Gisele Maria Correr

Influence of the interposition of ceramic spacers on the degree of conversion and the hardness of resin cements

This study evaluated: I) the effect of photo-activation through ceramics on the degree of conversion (DC) and on the Knoop hardness (KHN) of light- and dual-cured resin cements; and II) two different protocols for obtaining the spectra of uncured materials, to determine the DC of a dual-cured resin cement. Thin films of cements were photo-activated through ceramics [feldspathic porcelain (FP); lithium disilicate glass-ceramics of low translucency (e.max-LT), medium opacity (e.max-MO) and high translucency (e.max-HT); glass-infiltrated alumina composite (IC) and polycrystalline zirconia (ZR)] with thicknesses of 1.5 and 2.0 mm. DC was analyzed by Fourier transform infrared (FTIR) spectroscopy. Two protocols were used to obtain the spectra of the uncured materials: I) base and catalyst pastes were mixed, and II) thin films of base and catalyst pastes were obtained separately, and an average was obtained. KHN assessment was performed with cylindrical specimens. The results were analyzed by ANOVA and Tukeys test (α= 0.05). The light-cured cement showed higher DC (61.9%) than the dual-cured cement (55.7%). The DC varied as follows: FP (65.4%), e.max-HT (65.1%), e.max-LT (61.8%), e.max-MO (60.9%), ZR (54.8%), and IC (44.9%). The light-cured cement showed lower KHN (22.0) than the dual-cured (25.6) cement. The cements cured under 1.5 mm spacers showed higher KHN (26.2) than when polymerized under 2.0 mm ceramics (21.3). Regarding the two protocols, there were significant differences only in three groups. Thus, both methods can be considered appropriate. The physical and mechanical properties of resin cements may be affected by the thickness and microstructure of the ceramic material interposed during photo-activation.

Marginal and internal fit of zirconia copings obtained using different digital scanning methods.

The objective of this study was to evaluate the marginal and internal fit of zirconia copings obtained with different digital scanning methods. A human mandibular first molar was set in a typodont with its adjacent and antagonist teeth and prepared for an all-ceramic crown. Digital impressions were made using an intraoral scanner (3Shape). Polyvinyl siloxane impressions and Type IV gypsum models were also obtained and scanned with a benchtop laboratory scanner (3Shape D700). Ten zirconia copings were fabricated for each group using CAD-CAM technology. The marginal and internal fit of the zirconia copings was assessed by the silicone replica technique. Four sections of each replica were obtained, and each section was evaluated at four points: marginal gap (MG), axial wall (AW), axio-occlusal edge (AO) and centro-occlusal wall (CO), using an image analyzing software. The data were submitted to one-way ANOVA and Tukeys test (α = 0.05). They showed statistically significant differences for MG, AO and CO. Regarding MG, intraoral scanning showed lower gap values, whereas gypsum model scanning showed higher gap values. Regarding AO and CO, intraoral digital scanning showed lower gap values. Polyvinyl siloxane impression scanning and gypsum model scanning showed higher gap values and were statistically similar. It can be concluded that intraoral digital scanning provided a lower mean gap value, in comparison with conventional impressions and gypsum casts scanned with a standard benchtop laboratory scanner.

Effect of Enamel and Dentin Surface Treatment on the Self-Adhesive Resin Cement Bond Strength

The aim of this study was to evaluate the effect of enamel and dentin surface treatment on the micro-shear bond strength of self-adhesive cement. Seventy-two extracted third molars had their crowns embedded in acrylic resin and worn to obtain a flat enamel or dentin surface. The enamel and dentin specimens were randomly assigned to 8 groups (n=12) that were based on surface treatment (11.5% polyacrylic acid solution or no treatment), substrate condition (wet or dry) and storage period (1 day or 90 days), and treated accordingly. Cylinders (1 × 1 mm) were fabricated using self-adhesive resin cement (RelyX U200) following the manufacturers instructions. The specimens were stored in distilled water at 37 °C for either 1 day or 90 days and subjected to micro-shear bond strength test (EMIC DL 2000 at 0.5 mm/min). After this, the failure type of the specimens was determined. Data were subjected to statistical analysis (a=0.05). According to the results, the 11.5% polyacrylic acid application decreased the bond strength in both enamel and dentin samples. The moist groups showed higher bond strength than the dry ones, regardless of the substrate and surface treatment. Storage period did not influence bond strength. In conclusion, surface treatment with 11.5% polyacrylic acid and absence of moisture decreased the bond strength of the resin-cement (RelyU200), regardless of the storage period.

Marginal and Internal Adaptation of Zirconia Crowns: A Comparative Study of Assessment Methods

Marginal and internal adaptation is critical for the success of indirect restorations. New imaging systems make it possible to evaluate these parameters with precision and non-destructively. This study evaluated the marginal and internal adaptation of zirconia copings fabricated with two different systems using both silicone replica and microcomputed tomography (micro-CT) assessment methods. A metal master model, representing a preparation for an all-ceramic full crown, was digitally scanned and polycrystalline zirconia copings were fabricated with either Ceramill Zi (Amann-Girrbach) or inCoris Zi (Dentslpy-Sirona), n=10. For each coping, marginal and internal gaps were evaluated by silicone replica and micro-CT assessment methods. Four assessment points of each replica cross-section and micro-CT image were evaluated using imaging software: marginal gap (MG), axial wall (AW), axio-occlusal angle (AO) and mid-occlusal wall (MO). Data were statistically analyzed by factorial ANOVA and Tukey test (a=0.05). There was no statistically significant difference between the methods for MG and AW. For AO, there were significant differences between methods for Amann copings, while for Dentsply-Sirona copings similar values were observed. For MO, both methods presented statistically significant differences. A positive correlation was observed determined by the two assessment methods for MG values. In conclusion, the assessment method influenced the evaluation of marginal and internal adaptation of zirconia copings. Micro-CT showed lower marginal and internal gap values when compared to the silicone replica technique, although the difference was not always statistically significant. Marginal gap and axial wall assessment points showed the lower gap values, regardless of ceramic system and assessment method used.

