Operative Dentistry[JOURNAL]
Sun
200 papers
Injectable Flowable Resin-based Composite Veneers Prior to Ceramic Veneers.
Villalobos-Tinoco J, Jurado CA, Sanchez-Hernandez RA … +3 more , Elgreatly A, Alshabib A, Tsujimoto A
Oper Dent · 2023 Jul · PMID 37352465 · Publisher ↗
OBJECTIVES: This case report describes the clinical protocols for using injectable flowable resin-based composite veneers without tooth reduction as long-term prototype restorations, followed by conservative feldspathic...
OBJECTIVES: This case report describes the clinical protocols for using injectable flowable resin-based composite veneers without tooth reduction as long-term prototype restorations, followed by conservative feldspathic veneer restorations. CLINICAL CONSIDERATION: The patient's primary concern was to improve her smile. After clinical evaluation, injectable flowable resin composite veneers were recommended as long-term prototypes followed by conservative tooth preparation and ceramic veneers. Flowable composite veneers were created with a transparent silicone index fabricated from a diagnostic wax-up approved by the patient. No tooth reduction was required to place this type of composite veneer. Later, a printed reduction guide was used to provide conservative tooth preparation followed by the cementation of thin feldspathic porcelain veneers under full isolation with a rubber dam. CONCLUSIONS: Injectable flowable resin-based composite veneers can successfully act as long-term esthetic prototypes before ceramic veneers. The outcome of these restorations is very predictable because the diagnostic wax-up anatomy is transferred to the mouth through the transparent silicone index, and they can be placed without tooth reduction. Conservative tooth preparation can be performed on the composite veneers so that minimal tooth structure is removed to maximize the bonding performance of ceramic veneers.
Marginal and Internal Gaps, Surface Roughness and Fracture Resistance of Provisional Crowns Fabricated With 3D Printing and Milling Systems.
Al-Wahadni A, Abu Rashed BO, Al-Fodeh R … +2 more , Tabanjah A, Hatamleh M
Oper Dent · 2023 Jul · PMID 37352464 · Publisher ↗
PURPOSE: To compare the marginal and internal gap, surface roughness, fracture resistance and mode of failure of provisional crowns fabricated with 3D printing and CAD/CAM manufacturing techniques. Methods and Materials:...
PURPOSE: To compare the marginal and internal gap, surface roughness, fracture resistance and mode of failure of provisional crowns fabricated with 3D printing and CAD/CAM manufacturing techniques. Methods and Materials: A maxillary first premolar was prepared for an all-ceramic crown and reproduced in cobalt-chromium metal dies (n=30) following CAD/CAM technology. The die was digitally scanned and exocad software was used to design the missing crown, which was manufactured using a CAM milling machine and two types of 3D printing machines (SLA and DLP) to produce 10 provisional crowns per group. The crowns were cemented to their respective dies and stored in water (24 hours; 37°C) followed by 600 thermal cycles (5°C/55°C) and 100,000 mechanical cycles (at 50N). Marginal and internal gap measurements were carried out using a 3D superimposition technique. Surface roughness (Ra) was determined using a profilometer at 0.5 mm/ second cross-head speed. The crowns were loaded to fracture at 0.5 mm/minute cross-head speed. Fracture forces and mode of failure were recorded, and data were analyzed using one-way analysis of variance (ANOVA) and multiple comparisons post hoc tests (p<0.05). RESULTS: The SLA group exhibited higher marginal and internal gaps than both the CAD/CAM and DLP groups (p<0.05). The DLP group showed higher surface roughness than the CAD/CAM and SLA groups (p<0.01). The CAD/CAM and SLA groups showed higher resistance to fracture than the DLP (p<0.05) group. Mode of failure I: Minimal crown fracture or crack, was predominate among DLP and SLA crowns (60%), while the Mode II: Less than half of the crown lost, was predominant among CAD/CAM crowns (60%). CONCLUSIONS: Crowns manufactured following CAD/CAM technique have better marginal and internal fit, surface roughness than SLA and DLP crowns. The CAD/CAM and SLA crowns showed higher resistance to fracture than the DLP crowns.
Does Acid Etching Influence the Adhesion of Universal Adhesive Systems in Noncarious Cervical Lesions? A Systematic Review and Meta-analysis.
Assis P, Silva C, Nascimento A … +5 more , Anníbal H, Júnior S, Soares N, Junior R, Braz R
Oper Dent · 2023 Jul · PMID 37352462 · Publisher ↗
OBJECTIVE: To evaluate the adhesion of universal adhesive systems to the dentin of noncarious cervical lesions (NCCLs) by comparing the etch-and-rinse and self-etch strategies through a systematic review and meta-analysi...
