Clinical evaluation of ceramic inlays and onlays made with two systems after 2 years

As restaurações em cerâmica pura têm sido uma opção restauradora largamente utilizada em dentes posteriores devido a sua excelente estética. Diversos tipos de sistemas cerâmicos estão disponíveis no mercado para a fabricação de restaurações parciais e coroas. Este trabalho teve o objetivo de avaliar o comportamento clínico de restaurações, do tipo inlay e onlay, confeccionadas com dois sistemas cerâmicos: cerâmica convencional (Duceram, Dentsply-Degussa) D e cerâmica prensada (IPS Empress, Ivoclar- Vivadent) IPS pelo período de 02 anos. Oitenta e seis restaurações, sendo 44 IPS e 42 D, foram cimentadas em 35 pacientes de ambos os sexos, com idade média de 35 anos. Vinte e sete pré-molares e cinqüenta e nove molares receberam preparos cavitários classe II, num total de 33 onlays e 53 inlays. Todas as restaurações foram fixadas com cimento resinoso dual (Variolink II, Ivoclar-Vivadent) e sistema adesivo Syntac (Primer e Adhesive) e Heliobond (Ivoclar-Vivadent), sob isolamento absoluto. Os procedimentos operatórios foram realizados por apenas um operador. As avaliações foram realizadas por dois examinadores independentes no baseline, após 01 e 02 anos mediante o critério USPHS modificado, quanto aos aspectos: sensibilidade pulpar, reincidência de cárie, fratura, reprodução de cor, descoloração marginal, integridade marginal e textura superficial. Adicionalmente, radiografias e slides foram feitos. Após 02 anos, 100% das restaurações foram reavaliadas e consideradas clinicamente excelentes ou aceitáveis. Dentre os itens analisados os seguintes apresentaram critério Bravo: descoloração marginal IPS (31,82%); D (23,81%); integridade marginal IPS (18,18%); D (11,9%); reprodução de cor IPS (4,55%); D (9,52%) e textura superficial IPS (2,27%); D (14,29%). Nenhum escore Charlie" ou Delta" foi atribuído às restaurações. Os resultados obtidos foram submetidos ao Teste Estatístico de Fisher e McNemar. Não houve diferença estatisticamente significante entre as cerâmicas testadas após 02 anos. Dentre os aspectos avaliados, o item descoloração marginal apresentou uma crescente porcentagem de escores Bravo", para ambas as cerâmicas. Comparando-se esses dados com os obtidos no baseline verificou-se uma diferença estatisticamente significante (p > 0,05). Não houve diferença entre as restaurações do tipo inlay e onlay ou entre as restaurações fixadas nas regiões de pré-molares e molares. Na avaliação de 02 anos, o percentual de concordância entre os examinadores resultou em valores de Kappa acima de 0,8 para todos os critérios avaliados. Pôde-se concluir que os dois tipos de restaurações em cerâmica pura demonstraram um excelente desempenho clínico no período de dois anos.The dental ceramics have been a restorative option, largely utilized in posterior teeth, due to an excellent esthetics. Several types of all ceramic systems are available in the market to fabricate partial restorations and crowns. The aim of this study was to evaluate the clinical performance of ceramic inlays and onlays made with two systems: sintered (Duceram, Dentsply-Degussa) D and pressable (IPS Empress, Ivoclar-Vivadent) IPS for two years. Eighty-six restorations, being 44 IPS and 42 D, were cemented in 35 patients from both sexes, mean age of 35 years. Twenty-seven premolars and 59 molars received class II cavities, totaling 33 onlays and 53 inlays. All restorations were cemented with the dual-resin cement (Variolink II, Ivoclar-Vivadent) and Syntac (Primer and Adhesive) and Heliobond adhesive system (Ivoclar-Vivadent), under rubber dam. The operative procedures were made by one operator. The evaluations were done by two independent investigators at the baseline, after one and two years, using the modified USPHS criteria for postoperative sensitivity, secondary caries, fracture, color match, marginal discoloration, marginal integrity and surface texture. Additionally radiographs and slides were made. After two years 100% of the restorations were assessed and all the restorations were considered clinically excellent or acceptable. Among the analyzed criteria the fallowing received Bravo ratings: marginal discoloration IPS (31.82%); D (23.81%); marginal integrity IPS (18.18%); D (11.9%); color match IPS (4.55%); D (9.52%) and surface texture IPS (2.27%); D (14.29%). No Charlie" or Delta" scores were attributed to the restorations. The results were submitted to the Fisher and McNemar Statistical Tests. No significant differences were noticed between both ceramics after two years. Among the analyzed criteria only the marginal discoloration aspect presented an increased percentage of Bravo" scores, which enhanced with time for both ceramics. Compared to the baseline data, the difference was statistically significant (p> 0.05). No difference was found between inlays and onlays restorations or between the restorations placed in premolar or molar region. At 2 years, the interexaminer reliability yielded Kappa values above 0.8 for all criteria. In conclusion, these two types of ceramics demonstrated excellent clinical performance after two years

