The effectiveness of EDTA 17% as a cleaning solution for the fiber post space after filling with cements

Aim: To evaluate the resistance of the union between a glass fiber post and radicular dentine after cleaning the root with 17% EDTA and filling with different endodontic cements. Methods: Forty uniradicular bovine incisors were removed to obtain root lengths of 18 mm. Endodontic treatment was performed on all roots using different filling cements (zinc oxide and eugenol-based, OZE; cement based on epoxy resin, AH) and cleaning solutions (saline, SA or EDTA), which made it possible to obtain four groups: OZESA, OZEEDTA, AHSA and AHEDTA. Subsequently, 12 mm of filling material was removed from the roots, and they were prepared to receive fiber posts luted with resin cement. To execute the mechanical cycles (2x106 cycles, 90 N, 4 Hz), coronal reconstruction was performed with a silicon matrix. The roots were then sliced (2-mm thick) to perform the push-out test. The results were analyzed using analysis of variance (one factor and two factors) and Tukey’s test (α=0,05). Results: Bond strength (Mpa) was significantly higher for OZEEDTA (9,18) and AHEDTA (8,70) than for OZESA (6,06) AHSA (8,7). OZEEDTA also presented the highest values in the cervical region (15,18) but was significantly lower in the apical region (2,99). However, AHEDTA had a homogeneous bond strength in all thirds. Conclusion: Regardless of the endodontic cement used, EDTA was used as an irrigating solution, culminating in a higher bond strength between the glass fiber post and dentin.

Effect of staining on the mechanical, surface and biological properties of lithium disilicate

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Staining and glazing procedures affects the microbial adherence and surface roughness.

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Stained and glazed surfaces result in higher wear than polished ceramic surfaces.

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The stain and glaze layer on the ceramic surface promotes lower strength value.

Purpose

To simulate biodegradation and wear of stained and glazed CAD lithium disilicate ceramic, and evaluate their effects on the microbial adherence and mechanical and surface properties of lithium disilicate ceramic

Materials and methods

160 lithium disilicate ceramic discs were fabricated and divided in eight groups according to manual stain and glaze application with a fine paint brush (without stain and glaze; with stain and glaze) and aging procedures (no aging; wear at 30 N load, 1.7 Hz, 3 × 10⁵ cycles; biodegradation by exposure to microcosm biofilm; biodegradation + wear; biodegradation + wear). Profilometry was performed to determine the surface roughness and the wear consequences. Biaxial flexural strength test was performed, and a Streptococcus mutans adherence test was conducted to evaluate the number of colony forming units.

Results

Unaged samples with and without stain and glaze presented the lowest values of surface roughness (p < 0.001), but after aging (wear, biodegradation, or both), the samples in the stain and glaze groups were rougher than those in the no stain and glaze groups (p < 0.001). The stain and glaze groups showed the highest volume of wear after aging (p = 0.04), and had the lowest flexural strength values (p < 0.01), irrespective of the aging method. The aging method did not affect the flexural strength (p = 0.06). The number of colonies forming units was higher for biodegradation + no stain and glaze, biodegradation + wear + no stain and glaze, no aging + stain and glaze, biodegradation + stain and glaze, and biodegradation + wear + stain and glaze. The lowest values were observed for no aging + no stain and glaze.

Conclusion

The staining and glazing of lithium disilicate increased the surface wear and bacterial adherence, and decreased biaxial flexural strength of the material. When exposed to S. mutans, surface roughness increased, and biodegradation favored bacterial adherence.

Effect of different surface treatments on the biaxial flexure strength, Weibull characteristics, roughness, and surface topography of bonded CAD/CAM silica-based ceramics

OBJECTIVE

To investigate the influence of different surface treatments on biaxial flexure strength, roughness, and surface topography of lithium silicate/disilicate-based ceramics.

