A novel bioactive glass-ceramic for treating dentin hypersensitivity

Efficacy of Biosilicate Glass-ceramic and Fluoride Varnish in the Treatment of Dentin Hypersensitivity-A Randomized Controlled Clinical Trial

OBJECTIVE

The objective of this study was to compare the efficacy of Biosilicate and Duraphat in the treatment of dentin hypersensitivity (DH).

METHODS AND MATERIALS

This clinical trial was conducted with young adults presenting DH. A visual analogue scale (VAS) was used to assess the level of pain, using volatile and tactile tests. Forty participants presenting two teeth with DH were included, and these teeth were divided into two groups according to the treatment: Biosilicate or Duraphat. Each product was randomly applied on one tooth per participant once a week for 4 weeks and evaluated every 15 days for 60 days after the last application.

RESULTS

The mean and standard deviation (SD) of VAS values for the initial volatile sensitivity evaluation were 6.18 (1.99) and 6.08 (1.98) for the Biosilicate and Duraphat groups, respectively, and at the fourth week 0.48 (1.5) and 0.83 (1.58). After 60 days, the volatile sensitivity showed the following values: 0.63 (1.19) for Biosilicate and 1.03 (1.07) for Duraphat. The intragroup comparison showed a significant reduction of mean VAS values for DH-related pain assessed by volatile testing for both groups (p<0.001), and the assessment at the 60-day follow-up showed mean values statistically similar to those obtained at the end of treatment. Initial tactile sensitivity observed was 1.48 (2.39) for the Biosilicate and 1.4 (2.2) for the Duraphat group and at the 60-day follow-up 0.23 (0.73) and 0.15 (0.36), respectively, with significant statistical difference (p<0.002). When the reduction in tactile and volatile sensitivities between both groups was compared, no statistically significant difference was observed.

CONCLUSION

This study indicated that both products were able to promote an important reduction in dentin hypersensitivity with similar results within a 60-day follow-up.

Efficacy of a novel dentifrice containing bioactive glass-ceramic for dentinal hypersensitivity: A double-blind randomized controlled trial in Chinese adults

OBJECTIVE

To assess the efficacy and safety of a toothpaste containing 7.5 % HX-BGC in combating dentinal hypersensitivity.

METHODS

A single-center, randomized, double-blind, three-group parallel-controlled design was employed, with Schiff Index and Yeaple Index as measurement indicators. The study evaluated the effectiveness of HX-BGC toothpaste, NovaMin toothpaste, and a negative control toothpaste without desensitizing agents. Eligible subjects underwent baseline examination after a 2-week washout period, and those meeting inclusion criteria and not meeting exclusion criteria entered the study. Participants were randomly assigned to use one of the three toothpastes. Follow-up examinations were conducted immediately after a single use and at 2, 4, and 6 weeks. Intra-group and inter-group comparisons were made for Schiff and Yeaple indices. Safety of the experimental toothpastes was assessed through participant feedbacks and oral soft tissue examinations.

RESULTS

Subjects in the three groups were balanced in terms of age and gender distribution, with no baseline differences in indicators. Immediately after a single application of toothpaste, Yeaple indices increased, and Schiff indices decreased, with no significant differences among the groups. After 2 weeks of continuous use, Yeaple indices increased in all groups, with significant differences observed between the HX-BGC group and the other two groups. Schiff indices decreased in all groups, with the NovaMin group showing significant differences compared to the negative control group. At weeks 4 and 6, both indices in the HX-BGC group and the NovaMin group were significantly better than those in the negative control group, with the HX-BGC group outperforming the NovaMin group in the Yeaple index. No serious adverse reactions related to the study products were observed or reported by any participants.

CLINICAL SIGNIFICANCE

This clinical trial confirmed the efficacy of HX-BGC in anti-dentinal hypersensitivity and supported the clinical application of the dentifrice containing HX-BGC.

CONCLUSION

Compared to the negative control group, both HX-BGC and NovaMin toothpaste groups demonstrated more significant effects in combating dentinal hypersensitivity. No adverse reactions related to the experimental toothpastes were observed.

Dentine tubule occlusion effect of hydrolyzed casein in a bioactive glass-based dental desensitizing gel

OBJECTIVES

The effectiveness of three different groups of polyethylene glycol (PEG)-based gels containing powders on dentin hypersensitivity (DH) treatment were assessed and compared with Actimins® as commercial reference group.

METHODS

Hydroxyapatite nanorods (nHA) and sol-gel-derived 45S5 bioglass (SGD 45S5) powders were synthesized through hydrothermal and sol-gel methods, respectively. First, 25 demineralized dentin disks were divided into five groups. Then, the prepared gels based on 45S5 bioglass with and without hydrolyzed casein (HC) as experimental, nHA gel and Actimins® as positive and commercial reference groups were applied twice a day on disks by a micro applicator. To mimic the oral environment, treated disks were immersed in artificial saliva in a water bath at 37 °C for 7 days. However, in the negative control group, no agent was applied on the samples. FE-SEM, EDS, AFM, and XRD were performed to assess tubule occlusion. One-way ANOVA test was used for statistical analysis and p*<0.05 was set as the significance level.

RESULTS

The nHA with an average aspect ratio of 2.77 and the SGD 45S5 powders with a polygonal morphology and the average size of 48.64±11.38 µm were synthesized. After treatment, tubule occlusion in HC-SGD 45S5 and nHA gels were shown to be higher than other groups. The root mean square roughness (Rrms) of the above-mentioned gels showed to be 121.54±9.25 nm, and 312.6 ± 9 nm, respectively.

CONCLUSION

The nHA containing group exhibited the highest tubule occlusion efficiency (i.e., tubule diameter of 0.92±0.32 µm) with a superior mineral precipitation. HC as a novel material demonstrates to be potentially beneficial in DH treatment.

CLINICAL SIGNIFICANCE

DH as a common issue may be reduced or eliminated by occlusion of patent dentinal tubules. There are various types of desensitizing agents capable of controlling the DH by the occlusion of patent dentinal tubules. The desensitizing gels developed in this study showed to be promising for clinical and home-use applications.

Incorporation of bioactive glass-ceramic into coconut oil for remineralization of incipient carious lesions

This study evaluated the efficacy of incorporating different concentrations of bioactive glass-ceramic (Biosilicate) into coconut oil on the remineralizing potential and surface roughness of white spot lesions. Fragments (6 x 6 x 2mm) of bovine teeth were sectioned and initial microhardness (KHN) and surface roughness (Ra) readings were obtained. The samples were submitted to cariogenic challenge to form white spot lesions and were separated into six groups (n=13): 1) Artificial Saliva (AS); 2) Coconut Oil (CO); 3) CO+2% Biosilicate (CO+2%Bio); 4) CO+5% Biosilicate (CO+5%Bio); 5) 2% Biosilicate Suspension (2% Bio) and 6) 5% Biosilicate Suspension (5% Bio). The treatments for 1 cycle/day were: immersion into the treatments for 5 minutes, rinsing in distilled water, and storage in artificial saliva at 37ºC. After 14 days, KHN and Ra readings were taken. The surface roughness alteration ((Ra) was analyzed (Kruskal-Wallis, Dunn's post-test, p<0.05). CO+2%Bio had higher (p = 0.0013) (Ra followed by CO+5%Bio (p = 0.0244) than AS. The relative KHN and remineralization potential were analyzed (ANOVA, Tukey, p<0.05), and 5% Bio treatment presented a higher relative microhardness than all other groups (p>0.05). The remineralizing potential of all the treatments was similar (p > .05). When Biosilicate was added, the pH of the suspensions increased and the alkaline pH remained during the analysis. Biosilicate suspension is more efficient than the incorporation of particles into coconut oil at white spot lesion treatment. In addition to the benefits that coconut oil and Biosilicate present separately, their association can enhance the remineralizing potential of Biosilicate.

