RESUMO
OBJECTIVES: To evaluate the influence of a glutaraldehyde-based desensitizer (GL) on postoperative sensitivity (POS) in posterior bulk-fill resin composite restorations using an adhesive applied in the self-etch (SE) and etch-and-rinse (ER) strategies; and to assess the clinical performance of the restorations. METHODS: Posterior resin composite restorations (n = 228) at least 3 mm deep were inserted in 57 subjects using a split-mouth design. The adhesive was applied with/without prior application of a GL. A resin composite was used for all restorations. Spontaneous POS (risk and intensity), as well as POS caused by stimulation with an air blast and assess the response to horizontal and vertical percussion was assessed using two scales in the baseline and after 7, 14, and 30 days. In addition, some parameters were evaluated using FDI criteria up to 24 months of clinical service. RESULTS: No significant POS was observed (p > 0.05). A higher absolute risk and intensity of spontaneous POS was observed within 7 days (35.1%), without statistically significant differences among groups. At 24 months 5 restorations were considered clinically unsatisfactory, and 73 restorations showed minor discrepancies in adaptation, with no significant differences between groups (p > 0.05). SIGNIFICANCE: A GL agent does not influence POS in posterior restorations with bulk-fill resin composite. It may be considered a dispensable clinical step in the restorative protocol.
Assuntos
Resinas Compostas , Boca , Humanos , GlutaralRESUMO
OBJECTIVE: Dual-cured buildup composites and simplified light-cured adhesive systems are mixed with a chemical activator to prevent the incompatibility between them. To evaluate microshear bond strength (µSBS) and nanoleakage (NL) of three universal adhesives used under buildup composites using different curing modes, at baseline and after 6-months (6m). METHODOLOGY: Dentin specimens of 55 molars were assigned to: Clearfil Universal Bond[CFU], Prime&Bond Elect[PBE] and One Coat 7 Universal[OCU]. All-Bond Universal[ABU] and Adper Scotchbond Multi-Purpose[SMP] were used as controls. CFU, PBE, and OCU were: light-cured [LC], dual-cured using a self-curing activator [DC], and self-cured, using a self-curing activator and waiting for 20 min [SC]. Upon the application of the adhesive, transparent matrices were filled with a dual-cured buildup composite and light cured, then tested in mSBS. For NL, the specimens were submersed in ammoniacal silver nitrate and sectioned to observe under the SEM. Three-way ANOVA and Tukey's test were applied (α=0.05). RESULTS: OCU/LC-PBE/LC resulted in higher mean µSBS than ABU/LC. For SMP/DC higher mean µSBS were obtained than for both CFU/DC and OCU/DC (baseline). No universal adhesive was significantly affected by curing mode or storage time. CFU, PBE, and OCU did not undergo significant changes in any curing mode (p>0.05). NL (baseline) PBE/LC resulted in higher %NL compared to ABU/LC. SMP/DC resulted in higher %NL than CFU/DC-OCU/DC. CFU/LC/DC resulted in lower %NL than CFU/SC. PBE/SC resulted in lower %NL than PBE/DC. OCU/LC/SC showed lower %NL than OCU/DC. OCU showed significant lower %NL than CFU and PBE. All CFU groups, as well as OCU/SC, resulted in increased %NL at 6m when compared with baseline. CONCLUSION: For universal adhesives used in etch-and-rinse mode, self-cured activator and different curing modes did not influence µSBS. However, some interactions were observed for NL, but this influence was material-specific.
