Renata Pereira Ramos

Microleakage of a resin sealant after acid-etching, Er:YAG laser irradiation and air-abrasion of pits and fissures.

OBJECTIVE The aim of this in vitro study was to assess microleakage underneath a filled pit-and-fissure sealant bonded to occlusal surfaces treated by four enamel etching techniques. SUMMARY BACKGROUND DATA There has been no report of a study assessing microleakage of a pit-and-fissure sealant, comparing acid-etching, Er:YAG laser and air-abrasion for treating enamel surface. METHODS Forty extracted human third molars were selected and randomly assigned into four groups of ten teeth: group I, the occlusal surfaces were acid-etched; group II, a very short pulsed Er:YAG laser was used to treat the surfaces; group III, aluminum oxide air-abrasion was associated with acid-etching; group IV, Er:YAG laser was associated with acid-conditioning. The surfaces were sealed and the teeth were stored for 7 days in distilled water. Then, specimens were thermocycled, immersed in a 0.2% rhodamine solution, sectioned, and analyzed for leakage using an optical microscope connected to a video camera. The images were digitized and analyzed by software that allowed microleakage assessment in millimeters. RESULTS Statistical analysis showed that occlusal surfaces treated exclusively by the Er:YAG laser (group II) provided the poorest marginal sealing and that acid-etching (group I) was statistically similar to aluminum oxide air-abrasion + acid etching (group III) and to Er:YAG laser + acid-etching (group IV). CONCLUSIONS The results suggest that complementing either air-abrasion or Er:YAG laser irradiation with a subsequent acid-conditioning did not lessen microleakage at the enamel-sealant interface when compared with an acid-etched group. It was also observed that treating the enamel surface exclusively by Er:YAG laser resulted in the highest degree of leakage.

Assessing Microleakage on Class V Composite Resin Restorations after Er:YAG Laser Preparation Varying the Adhesive Systems

OBJECTIVE The aim of this study was to assess the performance of three bonding agents in preventing microleakage of class V cavities prepared and treated by Er:YAG laser associating with acid etching. BACKGROUND DATA There has been very little research comparing the efficiency of single-component and self-etching adhesive systems in preventing microleakage of cavities prepared and conditioned with Er:YAG laser. MATERIALS AND METHODS Thirty cavities - with occlusal margin in enamel and cervical in dentin/cementum - were prepared in sound human third molars using a short pulsed Er:YAG laser (500 mJ/5 Hz) The enamel and dentin surfaces were conditioned for 30 sec using lower dosimetries (120 mJ/4 Hz), and the samples were randomly assigned into three groups, according to the adhesive system: (I) Bond-1; (II) Prime & Bond NT; and (III) Etch & Prime 3.0. Groups I and II were acid-etched for 15 sec, and group III did not receive any acid treatment once a self-etching system was employed. Cavities were restored with a light-cured composite resin (JEK-Z250 Filtek-250), and after finishing, the samples were thermocycled, isolated with epoxy resin and nail varnish, immersed in a 0.2% Rhodamine B solution for 24 h, and sectioned longitudinally. The sections obtained were analyzed for leakage using an optical microscope connected to a computer and a video camera. We digitized the images using a special software program that allowed a quantitative evaluation of microleakage in millimeters. RESULTS Statistical analysis using the Kruskal-Wallis test showed statistically significant difference between both margins, and the occlusal region presented better marginal sealing. Comparing the three resin bonding systems, Prime & Bond NT entirely sealed both margins, while Etch & Prime 3.0 provided the poorest overall results, showing a statistically significant difference (p < 0.01). CONCLUSION It may be concluded that, for all the tested materials, microleakage values were higher in cervical (dentin/cementum) margins. Additionally, Prime & Bond NT provided a complete elimination of marginal infiltration at both margins, after treating the dental surface with laser irradiation associated with a sequent acid-etching.

Comparison of visual acuity and automated perimetry findings in patients with neuromyelitis optica or multiple sclerosis after single or multiple attacks of optic neuritis.

Objective: To review the clinical characteristics of patients with neuromyelitis optica (NMO) and to compare their visual outcome with those of patients with optic neuritis (ON) and multiple sclerosis (MS). Methods: Thirty-three patients with NMO underwent neuro-ophthalmic evaluation, including automated perimetry along with 30 patients with MS. Visual function in both groups was compared overall and specifically for eyes after a single episode of ON. Results: Visual function and average visual field (VF) mean deviation were significantly worse in eyes of patients with NMO. After a single episode of ON, the VF was normal in only 2 of 36 eyes of patients with NMO compared to 17 of 35 eyes with MS (P < 0.001). The statistical analysis indicated that after a single episode of ON, the odds ratio for having NMO was 6.0 (confidence interval [CI]: 1.6–21.9) when VF mean deviation was worse than -20.0 dB while the odds ratio for having MS was 16.0 (CI: 3.6–68.7) when better than -3.0 dB. Conclusion: Visual outcome was significantly worse in NMO than in MS. After a single episode of ON, suspicion of NMO should be raised in the presence of severe residual VF deficit with automated perimetry and lowered in the case of complete VF recovery.

