Intjdc cor e rugosidade


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Intjdc cor e rugosidade

  1. 1. ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(3):16-17 1 ORIGINAL RESEARCH ARTICLE 2 3 Evaluation of surface roughness and color stability of direct resin composites after 4 different polishing protocols 5 Carlos Eduardo dos Santos Bertoldo, Diogo Azevedo Miranda, Eduardo José Souza-Junior, Flávio Henrique 6 Baggio Aguiar , Débora Alves Nunes Leite Lima, José Roberto Lovadino 7 Abstract 8 Background: Polished and smooth composite resin restorations present a better esthetic 9 appearance and greater longevity. Aims: To compare the effect of different polishing protocols on surface10 roughness and color stability of two direct composites. Materials and Methods: Sixty specimens (6mm in11 diameter and 2mm in thickness) were divided into six experimental groups (n=10), composite resins (Z25012 and 4 Seasons) and polishing systems (Sof-Lex and Jiffy). Baseline readings from surface roughness and13 CIE L*a*b* color was obtained after polishing procedures. Final roughness readings were made after this14 step. The specimens were immersed in 2ml of coffee solution under the follow regime: 15 minutes/7 days.15 After this, new color measurements were realized, getting the color variation (ΔE). Results: The results16 were analyzed by two-way ANOVA and Tukey test (α =5%). For both values, the polishing systems17 differed between the group control (unpolished), and each other. The specimens polished with Jiffy showed18 lower roughness values and color variation. Z250 presents highest roughness values in comparison with 419 Seasons. Conclusion: The 4 Seasons composite polished with Jiffy System exhibits lower rates of surface20 roughness and staining susceptibility.21 Key Words: Roughness, color, resin composites22 1 The search for esthetic materials 33 produce a harder, more resistant and 2 has led to advances in the study of dental 34 esthetically acceptable surface.(2, 7) Several 3 materials, especially composite resins. The 35 studies have been conducted to determine 4 main advantages of resins are related to the 36 the effects of staining solutions on the 5 material’s esthetic properties, decrease of 37 surface characteristics of esthetic restorative 6 marginal leakage, increased resistance of the 38 materials.(6-8) The consumption of coffee 7 tooth remnant, and less need for removal of 39 and soft drinks, for example, has a high 8 healthy tooth structure.(1, 2) In addition, the 40 prevalence in the contemporary society, 9 reduced polymerization shrinkage and 41 especially in industrialized countries. It has 10 improved wear resistance of resins allow 42 been demonstrated that surface 11 their use not only in anterior but also in 43 discolorations in composite resins are 12 posterior teeth.(2, 3) The esthetics and 44 related to hygiene, eating habits and 13 longevity of restorations strongly depend on 45 smoking. The maintenance of the esthetics 14 the quality of the surface finishing and 46 of a restoration is therefore related to the 15 polishing. The presence of irregularities can 47 patients’ habits and lifestyle.(9) 16 influence appearance, plaque retention, 48 Various polishing protocols have 17 surface discoloration, gingival 49 been tested in vitro to evaluate their effects 18 inflammation.(4, 5) In addition, the surface 50 on the surface roughness of restorative 19 roughness of composites can reduce some 51 materials. These results have been useful to 20 mechanical properties such as hardness(5) 52 establish protocols for in vivo 21 and increase the wear of restorations. (6, 53 application.(10) Several composite resins 22 7)Thus, polished and smooth composite 54 have been the subject of surface roughness 23 resin restorations present a better esthetic 55 studies, but few investigations are available 24 appearance and greater longevity.(2, 6, 7) 56 comparing the surface roughness of 25 Another important aspect is the 57 microhybrid resins, as well as the use of a 26 need for removing the superficial resin layer 58 new silicon polishing system (Jiffy) recently 27 that does not polymerize when in contact 59 launched on the market. (2) This study was 28 with oxygen.(8) Studies have shown that a 60 conducted to evaluate surface roughness of 29 smoother surface is obtained when the resin 61 two composites (microhybrid and 30 is cured against a strip of appropriate 62 nanohybrid) after the use of different 31 matrix.(7) Removal of this surface by the 63 polishing systems, as well as to evaluate the 32 usually required finishing procedures will 64 effectiveness of these systems in the color ©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 3 JULY - SEPTEMBER 2011 16