Assuntos
Colagem Dentária , Resinas Compostas , Cimentos Dentários , Dentina , Adesivos Dentinários , Teste de Materiais , Cimentos de Resina , Resistência à TraçãoRESUMO
OBJECTIVE: To evaluate the five-year clinical performance of Scotchbond Universal Adhesive (SU; 3M Oral Care, St. Paul, MN, USA) in non-carious cervical lesions (NCCLs) using two evaluation criteria. METHODS: Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-ERm: etch-and-rinse + moist dentin; SU-ERd: etch-and-rinse + dry dentin; SU-Set: selective enamel etching; and SU-SE: self-etch. A nanofilled composite resin was placed incrementally. The restorations were evaluated at baseline and after 5 years using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The survival rates (retention/fractures) were calculated with the Kaplan-Meier and the log-rank test. For the secondary outcomes, Friedman repeated measures analysis of variance by rank was applied (α = 0.05). RESULTS: After 5 years the recall rate was 86%. The retention/fracture rates were 93% for Erm and ERd, 88.4% for SEet and 81.4% for SE. A significant difference was observed for SE vs. ERd and SE vs. ERm (p = 0.01). Also, marginal discoloration and adaptation showed significant differences with ERm and ERd resulting in fewer marginal discrepancies than SE (p < 0.05). SIGNIFICANCE: After 5 years, the clinical behavior of the universal adhesive in the etch-and-rinse strategy was better when compared to the self-etch strategy. The use of selective enamel etching is highly recommended for the self-etch strategy. The FDI and USPHS evaluation criteria showed similar results after 5 years.
Assuntos
Colagem Dentária , Adesivos Dentinários , Resinas Compostas , Cimentos Dentários , Adaptação Marginal Dentária , Falha de Restauração Dentária , Restauração Dentária Permanente , Humanos , Cimentos de ResinaRESUMO
We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.
Assuntos
Colagem Dentária/normas , Fidelidade a Diretrizes/normas , Guias de Prática Clínica como Assunto/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Colagem Dentária/métodos , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Viés de Publicação , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Projetos de Pesquisa/normas , Medição de Risco , Fatores de RiscoRESUMO
Abstract We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.
Assuntos
Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Colagem Dentária/normas , Guias de Prática Clínica como Assunto/normas , Fidelidade a Diretrizes/normas , Projetos de Pesquisa/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Fatores de Risco , Colagem Dentária/métodos , Viés de Publicação , Medição de Risco , Fidelidade a Diretrizes/estatística & dados numéricosRESUMO
OBJECTIVES: To measure microshear bond strength (µSBS) and nanoleakage (NL) of self-etch universal adhesives under core buildup restorations using different curing protocols, at 24h and after 6-month water storage. METHODS: Middle dentin of 55 molars was divided into: Clearfil Universal Bond [CFU], Prime&Bond Elect [PBE], and One Coat 7 Universal [OCU]. All-Bond Universal [ABU] and Clearfil SE Bond [CSE] were used as control. CFU, PBE and OCU were: light-cured [LC], dual-cured [DC] and self-cured [SC]. Data were analyzed separately (two-way ANOVA), Tukey's test (α=0.05). RESULTS: µSBS: At 24h OCU/LC resulted in statistically higher µSBS than ABU. CSE/DC showed statistically higher µSBS than all DC adhesives. PBE/LC resulted in significant lower µSBS than the respective DC/SC modes (p<0.001). At 6-month, both CFU and PBE (LC/SC), resulted in a significant decrease in µSBS. µSBS for OCU/DC decreased significantly (p<0.001) compared to the respective LC/SC modes. NL: At 24h, ABU showed %NL similar to CBU/LC and OCU/LC (p>0.05). CSE/DC resulted in significantly higher %NL than OCU/DC but significantly lower than PBE/DC. CFU/LC/SC resulted in significantly lower %NL than CFU/DC. PBE/SC resulted in significant lower %NL than PBE/LC and PBE/DC. OCU/LC and OCU/DC resulted in significant lower %NL than OCU/SC (p<0.001). At 6-month ABU, CSE, CFU/LC and CFU/SC, resulted in a significant increase in %NL. SIGNIFICANCE: Self-cured activator and different curing protocols influenced µSBS and NL of self-etch universal adhesives, but this influence was material-dependent.
