Minimal alterations on the enamel surface by micro-abrasion: in vitro roughness and wear assessments

Objective: To evaluate the in vitro changes on the enamel surface after a micro-abrasion treatment promoted by different products. Material and Methods: Fifty (50) fragments of bovine enamel (15 mm × 5 mm) were randomly assigned to five groups (n=10) according to the product utilized: G1 (control)= silicone polisher (TDV), G2= 37% phosphoric acid (3M/ESPE) + pumice stone (SS White), G3= Micropol (DMC Equipment), G4= Opalustre (Ultradent) and G5= Whiteness RM (FGM Dental Products). Roughness and wear were the responsible variables used to analyze these surfaces in four stages: baseline, 60 s and 120 s after the micro-abrasion and after polishing, using a Hommel Tester T1000 device. After the tests, a normal distribution of data was verified, with repeated ANOVA analyses (p?0.05) which were used to compare each product in different stages. One-way ANOVA and Tukey tests were applied for individual comparisons between the products in each stage (p?0.05). Results: Means and standard deviations of roughness and wear (µm) after all the promoted stages were: G1=7.26(1.81)/13.16(2.67), G2=2.02(0.62)/37.44(3.33), G3=1.81(0.91)/34.93(6.92), G4=1.92(0.29)/38.42(0.65) and G5=1.98(0.53)/33.45(2.66). At 60 seconds, all products tended to produce less surface roughness with a variable gradual decrease over time. After polishing, there were no statistically significant differences between the groups, except for G1. Independent of the product utilized, the enamel wear occurred after the micro-abrasion. Conclusions: In this in vitro study, enamel micro-abrasion presented itself as a conservative approach, regardless of the type of the paste compound utilized. These products promoted minor roughness alterations and minimal wear. The use of phosphoric acid and pumice stone showed similar results to commercial products for the micro-abrasion with regard to the surface roughness and wear

Effect of the Polishing Procedures on Color Stability and Surface Roughness of Composite Resins

Objectives. To evaluate the polishing procedures effect on color stability and surface roughness of composite resins. Methods. Specimens were distributed into 6 groups: G1: Filtek Supreme XT + PoGo; G2: Filtek Supreme XT + Sof-Lex; G3: Filtek Supreme XT + no polishing; G4: Amelogen + PoGo; G5: Amelogen + Sof-Lex.; G6: Amelogen + no polishing. Initial color values were evaluated using the CIELab scale. After polishing, surface roughness was evaluated and the specimens were stored in coffee solution at 37°C for 7 days. The final color measurement and roughness were determined. Results. Sof-Lex resulted in lower staining. Amelogen showed the highest roughness values than Filtek Supreme on baseline and final evaluations regardless of the polishing technique. Filtek Supreme polished with PoGo showed the lowest roughness values. All groups presented discoloration after storage in coffee solution, regardless of the polishing technique. Conclusion. Multiple-step polishing technique provided lower degree of discoloration for both composite resins. The final surface texture is material and technique dependent

Effect of deproteinization and tubular occlusion on microtensile bond strength and marginal microleakage of resin composite restorations

Dentin adhesion procedure presents limitations, especially regarding to lifetime stability of formed hybrid layer. Alternative procedures have been studied in order to improve adhesion to dentin. OBJECTIVE: The aim of this study was to evaluate in vitro the influence of deproteinization or dentin tubular occlusion, as well as the combination of both techniques, on microtensile bond strength (µTBS) and marginal microleakage of composite resin restorations. MATERIAL AND METHODS: Extracted erupted human third molars were randomly divided into 4 groups. Dentin surfaces were treated with one of the following procedures: (A) 35% phosphoric acid gel (PA) + adhesive system (AS); (B) PA + 10% NaOCl + AS; (C) PA + oxalate + AS and (D) PA + oxalate + 10% NaOCl + AS. Bond strength data were analyzed statistically by two-way ANOVA and Tukey's test. The microleakage scores were analyzed using Kruskal-Wallis and Mann-Whitney non-parametric tests. Significance level was set at 0.05 for all analyses. RESULTS: µTBS data presented statistically lower values for groups D and B, ranking data as A>C>B>D. The use of oxalic acid resulted in microleakage reduction along the tooth/restoration interface, being significant when used alone. On the other hand, the use of 10% NaOCl alone or in combination with oxalic acid, resulted in increased microleakage. CONCLUSIONS: Dentin deproteinization with 10% NaOCl or in combination with oxalate significantly compromised both the adhesive bond strength and the microleakage at interface. Tubular occlusion prior to adhesive system application seems to be a useful technique to reduce marginal microleakage

Comparação entre a dose e a distribuição de pontos de aplicação de toxina botulínica tipo A na eficácia para o tratamento de rítides glabelares. Ensaio clínico randomizado duplo cego / Comparison between dose and distribution of botulinum toxin type A application points in efficacy for the treatment of glabellar rhytids. Double blind randomized clinical trial

