The removal of direct composite veneers, when the retreatment is necessary, represents a challenge to the clinician, since the healthy dental structure must be preserved. Thus, the aim of this study was to compare the accuracy provided by different auxiliary devices during retreatment of direct composite veneers. Seventy-five bovine teeth were prepared for direct composite veneers, scanned (T1), and restored. Specimens were divided into 5 groups for retreatment: conventional high-speed handpiece without auxiliary device (WD); high-speed handpiece with a white LED (WL); high-speed handpiece with an UV light (UL); electric motor and multiplier 1/5 handpiece (EM); and conventional high-speed handpiece using magnifying loupe (ML). After retreatments, other scanning was performed (T2). Changes on dental wear or composite residues areas, as well as, the average between wear and presence of residues were measured. Data were submitted to Kruskal-Wallis and Dunn’s post-test (p≤ 0.05). There were greater areas of wear for ML, being statistically superior to WD and EM groups. The ML presented smaller residues areas, being statistically lower than the WD and EM groups. Regarding the average between wear and the presence of resin residues, additional wear occurred after re-preparation, regardless of the group. Magnifying loupe promoted greater areas of wear and smaller areas of resin residues than conventional high-speed handpiece and electric motor. Both techniques using light accessories did not differ from other ones.
Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT -SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.
Introduction: External cervical resorption (ECR) is a physiological or pathological event usually detected on radiographic examination, since there are no symptoms in its initial and intermediate phases. Objectives: This case is an important finding because the early detection of this lesion allowed an effective multidisciplinary approach to be carried out. Case Report: Radiography was taken in a 55-year-old male and revealed a radiolucent area on the distal surface of the permanent mandibular left first molar, suggesting ECR with impaired pulpal vitality. Based on the clinical and radiographic examinations, a multidisciplinary approach was established involving endodontic treatment, periodontal surgery and indirect restoration that provided an option for preserve the affected tooth. The early diagnosis of ECR was essential for the successful treatment in order to maintain the satisfactory function for five-year follow-up. Conclusion: Despite the procedures performed, the idiopathic etiology of the lesion contributed to the appearance of recurrences; however, monitoring and maintenance of the affected tooth proved to be important for the longevity of the treatment.
Introduction: Esthetics dental treatments involving ceramic laminate veneers can obtain optimal results through detailed considerations with respect to teeth preparations, gingival margins and esthetic factors. Objectives: This case report aims to present a conservative management for ceramic conservative preparation associated with the digital workflow for ceramic laminates, with 18-month follow-up. Case Report: Patient complaining of a child smile due to diastemas in the anterior region. The planning and design of the smile was carried out using a software (Keynote, Ceramill Mind). After molding and printing a 3D model, a mock-up was performed, which was used as a surgical guide for the performance of gingivoplasty. The conservative dental preparation was then performed, with cervical enamel preservation. The ceramic laminates were made after molding and scanning the model, using the CAD/CAM system and cemented on the dental surface. It was observed that there was an increase in gingival quality and thickness, achieving esthetics, color and marginal stability, after 18 months of follow-up. Conclusion: The conservative preparation technique associated with the digital workflow allowed the manufacture of thin ceramic laminate veneer, promoting stability of esthetics and periodontal health after 18 months.
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