A simplified restorative technique of fractured maxillary anterior teeth

Fractures of the anterior teeth consists of a clinical condition that generates not only aesthetic and psychological problems, but may also cause dental pain. Thus, the affected teeth should be treated as urgencies in dental offices and their resolution whenever possible should be in a single session. Direct resin composite restorations should wherever possible be preferred due to the speed and possibility of obtaining good results. Objective: The objective of this case report is to describe the clinical sequence for restoration of a maxillary central incisor that presented a crown fracture using an immediate insert technique for resin composite (a "free hand" technique) with a modification to obtain dentin layer. Case report: A patient sought treatment after she fractured tooth #21. The restoration was performed with resin composite using the immediate technique. To facilitate the layering technique, the immediate insertion technique was changed for making the dentin lobes with the aid of a Teflon tape and the support with the index finger. Conclusion: The restoration of fractured anterior teeth can be performed quickly with the use of resin composites of different opacities and the use of the technique of immediate insertion proposed in this case report

Influence of pH, bleaching agents, and acid etching on surface wear of bovine enamel

Development of new materials for tooth bleaching justifies the need for studies to evaluate the changes in the enamel surface caused by different bleaching protocols. Objective The aim of this study was to evaluate the bovine dental enamel wear in function of different bleaching gel protocols, acid etching and pH variation. Material and Methods Sixty fragments of bovine teeth were cut, obtaining a control and test areas. In the test area, one half received etching followed by a bleaching gel application, and the other half, only the bleaching gel. The fragments were randomly divided into six groups (n=10), each one received one bleaching session with five hydrogen peroxide gel applications of 8 min, activated with hybrid light, diode laser/blue LED (HL) or diode laser/violet LED (VHL) (experimental): Control (C); 35% Total Blanc Office (TBO35HL); 35% Lase Peroxide Sensy (LPS35HL); 25% Lase Peroxide Sensy II (LPS25HL); 15% Lase Peroxide Lite (LPL15HL); and 10% hydrogen peroxide (experimental) (EXP10VHL). pH values were determined by a pHmeter at the initial and final time periods. Specimens were stored, subjected to simulated brushing cycles, and the superficial wear was determined (μm). ANOVA and Tukey´s tests were applied (α=0.05). Results The pH showed a slight decrease, except for Group LPL15HL. Group LPS25HL showed the highest degree of wear, with and without etching. Conclusion There was a decrease from the initial to the final pH. Different bleaching gels were able to increase the surface wear values after simulated brushing. Acid etching before bleaching increased surface wear values in all groups

Indications and restorative techniques for glass ionomer cement

Introduction: Due to its chemical, mechanical and biological properties, the glass ionomer cements (GIC) consist in one of the most versatile direct restorative materials, with many potential clinical indications, especially in the context of minimally invasive dentistry. Nevertheless, they have some limitations and require the knowledge of their characteristics and procedures of application in order to achieve their maximum potential. Objective: To demonstrate through literature review the main characteristics, indications, limitations and future perspectives for the use of GIC. Literature review: The database, such as Pubmed and Lilacs were used. Additionally, books were also evaluated and included. Conclusion: The GIC is in constant evolution and is one of the materials that are best suited in the context of preventive and conservative dentistry. It has satisfactory properties and versatility. On the other hand, presents inferior properties when compared to other direct restorative materials, requiring caution during its handling

Protocol of finishing, texturing and polishing for direct composite resin restorations

