The use of adhesive systems significantly affected the ability to seal the repair/ tooth interface. However, at the level of the repair/restoration interface, the bonded amalgam technique may increase microleakage.
Aim:The aim of this randomized clinical trial was to compare the proximal contact of a silorane-based resin composite with a conventional methacrylate-based resin composite in class II restorations after a 6 months follow-up period. Materials and methods:After obtaining informed consent, 33 patients were randomly allocated into a test group (Filtek P90/Adhesive System-3M ESPE) or control group (Filtek P60/ Adper SE Plus-3M ESPE), and 100 direct resin composite restorations (n = 50) were placed. A single operator performed the cavities and restorations. After rubber dam placement, a metal matrix and wooden wedge were placed. The restorative systems were applied according to the manufacturer's instructions. After 1 week, the restorations were finished and polished. The proximal contacts were assessed blindly and independently by two calibrated examiners (kW = 0.8) at the baseline and after 6 months according to a three-step grading criteria. Data were analyzed with the Mann-Whitney U-test and Wilcoxon signed Rank tests (α = 0.05). Results: After 6 months, 96% of the restoration contacts were present for evaluation. The frequencies of restorations classified as Bravo in control and test groups were 6 and 8% at the baseline, and 6.25 and 12.75% after 6 months. No significant difference was found between the restorative materials (p > 0.05; Mann-Whitney U-test) neither between baseline and 6 months period (p > 0.05; Wilcoxon signed Rank tests). Conclusion:Both materials performed satisfactorily over 6 months follow-up period. Clinical significance:The short-term clinical performance of a silorane-based resin composite in the proximal contacts of class II restorations was similar to the well-known methacrylate-based resin composite.
Purpose: This study evaluated microleakage on amalgam restorations repaired by amalgam and bonded amalgam.Methods: Thirty extracted human pre-molars were restored by amalgam. A simulated defect was prepared and assigned to two treatment groups (n=15): G1 -repaired by amalgam (Permite C-SDI); G2 -repaired by bonded amalgam (Caulk 34% Tooth Conditioner Gel -Dentsply + Prime & Bond 2.1 -Dentsply + Permite C-SDI). The teeth were immersed in a 50% silver nitrate solution, thermocycled and then, sectioned longitudinally through the restoration center and examined by 3 examiners using a stereomicroscope. Microleakage was evaluated in a 0-4 scale for dye penetration. Microleakage data were analyzed by Kruskal Wallis and Dunn test.Results: The bonded amalgam technique was significantly the most effective in repair/tooth interfaces sealing (score 0=53.3%, P=0.0012). For repair/restoration interfaces, conventional amalgam was also statistically more effective in the sealing (score 0=86.7%, P<0.001).Conclusion: None of materials eliminated microleakage completely. The use of adhesive systems had significant effect on the ability to seal the repair/tooth interface, however, for repair/restoration interface, it can increase microleakage.
A reabilitação oral de um paciente desdentado total requer atenção para sua correta avaliação, criterioso planejamento e realização adequada desse planejamento. O presente trabalho relata caso de substituição de sistema de retenção barra-clipe pelo sistema Equator de uma overdenture inferior. Paciente do sexo feminino, 70 anos de idade, compareceu ao projeto de extensão “Overdenture para desdentados totais na geriatria”, queixando-se de um volume lingual grande da sua prótese inferior, dificultando sua alimentação e fonética e de fraturas sucessivas dessa prótese. O exame clínico intraoral revelou a presença de prótese total superior e overdenture inferior com o sistema de retenção barra-clipe, em que a posição espacial da barra estava inadequada e invadia o espaço da língua. Foi planejado a confecção de novas próteses e a substituição do sistema de retenção barra-clipe por um sistema independente. Ao levar o modelo de gesso inferior no delineador foi possível verificar que havia discrepância da inclinação dos implantes maior que 14º, selecionando-se assim o sistema Equator, o qual permite a captura de implantes com até 30º de discrepância. Este caso evidencia a necessidade de um planejamento reverso para a realização das cirurgias de implantes, de forma que um correto sistema de retenção seja escolhido ainda durante planejamento e a etapa cirúrgica seja executada de maneira a atender esse planejamento. Após a colocação das novas próteses e do novo sistema de retenção a paciente relatou melhora significativa na alimentação e fonética, bem como da estética das próteses, gerando bem estar físico, psíquico e social.
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