Abstract Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost. Objective This study aimed to evaluate the effect of beveling on the fracture resistance and pattern of class II (MOD) restored teeth. Methodology Ninety human premolars were randomly assigned into 9 groups: CTR (control/sound); NC (cavity preparation, non-restored); RU (restored, unbeveled); RTB (restored, entire angle beveling); RPB (restored, partial/occlusal beveling); EC (endodontic access/EA, non-restored); EU (EA, unbeveled); ETB (EA, entire angle beveling); EPB (EA, partial/occlusal beveling). Teeth were restored with Esthet X resin composite and stored in distilled water for 24 h before the inclusion in PVC cylinders. The axial loading tests were performed with 500 kgF at 0.5 mm/min crosshead speed until fracture of the specimens. Fracture resistance and pattern were accessed and data were analyzed using one-way ANOVA and Tukey’s HSD test (α=0.05). Results Mean (±SD) failure loads ranged from 136.56 (11.62) to 174.04 (43.5) kgF in the groups tested without endodontic access. For endodontically accessed teeth, fracture resistance ranged from 95.54 (13.05) to 126.51 (19.88) kgF. Beveling of the cavosurface angle promoted the highest fracture resistance values (p<0.05) and prevented catastrophic fractures. Conclusions Cavosurface angle beveling is capable of improving fracture resistance and pattern for both endodonticaly accessed and non-accessed teeth.

The objective of the present case report was to describe the aesthetic and functional rehabilitation of the upper anterior incisors of a patient with bruxism. A 23-year-old male patient, with bruxism, sought treatment for his upper anterior teeth due to diastemas and reduced lengths of the upper central incisors. The gingivoplasty and osteotomy were performed in the region of the upper central incisors to improve the positions of the gingival contours and increase the length of these teeth. After 90 days, teeth whitening was performed. After 1 month the composite resin veneers were made in the upper central incisors. During treatment, the needs and perspectives of the patient were considered to achieve clinical success. The treatments were finalized, and the final result was satisfactory. Therefore, an integrated treatment plan proved to be extremely important, especially when the patient is adequately informed of the available treatment options and collaborates with the treatment.

O objetivo do presente relato de caso clínico foi descrever a reabilitação estética e funcional dos incisivos anteriores superiores de um paciente com bruxismo. Paciente do gênero masculino, 23 anos de idade, bruxoma, procurou tratamento para os dentes anteriores superiores devido aos diastemas dentários e também por causa dos comprimentos reduzidos dos incisivos centrais superiores. Para isso, foi realizada a gengivoplastia e osteotomia na região dos incisivos centrais superiores com o objetivo de melhorar as posições dos contornos gengivais e aumentar o comprimento desses dentes. Após 90 dias, o clareamento dentário foi realizado. Depois de 1 mês as facetas de resina composta foram confeccionadas nos incisivos centrais superiores. Durante o tratamento as necessidades e perspectivas do paciente foram levadas em consideração para alcançar o sucesso clínico. Após a conclusão dos procedimentos, o resultado final foi satisfatório. Portanto, um plano de tratamento integrado se mostrou de extrema valia, principalmente quando o paciente é devidamente esclarecido das opções disponíveis de tratamento e colabora com o mesmo.

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.

La remodelación cosmética de los dientes naturales es una modalidad de tratamiento con beneficios estéticos que puede ser considerada económica y conservadora. No obstante, demanda del profesional no solo restaurar una sonrisa armoniosa, sino también, al mismo tiempo preocuparse con el aspecto funcional del tratamiento. Además, la remodelación cosmética pude ser relacionada a otros recursos operatorios como los restauradores adhesivos directos, proporcionando resultados aún más satisfactorios a los pacientes. De esta manera, este trabajo tiene por objetivo presentar un caso clínico, en el cual la remodelación cosmética asociada a diferentes recursos operatorios, puede ser empleada como una opción de tratamiento estético conservador

