Abstract Objectives To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. Material and Methods This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a “rather low” to “very high” caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. Results Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. Conclusions The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Objective:To investigate the mechanical properties of different classifications of composites indicated for posterior application as functions of the storage condition and of the energy dose.Material and Methods:Specimens (8x2x2 mm) were obtained according to the factors: I) Composites (3M ESPE): Filtek P60, Filtek Z350XT, and Filtek Silorane; II) Syringe storage conditions: room temperature, aged, oven, refrigerator, and freezer; and III) Energy dose: 24 J/cm2 and 48 J/cm2. After photoactivation, the specimens were stored at 37ºC for 24 h. After storage, a three-point bending test was carried out in a universal testing machine at 0.5 mm/min. Flexural strength (S) and flexural modulus (E) were calculated. Data were analyzed by three-way ANOVA and Tukey's test (α=0.05).Results:Different storage conditions significantly affected the silorane composite for S; conversely, no effects were noted in terms of E. The accelerated aging protocol significantly increased the S of Filtek P60 and Filtek Silorane, whereas storage in the oven significantly decreased the S for all of the composites tested. Filtek P60 was the only composite not affected by the lower storage temperatures tested for S, whereas for the silorane this parameter was impacted at the same conditions. The factor "dose" was not statistically significant.Conclusions:The syringe storage at different temperature conditions proved to influence mostly the flexural strength, a clinically important characteristic considering the posterior indication of the materials tested. The silorane composite should not be stored at lower temperatures.

Objective: To evaluate the hardness (KHN), color stability (DE), and superficial micromorphology of two categories of composites after immersion in either distilled water or grape juice for up to 45 days. MATERIAL AND METHODS: Cylindrical specimens (6 mm diameter x 2 mm thick) were obtained according to the factors: composite [Opallis (FGM) and Filtek Z350XT (3M ESPE)]; immersion solution (distilled water and grape juice); and evaluation time: 24 h and 7, 14, 21, 28, and 45 days. After photoactivation, the specimens were stored at 37ºC for 24 h. KHN (50 g/15 s) and ΔE were then repeatedly assessed according to the immersion solutions. Data were analyzed (three-way ANOVA/Tukey's test). Scanning electron microscopy (SEM) topographic analysis was also performed. RESULTS: In general, KHN of both composites reduced after 24 h, irrespective of the immersion solution and time. A significantly lower KHN was noted for Opallis compared with Filtek Z350XT in all parameters. An increase in ΔE over time was noted for both composites, irrespective of the immersion solution. Significantly higher ΔE was noted for Filtek Z350XT immersed in grape juice compared with Opallis, regardless of the evaluation time. The grape juice caused significantly higher DE compared with water in all periods. SEM analysis showed eroded areas for Filtek Z350XT but not for Opallis. CONCLUSIONS: The compositions and immersion solutions influence the composite hardness and the color stability. In spite of the higher hardness, the nanofilled composite is more susceptible to color change than the microhybrid when immersed in an acidic dyed solution.

Objective: To evaluate the influence of solvent evaporation in the kinetics of water diffusion (water sorption-WS, solubility-SL, and net water uptake) and nanoleakage of adhesive systems. Material and Methods: Disk-shaped specimens (5.0 mm in diameter x 0.8 mm in thickness) were produced (N=48) using the adhesives: Clearfil S3 Bond (CS3)/Kuraray, Clearfil SE Bond - control group (CSE)/Kuraray, Optibond Solo Plus (OS)/Kerr and Scotchbond Universal Adhesive (SBU)/3M ESPE. The solvents were either evaporated for 30 s or not evaporated (N=24/per group), and then photoactivated for 80 s (550 mW/cm2). After desiccation, the specimens were weighed and stored in distilled water (N=12) or mineral oil (N=12) to evaluate the water diffusion over a 7-day period. Net water uptake (%) was also calculated as the sum of WS and SL. Data were submitted to 3-way ANOVA/Tukey's test (α=5%). The nanoleakage expression in three additional specimens per group was also evaluated after ammoniacal silver impregnation after 7 days of water storage under SEM. Results: Statistical analysis revealed that only the factor "adhesive" was significant (p<0.05). Solvent evaporation had no influence in the WS and SL of the adhesives. CSE (control) presented significantly lower net uptake (5.4%). The nanoleakage was enhanced by the presence of solvent in the adhesives. Conclusions: Although the evaporation has no effect in the kinetics of water diffusion, the nanoleakage expression of the adhesives tested increases when the solvents are not evaporated.

