Eduardo Moreira da Silva

Surface degradation of composite resins by acidic medicines and ph-cycling

This study evaluated the effects of acidic medicines (Dimetapp® and Claritin®), under pH-cycling conditions, on the surface degradation of four composite resins (microhybrid: TPH, Concept, Opallis and Nanofilled: Supreme). Thirty disc-shaped specimens (Ø = 5.0 mm / thickness = 2.0 mm) of each composite were randomly assigned to 3 groups (n = 10): a control and two experimental groups, according to the acidic medicines evaluated. The specimens were finished and polished with aluminum oxide discs, and the surface roughness was measured by using a profilometer. After the specimens were submitted to a pH-cycling regimen and immersion in acidic medicines for 12 days, the surface roughness was measured again. Two specimens for each material and group were analyzed by scanning electron microscopy (SEM) before and after pH-cycling. Data were analyzed by the Students-t test, ANOVA, Duncans multiple range test and paired t-test (α=0.05). Significant increase in roughness was found only for TPH in the control group and TPH and Supreme immersed in Claritin® (p<0.05). SEM analyses showed that the 4 composite resins underwent erosion and surface degradation after being subjected to the experimental conditions. In conclusion, although the roughness was slightly affected, the pH-cycling and acidic medicines caused surface degradation of the composite resins evaluated. Titratable acidity seemed to play a more crucial role on surface degradation of composite resins than pH.

The diffusion kinetics of a nanofilled and a midifilled resin composite immersed in distilled water, artificial saliva, and lactic acid

This study investigated the diffusion kinetics of a nanofilled (Filtek Z350) and a midifill (Filtek P60) resin composite immersed in distilled water, artificial saliva and lactic acid. Resin composite specimens were desiccated, immersed in the media, weighed at suitable time intervals until they reached sorption equilibrium and were then desiccated again. Sorption and solubility (µg/mm3) were calculated based on ISO 4049:2000(E). The diffusion coefficient (m2.s−1) was determined according to Flick’s second law. The degree of conversion (DC%) was evaluated by FT-IR and the action of the media on the surfaces of the resin composite was evaluated by SEM. Z350 immersed in lactic acid presented the highest sorption (25.9 ± 1.3). The highest solubility was presented by Z350 immersed in lactic acid (5.6 ± 0.9), followed by P60 immersed in lactic acid (4.4 ± 0.5). The other groups presented no significant difference among them. The diffusion coefficients of both resin composites immersed in lactic acid and that of Z350 immersed in artificial saliva were significantly higher. The lowest diffusion coefficient was presented by P60 immersed in distilled water. The DC% was not significant, (p > 0.05). The SEM analysis showed that the effect of lactic acid on the resin composites was more deleterious than those of water and artificial saliva.

A critical analysis of the degree of conversion of resin-based luting cements.

Objective This study analyzed the degree of conversion (DC%) of four resin-based cements (All Ceram, Enforce, Rely X ARC and Variolink II) activated by two modes (chemical and dual), and evaluated the decrease of DC% in the dual mode promoted by the interposition of a 2.0-mm-thick IPS Empress 2 disc. Material and Methods In the chemical activation, the resin-based cements were prepared by mixing equal amounts of base and catalyst pastes. In the dual activation, after mixing, the cements were light-activated at 650 mW/cm2 for 40 s. In a third group, the cements were lightactivated through a 2.0-mm-thick IPS Empress 2 disc. The DC% was evaluated in a FT-IR spectrometer equipped with an attenuated total reflectance crystal (ATR). The data were analyzed by two-way ANOVA and Tukeys HSD test. Results For all resin-based cements, the DC% was significantly higher with dual activation, followed by dual activation through IPS Empress 2, and chemical activation (p<0.05). Irrespective of the activation mode, Rely X presented the highest DC% (p<0.05). Chemically activated Variolink and All Ceram showed the worst results (p<0.05). The DC% decreased significantly when activation was performed through a 2.0-mm-thick IPS Empress 2 disc (p<0.05). Conclusions The results of the present study suggest that resin-based cements could present low DC% when the materials are dually activated through 2.0 mm of reinforced ceramic materials with translucency equal to or less than that of IPS-Empress 2.

