Marina Guimarães Roscoe

Influence of alveolar bone loss, post type, and ferrule presence on the biomechanical behavior of endodontically treated maxillary canines: Strain measurement and stress distribution

STATEMENT OF PROBLEM Teeth restored with posts are more frequently associated with bone loss, but there is no evidence to suggest that the post type and the presence of bone loss influence biomechanical behavior. PURPOSE The purpose of this study was to evaluate the effect of alveolar bone loss, post type, and ferrule presence on the biomechanical behavior of endodontically treated maxillary canines. MATERIAL AND METHODS For the experimental analysis, 40 human canine teeth were selected and divided into 8 experimental groups (n=5) according to 3 treatment variations: with or without 5.0 mm of bone loss (bl), with or without a ferrule, and restored with cast post and cores or glass fiber post. The restored canines were loaded at 15 degrees, and deformation was measured with strain gauges placed on the buccal and proximal root surfaces. Strain results were analyzed by 3-way analysis of variance (ANOVA) and the Tukey HSD tests (α=.05). For the finite element analysis, eight 3D models were created by following the same variations of the experimental analysis. The models were analyzed by using the maximum principal stress criteria for stress distribution analysis. RESULTS The absence of a ferrule significantly increased the buccal and proximal strain values. The post type influenced the stress distribution, mainly at the interface of post and dentin. The bone loss significantly increased the stress concentration and strain values, mainly on root dentin and surrounding cortical bone. CONCLUSIONS The presence of a ferrule improved the mechanical behavior. The 5.0 mm of bone loss significantly increased the stress concentration and the strain on the root dentin.

Root Dentin Strain and Temperature Rise During Endodontic Treatment and Post Rehabilitation

This study investigated the effects of endodontic treatment procedures and different post systems rehabilitation steps on the strain and temperature rise on apical and cervical root dentin regions. Twenty-one extracted human canine teeth had two strain gages attached to the distal root surface and two thermocouples attached to the mesial root surface (cervical and apical). The strain and temperature rise were recorded during the following procedures: root canal preparation, final rinse and drying, root canal filling and canal relief. Then the teeth were divided into three groups (n=7), according to the type of post system: CPC, cast post and core; FGP, fiberglass post; and PSP, prefabricated steel post. Data continued to be recorded during the post space preparation, post modeling (only for CPC), post trying and post cementation. Data were subjected to a two-way ANOVA followed by Tukeys test (α=0.05). The post-space preparation caused the highest temperature rise (4.0-14.9 °C) and the highest strain in the apical region during irrespective of post type. The resin cement light-activation resulted in significant temperature increases in the cervical region for all of the groups. The canal relief and the post-space preparation produced highest temperature rises. The CPC post modeling resulted in higher root strain level similarly the level of post preparation. The PSP resulted in highest strain during post trying and post cementation.

Impact of rehabilitation with metal-ceramic restorations on oral health-related quality of life

Dental ceramics present excellent ability to reproduce the natural teeth regarding esthetic and biomechanics. Recently, due to the advancement of ceramic technology, metal-free restorations were developed. However, the traditional metal-ceramic restorations still present the requirements of high strength, long survival in the oral environment and favorable aesthetics. In this context, it is essential to know the specificity of each ceramic system available in order to apply it properly to various clinical situations. This report describes an integrated rehabilitation using metal-ceramic restorations of a patient at 50 years of age, who presented edentulous spaces, and previous unsatisfactory composite and amalgam restorations, and indirect metallic restorations, leading to compromised quality of life in both functional and psychosocial aspects. The impact on quality of life was measured using a generic instrument, OHIP-14, validated for the World Health Organization, which covers both the biological and the psychosocial dimensions. This instrument was applied to the patient before and after treatment. The patient had an overall OHIP-14 score of 28 before the treatment and after treatment the score decreased to 0, showing that dental and oral health conditions are factors that do impact on the quality of life. Rehabilitation has provided functional and aesthetic restorations, harmony of the stomatognathic system and improvement of life quality.

Effect of Silane Type and Air-Drying Temperature on Bonding Fiber Post to Composite Core and Resin Cement

This study evaluated the influence of silane type and temperature of silane application on push-out bond strength between fiberglass posts with composite resin core and resin cement. One hundred and sixty fiberglass posts (Exacto, Angelus) had the surface treated with hydrogen peroxide 24%. Posts were divided in 8 groups according to two study factors: air-drying temperature after silane application (room temperature and 60 ºC) and silane type: three pre-hydrolyzed--Silano (Angelus), Prosil (FGM), RelyX Ceramic Primer (3M ESPE) and one two-component silane--Silane Coupling Agent (Dentsply). The posts (n=10) for testing the bond strength between post and composite core were centered on a cylindrical plastic matrix and composite resin (Filtek Z250 XT, 3M ESPE) that was incrementally inserted and photoactivated. Eighty bovine incisor roots (n=10) were prepared for testing the bond strength between post and resin cement (RelyX U100, 3M ESPE) and received the fiberglass posts. Push-out test was used to measure the bond strength. Data were analyzed by two-way ANOVA followed by Tukeys test (α=0.05). ANOVA revealed that temperature and silane had no influence on bond strength between composite core and post. However, for bond strength between post and resin cement, the temperature increase resulted in a better performance for Silane Coupling Agent, Silano and RelyX Ceramic Primer. At room temperature Silane Coupling Agent showed the lowest bond strength. Effect of the warm air-drying is dependent on the silane composition. In conclusion, the use of silane is influenced by wettability of resinous materials and pre-hydrolyzed silanes are more stable compared with the two-bottle silane.

