Effect of NaOCl storage on morphologic degradation of adhesive interface and bond strength in different substrates

Orientadores: Luiz Andre Freire Pimenta, Lourenço Correr SobrinhoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo deste estudo in vitro foi analisar o efeito da armazenagem em solução de hipoclorito de sódio a 10% (NaOCl), para acelerar a degradação hidrolítica e simular o envelhecimento da interface adesiva ao longo do tempo, através da avaliação da resistência de união adesiva com a utilização do teste de microtração. A solução de hipoclorito de sódio a 10% é usada em curtos períodos de tempo (horas) resultando em decréscimo significante da resistência de união no substrato dentinário após a armazenagem nesta solução; entretanto, o mecanismo de degradação gerado por esta solução não é totalmente compreendido, desde que o NaOCL é um agente proteolítico nãoespecífico, que poderia degradar não apenas as fibrilas colágenas expostas não encapsuladas na camada híbrida, mas também a interface adesiva. Foram avaliados 2 sistemas adesivos comercialmente disponíveis: um sistema adesivo de frasco único Single Bond (SB) e um sistema adesivo contendo primer autocondicionante Clearfil SE Bond (SE). Foram utilizados neste experimento, 80 incisivos bovinos hígidos, 40 para esmalte e 40 para dentina, e 40 blocos confeccionados em resina composta, totalizando 120 unidades experimentais divididas em 12 grupos (n = 10). Após a restauração com resina composta Filtek Z250, a amostra foi armazenada em água destilada por 24 horas, a 37 'GRAUS'C. Para a realização do teste de microtração, as unidades experimentais foram cortadas em forma de palitos de 1 mm2 e 8 palitos de cada unidade experimental foram armazenados em solução de hipoclorito de sódio a 10 % (NaOCl) por 2 horas (Grupos experimentais) ou em água destilada (H2O) por 24 horas (Grupos controle). O padrão de fratura foi observado com o auxílio da Microscopia Eletrônica de Varredura e foram realizadas fotomicrografias em magnitude de 80X para classificação do padrão de fratura e 1000X para caracterização dos detalhes das regiões mais expressivas das superfícies analisadas. As médias convertidas em MPa para os valores de união foram analisadas pelo teste de Análise de Variância (ANOVA) fatorial (3X2X2) e teste de Tukey para comparação das médias, ambos ao nível de 5 %. Os valores médios de microtração foram: Esmalte/NaOCl/SB = 29.3(4.0) a; Esmalte/NaOCl/SE = 20.7(3.4) b; Esmalte/H2O/SB = 31.2(5.0) a; Esmalte/H2O/SE = 20.8(2.9) b; Dentina/NaOCl/SB = 13.5(1.6) c; Dentina/NaOCl/SE = 7.5(1.1) d;Dentina/H2O/SB = 34.9(3.4) a; Dentina/H2O/SE = 20.3(3.7) b;ResinaComposta/NaOCl/SB = 24.1(7.0) b; ResinaComposta/NaOCl/SE = 42.8(4.7) a;ResinaComposta/H2O/SB =26.6(2.7) b; ResinaComposta/H2O/SE = 41.3(3.5) a. O padrão de fratura foi predominantemente adesivo para os substratos esmalte e resina composta,independentemente do sistema adesivo empregado e, para dentina, o padrão de fratura para a armazenagem em H2O foi predominantemente adesivo e para a armazenagem em NaOCl foi predominantemente na área de degradação. A armazenagem em NaOCl apresentou maior potencial significante de degradação e desproteinização para o substrato dentinário e o sistema autocondicionante empregado