Cosmetic contouring of natural teeth is a treatment with aesthetic benefits that can be considered economical as well as conservative. The dental professional has however not only to restore the smile harmony, but the functional aspects have to be considered at the same time in the treatment planning. Other treatments such as direct adhesive restorative treatments may additionally be used to provide better outcomes to the patients. The aim of the present work thus is to present a case of cosmetic contouring as a suitable aesthetic treatment option

OBJECTIVES: This in vitro study evaluated the fracture resistance of weakened human premolars (MOD cavity preparation and pulp chamber roof removal) restored with condensable resin composite with and without cusp coverage. MATERIAL AND METHODS: Thirty human maxillary premolars were divided into three groups: Group A (control), sound teeth; Group B, wide MOD cavities prepared and the pulp chamber roof removed and restored with resin composite without cusp coverage; Group C, same as Group B with 2.0 mm of buccal and palatal cusps reduced and restored with the same resin. The teeth were included in metal rings with self-curing acrylic resin, stored in water for 24 h and thereafter subjected to a compressive axial load in a universal testing machine at 0.5 mm/min. RESULTS: The mean fracture resistance values ± standart deviation (kgf) were: group A: 151.40 ± 55.32, group B: 60.54 ± 12.61, group C: 141.90 ± 30.82. Statistically significant differences were found only between Group B and the other groups (p<0.05). The condensable resin restoration of weakened human premolars with cusp coverage significantly increased the fracture resistance of the teeth as compared to teeth restored without cusp coverage. CONCLUSION: The results showed that cusp coverage with condensable resin might be a safe option for restoring weakened endodontically treated teeth.

En Odontología, un problema observado constantemente en pacientes adultos en este inicio de siglo es sin duda, el desgaste dental patológico. Este tipo de desgaste ocurre cuando existe pérdida acentuada de la estructura dentaria, lo que generalmente ocasiona el compromiso estético de los dientes antero superiores. En consecuencia, la sociedad se está concientizando sobre la importancia de la salud y de la estética, de esta manera, la demanda por tratamientos estéticos rehabilitadores en casos de desgaste dental patológico ha aumentado. La rehabilitación estética puede ser realizada tanto por medio de tratamientos directos como indirectos. Debido a las ventajas de las resinas compuestas, el presente trabajo tiene por finalidad describir la técnica operatoria para el restablecimiento de la guía anterior con resina compuesta, mediante la técnica de estratificación, que permite simular las características ópticas de la estructura dental. Así, con la evolución de los sistemas adhesivos, asociado a las mejoras en las propiedades químicas, mecánicas y estéticas de las resinas compuestas, tratamientos restauradores extensos, como la reconstrucción directa de las guías anteriores en los casos de desgaste dental patológico, se tornan viables.

In Dentistry, a common problem observed in this beginning of century is the pathologic tooth wear. This type of wear occurs when there is accentuated loss of tooth structure, which frequently results in aesthetic compromise of the anterior maxillary teeth. As a result of the society’s awareness of the importance of health and aesthetics, the request for reparative aesthetic treatments in cases of pathologic tooth wear has increased. This aesthetic rehabilitation may be achieved either through indirect or direct treatments. Due to the advantages of the resin composites, the aim of the present paper is to show specifically the direct approach throughout the use of a layering technique to simulate the optical characteristics of the tooth structure. Hence with the evolution of the adhesive systems associated with improving in the chemical-mechanical-aesthetical charecterics of the resin composites, extensive restorative treatments as the direct reconstruction of the anterior guidance in cases of pathologic tooth wear are now feasible.