OBJECTIVE: To evaluate the adhesion of universal adhesive systems to the dentin of noncarious cervical lesions (NCCLs) by comparing the etch-and-rinse and self-etch strategies through a systematic review and meta-analysis. METHODS: Systematic electronic searches were performed by two independent reviewers into the following databases: PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library until December of 2021. Only randomized clinical trials were selected, comparing etch-and-rinse and self-etch strategies and using universal adhesive systems in NCCLs. This systematic review was conducted according to the PRISMA guidelines and registered into PROSPERO. RESULTS: After the removal of duplicates, 170 articles were identified. In an initial screening of titles and abstracts, 146 records did not satisfy the inclusion criteria and were, therefore, excluded. Twenty-four studies were eligible for evaluation of the full text, and four were excluded after this step. Finally, 20 randomized clinical trials were included in this systematic review and meta-analysis. CONCLUSION: This systematic review and meta-analysis revealed that applying universal adhesive systems in the etch-and-rinse strategy could lead to better medium-term (>12 to 36 months) retention of NCCL restorations than the self-etch strategy, as well as resulting in lower percentages of marginal discoloration, marginal adaptation, and secondary caries. However, the use of a self-etching strategy can lead to lower postoperative sensitivity.
Effect of Acidic Beverages on the Hardness, Elastic Modulus and Wear Resistance of Giomer and Nongiomer Bulk-fill Materials.
Batu Eken Z, Miyajima H, Bedair E … +3 more , Gunal S, Ucok M, Ozer F
Oper Dent · 2023 Jul · PMID 37352458 · Publisher ↗
OBJECTIVES: The aim of this study was to evaluate and compare the effect of acidic beverages on the hardness, elastic modulus, and wear resistance of four different resin-based restorative materials. METHODS AND MATERIAL...
OBJECTIVES: The aim of this study was to evaluate and compare the effect of acidic beverages on the hardness, elastic modulus, and wear resistance of four different resin-based restorative materials. METHODS AND MATERIALS: A total of 128 specimens (10 mm diameter, 4 mm thickness) were prepared from a conventional resin composite (Filtek Z250 [Z250]), a giomer bulk-fill (Beautifil Bulk Restorative [BBR]) and two nongiomer bulk-fill materials (Tetric N-Ceram Bulk Fill [TNC] and SonicFill 2 [SF2]). Each material group was divided into four subgroups (n=8) according to the storage media: artificial saliva (control), orange juice, regular Coke, and sports drink. The experimental specimens were immersed in the solutions for 30 minutes, five times a day for 5 days and kept in artificial saliva for an hour between the immersion periods. Control specimens were stored in artificial saliva for 5 days. The nanoindentation test with a Berkovich diamond tip was used to determine the hardness and elastic modulus before and after the 5-day storage periods. Following the nanoindentation tests, the specimens were subjected to a chewing simulator for 120,000 cycles. The specimens were then scanned with a three-dimensional scanner. The wear resistance was analyzed by measuring the volume and height loss. Specimens were observed by environmental scanning electron microscopy. The statistical analyses were performed by analysis of variance, Tukey HDS test, and paired samples t-test (α=0.05). RESULTS: Z250 showed significantly higher elastic modulus in all groups (p<0.05). After erosive cycles, the greatest decrease in hardness and elastic modulus was observed for BBR. TNC showed higher wear resistance than the other resin-based materials (p<0.05). The BBR specimens immersed in acidic solutions showed higher wear rates than the artificial saliva group (p<0.05). CONCLUSIONS: Conventional resin composite showed higher hardness and elastic modulus than bulk-fill materials when exposed to acidic beverages but comparable or lower wear resistance. Degradation due to acidic beverages most affected the mechanical properties of giomer bulk-fill.
Effect of Photo-polymerization Delay on the Bond Strength and Microhardness of Dual-polymerizing Resin Cements.
Alsayed B, Suliman AA, Clark W … +2 more , Cook R, Sulaiman TA
Oper Dent · 2023 Jul · PMID 37352457 · Publisher ↗
STATEMENT OF PROBLEM: To fully maximize the potential of dual-polymerizing resin cements, a thorough understanding of how the light- and chemical-polymerizing components interact in a resin system is required. Disorder i...
STATEMENT OF PROBLEM: To fully maximize the potential of dual-polymerizing resin cements, a thorough understanding of how the light- and chemical-polymerizing components interact in a resin system is required. Disorder in the polymerization process between the two components may hurt one of the components versus the other, affecting the overall properties and performance of the resin cements. PURPOSE: Evaluate photo-polymerization delay time on dentin shear-bond strength and Vickers microhardness of dual-polymerizing resin cements. METHODS AND MATERIALS: Shear bond strength (SBS) of self-adhesive (RelyX Unicem 2, 3M ESPE) and adhesive (RelyX Ultimate, 3M ESPE) dual-polymerizing resin cements were evaluated. Dentin specimens (n=80) were prepared for the SBS test according to ISO standard 29022:2013. Teeth were randomly allocated into eight groups based on the type of cement, and photo-polymerization delay times (0, 2, 5, and 10 minutes). Vickers microhardness test (HV) was performed following ASTM E384-17 (n=32) prepared based on cement type and photo-polymerization delay times; specimens were tested after 24 hours of storage. Statistical analysis was performed using two-way ANOVA to determine the individual and combined effects of resin cement type and photo-polymerization delay time on SBS and HV. RESULTS: Resin cement and photo-polymerization delay times for the adhesive cement at 0- and 2-minute pairings had significantly higher SBS means than all other combinations (p<0.0001). Resin cement type was also statistically significant (p<0.0001). Resin cement type and photo-polymerization delay times were not significant (p=0.3550) for HV. CONCLUSIONS: Photo-polymerization delay time affected dentin SBS with higher bond strength when photo-polymerization delay time was performed between 2 and 5 minutes with a self-adhesive resin cement, and between 0 and 2 minutes with an adhesive resin cement. Delaying photo-polymerization time to 10 minutes led to inferior dentin SBS and HV for both self-adhesive and adhesive dual-polymerizing resin cements.