O objetivo deste estudo foi o de avaliar o efeito da substituição de um componente do adesivo autocondicionante Adper Scotchbond SE (líquido A + líquido B) por clorexidina (CHX) a 2% na resistência da união à dentina após 1 dia, 3 meses ou 6 meses de armazenamento em água. Oito dentes humanos foram seccionados para expor uma superfície plana de dentina e, em seguida, foram aleatoriamente divididos em dois grupos. No grupo controle, as superfícies de dentina foram tratadas com o adesivo de acordo com as instruções do fabricante. No grupo experimental, o líquido A foi substituído por CHX a 2%. Em seguida, um bloco de resina composta com 6 mm de altura foi construído sobre a superfície de união. Os dentes restaurados foram então seccionados para produzir espécimes em forma de palito (área transversal - 0,8 mm2). A resistência da união à microtração (µT) foi mensurada e os padrões de fratura avaliados. Os dados foram analisados por meio de teste de ANOVA dois critérios de medidas repetidas (α=0,05). Quatro dentes adicionais foram processados a fim de realizar uma análise micromorfológica da interface resina-dentina. Os valores de µT não diminuíram significativamente após armazenamento em água em ambos os grupos controle e experimental, cujos valores não diferiram significativamente entre si independentemente do tempo de armazenamento. O aspecto morfológico da interface adesiva parece não ter sido afetado pela CHX. Uma maior incidência de falhas coesivas no adesivo e falhas mistas (coesivas no adesivo e na resina composta) foi observada em ambos os grupos. Pode-se concluir que o pré-tratamento da dentina com CHX a 2% não influenciou significativamente o desempenho do adesivo avaliado.

The purpose of this study was to evaluate the effect of replacing a component of the self-etch adhesive Adper Scotchbond SE (liquid A + liquid B) by 2% chlorhexidine (CHX) on bond strength to dentin after 1 day, 3 months or 6 months of water storage. Eight human teeth were sectioned to expose a flat dentin surface and were then randomly assigned to 2 groups. In the control group, the dentin surfaces were treated with the adhesive according to the manufacturer's instructions. In the experimental group, liquid A was replaced by 2% CHX. Next, a 6-mm-high resin composite block was incrementally built on the bonded surfaces. The restored teeth were then sectioned to produce stick-shaped specimens (cross-sectional area - 0.8 mm2). The microtensile bond strength (µTBS) was recorded, and the failure modes were assessed. Data were analyzed by two-way repeated measures ANOVA (α=0.05). Four additional teeth were processed in order to conduct a micromorphological analysis of the resin-dentin interface. The µTBS values did not significantly decrease after water storage in either the control or the experimental group, whose values did not differ significantly irrespective of storage time. The morphological aspect of the bonding interface appears not to have been affected by CHX. A higher incidence of cohesive failures within the adhesive and mixed failures (cohesive within adhesive and resin composite) was observed for both groups. It may be concluded that dentin pre-treatment with 2% CHX did not influence significantly the bonding performance of the evaluated adhesive.

