Influence of the combined effect of desensitizing dentifrices and universal adhesives on dentin bond strength under erosive conditions

OBJECTIVE

This study aimed to evaluate whether the use of desensitizing dentifrices containing obliterating agents can affect bond strength of eroded/abraded dentin.

METHODOLOGY

A total of 100 dentin samples were obtained from human molars. The teeth were cut into 3 mm-thickness discs and allocated in five groups (n=20), according to the toothpaste used: WoF - abrasion with fluoride-free toothpaste (Cocoricó); Arg - toothpaste containing arginine (Colgate Sensitive Pro-Relief); Nov - calcium sodium phosphosilicate toothpaste (Sensodyne Repair and Protect); SnF - fluoride-containing toothpaste (AmF/SnCl2/SnF2 - Elmex Erosion); and Control (no erosive/abrasive process). The erosive/abrasive cycle consisted of immersion in citric acid (1%, pH 2.6, 5 min, 4×/day) and abrasion (2×/day, 120-20 sec abrasion, 100 sec immersion) with each toothpaste. During intervals, samples were immersed in artificial saliva. This cycle was performed for five days. Two resin cylinders (2 mm in diameter) were constructed on each sample for the shear bond strength test using a universal adhesive system. The self-etch and etch-and-rinse (Scotchbond Universal) strategies were employed, each in half of the total sample (n=10). Bond strength (MPa) was measured in a shear test and failure modes were assessed with a stereomicroscope. Statistical analysis was performed using the two-way analysis of variance (ANOVA) and Tukey tests (p<0.05).

RESULTS

A statistically significant difference was found between the adhesive strategies tested (p<0.001), with the self-etching form showing higher values than the etch-and-rinse. Moreover, no significant differences were observed between the tested toothpastes (p=0.750) and interactions (p=0.438).

CONCLUSION

The use of toothpaste containing obliterating agents does not affect bond strength to dentin subjected to erosive/abrasive conditions when a universal adhesive is used. However, the self-etch strategy might be preferred for eroded/abraded dentin.

Physical analysis of an acrylic resin modified by metal and ceramic nanoparticles

BACKGROUND

Nanoparticles (NPs) have gained significant attention in various fields due to their unique properties and potential applications. Polymethyl methacrylate (PMMA) is an acrylic resin widely used in dentistry and medicine. However, the effect of different types of NP fillers on the physical properties of PMMA-based resins has not been thoroughly explored in the literature.

OBJECTIVES

The present study aimed to evaluate the effects of 3 different types of NP fillers on the physical properties of an experimental PMMA-based resin as a function of the NP content and concentration.

MATERIAL AND METHODS

Ten groups (n = 10) were designed. The specimens were composed of an acrylic resin, silicon dioxide (SiO2), cerium dioxide (CeO2), and titanium dioxide (TiO2) at the following ratios (wt%): group 1 (G1) - control; group 2 (G2) - 0.5% SiO2; group 3 (G3) - 1% SiO2; group 4 (G4) - 3% SiO2; group 5 (G5) - 0.5% CeO2; group 6 (G6) - 1% CeO2; group 7 (G7) - 3% CeO2; group 8 (G8) - 0.5% TiO2; group 9 (G9) - 1% TiO2; and group 10 (G10) - 3% TiO2. Transmission electron microscopy (TEM) was used to assess the quality of NP dispersion. Thermal stability was assessed with thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The effects of the abovementioned NPs on the properties of the resin were evaluated using the Archimedes principle for density, the Vickers hardness (VH) test and the impact strength (IS) test. Data analysis employed the oneand two-way analysis of variance (ANOVA), followed by Duncan's post hoc test at a significance level of 0.05.

RESULTS

Transmission electron microscopy showed partial NP dispersion. All types of NPs enhanced the mechanical properties of the acrylic resin except for IS, which was similar to that of the control group. Among the types of NPs, irrespective of the weight percentage, CeO2 showed higher thermal stability and higher IS for 0.5 wt% and 1 wt% as compared to other groups, as well as the highest values of density at 0.5 wt%, 1 wt% and 3 wt%. Titanium oxide at 1 wt% presented a higher VH as compared to other groups. The fracture pattern was the same for all groups.

CONCLUSIONS

Incorporating the tested NPs into the acrylic resin resulted in enhanced physical properties, primarily attributed to a lower NP content.

