A randomized double-blind clinical trial of posterior composite restorations with or without bevel: 1-year follow-up

Objective

This randomized double-blind clinical trial compared the performance of posterior composite restorations with or without bevel, after 1-year follow-up.

Material and Methods

Thirteen volunteers requiring at least two posterior composite restorations were selected. Twenty-nine cavities were performed, comprising 14 without bevel (butt joint) and 15 with bevel preparation of the enamel cavosurface angle. All cavities were restored with simplified adhesive system (Adper Single Bond) and composite resin (Filtek P60). A halogen light curing unit was used through the study. Restorations were polished immediately. Analysis was carried out at baseline, after 6 months and after 1 year by a calibrated evaluator (Kappa), according to the FDI criteria. Data were statistically analyzed by Mann-Whitney test (p<0.05).

Results

Beveled and non-beveled cavities performed similarly after 1 year follow-up, regarding to fractures and retention, marginal adaptation, postoperative hypersensitivity, recurrence of caries, surface luster and anatomic form. However, for surface and marginal staining, beveled cavities showed significantly better performance (p<0.05) than butt joint restorations.

Conclusions

It was concluded that the restorations were acceptable after 1 year, but restorations placed in cavities with marginal beveling showed less marginal staining than those placed in non-beveled cavities.     

Durability of resin composite restorations in high C-factor cavities: A 12-year follow-up

Objective

Polymerization shrinkage and shrinkage stress has been considered as one of the main disadvantages of resin composite restorations. Cavities with high C-factors increase the risk for interfacial failures. Several restorative techniques have been suggested to decrease the shrinkage stress. The purpose of this study was to evaluate the durability of techniques as oblique layering, indirect curing and/or a laminate with a poly-acid modified resin composite in direct Class I resin composite restorations in a 12-year follow-up.

Methods

Each of 29 patients received one or two pair(s) rather extensive Class I restorations. The first restoration was a poly-acid modified resin composite/resin composite sandwich restoration and the second a direct resin composite restoration. Both restorations, except for the laminate layer, were placed with oblique layering and two-step curing technique. 90 restorations were evaluated annually with slightly modified USPHS criteria during 12 years.

Results

At 12 years, 38 pairs were evaluated. Two cases of slight post-operative sensitivity were observed in one patient. A cumulative failure rate of 2.4% was observed for both the resin composite and the laminate restorations. One laminate restoration showed non-acceptable color match, but was not replaced and one resin composite restoration showed a chip fracture. Five restorations were replaced due to primary proximal caries.

Conclusions

The high failure rate expected in the high C-factor Class I cavity, associated with polymerization shrinkage and shrinkage stress, were not observed. The techniques used resulted in an excellent durability for the Class I resin composite restorations.     

Effect of resin-modified glass-ionomer cement lining and composite layering technique on the adhesive interface of lateral wall

Interface integrity can be maintained by setting the composite in a layering technique and using liners.

Objective

The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations.

Material and Methods

Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) – no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37^oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher’s test.

Results

There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups.

Conclusions

RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations.     

Non-destructive examination of interfacial debonding using acoustic emission

Objectives

This study aims to assess the viability of using the acoustic emission (AE) measurement technique to detect and monitor in situ the interfacial debonding in resin composite restorations due to build-up of shrinkage stresses during polymerization of the composite.

Materials and methods

The non-destructive testing technique that measures acoustic emission (AE) was used to detect and monitor the interfacial debonding in resin composite during curing of the composite. Four groups of specimens, n = 4 each, were tested: (1) intact human molars with Class-I cavities restored with the composite Z100 (3M ESPE, USA); (2) intact human molars with Class-I cavities restored with the composite Filtek™ P90 (3M ESPE, USA); (3) ring samples prepared from the root of a single bovine tooth and ‘restored’ with Z100; (4) freestanding pea-size specimens of Z100 directly placed on the AE sensor. The restorations in Groups (1)-(3) were bonded to the tooth tissues with the adhesive Adper™ Scotchbond™ SE Self-Etch (3M ESPE, USA). The composites in all the specimens were cured with a blue light (3M ESPE, USA) for 40 s. The AE signals were recorded continuously for 10 min from the start of curing. Non-destructive 3D imaging was performed using X-ray micro-computed tomography (micro-CT) to examine the bonding condition at the tooth-restoration interface.