Assuntos
Cimentos Dentários , Dentina , Cimentos de Resina , Resinas Compostas , Colagem Dentária , Adesivos Dentinários , Humanos , Teste de Materiais , Resistência à TraçãoRESUMO
STATEMENT OF THE PROBLEM: It is still debatable which technique should be used with universal adhesives, either etch-and-rinse (wet or dry) or self-etch strategy (with or without selective enamel etching). PURPOSE OF THE STUDY: To evaluate the 36-month clinical performance of Scotchbond Universal Adhesive (SU, 3M ESPE) in non-carious cervical lesions (NCCLs) using two evaluation criteria. METHODS/MATERIALS: Thirty-nine patients participated in this study. Two-hundred restorations were assigned to four groups: ERm: etch-and-rinse+moist dentin; ERd: etch-and-rinse+dry dentin; Set: selective enamel etching; and SE: self-etch. The same composite resin was inserted for all restorations in up to 3 increments. The restorations were evaluated at baseline and at 6-, 18-, and 36-months using both the FDI and the USPHS criteria. Statistical analyses were performed with Friedman repeated measures ANOVA by rank and McNemar test for significance in each pair (α=0.05). RESULTS: Eight restorations (ERm: 1; ERd: 1; Set: 1 and SE: 5) were lost after 36 months, but only significant for SE when compared with baseline (p=0.02 for either criteria). Marginal staining occurred in 6.8% of the restorations (groups ERm, ERd, and Set) and 17.5% of the restorations (group SE), with significant difference for each group when compared with baseline using the FDI criteria (p<0.04), while statistical significance was reached only for SE when compared with baseline using the USPHS criteria (p<0.03). Twenty-eight and 49 restorations were scored as bravo for marginal adaptation using the USPHS and FDI criteria, respectively, with significant difference for each group when compared with baseline (p<0.05). CONCLUSIONS: While there was no statistical difference among bonding strategies when a universal adhesive was used, there were signs of degradation when the universal adhesive was applied in SE mode. The FDI criteria remain more sensitive than the USPHS criteria, especially for the criteria marginal staining and marginal adaptation.
Assuntos
Cimentos Dentários , Corrosão Dentária/métodos , Restauração Dentária Permanente/métodos , Adulto , Falha de Restauração Dentária , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto JovemRESUMO
OBJECTIVES: To evaluate the effect of adhesion strategy on the enamel microshear bond strengths (µSBS), etching pattern, and in situ degree of conversion (DC) of seven universal adhesives. METHODS: 84 extracted third molars were sectioned in four parts (buccal, lingual, proximal) and divided into 21 groups, according to the combination of the main factors adhesive (AdheSE Universal [ADU], All-Bond Universal [ABU], Clearfil Universal [CFU], Futurabond U [FBU], G-Bond Plus [GBP], Prime&Bond Elect (PBE), and Scotchbond Universal Adhesive [SBU]), and adhesion strategy (etch-and-rinse, active self-etch, and passive self-etch). Specimens were stored in water (37°C/24h) and tested at 1.0mm/min (µSBS). Enamel-resin interfaces were evaluated for DC using micro-Raman spectroscopy. The enamel-etching pattern was evaluated under a field-emission scanning electron microscope (direct and replica techniques). Data were analyzed with two-way ANOVA and Tukey's test (α=0.05). RESULTS: Active self-etch application increased µSBS and DC for five out of the seven universal adhesives when compared to passive application (p<0.001). A deeper enamel-etching pattern was observed for all universal adhesives in the etch-and-rinse strategy. A slight improvement in etching ability was observed in active self-etch application compared to that of passive self-etch application. Replicas of GBP and PBE applied in active self-etch mode displayed morphological features compatible with water droplets. The DC of GBP and PBE were not affected by the application/strategy mode. CONCLUSIONS: In light of the improved performance of universal adhesives when applied actively in SE mode, selective enamel etching with phosphoric acid may not be crucial for their adhesion to enamel. CLINICAL SIGNIFICANCE: The active application of universal adhesives in self-etch mode may be a practical alternative to enamel etching in specific clinical situations.
