Is the whitening effect of charcoal-based dentifrices related to their abrasive potential or the ability of charcoal to adsorb dyes?

OBJECTIVES

To evaluate if tooth color alteration of activated charcoal-based dentifrices may be attributed to the dye adsorption potential of charcoal (chemical action - C - slurry only) or to the association of dye adsorption with abrasion (chemo-mechanical action - CM- slurry/toothbrushing). Potential adverse effects in surface roughness, gloss, and wear were also assessed.

METHODS

Bovine enamel/dentin specimens were randomly allocated into the groups according to treatments and test model (n = 15): deionized water (negative control- NC); Colgate Maximum Anticaries Protection (conventional toothpaste- positive control- PC); Colgate Luminous White Activated Charcoal (LW); Oral-B 3D White Therapy Charcoal (WT); Curaprox Black is White (BW); Dermavita Whitemax (Activated charcoal powder- WP). Specimens were exposed to the C or CM models, in 28-day staining-treatment cycling. Color change (ΔE00), whiteness index (ΔWID), percentage of alteration of surface roughness (%Raalt), and gloss (%GUalt) were calculated. Additional specimens (n = 9) were indented with a Knoop diamond and subjected to 100,000 abrasion cycles. Enamel wear was determined by calculating the decrease in indentations geometry. Data were analyzed by ANOVA/Tukey tests (α = 0.05).

RESULTS

The CM-model produced lower color change (staining) than C (p = 0.0001). PC, LW, WT, BW, and WP showed similar color results for both models, differing from NC (p < 0.05).%Ra and%GU did not differ among the C-model groups (p > 0.05) and WP exhibited the highest variation (%Ra and%GU) under CM-model. Enamel wear values were lowest in the NC and PC groups, intermediate for LW, WT, BW, and highest for the WP (p < 0.05).

CONCLUSION

Activated charcoal-based dentifrices have a similar ability to minimize tooth staining as the conventional toothpaste, with increased enamel wear potential in the long term (after 100,000 cycles). The activated charcoal powder damaged the enamel surface, showing a higher deleterious effect on enamel roughness, gloss, and wear.

CLINICAL SIGNIFICANCE

Dentifrices containing activated charcoal do not provide superior results to minimize tooth staining compared to conventional toothpaste. Charcoal powder should be used with caution because it promotes higher superficial alterations on the enamel surface.

Effect of Remineralization Pretreatments on Human Dentin Permeability and Bond Strength

This study aimed to evaluate Nd:YAG laser, calcium phosphate, and adhesive system effect as different pretreatments in different protocols on dentin permeability (DP) and bond strength (BS). Fifty human dentin discs were used (4 mm in diameter and 1,5 mm in height). Specimens were divided into five groups (n = 10): (A): adhesive system (control); (AL): adhesive system + Nd:YAG laser; (LAL): Nd:YAG laser + adhesive system + Nd:YAG laser; (PAL): calcium phosphate-based dentin desensitizer TeethMate + adhesive system + Nd:YAG laser; and group (PLAL): Nd:YAG laser + calcium phosphate-based dentin desensitizer + adhesive system + Nd:YAG laser. All materials were used according to the manufacturers' instructions. The specimens were submitted to artificial aging (5,000 thermal cycles and 12 × 10⁴ mechanical cycles) then a bond test was performed. DP was measured using the split chamber model. Data were submitted to one-way analysis of variance (ANOVA), paired t-test, RM ANOVA, and Tukey test (p < 0.05). All treatments were effective in DP reduction. For BS, the groups PAL and PLAL had improved BS with a statistically significant difference of the control group (A). Nd:Yag laser irradiation and calcium phosphate-based desensitizing agents significantly reduced DP, and the association between them could improve the BS on resin-human dentin interface.

Effect of whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge

OBJECTIVE

To investigate the effect of fluoride-containing whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge.

MATERIALS AND METHODS

Bovine enamel specimens (n = 120) with three areas [non-treated sound enamel (NSE), treated sound enamel (TSE), and treated artificial caries lesion (TACL)] were randomly assigned to the four groups: whitening mouthrinse (WM: 2.5% hydrogen peroxide-100 ppm F-), placebo mouthrinse (PM: 0% hydrogen peroxide-100 ppm F-), whitening gel (WG: 10% carbamide peroxide-1130 ppm F-), and deionized water (negative control; NC). The treatments (2 min for WM, PM, and NC, and 2 h for WG) were carried out during a 28-day pH-cycling model (6 × 60 min demineralization/day). Relative surface reflection intensity (rSRI) and transversal microradiography (TMR) analyses were performed. Fluoride uptake (surface and subsurface) was measured in additional enamel specimens.

RESULTS

For TSE, a higher value of rSRI was observed in WM (89.99% ± 6.94), and a greater decrease in rSRI was observed for WG and NC, and no sign of mineral loss was verified for all groups (p > 0.05). For TACL, rSRI significantly decreased after pH-cycling for all experimental groups with no difference between them (p < 0.05). Higher amounts of fluoride were found in WG. WG and WM exhibited intermediate values of mineral loss, similar to PM.

CONCLUSIONS

The whitening products did not potentialize the enamel demineralization under a severe cariogenic challenge, and they did not exacerbate mineral loss of the artificial caries lesions.

CLINICAL RELEVANCE

Low concentrated hydrogen peroxide whitening gel and mouthrinse containing fluoride do not intensify the progression of caries lesions.

Optical properties of esthetic temporary cements and final restoration color

BACKGROUND

Opaque cements can be esthetically unfavorable and alternative translucent materials have been developed. The aim of this study was to evaluate the color interference of a new translucent cement compared with conventional materials, in association with interim restoration with different thickness and shades.

METHODS

Bis-acryl composite disks were prepared in 2 thicknesses (1.2 mm, 0.6 mm) and 3 shades (A3.5, A2, bleached) to simulate the restorations. Cementation over dentin disks was performed with 1 translucent cement (Provicol QM Aesthetic; VOCO), 2 conventional cements (Provicol; VOCO, Temp-Bond NE; Kerr Dental), and 1 transparent liquid (polyethylene glycol 400). The difference between the color of the specimens cemented with the transparent liquid and that of the specimens cemented with each cement was calculated (ΔEab). The data were analyzed using 3-way analysis of variance and Tukey tests (5%).

RESULTS

Significant differences were observed for all factors and some interactions (P < .05). For Provicol QM Aesthetic, the shade and thickness did not influence the ΔEab. For Provicol and Temp-Bond NE, the lighter and thinner the specimen, the higher the ΔEab. Only Provicol QM Aesthetic had smaller means than the perceptibility threshold. Temp-Bond NE and Provicol had higher values than the acceptability threshold for some combinations.

CONCLUSIONS

The highly translucent cement had less color interference than the conventional materials. The thickness and resin shade only affected the results for the opaque cements. The thinner specimens and the lighter shades had higher color interference.

PRACTICAL IMPLICATIONS

The use of a more translucent cement can produce a smaller color interference on the esthetic outcome of interim restorations.

Chemical behavior of 20%-22% carbamide peroxide gels in at-home bleaching: Randomized crossover in situ trial

OBJECTIVE

To evaluate if distinct 20%-22% carbamide peroxide bleaching gels present similar decomposition pattern and pH during the clinical use in both arches, as well as gels viscosity.

METHODS

Participants randomly received treatments with carbamide peroxide gels (n = 10): OPF (OpalescencePF-20%); PNT (Polanight-22%); and WPC (Whiteness Perfect-22%) in three different days, with 2-day washout. Decomposition pattern was assessed by peroxide concentration. Both PC and pH of bleaching gels were measured in different time points in upper and lower trays during a total of 120 min of clinical use. Viscosity of bleaching gels was measured in triplicate. ANOVA and Tukey's test were applied (α = 0.05).

RESULTS

Regarding decomposition pattern, no significant differences were observed for the interaction between gel, time, and tray position factors. The peroxide concentration progressively reduced until 120 min of trays use (p < 0.001), being overall more notable in lower trays (p < 0.001). Regarding pH, the lowest values were verified in WPC within time. At 120 min, an increase of pH was observed for both WPC and OPF (p < 0.001) compared to baseline means. PNT exhibited constant pH values over time. The values of viscosity were: OPF (1.682.000 ± 19 cP)a, WPC (1.388.667 ± 172.63 cP)ab, PNT (579.567 ± 0.98 cP)b.