Results

The development of AE events followed roughly that of the shrinkage stress, which was determined separately by the cantilever beam method. The number of AE events in the real human tooth samples was more than that in the ring samples, and no AE events were detected in the pea-size specimens placed directly on the AE sensor. The number of AE events recorded in the specimens restored using Z100 was more than that found in specimens restored with Filtek P90. The micro-CT imaging results showed clear interfacial debondings in the tooth specimens restored with Z100 after curing, but no clear debonding was found in the P90 specimens.

Conclusions

The AE technique is an effective tool for detecting and monitoring in situ the interfacial debonding of composite restorations during curing. It can potentially be employed to evaluate the development of shrinkage stress and the quality of interfacial bonds in teeth restored with different composite materials, cavity geometries, and restorative techniques.     

Marginal adaptation of class V composite restorations submitted to thermal and mechanical cycling

Objective:

This study evaluated the effect of the margin location and an adhesive system on the marginal adaptation of composite restorations.

Material and Methods:

Class V cavities were prepared in bovine teeth with the gingival margin on the dentin and the incisal margin on the enamel. The cavities were restored with a micro-hybrid composite resin using an etch-and-rinse [Single Bond 2 (SB)] or a self-etching adhesive [Clearfil SE Bond (CL)]. After finishing and polishing the restorations, epoxy replicas were prepared. The marginal adaptation was analyzed using scanning electronic microscopy (SEM, 500 x magnification). The higher gap width in each margin was recorded (T0). After the first evaluation, the samples were submitted to thermal cycling (2,000 cycles of 5ºC±2ºC followed by 55ºC±2ºC - T1) and mechanical cycling (100,000 cycles of 50 kN and 2 Hz - T2). Replicas of samples were rebuilt after each cycling and analyzed under SEM. The data were submitted to Mann-Whitney, Wilcoxon and Friedman testing (a=0.05).

Results:

The SB presented higher gaps in the dentin than the enamel, while there was no difference between the substrate for the CL. In the dentin, the CL showed better marginal sealing than the SB. The opposite occurred in the enamel. There were no significant differences between the baseline, thermal and mechanical cycling for any experimental condition.

Conclusions:

The outcomes of the present study showed that the adhesive system and margin location have an important effect on the marginal adaptation of composite restorations.     

56-month clinical performance of Class I and II resin composite restorations

Objective

This study evaluated the 56-month clinical performance of Class I and II resin composite restorations. Filtek P60 was compared with Filtek Z250, which are both indicated for posterior restorations but differ in terms of handling characteristics. The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth.

Material and Methods

Thirty-three patients were treated by the same operator, who prepared 48 Class I and 42 Class II cavities, which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems. Restorations were evaluated by two independent examiners at baseline and after 56 months, using the modified USPHS criteria. Data were analyzed statistically using Chi-square and Fisher''s Exact tests (a=0.05).

Results

After 56 months, 25 patients (31 Class I and 36 Class II) were analyzed. A 3% failure rate occurred due to secondary caries and excessive loss of anatomic form for P60. For both restorative systems, there were no significant differences in secondary caries and postoperative sensitivity. However, significant changes were observed with respect to anatomic form, marginal discoloration, and marginal adaptation. Significant decreases in surface texture were observed exclusively for the Z250 restorations.

Conclusions

Both restorative systems can be used for posterior restorations and can be expected to perform well in the oral environment.     

Characterization of aqueous silver nitrate solutions for leakage tests

Objectives

To determine the pH over a period of 168 h and the ionic silver content in various concentrations and post-preparation times of aqueous silver nitrate solutions. Also, the possible effects of these factors on microleakage test in adhesive/resin restorations in primary and permanent teeth were evaluated.