apresentou uma menor suscetibilidade à degradação. Este experimento in vitro provou ser efetivo na degradação de apenas das fibrilas colágenas na dentina, este método poderia útil para se predizer o desempenho clínico dos sistemas adesivosAbstract: The purpose of this in vitro study was to investigate the fast effect of the 10 % hypochrorite sodium storage in simulation to hydrolytic degradation and adhesive interface aged for long time, through to evaluate the bond strength of microtensile bond test. The 10% NaOCl solution used in short periods of time (hours) resulting in a significant decrease in bond strength in dentin after storage in that solution; however the mechanism of degradation generated by this solution is not totally understood, since sodium hypochlorite is a non-specific proteolytic agent, which could degrade not only the exposed collagen fibrils underneath the hybrid layer, but also the adhesive interface. For 2 adhesive systems avaliable commercially: one-bottle total-etch adhesive system Single Bond (SB) and primer self-etching adhesive system Clearfil SE Bond (SE). For this study, 80 ound bovine incisors, 40 for enamel and 40 for dentin, and 40 blocks building-up in composite resin, entirety 120 experimental units (n = 10). After sample restoration with resin composite Filtek Z250, the sample was storaged in distilled water at 37° C for 24 hours. For the microtensile bond test performance, the experimental units was sectioned into 1 mm² beams and 8 beams for each experimental unit was storaged in 10 % hypochrorite sodium (NaOCl) for 2 hours (Experimental groups) or in destilled water (H2O) for 24 hours (Control groups), entirety 960 beams observed. The failure pattern was observed in Scanning Electron Microscope (MEV) and photomicrographs was accomplished in 80X magnification for failure pattern classification and 1000X for details characterization of the more expressive areas for analysed surfaces. The means converted in MPa for the bond strength values were analysed by the Statistical Analysis (ANOVA) fatorial (3X2X2) and Tukey test for multiple comparison, both at level 5%. The means values for the microtensile test were: Enamel/NaOCl/SB = 29.3(4.0) a; Enamel/NaOCl/SE = 20.7(3.4) b; Enamel/H2O/SB = 31.2(5.0) a; Enamel/H2O/SE = 20.8(2.9) b; Dentin/NaOCl/SB = 13.5(1.6) c; Dentin/NaOCl/SE = 7.5(1.1) d; Dentin/H2O/SB = 34.9(3.4) a; Dentin/H2O/SE = 20.3(3.7) b; ResinComposite/NaOCl/SB = 24.1(7.0) b; ResinComposite/NaOCl/SE = 42.8(4.7) a; ResinComposite/H2O/SB =26.6(2.7) b; ResinComposite/H2O/SE = 41.3(3.5) a. The failure pattern was predominantly adhesive for the substrates enamel e resin composite, independently adhesive system utilized and, for dentin, the failure pattern for H2O storage was predominantly adhesive and for NaOCl storage was predominantly in degradation area. NaOCl storage showed a bigger degradation and desproteinization potencial significantly for the dentin substrate and the self-etching adhesive system tested showed smaller degradation susceptibility. This in vitro test proves to be effective in degrading just the collagen fibrils in dentin, this method might be very useful to predict the performance of the adhesive systems in clinicsMestradoDentísticaMestre em Clínica Odontológic