Finite Element Analysis in Dentistry - Improving the Quality of Oral Health Care

The primary function of the human dentition is preparation and processing of food through a biomechanical process of biting and chewing. This process is based on the transfer of masticatory forces, mediated through the teeth (Versluis & Tantbirojn, 2011). The intraoral environment is a complex biomechanical system. Because of this complexity and limited access, most biomechanical research of the oral environment such as restorative, prosthetic, root canal, orthodontic and implant procedures has been performed in vitro (Assuncao et al., 2009). In the in vitro biomechanical analysis of tooth structures and restorative materials, destructive mechanical tests for determination of fracture resistance and mechanical properties are important means of analyzing tooth behavior. These tests, however, are limited with regard to obtaining information about the internal behavior of the structures studied. Furthermore, biomechanics are not only of interest at the limits of fracture or failure, but biomechanics are also important during normal function, for understanding property-structure relationships, and for tissue response to stress and strain. For a more precise interrogation of oral biomechanical systems, analysis by means of computational techniques is desirable.

Effect of Surface Treatment of Fiberglass Posts on Bond Strength to Root Dentin

This study evaluated the influence of the surface treatments of fiberglass posts on bond strength to root dentin using push-out test. Forty bovine incisor roots were endodontically treated. The surface of the fiberglass posts (Exacto #2, Angelus) were treated using 4 different protocols (n=10): Control - 70% ethanol for 1 min; 37% phosphoric acid for 1 min; 10% hydrofluoric acid for 1 min; and 24% hydrogen peroxide for 1 min. After a silane coupling agent was applied for 1 min and all posts were cemented using self-adhesive resin cement (RelyX Unicem, 3M-ESPE). The roots were sectioned and two 1-mm-thick slices were obtained from each third: cervical, middle and apical. The specimens were subjected to the push-out test with a crosshead speed of 0.5 mm/min. Data were analyzed by repeated measures ANOVA followed by Tukeys HSD tests (=0.05). The surface treatment (p<0.001) and root third region (p=0.007) factors were significant. The retention to root canal was affected by surface treatment type. The post surface treatment with 24% hydrogen peroxide for 1 min yielded significantly higher bond strength when the fiberglass posts were cemented with RelyX Unicem.

A 12-Year Retrospective Study of Avulsion Cases in a Public Brazilian Dental Trauma Service.

This study assessed the epidemiological characteristics and management of the permanent teeth avulsion cases attended in a Brazilian dental trauma service from December 2005 to August 2016. A retrospective study was conducted of case records of 93 patients involving 139 avulsed teeth. Data included sex, age, trauma etiology, location of the accident, number and position of avulsed teeth, and presence and type of associated traumatic lesions. Management of the avulsed teeth was addressed as: time elapsed until teeth were retrieved from the accidents location; teeths cleaning method and storage media; time elapsed until seeking treatment and replantation. The majority of the patients were children from 6-10 (31.2%) and 11-15 years old (26.9%). Male patients were more affected than female. Bicycle accident was the main etiological factor (31.2%). In 56 (60.2%) cases, traumatic lesions to neighboring teeth were present. In 55 (59.1%) cases, lesions to adjacent soft tissues were reported. In 82 (88.2%) cases, patients requested treatment at the same day of the accident. Sixty-four teeth (46.0%) were immediately retrieved and 28 (20.1%) were not found. Forty-two teeth (30.2%) were kept dry. Only one tooth (0.7%) was immediately replanted at the accidents site, while 51 teeth (36.7%) were not replanted. Numerous avulsed teeth were inappropriately managed and immediate replantation was not frequent. Public policies must be created to raise awareness towards the particularities of avulsion cases.

Influence of Resin Cements on Color Stability of Different Ceramic Systems

The purpose of this study was to evaluate color stability of two dental ceramics cemented with two resin cements, assessing the color difference (ΔE00) by the measurement of L*, a*, b*, c* and h* of transmittance. The combination of two ceramic system (feldspathic and lithium disilicate) and two resin cements - color A3 (RelyX ARC and Variolink II) resulted in 4 groups (n=5). Ten disks-shaped specimens were fabricated for each ceramic system (10x1.5 mm), etched with hydrofluoric acid (10%) and silanized prior to cementation. The color analysis was performed 24 h after cementation of the samples and after 6 months of storage in relative humidity by means of spectrophotometry. The ΔE00 values were analyzed statistically by two-way ANOVA followed by the Tukey test (p<0.05). One-way ANOVA were calculated for the means of individual color coordinates (L*, a*, b*, c* and h*). Two-way ANOVA showed that only the ceramic factor was significant (p=0.003), but there was no difference for the cement factor (p=0.275) nor for the ceramic/cement interaction (p=0.161). The feldspathic ceramic showed the highest values of ΔE00. Variations in L*, a*, b*, c* and h* were more significant for feldspathic ceramic. In conclusion, storage alters similarly the optical properties of the resin cements and feldspathic porcelain was more susceptible to cement color change after aging.