Effect of limonene associated with bioactive glass-ceramic on dentin/adhesive interface

This study evaluated the effect of pretreatment with limonene and/or biosilicate on the bond strength of a universal adhesive system in self-etch mode to dentin. Occlusal cavities were prepared in 80 human molars and the teeth were randomly allocated to one of four groups (n = 20), according to the pretreatment regimens applied before the adhesive. The pretreatments were (i) Control, no pretreatment, (ii) LIM, 0.5% limonene; (iii) Bio, 10% biosilicate; and (iv) LIMBio, LIM + Bio. After adhesive application and restoration, the specimens were sectioned into sticks, separated, and stored in distilled water at 37°C for 24 h or 6 months. Microtensile bond strength test was carried out and measurements were compared across pretreatment groups and storage times. Fracture patterns and adhesive interfaces were observed. Loss of dry mass was calculated (n = 10). There was no statistically significant difference in the bond strength between the groups and the most prevalent fracture pattern was the non-adhesive. LIM and LIMBio resulted in more open dentinal tubules. LIM and Bio, whether separate or combined, showed particles of those substances, which decreased in size and number after 6 months. All groups lost mass weight after treatment, with no statistically significant differences between them. Limonene and biosilicate pretreatment did not affect the bond strength to dentin of the universal adhesive system, but resulted in more non-adhesive fractures, even after 6 months.

Using Antimicrobial Photodynamic Therapy with Ultrasound Devices and Bioactive Glasses as a Combined Approach for Treating Dentin Caries Lesions

Novel approaches for caries lesion removal and treatment have been proposed. This study evaluates the combined use of an experimental ultrasound, aPDT (antimicrobial photodynamic therapy) and bioactive glasses on the removal, decontamination and remineralization of dentin caries lesions. A biological model created with a duo species biofilm (Streptococcus mutans and Lactobacillus acidophilus) was used for the development of a caries-like lesion over the dentin for 7 days. Bovine dentin specimens (4 × 4 × 2 mm) were randomized according to the following caries removal techniques: bur (BUR) or ultrasound (ULT), decontamination (with or without aPDT) and remineralization materials (45S5 or F18 bioactive glasses). The following different groups were investigated: caries lesion (control); sound dentin (control); BUR; BUR + aPDT; ULT; ULT + aPDT; BUR + 45S5, BUR + F18; ULT + 45S5; ULT + F18; BUR + aPDT + 45S5; BUR + aPDT + F18; ULT + aPDT + 45S5; and ULT + aPDT + F18. Transverse microradiography (TMR), cross-sectional microhardness (CSH), FT-Raman spectroscopy and confocal microscopy (CLSM) were performed. A two-way ANOVA and Tukey's test were used (α = 0.05). (3) Results: The TMR revealed a lesion depth of 213.9 ± 49.5 μm and a mineral loss of 4929.3% vol.μm. The CSH increases as a function of depth, regardless of the group (p < 0.05). Removal with BUR (24.40-63.03 KHN) has a greater CSH than ULT (20.01-47.53 KHN; p < 0.05). aPDT did not affect the CSH (p > 0.05). No difference was observed between 45S5 or F18 (p > 0.05), but a change was observed for ULT (p > 0.05). The FT-Raman shows no differences for the phosphate (p > 0.05), but a difference is observed for the carbonate and C-H bonds. The CLSM images show that aPDT effectively inactivates residual bacteria. A combination of ULT, aPDT and bioactive glasses can be a promising minimally invasive treatment.

Enhanced effect of a novel bioactive glass-ceramic for dental application

OBJECTIVES

Dental caries is the most common chronic disease in humans, caused by the acid produced by the microflora in the mouth that dissolves the enamel minerals. Bioactive glass (BAG) has been used in various clinical applications due to its unique bioactive properties, such as bone graft substitutes and dental restorative composites. In this study, we introduce a novel bioactive glass-ceramic (NBGC) prepared through a sol-gel process under a water-free condition.

MATERIALS AND METHODS

The anti-demineralization and remineralization effects of NBGC were evaluated by comparing the measurements of bovine enamel surface morphology, surface roughness, surface micro-hardness, enamel elements, and mineral content before and after related treatments with a commercial BAG. The antibacterial effect was characterized by minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC).

RESULTS

Results showed that NBGC had greater acid resistance and remineralization potential compared to commercial BAG. The fast formation of a hydroxy carbonate apatite (HCA) layer suggests efficient bioactivity.

CLINICAL RELEVANCE

In addition to its antibacterial properties, NBGC shows promise as an ingredient in oral care products that can prevent demineralization and restore enamel.

In vitro dentin permeability and tubule occlusion of experimental in-office desensitizing materials

OBJECTIVES

This study investigates the dentin permeability (by hydraulic conductance) and tubule occlusion (by confocal and scanning electron microscopies) of in-office desensitizing materials.

MATERIALS AND METHODS

Bovine dentin blocks were immersed in EDTA to open dentinal tubules. Placebo varnish (PLA), fluoride varnish (FLU), NaF 5% + 5% nanoparticulate sodium trimetaphosphate varnish (TMP), universal adhesive system (SBU), S-PRG filler varnish (SPRG), Biosilicate (BIOS), and amelotin (AMTN) solution were the materials tested. After application, the specimens underwent an erosive-abrasive challenge. Dentin permeability was evaluated at T0 (initial), T1 (after treatment), and T2 (after challenge). Confocal and scanning electron microscopy (SEM) were used to evaluate, respectively, length and number of dentinal tubule occlusions and opened dentinal tubules, after challenge. Permeability and SEM data were analyzed by two-way repeated measures ANOVA and Tukey's tests. Confocal data were analyzed by one-way ANOVA, Tukey's test, and Kruskal-Wallis and Dunn's tests. Spearman and Pearson's correlation tests were also used. Significance level was set at 5%.

RESULTS

At T1, the AMTN group showed the lowest permeability value, following the increasing order at T2: AMTN = SBU < BIOS = SPRG < TMP < FLU < PLA. The SBU group had the highest value of occluded dentinal tubule length. The AMTN group presented more occluded dentinal tubules compared to PLA and FLU. AMTN and SBU had the lowest values of opened dentin tubules. Results showed a negative correlation between the analyses.

CONCLUSION

The SBU and AMTN solution were more effective in reducing dentin permeability by occluding dentin tubules.

CLINICAL RELEVANCE

All materials reduced permeability after challenge, except fluoride varnish.

Investigation of Multicomponent Fluoridated Borate Glasses through a Design of Mixtures Approach

Due to their enhanced dissolution, solubility and reaction speed, borate glasses offer potential advantages for the design and development of therapeutic ion-release systems. However, the field remains poorly understood relative to traditional phosphosilicate and silicate bioglasses. The increased structural complexity and relative lack of published data relating to borates, particularly borofluorates, also decreases the accuracy of artificial intelligence models, which are used to predict glass properties. To develop predictive models for borofluorate networks, this paper uses a design of mixtures approach for rapid screening of composition-property relationships, including the development of polynomial equations that comprehensively establish the predictive capabilities for glass transition, density, mass loss and fluoride release. A broad range of glass compositions, extending through the boron anomaly range, were investigated, with the inclusion of 45 to 95 mol% B₂O₃ along with 1-50 mol% MgO, CaO and Na₂O as well as 1-30% KF and NaF. This design space allows for the investigation of the impact of fluorine as well as mixed alkali-alkaline earth effects. Glass formation was found to extend past 30 mol% KF or NaF without a negative impact on glass degradation in contrast to the trends observed in phosphosilicates. The data demonstrates that fluoroborate materials offer an exceptional base for the development of fluoride-releasing materials.