The aim of the present study was to evaluate the fracture resistance of teeth restored with resin composite. Forty-eight maxillary premolar teeth were chosen and randomly divided to six groups: G1 (control): sound teeth; G2: MOD preparation, unrestored; G3: MOD + Adper Single Bond 2/P60; G4: MOD + Adper Easy One/P60; G5: MOD + P90 restorative system; G6: MOD + Adper Easy One/P90 Bond/P90. Specimens were subjected to compressive axial loading (0.5 mm/min). Flexural strength and the modulus of elasticity were also tested (n = 7). The only statistical equivalence with sound teeth was noted for G3 (p < 0.05). Flexural strength and the modulus of elasticity varied among the composites tested (n = 10). The reestablishment of the resistance to fracture in premolars subjected to Class II MOD preparations is restorative-system-dependent. The silorane restorative system is not able to recover the resistance to fracture.

Este estudo avaliou a união ao esmalte íntegro e desgastado obtida com diferentes estratégias. Para tanto, 24 terceiros molares hígidos foram seccionados ao meio. Um plano de esmalte foi delimitado nos fragmentos de dente, aleatoriamente distribuídos em 8 grupos (n=6) conforme a condição do esmalte (íntegro ou desgastado) e o adesivo (Adper Single Bond 2: SB2; Adper Prompt L-Pop: PLP; Adper Prompt: AD; Clearfil SE Bond: SE). Estes foram aplicados seguindo recomendações dos fabricantes e uma "coroa" de compósito (altura - 6 mm) incrementalmente construída. Espécimes (ampulheta/secção transversal - 0,8 mm²) foram confeccionados. O ensaio de resistência da união à micro-tração (RUµT) foi realizado e os padrões de fratura classificadas. Os resultados analisados pela ANOVA (dois fatores) e teste de Tukey (α=0,05). Os valores de RUµT do SB2, PLP e AD não foram significativamente diferentes entre si (p>0,05); SE foi inferior (p0,05). Houve prevalência de fratura no esmalte, adesivo e compósito no SB2. Nos adesivos autocondicionantes, predominou a fratura no adesivo. A condição do esmalte não influenciou significativamente as características da união, considerando o mesmo adesivo. Em conclusão, os adesivos apresentaram RUµT e padrões de fratura específicos, devido a forma de interação com o esmalte.

This study evaluated the bonding characteristics to ground and unground enamel obtained with different strategies. For this purpose, 24 sound third-molars were bisected mesiodistally to obtain tooth halves. A flat enamel area was delimited in the tooth sections, which were randomly distributed into 8 groups (n=6), according to the enamel condition (ground and unground) and adhesive system (Adper Single Bond 2 - SB2; Adper Prompt L-Pop - PLP; Adper Prompt - AD; Clearfil SE Bond - SE). Each system was applied according manufacturers' instructions and a 6-mm-high resin composite "crown" was incrementally built up on bonded surfaces. Hourglass-shaped specimens with 0.8 mm² cross-section were produced. Microtensile bond strength (μTBS) was recorded and the failure patterns were classified. Results were analyzed by two-way ANOVA and Tukey's test (α=0.05). There were no statistically significant differences among the μTBS values of SB2, PLP and AD (p>0.05). SE values were significantly lower (p0.05). There was prevalence of cohesive failure within enamel, adhesive system and resin composite for SB2. The self-etch systems produced higher incidence of cohesive failures in the adhesive system. Enamel condition did not determine significant differences on bonding characteristics for the same bonding system. In conclusion, the bonding systems evaluated in this study resulted in specific μTBS and failure patterns due to the particular interaction with enamel.