CONCLUSIONS

The bleaching gels presented overall decomposition pattern clinically equivalent, being more notable in lower trays over time. Nevertheless, distinct pH and viscosities were observed among the products.

CLINICAL SIGNIFICANCE

Although the manufacturers recommend different times of use for bleaching gels with similar peroxide concentrations, the commercial products tested did not exhibit clinically relevant difference in the decomposition pattern during the 120 min of clinical procedure.

Viscosity modulation of resin composites versus hand application on internal adaptation of restorations

OBJECTIVE

To compare the effect of the injection of viscosity modulated resin composites versus hand application without modulation, on the internal adaptation of different material to the gingival wall of class II preparations.

MATERIALS AND METHODS

Class II cavities were created on mesial and distal surfaces of 60 extracted human molars, resulting on 120 tooth preparations (n = 120). The preparations were restored with four resin composites: VIS-VisCalor (Voco); GRA-GrandioSO (Voco); FIL-Filtek One Bulk Fill (3 M/ESPE); and SON-SonicFill (Kerr). Each composite was applied by two different techniques: by hand (H) or assisted (A). For the hand technique, the material was placed into the preparation using a spatula. For the assisted technique, the resin composite was heated up to 65 °C (for VIS, GRA, and FIL) or sonicated (for SON) and injected into the preparation. After the restorative procedures, the teeth were completely demineralized to allow the restoration removal. The total area of the gingival wall and the area occupied by interfacial defects of adaptation (TDA) were measured by optical microscopy and digital software. The percentage of the area occupied by the defects (%TDA) in relation to the total area was calculated. The data were analyzed by two-way ANOVA and Tukey tests.

RESULTS

Significant differences were observed for the application technique (p = 0.0403) and for the materials (p = 0.0184), as well for the interaction between them (p = 0.0452). The mean (standard deviation) of %TDA and results of Tukey test for the interaction were as follows: SON/H - 1.04(0.75)a; VIS/A - 2.01(0.92)a; VIS/H - 3.62(0.99)b; GRA/A - 6.23(3.32)b; FIL/H - 7.45(3.31)bc; GRA/H - 9.21(4.53)c; SON/A - 11.26(4.04)a; FIL/A - 17.89(5.08)d.

CONCLUSION

The injection of heated resin composites improves the adaptation to the walls in relation to the hand technique for VisCalor and GrandioSO but worsens for Filtek One. Sonic vibration increases the number of interfacial defects for SonicFill.

CLINICAL RELEVANCE

The physical modulation of the resin composite viscosity can improve or worsen the material adaptation to the walls of class II restoration. It had a positive impact for VisCalor and GrandioSO but a negative for Filtek One and SonicFill.

Efficacy of S-PRG filler varnishes on enamel caries remineralization

OBJECTIVES

To evaluate the remineralizing effect of varnishes containing different concentrations of S-PRG filler or sodium fluoride on enamel caries lesions.

METHODS

Enamel specimens were obtained from bovine incisors, flattened and polished. Half of the surface was protected, and artificial caries lesion was created in the unprotected area. They were assigned into six groups (n=20) according to the varnish applied: four containing S-PRG filler with different concentrations (10%, 20%, 30% and 40% w/w), one containing 5% sodium fluoride (5%NaF) as positive control, and one without treatment as a negative control (NC). Varnishes were applied on specimen's caries-affected surface and removed after 24h. Varnish application and pH cycling (8 days) were performed twice. Cross-sectional microhardness was measured (10-100 µm depth). Knoop microhardness percentage (KHN%) of caries affected/treated area in relation to the sound enamel area at the same depth was calculated. The area under the curve (AUC) and the Δ_AUC were also calculated. Statistical analysis was performed by two-way ANOVA for KHN% and one-way ANOVA for Δ_AUC, followed by Tukey test (α=5%).

RESULTS

Significant differences were found for the factors "treatment" (p=0.0001) and "depth" (p=0001). For the factor "treatment", the results of the Tukey test were: NC-62.2(10.3)a, 10%S-PRG-69.2(9.3)b, 20%S-PRG-71.8(9.7)bc, 30%S-PRG-74.5(9.4)c, 5%NaF-79.6(8.7)d, 40%S-PRG-85.6(8.4)e. In relation to Δ_AUC, significant differences were observed among the groups (p=0.0001) and better results for 40% S-PRG and 5%NaF.

CONCLUSIONS

The varnish containing 40% S-PRG fillers was the most effective to promote the enamel caries remineralization, followed by the one containing 5% sodium fluoride.

CLINICAL SIGNIFICANCE

The varnish containing 40% of S-PRG fillers represents an alternative for initial enamel caries remineralization, since it was more effective than the conventional 5% NaF based product.

Fracture resistance and stress distribution of weakened teeth reinforced with a bundled glass fiber-reinforced resin post

OBJECTIVES

To make an in vitro assessment of fracture resistance of weakened and non-weakened teeth receiving intraradicular reinforcement using Rebilda bundled glass fiber-reinforced composite posts (GT), Rebilda conventional glass fiber posts (RP), or both systems combined (GT + RP).

MATERIALS AND METHODS

Eighty sound bovine incisors were prepared and divided randomly into eight groups as follows: (a) nWnR: without simulating weakness, and without intraradicular reinforcement; (b) WnR: simulating weakness, but without intraradicular reinforcement; (c) nWGT: without simulating weakness, but with GT; (d) WGT: simulating weakness, and with GT; (e) nWRP: without simulating weakness, but with RP; (f) WRP: simulating weakness, and with RP; (g) nWGTRP: without simulating weakness, but with GT + RP; (h) WGTRP: simulating weakness, and with GT + RP. The specimens were subjected to the load-to-fracture test using the DL-2000MF universal testing machine. The finite element method assessed the mechanical behavior and stress distribution in endodontically treated teeth.

RESULTS

The groups nWGTRP and WGTRP presented the best results in the load-to-fracture test, with the former being better than the latter, but with no statistically significant difference (P > 0.05). However, there was a significant difference between these and the other groups (P < 0.05), except for nWRP. Stress distribution inside the canal wall was different among the groups, with promising mechanical behavior for nWGTRP and nWRP.

CONCLUSIONS

The Rebilda conventional fiber post (RP), combined with the Rebilda bundled glass fiber-reinforced composite post (GT) improves the resistance and stress distribution of immature teeth.

CLINICAL RELEVANCE

Longitudinal fracture is less frequent in teeth restored with GT and RP posts.

Protection of calcium silicate/sodium phosphate/fluoride toothpaste with serum on enamel and dentin erosive wear

Objective

To evaluate the effect of a toothpaste containing calcium silicate/sodium phosphate/fluoride associated or not to the boost serum (BS) against erosive tooth wear (ETW) on enamel and dentin.

Methodology

Bovine enamel and dentin specimens were subjected to an erosion-abrasion cycling model (1% citric acid - pH 3.6 -2 min / artificial saliva – 60 min, 4×/day, 5 days). Toothbrushing was performed for 15 s (2 min exposed to slurry), 2×/day, with the toothpastes (n=10): control without fluoride (Weleda), Arg/Ca/MFP (Colgate Pro-Relief), Si/PO₄/MFP (Regenerate-Unilever), and Si/PO₄/MFP/BS (Si/PO₄/MFP with dual BS – Advanced Enamel Serum-Unilever). The effect of treatments on the eroded tissues was assessed by surface microhardness in the first day, and surface loss (SL) resulting from ETW was evaluated by profilometry (μm) after three and five days. Additional dentin specimens (n=5/group) were subjected to 20,000 brushing cycles to verify the abrasivity of the toothpastes. Data were subjected to ANOVA and correlation tests (5%).

Results

For enamel, no difference in microhardness was observed among the treated groups, and similar SL was obtained after 5 days. For dentin, Si/PO₄/MFP/BS resulted in higher microhardness values, but none of the groups presented significantly lower SL than the control. There was no significant correlation between SL and abrasiveness.

