Comparison between a bulk-fill resin-based composite and three luting materials on the cementation of fiberglass-reinforced posts

Objectives

This study verified the possibility of cementing fiberglass-reinforced posts using a flowable bulk-fill composite (BF), comparing its push-out bond strength and microhardness with these properties of 3 luting materials.

Materials and Methods

Sixty endodontically treated bovine roots were used. Posts were cemented using conventional dual-cured cement (CC); self-adhesive cement (SA); dual-cured composite (RC); and BF. Push-out bond strength (n = 10) and microhardness (n = 5) tests were performed after 1 week and 4 months of storage. Two-way repeated measures analysis of variance (ANOVA), 1-way ANOVA, t-test, and Tukey post-hoc tests were applied for the push-out bond strength and microhardness results; and Pearson correlation test was applied to verify the correlation between push-out bond strength and microhardness results (α = 0.05).

Results

BF presented higher push-out bond strength than CC and SA in the cervical third before aging (p < 0.01). No differences were found between push-out bond strength before and after aging for all the luting materials (p = 0.84). Regarding hardness, only SA presented higher values measured before than after aging (p < 0.01). RC and BF did not present 80% of the maximum hardness at the apical regions. A strong positive correlation was found between the luting materials' push-out bond strength and microhardness (p < 0.01, R2 = 0.7912).

Conclusions

The BF presented comparable or higher push-out bond strength and microhardness than the luting materials, which indicates that it could be used for cementing resin posts in situations where adequate light curing is possible.

HIV Infection and Oral Manifestations: An Update

Human immunodeficiency virus (HIV) causes a complete depletion of the immune system; it has been a major health issue around the world since the 1980s, and due to the reduction of CD4+ T lymphocytes levels, it can trigger various opportunistic infections. Oral lesions are usually accurate indicators of immunosuppression because these oral manifestations may occur as a result of the compromised immune system caused by HIV infection; therefore, oral lesions might be initial and common clinical features in people living with HIV. So, it is necessary to evaluate and understand the mechanism, prevalence, and risk factors of oral lesions to avoid the increase morbidity among those with oral diseases.

Interplay between different manual toothbrushes and brushing loads on erosive tooth wear

OBJECTIVE

To investigate the effect of different types of manual toothbrushes and brushing loads on the progression of erosive tooth wear (ETW) on enamel.

METHODS

Bovine enamel specimens (n = 10) were submitted to a 5-day erosive-abrasive cycling model (0.3 % citric acid for 5 min, artificial saliva for 60 min, 4x/day). Toothbrushing was carried out 2x/day for 15 s, according to the toothbrushes tested (ultra-soft (a): Curaprox 5460; ultra-soft (b): Sensodyne Repair & Protect; soft (a): Colgate Slim Soft; soft (b): Oral-B Indicator Plus; medium: Johnson's Professional; hard: Tek) and brushing loads (1.5 N, 3 N). Surface loss (SL, in μm) was assessed by optical profilometry on conclusion of the cycling. Some of the toothbrush characteristics were evaluated. Data were statistically analyzed (α = 0.05).

RESULTS

For the 1.5 N load, the hard brush showed the highest SL value, with statistical significance. The other toothbrushes did not differ significantly, except that ultra-soft (a) caused significantly higher SL than ultra-soft (b). For the 3 N load, hard and soft (a) exhibited the highest SL. Soft (b) and medium had the lowest SL value, with statistical significance. Only soft (a) and ultra-soft (b) showed significant difference between loads, with lower SL for the load of 1.5 N. None of the toothbrush characteristics were significantly correlated with SL.

CONCLUSIONS

Although different degrees of enamel surface loss were observed with use of the different toothbrushes, no association was found between the toothbrush characteristics and SL. Depending on the toothbrush, the force of brushing was capable of modulating the ETW of enamel. Based on the brushing loads usually applied by healthy individuals, hard brushes are not recommended for use by patients with ETW.

CLINICAL SIGNIFICANCE

The use of hard bristle brushes is not recommended for use by individuals who exert healthy forces when brushing their teeth. The toothbrush characteristics are of secondary importance in terms of causing enamel loss in ETW.

Mechanical Properties of the Mandible in Postmenopausal Women Under Aledronate Treatment

AIMS

This study evaluated the mechanical properties of mandibular bone tissue retrieved from postmenopausal women under alendronate treatment.