Bonding Protocols to Reverse the Bond Strength of a Universal Adhesive to Hemostatic Agent-contaminated Dentin.
Pratabsingha J, Noppawong S, Thamsoonthorn C … +2 more , Vichathai W, Saikaew P
Oper Dent · 2023 Jul · PMID 37326305 · Publisher ↗
OBJECTIVE: To evaluate the effect of different bonding protocols on the microtensile bond strength (μTBS) of a universal adhesive to dentin contaminated with a hemostatic agent. METHODS AND MATERIALS: Ninety-five extract...
OBJECTIVE: To evaluate the effect of different bonding protocols on the microtensile bond strength (μTBS) of a universal adhesive to dentin contaminated with a hemostatic agent. METHODS AND MATERIALS: Ninety-five extracted premolars were used in this study. For the μTBS test, 80 teeth were cut to expose mid-coronal dentin and randomly divided into two groups (uncontaminated dentin and hemostatic agent-contaminated dentin). Each group was further divided into five subgroups (n=8/group): 1) SE: no additional treatment, 2) ER: etching with 32% phosphoric acid, 3) CHX: rinsing with 0.2% chlorhexidine, 4) EDTA: rinsing with 17% EDTA, and 5) T40: application of universal adhesive for 40 seconds. A universal adhesive was applied followed by resin composite build-up. μTBS test was performed after 24 hours of water storage. Two-way analysis of variance (ANOVA) was calculated followed by the Duncan testing (α=0.05). The failure mode was analyzed using light microscopy. Additional teeth were prepared for energy-dispersive X-ray (EDX) analysis (n=1/group) and resin-dentin interface observation (n=2/group) using scanning electron microscopy. RESULTS: Adverse effects of hemostatic agent contamination on the bonding performance of a universal adhesive was found in the SE, CHX, and T40 groups (p<0.05). Fewer and shorter resin tags were observed in the SE, CHX, and T40 groups. A higher percentage of adhesive failure and mixed failure was found in contaminated dentin. All bonding protocols revealed lower amounts of Al and Cl after dentin contamination, except for the SE group. CONCLUSIONS: Hemostatic agent contamination adversely affected dentin bond strength. However, this bond strength could be reversed using the etch-and-rinse technique or rinsing with EDTA prior to adhesive application.
Effect of Antioxidant Agents After Dental Bleaching on Color Stability and Mechanical Properties of Bonding Interface Components in Ceramic Laminate Veneer Luting.
Strazzi-Sahyon HB, Seixas DA, Maluly-Proni AT … +4 more , Briso A, Yoshimura HN, Constantino C, Dos Santos PH
Oper Dent · 2023 Jul · PMID 37302146 · Publisher ↗
PURPOSE: Few studies have evaluated the influence of antioxidant agents on the optical and mechanical properties of ceramic laminate veneers after dental bleaching. Thus, this in vitro study aimed to evaluate the influen...
PURPOSE: Few studies have evaluated the influence of antioxidant agents on the optical and mechanical properties of ceramic laminate veneers after dental bleaching. Thus, this in vitro study aimed to evaluate the influence of antioxidant agents on the color stability and mechanical properties, such as nanohardness (HIT), elastic modulus (Eit*), and degree of conversion (DC) of the bonding interface components after dental bleaching in ceramic laminate veneer luting. METHODS AND MATERIALS: A total of 143 bovine teeth were distributed into experimental groups, according to the procedure method (unbleached or bleached with Whiteness HP Maxx 35%), antioxidant type (control, 10% ascorbic acid, or 10% α-tocopherol), and luting period (24 hours or 14 days) (n=13). The Tetric N-Bond Universal adhesive system and Variolink Esthetic LC resin cement were used as luting agents to lute IPS e.max ceramic restorations (0.6 mm in thickness) to enamel. A UV-visible spectrophotometer was used to assess color stability before and after UV-B artificial accelerated aging for 252, 504, and 756 hours (n=8). The HIT and Eit* of the adhesive and resin cement were measured using a nanohardness tester under a load of 1000 μN, and the DC was measured using a micro-Raman spectrometer (n=5). The color stability and mechanical properties were measured and evaluated by twoway and one-way ANOVA, respectively, and Tukey test (α=0.05). RESULTS: Distinct aging periods exerted significant changes on the color stability of the restorations luted in enamel associated with ascorbic acid, bleached and unbleached, and the bleached enamel under no antioxidant agent action, for the experimental groups evaluated after 14 days (p<0.05). The use of the α-tocopherol antioxidant solution after the bleaching process for 24 hours did not alter the optical and mechanical properties of the adhesive interface of the laminate restorations compared to those of the control group (p>0.05). CONCLUSION: The use of a 10% α-tocopherol antioxidant solution produced promising results, suggesting that it could be mediately used after tooth bleaching to lute ceramic laminate veneers.
