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SUMMARY Objectives: To analyze the effect of the porosity caused by incremental and bulk resin composite filling techniques using low- and high-viscosity composite resins on the biomechanical performance of root-treated molars. Methods: Forty intact molars received standardized mesio-occlusal-distal (MOD) cavity preparation, were root treated, and randomly divided into four groups with different filling techniques (n=10). The first involved two incremental filling techniques using VIT/Z350XT, a nanofilled composite resin (Filtek Z350XT, 3M ESPE) associated with a resin-modified glass ionomer cement, and resin-modified glass ionomer cement (RMGIC; Vitremer, 3M ESPE) for filling the pulp chamber. The second involved TPH/VIT, a microhybrid composite resin TPH3 Spectrum associated with Vitremer. The third and fourth involved two bulk-fill composite resins: SDR/TPH, a low-viscosity resin composite (Surefill SDR flow, Dentsply) associated with TPH3 Spectrum, and POST, a high-viscosity bulk-fill resin composite (Filtek Bulk Fill Posterior, 3M ESPE). The volume of the porosity inside the restoration was calculated by micro-CT. The cusp deformation caused by polymerization shrinkage was calculated using the strain-gauge and micro-CT methods. The cusp deformation was also calculated during 100 N occlusal loading and loading to fracture. The fracture resistance and fracture mode were recorded. Data were analyzed by one-way analysis of variance and Tukey test. The fracture mode was analyzed by the χ2 test. The volume of the porosity was correlated with the cusp deformation, fracture resistance, and fracture mode (a=0.05). Results: Incremental filling techniques associated with RMGIC resulted in a significantly higher porosity than that of both bulk-fill techniques. However, no significant difference was found among the groups for the fracture resistance, fracture mode, and cusp deformation, regardless of the measurement time and method used. No correlation was observed between the volume of the porosity and all tested parameters. Conclusions: The porosity of the restorations had no influence on the cuspal deformation, fracture resistance, or fracture mode. The use of the RMGIC for filling the pulp chamber associated with incremental composite resins resulted in similar biomechanical performance to that of the flowable or regular paste bulk-fill composite resin restorations of root-treated molars.

To describe a method of measuring the molar cusp deformation using micro-computed tomography (micro-CT), the propagation of enamel cracks using transillumination, and the effects of hygroscopic expansion after incremental and bulk-filling resin composite restorations.Twenty human molars received standardized Class II mesio-occlusal-distal cavity preparations. They were restored with either a bulk-fill resin composite, X-tra fil (XTRA), or a conventional resin composite, Filtek Z100 (Z100). The resin composites were tested for post-gel shrinkage using a strain gauge method. Cusp deformation (CD) was evaluated using the images obtained using a micro-CT protocol and using a strain-gauge method. Enamel cracks were detected using transillumination.The post-gel shrinkage of Z100 was higher than XTRA (P 0.001). The amount of cusp deformation produced using Z100 was higher compared to XTRA, irrespective of the measurement method used (P 0.001). The thinner lingual cusp always had a higher CD than the buccal cusp, irrespective of the measurement method (P 0.001). A positive correlation (r = 0.78) was found between cusp deformation measured by micro-CT or by the strain-gauge method. After hygroscopic expansion of the resin composite, the cusp displacement recovered around 85% (P 0.001). After restoration, Z100 produced more cracks than XTRA (P = 0.012).Micro-CT was an effective method for evaluating the cusp deformation. Transillumination was effective for detecting enamel cracks. There were fewer negative effects of polymerization shrinkage in bulk-fill resin restorations using XTRA than for the conventional incremental filling technique using conventional composite resin Z100.Shrinkage and cusp deformation are directly related to the formation of enamel cracks. Cusp deformation and crack propagation may increase the risk of tooth fracture.

CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais This in vitro study aimed to assess the effects of different pretreatments used to adapt glass-fiber posts cemented to root canals with different resin cements, regarding porosity percentage and bond strength. Twelve bovine incisor roots were prepared with Largo drills. After post space preparation, the specimens were randomized into two types of pretreatment groups (n = 3): water-wet bonding and ethanol-wet bonding. After the post were cemented, the roots were stored in 100% humidity at room temperature for 7 days. The samples were scanned by microcomputed tomography (micro-CT). Images were reconstructed by NRecon software, and CTAn software was used to analyze the porosity percentage (%) at the luting interface. Evaluation of the push-out bond strength was performed by serially cutting the roots, and submitting the slices to testing. Additionally, the resin cement post-gel shrinkage values (%) were measured using the strain-gauge method (n = 10). Data were analyzed by two-way ANOVA, Tukey's test and Student's t test (a = 0.05). The roots prepared with ethanol-wet bonding using RelyX™ U200 had significantly lower porosity in the coronal and apical thirds (p < 0.05). The group prepared with ethanol-wet bonding using RelyX™ ARC presented better bond strength results in the coronal and apical thirds (p < 0.05). RelyX™ ARC (0.97%) produced a higher post-gel shrinkage value than RelyX™ U200 (0.77%). Canals pretreated with ethanol-wet bonding presented better outcomes in regard to porosity percentage and push-out bond strength

