Effect of gastric acid on the surface roughness and bacterial adhesion of bulk-fill composite resins

The purpose of this in vitro study was to evaluate the effect of gastric acid on the surface roughness and biofilm formation of bulk-fill composite resins. Twenty-seven samples of each composite resin were obtained: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). The samples were quantitatively analyzed for surface roughness (Ra) using a roughness tester (n=15) and for biofilm formation (Cn) by the counting of colony-forming units (CFUs/mL) (n=9) in three different moments: after polishing (Ra0 and Cn0), after gastric acid immersion (Ra1 and Cn1), and after gastric acid and simulated tooth brushing (Ra2 and Cn2). Qualitative analysis through surface topography (n=3) was evaluated by scanning electron microscopy (SEM). Ra values were subjected to two-way repeated measures ANOVA, followed by Tukey's test. Cn values were subjected to Kruskal-Wallis analysis, followed by multiple comparisons analysis (α=0.05). Z250 and FTK showed significant increases in surface roughness at Ra1. There were fewer CFUs/mL on TTC and AUR in relation to those of Z250 and FTK for Cn0, Cn1 and Cn2. The SEM images showed that gastric acid increased the formation of cracks, exposure of fillers and micro cavities for all composite resins. After tooth brushing, the topographical changes were more evident but did not influence biofilm formation. The gastric acid promoted both degradation of the surfaces and bacterial adhesion for all composite resins.

Effect of Cariogenic Challenge on the Degradation of Adhesive-Dentin Interfaces

The aim was to evaluate, in vitro, the influence of pH cycling on microtensile bond strength (µTBS) and percentage of nanoleakage (%NL) in the dentin-adhesive interface. Flat dentin surfaces were obtained in 56 extracted third molars. The teeth were randomly divided into four groups (n=14): G1- Single Bond Universal (etch-and-rinse mode); G2- Single Bond Universal (self-etch mode); G3- Scotchbond Multi-Purpose; G4- Clearfil SE Bond. A block of composite was built on the adhesive area. Eight tooth/resin sets were cut parallel to the tooth's long axis to obtain 48 beams (0.8 mm2) for each group. Half of the beams were submitted to four cycles of pH cycling (demineralizing solution for 6 h and remineralizing solution for 18 h). The samples were submitted to µTBS test in a universal testing machine. Six tooth/resin sets were cut parallel to the tooth's long axis to obtain three slices of the central region (1.0 mm thickness). Half of the slices were submitted to pH cycling. The nanoleakage methodology was applied to obtain the %NL at the adhesive interfaces. According to two-way ANOVA, the interaction between factors (adhesive system x storage) was significant (p=0.0001) for µTBS and %NL. After pH cycling, there was a significant decrease in µTBS and a significant increase in %NL for all adhesives. The adhesives applied in the self-etch mode obtained lower %NL, differing significantly from the etch-and-rinse adhesives. It was concluded that the pH cycling negatively influenced the µTBS and %NL for all adhesives evaluated. However, self-etch adhesives allowed less %NL.

Effect of pH Cycling Followed by Simulated Toothbrushing on the Surface Roughness and Bacterial Adhesion of Bulk-fill Composite Resins

The aim was to evaluate, in vitro, quantitatively and qualitatively, the effect of pH cycling and simulated toothbrushing on surface roughness (Ra) and bacterial adhesion (Cn) of bulk-fill composite resins. Thirty specimens of each composite resin, 5 mm wide and 4 mm high, were obtained: group 1 (control): Filtek Z250 (Z250); group 2: Filtek Bulk-Fill (FTK); group 3: Tetric N-Ceram Bulk-Fill (TTC); and group 4: Aura Bulk-Fill (AUR). After 24 hours, the specimens were polished and then alternated with demineralization/remineralization solutions for 15 cycles of 24 hours each at 37°C. Then the specimens were submitted to simulated toothbrushing. The Ra and Cn measurements were quantitatively analyzed in three stages: after polishing (Ra0 and Cn0), after pH cycling (Ra1 and Cn1), and after simulated toothbrushing (Ra2 and Cn2). The Ra values were submitted to two-way analysis of variance, followed by the Tukey test (α=0.05). The Kruskal-Wallis test, followed by multiple comparisons, was applied for Cn analysis. Surface topography and bacterial adhesion were observed by scanning electron microscopy (SEM). Z250, FTK, and TTC showed no significant change in Ra regardless of the treatment performed; AUR obtained increased Ra at Ra2 (p<0.05). FTK differed from the others at Cn0 and Cn1 (p<0.05). At Cn2, there was no difference among the composite resins. SEM images showed the exposure of fillers and microcavities at Ra1 and Ra2. There was greater bacterial adhesion at Cn1 for Z250 and FTK. It was concluded that the pH cycling caused surface degradation of all composite resins, which was potentiated by simulated toothbrushing. However, only AUR presented an increased Ra. Bacterial adhesion occurred on all composite resins after pH cycling; however, after simulated toothbrushing, adhesion of dispersed bacteria was similar for all the composite resin groups.