Este estudo avaliou o efeito da aplicação de uma resina flow na resistência de união (RU) (microtração) de sistemas adesivos à dentina. Superfícies oclusais de terceiros molares humanos foram abrasionadas para formar superfícies dentinárias planificadas. As coroas foram seccionadas no sentido ocluso-gengival em quatro partes de tamanhos similares com disco diamantado sob refrigeração. Os sistemas adesivos (Scotchbond Multipurpose; Single Bond; Adper Prompt e Clearfil SE Bond) foram aplicados nas superfícies dentinárias, de acordo com as instruções dos fabricantes, sendo cada um deles em uma das quatro partes de um mesmo dente. Os grupos experimentais e controle receberam o mesmo tratamento, porém a resina flow (Filtek Flow) foi aplicada e fotoativada sobre os sistemas adesivos nos espécimes dos grupos experimentais. Um bloco de compósito (Filtek Z250) foi confeccionado em incrementos sobre as superfícies tratadas com o sistema adesivo e fotoativado por 20 s. Os dentes restaurados foram armazenados em água a 37ºC por 24 h e seccionados longitudinalmente para obtenção de espécimes com formato de paralelepípedo, com 0,9 mm² na área de união. O ensaio de tração foi realizado em máquina universal de ensaios e os valores de RU foram expressos em MPa. Os dados foram analisados pela ANOVA (dois fatores) e teste de Tukey (5%). A aplicação da resina flow na dentina previamente hibridizada aumentou a RU para todos os sistemas adesivos, entretanto, foi estatisticamente significativa somente para o adesivo Clearfil SE Bond (p<0,05). Quando as restaurações foram confeccionadas sem a resina de baixa viscosidade, o Clearfil SE Bond obteve maior valor de RU que o adesivo Adper Prompt (p<0,05). Para os grupos com a resina flow, o Clearfil SE Bond resultou no maior valor médio de RU à dentina. Conclui-se que o efeito da aplicação da resina flow foi depende do sistema adesivo utilizado e indicou um aumento na RU para todos os sistemas adesivos testados, entretanto, somente para o adesivo Clearfil SE Bond o aumento foi significativo.

This study evaluated the effect of flowable composite resin application on the microtensile bond strength (muTBS) of adhesive systems to dentin. Occlusal surfaces of human third molars were ground to obtain flat dentin surfaces. The crown of each tooth was sectioned occluso-gingivally into four quarters with a water-cooled diamond saw. One of the following adhesive systems was applied to dentin surface in each quarter of the same tooth, following manufacturers' instructions: Scotchbond Multipurpose, Single Bond Adper Prompt and Clearfil SE Bond. Experimental and control groups received the same treatment, except for the fact that a layer of flowable composite (Filtek Flow) was placed and light-cured on top of the adhesive layer in the specimens of the experimental groups. Resin composite (Filtek Z250) crown buildups were then made on the bonded surfaces and incrementally light-cured for 20 s. The restored teeth were stored in water at 37ºC for 24 h. Each tooth quarter was serially cut in a longitudinal direction in order to obtain several bonded sticks (0.9-mm² in cross-section). Maximal microtensile stress (in MPa) at failure was recorded using a universal testing machine. Data were analyzed by two-way ANOVA and Tukey's test at 5% significance level. Placement of a low-viscosity resin to the hybridized dentin increased the muTBS for all tested adhesive systems. However, such increase was significant only for Clearfil SE Bond (p<0.05). When the restorations were placed without low-viscosity resin, Clearfil SE Bond presented higher muTBS than Adper Prompt (p<0.05). For the groups treated with flowable composite, Clearfil SE Bond produced the highest muTBS means to dentin. In conclusion, the effect of the addition of an intermediate flowable composite layer on muTBS to dentin was material-dependent and resulted in an increased adhesion for all tested materials, though with significance only for Clearfil SE Bond.

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.