  2. 2. ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(3):16-1765 stability of the material after staining with a 95 In the controls groups of each resin,66 coffee solution. 96 the specimens were not submitted to any67 Materials and Methods 97 polishing procedure after curing under a68 Two resin composites were 98 polyester matrix.69 selected: 4 Seasons (A3 - Ivoclar Vivadent, 99 The specimens polished with70 Schaan, Liechtenstein) and Z250 (A3 - 3M 100 aluminum oxide-impregnated disks (Sof-71 ESPE, St. Paul, MN,USA). The composition 101 Lex®, 3M/ESPE) (dark blue, medium blue72 of the resin composites is described in Table 102 and light blue back, measuring 19.05 mm in73 1. Two polishing system were chosen: 103 diameter) at intermittent pressure and low74 SofLex (3M/ESPE, St. Paul, MN, USA) and 104 speed for 20 s each. The specimens were75 Jiffy (Ultradent Products Inc. South Jordan 105 washed with an air/water spray to remove76 UT, USA), the composition is described in 106 debris, air dried and then polished with77 Table 1, divided in accord to resin used 107 another disk of lower grit for the same78 (n=10). 108 period of time. Resin Manufacturer Composition 109 The specimens were polished with Z250 3M ESPE, St. Bis – GMA, UDMA, 110 silicon discs (Jiffy System - Ultradent) Paul, Bis – EMA, 111 (green, yellow and white) at intermittent MN,USA Zirconium, Silica 112 pressure and low speed for 20 s each. The 60% (0,01 a 3,5µm) 113 specimens were washed with an air/water 4 Ivoclar Bis-GMA, 114 spray to remove debris, air dried and then Seasons Vivadent TEGDMA, UDMA 115 polished with another disk of lower grit for (Schaan, 76 wt% of barium 116 the same period of time. Liechtenstein) glass load, trifluor terbium, Ba-Al Fluor 117 Average surface roughness (Ra, in Silicate glass and 118 μm) of the specimens was determined with a dispersed silica with 119 previously calibrated mechanical roughness load particles sized 120 tester (Surftest 301, Mitutoyo America 0.04 – 3.0 μm, and 121 Corporation, Suzano, SP, Brazil) over a load average size of 122 distance of 0.25 mm. Six measurements 0.6µm. 123 were made in the center of each specimen in Sof- 3M/ESPE, St. Aluminum oxide. 124 two directions (three in the vertical and 3 in Lex® Paul, Medium (29μm), 125 the horizontal direction). MN,USA Fine (14μm), 126 A baseline photoreflectance Extrafine (5μm). 127 reading (L1) was taken for each sample after Jiffy Ultradent Abrasive, silicon- Products Inc. impregnated rubber. 128 polishing procedures utilizing a South Jordan Latex free material. 129 spectrophotometer CM-700d (Konica UT, USA 130 Minolta Sensing Americas, Ramsey, New Table 1. Restorative materials and polishing 131 Jersey, USA) coupled to a cabin light (MM- systems tested. Information supplied by the 132 1eUV/D65). Data obtained was submitted to manufacturer. 133 interpretation on a software OnColor QC79 Cylindrical specimens were 134 Lite and the results were tabulated as CIE80 prepared in teflon ring molds (6.0 mm Ø and 135 L*a*b* System.81 2 mm height). A polyester strip was placed 136 Each specimen was stored and82 on a glass slab (Dentsply, Petropólis, Rio de 137 immersed in 2ml of artificial saliva (pH 7,0)83 Janeiro, Brazil) and teflon matrix. After 138 which was changed daily throughout the84 filling the mold to excess, the material 139 experiment. The staining solution used in85 surface was covered with another polyester 140 this study (Café Pilão, União, São Paulo, SP,86 strip and a glass slide, and compressed with 141 Brazil) was prepared in a drip-style87 a device (500 g) for 20s to place the 142 coffeemaker (Britânia, São José dos Pinhais,88 composite and remove the material excess. 143 Paraná, PR, Brazil), using 8g of ground89 All the resin composite specimens were 144 coffee/100ml of water16. The specimens90 light-cured with a Ligh Emitting Diode 145 were immersed in 2 ml of coffee during 1591 (LED) curing unit (Flash Light 1401 Discus 146 minutes/10 days. After this period, the92 Dental, CA, USA) with 600 mW/cm2 for 40 147 samples were washed in running water and93 seconds, and stored in distilled water for 24h 148 in a sonic tub (Marconi, Piracicaba, SP,94 at 37 ˚C 149 Brazil) during 15 minutes. In the end of ©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 3 JULY - SEPTEMBER 2011 17
