RESUMEN
OBJECTIVES: To evaluate the longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores using a self-adhesive resin cement in a prospective clinical descriptive study. METHODS: A total of 152 teeth were endodontically treated and received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. 91.5% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analyzed considering the loss of crown retention (crown debonding) and tooth loss as the primary outcome. In addition, post debonding, and root fracture occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression with 95% confidence interval were applied for the statistical analysis. RESULTS: Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (91.5%), with 8 crown debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurring after the evaluation period. For secondary outcomes, 9 root fractures and 4 post debondings occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters. CONCLUSION: The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 91.5% after an average of 62 months of follow-up. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding). CLINICAL SIGNIFICANCE: The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns onto resin composite prosthetic cores.
Asunto(s)
Cementos Dentales , Cementos de Resina , Humanos , Estudios de Seguimiento , Estética Dental , Resinas Compuestas , Coronas , Cementación/métodos , Cerámica , Ensayo de Materiales , Fracaso de la Restauración DentalRESUMEN
PURPOSE: To investigate the mechanical performance and fracture behavior of endocrown restorations prepared using different composite materials and following a direct technique. METHODS: Sound molars were cut at 2 mm above the cementoenamel junction, endodontically treated, and allocated according to the type of restoration (n = 7): without post (endocrowns) or with post (post-retained restorations). Endocrowns were fabricated with conventional composite (Filtek Z350); bulk fill composite (Filtek Bulk Fill); conventional composite modeled using resin adhesives (SBMP: Scotchbond Multipurpose Adhesive; or SBU: Scotchbond Universal Adhesive); and lithium disilicate ceramic (E.max; Positive control). The post-retained restorations were fabricated with glass-fiber post combined with conventional or bulk fill composites. All restorations were bonded following an etch-and-rise adhesive approach or self-adhesive resin cement. The teeth were submitted to fatigue (Byocycle) and compression (EMIC DL500) testing at a crosshead speed of 1 mm/min. Data were analyzed with ANOVA and Tukey (p < 0.05) and Weibull analysis was carried out in order to evaluate the reliability of restorations. RESULTS: The bulk-fill-based endocrown showed a stronger performance than the control. The presence of SBMP or the use of bulk-fill composite resulted in the occurrence of less aggressive fractures than the other restorative systems. Endocrowns bonded directly to the tooth seemed to produce similar fracture strength properties as compared to endocrowns bonded using self-adhesive resin cementation. The bulk-fill-based endocrown showed the greatest reliability of study. CONCLUSION: Resin-based restorative materials seem to be interesting alternative options to fabricate large dental restorations in lieu of the more traditionally used glass ceramics or root canal post systems.
Asunto(s)
Coronas , Cementos de Resina , Resinas Compuestas , Análisis del Estrés Dental , Ensayo de Materiales , Diente Molar , Reproducibilidad de los Resultados , Tratamiento del Conducto RadicularRESUMEN
Abstract The aim of this study was to evaluate the effect of post-space irrigation with NaOCl and CaOCl at different concentrations on the bond strength of posts cemented with a self-adhesive resin cement. Eighty premolars were sectioned 14 mm from the apex, and endodontically treated. The root canal filling was partially removed. Specimens were randomly assigned into 8 groups (n=10), according to the irrigant for post-space irrigation: SS - 0.9% saline solution (control group); CHX - 2% chlorhexidine; 1% NaOCl - 1% sodium hypochlorite; 2.5% NaOCl - 2.5% sodium hypochlorite; 5% NaOCl - 5% sodium hypochlorite; 1% CaOCl - 1% calcium hypochlorite; 2.5% CaOCl - 2.5% calcium hypochlorite; and 5% CaOCl - 5% calcium hypochlorite. For each group, irrigation was performed continuously with 2 ml of solution. The post-spaces were dried with paper points (#80), and glass fiber posts were cemented using a self-adhesive resin cement. The specimens were sectioned perpendicularly and the push-out test was performed. Optical microscopy was used to analyze the failure mode. ANOVA and Bonferroni tests analyzed the bond strength data. NaOCl and CaOCl presented similar bond strength regardless the concentration used to irrigate the post-space (p>0.05). SS showed the highest bond strength (11.47 MPa) (p<0.05). Adhesive failures at the cement/dentin interface were predominant (58.33%). Saline solution should be irrigant of choice to irrigate the post-space before fiber post cementation with self-adhesive resin cement. NaOCl and CaOCl negatively affect the bond strength values.
