Effect of different activation modes on the degree of conversion, tensile bond strength and interfacial morphology of dual-cured cementing systems used in indirect composite restorations

Orientador: Marcelo GianniniTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ondontologia de PiracicabaResumo: A não fotoativação do sistema adesivo previamente à aplicação do cimento resinoso tem sido proposta quando sistemas de cimentação de dupla ativação (SCDA - sistemas adesivos de dupla ativação / cimentos resinosos de dupla ativação) são utilizados. Entretanto, existe uma carência de relatos científicos a respeito da efetividade dos SCDA. Os objetivos deste estudo foram: 1- avaliar a resistência de união (RU) e a morfologia da interface de união de restaurações indiretas de compósito através da utilização da microscopia confocal laser quando os sistemas adesivos de dupla ativação foram ou não fotoativados previamente à aplicação dos cimentos resinosos; 2- analisar o grau de conversão (GC), através da Espectroscopia Infravermelha Transformada de Fourier (FTIR), e a RU de SCDAs quando a fotoativação não foi realizada ou atenuada pela presença da restauração indireta; 3- avaliar o GC e resistência coesiva de sistemas de união quando utilizados diferentes unidades de fotoativação (LEDs e de luz halógena). A RU e resistência coesiva foram avaliadas através do ensaio de microtração. Para a análise em microscopia confocal laser, diferentes corantes foram incorporados nos SCDAs previamente à sua aplicação. Para a análise do GC, os SCDAs foram aplicados na superfície do diamante da unidade de reflectância total atenuada acoplada ao espectrômetro infravermelho. O GC dos sistemas de união não relacionados aos SCDAs foi obtido utilizando-se filmes de resina adesiva. Os resultados demonstraram que a não fotoativação do sistema adesivo de dupla ativação previamente à cimentação não afetou a RU, e que os valores foram até superiores para um SCDA de 4ª geração quando o agente de união não foi fotoativado. A análise em microscopia confocal laser exibiu variação nas características morfológicas da interface de união, variando de acordo com o SCDA utilizado e com o modo de ativação de ambos componentes (sistema adesivo e cimento resinoso). Para alguns SCDAs, o GC foi reduzido pela presença do disco de compósito posicionado entre o SCDA e a ponta da unidade fotoativadora. A não fotoativação dos SCDAs resultou em GC inferiores aos obtidos com exposição direta da luz. A não fotoativação da maioria dos SCDAs também resultou em valores inferiores de RU, exceto quando um sistema de 4ª geração foi utilizado. A utilização de LED resultou em GC inferior ao obtido quando a luz halógena foi utilizada mas não afetou a resistência coesiva dos sistemas adesivos avaliados. Pode-se concluir que a não fotoativação dos sistemas adesivos é uma alternativa aceitável durante a cimentação de restaurações indiretas, porém os SCDAs necessitam de luz fotoativadora para garantir adequada RU. A utilização de LEDs pode comprometer o GC dos sistemas adesivosAbstract: The lack of light-activation of dual-cured bonding agents before the resin cement application has been an alternative technique of cementing indirect restorations when dual-cured cementing systems are used (DCS ¿ dual-cured bonding agents / dual-cured resin cements). However, few reports exist regarding the effectiveness of DCS when dual-cured bonding agents are left in the uncured state before the seating of the indirect restoration. Therefore, the aims of this study were: 1- to evaluate the microtensile bond strength (MTBS) and micromorphology of the adhesive interface of indirect restorations by confocal laser microscopy (CLSM) when the dual-cured bonding agents were left in the uncured state; 2- to analyze the degree of conversion (DC) by Fourier Transformed Infrared Spectroscopy and the bond strength of indirect restorations when DCSs were applied to the tooth and light activated or allowed to self-cure; 3- to evaluate the DC and ultimate tensile strength (UTS) of bonding agents light-activated with light curing units (LEDs and halogen light). The MTBS and UTS were analyzed using microtensile bond strength test. Different dyes were incorporated to the DCSs before they were applied to teeth for the CSLM analysis. For the DC analysis, the DSCs were applied to the diamond surface of attenuated total reflectance unit of the infrared device. The DC of the bonding agents related to the study evaluating the effectiveness of light-curing units was obtained from thin resin adhesive films. The results demonstrated that the MTBS was not affected, and the values were even higher for one 4th generation DCS, when the dual-bonding agents were left in the uncured state before the resin cement application. The CLSM analysis exhibited some variation in the micromorphological features, which depended on the DCSs and on the curing modes of bonding agents and resin cements. Some DCSs showed lower DC when pre-cured resin composite discs were used. The self-cured groups exhibited lower MTBS than the light-activated ones, except for one 4th generation DCS. The LED promoted lower DC in all bonding agents than did the halogen light. No difference in UTS was observed when LED was used. It was concluded that leaving the dual-cured bonding agent in the uncured state before seating the indirect restoration may be a reliable technique to ensure adequate MTBS, but most DCSs should be light-activated after seating the indirect restoration to provide optimal bond strength. Some LEDs can compromise the DC of adhesive systemsDoutoradoDentísticaDoutor em Clínica Odontológic

Comparison of in vivo and in vitro models to evaluate pulp temperature rise during exposure to a Polywave® LED light curing unit