Long-term degradation of resin-based cements in substances present in the oral environment: influence of activation mode

Indirect restorations in contact with free gingival margins or principally within the gingival sulcus, where the presence of organic acids produced by oral biofilm is higher, may present faster degradation of the resin-based cement pellicle. Objectives: To investigate the degradation of four resin-based cements: Rely X ARC (R), Variolink II (V), enforce (E) and All Cem (A), after immersion in distilled water (DW), lactic acid (LA) and artificial saliva (AS) and to analyze the influence of the activation mode on this response. Material and Methods: Two activation modes were evaluated: chemical (Ch) and dual (D). In the dual activation, a two-millimeter thick ceramic disk (IPS empress System) was interposed between the specimen and light-curing unit tip. Specimens were desiccated, immersed in distilled water, artificial saliva and lactic acid 0.1 M at 37ºC for 180 days, weighed daily for the first 7 days, and after 14, 21, 28, 90 and 180 days and were desiccated again. Sorption and solubility (µg/mm3) were calculated based on ISO 4049. The data were submitted to multifactor analysis of variance (MANOVA) and Tukeys HSD test for media comparisons (α=0.05). Results: Sorption was higher after immersion in LA (p<0.05) and increased significantly with time (p<0.05). Sorption was influenced by the activation mode: Ch>D (p<0.05). The lowest solubility was presented by R (p<0.05). Conclusions: Lactic acid increased the degradation of resin-based cements. Moreover, the physical component of activation, i.e., light-activation, contributed to a low degradation of resin-based cements.

Influence of the degree of dentine mineralization on pulp chamber temperature increase during resin-based composite (RBC) light-activation

OBJECTIVES To analyse the influence of the degree of dentine mineralization on the pulp chamber temperature increase during composite light-activation. METHODS Dentine discs (2mm thick) obtained from recently extracted teeth or those with extensive dentine sclerosis were analysed by FT-IR spectrometry in order to choose the two discs with the greatest difference in the degree of mineralization. A model tooth was set up with the dentine discs between a molar with the pulp chamber exposed and a crown with a standardized class II cavity. A K-type thermocouple was introduced into the molar root until it came into contact with the dentine discs and the cavity was filled with P60 resin composite. The temperature rise was measured for 120s after light-activation began: Standard (S) 600 mW/cm(2)/40s; Ramp (R) 0-->800 mW/cm(2)/10s+800 mW/cm(2)/10s; Boost (B) 85 0mW/cm(2)/10s and LED (L) 1.300 mW/cm(2)/40s (n=10). The same protocol was repeated after grinding the dentine discs to 1.0 and 0.5mm thickness. RESULTS The temperature increase was significantly higher in dentine with high degree of mineralization (p<0.05). With respect to the dentine thickness, the following result was found: 2mm<1mm<0.5mm (p<0.05). The light-activation mode also presented significant difference as follows: S>R=L>B (p<0.05). CONCLUSIONS The higher the degree of dentine mineralization the greater the increase in pulp chamber temperature. The temperature increase was influenced by the light-polymerization mode and dentine thickness.

Influence of post-cure treatments on hardness and marginal adaptation of composite resin inlay restorations: an in vitro study

Objectives: The purpose of this study was to evaluate the Vickers hardness number (VHN) and the in vitro marginal adaptation of inlay restorations of three hybrid composite resins (Filtek Z250, Opallis and Esthet-X) subjected to two post-cure treatments. Material and Methods: For the microhardness test, three different groups were prepared in accordance with the post-cure treatments: control group (only light cure for 40 s), autoclave group (light cure for 40 s + autoclave for 15 min at 130°C); and microwave group (light cure for 40 s + microwave for 3 min at 450 W). To assess the marginal adaptation, the composite resin was inserted incrementally into a mesial-occlusal-distal cavity brass mold and each increment light-cured for 40 s. A previous reading in micrometers was taken at the cervical wall, using a stereomicroscope magnifying glass equipped with a digital video camera and image-analysis software. Subsequently, the specimens were subjected to the post-cure treatments (autoclave and microwave) and a reading was taken again at the cervical wall. Data were compared using ANOVA for the hardness test, split-plot ANOVA for the adaptation assessment and Tukeys test for multiple comparisons. A significance level of 5% was adopted for all analyses. Results: The post-cure treatments increased the hardness of conventional composites (p<0.001) and the gap values of inlay restorations (p<0.01). Filtek Z250 showed higher hardness (p<0.001) and lower gap values than Opallis and Esthet-X (p<0.05). Gap values did not exceed 90 μm for any of the experimental conditions. Conclusion: The post-cure treatments increased the VHN and the gap values on the cervical floor of composite resin inlays. Moreover, Filtek Z250 showed the best results, with higher hardness and lower gap values.

Influence of organic acids present in the oral biofilm on the microtensile bond strength of adhesive systems to human dentin.