Material and Methods

A digital pHmeter was used for measuring the pH of the solutions prepared with three types of water (purified, deionized or distilled) and three brands of silver nitrate salt (Merck, Synth or Cennabras) at 0, 1, 2, 24, 48, 72, 96 and 168 h after preparation, and storage in transparent or dark bottles. Ionic silver was assayed according to the post-preparation times (2, 24, 48, 72, 96, 168 h) and concentrations (1, 5, 25, 50%) of solutions by atomic emission spectrometry. For each sample of each condition, three readings were obtained for calculating the mean value. Class V cavities were prepared with enamel margins on primary and permanent teeth and restored with the adhesive systems OptiBond FL or OptiBond SOLO Plus SE and the composite resin Filtek Z-250. After nail polish coverage, the permanent teeth were immersed in 25% or 50% AgNO₃ solution and the primary teeth in 5% or 50% AgNO₃ solutions for microleakage evaluation. ANOVA and the Tukey''s test were used for data analyses (α=5%).

Results

The mean pH of the solutions ranged from neutral to alkaline (7.9±2.2 to 11.8±0.9). Mean ionic silver content differed depending on the concentration of the solution (4.75±0.5 to 293±15.3 ppm). In the microleakage test, significant difference was only observed for the adhesive system factor (p=0.000).

Conclusions

Under the tested experimental conditions and based on the obtained results, it may be concluded that the aqueous AgNO₃ solutions: have neutral/alkaline pH and service life of up to 168 h; the level of ionic silver is proportional to the concentration of the solution; even at 5% concentration, the solutions were capable of indicating loss of marginal seal in the composite restorations; the 3-step conventional adhesive system had better performance regarding microleakage in enamel on primary and permanent teeth.     

Evaluation of bond strength of silorane and methacrylate based restorative systems to dentin using different cavity models

Objective

The aim of this in vitro study was to evaluate the microtensile bond strength (µTBS) to dentin of two different restorative systems: silorane-based (P90), and methacrylate-based (P60), using two cavity models.

Material and Methods

Occlusal enamel of 40 human third molars was removed to expose flat dentin surface. Class I cavities with 4 mm mesial-distal width, 3 mm buccal-lingual width and 3 mm depth (C-factor=4.5) were prepared in 20 teeth, which were divided into two groups (n=10) restored with P60 and P90, bulk-filled after dentin treatment according to manufacturer''s instructions. Flat buccal dentin surfaces were prepared in the 20 remaining teeth (C-factor=0.2) and restored with resin blocks measuring 4x3x3 mm using the two restorative systems (n=10). The teeth were sectioned into samples with area between 0.85 and 1.25 mm² that were submitted to µTBS testing, using a universal testing machine (EMIC) at speed of 0.5 mm/min. Fractured specimens were analyzed under stereomicroscope and categorized according to fracture pattern. Data were analyzed using ANOVA and Tukey Kramer tests.

Results

For flat surfaces, P60 obtained higher bond strength values compared with P90. However, for Class I cavities, P60 showed significant reduction in bond strength (p<0.05). No statistical difference between restorative systems was shown for Class I cavity model (p>0.05), or between Class I Cavity and Flat Surface group, considering P90 restorative system (p>0.05). Regarding fracture pattern, there was no statistical difference among groups (p=0.0713) and 56.3% of the fractures were adhesive.

Conclusion

It was concluded that methacrylate-based composite µTBS was influenced by cavity models, and the use of silorane-based composite led to similar bond strength values compared to the methacrylate-based composite in cavities with high C-factor.     

Six-month evaluation of a resin/dentin interface created by methacrylate and silorane-based materials

Objectives:

This study aimed to compare the micro-tensile bond strength of methacrylate resin systems to a silorane-based restorative system on dentin after 24 hours and six months water storage.

Material and Methods:

The restorative systems Adper Single Bond 2/Filtek Z350 (ASB), Clearfil SE Bond/Z350 (CF), Adper SE Plus/Z350 (ASEP) and P90 Adhesive System/Filtek P90 (P90) were applied on flat dentin surfaces of 20 third molars (n=5). The restored teeth were sectioned perpendicularly to the bonding interface to obtain sticks (0.8 mm²⁾ to be tested after 24 hours (24 h) and 6 months (6 m) of water storage, in a universal testing machine at 0.5 mm/min. The data was analyzed via two-way Analysis of Variance/Bonferroni post hoc tests at 5% global significance.