Assuntos
Cimentos Dentários , Esmalte Dentário , Corrosão Dentária/métodos , Dente Molar , Análise de Variância , Cimentos Dentários/química , Esmalte Dentário/química , Esmalte Dentário/ultraestrutura , Falha de Restauração Dentária , Humanos , Microscopia Eletrônica de Varredura , Dente Molar/química , Dente Molar/ultraestrutura , Ácidos Fosfóricos/administração & dosagem , Distribuição Aleatória , Resistência ao Cisalhamento , Análise Espectral Raman , ÁguaRESUMO
PURPOSE: To evaluate the 18-month clinical performance of four adhesive strategies in posterior composite restorations placed in private practice. MATERIALS AND METHODS: Upon approval by an institutional review board, 144 restorations were inserted in 45 subjects (average age = 32.6) to treat caries lesions or to replace existing restorations in vital molars and premolars. The adhesives OptiBond FL (three-step etch-and-rinse), OptiBond SOLO Plus (two-step etch-and-rinse), OptiBond XTR (two-step self-etch), and OptiBond All-in One (one-step self-etch) were applied as per manufacturer's (Kerr Co.) instructions followed by a nanofilled resin composite (Filtek Z350XT, 3M ESPE) under rubber dam isolation. Restorations were evaluated at baseline and at 18 months using United States Public Health Service (USPHS)-modified criteria and high-resolution digital photographs. Statistical analyses included the McNemar and the Mann-Whitney non-parametric tests (p < 0.05). RESULTS: A total of 137 restorations were evaluated after 18 months. The number of alfa ratings did not change significantly from baseline to 18 months for any of the adhesion strategies. When the 18-month evaluation criteria were pooled by pairs of adhesives, none of the adhesives resulted in a significantly different number of alfa ratings for any of the criteria compared with the other adhesives. CONCLUSION: Bonding strategy did not influence the clinical performance of posterior composite restorations under the clinical conditions used in this study. CLINICAL SIGNIFICANCE: When used in ideal clinical conditions, the composition of current dentin adhesives may be more clinically relevant than their adhesion strategy.
Assuntos
Cimentos Dentários , Restauração Dentária Permanente , Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
The aim of this study was to quantify tooth sensitivity during bleaching and after a desensitizing treatment. Sensitivity was measured with a new device, TSA-II, which uses thermal stimuli for Quantitative Sensory Testing (QST). Ten patients underwent bleaching treatment using Whiteness HP Maxx (FGM Produtos Odontológicos Ltda) containing 35% hydrogen peroxide. After the bleaching session, the teeth were cleaned with air/water spray and the product Desensibilize KF 2% (FGM Produtos Odontológicos Ltda) was applied to the upper left teeth. Saline solution at room temperature was applied in the upper right teeth. QST was performed before bleaching, immediately after bleaching, and immediately after desensitizing treatment. In order to standardize tooth analysis, a 100% ethylene copolymer and vinyl acetate tray with circular perforations was used during measurements. Analysis of variance and the Student's t-test were used (a=0.05). Mean temperatures (SD) of cold sensation threshold for the upper right quadrant were: BB-13.898 (4.81), AB- 19.241 (3.68), AD-20.646 (3.72) and for the upper left quadrant they were: BB-14.102 (3.22), AB-19.646 (4.82), AD- 13.835 (3.63). Dental bleaching with highly concentrated peroxides changed dental cold sensation thresholds, but the topical desensitizer changed the immediate cold sensation thresholds produced by the cold stimulus.
O objetivo do presente estudo foi quantificar a sensibilidade dentária durante o tratamento clareador e após a aplicação de um dessensibilizante utilizando um equipamento de análise neurosensorial, o TSA II, que utiliza estímulos térmicos para a realização do Teste Sensorial Quantitativo (QST). Assim, dez pacientes (n=10) receberam o tratamento clareador com Whiteness HP Maxx (FGM Produtos Odontológicos Ltda.) contendo peróxido de hidrogênio a 35%. Após a sessão clareadora, os dentes foram limpos com jatos de ar/água e foi realizada a aplicação do Desensibilize KF 2% (FGM Produtos Odontológicos Ltda.), um dessensibilizante tópico a base de nitrato de potássio a 5% e fluoreto de sódio a 2%, apenas no hemi-arco esquerdo da maxila, utilizando o método da boca dividida. No hemi-arco direito foi aplicada uma solução salina a temperatura ambiente (controle). O QST foi realizado antes do clareamento (AC), imediatamente depois do clareamento (DC) e imediatamente após a aplicação do dessensibilizante (DD). Para padronizar o local do estímulo, uma moldeira de acetato com perfurações circulares foi utilizada durante as mensurações. A análise estatística foi realizada por meio do teste t de Student (α=0,05). As temperaturas médias (DP) do limiar de sensação ao frio para o hemi-arco direito foram: AC- 13,898 (4,81), DC-19,241 (3,68), DD-20,646 (3,72) e para o hemi-arco esquerdo foram: AC-14,102 (3,22), DC-19,646 (4,82), DD-13,835 (3,63). Clareamento dental com peróxidos de alta concentração exacerbaram a sensibilidade dental ao estímulo térmico e o uso do dessensibilizante foi efetivo para reverter esta situação.
