RESUMO
La estética ha llegado a formar una parte muy importante en la odontología actual. Sin embargo, no debemos sobreponer las necesidades estéticas sobre las necesidades funcionales. La pérdida de estructura dental asociada a bruxismo puede ser considerada patológica cuando compromete la guía anterior, la cual es la influencia en los movimientos mandibulares que proveen las superficies contactantes de los dientes maxilares anteriores con los mandibulares anteriores y evita contactos excéntricos dañinos en los dientes posteriores. El objetivo de este reporte de caso es presentar una alternativa conservadora para restablecer tanto la estética como la funcionalidad de una paciente de 34 años de edad que acudió a la Clínica de Prostodoncia de la Universidad Autónoma de Guadalajara en busca de rehabilitación estética de dientes anteriores. Una vez realizada su evaluación inicial se llegó al diagnóstico de pérdida de guía anterior por desgaste patológico asociado a bruxismo. El tratamiento incluyó tratamientos de conductos, remoción de caries y restauraciones mal ajustadas, coronas y carillas para restablecer la guía anterior. Se cumplieron con las expectativas estéticas que tenía la paciente al igual que con las necesidades funcionales que fueron objetivo desde el inicio, logrando un restablecimiento de la guía anterior de manera conservadora (AU)
Esthetics has become a very important part of dentistry today. However, we should not superimpose esthetic needs over functional needs. The loss of tooth structure associated with bruxism can be considered pathologic when it compromises the anterior guidance, which is the influence on mandibular movements that provides the contacting surfaces of the maxillary anterior teeth with the mandibular anterior teeth and avoids damaging eccentric contacts in the posterior teeth. The aim of this case report is to present a conservative way to restore both esthetics and function in a 34-year-old patient who came to the Prosthodontics Clinic of the Universidad Autónoma de Guadalajara in search of an esthetic appearance of her anterior teeth. After her initial evaluation, a diagnosis of anterior guide loss due to pathological wear associated with bruxism was made. Treatment included root canal treatment, removal of caries, and ill-fitting restorations, crowns, and veneers to reestablish the anterior guidance. The aesthetic expectations of the patient have met as well as the functional needs that were aimed from the beginning, achieving a conservative reestablishment of the anterior guidance system (AU)
Assuntos
Humanos , Feminino , Adulto , Bruxismo/fisiopatologia , Adesivos Dentinários/uso terapêutico , Estética Dentária , Desgaste dos Dentes/reabilitação , Planejamento de Assistência ao Paciente , Placas Oclusais , Preparo do Dente/métodos , Coroas , MéxicoRESUMO
OBJECTIVES: To evaluate the influence of dentin moisture on the clinical behavior of a universal adhesive on posterior teeth after 36 months of follow-up. METHODS: Forty-five patients participated in this study. Following a split-mouth design, three operators placed 90 Class I/Class II restorations over moist dentin (MD) or dry (DD) (n = 45) with resin composite (Filtek Bulk Fill) and a universal adhesive used in the etch-and-rinse mode (Single Bond Universal). Each restoration was evaluated according to the FDI and USPHS criteria (postoperative sensitivity, fracture and retention, marginal staining, marginal adaptation, and recurrence of caries) at baseline and after 6-, 12-, and 36 months. For statistical analysis, Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used. RESULTS: No significant difference between groups was observed in each FDI criterion after 36 months of clinical evaluation (p > 0.05). The retention rates (confidence interval 95 %) were 97.37 % (86.5 - 99.5) for both MD and DD without significant difference between them (p > 0.05). Eight restorations (MD = 4; DD = 4) showed minimal marginal staining defects (p > 0.05). Two restorations were lost (MD = 1; DD = 1). Fifteen restorations (MD = 8; DD = 7) presented minor marginal discrepancies according to the FDI criteria (p > 0.05). CONCLUSION: The clinical performance of the universal adhesive when applied in etch-and-rinse mode was not influenced by dentin moisture in posterior bulk-fill composite restorations. CLINICAL SIGNIFICANCE: The level of dentin moisture appears not to influence the clinical efficacy of a universal adhesive when applied using the etch-and-rinse technique in posterior composite resin restorations.
Assuntos
Bis-Fenol A-Glicidil Metacrilato , Resinas Compostas , Cárie Dentária , Adaptação Marginal Dentária , Falha de Restauração Dentária , Restauração Dentária Permanente , Sensibilidade da Dentina , Adesivos Dentinários , Dentina , Cimentos de Resina , Humanos , Restauração Dentária Permanente/métodos , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Feminino , Masculino , Método Duplo-Cego , Adulto , Cimentos de Resina/química , Pessoa de Meia-Idade , Bis-Fenol A-Glicidil Metacrilato/química , Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Cárie Dentária/terapia , Adesivos Dentinários/química , Adesivos Dentinários/uso terapêutico , Seguimentos , Adulto Jovem , Resultado do Tratamento , Colagem Dentária/métodos , Condicionamento Ácido do DenteRESUMO
OBJECTIVE: To evaluate the effect of prolonged (P) polymerization time of a universal adhesive system applied in etch-and-rinse (ER) or self-etch (SE) strategies on the clinical performance of restorations in non-carious cervical lesions (NCCLs), after 36 months of clinical service. METHODS: A total of 140 restorations were randomly placed in 35 subjects according to the polymerization time groups: ER (10 s); ER-P (40 s); SE (10 s); and SE-P (40 s) at 1,200 mW/cm2. Composite resin was placed incrementally. The restorations were evaluated immediately and after 6, 12, 18, and 36 months using the FDI criteria. Data were analyzed using the Kaplan-Meier survival test for retention loss, and the Kruskal-Wallis' test for secondary outcomes (α = 0.05). RESULTS: After 36 months, 19 restorations were lost: ER 6, ER-P 2, SE 9, SE-P 2. The retention rates were 82.3% for ER; 94.1 % for ER-P; 73.5 % for SE; and 94.1 % for SE-P, with a significant difference between ER vs. ER-P and SE vs. SE-P, as well as ER vs. SE-P and ER-P vs. SE (p < 0.0001). Minor defects were observed in 18 restorations for the marginal staining criteria: ER 5, ER-P 2, SE 8, SE-P 3; and in 33 restorations for the marginal adaptation criteria: ER 11, ER-P 4, SE 12, and SE-P 6 (p > 0.05). No restorations showed recurrence of caries or postoperative sensitivity. CONCLUSIONS: A prolonged polymerization time of 40 s improves the clinical performance of the universal adhesive for both adhesive strategies evaluated, even after 36 months. CLINICAL SIGNIFICANCE: Prolonging the polymerization time of a universal adhesive from 10 to 40 s has been shown to improve its clinical performance when used in NCCLs.