Results:

Overall outcomes did not indicate a statistical difference for the resin systems (p=0.26) nor time (p=0.62). No interaction between material x time was detected (p=0.28). Mean standard-deviation in MPa at 24 h and 6 m were: ASB 31.38 (4.53) and 30.06 (1.95), CF 34.26 (3.47) and 32.75 (4.18), ASEP 29.54 (4.14) and 33.47 (2.47), P90 30.27 (2.03) and 31.34 (2.19).

Conclusions:

The silorane-based system showed a similar performance to methacrylate-based materials on dentin. All systems were stable in terms of bond strength up to 6 month of water storage.     

Effect of a multi-layer infection control barrier on the micro-hardness of a composite resin

Objective

The aim of this study was to evaluate the effect of multiple layers of an infection control barrier on the micro-hardness of a composite resin.

Material and Methods

One, two, four, and eight layers of an infection control barrier were used to cover the light guides of a high-power light emitting diode (LED) light curing unit (LCU) and a low-power halogen LCU. The composite specimens were photopolymerized with the LCUs and the barriers, and the micro-hardness of the upper and lower surfaces was measured (n=10). The hardness ratio was calculated by dividing the bottom surface hardness of the experimental groups by the irradiated surface hardness of the control groups. The data was analyzed by two-way ANOVA and Tukey''s HSD test.

Results

The micro-hardness of the composite specimens photopolymerized with the LED LCU decreased significantly in the four- and eight-layer groups of the upper surface and in the two-, four-, and eight-layer groups of the lower surface. The hardness ratio of the composite specimens was <80% in the eight-layer group. The micro-hardness of the composite specimens photopolymerized with the halogen LCU decreased significantly in the eight-layer group of the upper surface and in the two-, four-, and eight-layer groups of the lower surface. However, the hardness ratios of all the composite specimens photopolymerized with barriers were <80%.

Conclusions

The two-layer infection control barrier could be used on high-power LCUs without decreasing the surface hardness of the composite resin. However, when using an infection control barrier on the low-power LCUs, attention should be paid so as not to sacrifice the polymerization efficiency.     

EFFECT OF CYCLIC LOADING ON FRACTURE STRENGTH OF ENDODONTICALLY TREATED TEETH RESTORED WITH CONVENTIONAL AND ESTHETIC POSTS

Introduction:

Esthetic post and core systems were recently introduced. There are few reports regarding their behavior under cyclic loading.

Objectives:

This study compared the effect of cyclic loading on survival rate, residual strength and mode of fracture of endodontically treated teeth restored with esthetic and direct metallic post systems subjected to mechanical cyclic loading.

Materials and Methods:

Thirty canines were endodontically treated, decoronated and prepared for metal free ceramic crowns, leaving 1.5 mm of dentin for ferrule effect. They were distributed in 3 groups and restored as follows: group 1 with zirconia posts (Cosmopost) and glass-ceramic cores (IPS Empress Cosmopost); group 2 with fiber reinforced composite posts (FibreKor) and group 3 with titanium posts (AZthec Anchor). Direct resin composite (Build It FR Resin Composite) was used as core in groups 2 and 3. All specimens were restored with all ceramic crowns (IPS Empress 2). A resin cement/adhesive system (Cement It/Bond It Primer A+B) was used to lute the posts to root canals and metal free porcelain crowns to the teeth preparation. Specimens were subjected to mechanical load of 250 N for 500,000x at a frequency of 1.7 Hz and then to static load until failure in a universal testing machine. Data were analyzed using One-way ANOVA and Fischer Exact tests α=0.05.

Results:

All groups had 100% survival rate after cyclic loading; fracture strength values (SD) in N were: group 1 = 886.5(170.6), group 2 = 762.2(113.6) and group 3 = 768.9(72.9); there was no difference among groups (p=0.08); the percentage of mode of favorable fracture found was: group 1 = 60%, group 2 = 90% and group 3 = 50%; there was no correlation between the mode of failure and post and core system used (P=0.142).

Conclusions:

Esthetic post and core systems showed statistically equivalent fracture strength values, mode of failure and survival rate compared to conventional direct metallic post and resin composite core system after cyclic loading.     

Luting glass ceramic restorations using a selfadhesive resin cement under different dentin conditions

Objectives

The aim of this study was to investigate the bond strength of ceramic restorations luted using a self-adhesive resin cement (RelyX Unicem, 3M ESPE) under different dentin conditions.