A toxina botulínica tem sido empregada de forma segura e eficaz para o tratamento das rítides glabelares. Entretanto, a prática clínica tem sido variada, permanecendo dúvidas sobre a dose ótima desejável bem como a quantidade de pontos de aplicação. O objetivo desse trabalho é, portanto, avaliar o efeito da concentração e dos pontos de aplicação da toxina botulínica na região glabelar sobre a diminuição das linhas de expressão. Quarenta voluntários foram randomicamente divididos em 4 grupos, a saber : G1: injetado um ponto de aplicação no músculo prócero com 5U e um ponto de aplicação em cada músculo corrugador com 5U por ponto; G2: um ponto de aplicação no prócero com 5U e dois pontos de aplicação em cada músculo corrugador com 2,5U em cada ponto; G3: injetado um ponto de aplicação no músculo prócero com 7U e um ponto de aplicação em cada músculo corrugador com 7U por ponto; G4: um ponto de aplicação no prócero com 7U e dois pontos de aplicação em cada músculo corrugador com 5U em cada ponto. Os participantes foram avaliados nos tempos baseline e nas semanas 2, 8, 16 pelo método Facial Wrinkle Scale. Os resultados desse estudo sugerem que entre as dosagens estudadas, 21 U aplicadas em um ponto por músculo é a dose mais efetiva para o tratamento da região glabelar, com durabilidade de 4 meses.

Clinical strategies for esthetic excellence in anterior tooth restorations: understanding color and composite resin selection

Direct composite resin restorations have become a viable alternative for patients that require anterior restorative procedures to be integrated to the other teeth that compose the smile, especially for presenting satisfactory esthetic results and minimum wear of the dental structure. Technological evolution along with a better understanding of the behavior of dental tissues to light incidence has allowed the development of new composite resins with better mechanical and optical properties, making possible a more artistic approach for anterior restorations. The combination of the increasing demand of patients for esthetics and the capacity to preserve the dental structure resulted in the development of different incremental techniques for restoring fractured anterior teeth in a natural way. In order to achieve esthetic excellence, dentists should understand and apply artistic and scientific principles when choosing color of restorative materials, as well as during the insertion of the composite resin. The discussion of these strategies will be divided into two papers. In this paper, the criteria for color and material selection to obtain a natural reproduction of the lost dental structures and an imperceptible restoration will be addressed

Influência da variação da densidade de potência na contração de polimerização e adaptação marginal de resinas compostas à base de metacrilato e silorano

Este estudo avaliou quantitativamente a contração de polimerização em função do aumento dos valores de densidade de potência irradiados em compósitos à base de metacrilatos e silorano, e qualitativamente a interface restauradora em relação à abertura de fendas marginais, em função da variação do tipo de substrato dentário. As resinas Filtek Z250 e Filtek P90 foram fotoativadas com 200, 400, 600, 800 e 1000 mW/cm2, em um volume constante de 12 mm3, e os valores de contração aferidos por meio da máquina de ensaios universal. Para análise qualitativa da interface restauradora, preparos cavitários classe V de 2x2x2 mm foram restaurados em incisivos bovinos, fotoativados com os mesmos valores de irradiância, e analisados em microscopia eletrônica de varredura nas interfaces da parede circundante em esmalte, parede circundante em dentina e parede axial. Os resultados quantitativos da contração de polimerização foram analisados pelo teste ANOVA a dois critérios e Tukey (p0,05), enquanto para os dados qualitativos os testes Mann-Whitney, Kruskal-Wallis e Miller foram empregados. O aumento progressivo da densidade de potência influenciou diretamente na contração de polimerização dos materiais estudados, não obstante a resina composta à base de silorano ter demonstrado valores significativamente menores. A integridade marginal sofreu influência do subtrato dentário bem como da densidade de potência utilizada, para as duas resinas estudadas.Shrinkage is a limitation of resin composite, compromising the clinical longevity of the restorative procedure. In an attempt to reduce their harmful effects, researchers have studied monomers with lower values of contraction. As a result, low-shrinkage composites wer developed. This study evaluated quantitatively the shrinkage by a universal testing machine as a function of power density increase based on methacrylates, comparing them with silorane based resin, and qualitatively regarding gap formation between the adhesive interface as function of tooth substrate. Resin Filtek P90 and Filtek Z250 were polymerized with the device Blue Star 3 with 200, 400, 600, 800 and 1000 mW/cm2 keeping volume constant in 12 mm3. For qualitative analysis of restorative interface, class V cavity preparations in bovine incisors were restored in (2x2x2 mm), photoactivated with the same values of irradiance, and analyzed by scanning electron microscopy at the interface of the wall surrounding enamel, dentin and axial. The quantitative results of the polymerization shrinkage were analyzed by two-way ANOVA and Tukey\'s test (p0,05), while qualitative data for the Mann-Whitney, Kruskal-Wallis and Miller were employed. The progressive increase in power density directly influenced the polymerization shrinkage of the materials studied, despite the silorane based resin have demonstrated significantly lower values. The marginal integrity was influenced by the dental substrate and the power density used

Influência de diferentes métodos de fotoativação e meios de armazenamento na resistência à abrasão de uma resina composta