Resumo O objetivo deste estudo foi avaliar o efeito da irrigação do espaço preparado para o pino com NaOCl e CaOCl em diferentes concentrações na resistência adesiva de pinos cimentados com um cimento resinoso autoadesivo. Oitenta pré-molares foram seccionados 14 mm do ápice e endodonticamente tratado. As obturações foram parcialmente removidas. Os espécimes divididos randomicamente em 8 grupos (n=10) de acordo com o irrigante usado para irrigação do espaço preparado para pino: SF - soro fisiológico 0,9% (grupo controle); CHX - clorexidina 2%; NaOCl 1% - hipoclorito de sódio 1%; NaOCl 2,5% - hipoclorito de sódio 2,5%; NaOCl 5% - hipoclorito de sódio 5%; CaOCl 1% - hipoclorito de cálcio 1%; CaOCl 2,5% - hipoclorito de cálcio 2,5%; CaOCl 5% - hipoclorito de cálcio 5%. Para cada grupo, irrigação foi realizada com 2 mL de solução. O espaço preparado para pino foi seco com cone de papel absorvente (#80) e os pinos de fibra foram cimentados com cimento resinoso autoadesivo. Os espécimes foram seccionados perpendicularmente e o teste de push-out foi realizado. Microscopia óptica foi usada para analisar o padrão de falha. Os testes de ANOVA e Bonferroni analisaram os dados de resistência adesiva. NaOCl e CaOCl apresentaram similar resistência adesiva, independentemente da concentração usada para irrigar o espaço preparado para pino (p>0,05). SF apresentou os maiores valores de resistência adesiva (11,47 MPa) (p<0,05). Falhas adesivas na interface cimento/dentina foram predominantes (58,33%). Soro fisiológico deve ser o irrigante de escolha para irrigar o espaço preparado para pino antes da cimentação de pinos de fibra com cimentos resinosos autoadesivos. NaOCl e CaOCl afetam negativamente os valores de resistência adesiva.
Asunto(s)
Humanos , Irrigantes del Conducto Radicular/química , Clorhexidina/química , Técnica de Perno Muñón , Recubrimiento Dental Adhesivo , Compuestos de Calcio/química , Cementos de Resina/química , Hipoclorito de Sodio/química , Diente Premolar , Técnicas In Vitro , Cloruro de Sodio/química , Preparación del Conducto Radicular , Irrigación Terapéutica/métodosRESUMEN
PURPOSE: To evaluate the degree of conversion, absorption, and solubility in water of self-adhesive resin cements subjected to different time intervals between material preparation and the photoactivation procedure. MATERIALS AND METHODS: Two dual self-adhesive resin cements were tested: RelyX Unicem and SmartCem2. The degree of conversion as a function of time was evaluated by Fourier-transformed infrared spectroscopy using the attenuated total reflectance technique. Three time intervals between handling and photoactivation were applied: Group 1 = immediately; Group 2 = a 1-minute interval; Group 3 = a 4-minute interval. All specimens were irradiated with a light-emitting diode source for 40 seconds. Thirty discs of each cement (1 mm thick × 6 mm diameter, n = 10) were prepared for the absorption and solubility tests. These specimens were stored in distilled water at 37°C for 90 days. The results were subjected to ANOVA with two factors (material and activation time intervals) and Tukey's test (95% significance). RESULTS: The 4-minute interval significantly reduced the degree of conversion of SmartCem2 (30.6% ± 8.3%). No other significant changes were observed for the degree of conversion; however, the time intervals before photoactivation interfered significantly in the water absorption of the RelyX Unicem specimens but not the SmartCem2 specimens. The time intervals did not affect the solubility of either cement. In all cases, SmartCem2 had higher solubility than RelyX Unicem. CONCLUSION: The time interval between handling and photoactivation significantly influenced the degree of conversion and water sorption of the resin-based cements. In general, one can say that the self-adhesive resin cements should be photoactivated as soon as possible after the material handling process.