Material and Methods

In the experimental groups, ceramic restorations were luted to bovine incisors with RelyX Unicem under the following conditions: [Dry dentin]: surface was dried using air stream for 15 s; [Moist dentin]: excess dentin moisture was removed with absorbent paper; [Bonding agent]: Clearfil SE Bond (Kuraray) self-etching adhesive system was previously applied to dentin. In the Control group, cementation was done using an etch-and-rinse adhesive (Excite DSC) and Variolink II resin cement (Ivoclar Vivadent). Photoactivation of the resin cements was performed with UltraLume LED 5 unit (Ultradent). The restorations (n=5 per group) were sectioned into beams and microtensile testing was carried out. Data were subjected to ANOVA and Tukey''s test (p<0.05). Failure modes were classified under Scanning Electron Microscopic (SEM) (×120 magnification).

Results

The bond strength was dependent on the moisture status of the dentin. Bond strength in the "dry dentin group" was significantly lower than that of all other groups, which showed similar results. A predominance of mixed failures was detected for the control group, while a predominance of adhesive failures was observed for the "bonding agent" and "dry dentin" groups. The "moist dentin" group presented predominantly cohesive failures within the luting material. The previous application of a self-etching adhesive showed no significant effect.

Conclusions

Only excess dentin moisture should be removed for the cementation of ceramic restorations with self-adhesive resin cements.     

COMPOSITE DEPTH OF CURE USING FOUR POLYMERIZATION TECHNIQUES

The light-curing technique is relevant to reduce the degree of polymerization shrinkage, improving clinical and esthetic success of composite resin restorations.

Objective:

To evaluate in vitro the effect of four light-curing techniques on depth of cure of a composite resin.

Material and Methods:

Ten specimens of a composite resin were made in cylindrical cavities prepared in PVC plates (3.0 X 7.0 mm) for each light-curing technique. Four photoactivation methods were investigated: stepped, ramped, pulse-delay and traditional. Specimens were longitudinally sectioned and polished for microhardness measurements (kg/mm²), which were made at 0.1, 1.0, 2.0 and 4.0 mm from the irradiated surface. Data were subjected to ANOVA and Tukey''s test.

Results:

The effect of factors studied (curing method and distance from the surface) and the interaction of these factors was statistically significant (p<0.05). The traditional method of cure provided higher microhardness values (69.6 ± 2.5) than the stepped (63.5 ± 3.1) and pulsed (63.9 ± 3.2) methods at all depths evaluated, but it did not differ from the ramped method (66.7± 4.4) at 0.1 and 1.0 mm of depth.

Conclusion:

All techniques employed provided satisfactory cure of the composite resin up to the depth of 2.0 mm from the irradiated surface.     

Thermal analysis of bulk filled composite resin polymerization using various light curing modes according to the curing depth and approximation to the cavity wall

Objective

The purpose of this study was to investigate the polymerization temperature of a bulk filled composite resin light-activated with various light curing modes using infrared thermography according to the curing depth and approximation to the cavity wall.

Material and Methods

Composite resin (AeliteFlo, Bisco, Schaumburg, IL, USA) was inserted into a Class II cavity prepared in the Teflon blocks and was cured with a LED light curing unit (Dr''s Light, GoodDoctors Co., Seoul, Korea) using various light curing modes for 20 s. Polymerization temperature was measured with an infrared thermographic camera (Thermovision 900 SW/TE, Agema Infra-red Systems AB, Danderyd, Sweden) for 40 s at measurement spots adjacent to the cavity wall and in the middle of the cavity from the surface to a 4 mm depth. Data were analyzed according to the light curing modes with one-way ANOVA, and according to curing depth and approximation to the cavity wall with two-way ANOVA.

Results

The peak polymerization temperature of the composite resin was not affected by the light curing modes. According to the curing depth, the peak polymerization temperature at the depth of 1 mm to 3 mm was significantly higher than that at the depth of 4 mm, and on the surface. The peak polymerization temperature of the spots in the middle of the cavity was higher than that measured in spots adjacent to the cavity wall.