Assuntos
Sensibilidade da Dentina , Sensibilidade da Dentina/induzido quimicamente , Humanos , Peróxido de Hidrogênio , Peróxidos , Clareamento Dental/efeitos adversos , Clareadores Dentários , UreiaRESUMO
OBJECTIVE: To evaluate the microtensile bond strengths (µTBS) and nanoleakage (NL) of three universal or multi-mode adhesives, applied with increasing solvent evaporation times. METHODS: One-hundred and forty caries-free extracted third molars were divided into 20 groups for bond strength testing, according to three factors: (1) Adhesive - All-Bond Universal (ABU, Bisco, Inc.), Prime&Bond Elect (PBE, Dentsply), and Scotchbond Universal Adhesive (SBU, 3M ESPE); (2) Bonding strategy - self-etch (SE) or etch-and-rinse (ER); and (3) Adhesive solvent evaporation time - 5s, 15s, and 25s. Two extra groups were prepared with ABU because the respective manufacturer recommends a solvent evaporation time of 10s. After restorations were constructed, specimens were stored in water (37°C/24h). Resin-dentin beams (0.8mm(2)) were tested at 0.5mm/min (µTBS). For NL, forty extracted molars were randomly assigned to each of the 20 groups. Dentin disks were restored, immersed in ammoniacal silver nitrate, sectioned and processed for evaluation under a FESEM in backscattered mode. Data from µTBS were analyzed using two-way ANOVA (adhesive vs. drying time) for each strategy, and Tukey's test (α=0.05). NL data were computed with non-parametric tests (Kruskal-Wallis and Mann-Whitney tests, α=0.05). RESULTS: Increasing solvent evaporation time from 5s to 25s resulted in statistically higher mean µTBS for all adhesives when used in ER mode. Regarding NL, ER resulted in greater NL than SE for each of the evaporation times regardless of the adhesive used. A solvent evaporation time of 25s resulted in the lowest NL for SBU-ER. SIGNIFICANCE: Residual water and/or solvent may compromise the performance of universal adhesives, which may be improved with extended evaporation times.
Assuntos
Cimentos Dentários , Dentina , Solventes/química , Infiltração Dentária , Humanos , Resistência à TraçãoRESUMO
OBJECTIVES: To evaluate the effect of an additional hydrophobic resin coating (HE) on the resin-dentine microtensile bond strengths (µTBS), nanoleakage (NL), and in situ degree of conversion (DC) of three universal adhesives used in the etch-and-rinse (ER) and the self-etch (SE) modes. METHODS: Sixty caries-free extracted third molars were divided into 12 groups according to the combination of the factors adhesive (All-Bond Universal [ABU]; G-Bond Plus [GBP] and Scotchbond Universal [SBU]), adhesive strategy (ER and SE), and the use of HE (Heliobond; yes or no). After restorations were constructed, specimens were stored in water (37°C/24h) and sectioned into resin-dentine beams (0.8mm(2)) to be tested under tension (0.5mm/min). Selected beams from each tooth were used for DC quantification and for NL evaluation. Data from each adhesive were analyzed with two-way ANOVA and Tukey's test (α=0.05). RESULTS: ABU and GBP resulted in higher µTBS in the ER mode. The use of HE increased the µTBS of ABU and GBP only in the SE mode. Lower NL was observed for SBU and ABU in the ER mode+HE, and for GBP in the SE mode+HE. SBU and GBP showed higher DC when used in the ER mode, which was increased with HE application. The DC of ABU was similar in all conditions. CONCLUSIONS: The conversion of 1-step SE to 2-step SE may increase the µTBS and DC of current universal adhesives. The reduction in the NL is more dependent on the adhesive composition than on the bonding strategy.