Asunto(s)
Curación por Luz de Adhesivos Dentales/métodos , Cementos de Resina/química , Absorción Fisicoquímica , Bisfenol A Glicidil Metacrilato/química , Bisfenol A Glicidil Metacrilato/efectos de la radiación , Desecación , Humanos , Ensayo de Materiales , Metacrilatos/química , Metacrilatos/efectos de la radiación , Polietilenglicoles/química , Polietilenglicoles/efectos de la radiación , Polimerizacion , Ácidos Polimetacrílicos/química , Ácidos Polimetacrílicos/efectos de la radiación , Poliuretanos/química , Poliuretanos/efectos de la radiación , Cementos de Resina/efectos de la radiación , Solubilidad , Espectroscopía Infrarroja por Transformada de Fourier/métodos , Propiedades de Superficie , Temperatura , Factores de Tiempo , Agua/químicaRESUMEN
This study evaluated the influence of the surface treatments of fiberglass posts on bond strength to root dentin using push-out test. Forty bovine incisor roots were endodontically treated. The surface of the fiberglass posts (Exacto #2, Angelus) were treated using 4 different protocols (n=10): Control - 70% ethanol for 1 min; 37% phosphoric acid for 1 min; 10% hydrofluoric acid for 1 min; and 24% hydrogen peroxide for 1 min. After a silane coupling agent was applied for 1 min and all posts were cemented using self-adhesive resin cement (RelyX Unicem, 3M-ESPE). The roots were sectioned and two 1-mm-thick slices were obtained from each third: cervical, middle and apical. The specimens were subjected to the push-out test with a crosshead speed of 0.5 mm/min. Data were analyzed by repeated measures ANOVA followed by Tukey's HSD tests (=0.05). The surface treatment (p<0.001) and root third region (p=0.007) factors were significant. The retention to root canal was affected by surface treatment type. The post surface treatment with 24% hydrogen peroxide for 1 min yielded significantly higher bond strength when the fiberglass posts were cemented with RelyX Unicem.
Este estudo avaliou a influência de tratamentos de superfície de pinos de fibra de vidro na resistência de união à dentina radicular por meio do teste de push-out. Quarenta raízes de incisivos bovinos foram submetidas a tratamento endodôntico. A superfície dos pinos de fibra de vidro (Exacto #2, Angelus) foram tratadas com 4 protocolos diferentes (n=10): Controle - 70 % de etanol durante 1 min; 37 % de ácido fosfórico durante 1 min, 10% de ácido fluorídrico durante 1 min e 24 % de peróxido de hidrogênio durante 1 min. Depois foi aplicado agente de união silano por 1 min e todos os pinos foram cimentados com cimento resinoso auto-adesivo (RelyX Unicem, 3M- ESPE). As raízes foram seccionadas e foram obtidas duas fatias de 1 mm de espessura em cada terço: cervical, médio e apical. Os espécimes foram submetidos ao teste de push-out com uma velocidade de 0.5 mm/min. Os dados foram analisados pelo teste ANOVA com medidas repetidas, seguido pelo teste de Tukey HSD (=0,05). Os fatores tratamento de superfície (p<0,001) e região do terço radicular (p=0,007) foram significantes; no entanto, a interação entre os dois fatores não foi significante (p=0,827). A retenção ao canal radicular foi afetada pelo tipo de tratamento de superfície. O tratamento de superfície com 24% de peróxido de hidrogênio por 1 min rendeu significativamente maior resistência de união quando os pinos de fibra de vidro foram cimentados com RelyX Unicem.
Asunto(s)
Dentina , Vidrio , Técnica de Perno Muñón , Raíz del Diente , Microscopía Confocal , Propiedades de SuperficieRESUMEN
The objective of this study was to analyze the dentin-resin cements interfacial ultramorphologies using two different methods: scanning (SEM) and transmission electron microscopy (TEM). Four commercial products were evaluated: two conventional cementing system (RelyX ARC/Adper™ Scotchbond™ Multi-Purpose Plus, 3M ESPE and Clearfil Esthetic Cement/DC Bond, Kuraray) and two self-adhesive resin cements (RelyX Unicem, 3M ESPE and Clearfil SA Cement, Kuraray). Prepolymerized resin disks (Sinfony, 3M ESPE) were cemented on oclusal dentin surfaces of 24 third human molars, simulating the indirect restorations. After 24 h, teeth were sectioned into 0.9-mm thick slabs and processed for microscopy analyses (SEM or TEM/ n = 3). Qualitative characterization of dentin-resin cement interface was performed. Hybrid layer formation with long and dense resin tags was observed only for RelyX ARC cementing system. Clearfil Esthetic Cement/DC Bond system revealed few and short resin tags formation, whereas no hybridization and resin tags were detected for self-adhesive resin cements. Some interfacial regions exhibited that the self-adhesive resin cements were not bonded to dentin, presenting bubbles or voids at the interfaces. In conclusion, TEM and SEM bonding interface analyses showed ultramorphological variations among resin cements, which are directly related to dental bonding strategies used for each resin cement tested.