Restoration of teeth with customized CAD/CAM glass fiber posts: report of 2 cases

This article presents 2 cases in which computer-aided design/computer-aided manufacturing (CAD/CAM) was used to fabricate glass fiber posts to restore an anterior tooth and a posterior tooth with severe coronal destruction. In the past decade, CAD/CAM technology has improved, allowing high-precision milling of customized glass fiber posts. This can enhance the biomechanical behavior of the restoration, as the post and core are milled in a single unit, decreasing the risk of failure near the core junction or in the body of the core. The customized post also provides better adaptation and requires a thinner layer of cement, thus minimizing voids. In case 1, the patient had a severely damaged maxillary right canine with a ferrule from a previous restoration. In case 2, the patient presented with a mandibular left first molar exhibiting severe coronal destruction. In both cases, impressions of the root canal were scanned with a bench scanner, and the posts were fabricated using a glass fiber material designed for CAD/CAM technology. A self-adhesive resin cement was used to cement the posts in the root canals, and a metal-free crown (case 1) and overlay (case 2) were fabricated and placed. Satisfactory retention and esthetics were achieved, and both patients was pleased by the final results. These cases demonstrate the viability of CAD/CAM to restore endodontically treated teeth, and this technology can be an option for dentists interested in using a digital workflow. The longevity of the posts produced via this technique needs to be evaluated in clinical trials.

Comparative Evaluation of Bulk-Fill Composite Resins: Knoop Microhardness, Diametral Tensile Strength and Degree of Conversion

Purpose

Bulk-fill composite resins were developed to reduce time and facilitate the restorative procedure. However, considering their recent introduction on the market and the new formulations, their performance still requires evaluation. This study aimed to evaluate Knoop microhardness (KHN), diametral tensile strength (DTS) and degree of conversion (DC) of three Bulk-Fill composite resins and a conventional one.

Materials and Methods

Sixty samples (n = 15; 8 mm ø x 4 mm height) were confectioned using a mold. Filtek Bulk-Fill (FBF), Tetric N-Ceram Bulk-Fill (TNC) and SonicFill 2 (SF2) were placed in 4 mm increments, and Filtek Z350 (FZ350) was placed in 2 mm increments. The KHN of top and bottom surfaces were tested using Knoop Hardness tester at 10 gf/10s. The DTS was tested under compressive load at 1.0 mm/min. The DC was measured by Fourier Transform Infrared (FTIR) spectroscopy. Differences in DTS and DC were analyzed by ANOVA and Tukey post hoc test. For KHN, Kruskal–Wallis and Wilcoxon tests were performed at α = 0.05.

Results

Top surfaces of all composite resins had higher KHN than bottom surfaces. At top and bottom surfaces, FZ350 showed higher KHN than TNC and SF2. The highest DTS was obtained by FBF, followed by FZ350 and SF2. The highest DC was obtained by SF2, the lowest one was obtained by FBF.

Conclusion

From Bulk-Fill composite resins, FBF presented the best KHN and DTS results. The SF2 showed the best DC. Further studies are required to ensure whether these differences can negatively influence the behavior of in vivo restorations.

Mechanical Properties of Experimental Composites with Different Photoinitiator

Objective  The effect of different photoinitiators on mechanical properties of experimental composites was evaluated.

Materials and Methods  Resin composites were formulated by using a blend of bisphenol A-glycidyl and triethylene glycol (50/50 wt%) dimethacrylate monomers, and 65 wt% of barium aluminium silicate and silica filler particles. Photoinitiators used were 0.2% camphorquinone (CQ) and 0.8% co-initiator (DMAEMA); 0.2% phenyl-propanedione and 0.8% DMAEMA; 0.1% CQ + 0.1% phenyl propanedione and 0.8% DMAEMA; 0.42% mono(acyl)phosphine oxide (MAPO); and 0.5% bis(acyl)phosphine oxide (BAPO). Specimens ( n = 10) were light cured by using a multiple-emission peak light-emitting diode for 20 seconds at 1,200 mW/cm ² of irradiance and Knoop hardness and plasticization, depth of cure, flexural strength, and elastic modulus were evaluated. Data were statiscally analyzed at significance level of α = 5%.

Results  Experimental composites containing MAPO and BAPO photoinitiators showed the highest values of flexural strength, elastic modulus, top surface hardness, and lower hardness reduction caused by alcohol compared with CQ. Composites containing CQ and PPD showed similar results, except for depth of cure and hardness of bottom surface.