Assuntos
Resinas Compostas/química , Colagem Dentária , Materiais Dentários/química , Dentina/ultraestrutura , Cimentos de Resina/química , Condicionamento Ácido do Dente/métodos , Acrilatos/química , Bis-Fenol A-Glicidil Metacrilato/química , Infiltração Dentária/classificação , Humanos , Interações Hidrofóbicas e Hidrofílicas , Teste de Materiais , Metacrilatos/química , Ácidos Fosfóricos/química , Polietilenoglicóis/química , Polimerização , Ácidos Polimetacrílicos/química , Distribuição Aleatória , Temperatura , Resistência à Tração , Fatores de Tempo , Água/químicaRESUMO
Los sistemas adhesivos tienden a ser cada vez más simplificados y versátiles. Hasta el presente, el clínico todavía debe elegir entre adhesivos autoacondicionantes o convencionales. Objetivo: mostrar la aplicación clínica de un nuevo sistema adhesivo considerado universal, debido a que puede ser usado como adhesivo autoacondicionante o como uno convencional. Caso clínico: fueron realizadas restauraciones cervicales en lesiones no cariosas con varias posibilidades de utilización de un nuevo adhesivo (Scotchbond(TM) Universal, 3M Espe), aplicando el ácido fosfórico en toda la cavidad y dejando la dentina seca o húmeda, o aplicando el ácido fosfórico solamente en el esmalte, o aplicando sólo el adhesivo sin grabado previo con ácido fosfórico. Después de restaurar con resina compuesta, todos los casos fueron evaluados clínicamente en el inicio del tratamiento y a los 6 meses. Conclusión: los resultados demostraron un excelente desempeño clínico de este nuevo sistema adhesivo, utilizado con cualquiera de las distintas técnicas clínicas propuestas. No obstante, deben realizarse estudios de larga duración en un mayor número de casos clínicos, a fin de comprobar los resultados aquí presentados (AU)
Assuntos
Humanos , Colagem Dentária/métodos , Adesivos Dentinários/química , Colo do Dente/lesões , Restauração Dentária Permanente/métodos , Resinas Compostas/química , Ácidos Fosfóricos/químicaRESUMO
Los sistemas adhesivos tienden a ser cada vez más simplificados y versátiles. Hasta el presente, el clínico todavía debe elegir entre adhesivos autoacondicionantes o convencionales. Objetivo: mostrar la aplicación clínica de un nuevo sistema adhesivo considerado universal, debido a que puede ser usado como adhesivo autoacondicionante o como uno convencional. Caso clínico: fueron realizadas restauraciones cervicales en lesiones no cariosas con varias posibilidades de utilización de un nuevo adhesivo (Scotchbond(TM) Universal, 3M Espe), aplicando el ácido fosfórico en toda la cavidad y dejando la dentina seca o húmeda, o aplicando el ácido fosfórico solamente en el esmalte, o aplicando sólo el adhesivo sin grabado previo con ácido fosfórico. Después de restaurar con resina compuesta, todos los casos fueron evaluados clínicamente en el inicio del tratamiento y a los 6 meses. Conclusión: los resultados demostraron un excelente desempeño clínico de este nuevo sistema adhesivo, utilizado con cualquiera de las distintas técnicas clínicas propuestas. No obstante, deben realizarse estudios de larga duración en un mayor número de casos clínicos, a fin de comprobar los resultados aquí presentados
Assuntos
Humanos , Adesivos Dentinários/química , Colo do Dente/lesões , Colagem Dentária/métodos , Restauração Dentária Permanente/métodos , Ácidos Fosfóricos/química , Resinas Compostas/químicaRESUMO
STATEMENT OF THE PROBLEM: Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. PURPOSE OF THE STUDY: To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. METHODS/MATERIALS: Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). RESULTS: Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). CONCLUSIONS: The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. CLINICAL SIGNIFICANCE: At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed.