The aim of this study was to evaluate the effect of magnification during post space preparation on root cleanness and on fiber post bond strength. Methods: Thirty human central upper incisors with similar root canal in size and shape were selected, decoronated to 15 mm and endodontically filled. The teeth were assigned into 3 groups (n=10), according to the method of magnification during post space preparation inspection: Control, using naked eye; loupe, using a dental surgical 3x magnifying glass; surgical microscope, using a 6x surgical microscope. The roots were scanned by using micro-CT before and after post space preparation for residue remnants evaluation. Fiber posts were cemented using self-adhesive resin cement (Rely X U200, 3M-ESPE). Two 1-mm-thick slices from the cervical, medium and apical thirds were submitted to a push-out test (PBS). Failures modes were classified. PBS data were analyzed by using two-way ANOVA with repeated measurement and the Tukey test. The significance level was set at 5%. The method of visualization had no effect on PBS (p=0.556). The cervical region had higher values than apical region irrespective of the inspection method (p=0.012). Adhesive failure between the resin cement and dentin was the prevalent failure mode for all groups. Micro-CT analysis showed no difference on root cleanness into the root canal after post space preparation. The use of magnification devices as loupe and microscope while performing post space do not improve the PBS and did not affect sealer remain of decoronated anterior teeth. Resumo Avaliar o efeito do método de visualização durante o preparo do espaço do pino sobre o remanescente de material obturador endodôntico e sobre a resistência adesiva do pino de fibra de vidro. Trinta incisivos centrais superiores humanos com canal radicular circular foram selecionados, foram desobstruídos a 15 mm e obturados. Os dentes foram divididos em 3 grupos (n=10), de acordo com o método de ampliação utilizado para inspeção do preparo: Controle, usando olho nu; lupa, usando uma lupa cirúrgica 3x cirúrgica; microscópio cirúrgico, usando um microscópio cirúrgico 6x. As raízes foram digitalizadas usando micro-CT antes e após a preparação do espaço para avaliação de resíduos remanescentes. Os pinos de fibra foram cimentados com cimento resinoso autoadesivo (RelyX U200, 3M-ESPE). Duas fatias de 1 mm de espessura dos terços cervical, médio e apical foram submetidas ao teste push-out (PBS). Os padrões de falhas foram classificados. Os dados de PBS foram analisados usando análise de variância em dois fatores com medição repetida e o teste de Tukey. O nível de significância foi estabelecido em 5%. Resultados: O método de visualização não teve efeito no PBS (p=0,556). A região cervical apresentou valores maiores que a região apical, independentemente do método de inspeção (p=0,012). A falha adesiva entre o cimento resinoso e a dentina foi o modo de falha prevalente para todos os grupos. A análise de micro-CT não mostrou diferença na limpeza da raiz no canal radicular após a preparação do espaço do pino. Conclusão: O uso de dispositivos de ampliação como lupas e microscópios durante a realização de preparo não melhora o PBS e não afetou a permanência do material obturador remanescente de dentes anteriores.

The aim of this study was to evaluate the biomechanical properties expressed by shrinkage stress, cuspal strain, fracture strength and failure mode in molars with large class II mesio-occlusal-distal restorations. Sixty-four human caries-free third molars were selected and distributed randomly into four groups: Z100 restorative material (Z100), Tetric N-Ceram Bulk-Fill (TNC), Filtek Bulk-Fill (FBF) and Aura Ultra Universal (ABF). The bulk-fill materials were inserted in one singular bulk increment and the conventional composite resin in three ones. Polymerisation shrinkage stress was evaluated by optical Fibre Bragg Gratings (FBG) sensors (n = 6). The cuspal deformation was measured using an extensometer during three moments: restorative procedure, axial compressive loading and at fracture (n = 10). The fracture strength was evaluated on a universal machine. The failure mode was analysed by Scanning Electron Microscopy (SEM). Data were analysed using one-way ANOVA tests with Tukey's posthoc test (α = 5%). Data of the failure mode were submitted to a likelihood ratio chi-square test. Z100 presented the highest mean value for the shrinkage stress (p 0.05) by FBG evaluation, whereas bulk-fill resin groups presented low polymerisation stress mean value, especially the TNC (p 0.05). The cuspal deformation test showed that Z100 presented a significant difference mean value compared to the other groups (p 0.01) during the restoration and compressive axial force; however, load until the fracture presented a difference only between TNC and FBF (p 0.05). The fracture strength of TNC was statistically different from Z100 (p 0.01). The failure mode was not statistically different in all the groups (p 0.05). Bulk-fill composites promoted less polymerisation shrinkage stress than conventional microhybrid composite during and after the light curing process in class II posterior resin composite restorations.

Background/aim Custom-fitted mouthguards are devices used to prevent dental injuries. The aim of this study was to verify the influence of the antagonist contact on the stresses and strains of the anterior teeth, shock absorption and displacement of EVA custom-fitted mouthguards during a horizontal impact. Materials and methods Finite element models of human maxillary central incisors with and without a mouthguard for different occlusion conditions (with and without antagonist contact) were created based on tomography. A nonlinear dynamic impact analysis using the single-step Houbolt method was performed in which a rigid object hit the model at 1 m s-1 . Strain and stress were evaluated by means of Von Mises and Critical modified Von Mises criterion and shock absorption during impact were calculated as well as the mouthguard displacement. Results The model without mouthguard and without antagonist contact showed the highest stress and strain values at the enamel and dentin in the tooth crown on impact compared to the model without mouthguard and with antagonist contact. Mouthguard presence reduced the stress and strain values regardless of the occlusion condition. The mouthguard displacement decreased with the mandibular antagonist contact. Conclusions Mouthguards are efficient at decreasing the stress and strain values on the tooth in front of an impact reaching more than 90% of shock absorption. A mouthguard with balanced occlusion and maximum number of contacts with mandibular anterior teeth should be considered because it reduces mouthguard displacement.

SUMMARY Objectives To evaluate the effect of the restorative protocol on cuspal strain, fracture resistance, residual stress, and mechanical properties of restorative materials in endodontically treated molars. Methods Forty-five molars received mesio-occlusal-distal (MOD) Class II preparations and endodontic treatment followed by direct restorations using three restorative protocols: composite resin (CR) only (Filtek Supreme, 3M-ESPE), resin modified glass ionomer cement in combination with CR (Vitremer, 3M-ESPE in pulp chamber and Filtek Supreme in MOD cavity), conventional glass ionomer cement in combination with composite resin (CGI-CR) (Ketac Fil, 3M-ESPE in pulp chamber and Filtek Supreme in MOD cavity). Cuspal strain was measured using strain gauges, and fracture resistance was tested with an occlusal load. Elastic modulus (EM) and Vickers hardness (VH) of the restorative materials were determined at different depths using dynamic microhardness indentation. Curing shrinkage was measured using the strain gauge technique. The restorative protocols were also simulated in finite element analysis (FEA). The shrinkage strain, cuspal strain, EM, VH, and fracture resistance data were statistically analyzed using split-plot analysis of variance and Tukey test (p=0.05). Residual shrinkage stresses were expressed in modified von Mises equivalent stresses. Results Shrinkage strain values (in volume %) were Ketac Fil (0.08±0.01) < Vitremer (0.18±0.01) < Filtek Supreme (0.54±0.03). Cuspal strain was higher and fracture resistance was lower when using CR only compared with the techniques that used glass ionomer. The EM and VH of the materials in the pulp chamber were significantly lower for glass ionomer. The FEA showed that using CR only resulted in higher residual stresses in enamel and root dentin close to the pulp chamber than the combinations with glass ionomers (RMGI-CR and CGI-CR). Conclusions The choice of restorative protocol significantly affected the biomechanical behavior of endodontically treated molars. Using glass ionomer to fill the pulp chamber is recommended when endodontically treated molars receive direct composite restorations because it reduces cuspal strain and increases fracture resistance.