As resinas compostas fotoativáveis apresentam limitações inerentes ao sistema restaurador, como a tensão gerada durante a contração volumétrica de polimerização e a baixa resistência ao desgaste, principalmente nas regiões de contato oclusal. Na tentativa de diminuir estas tensões ou minimizar os seus efeitos, o uso de baixa densidade de potência nos momentos iniciais da reação de polimerização tem sido proposto. Acredita-se, no entanto, que as propriedades físicoquímicas do material possam ser afetadas negativamente, podendo resultar em um polímero mais frágil mecanicamente e mais susceptível à degradação. Face à esta problematização, avaliou-se o efeito que diferentes métodos de fotoativação exercem na resistência ao desgaste de uma resina composta, bem como na suscetibilidade da estrutura polimérica final formada, em função da variação do meio de armazenamento, aquoso ou alcoólico. O aparelho VIP (BISCO), que possibilita comandos independentes de densidade de potência e tempo foi selecionado. Quatro diferentes métodos de fotoativação foram investigados: Convencional (C: 600mW/cm2 X 40s), Pulse-delay (PD: 200mW/cm2 X 3s + 3 min + 600mW/cm2 X 37s), Pulse-delay plus (PDP: 600mW/cm2 X 3s + 3 min + 600mW/cm2 X 37s) e Softstart (SS: 200mW/cm2 X 10s + 600mW/cm2 X 30s). Após a fotoativação, os espécimes foram armazenados em dois meios distintos, água destilada e solução de etanol a 75%, por 24 horas, e submetidos ao teste de escovação simulada. Os dados foram analisados pelos testes estatísticos ANOVA à 2 critérios e key. Os métodos de fotoativação que utilizaram baixa densidade de potência inicial não comprometeram a resistência à abrasão da resina composta testada.In an attempt to reduce the stresses generated during polymerization shrinkage of composite resins or minimize its effects, different light-curing techniques have been proposed as alternatives to the conventional technique, which are known as lightcuring modulation techniques, and suggest the use of low power density at the initial moments of the polymerization reaction. However, due to the low power density applied to the composite resin, it is believed that some properties of the material would be negatively affected, which might produce a polymer mechanically more fragile. Considering that, this study was conducted to investigate the in vitro abrasive wear of a composite resin subjected at four different photoactivation methods, as well as in the susceptibility of the final polymer structure formed, in function of the variation of the way of storage, watery or alcoholic. Device VIP (BISCO), that it makes possible independent commands of power density and time was selected. Four different photoactivation methods had been investigated: Conventional (C: 600mW/cm2 X 40s), Pulse-delay (PD: 200mW/cm2 X 3s 3 min wait 600mW/cm2 X 37s), Pulse-delay plus (PDP: 600mW/cm2 X 3s 3 min wait 600mW/cm2 X 37s) and Soft-start (SS: 200mW/cm2 X 10s 600mW/cm2 X 30s). After the photoactivation, the specimens had been stored in two distinct ways, distilled water and solution of ethanol 75%, for 24 hours, and submitted to the test of simulated toothbrushing. The data had been analyzed by statistical tests two-way ANOVA and Tukey. Photoactivation methods which use low power density had not compromised the abrasive resistance of the composite resin tested, when comparable to that with high intensity

TRATAMIENTO DE LA PIGMENTACIÓN SISTÉMICA Y LA FLUOROSIS POR MEDIO DE BLANQUEAMIENTO EN CONSULTORIO ASOCIADO A MICROABRASIÓN DE ESMALTE

La resolución estética de los más diversos tipos de alteraciones de color de los dientes representa ungran desafío para el odontólogo. A través del correcto diagnóstico de estas alteraciones, el profesionalpuede decidir cuál es el mejor tratamiento estético u optar por la asociación de diferentes métodos detratamiento a fin de alcanzar un resultado estético satisfactorio con un mínimo desgaste de lasestructuras dentales. En la tentativa de promover mejoras en la estética de la sonrisa, el profesionalpuede usar el blanqueamiento dental en combinación con la microabrasión del esmalte como una opciónsegura y eficaz para la solución de algunas manchas. En el caso clínico presentado, las técnicas deblanqueamiento en consultorio con energía híbrida LASER/LED y la microabrasión del esmalte con pastade ácido fosfórico 37% y piedra pómez fueron utilizadas para establecer un color armónico en los dientesque presentaban de pigmentación sistémica y fluorosis dental.ABSTRACT he esthetic treatment of color alterations in dental organ meant a great challenge to the profession. Bymeans of a comprehensive diagnostic, clinicians have to decide which the best esthetic solution is or toassociate several methods in order to achieve a satisfactory esthetic treatment through a conservativeapproach. In an attempt to provide esthetic improvement, clinicians can combine bleaching and enamelmicroabrasion therapies as a safe and effective measure to solve dental staining. In this clinical case,bleaching at the dental office with hybrid LASER/LED energy and enamel microabrasion with 37%phosphoric acid and pumice paste were used to establish color harmony in teeth affected by systemic pigmentation and dental fluorosis