Assuntos
Cimentos Dentários , Adesivos Dentinários , Humanos , Resinas Compostas/uso terapêutico , Adaptação Marginal Dentária , Falha de Restauração Dentária , Restauração Dentária Permanente , Adesivos Dentinários/uso terapêutico , Polimerização , Cimentos de Resina/uso terapêutico , Colo do Dente/patologia , Método Duplo-CegoRESUMO
OBJECTIVE: To evaluate the adhesion of universal adhesive systems to the dentin of noncarious cervical lesions (NCCLs) by comparing the etch-and-rinse and self-etch strategies through a systematic review and meta-analysis. METHODS: Systematic electronic searches were performed by two independent reviewers into the following databases: PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library until December of 2021. Only randomized clinical trials were selected, comparing etch-and-rinse and self-etch strategies and using universal adhesive systems in NCCLs. This systematic review was conducted according to the PRISMA guidelines and registered into PROSPERO. RESULTS: After the removal of duplicates, 170 articles were identified. In an initial screening of titles and abstracts, 146 records did not satisfy the inclusion criteria and were, therefore, excluded. Twenty-four studies were eligible for evaluation of the full text, and four were excluded after this step. Finally, 20 randomized clinical trials were included in this systematic review and meta-analysis. CONCLUSION: This systematic review and meta-analysis revealed that applying universal adhesive systems in the etch-and-rinse strategy could lead to better medium-term (>12 to 36 months) retention of NCCL restorations than the self-etch strategy, as well as resulting in lower percentages of marginal discoloration, marginal adaptation, and secondary caries. However, the use of a self-etching strategy can lead to lower postoperative sensitivity.
Assuntos
Cimentos Dentários , Adesivos Dentinários , Humanos , Cimentos Dentários/uso terapêutico , Adesivos Dentinários/uso terapêutico , Cimentos de Resina , Resinas Compostas/uso terapêutico , Colo do Dente , Restauração Dentária Permanente/métodos , Adaptação Marginal DentáriaRESUMO
Os sistemas adesivos estão diretamente envolvidos nos procedimentos mais corriqueiros da prática clínica odontológica, o que torna o seu conhecimentoindispensável para os profissionais. O objetivo do presente estudo foi avaliar o perfil de conhecimento sobre sistemas adesivos e verificar os fatores que influenciam nesse desfecho, com ênfase na formação profissional. A coleta de dados foi realizada pormeio de um questionário levando em consideração: I. Perfil do profissional; II. Conhecimento, uso e preferências sobre os sistemas adesivos. A amostra foi composta por 501 cirurgiões-dentistas brasileiros e os dados foram analisados no programa Sigma Stat5.0 (p<0,05). O percentual mínimo de acertos das questões considerado adequado foi definido como 80%. Os resultados mostraram que apenas 46,3% dos profissionais demonstraram conhecimento adequado sobre o assunto. Além disso, verificou-se associação estatisticamente significativa entre o baixo nível de acertos e profissionais com preferência por sistemas adesivos simplificados (p=0,046), especialistas em ortodontia [OR=0,24 (0,08-0,67)] e cirurgiões-dentistas graduados em instituições privadas [OR=1,58 (1,03-2,42)]. Esse cenário alerta para a necessidade iminente de sanar essa fragilidade por meio de melhorias nas matrizes curriculares, além da educação continuada de docentes e constante atualização dos profissionais (AU).
Los sistemas adhesivos están directamente involucrados en los procedimientos más comunes de la práctica clínica dental, lo que hace que su conocimiento sea fundamental para los profesionales. El objetivo del presente estudio fue evaluar el perfil de conocimiento sobre sistemas adhesivos y verificar los factores que influyen en ese resultado, con énfasis en la formación profesional. La recolección de datos se realizó a través de un cuestionario teniendo en cuenta: I. Perfil del profesional; II. Conocimiento,uso y preferencias sobre los sistemas adhesivos. La muestra estuvo compuesta por 501 dentistas brasileños y los datos fueron analizados mediante el programa Sigma Stat 5.0 (p<0,05). El porcentaje mínimo de respuestas correctas a las preguntas considerado adecuado se definió en el 80%. Los resultados mostraron que sólo el 46,3% de los profesionales demostraron conocimientos adecuados sobre el tema. Además, hubo una asociación estadísticamente significativa entre el bajo nivel de aciertos y los profesionalescon preferencia por los sistemas adhesivos simplificados (p=0,046), especialistas en ortodoncia [OR=0,24 (0,08-0,67)] y odontólogos egresados de instituciones privadas [OR=1,58 (1,03-2,42)]. Este escenario advierte de la inminente necesidad de subsanar esta debilidad a través de mejoras en las matrices curriculares, además de la formación continua de los docentes y la constante actualización de los profesionales (AU).