In the present study, two types of tests (tensile strength test and polymerization inhibition test) were performed to evaluate the physical and chemical properties of four impression materials [a polysulfide (Permlastic), a polyether (Impregum), a condensation silicone (Xantopren) and a polyvinylsiloxane (Aquasil),3; when polymerized in contact with of one conventional (Hemostop) and two experimental (Vislin and Afrin) gingival retraction solutions. For the tensile strength test, the impression materials were mixed and packed into a steel plate with perforations that had residues of the gingival retraction solutions. After polymerization, the specimens were tested in tensile strength in a universal testing machine. For the polymerization inhibition test, specimens were obtained after taking impressions from a matrix with perforations that contained 1 drop of the gingival retraction solutions. Two independent examiners decided on whether or not impression material remnants remained unpolymerized, indicating interference of the chemical solutions. Based on the analysis of the results of both tests, the following conclusions were reached: 1. The tensile strength of the polysulfide decreased after contact with Hemostop and Afrin. 2. None of the chemical solutions inhibited the polymerization of the polysulfide; 3. The polyether presented lower tensile strength after polymerization in contact with the three gingival retraction agents; 4. The polyether had its polymerization inhibited only by Hemostop; 5. None of the chemical solutions affected the tensile strength of the condensation silicone; 6. Only Hemostop inhibited the polymerization of the condensation silicone; 7. The polyvinylsiloxane specimens polymerized in contact with Hemostop had significantly lower tensile strength; 8. Neither of the chemical solutions (Afrin and Vislin) affected the tensile strength of the polyvinylsiloxane and the condensation silicone; 9. Results of the tensile strength and polymerization inhibition tests suggest that Vislin can be used as substance of gingival retraction without affecting the tested properties of four impression materials.

The purpose of this study was to investigate the effect of different surface treatments on shear bond strength of saliva-contaminated resin-resin interfaces. Flat resin surfaces were fabricated. In the control group, no contamination or surface treatment was performed. The resin surfaces of the experimental groups were contaminated with saliva and air-dried, and then submitted to: (G1) rinsing with water and drying; (G2) application of an adhesive system; (G3) rinsing and drying, abrasion with finishing disks, etching and application of adhesive system; (G4) rinsing and drying, etching, application of silane and adhesive system. Resin cylinders were placed over the treated surfaces. The specimens were stored in water or ethanol. Shear bond strength tests were performed and the mode of failure was evaluated. Data were submitted to two-way ANOVA and Dunnett T3 test. Contamination of resin-resin interfaces with saliva significantly reduced shear strength, especially after prolonged storage (p<0.05). Similar values to the original bond strength were obtained after abrasion and application of adhesive (G3) or etching and application of silane and adhesive (G4). If contamination occurs, a surface treatment is required to guarantee an adequate interaction between the resin increments.

O objetivo deste estudo foi avaliar, in vitro, a perda de estrutura dentária após o preparo cavitário para restaurações diretas e indiretas e sua relação com a resistência à fratura do dente. 60 pré-molares superiores humanos foram divididos em 6 grupos (n=10). Cavidades MOD para resina composta direta (Grupos I, II e III) e cavidades "inlay" (Grupos IV, V e VI) foram preparadas mantendo dimensões padronizadas. A extensão vestíbulo-lingual da caixa oclusal foi estabelecida em 1/4 (Grupos I e IV), 1/3 (Grupos II e V) ou 1/2 (Grupos III e VI) da distância intercuspídea. Os dentes foram pesados, em uma balança de precisão, antes e após o preparo cavitário para aferir a perda de massa dentária. Os dentes preparados foram submetidos à força de compressão para determinar a resistência à fratura em uma máquina universal de ensaios sob uma velocidade de 0.5 mm/min. Os dados foram submetidos à análise de variância a dois critérios e ao teste de Tukey (alfa = 0.05). As cavidades do tipo "1/4-inlay" apresentaram maior percentual de perda de massa (9.71%) em relação às cavidades para resina composta com mesma extensão (7.07%). As cavidades do tipo "1/3-inlay" também apresentaram maior percentual de perda de massa (13.91%) quando comparada às cavidades para resina composta com a mesma extensão (10.02%). As cavidades do tipo "1/2-inlay" apresentaram 21.34% de perda de massa, enquanto as cavidades com extensão de 1/2 para resina composta apresentaram uma perda de 16.19%. As médias de resistência à fratura (em kgf) foram: GI = 187.65; GII = 143.62; GIII = 74.10; GIV = 164.22; GV = 101.92; GVI = 50.35. Diferenças estatisticamente significantes (p<0.5) foram observadas entre os Grupos I e IV, II e V, III e VI. Maior perda de estrutura dentária e menor resistência à fratura foram verificadas após os preparos do tipo "inlay" quando comparados aos preparos para resina composta direta.

