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

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.

AIMS: To investigate the effect of the storage period on the accuracy of recently developed elastomeric materials. METHODS: Simultaneous impressions of a steel die were taken using a polyether (I: Impregum Soft Heavy and Light body, 3M ESPE) and vinyl polysiloxane (P: Perfectim Blue Velvet and Flexi-Velvet, J.Morita). The trays were loaded with the heavy-bodied impression materials while the light-bodied impression materials were simultaneously spread on the steel die. The impressions were poured after 2 hours, 24 hours, and 7 days. Impressions were stored at approximately 55% relative humidity and room temperature. Ten replicas were produced for each experimental condition (n=60). Accuracy of the stone dies was assessed with a depth-measuring microscope. The difference in height between the surface of the stone die and a standard metallic ring was recorded in micrometers at four demarcated points, by two independent examiners. Data were submitted to two-way ANOVA and Tukey test (a = 0.05). RESULTS: Significant differences were found among the groups. Smaller discrepancies were observed when pouring was performed up to 24 hours (I-2h= 65.0 ± 15.68 µm; I-24h= 81.6 ± 11.13 µm) for the polyether, and up to 7 days for the vinyl polysiloxane (P-2h= 79.1 ± 13.82 µm; P-24h= 96.8 ± 6.02 µm; P-7d= 81.4 ± 4.3 µm). Significant dimensional discrepancies, however, were observed when polyether was stored for 7 days (I-7d= 295.3 ± 17.4 µm). CONCLUSION: Storage may significantly affect the dimensional accuracy of impressions and, thus, a maximum period and storage condition should be specified for the recently developed materials.

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.

Desde o aumento da popularidade de tratamentos clareadores, o interesse em se pesquisar os efeitos dos peróxidos nos tecidos dentais duros é crescente. Proposta: O objetivo deste trabalho foi conduzir uma análise qualitativa in vitro do esmalte dental humano após clareamento com agentes para consultório, por meio de Microscopia Eletrônica de Varredura (MEV). Material e métodos: Foram utilizados 20 terceiros molares humanos hígidos, extraídos por motivos ortodônticos, sendo aleatoriamente divididos em 4 grupos (n=5) e tratados da seguinte forma: G1-armazenamento em saliva artificial (grupo controle); G2- 4 aplicações de peróxido de carbamida a 35% por 30 min (tempo total de aplicação: 2h); G3- 4 aplicações de peróxido de carbamida a 35% por 2 h (tempo total de aplicação: 8h); G4- 2 aplicações de peróxido de hidrogênio a 35%, que foi foto-ativado com lâmpada halógena a 700mW/cm² por 7 min e mantido em contato com o dente durante 20 min (tempo total de aplicação: 40min). A avaliação dos grupos submetidos ao clareamento com peróxido de carbamida a 35% após 2 tempos de aplicação (30 minutos e 2 horas por sessão) para testar as situações extremas recomendadas pelo fabricante. As amostras foram recobertas com ouro para análise em MEV e foram examinadas utilizando 15kV e aumentos de 500x e 2000x. Resultados: Foram detectadas alterações morfológicas similares na superfície do esmalte após o clareamento com peróxido de carbamida a 35% e peróxido de hidrogênio a 35%. Porosidades e irregularidades caracterizando um processo erosivo foram observadas no esmalte humano. Áreas de depressão, incluindo a formação de crateras e exposição dos prismas de esmalte também foram observadas. Conclusão: Os efeitos do clareamento na morfologia do esmalte encontraram-se distribuídos aleatoriamente por toda a superfície do esmalte e danos em diferentes intensidades puderam ser evidenciados. Significância clínica: Agentes concentrados para clareamento em consultório podem comprometer a morfologia do esmalte e, portanto, devem ser utilizados com cautela.