Assuntos
Adesivos Dentinários/química , Cimentos de Resina/química , Condicionamento Ácido do Dente/métodos , Adulto , Cor , Resinas Compostas/química , Colagem Dentária , Cárie Dentária/classificação , Esmalte Dentário/patologia , Adaptação Marginal Dentária , Falha de Restauração Dentária , Restauração Dentária Permanente/métodos , Dentina/patologia , Sensibilidade da Dentina/classificação , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Metacrilatos/química , Pessoa de Meia-Idade , Propriedades de Superfície , Desgaste dos Dentes/terapia , Adulto JovemRESUMO
Apesar de se tentar com que os adesivos atuais sejam cada vez mais simplificados e versáteis, até o momento o clinico deve optar por adesivos autocondicionantes ou convencionais. O presente relato de caso visa apresentar a aplicação clínica de um novo sistema adesivo considerado universal, pois pode ser usado na técnica autocondicionante ou convencional. Foram realizadas restaurações de lesões cervicais não cariosas com as várias possibilidades de aplicação do adesivo Single Bond Universal, ou seja, aplicando o ácido fosfórico em toda a cavidade e deixando a dentina seca ou úmida; aplicando o ácido fosfórico apenas no esmalte, ou aplicando apenas o adesivo sem a utilização do ácido fosfórico. Após a realização das restaurações com resina composta, estas foram avaliadas inicialmente e após seis meses. Os resultados demonstraram um excelente desempenho clínico quando este novo sistema adesivo foi utilizado em quaisquer das estratégias propostas. Estudos de longa duração e um maior número de casos clínicos devem ser realizados para comprovar os resultados aqui apresentados
In spite of trying to make the current adhesive systems more simplified and versatile, until the moment the clinician should choose self-etch or etch-and-rinse adhesives. This case report aims to present the clinical application of a new adhesive system considered as universal, as it can be used under the self-etch or etch-and-rinse protocols. Caries-free cervical lesions were restored with the different application modes of the adhesive Single Bond Universal, that is, etching the entire cavity leaving dry or moist dentin, enamel etching only or applying the adhesive without etching. After finishing the restoration with resin composite, there were evaluated at baseline and after 6 months. The results demonstrated an excellent clinical behavior when this new adhesive system was used under any protocol proposed. Long term studies and more clinical reports are needed to prove the results here presented
Assuntos
Humanos , Masculino , Adulto , Resinas Compostas , Dentina , Adesivos DentináriosRESUMO
This study compared the clinical outcome of bleaching techniques in vital teeth. After IRB approval and informed consent, 90 subjects were selected based on the shade of their anterior teeth (A2 or darker, Vita Classic shade guide). Subjects were assigned to three treatment groups in a split-mouth study design: Group I: HB (at-home bleaching with 10% carbamide peroxide for two weeks) vs OBL (in-office bleaching with 35% hydrogen peroxide, two sessions, two-week intervals, with light irradiation); Group II: OB (in-office bleaching without light irradiation) vs OBL; Group III: HB vs combination (one session plus HB). Color change and color rebound (deltaE) were measured for a 16-week period. Color measurements were carried out with both a spectrophotometer and a shade guide at baseline, 1, 2, 4, 8 and 16 weeks. Tooth sensitivity was evaluated using a VAS scale for 15 days. Both the Student's t-test and Tukey-Kramer test were used to analyze the results (p < 0.05). After one week, one session of OBL followed by HB resulted in lower color values, compared with the other bleaching methods. Group III resulted in the least shade values at one-week evaluation, when compared with the other bleaching methods. After two weeks, HE alone resulted in similar color changes as OB, OBL and OBL+HB. The use of light irradiation did not improve bleaching efficacy (OB = OBL). OBL and OB resulted in higher sensitivity rates than HB.