Effect of 45S5 bioactive glass on the microshear bond strength of dental fluorosis

The aim of this in vitro study was to estimate the effect of the species concentration of 45S5 bioactive glass (BAG) used as pretreatment on the microshear bond strength (MSBS) of dental fluorosis (DF). Based on the Thylstrup and Fejerskov index, 80 teeth were randomly divided equally into four groups: TFI 0, sound dentin; TFI 1-3, mild fluorosis; TFI 4-5, moderate fluorosis; and TFI 6-9, severe fluorosis. Each group was randomized into five subgroups. After preparing the dentin hypersensitivity model of DF, the dentin was pretreated as follows, Subgroup 1: deionized water (Control group); Subgroup 2: 1% BAG; Subgroup 3: 5% BAG; Subgroup 4: 10% BAG, and Subgroup 5: 20% BAG. Stochastically one specimen was selected from each subgroup for scanning electron microscope and energy dispersive spectrometer analysis. After being made of resin-tooth bonding samples, the remains were in water bath at 37 °C for 24 hr. Subsequently, samples from each subgroup were randomly selected to test MSBS without aging, or after a thermocycle of 5,000 and 10,000 times, respectively. The fracture modes were analyzed. Compared with the group of 1% BAG and Control, the exposure area of tubules in 5%, 10%, and 20% BAG group had significant difference (p < .05). MSBS results indicated that there were significant differences between 10% BAG with other groups. The 20% BAG group showed the lowest MSBS among all groups. Pretreatment of 10% BAG solution may be conductive to enhance the bond strength of DF, while 20% BAG solution adversely.

Effect of bioactive glasses containing strontium and potassium on dentin permeability

Dentin hypersensitivity (DH) is characterized by pain caused by an external stimulus on exposed dentin. Different therapeutic approaches have been proposed to mitigate this problem; however, none of them provide permanent pain relief. In this study, we synthesized and characterized experimental bioactive glasses containing 3.07 mol% SrO or 3.36 mol% K₂ O (both equivalent to 5 wt% in the glass), and evaluated their effect on dentin permeability to verify their potential to treat DH. The experimental materials were characterized by field-emission scanning electron microscopy, Fourier transform infrared spectroscopy, micro-Raman spectroscopy, and X-ray diffraction to confirm the respective structures and chemical compositions. The reduction in the hydraulic conductance of dentin was evaluated at the three stages: minimum permeability; maximum permeability (24% ethylenediaminetetraacetic acid [EDTA] treatment); and final dentin permeability after treatment with the bioactive glasses. They all promoted a reduction in dentin permeability, with a significant difference for each sample and posttreatment group. Also, a significant reduction in dentin permeability was observed even after a simulated toothbrushing test, demonstrating effective action of these materials against DH. Besides, incorporating 3.07 mol% SrO was a positive factor. Therefore, strontium's desensitizing and re-mineralizing properties can be further exploited in bioactive glasses to promote a synergistic effect to treat DH.

Silica-Based Bioactive Glasses and Their Applications in Hard Tissue Regeneration: A Review

Regenerative medicine is a field that aims to influence and improvise the processes of tissue repair and restoration and to assist the body to heal and recover. In the field of hard tissue regeneration, bio-inert materials are being predominantly used, and there is a necessity to use bioactive materials that can help in better tissue-implant interactions and facilitate the healing and regeneration process. One such bioactive material that is being focused upon and studied extensively in the past few decades is bioactive glass (BG). The original bioactive glass (45S5) is composed of silicon dioxide, sodium dioxide, calcium oxide, and phosphorus pentoxide and is mainly referred to by its commercial name Bioglass. BG is mainly used for bone tissue regeneration due to its osteoconductivity and osteostimulation properties. The bioactivity of BG, however, is highly dependent on the compositional ratio of certain glass-forming system content. The manipulation of content ratio and the element compositional flexibility of BG-forming network developed other types of bioactive glasses with controllable chemical durability and chemical affinity with bone and bioactivity. This review article mainly discusses the basic information about silica-based bioactive glasses, including their composition, processing, and properties, as well as their medical applications such as in bone regeneration, as bone grafts, and as dental implant coatings.

Antibacterial silver-containing mesoporous bioglass as a dentin remineralization agent in a microorganism-challenged environment

OBJECTIVES

To provide a suitable material capable of treating dentin hypersensitivity with simultaneous active antibacterial activity.

METHODS

We developed silver-containing mesoporous bioglass (MBG-Ag) using the sol-gel technique, which loaded silver nanoparticles as promising bacteriostatic agents. The MBG-Ag with a powder-to-liquid ratio of 0.5 g: 0.01 mL were uniformly mixed with 20 %, 30 %, and 40 % phosphoric acid for 5, 10 and 20 min, respectively. Furthermore, we evaluated the occlusion efficiency, depth of penetration, and antibacterial activity of dentin specimens by simulating a Streptococcus mutans (S. mutans) infection on dentin. Scanning electron microscopy (SEM), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR) were used to characterize the powders and assess tubule occlusion. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the MBG-Ag against S. mutans were determined via time-killing curves and colony formation assays.

RESULTS

The MIC ranged from 2.5 to 5 mg/mL, and the MBC ranged from 5 to 10 mg/mL. The highest dentinal tubule occlusion efficiency was over 90 %. The colony formation assay confirmed that 5 mg/mL MBG-Ag mixed with phosphoric acid reached the bactericidal concentration.

CONCLUSION

The MBG-Ag 40PA achieved a good occlusion efficiency and deep apatite precipitation in a short time, implying its superiority in clinical applications.

CLINICAL RELEVANCE

The MBG-Ag formed in this study is a promising candidate for the treatment of demineralized dentin and confers antibacterial effects on the remineralized dentin surface against S. mutans.

The effects of 45S5 bioactive glass and Er:YAG Laser on the microtensile bond strength of fluorosed teeth

This vitro study aimed to evaluate the effects of 45S5 bioactive glass (BAG) and Er:YAG laser as desensitization treatments on the microtensile bond strength (MTBS) of fluorosed teeth. The 120 noncarious fluorosis were to obtain superficial dentin, being classified into four groups according to the Thylstrup and Fejerskov Index (TFI). Specimens from each group were randomly divided into five subgroups. After fluorosed teeth hypersensitivity models were established, the following pretreatments were applied on dentine surface: Subgroup 1: deionized water (Control); Subgroup 2: BAG; Subgroup 3: Er:YAG laser; Subgroup 4: BAG + Er:YAG laser, and Subgroup 5: Er:YAG laser + BAG. One sample was randomly selected from each subgroup for scanning electron microscope (SEM). The remaining samples were bonded with composite resin by Adper Single Bond 2 adhesive. Then water bath at 37°C for 24 hr. After 5,000 thermocycling, MTBS was tested and fracture mode was analyzed. The difference of MTBS between BAG group and Control group was found statistically significant (p < .05) in fluorosis. The Er:YAG laser + BAG group showed lowest MTBS values in fluorosis. In conclusion, the pretreatment of BAG might be beneficial to the adhesive of fluorosed teeth. Er:YAG laser desensitization alone or using BAG first and then Er:YAG laser desensitization might not affect the adhesive of fluorosed teeth, while Er:YAG laser desensitization followed by the pretreatment of BAG would be not conducive to the adhesive of fluorosed teeth.

Experimental gel containing bioactive glass-ceramic to minimize the pulp damage caused by dental bleaching in rats

Objectives

This study evaluated if the use of a bioactive glass-ceramic-based gel, named Biosilicate (BS), before, after or mixed with bleaching gel, could influence the inflammation of the dental pulp tissue of rats’ molars undergoing dental bleaching with hydrogen peroxide (H₂O₂).