Conclusion

In the photopolymerization of the composite resin, the temperature was higher in the middle of the cavity compared to the outer surface or at the internal walls of the prepared cavity.     

Two-year clinical evaluation of three adhesive systems in non-carious cervical lesions

Objectives

Adhesive systems are continuously being introduced to Dentistry, unfortunately often without sufficient clinical validation. The aim of this study was to evaluate the clinical performance of cervical restorations done with three different adhesive systems.

Material and methods

158 non-carious cervical lesions of 23 patients were restored with a nanofilled composite resin (Filtek Supreme, 3M/ESPE) combined with Single Bond (3M/ESPE, group SI), Clearfil SE (Kuraray Medical Inc., group CL) and Xeno III (De Trey Dentsply, group XE). In groups SI-B, CL-B and XE-B, the outer surface of the sclerotic dentin was removed by roughening with a diamond bur before application of the respective adhesive systems. In groups CL-BP and XE-BP, after removal of the outer surface of the sclerotic dentin with the bur, the remaining dentin was etched with 37% phosphoric acid and the self-etch adhesive systems Clearfil SE and Xeno III were applied, respectively. Lesions were evaluated at baseline, and restorations after 3 months, 1 year and 2 years using modified USPHS criteria.

Results

After 2 years, no significant difference was found between the retention rates of the groups (p >0.05). Although groups CL and SI showed significantly better marginal adaptation than group XE (p<0.05) at 2 years, no significant difference was found between the marginal adaptation of the groups SI-B, CL-B and XE-B (p>0.05). After 2 years no significant difference was observed among the marginal staining results of all groups (p>0.05).

Conclusion

Although all adhesive systems showed similar retention rates, Clearfil SE and Single Bond showed better marginal adaptation than Xeno III after 2 years of follow-up.     

Stress distribution on dentin-cement-post interface varying root canal and glass fiber post diameters. A three-dimensional finite element analysis based on micro-CT data

Objective

The aim of the present study was to analyze the influence of root canal and glass fiber post diameters on the biomechanical behavior of the dentin/cement/post interface of a root-filled tooth using 3D finite element analysis.

Material and Methods

Six models were built using micro-CT imaging data and SolidWorks 2007 software, varying the root canal (C) and the glass fiber post (P) diameters: C1P1-C=1 mm and P=1 mm; C2P1-C=2 mm and P=1 mm; C2P2-C=2 mm and P=2 mm; C3P1-C=3 mm and P=1 mm; C3P2-C=3 mm and P=2 mm; and C3P3-C=3 mm and P=3 mm. The numerical analysis was conducted with ANSYS Workbench 10.0. An oblique force (180 N at 45º) was applied to the palatal surface of the central incisor. The periodontal ligament surface was constrained on the three axes (x=y=z=0). Maximum principal stress (σ_max) values were evaluated for the root dentin, cement layer, and glass fiber post.

Results:

The most evident stress was observed in the glass fiber post at C3P1 (323 MPa), and the maximum stress in the cement layer occurred at C1P1 (43.2 MPa). The stress on the root dentin was almost constant in all models with a peak in tension at C2P1 (64.5 MPa).

Conclusion

The greatest discrepancy between root canal and post diameters is favorable for stress concentration at the post surface. The dentin remaining after the various root canal preparations did not increase the stress levels on the root.     

ANALYSIS OF GAP FORMATION AT TOOTH-COMPOSITE RESIN INTERFACE: EFFECT OF C-FACTOR AND LIGHT-CURING PROTOCOL

Objective:

The aim of this study was to evaluate the effect of C-factor and light-curing protocol on gap formation in composite resin restorations.

Material and Methods:

Cylindrical cavities with 5.0 mm diameter and three different depths (A=1.0, B=2.0 and C=3.0 mm) were prepared on the occlusal surface of 30 human molars and restored in a single increment with P 60. The composite resin was light-cured according to two protocols: standard - 850 mW/cm² / 20 s and gradual - 100 up to 1000 mW/cm²/ 10 s + 1000 mW/cm² / 10 s. After storage in distilled water (37°C/7 days), the restorations were cut into three slices in a buccolingual direction and the gap widths were analyzed using a 3D-scanning system. The data were submitted to ANOVA and Student-Newman-Keuls test (α=0.05).