The aim of this study was to evaluate the effect of porosity of self-adhesive resin on the stress distribution, post retention and failure mode of fiber post cemented to human root dentin. Ten human central upper incisors with circular root canal were selected. They were sectioned with 15 mm and were endodontically filled. The roots were scanned using micro-CT after post space preparation for root filling remaining evaluation. Fiber posts were cemented using self-adhesive resin cement (Rely X U200, 3M-ESPE). Two 1-mm-thick slices from the cervical, medium and apical thirds were scanned for resin cement bubbles volume measurements and submitted to a push-out test (PBS). Three operators using stereomicroscopy and confocal laser microscopy classified the failure mode. Stress distributions during the push-out test were analyzed using 3D finite element analysis. PBS values (MPa) were submitted to one-way ANOVA and Tukey's post hoc tests and the failure modes using the Kappa coefficient to assess inter-operator agreement. Chi-square test was used to determine significant differences between the methods ( = 0.05). Push-out bond strength was significantly affected by the bubbles presence in all root depth (p

SUMMARY Objectives This study tested the hypothesis that photoactivation timing and resin cement affect mechanical properties and bond strength of fiberglass posts to root dentin at different depths. Methods Fiberglass posts (Exacto, Angelus) were luted with RelyX Unicem (3M ESPE), Panavia F 2.0 (Kuraray), or RelyX ARC (3M ESPE) using three photoactivation timings: light curing immediately, after three minutes, or after five minutes. Push-out bonding strength, PBS (n=10) was measured on each root region (coronal, middle, apical). The elastic modulus (E) and Vickers hardness (VHN) of the cement layer along the root canal were determined using dynamic indentation (n=5). A strain-gauge test was used to measure post-gel shrinkage of each cement (n=10). Residual shrinkage stress was assessed with finite element analysis. Data were analyzed with two-way analysis of variance in a split-plot arrangement and a Tukey test (α=0.05). Multiple linear regression analysis was used to determine the influence of study factors. Results The five-minute delay photoactivation timing significantly increased the PBS for all resin cements evaluated. The PBS decreased significantly from coronal to apical root canal regions. The mean values for E and VHN increased significantly with the delayed photoactivation for RelyX Unicem and decreased from coronal to apical root regions for all resin cements with the immediate-curing timing. Conclusions The PBS of fiber posts to root dentin, E, and VHN values were affected by the root canal region, photoactivation timing, and resin cement type. Shrinkage stress values decreased gradually with delayed photoactivation for all the cements.

Objective This study aimed to evaluate the effect of the cavity preparation and ceramic type on the stress distribution, tooth strain, fracture resistance and fracture mode of human molar teeth restored with onlays. Material and Methods Forty-eight molars were divided into four groups (n=12) with assorted combinations of two study factors: BL- conventional onlay preparation with boxes made from leucite ceramic (IPS-Empress CAD, Ivoclar Vivadent); NBL- conservative onlay preparation without boxes made from leucite ceramic; BD- conventional onlay preparation with boxes made from lithium disilicate glass ceramic (IPS e.max CAD, Ivoclar Vivadent); NBL- conservative onlay preparation with boxes made from lithium disilicate glass ceramic cuspal deformation (µS) was measured at 100 N and at maximum fracture load using strain gauge. Fracture resistance (N) was measured using a compression test, and the fracture mode was recorded. Finite element analysis was used to evaluate the stress distribution by modified von Mises stress criteria. The tooth strain and fracture resistance data were analyzed using the Tukey test and two-way ANOVA, and the fracture mode was analyzed by the chi-square test (α=0.05). Results The leucite ceramic resulted in higher tooth deformation at 100 N and lower tooth deformation at the maximum fracture load than the lithium disilicate ceramic (P

Posterior composite restorations may be negatively affected by acidic and colored drinks. Little information is available about the effect of acidic drinks on bulk-fill composite resins.The purpose of this in vitro study was to investigate the effect of acidic drinks on the different properties of conventional and bulk-fill composite resins.A conventional composite resin and 2 representative bulk-fill composite resins were used to prepare disk-shaped specimens. The degree of conversion (DC) was monitored by spectroscopy (n=5). The specimens were divided into 5 groups: control, artificial saliva, acai juice, red wine, and Coca-Cola and were maintained for 30 days of challenge (3 periods of 15 min/d). Surface topography parameters were measured by interferometry (n=5). Elastic modulus (E) and Vickers hardness (VH) were determined by microhardness dynamic indentation (n=5). Diametral tensile strength (DTS) was determined at 0.5 mm/min (n=5). Shade matching was evaluated by using the Vitapan Classic Shade Guide. The DC, Sa, Ssk, Sku, Sdq, and DTS were statistically analyzed using 2-way ANOVA, followed by the Tukey HSD tests. E and VH were statistically analyzed by 3-way ANOVA, followed by Tukey HSD tests (α=.05). Shade matching was analyzed with the Kruskal-Wallis test.DC values were similar for the immediate evaluation and after 24 hours, regardless of the composite resin (P.05). All surface topography parameters increased significantly after the acidic drinks and were greatest for Coca-Cola. The E, VH, and DTS decreased significantly for all composite resins tested (P.05). Acai juice and red wine produced more surface staining than Coca-Cola.Acidic drinks negatively influenced the physical and mechanical properties of conventional and bulk-fill composite resins.