METHODS

225 discs (∅: 12 mm; 1.2 mm - ISO 6872) were made from three ceramics: IPS e.max CAD (LD - Ivoclar Vivadent), Suprinity (LSS - Vita) and Celtra Duo (LSC - Dentsply). The samples were randomly divided into 5 groups (n = 15): no treatment (C); 10% hydrofluoric acid + silane (HF); sandblasting Al₂O₃ + silane (SB); silicatization + silane (SC); and self-etching ceramic primer (SEP). After surface treatment, a resin cement layer was applied to the disc surface (RelyX U200, 3M ESPE), mechanical cycled (1.2 × 10⁶ cycles, 50 N, 3.8 Hz) and submitted to biaxial flexural strength test (1 mm/min, 1000 Kgf). Roughness, EDS and SEM were also performed. Data were analyzed by one-way ANOVA, Tukey test (5%) and Weibull.

RESULTS

ANOVA revealed that the "surface treatment" factor was significant for all ceramics (p < 0.05). The groups LD-HF (289.30 ± 40) LD-SEP (298. 87 ± 53.29), LSC-HF (195.51 ± 42.12), LSS-HF (269.58 ± 27.07) and LSS-SEP (207.45 ± 28.63) presented significantly higher biaxial flexure strength than respective control groups, except for the LSC-SEP (165.41 ± 33.86), which was statistically similar to the control. The Weibull modulus was significantly higher for the LD-SB, LSC-SC groups. Additionally, the LD-SB, LSC-SC and LSS-HF groups showed higher roughness compared to the other treatments.

SIGNIFICANCE

HF etching followed by silanization and self-etching ceramic primer are the most suitable surface treatments for lithium silicate/disilicate-based glass-ceramics.

Could polypropylene mesh impair male reproductive organs? Experimental study with different methods of implantation

PURPOSE

To evaluate the vas deferens and testicles of rats submitted to bilateral inguinotomy and polypropylene (PP) mesh placement.

METHOD

Sixty Wistar rats were randomized into three groups: Control (inguinotomy only), mesh placement over the vas deferens (Mesh-DD) or under the spermatic funiculus (Mesh-SF). The following analyses were performed: vas deferens morphometry (lumen area and wall thickness), quantification of collagen fibers, spermatogenesis, apoptosis (cleaved caspase-3 and TUNEL) and cellular proliferation (Ki67). Quantitative gene expression (qPCR) for apoptosis and inflammatory cytokines were evaluated by RT-PCR.

RESULTS

In the apoptosis pathway, Mesh-DD showed one upregulated gene (Il10) and three downregulated genes (Fadd, Tnfrsf1b and Xiap). In Mesh-SF, 17 genes were downregulated. In the inflammation pathway (Mesh-DD), one gene was upregulated (Il1r1), and one gene was downregulated (Ccl12). In Mesh-SF, three genes were upregulated (Il1r1, Tnfsf13b and Csf1), and two were downregulated (Ccl12 and Csf2). PP mesh placement preserved spermatogenesis and did not alter the vas deferens or the testicle. In the ductus deferens, there was reduced luminal area (30 days), increased wall thickness (90 days), and increased type III collagen and cell proliferation (30 and 90 days) (p < 0.05). In the testicle, cell proliferation was greater in the Mesh-DD (p < 0.05).

CONCLUSIONS

PP mesh, whether or not in direct contact with spermatic funicular structures, induces changes that were not sufficient to cause damage to the evaluated organs.

Can different etching protocols change the properties of a hybrid ceramic?

The aim of this study was to evaluate the effects of different concentrations of hydrofluoric acid (HF) and etching times on the flexural strength, roughness, wettability, and type of failure of a hybrid ceramic (VITA ENAMIC). Blocks of the ceramic material were made according to the norms of International Organization for Standardization standard 6872:2015 and randomly divided into 7 groups (n = 13): control (no treatment); surface etching with 5% HF for 30 (HF5-30), 60 (HF5-60), or 90 (HF5-90) seconds; and surface etching with 10% HF for 30 (HF10-30), 60 (HF10-60), or 90 (HF10-90) seconds. The adhesive surface of 10 specimens in each group was cemented with dual-curing resin cement. The specimens were submitted to biaxial flexural tests and fractographic analysis. Surface analyses were carried out using 3 noncemented specimens from each group. The surface roughness was evaluated through optical profilometry and the surface wettability through goniometry (contact angle). The values obtained were analyzed by a Dunnett test followed by 2-way analysis of variance and Tukey test (α = 5%). The flexural test results indicated a statistically significant reduction in the resistance of the ceramic when conditioned with 10% acid (P < 0.01). Etching with HF, at any concentration used for any applied time, significantly modified the ceramic roughness of the experimental groups (P < 0.01). The wettability was also significantly altered in the HF5-90 group and in all HF10 groups (P < 0.01). The higher the concentration of the acid, the lower the wettability of the ceramic (P < 0.01). Based on these results, a 5% HF concentration is best indicated for the surface treatment of VITA ENAMIC.