Effect of Simulated Annual At-home Bleaching on Susceptibility to Staining, Translucency, and Whiteness Variations of Computer-aided Design and Computer-aided Manufacturing Monolithic Materials.
Ramos AC, Peña RC, Dovigo LN … +2 more , Pérez MM, Fonseca RG
Oper Dent · 2023 Jul · PMID 37302142 · Publisher ↗
The effect of annual at-home bleaching on the color, translucency, and whiteness properties of computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic materials requires investigation. The aim of the...
The effect of annual at-home bleaching on the color, translucency, and whiteness properties of computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic materials requires investigation. The aim of the present in vitro study was to evaluate the effect of simulated annual at-home bleaching (consisting of daily applications for 10 hours a day for 14 days), for up to 3 years, on susceptibility to staining (ΔE00), translucency (ΔTP00), and whiteness (ΔWID) variations and on topography of CAD-CAM monolithic materials. Disks from the Lava Ultimate (LU), Vita Enamic (VE), IPS Empress CAD (EMP), and IPS e.max CAD (EMAX) were allocated as follows: 1) nonbleached or 2) bleached with 10% carbamide peroxide. After reading the CIE L*a*b* coordinates at baseline (R0), specimens were bleached or not and subsequently immersed for a 1-year simulated period in coffee before the next reading (R1). This process was repeated two more times, resulting in R2 and R3. The ΔE00, ΔTP00, and ΔWID between R1, R2, and R3 in relation to R0 were calculated. The surface topography was analyzed by scanning electron microscopy. In general, bleaching increased the staining susceptibility of all materials when compared to the nonbleached groups and that of the LU, VE, and EMAX over the years. Bleaching decreased the translucency of the VE in all years and over the years. When compared to the nonbleached groups, bleaching decreased the whiteness of the LU and EMAX and increased the whiteness of the EMP, while the VE was not affected. In the LU, the whiteness decreased over the years in both treatments, whereas the other materials were not affected with time. All materials showed progressive topographic changes over the years. The simulated annual at-home bleaching with 10% carbamide peroxide adversely affected the topography and the optical and/or colorimetric properties of the evaluated materials.
Errata.
Oper Dent · 2023 May · PMID 37269554 · Publisher ↗
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LETTER TO EDITOR.
Grover S
Oper Dent · 2023 May · PMID 37269553 · Publisher ↗
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Wear of Bulk-fill Composite Resins After Thermo-mechanical Loading.
Zancopé K, Borges G, Ribeiro M … +3 more , Miranda RR, Peres TS, Soares CJ
Oper Dent · 2023 Jul · PMID 37226712 · Publisher ↗
STATEMENT OF PROBLEM: Wear of conventional composite resin presented many challenges when restoring posterior teeth and resulted in clinical complications. Bulk-fill composite resins have been proposed as a more suitable...
STATEMENT OF PROBLEM: Wear of conventional composite resin presented many challenges when restoring posterior teeth and resulted in clinical complications. Bulk-fill composite resins have been proposed as a more suitable and wear-resistant alternative. OBJECTIVE: To evaluate and compare the volumetric wear (mm3) of bulk-fill composite resins to a conventional composite resin and enamel after thermo-mechanical loading. METHODS AND MATERIALS: Five composite resins (n=10) were evaluated: four bulk-fill composite resins (Filtek One Bulk Fill [3M Oral Care], Tetric EvoCeram Bulk Fill [Ivoclar Vivadent], Tetric PowerFill [Ivoclar Vivadent], SonicFill 3 [Kerr Corp]); and one conventional composite resin (Filtek Supreme Ultra [3M Oral Care]). Enamel from recently extracted human teeth was used as a control. Specimens were subjected to a 2-body volumetric wear evaluation using a chewing simulator (CS-4.8, Mechatronik). Disc-shaped specimens (10 mm in diameter × 3 mm in thickness) received 500,000 load cycles against steatite antagonists while simultaneously thermocycled (5000 cycles, 5-55°C). Volumetric wear (mm3) was measured using the Geomagic Control X software (3D Systems) based on digital scans of the specimens obtained before and after thermo-mechanical loading, with a Trios 3 (3Shape) digital scanner. Scanning electron microscopy analysis of wear facets and composite resin filler shape and size was performed. Volumetric wear was statistically analyzed using the one-way ANOVA and Tukey's post-hoc test (α=0.05). RESULTS: All tested composite resins wore at rates significantly higher than enamel (p<0.05). The mean volumetric wear of the composite resins ranged from 1.01 mm3 to 1.48 mm3, while enamel had a mean volumetric wear of 0.25 mm3. Bulk-fill composite resins showed higher wear resistance than the conventional composite resin (p<0.05). CONCLUSIONS: Bulk-fill composite resins showed higher wear resistance than the conventional composite resin, and both types of composite resin were not as wear-resistant as enamel.