This study evaluated, in vitro, the loss of tooth substance after cavity preparation for direct and indirect restorations and its relationship with fracture strength of the prepared teeth. Sixty sound human maxillary first premolars were assigned to 6 groups (n=10). MOD direct composite cavities (Groups I, II and III) and indirect inlay cavities (Groups IV, V and VI) were prepared maintaining standardized dimensions: 2-mm deep pulpal floors, 1.5-mm wide gingival walls and 2-mm high axial walls. Buccolingual width of the occlusal box was established at 1/4 (Groups I and IV), 1/3 (Groups II and V) or 1/2 (Groups III and VI) of the intercuspal distance. Teeth were weighed (digital balance accurate to 0.001 g) before and after preparation to record tooth substance mass lost during cavity preparation. The prepared teeth were submitted to occlusal loading to determine their fracture strength using a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed by two-way ANOVA and Tukey test (alpha= 0.05). 1/4-inlay cavities had higher percent mean mass loss (9.71%) than composite resin cavities with the same width (7.07%). 1/3-inlay preparations also produced higher percent mean mass loss (13.91%) than composite resin preparations with the same width (10.02%). 1/2-inlay cavities had 21.34% of mass loss versus 16.19% for the 1/2-composite resin cavities. Fracture strength means (in kgf) were: GI = 187.65; GII = 143.62; GIII = 74.10; GIV = 164.22; GV = 101.92; GVI = 50.35. Statistically significant difference (p<0.05) were observed between Groups I and IV, II and V, III and VI. Higher tooth structure loss and lower fracture strength were recorded after preparation of inlay cavities, regardless of the width of the occlusal box, compared to the direct composite resin cavities.

O objetivo deste estudo foi avaliar a resistência ao desgaste de compômeros submetidos a um teste escovação simulada. A hipótese nula testada foi que não haveria diferenças em perda de massa e alterações de rugosidade superficial entre os compômeros após o teste. Os materiais empregados foram o Dyract (Dentsply), Dyract AP (Dentsply), Compoglass F (Vivadent), Freedom (SDI), F2000 (3M ESPE), comparados às resinas compostas Z100 (3M ESPE) e Silux Plus (3M ESPE). Para cada material, dez espécimes cilíndricos foram confeccionados com 5 mm de diâmetro e 3 mm de espessura. Para o teste de abrasão, uma máquina com escovas de cerdas macias e uma solução de dentifrício e água deionizada foi utilizada. Foram realizados 100.000 ciclos de escovação simulada. A perda de massa foi verificada através da diferença em porcentagem entre a massa inicial (antes da escovação) e massa final (após a escovação) através de uma balança analítica Sartorius. A alteração de rugosidade superficial foi determinada pela diferença em porcentagem entre as médias de rugosidade inicial e final, após 5 leituras aleatórias por espécime realizado pelo rugosímetro Hommel Tester T 1000 antes e depois do teste de abrasão. A análise estatística (Teste t pareado, ANOVA e Tukey, á=0,05) demonstrou que todos os materiais do estudo apresentaram perda de massa e aumento significante de rugosidade. Todos os compômeros apresentaram maior perda de massa em relação às resinas compostas. Entre os compômeros, Freedom e Dyract AP apresentaram a menor perda de massa. F2000 apresentou a maior alteração de massa sem diferenças estatísticas quando comparado ao Dyract. Quanto à rugosidade superficial, Dyract, Dyract AP, Z100, Compoglass F e Silux Plus se tornaram mais rugosos, porém sem diferenças estatísticas entre si. Freedom apresentou a maior alteração de rugosidade após o teste de escovação simulada.