Study of variables that act in the luting process of ceramic restorations : light attenuation, activation mode, and surface treatment

Orientador: Lourenço Correr SobrinhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: A durabilidade de uma restauração cerâmica depende de fatores como grau de conversão do agente de cimentação e interação deste agente de cimentação com a superfície interna da cerâmica. Estes estudos in vitro avaliaram: (1) a influência de diferentes cerâmicas e o efeito de diferentes modos de ativação na microdureza Knoop (KHN) de um agente de cimentação resinoso dual, imediatamente e 24 horas após a polimerização e (2) a resistência de união de um novo tratamento de superfície à base de glaze na união entre a cerâmica à base de zirconia e um agente de cimentação resinoso dual, em associação com os tratamentos: jateamento com partículas de óxido de alumínio com 50 e 110µm, condicionamento com ácido fluorídrico a 10% e silanização. Para avaliação da atenuação da luz e dos modos de ativação, 10 discos do cimento resinoso Panavia F 2.0 foram confeccionados para cada grupo e ativados por fotoativação direta, ativação química ou através de discos de diferentes cerâmicas com 1.2mm de espessura. Os valores de KHN foram obtidos imediatamente e após 24 horas de armazenagem a 37 oC. Para a análise da resistência de união à cerâmica à base de zircônia, 80 discos de cerâmica à base de zirconia tetragonal estabilizada por ítrio foram confeccionados e receberam 8 tratamentos de superfície: Grupo I- jateamento com partículas de óxido de alumínio com 110µm, Grupo II- jateamento com partículas de óxido de alumínio com 110µm e silanização, Grupo III - jateamento com partículas de óxido de alumínio com 50µm, Grupo IV- jateamento com partículas de óxido de alumínio com 50µm e silanização, Grupo V- glaze e condicionamento com ácido fluorídrico 10%, Grupo VI- glaze, condicionamento com ácido fluorídrico 10% e silanização, Grupo VII- glaze e jateamento com partículas de óxido de alumínio com 50µm e Grupo VIII- glaze, jateamento com partículas de óxido de alumínio com 50µm e silanização. Após os tratamentos, o cimento resinoso dual Enforce foi inserido em microtúbulos Tygon em contato com a superfície das cerâmicas e fotoativado por 40s. A resistência de união foi obtida por ensaio de microcisalhamento. Os dados foram submetidos à Análise de Variância e ao teste de Tukey (5%) e mostraram que o agente de cimentação fotoativado através das cerâmicas à base de vidro e di-silicato apresentaram KHN superiores aos fotoativados através das cerâmicas à base de alumina e zircônia, imediatamente e após 24 horas. A fotoativação direta levou a valores de KHN superiores aos grupos que foram ativados através das cerâmicas e ativação química, para o tempo imediato e 24 horas. A resistência de união à cerâmica zircônia foi afetada pelos diferentes tratamentos de superfície e a associação entre o glaze e o ácido fluorídrico apresentou os melhores resultados, independentemente do processo de silanização. Dessa forma, pode-se concluir que a fotoativação através das cerâmicas promove atenuação da luz e KHN superior para o tempo de armazenagem de 24 horas, exceto para o modo de ativação direto. O tratamento com glaze promove significante aumento nos valores de resistência de união.Abstract: The durability of ceramic restoration depends of factors like the conversion degree of a luting agent and the interaction of this luting agent with the ceramic internal surface. These in vitro studies evaluate: (1) the influence of different ceramics and the effect of different activation modes on Knoop Hardness Number (KHN) of a dual agent luting, immediately and 24 hours after polymerization and (2) the bond strength of a novel surface treatment that use a glaze for promotes a bond between zirconia-based ceramic and a dual resin luting agent, in association with the treatments: 50 e 110µm air particle abrasion, 10% hydrofluoric acid etching and silanization. For the light attenuation and activated modes evaluation, 10 discs of Panavia F 2.0 resin cement were fabricated for each group and activated by directly photoactivation, chemical and activation through different ceramic discs of 1.2 mm thickness. KHN was obtained using microhardness immediately and after storage at 37oC for 24 hours. For the bond strength analysis to zirconia-based ceramic, 80 ceramic discs based on Yttrium-stabilized tetragonal Zirconia were fabricated and received 8 different surface treatments: Group I- 110µm aluminum oxide particle abrasion, Group II- 110µm aluminum oxide particle abrasion and silanization, Group III- 50µm aluminum oxide particle abrasion, Group IV- 50µm aluminum oxide particle abrasion and silanization, Group V- glaze and hydrofluoric acid conditioning, Group VIglaze, hydrofluoric acid conditioning and silanization, Group VII- glaze and 50µm aluminum oxide particle abrasion, and Group VIII- glaze, 50µm aluminum oxide particle abrasion and silanization. After the treatments, Enforce resin cement was placed into micro bore Tygon tubing in contact with the ceramic surfaces and photoactivated for 40s. The bond strength was obtained by the microshear bond test. The data were submitted to Analysis of Variance and Tukey's test (5%) and showed that the glass and di-silicate based ceramics presented higher KHN than alumina and zirconia based ceramics, immediately and after 24 hours. The direct photoactivation showed higher KHN than the activated through the ceramics groups and chemical activation for immediate and 24 hours. The bond strength to zirconia was affected by different treatments and the association between glaze and fluoric acid showed the best results, independent of the silanization process. Of this form, it can be concluded that the photoactivation through the ceramics promotes light attenuation and an improvement of KHN was found after 24 hours storage except for directly activated mode. The treatment with glaze promoted a significant increase of bond strength values.DoutoradoDentísticaDoutor em Clínica Odontológic

Effect of the flask contention method on the displacement of maxillary denture teeth

Keeping the flask closed may reduce the stress released by the resin dough after the pressing step, preserving the tooth relationship pattern. The aim of this study was to analyze the influence of the flask contention method on tooth displacement in acrylic resin complete dentures. Twenty identical maxillary complete dentures were made using the heat-cured acrylic resins Classico and QC-20, polymerized by long and fast polymerization cycles respectively, and randomly assigned to 4 test groups according to the conventional packing method and RS tension system. Transversal and anteroposterior distances between specific teeth were measured with a linear optical microscope before and after denture processing. Analysis of variance (ANOVA) and Tukey test were used to compare the groups (p<.05). Results showed that tooth movement was significantly greater for the distance RI-LI in comparison with the others, and the tooth movement was not significantly influenced by the packing method. Within the limitations of this study, the RS tension system presented a similar performance in reducing the tooth movement, when compared with the conventional packing method. The anterior region of the denture may present changes in the tooth position after processing, which need to be clinically adjusted