Conclusion  BAPO and MAPO showed higher flexural strength, elastic modulus, hardness on top surface, and lower polymer plasticization to CQ.

Effectiveness and Adverse Effects of Over-the-Counter Whitening Products on Dental Tissues

The role of bleaching agents (e.g., hydrogen peroxide) in tooth bleaching is quite well-described in a few literature studies and considered as the option choice for those desiring brighter teeth, but alternative methods have emerged to fulfill the desire of patients in a faster, easier, and cheaper way. In this context, whitening over-the-counter (OTC) products are available in several vehicles, such as toothpaste, rinses, gums, paint-on varnishes, and strips, but their effectiveness in terms of bleaching is questioned. This review aimed to describe their mode of action, whitening effectiveness, and harmful effects associated with the indiscriminate use of these products. Dentifrices usually present a combination of abrasives that can induce damage to the tooth surface without evidence of promoting real bleaching. The same was found for rinses, which might present a low pH, with an erosive potential. Charcoal has been included in the composition of these products to improve their whitening effect but there is no evidence supporting it. Regarding strips, they present hydrogen peroxide in a variety of concentrations and are the only OTC products able to promote bleaching. Despite the vehicle, an indication for the use of these products should be made after a careful individual diagnosis of the etiology of the dental staining, considering that most of them seem to be effective only in removing extrinsic stains or preventing their formation over enamel. Also, their indiscriminate use might induce damage and deleterious effects over tooth tissues or gingival tissues. The dentist should be aware of the composition and mode of action of each individual product as they change according to the composition and the vehicle used to recommend the best mode of usage. Still, there is no sound evidence that any of the described OTC products promote a better bleaching effect than the products indicated for a professional.

Influence of Erosion/Abrasion and the Dentifrice Abrasiveness Concomitant with Bleaching Procedures

Purpose

The aim of this study was to evaluate the effect of erosive/abrasive cycles and two different levels of abrasiveness of dentifrices over enamel and dentin subjected to bleaching.

Methods

Enamel and dentin bovine specimens were prepared and submitted to an at-home bleaching treatment using 9.5% hydrogen peroxide gel, which was applied daily (30 min/14 days). Concomitant with bleaching, an erosive cycle was performed using citric acid (0.3%, pH 3.8, 5 mins, 3×/day), followed by immersions in artificial saliva for remineralization (30 mins). Abrasion was done with two (high and low abrasiveness) dentifrices (2×/day, 120 seconds) after the first and third erosive immersion each day. Enamel and dentin softening were assessed by microhardness and erosive tooth wear by optical profilometry. Data were submitted to repeated measures ANOVA, followed by the Tukey’s test with a significance level of 5%.

Results

For the enamel and considering the erosive-abrasive cycle, significant differences were found between the groups tested, the bleaching, and the abrasiveness of the dentifrice tested; however, the final microhardness values were significantly lower than the initial ones. For dentin, differences were found between the eroded/abrasion and the non-eroded/abrasion groups, with the former presenting lower microhardness values compared with the latter. In addition, bleaching decreased the microhardness values only for the highly abrasive dentifrice, and the final values were lower than for the initial ones for all tested groups.

Conclusion

The use of high and low abrasiveness dentifrices during bleaching and concomitant with erosion/abrasion cycles is more harmful to dentin than to enamel.

Clinical Relevance

Although bleaching is considered a conservative treatment, it can cause deleterious effects to dental hard tissue. The association of an at-home bleaching technique with erosion and high- or low- abrasive dentifrices harms dentin more than enamel.

Physicochemical changes in enamel submitted to pH cycling and bleaching treatment

Objective

The purpose of this study was to assess the hardness, mineral content, surface roughness, and micromorphology of sound and slightly demineralized enamels, before and after bleaching procedure using 10% carbamide peroxide.

Methods

Sixty bovine dental blocks were randomly divided into the following two groups: 30 slabs were submitted to three cycles of pH and 30 slabs were noncycled. Hardness (n=10) was measured using the microhardness tester with Knoop indenter under a 50 g load for 5 seconds. The calcium/phosphate (Ca/P) ratio (n=10) was obtained using a micro-energy-dispersive X-ray fluorescence (μ-EDXRF) spectrometer. The measurement of roughness average (n=10) was performed using a surface roughness tester. Specimens were bleached 6 hours/day during 21 days, and then, physicochemical properties were re-evaluated. Two additional specimens were carried out to evaluate surface micromorphology using the scanning electron microscopy. Data were statistically analyzed by ANOVA and Tukey's test (α=0.05).

