Abstract: Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT – SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.

Dental caries is considered a disease of high prevalence and a constant problem in public health. Proanthocyanidins (PAs) are substances that have been the target of recent studies aiming to control or treat caries. Objective The aim of this in vitro study was to evaluate the efficacy of a treatment with grape seed extract, under cariogenic challenge, to minimize or even prevent the onset of caries in the enamel and dentin. Material and Methods Blocks of enamel and dentin (6.0x6.0 mm) were obtained from bovine central incisors, polished, and selected by analysis of surface microhardness (SH). The blocks were randomly divided into 3 groups (n=15), according to the following treatments: GC (control), GSE (grape seed extract), GF (fluoride – 1,000 ppm). The blocks were subjected to 6 daily pH cycles for 8 days. Within the daily cycling, the specimens were stored in buffered solution. The blocks were then analyzed for perpendicular and surface hardness and polarized light microscopy. Results The means were subjected to statistical analysis using the ANOVA and Fisher's PLSD tests (p<0.05). For enamel SH, GF showed the highest hardness values. In the dentin, GF was also the one that showed higher hardness values, followed by GSE. Regarding the cross-sectional hardness values, all groups behaved similarly in both the enamel and dentin. The samples that were treated with GSE and fluoride (GF) showed statistically higher values than the control. Conclusion Based on the data obtained in this in vitro study, it is suggested that grape seed extract inhibits demineralization of artificial carious lesions in both the enamel and dentin, but in a different scale in each structure and in a smaller scale when compared to fluoride.

OBJETIVO: Apesar dos sistemas adesivos autocondicionantes (SAA) serem indicados para aplicação no esmalte dental, preocupação tem sido relatada com relação a sua efetividade. O objetivo deste estudo foi avaliar o padrão de condicionamento ácido (PCA) promovido por nove SAA e comparar ao PCA produzido pelo ácido fosfórico (35% e 34% - AF) no esmalte intacto (EI) ou abrasionado (EA). MATERIAIS E MÉTODOS: Vinte e dois terceiros molares humanos foram seccionados nos sentidos mésio-distal e vestíbulo-lingual, e quatro fragmentos dentais foram obtidos a partir de cada dente. Metade dos fragmentos tiveram o esmalte abrasionado com lixas de SiC (600) e a outra metade permaneceu intacta. Os fragmentos foram divididos em 22 grupos, de acordo com a textura da superfície do esmalte (EI e EA) e a técnica de condicionar o esmalte (AF 34 %, AF 35%, AdheSE primer; Brush & Bond; Clearfil Protect Bond primer; iBond; One-up Bond F; OptiBond Solo Plus primer; Tyrian SPE primer; Unifil Bond primer e Xeno III). Os agentes condicionadores foram aplicados nos EI e EA, de acordo com as instruções dos fabricantes. Espécimes tratados com AF foram lavados com água, enquanto os dentes tratados com SAA foram tratados com banhos alternados de álcool e acetona. Os espécimes foram secos, metalizados e observados em microscopia eletrônica de varredura. RESULTADOS: Em ambas as superfícies (EI e EA), o PCA dos AF (34 e 35%) foi mais profundo e homogêneo, quando comparados ao PCA produzido pelos SAA, exceto para o adesivo Tyrian SPE. A ação dos monômeros ácidos dos SAA foi mais efetiva no EA. CONCLUSÃO: A maioria dos SAA é menos agressiva que o ácido fosfórico e seus efeitos condicionadores são reduzidos em superfícies de EI.

ABSTRACT OBJECTIVE: Although self-etching bonding systems (SES) are indicated to prepare dental enamel for bonding, concerns have been expressed regarding their effectiveness. The aim of this study was to analyze the etching pattern (EP) of nine SES in comparison with 35% and 34% phosphoric acid etchants (FA) on intact (IN) and ground (GR) enamel surface. MATERIALS AND METHODS: Twenty-two human third molars were sectioned in mesial-distal and buccal-lingual directions, and four dental fragments were obtained from each tooth. Half of the fragments were ground using 600-grit SiC paper and the other half remained intact. The fragments were randomly assigned into 22 groups, according to the texture of enamel surface (IN and GR) and the technique to etch the enamel (34% FA, 35% FA, AdheSE primer; Brush & Bond; Clearfil Protect Bond primer; iBond; One-up Bond F; OptiBond Solo Plus primer; Tyrian SPE primer; Unifil Bond primer and Xeno III). Conditioners were applied to IN and GR enamel surfaces, according to the manufacturer's instructions. Specimens etched with phosphoric acids were washed with water, while the surfaces treated with SES were submitted to alternate rinsing with alcohol and acetone. The specimens were dried, sputter-coated and examined under a scanning electron microscope. RESULTS: For both IN and GR enamel surfaces, the EP of 34 and 35% FA was deeper and more homogeneous in comparison to EP of SES, except for Tyrian SPE. The acidic monomer action of self-etching systems was more effective on GR enamel. CONCLUSION: Most of the SES are less aggressive than phosphoric acid etchants and their etching effects were reduced on intact enamel surfaces.