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Biomedical subjects

Flávio Fernando Demarco

Publications and source records attributed to Flávio Fernando Demarco.

At least 19 recordsLinked to original sources

Microleakage of seven adhesive systems in enamel and dentin.

AIM: The aim of this study was to evaluate the microleakage of seven adhesive systems on two substrates (enamel and dentin). METHODS AND MATERIALS: Class V cavities were performed in buccal and lingual surfaces of 56 bovine incisors. The cervical margin was located in dentin and the incisal margin in enamel. The specimens were randomly divided into seven groups (n=16), according to the adhesive system employed: Single Bond; Excite; One Step Plus; Gluma One Bond; Magic Bond; One Up Bond F; and One Coat Bond. The cavities were incrementally filled with a hybrid composite Filtek Z250 and polymerized with a XL 3000 light curing unit. After polishing, the specimens were submitted to thermal cycling followed by dye immersion. Leakage was evaluated under magnification (40X) based on a standard ranking. Data were subjected to statistical analysis (Kruskal-Wallis). RESULTS: Enamel margins exhibited lower leakage than dentin margins (p<0.01). The majority of the specimens were leakage-free and materials performed similarly. Conversely, in dentin most of the specimens exhibited the highest leakage degree and significant differences among materials (p<0.05) were found, with Excite exhibiting the lowest leakage degree. It was concluded enamel provided better sealing and the adhesive system was a significant factor only in dentin.

Adhesives↗

Class II composite restorations with metallic and translucent matrices: 2-year follow-up findings.

OBJECTIVE: The aim of this randomized, clinical study was to evaluate the performance of composite restorations placed with two matrix and wedge systems after a 2-year follow-up. METHODS: Twenty-three patients were selected, and received at least two Class II restorations, one with metallic matrix and wooden wedge and other with polyester matrix and reflective wedge. One dentist placed all the 109 restorations. All cavities were restored using Single Bond and P-60 (3M ESPE), according to manufacturer's instructions. In the metal matrix group, polymerization was performed from occlusal, and in the polyester group, through the reflective wedge. Restorations were evaluated at baseline and after 12 and 24 months by the modified USPHS criteria, and data were analyzed with Mann-Whitney and Wilcoxon Signed Rank tests (alpha=0.05). RESULTS: Fifteen subjects and 78 restorations were re-evaluated after 24 months. A significant decrease in the quality of cervical adaptation and proximal contacts by radiographic evaluation was evidenced (p<0.05), but no differences between the two matrix systems were detected (p>0.05). In the clinical evaluation there were no significant differences between matrices after 2 years (p>0.05). A compromising of marginal adaptation, marginal staining and proximal contacts aspects for both matrix systems was evidenced, and restorations placed with translucent matrices showed loss of color stability (p<0.05). CONCLUSIONS: Whereas restorations presented some clinical aspects somewhat compromised after 2 years, the matrix and wedge systems evaluated showed similar clinical performance.

Adolescent↗

One-bottle adhesives: in vitro analysis of solvent volatilization and sealing ability.

The aim of this study was to compare the solvent volatilization rate and evaluate the sealing ability of different one-bottle adhesives that were in constant clinical use--an ethanol/water-based adhesive (Single Bond, 3M/ESPE-SB) and an acetone-based adhesive (Prime & Bond 2.1, Dentsply/Caulk-PB). Nine bottles of each agent were collected from the clinics of a dental school, and new ones were used as controls. The weight of all bottles and of empty bottles was determined using an analytical balance. A drop of each solution was dispensed onto the balance, taking its initial weight (IW) and, after 10 min, its final weight (FW). The IW/FW ratio was used to determine the solvents volatilization rate. The bottles with the highest evaporation levels (SB Control and PB Control) and with the lowest evaporation levels (SB Test and PB Test) of each agent were applied in Class V restorations with margins in dentin. Specimens were thermocycled and immersed in a 0.5% basic fuchsin solution. Dye penetration was evaluated under magnification and the data were submitted to the Kruskal-Wallis test. Solvent volatilization was faster for the acetone-based adhesive. IW/FW ratios ranged from 1.239 to 1.515 for SB, and from 3.488 to 6.476 for PB. The PB-Control and SB-Control groups exhibited similar microleakage patterns. The highest dye penetration scores were found for the PB-Test group (p < 0.05). Results indicate that the sealing ability can be affected by the repeated opening of acetone-based adhesive bottles.