SUMMARY Objectives: To compare radiopacity and porosity as expressed by the presence of voids in restorations carried out using bulk-fill and incremental filling techniques to restore large mesio-occlusal-distal (MOD) cavities. Methods: Fifty-five molars with MOD preparations were incrementally filled with Filtek Z-350XT (Z350XT) or bulk-fill composite: Filtek Bulk Fill/Z-350XT (FBF/Z350XT), Venus Bulk Fill/Charisma Diamond (VBF/CHA), SDR/Esthet-X HD (SDR/EST-X), Tetric EvoCeram Bulk Fill (TEC). Digital radiographic images (Vistascan scanner) were taken of restored molars and analyzed at the gingival and isthmus floors. Radiodensity measurements were performed using standardized points symmetrically distributed over each region of composite and tooth structure. Three calibrated evaluators visually assessed the presence of voids. Confidence intervals were calculated, and data were analyzed using analysis of variance and χ2 tests. Results: TEC and VBF/CHA showed significantly higher radiodensities, while the lowest values were observed for FBF/Z350XT and Z350XT. Radiodensity at the cervical regions tended to be greater than that found at the isthmus floor. The lowest incidence of voids was found for VBF/CHA, whereas the incremental insertion technique resulted in the highest rate of voids. Conclusion: Bulk-fill composite resin demonstrated an adequate level of radiodensity and a reduced presence of voids compared with the incremental filling technique.

SUMMARY Objectives: To evaluate the effect of flowable bulk-fill or conventional composite resin on bond strength and stress distribution in flat or mesio-occlusal-distal (MOD) cavity preparations using the microtensile bond strength (μTBS) test. Methods: Forty human molars were divided into two groups and received either standardized MOD or flat cavity preparations. Restorations were made using the conventional composite resin Z350 (Filtek Z350XT, 3M-ESPE, St Paul, MN, USA) or flowable bulk-fill (FBF) composite resin (Filtek Bulk Fill Flowable, 3M-ESPE). Postgel shrinkage was measured using the strain gauge technique (n=10). The Z350 buildup was made in two increments of 2.0 mm, and the FBF was made in a single increment of 4.0 mm. Six rectangular sticks were obtained for each tooth, and each section was used for μTBS testing at 1.0 mm/min. Polymerization shrinkage was modeled using postgel shrinkage data. The μTBS data were analyzed statistically using a two-way analysis of variance (ANOVA), and the postgel shrinkage data were analyzed using a one-way ANOVA with Tukey post hoc test. The failure modes were analyzed using a chi-square test (α=0.05). Results: Our results show that both the type of cavity preparation and the composite resin used affect the bond strength and stress distribution. The Z350 composite resin had a higher postgel shrinkage than the FBF composite resin. The μTBS of the MOD preparation was influenced by the type of composite resin used. Irrespective of composite resin, flat cavity preparations resulted in higher μTBS than MOD preparations (p Conclusions: FBF composite resin had lower shrinkage stress than Z350 conventional composite resin. The μTBS of the MOD preparation was influenced by the composite resin type. Flat cavity preparations had no influence on stress and μTBS. However, for MOD preparation, composite resin with higher shrinkage stress resulted in lower μTBS values.

SUMMARY Objectives: To analyze the effect of pulp-capping materials and resin composite light activation on strain and temperature development in the pulp and on the interfacial integrity at the pulpal floor/pulp-capping materials in large molar class II cavities. Methods: Forty extracted molars received large mesio-occlusal-distal (MOD) cavity bur preparation with 1.0 mm of dentin remaining at the pulp floor. Four pulp-capping materials (self-etching adhesive system, Clearfil SE Bond [CLE], Kuraray), two light-curing calcium hydroxide cements (BioCal [BIO], Biodinâmica, and Ultra-Blend Plus [ULT], Ultradent), and a resin-modified glass ionomer cement– (Vitrebond [VIT], 3M ESPE) were applied on the pulpal floor. The cavities were incrementally restored with resin composite (Filtek Z350 XT, 3M ESPE). Thermocouple (n=10) and strain gauge (n=10) were placed inside the pulp chamber in contact with the top of the pulpal floor to detect temperature changes and dentin strain during light curing of the pulp-capping materials and during resin composite restoration. Exotherm was calculated by subtracting postcure from polymerization temperature (n=10). Interface integrity at the pulpal floor was investigated using micro-CT (SkyScan 1272, Bruker). The degree of cure of capping materials was calculated using the Fourier transform infrared and attenuated total reflectance cell. Data were analyzed using one-way analysis of variance followed by the Tukey test (α=0.05). Results: Pulpal dentin strains (μs) during light curing of CLE were higher than for other pulp-capping materials (p Conclusions: Light curing of pulp-capping materials caused deformation of pulpal dentin and increased pulpal temperature in large MOD cavities. Shrinkage of the resin composite restoration caused debonding of BIO from the pulpal floor.

Objectives: To evaluate the effects of direct composite resin without a post or with one or two fiberglass posts on the restoration of severely compromised endodontically treated molars. Methods and Materials: Forty-five molars with 2 mm of “remaining tooth structure” were divided into three groups: Wfgp, restored with Filtek Z350XT without a fiberglass post; 1fgp, restored with Z350XT with one fiberglass post in the distal root canal; and 2fgp, restored with Z350XT with two fiberglass posts, one in the distal root canal and the other in the mesial-buccal root canal. The teeth were load cycled. Tooth remaining strain was measured using strain gauges (n=10) at two moments: TrSt-100 N, during 100 N occlusal loading, and TrSt-Fr, at fracture load. Fracture resistance was calculated, and fracture mode was classified. The elastic modulus and Vickers hardness were calculated using dynamic indentation (n=5). Stress distribution was analyzed by three-dimensional finite element analysis. Results: The use of two fiberglass posts resulted in lower fracture resistance than was noted in the groups with one fiberglass post and without fiberglass posts. The lingual surface of the remaining tooth had higher strain values than the buccal surface, regardless of the restorative technique and moment of evaluation. The absence of a fiberglass post resulted in significantly higher strain values and more irreparable fracture modes than were noted in the other groups. The use of one fiberglass post had a better strain/fracture resistance ratio. Stresses were concentrated in the occlusal portion of the post and in the furcation region. The presence of one fiberglass post resulted in better stress distribution in the entire distal root dentin, reducing stress on the critical areas. Conclusions: The use of one fiberglass post for restoring molars with direct composite resin resulted in higher fracture resistance than did the use of two fiberglass posts; it also resulted in better tooth remaining strain and stress distribution and more reparable fracture modes than were seen in the group without a fiberglass post.

