Prosthetic Rehabilitation of a Patient With Gastroesophageal Reflux Disease: Five-Year Follow-up

Effect of hydrofluoric acid concentration and aging on the bond strength ceramics to a resin cement

This study evaluated the influence of hydrofluoric acid (HF) concentration and thermal cycling on the microshear bond strength (µSBS) of a resin luting agent to IPS e.max® CAD and Rosetta® SM. Ceramic specimens (12.0 x 14.0 x 1.5mm) were randomized into 8 groups (n=10) according to HF concentration, commercial brand, and aging. Immediately after polishing, and etching, all specimens were silanized and a layer of adhesive was applied. A PVS mold of 3 mm thickness and 10mm diameter with (four) 1.0mm holes was fabricated, placed on each specimen, and then filled with a resin luting agent. Half of the specimens were subjected to the µSBS test using an Instron at a speed of 1.0 mm/min, following a 24-hour storage in deionized water at 37ºC. The remaining specimens were subjected to thermal cycling (5ºC-55ºC, 30 seconds per bath) and µSBS. The data were evaluated utilizing a three-way ANOVA and Tukey's post-hoc test (α=0.05). Significant differences were found for HF concentration and aging (p<0.0001). No significant difference in µSBS was found for commercial brands (p=0.085). The interaction between brand and HF concentration (p=0.358), brand and aging (p=0.135), and HF concentration and aging (p=0.138) were not statistically significant. The triple interaction among these factors was not statistically significant (p=0.610). In conclusion, the bond strength is affected by the HF concentration. No statistical difference was observed between the two ceramics. Thermal cycling significantly reduced µSBS.

Effect of lithium disilicate ceramic thickness, shade and translucency on transmitted irradiance and knoop microhardness of a light cured luting resin cement

This in vitro study evaluates the influence of pressed lithium disilicate thickness, shade and translucency on the transmitted irradiance and the Knoop microhardness (KHN) of a light-cured resin cement at two depths. One hundred and thirty-five ceramic discs of IPS e.max Press (Ivoclar Vivadent) were fabricated and divided into twenty-seven groups (n = 5) according to the association between translucency: HT (hight translucency), LT (low translucency), and MO (medium opacity); shade: BL2, A1 and A3.5; and thickness: 0.5 mm, 1.5 mm, and 2.0 mm. One side of each ceramic disc was finished, polished and glazed. The irradiance (mW/cm²) of a multiwave LED light curing unit (Valo, Ultradent) was evaluated with a potentiometer (Ophir 10ª-V2-SH, Ophir Optronics) without (control group) or with interposition of ceramic samples. The microhardness of Variolink Esthetic LC resin cement (Ivoclar Vivadent) was evaluated after 24 h at two depths (100 μm and 700 μm). Data were submitted to ANOVA followed by Tukey's test (α = 0.05). Irradiance and KHN were significantly influenced by ceramic thickness (p < 0.0001), shade (p < 0.001), translucency (p < 0.0001) and depth (p < 0.0001). Conclusions: the interposition of increasing ceramic thicknesses significantly reduced the irradiance and microhardness of resin cement. Increased depth in the resin cement showed significantly reduced microhardness for all studied groups. Increased ceramic opacity reduced the KHN of the resin cement at both depths for all ceramic thicknesses and shades.

Influence of ceramic veneer thickness and antagonist on impact stresses during dental trauma with and without a mouthguard assessed with finite element analysis

BACKGROUND/AIM

Little is known about the effect of dental trauma and mouthguards (MG) on teeth with ceramic laminate veneers (CLV). The aim was to evaluate the influence of CLV thickness and the presence of a MG with and without antagonist tooth contact on impact stresses during dental trauma.

