An in vitro screening assay for dental stain cleaning

In Vitro Model to Evaluate the Development of Discolorations on Human Enamel Caused by Treatment with Mouth Rinses and Black Tea Considering Brushing

OBJECTIVES

 The study aimed to develop and test an in vitro model to investigate the staining potential of mouth rinses on human enamel, considering alternating intake of black tea and tooth brushing, thus mimicking the situation in the oral cavity more realistically.

MATERIALS AND METHODS

 Eight mouth rinses with six different active ingredients (benzydamine hydrochloride [BNZ], polyhexamethylene biguanide hydrochloride [PHMB], chlorhexidine digluconate [CHX], hexetidine gluconate [HEX], octenidine dihydrochloride [OCT] and octenidine dihydrochloride + 2-phenoxyethanol [OCTP]) and concentrations were tested. Sets of six halved human molar crowns were initially pretreated by soaking in artificial saliva (30 min). Afterward, the cyclic treatment was started by soaking in artificial saliva (2 min), staining with black tea (1 min), brushing with toothpaste (5 s), and soaking in the mouth rinse (30 s). Samples were rinsed with distilled water after each treatment step. The cyclic treatment was repeated 30 times, mimicking the consumer behavior after 15 days. Photographic images were taken after 0, 10, 20, and 30 cycles. Color measurements were conducted after each staining and brushing step using a VITA-Easyshade spectrophotometer to determine the difference in lightness ∆L and the total color difference ∆E.

STATISTICAL ANALYSIS

 Analysis of variance and post-hoc Tukey test (α = 0.05) were applied.

RESULTS

 The new testing model with included brushing sequences allowed to assess the staining behavior on human teeth and provided a clear differentiation between the different investigated products. In detail, up to cycle 10, ΔE values increased for all mouth rinses with each additional cycle number. However, while ΔE values continued to increase for 0.15% BNZ, 0.1% PHMB, and 0.2% CHX between treatment cycle 10 and 30, ΔE values only slightly increased after treatment with 0.08% OCTP, 0.1% OCTP, 0.1% OCT, and 0.1% HEX. After 20 and 30 cycles, significantly less staining was found for 0.08% OCTP, 0.1% OCT, 0.1% HEX as compared to 0.2% CHX, 0.15% BNZ, and 0.1% PHMB (p < 0.05). ΔE-values were significantly lower after treatment with 0.1% OCTP as compared to 0.2% CHX1 and 0.2% CHX2 (p < 0.05).

CONCLUSION

 The proposed new methodology was found to be appropriate for assessing the staining progression of mouth rinses over a simulated application period of 15 days. The model allows differentiation of products with different active ingredients and concentrations.

Evaluation of the efficacy of a charcoal-based tooth whitening dentifrice on coffee stains: an in vitro study

Background

Charcoal-based preparations have recently gained popularity, particularly in oral hygiene products such as tooth whitening dentifrices, owing to their abrasive and adsorptive properties. The present in vitro study evaluates the efficacy of a charcoal-based tooth whitening dentifrice compared with a non-charcoal-based whitening dentifrice in removing coffee stains on tooth surfaces.

Methods

Thirty-three human extracted tooth specimens were randomly assigned to 1 of 3 study groups: Group 1 (charcoal-based whitening dentifrice [CBWD]), Group 2 (non-charcoal-based whitening dentifrice [NCBWD]), and Group 3 (distilled water [DW]). All tooth specimens were immersed in a prepared coffee extract for 4 weeks to facilitate staining and then mounted on blocks where they were brushed with an electric toothbrush daily for 8 seconds with 1 of the 2 allocated dentifrices or with DW for 4 weeks following staining. Spectrophotometric analysis was conducted using the CIELAB system to measure the L*, a*, and b* values at 3 time points: before staining, after staining, and following the brushing protocol. These values were used to calculate the colour change (ΔE) between time points.

Results

Following the coffee staining, the tooth samples' whiteness (ΔL) decreased with the overall colour change (ΔE). Next, there was a significant improvement in the degree of tooth whiteness (ΔL) values following the brushing protocol in all 3 groups (p = 0.003), with the greatest improvement occurring in the CBWD group. However, the overall colour change (ΔE) was not significantly different between the groups.

Conclusion

CBWD, NCBWD, and DW were effective in removing coffee stains from the tooth surface. However, the amount of colour change (ΔE) produced by CBWD was not significantly different from NCBWD or DW.

Influence of the Amount of Toothpaste on Cleaning Efficacy: An In Vitro Study

OBJECTIVES

 The aim of this in vitro study was to test the influence of the amount of toothpaste on enamel cleaning efficacy.