SUMMARYNoncarious cervical lesions (NCCLs) are characterized by a loss of dental structure at the cementoenamel junction (CEJ) caused by stress, biocorrosion, and attrition. Variations in occlusal loading can promote different stress and strain patterns on the CEJ. Restoration of NCCLs is part of lesion management; however, there is still no conclusive restorative protocol for NCCLs. This study aimed to evaluate the stress and strain distribution of maxillary premolars with NCCLs according to three factors: 1) restorative technique; 2) direction of occlusal loading; and 3) mechanical fatigue. Three-dimensional (3D) finite element analysis (FEA) and strain gauge testing were used to assess stress and strain, respectively. 3D-FEA orthotropic, linear, and elastic models were generated: sound tooth (SO); unrestored NCCL; or NCCL restored with glass ionomer; flowable composite resin; nanofilled composite resin (CR); lithium disilicate ceramic; and nanofilled composite resin core associated with a lithium disilicate laminate (CL). A 150-N compressive static load was applied in two conditions: axially in both cusps (Al); and at a 45° angle to the long axis of the tooth applied to the palatine cusp (Ol). For the experimental tests, specimens were treated as described previously, and one strain gauge was attached to the buccal surface of each tooth to record tooth strains before and after cyclic loading (200,000 cycles, 50 N). FEA showed that the association of NCCL and Ol resulted in higher stress values. CR and CL restorations showed the closest biomechanical behavior to SO for both loading types. Loaded Al or Ol specimens showed higher strain values after mechanical fatigue. Lower stress and strain were observed with Al when compared with Ol. The restoration of NCCLs with composite resin only or associated with ceramic laminates seems to be the best approach because the results for those groups were similar in biomechanical behaviors to sound teeth.

SUMMARY Objectives To evaluate the effect of composite resins (one conventional and two low-shrink composites) and filling techniques on cuspal strains (CS), microtensile bond strength (μTBS), composite ultimate tensile strength (UTS), and mechanical properties of the composites at various depths in molars with large Class II restorations. Materials and Methods One hundred seventeen human molars received standardized Class II mesio-oclusal-distal cavity preparations and restorations with three composites (Filtek LS [3M-ESPE]; Aelite LS [BISCO]; and Filtek Supreme [3M-ESPE]) using three filling techniques (bulk, eight increments, and 16 increments). CS was measured using strain gauges, after which the same restored teeth were used to assess μTBS and UTS. The elastic modulus (E) and Vickers hardness (VH) at different depths were determined from microhardness indentations. The CS, μTBS, UTS, E, and VH data were statistically analyzed using split-plot analysis of variance and Tukey test (p=0.05). Results The CS was higher when using 16 increments. The ‘low-shrink' composites caused lower CS. The μTBS and UTS were similar for eight- and 16-increment techniques and higher when compared to the bulk filling in all composites. E and VH were constant through the depth when applied in eight or 16 increments. Conclusions Type of composite and filling technique affected the CS, μTBS, UTS, and mechanical properties of large Class II restorations. The eight-increments filling technique resulted in generally less CS with the same μTBS and UTS than was obtained with 16 increments, without affecting E and VH through the depth of the composites.

This study investigated the effects of endodontic treatment procedures and different post systems rehabilitation steps on the strain and temperature rise on apical and cervical root dentin regions. Twenty-one extracted human canine teeth had two strain gages attached to the distal root surface and two thermocouples attached to the mesial root surface (cervical and apical). The strain and temperature rise were recorded during the following procedures: root canal preparation, final rinse and drying, root canal filling and canal relief. Then the teeth were divided into three groups (n=7), according to the type of post system: CPC, cast post and core; FGP, fiberglass post; and PSP, prefabricated steel post. Data continued to be recorded during the post space preparation, post modeling (only for CPC), post trying and post cementation. Data were subjected to a two-way ANOVA followed by Tukey's test (α=0.05). The post-space preparation caused the highest temperature rise (4.0-14.9 °C) and the highest strain in the apical region during irrespective of post type. The resin cement light-activation resulted in significant temperature increases in the cervical region for all of the groups. The canal relief and the post-space preparation produced highest temperature rises. The CPC post modeling resulted in higher root strain level similarly the level of post preparation. The PSP resulted in highest strain during post trying and post cementation. Este estudo investigou os efeitos de diferentes etapas do tratamento endodôntico e da inserção de diferentes tipos de retentores na deformação e aumento de temperatura na dentina radicular apical e cervical. Vinte e um dentes caninos humanos extraídos tiveram dois extensômetros colados à superfície da raiz distal e dois termopares ligados à superfície da raiz mesial (cervical e apical). A deformação e aumento de temperatura foram registrados durante os seguintes procedimentos: preparo do canal radicular, irrigação final e secagem, obturação do canal, alívio do canal; em seguida, os dentes foram divididos em três grupos (CPC, núcleo moldado e fundido; FGP, pino de fibra de vidro, e PSP pino pré-fabricado em aço-inoxidável, n=7). Os dados foram continuamente mensurados durante a modelagem do núcleo (somente para o CPC), inserção e cimentação dos retentores. Os dados foram submetidos a análise de variância fatorial, seguido pelo teste de Tukey (α=0,05). O preparo do canal para o retentor causou o maior aumento de temperatura (4,0-14,9 °C) e maior deformação na região apical independente do tipo de retentor. A ativação com luz resultou em significativo aumento de temperatura na região cervical, para todos os grupos. O alívio do canal e o preparo para o pino produziram maiores aumentos de temperatura. A modelagem do CPC resultou em maior nível de deformação da raiz em nível similar ao preparo para o retentor. O PSP resultou em maior deformação durante a inserção e ao final da cimentação.

SUMMARY Objective: The aim of this study was to investigate the effect of delayed photo-activation on elastic modulus, Knoop hardness, and post-gel shrinkage of dual cure resin cements and how this affects residual shrinkage stresses in posterior teeth restored with ceramic inlays. Methods and Materials: Four self-adhesive (RelyX Unicem, 3M ESPE; GCem, GC; MonoCem, Shofu; and seT, SDI) and two conventional (RelyX ARC, 3M ESPE; and AllCem, FGM) dual cure resin cements for cementing posterior ceramic inlays were tested. Strain gauge and indentation tests were used to measure the post-gel shrinkage (Shr), elastic modulus (E), and Knoop hardness (KHN) when photo-activated immediately and 3 and 5 minutes after placement (n=10). Shr, E, and KHN results were analyzed using two-way analysis of variance followed by Tukey honestly significant difference post hoc tests (α=0.05). The experimentally determined properties were applied in a finite element analysis of a leucite ceramic inlay (Empress CAD, Ivoclar Vivadent) cemented in a premolar. Modified von Mises stresses were evaluated at the occlusal margins and cavity floor. Results: Shr, E, and KHN varied significantly among the resin cements (p Conclusions: KHN and E values varied among the different resin cements. Residual shrinkage stress levels decreased with increasing photo-activation delay with all resin cements.

