05). The percentage of occlusal force in the onlay group and the con-trala-teral molar showed no statistical difference (P>0.05). The gingival and approximal conditions also demon-strated no stati-stical differences (P>0.05). CONCLUSIONS: The ceramic onlay repair method is better than resin composite filling in marginal fitness, surface smoothness, and recovery of the occlusal function when restoring young permanent molars with serious defects.


Assuntos
Resinas Compostas , Restauração Dentária Permanente , Restaurações Intracoronárias , Dente Molar , Força de Mordida , Cerâmica , Restauração Dentária Permanente/métodos , Humanos , Cimentos de Resina
16.
Niger J Clin Pract ; 22(5): 633-641, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31089017

RESUMO

Aims: The aim of this study was to evaluate and correlate marginal adaptation and microleakage of different low-shrinking composites. Materials and Methods: Standardized class V cavities (n = 20/group) with occlusal margin in enamel and gingival margin in dentin were restored with low-shrinking silorane-based (Filtek Silorane) or methacrylate-based (Clearfil Majesty Posterior, Grandio, Reflexions XLS, Tetric EvoCeram, Premise, Ceram-X Duo, Aelite LS Posterior) composites and a conventional composite (Filtek Z250). All teeth were stored in water (24 h), thermocycled (5000×), and mechanically loaded (60,000×). Marginal adaptation of epoxy resin replicas was analyzed using scanning electron microscope. Microleakage of the restoration was assessed by dye penetration on sectioned specimens under stereomicroscopy. Data were statistically analyzed with Mann-Whitney U test, with a significance of P < 0.05. Pearson's correlation test was used to evaluate the correlation between results of margin analysis and microleakage. Results: No statistical difference in marginal gap formation was determined between Filtek Silorane and Z250. The lowest microleakage score at dentin margins was recorded for Filtek Silorane, which was not significantly different from that of all other groups. No similar ranking between the results of microleakage at enamel and dentin margins was observed for the materials tested. Marginal adaptation was not correlated to microleakage, except for Filtek Silorane, Grandio, and Filtek Z250. Conclusions: Compared to the conventional composite Filtek Z250, Filtek Silorane demonstrated no improvements with reduced marginal gap formation. Low-shrinking properties of composites appear to have no ability of sealing restoration margins and preventing leakage.


Assuntos
Resinas Compostas , Preparo da Cavidade Dentária , Adaptação Marginal Dentária , Restauração Dentária Permanente/métodos , Metacrilatos , Esmalte Dentário , Dentina , Humanos , Teste de Materiais , Resinas de Silorano , Estresse Mecânico
17.
J Appl Oral Sci ; 27: e20180358, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30994773

RESUMO

OBJECTIVE: The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). MATERIAL AND METHODS: Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). RESULTS: The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. CONCLUSION: GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.


Assuntos
Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Resinas Compostas/uso terapêutico , Cárie Dentária/terapia , Corrosão Dentária/métodos , Restauração Dentária Permanente/métodos , Glutaral/uso terapêutico , Metacrilatos/uso terapêutico , Ácidos Polimetacrílicos/uso terapêutico , Adulto , Distribuição por Idade , Adaptação Marginal Dentária , Falha de Restauração Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Distribuição por Sexo , Fatores de Tempo , Resultado do Tratamento
18.
Gen Dent ; 67(2): e7-e10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30875313