Methodology

The upper molars of Wistar rats (Rattus norvegicus, albinus) were divided into Ble: bleached (35% H₂O₂, 30-min); Ble-BS: bleached and followed by BS-based gel application (20 min); BS-Ble: BS-based gel application and then bleaching; BS/7d-Ble: BS-based gel applications for 7 days and then bleaching; Ble+BS: blend of H₂O₂ with BS-based gel (1:1, 30-min); and control: placebo gel. After 2 and 30 days (n=10), the rats were euthanized for histological evaluation. The Kruskal-Wallis and Dunn statistical tests were performed (P<0.05).

Results

At 2 days, the Ble and Ble-BS groups had significant alterations in the pulp tissue, with an area of necrosis. The groups with the application of BS-based gel before H₂O₂ had moderate inflammation and partial disorganization in the occlusal third of the coronary pulp and were significantly different from the Ble in the middle and cervical thirds (P<0.05). The most favorable results were observed in the Ble+BS, which was similar to the control in all thirds of the coronary pulp (P>0.05). At 30 days, the pulp tissue was organized and the bleached groups presented tertiary dentin deposition. The Ble group had the highest deposition of tertiary dentin, followed by the Ble-BS, and both were different from control (P<0.05).

Conclusion

A single BS-based gel application beforehand or BS-based gel blended with a bleaching gel minimize the pulp damage induced by dental bleaching.

Effects of Bioactive Agents on Dentin Mineralization Kinetics After Dentin Bleaching

Objectives:

This study evaluated effects of Bioglass 45S5 (BG) and Biosilicate (BS) remineralization on the chemical composition and bond strength of control dentin (CD) and bleached dentin (BD) surfaces.

Methods and Materials:

Dentin bleaching treatment was performed using the walking bleaching technique with 0.01 g of sodium perborate and 0.5 mL of 3% hydrogen peroxide for 14 days. Remineralization treatment was carried out by rubbing a remineralization solution (0.015 g of BG or BS diluted in 1.35 mL of distilled water) on the etched dentin surface for 30 seconds. Micro-Raman spectroscopy (MRS) was used to quantitatively analyze the mineral matrix ratios of CD and BD (n=5) after remineralization treatment with BG and BS over 15 days of incubation in artificial saliva. The CD and BD discs (n=10) with and without remineralization treatment with BG and BS were restored using a two-step etch-and-rinse adhesive system (Optibond S, Kerr) and five layers of 1-mm-thick composite resin (Filtek Z250, 3M ESPE). The restored dentin discs were sectioned into nine bonded beams with cross-sectional areas of approximately 0.9 mm2 and tested for microtensile bond strength (μTBS). The dentin surface of one fractured beam per tooth was submitted to MRS to characterize the physicochemical composition (n=10) at the interface. The data were analyzed using one-way analysis of variance and the Tukey-Kramer post hoc test (p&lt;0.005).

Results:

MRS bioactive analyses revealed that both BG and BS promoted increased mineral matrix ratios in the CD and BD. Significantly higher μTBS values were found after CD treatment with BG (CD: 57 MPa±11; CD-BG: 78 MPa±15) and when BG and BS were applied to the BD (BD: 42 MPa±5; BD-BG: 71 MPa±14; BD-BS: 64 MPa±11) (p&lt;0.005). The MRS analysis of the fractured dentin beam showed that the remineralization treatment significantly increased the dentin relative mineral concentration and promoted the appearance of new interface peaks, indicating a chemical interaction (p&lt;0.005).

Conclusion:

Remineralization of BD is an effective therapy to restore damage caused by dentin bleaching and acid conditioning. This approach not only increases dentin mineral compounds but also improves dentin's ability to interact chemically with the adhesive system.

Bioactive Glass Applications in Dentistry

At present, researchers in the field of biomaterials are focusing on the oral hard and soft tissue engineering with bioactive ingredients by activating body immune cells or different proteins of the body. By doing this natural ground substance, tissue component and long-lasting tissues grow. One of the current biomaterials is known as bioactive glass (BAG). The bioactive properties make BAG applicable to several clinical applications involving the regeneration of hard tissues in medicine and dentistry. In dentistry, its uses include dental restorative materials, mineralizing agents, as a coating material for dental implants, pulp capping, root canal treatment, and air-abrasion, and in medicine it has its applications from orthopedics to soft-tissue restoration. This review aims to provide an overview of promising and current uses of bioactive glasses in dentistry.

Analysis of the Degradation During Melt Processing of PLA/Biosilicate® Composites

Poly (lactic acid) (PLA)/bioactive composites are emerging as new biomaterials since it is possible to combine stiffness, mechanical resistance, and bioactive character of the bioglasses with conformability and bioabsorption of the PLA. In this study, PLA/Biosilicate® composites were prepared using a melt-processing route. The processability and properties were evaluated aiming to produce composites with bioactive properties. Two different PLA (PLA 2003D and PLA 4043D) were tested with the addition of 1 wt. % of Biosilicate®. Both materials presented a huge reduction in melt viscosity after internal mixer processing. The degradation effects of the addition of Biosilicate® in the PLAs matrices were evaluated using zeta potential tests that showed a very high liberation of ions, which catalyzes PLA thermo-oxidative reactions. To understand the extension of degradation effects during the processing, the composites were characterized using thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), gel permeation chromatography (GPC), and rheological tests. GPC results showed that PLA with the lowest residual acid content (RAC), PLA 2003D, presented higher thermal stability, higher molecular weight, and viscosity baseline compared to PLA 4043D. The composites showed a significant decrease in molecular weight for both PLA with the addition of Biosilicate®. TGA results showed that Biosilicate® might have reduced the activation energy to initiate thermodegradation reactions in PLAs and it occasioned a reduction in the Tonset by almost 40 °C. The DSC results showed that severe matrix degradation and the presence of bioglass did not significantly affect glass transition temperature (Tg), melting temperature (Tm) and crystallinity of PLAs, but it influenced cold crystallization peak (Tcc). In this way, the type of PLA used influences the processability of this material, which can make the production of filaments of this material for 3D printing unfeasible.

Effect of Methods of Biosilicate Microparticle Application on Dentin Adhesion

Restorative procedures associated with bioglasses have shown to be a strategy to satisfy the contemporary concept of minimally invasive dentistry. Thus, the aim of this study was to evaluate bond strength to dentin treated by two different methods of biosilicate microparticle application. Dentin surfaces from 30 sound human molars were exposed and randomly assigned into three groups (n = 10) according to the surface treatment: (1) blasting with biosilicate microparticles (distance = 1 cm/pressure = 5 bar/time = 1 min); (2) 10% biosilicate microparticles paste; and (3) control (no treatment). After, dentin surfaces were restored with self-etch adhesive (Adper Easy Bond) and nanofilled composite (Filtek Z350). Specimens were sectioned perpendicularly to the adhesive interface to obtain sticks (cross-section area = 1 mm²), which were submitted to microtensile test (0.5 mm/min; 50 kgf). Data were analyzed by ANOVA and Tukey's test (α = 5%). Dentin/adhesive interfaces were morphologically analyzed by scanning electron microscopy (SEM). Data analysis showed that biosilicate-treated groups reached similar results (p > 0.05) and both of them demonstrated higher values (p < 0.05) than control group. SEM micrographs revealed hybridization with clear resin tags and no separation between resin-dentin adhesive interfaces. Within the limitations of this study, surface treatment with biosilicate positively influenced the adhesion to dentin and does not alter the morphology of the adhesive interface.

Bioactive glass ceramic can improve the bond strength of sealant/enamel?

AIM

Evaluate the influence of enamel pre-treatment using Biosilicate, associated or not to other treatments; on the bond strength (BS) of pit-and-fissure sealant, with or without saliva contamination.