Objectives To compare bulk-fill with incremental filling techniques for restoring large mesio-occlusal-distal (MOD) restorations. Methods Seventy-five molars with MOD preparations were divided into five groups: Z350XT, incrementally filled with Filtek Z350XT and four bulk-fills—FBF/Z350XT, Filtek Bulk Fill/Filtek Z350XT; VBF/CHA, Venus Bulk Fill/Charisma Diamond; SDR/EST-X, SDR/Esthet-X HD; TEC, TetricEvoCeram Bulk Fill. Cuspal strains were measured using strain-gauges ( n = 10): CSt-Re, during restorative procedure; CSt-100N, during 100N occlusal loading; CSt-Fr, at fracture load. Before fracture load, teeth were load-cycled. Fracture resistance, fracture mode, and enamel cracks were recorded. The other five teeth were used for Elastic modulus (E) and Vickers hardness (VH). Post-gel shrinkage (Shr), diametral tensile strength (DTS) and compressive strength (CS) were determined ( n = 10). Shrinkage stresses were analyzed using finite element analysis. Results SDR had similar CS values as TEC, lower than all other composites. CHA had similar DTS values as Z350XT, higher than all other composites. Z350XT had the highest mean Shr and SDR the lowest Shr. New enamel cracks and propagation was observed after the restoration, regardless of filling technique. Z350XT had lower fracture resistance than bulk-fill composite techniques. No significant differences in failure modes were found. E and VH were constant through the depth for all techniques. Bulk-filling techniques had lower stresses compared to Z350XT. Conclusions Flowable bulk-fill composites had lower mechanical properties than paste bulk-fill and conventional composites. All bulk-fill composites had lower post-gel shrinkage than conventional composite. Bulk-fill filling techniques resulted in lower cusp strain, shrinkage stress and higher fracture resistance. Clinical significance Using bulk-fill composites cause lower CSt wich indicates lower stress in restored tooth. Furthermore, bulk-fill composites have a higher fracture resistance. Therefore, clinicians may choose the bulk-fill composite to decrease undesirable effects of restoration while simplifying filling procedure.

Avaliar o efeito do método de mistura e inserção no canal radicular na porosidade do cimento e resistência de união (RU) de pino de fibra de vidro (PFV). Cento e vinte dentes unirradiculares foram cortados com 15 mm, obturados e tiveram PFV cimentados com 3 cimentos resinosos autoadesivos (U200, RelyX 2000 sET e PSA, Panavia SA) utilizando 4 métodos de mistura/técnicas de inserção (handmix/lima endodôntica handmix/Seringa Centrix automix/ponta convencional e automix/endo tip). As amostras foram escaneadas por micro-CT e seccionadas em fatias (2 por terços: cervical, médio e apical) que foram submetidos à RU, e o padrão de falha foi classificado. Os dados de RU, volume de cimento e de porosidade foram analisados utilizando ANOVA e teste de Tukey, com significância de 5%. O volume de cimento foi similar independente da mistura ou método de inserção. A porosidade foi menor para automix/endo tip e maior para handmix/lima endodôntica. O uso de seringa Centrix e endo tip reduziu a porosidade no terço apical e aumentou RU quando comparados ao uso de lima. A profundidade do canal reduziu RU para U200 e seT quando associados a handmix/lima endodôntica. U200 e seT associados a automix resultou em maior RU eliminando efeito da região, independentemente do método de inserção. Em geral, U200 mostrou maior RU e PSA o menor. A falha do tipo adesiva entre cimento e dentina foi predominante. A RU e porosidade são influenciadas negativamente pelo método handmix/lima endodôntica. Já o método automix/ endo tip produziu melhores resultados na cimentação de PFV.Palavras-chave: Manipulação. Inserção. Cimento Resinoso. Resistência de União.

O objetivo foi propor método para mensuração da deflexão de cúspide utilizando microtomografia computadorizada (micro-CT) e de trincas em esmalte utilizando transiluminação de restaurações de resina composta. Vinte molares humanos receberam preparos padronizados classe II e restaurações com resina composta de incremento único (Xtrafil - XTRA) ou resina convencional (Filtek Z100 - Z100). Contração pós-gel das resinas compostas foi mensurada utilizando método de Extensometria. Deformação de cúspide foi mensurada por meio de novo protocolo empregando micro-CT e validado pelo método de extensometria. Trincas em esmalte foram detectadas pelo método de transiluminação. Contração pós-gél de Z100 foi superior a XTRA. Deformação de cúspide para Z100 foi superior à XTRA, independentemente dos métodos. A cúspide lingual apresentou maior deformação do que a vestibular. Os métodos de deformação de cúspide por micro-CT e Extensometria apresentaram alta correlação (r 0,78). A expansão higroscópica recuperou significativamente a deformação de cúspide, porém resultou em ampliação de trincas. Z100 resultou em maior ocorrência de trincas com maior extensão que XTRA. As trincas foram predominantemente horizontais, localizadas na região correspondente à base da cavidade, envolvendo principalmente o centro e a região distal. O método que emprega micro-CT provou ser viável e eficaz para avaliar deflexão de cúspide, assim como a transiluminação para detecção de trincas.Palavras-chave: Resinas Compostas. Polimerização. Microtomografia.