Acetone↗

In vivo and in vitro evaluation of Class II composite resin restorations with different matrix systems.

PURPOSE: To investigate in vivo and in vitro Class II composite restorations performed with two matrix and wedge systems. MATERIALS AND METHODS: One hundred nine Class II restorations were performed in 23 patients, 59 with metallic matrices and wooden wedges (group 1) and 50 with polyester matrices and reflective wedges (group 2). All cavities were restored using Single Bond and P-60 (3M ESPE). In the metal matrix group, polymerization was performed from the occlusal, and in the polyester group through the reflective wedge. To assess microleakage, 40 proximal standard slot cavities were prepared in 20 noncarious human third molars. In the mesial cavity, the gingival margin was located at the enamel level, and in the distal cavity at the cementum/dentin. Specimens were randomly divided into two groups (n = 20) and restored with Single Bond, Z-250 (3M ESPE), and the same techniques used in the in vivo study: metal matrix/wooden wedge (group 1) and polyester matrix/reflective wedge (group 2). Specimens were thermocycled (500 times, 5 degrees C to 55 degrees C), then isolated with nail varnish and immersed in fuchsin for 8 h. Specimens were sectioned longitudinally and microleakage was assessed under magnification (40X) using a standard scoring system. RESULTS: Data were subjected to the chi-square test, Mann-Whitney U-test, and Kruskal-Wallis H-test. Matrix systems presented similar results in the clinical evaluation and the in vitro microleakage test of Class II composite restorations. Dye leakage was minimal at enamel margins, and statistically lower (p < 0.05) than at cementum/dentin margins. CONCLUSION: The different matrix systems had no influence on clinical performance or in vitro sealing ability of Class II composite restorations.

Adolescent↗

Demographic, socio-economic, behavioural and clinical variables associated with caries activity.

This study investigated the association between several demographic, socio-economic, behavioural and clinical variables on caries activity. One hundred and two patients were randomly retrieved from the files of the Operative Dentistry Clinic (UFPel-Brazil). The patients gave written consent to participate in the study. They were interviewed reporting demographic (sex and age), socio-economic data (income, educaional level) and oral health behaviours (tooth-brushing frequency, dental floss usage and snacks frequency). Intraoral examination was performed to investigate the clinical variables (presence and quality of biofilm, DMFT and modified DMFT index and bleeding points). Patients were divided between caries-active (n=51) and caries-inactive (n=51), according to the presence of white spot lesions and/or active cavity lesions. Statistical analysis was carried tout using Chi-square or Fischer's exact test, with the confidence level at 95%. Results demonstrated that several conditions (younger subjects, lower educational or income levels, lower tooth-brushing frequency, higher snacks frequency, adherent biofilm, presence of bleeding points and higher modified DMFT index) were associated with caries activity in the studied population. Within the limitations of the experimental design, and considering the population under investigation, it was verified that demographic (age), socio-economic (income and educational levels), behavioural (tooth brushing and snacks frequencies) and clinical (modified DMFT index, presence and quality of biofilm, and bleeding points) variables were associated with caries-active patients.

Adolescent↗

2,3-Epithiopropyl methacrylate as functionalized monomer in a dental adhesive.

OBJECTIVES: The aim of this study was to investigate new dentin bonding agents formulated with 2,3-epithiopropyl methacrylate (ETMA) comonomer blends. METHODS: Synthesis and characterization of ETMA were performed. Adhesive resins with three different ETMA concentrations (0.1, 1 and 10 wt.%) were prepared. To comparison a blend with only Bis-GMA/HEMA and with 1% of GMA were used as controls. FTIR analysis was used to verify the degree of conversion. Blend copolymerization was investigated by (1)H NMR spectroscopy analysis. To investigate immediate properties of experimental adhesives, microtensile bond strength to human dentin and SEM fractographic analysis were studied. RESULTS: ETMA was synthesized with 90% yield through a one step synthetic route. Degree of conversion for the experimental and control resins was not significantly different. Different monomers showed copolymerization among them, not presenting traces of ETMA release in 0.1 and 1% groups. Bonding agents containing ETMA had statistically higher microtensile bond strength values than the no ETMA adhesive (p<0.05). CONCLUSIONS: Dental adhesive resin-ETMA mixtures produced increased bond strengths without harming the other properties investigated.