  3. 3. ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(3):16-17150 exposure time, new color readings were 191 comparison with control. The composites151 made (L2). 192 doesn’t presented statistical difference152 The obtained results for 193 between themselves only for control.153 roughness and color variation were Polishing System154 tabulated, and the homogeneity was verified Resin155 by Shapiro-Wilk tests. After observation of Control Jiffy SofLex156 these parameters, a two-way Analysis of 4,72157 Variance was performed for roughness. To 4 2,76 3,35 (1,12)B158 color variation a two-way Analysis of Seasons (0,91)Aa (1,02)Aa a159 Variance of repeated-measures was 5,47160 performed. When the difference was 2,5 4,63 (1,34)C161 statistically significant (p<0.05), the Tukey Z250 (0,87)Aa (1,23)Bb b162 test was used for comparison between Table 3: ΔE Means (standard deviation).163 means. The statistical analysis was carried Mean values followed by distinct letters164 out by SAS 9.2 (SAS Institute, Cary, NC, (uppercase in horizontal rows and lowercase165 USA). in vertical columns) show statistical166 Results differences among the groups according to167 The analysis of variance showed the Tukey test(p<0.05)168 the interaction between the variables 194 Discussion169 “composite resins” and “polishing systems” 195 Studies have shown that tooth color170 (p=0.017). Means from roughness and 196 differences showing Δ E > 1 can be171 standard deviations as well as results of 197 visually detectable, judging Δ E > 3.3 the172 Tukey test are presented in Table 2. There 198 critical value for clinical acceptability of a173 was a significant roughness increasing for 199 restoration.(9) Moreover,174 all resins after any type of polishing. 200 any color difference175 However the resins polished with SofLex 201 (ΔE=0) indicates a material with full color176 System presented higher roughness values. 202 stability or not stained by pigments.(11)177 The composites presented statistical 203 The use of nanotechnology induces the178 difference between themselves only when 204 resin composite manufacturers to develop179 were polished with SofLex. 205 this type of composites, such as 4 Seasons, Polishing System 206 both for anterior and posterior tooth Resin 207 restoration. The resin composites with nano- Control Jiffy SofLex 208 size particles in its composition are new 4 209 materials that improve their surface Season 0,15 0,30 0,41 210 polishing due to their reduced size filler s (0,03)Aa (0,09)Ba (0,12)Ca 211 particles19. This fact allows the combination 0,17 0,35 0,62 212 of good mechanical properties and Z250 (0,05)Aa (0,11)Ba (0,19)Cb 213 polishing.(12, 13) However, according to Table 2: Means Roughness - Ra pattern 214 some studies, it was observed in this study (standard deviation). Mean values followed 215 that groups not subjected to any polishing by distinct letters (uppercase in horizontal 216 procedure had lower values of surface rows and lowercase in vertical columns) 217 roughness and staining.(2, 14) show statistical differences among the 218 The chemical composition of resin groups according to the Tukey test (p<0.05). 219 composites may interfere in the polishing180 The analysis of variance showed 220 quality. Z250 presented higher roughness181 the interaction between the variables 221 compared to 4 Seasons. This composite182 “composite resins” and “polishing systems” 222 contains Bis-EMA, and reduced amount of183 (p<0,001). Means from color variation and 223 TEGDMA, and these characteristics184 standard deviations as well as results of two- 224 promote better resistance of the polymer185 way ANOVA with repetition are presented 225 network in addition to the filler particle size,186 in Table 3. There was a significant color 226 that is higher than the glass fillers presented187 alteration for 4 Seasons composite only 227 in the 4 Seasons composite composition and188 when the polishing with SofLex was 228 consequently higher microhardness. Thus,189 performed. To Z250 composite, all types of 229 the Z250 resin composite becomes less190 polishing presented higher ΔE values in ©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 3 JULY - SEPTEMBER 2011 18