Analisar o efeito da fotoativação de materiais de proteção pulpar e da resina composta na deformação, temperatura pulpar e na integridade da interface de teto da câmara pulpar/materiais de proteção em molares com cavidades MOD com 1,0mm dentina na parede pulpar. Quatro materiais de proteção: adesivo auto-condicionante CLE, Clearfil SE Bond (Kuraray) 2 hidróxidos de cálcio fotoativados: BIO, Biocal (Biodinâmica); ULT, Ultrablend plus (Ultradent) e cimento de ionômero de vidro modificado por resina composta VIT, Vitrebond (3M-ESPE). As cavidades foram restauradas com resina composta (Filtek Z350 XT, 3M-Espe) (n10). Termopares e extensômetros foram utilizados para detectar mudanças de temperatura, deformação durante a fotoativação. A deformação dentinária (µS) durante a fotoativação de CLE foi maior que os outros materiais de proteção pulpar (P

Fundação de Amparo a Pesquisa do Estado de Minas Gerais The composite resins have been widely used over years in posterior restorations. However, the composite resins have an inherent characteristic called polymerization shrinkage which may be associated with undesirable clinical manifestations such as post-operative sensitivity, microleakage and recurrent caries. The aim of this study was to investigate the influence of some factors such as occlusal loading, restorative technique, mechanical properties of materials, use of liner and environment conditions on the biomechanical behavior of direct composite resin restorations in posterior teeth through laboratory and computational studies. This study was divided into five specific objectives; objective 1: To investigate the effect of occlusal loading and mechanical properties of composites on shrinkage stress in premolars; objective 2: To investigate the effect of environmental conditions, such as temperature and humidity, mechanical properties on biomechanical behavior of molars with class II MOD; objective 3: to investigate the effect of glass ionomer resin liner and filling technique on biomechanical behavior of class II MOD composite resin restoration, specifically analysing cuspal strain by strain gage test, termal and mechanical fatigue and fracture resistance; objective 4: to investigate the effect of the same parameters of objective 3 on mechanical properties of restorative materials, marginal adaptation and shrinkage stress distribution; objetivo 5: To generate an article with all conclusions about shrinkage and posterior restorations by the Brazilian clinical communication contributing with the social function of knowledge generation. The methods used on the all studies were cuspal strain by strain gage test, post-gel measurments by strain gage test, thermal and mechanical fatigue, fracture resistance, marginal adaptation and fracture mode under scanning electron microscopy, dynamic indentation test for calculation of Vickers Hardness and elastic modulus, indentation test for hardness Knoop calculation, finite element analysis 2D and 3D. After data analysis it can be concluded that materials with higher elastic modulus cause greater shrinkage stress; occlusal loading on the margin of restoration cause great stress concentration at interface; occlusal stable contact in the center of restoration cause low stress concentration; high temperature and humidity affect the post-gel shrinkage, elastic modulus, cuspal strain, bond strength and stress shrinkage in the teeth restored with direct composite resins; the simulation of oral environment should be performed in laboratory tests to evaluate the shrinkage and cuspal strain; the order of filling technique, represented by sequence of the oblique increments, had no influence the cuspal strain, fracture resistance, fracture mode, marginal adaptation and stress distribution in molars restored with composite resin; cuspal strain and shrinkage stress decreased significantly with the presence of resin modified glass ionomer resin liner in direct posterior composite resin restorations; the fracture resistance and fracture mode was not influenced by the presence of liner in molars restored with composite resin; gingival margin had higher gap formation than proximal margins in molar restored with direct composite resin restoration. As resinas compostas tem sido amplamente utilizadas ao longo dos anos nas restaurações de dentes posteriores. No entanto, os materiais resinosos apresentam característica inerente, a contração de polimerização que pode ser associada à manifestações clínicas indesejáveis como sensibilidade pós-operatória, infiltração marginal e cáries recorrentes. O objetivo geral deste estudo foi investigar a influência de fatores como carregamento oclusal, propriedades mecânicas dos materiais, uso de forramento cavitário, condições de ambiente e técnica restauradora no comportamento biomecânico de restaurações em resina composta em dentes posteriores por meio de estudos laboratoriais e computacionais. Este estudo foi dividido em cinco objetivos específicos; objetivo 1: investigar o efeito da condição de carregamento oclusal e das propriedades mecânicas de resinas compostas nas tensões de contração de polimerização de resinas compostas em pré-molares; objetivo 2: investigar o efeito das condições ambientais, determinadas pela temperatura e umidade, nas propriedades mecânicas e no comportamento biomecânico de molares com restaurações diretas extensas em resina composta; objetivo 3: investigar o efeito do uso de base de ionômero de vidro como protetor pulpar e da técnica de inserção de resina composta no comportamento biomecânico de restaurações molares com restaurações diretas extensão em resina composta, especificamente na deformação de cúspide em diferentes momentos e o reflexo na resistência à fratura; objetivo 4: investigar o efeito dos mesmos parâmetros avaliados no objetivo 3 nas propriedades mecânicas dos materiais restauradores, adaptação marginal e geração de tensões de contração de polimerização; objetivo 5: gerar síntese dos achados dos objetivos 1, 2, 3 e 4 em um artigo de comunicação aos clínicos brasileiros cumprindo a função social da geração do conhecimento. Os métodos experimentais utilizados foram extensometria para deformação de cúspide e para cálculo de contração pós-gel, fadiga térmica e mecânica, resistência à fratura, teste de microtração, microscopia eletrônica de varredura para análise de modo de fratura e adaptação marginal, teste de indentação dinâmico para cálculo de dureza Vickers e módulo elástico, teste de indentação para cálculo de dureza Knoop, análise por elementos finitos 2D e 3D. Após análise estatística dos resultados pode-se concluir que materiais com maiores valores de módulo elástico causam maiores tensões de contração; contato oclusal localizado na margem da restauração de resina composta posterior aumentam as tensões geradas na interface; o carregamento oclusal aumenta os níveis de tensões em dentes restaurados mesmo quando utilizados resinas composta de baixos valores de contração de polimerização; contatos oclusais estáveis no centro da restauração resultaram em melhor distribuição de tensões; umidade e temperatura que simulam as condições de ambiente oral afetam significativamente a contração pós-gel, módulo de elasticidade, deformação de cúspide, resistência adesiva e tensões de contração em dentes com restaurações diretas em resinas compostas; simulação do ambiente bucal deve ser realizada nos testes de laboratório para avaliar estes parâmetros biomecânicos; a ordem de preenchimento dos incrementos de resina composta, se iniciado pelas caixas proximais ou pela cúspide vestibular, não influenciou na deformação de cúspide, resistência à fratura, modo de fratura, adaptação marginal e tensões geradas de molares restaurados com resina composta; a deformação de cúspide e as tensões de contração diminuíram com a presença de ionômero de vidro modificado por resina usado como material de proteção do complexo dentinho-pulpar em restaurações posteriores; a resistência à fratura e modo de fratura não foram influenciados pela presença de material de base em molares restaurados com resina composta; a margem restauradora com maior desadaptação em molares classe II MOD é a margem gengival. O clínico deve se ater as condições de controle técnico e fazer uso de materiais restauradores adequados em termos de propriedades mecânicas e contração de polimerização objetivando potencializar o sucesso de restaurações diretas em resina composta em dentes posteriores. Doutor em Odontologia