Bisphenol A-Glycidyl Methacrylate↗

A clinical evaluation of posterior composite restorations: 17-year findings.

OBJECTIVE: Since an increasing number of composite restorations in posterior teeth are placed as a routine, this study was conducted to evaluate long-term survival of these restorations placed in general practice. METHODS: Patients from a private dental office that received restorations in posterior teeth between 1987 and 1988 with P-50 (3M) or Herculite XR (Kerr) resin composites were selected and invited to participate. Restorations were placed under rubber dam isolation. Dentine walls were covered with glass ionomer cement, and composites were placed according to manufacturer's instructions. Thirty-eight patients agreed to participate and signed an informed consent prior to the evaluation. Two calibrated operators worked independently in the evaluation, using modified USPHS criteria. Survival of restorations or subsets of restorations grouped on the basis of variables (material, tooth, cavity type and size) was determined using Kaplan-Meier survival curves. RESULTS: Ninety-eight failures were recorded among the 282 restorations providing a crude estimate of 34.8% failures. The survival rate was not significant for material (p=0.92) but was significant between tooth (lower premolars and lower molars, p<0.0001), cavity type (p<0.001) and size (p<0.001). The majority of restorations exhibited A or B scores for the evaluated criteria. The main failure cause was fracture of both composites. CONCLUSIONS: The clinical performance of posterior resin composite restorations evaluated was acceptable after 17-year evaluation. However, the probability of failure of resin composite restorations in molars, Class II, and large restorations is higher.

Adult↗

Root-end filling materials: apical microleakage and marginal adaptation.

The purpose of this study was to evaluate the root-end sealing ability through dye leakage evaluation and the marginal adaptation through scanning electron microscopy (SEM) of some root-end filling materials. Thirty human uniradicular teeth were used. Teeth were divided into three groups: (1) retrofilled with MTA-Angelus, (2) with SuperEBA, and (3) with Vitremer. The root surfaces were isolated with nail polish and teeth were immersed in silver nitrate. Roots were sectioned transversally at each millimeter, in three sections and evaluated at a stereomicroscope to observe dye penetration. Using SEM the distance between the tested root-end filling materials and the surrounding dentin was measured at four points. The statistical analysis showed significant differences among the three materials in relation to the sealing ability (p < 0.05). Concerning marginal adaptation, MTA-Angelus presented the best results (p < 0.01). Absence of correlation between the two methodologies was clearly observed.

Aluminum Compounds↗

Microleakage in bonded amalgam restorations using different adhesive materials.

The aim of this study was to verify the ability of different adhesive materials to prevent microleakage in bonded amalgam restorations. Standard cavities were prepared in both buccal and lingual surfaces of 35 bovine incisors. The gingival wall was located in cementum/dentin and the occlusal wall in enamel. Teeth (n=35) were divided into 5 groups, according to material employed (one glass-ionomer cement, two resin cements, one adhesive system, and Copalex varnish as a control). Following restoration, the teeth were submitted to thermal cycling. The teeth were subsequently immersed in methylene blue dye and sectioned to allow assessment of microleakage. Non-parametric statistical analysis indicated that all materials demonstrated less leakage than the control group (p<0.01). No leakage was found using the resin-modified glass-ionomer cement, which was significantly different from the other adhesive materials (p<0.05). Leakage in enamel was lower than in cementum/dentin margins. It was concluded that bonded amalgam was an effective technique, since all materials prevented microleakage in enamel and cementum/dentin, when compared to the control group, except Panavia in cementum/dentin margins.

Animals↗

[Twenty-four months of external control of fluoride levels in the public water supply in Pelotas, Rio Grande do Sul, Brazil].

The aim of the present study was monthly evaluation of fluoride levels in the public water supply in Pelotas, Rio Grande do Sul State, Brazil, and the validity of forming external control groups. Pelotas was divided into 16 geographic regions, including the three public water treatment stations. Water samples were collected from November 1999 to October 2001. Two samples were drawn from each region. Samples were sent to the Fluoride Health Surveillance Laboratory at Universidade do Vale do Itajaí. Fluoride analysis used an electrometric method (Orion 920 A/Electrometer Orion 9609). After 24 months, 764 samples were collected, demonstrating a discontinuity in the fluoride levels. There was an increase in the number of samples with an ideal concentration of fluoride. However, several points with excessive fluoride levels (> 0.9ppmF) also appeared. Based on these results it was concluded that external control is essential for monitoring fluoride levels in the public water supply.