Dental adhesive systems are directly involved in common procedures of clinical dentistry, which makes knowledge about this topic indispensable for professionals. The objectives of the current study are to analyze the knowledge profile of dental professionals about dental adhesive systems and verify factors that influence this closure, with emphasis on professional education. The data was collected using a list of questions that consider: I) Professional profile and II) Knowledge, use, and preferences of adhesive systems. The sample considers 501 Brazilian dentists and the data was analyzed using the software Sigma Stat 5.0 (p<0.05). The minimum percentual of correct questions considered adequate was defined as 80%. The results show that only 46.3% of the professionals demonstrated satisfactory knowledge on the subject. In addition, it verified relevant statistical association between low level of correct questions and professionals with preferences for simplified adhesive systems (p=0.046), orthodontic specialists [OR=0.24 (0.080.67)], and dentists with private education degrees [OR=1.58 (1.032.42)]. This context indicates the imminent necessity to resolve this weakness through improvements in the educational curriculum, as well as continuing education of faculty and constant updating of professionals (AU).
Assuntos
Masculino , Feminino , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Adesivos Dentinários/uso terapêutico , Odontólogos , Educação em Odontologia , Odontologia Baseada em Evidências , Estudos Epidemiológicos , Distribuição de Qui-Quadrado , Estudos Transversais/métodos , Inquéritos e Questionários , Interpretação Estatística de Dados , Estudo Observacional , Descrição de CargoRESUMO
Dental fluorosis can cause changes in the enamel surface, conditioning its functionality and esthetics. The application of dental adhesives is a treatment option; however, their use on fluorotic teeth can result in limitations. The aim of this study was to compare the shear bond strength of two different adhesives, one with 10-MDP and one without 10-MDP, in different degrees of dental fluorosis.This is an in vitro study on dental enamel samples, a total of 180 samples with the inclusion criteria were treated, randomly divided into two groups of 90, according to the type of dental adhesive, where each group was again divided into three groups of 30 samples, representing different degrees of dental fluorosis according to the Thylstrup-Fejerskov index (Group I: TF1 and TF2; Group II: TF3; Group III: TF4). Normality tests, two-factor ANOVA, and post-hoc tests were used to determine differences between the groups, with a significance level of 95%. As results, a statistically significant difference was shown between the use of dental adhesive with 10-MDP and the three groups of dental fluorosis (p=0.011), in addition, a Tukey post-hoc test on the groups treated with 10-MDP adhesive revealed a statistically significant difference between group I versus group II, and group I versus group III, (p=<0.05). It is concluded that the use of adhesive systems with 10-MDP presents a better shear bond strength on enamel with dental fluorosis grades I and II in the Thylstrup-Fejerskov index.
La fluorosis dental puede ocasionar cambios en la superficie del esmalte, condicionando su funcionalidad y estética, la aplicación de adhesivos dentales es una opción de tratamiento, sin embargo, su uso en dientes fluoroticos puede resultar en limitaciones. El objetivo de este estudio consistió en comparar la fuerza de adhesión a la cizalladura de dos diferentes adhesivos, uno con 10-MDP y otro sin 10-MDP, en diferentes grados de fluorosis dental. Se trata de un estudio in vitro en muestras de esmalte dental, un total de 180 muestras con los criterios de inclusión fueron tratadas, aleatoriamente divididas en dos grupos de 90, de acuerdo al tipo de adhesivo dental, donde cada grupo fue dividido nuevamente en tres grupos de 30 muestras, representando diferentes grados de fluorosis dental según el índice de Thylstrup- Fejerskov (Grupo I: TF1 y TF2; Grupo II: TF3; Grupo III: TF4). Para determinar diferencias entre los grupos se utilizaron pruebas de normalidad, ANOVA de dos factores, y pruebas post-hoc, con un nivel de significancia de 95%. Como resultados, se mostró una diferencia estadísticamente significativa entre el uso de adhesivo dental con 10- MDP y los tres grupos de fluorosis dental (p=0.011), además, una prueba post hoc de Tukey sobre los grupos tratados con adhesivo 10-MDP revelaron una diferencia estadísticamente significativa entre el grupo I frente al grupo II, y el grupo I frente al grupo III, (p=<0.05) Se concluye que el uso de sistemas adhesivos con 10-MDP presentan una mejor resistencia de adhesión al cizallamiento en esmalte con grados de fluorosis dental I y II en el índice de Thylstrup-Fejerskov
Assuntos
Adesivos Dentinários/uso terapêutico , Fluorose Dentária/diagnóstico , Cimentos de ResinaRESUMO
OBJECTIVES: The present study evaluated the influence of a flowable resin layer on bond strength between resin cement and a universal adhesive applied using an immediate dentin sealing (IDS) technique. METHODS AND MATERIALS: Coronary portions of bovine teeth were randomly divided into six groups (n=15). In the IDS.U group, the exposed dentin was immediately sealed with the Single Bond Universal adhesive (3M ESPE) following the self-etching protocol. In the IDS.UF group, a layer of Filtek Z350 (3M ESPE) flow resin was applied over the universal adhesive. In the DDS (control) group, the dentin was kept "fresh" and delayed dentin sealing was performed. After 24 hours in distilled water at 37°C, dentin surfaces were treated with pumice, phosphoric acid, and the application of the universal adhesive in the IDS.U and IDS. UF groups. The DDS group was treated with pumice and the universal adhesive was applied. The samples received cylinders of resin cement Rely X Ultimate (3M ESPE) made with the aid of starch tubes of 0.96 mm in diameter and 2 mm in length. They were submitted to the microshear bond strength test (µSBS) at 0.5 mm/min, after 24 hours (T1) and 3 months (T2). The fracture areas were evaluated qualitatively using a DSM 300 microscope (KOZO) with 45× magnification and classified as: adhesive, cohesive in cement, cohesive in dentin, or mixed. Samples were analyzed by scanning electron microscopy (SEM). The data were compared statistically between groups using the Kruskal-Wallis test, and intra-groups using the Mann-Whitney test (α=0.05). RESULTS: There were no significant differences between groups for the bond strength values (p>0.05). The IDS.UF group showed higher values at 3 months, when compared to the values of 24 hours (p<0.001). All groups showed a predominance of adhesive fracture (86.7% to 100%). SEM showed dentinal tubules exposed in the IDS.U and DDS groups; in the IDS.UF group, the tubules were completely sealed. CONCLUSIONS: The flow resin can be used on the adhesive when using the IDS technique because it increased the bond strength values after 3 months and promoted effective sealing of the dentinal tubules.