Conclusion

The calcium silicate/sodium phosphate toothpaste and serum increased microhardness of eroded dentin, but they did not significantly reduce enamel and dentin loss compared to the non-fluoride control toothpaste. The abrasiveness of the toothpastes could not predict their effect on ETW.

Computer-aided design and computer-aided manufacturing indirect versus direct composite restorations: A randomized clinical trial

OBJECTIVE

This study compared the clinical performance of large indirect restorations (IRs) versus direct restorations (DRs) in posterior teeth.

METHODS

Thirty subjects received two class II restorations (n = 60), one fabricated from a precured composite block (Grandio Blocs, VOCO) for the indirect technique (IT) and the other with light-cured composite (GrandioSO, VOCO) for the direct technique (DT). For IT, the restoration was created using the computer-aided design and computer-aided manufacturer (CAD/CAM) system. For DT, the material was applied light-cured by using a layering technique. All restorations were evaluated by using the World Dental Federation criteria.

RESULTS

Twenty-three subjects attended the 2-year recall, and 46 restorations were evaluated. No significant differences were detected between the techniques for most parameters analyzed (p > 0.05). For "color match" at 7 days and 6 months, better results were observed for the DT. In relation to the overall scores, all restorations were esthetically acceptable after 2 years, while 93.3% of DT and 90% of IT showed acceptable function. For biological scores, 96.67% of DRs and 100% of IRs was acceptable after 24 months. Considering all properties, the success rates were 93.3% for DRs and 90% for IRs.

CONCLUSIONS

After 2 years, both restorations presented similar and good clinical behavior for all the properties analyzed.

CLINICAL SIGNIFICANCE

Light-cured direct posterior composite restorations may perform similarly to indirect composite restorations made with precured CAD/CAM composite blocks up to 2 years.

The effects of polishing techniques on surface roughness and gloss of different composites

The aim of this study was to evaluate the effects of different polishing techniques on the surface roughness and gloss of various composites. A total of 360 composite cylinders (6 mm in diameter and 2 mm in thickness) were made using a silicone matrix and 1 of the following 6 restorative materials (n = 60): Admira Fusion, GrandioSO, Filtek Supreme, Filtek Z250, TPH Spectra ST, and Herculite Classic. The composite specimens were cured and then immersed in water for 24 hours. The baseline roughness was standardized with 600-grit silicon carbide paper used in a polishing device for 30 seconds. The specimens were divided into 6 subgroups (n = 10) according to the polishing technique: abrasive discs (Sof-Lex); abrasive discs (Sof-Lex) and diamond paste (Diamond Excel); abrasive rubber point (Dimanto); silicon carbide polishing brush (OptiShine); rubber spiral wheels (Sof-Lex Spiral Wheels - Diamond Polishing System); or sequential application of polishing pastes (Diamond ACI and ACII). After polishing was completed, the surface roughness and gloss were measured, and the data underwent 2-way analysis of variance and the Tukey test (P < 0.05). Statistically significant differences were observed for roughness (P < 0.001) and gloss (P < 0.001) for both factors analyzed (composite material and polishing technique). Admira Fusion exhibited the highest roughness and lowest gloss values of all of the composites, and Filtek Supreme exhibited the lowest roughness and highest gloss values. Sof-Lex Spiral Wheels and OptiShine polishing brush exhibited lower roughness and higher gloss than the other polishing techniques. The effects of different polishing techniques were material dependent, but all systems tested provided clinically acceptable results. The use of a single polishing technique for all types of composite materials might result in undesirable clinical outcomes.

Efficacy of fluoride varnishes with different compositions on white spot lesions remineralization

Objective: To evaluate the efficacy of different fluoride varnishes on white spot lesions (WSL) remineralization. Material and Methods: Polished bovine enamel specimens were obtained (n = 60) and had their initial surface Knoop microhardness (SMH) determined. WSL were created and the SMH was measured again. Then, specimens were allocated into six groups: C – Control (without varnish); BF – Bifluorid 12 (6% NaF + 6% CaF2); DP – Duraphat (5% NaF); PF – Profluorid (5% NaF); FP - Fluor Protector (0.2% NaF + 0.9% difluorsilane); CW - Clinpro White Varnish (5% NaF + 5% TCP). After varnishes application, specimens were immersed in artificial saliva for 24 h. Then, pH-cycling was performed for 8 days and SMH was measured. Data were analyzed by one-way ANOVA and Tukey’s test. Results: Non-significant differences were observed among the groups at baseline (p = 0.187) and after WSL formation (p = 0.999). After treatments, significant differences were observed among the groups (p = 0.001). Mean % of alteration (SD) and results of Tukey test were: C- 92.40 (12.10)a; PF- 88.66 (10.66)a; FP-  85.90 (14.49)ab; BF-  67.85 (17.86)bc; CW- 66.60 (18.48)c; DP- 58.62 (8.69)c. Conclusion:.  Bifluorid 12, Clinpro White Varnish, and Duraphat showed higher efficacy than artificial saliva in promoting the remineralization of WSL, nevertheless, none of the treatments were able to recover sound enamel baseline microhardness.   Keywords Dental caries; Fluoride; Fluoride varnishes.

Effect of bioactive glasses and neodymium:yttrium-aluminum-garnet laser on dentin permeability

Context:

Dental hypersensitivity and loss of dental tissues are commonly observed in patients, and most of the problems are caused due to total or partial exposure of dentinal tubules.

Aims:

The purpose of this study is to evaluate the performance of 45S5 bioactive glass and niobophosphate (NbG) associated with neodymium: yttrium-aluminum-garnet (Nd:YAG) laser for the reduction of dentin permeability.

Materials and Methods:

Fifty bovine dentin discs were made and distributed randomly into five groups (n = 10). The Nd:YAG laser was applied with the bioactive glasses using the energy parameters (60 and 80 mJ), forming the groups; NbG_60: NbG + Nd:YAG (60 mJ); NbG_80: NbG + Nd:YAG (80 mJ), 45S5_60: 45S5 + Nd:YAG (60 mJ); 45S5_80: 45S5 + Nd:YAG (80 mJ) and C: control (untreated dentin). The permeability was measured with a split chamber device. The samples were subjected to the erosive challenge and a new permeability measurement was done. Furthermore, the dentin was analyzed by scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS).

Statistical Analysis Used:

The data were analyzed using Kruskal–Wallis and Dunn's tests (α = 0.05).

Results:

Greater reduction in dentinal permeability was observed for 45S5 bioactive glasses (45S5_60 and 45S5_80) followed by NbG_80 and NbG_60 (P < 0.05). The SEM/EDS analysis showed the formation of a barrier after the dentin treatment.

Conclusions:

Bioactive glasses with Nd:YAG laser on the dentin surface may be a promising alternative for the reduction of dentin permeability.

Could different direct restoration techniques affect interfacial gap and fracture resistance of endodontically treated anterior teeth?

Objectives

To evaluate different direct restoration techniques on various cavity designs in anterior endodontically treated teeth (ETT).

Materials and methods

Ninety upper central incisors (n = 90) were selected, endodontically treated, and divided into three groups (n = 30) accordingly to the cavity design: minimal endodontic cavity access (group A), endodontic access + mesial class III cavity (group B), and endodontic access + two class III cavities (group C). Three subgroups (n = 10) were then created accordingly to the restoration technique: nano hybrid composite restoration (subgroup a), glass fiber post + dual-cure luting cement (subgroup b), and bundled glass fiber + dual-cure luting cement (subgroup c). Samples underwent micro-CT scan, chewing simulation, and a second micro-CT scan. 3D quantification (mm³) of interfacial gap progression was performed; then, samples underwent fracture resistance test. Data were statistically analyzed setting significance at p < 0.05.

Results

Groups A and B showed significantly lower interfacial gap progression compared with group C. Subgroup b performed significantly better compared with subgroups a and c. Improved fracture strength was reported for group C compared with group A, while both subgroups b and c performed better than subgroup a.