MATERIALS AND METHODS

 The hydrated silica-based test toothpaste (radioactive dentin abrasion: 60.19 ± 1.35) contained all ingredients of a regular fluoride toothpaste. The cleaning efficacy of four different toothpaste amounts (1.00 g, 0.50 g [both "full length of brush"], 0.25 g ["pea-size"], and 0.125 g ["grain of rice-size"]) diluted in 1.00 mL water were each tested for different brushing times (10, 30, 60, 120, 180, and 300 seconds) using a standardized staining model on human molars with a brushing machine. Photographic documentation and colorimetric measurements were conducted, respectively, initially, after staining and after each brushing step. Colorimetric measurements were used to calculate the stain removal (in %).

STATISTICAL ANALYSIS

 Results were analyzed by one-way analysis of variance with post hoc Tukey test and Levene's test for analysis of homogeneity of variance. The level of significance α was set at ≤ 0.05.

RESULTS

 The cleaning efficacy decreased significantly when using smaller toothpaste amounts. Stain removal after 120 seconds brushing time was: 77.4 ± 5.0% (1.00 g toothpaste), 75.7 ± 3.4% (0.50 g toothpaste), 54.1 ± 6.7% (0.25 g toothpaste), and 48.2 ± 7.1% (0.125 g toothpaste), respectively.

CONCLUSION

 In this in vitro study the cleaning efficacy of a medium-abrasive, hydrated silica-based toothpaste was analyzed. Note that 1.00 g toothpaste showed for all brushing times a significantly higher cleaning efficacy than 0.25 g toothpaste and 0.125 g toothpaste.

Composite surface roughness and color change following airflow usage

Background

Esthetic dental restorations have gained increasing popularity. The surface of restorations should be smooth enough to achieve maximum esthetics and prevent the adhesion of microorganisms and food particles. This study aimed to assess the surface roughness and color change of composite specimens following airflow usage.

Methods

In this in vitro, experimental study, 30 Tokuyama composite discs were fabricated and randomly divided into three groups (n = 10) for the use of airflow with calcium carbonate/bicarbonate powder and conventional polishing with FlexiDisc. The surface roughness of the specimens was measured by profilometry while the color change was assessed by measuring the L*, a* and b* color parameters using spectrophotometry before polishing (T1). The composite specimens were then polished for stain removal, and their surface roughness as well as color parameters were remeasured after polishing (T2). Paired t-test and Tukey’s test were applied for within-group and between-group comparisons.

Results

Significant differences were noted in roughness average (Ra) between airflow with calcium carbonate (0.251 ± 0.014 μm) and airflow with sodium bicarbonate (0.421 ± 0.208 μm), and between airflow with sodium bicarbonate and FlexiDisc (0.207 ± 0.076 μm) groups after polishing (P < 0.05). Regarding the correlation of change in surface roughness and color parameters at T1 and T2, an inverse correlation was noted between the change in surface roughness and all color parameters except for L*. In other words, reduction in surface roughness decreased the a* and b* color parameters.

Conclusions

Within the limitations of this study, the results showed that the airflow device used in this study had no significant difference with conventional polishing in terms of reduction in surface roughness and staining. Considering the cost and maintenance of the airflow device, it is not suggested as a suitable alternative to the conventional polishing procedures.

Trial Registration Number: This study does not involve human subjects.

Tangerine mediated synthesis of zirconia as potential protective dental coatings

Demand of bioactive materials that may create a bacteria-free environment while healing and regenerating the defect area is increasing day by day. Zirconia is a very interesting material because of its biocompatibility and high fracture toughness. In this research work, zirconia nanoparticles (NPs) have been synthesized using sol-gel method. Molarity of sols is varied in the range of 25 to 125 mM. The effect of acidic and basic nature of sols is studied by maintaining acidic (2) and basic (9) pH. As-synthesized NPs are made soluble in deionized (DI) water using tangerine drops. Dissolved NPs are spin coated onto glass substrate prior to characterization. Pure tetragonal phase, observed under all conditions using basic medium (pH 9), is accompanied by smaller crystallite size and unit cell volume. Presence of stabilized zirconia phase leads to higher value of density and higher mechanical strength. Nanodendrites with distinct features are observed for the sample prepared with high molarity using basic medium. Whereas, soft agglomerated nanodendrites are observed using acidic medium. Optical properties show transmission of 60-80% in the visible and infrared regions for acidic based samples and ~84% for basic samples. Direct energy band gap is varied from 4.96 eV to 5.1 eV in acidic (pH 2) and 4.91 eV to 4.97 eV in basic (pH 9) media. FTIR spectra show the formation of fundamental tetragonal band at 490 cm^-1 for basic samples. Antibacterial response of zirconia is tested against E. coli, Streptococcus and Bacillus bacteria. Human teeth, bare and zirconia coated, are tested for their possible weight loss after dipping in various beverages. Zirconia coated tooth shows negligible degradation in hardness and weight after 24 hr dipping period. Thus, coatings prepared using water soluble zirconia (WSZ) nanoparticles, without the use of toxic solvents/reagents, are promising material to be used as protective coatings in biomedical applications.

