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Objectives: The aim of this study was to evaluate the 12-year clinical performance of sintered (Duceram, Dentsply-Degussa, Dentsply International Inc., PA, USA)—D and pressable (IPS Empress, Ivoclar-Vivadent, Schaan, Leichtenstein)—IPS ceramic inlay and onlay restorations. Methods: Eighty-six restorations were placed in 35 patients with a median age of 33 years by a single operator. The restorations were luted with dual-cured resin luting material (Variolink II, Ivoclar-Vivadent, Schaan, Leichtenstein) and Syntac Classic adhesive under rubber dam. The evaluations were conducted by two independent investigators at the baseline, 1, 2, 3, 5, and 12 years using the modified USPHS criteria. Results: At the 12-year recall, 22 patients were evaluated (62.86 %), totalling 48 (55.81 %) restorations. Seven restorations were fractured (one from Duceram and six from IPS), eight restorations presented secondary caries (three from Duceram and five from IPS), nine restorations showed unacceptable defects at the restoration margin and needed repair or replacement (two from Duceram and seven from IPS), and four IPS restorations presented pulp sensitivity. Conclusion: Chi-square and Mann-Whitney tests revealed that IPS Empress system showed the best results for color match and surface texture (p < 0.05) but a significant worse result for fracture (p = 0.05). Wilcoxon test showed significant differences in relation to color match, surface texture, marginal discoloration, and marginal integrity between the baseline and 12-year recall for both ceramic systems. Clinical significance: This long-term clinical study observed that the main reasons for failure of ceramic restorations were related to fracture, recurrent caries, and decreased marginal integrity over time. Carefully monitoring of the ceramic-tooth interface may extend their clinical longevity.

Interface integrity can be maintained by setting the composite in a layering technique and using liners. Objective The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations. Material and Methods Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) – no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher’s test. Results There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups. Conclusions RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations.

Aim: The aim of this in vitro study was to evaluate the influence of dye solution on enamel color change after bleaching protocols and the effectiveness in maintaining the color of these agents.Material and Methods: The buccal surfaces of sixty-five bovine incisors were cleaned and polished, and the enamel specimens were divided into thirteen groups: G1 to G6: treated with 6% hydrogen peroxide using different surface agents; G7 to G12: treated with 15% hydrogen peroxide using different surface agents; G13: control. After 24 hours, the groups treated were immersed in black tea solution; the control group was stored in artificial saliva. The color was evaluated prior to bleaching, 24 hours later and after immersion in the dye solution; the roughness was measured immediately after bleaching, 24 hours later and 7 days after immersion in the dye solution. The data was analyzed using the Kruskal-Wallis test, followed by the Miller test for roughness analysis, and the Duncan test for color change analysis. It was used 5% significant level with p

The available options for restoring multiple surface cavities are: amalgam, composite resin, or indirect restorations. Adhesive system and intradentinal pin-retained composite resin restorations should have a similar performance to pin-retained amalgam, regarding resistance to support occlusal forces. Polymerization shrinkage is a major concern when performing direct posterior composite resin restorations and the incremental insertion technique can provide less stress and outstanding margin behavior. Intradentinal pins can potentially enhance composite resin's retention, while reducing gaps caused by polymerization shrinkage. This article reports a clinical case involving an extensive restoration on a posterior tooth with cusp loss that was successfully treated using an intradentinal pin and direct nano-hybrid composite resin restoration.

Este estudo teve como objetivo avaliar o efeito da base de cimento de ionômero de vidro modificado por resina (CIVMR) e das técnicas de inserção incremental de resina composta na interface de parede circundante de restauração adesiva à dentina. Foram confeccionadas cavidades com 4,5mm X 3mm X 5mm em 52 molares humanos extraídos divididos em 4 grupos: Grupo 1 (controle): Sistema Adesivo (Adper Single Bond) + Resina Composta (Filtek Z250) com inserção em 2 incrementos horizontais (Fator C = 5); Grupo 2: Sistema Adesivo (Adper Single Bond) + Resina Composta (Filtek Z250) em 4 incrementos oblíquos (Fator C=2); Grupo 3: Base de CIVMR (Vitrebond) + Sistema Adesivo (Adper Single Bond) + Resina Composta (Filtek Z250) em 2 incrementos horizontais (Fator C = 5) e Grupo 4: Base de CIVMR (Vitrebond) + Sistema Adesivo (Adper Single Bond) + Resina Composta (Filtek Z250) em 4 incrementos oblíquos (Fator C = 2). Após a restauração, os dentes permaneceram em água deionizada em estufa a 37ºC por 24 horas. Depois foram seccionados em uma máquina de cortes com disco de diamante em espessura de 0,8mm no sentido vestíbulolingual. Uma fatia de cada dente foi separada aleatoriamente para análise em Microscópio Confocal para verificação e mensuração de fendas internas na interface dentina/resina composta. As demais fatias foram seccionadas para a confecção de palitos (0,8mm X 0,8mm) que foram submetidos a testes de microtração em uma máquina de ensaios universal EMIC. Os resultados de resistência de união foram submetidos à análise de variância a dois critério ANOVA a 5% e ao teste de Fisher para as variáveis de presença de fendas internas. Não houve diferença estatisticamente significante entre os quatro grupos (p>0,05) com relação à resistência adesiva. Quanto à presença de fendas internas, foi evidenciada sua presença nos grupos 1, 3 e 4, sem diferença estatisticamente significante entre os grupos testados (p>0,05). Conclui-se, portanto, que o uso da base de cimento de ionômero de vidro modificado por resina e das técnicas de inserção incremental de resina composta não influenciam a resistência adesiva e presença de fendas da resina composta à dentina. The aim of this study was to evaluate the effect of resin-modified-glassionomer linning and incremental technique on the bond strength of the composite restoration interface. Methods: Cavities were made (4.5mm X 3mm X 5mm) in 52 extracted human molars, divided into 4 groups: Group 1 (control) no linning + two horizontal increments (C Factor = 5); Group 2: no linning + four oblique increments (C Factor = 2); Group 3: RMGIC linning (Vitrebond) + two horizontal increments; and Group 4: RMGIC linning (Vitrebond) + four oblique increments. All teeth were restored with Adper Single Bond and Filtek Z250 and stored in deionized water at 37ºC for 24 hours before sectioned into 0.8 mm sticks (bucco-lingually). One slice of each tooth was randomly selected for confocal microscopy for analysis of the interface resin/dentin. The other slices were sectionated in sticks (mesio-distally) for microtensile test in a Universal Testing Machine (EMIC) at 0.5mm/min. The data were analyzed by Two-way ANOVA (5%) and Fishers test for variables of presence of gap. No statistical difference on adhesive strength among groups (G1 14.55 ± 4.228 MPa, G2 17.25 ± 7.31 MPa, G3 12.81 ± 4.97 MPa and G4 13.39 ± 4.115 MPa). No significant statistical difference was observed regarding the presence of gap at the interface dentin/resin among groups (p>0.05). It can be concluded, that resin-modified glass-ionomer cement linning and resin composite techniques showed no effect on the adhesive interface to dentin.

The concepts introduced by the Minimally Invasive Dentistry (MID) allowed the rising of new conservative treatment and assessment system for caries lesions’ classification. In this context, the approaches of the incipient caries lesions surpass the use of only traditional restorative techniques. The aim of this study was to review the new caries classifications criteria (ICDAS and CAST), the importance of the early diagnosis of caries lesions and the clinical procedures for treatment in MID.