Results:

ANOVA detected a significant influence for the C-factor and light-curing protocol as independent factors, and for the double interaction C-factor vs. light-curing protocol. Cavities with higher C-factor presented the highest gap formation. The gradual light-curing protocol led to smaller gap formation at cavity interfaces.

Conclusions:

The findings of this study suggest that the C-factor played an essential role in gap formation. The gradual light-curing protocol may allow relaxation of composite resin restoration during polymerization reaction.     

ASSOCIATION BETWEEN INTRA-RADICULAR POSTS AND PERIAPICAL LESIONS IN ENDODONTICALLY TREATED TEETH

Introduction:

A significant number of endodontically treated teeth restored with posts have associated periapical lesions, and several authors have discussed the probable causes of the development of these. Attention has been focused on restorative procedures performed after endodontic treatment and their association with the prognosis of endodontic therapy because a number of root-filled teeth will require post- and core-retained restorations.

Purpose:

The purpose of this study was to evaluate, by examination of periapical radiographs, whether the placement of intra-radicular posts in endodontically treated teeth may act as a risk factor for development of periapical lesions.

Material and Methods:

This case-control study analyzed periapical radiographs of 72 endodontically treated teeth with coronal restorations. All radiographs were obtained from a single private practice. Specimens were assigned to 2 groups: Group 1 (control) was composed of teeth without periapical lesions and Group 2 (case) was composed of teeth with periapical lesions. The number of teeth with and without posts in each group was recorded. Three calibrated examiners analyzed the radiographs visually under X4 magnification.

Results:

In Group 1, 28 (65.1%) out of 43 teeth were restored with posts. In Group 2, 24 (82.8%) out of 29 teeth had intra-radicular posts. The interpretation of chi-square test showed that these percentages were not significantly different (x²=2.687; p=0.101). Odds ratio was 2.571 (0.8158.118), which indicates that there was no statistically significant association between periapical lesions and posts.

Conclusion:

Intra-radicular posts placed in endodontically treated teeth were not a significant risk factor for development of periapical lesions in the practice where the cohort of patients was treated.     

FRACTURE RESISTANCE AND FAILURE PATTERN OF TEETH SUBMITTED TO INTERNAL BLEACHING WITH 37% CARBAMIDE PEROXIDE,WITH APPLICATION OF DIFFERENT RESTORATIVE PROCEDURES

Objective.

This study investigated the compressive fracture strength and failure pattern in premolars submitted to endodontic treatment and internal bleaching with 37% carbamide peroxide for 21 days, with application of different restorative procedures.

Material and methods.

Six groups were employed (n = 10): 1) non-bleached teeth and pulp chamber sealed with IRM; 2) bleached teeth and pulp chamber sealed with IRM; 3) bleached teeth and pulp chamber filled with light cured composite resin; 4) bleached teeth, root canals prepared at 10mm, filling of the root canal and pulp chamber with IRM; 5) bleached teeth, root canals prepared at 10mm, luting of prefabricated metallic post with zinc phosphate and pulp chamber sealed with composite resin; 6) bleached teeth, root canals prepared at 10mm, luting of glass fiber post with resin cement and pulp chamber sealed with composite resin. After 24-hour storage in distilled water, the specimens were submitted to compressive fracture strength testing in a universal testing machine.

Results.

The following values were found: Group 1 – 56.23kgf; Group 2 – 48.96kgf; Group 3 – 53.99kgf; Group 4 – 45.72kgf; Group 5 – 54.22kgf; Group 6 – 60.12kgf. The analysis of variance did not reveal statistically significant difference between groups (p<0.05), suggesting that internal bleaching with 37% carbamide peroxide did not weaken the dental tissues. The largest number of unfavorable fractures was observed for Groups 2 (50%), 4 (40%), and 5 (30%). Group 6 exhibited the most favorable failure pattern.

Conclusions.

The results suggest that internal bleaching with 37% carbamide peroxide did not significantly weaken the teeth. Among the bleached teeth, those with temporary IRM restorations or metallic posts demonstrated the most unfavorable fracture pattern, whereas the most favorable fracture pattern occurred in teeth restored with composite resin and glass fiber posts.