METHODS

Ninety slices (4 mm × 4 mm) were obtained from 30 bovine incisors. Each slice was embedded in acrylic resin with their buccal surface exposed and polished to obtain a flat enamel surface. Half of them were contaminated with human saliva. All specimens were randomly divided into five groups (n = 9) according to the surface pre-treatment tested: acid etching (AE); AE + Biosilicate (B); AE + B + total-etch adhesive (Ad); Biosilicate; control (no treatment). Then, a 1 mm layer of sealant (Clinpro XT Varnish, 3M ESPE) was applied; and to provide support, a composite resin (Opallis, FGM) block was built up over it. Samples were thermocycled (500 cycles/5-55 °C) and sectioned obtaining sticks (1 × 1 × 10 mm) for microtensile BS testing (0.5 mm/min). Data were analysed with two-way ANOVA, Bonferroni test, p < 0.05. Failure patterns were evaluated using a stereomicroscope.

RESULTS

There was no difference among contaminated and non-contaminated groups, and between non-contaminated groups (p > 0.05). When contaminated, AE + B + Ad Group showed the highest BS values, differing (p < 0.05) from B Group and Control; similar between them (p > 0.05). Cohesive fractures were found in AE + B + Ad Group, submitted or not to contamination.

CONCLUSIONS

Since a surface pre-treatment was used, whether Biosilicate was applied or not, the sealant/enamel BS was the same in saliva-contaminated or non-contaminated enamel.

Fabrication and Characterization of Scaffolds of Poly(ε-caprolactone)/Biosilicate® Biocomposites Prepared by Generative Manufacturing Process

Scaffolds of poly(ε-caprolactone) (PCL) and their biocomposites with 0, 1, 3, and 5 wt.% Biosilicate® were fabricated by the generative manufacturing process coupled with a vertical miniscrew extrusion head to application for restoration of bone tissue. Their morphological characterization indicated the designed 0°/90° architecture range of pore sizes and their interconnectivity is feasible for tissue engineering applications. Mechanical compression tests revealed an up to 57% increase in the stiffness of the scaffold structures with the addition of 1 to 5 wt.% Biosilicate® to the biocomposite. No toxicity was detected in the scaffolds tested by in vitro cell viability with MC3T3-E1 preosteoblast cell line. The results highlighted the potential application of scaffolds fabricated with poly(ε-caprolactone)/Biosilicate® to tissue engineering.

Clinical, double blind, randomized controlled trial of experimental adhesive protocols in caries-affected dentin

OBJECTIVE

To evaluate the clinical performance of posterior resin composite restorations regarding experimental and regular adhesive protocols in caries affected-dentin (CAD).

MATERIAL AND METHODS

A total of 92 class I and class II cavities with carious lesions were selected and randomly assigned to the following groups: (1) bioactive glass-ceramic powder/two-step etch and rinse system, (2) control/two-step etch and rinse system, (3) bioactive glass-ceramic powder/two-step self-etching system, and (4) control/two-step self-etching system. Two operators carried out the adhesive protocols and restored the cavities with a nano-hybrid resin composite. Participants were followed up at 1 week and 6, 12, and 18 months for clinical evaluation performed by two blinded examiners and calibrated according to FDI criteria. Data were analyzed using Kruskal-Wallis and Dunn tests with a confidence of 95%.

RESULTS

The clinical performance of resin composite restoration was not affected by the experimental use of an adhesive protocol including a bioactive glass-ceramic powder for 18 months post-procedure. However, there was a significant difference between group 2 and group 4 (p < 0.05) for marginal adaptation (18 months). Group 2 was significantly different from group 3 (p < 0.05) for fracture of material/retention (18 months) and marginal adaptation (1 week); group 2 showed a better performance.

CONCLUSION

Adhesive protocols can alter the clinical performance of posterior restorations in terms of marginal adaptation and the fracture of material/retention in CAD.

CLINICAL SIGNIFICANCE

Adhesive protocols may influence the success of resin composite restorations in CAD; this is important because failure can lead to caries, re-incidence, and/or clinical re-work.

Novel treatment of in-office tooth bleaching sensitivity: A randomized, placebo-controlled clinical study

OBJECTIVES

Aim of this clinical trial was to investigate the effect of a calcium phosphate based desensitizer paste applied prior to in-office tooth whitening on bleaching sensitivity (BS).

METHODS

This crossover study was designed as randomized double-blinded, placebo-controlled trial. The desensitizer paste Teethmate AP (TAP) contains tetracalcium phosphate and dicalcium phosphate anhydrous in glycerol and polyethylene glycol, whereas placebo (PLA) is a calcium phosphate free analog. Fifty patients with sound maxillary incisors and canines were enrolled. Tooth shades were determined with a Vitapan Classic Shade guide. Randomly, TAP and PLA were applied to the left or to the right anterior teeth. After rinsing and air-drying the bleaching gel (Opalescence Boost PF 40%) was applied and left on the labial surfaces for 15 minutes. Sensitivity was recorded using a 10 cm visual analog scale (VAS) before, at 5, 10, and 15 minutes during, and at 1 hour, 1, 2, and 7 days after bleaching. Tooth whitening was determined with the shade guide after 1 day and 1 week.

RESULTS

Prebleaching desensitization with TAP reduced BS significantly when compared with PLA. Between 1 and 7 days the average sensitivity scores were close to zero, whereas the average scores for PLA were significantly higher during this time interval. Independent from the desensitizing treatment after 1 and 7 days the medians of the shades were between 5 and 3.5 units brighter.

CONCLUSIONS

Prebleaching desensitization with TAP was effective in reducing BS during and after tooth whitening treatment and had no adverse effect on the bleaching result.

CLINICAL SIGNIFICANCE

Prebleaching topical application of a calcium phosphate containing compound reduced significantly bleaching sensitivity during a single 15 minutes treatment and up to one week with a 40% hydrogen peroxide containing gel without compromising tooth whitening.

Bond strength of adhesive systems to sound and demineralized dentin treated with bioactive glass ceramic suspension

OBJECTIVE

The objective of this study was to evaluate the effect of a Biosilicate®, associated with dentin adhesive system, on microtensile bond strength (μTBS) to sound and demineralized dentin.

MATERIALS AND METHODS

Eighty sound-extracted molars had their middle occlusal dentin exposed. In forty teeth, dentin was artificially demineralized (pH cycling). Sound and demineralized dentin teeth were separated into four groups (n = 10), according to the substrate treatment before restoration: Group 1-total-etching adhesive Adper TM Single bond 2 (ASB) + Biosilicate®, Group 2-ASB (without Biosilicate®), Group 3-AdheSE self-etching adhesive system (AdSE) + Biosilicate®, and Group 4-AdSE (without Biosilicate®). Each tooth was restored with a hybrid composite and stored in water at 37 °C for 6 months. After water aging, teeth were cut in sticks (≈ 1 mm² cross-sectional area) and all samples were submitted to μTBS test. The fracture modes of the samples were analyzed by stereomicroscopy. The representatively fractured samples were observed by scanning electron microscopy. Representative samples of each group were analyzed on energy dispersive X-ray spectrometry (EDX). The μTBS and Ca-P ratio values were analyzed by 2-way ANOVA, Bonferroni, and Tukey test, respectively, p < .05.

RESULTS

ASB + Biosilicate® presented the highest μTBS values (p < .05), and lowest μTBS values (p < .05) were found in AdSE Group. There was no statistical difference (p < .05) on μTBS when substrates were compared, except for Group 2. The fracture pattern analysis showed prevalence of adhesive fractures in all groups.

CONCLUSION

Biosilicate® enhanced bond strength of self-etching and etch-and-rinse adhesives to sound and demineralized dentin.

CLINICAL RELEVANCE

Bioactive glass ceramic suspension could be recommended to be used to improve the dentin bond strengths of the total-etching and self-etching adhesives after acid-etching and priming.