This study evaluated the influence of organic acids present in the oral biofilm on the microtensile bond strength (μTBS) of adhesive systems to human dentin. Sixty occlusal dentin surfaces were wet ground with 600 grit SiC abrasive paper and divided into four groups according to the adhesive systems: Scotchbond Multipurpose (SMP), Adper Single Bond 2, Adper Scotchbond SE (ASE), and Clearfill SE Bond (CSE). After the adhesive systems were applied, a block of resin composite was built up on the dentin surfaces. After 24 h storage in distilled water at 37°C, the teeth were perpendicularly cut to obtain beams (1 mm(2)). For each adhesive system, the beams were divided into three groups according to storage media: artificial saliva (AS); propionic acid (PA), and lactic acid (LA). After 7 days storage at 37°C, the beams were submitted to μTBS testing. The μTBS ranged from 36.0 ± 1.6 (ASE-PA) to 52.5 ± 1.2 (CSE-AS). For all adhesive systems, the μTBS values after storage in PA were lower than those in AS. Except for the SMP, the values of μTBS after storage in LA were lower than those in AS. The adhesive ASE presented the lowest values of μTBs in the three media. The acids present in the oral biofilm may affect the bond strength of adhesive systems to human dentin.

Depth of cure of dental composites submitted to different light-curing modes

Objective: This study evaluated the depth of cure of five dental composites submitted to different light-curing modes. Material and Methods: Canal-shaped cavities with 5mm of length were prepared on the buccal surfaces of extracted third molars, and restored using P-60, A-110, Admira, Z-250 and Supreme resin composites. Materials were light-cured from the top, according to three modes (Group 1- Conventional (C): 500 mW/cm2/ 40 s; Group 2 – Soft-Start (SS):250 mW/cm2/ 20 s + 500 mW/cm2/ 20 s + 500 mW/cm2/ 10 s and Group 3 – LED: 250 mW/cm2/ 40 s). After that, cavity longitudinal surfaces were polished and marked with a millimeter scale of 4mm of length. Depth of cure was evaluated by means of Knoop hardness number (KHN), so that five indentations were performed at each millimeter. Original data were submitted to three-way ANOVA and Fishers LSD test (α = 0.01). Results: All materials presented a significant reduction on KHN from first to third millimeter. Regarding depth of cure, the results obtained for Conventional and Soft-Start modes were similar, but statistically superiors to those found for group 3 (LED). Conclusion: This performance may be related to the differences among energy densities obtained with different light-curing modes.

Analysis of gap formation at tooth-composite resin interface: effect of C-factor and light-curing protocol

Objective: The aim of this study was to evaluate the effect of C-factor and light-curing protocol on gap formation in composite resin restorations. Material and Methods: Cylindrical cavities with 5.0 mm diameter and three different depths (A=1.0, B=2.0 and C=3.0 mm) were prepared on the occlusal surface of 30 human molars and restored in a single increment with P 60. The composite resin was light-cured according to two protocols: standard - 850 mW/cm2 / 20 s and gradual - 100 up to 1000 mW/cm2/ 10 s + 1000 mW/cm2 / 10 s. After storage in distilled water (37°C/7 days), the restorations were cut into three slices in a buccolingual direction and the gap widths were analyzed using a 3D-scanning system. The data were submitted to ANOVA and Student-Newman-Keuls test (α=0.05). Results: ANOVA detected a significant influence for the C-factor and light-curing protocol as independent factors, and for the double interaction C-factor vs. light-curing protocol. Cavities with higher C-factor presented the highest gap formation. The gradual light-curing protocol led to smaller gap formation at cavity interfaces. Conclusions: The findings of this study suggest that the C-factor played an essential role in gap formation. The gradual light-curing protocol may allow relaxation of composite resin restoration during polymerization reaction.

Remineralizing potential of CPP-ACP creams with and without fluoride in artificial enamel lesions

BACKGROUND This study evaluated the effect of pastes containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) with and without fluoride on enamel demineralization. METHODS Human enamel blocks were used and after incipient caries-like lesions were formed, they were assigned to four groups: G1 - saliva; G2 - MI Paste (RecaldentTM ); G3 - MI Paste Plus (RecaldentTM 900 ppm as NaF); and G4 - Crest™ (1.100 ppm as NaF). The specimens were soaked in demineralizing solution for 6 hours and remineralized in artificial saliva for 18 hours alternatively for 10 days. The dentifrice was prepared with deionized water in a 1:3 proportion (w/w) or applied undiluted in the case of the CPP-ACP formula. Demineralized enamel changes were analysed by surface microhardness (SMH), 3D-profilometry and SEM. Data were analysed by non-parametric Kruskal-Wallis and Mann-Whitney test comparisons and one-way ANOVA and Tukeys HSD post hoc test (α = 0.05). RESULTS The SMH values observed in the G2 (47.8 ± 28.5) and G3 (53.6 ± 27.6) groups were different from that of G4 (90.2 ± 17.1), which were significantly higher than that found in G1 (39.4 ± 14.2). The %SMH was significantly lower in G4 when compared to G1 (p < 0.001) and G3 (p < 0.05). CONCLUSIONS MI Paste Plus demonstrated a greater protective effect against demineralization than MI Paste and showed smoother surfaces.