Brazil↗

Fracture resistance of re-attached coronal fragments--influence of different adhesive materials and bevel preparation.

The purpose of this study was to investigate the fracture resistance of re-attached coronal fragments of teeth using different materials and tooth preparations. Seventy-two recently extracted bovine incisors were selected. Eight incisors were maintained without any preparation as a control group. The incisal third of the other teeth was sectioned using a diamond saw. In one group (n = 32), a 2-mm bevel was prepared, whereas in the second group no preparation was made (n = 32). The specimens (beveled and non-beveled) were divided in four groups (n = 8) and re-attached with the following materials: a dual-cured resin cement RelyX ARC (RX); a chemically cured composite Bisfil 2B (B2); a light-cured composite Z250 (Z2); and a one-bottle adhesive Single Bond (SB). The bevel region was restored with adhesive and composite. All materials were used according to manufacturer's directions. A light-curing unit was used to polymerize the materials. Specimens were stored in saline solution for 72 h. De-bonding procedures were performed in a testing machine with cross-head speed of 0.6 mm min(-1). The load was applied in the incisal third. The resistance to fracture for control group was 70 (7) kg. The fracture resistance for non-beveled and beveled specimens were: SB, 3.3 (2.4) and 17.0 (4.1); RX, 11.5 (3.0) and 16.3 (3.1); Z2, 14.4 (4.2) and 20.5 (1.7); and B2, 19.5 (3.5) and 32.5 (7.4) kg. Analysis of variance (anova) and Fisher's protected least significant difference (PLSD) test disclosed significant influence for materials and cavity designs (P = 0.001). The highest failure loads were obtained with the B2 group and then with the Z2 with either bevel or non-bevel. RX produced lower failure loads than the restorative composites. The lowest failure load was obtained with SB in the non-beveled group. No technique studied was able to attain the fracture resistance of the control group and both materials and tooth preparation influenced the fracture resistance.

Analysis of Variance↗

One-year clinical evaluation of two polyacid-modified resin composites (compomers) in posterior permanent teeth.

PURPOSE: The aim of this study was to evaluate the clinical performance of two polyacid-modified resin composites (Dyract AP and F2000) in posterior teeth after 1 year of clinical service. MATERIALS AND METHODS: Seventy-two Class I restorations were performed in 33 patients (average age 25 years) by one operator. Eighty-two per cent of the restorations were located in molars. Before the proceedings, patients were informed about the aim of the study and they gave written consent to participate. At least one restoration of each material was placed in each individual. The materials were applied according manufacturer's instructions. Following finishing and polishing, one examiner performed the clinical baseline examination using the adapted USPHS system. To be included in the clinical trial, a restoration had to be rated "Alpha". After one year, 25 patients were recalled and 56 restorations were evaluated using the adapted USPHS system. RESULTS: All restorations were classified as clinically satisfactory (Alpha or Bravo). However, there was a decrease in restoration quality compared to baseline. Statistical analysis (chi2 and Fisher's exact test) demonstrated differences only in relation to superficial roughness, with exhibiting F2000 more surface roughness than Dyract AP (p < 0.01). CONCLUSION: Based on the methodology employed, all restorations were satisfactory after one year and the two materials performed similarly, except for the surface roughness criteria.

Acid Etching, Dental↗

Tensile bond strength of four resin luting agents bonded to bovine enamel and dentin.