Conclusions

Cavity design significantly influenced interfacial gap progression and fracture resistance. Fiber posts significantly lowered gap progression and improved fracture resistance while bundled fibers only increased fracture resistance. A significant reduction of non-repairable fractures was recorded when fibers were applied.

Clinical relevance

A minimally invasive approach, conserving marginal crests, should be applied whenever possible. Inserting a fiber post is indicated when restoring anterior ETT, in order to reduce gap progression, improve fracture resistance, and avoid catastrophic failures.

Protective Effect of Solutions Containing Polymers Associated with Fluoride and Stannous Chloride on Hydroxyapatite Dissolution

This study investigated the protective effect of experimental solutions containing 4 polymers (polyoxirane, hydroxypropylmethylcellulose [HPMC], pectin, and an amino methacrylate copolymer [AMC]) in 2 concentrations (low and high) associated or not with sodium fluoride (F; 225 ppm F-) or sodium fluoride plus stannous chloride (FS; 800 ppm Sn2+) on the dissolution of hydroxyapatite crystals (HA). Deionized water was the control. The pretreated HA was added to a 0.3% citric acid solution (pH 3.8). An automatic titrant machine added aliquots of 0.1 N HCl at a rate of 28 μL/min, in a total reaction time of 5 min. Groups were compared with 2-way ANOVA and Tukey's test, and concentrations with Student t test (5%). The zeta potential of the HA treated with the solutions was measured. Significant differences were found for both factors and interaction (p < 0.0001). The treatments with F and FS solutions resulted in a lower amount of dissolved HA than the control. Among the polymers' solutions, only AMC was able to reduce the amount of dissolved HA, changing the surface charge of HA to positive. AMC improved the protective effect of F, but it did not affect FS. Polyoxirane and HPMC reduced the protective potential of the FS solution. No differences were found between the concentrations of the polymers. It was concluded that F and FS reduced the amount of dissolved HA. The protective effect of the experimental solutions against HA dissolution was polymer dependent. The F effect was enhanced by its combination with AMC, but the protection of FS was impaired by polyoxirane and HPMC.

Protective effect of anti-erosive solutions enhanced by an aminomethacrylate copolymer

OBJECTIVE

To investigate if an aminomethacrylate copolymer (AMC) could potentiate the anti-erosive effect of solutions containing sodium fluoride -F (225 ppm F^-) and sodium fluoride associated to stannous chloride -FS (800 ppm Sn²⁺).

METHODS

The experimental solutions (F, FS, AMC, AMC + F, AMC + FS, and deionized water-DW as negative control) were tested in the presence of acquired pellicle. Polished bovine enamel specimens (n = 13/group) were submitted to an erosion-rehardening cycle (2 h immersion in human saliva, 5 min in 0.3 % citric acid, 1 h in human saliva, 4×/day, 5 days). Treatment with the solutions was performed for 2 min, 2×/day. The rehardening (%Re) and protective (%Prot) potential of the solutions were assessed in the beginning of the experiment, and the surface loss (SL) by contact profilometry after 5 days. Additional bovine specimens (n = 5/group) were prepared to evaluate the contact angle on the treated enamel surface. The zeta potential of the dispersed hydroxyapatite (HA) crystals after the treatment with the solutions was also measured (n = 3/group). Data were statistically analyzed (α = 0.05).

RESULTS

The association with AMC improved the %Re and the %Prot for W and F, but not for FS. The results of SL were: AMC + F = AMC + FS < AMC < FS < F < DW. The presence of AMC significantly reduced the contact angle on enamel surfaces. The HA presented a strong negative surface charge after the treatment with DW, F and FS, whereas after the treatment with the solutions containing AMC it became positive.

CONCLUSION

AMC has potential to enhance the anti-erosive effect of fluoride solutions.

CLINICAL SIGNIFICANCE

The aminomethacrylate copolymer (AMC) may be a promising agent to be added to oral care products for the prevention of erosive tooth wear.

Efficacy of S-PRG filler containing varnishes on enamel demineralization prevention

This study evaluated the efficacy of S-PRG vanishes on preventing enamel demineralization. Bovine enamel specimens were obtained, polished and the baseline Knoop microhardness was evaluated. Specimens were stratified into six groups (n = 15), according to the varnish applied: S10—experimental varnish containing 10% of S-PRG fillers, S20—20% of S-PRG fillers, S30—30% of S-PRG fillers; S40—40% of S-PRG fillers; PC (positive control)—5% of NaF; NC (negative control)—no treatment was performed. Half of enamel surfaces were protected to work as a control and varnishes were applied over the unprotected area. A demineralizing pH-cycling was performed, and surface and cross-sectional microhardness were measured. The percentage of microhardness of the treated area was calculated comparing with the untreated area. Statistical analysis was performed by one-way ANOVA and Tukey’s test (p = 5%). All experimental S-PRG varnishes protected against demineralization in relation to no treatment, but S40 was the most effective on the surface. For all depths, S30 and S40 were superior in enamel demineralization prevention than other S-PRG filler concentrations and 5% NaF. It was concluded that S-RPG filler containing varnishes were effective to prevent enamel demineralization. The higher concentrated products were more effective than 5% sodium fluoride on surface demineralization prevention.

Enhancing the Anti-Erosive Properties of Fluoride and Stannous with the Polymer Carbopol

This in vitro study investigated whether Carbopol 980 polymer could potentiate the anti-erosive effect of solutions containing sodium fluoride (F) and sodium fluoride associated with stannous chloride (FS). The dissolution of hydroxyapatite treated with the experimental solutions (F [500 ppm F-], F + Carbopol [0.1%], FS [500 ppm F- + 800 ppm Sn2+], FS + Carbopol) was evaluated. Deionized water was the negative control, and a commercial mouth rinse (AmF/NaF/SnCl2; 500 ppm F + 800 ppm Sn2+; Elmex® Erosion Protection) was the positive control. The solutions were also evaluated in an erosion-rehardening protocol, with two treatments per day, using bovine enamel specimens (n = 15) and human saliva. The acid challenge was performed using 0.3% citric acid (pH 2.6) for 2 min. Microhardness was measured at different times: baseline, after the first erosive challenge, after treatment, and after the second erosive challenge. Based on microhardness values, the demineralization, rehardening, and protective potentials were calculated. The alkali-soluble fluoride on enamel surfaces was also measured. Data were analyzed using ANOVA and Tukey tests (α = 0.05). Groups treated with FS + Carbopol showed the lowest hydroxyapatite dissolution and the highest rehardening and protective potentials. The measurement of alkali-soluble fluoride on enamel surfaces was also higher in the FS + Carbopol group. Carbopol was able to significantly increase the protective effect of the fluoridated solutions in addition to optimizing the adsorption of fluoride on the enamel surface.

The influence of a liner on deep bulk-fill restorations: Randomized clinical trial

OBJECTIVE

The aim of this study was to evaluate the influence of a liner on the clinical performance of deep posterior restorations performed with bulk-fill composite.

METHODS

30 subjects received two restorations on deep preparations in posterior teeth, without pulpal exposure, after selective carious-tissue removal in one-stage. The internal walls reached the inner quarter of dentin, but with a radiographically detectable zone of firm dentin remaining. The pulpal protection using a layer of glass ionomer composite liner (Ionoseal, Voco) was applied in just one preparation. The adhesive system Futurabond U (Voco) was applied in all preparations, which were restored with the bulk-fill pure Ormocer nanohybrid composite (Admira Fusion Xtra - Voco), in up to 4 mm thick increments. All restorations were evaluated using the FDI criteria after 7 days, 6, 12 and 24 months postoperatively.

RESULTS

After 24-months, 25 patients attended the recall and 50 restorations were evaluated. The Fisher's statistical analysis (5%) showed no difference between the techniques for the esthetic, functional and biological properties. No postoperative sensitivity was reported for both groups.

CONCLUSION

The application of a liner did not influence the clinical performance of deep restorations with bulk-fill Ormocer composite.

CLINICAL RELEVANCE

The application of a liner with a GIC-based material did not have a significant effect on the clinical performance of bulk-fill restorations and seems to be unnecessary for the material tested.