This clinical case report describes a conservative approach to optimize the composite resin direct veneer. In order to improve the anatomy and surface texture of previous restorations, the treatment was based on a predictable and reproducible finishing and polishing protocol which ensured a harmonic smile without exposing the patient to a repetitive restorative cycle. Firstly, the strategy consisted of removing excess resin, thus defining the primary anatomy of the teeth, following the definition of the vertical and horizontal grooves to mimic the natural surface characteristics, providing an aesthetic surface, favorable to light reflection. In addition, polishing was conducted in order to obtain smooth and shiny restorations, which provide greater longevity to the aesthetic restorative treatments.O presente relato de caso clínico descreve uma abordagem conservadora para otimização de facetas diretas em resina composta. Para melhoria da anatomia e textura superficial das restaurações antigas, o tratamento baseou-se em um protocolo previsível e reprodutível de acabamento e polimento, o qual garantiu a obtenção de um sorriso equilibrado sem expor a paciente ao ciclo restaurador repetitivo. Inicialmente, a estratégia consistiu na remoção dos excessos de resina, definindo a anatomia primária dos dentes, seguindo a definição dos sulcos verticais e horizontais para mimetizar as características superficiais naturais, proporcionando superfície mais estética e favorável à reflexão de luz. Em adição, o polimento foi conduzido de modo a obter restaurações lisas e brilhantes, que proporcionam maior longevidade aos tratamentos restauradores estéticos

Liberação de flúor do Vitremer em diferentes proporções pó/líquido, em compação com dois selantes de fóssulas e fissuras

The purpose of this in vitro study was to evaluate the fluoride (F) release of Vitremer/3M in 3 groups with different powder/liquid ratios (VT 1:1, VT ½:1 e VT ¼:1) in comparison with two sealants FluroShield/Dentsply (FS) and Vitro-Seal Alpha/DFL (VS). Eight specimens were submitted to a pH-cycling system. They were immersed alternatively in de (6h) and re-mineralization solutions (1 h), while 8 specimens were immersed in agitated non ionized water at 37oC, exchanged daily during 15 days. The F concentration released in 24 hour periods, in 7 and 15 days, was measured by using the ion specific electrode (Orion 9609), after buffering with TISAB II. Vitremer in the powder/liquid ratio of ½:1 and ¼:1 both in water and in de/re-mineralization solutions had a higher F release when compared to the other groups, as revealed by the results of the ANOVA and the Tukey’s test (p < 0,05). There were no significant differences between VT ½ and VT ¼ in de and re-mineralization solutions. Thus, the alteration of the Vitremer consistence, as far as the fluidity is concerned, suggests that it may be a favorable alternative concerning the F release.A proposta deste estudo in vitro foi avaliar a liberação de flúor do cimento de ionômero de vidro Vitremer/3M em três diferentes proporções pó/líquido (1:1, ½:1 e ¼:1), em comparação com dois selantes: FluroShield/Dentsply e Vitro-Seal Alpha/DFL. Oito espécimes foram submetidos a um modelo de ciclagem de pH, sendo imersos alternadamente em soluções de desmineralização (6h) e remineralização (18h) e outros oito mantidos em água deionizada a 37oC sob agitação, trocada diariamente, por 15 dias. A concentração de F liberada nos períodos de 24 horas, 7 e 15 dias foi analisada através do eletrodo íon específico (Orion 9609), após tamponamento com TISAB II. Os resultados, em µgF/cm2 demonstraram que o Vitremer nas proporções ½:1 e ¼:1, tanto em H2O como em des-/re-, apresentou liberação de F significativamente maior em relação aos demais grupos, conforme mostrado pela ANOVA e pelo teste de Tukey (p < 0,05), não tendo havido diferença estatística significativa entre o Vitremer ½:1 e ¼:1 nas soluções de des-/re-. Assim, a alteração na consistência do Vitremer, tornando-o mais fluido, parece ser uma alternativa favorável sob o aspecto de liberação de F

Abordagem restauradora estética e conservadora para o fechamento de diastemas múltiplos após tratamento ortodôntico: relato de caso