Five-year Clinical Evaluation of Universal Adhesives in Noncarious Cervical Lesions.
Ruschel VC, Stolf SC, da Luz Baratieri C … +4 more , Chung Y, Boushell LW, Baratieri LN, Walter R
Oper Dent · 2023 Jul · PMID 37226698 · Publisher ↗
OBJECTIVES: To compare the clinical performance of mildly acidic universal adhesives Scotchbond Universal (SU, 3M Oral Care, St Paul, MN, USA) and Prime & Bond Elect (PBE, Dentsply Sirona, Charlotte, NC, USA) in the rest...
OBJECTIVES: To compare the clinical performance of mildly acidic universal adhesives Scotchbond Universal (SU, 3M Oral Care, St Paul, MN, USA) and Prime & Bond Elect (PBE, Dentsply Sirona, Charlotte, NC, USA) in the restoration of noncarious cervical lesions (NCCLs). METHODS AND MATERIALS: A total of 63 patients in need of 203 NCCL restorations participated in this randomized controlled clinical trial. Notch-shaped lesions were restored with Kalore (GC Corporation, Tokyo, Japan) after application of either SU or PBE, following the etch-and-rinse (ER) or self-etch (SE) techniques. Subjects were followed up for 60 months. The focus of the statistical analyses was on the change of outcome over time as assessed by the Modified USPHS rating system (ie, Alfa vs Bravo + Charlie outcomes). Logistic regression was performed for each outcome separately with compound symmetric variance-covariance structure assumed to consider a correlation of restorations within subjects. All analyses were conducted using SAS 9.4 (SAS, Cary, NC, USA). RESULTS: One-hundred twenty-nine teeth in 35 subjects were assessed at the 60-month follow-up. In addition, three restorations that failed prior to the 60-month evaluation, two of which were in subjects who did not present for the 60-month follow-up, were included in the statistical analysis. In total, two restorations in the SU_ER group and three restorations in the PBE_SE group failed the retention category. Statistically significant differences were obtained for the comparison of restorations in the PBE_SE and PBE_ER groups, where the former was 58% less likely to maintain a score of Alfa for marginal discoloration than the latter. CONCLUSIONS: SU and PBE demonstrated acceptable clinical performance at 60 months with regard to restoration retention. Phosphoric-acid etching of the NCCLs prior to adhesive application significantly improved the performance of PBE in regard to marginal discoloration.
Effects of an Acidic Environment on the Strength and Chemical Changes of Resin-based Composites.
Kang S, Cho BH
Oper Dent · 2023 Jul · PMID 37079919 · Publisher ↗
The objective of this study was to evaluate the aging effects of long-term exposure to acidic beverages on the flexural strength (FS) and chemical reactions of two resin-based composites (RBCs) and one giomer. The FS of...
The objective of this study was to evaluate the aging effects of long-term exposure to acidic beverages on the flexural strength (FS) and chemical reactions of two resin-based composites (RBCs) and one giomer. The FS of composite specimen bars (2 mm × 2 mm × 25 mm) was measured using a universal testing machine at various levels of thermocycling (TC; 0, 10,000, 50,000, and 100,000 cycles) in two beverages with different pH values (distilled water [DW], pH 7.0; Coca-Cola, pH 2.4-2.8). The FS data were analyzed using three-way analysis of variance with the post hoc Tukey test and t-test at a significance level of a=0.05. In DW, the FS of an RBC and a giomer did not decrease until 10,000 cycles. The other RBC, Z250, decreased rapidly until 50,000 cycles (p<0.05), followed by no additional decrease until 100,000 cycles. In Coca-Cola, the FS of two RBCs and a giomer decreased more rapidly than in DW from 10,000 cycles (t-test, p<0.05). In Coca-Cola, the increased porosity observed in scanning electron microscopy (SEM) images, the changes of the hydroxyl peak at 3340 cm-1 and ester peak at 1730-1700 cm-1 in Fourier-transform infrared spectroscopy in attenuated total reflectance mode (FTIR-ATR) spectra, and the continuous increase of the Si-O/Si-C peak height ratio from 10,000 cycles to 100,000 cycles in X-ray photoelectron spectroscopy (XPS) suggested an increased loss of silane-carbon bond between the matrix and fillers of the Z250 RBC, compared to those in DW. In conclusion, when TC was performed in DW, unreacted monomers and a coupling agent were washed out, which caused porosity and reduced FS. In Coca-Cola, acidic conditions accelerated the removal of the matrix through the hydrolysis reaction at the ester groups, resulting in more porosity and a faster decrease in FS than in DW.