Results

Sound and slightly demineralized enamels showed no difference in Ca/P ratio after dental bleaching according to the μ-EDXRF analysis, but the Ca/P ratio decreased after bleaching for slightly demineralized enamel. Bleaching treatment decreased the hardness and increased the surface roughness, causing micromorphology alterations.

Conclusion

Therefore, bleaching procedure promoted change in bovine enamel surface and increased the demineralization of slightly demineralized enamel but not affected the mineral content of sound enamel.

Effect of preheating and light-curing unit on physicochemical properties of a bulk fill composite

Objective

The aim of this study is to evaluate the effect of composite preheating and polymerization mode on degree of conversion (DC), microhardness (KHN), plasticization (P), and depth of polymerization (DP) of a bulk fill composite.

Methods

Forty disc-shaped samples (n = 5) of a bulk fill composite were prepared (5 × 4 mm thick) and randomly divided into 4 groups according to light-curing unit (quartz–tungsten–halogen [QTH] or light-emitting diode [LED]) and preheating temperature (23 or 54 °C). A control group was prepared with a flowable composite at room temperature. DC was determined using a Fourier transform infrared spectrometer, KHN was measured with a Knoop indenter, P was evaluated by percentage reduction of hardness after 24 h of ethanol storage, and DP was obtained by bottom/top ratio. Data were statistically analyzed by analysis of variance and Tukey’s test (α = 0.05).

Results

Regardless of light-curing, the highest preheating temperature increased DC compared to room temperature on bottom surface. LED showed a higher DC compared to QTH. Overall, DC was higher on top surface than bottom. KHN, P, and DP were not affected by curing mode and temperature, and flowable composite showed similar KHN, and lower DC and P, compared to bulk fill.

Conclusion

Composite preheating increased the polymerization degree of 4-mm-increment bulk fill, but it led to a higher plasticization compared to the conventional flowable composite evaluated.

Microhardness evaluation of silorane and methacrylate composites submitted to erosion and abrasion processes

Objective: The aim of this study was to evaluate the Knoop hardness number (KHN) of methacrylate (MC) and silorane (SC) composites after being submitted to erosion and abrasion processes. Material and methods: Forty samples were made with each composite: MC and SC. The samples were divided into eight groups (n = 10) according to the type of composite (G1-G4, MC; G5-G8, SC) and the beverages involved in the erosion process (G1 and G5 - Control (C), without erosion, with abrasion; G2 and G6 - Orange Juice (OJ), abrasion; G3 and G7 - Smirnoff Ice® (SI), abrasion; G4 and G8 - Gatorade® (GA), abrasion). The KHN test was performed 24 h after the last cycle of erosion/abrasion. Results: The MC groups showed smaller KHN values for the SI group (p < 0.05) when compared to the Control and OJ groups; however, for the SC groups, no differences were found (p > 0.05). Conclusion: Methacrylate composite when submitted to acidic beverages erosive challenge combined with abrasive process might alter its surface microhardness. However, the beverages used in the present study were not able to interfere in silorane composite surface microhardness.

In vitro effects of hydrogen peroxide combined with different activators for the in-office bleaching technique on enamel

OBJECTIVE

The aim of this study was to evaluate the alteration of human enamel bleached with high concentrations of hydrogen peroxide associated with different activators.

MATERIALS AND METHODS

Fifty enamel/dentin blocks (4 × 4 mm) were obtained from human third molars and randomized divided according to the bleaching procedure (n = 10): G1 = 35% hydrogen peroxide (HP - Whiteness HP Maxx); G2 = HP + Halogen lamp (HL); G3 = HP + 7% sodium bicarbonate (SB); G4 = HP + 20% sodium hydroxide (SH); and G5 = 38% hydrogen peroxide (OXB - Opalescence Xtra Boost). The bleaching treatments were performed in three sessions with a 7-day interval between them. The enamel content, before (baseline) and after bleaching, was determined using an FT-Raman spectrometer and was based on the concentration of phosphate, carbonate, and organic matrix. Statistical analysis was performed using two-way ANOVA for repeated measures and Tukey's test.