Assuntos
Colagem Dentária , Cimentos de Resina , Animais , Bovinos , Colagem Dentária/métodos , Cimentos Dentários/química , Cimentos Dentários/uso terapêutico , Análise do Estresse Dentário , Dentina , Adesivos Dentinários/química , Adesivos Dentinários/uso terapêutico , Teste de Materiais , Cimentos de Resina/química , Cimentos de Resina/uso terapêutico , Resistência à TraçãoRESUMO
OBJECTIVES: This double-blind, randomized clinical trial evaluated the influence of dentin moisture on postoperative sensitivity (POS), as well as, on clinical performance in posterior bulk-fill composite restorations, using a universal adhesive, until 12 months after clinical service. METHODS AND MATERIALS: In accordance with a split-mouth design, 45 patients received posterior restorations, restored with a bulk-fill resin composite (Filtek Bulk Fill, 3M Oral Care) and a universal adhesive used in etch-and-rinse mode (SBU; Single Bond Universal Adhesive), which were applied on dry or moist dentin, with a cavity depth of at least 3 mm. Three operators placed 90 Class I/Class II restorations. Patients were evaluated for spontaneous and stimulated POS in the baseline, and after 48 hours, 7 days, and at 6 and 12 months. In addition, secondary parameters (marginal discoloration, marginal adaptation, fracture, and recurrent caries) were evaluated by World Dental Federation (FDI) criteria after 7 days and at 6 and 12 months. Statistical analyzes were performed using the Chi-square, Fisher exact, Friedman, Kruskall-Wallis, and Mann-Whitney tests (α=0.05). RESULTS: No significant spontaneous and stimulated POS was observed when SBU was applied in dry and moist dentin (p>0.05). A significant and higher risk of spontaneous POS (20.0%; 95%CI 10.9-33.82 for dry dentin and 22.22%; 95%CI 12.54-36.27 for moist dentin) occurred up to 48 hours after restoration placement for the dry and moist dentin groups (p<0.02). However, the POS intensity was mild up to 48 hours with no significant difference between dry and moist dentin groups (p>0.79). When secondary parameters were evaluated, no significant differences between the groups were observed. CONCLUSION: Dentin moisture did not influence POS in posterior bulk-fill composite restorations when associated with a universal adhesive applied in etch-and-rinse mode.
Assuntos
Cárie Dentária , Adesivos Dentinários , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Cimentos Dentários , Adaptação Marginal Dentária , Restauração Dentária Permanente/métodos , Dentina , Adesivos Dentinários/química , Adesivos Dentinários/uso terapêutico , Humanos , Cimentos de Resina/químicaRESUMO
OBJECTIVES: To evaluate the 5-year clinical performance of two-step etch-and-rinse adhesives in noncarious cervical lesions (NCCL). METHODS AND MATERIALS: The sample comprised 35 adults with at least two similar-sized NCCL. Seventy restorations were placed, according to one of the following groups: Adper Single Bond 2 (SB) and Ambar (AM). The restorations were placed incrementally using a resin composite (Opallis). The restorations were evaluated at baseline and after 6 and 18 months and 5 years using some items of the FDI criteria. The differences in the ratings of the two materials after 6 months, 18 months, and 5 years were performed with Friedman repeated measures ANOVA by rank and McNemar test for significance in each pair (α=0.05). RESULTS: Five patients did not attend the 60-month recall. No significant differences were observed between the materials for any criteria evaluated. Twenty-one restorations failed (12 for SB and 9 for AM) after 60 months. Thus, the retention rate for SB at 60 months were 55.6% for SB and 71% for AM (p=0.32). After 60 months, 12 restorations (6 for SB and 6 AM) showed some loss of marginal adaptation (p=1.0). Slight marginal discoloration was observed in 10 restorations (6 for SB and 4 AM; p=0.91). Five restorations (2 for SB and 3 for AM) showed recurrences of caries (p=1.0). CONCLUSIONS: Both two-step etch-and-rinse adhesives-Adper Single Bond 2, a polyalkenoic acid-containing adhesive, and Ambar, a 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing adhesive-showed acceptable clinical performance after 60 months.