Objetivos: A presença de diastemas múltiplos na região anterior compromete a estética do sorriso e a harmonia da face, podendo interferir severamente na qualidade de vida do paciente. Este relato clínico tem como objetivo abordar uma técnica restauradora direta e conservadora para a resolução estética de diastemas anteriores múltiplos, empregando resina composta e abordando os princípios restauradores para maior previsibilidade de resultado. Materiais e métodos: O tratamento consistiu no clareamento caseiro com gel à base de peróxido de carbamida 16% durante 14 dias por três horas diárias. Após moldagem e obtenção dos modelos de gesso, o enceramento de diagnóstico foi realizado e a guia palatina em silicone de condensação, obtida. As restaurações diretas em resina composta para o fechamento dos diastemas foram realizadas na cor E-bleaching L, D-bleaching e T-neutral (Opalis, FGM, Joinville, SC, Brasil), proporcionando o reposicionamento da linha média e conferindo adequada inclinação e alinhamento aos dentes anteriores. Após sete dias foi realizado o acabamento, RX final, remoção dos excessos e polimento das restaurações. Resultados: o controle clínico foi realizado periodicamente, mostrando resultado satisfatório após um ano e oito meses de acompanhamento. Conclusões: o conhecimento em relação aos materiais restauradores diretos e o domínio da técnica operatória promovem maior previsibilidade e melhor desempenho clínico das restaurações estéticas em resinas compostas.Objectives: The presence of multiple diastema in anterior teeth compromises the smile esthetics and the harmony of the face, often interfering in the quality of life of the patient. This case report aims to address a direct and conservative restorative technique with composite resin for the esthetic resolution of multiple anterior diastema, reporting the restorative principles and indications for greater outcome predictability. Materials and methods: The treatment consisted of at-home whitening with 16% carbamide peroxide gel in a custom-fitted tray for 14 days. After obtaining the impressions, the gypsum models were obtained, and the wax-up and palatal silicone guide were performed. The direct composite resin restorations for diastema closure were performed utilizing the shades E-bleaching L, D-bleaching and T-neutral (Opalis, FGM, Joinville, Brasil), providing repositioning of the midline, adequate inclination and alignment of the anterior teeth. Results: After 7 days the restorations were finished and polished and final X Ray was obtained. Conclusion: Based on the results after 1 year and 8 months, it is important to know the relationship between direct restorative materials and the domain of operative technique in order to provide greater predictability and satisfactory aesthetic results

RSBO Revista Sul-Brasileira de Odontologia Curing depth of a silorane-based resin composite

Curing depth of a silorane-based resin composite RSBO Revista Sul-Brasileira de Odontologia, vol. 12, núm. 2, abril-junio, 2015, pp. 196-201 Universidade da Região de Joinville Joinville, Brasil Abstract Introduction: The silorane-based resin appears aiming to minimize the effects of polymerization shrinkage, but other properties must be studied. Objective: To evaluate the polymerization depth of two composites with different organic matrix. Material and methods: 80 cylindrical specimens were prepared using a metallic matrix, with three layers (top, middle and bottom), 1 mm high and 5 mm in diameter. The specimens were divided into eight groups (n = 10) according to the composite resins: Filtek P90 (3M/ESPE); Filtek Z250 (3M/ESPE), light-cured with a LED device with different irradiance and times (600mW/cm 2 x 40s, 1000mW/cm 2 x 40s, 1000mW/cm 2 x 20s; 1400mW/cm 2 x 20s). The irradiance was controlled by placing plastic rings coupled to the device&apos;s tip. Immediately after polymerization, the specimens&apos; layers were separated and five Knoop microhardness readings (initial hardness) were performed on each one of the four layers (0, 1, 2, and 3 mm). After 7 day storage in water at 37ºC, new readings were performed (final microhardness). The data were analyzed by four-way ANOVA (resin, energy density, depth and time) and Tukey test (α = 0.05). Results: The microhardness decreased with the depth increasing both in the initial and 7 day readings. The hardness increased with the highest power densities. The resin P90 had lower hardness values. Conclusion: The silorane-based resin showed Knoop microhardness values significant smaller than those of methacrylate-based resin in almost all evaluated parameters. However, both presented similar behaviors in relation to the curing depth