The effect of standoff distance and surface roughness on biofilm disruption using cavitation

Effective biofilm removal from surfaces in the mouth is a clinical challenge. Cavitation bubbles generated around a dental ultrasonic scaler are being investigated as a method to remove biofilms effectively. It is not known how parameters such as surface roughness and instrument distance from biofilm affect the removal. We grew Strepotococcus sanguinis biofilms on coverslips and titanium discs with varying surface roughness (between 0.02-3.15 μm). Experimental studies were carried out for the biofilm removal using high speed imaging and image analysis to calculate the area of biofilm removed at varying ultrasonic scaler standoff distances from the biofilm. We found that surface roughness up to 2 μm does not adversely affect biofilm removal but a surface roughness of 3 μm caused less biofilm removal. The standoff distance also has different effects depending on the surface roughness but overall a distance of 1 mm is just as effective as a distance of 0.5 mm. The results show significant biofilm removal due to an ultrasonic scaler tip operating for only 2s versus 15-60s in previous studies. The technique developed for high speed imaging and image analysis of biofilm removal can be used to investigate physical biofilm disruption from biomaterial surfaces in other fields.

Dental prophylaxis influence in tooth color assessment-Clinical study

OBJECTIVE

To evaluate dental prophylaxis influence in tooth color assessment with the use of different methods.

MATERIALS AND METHODS

Volunteers were consecutively recruited and screened according to appropriate inclusion/exclusion criteria. Each participant's upper right central incisive and canine color was measured before and after dental prophylaxis with a one-week interval. Tooth color assessment was performed by calibrated operators and the patient using a VITA Classical shade guide and by spectrophotometric methods with a proper device (SpectroShade). Color was reported as mean with SD of Commission Internationale De l'Eclairage (CIE) L*a*b* values, ΔE_ab and ΔE₀₀ . One-way analysis of variance and Tukey post hoc were performed to assess differences between methods and paired t test for assessing differences in tooth color coordinates after dental prophylaxis. Values of P < .05 were taken as significant.

RESULTS

Fifty patients were included. Self-assessed dental prophylaxis effects equated to a significantly different mean ΔE₀₀ value of 2.3 ± 1.7 (P < .01), when compared to the calibrated operator reported 0.8 ± 1.1 and the spectrophotometer 1.0 ± 0.5. Half of volunteer's ΔE₀₀ values surpassed the acceptability threshold, when compared to 28% from investigator and 10% from spectrophotometer.

CONCLUSION

Performing a dental prophylaxis did have an influence in tooth color perception with a higher self-perceived effect in the patient assessment.

CLINICAL SIGNIFICANCE

The results of this study suggest that performing professional dental prophylaxis presented a perceived effect in tooth color regardless of the method used being that patients precepted whiter and less yellowish teeth. Since extrinsic stain is considered as one of the factors that could influence tooth color assessment, performing professional dental prophylaxis prior to composite or ceramic color selection in anterior teeth restorations could consequently increase treatment predictability.

A swift, easy and cheap protocol to evaluate the tooth bleaching in vitro

Background

This study aims to develop a protocol that optimizes in vitro dental bleaching procedures in a cheap, fast and accessible manner.

Material and Methods

18 bovine incisors were cut and polished in enamel/dentin and submitted to staining in coffee solution during 72 hours. After the standardization and staining of the enamel surfaces, three groups (n = 6) were formed to receive three different gels, WHITENESS (commercial gel); H2O2 - 5% (manipulated gel); CARBOPOL GEL (manipulated gel and without H2O2). The color of the enamel surfaces was evaluated using digital images, obtained with digital camera and controlled luminosity, before and after staining, as well as after each bleaching step.

Results

The average bleaching after 48 hours of procedure was: WHITENESS with 13.6 (± 1.2); H2O2 (5%) with 9.8 (± 1.4) and CARBOPOL GEL with 2.9 (± 0.6). After 72 hours, WHITENESS presented a mean of 15.8 (± 0.7), the H2O2 group (5%) 14.4 (± 1.5) and CARBOPOL GEL 4.6 (± 1.0). After completing 96 hours of whitening, WHITENESS presented an average of 18.3 (± 0.8), H2O2 (5%) 16.7 (± 1.4) and CARBOPOL GEL 7.3 (± 0.8). Our data demonstrated that the protocol development for us can be used to evaluate dental bleaching in a short time, with 96 hours already was possible to detect significant differences, when compared with the longer times of experimental dental bleaching.

Conclusions

The proposed protocol guarantees statistically significant results in 96 hours, confirming the efficacy, cheapness, viability and practicality of the protocol developed in this study.

Key words:Enamel, color, aesthetics.