Kátia Regina Hostílio Cervantes Dias

Influence of two self-etching primer systems on enamel adhesion

The aim of this study was to compare two self-etching and a total-etch adhesive systems by assessing their shear bond strength to bovine enamel and the microleakage on class V composite restorations prepared on bovine enamel. Bovine teeth selected and allocated in three groups: Group 1: Scothbond Multi-Purpose; Group 2: Clearfil Liner Bond 2V; Group 3: Etch & Prime 3.0. For the microleakage test, each group was composed of ten class V restorations on the buccal surface. Two examiners attributed scores ranging from 0 (without leakage) to 3 (maximum leakage) to determine silver nitrate penetration at enamel-composite interface. Microleakage data were analyzed statistically by Kruskal-Wallis and Mann-Whitney tests at 5% significance level. For the bond strength test, ten teeth of each group were included, had their buccal surfaces flattened in order to obtain a 3-mm-diameter area to which a resin cylinder was bonded. After one week, the specimens were tested in shear strength at a crosshead speed of 0.5 mm/min. Bond strength data were treated by ANOVA and LSD tests at 5% significance level. The debonded interfaces were examined under scanning electron microscopy. No leakage was observed along enamel margins. Means (+/- SD) in MPa were: 18.75 (+/-5.83), 22.17 (+/-4.95) and 14.93 (+/-6.7) for Groups 1, 2, and 3, respectively. According to the results of this study, the self-etching primer systems presented statistically similar behavior (p>0.05) to that of the total-etch adhesive system (used as a control), not only regarding marginal leakage at bovine enamel-composite resin interface, but also regarding the shear bond strength of the bovine enamel. However, the self-etching primer systems differed significantly (p>0.05) to each other, with better results for Clearfil Liner Bond 2V. In conclusion, the self-etching primer systems had a performance comparable to that of the total-etch adhesive system.

Oral health in Brazil - Part II: Dental Specialty Centers (CEOs)

The concepts of health promotion, self-care and community participation emerged during the 1970s and, since then, their application has grown rapidly in the developed world, showing evidence of effectiveness. In spite of this, a major part of the population in the developing countries still has no access to specialized dental care such as endodontic treatment, dental care for patients with special needs, minor oral surgery, periodontal treatment and oral diagnosis. This review focuses on a program of the Brazilian Federal Government named CEOs (Dental Specialty Centers), which is an attempt to solve the dental care deficit of a population that is suffering from oral diseases and whose oral health care needs have not been addressed by the regular programs offered by the SUS (Unified National Health System). Literature published from 2000 to the present day, using electronic searches by Medline, Scielo, Google and hand-searching was considered. The descriptors used were Brazil, Oral health, Health policy, Health programs, and Dental Specialty Centers. There are currently 640 CEOs in Brazil, distributed in 545 municipal districts, carrying out dental procedures with major complexity. Based on this data, it was possible to conclude that public actions on oral health must involve both preventive and curative procedures aiming to minimize the oral health distortions still prevailing in developing countries like Brazil.

Evaluation of the risk of a stripping perforation with gates-glidden drills: serial versus crown-down sequences

The aim of this study was to evaluate the remaining dentine/cementum thickness using Gates-Glidden burs in serial and crown-down sequences and to observe which of the two sequences is the safest for preparing mesial roots of molars. Thirty-six left and right human mandibular first molars were selected. Standard access cavities were made and initially explored with Flexofiles sizes 10 and 15 until the tip was visible at the apex. The teeth were embedded in a muffle specially developed for this study using a PVC tube with two parallel metal rods in its lid. Each tooth-block was sectioned 3 mm apically to the furcation using a low-speed saw with a diamond disc. The tooth-block was examined under a microscope and an initial image was captured by a digital video system with 8 X and 12 X magnifications. Finally, the tooth-blocks were reassembled in the muffle so that the canals could be instrumented. After instrumentation the area of each mesial canal as well as the smallest distance to the root furcation were measured again. The mesio-buccal canals (crown-down order) and the mesio-lingual canals (serial sequence) presented an average area of 0.46 +/- 0.16 mm(2) and 0.88 +/- 0.27 mm(2) (P < 0.01), respectively. The mean values of the smallest distance to the furcation for the mesio-buccal and mesio-lingual canals were 0.66 +/- 0.19 mm and 0.39 +/- 0.13 mm (P < 0.01), respectively. The remaining dentine/cementum thickness using Gates-Glidden burs was greater in the crown-down sequence than in the serial sequence.