Effects of calcium-phosphate, laser and adhesive on dentin permeability and bond strength

Objectives

The present study examined a technique for reducing dentin permeability through the application of a calcium phosphate (CaP)-based desensitiser with a laser-assisted process and evaluated adhesive-dentin bond strength. Methods: Thirty dentin discs were divided into two groups according to whether the selected desensitiser (TeethMate; Kuraray Noritake) was used prior to dentin bonding. Each group was subdivided into three subgroups (n = 5): A- Adhesive (Single Bond Universal, 3M ESPE), AL- Adhesive + Laser (Nd:YAG 60 mJ) and LAL- Laser + Adhesive + Laser. Dentin permeability values (%) were recorded before and after desensitiser application. Resin composites were placed over the bonded specimens; the latter were aged prior to microtensile bond strength evaluation. Gelatinolytic activity within the hybrid layers was examined with in-situ zymography using confocal laser scanning microscopy. Data were analysed with ANOVA and Tukey test (α = 0.05).

Results

Significant differences in dentin permeability were identified for all groups (p = 0.00). Both laser treatment (p = 0.182) and desensitiser application (p = 0.687) did not significantly improve dentin bond strength. Ultrastructure of the resin-dentin interface identified presence of calcium phosphate within dentinal tubules. Laser treatment did not affect hybrid layer ultrastructure. Both treatment modalities (intratubular CaP occlusion and laser) had no influence on gelatinolytic activity within hybrid layers.

Conclusion

Although intratubular CaP occlusion and laser treatment were effective in reducing dentin permeability, they did not affect bond strength, interfacial ultrastructure and gelatinolytic activity within hybrid layers.

Clinical relevance

Treatment of etched dentin with Nd:YAG Laser at 60 mJ does not adversely affect collagen ultrastructure and gelatinolytic activity within the hybrid layer. The application of a calcium phosphate-based desensitiser to etch dentin does not affect dentin bond strength.

Randomized in situ trial on the efficacy of Carbopol in enhancing fluoride / stannous anti-erosive properties

OBJECTIVE

To evaluate if the bioadhesive polymer (Carbopol 980) could potentiate the protective effect of sodium fluoride with stannous chloride (FS) solution on the control of enamel erosive wear.

METHODS

Cylindrical bovine enamel specimens were polished and randomly allocated into three groups (n = 60): FS (500 ppm F^- +800 ppm Sn²⁺ - positive control), FS + Carbopol (0.1% Carbopol), and ultrapure water (negative control). A randomized double-blind cross-over in situ model with three phases was used. In each phase, volunteers (n = 15) used a palatal appliance containing 4 specimens: two were submitted to an erosion model (2 h of pellicle formation; immersion in 1% citric acid, pH 2.3, for 5 min, 4x/day; 1 h intervals of saliva exposure; and treatment with the test solutions for 1 min, 2x/day). Besides erosion, the other two specimens were also subjected to abrasion (2x/day, 15 s) with active electric toothbrush, before the treatment with the solutions. After 5 days, enamel surface loss (μm) was evaluated by profilometry. Data were analyzed by two-way RM-ANOVA and Tukey tests (5%).

RESULTS

There were significant differences for both challenge and treatment factors. Erosion/abrasion challenge resulted in significantly higher enamel loss than erosion only (p < 0.05). The surface loss values for the erosion/remineralization model were (means ± SL): C = 14.7 ± 5.8b; FS = 9.0 ± 7.5ab; FS + Carbopol = 5.9 ± 3.8a; and for erosion/abrasion: C = 26.6 ± 10.1c; FS = 15.0 ± 8.8b; FS + Carbopol = 12.3 ± 7.9ab.

CONCLUSION

The association of Carbopol to the FS solution significantly protected the enamel against erosive wear, but it was not significantly superior to FS only.

CLINICAL SIGNIFICANCE

Under highly erosive and abrasive conditions, rinsing with solutions containing sodium fluoride plus stannous chloride, associated or not with the Carbopol polymer, is an effective approach to control enamel erosive wear.

Color masking prediction of posterior white spot lesions by resin infiltration in vitro

OBJECTIVE

To investigate parameters that could predict the color masking effect (ME) of white spot lesions (WSLs) after resin infiltration (RI).

METHODS

Sixty extracted human teeth with natural WSLs were selected (28 premolars, 29 molars and 3 incisors). At baseline, the laser fluorescence (LF) of surrounding sound enamel (SE) and the WSLs were analyzed with DIAGNOdent. Standardized photographs were obtained under D65 and UV illuminants, from which the CIE L*a*b* color coordinates and natural fluorescence (NF) of the WSLs and SE were obtained. The color difference (ΔE₀₀) and differences of NF and LF between the SE and WSLs were calculated. The lesion dimensions (area, perimeter, width, and height) were determined. After RI, the assessments were repeated. ME was considered as the reduction of ΔE₀₀ values after RI. One-way ANOVA and the Tukey tests were used to analyze the absolute means of the LF and NF values. The t test was used to compare the ΔE₀₀ values and lesion dimensions before and after infiltration. The correlations between all parameters at baseline and ME were analyzed.

RESULTS

The absolute mean values of LF at the baseline (B) and after infiltration (I) were SE/B-3.98a, WSL/B-13.28c, SE/I-3.36a, WSL/I-7.95b (p = 0.001). The mean values for NF were SE/B-7.93a; WSL/B-6.29b, SE/I-7.93a, WSL/I-7.27a (p = 0.001). The results for ΔE₀₀ were B-11.74a, I-8.66b (p = 0.001). RI significantly reduced lesion dimensions. No correlations were observed between the baseline parameters and the ME.

CONCLUSIONS

The WSLs presented higher LF and smaller NF than SE, which were respectively reduced and increased after RI. Prediction of the masking effect by the parameters evaluated at baseline was not possible, which could be due to the choice of mainly caries lesions in posterior teeth. Nonetheless, infiltration was found suitable to mask most of the WSL.

CLINICAL SIGNIFICANCE

The color masking effect of white spot lesions after resin infiltration cannot be predicted by a previous analysis of fluorescence, color, or dimensions of the lesion.

Adhesive systems effect over bond strength of resin-infiltrated and de/remineralized enamel

Background: The purpose of this study was to evaluate the effect of different bonding agents on bond-strength to demineralized enamel after remineralizing treatments and resin infiltration. Methods: Buccal enamel of 120 bovine incisors was polished and then were divided into five experimental groups: SE (sound enamel); DE (demineralized enamel); AS (demineralized enamel immersed in artificial saliva for eight weeks); NaF (demineralized enamel treated with 0.05% sodium fluoride solution (one minute) for eight weeks); Ic (demineralized enamel infiltrated with a low-viscosity resin (Icon-DGM). These groups were subdivided according to adhesive system used: self-etching adhesive Adper Easy One (3M/ESPE) and etch-and-rinse adhesive Single Bond (3M/ESPE). The composite resin blocks were fabricated using a Teflon matrix. A thermomechanical cycling machine was used to carry out the artificial aging of the specimens and thus were sectioned into sticks. The microtensile tests were performed using a universal testing machine at a cross-head speed of 1 mm/min. Data (in MPa) were subjected to two-way ANOVA and Tukey's tests (5%). Results: Significant differences were found for both factors tested and interactions (p<0.05). Tukey's test results of µTBS (mean ± SD) were: etch-and-rinse SE (28.79±3.93); DE (30.41±7.22); AS (29.03±3.33); NaF (29.81±4.06)a; Ic (29.47±5.5);  and self-etching SE (30.37±6.96); DE (14.62±4.47); AS (9.79±2.32); NaF (9.36±2.31); Ic (30.78±8.68).   Conclusions: Resin infiltration did not affect the bond strength of demineralized enamel for both adhesive systems tested. For etch-and-rinse adhesive, no differences were observed for the tested groups. For self-etching adhesive, only the resin-infiltrated group showed similar bond strength to sound enamel. Both etch-and-rinse and self-etching adhesive systems can be used in resin-infiltrated enamel, if a composite restoration needs to be further performed. In enamel that has undergone the de/remineralization process, the use of a total-etch adhesive might be preferable for the restorative procedure.