Assuntos
Cárie Dentária , Adesivos Dentinários , Adesivos , Adulto , Cor , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Cárie Dentária/patologia , Adaptação Marginal Dentária , Restauração Dentária Permanente/métodos , Adesivos Dentinários/química , Adesivos Dentinários/uso terapêutico , Humanos , Cimentos de Resina/química , Cimentos de Resina/uso terapêutico , Colo do Dente/patologiaRESUMO
This study evaluated the influence of new monomers derived from cashew nut shell liquid (CNSL) applied for dentin biomodification on resin-dentin bond strength, nanoleakage, and micropermeability to sound and artificially-created caries-affected dentin. Human dentin specimens were assigned to five groups, according to the following dentin pretreatment solutions: Absolute ethanol (control), 2 wt% grape seed extract (Vitis vinifera), 2 wt% cardol [from cashew nut shell liquid (CNSL)], 2 wt% cardol-methacrylate or 2 wt% cardanol-methacrylate applied on sound and artificial caries-affected dentin. Specimens were analyzed after 24 hour or 1 year of water storage. Microtensile bond strength (µTBS) (n=6), interface micropermeability (n=3), and silver nanoleakage (n=6) were assessed using a universal testing machine, confocal laser scanning microscope, and scanning electron microscope, respectively. In sound dentin, no difference in bond strength was observed between the groups in either storage period. In artificial caries-affected dentin, pretreatment with cardol-methacrylate resulted in statistically higher bond strength than all the other treatments in both storage periods. Cardol-methacrylate treatment resulted in less nanoleakage, along with improved interfacial integrity, compared to further treatments in artificial caries-affected dentin. Regarding micropermeability analysis, all treatments depicted deficient sealing ability when applied on artificial caries-affected dentin, with the presence of gaps in the control group. In conclusion, cardol-methacrylate is a promising plant-derived monomer to reinforce the hybrid layer, since it preserved resin-dentin bond strength and improved dentin bonding, especially to caries-affected dentin, a well-known harsh substrate for adhesion longevity.
Assuntos
Colagem Dentária , Cárie Dentária , Colagem Dentária/métodos , Cárie Dentária/terapia , Suscetibilidade à Cárie Dentária , Dentina , Adesivos Dentinários/química , Adesivos Dentinários/uso terapêutico , Humanos , Teste de Materiais , Metacrilatos , Cimentos de Resina/química , Resistência à TraçãoRESUMO
O objetivo deste estudo clínico, controlado, randomizado, cego e prospectivo foi de avaliar a efetividade clínica de restaurações em lesões não cariosas (cavidades Classe V) realizadas em superfícies dentais pré-tratadas ou não com laser de Er:YAG e utilizando dois sistemas adesivos autocondicionantes. Este estudo foi realizado com um total de 91 lesões e divididas em 4 grupos (n = 23) :G1(FL): Sem pré-tratamento e utilizando o adesiso FL-Bond II/Shofu; G2 (CF): sem pré-tratamento e utilizando o adesivo Clearfil SE Bond 2/Kuraray Noritake; G3 (Laser + FL): pré-tratamento associado ao uso do FL-Bond II/Shofu e G4 (Laser + CF): pré-tratamento associado ao uso do Clearfil SE Bond 2/Kuraray Noritake Os dentes avaliados foram os pré-molares de ambas as arcadas. A avaliação foi feita imediatamente após o tratamento e ao longo do tempo, em 3, 6 e 12 meses após a finalização da restauração. Para a avaliação da sensibilidade foi considerado a EVA (Escala Visual Analógica) e para a qualidade da restauração o método do USPHS modificado, considerando a avaliação de perda de retenção, integridade marginal, pigmentação marginal, presença de lesão de cárie em margem de restauração, vitalidade pulpar e sensibilidade pós-operatória. Os dados foram registrados em tabelas de frequência, e os escores transformados em postos para a aplicação do teste ANOVA. A significância estatística foi considerada para valores de p<0,05. Para os resultados da avaliação de sensibilidade houve uma diferença estatística significante da sensibilidade ao longo do tempo (p<0,001), sendo que essa diferença se deu a partir da avaliação T1 (48 horas) em todos os grupos. Em relação aos critérios avaliados no USPHS, foram encontrados variações estatísticas em alguns tópicos: Pigmentação marginal - G1 (FL) (p=0,041) e G2 ( Laser + FL) (p=0,009) e Integridade marginal G1(FL)( p=0,036). Os demais grupos e critérios não apresentaram variações estatísticas significantes.Pré-tratamentos com laser Er:YAG podem ser uma alternativa viável em restaurações adesivas do tipo classe V; no entanto, nenhum efeito sinérgico de ambos os tratamentos combinados foi observado.
The objective of this clinical, controlled, randomized, blinded and prospective study was to evaluate the clinical effectiveness of restorations in non-carious lesions (Class V cavities) performed on dental surfaces pre-treated or not with Er:YAG laser and using two adhesive systems self-conditioning. This study was carried out with a total of 91 lesions and divided into 4 groups (n = 23) :G1(FL): No pre-treatment and using the FL-Bond II/Shofu adhesive; G2 (CF): without pre-treatment and using Clearfil SE Bond 2/Kuraray Noritake adhesive; G3 (Laser + FL): pre-treatment associated with the use of FL-Bond II/Shofu and G4 (Laser + CF): pre-treatment associated with the use of Clearfil SE Bond 2/Kuraray Noritake The teeth evaluated were the premolars of both arcades. Assessment was performed immediately after treatment and over time, at 3, 6, and 12 months after completion of the restoration. The VAS (Visual Analogue Scale) was used for the sensitivity assessment and the modified USPHS method for the quality of the restoration, considering the assessment of loss of retention, marginal integrity, marginal pigmentation, presence of caries in the restoration margin. , pulp vitality and postoperative sensitivity. Data were recorded in frequency tables, and the scores were transformed into ranks for the application of the ANOVA test. Statistical significance was considered for values of p<0.05. For the results of the sensitivity evaluation, there was a statistically significant difference in sensitivity over time (p<0.001), and this difference occurred from the T1 evaluation (48 hours) in all groups. Regarding the criteria evaluated at the USPHS, statistical variations were found in some topics: Marginal pigmentation - G1 (FL) (p=0.041) and G2 (Laser + FL) (p=0.009) and Marginal integrity - G1(FL)( p =0.036). The other groups and criteria did not present significant statistical variations. Pretreatments with Er:YAG laser can be a viable alternative in class V adhesive restorations; however, no synergistic effect of both treatments combined was observed.
Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Doenças Dentárias/terapia , Adesivos Dentinários/uso terapêutico , Restauração Dentária Permanente/métodos , Lasers de Estado Sólido/uso terapêutico , Método Simples-Cego , Estudos Prospectivos , Seguimentos , Resultado do Tratamento , Sensibilidade da DentinaRESUMO
La adhesión a dentina con sistemas adhesivos polimé-ricos representa un desafío que surge de la necesi-dad de vincular un sustrato dentario heterogéneo y variable con materiales que presentan todavía cier-tos aspectos a atender para poder conseguir el máxi-mo desempeño. El propósito del presente artículo es evaluar algunas de las estrategias propuestas para mejorar la adhesión a dentina, y sugerir un protocolo de trabajo con los diferentes tipos de sistemas adhesivos (AU)
Dentin bonding with polymeric adhesive systems represents a challenge that arises from the need to link a heterogeneous and variable dental substrate with materials that still have certain aspects to be addressed in order to achieve maximum performance. The aim of this article is to evaluate some of the proposed strategies to improve dentin bonding and to suggest a protocol for each different type of bonding systems (AU)
Assuntos
Protocolos Clínicos , Adesivos Dentinários/uso terapêutico , Dentina/efeitos dos fármacos , Ácidos Fosfóricos/química , Condicionamento Ácido do Dente/métodos , Camada de Esfregaço , Resinas Compostas/química , Esmalte Dentário/efeitos dos fármacos , PolimerizaçãoRESUMO
OBJECTIVE: To evaluate the mechanical stability and the proteolytic activity of bonds created by a two-step, etch-and-rinse adhesive applied to cross-linked and air-dried etched dentin. METHODS: Flat dentin surfaces were produced in 64 extracted sound human molars. The dentin was etched with 35% phosphoric acid for 15 seconds, and then the teeth were divided into groups according to the cross-linking solution applied on the etched dentin. Group 1: 5% grape seed extract (GSE), Group 2: 5% glutaraldehyde, Group 3: Gluma Desensitizer, or Group 4: deionized water (control). Solutions were applied for 60 seconds, followed by rinse and blot drying. Then, the teeth were separated into two subgroups where the etched dentin was kept moist or air-dried. The adhesive was applied followed by a composite resin buildup. After 24 hours, the teeth were cut into beams (0.81 mm²) that were tested for microtensile strength immediately or after 12 months of aging in a 37°C saliva-like buffer. Additional teeth (n=32) were bonded as described and cut into 0.5-mm-thick slabs. The slabs were prepared for nanoleakage (scanning electron microscopy) and in situ zymography (EnzChek Protease Assay Kit). Bond strength data were submitted to ANOVA and Tukey tests (α =0.05). RESULTS: Significant reduction in immediate bond strength (ca 65%) and increase in proteolytic activity was seen when the etched dentin was air dried without previous cross-linking biomodification. Conversely, bond strengths did not differ from those produced on wet dentin when collagen was cross-linked before air drying, irrespective of the solution applied. For both moist and air-dried etched dentin, collagen cross-linking resulted in mechanically stable bonds and reduced proteolytic activity after 12 months of storage. CONCLUSION: Bonds produced by the application of a two-step, etch-and-rinse adhesive to cross-linked, air-dried, etched dentin were mechanically stable and revealed reduced proteolytic activity after 1 year of aging.
Assuntos
Colagem Dentária , Adesivos Dentinários , Colágeno , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Colagem Dentária/métodos , Cimentos Dentários/uso terapêutico , Dentina , Adesivos Dentinários/química , Adesivos Dentinários/uso terapêutico , Teste de Materiais , Cimentos de Resina/química , Cimentos de Resina/uso terapêutico , Resistência à TraçãoRESUMO
PURPOSE: The following PICO (Patient/Population, Intervention, Comparison, and Outcomes) question was proposed: "Are retention rates of composite resin restorations in noncarious cervical lesions (NCCLs) when using adhesives considered "gold standard" (OptiBond FL and Clearfil SE Bond) higher than those obtained with other adhesives brands"? METHODS: A search was performed in February 2019 (updated in November 2019) in the PubMed/MEDLINE, EMBASE, LILACS, BBO, Web of Science, Cochrane Library, Grey Literature, and IADR abstracts (1990-2018); unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (RCTs) conducted in NCCLs that compared either OptiBond FL or Clearfil SE Bond adhesive with other commercially available adhesives were included. The risk of bias (RoB) was applied by using the Cochrane Collaboration tool. A meta-analysis was performed for retention rates at different follow-up times using a random effects model for both the adhesives. Heterogeneity was assessed with the Cochran Q test and I2 statistics. Grading of Recommendations: Assessment, Development and Evaluation (GRADE) assessed the quality of evidence. RESULTS: After removal of duplicates and noneligible articles, 25 studies remained for qualitative synthesis, as one study was common to the two adhesives, of which 9 studies were used for the OptiBond FL meta-analysis and 14 for the Clearfil SE Bond meta-analysis. No significant differences were observed for retention rates in follow-up periods of 12-24 months (p=0.97), 36-48 months (p=0.72), or 108-156 months (p=0.73) for OptiBond FL; and for 12-24 months (p=0.10) and 36-48 months (p=0.17) for Clearfil SE Bond. A significant difference was only found for OptiBond FL at 60-96 months (p=0.02), but only three studies were included in this meta-analysis. CONCLUSIONS: The evidence from available RCTs conducted in NCCLs that compared OptiBond FL or Clearfil SE Bond does not support the widespread concept that these adhesives are better than any other competitive brands available in the dental market.