METHODS

Twenty postmenopausal women were divided into two groups: healthy postmenopausal subjects (control group) and osteoporotic subjects treated with alendronate (alendronate group). Mandibular bone samples were retrieved with a trephine bur at the time of dental implant placement and fixed in 4% formalin. Samples were processed for hard tissue histology, and the bone surface was analyzed for nanohardness measurement. Nanohardness and elastic modulus were evaluated by using a Berkovich tip with elastic modulus of 1.016x106 MPa, Poisson coefficient of 0.3, and a load of 100 mN. Each cycle was configured with a load time of 18 seconds (speed of 1 mN/second), the discharge time of 18 seconds, and a rest time of 5 seconds during indentation at a depth of 10 μm.

RESULTS

The control group presented the highest values for nanohardness and elastic modulus (p less than 0.05) in relation to the osteoporotic subjects.

CONCLUSIONS

Within the limitations of the study, it can be concluded that treatment with alendronate negatively influenced the mechanical properties of mandibular bone in postmenopausal women by reducing bone nanohardness and elastic modulus.

Five second photoactivation? A microhardness and marginal adaptation in vitro study in composite resin restorations

INTRODUCTION

Studies defining the characteristics of light curing units and photoactivation methods are necessary to allow the correct choices to be made in daily practice. This study aimed to determine whether different photoactivation protocols for composite resins [periodic level shifting (PLS) - 5 second and soft-start] are able to maintain or enhance the mechanical properties and marginal adaptation of restorations.

METHODS

Restorations were placed in bovine teeth using the following photoactivation methods: continuous light for 20 seconds (control group); PLS technology (PLS - 5 second group); and continuous light and a light guide tip distance of 6 mm after which the tip was placed at the surface of the restoration (soft-start group). The teeth were transversely sectioned in the incisal-cervical direction. Thirty halves were randomly selected for Knoop microhardness testing (n = 10). The other 30 halves were subjected to scanning electron microscopy analysis. The images obtained were measured to identify the highest marginal gap, and statistical tests for variance analysis were conducted.

RESULTS

Microhardness tests showed no statistically significant difference between the photoactivation methods analysed (P ≥ 0.01). The tests showed a difference among depths (P < 0.01), with the deeper layers being the hardest. In analysing marginal adaptation, no significant difference was identified between the higher marginal gap values in the continuous (mean = 10.36) and PLS - 5 second (mean = 10.62) groups, and the soft-start group (mean = 5.83) presented the lowest values (P < 0.01).

CONCLUSIONS

The PLS - 5 second and soft-start protocols did not alter the hardness of the restorations. Moreover, the PLS - 5 second protocol did not alter the marginal adaptation, whereas the soft-start protocol improved marginal adaptation.

Influence of Curing Units and Indirect Restorative Materials on the Hardness of Two Dual-curing Resin Cements Evaluated by the Nanoindentation Test

PURPOSE

To evaluate the hardness of a dual-curing self-adhesive resin cement (RelyX U200) and a conventional dual-curing resin cement (RelyX ARC) cured with different light curing units of different wavelengths (Elipar Freelight 2 LED [430 to 480 nm, conventional], Bluephase LED [380 to 515 nm, polywave], AccuCure 3000 Laser [488 nm]) by means of the nanoindentation test.

MATERIALS AND METHODS

Bovine incisors were cleaned and then sectioned at the cementoenamel junction to remove the crown. After embedding in acrylic, dentin surfaces of the specimens were exposed and ground flat to standardize the surfaces. To simulate clinically placing indirect restorations, ceramic (IPS e.maxPress/Ivoclar Vivadent) or indirect composite resin (SR Adoro/Ivoclar Vivadent) slabs were cemented on dentin surfaces. The specimens were sectioned longitudinally at low speed under constant irrigation and then polished. In the positive control group, the cement was light cured without the interposition of indirect restorative material; in the negative control group, after the indirect restorative material was cemented, no light curing was performed, allowing only chemical polymerization of the cement. All specimens were stored in distilled water at 37°C for 7 days. Nanoindentadion hardness of the cement layer was measured under a 100-mN load. Data were statistically analyzed using ANOVA and Tukey's test (p < 0.05).

RESULTS

Although the self-adhesive cement is technically simple, conventional cement showed the best polymerization performance. The polywave LED technology did not differ significantly from other light-curing units. The hardness of the resin cements evaluated was negatively influenced by the interposition of an indirect restorative material; only the LEDs were able to maintain the same degree of cement polymerization when an indirect restorative material was used.

CONCLUSION

The photoactivation step is required during the cementation of indirect restorations to ensure adequate polymerization of dual-curing resin cements.