Effect of a Bioactive Glass Ceramic on the Control of Enamel and Dentin Erosion Lesions

Abstract This study evaluated the effect of a bioactive glass ceramic for the control of erosion and caries lesions. Fragments (n=10) of bovine enamel and root dentin received daily application of different treatments (Biosilicate; Acidulated Phosphate Fluoride- APF; Untreated - control) during the performance of erosive cycles. Surfaces were analyzed with 3D optical profilometry to quantify the superficial loss in four periods (1, 7, 14 and 21 days), as well as the lesion depth with confocal laser scanning microscopy. For caries progression assessment, initial Knoop microhardness was measured on enamel bovine fragments. Initial carious lesions were developed and specimens were divided into three groups (n=10), according to the daily topical application (Biosilicate; APF; no application - control), during the de-remineralization cycles for 14 days. Final microhardness was obtained to calculate the change of surface microhardness. Subsurface demineralization was analyzed using cross-sectional microhardness (depths 10, 30, 50, 70, 90, 110 and 220 µm). Data were tested using ANOVA and Tukey’s test (a=5%). Results of erosive evaluation showed that Biosilicate promoted the lowest (p<0.05) values of surface loss, regardless of time, for both enamel and dentin; APF promoted lower (p<0.05) surface loss than control; analyzing different periods of time, APF did not show difference (p>0.05) between 14 and 21 days of demineralization. Results of enamel caries assessment showed that Biosilicate resulted in higher (p<0.05) surface and subsurface microhardness than both APF and control-applications. It may be concluded that Biosilicate application showed a higher potential to reduce surface loss and development of erosion and caries lesions.

Structural analysis of fluorine-containing bioactive glass nanoparticles synthesized by sol-gel route assisted by ultrasound energy

In the last decades, studies about the specific effects of bioactive glass on remineralization of dentin were the focus of attention, due to their excellent regenerative properties in mineralized tissues. The incorporation of Fluorine in bioactive glass nanoparticles may result in the formation of fluorapatite (FAP), which is chemically more stable than hydroxyapatite or carbonated hydroxyapatite, and therefore is of interest for dental applications. The aim of this study was to synthesize and characterize a new system of Fluorine-containing bioactive glass nanoparticles (BGNPF). A sol-gel route assisted by ultrasound was used for the synthesis of BGNPF. The particles obtained were characterized by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), atomic force microscopy (AFM), X-ray diffraction (XRD), dynamic light scattering (DLS), nitrogen adsorption, and X-ray photoelectron spectroscopy (XPS). SEM micrographs showed that the particles are quite uniform spherical nanostructures, occurring agglomeration or partial sinterization of the particulate system after heat treatment. XRD and XPS analysis results suggest the formation of fluorapatite crystals embedded within the matrix of the bioactive glass nanoparticles. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 360-366, 2018.

Bioactive and inert dental glass-ceramics

The global market for dental materials is predicted to exceed 10 billion dollars by 2020. The main drivers for this growth are easing the workflow of dentists and increasing the comfort of patients. Therefore, remarkable research projects have been conducted and are currently underway to develop improved or new dental materials with enhanced properties or that can be processed using advanced technologies, such as CAD/CAM or 3D printing. Among these materials, zirconia, glass or polymer-infiltrated ceramics, and glass-ceramics (GCs) are of great importance. Dental glass-ceramics are highly attractive because they are easy to process and have outstanding esthetics, translucency, low thermal conductivity, high strength, chemical durability, biocompatibility, wear resistance, and hardness similar to that of natural teeth, and, in certain cases, these materials are bioactive. In this review article, we divide dental GCs into the following two groups: restorative and bioactive. Most restorative dental glass-ceramics (RDGCs) are inert and biocompatible and are used in the restoration and reconstruction of teeth. Bioactive dental glass-ceramics (BDGCs) display bone-bonding ability and stimulate positive biological reactions at the material/tissue interface. BDGCs are suggested for dentin hypersensitivity treatment, implant coating, bone regeneration and periodontal therapy. Throughout this paper, we elaborate on the history, processing, properties and applications of RDGCs and BDGCs. We also report on selected papers that address promising types of dental glass-ceramics. Finally, we include trends and guidance on relevant open issues and research possibilities. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 619-639, 2017.

Efficacy of a bioactive material and nanostructured desensitizing on dentin hypersensitivity treatment

Abstract Introduction Dentin hypersensitivity is a frequent occurrence in dental practice. It is clinically characterized by acute, short, and temporary pain in response to mechanical, chemical, thermal, or osmotic stimuli resulting from dentin exposure. Objective To compare in vivo the effect of an experimental crystalline bioactive material and nanostructured desensitizing on the pain assessment among patients with cervical dentin hypersensitivity. Material and method Thirty patients were selected for this study, who were randomly assigned to two groups (n=15) in a split-mouth design. Each patient received two treatments: group 1 (fluoride gel and bioactive material) and group 2 (fluoride gel and nanostructured desensitizing). Pain analyses were performed using a visual analogue scale, ranging 0-10. Baseline pain measurement was performed prior to initial treatment (T0) and new measurements were carried out weekly for 3 weeks (T1, T2, and T3) before materials were reapplied. Final pain analysis was performed 3 months after initial treatment (T4). Degree of pain reduction was calculated using the formula T0 - Tperiod after treatment. The data of the pain measurements were analyzed using 2-way repeated measure ANOVA and Tukey’s test (α=0.05). Result Regardless of evaluation period, there was no statistical difference on pain reduction between the treatments (p>0.05). The degree of pain was reduced significantly in each evaluated period for all tested treatments (p<0.05), by approximately three degrees after 3 months. Conclusion The tested desensitizing materials were effective on dentin hypersensitivity reduction.

Acid Neutralizing Ability and Shear Bond Strength Using Orthodontic Adhesives Containing Three Different Types of Bioactive Glass

The objective of the study was to compare the acid neutralizing ability and shear bond strength (SBS) of three different types of orthodontic adhesives containing bioactive glasses (BAGs). 45S5, 45S5F and S53P4 BAGs were prepared using the melting technique and ground to fine particles. Orthodontic adhesives containing three types of BAGs were prepared as follows: 52.5% 45S5 BAG + 17.5% glass (45S5_A); 61.25% 45S5 BAG + 8.75% glass (45S5_B); 52.5% 45S5F BAG + 17.5% glass (45S5F_A); 61.25% 45S5F BAG + 8.75% glass (45S5F_B); 52.5% S53P4 BAG + 17.5% glass (S53P4_A); 61.25% S53P4 BAG + 8.75% glass (S53P4_B); and 70.0% glass (BAG_0). To evaluate the acid neutralizing properties, specimens were immersed in lactic acid solution, and pH changes were measured. SBS was measured with a universal testing machine. For all of the BAG-containing adhesives, the one with 61.25% of BAG showed a significantly greater increase of pH than the one with 52.5% of BAG (p < 0.05). Groups with 61.25% of BAG showed lower SBS than samples with 52.5% of BAG. 45S5F_A showed no significant difference of SBS compared to BAG_0 (p > 0.05). The adhesive containing 61.25% of 45S5F BAG exhibited clinically acceptable SBS and acid neutralizing properties. Therefore, this composition is a suitable candidate to prevent white spot lesions during orthodontic treatment.