Assuntos
Clareamento Dental/métodos , Peróxido de Carbamida , Cor , Consultórios Odontológicos , Sensibilidade da Dentina/etiologia , Combinação de Medicamentos , Seguimentos , Humanos , Peróxido de Hidrogênio/uso terapêutico , Oxidantes/uso terapêutico , Peróxidos/uso terapêutico , Fototerapia , Autocuidado , Espectrofotometria , Dente/patologia , Descoloração de Dente/patologia , Descoloração de Dente/terapia , Resultado do Tratamento , Ureia/análogos & derivados , Ureia/uso terapêuticoRESUMO
OBJECTIVES: To study the nanoleakage pattern in the dentin hybrid layer by using different dentin adhesives. The null hypotheses tested in this study were: 1) dentin conditioning time does not affect nanoleakage within the hybrid layer; 2) the type of dentin adhesive used does not affect nanoleakage. METHODS: Standardized Class V cavities were prepared in 30 intact human molars on the buccal and lingual surfaces. The specimens were randomly assigned to 2 total-etch dentin adhesives (OptiBond SOLO Plus [OPS, Kerr] and One-Step [ONS, BISCO Inc]) and 2 self-etch dentin adhesives (Clearfil SE Bond [CSE, Kuraray] and Adper Prompt L-Pop [APL, 3M ESPE]). The specimens were etched or conditioned for 15 seconds, 30 seconds or 60 seconds. Upon restoration of the Class V cavities with the proprietary resin composite, the specimens were isolated with nail polish except for a 2.0-mm rim around the restoration, and they were immersed in 50 wt% ammoniacal silver nitrate solution (pH=9.5) for 24 hours followed by 8 hours of immersion in photo-developing solution to reduce the silver ions to metallic silver. The specimens were fixed, dehydrated and processed for FESEM and TEM. Silver penetration was measured along the cervical wall, and data were analyzed with Kruskal-Wallis non-parametric tests at a significance level of 95%. RESULTS: There were no statistically significant differences among the experimental groups for the factor "conditioning time" (p>0.926). There were significant differences for the variable "dentin adhesive" (p<0.0001). The least amount of nanoleakage within the hybrid layer occurred with CSE, while ONS resulted in the greatest penetration of silver ions. The adhesives OPS and APL ranked in the intermediary subset. Under TEM, all adhesives resulted in some degree of nanoleakage within the hybrid layer. Both spotted/reticular and water-tree nanoleakage patterns were observed. SIGNIFICANCE: Longer conditioning times did not increase nanoleakage within the hybrid layer. Nanoleakage varied with the type of adhesive used.
Assuntos
Infiltração Dentária/classificação , Adesivos Dentinários/química , Dentina/ultraestrutura , Condicionamento Ácido do Dente , Resinas Compostas/química , Preparo da Cavidade Dentária/classificação , Restauração Dentária Permanente , Humanos , Teste de Materiais , Metacrilatos/química , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Dente Molar , Nanotecnologia , Cimentos de Resina/química , Coloração pela Prata , Propriedades de Superfície , Fatores de TempoRESUMO
The objective of this study was to compare the shear bond strength of 3 simplified adhesive systems applied on shallow vs deep dentin. For superficial dentin, 30 human molars were sectioned with a diamond saw to expose dentin immediately below the dentoenamel junction. For deep dentin, 30 molars were sectioned 3 mm below the dentoenamel junction. The teeth were mounted, polished to 600-grit, and randomly assigned to 3 groups (n=10): Single Bonda and OptiBond Solo, total-etch adhesives, and Clearfil Liner Bond 2V, a self-etching primer adhesive. Adhesives were applied, the restorative material Filtek Z250 inserted in a No. 5 gelatin capsule, and light-cured. After 24 hours in water at 37 degrees C, shear bond strength was measured with an Instron at 5 mm/min. The data were analyzed with 2-way ANOVA and Duncan's post-hoc test. The results showed the following shear bond strengths (mean +/- SD in MPa): Single Bond/superficial dentin = 22.1 +/- 2.8; Single Bond/deep dentin = 14.2 +/- 7.0; OptiBond Solo/superficial dentin = 18.9 +/- 4.1; OptiBond Solo/deep dentin = 18.4 +/- 4.8; Clearfil Liner Bond 2V/superficial dentin = 21.0 +/- 7.4; Clearfil Liner Bond 2V/deep dentin = 17.6 +/- 5.9. There were no significant differences between mean shear bond strength for the factor "adhesive system" (P>.822). The Duncan's test showed that Single Bond resulted in higher shear bond strength on superficial dentin than on deep dentin. The mean shear bond strength for Clearfil Liner Bond 2V and OptiBond Solo were not influenced by dentin depth. When data were pooled for dentin depth, deep dentin resulted in statistically lower bond strengths than superficial dentin (P<.01). The influence of dentin depth on shear bond strength depends on the specific composition of the dentin adhesive.