  4. 4. ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(3):16-17230 susceptible to polishing procedures in 285 shown a high capacity of staining anterior231 comparison with nanofilled resins.(15) 286 composite resins and natural teeth.(9)232 The effectiveness of surface 287 A positive correlation was observed233 finishing and polishing procedures is of 288 between surface roughnesses and staining.234 fundamental importance for any 289 The specimens showed greater color235 restoration.(16) These procedures are 290 variation according to the largest surface236 commonly required after placement of direct 291 roughness obtained, so the groups polished237 composite resin restorations since they 292 with Jiffy system showed lower roughness238 minimize the retention of plaque and stains 293 values and color variation in comparison239 and other problems resulting from the 294 with Sof-Lex groups. Lower staining for240 exposure of rough surfaces to the oral 295 control groups was also observed, which241 environment.(17) Smoother composite 296 was cured under polyester matrix and had242 surfaces are obtained when the material was 297 lower roughness values.243 cured against a polyester matrix.(18) Even if 298 Conclusion244 care is taken in the placement of the matrix 299 Under the conditions of this in vitro245 removal of the excess material and 300 study, it may be concluded that: (1) when246 recontouring of restorations are frequently 301 any polishing procedure was realized, the247 necessary. However, as observed in this 302 resin composites presented greater surface248 study, these procedures significantly 303 smoothness and lower staining, (2) the249 increase surface roughness.(17) Thus, a 304 silicon polishing system presented lower250 large number of polishing techniques is 305 roughness values and coffee staining.251 available for composites.(19) 306 Authors Affiliations: 1.Carlos Eduardo dos252 The polishing methods tested had 307 Santos Bertoldo, 2. Diogo Azevedo253 different effects on the surface of the 308 Miranda, 3. Eduardo José Souza-Junior, 4.254 composites. The lowest Ra was observed 309 Flávio Henrique Baggio Aguiar, 5. Débora255 after polishing with the Jiffy system for both 310 Alves Nunes Leite Lima, 6. José Roberto256 composites. The present results showed a 311 Lovadino, Piracicaba Dental School, State257 significant change on composites’ surfaces 312 University of Campinas, Department of258 according to the polishing system used. This 313 Restorative Dentistry, Paulo, Brazil.259 findings are in agreement with those 314 References260 reported in previous studies.(20, 21) 315 1. Ritter AV. Posterior Resin Based Composite261 A similar study reported that the 316 Restorations: Clinical Recommendations for262 polishing approach for Z250 composite resin 317 Optimal Success. Journal of Esthetic and263 with micro-polisher disks (PoGo), a similar 318 Restorative Dentistry. 2001;13(2):88-99.264 method to Jiffy System used in our article, 319 2. Scheibe KGBA, Almeida KGB, Medeiros 320 IS, Costa JF, Alves CMC. Effect of different265 (0.51 ±0 .15) resulted in lower surface 321 polishing systems on the surface roughness266 roughness than the use of aluminum oxide 322 of microhybrid composites. Journal of267 (Sof-Lex) (1.12 ± 0.27) and rubber polishing 323 Applied Oral Science. 2009;17(1):21-6.268 disks (Identoflex) (1.53 ± 1.70). In addition, 324 3. Hickel R, Manhart J. Longevity of269 no significant difference in surface 325 restorations in posterior teeth and reasons270 roughness was found between unfinished 326 for failure. The Journal of Adhesive271 materials (polyester matrix surface).(22) 327 Dentistry. 2001;3(1):45-64.272 This study agrees with our findings. 328 4. Jefferies SR. The art and science of abrasive273 Color change can be assessed both 329 finishing and polishing in restorative 330 dentistry. Dental Clinics of North America.274 visually and by specific instruments.