Effect of repeated firings and staining on the mechanical behavior and composition of lithium disilicate

OBJECTIVE

To evaluate the composition, flexural strength and fatigue behaviour of lithium disilicate ceramic (LD) after repeated firings and different staining techniques.

METHODS

LD discs were fabricated and divided according to number of firing cycles and staining technique: CO - control, discs were crystallized (850°C/10min); SC - single-step characterization - crystallization and staining (applied with a thin brush) were performed in a single step with one firing cycle (850°C/10min); and DC - double-step characterization - crystallization firing cycle was performed first (850°C/10min), followed by staining firing cycle (770°C/90s). Specimens were fired two, four or six times (one crystallization firing cycle and one, three or five staining firing cycles), resulting into 9 groups (n=30): COII, COIV, COVI, SCII, SCIV, SCVI, DCII, DCIV and DCVI. The composition of the specimens was investigated (EDS, XRD, Raman spectroscopy), and the biaxial flexural strength (n=10) and staircase tests (n=20, 5×10⁴ cycles, 5Hz) were performed. Data were subjected to one-way ANOVA and Tukey's test (α=0.05).

RESULTS

EDS and XRD revealed amorphous content for stained groups. Biaxial flexural strength was not affected by repeated firings in any group, but stained groups presented lower flexural strength than control groups (p=0.001). The fatigue limit results decreased in all groups compared to flexural strength. SC groups showed similar (SCII and SCIV) or even higher fatigue limits (SCVI) than the control groups, and DC showed the lowest fatigue limit values. SEM and Raman suggested that the interfaces between staining and the LD showed only an overlap for the DC groups, whereas for the SC it was suggested an interaction between the stain and the LD.

SIGNIFICANCE

Repeated firings did not result in decreased lithium disilicate flexural strength.Staining affected flexural strength and also resulted in increased amorphous content in the characterized specimens. Single-step staining resulted in the highest fatigue limit.

Effect of extrinsic pigmentation and surface treatments on biaxial flexure strength after cyclic loading of a translucent ZrO2 ceramic

OBJECTIVE

To evaluate the influence of extrinsic pigmentation on the biaxial flexural strength and surface topographic of translucent Y-TZP (InCoris TZI - Sirona - USA) subjected to several surface treatments.

METHODS

Sintered zirconia discs-shaped specimens (n=120) (ø:12mm; thickness:1.2mm; ISO 6872) were prepared and divided (n=15) according to various factors: "extrinsic pigmentation" (n: without; p: with) and "surface treatments" (C: control - as sintered; A: abraded with silica-coated alumina particles (30μm); G: glazed with a thin film of low-fusing porcelain glaze; GH: glazed and etched with 10% hydrofluoridric acid for 60s. Mechanical cycling (1.2×106 cycles, 200N, 3.8Hz) and flexural strength test (1mm/min - 1000kg cell) were performed. Two-way ANOVA and Tukey's were used for statistical test (α=0.05). Weibull analysis was used to evaluate the strength reliability. Samples were analyzed via (1) an optical profilometer to determine the surface roughness (Ra); (2) an X-ray diffraction (XRD) to evaluate phase transformations; and (3) a SEM equipped with an energy dispersive X-ray spectroscopy (EDX) to elucidate morphological properties and chemical compositions.