Effect of Calcium and Fluoride Addition to Hydrogen Peroxide Bleaching Gel On Tooth Diffusion, Color, and Microhardness

Objectives:

The aim of this study was to evaluate the effect of calcium and fluoride addition to a 35% hydrogen peroxide (HP) bleaching gel with regard to its diffusion through the tooth structure, enamel microhardness, and bleaching efficacy.

Methods and Materials:

Eighty specimens (6 mm in diameter and 2 mm in height; 1 mm/enamel and 1 mm/dentin) were obtained from bovine incisors that were polished and divided into four groups (n=20) according to the remineralizing agent added to the gel: Ca = 0.5% calcium gluconate; F = 0.2% sodium fluoride; Ca+F = 0.5% calcium gluconate and 0.2% sodium fluoride; and control = no agent. Initial microhardness and color were assessed. The samples were positioned over simulated pulpal chambers filled with acetate buffer solution to capture the HP. Gels were applied over enamel for 30 minutes, and HP diffusion was assessed by spectrophotometry two hours after bleaching. Microhardness was measured immediately after bleaching and then the specimens were immersed into artificial saliva for seven days for final color assessment. Data were analyzed by one-way analysis of variance followed by Tukey test.

Results:

Bleaching reduced microhardness for all groups (p=0.0001), but the Ca+F and F groups showed lower reductions after bleaching. The addition of Ca, F, and Ca+F decreased the peroxide penetration through the tooth structure (p=0.0001), but there were no differences in color change for ΔL (p=0.357), Δa (p=0.061), Δb (p=0.823), and ΔE (p=0.581).

Conclusion:

The addition of calcium and fluoride in the gel did not affect bleaching efficacy, but it was able to reduce both the peroxide diffusion and the bleached enamel microhardness loss.

Fluorescence properties of demineralized enamel after resin infiltration and dental bleaching

PURPOSE

To evaluate the effects of different white spot lesion (WSL) treatments associated with dental bleaching on the fluorescence of dental enamel.

METHODS

80 flat enamel disks (3 mm diameter and 1 mm thick) were obtained from bovine incisors. The initial fluorescence (fluorescent emission or Delta E*ab- FL units) of the specimens was measured using a spectrophotometer. Artificial caries was created in all specimens, and the measurements were repeated. The specimens were divided into four groups according to the treatment applied (n = 20): CON (control) - immersion in ultrapure water for 8 weeks; SAL - immersion in artificial saliva for 8 weeks; FL - daily application of 0.05% sodium fluoride for 1 minute/artificial saliva for 8 weeks; and ICON - resin infiltration (Icon). After the treatments, the assessments were repeated. Dental bleaching using 35% hydrogen peroxide gel was performed on all specimens for 30 minutes, and the measurements were made again after 7 days. Data were submitted to ANOVA and Tukey tests across the treatments for each moment of evaluation.

RESULTS

Fluoride and saliva remineralization were not able to change enamel fluorescence, even after bleaching. Only resin infiltration increased the enamel fluorescence; however, after bleaching, all groups presented similar values. Icon increased translucency immediately after application, but bleaching reduced it to its initial values.

CLINICAL SIGNIFICANCE

Changes of fluorescence in infiltrated enamel might lead to unsatisfactory esthetics under certain conditions such as ultraviolet light.

Effect of Remineralizing Gels on Microhardness, Color and Wear Susceptibility of Bleached Enamel

Objectives:

To evaluate the effect of a remineralizing gel combining fluoride and calcium silicate/phosphate or a sodium fluoride gel on bleached enamel microhardness, color, and wear susceptibility.

Methods and Materials:

Two hundred forty bovine enamel-dentin samples were prepared. Baseline analysis of Knoop microhardness, color coordinates (L*a*b*), and surface profile were performed. According to the baseline microhardness values, specimens were stratified into six groups (n=40): NC (negative control)—no treatment; BL (positive control)—bleaching with 40% hydrogen peroxide gel (Opalescence Boost, Ultradent); BL/Rs—bleaching + application of calcium silicate/phosphate gel (Regenerate Serum, Unilever - Rs); Rs/BL—Rs + bleaching; Rs/BL/Rs—Rs + bleaching + Rs; and BL/F—bleaching + 2% sodium fluoride gel. After the treatment described for each group, color change (ΔE) and microhardness were evaluated again. To evaluate abrasion susceptibility, samples were randomly divided into two subgroups, according to the toothpaste used (Cp—Close Up or Rt—Regenerate), and underwent 100,000 brushing strokes. The profile of each sample was evaluated and the mean wear calculated. The data were analyzed by ANOVA and Tukey tests.

Results:

All bleached groups showed a significant reduction of microhardness in relation to the negative control. The groups treated with remineralizing gels showed a significantly higher microhardness and less wear than the positive control, although nonsignificant differences were observed among them. Nonsignificant differences in ΔE were found among bleached groups. The groups brushed with Regenerate toothpaste showed significantly less wear than those brushed with Close Up toothpaste.

Conclusions:

The remineralizing gels did not interfere with bleaching efficacy. However, all the treatments minimized the surface hardness reduction caused by the bleaching procedure and enamel loss after abrasion. Regenerate toothpaste resulted in less enamel abrasion.

Effect of whitening toothpastes on wear and roughness of ormocer and methacrylate-based composites

PURPOSE

To investigate the effects of whitening toothpastes over the wear and surface roughness of ormocer and methacrylate composites.

METHODS

Cylindrical specimens (n=120) were prepared using methacrylate-based composites (Filtek Z350 XT, TPH3 and GrandioSO) and a pure-ormocer composite (Admira Fusion). Brushing abrasion (100,000 strokes) was performed using whitening toothpastes containing different abrasives: alumina (Colgate Ultrawhite), perlite (CloseUp Whitening) and sodium bicarbonate (Kin Progressive Whitening). Wear and roughness alteration were evaluated. Additional analyses of microhardness, degree of conversion and scanning electron microscopy were also performed.

RESULTS

Data were separately analyzed with Kruskal-Wallis and ANOVA tests. Statistically significant differences were found for the composites and whitening toothpastes (P<0.05). For all toothpastes, GrandioSO showed lower wear than Z350 XT and Admira Fusion, although non-significant differences in relation to TPH3 were observed. For perlite and bicarbonate-based toothpastes, Z350 XT, Admira Fusion and TPH3 did not present significant differences among them for wear. For alumina-based toothpaste, Z350 XT showed higher wear than TPH3, while Admira Fusion showed intermediate values. Higher wear and roughness alteration were observed after using alumina-containing toothpaste. All composites tested showed increased roughness after brushing. Z350 XT presented the lowest roughness alteration, while Admira Fusion the highest.

CLINICAL SIGNIFICANCE

The alumina-containing whitening toothpaste significantly increased the wear and roughness of composites in relation to the other abrasives tested. However, using the ADA standards, the wear promoted by all whitening toothpastes tested would be considered clinically acceptable for all materials. The type of organic matrix in a composite is not the main factor that determines the wear rate, but also its interaction with the inorganic fillers and the filler content. The composite GrandioSO showed the lowest overall wear values, while Z350 XT resulted in the smoothest surfaces.

Effect of whitening mouthrinses on enamel toothbrush abrasion

PURPOSE

To evaluate the effect of whitening mouthrinses used before toothbrushing on enamel microhardness and wear.

METHODS

80 polished bovine enamel specimens were randomly assigned into four groups according to the mouthrinses tested (n=20): PW: Plax Whitening - 1.5% hydrogen peroxide (HP); LW: Listerine Whitening Pre-Brush Rinse - 2% HP; U: Ultradex - Chlorine dioxide; C: Control - Artificial saliva. The specimens were immersed in the mouthrinses for 1 minute and brushed with 10 strokes, using a dentifrice containing sodium fluoride. After treatments, they were immersed in artificial saliva for 30 minutes. A total of 540 cycles were performed simulating 9 months of use. Enamel surface was assessed with a Knoop microhardness tester and by a contact profilometer before and after treatments to obtain the surface microhardness (KHN) and enamel loss (µm) values. The specimens were immersed in artificial saliva for an additional 30 days and microhardness was measured again. Data were analyzed by ANOVA and Tukey's tests (5%).