Assuntos
Colagem Dentária , Restauração Dentária Permanente , Resinas Compostas/uso terapêutico , Cimentos Dentários/uso terapêutico , Adesivos Dentinários/uso terapêutico , Humanos , Cimentos de ResinaRESUMO
The objective of this in vitro study was to assess the effects of two antioxidants (sodium ascorbate [SA] and alpha-tocopherol [AT]) on the adhesive interface and dentin bond strength immediately after bleaching with 38 % hydrogen peroxide (38HP) in endodontically-treated teeth. Two stages of experimentation were carried out. Bovine incisors were allocated into four groups (n = 10/group for each experiment): NB, non-bleached restored crowns; 38HP, bleached and immediately restored crowns; 38HP-SA, bleached crowns and SA use; and 38HP-AT, bleached crowns and AT use. Hybrid layer length in dentin (μm) and bond strength (MPa) were assessed with confocal microscopy laser and micro-shear bond strength (μSBS) test, respectively. Failure mode was determined by stereomicroscope. Data analysis was performed with analysis of variance (ANOVA) and Kruskal-Wallis, Dunn, Tukey, and Fisher-exact tests (a = 0.05). Higher values of hybrid layer length were observed similarly in the NB and 38HP-SA groups. The highest μSBS mean values were observed in the NB group (18 .51 ? 1.33), whereas the SBS values for 38HP-AT (1.68 ? 0.32) were similar to the 38HP group (1.61 ? 0.51) (p > 0.05) and significantly lower than the 38HP-SA group (5.78 ? 0.71). Adhesive failures were predominant in the 38HP and 38HP-AT groups. Cohesive and mixed failures were mostly observed in the NB and 38HP-SA groups, respectively. In conclusion, AT has no immediate effect on the hybrid layer formation and μSBS of dentin. Although SA promotes an increase in hybrid layer formation, it was not reflected in the μSBS values.
El objetivo de este estudio in vitro fue evaluar los efectos de dos antioxidantes (ascorbato de sodio [AS] y alfa-tocoferol [AT]) sobre la interfaz adhesiva y la fuerza de unión de la dentina inmediatamente después del blanqueamiento con peróxido de hidrógeno al 38 % (38HP) en endodoncia. -Dientes tratados. Se llevaron a cabo dos etapas de experimentación. Los incisivos bovinos se dividieron en cuatro grupos (n = 10 / grupo para cada experimento): NB, coronas restauradas no blanqueadas; 38HP, coronas blanqueadas y restauradas inmediatamente; 38HP- AS, coronas blanqueadas y uso SA; y 38HP-AT, coronas blanqueadas y uso de AT. La longitud de la capa híbrida en dentina (μm) y la fuerza de unión (MPa) se evaluaron con láser de microscopía confocal y la prueba de fuerza de unión por micro-cizallamiento (μSBS), respectivamente. El modo de falla se determinó mediante estereomicroscopio. El análisis de los datos se realizó con análisis de varianza (ANOVA) y pruebas de Kruskal-Wallis, Dunn, Tukey y Fisher (α = 0,05). De manera similar, se observaron valores más altos de longitud de capa híbrida en los grupos NB y 38HP-AS. Los valores medios más altos de μSBS se observaron en el grupo NB (18,51 ? 1,33), mientras que los valores de SBS para 38HP-AT (1,68 ? 0,32) fueron similares a los del grupo 38HP (1,61 ? 0,51) (p> 0,05) y significativamente más bajos que el grupo 38HP-AS (5,78 ? 0,71). Las fallas adhesivas fueron predominantes en los grupos de 38HP y 38HP-AT. Las fallas cohesivas y mixtas se observaron principalmente en los grupos NB y 38HP-AS, respectivamente. En conclusión, la AT no tiene un efecto inmediato sobre la formación de la capa híbrida y el μSBS de dentina. Aunque AS promueve un aumento en la formación de capas híbridas, no se refleja en los valores de μSBS.
Assuntos
Humanos , Ácido Ascórbico/uso terapêutico , Colagem Dentária/métodos , alfa-Tocoferol/uso terapêutico , Peróxidos/uso terapêutico , Clareamento Dental/métodos , Adesivos Dentinários/uso terapêutico , Resistência ao Cisalhamento , Análise do Estresse Dentário , Clareadores Dentários/uso terapêutico , Peróxido de Hidrogênio/uso terapêuticoRESUMO
RESUMEN La preservación de tejido dental sano contribuye a la práctica de una Odontología conservadora, permitiendo la aplicación de los principios biológicos y mecánicos de una forma más predecible. Las preparaciones cavitarias mínimamente invasivas son el complemento de la correcta selección de materiales adhesivos y de resina compuesta. La correcta aplicación de un protocolo adhesivo nos proporcionará resultados estéticos imperceptibles y un longevo desempeño clínico.
ABSTRACT The preservation of healthy dental structures contributes to the practice of a conservative dentistry. This concept involves the implementation of biological and mechanical principles in a more predictable manner. Minimally invasive cavity preparations are the complement to the selection of adhesive and composite resin materials. The correct application of an adhesive protocol will provide imperceptible aesthetic restorations and adequate clinical performance.