Clinical evaluation of ceramic inlays and onlays made with two systems after 2 years

As restaurações em cerâmica pura têm sido uma opção restauradora largamente utilizada em dentes posteriores devido a sua excelente estética. Diversos tipos de sistemas cerâmicos estão disponíveis no mercado para a fabricação de restaurações parciais e coroas. Este trabalho teve o objetivo de avaliar o comportamento clínico de restaurações, do tipo inlay e onlay, confeccionadas com dois sistemas cerâmicos: cerâmica convencional (Duceram, Dentsply-Degussa) D e cerâmica prensada (IPS Empress, Ivoclar- Vivadent) IPS pelo período de 02 anos. Oitenta e seis restaurações, sendo 44 IPS e 42 D, foram cimentadas em 35 pacientes de ambos os sexos, com idade média de 35 anos. Vinte e sete pré-molares e cinqüenta e nove molares receberam preparos cavitários classe II, num total de 33 onlays e 53 inlays. Todas as restaurações foram fixadas com cimento resinoso dual (Variolink II, Ivoclar-Vivadent) e sistema adesivo Syntac (Primer e Adhesive) e Heliobond (Ivoclar-Vivadent), sob isolamento absoluto. Os procedimentos operatórios foram realizados por apenas um operador. As avaliações foram realizadas por dois examinadores independentes no baseline, após 01 e 02 anos mediante o critério USPHS modificado, quanto aos aspectos: sensibilidade pulpar, reincidência de cárie, fratura, reprodução de cor, descoloração marginal, integridade marginal e textura superficial. Adicionalmente, radiografias e slides foram feitos. Após 02 anos, 100% das restaurações foram reavaliadas e consideradas clinicamente excelentes ou aceitáveis. Dentre os itens analisados os seguintes apresentaram critério Bravo: descoloração marginal IPS (31,82%); D (23,81%); integridade marginal IPS (18,18%); D (11,9%); reprodução de cor IPS (4,55%); D (9,52%) e textura superficial IPS (2,27%); D (14,29%). Nenhum escore Charlie" ou Delta" foi atribuído às restaurações. Os resultados obtidos foram submetidos ao Teste Estatístico de Fisher e McNemar. Não houve diferença estatisticamente significante entre as cerâmicas testadas após 02 anos. Dentre os aspectos avaliados, o item descoloração marginal apresentou uma crescente porcentagem de escores Bravo", para ambas as cerâmicas. Comparando-se esses dados com os obtidos no baseline verificou-se uma diferença estatisticamente significante (p > 0,05). Não houve diferença entre as restaurações do tipo inlay e onlay ou entre as restaurações fixadas nas regiões de pré-molares e molares. Na avaliação de 02 anos, o percentual de concordância entre os examinadores resultou em valores de Kappa acima de 0,8 para todos os critérios avaliados. Pôde-se concluir que os dois tipos de restaurações em cerâmica pura demonstraram um excelente desempenho clínico no período de dois anos.The dental ceramics have been a restorative option, largely utilized in posterior teeth, due to an excellent esthetics. Several types of all ceramic systems are available in the market to fabricate partial restorations and crowns. The aim of this study was to evaluate the clinical performance of ceramic inlays and onlays made with two systems: sintered (Duceram, Dentsply-Degussa) D and pressable (IPS Empress, Ivoclar-Vivadent) IPS for two years. Eighty-six restorations, being 44 IPS and 42 D, were cemented in 35 patients from both sexes, mean age of 35 years. Twenty-seven premolars and 59 molars received class II cavities, totaling 33 onlays and 53 inlays. All restorations were cemented with the dual-resin cement (Variolink II, Ivoclar-Vivadent) and Syntac (Primer and Adhesive) and Heliobond adhesive system (Ivoclar-Vivadent), under rubber dam. The operative procedures were made by one operator. The evaluations were done by two independent investigators at the baseline, after one and two years, using the modified USPHS criteria for postoperative sensitivity, secondary caries, fracture, color match, marginal discoloration, marginal integrity and surface texture. Additionally radiographs and slides were made. After two years 100% of the restorations were assessed and all the restorations were considered clinically excellent or acceptable. Among the analyzed criteria the fallowing received Bravo ratings: marginal discoloration IPS (31.82%); D (23.81%); marginal integrity IPS (18.18%); D (11.9%); color match IPS (4.55%); D (9.52%) and surface texture IPS (2.27%); D (14.29%). No Charlie" or Delta" scores were attributed to the restorations. The results were submitted to the Fisher and McNemar Statistical Tests. No significant differences were noticed between both ceramics after two years. Among the analyzed criteria only the marginal discoloration aspect presented an increased percentage of Bravo" scores, which enhanced with time for both ceramics. Compared to the baseline data, the difference was statistically significant (p> 0.05). No difference was found between inlays and onlays restorations or between the restorations placed in premolar or molar region. At 2 years, the interexaminer reliability yielded Kappa values above 0.8 for all criteria. In conclusion, these two types of ceramics demonstrated excellent clinical performance after two years

Adhesive Cementation of Etchable Ceramic Esthetic Restorations

This article describes the different materials and techniques that are used for adhesive cementation. Particular attention is given to treatments suitable for dentin, as well as the selection of surface treatments for various restorative materials. Factors related to the durability and stability of the adhesive process, as well as the clinical and laboratory procedures required for cementation, are also discussed

CAD/CAM technology and esthetic dentistry: a case report.