RESULTS

Significant differences were observed in KHN (P= 0.0001) and wear (P= 0.0001). Results of Tukey's for KHN: U-320.08±13.86a, PW-323.58±32.75a, LW-331.66±24.74a, C-354.24±16.40b. Wear (µm) : PW-10.03±0.94a, LW-9.92±0.81a, U-8.88±1.02b, C-6.56±0.91c. Groups followed by the same letters do not present significant differences. After 30 days in saliva, there was no significant difference for SMH among the groups.

CLINICAL SIGNIFICANCE

The continuous use of whitening mouthrinses can increase the enamel abrasion potential promoted by daily toothbrushing; therefore, they should be used with caution.

Effects of artificial staining on bulk-filled resin composites

PURPOSE

To evaluate the color stability of bulk-fill resin composites (RC) in comparison to conventional RC submitted to artificial staining.

METHODS

15 specimens of each RC were prepared. Five bulk-fill RC [X-tra Base (XB), Filtek Bulk-Fill Flowable (FBF), Admira Fusion X-tra (AD), Tetric N-Ceram Bulk-Fill (TB), and Filtek Bulk-Fill (FB) ], and two conventional RC [GrandioSO (GO) and Filtek Z350XT (FXT) ] were used. After preparation of the samples, the specimens were immersed in a staining broth for 5 weeks and repolished. The color change was assessed using a spectrophotometer. Data were analyzed using one-way ANOVA, Tukey's tests, and paired t-test.

RESULTS

The bulk-fill flowable (XB and FBF) presented color change clinically acceptable (ΔE< 2.7) after staining. Among the bulk-fill regular resins, only AD presented clinically acceptable values (ΔE= 1.99). Regarding the conventional resins, GO presented a significantly lower color change than the other resins, but was not significantly different from AD. For all the resins, except AD, the repolishing procedures resulted in a significant decrease of color change. Tested resins did not present the same behavior under staining, despite their similarities. All the resins stained above the perceptibility threshold (ΔE> 1.2). After repolishing, the color change was reduced overall.

CLINICAL SIGNIFICANCE

Color stability of resin composites was related to the properties of the resin material. The staining degree was related to the replacement of the restorations and repolishing contributes to the maintenance and longevity of these composites.

Effect of pH on whitening efficacy of 35% hydrogen peroxide and enamel microhardness

OBJECTIVE

This study aimed to evaluate the effect of 35% hydrogen peroxide at different pH values and the degree of tooth staining on whitening efficacy and enamel microhardness.

MATERIALS AND METHODS

90 enamel-dentin specimens were obtained from bovine incisors. They were randomly divided into 2 groups (n = 45), 1 group was immersed in a staining broth for 14 days, and another group was not stained and kept in distilled water at 37°C. Twenty-four hours after the staining procedure, each group was distributed into 3 subgroups that were whitened by 35% hydrogen peroxide with different pH values (5, 7, and 8.4) for 30 minutes. The color was measured at baseline and 7 days after whitening. Microhardness was measured at baseline, immediate, 24 hours, and 1 month after the whitening procedure. Data were submitted to 2-way analysis of variance (ANOVA) and the Tukey test for multiple comparisons for color analysis. Repeated measures ANOVA and the Tukey test were used to analyze microhardness data.

RESULTS

The color change of the stained groups (ΔE₀₀  = 4.6) was significantly higher than that of the nonstained groups (ΔE₀₀  = 3.7). Microhardness value decreased significantly immediately after whitening for all subgroups and did not return to initial values. For each measurement time, microhardness was not significantly different among subgroups with different pH values.

CONCLUSIONS

Despite the effectiveness of 35% hydrogen peroxide, changes on gel pH did not affect the whitening efficacy, and the enamel was superficially demineralized, regardless of pH values.

CLINICAL SIGNIFICANCE

Independently of the pH value of whitening gel, enamel undergoes superficial demineralization and with a reduction in superficial microhardness that does not return to the initial values. However, using hydrogen peroxide with different pH values does not alter the whitening effect.

Influence of Hemostatic Solution on Bond Strength and Physicochemical Properties of Resin Cement

The aim of this study was to evaluate the degree of conversion, color stability, chemical composition, and bond strength of a light-cured resin cement contaminated with three different hemostatic solutions. Specimens were prepared for the control (uncontaminated resin cement) and experimental groups (resin cement contaminated with one of the hemostatic solutions) according to the tests. For degree of conversion, DC (n = 5) and color analyses (n = 10), specimens (3 mm in diameter and 2 mm thick) were evaluated by Fourier transform infrared spectroscopy (FTIR) and CIELAB spectrophotometry (L*, a*, b*), respectively. For elemental chemical analysis (n = 1), specimens (2 mm thick and 6 mm in diameter) were evaluated by x-ray energy-dispersive spectroscopy (EDS). The bond strengths of the groups were assessed by the microshear test (n = 20) in a leucite-reinforced glass ceramic substrate, followed by failure mode analysis by scanning electron microscopy (SEM). The mean values, except for the elemental chemical evaluation and failure mode, were evaluated by ANOVA and Tukey's HSD test. The color stability was influenced by storage time (p<0.001) and interaction between contamination and storage time (p<0.001). Hemostop and Viscostat Clear contamination did not affect the DC, however Viscostat increased the DC. Bond strength of the resin cement to ceramic was negatively affected by the contaminants (p<0.001). Contamination by hemostatic agents affected the bond strength, degree of conversion, and color stability of the light-cured resin cement tested.

The combined effect of food-simulating solutions, brushing and staining on color stability of composite resins

Objective: This study evaluated the effect of food-simulating media associated with brushing and coffee staining on color stability of different composite resins.

Materials and methods: Eighty specimens were prepared for each composite: Grandio SO (Voco), Amaris (Voco), Filtek Z350XT (3M/ESPE), Filtek P90 (3M/ESPE). They were divided into four groups according to food-simulating media for 7 days: artificial saliva (control), heptane, citric acid and ethanol. The composite surface was submitted to 10,950 brushing cycles (200 g load) in an automatic toothbrushing machine. The specimens were darkened with coffee solution at 37 °C for 24 h. After each treatment, color measurements were assessed by spectrophotometry, using CIE L*a*b* system. The overall color change (ΔE) was determined for each specimen at baseline (C1) and after the treatments (food-simulating media immersion/C2, brushing/C3 and dye solution/C4). Data were analyzed by two-way repeated measures ANOVA and Tukey’s tests (p < .05).

Results: The results of RM-ANOVA showed significant differences for composites (p = .001), time (p = .001) and chemical degradation (p = .002). The mean of ΔE for composites were: Z350XT (5.39)^a, Amaris (3.89)^b, Grandio (3.75)^bc, P90 (3.36)^c. According to food-simulating media: heptane (4.41)^a, citric acid (4.24)^a, ethanol (4.02)^ab, artificial saliva (3.76)^b. For the treatments: dye solution (4.53)^a, brushing (4.26)^a, after food-simulating media (3.52)^b.

Conclusions: The composite resin Filtek Z350XT showed significantly higher staining than all other composite resin tested. The immersion in heptane and citric acid produced the highest color alteration than other food-simulating media. The exposure of samples to brushing protocols and darkening in coffee solution resulted in significant color alteration of the composite resins.

Bond Strength to Eroded Enamel and Dentin Using a Universal Adhesive System

PURPOSE

To evaluate the influence of previous acid etching on the bond strength of a self-etch universal adhesive system on sound and eroded enamel and dentin.

MATERIALS AND METHODS

Flat enamel and dentin surfaces were obtained from bovine incisors (n = 44) and divided into two groups according to the exposure to erosive conditions: sound (without erosion) and eroded (after erosive challenge with 0.3% citric acid, pH 2.6, 5 min, 4x/day, 5 days). Each group was then divided into two subgroups (n = 11) according to the application or not of 37% phosphoric acid before applying a universal self-etch adhesive. Single Bond universal adhesive (3M ESPE) was applied and composite blocks were built up using Amelogen Plus (Ultradent). Sticks (1 × 1 mm) were obtained and the microtensile bond strength (µTBS) was assessed using a universal testing machine at a speed of 1 mm/min. Data were analyzed with two-way ANOVA and Tukey's tests (p < 0.05).