RESULTS

Regardless of the surface treatment (p=0.5459) (Cn: 560.16MPa; Gn: 573.36MPa; An: 643.51MPa; GHn: 542.94MPa; Cp: 628.04MPa; Gp: 641.90MPa; Ap: 554.47MPa; GHp :602.84MPa) and extrinsic pigmentation (p=0.1280) there was no difference in the flexural strength among the experimental groups. According to the XRD analysis, phase transformations occurred in the An group (t→m) and in Ap group (t→c). Surface roughness was affected by surface treatments (An - p=0.001) and extrinsic pigmentation (Gp - p=0.001).

SIGNIFICANCE

The biaxial flexural strength of the tested samples was not affected neither by surface treatments nor by pigmentation, although it can cause phase transformation and promote surface roughness.

Different surface treatment protocols of a Y-TZP ceramic with a superficial glaze layer

Aim: evaluate the influence of etching time with hydrofluoric acid on the bond strength of a Yttrium-stabilized polycrystalline tetragonal zirconia (Y-TZP) ceramic with a superficial glaze layer and a resin cement. Methods: Y-TZP blocks were cut to obtain 40 samples. They were distributed into four groups (n = 10): control treated by sandblasting with silica-coated alumina (RS) and three glazed experimental groups with different etching times: GS20s, GS60s and GS100s. Cementation was done with a universal adhesive and a resin cement. Two cement cylinders were made in each block. After thermocycling, the shear bond test was performed. Two extra samples of each group were made to obtain profilometry, scanning electron microscopy, mapping and backscattered electron detector images. Energy dispersive spectrometry and goniometry were also performed. Results: Kruskal-Wallis and Dunn tests demonstrated bond strength differences only between the RS (22.10MPa) and the GS groups (GS20s: 8,10Mpa; GS60s: 10.49MPa; GS100s: 7.53MPa) (p = 0.001), but there was no difference among the experimental groups (p > 0.05). The contact angles were 55.33º (RS); 70.78° (GS100s); 48.20º (GS60s) and 28.73º (GS20s). ANOVA and Tukey test demonstrated similar wettability of RS to GS60s and GS100s (p > 0.05), but all the experimental groups were statistically different between them (p < 0.001). Qualitative image analysis revealed an irregular glaze distribution after etching. The thickness of the remaining glaze layer measured by profilometry was 5±1μm (GS20S), 4±1μm (GS60S) and 3±1μm (GS100s). Conclusion: The etching time of glazed zirconia did not influence the adhesive strength of the ceramic to the resin cement.

Can low-fusing glass application affect the marginal misfit and bond strength of Y-TZP crowns?

To evaluate the effect of different surface treatments on the marginal misfit and retentive strength between Y-TZP crowns and an epoxy resin. Forty (40) epoxy resin (G10) abutments (height: 5mm, conicity: 60, finish line: large chamfer) with equal dimensions were milled and included in polyurethane to simulate the periodontal ligament. Next, 40 Y-TZP crowns (thickness: 1mm) were milled (Cerec in Lab) and randomly divided into four groups (n=10) according to the surface treatment: GS(glaze spray), GP(glaze powder/liquid), P(zirconia primer) and RS(tribochemical silica coating). The conditioned surfaces were cemented with dual self-adhesive cement, light cured and submitted to thermomechanical cycling (2x106, 100N, 4Hz, 5°/55°C). Marginal misfit was analyzed by a stereomicroscope and SEM. Retentive strength test was performed (1mm/min) until crown debonding. Glaze layer thickness was also performed to GS and GP groups. Marginal misfit data were analyzed by Kruskal Wallis and Dunn tests; one-way ANOVA and Tukey (5%) analyzed the tensile strength data. The marginal misfit of the GS (48.6±19.9μm) and GP (65.4±42.5μm) were statistically lower than the RS (96±62.9μm) and P (156±113.3μm) (p=0.001). The retentive strength of the GP (470.5±104.1N) and GS (416.8±170.2N) were similar to the P (342.1±109.7N), but statistically higher than those of the RS (208.9±110N). The GS and GP glaze layer was 11.64μm and 9.73μm respectively. Thus, glaze application promoted lower marginal discrepancy and higher retentive strength values than conventional techniques.