RESULTS

The results showed no significant differences between time of analysis (p = 0.5175) for most treatments and peak areas analyzed; and among bleaching treatments (p = 0.4184). The comparisons during and after bleaching revealed a significant difference in the HP group for the peak areas of carbonate and organic matrix, and for the organic matrix in OXB and HP+SH groups. Tukey's analysis determined that the difference, peak areas, and the interaction among treatment, time and peak was statistically significant (p < 0.05).

CONCLUSION

The association of activators with hydrogen peroxide was effective in the alteration of enamel, mainly with regards to the organic matrix.

Does an additional UV LED improve the degree of conversion and Knoop Hardness of light-shade composite resins?

Objective: The purpose of this study was to evaluate the degree of conversion (DC) using FTRaman spectroscopy and the Knoop hardness (KHN) of composites cured by second and third-generation LED light curing-units (LCU), Radii Cal and Ultralume 5.

Methods: Three composites (Filtek Supreme XT, Filtek Z350, and Esthet X) were selected for this study. KHN testing (n=10) was performed with 10 indentations for the top (T) and bottom (B) surfaces. For DC (n=10), both the T and B surfaces were analyzed.

Results: For KHN, the three composites differed in hardens. There was a “LCU-surface” interaction, in which Radii Cal showed significantly greater hardens in the B surface. For DC, there was a “composite-surface-LCU” interaction. For the “composite” factor, there was no significant difference between the groups, except for Supreme XT-Radii Cal (T or B surfaces). For the “LCU” factor there was a significant difference for Supreme XT T surface, Ultralume 5 obtained a higher DC. For the Z350 T surface, a significant difference in the DC in which Radii Cal obtained better results. For the “surface” factor, all groups presented T surfaces with a higher DC than the B surfaces, the sole exceptions involved Esthet X-Radii Cal and Z350-Ultralume 5.

Conclusion: Knowledge regarding composite composition and the characteristics of LCUs are important for effective polymerization. (Eur J Dent 2012;6:396-401)

Does an additional UV LED improve the degree of conversion and Knoop Hardness of light-shade composite resins?

OBJECTIVE

The purpose of this study was to evaluate the degree of conversion (DC) using FT-Raman spectroscopy and the Knoop hardness (KHN) of composites cured by second and third-generation LED light curing-units (LCU), Radii Cal and Ultralume 5.

METHODS

Three composites (Filtek Supreme XT, Filtek Z350, and Esthet X) were selected for this study. KHN testing (n=10) was performed with 10 indentations for the top (T) and bottom (B) surfaces. For DC (n=10), both the T and B surfaces were analyzed.

RESULTS

For KHN, the three composites differed in hardens. There was a "LCU-surface" interaction, in which Radii Cal showed significantly greater hardens in the B surface. For DC, there was a "composite-surface-LCU" interaction. For the "composite" factor, there was no significant difference between the groups, except for Supreme XT-Radii Cal (T or B surfaces). For the "LCU" factor there was a significant difference for Supreme XT T surface, Ultralume 5 obtained a higher DC. For the Z350 T surface, a significant difference in the DC in which Radii Cal obtained better results. For the "surface" factor, all groups presented T surfaces with a higher DC than the B surfaces, the sole exceptions involved Esthet X-Radii Cal and Z350-Ultralume 5.

CONCLUSION

Knowledge regarding composite composition and the characteristics of LCUs are important for effective polymerization.

Secondary caries inhibition promoted by adhesive systems and bleaching agents with fluoride

PURPOSE

To evaluate the initial caries development at adhesive/enamel interface after 10% carbamide peroxide bleaching (CP) with or without fluoride (F) under dynamic pH-cycling.

METHODS

Standard cavities were prepared on the bucal surface of 60 bovine incisors, which were restored with two fluoride-containing adhesives: Optibond FL (FL) and Optibond Solo Plus (SP). The restored teeth were submitted to thermal cycling process in order to age the adhesive/enamel interface. Both SP and FL adhesive-restored teeth were divided into groups (n= 10) and bleached with 10% CP (CP) and 10% CP + F (CPF) or remained unbleached (Control). Bleaching was performed for 14 days simultaneously with pH-cycling. The specimens were prepared for cross-section microhardness evaluation and polarized light microscopy analysis to evaluate caries lesions at different depths around the bonded interface.

RESULTS

Group FL (not bleached) presented the lowest mineral loss rate among groups, but secondary caries formation was observed for all groups around the bonded interface. An inhibition zone was observed for all groups, with caries lesion detected at 5 microm from the cavity wall.