Comparative SEM evaluation of penetration of adhesive systems in human dentin with a non-rinse conditioner and a self-etching primer

The purpose of this study was to compare the effect of a self-etching primer and a non-rinse conditioner with the effect of a conventional adhesive system on the penetration depth in dentin of human teeth, using scanning electronic microscopy (SEM). Fifteen human third molar teeth were sectioned into 2 pieces. All pieces were flattened with grade 600 to 1200 silicon carbide paper and divided into 6 groups: group 1 - Prime & Bond NT (NT), negative control; group 2 - 37% phosphoric acid + Prime & Bond NT (PANT), positive control; group 3 - Non-rinse Conditioner (NRC) + Prime & Bond NT (NRCNT); group 4 - NRC + Prime & Bond 2.1 (NRCPB); group 5 - NRC + Scotchbond MP (NRCSB); group 6 - Prompt L-Pop (PLP). All teeth were covered with Dyract AP. The tooth fragments were decalcified, and its resin replicas were evaluated by SEM by three previously standardized examiners. The penetration was scored from 0 (no penetration) to 3 (maximum penetration). The Kruskal-Wallis and Mann-Whitney U tests (p<0.05) showed three statistically homogeneous groups: (NT, NRCPB, NRCSB and PLP), (NRCNT) and [PANT]. The authors concluded that the self-etching primer and the non-rinse conditioner provide a lower penetration depth in human tooth dentin than the conventional adhesive system.

Stress distribution in the cervical region of an upper central incisor in a 3D finite element model

The aim of this study was to evaluate the stress distribution in the cervical region of a sound upper central incisor in two clinical situations, standard and maximum masticatory forces, by means of a 3D model with the highest possible level of fidelity to the anatomic dimensions. Two models with 331,887 linear tetrahedral elements that represent a sound upper central incisor with periodontal ligament, cortical and trabecular bones were loaded at 45 masculine in relation to the tooths long axis. All structures were considered to be homogeneous and isotropic, with the exception of the enamel (anisotropic). A standard masticatory force (100 N) was simulated on one of the models, while on the other one a maximum masticatory force was simulated (235.9 N). The software used were: PATRAN for pre- and post-processing and Nastran for processing. In the cementoenamel junction area, tensile forces reached 14.7 MPa in the 100 N model, and 40.2 MPa in the 235.9 N model, exceeding the enamels tensile strength (16.7 MPa). The fact that the stress concentration in the amelodentinal junction exceeded the enamels tensile strength under simulated conditions of maximum masticatory force suggests the possibility of the occurrence of non-carious cervical lesions such as abfractions.

Compressive strength of esthetic restorative materials polymerized with quartz-tungsten-halogen light and blue LED

This study compared the compressive strength of a composite resin and compomer photoactivated with a conventional quartz-tungsten halogen-light (XL 3000, 3M/SPE) and a blue light-emitting diode (LED) (SmartLite PS; Dentsply/De Trey). Forty disc-shaped specimens were prepared using a split polytetrafluoroethylene matrix (4.0 mm diameter x 8.0 mm hight) in which the materials were inserted incrementally. The curing time of each increment was of 40 s with the QTH and 10 s with the LED. The specimens were randomly assigned to 4 groups (n=10), according to the light source and the restorative material. After storage in distilled water at 37 degrees C +/- 2 degrees C for 24 h, the specimens was tested in compressive strength in a universal testing machine with load cell of 500 kgf running at a crosshead speed of 0.5 mm/min. Data (in MPa) were analyzed statistically by ANOVA and Student-Newman-Keuls test (p<0.05). For the composite resin, light curing with the QTH source did not produce statistically significant difference (p>0.05) in the compressive strength when compared to light curing with the LED source. However, light curing of the compomer with the QTH source resulted in significantly higher compressive strength than the use of the LED unit (p>0.05). The composite resin presented significantly higher (p>0.05) compressive strength than the compomer, regardless of the light source. In conclusion, the compressive strength of the tested materials photoactivated with a QTH and a LED light source was influenced by the energy density employed and the chemical composition of the esthetic restorative materials.