STATEMENT OF PROBLEM: The resistance to fracture of ceramic restorations depends on adequate bonding to tooth structure. The dental substrate and the types of resin luting agents used are believed to produce variability in adhesive properties. PURPOSE: The purpose of this study was to evaluate the tensile bond strength of 4 resin luting agents to bovine enamel and dentin. MATERIAL AND METHODS: Forty bovine incisors were embedded in acrylic resin and ground horizontally with water-cooled silicon carbide paper to expose enamel (20 teeth) and dentin at the enamel/dentin junction (20 teeth). Ten standard cone-shaped specimens with a 3-mm diameter base were prepared for each of the following resin cements: Resin Cement, Rely X ARC, Nexus, and Enforce. Five specimens of each material were bonded to enamel and the other 5 to dentin with these resin luting agents and their respective adhesive systems, according to the manufacturers' directions. After 7 days of storage in distilled water at 37 degrees C, specimens were subjected to tensile forces in a universal testing machine at a crosshead speed of 0.5 mm/min until fracture. Bond strength data were analyzed with analysis of variance for substrate and material. Means were compared with Tukey's test at the 0.05 level of significance. RESULTS: Analysis of variance disclosed that both substrate (P<.001) and material (P<.05) demonstrated statistically significant differences, but their interaction was not significant. The bond strengths (MPa) obtained for Resin Cement (11.5 +/- 3.0), Rely X ARC (11.4 +/- 3.1), Nexus (10.0 +/- 1.4), and Enforce (11.8 +/- 2.8) were statistically the same for enamel. For dentin, bond strengths (MPa) for Rely X ARC (9.6 +/- 1.8), Resin Cement (9.3 +/- 0.9), and Enforce (7.8 +/- 2.9) were significantly higher than for Nexus (3.5 +/- 0.8). Significantly higher bond strengths (MPa) were also observed for enamel (11.2 +/- 2.5) than dentin (7.5 +/- 1.6). CONCLUSION: Within the limitations of this study, tensile bond strengths of resin luting agents to enamel were higher than those to dentin, and the bond strength values of Nexus to dentin were significantly lower (P<.05) than the other cements tested.

Adhesiveness↗

Microleakage in ceramic inlays luted with different resin cements.

PURPOSE: The objective of this in vitro study was to evaluate the microleakage in ceramic inlays using different resin cements with margins in enamel and cementum/dentin interfaces. MATERIALS AND METHODS: Standard Class II MOD inlay cavities were prepared in 32 noncarious human premolars. The cavities were randomly divided into 4 groups (n = 8): CONTROL GROUP: cavities were treated with Single Bond and incrementally filled with a composite resin (P60); Enforce group: feldspathic ceramic inlays were luted using Prime & Bond 2.1 and Enforce; RelyX group: inlays were cemented with Single Bond and RelyX ARC; Resin Cement group: ceramic inlays were bonded using Single Bond and Resin Cement. Ceramic inlays were previously treated with 10% hydrofluoric acid for 2 min, followed by silane application. After 7 days of storage in distilled water, teeth were submitted to thermocycling. After applying nail varnish, specimens were immersed in 2% aqueous solution of methylene blue for 8 h. After washing, teeth were cut into three sections through the restorations, and the leakage was assessed using a standardized score. RESULTS: Data were submitted to statistical analysis using nonparametric tests (Mann-Whitney and Kruskal-Wallis). Dye leakage at margins in enamel was statistically lower (p < 0.01) than at cementum/dentin interfaces. RelyX ARC performed better (p < 0.05) than resin cement (enamel) and composite restorations (cementum/dentin). No other statistical differences were observed. CONCLUSIONS: Both the material and the substrate interface influenced microleakage of the ceramic inlays.

Acid Etching, Dental↗

Sealing ability of MTA, Super EBA, Vitremer and amalgam as root-end filling materials.

This study evaluated the root-end sealing ability of mineral trioxide aggregate (MTA Angelus), reinforced zinc oxide-eugenol cement (Super EBA), resin-modified glass ionomer (Vitremer) and zinc-free amalgam (GS-80) (control). The root canals of eighty human lower molars were accessed, cleansed, shaped and obturated. Apexes were resected and cavities were prepared. Teeth were divided into 4 groups of 40 cavities, root-end filled with the materials, and immersed in methylene blue for 72 h at 37 degrees C. Roots were then sectioned transversally at each millimeter and evaluated under magnification, observing the dye penetration in each section. Data were evaluated using Kruskal-Wallis test at a 5% level of significance, showing the differences among all materials (p < 0.001). The crescent order of microleakage was MTA < Vitremer < Super EBA < amalgam. Higher leakage levels were observed in the first millimeter sections of amalgam, Vitremer and MTA, when compared with the third millimeter section (p < 0.05).

Bismuth↗

Dentin penetrability evaluation of three different dyes in root-end cavities filled with mineral trioxide aggregate (MTA).