Streptococcus mutans biofilm adhesion on composite resin surfaces after different finishing and polishing techniques

This study evaluated Streptococcus mutans biofilm adhesion on the surface of three composite resins (nanofilled, Filtek Z350, 3M ESPE, Salt Lake City, UT, USA; nanohybrid, Vit-1-escence, Ultradent Products, South Jordan, UT, USA; and microhybrid, Esthet X, Dentsply, Milford, DE, USA) following different finishing and polishing techniques. Sixty standardized samples (6 × 3 mm) of each composite were produced and randomly divided into three finishing and polishing treatments (n=20): 1) control group: composite resin surface in contact with Mylar matrix strips with no finishing or polishing performed, 2) Sof-Lex aluminum oxide disc technique (3M ESPE, and 3) carbide bur finishing and Astrobrush polishing technique (Ultradent). Half the samples of each group were incubated in human saliva for 1 hour, and all the samples were subjected to S mutans (ATCC 35688) biofilm development. The mean log of CFU/mL present in the S mutans biofilm was calculated, and data were statistically analyzed by three-way analysis of variance and the Tukey test (p<0.05). Human saliva incubation promoted a significant increase of bacterial adherence on all three of the composites' surfaces, regardless of the polishing treatment performed (p<0.05). Of the three, the nanofilled composite (Filtek Z350) had the lowest bacterial adherence with each of the finishing and polishing techniques despite the presence or absence of human saliva (p<0.05). Mylar matrix strips (control group) promoted the lowest bacterial adhesion on the surface of the microhybrid and nanofilled composites in the absence of human saliva.

Evaluation of surface roughness of microhybrid and nanofilled composites after pH-cycling and simulated toothbrushing

AIM

This study evaluated the surface roughness patterns of two resin-based composite restorative materials, a microhybrid (Filtek Z250, 3M ESPE) and a nanofilled (Filtek Supreme, 3M ESPE), subjected to a regimen that simulated dynamic pH-cycling and toothbrushing.

METHODS AND MATERIALS

Twelve standardized cylindrical specimens of each resin-based composite material were prepared, finished, and mechanically polished. The experimental units were submitted to a pH-cycling regimen followed by 50,000 toothbrushing cycles, after which the surface roughness was measured using an atomic force microscope (AFM). AFM surface roughness was evaluated at three intervals: (1) immediately after specimen preparation (baseline), (2) after pH-cycling, and (3) after simulated toothbrushing. The results were then analyzed using a split-plot design and followed by linear regression and a Tukey's test at a significance level of p<0.05.

RESULTS

The results obtained indicated that simulated toothbrushing provoked a remarkable increase in surface roughness for both types of composite resins tested (p=0.0031). However, pH-cycling did not alter the surface of the composite under the conditions of this experiment.

CONCLUSION

Based on the results obtained, it was concluded that simulated toothbrushing was capable of increasing the surface roughness of the microhybrid (Filtek Z250) and the nanofilled (Filtek Supreme) composites tested.

CLINICAL SIGNIFICANCE

Surface roughness of nanofilled and microhybrid composites is significantly increased after toothbrushing, although pH-cycling, as tested in this study, does not appear to affect the morphology of either composite material.

FT-Raman and energy dispersive X-ray fluorescence spectrometric analyses of enamel submitted to 38% hydrogen peroxide bleaching, an acidic beverage, and simulated brushing

OBJECTIVE

This study aimed to investigate the effects on enamel surface treated with hydrogen peroxide bleaching and acidic soft drink immersion and/or brushing with whitening dentifrices.

MATERIALS AND METHODS

Fifty-six standardized enamel slabs obtained from labial surfaces of bovine incisors were used. Enamel slabs were ground flat, polished, and randomly assigned to one of seven treatment groups: (1) control, in which no treatment was performed, (2) soft drink immersion, (3) 38% hydrogen peroxide bleaching, (4) simulated toothbrushing with whitening dentifrice, (5) soft drink immersion and bleaching, (6) soft drink immersion, bleaching, and toothbrushing, and (7) bleaching and toothbrushing. The mineral concentration of enamel surfaces was determined before and after treatments by means of Fourier transform (FT)-Raman spectroscopy and energy dispersive x-ray fluorescence spectrometry (EDXRF). Data were statistically analyzed by ANOVA and Tukey test (p < 0.05).