The Efficacy of At-home, In-office, and Combined Bleaching Regimens: A Randomized Controlled Clinical Trial.
Zhong BJ, Yang S, Hong DW … +3 more , Cheng YL, Attin T, Yu H
Oper Dent · 2023 May · PMID 37079917 · Publisher ↗
OBJECTIVE: The aim of this study was to compare the clinical efficacy of at-home, in-office, and combined bleaching regimens. METHODS: Forty-eight participants were recruited and randomly divided into four groups based o...
OBJECTIVE: The aim of this study was to compare the clinical efficacy of at-home, in-office, and combined bleaching regimens. METHODS: Forty-eight participants were recruited and randomly divided into four groups based on the bleaching regimen (n=12) as follows: 1) at-home bleaching using 10% carbamide peroxide (Opalescence PF 10%, Ultradent) for 14 days (HB); 2) two sessions of in-office bleaching using 40% hydrogen peroxide (Opalescence BOOST PF 40%, Ultradent) with a one-week interval (OB); 3) one session of in-office bleaching followed by at-home bleaching for seven days (OHB); and 4) at-home bleaching for seven days followed by one session of in-office bleaching (HOB). Tooth color was measured using a spectrophotometer (Easyshade, Vita ZahnFabrik) at baseline (T0), day 8 (T1), day 15 (T2), and day 43 (T3, four weeks after the end of the bleaching treatment). The color data were calculated using the CIEDE2000 (ΔE00) and whiteness index for dentistry (WID) formulas. Tooth sensitivity (TS) was recorded using a visual analogue scale (VAS) for 16 days. Data were analyzed by one-way analysis of variance (ANOVA) and the Wilcoxon signed-rank test (α=0.05). RESULTS: All bleaching regimens resulted in a significant increase in WID values (all p<0.05), while no significant differences in WID and ΔWID values were found among the different groups at each time point (all p>0.05). Significant differences in ΔE00 values were observed between T1 and T3 for all groups (all p<0.05), while no significant differences in ΔE00 values were found among the different groups at any time point (all p>0.05). Significantly lower TS values were observed in the HB group than in the OB and HOB groups (p=0.006 and p=0.001, respectively). CONCLUSIONS: All bleaching regimens resulted in great color improvement, and different regimens led to similar color changes at any of the evaluation time points. The sequence of treatments applying in-office bleaching or at-home bleaching did not affect the bleaching efficacy. The in-office bleaching and combined bleaching regimens yielded a higher intensity of TS than did at-home bleaching.
Translucency and Radiopacity of Dental Resin Composites - Is There a Direct Relation?
Rosado L, Münchow EA, de Oliveira E … +4 more , Lacerda-Santos R, Freitas DQ, Carlo HL, Verner FS
Oper Dent · 2023 May · PMID 37079916 · Publisher ↗
OBJECTIVES: The purpose of this study was to correlate the translucency degree of varying resin composites with their radiopacity. METHODS AND MATERIALS: Twenty-four resin composites (conventional or bulk-fill) of variou...
OBJECTIVES: The purpose of this study was to correlate the translucency degree of varying resin composites with their radiopacity. METHODS AND MATERIALS: Twenty-four resin composites (conventional or bulk-fill) of various shades and opacities were selected from the following manufacturers: 3M ESPE (nanofilled), Ivoclar (nanohybrid), and FGM (microhybrid). Resin composite samples (n=5) were prepared (5-mm diameter × 1.5-mm thickness) for comparison using prepared samples of human dentin and enamel as controls. The translucency of each sample was measured using the translucent parameter (TP) method with a digital spectrophotometer (Vita Easyshade) and CIEL*a*b* color system over white and black backgrounds. The samples were also x-rayed using a photostimulable phosphor plate system for measurement of their radiopacity (in mmAl). All data were analyzed using one-way ANOVA and Student-Newman-Keuls (α=0.05); data for TP and radiopacity were correlated using the Spearman correlation test. RESULTS: Overall, the translucent shades and bulk-fill resin composites showed greater translucency than the other resins. While "body" and "enamel" shades demonstrated intermediate translucency to dentin and enamel, the "dentin" shades were more standardized, showing similar translucency to human dentin. All tested resin composites showed similar or greater radiopacity to human enamel, except the Empress Direct (Ivoclar) resin with Trans Opal shade, which was not radiopaque. Dentin and enamel showed radiopacity similar to 1 and 2 mmAl (millimeters of aluminum), respectively. CONCLUSIONS: The resin composites investigated in this study differed regarding their translucency degree and radiopacity level, without any positive relationship between the two properties.
Ultrathin Partial Ceramic Veneers in the Esthetic Zone with Tooth Whitening: A 5-year Case Report.