SUMMARY Objectives Finite element analysis (FEA) was used to study polymerization shrinkage stress in molars restored with composites and to correlate those stresses with experimentally measured tooth deformation. Methods Three composites (Filtek LS, Aelite LS Posterior, Filtek Supreme) and three filling techniques (bulk, 2.0-mm increments, and 1.0-mm increments) for restoring a molar were simulated in a two-dimensional FEA. Polymerization shrinkage was modeled using post-gel shrinkage, which was measured using the strain gauge technique (n=10). Cuspal tooth deformation, measured at the buccal and lingual surfaces with strain gauges in a laboratory study, was used to validate the analysis. Residual shrinkage stresses were expressed in modified von Mises equivalent stresses. Linear Pearson correlations were determined between the laboratory and FEA results. Results Post-gel shrinkage values (in volume %) were: Filtek LS (0.11 ± 0.03) < Aelite LS Posterior (0.51 ± 0.02) < Filtek Supreme (0.62 ± 0.09). The 1.0-mm increment filling caused substantially higher stresses and strains in the cervical enamel region. Significant correlations were found between: elastic modulus and FEA strain, elastic modulus and FEA stress, post-gel shrinkage and FEA strain, post-gel shrinkage and FEA stress, FEA strain and cuspal deformation by strain gauge, and FEA stress and cuspal deformation by strain gauge (p Conclusions Increasing the number of increments and high post-gel shrinkage and/or elastic modulus values caused higher stresses in the remaining tooth structure and tooth/restoration interface. Cuspal deformation measured with the strain gauge method validated the finite element analyses.

Objective to correlate polymerization stress data obtained under two compliance conditions with those from different interfacial quality tests. Methods Six commercial composites were tested (Filtek Z250/3M ESPE, Heliomolar/Ivoclar Vivadent, Aelite LS Posterior/Bisco, Filtek Supreme/3M ESPE, ELS/Saremco and Venus Diamond/Heraeus Kulzer). Bond strength (BS) was evaluated by push-out test on slices of bovine dentin (2-mm thick) with tapered cavities. For microleakage (ML) and gap analysis, cylindrical cavities in bovine incisors (4-mm diameter and 1.5-mm height) were restored and epoxy replicas of the cavo-surface margins were prepared for analysis under scanning electron microscopy (200×). The same specimens were submitted to a microleakage protocol using AgNO 3 as tracer. After sectioned twice perpendicularly, ML was determined under a stereomicroscope (60×). Polymerization stress (PS, n = 5) was determined by the insertion of the composite ( h = 1.5 mm) between poly(methyl methacrylate), PMMA, or glass rods (O = 4 mm) attached to a universal testing machine. Data were analyzed using Kruskal–Wallis (ML and gaps), and ANOVA/Tukey (BS and PS, α = 5%). Pearson's correlation test was used to verify correlations between stress and interfacial quality. Results BS varied from 4.7 to 7.9 MPa. Average ML data ranged from 0.34 to 0.89 mm. Maximum ML varied from 0.61 to 1.34 mm. Gap incidence varied from 13 to 47%. PS ranged from 2.5 to 4.4 MPa in PMMA, and between 2.1 and 8.2 in glass. Statistically significant correlations were observed between stress and interfacial quality, except between BS and PS in glass. These correlations were stronger when PMMA was used as bonding substrate. Conclusions PS data obtained using a high compliance testing system showed a stronger correlation with “in vitro” interfacial integrity results, compared to data from a low compliance system.

The primary function of the human dentition is preparation and processing of food through a biomechanical process of biting and chewing. This process is based on the transfer of masticatory forces, mediated through the teeth (Versluis & Tantbirojn, 2011). The intraoral environment is a complex biomechanical system. Because of this complexity and limited access, most biomechanical research of the oral environment such as restorative, prosthetic, root canal, orthodontic and implant procedures has been performed in vitro (Assuncao et al., 2009). In the in vitro biomechanical analysis of tooth structures and restorative materials, destructive mechanical tests for determination of fracture resistance and mechanical properties are important means of analyzing tooth behavior. These tests, however, are limited with regard to obtaining information about the internal behavior of the structures studied. Furthermore, biomechanics are not only of interest at the limits of fracture or failure, but biomechanics are also important during normal function, for understanding property-structure relationships, and for tissue response to stress and strain. For a more precise interrogation of oral biomechanical systems, analysis by means of computational techniques is desirable.

Purpose: This study evaluated the bond strength of adhesive luting agents applied to caries-affected dentin (CAD). Methods and materials: Thirty-six non-carious human third molars were abraded to expose an occlusal dentin surface. Caries lesions were induced in half of the samples using a microcosm biofilm model. Biofilm was cultivated under an anaerobic atmosphere for 14 days in a medium enriched with mucin. The same medium containing 1% sucrose was alternated for 4h per day. Cylinders of resin cement (RelyX ARC, RelyX U200 or BisCem) were built up over the dentin substrate and submitted to shear bond load. The samples were then longitudinally sectioned. The hardness and elastic modulus of dentin was measured at depths of 10, 20, 30, 40, 50, 100, 150 and 200 m from the occlusal surface. A three-dimensional finite element simulation was performed to analyze the residual stress distribution for each experimental condition during the shear bond strength test. Bond strength data were analyzed by two-way ANOVA and hardness and elastic modulus by split-plot ANOVA. Multiple comparisons were performed with the Student–Newman–Keuls test (a=0.05). Results: Independent of the type of cement, the highest bond strengths were observed in sound dentin. Relyx ARC bond strength was similar to that of RelyX U200 for both substrates; BisCem had the lowest values. CAD had lower hardness values than sound dentin above a depth of 100 m. Elasticmodulus exhibited a similar trend, but above a depth of 150 m. Stress distribution during the bond strength test was similar under all experimental conditions. Conclusion: Impairment of the mechanical properties of dentin promoted by carious lesions reduced the bond strength of adhesive luting agents.