Influence of indirect reinforcements on the flexural strength of a thermally activated acrylic resin used for complete dentures

Objetive: This research aimed to verify the performance of thermally activated acrylic resin (TAAR) combined with a mix of glass and aramid fibers and/or composite resin of indirect use by a tree point bending test. Material and Methods: Ten samples, with 65 x 10 x 2.5 mm, were prepared for each group (n = 10): CO, control of only TAAR; CR, in which an 60 mm indirect composite resin was polymerized together with the acrylic resin during the thermo-polymerization cycle; SS, in which ceramic glass mixed with aramid fibers cut 60 mm in length were incorporated into the samples; and SC, in which the same fibers were incorporated with addiction of the indirect composite resin. A three-point flexural strength test was performed with a universal testing machine with a load of 50KgF at a speed of 5 mm/min in the center of the samples supported by a suitable device. The reinforced face was placed to the tensile side. The statistical one-way ANOVA and Tukey tests were made with a significance level of 95%. Results: The mean value for the CO was 60,27 ± 24,18 MPa, for CR it was 38,39±12,75 MPa, for SS it was 79,97±12,75 Mpa and for CS it was 32,40±9,05 MPa. Conclusion: The use of glass and aramid fibers at the base of a TAAR increased the three-point flexural strength, however when indirect composite resin was incorporated, a significant drop of this mechanical property was observed. KeywordsAcrylic resin; Complete denture; Composite resin.

Effect of fatigue protocols on flexural strength of lithium disilicate bars with clamped-ends

The aim of this study was compare the effect of two in vitro ageing protocols to intraoral aging on the flexural strength of a lithium disilicate (LD) ceramic bars with clamped ends. After polishing and crystallization, the both ends of the bars were cemented to a metallic device and subjected to mechanical cycling, thermomechanical cycling, or intraoral ageing. Ten volunteers used an intraoral device - similar to an occlusal splint with a balanced contact condition on the occlusal surface of the ceramic bar - during 8 h night time / 30 days. Both in vitro and intraoral ageing decreased the flexural residual strength of LD, with the lowest values obtained after intraoral ageing. Thus, the in vitro ageing protocols tested in this study revealed to be less deleterious than intraoral ageing of LD.

Surface roughness and volumetric contraction of a Y-TZP ceramic sintered by microwave energy and by resistive heating

Objective: The aim of this study was to evaluate a Y-TZP ceramic sintered by a microwave protocol on volume shrinkage and surface roughness. Material and Methods: Twenty four (N=24) Y-TZP discs were fabricated by milling in CAD/CAM for size standardization. The mean final dimensions of the specimens were 15 mm X 1.6 mm. Samples were divided into 2 groups (n=12): conventional resistive heating sintering protocol (C - Control) and microwave sintering protocol (MO - experimental). For the characterization of the specimens, surface roughness (Ra and Rz parameters) was evaluated with a roughness tester, and volume shrinkage was measured with a hand micrometer. Data were statistically evaluated by Student’s t and Mann-Whitney U tests (?=0.05). Results: The roughness results were: 0.25 ?m ± 0.02 (Ra) and 2.68 ?m ± 0.666 (Rz) for the MO samples; 0.26 ?m ± 0.04 (Ra) and 2.73 ?m ± 0.461 (Rz) for the C group (Ra: p = 0.19; Rz: p = 0.81). The shrinkage results was: MO (21.02% ± 2.70) and C (20.10% ± 0.52) (p = 0.274). Conclusion: The conventional and microwave sintering methods were similar regarding surface roughness and volume shrinkage of Y-TZP dental ceramic.KeywordsBioceramics; Microwave sintering; Roughness surface; Zirconia.

Are non-carious cervical lesions more frequent in sleep bruxism patients?