RESULTS

Raman spectroscopy results indicated that enamel mineral content decreased after all treatments except in group 1, whereas EDXRF results exhibited mineral decrease in groups 3, 4, 5, and 7.

CONCLUSION

Bleaching alone or in combination with soft drink immersion and brushing decreases enamel mineral content.

Influence of saliva contamination on the shear bond strength of orthodontic brackets bonded with self-etching adhesive systems

INTRODUCTION

Our objective was to evaluate the influence of saliva contamination on the shear bond strength of orthodontic brackets bonded with self-etching primers.

METHODS

One hundred thirty-five bovine incisors were randomly divided into 3 groups, and exposed enamel surfaces were bonded with Transbond Plus Self Etching Primer (TB) (3M Unitek, Monrovia, Calif), Adhese Single Bottle (AD) (Ivoclar, Vivadent, Schaan, Liechtenstein), and Self Etch Bond (SE) (Vigodent, Rio de Janeiro, Brazil). Each group was subdivided into 3 treatments (n = 15): saliva contamination (S), saliva contamination and deionized water rinsing (SW), and no salivary contamination (C). Resin composite (Z-100, 3M/ESPE, Salt Lake City, Utah) was applied to all samples to bond the orthodontic brackets. Shear bond strength testing was carried out in a universal testing machine operating at 1.0 mm per minute.

RESULTS

The results were statistically analyzed with 2-way analysis of variance (ANOVA) and Tukey tests (P <0.05). Saliva contamination caused a significant decrease of enamel strength in the groups bonded with TB and SE compared with the SW and C groups. Enamel bond strengths of the C and SW groups were higher than those of the TB group, followed by the AD and SE groups. Enamel bond strength after S was higher than AD, followed by TB and SE.

CONCLUSIONS

The shear bond strengths of orthodontic brackets to enamel and the performance of the adhesive systems were influenced by contamination with saliva.

Concurrence between the maxillary midline and bisector to the interpupillary line

PURPOSE

Symmetry is one of the factors that contributes to facial harmony, and in oral rehabilitation it determines the success of esthetic treatment. Therefore, the aim of the present study was to analyze the axial symmetry between the bipupillar midline and maxillary central incisors midline of 102 dental students (both genders) distributed across five Brazilian dental schools.

MATERIALS AND METHODS

Students with no teeth missing and who had never been subjected to any dental treatment were selected. Photographs were taken with a Dental Eye III camera with a 100-mm macro objective and ratio of 1:10 from natural size, recorded on an Ektachrome ASA/ISO 100 film. The images were developed and applied to Microsoft Office Power Point 2007 software. The results were analyzed by analysis of variance and Student's t-test (alpha = 0.05).

RESULTS

There was no significant correlation between bipupillar midline and the maxillary dental midline, irrespective of gender.

CONCLUSION

No significant coincidence was observed between the interpupillary and dental midline. However, the interpupillar distance and its relationship with other anatomic structures may be used as a reference in treatment, but measurements must be assessed individually.

CLINICAL SIGNIFICANCE

Anatomic measurements and facial proportions can be helpful during the planning of esthetic oral rehabilitation.

The effect of coffee solution on tooth color during home bleaching applications

PURPOSE

To quantify the change in color of human and bovine teeth exposed to a coffee solution during a 16% carbamide peroxide (16% CP) home application bleaching treatment using photoreflectance analysis.

METHODS

40 enamel slabs (4 x 4 x 2 mm) were obtained from seven unerupted third human molars and seven bovine incisors, which were allocated into four groups: G1: human control group whitened and not exposed to a coffee solution; G2: bovine control group whitened and not exposed to a coffee solution; G3: human teeth whitened and exposed to a coffee solution; G4: bovine teeth whitened and exposed to a coffee solution. The home bleaching procedure was performed using 16% CP gel applied in a 1 mm-thick layer on the tooth surface over a period of 6 hours per day, for 28 days. Tooth color was evaluated using photoreflectance analysis throughout the bleaching procedure at intervals of 7, 14, 21 and 28 days, and posttreatment at 7, 15 and 30 days. Results were statistically analyzed using ANOVA and Tukey-Kramer tests.

RESULTS

After 28 days of bleaching treatment, no significant difference was detected between photoreflectance analysis of specimens exposed to coffee solution and specimens not exposed to coffee solution (P < 0.05). However, when the teeth were exposed to a coffee solution during home bleaching treatment, the whitening effect was observed to be less stable (P < 0.05). Bovine and human enamel substrates behaved similarly in terms of staining and bleaching effects, although they presented inherent differences in color (P < 0.05).