MATERIALS AND METHODS

Twelve 2D-finite element models of a head with maxillary structures and upper incisors, six with and six without antagonist tooth, were created in three CLV conditions: sound incisor (no CLV), 0.3 mm CLV, and 1.0 mm CLV. These were evaluated with and without a 4.0-mm ethylene-vinyl acetate MG, with and without an antagonist tooth. An impact analysis was performed in which the head frontally hits a rigid surface at a speed of 1 m/s (3.6 km/h). The results were analyzed using Critical modified von Mises (MPa). The mean of the 10% highest modified von Mises stresses in each structure was collected.

RESULTS

MG presence substantially reduced impact stresses in the CLV and tooth structures. The contact of the antagonist tooth promoted better stress distribution and reduced the stress levels in the traumatized tooth. Critical stress areas were found in the palatal enamel, incisal enamel, labial cervical area, and enamel under the CLV for all models without MG. In the models with MG, the stresses reduced significantly. Critical modified von Mises stress showed that sound or prepared enamel experienced more critical impact stresses than 0.3 or 1.0-mm thick CLV.

CONCLUSIONS

The use of 4.0 mm EVA mouthguard reduced the impact stress levels in models with 0.3-mm CLV and 1.0-mm CLV, similar to a sound tooth. The contact of an antagonist tooth and the MG better distributed the stresses and reduced the impact stress in the traumatized tooth.

Minimally Invasive Adhesive Rehabilitation for a Patient With Tooth Erosion: Seven-year Follow-up

Tooth wear is a multifactorial condition of growing concern. In clinical practice, it is often a challenge for prevention and treatment since many etiological factors may be involved. This case report describes an esthetic rehabilitation of a young patient presenting tooth wear due to erosion. The etiological factor of this case was the patient sucking on lemons, an acidic fruit. The main complaint of the patient was the appearance of short maxillary incisors. The treatment involved orthodontic and restorative dentistry techniques. First of all, an orthodontic device was used to increase the vertical dimension of occlusion and create an adequate space for the direct restorations. The posterior teeth were restored with two direct composite resin techniques; the anterior teeth were then restored using a balanced occlusion. The seven-year follow-up of the case is presented. Replicas of the restorations were made and visualized under scanning electron microscopy up to the 12-month evaluation. In the clinical follow-up at seven years, maintenance of the results and restorations can be clearly seen.

Effect of Hydrofluoric Acid Concentration and Etching Time on Bond Strength to Lithium Disilicate Glass Ceramic

The aim of this study was to evaluate the influence of different concentrations of hydrofluoric acid (HF) associated with varied etching times on the microshear bond strength (μSBS) of a resin cement to a lithium disilicate glass ceramic. Two hundred seventy-five ceramic blocks (IPS e.max Press [EMX], Ivoclar Vivadent), measuring 8 mm × 3 mm thickness, were randomly distributed into five groups according to the HF concentrations (n=50): 1%, 2.5%, 5%, 7.5%, and 10%. Further random distribution into subgroups was performed according to the following etching times (n=10): 20, 40, 60, 120, and 20 + 20 seconds. After etching, all blocks were treated with a silane coupling agent followed by a thin layer of an unfilled resin. Three resin cement cylinders (∅=1 mm) were made on each EMX surface, which was then stored in deionized water at 37°C for 24 hours before testing. The μSBS was in a universal testing machine at a crosshead speed of 1 mm/min until failure. Data were submitted to two-way analysis of variance, and multiple comparisons were performed using the Tukey post hoc test (α=0.05). One representative EMX sample was etched according to the description of each subgroup and evaluated using scanning electron microscopy for surface characterization. The HF concentrations of 5%, 7.5%, and 10% provided significantly higher μSBS values than 1% and 2.5% (p<0.05), regardless of the etching times. For 1% and 2.5% HF, the etching times from 40 to 120 seconds increased the μSBS values compared with 20 seconds (p<0.05), but etching periods did not differ within the 5%, 7.5%, and 10% HF groups (p>0.05). The effect of re-etching was more evident for 1% and 2.5% HF (p<0.05). Different HF concentrations/etching times directly influenced the bond strength and surface morphology of EMX.