Effect of in-office bleaching agents on the surface roughness and morphology of different dental composites: an AFM study.

The aim of this study was to evaluate, using atomic force microscopy, the effect of two different bleaching agents on the modification of dental composites materials. This modification will be judged by analyzing the variation of surface roughness and surface morphology of two different composites: one containing nanoparticles and other consisting of microhybrid resin. The bleaching was performed by using two different concentrations of hydrogen peroxide: HP Blue (20% hydrogen peroxide) and Whiteness HP Maxx (35% hydrogen peroxide). Disks of Esthet X and Filtek™ Z350 composites were used. Atomic force microscopy was used for analyses of the same place of the sample before and after treatment. A total of 12 analyses were performed per group (n = 12). The samples were analyzed qualitatively by evaluating morphological changes in the images and quantitatively by using roughness parameters (Ra). Data were analyzed statistically using Kruskal–Wallis, Mann–Whitney, and Friedman tests (P < 0.05). Changes were observed both qualitatively and quantitatively only in the groups where Esthet X resin was used. The use of hydrogen peroxide bleaching agents caused changes only in the surface of microhybrid composites, with no changes being observed in the composite containing nanoparticles. Despite being even significant, these alterations are clinically slight and can be eliminated by polishing them. Microsc. Res. Tech. 76:481–485, 2013.

Changes in surface roughness and color stability of two composites caused by different bleaching agents

The objective of this study was to evaluate the effect of two bleaching agents (10% and 35% hydrogen peroxide) on the color stability and surface roughness of two composites, one nanohybrid and one nanoparticle. Specimens were polished, aged, stained, bleached and polished again. The action of the bleaching agents on the composites was analyzed using a profilometer (surface roughness) and a spectrophotometer (color stability). The effect of polishing the composites on the surface roughness and the resumption of the composite color was also evaluated. The results were analyzed statistically by ANOVA and Tukeys test at 5% significance level. The analysis indicated that the nanohybrid composite was more affected by staining. The bleaching agents were not able to promote bleaching of either composite over the evaluation period. Surface polishing returned nanohybrid composite to its original color condition, which did not occur for the nanoparticle composite. Additionally, polishing did not return the surface roughness of either composite to its original value. It may be concluded that polishing surface after bleaching should not be the treatment of choice, as it was not possible to reverse the roughness of the composites to their original values, suggesting that a more extensive and irreversible degradation might have occurred.

Dual-scan technique for the customization of zirconia computer-aided design/computer-aided manufacturing frameworks.

The use of bi-layered all-ceramic crowns has continuously grown since the introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia cores. Unfortunately, despite the outstanding mechanical properties of zirconia, problems related to porcelain cracking or chipping remain. One of the reasons for this is that ceramic copings are usually milled to uniform thicknesses of 0.3-0.6 mm around the whole tooth preparation. This may not provide uniform thickness or appropriate support for the veneering porcelain. To prevent these problems, the dual-scan technique demonstrates an alternative that allows the restorative team to customize zirconia CAD/CAM frameworks with adequate porcelain thickness and support in a simple manner.

Evaluation of the Potential Cytotoxicity of Dental Bleaching Agents

We studied the effects of dental bleaching agents (Insta-Brite ™ , Karisma ™ , Opalescence ™ and Whiteness ™ ) on the lysogenic induction and survival of Escherichia coli strains with different abilities to repair DNA damage. To evaluate lysogenic induction, an E. coli GY5027 ( u ) culture was incubated with solutions of bleaching agents. Cultures of E. coli AB1157 ( wild type ), AB2463 ( recA ) and BW9091 ( xthA ) were incubated with the bleaching agents and the survival fractions determined. The bleaching agents were found to promote lysogenic induction and to decrease the survival of the bacterial strains. These results suggest that bleaching agents are capable of inducing DNA damage in oral bacteria.