<p><strong>Objective</strong>: to verify the frequency in non-carious lesions in patients with and without sleep bruxism and to try to list the occurrence of such lesions in patients with this parafunctional habit. <strong>Materials and Methods:</strong> 67 patients ranging from 18 to 70 years of age, which all signed a free and consent form were evaluated. Patients with neurological diseases and/or partially or totally edentulous were excluded from the study. Bruxism diagnosis was performed using a validated questionnaire based on the combination of at least two positive confirmations of bruxism. Diagnosis of non-carious cervical lesions (NCCL) was performed by a single calibrated examiner, using #5 clinical probe, intraoral mirror and air flow, analyzing all surfaces of the teeth present in the mouth. The lesions were classified as abfraction, abrasion or erosion. Statistical analysis was performed by U Mann-Whitney test, at 5% level of significance. <strong>Results</strong>: sixty patients were diagnosed with bruxism (91.3%) and only seven patients (8.7%) did not present this parafuctional habit. Regardless the gender, five patients (10.1%) presented absence of lesions and 62 patients (89.9%) presented some NCCL. 70% presented abfraction, 41% abrasion and no patient presented erosion. Statistical analysis showed a p-value of 0.03, which demonstrated significant statistical difference of NCCL between the groups. <strong>Conclusion</strong>: a higher frequency of NCCL in patients with bruxism was observed when compared to patients without this parafuction.</p><p><strong>Keywords</strong></p><p>Abfraction; Bruxism; Non-carious cervical lesions.</p>

Importance of stability and retention of double total prostheses: factors related to its use in the etiology of temporomandibular disorders

Objective: Evaluate the prevalence of Temporomandibular Disorder in patients with full double prosthesis. Material and Methods: The sample was composed of 40 volunteer patients, aged between 34 and 92 years, with upper and lower dentures, assisted at the Total Prosthodontics Clinic of the School of Dentistry at the Federal University of Juiz de Fora. Patients were evaluated by a single trained examiner and the diagnosis of TMD was established from the axis I of the RDC/TMD. Results: The prevalence of TMD in the sample was 42.5%, and most patients were female. Although there was no statistical significance between the time of use of the prosthesis and the presence of TMD was found, there was a correlation between time without use of prosthesis and the presence of disc displacement. Conclusion: According to the methodology applied and the results of this study, it can be concluded that there was a considerable prevalence of TMD in patients with double dentures, but there was no correlation between the use of full and DTM prosthesis.Keywords: Facial Pain; Temporomandibular Joint Dysfunction Syndrome; Complete Denture.

Evaluation of the life quality in patients with Temporomandibular Disorders

<p><strong>AIMS: </strong>To evaluate influence of variables gender, diagnosis and severity of types of Temporomandibular Disorder (TMD) on the quality of life of the individual. <strong>METHODS: </strong>The sample consisted of one hundred one individuals seeking TMD treatment at the Faculdade de Odontologia/ Universidade Federal de Juiz de Fora. The TMD diagnosis was done through the RDC/TMD: Axis I (<em>Research Diagnostic Criteria/Temporomandibular Disorder)</em>. The severity of TMD was established by the Temporomandibular Index (TMI) and the impact on quality of life by the OHIP-14 (<em>Oral Health Impact Profile</em>). The data was tabulated and analyzed by the Mann-Whitney test, T student test and Spearman correlation analysis (α=0,05). <strong>RESULTS: </strong>Most patients had diagnosis of muscular disorder, followed by diagnoses of arthralgia and disk displacement, respectively. All patients had a negative impact on at least one question from OHIP-14.<strong><strong>CONCLUSIONS</strong>: </strong>Women presented worse quality of life when compared to men. The presence of muscular disorder was related to greater impact on quality of life (p&lt;0,05). The relationship between severity of TMD and quality of life in the muscle sub-index of TMI was observed in all domains of OHIP-14 (p&lt;0,05). In addition, there was positive correlation between TMI and the psychological incapacity.</p>

[Uncommon aspects of infantile paracoccidioidomycosis]

São relatados dois casos de paracoccidioidomicose (PCM) infantil. Em um deles, a principal manifestação da doença foi tumoração abdominal, simulando linfoma maligno não Hodgkin. O outro apresentou acentuado envolvimento articular, com ruptura da cápsula. Representam o segundo e terceiro casos de PCM infantil observados na Bahia, ambos procedentes de áreas urbanas.