After bleaching enamel remineralization using a bioactive glass-ceramic (BioSilicate®)

Tooth bleaching agents may weaken the tooth structure, therefore, it is important to minimize any risks of enamel and dentine damage caused by them. In this way, different materials have been used to avoid or minimize the tooth damage during bleaching. Recently, bioactive glasses have been demonstrated to be effective in mineralization of dental structures. Therefore, this study evaluated the effect of BioSilicate® (a polycrystalline bioactive glass-ceramic) after bleaching by Laser-induced breakdown spectroscopy (LIBS) technique. Bovine dental blocks with 4 × 4 × 3 mm were obtained (n = 20), sequentially embedded in epoxy resin and then polished. Bleaching was performed using 35% hydrogen peroxide (Whiteness HP). Calcium (Ca) and phosphate (P) intensity values by LIBSwere obtained before the treatment (T0, baseline – control Group), after bleaching (T1), and after BioSilicate® application (T2). The use of BioSilicate® after bleaching showed to be an optimal way to remineralize enamel surface making BioSilicate® application a promising adjunct step to avoid or minimize the mineral loss on enamel surface after bleaching.

Use of poly (amidoamine) dendrimer for dentinal tubule occlusion: a preliminary study

The occlusion of dentinal tubules is an effective method to alleviate the symptoms caused by dentin hypersensitivity, a significant health problem in dentistry and daily life. The in situ mineralization within dentinal tubules is a promising treatment for dentin hypersensitivity as it induces the formation of mineral on the sensitive regions and occludes the dentinal tubules. This study was carried out to evaluate the in vitro effect of a whole generation poly(amidoamine) (PAMAM) dendrimer (G3.0) on dentinal tubule occlusion by inducing mineralization within dentinal tubules. Dentin discs were treated with PAMAM dendrimers using two methods, followed by the in vitro characterization using Attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR), X-ray diffraction (XRD), Field emission scanning electron microscopy (FE-SEM) and Energy-Dispersive X-ray Spectroscopy (EDS). These results showed that G3.0 PAMAM dendrimers coated on dentin surface and infiltrated in dentinal tubules could induce hydroxyapatite formation and resulted in effective dentinal tubule occlusion. Moreover, crosslinked PAMAM dendrimers could induce the remineralization of demineralized dentin and thus had the potential in dentinal tubule occlusion. In this in vitro study, dentinal tubules occlusion could be achieved by using PAMAM dendrimers. This could lead to the development of a new therapeutic technique for the treatment of dentin hypersensitivity.

The effect of home-use and in-office bleaching treatments combined with experimental desensitizing agents on enamel and dentin

OBJECTIVE

This study aimed to evaluate in vitro the effect of formulations containing Biosilicate to treat enamel and dentin bovine samples exposed to dental bleaching agents.

MATERIALS AND METHODS

On enamel and dentin bleached with commercial gels containing 16% carbamide peroxide (CP) (14 days/4 h) or 35% hydrogen peroxide (single session/45 min), desensitizing dentifrices (Sensodyne(®); experimental dentifrice of Biosilicate(®); Odontis RX(®); Sorriso(®)) were applied along 14 days and desensitizing pastes (Biosilicate(®)/water 1:1; Dessensebilize NanoP(®); Bioglass type 45S5/water 1:1) were applied on days 1, 3, 7, 10 and 14. Distilled water was the control. Microhardness (MH) and roughness measurements were the variables measured on the samples before and after the treatments. Student's t-test analyzed differences before and after the treatments. Two-way analysis of variance and post-hoc Tukey test analyzed differences among the factors desensitizing, bleaching agents and substrate.

RESULTS

Tukey test showed no differences in roughness for both bleaching treatments and among the desensitizing agents (P > 0.05). Differences in MH appeared on enamel treated with in-home bleaching when control group (lower values) was compared with Sensodyne, Biosilicate dentifrice, Biosilicate paste, and Bioglass paste (higher values). Comparisons between desensitizing agents on dentin treated with both bleaching gels showed no statistical differences.

CONCLUSIONS

The effect of formulations containing Biosilicate (Biosilicate dentifrice and paste) was significant in the MH of enamel bleached with 16% CP.

Cytotoxicity of resin composites containing bioactive glass fillers

OBJECTIVE

To determine the in vitro cytotoxicity of dental composites containing bioactive glass fillers.

METHODS

Dental composites (50:50 Bis-GMA/TEGDMA resin: 72.5wt% filler, 67.5%Sr-glass and 5% OX50) containing different concentrations (0, 5, 10 and 15wt%) of two sol-gel bioactive glasses, BAG65 (65mole% SiO2, 31mole% CaO, 4mole% P2O5) and BAG61 (3mole% F added) were evaluated for cytotoxicity using Alamar Blue assay. First, composite extracts were obtained from 7 day incubations of composites in cell culture medium at 37°C. Undifferentiated pulp cells (OD-21) were exposed to dilutions of the original extracts for 3, 5, and 7 days. Then freshly cured composite disks were incubated with OD-21 cells (n=5) for 2 days. Subsequently, fresh composite disks were incubated in culture medium at 37°C for 7 days, and then the extracted disks were incubated with OD-21 cells for 2 days. Finally, fresh composites disks were light cured for 3, 5, and 20s and incubated with OD-21 cells (n=5) for 1, 3, 5, and 7 days. To verify that the three different curing modes produced different levels of degree of conversion (DC), the DC of each composite was determined by FTIR. Groups (n=5) were compared with ANOVA/Tukey's (α≤0.05).

RESULTS

Extracts from all composites significantly reduced cell viability until a dilution of 1:8 or lower, where the extract became equal to the control. All freshly-cured composites showed significantly reduced cell viability at two days. However, no reduction in cell viability was observed for any composite that had been previously soaked in media before exposure to the cells. Composites with reduced DC (3s vs. 20s cure), as verified by FTIR, showed significantly reduced cell viability.

SIGNIFICANCE

The results show that the composites, independent of composition, had equivalent potency in terms of reducing the viability of the cells in culture. Soaking the composites for 7 days before exposing them to the cells suggested that the "toxic" components had been extracted and the materials were no longer cytotoxic. The results demonstrate that the cytotoxicity of composites with and without BAG must predominantly be attributed to the release of residual monomers, and not to the presence of the BAG.

Use of multifunctional phosphorylated PAMAM dendrimers for dentin biomimetic remineralization and dentinal tubule occlusion

Phosphorylated poly(amidoamine) dendrimers can induce biomimetic remineralization of demineralized dentin as analogs of non-collagenous proteins in the presence of polyacrylic acid, an amorphous calcium phosphate stabilizing agent.

A clinical efficacy of 30% ethenolic extract of Indian propolis and Recaldent™ in management of dentinal hypersensitivity: A comparative randomized clinical trial

Objective:

The aim of this study is to evaluate the efficacy of 30% ethenolic extract of Indian propolis compared with Recaldent^™ (casein phosphopeptide-amorphous calcium phosphate) in reduction of dentinals hypersensitivity, a randomized, double-blind, split mouth, controlled clinical trial was conducted among the patients residing in Central Jail.

Materials and Methods:

A sample of 73 teeth from 13 patients having at least three teeth with dentinal hypersensitivity (DH) were randomly allocated into three treatment groups: Group A: 30% ethenolic extract of Indian propolis, Group B: Recaldent^™, Group C: Sterile water. Verbal rating scale was used to record the degree of hypersensitivity based on patient's response to tactile and air blast stimuli. The baseline scores were obtained. Each intervention group received applications of their respective agents consecutively on 1^st, 7^th, 14^th, and 21^st day. After each application the scores were recorded.

Results:

Both the 30% Indian propolis and Recaldent^™ showed significant reduction in DH.

Conclusion:

Recaldent^™ was found to be significantly better in reducing the DH compared to propolis and sterile water (P < 0.01).