Tooth structure and fracture strength of cavities

This study evaluated, in vitro, the loss of tooth substance after cavity preparation for direct and indirect restorations and its relationship with fracture strength of the prepared teeth. Sixty sound human maxillary first premolars were assigned to 6 groups (n=10). MOD direct composite cavities (Groups I, II and III) and indirect inlay cavities (Groups IV, V and VI) were prepared maintaining standardized dimensions: 2-mm deep pulpal floors, 1.5-mm wide gingival walls and 2-mm high axial walls. Buccolingual width of the occlusal box was established at 1/4 (Groups I and IV), 1/3 (Groups II and V) or 1/2 (Groups III and VI) of the intercuspal distance. Teeth were weighed (digital balance accurate to 0.001 g) before and after preparation to record tooth substance mass lost during cavity preparation. The prepared teeth were submitted to occlusal loading to determine their fracture strength using a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed by two-way ANOVA and Tukey test (alpha= 0.05). 1/4-inlay cavities had higher percent mean mass loss (9.71%) than composite resin cavities with the same width (7.07%). 1/3-inlay preparations also produced higher percent mean mass loss (13.91%) than composite resin preparations with the same width (10.02%). 1/2-inlay cavities had 21.34% of mass loss versus 16.19% for the 1/2-composite resin cavities. Fracture strength means (in kgf) were: GI = 187.65; GII = 143.62; GIII = 74.10; GIV = 164.22; GV = 101.92; GVI = 50.35. Statistically significant difference (p<0.05) were observed between Groups I and IV, II and V, III and VI. Higher tooth structure loss and lower fracture strength were recorded after preparation of inlay cavities, regardless of the width of the occlusal box, compared to the direct composite resin cavities.

Microhardness of composite resins at different depths varying the post-irradiation time

Objective: The purpose of this study was to assess the microhardness of posterior composite resins at different depths varying the post-irradiation time. Materials and methods: For each composite resin [Solitaire 2 (SO) - Heraus Kulzer, P60 (P) - 3M, Prodigy Condesable (PC) - Kerr, Surefil (S) - Dentsply and Alert (A) - Pentron], 6 specimens (3 mm in diameter; 4mm high) were prepared using a black polyurethane cylindrical matrix. The resins were inserted in a bulk increment and light cured for 40 seconds. Microhardness was analyzed at different depths (top, 0.4 mm, 1.0 mm, 2.0mm, 3.0 mm and 4.0 mm) and at two moments (20 minutes and 24 hours after light-curing). Data were analyzed by ANOVA and Tukeys test (p<0.05). Results: Overall, microhardness means decreased significantly with the increase of depth, being lower in the first moment tested. P, S and PC showed the highest microhardness means. Conclusion: It may be concluded that the tested composite resins presented a gradual decrease of microhardness as depth increased and this drop was more accentuated for depths beyond 2 mm. For all materials, higher microhardness means were recorded 24 hours after light activation. P60 yielded the best results at the different depths evaluated.

In vitro evaluation of microleakage of a flowable composite in class V restorations

The aim of this study was to evaluate microleakage around class V restorations using a flowable composite compared to a hybrid composite. Forty class V cavities were prepared on buccal and lingual surfaces of 20 human teeth, with occlusal and cervical margins at the enamel and cementum/dentin levels, respectively. Specimens were divided into 2 groups with 10 samples each. Group 1: buccal cavities received Paama 2 (conventional bonding agent) + Wave (flowable composite); lingual cavities were restored with Paama 2 + Glacier (hybrid composite). Group 2: buccal cavities received Optibond Solo (self-priming bonding agent) + Wave; lingual cavities were restored with Optibond Solo + Glacier. After being stored in distilled water and finished, the teeth were thermocycled, immersed in a 50% silver nitrate solution and embedded in resin. They were sectioned and the depth of tracer penetration was scored. The results were analyzed using Kruskal-Wallis and Wilcoxon tests. The restorations with flowable composite and those with hybrid composite from the same group showed similar results of microleakage for both occlusal and cervical margins. Optibond Solo improved the sealing of the restorations when compared with Paama 2 (p < 0.01). None of the restorative materials completely sealed the tooth/restoration interface at the cervical margins.

Evaluation of the surface hardness of composite resins before and after polishing at different times

Purpose: The aim of this study was to evaluate the surface hardness of six composite resins: Revolution, Natural Flow, Fill Magic Flow, Flow-it! (flowables), Silux Plus (microfilled) and Z100 (minifilled) before and after polishing at different times. Materials and Methods: For this purpose, 240 specimens (5mm diameter, 1.4mm high) were prepared. Vickers hardness was determined before and after polishing at different times: immediately, 24h, 7 and 21 days after preparation of the samples. Statistical analysis was performed by ANOVA and Tukey test. Results: There was no difference in the hardness of flowable resins, which had lower hardness than the minifilled resin. The minifilled resin showed the highest surface hardness as compared to the other materials (p<0.01). All materials exhibited higher hardness after polishing, being more evident after 7 days. Conclusion: It may be concluded that, regardless of the composite resin, surface hardness was considerably increased when polishing was delayed and performed 1 week after preparation of the samples.

Microhardness of esthetic restorative materials at different depths

The aim of this study was to analyze the microhardness of two resin-modified glass ionomer cements (Vitremer; Fuji II LC); two polyacid-modified composite resins (Freedom; F2000) and a hybrid composite resin (Prodigy), at different depths from the upper surface. Six hemi-cylinders (3 mm height; 3 mm radius) per tested material were obtained. Vickers Hardness was determined using a micro-indentation tester. For each hemi-cylinder, three indentations were taken at one of the following depths: 0.4, 1.0, 2.0 and 2.6 mm. For each material, microhardness average was calculated. Statistical analysis was performed using two-way ANOVA and Tukey test Fuji II LC and Vitremer showed no statistically significant difference among hardness means recorded at the four analyzed depths. The hybrid and the polyacid-modified composite resins showed significant decrease microhardness with increasing depth. It may be concluded that for the RMGIC, microhardness was not affected at depths up to 2.6 mm. On the other hand, both hybrid and PMCRs should de better placed in increments not thicker than 2 mm to achieve optimal hardness throughout the restoration.