The purpose of this study was to evaluate the penetration of three dyes in MTA root-end fillings. In 30 single-rooted teeth, cavities for retrofilling were prepared with an ultrasound appliance and filled with MTA. The specimens were randomly assigned to three groups (n = 10) and immersed in the following solutions: 2% methylene blue (MET), 50% silver nitrate (NIT) and 0.2% rhodamine B (ROD). Two transversal slices (1 mm) of the retrofilling region were obtained and evaluated using the Image Tool 3.0 software to obtain a quantitative evaluation (in mm2) of the dye penetration around the retrofillings. Data were submitted to statistical analysis using Students t-test. The lowest degree of dye penetration was observed for the NIT group, in both slices (p < 0.05). Dye penetration was significantly larger in the ROD group when compared to the NIT group, in both slices (p < 0.05), and to the MET group, only in slice 1 (p < 0.05). Within the limitations of this study, it was concluded that the choice of dye could influence the penetration evaluation in root-end filling studies, and that the NIT had the lowest penetration capacity in the apical dentine.

Aluminum Compounds↗

Shrinkage stress of three composites under different polymerization methods.

The aim of this study was to evaluate the shrinkage stress of three composites under different polymerization methods: halogen conventional polymerization (G1), halogen "soft-start" polymerization (G2) and LED polymerization (G3). The composites tested were Filtek Z-100 (3M/ESPE), Filtek Z-250 (3M/ESPE) and Solitaire 2 (Heraeus Kulzer). For G1, an XL-3000 (3M/ESPE) curing unit with light intensity of 507 mW/cm2 was employed. In G2, the same light unit was used, but with a reduced light intensity in the first 20 s (166 mW/cm2). In G3, an Ultrablue I (DMC) LED curing unit with light intensity of 125 mW/cm2 was used. The test was performed with a DL 2000 (EMIC) universal testing machine and two metallic molds with a 1 mm space between them. The composites were inserted in the space between the molds and light cured according to the protocols mentioned above. Stress was registered in different periods of time: 10, 20, 40, 60, 90 and 120 s. A significant linear increase of the shrinkage stress over time was observed, except for Z-100 in G2. Generally, LED polymerization (G3) reduced the generated stress when compared to conventional halogen polymerization (G1). In G3, the composite with the additional co-initiator presented lower stress when compared to the other composites tested. The combination between composite and polymerization method produced different patterns of stress behavior. LED polymerization reduced the initial shrinkage stress of the three materials and was influenced by the presence of co-initiators in the composites.

Analysis of Variance↗

Effect of polishing techniques and time on surface roughness, hardness and microleakage of resin composite restorations.

This study evaluated the effects of immediate and delayed polishing on the surface roughness, microhardness and microleakage of a microfilled (Filtek A110) and a hybrid (Filtek Z250) resin composite. Standardized preparations were made on the buccal surfaces of 256 bovine teeth; half were restored with each composite (128 teeth per composite). Immediately after curing, gross finishing was carried out with #280 sandpaper. The specimens restored with each composite were divided into two subgroups. The first group (IM) was polished immediately after gross finishing, using three different systems (n=16): Sequence A, Sof-Lex; Sequence B, Flexicups and Sequence C, Flexicups + Jiffy Polishing Brush + Flexibuffs. The specimens were then stored for three weeks in saline 37 degrees C. The second group (DE) was stored for two weeks, then polished with the same systems and stored for one additional week. The controls (n=16) were analyzed without polishing. Five readings per specimen were taken for surface roughness and hardness. After immersion in basic fuchsin, microleakage was evaluated (40x) using standardized scores. The data were analyzed at a significance level of 0.05, with analysis of variance and an SNK test (surface roughness and microhardness) or with Kruskal-Wallis (microleakage). In both composites, only for the sequential technique was there an influence of delay in polishing on roughness (Ra). Flexicups exhibited the highest Ra of the three systems. The IM and Filtek Z-250 groups showed higher hardness than the DE and Filtek A-110 groups, respectively. Dentin margins showed more leakage than enamel margins; the sequential technique produced more leakage than the other techniques in dentin (p<0.05) and delay of polishing was not significant in the majority of situations. In conclusion, several conditions--composite, time and polishing technique--had a significant influence on surface roughness, hardness and microleakage. Generally, immediate polishing produced no detrimental effect compared to delayed polishing.

Animals↗