Villalobos-Tinoco JV, Fischer NG, Jurado CA … +3 more , Flores-Reyes J, Karimi K, Tsujimoto A
Oper Dent · 2023 Jul · PMID 37079913 · Publisher ↗
OBJECTIVE: This case report describes a minimally invasive approach with tooth whitening and partial ceramic veneers in the esthetic zone with a 5-year follow-up. CLINICAL CONSIDERATIONS: The patient was initially concer...
OBJECTIVE: This case report describes a minimally invasive approach with tooth whitening and partial ceramic veneers in the esthetic zone with a 5-year follow-up. CLINICAL CONSIDERATIONS: The patient was initially concerned about the tooth color and previous direct resin composite restorations that chipped on the incisal edges of both maxillary central incisors. Tooth whitening and partial veneers for both central incisors were recommended after clinical evaluation. Two sessions of in-office tooth whitening, first with 35% hydrogen peroxide and later with 10% carbamide peroxide from first premolar to first premolar, were provided. Minimal tooth preparation that only removed the fractured composite restorations was performed followed by placement of feldspathic porcelain ultrathin partial ceramic veneers for both central incisors. We emphasize the benefits of minimal tooth preparation paired with partial ceramic veneers and the importance of masking discolored tooth structure with such thin veneers, including potential tooth whitening. CONCLUSIONS: Overall, we demonstrate a well-planned and executed restorative procedure combining tooth whitening and ultrathin partial ceramic veneers to achieve desired results in the esthetic zone that remained successful for five years.
Radiopacity of Posterior Restorative Materials: A Comparative In Vitro Study.
Balci M, Turkun LS, Boyacıoglu H … +2 more , Guneri P, Ergucu Z
Oper Dent · 2023 May · PMID 37079911 · Publisher ↗
BACKGROUND: The objective was to investigate the radiopacity of 11 commercial posterior restorative materials by establishing their mean gray values (MGVs) and comparing them with dental hard tissues. METHODS AND MATERIA...
BACKGROUND: The objective was to investigate the radiopacity of 11 commercial posterior restorative materials by establishing their mean gray values (MGVs) and comparing them with dental hard tissues. METHODS AND MATERIALS: Five-disc specimens were prepared for each of the following materials: Cerasmart 270 CAD/CAM block A3LT (CS), Amalgam (A), Ketac Molar A3 (KM), Cention-N A2 (CN), G-aenial Universal Flo AO2 (GO2) and A2 (G2), Ever-X Flow Dentine (EXD) and Bulk (EXB) shades, Equia Forte HT Fil A2 (EF2) and A3 (EF3), and Equia Fil A3 (E3). Freshly extracted maxillary premolar teeth were used as a control. The MGVs of specimens and a 10-step aluminum stepwedge (Al) were measured with Adobe Photoshop. ANOVA and Dunnett T3 tests were used to assess the significance of the differences (α=0.05). RESULTS: Statistically significant differences were revealed between some of the groups. Amalgam had the highest radiopacity. The radiopacity of dentin and CS were close to that of 1 mm Al. G2, KM, GO2, EXB, and EXD showed higher mean radiopacity than dentin. Enamel had a radiopacity equivalent to 2 mm Al. CN, EF2, and E3 had higher mean radiopacity than enamel. CONCLUSIONS: All materials met the ISO requirements. Alkasite and reinforced glass ionomer restoratives demonstrated higher mean radiopacity than the posterior flowable composites. Material shades did not affect the radiopacity.
Management of Multifactorial Stained Enamel Defects on Anterior Dentition Using a Combination Treatment of Whitening, Microabrasion, Resin Infiltration and Resin-based Composite Restoration.
Alkhazaleh A, Tsujimoto A
Oper Dent · 2023 May · PMID 37015014 · Publisher ↗
OBJECTIVES: This case report describes a combination treatment composed of tooth whitening, microabrasion, resin infiltration, and resin-based composite restoration to manage multifactorial stained enamel lesions on ante...
OBJECTIVES: This case report describes a combination treatment composed of tooth whitening, microabrasion, resin infiltration, and resin-based composite restoration to manage multifactorial stained enamel lesions on anterior teeth. CLINICAL CONSIDERATIONS: The patient's primary concern was to improve the esthetics of their smile after about a decade of extensive orthodontic and orthognathic procedures. After clinical evaluation and history taking, the authors determined that the enamel defects were the result of carious and developmental factors. In-office tooth whitening took place in one visit, followed by micro abrasion and resin infiltration in another visit. Thirteen months later, a follow-up visit showed that the results were stable and that the patient was satisfied with the overall outcome. A small resin composite restoration was added at the follow up visit to repair a previous restoration and to reestablish the facial contours of the central incisor. CONCLUSIONS: A combination treatment protocol composed of tooth whitening, microabrasion, and resin infiltration can improve patient satisfaction and avoid unnecessary invasive treatment.
Evaluation of Different Protocols with 4% Hydrogen Peroxide in Bleaching Efficacy and Tooth Sensitivity - A Single-blind, Randomized Clinical Trial.