Effect of the flask contention method on the displacement of maxillary denture teeth

the flask closed may reduce the stress released by the resin dough after the pressing step, preserving the tooth relationship pattern. The aim of this study was to analyze the influence of the flask contention method on tooth displacement in acrylic resin complete dentures. Twenty identical maxillary complete dentures were made using the heat-cured acrylic resins Classico and QC-20, polymerized by long and fast polymerization cycles respectively, and randomly assigned to 4 test groups according to the conventional packing method and RS tension system. Transversal and anteroposterior distances between specific teeth were measured with a linear optical microscope before and after denture processing. Analysis of variance (ANOVA) and Tukey test were used to compare the groups (p<.05). Results showed that tooth movement was significantly greater for the distance RI-LI in comparison with the others, and the tooth movement was not significantly influenced by the packing method. Within the limitations of this study, the RS tension system presented a similar performance in reducing the tooth movement, when compared with the conventional packing method. The anterior region of the denture may present changes in the tooth position after processing, which need to be clinically adjusted

Effect of surface treatment and storage on the bond strength of different ceramic systems

Aim: The aim of this study was to evaluate the micro shear bond strength of different ceramic systems - IPS Empress 2, Cergogold, In-Ceram Alumina and Cercon - and a dual luting agent. Methods: Twelve specimens of each ceramic were fabricated and divided according different surface treatments: Group 1: No additional treatment was applied to the ceramic surface; Group 2: Ceramics were etched with 9.5% hydrofluoric acid; Group 3: specimens treated with airborne particle abrasion for each ceramic system in accordance with manufacturer’s instructions (n=20). The tests were performed after 24 h or after water storage for 6 months. Data were then assessed statistically using the 3-way ANOVA and the Tukey’s test (P<0.05). Results: For Cergogold and IPS Empress 2 systems, the treatments performed with airborne particle abrasion and hydrofluoric acid showed no significant differences from each other, and both were superior to the groups without treatment. For Cercon and In-Ceram ceramics, no differences were found among the groups (P<0.05). When the surface was treated with hydrofluoric acid, the highest bond strength was found to IPS Empress 2 in the 6-month storage period (P<0.05). Conclusion: Lower bond strength values were only observed with IPS Empress 2 ceramic for the control group in the 6-month storage (P<0.05)

Esthetic analysis of the smile

This study analyzed the esthetics components of the smile, evaluating the relationship between the curve formed by the incisal line of the anterior superior teeth and the curve of the inferior lip, the touch of this incisal line on the inferior lip, the teeth displayed during smile, the relationship between the facial midline with the arch midline, the location of the arch midline and gender differences. Eighty-eight undergraduate students of the dentistry course of the Tiradentes University were selected. Two photographs were taken (smiling face and smile) using digital camera. The statistical analysis was performed after image tracing evaluation. Results show that the coincidence of the facial midline with the arch midline occurred only on half of the students. Most of the students presented parallelism between the incisal plan and the interpupillary line. Smiles with or without touch of the incisal line on the lower lip, smiles revealing up to the seconds premolars or firsts molars, and parallel or straight smiles were also most commonly observed. The majority of the men presented centered midline arch while women presented deviation to the right. No difference was found between the distribution of the arch midline

Effect Of 10% Carbamide Peroxide Dental Bleaching On Microhardness Of Filled And Unfilled Sealant Materials.

The purpose of this study was to quantitatively evaluate the effect of 10% carbamide peroxide on the microhardness of pit and fissure sealant materials. Fluroshield, Vitroseal Alfa, and one unfilled (Clinpro) sealants were placed in Teflon matrices (4 mm in diameter by 2 mm in height) and polymerized for 40 seconds. A total of 20 specimens were prepared for each material, in which half were assigned as the control group (stored in artificial saliva and no bleaching treatment). For the remaining half, Clarigel Gold bleaching agent (10% carbamide peroxide) was placed over the specimen surface for 4 hours/day during 4 weeks. When specimens were not under bleaching treatment, they were kept in artificial saliva. Afterwards, specimens were subjected to Knoop microhardness testing using a 25-g load for 5 seconds. Five measurements were made on the sealants' surfaces and then calculated in Knoop hardness values. The data were statistically analyzed by two-way analysis of variance and Tukey's tests with a 5% confidence level. The results of this in vitro study showed that the application of a carbamide peroxide-based bleaching material significantly affected the microhardness values of filled sealant materials. The bleaching agent did not affect the microhardness of the unfilled sealant. CLINICAL SIGNIFICANCE The results of this in vitro study suggest that the bleaching agents altered the surface hardness of filled sealant restorative materials. This could possibly lead to increased wear and surface roughness.18273-8; discussion 27