Influence of the Resin Cement Thickness on the Push-Out Bond Strength of Glass Fiber Posts

The objective of the present study was to evaluate the influence of resin cement thickness on the bond strength of prefabricated and customized glass fiber posts after storage in distilled water. Thirty human uniradicular roots were treated endodontically. The roots were divided into 3 groups: THIN (thin cement layer) - post space preparation with #0.5 drill and cementation of #0.5 post; THICK (thick cement layer) - post space preparation with #1 drill and cementation of #0.5 post; and CUSTOM (customized cement layer) - post space preparation with #1 drill and cementation of a customized post (#0.5 glass fiber posts customized with resin composite). All posts were luted with self-adhesive resin cement. The push-out test was carried out after storage for 24 h and 90 days in distilled water at 37 °C. The data were analyzed with three-way ANOVA and Tukeys test (a=0.05). Bond strengths were significantly higher for CUSTOM (9.37 MPa), than for THIN (7.85 MPa) and THICK (7.07 MPa), which were statistically similar. Considering the thirds, the bond strength varied in the sequence: apical (7.13 MPa) < middle (8.22 MPa) = coronal (8.94 MPa). Bond strength for 24 h storage was significantly higher (8.80 MPa) than for 90-day storage (7.40 MPa). It may be concluded that the thickness of resin cement influenced the bond strength of glass fiber posts. The customized posts presented higher bond strength. Storage in water for 90 days affected negatively the values of bond strength, especially for thick cement layers in the apical third.

Endocrown with Leucite-Reinforced Ceramic: Case of Restoration of Endodontically Treated Teeth

A common problem encountered by dentists is the restorative treatment of nonvital teeth. When the pulp chamber presents appropriate conditions for retention, the endocrown is indicated. This monolithic, ceramic adhesive restoration is singularly used yet warrants wider recognition and use. The endocrown allows preservation of the tooth structure and is minimally invasive. Currently, this treatment option, of a core buildup and full coverage restoration, reduces tooth structure excessively. This treatment presents not only functional limitations but also aesthetic concerns. Recently, the VITA-PM9 system, a leucite-reinforced glass ceramic, has been increasingly used in a variety of clinical situations due to its satisfactory physical-mechanical and aesthetic properties. Therefore, the present study describes a case of surgical restoration of a nonvital tooth using the endocrown technique and the VITA-PM9.

Effect of surface treatments on the bond strength of CAD/CAM fiberglass posts

Background There is no ideal protocol for the surface treatment of fiber posts, especially when using a computer-aided design/computer-aided manufacturing (CAD/CAM) experimental fiberglass block. The purpose of this study was to evaluate the bond strength of a CAD/CAM customized glass fiber post and core after applying different surface treatment techniques. Material and Methods Forty premolars were prepared to receive a customized CAD/CAM glass-fiber post and core obtained from an experimental block of glass fiber and epoxy resin. The specimens were randomly distributed in 4 groups (n=10) according to the post and core surface treatment: ETH - 70% ethanol; HP - 24% hydrogen peroxide for 1 minute; ETH/S - 70% ethanol + silane; HP/S - 24% hydrogen peroxide + silane. The universal adhesive containing silane was applied on the posts and prepared post spaces in all groups. The posts were cemented using dual cure resin cement. The specimens were stored in distilled water at 37°C for 24 h, cut (two slices of 1 mm for each root third - coronal, middle, and apical) and subjected to push-out test (0.5 mm/min). Data was subjected to two-way ANOVA (surface treatment and root third) and Tukey’s test (α=0,05). Results There was no significant difference of bond strength values among groups, regardless the surface treatment (p >0.05). There was significant difference on bond strength values for the different root thirds (p<0.05) (coronal>middle=apical). Conclusions The different surface treatment and application of additional silane in the CAD/CAM customized glass-fiber post and core does not interfere on bond strength values. The root dentin third interfered on the bond strength, with higher values for the coronal third. Key words:Post and core technique, cad/cam, shear strength, hydrogen peroxide.

Twenty-year clinical experience with fixed functional appliances

ABSTRACT Introduction: Considering the large number of fixed functional appliances, choosing the best device for your patient is not an easy task. Objective: To describe the development of fixed functional appliances as well as our 20-year experience working with them. Methods: Fixed functional appliances are grouped into flexible, rigid and hybrid. They are different appliances, whose action is described here. Four clinical cases will be reported with a view to illustrating the different appliances. Conclusions: Rigid fixed functional appliances provide better skeletal results than flexible and hybrid ones. Flexible and hybrid appliances have similar effects to those produced by Class II elastics. They ultimately correct Class II with dentoalveolar changes. From a biomechanical standpoint, fixed functional appliances are more recommended to treat Class II in dolichofacial patients, in comparison to Class II elastics.