Paula AM, Hanzen TA, de Oliveira M … +2 more , Loguercio AD, Reis A
Oper Dent · 2023 May · PMID 36929775 · Publisher ↗
OBJECTIVES: To compare the bleaching efficacy and tooth sensitivity (TS) of 4% hydrogen peroxide (HP) in adults using a continuous or fractioned protocol. METHODS AND MATERIALS: A single-blind randomized controlled trial...
OBJECTIVES: To compare the bleaching efficacy and tooth sensitivity (TS) of 4% hydrogen peroxide (HP) in adults using a continuous or fractioned protocol. METHODS AND MATERIALS: A single-blind randomized controlled trial with a parallel design was conducted. Eighty-six patients with upper canines A2 or darker were submitted to bleaching with 4% HP gel for three weeks after random allocation into the fractioned protocol (two 30-minute daily applications) or continuous protocol (single one-hour application). We evaluated the color change at baseline, weekly, and 30 days after the bleaching using Vita Classical and Vita Bleachedguide using the units of shade guides (SGU) and by spectrophotometer using CIELab 1976 (ΔEab) and CIEDE 2000 formulas (ΔE00), as well as Whiteness Index (ΔWID). We assessed the absolute risk of TS with a visual analog scale (VAS) and numeric rating scale (NRS). Color changes in each recall were compared with the Student t-test. The risk of TS was evaluated by the Chi-square test, and the intensity by Mann-Whitney test (NRS) and Student t-test (VAS). RESULTS: The mean difference for the ΔSGU Vita Classical (0.5; 95% CI: -0.5 to 1.5), ΔSGU Vita Bleachedguide (-0.4; 95% CI: -1.5 to 0.7), ΔEab (1.4; 95% CI: -0.1 to 2.9), ΔE00 (0.6; 95% CI: -0.4 to 1.6), and ΔWID (-3.2; 95% CI: -7.3 to 0.9) after three weeks of bleaching was not clinically or statistically significant (p>0.10). The absolute risk of TS was 44% (95% CI: 30-58%) and 46% (95% CI: 32-61%) in the fractioned and continuous protocols, respectively (RR=1.0; 95% CI: 0.6 to 1.5; p>0.91). CONCLUSION: A fractioned bleaching protocol with 4% HP (30 minutes twice daily) did not increase the whitening degree nor affect the risk and intensity of TS when compared with the one-hour continuous protocol.
Effect of Ceramic Conditioners on Surface Morphology, Roughness, Contact Angle, Adhesion, Microstructure, and Composition of CAD/CAM Ceramics.
Oliveira LT, de Castro EF, Azevedo V … +5 more , de Andrade OS, Faraoni JJ, Palma-Dibb RG, Dias C, Giannini M
Oper Dent · 2023 May · PMID 36929774 · Publisher ↗
The objective of this study was to investigate the effect of surface treatments in maximum profile valley depth (Rv), surface roughness (Sa), contact angle (Ca), shear bond strength (SBS) of a light-cured resin cement, m...
The objective of this study was to investigate the effect of surface treatments in maximum profile valley depth (Rv), surface roughness (Sa), contact angle (Ca), shear bond strength (SBS) of a light-cured resin cement, microstructure, and composition of two CAD/CAM ceramics: Cerec Blocs/Dentsply Sirona (feldspathic - FEL) and Empress CAD/Ivoclar Vivadent (leucite-reinforced - LEU). The ceramic specimens were submitted to six surface treatments: (1) 5% hydrofluoric acid (HF) - 20 seconds; (2) 5% HF - 60 seconds; (3) 10% HF - 20 seconds; (4) 10% HF - 60 seconds; (5) self-etching ceramic primer (MEP) - 20 seconds; and (6) MEP - 60 seconds. Specimens treated with HF received silane application for 1 minute. Rv and Sa were evaluated in a confocal laser microscope (n=10) and the Ca in a goniometer (n=6). For the SBS test, two resin cement cylinders were bonded to each specimen, one tested after 24 hours in distilled water storage (37°C) and the other after one year (n=10). The microstructures and compositions were analyzed by scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS) (n=4). Rv, Sa, and Ca data were analyzed by two-way ANOVA, and the SBS data by three-way ANOVA, all followed by post-hoc Tukey's test (α=0.05). Results: Surface treatments with HF always produced higher Rv and Sa, and lower Ca than MEP 60s for both ceramics. After 1-year water storage, FEL ceramic treated with MEP for 60 seconds produced higher SBS values than HF treatments, whereas for LEU ceramic there were no differences among treatments. Application of MEP for 20 or 60 seconds produced no difference in Rv, Sa, Ca, and SBS for both ceramics. Surface treatments produced considerable differences in ceramic topography, but subtle ones in composition, for both ceramics. Conclusions: The results indicated that for FEL ceramic, MEP application for 60 seconds yielded higher SBS compared with HF etching, while for LEU ceramic the surface treatments did not influence the SBS results.
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