Since bleaching has become a popular procedure, the effect of peroxides on dental hard tissues is of great interest in research. Purpose: The aim of this in vitro study was to perform a qualitative analysis of the human enamel after the application of in-office bleaching agents, using Scanning Electron Microscopy (SEM). Materials and Methods: Twenty intact human third molars extracted for orthodontic reasons were randomly divided into four groups (n=5) treated as follows: G1- storage in artificial saliva (control group); G2- four 30-minute applications of 35% carbamide peroxide (total exposure: 2h); G3- four 2-hour exposures to 35% carbamide peroxide (total exposure: 8h); G4- two applications of 35% hydrogen peroxide, which was light-activated with halogen lamp at 700mW/cm² during 7min and remained in contact with enamel for 20min (total exposure: 40min). All bleaching treatments adopted in this study followed the application protocols advised by manufacturers. Evaluation of groups submitted to 35% carbamide peroxide was carried out after two time intervals (30 minutes and 2 hours per session), following the extreme situations recommended by the manufacturer. Specimens were prepared for SEM analysis performing gold sputter coating under vacuum and were examined using 15kV at 500x and 2000x magnification. Results: Morphological alterations on the enamel surface were similarly detected after bleaching with either 35% carbamide peroxide or 35% hydrogen peroxide. Surface porosities were characteristic of an erosive process that took place on human enamel. Depression areas, including the formation of craters, and exposure of enamel rods could also be detected. Conclusion: Bleaching effects on enamel morphology were randomly distributed throughout enamel surface and various degrees of enamel damage could be noticed. Clinical significance: In-office bleaching materials may adversely affect enamel morphology and therefore should be used with caution.

O objetivo deste estudo foi comparar a microdureza de 4 resinas compostas indiretas. Quarenta amostras cilíndricas foram obtidas com o auxílio de uma matriz de teflon, seguindo-se as recomendações dos fabricantes. Foram obtidas 10 amostras para cada material testado, contituindo-se 4 grupos (n=10) como se segue: G1-Artglass; G2-Sinfony; G3-Solidex; G4-Targis. A microdureza foi determinada pela técnica da indentação Vickers com uma carga de 300g por 10 segundos. Quatro indentações foram realizadas em cada amostra, obtendo-se um valor médio. Os dados da análise estatística descritiva para cada condição experimental foram: G1-Artglass (média ± desvio padrão:55,26 ± 1,15HVN; mediana: 52,6); G2- Sinfony (31,22 ± 0,65HVN; 31,30); G3- Solidex (52,25 ± 1,55HVN; 52,60); G4- Targis (72,14 ± 2,82HVN; 73,30). Uma análise exploratória dos dados foi realizada para determinar o teste estatístico mais apropriado: (I) Teste de Levene para variâncias homogêneas; (II) Teste de ANOVA (Kruskal-Wallis); (III) Teste de comparação múltipla de Dunn. O Targis apresentou os maiores valores de microdureza, enquanto que o Sinfony apresentou os menores valores. O Artglass e o Solidex se comportaram como materiais intermediários. Estes resultados indicaram que propriedades mecânicas distintas podem ser observadas nos materiais. A composição de cada material, bem como as variações nos métodos de polimerização são possivelmente responsáveis pelas diferenças observadas na microdureza. Portanto, materiais resinosos indiretos que garantam estética e propriedades mecânicas satisfatórias podem ser considerados como substitutos dos dentes naturais.

The purpose of this study was to compare the microhardness of four indirect composite resins. Forty cylindrical samples were prepared according to the manufacturer’s recommendations using a Teflon mold. Ten specimens were produced from each tested material, constituting four groups (n=10) as follows: G1 - Artglass; G2 - Sinfony; G3 - Solidex; G4 - Targis. Microhardness was determined by the Vickers indentation technique with a load of 300g for 10 seconds. Four indentations were made on each sample, determining the mean microhardness values for each specimen. Descriptive statistics data for the experimental conditions were: G1 - Artglass (mean ±standard deviation: 55.26 ± 1.15HVN; median: 52.6); G2 - Sinfony (31.22 ± 0.65HVN; 31.30); G3 - Solidex (52.25 ± 1.55HVN; 52.60); G4 - Targis (72.14 ± 2.82HVN; 73.30). An exploratory data analysis was performed to determine the most appropriate statistical test through: (I) Levene's for homogeneity of variances; (II) ANOVA on ranks (Kruskal-Wallis); (III) Dunn's multiple comparison test (0.05). Targis presented the highest microhardness values while Sinfony presented the lowest. Artglass and Solidex were found as intermediate materials. These results indicate that distinct mechanical properties may be observed at specific materials. The composition of each material as well as variations on polymerization methods are possibly responsibles for the difference found in microhardness. Therefore, indirect composite resin materials that guarantee both good esthetics and adequate mechanical properties may be considered as substitutes of natural teeth.