Carlos Eduardo Francci

Composite pre-heating: Effects on marginal adaptation, degree of conversion and mechanical properties

OBJECTIVES This study evaluated the effect of composite pre-polymerization temperature and energy density on the marginal adaptation (MA), degree of conversion (DC), flexural strength (FS), and polymer cross-linking (PCL) of a resin composite (Filtek Z350, 3M/ESPE). METHODS For MA, class V cavities (4 mm x 2 mm x 2 mm) were prepared in 40 bovine incisors. The adhesive system Adper Single Bond 2 (3M/ESPE) was applied. Before being placed in the cavities, the resin composite was either kept at room-temperature (25 degrees C) or previously pre-heated to 68 degrees C in the Calset device (AdDent Inc., Danbury, CT, USA). The composite was then light polymerized for 20 or 40s at 600 mW/cm(2) (12 or 24 J/cm(2), respectively). The percentage of gaps was analyzed by scanning electron microscopy, after sectioning the restorations and preparing epoxy resin replicas. DC (n=3) was obtained by FT-Raman spectroscopy on irradiated and non-irradiated composite surfaces. FS (n=10) was measured by the three-point-bending test. KHN (n=6) was measured after 24 h dry storage and again after immersion in 100% ethanol solution for 24h, to calculate PCL density. Data were analyzed by appropriate statistical analyses. RESULTS The pre-heated composite showed better MA than the room-temperature groups. A higher number of gaps were observed in the room-temperature groups, irrespective of the energy density, mainly in the axial wall (p<0.05). Composite pre-heating and energy density did not affect the DC, FS and PCL (p>0.05). SIGNIFICANCE Pre-heating the composite prior to light polymerization similar in a clinical situation did not alter the mechanical properties and monomer conversion of the composite, but provided enhanced composite adaptation to cavity walls.

Influence of Photoactivation Protocol and Light Guide Distance on Conversion and Microleakage of Composite Restorations

PURPOSE To evaluate the effect of light guide distance and the different photoactivation methods on the degree of conversion (DC) and microleakage of a composite. METHODS AND MATERIALS Three photoactivation protocols (600 mW/cm2 x 40 seconds; 400 mW/cm2 x 60 seconds or 200 mW/cm2 x 20 seconds, followed by 500 mW/cm2 x 40 seconds) and three distances from the light source (0, 3 or 7 mm) were tested. Cylindrical specimens (5 mm diameter; 2 mm tall; n=3) were prepared for the DC test (FT-Raman). Class V cavities were made in 90 bovine incisors to conduct the microleakage test. The specimens were conditioned for 15 seconds with phosphoric acid (37%), followed by application of the adhesive system Prime & Bond NT (Dentsply/Caulk). The preparations were restored in bulk. The specimens were stored for 24 hours in distilled water (37 degrees C) before being submitted to the silver-nitrate microleakage protocol. The restorations were sectioned and analyzed under 25x magnification. RESULTS Statistical analyses (two-way ANOVAs and Tukey test, alpha=0.05) found significance only for the factor distance (p=0.015) at the top of the composite for the DC test. Conversion was statistically lower for the 7 mm groups compared to the 0 and 3 mm groups, which were equivalent to each other. At the bottom of the specimens, none of the factors or interactions was significant (p<0.05). The Kruskal-Wallis test showed that, in general, the soft-start method led to lower microleakage scores when compared to the continuous modes, mainly when associated with a distancing of 7 mm (p<0.01). With the exception of specimens irradiated with 400 mW/cm2 that did not demonstrate variations on scores for the distances tested, higher microleakage was observed for shorter distances from the light source. CONCLUSIONS Soft-start methods may reduce microleakage when the light guide distancing provides a low level of irradiance, which also causes a discrete reduction in the DC.

Temperature Increase at the Light Guide Tip of 15 Contemporary LED Units and Thermal Variation at the Pulpal Floor of Cavities: An Infrared Thermographic Analysis

In this study, a comprehensive investigation on the temperature increase at the light guide tip of several commercial light-emitting diode (LED) light-curing units (LCUs) and the associated thermal variation (ΔT) at the pulpal floor of dental cavities was carried out. In total, 15 LEDs from all generations were investigated, testing a quartz-tungsten-halogen (QTH) unit as a reference. The irradiance level was measured with a power meter, and spectral distribution was analyzed using a spectrometer. Temperature increase at the tip was measured with a type-K thermocouple connected to a thermometer, while ΔT at the pulpal floor was measured by an infrared photodetector in class V cavities, with a 1-mm-thick dentin pulpal floor. The relationship among measured irradiance, ΔT at the tip, and ΔT at the pulpal floor was investigated using regression analyses. Large discrepancies between the expected and measured irradiances were detected for some LCUs. Most of the LCUs showed an emission spectrum narrower than the QTH unit, with emission peaks usually between 450 and 470 nm. The temperature increase at the tip followed a logarithmic growth for LCUs with irradiance ≥1000 mW/cm(2), with ΔT at the tip following the measured irradiance linearly (R(2)=0.67). Linear temperature increase at the pulpal floor over the 40-second exposure time was observed for several LCUs, with linear association between ΔT at the pulpal floor and measured irradiance (R(2)=0.39) or ΔT at the tip (R(2)=0.28). In conclusion, contemporary LED units show varied irradiance levels that affect the temperature increase at the light guide tip and, as a consequence, the thermal variation at the pulpal floor of dental cavities.