(21) 331 1998;42(4):613-27.275 The methodology used in this study is in 332 5. Roeder L, Tate W, Powers J. Effect of276 accordance with previous studies that used 333 finishing and polishing procedures on the277 spectrophotometry and the CIE L*a*b* 334 surface roughness of packable composites.278 coordinates system.(16) The CIE L*a*b* 335 Operative Dentistry. 2000;25(6):534-43.279 system was chosen to evaluate color 336 6. Reis AF, Giannini M, Lovadino JR,280 variation (ΔE) because it is well suited for 337 Ambrosano GM. Effects of various finishing281 small color changes determination and have 338 systems on the surface roughness and282 advantages such as repeatability, sensitivity 339 staining susceptibility of packable composite 340 resins. Dental Materials. 2003;19(1):12-8.283 and objectivity. Coffee was chosen as a 341 7. Reis A, Giannini M, Lovadino J, dos Santos284 staining solution in this study because it has 342 DCT. The effect of six polishing systems on 343 the surface roughness of two packable resin- ©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 3 JULY - SEPTEMBER 2011 19
  5. 5. ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(3):16-17344 based composites. American journal of 383 16. Fontes ST, Fernández MR, Moura CM,345 dentistry. 2002;15(3):193-6. 384 Meireles SS. Color stability of a nanofill346 8. Ryba T, Dunn W, Murchison D. Surface 385 composite: effect of different immersion347 roughness of various packable composites. 386 media. Journal of Applied Oral Science.348 Operative Dentistry. 2002;27(3):243-7. 387 2009;17(5):388-91.349 9. Mundim FM, Garcia LFR, Pires-de-Souza 388 17. Moraes RR, Sinhoreti MAC, Correr-350 FCP. Effect of staining solutions and 389 Sobrinho L, Ogliari FA, Piva E, Petzhold351 repolishing on color stability of direct 390 CL. Preparation and evaluation of dental352 composites. Journal of Applied Oral 391 resin luting agents with increasing content of353 Science. 2010;18(3):249-54. 392 bisphenol-A ethoxylated dimethacrylate.354 10. Neme A, Frazier K, Roeder L, Debner T. 393 Journal of biomaterials applications.355 Effect of prophylactic polishing protocols on 394 2010;24(5):453-73.356 the surface roughness of esthetic restorative 395 18. Jung M. Finishing and polishing of a hybrid357 materials. Operative Dentistry. 396 composite and a heat-pressed glass ceramic.358 2002;27(1):50-8. 397 Operative dentistry. 2002;27(2):175.359 11. Mitra SB, Wu D, Holmes BN. An 398 19. Jung M, Hornung K, Klimek J. Polishing360 application of nanotechnology in advanced 399 occlusal surfaces of direct Class II361 dental materials. The Journal of the 400 composite restorations in vivo. Operative362 American Dental Association. 401 dentistry. 2005;30(2):139.363 2003;134(10):1382. 402 20. Lu H, Roeder LB, Powers JM. Effect of364 12. Asaka Y, Miyazaki M, Aboshi H, Yoshida 403 polishing systems on the surface roughness365 T, Takamizawa T, Kurokawa H, et al. EDX 404 of microhybrid composites. Journal of366 fluorescence analysis and SEM observations 405 Esthetic and Restorative Dentistry.367 of resin composites. Journal of oral science. 406 2003;15(5):297-304.368 2004;46(3):143. 407 21. Yap A, Tan K, Bhole S. Comparison of369 13. Attar N, Tam LE, McComb D. Flow, 408 aesthetic properties of tooth-colored370 strength, stiffness and radiopacity of 409 restorative materials. Operative Dentistry.371 flowable resin composites. Journal of 410 1997;22(4):167-72.372 Canadian Dental Association. 411 22. St-Georges A, Bolla M, Fortin D, Muller-373 2003;69(8):516-21. 412 Bolla M, Thompson J, Stamatiades P.374 14. Fraga R, Luca‐Fraga L, Pimenta L. Physical 413 Surface finish produced on three resin375 properties of resinous cements: an in vitro 414 composites by new polishing systems.376 study. Journal of oral 415 Operative dentistry. 2005;30 (5):593.377 rehabilitation.2000;27(12):1064-7. 416 Address for Correspondence378 15. Özgünaltay G, Yazici A, Görücü J. Effect of 417 Eduardo José Souza-Junior379 finishing and polishing procedures on the 418 Av. Limeira, 901, Areião.380 surface roughness of new tooth‐coloured 419 Zip-code: 13.414-903, Piracicaba,381 restoratives. Journal of oral rehabilitation. 420 São Paulo, Brazil382 2003;30(2):218-24. 421 Ph: +55 11 8163 5558 422 E-mail: Source of Support: Nil, Conflict of Interest: None Declared ©INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 3 JULY - SEPTEMBER 2011 20