The Efficacy of Selected Desensitizing OTC Products: A Systematic Review

Objectives. The aim of the present study was to review the published literature in order to identify relevant studies for inclusion and to determine whether there was any evidence on the clinical effectiveness of selected desensitizing toothpastes, calcium sodium phosphosilicate (CSPS), amorphous calcium phosphate (ACP), nanohydroxyapatite, and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) on reducing dentine hypersensitivity (DH). Materials and Methods. Following a review of 593 papers identified from searching both electronic databases (PUBMED) and hand searching of relevant written journals, only 5 papers were accepted for inclusion. Results. Analysis of the included studies (3 CSPS and 2 ACP) would suggest that there may be some benefit for patients using these products for reducing DH. No direct comparative studies were available to assess all these products under the same conditions neither were there any comparative randomised controlled studies that compared at least two of these products in determining their effectiveness in treating DH. Conclusions. Due to the small number of included studies, there are limited clinical data to support any claims of clinical efficacy of these OTC products. Further studies are therefore required to determine the efficacy of these products in well-controlled RCT studies with a larger sample size.

Characterization and in vivo biological performance of biosilicate

After an introduction showing the growing interest in glasses and glass-ceramics as biomaterials used for bone healing, we describe a new biomaterial named Biosilicate. Biosilicate is the designation of a group of fully crystallized glass-ceramics of the Na₂O-CaO-SiO₂-P₂O₅ system. Several in vitro tests have shown that Biosilicate is a very active biomaterial and that the HCA layer is formed in less than 24 hours of exposure to “simulated body fluid” (SBF) solution. Also, in vitro studies with osteoblastic cells have shown that Biosilicate disks supported significantly larger areas of calcified matrix compared to 45S5 Bioglass, indicating that this bioactive glass-ceramic may promote enhancement of in vitro bone-like tissue formation in osteogenic cell cultures. Finally, due to its special characteristics, Biosilicate has also been successfully tested in several in vivo studies. These studies revealed that the material is biocompatible, presents excellent bioactive properties, and is effective to stimulate the deposition of newly formed bone in animal models. All these data highlight the huge potential of Biosilicate to be used in bone regeneration applications.

In vitro evaluation of Biosilicate® dissolution on dentin surface: a SEM analysis

INTRODUCTION: Biomaterials such as bioactive glasses and glass-ceramics have been proposed for the treatment of dentinal hypersensitivity. OBJECTIVE: to evaluate by scanning electron microscopy (SEM), the dissolution of a novel bioactive glass-ceramic (Biosilicate® 1-20 µm particles) on dentin surface samples, with different application methods and different dilution medium used for applying Biosilicate®. MATERIAL AND METHOD: 280 dentin samples were randomly divided into four groups: (1) Biosilicate® plus fluoride gel applied with Robinson brush; (2) Biosilicate® plus fluoride gel applied with microbrush; (3) Biosilicate® plus distilled water applied with Robinson brush; (4) Biosilicate® plus distilled water applied with microbrush. After treatment, the samples were immersed in saliva at different periods (0, 15 and 30 minutes, 1, 2, 12 and 24 hours). Two photomicrographs were obtained from each sample and were further analyzed by a blind calibrated examiner according to a "Particle Dissolution Index" created for this study. RESULT: The data were analyzed using the Mann-Whitney, Kruskal-Wallis and Dunn's tests. There was no statistical difference among the degrees of dissolution between the 4 groups in any period. CONCLUSION: Biosilicate® can be incorporated in both substances without differences in the degree of dissolution of the particles in any of the evaluated periods and the application of dentine can be performed with both methods evaluated.

Biosilicate®-gelatine bone scaffolds by the foam replica technique: development and characterization

The development of bioactive glass-ceramic materials has been a topic of great interest aiming at enhancing the mechanical strength of traditional bioactive scaffolds. In the present study, we test and demonstrate the use of Biosilicate^® glass-ceramic powder to fabricate bone scaffolds by the foam replica method. Scaffolds possessing the main requirements for use in bone tissue engineering (95% porosity, 200-500 μm pore size) were successfully produced. Gelatine coating was investigated as a simple approach to increase the mechanical competence of the scaffolds. The gelatine coating did not affect the interconnectivity of the pores and did not significantly affect the bioactivity of the Biosilicate^® scaffold. The gelatine coating significantly improved the compressive strength (i.e. 0.80 ± 0.05 MPa of coated versus 0.06 ± 0.01 MPa of uncoated scaffolds) of the Biosilicate^® scaffold. The combination of Biosilicate^® glass-ceramic and gelatine is attractive for producing novel scaffolds for bone tissue engineering.

Effects of dentifrice containing hydroxyapatite on dentinal tubule occlusion and aqueous hexavalent chromium cations sorption: a preliminary study

In order to endow environmental protection features to dentifrice, hydroxyapatite (HA) was added to ordinary dentifrice. The effects on dentinal tubule occlusion and surface mineralization were compared after brushing dentine discs with dentifrice with or without HA. The two types of dentifrice were then added to 100 µg/ml of hexavalent chromium cation (Cr⁶⁺) solution in order to evaluate their capacities of adsorbing Cr⁶⁺ from water. Our results showed that the dentifrice containing HA was significantly better than the ordinary dentifrice in occluding the dentinal tubules with a plugging rate greater than 90%. Moreover, the effect of the HA dentifrice was persistent and energy-dispersive spectrometer (EDS) revealed that the atomic percentages of calcium and phosphorus on the surface of dentine discs increased significantly. Adding HA to ordinary dentifrice significantly enhanced the ability of dentifrice to adsorb Cr⁶⁺ from water with the removal rate up to 52.36%. In addition, the sorption was stable. Our study suggests that HA can be added to ordinary dentifrice to obtain dentifrice that has both relieving dentin hypersensitivity benefits and also helps to control environmental pollution.

Seal that Heals

Introduction

Dentinal hypersensitivity can be treated by dentinal tubule occlusion which prevents any stimuli from causing dentinal fluid movement. This in vitro study aims to compare the dentinal tubule occluding capability of four chemical compounds, a bonding agent, a compound of fluoride and hydroxyapatite, potassium oxalate gel and sodium fluoride varnish.

Materials and methods

Forty dentin samples were divided into four groups of 10 samples each. Group A (treated with Clearfil SE Bond), Group B (treated with Remin Pro), Group C (treated with Potassium Oxalate, Vi-sense,) and Group D (treated with Pro Fluoride varnish). The samples were treated with ethylene diamine tetraacetic acid (EDTA) gel prior to application of desensitizing agents to remove the smear layer and open the dentinal tubule orifice. Following the desensitizing treatment the specimens were washed and dehydrated using graded series of ethanol treatments (25, 50, 75, 90 and 100%). After each treatment tubule occlusion was analyzed by scanning electron microscope.

Results

Qualitative and quantitative analysis demonstrated potassium oxalate gel to cause maximum tubule occlusion followed by Remin Pro > Sodium fluoride varnish > Clearfil SE Bond.

Conclusion

Life expectancy is increasing and patients are retaining their natural teeth for a longer time due to effective treatment strategies. The results showed the potential use of these products as an effective means of tubule occlusion.

How to cite this article

Benjamin S, Roshni, Pradhan S, Nainan MT. Seal that Heals. World J Dent 2012;3(3):243-246.

Dentin hypersensitivity after treatment with desensitizing agents: a randomized, double-blind, split-mouth clinical trial

The aim of this study was to evaluate the efficacy of two desensitizing agents in the reduction of dentin hypersensitivity in a randomized, double-blind, split-mouth clinical trial. Seventy-seven teeth from 13 patients that presented some degree of sensitivity to probing and/or air stimulation were treated with one of the following desensitizing agents: Oxa-Gel (G1), Sensi Kill (G2) and placebo gel (G3 - control). According to paired t-test, all treatments, even the placebo gel, were capable of reducing sensitivity scores for both stimuli. Analysis of data by ANOVA and Tukey's test (?=0.05) showed that the sensitivity scores were significantly lower only for Sensi Kill in comparison to the other products (Oxa-Gel and placebo), when air stimulus was applied. It may be concluded that treatment with Sensi Kill presented a slightly better performance in reducing dentin hypersensitivity when compared to the other desensitizing agent.