Asunto(s)
Resinas Compuestas/química , Restauración Dental Permanente/métodos , Recubrimientos Dentinarios/química , Cementos de Resina/química , Bisfenol A Glicidil Metacrilato/química , Análisis del Estrés Dental , Dentina/química , Humanos , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Tercer Molar , Polietilenglicoles/química , Ácidos Polimetacrílicos/química , Resistencia a la TracciónRESUMEN
Este estudo objetivou analisar o grau de conversão (GC) e a microdureza de um cimento resinoso utilizando diferentes protocolos de ativação, e, caracterizar o cimento quanto à composição monomérica, diâmetro médio das partículas inorgânicas e porcentagem em peso das frações orgânica e inorgânica. Foram preparados quarenta espécimes (8mm de diâmetro, 0,5mm de espessura), sendo metade usada para a determinação do GC e a outra metade usada no teste de microdureza. Os espécimes foram divididos em quatro grupos: GR1 fotoativação realizada diretamente sobre o cimento por 20s, GR2 fotoativação através de um disco de porcelana com 2mm de espessura por 20s, GR3 fotoativação através de um disco de porcelana com 2mm de espessura por 40s, e GR4 fotoativação foi omitida e o material foi polimerizado exclusivamente por seus componentes químicos. A dureza Vickers (HV) e o GC, determinado através de FTIR-ATR, foram realizados imediatamente após a fotoativação (GR1, GR2 e GR3) ou cinco minutos após o início da polimerização (GR4). Após armazenagem em ambiente seco e escuro por 24h, os espécimes foram novamente submetidos aos testes de HV e GC. Para a caracterização do material avaliado, foram realizadas as análises: Termogravimétrica, Espectrometria no Infravermelho, Espectrometria de Ressonância Magnética Nuclear e Microscopia Eletrônica de Varredura. Os resultados foram analisados estatisticamente por ANOVA, teste t e teste de Bonferroni (P≤0,05). Os valores do GC nos períodos imediato e 24h foram, respectivamente: GR1: 29.64% ± 4.05 / 32.58% ± 2.99; GR2: 27.07% ± 2.39 / 28.9%1 ± 3.9 / GR3: 28.18% ± 3.6 / 32.34% ± 4.04; GR4: 7.94% ± 2.4 / 20.38% ± 4.89. Os valores de HV nos períodos imediato e 24h foram, respectivamente: GR1: 7.98HV ± 1.8 / 14.88HV ± 2.33; GR2: 4.84HV ± 0.13 / 9.06HV ± 1.63; GR3: 6.53HV ± 2.51 / 11.42HV ± 1.97...
The aim of this study was to evaluate the degree of conversion (DC) and the microhardness of a self-adhesive resin cement under different activation protocols, immediately and after 24 hours of the beginning of the polymerization, and, defining cement regarding monomer composition, average diameter of the inorganic fillers and the percentage by weight of the organic and inorganic portions. Forty specimens (8 mm in diameter, 0.5 mm in height) were prepared. Half of them were used to determine DC and the other half were used on the microhardness test. The specimens were divided into four groups: GR1 direct photoactivation for 20s, GR2 photoactivation through 2mm porcelain disc for 20s, GR3 photoactivation through 2 mm porcelain disc for 40 s, and GR4 photoactivation was omitted and curing was reliant on the chemical reaction only. Vickers microhardness (HV) and DC, by FTIR-ATR, were determined immediately after photoactivation (GR1, GR2 e GR3) or after five minutes from the beginning of the polymerization (GR4). After dry storage in the dark, for 24 hours, the samples were submitted to the tests again. In order to define the studied cement, the Thermogravimetric method was applied, as well as the Infrared Spectometry, Nuclear Magnetic Ressonance Spectroscopy and Scanning Electron Microscope. Data were statistically analyzed by one-way ANOVA, t-Test and Bonferroni Test (P≤0,05) and the degree of conversion values obtained immediately after polymerization and after 24 hours were, respectively: GR1: 29.64% ± 4.05 / 32.58% ± 2.99; GR2: 27.07% ± 2.39 / 28.9%1 ± 3.9 / GR3: 28.18% ± 3.6 / 32.34% ± 4.04; GR4: 7.94% ± 2.4 / 20.38% ± 4.89. HV values obtained immediately after polymerization and after 24 hours were, respectively: GR1: 7.98HV ± 1.8 / 14.88HV ± 2.33; GR2: 4.84HV ± 0.13 / 9.06HV ± 1.63; GR3: 6.53HV ± 2.51 / 11.42HV ± 1.97...