A influência da técnica do preparo cavitário utilizando laser Er: YAG e dos tipos de materiais restauradores na prevenção de cárie secundária

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

The influence of the cavity preparation technique and the types of restorative materials containing fluorides in the prevention of the secondary caries lesions was evaluated in this in vitro study. In a logic sequence the subject was approach by four manuscripts. The first study made a bibliographic revision about the laser employment in the prevention of the secondary caries lesions. The second and the third manuscripts, human dental enamel blocks were distributed into 2 groups for cavity preparations (1.6 mm Æ), performed with diamond burs or Er:YAG laser (LA - 6Hz, 300mJ) both refrigerated. Each group was divided into 3 sub-groups that were restored using a glass-ionomer cement (GI), a resin-modified glass-ionomer (RM), or a composite resin (CR). The blocks were thermocycled (5 - 55C 2C, 1000 cicles) and submitted to a pH challenge. In the second work the slabs were analyzed by visual examination by 3 calibrated examiners (Kappa>0.73) according to an ordinal scale ranked (0- 3). The results were analyzed by the Kruskal-Wallis test and the Dunn test (=0.05). Non cariostatic effect in the cavities performed with diamond burs and restored with composite resin was observed. No differences in the cariostatic effect of the cavities restored with the same material and prepared with diamond burs or Er:YAG laser was observed. However, cavities prepared with Er:YAG laser showed less caries lesions formation than cavity preparation with diamond burs. In the third study the blocks were analyzed by the microhardness test (Knoop) in a distance of 100μm from the cavity walls. The average of 4 indentations was used in the ANOVA followed by Tukeys test. The development of caries lesion around lased cavity preparation were lesser than the cavities prepared with diamond burs, however, no synergistic cariostatic effect was observed between Er:YAG laser and glass ionomer cement. In the fourth study the correlation of in vitro artificial secondary caries diagnosis on enamel between visual evaluation and superficial microhardness test (Knoop) was verified by Spearmans rho nonparametric correlation that showed a statistical significant weak negative agreement between the response variables. Based in the manuscripts presented it was observed that the Er:YAG laser provide cariostatic effect around the cavities preparation, which was more evidenced with the microhardness analysis. The GI presented more cariostatic effect than RM and no cariostatic effect was observed in CR despite the cavity preparation technique.

ASSUNTO(S)

fluoretos laser microhardness compósitos resinosos dental enamel cariostatic agents laser flúor microdureza esmalte dental fluoride dental caries cimento de ionômero de vidro odontologia glass-ionomer cement composite resin cárie dental

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