In vitro evaluation of the effectiveness of bleaching agents activated by different light sources

PURPOSE

This study evaluated the efficacy of tooth whitening and color stability at different time periods after treatment.

MATERIALS AND METHODS

Blocks obtained from human molars were divided into 15 groups (n = 5) by bleaching agents: 35% hydrogen peroxide (Whiteness HP and Opalescence Xtra) and 37% carbamide peroxide (Whiteness Super); and light sources: halogen lamp and plasma arc lamp (bleach mode), LED/diode laser, argon laser, and no light source. The efficacy of bleaching was measured using a spectrophotometer. Six bleaching sessions were performed (times 1 to 6). The specimens were submitted to another reading 7, 15, and 30 days after the end of bleaching (times 7, 8, and 9). The results were submitted to ANOVA followed by Tukey test and polynomial regression (p < 0.05).

RESULTS

Carbamide peroxide significantly differed from hydrogen peroxide, presenting low reflectance values. Activated versus non-activated bleaching did not differ significantly for any gel tested, except for Whiteness HP activated by argon laser, which presented the lowest mean reflectance values. The results obtained with hydrogen peroxide revealed a decrease in reflectance values one month after the end of treatment. For carbamide peroxide, this decrease was not observed.

CONCLUSION

The halogen lamp presented the same or higher efficacy than non-activated bleaching, which had a longer gel contact period. When hydrogen peroxide was used, a decrease in reflectance values was observed 30 days after the end of bleaching.

Influence of coffee on reflectance and chemistry of resin composite protected by surface sealant

PURPOSE

To assess the influence of the light-curing unit type and whether or not it was worth using surface sealant protection on resin composite restorative materials stained by coffee. Another objective was to propose the monitoring of coffee staining by FT-Raman spectroscopy using carbon-hydrogen (C-H) bonds as reference to the composite matrix degradation.

METHODS

Sixty cylindrical specimens of resin composite were prepared and divided into six groups: HC (control)--cured with a halogen light; LC (control) cured with a LED; HF--cured with a halogen light + Fortify Plus; LF--cured with a LED + Fortify Plus; HP--cured with a halogen light + PermaSeal; LP--cured with a LED + PermaSeal. After storage for 24 hours at 37% and 100% of relative humidity, the top surface was protected, and the other surfaces isolated. Polishing with paper discs was performed after 24 hours of curing and prior to FT-Raman spectroscopy and reflectance measurements. All specimens were submitted to coffee staining for 14 days and evaluated by both systems. Results were statistically analyzed by ANOVA and Tukey tests.

RESULTS

FT-Raman spectrum only showed significant changes in groups LC and LP (P< 0.05). Reflectance demonstrated that staining was present in all specimens protected by sealants. Sealant staining was larger in the HF (P < 0.001) group.

The Effect of Soft-start Polymerization by Second Generation LEDs on the Degree of Conversion of Resin Composite

Photo-polymerization using second generation LED and halogen light in the soft-start mode of curing was able to produce an adequate degree of conversion in resin composites. The lower degree of conversion produced by low power LED in the soft-start mode could lead to restoration failure, degradation of the organic matrix and recurrent caries.

Analyses by photoreflectance spectroscopy and Vickers hardness of conventional and laser-assisted tooth bleaching

PURPOSE

To evaluate the in vitro effects of two bleaching products developed to be used with halogen or argon laser lights.

METHODS

20 human embedded third molars were cut into four parts resulting in 75 useful specimens. The specimens were divided at random into five groups and submitted to the traditional power bleaching procedure for enamel. Group C was separated as a control group. Group 37L was exposed to a 37% carbamide peroxide bleaching solution and exposed to 488 nm argon laser radiation. The same solution was used in Group 37H but the bleaching was exposed to a halogen lamp-based unit. The 35% carbamide peroxide was used in Groups 35L and 35H. One was treated as in Group 37L and the other as in Group 37H. The samples were analyzed for Vickers hardness and also by photoreflectance.

RESULTS

Group 37L presented more white spectra than Group 37H. However, Groups 35L and 35H showed similar results. Comparing both bleaching products, the 35% carbamide peroxide was more effective as a bleaching agent than the 37% formulation. No significant difference in Vickers hardness was noted between the two bleaching products.