El elongamiento y mineralización del proceso estilóide ha sido descrito en la literatura como un acontecimiento que puede ser asintomático o manifestarse como Síndrome estiloestilohióideo o Síndrome de Eagle. Este estado, se caracteriza por un conjunto de señales y síntomas como el dolor facial leve, disconformidad en la deglución, limitaciones en los movimientos de la cabeza, cuello y la abertura bucal, otalgia, cefalea y disfagia que pueden ser confundidos con el Desorden Temporomandibular. Uno de los principales recursos de diagnóstico para el elongamiento del proceso estiloide es la evaluación radiográfica. El propósito de este trabajo fue investigar en la población adulta totalmente desdentada, la prevalencia del elongamiento del proceso estiloide. En este trabajo, los autores analizaron 233 radiografías panorámicas del servicio de tiraje de la FOP-UNICAMP en pacientes adultos, de ambos sexos, totalmente desdentados. Fueron realizadas mediciones de las imágenes de los procesos estiloides y fueron consideradas elongadas las imágenes de los procesos estiloides mayores de 30 milímetros conforme a los estudios obtenidos en la revisión de la literatura. Las imágenes que no permitieron realizar las mediciones en forma segura fueron despreciadas. Los resultados fueron organizados en tablas y divididos según los factores de edad, sexo y lado predominante. Los datos permitieron observar que de las 233 radiografías analizadas, fue posible medir 341 procesos estiloides, siendo que de estos, 50,1%(n=176) presentaron medida mayor de que 30 milímetros . De estas imágenes, 64%(n=113), fueron mujeres y 35%(n=63) hombres. Los valores promedios obtenidos fueron de 33, 5 milímetros para los individuos de sexo masculino y de 31,38 milímetros para los de sexo femenino. En relación con la edad, la mayor prevalencia fue comprendida entre 61 y 70 años, con un porcentaje de 61,8 % (nt=110; n=68), seguida de la facha hectárea entre 51 años y 60 años, con un porcentaje de 52%(nt=341; nd=159; n=82) para el lado derecho y de 28,4% (nt=341; ne=182; n=97) para el lado izquierdo. Los autores concluyeron que: existió una mayor prevalencia de proceso estiloide elongado en individuos de sexo femenino, no ocurrió predominio en cuanto al lado de presencia del proceso elongado, existió una mayor prevalencia de elongamiento del proceso estilóide en los individuos de edades entre 51 y 70 años, y baja prevalencia entre los individuos con menos de 30 años.

The elongation and mineralization of the styloid process is described in the literature as an occurrence that may be asymptomatic or that can be manifested as a stylohyoid-style syndrome or Eagle’s Syndrome. This morbid state is characterized by a set of signs and symptoms such as vague facial pain, discomfort when swallowing, limited movement of the head, neck and mouth opening, otalgia, dysphagia and dizziness, which may be mistaken for the symptoms of Temporomandibular Disorder. One of the main diagnostic resources for elongation of the styloid process is X-ray evaluation. The purpose of this study was to investigate the prevalence of elongation of the styloid process in a totally edentate adult population. In this work, the authors analyzed 233 panoramic X-rays of totally edentate adult patients of both sexes from the screening service of the Piracicaba School of Dentistry (FOP-Unicamp). Measurements were made of styloid process images and those larger than 30 mm were considered elongated, according to the literature. The images that did not allow for accurate measurements were neglected. The findings were organized into tables and divided according to the factors of age group, sex and predominant side. These data revealed that, of the 233 analyzed X-rays, 341 styloid processes were measurable, of which 50.1% (n=176) showed a measure of more than 30 mm . Of these images, 64% (n=113) were taken from females and 35% (n=63) from males. The mean values obtained were 33.5 mm for the males and 31.38 mm for the females. With regard to the age group factor, the highest prevalence was found in the 61 to 70 age group, with a percentage of 61.8% (nt=110; n=68), followed by the 51 to 60 age group, with a percentage of 52% (nt=100; n=52). As for the side, 159 images of the right hand side styloid process and 182 of the left hand side were measured. A prevalence of 24% (nt=341; nd= 159; n=82) was found for the right hand side and of 28,4% (nt=341; ne=182; n=97) for the left. The authors concluded that the females showed a greater prevalence of elongated styloid process; the elongation process was not found to predominate on either side; the greatest prevalence of elongation of the styloid process was found in the 51 to 70 age group, and a low incidence among individuals under 30.