Surface roughness of monolithic zirconia ceramic submitted to different polishing systems

Aim: The objective was to evaluate, quantitative and qualitative, the abrasive effect of three polishing systems on the monolithic zirconia ceramic. Methods: Thirty disk-shaped samples of Yttria Tetragonal Zirconia Polycrystal (Y-TZP) were randomly distributed in three groups (n = 10) according to polishing system: G1- Komet system (KO); G2 - CeraGloss system (CG); G3 - Eve Diacera system (EV). The surface roughness (Ra) was obtained with Rugosimeter in four different moments: a) initial - glaze sample (Ra0); b) after occlusal adjustment with diamond burs (Ra1); c) after polishing with the abrasive systems (Ra2); d) after polishing with felt disc and diamond paste (Ra3). Four additional samples were observed in scanning electron microscopy (SEM). Results: According to the Generalized Estimating Equation followed by the Bonferroni test (α = 0.05), the CG provided the lowest Ra2 (0.63 μm), not differing significantly from the KO (0.78 μm). The highest Ra2 was obtained with the EV (0.97 μm), which did not differ significantly from the KO. There was no statistical difference in Ra between the polishing with the abrasive systems (Ra2) and the final polishing with diamond paste (Ra3). SEM images showed that the polishing systems did not completely remove the grooves caused by the diamond burs during the occlusal adjustment. Conclusion: It was concluded that CG promoted smoother surface of the monolithic zirconia ceramic compared to EV, and intermediate smoothness was obtained with KO.

Aesthetic Rehabilitation in Teeth with Wear from Bruxism and Acid Erosion

Background:

Bruxism is defined as a repetitive activity of grinding the teeth through lateral or protrusive movements of the mandible, and it is considered the most complex and destructive functional disorder. In addition, erosion caused by diet or reflux can damage the remaining teeth.

Objective:

In this report, a patient with bruxism and dental erosion was treated with a multidisciplinary approach to restore the function and aesthetic.

Methods:

This clinical report describes the management of an adult woman, 33 years old, who was dissatisfied with the aesthetics of her smile and complained of joint pain and headaches. As result of her condition, the patient’s dentition exhibited generalized wear on the vestibular and incisal surface of the upper incisors incompatible with her age, moderate darkening of the teeth and excess gingival tissue in the upper incisors. After a detailed anamnesis and clinical examination, a diagnosis of bruxism and acid erosion caused by a diet rich in citrus foods and beverages was obtained. Forthwith, a treatment plan was established, and the patient underwent home bleaching, gingivoplasty and ceramic laminates of lithium disilicate on the anterior teeth. After the rehabilitation was completed, a night guard was made to reduce the symptoms of bruxism and avoid fracture of the ceramic restorations. The patient was followed at different time intervals.

Conclusion:

The improvement in the aesthetics of the teeth was significant and remained stable after periodic controls in which no adverse effects were observed.

Bond Capability of Universal Adhesive Systems to Dentin in Self-etch Mode after Short-term Storage and Cyclic Loading

Objective:

The aim was to evaluate, in vitro, the tensile bond strength to dentin of Scotchbond Universal (SU), All-Bond Universal (AU) and One Coat 7 Universal (OC7) adhesives applied in self-etch mode, after 24 h of storage and after 500,000 loading cycles, using Clearfil SE Bond (SE) as a control.

Materials and Methods:

The adhesives were applied on the dentin of bovine teeth, followed by the application of a composite resin. Thirty specimens were obtained for each adhesive. Half of the specimens were submitted to cyclic loading for 500,000 cycles. All specimens were submitted to a tensile bond strength test in a universal testing machine at a crosshead speed of 0.5 mm/minute.

Results:

According to two-way ANOVA and Tukey’s test (α=5%), the interaction between the adhesive and cyclic loading factors was significant (p=0.001). The means followed by the same letter represent no significant difference in the bond strength (MPa) after 24 h: OC7=7.86^A (±2.90), SU=6.78^AB (±2.03), AU=5.61^BC (±2.32), and SE=3.53^C (±1.89). After cyclic loading, SE, SU and AU maintained bond strength comparable to 24 h period. There was a significant decrease only for OC7.

Conclusion:

SU, AU and OC7 had bond strength to dentin comparable to that of SE. Only OC7 had decreased bond strength to dentin after cyclic loading.

Bond Strength of a Novel One Bottle Multi-mode Adhesive to Human Dentin After Six Months of Storage

Objective:

The aim of the study was to evaluate the microtensile bond strength (µTBS) of Scotchbond Universal to dentin using the etch-and-rinse or the self-etch technique after 24 h and 6 months of storage.

Materials and Methods:

Flat dentin surfaces were obtained in 24 third molars. The teeth were divided into four groups: G1 – Scotchbond Universal applied in the etch-and-rinse mode; G2 – Scotchbond Universal applied in the self-etch mode; G3 – Scotchbond Multi-Purpose; G4 – Clearfil SE Bond. A block of composite was built on the adhesive area. The tooth/resin sets were cut parallel to the long axis to obtain 40 beams (~0.8 mm²) for each group. Twenty specimens were immediately submitted to the µTBS test, and the remaining 20 were stored in water for 6 months. Failures and the adhesive interface were analyzed by SEM.

Results:

According to two-way ANOVA, the interaction between adhesive and storage time was significant (p=0.015).The µTBS (MPa) means were the following: 24 h – G1 (39.37±10.82), G2 (31.02±13.76), G3 (35.09±14.03) and G4 (35.84±11.06); 6 months – G1 (36.99±8.78), G2 (40.58±8.07), G3 (32.44±6.07) and G4 (41.75±8.25). Most failures were mixed. Evidence of hybrid layer and numerous resin tags were noted for Scotchbond Universal applied with the etch-and-rinse mode and Scotchbond Multi-Purpose. A thinner hybrid layer and fewer resin tags were noted for Scotchbond Universal applied in the self-etch mode and Clearfil SE Bond.

Conclusion:

The results indicate that the µTBS for Scotchbond Universal is comparable to the gold-standard adhesives. Scotchbond Universal applied in the self-etch mode and Clearfil SE Bond revealed higher bond stability compared to the etch-and-rinse mode.