RESUMO

The purpose of this in vitro study was to evaluate the influence of depth (3.0 vs 5.0 mm) of mesio-occlusodistal (MOD) cavity preparation and mechanical cycling on fracture resistance of maxillary premolars restored with resin-based composite (RBC). Seventy premolars were randomly divided into 7 groups (n = 10): NP, no cavity preparation (control); MOD3, 3.0-mm-deep MOD preparation, not restored; MOD3R, 3.0-mm-deep MOD preparation restored with RBC; MOD5, 5.0-mm-deep MOD preparation, not restored; MOD5R, 5.0-mm-deep MOD preparation restored with RBC; MOD3RC, 3.0-mm-deep MOD preparation restored with RBC and subjected to mechanical cycling; and MOD5RC, 5.0-mm-deep MOD preparation restored with RBC and subjected to mechanical cycling under the same conditions as MOD3RC. All specimens were tested using a universal testing machine, resulting in the following mean (SD) values: NP, 224.65 (35.66) kgf; MOD3, 58.92 (15.48) kgf; MOD3R, 95.58 (13.88) kgf; MOD5, 68.06 (10.12) kgf; MOD5R, 98.49 (13.16) kgf; MOD3RC, 83.68 (14.39) kgf; and MOD5RC, 54.25 (11.56) kgf. Analysis of variance and Tukey test showed no statistically significant difference among MOD3, MOD5, and MOD5RC; between MOD5 and MOD3RC; or among MOD3R, MOD5R, and MOD3RC (P > 0.05). MOD3RC had significantly greater fracture resistance than MOD5RC (P < 0.05). NP had the highest fracture resistance of all groups (P < 0.05). The results showed that the depth of the cavity preparation only influenced fracture resistance after mechanical cycling of the specimens.


Assuntos
Preparo da Cavidade Dentária , Restauração Dentária Permanente , Fraturas dos Dentes , Dente não Vital , Dente Pré-Molar , Resinas Compostas , Preparo da Cavidade Dentária/métodos , Restauração Dentária Permanente/métodos , Análise do Estresse Dentário , Humanos , Técnicas In Vitro , Estresse Mecânico
19.
BMJ Case Rep ; 12(3)2019 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-30904898

RESUMO

Haemorrhagic disorders combined with soft tissue inflammation and infection may lead to severe bleeding complications before, during or after dental treatment. In selected cases, a combined therapeutic approach involving clinical therapies and systemic and local medication could improve the treatment outcomes and the patient's quality of life. This clinical case report, presents for the first time a successful combined approach, completed in a 38-year-old male patient with severe type-B haemophilia in which an infected tooth was extracted, an immediate implant was inserted, bone grafting was performed and early implant loading was successfully applied. In addition to the clinical therapy, medication was provided orally, systemically and locally, thus preventing the haemorrhagic complications and improving the patient's quality of life.


Assuntos
Restauração Dentária Permanente/métodos , Hemofilia B/complicações , Hemorragia/prevenção & controle , Adulto , Transplante Ósseo , Implantação Dentária Endo-Óssea , Humanos , Masculino , Qualidade de Vida , Extração Dentária , Resultado do Tratamento
20.
Niger J Clin Pract ; 22(3): 328-334, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30837419

RESUMO

Aims: The aim of this study was to compare the effect of different restoration techniques on fracture resistance of endodontically treated teeth with different wall thicknesses. Materials and Methods: Extracted and endodontically treated 210 premolars were randomly divided into three thickness groups [2 mm (A), 1.5 mm (B), and 1 mm (C)] and, each group was further divided into seven restoration subgroups (n = 10): direct composite (control) (K), composite with fiber on cavity floor (KT), composite with fiber on occlusal level (KO), fiber post and composite (FP), inlay (L), fiber on cavity floor and inlay (LT), and inlay and fiber on occlusal level (LO). Fracture test was performed, and data were compared with Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). Results: There were no differences between the subgroups in A and C statistically (P > 0.05). However, in B, KO subgroup showed statistically higher values (P = 0.039). Conclusion: Wall support of 2 mm was adequate, and support of 1 mm was completely insufficient. When the wall thickness was 1.5 mm, direct restoration with fiber at the occlusal level significantly improved resistance.


Assuntos
Resinas Compostas/uso terapêutico , Cárie Dentária , Preparo da Cavidade Dentária , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Fraturas dos Dentes/prevenção & controle , Dente não Vital/terapia , Dente Pré-Molar , Resinas Compostas/química , Materiais Dentários/uso terapêutico , Análise do Estresse Dentário , Humanos , Fraturas dos Dentes/etiologia , Dente não Vital/complicações
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