Phosphoric acid concentration affects dentinal MMPs activity

OBJECTIVES To evaluate whether the concentration of phosphoric acid (PA) has an effect on the proteolytic activity of sound human demineralized dentin. It is hypothesized that the activity of matrix-bound and extracted enzymes depends on the PA concentration used to demineralize dentin. METHODS One-gram aliquots of mid-coronal human dentin powder were demineralized with 1wt%, 10wt% and 37wt% PA. Concentrations of released calcium were measured for each set of demineralization. Extracted MMP-2 was immunologically identified by western blot and its activity was determined by conventional gelatin zymography. Analysis of released hydroxyproline (HYP) and in situ zymography were performed to evaluate the activity of insoluble, bound-matrix enzymes. RESULTS The amount of released calcium from dentin powder treated with 37wt% PA was significantly higher (p≤0.05) than that obtained by dentin demineralization with 10wt% and 1wt% PA. Expression and activity of endogenous enzymes, extracted from or bound to dentin matrix, were detected for all samples regardless of the PA concentration. However, the expression and activity of extracted MMP-2 were significantly higher when dentin was treated with 10wt% PA (p<0.05), followed by 1wt% and 37wt% PA. Similarly, the highest concentration of released HYP (i.e. meaning higher percentage of collagen degradation) and the highest activity in in situ zymography were observed when dentin samples were treated with 10wt% PA (p<0.05). CONCLUSIONS It was confirmed that PA does not denature endogenous enzymes of dentin matrices, but it may somehow modulate the expression and activity of these enzymes in a concentration-dependent manner. CLINICAL SIGNIFICANCE Endogenous proteases have been identified and suggested to be responsible for the digestion of dentin matrix when activated by the acidic components of dental adhesives. Proteolytic activity of dentinal MMPs showed to be dependent on phosphoric acid concentration. The clinically-used concentration (37%) does not inhibit MMPs activity, but slows it.

Qualitative SEM/EDS analysis of microleakage and apical gap formation of adhesive root-filling materials

Objective The aim of this study was to compare the correspondence between gap formation and apical microleakage in root canals filled with epoxy resin-based (AH Plus) combined or not with resinous primer or with a dimethacrylate-based root canal sealer (Epiphany). Material and Methods Thirty-nine lower single-rooted human premolars were filled by the lateral condensation technique (LC) and immersed in a 50-wt% aqueous silver nitrate solution at 37ºC (24 h). After longitudinal sectioning, epoxy resin replicas were made from the tooth specimens. Both the replicas and the specimens were prepared for scanning electron microscopy (SEM). The gaps were observed in the replicas. Apical microleakage was detected in the specimens by SEM/energy dispersive spectroscopy (SEM/EDS). The data were analyzed statistically using an Ordinal Logistic Regression model and Analysis of Correspondence (α=0.05). Results Epiphany presented more regions containing gaps between dentin and sealer (p<0.05). There was correspondence between the presence of gaps and microleakage (p<0.05). Microleakage was similar among the root-filling materials (p>0.05). Conclusions The resinous primer did not improve the sealing ability of AH Plus sealer and the presence of gaps had an effect on apical microleakage for all materials.

The influence of handling on the elasticity of addition silicone putties

The handling of vinyl polysiloxane (addition silicone) impression putties with latex gloves is said to interfere with the setting of these impression materials. The aim of this study is to evaluate the effect of handling techniques on the setting of vinyl polysiloxane impression putties using several types of gloves. The setting of these materials was evaluated by means of an elasticimeter. Four vinyl polysiloxane putty impression materials and five brands of gloves (one made of vinyl, one of synthetic rubber, and three of natural rubber) were studied. Based on the type of glove, they were previously washed or not, and a spatula was used or not for initial mixing (before handmixing). The vinyl, the synthetic and one of the natural rubber gloves did not require the previous washing procedure and/or the use of a spatula for initial mixing. Two other natural rubber gloves - depending on the silicone -, showed satisfactory results only when the initial mixing was performed with a spatula. It was concluded that setting inhibition depends on the kind of vinyl polysiloxane impression material and the kind of gloves used, but when the initial mixing was performed with the spatula this setting inhibition was overcome. The results of this study also showed that it is possible to associate cross-contamination control and satisfactory performance of addition silicone putty materials. When doubts arise from the compatibility between vinyl polysiloxane impression putties and gloves, the initial mixing should be performed with a spatula.

A comparative study of bulk-fill composites: degree of conversion, post-gel shrinkage and cytotoxicity

Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukeys test (α = 0.05). All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4%) than that of conventional composites (1.7-2.1%). However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

Prefabricated resin veneer:A case report of a simplified restorative technique

Background: the aim of the study was to describe the step-by-step of clinical cases using prefabricated composite resin veneers (PCRVs), manufactured with the composite Brilliant New Generation (Coltene, Altstätten, Switzerland). Direct composite veneers presented some drawback as the difficult of execution and color instability of the composite over the time. The simplified application of the PCRVs presented as an interesting alternative in cases of smile asymmetry, large deficient restorations and discolored tooth. In the present investigation, the complete description of the PCRVs technique can help the dentist during the planning and execution of treatments with the Componeer system. Conclusion: the treatment with Componeer Brilliant NG showed excellent aesthetic results. PCRVs technique is simpler than direct composite veneers. The specific characteristics of the system can promote results with greater aesthetic longevity. It is important to highlight that this procedure does not replace the already established veneer technique with dental ceramics. Clinical implication: PCRVs presented an excellent surface gloss. Their dimensions based on the golden ratio facilitate the technique and turns as an excellent alternative in the aesthetic restorative treatment in the anterior region.