Assuntos
Humanos , Feminino , Adulto , Adesivos Dentinários/uso terapêutico , Resinas Compostas/uso terapêutico , Hipoplasia do Esmalte Dentário/cirurgia , Restauração Dentária Permanente/métodosRESUMO
La incorporación de nanopartículas a la fase inorgánica de las resinas compuestas procura mejorar propiedades mecánicas y ópticas, aumentando el porcentaje de relleno y reduciendo consecuentemente los fenómenos de contracción de polimerización. El caso clínico que se presenta refleja alguna de las indicaciones en las cuales se aplican estas innovaciones tecnológicas. (AU)
Incorporation of nanosized fillers in the inorganic phase of resin composites aims at improving their mechanical and optical properties, increasing the proportion of ceramic particles thus reducing the polymerization shrinkage. The case reported in this article reflects one of the indications of these enhanced materials, where technological innovations are applied. (AU)
Assuntos
Humanos , Adulto , Dente Pré-Molar , Resinas Compostas/uso terapêutico , Nanotecnologia/métodos , Cimentos Dentários/uso terapêutico , Restauração Dentária Permanente/métodos , Adesivos Dentinários/uso terapêutico , Esmalte Dentário , OdontologiaRESUMO
Objective: to compare, through a systematic review and a meta-analysis, the clinical effect of the adhesive strategies of universal adhesives (UA) in the treatment of non-carious cervical lesions (NCCLs). material and method: a search of the literature was carried out up to january 2018, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, SIGLE, LILACS, BBO, Google Scholar and the Central Register of Cochrane Clinical Trials. the selection criteria of the studies were as: randomized clinical trials, with a maximum age of 5 years and which report the clinical effects (marginal adaptation, discoloration or marginal staining, presence of secondary caries, postoperative sensitivity, retention and fractures) of the UA in the treatment of NCCLs. the risk of study bias was analyzed through the Cochrane Handbook of systematic reviews of interventions. results: the search strategy resulted in eight articles that reported no difference in marginal adaptation, discoloration or marginal staining, presence of secondary caries and postoperative sensitivity among the adhesive strategies of the UA; however they reported a difference between the retention and the presence of fractures, with the conventional adhesive strategy resulting in a better clinical effect. conclusion: the reviewed literature suggests that the conventional adhesive strategy of UAs results in greater retention and absence of fractures in the treatment of NCCLs.
Assuntos
Humanos , Colagem Dentária/métodos , Colo do Dente , Cárie Dentária/terapia , Restauração Dentária Permanente/métodos , Descoloração de Dente , Metanálise como Assunto , Adesivos Dentinários/uso terapêuticoRESUMO
BACKGROUND/AIM: Several strategies have been developed for tooth fragment reattachment following fracture. Although many techniques have been reported, there is no consensus on which one has the best results in terms of the bond strength between the fragment and the dentin over time. The aim of this study was to assess the currently reported tooth fragment reattachment techniques for fractured crowns of anterior teeth. MATERIALS AND METHODS: The PubMed, LILACS, Web of Science, Cochrane, and Scopus databases were searched in October 2016, and the search was updated in February 2017. A search of the gray literature was performed in Google Scholar and OpenGrey. Reference lists of eligible studies were cross-checked to identify additional studies; gray literature and ongoing trials were investigated. Two authors assessed studies to determine inclusion and undertook data extraction. Case reports/series of three or more cases, cross-sectional studies, cohort studies, and in vivo clinical trials in all languages were included. RESULTS: Five articles remained after screening. These studies predominantly reported on fragment reattachment with composite resin and resin cement. There was little consistency among the studies in regard to the technique used for tooth fragment reattachment and length of the follow-up period. CONCLUSIONS: According to the evidence found in the studies included in this review, simple tooth fragment reattachment was the preferred reattachment technique. An increase in the bond strength between tooth fragment and dentin was observed when an intermediate material was used. Further investigation is needed, using standard follow-up periods and larger samples.
Assuntos
Colagem Dentária/métodos , Restauração Dentária Permanente/métodos , Adesivos Dentinários/uso terapêutico , Fraturas dos Dentes/terapia , Resinas Compostas/uso terapêutico , Humanos , Cimentos de Resina/uso terapêutico , Coroa do DenteRESUMO
OBJECTIVE: This double-blind randomized clinical trial evaluates the influence of dentin roughening (RO) on the clinical behavior of a new universal multi-mode adhesive (Tetric N-Bond Universal; Ivoclar-Vivadent) applied as self-etch and as etch-and-rinse in non-carious cervical lesions (NCCLs). METHODS: A total of 192 restorations were randomly placed in 48 patients according to the following groups: ER - Etch-and-rinse (no preparation); SE - self-etch (no preparation); ER+RO and; SE+RO. The resin composite Empress Direct (Ivoclar-Vivadent) was placed incrementally. The restorations were evaluated after one week (baseline), 6 and 18 months, using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α=0.05). RESULTS: Fifteen restorations were lost at 18 months (3 for SE, 2 for ER, 5 for SE+RO and 5 for ER+RO) (p >0.05 between groups). Post-operative sensitivity wasn't observed in any of the recall periods. Eighty-four restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall using the FDI criteria (24 for SE, 18 for ER, 22 for SE+RO and 20 for ER+RO; p >0.05 between groups). Nineteen restorations were considered to have minor discrepancies in marginal discoloration at the 18-month recall (10 for SE, 03 for ER, 05 for SE+RO and 01 for ER+RO; p >0.05 between groups). CONCLUSION: The dentin roughening before application of Tetric N-Bond Universal as self-etch and etch-and-rinse didn't affect the clinical behavior of composite restorations placed in NCCLs.