This study aimed at analyzing the compomers wear by an "in vitro" toothbrushing abrasion test. The null hypotheses tested were that there would be no differences in weight loss and no significant changes in surface roughness of the compomers after this test. The utilized commercial brands were Dyract (Dentsply), Dyract AP (Dentsply), Compoglass F (Vivadent), Freedom (SDI), F2000 (3M ESPE), which were compared to the two resin composites Z100 (3M ESPE) and Silux Plus (3M ESPE). Ten cylindrical specimens for each commercial brand were prepared with 5mm diameter and 3mm thickness. An appropriate machine with soft bristle tips containing dentifrice solution and deionized water was used. A total of 100,000 brushing cycles were performed. The amount of weight loss was measured by the percentage alteration between the initial (before toothbrushing) and final weight (after toothbrushing), measured by a Sartorius analytical balance. The surface roughness change was determined by the percentage difference between initial and final means after 5 tracings by a T 1000 Hommel Tester roughness meter on the specimen's surfaces before and after toothbrushing abrasion test. The statistical analysis (Students paired t-test, ANOVA and Tukey, á=0.05) showed that all materials presented statistically significant weight loss and roughness increase after abrasion test. All compomers presented higher weight loss than resin composites. Freedom and Dyract AP presented the lowest weight loss among compomers. F2000 presented the worst abrasion resistance, without statistical differences with Dyract. For roughness changes, Dyract, Dyract AP, Z100, Compoglass F and Silux Plus showed the lowest surface roughness alteration, in increasing order, without statistical differences between them. Freedom was the statistically roughest material of the study.

O objetivo desse estudo foi avaliar a alteração de rugosidade superficial de três cimentos resinosos após submetê-los a ciclos de escovação simulada e analisar qualitativamente a sua superfície através de observações microscópicas. Os materiais empregados neste estudo foram Enforce Sure Cure (Dentsply), Rely X (3M-ESPE) e Variolink II (Vivadent). Estes foram submetidos à ciclos de escovação simulada (100.000 ciclos para cada espécime) e a alteração de sua rugosidade superficial (antes e após escovação) foi avaliada. Para cada material e condição de rugosidade, espécimes foram selecionados, metalizados e observados em microscopia eletrônica de varredura (DSM 900 Zeiss). Baseado nas observações microscópicas e nos valores de alteração de rugosidade, todos os materiais apresentaram aumento de rugosidade aritmética (Ra) após ciclos de escovação simulada.

The objective of this work was to evaluate the surface roughness changes of three current resin cements after tooth brushing simulation, as well as discuss its relation with scanning electron microscopic observations. The materials employed were Enforce Sure Cure (Dentsply), Rely X (3M-ESPE) and Variolink II (Vivadent). They were subjected to brushing abrasion (100,000 strokes for each specimen) and the surface roughness alterations (before and after strokes) were detected. For each roughness test condition, specimens were coated with gold-palladium and observed on a DSM 900 Zeiss scanning electron microscope. Roughness changes values (Ra) were statistically increased after brushing strokes. Based on the microscopic observations and roughness changes analysis, all cements studied became rougher after brushing strokes.

O polimento das restaurações com amálgama fornece uma superfície final mais lisa, diminuindo a quantidade de porosidades e favorecendo a resposta dos tecidos periodontais, aumentando, deste modo, sua longevidade. Desta forma, várias técnicas têm sido descritas, visando contribuir para a melhor qualidade das restaurações. Recentemente, a tecnologia do jateamento com óxido de alumínio tem sido difundida na clínica odontológica e, assim, os autores descrevem uma técnica alternativa de acabamento e polimento de restaurações com amálgama, utilizando o jato de óxido de alumínio, que permite obter clinicamente boas condições de lisura superficial.

Polishing amalgam restorations results in a smoother surface, reducing the presence of porosities, favouring a good response of periodontal tissues and thus increasing the longevity of those restorations. Therefore, several techniques have been described in order to contribute to higher quality restorations. Recently, sandblasting devices have been introduced in dental practice and the authors describe an alternative technique for finishing and polishing amalgam restorations using sandblasting, which results in clinically adequate superficial characteristics.