Objectives: To measure and compare in vivo and in vitro pulp temperature (PT) increase (ΔTEMP) over baseline, physiologic temperature using the same intact upper premolars exposed to the same Polywave® LED curing light. Methodology: After local Ethics Committee approval (#255,945), local anesthesia, rubber dam isolation, small occlusal preparations/minute pulp exposure (n=15) were performed in teeth requiring extraction for orthodontic reasons. A sterile probe of a temperature measurement system (Temperature Data Acquisition, Physitemp) was placed within the pulp chamber and the buccal surface was sequentially exposed to a LED LCU (Bluephase 20i, Ivoclar Vivadent) using the following exposure modes: 10-s low or high, 5-s Turbo, and 60-s high. Afterwards, the teeth were extracted and K-type thermocouples were placed within the pulp chamber through the original access. The teeth were attached to an assembly simulating the in vivo environment, being similarly exposed while real-time temperature (°C) was recorded. ΔTEMP values and time for temperature to reach maximum (ΔTIME) were subjected to two-way ANOVA and Bonferroni's post-hoc tests (pre-set alpha 0.05). Results: Higher ΔTEMP was observed in vitro than in vivo. No significant difference in ΔTIME was observed between test conditions. A significant, positive relationship was observed between radiant exposure and ΔTEMP for both conditions (in vivo: r2=0.917; p<0.001; in vitro: r2=0.919; p<0.001). Conclusion: Although the in vitro model overestimated in vivo PT increase, in vitro PT rise was close to in vivo values for clinically relevant exposure modes

Effects of radiant exposure values using second and third generation light curing units on the degree of conversion of a lucirin-based resin composite

Alternative photoinitiators with different absorption wavelengths have been used in resin composites (RCs), so it is crucial to evaluate the effectiveness of light-curing units (LCUs) on these products. Objective Using Fourier transform infrared analysis (FTIR) in vitro, the effects of varying radiant exposure (RE) values generated by second and third generation LED LCUs on the degree of conversion (DC) and maximum rate of polymerization (Rpmax) of an experimental Lucirin TPO-based RC were evaluated. Material and Methods 1 mm or 2 mm thick silicon molds were positioned on a horizontal attenuated total reflectance (ATR) unit attached to an infrared spectroscope. The RC was inserted into the molds and exposed to varying REs (18, 36 and 56 J/cm2) using second (Radii Plus, SDI) and third generation LED LCUs (Bluephase G2/Ivoclar Vivadent) or a quartz tungsten based LCU (Optilux 501/SDS Kerr). FTIR spectra (n=7) were recorded for 10 min (1 spectrum/s, 16 scans/spectrum, resolution 4 cm-1) immediately after their application to the ATR. The DC was calculated using standard techniques for observing changes in aliphatic to aromatic peak ratios both prior to, and 10 min after curing, as well as during each 1 second interval. DC and Rpmax data were analyzed using 3-way ANOVA and Tukey’s post-hoc test (p=0.05). Results No significant difference in DC or Rpmax was observed between the 1 mm or 2 mm thick specimens when RE values were delivered by Optilux 501 or when the 1 mm thick composites were exposed to light emitted by Bluephase G2, which in turn promoted a lower DC when 18 J/cm2 (13 s) were delivered to the 2 mm thick specimens. Radii Plus promoted DC and Rpmax values close to zero under most conditions, while the delivery of 56 J/cm2 (40 s) resulted in low DC values. Conclusions The third generation LCU provided an optimal polymerization of Lucirin TPO-based RC under most tested conditions, whereas the second generation LED-curing unit was useless regardless of the RE

Estudo da união de sistemas adesivos no substrato dentinario afetado por carie. Efeito do condicionamento adicional na resistencia a tração

Orientador: Marcelo GianniniDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ondontologia de PiracicabaMestrad

Influence of resin cement shade on the color and translucency of ceramic veneers

Objective This in vitro study evaluated the effect of two different shades of resin cement (RC- A1 and A3) layer on color change, translucency parameter (TP), and chroma of low (LT) and high (HT) translucent reinforced lithium disilicate ceramic laminates. Material and Methods One dual-cured RC (Variolink II, A1- and A3-shade, Ivoclar Vivadent) was applied to 1-mm thick ceramic discs to create thin RC films (100 µm thick) under the ceramics. The RC was exposed to light from a LED curing unit. Color change (ΔE) of ceramic discs was measured according to CIEL*a*b* system with a standard illuminant D65 in reflectance mode in a spectrophotometer, operating in the light range of 360-740 nm, equipped with an integrating sphere. The color difference between black (B) and white (W) background readings was used for TP analysis, while chroma was calculated by the formula C*ab=(a*2+b*2)½. ΔE of 3.3 was set as the threshold of clinically unacceptable. The results were evaluated by two-way ANOVA followed by Tukey's post hoc test. Results HT ceramics showed higher ΔE and higher TP than LT ceramics. A3-shade RC promoted higher ΔE than A1-shade cement, regardless of the ceramic translucency. No significant difference in TP was noted between ceramic discs with A1- and those with A3-shade cement. Ceramic with underlying RC showed lower TP than discs without RC. HT ceramics showed lower chroma than LT ceramics, regardless of the resin cement shade. The presence of A3-shade RC resulted in higher chroma than the presence of A1-shade RC. Conclusions Darker underlying RC layer promoted more pronounced changes in ceramic translucency, chroma, and shade of high translucent ceramic veneers. These differences may not be clinically differentiable