Advances in dental materials as well as in computer technology have made CADCAM-fabricated restorations not just possible in dentistry but plentiful. When using CADCAM systems, operators can fabricate restorations from several materials, including ceramics, metal alloys, and various composites. This case report describes the replacement of a porcelain-layered zirconia-based (coping) crown on a left lower cuspid that presented with a veneering ceramic chipping on a lithium-disilicate CADCAM-fabricated crown. It demonstrates how all-ceramic systems offer a promising alternative in the restoration of anterior teeth

Retrospective clinical evaluation of ceramic onlays placed by dental students.

STATEMENT OF PROBLEM: Indirect restorations with partial or complete occlusal surface coverage have been recommended to restore teeth with weakened walls in order to prevent cusp fracture. The success of these restorations when performed by dental students is unknown. PURPOSE: The purpose of this retrospective study was to evaluate the clinical performance of adhesively bonded ceramic onlay restorations placed by third- and fourth-year dental students. MATERIAL AND METHODS: Sixty-five ceramic onlays were placed in patients between 2009 and 2015. The onlays were laboratory or chairside fabricated with a computer-aided design and computer-aided manufacturing (CAD-CAM) system, using either IPS e.max Press or IPS e.max CAD. An adhesive technique and luting composite resin agent were used to cement the restorations. Thirty-seven onlays were evaluated clinically using the modified United States Public Health Service (USPHS) criteria. Data were statistically analyzed using the Cox proportional hazards model to compare tooth type and failures and the Fisher exact and McNemar tests to compare the USPHS criteria for significant differences (α=.05). Survival probability was calculated using the Kaplan-Meier algorithm. RESULTS: Five onlays were considered to be failures and needed replacement. According to the Kaplan-Meier analysis, the estimated survival rate was 96.3% after 2 years and 91.5% at 4 years. All 5 of the failures occurred on molars (13.5%) and none on premolars (P=.025). A statistically significant difference was found for marginal discoloration between onlays placed within 0 to 3 years and 3 to 6 years (P CONCLUSIONS: Ceramic onlays placed by dental students demonstrated acceptable long-term clinical performance

Accuracy of mechanical torque devices for implants used in Brazilian dental offices

The purpose of this study was to determine the accuracy of mechanical torque devices in delivering target torque values in dental offices in Salvador, Brazil. A team of researchers visited 16 dental offices, and the clinicians applied torque values (20 and 32 Ncm) to electronic torque controllers. Five repetitions were completed at each torque value and data were collected. When 20 Ncm of torque was used, 62.5% of measured values were accurate (within 10% of the target value). For 32 Ncm, however, only 37.5% of these values were achieved. Several of the tested mechanical torque devices were inaccurate. © 2011 by Quintessence Publishing Co Inc

Microleakage and microtensile bond strength of silorane-based and dimethacrylate-based restorative systems.

To evaluate the microleakage and bond strengths (microTBS) of silorane-based (SBC) and dimethacrylate-based (DBC) restorative systems. The null hypotheses are: 1) there is no difference in microleakage between the resin composites and the adhesive systems tested at the enamel and dentin margins; 2) there is no significant difference in microTBS between the composite restorative systems using self-etch and etch-and-rinse adhesive versions. Microleakage: Class V cavity preparations with cervical margin in dentin were performed on pristine extracted human molars and were randomly distributed among the following three groups: Group 1-DBC/etch-and-rinse adhesive system (Filtek™ Supreme Ultra/Adper™ Single Bond Plus, 3M ESPE, www.3MESPE.com); Group 2-SBC/self-etch adhesive (Filtek LS Low Shrink Posterior Restorative System/LS self-etch adhesive, 3M ESPE); Group 3-DBC/self-etch adhesive (Filtek Supreme Ultra/ Adper Easy Bond Self-Etch, 3M ESPE). Restorations were thermocycled and immersed in 0.2 percent methylene blue dye for 24 hours. Samples were assessed visually under 10x magnification; microTBS: Bond sticks (0.9 mm2) were prepared from each group and tested on a universal testing machine. The Kruskal-Wallis test revealed no significant difference in microleakage among the experimental groups at the enamel margin (P=0.191). At the dentin margins, silorane/self-etch restorative system showed significantly less leakage than the dimethacrylate/etch-and-rinse restorative system (P=0.008). Tukey\u27s B rank order test showed that the dimethacrylate/etch-and-rinse restorative system presented the highest microTBS. SBC/self-etch system showed less microleakage at the dentin margins, while DBC/etch-and-rinse system presented higher bond strength

The effect of prophylactic powders on the surface roughness of enamel

OBJECTIVE: To assess the effect of dental prophylactic methods on the surface roughness of enamel