RESULTS

For enamel groups, significant differences were observed for erosive challenge (p = 0.034) and acid etching (p = 0.047), but not for the interaction between them (p = 0.182). The means ± SD (MPa) for the erosive conditions were: sound, 25.02 ± 5.82a; eroded, 28.45 ± 5.92b; and for acid etching: without, 24.89 ± 5.39a; with, 28.58 ± 6.23b (different superscript letters indicate significant differences). For dentin, both the erosive condition (p = 0.936) and acid pretreatment (p = 0.084), as well as their interaction (p = 0.107), did not affect the bond strength.

CONCLUSION

The erosive challenge and previous acid etching significantly increased the bond strength of the tested universal adhesive to enamel but not to dentin.

Er:YAG pre-treatment for bonding of orthodontic bracket: 1 year of in vitro treatment

Objective

The aim of this study was to evaluate in vitro bond strength of metal brackets bonded with: total etch, total etch with erbium: yttrium aluminum garnet laser (Er:YAG) and self-etching adhesive systems, submitted to thermal-mechanical cycling, simulating 1 year of orthodontic treatment.

Materials and methods

For the study, 80 bovine incisors were randomly divided into 3 experimental groups (n=16 each): XT- acid etching + Transbond XT, XT/Er:YAG- Transbond XT associated with Er:YAG laser irradiation (λ=2.94 μm, 60 mJ, 10 Hz) and SEP- Transbond Plus Self Etching Primer. Samples were submitted to thermal-mechanical cycling, simulating 1 year of orthodontic treatment. Afterward, the shear bond strength test was performed in a universal test machine at a speed of 0.5mm/min. Samples were evaluated under a stereomicroscope and by scanning electron microscopy for analysis of enamel surface and adhesive remnant index. Data were analyzed using Kruskal–Wallis and Mann–Whitney (with Bonferroni correction) statistical tests.

Results

Statistically significant difference was observed between the groups studied (p<0.05). Groups XT and SEP showed the highest bond strength values, without statistical difference between them, while group XT/Er:YAG showed reduction in bond strength values. Higher frequency of adhesive failures between enamel and adhesive system was verified for groups XT and XT/Er:YAG.

Conclusion

The conventional (XT) and self-etching (SEP) adhesive systems showed mean bond strength values, similar between them, whereas the previous application of Er:YAG laser promoted the lowest bond strength values.

Influence of previous acid etching on bond strength of universal adhesives to enamel and dentin

The objective of this study was to evaluate the effect of acid pretreatment on the bond strength of composite resin bonded to enamel and dentin with 2 different universal self-etching adhesives. The null hypothesis was that the acid treatment performed prior to adhesive application would not significantly change the bond strength to enamel or dentin for either universal adhesive tested. A sample of 112 bovine incisors were selected and embedded in acrylic resin. Half were ground until a flat enamel surface was obtained, and the other half were polished until a 6 × 6-mm area of dentin was exposed, resulting into 2 groups (n = 56). The enamel and dentin groups were divided into 2 subgroups according to the adhesive system applied: Futurabond U or Scotchbond Universal. Each of these subgroups was divided into 2 additional subgroups (n = 14); 1 subgroup received phosphoric acid pretreatment, and 1 subgroup did not. The bond strength was assessed with a microtensile test. Data from enamel and dentin specimens were analyzed separately using 1-way analysis of variance. The acid pretreatment did not significantly change the bond strength of the adhesives tested, either to enamel (P = 0.4161) or to dentin (P = 0.4857). The acid etching pretreatment did not affect the bond strength to dentin and enamel when the tested universal multipurpose adhesive systems were used.

Influence of bioadhesive polymers on the protective effect of fluoride against erosion

OBJECTIVE

This study investigated if the incorporation of the bioadhesive polymers Carbopol 980, Carboxymethyl cellulose (CMC), and Aristoflex AVC in a fluoridated solution (NaF-900ppm) would increase the solution's protective effect against enamel erosion.

METHODS

Enamel specimens were submitted to a 5-day de-remineralization cycling model, consisting of 2min immersions in 0.3% citric acid (6x/day), 1min treatments with the polymers (associated or not with fluoride), and 60min storage in artificial saliva. Ultrapure water was used as the negative control and a 900ppm fluoride solution as positive control. The initial Knoop microhardness (KHN1) was used to randomize the samples into groups. Another two microhardness assessments were performed after the first (KHN2) and second (KHN3) acid immersions, to determine initial erosion in the first day. The formula: %KHN_alt=[(KHN3-KHN2)/KHN2]*100 was used to define the protective effect of the treatments. After the 5-day cycling, surface loss (SL, in μm) was evaluated with profilometry. Data were analyzed with 2-way ANOVA and Tukey's tests (p<0.05).

RESULTS

For %KHN_alt, the polymers alone did not reduce enamel demineralization when compared to the negative control, but Carbopol associated with NaF significantly improved its protective effect. The profilometric analysis showed that Carbopol, associated or not with NaF, exhibited the lowest SL, while CMC and Aristoflex did not exhibit a protective effect, nor were they able to improve the protection of NaF.

CONCLUSIONS

It is concluded that Carbopol enhanced NaF's protection against initial erosion. Carbopol alone or associated with NaF was able to reduce SL after several erosive challenges.

CLINICAL SIGNIFICANCE

Carbopol by itself was able to reduce the erosive wear magnitude to the same extent as the sodium fluoride, therefore, is a promising agent to prevent or control enamel erosion.

Influence of de/remineralization of enamel on the tensile bond strength of etch-and-rinse and self-etching adhesives

PURPOSE

To evaluate the bonding behavior of resin composite and different adhesives applied to demineralized or remineralized enamel.

METHODS

Bovine tooth crowns were polished to prepare a 5 mm2 enamel bonding area, and divided into five groups (n= 48) according to the surface treatment: CONT (sound enamel control), DEM (demineralized with acid to create white spot lesions), REMS (DEM remineralized with artificial saliva), REMF (DEM remineralized with sodium fluoride) and INF (DEM infiltrated with Icon resin infiltrant). The surface-treated teeth were divided into two subgroups (n= 24) according to adhesive type: ER (etch-and-rinse; Single Bond Universal) and SE (self-etching; Clearfill S3 Bond), and further subdivided into two categories (n= 12) according to aging process: Thermo (thermocycling) and NA (no aging). Composite blocks were made over bonded enamel and sectioned for microtensile bond strength (MTBS) testing. Data were analyzed with three-way ANOVA and post-hoc Tukey's test (α= 0.05).

RESULTS

Significant differences were observed for enamel surface treatment (P< 0.0001), adhesive type (P< 0.0001) and aging (P< 0.0001). CONT and INF groups had higher MTBS than the other groups; Single Bond Universal had higher MTBS than Clearfil S3 Bond; thermo-aging resulted in lower MTBS irrespective of adhesive type and surface treatment condition. The predominant failure mode was mixed for all groups. Enamel surface infiltrated with Icon does not interfere with adhesive resin bonding procedures.

CLINICAL SIGNIFICANCE

Treatment of enamel surface containing white spot lesions or cavities with cavosurface margins in partially-demineralized enamel can benefit from infiltration with a low viscosity resin infiltrant prior to adhesive bonding of resin composites.

Evaluation of bond strength of composite resin to enamel demineralized, exposed to remineralization and subjected to caries infiltration

Objective: To evaluate the bond strength between resin composite and different enamel substrates: sound enamel; demineralized enamel submitted or not to remineralization; and demineralized enamel infiltrated with aninfiltrating resin. Material and Methods: 120 bovine teeth were selected, the root portion was removed and the enamel finished. Specimens were divided into the following groups: (A) Control (n=24): adhesively treated and restored; (B) (n=96): the samples were immersed in a demineralization solution to create white spot lesions and divided into four subgroups: (B1) demineralized enamel; (B2) samples were stored in artificial saliva (8 weeks); (B3) samples were stored in a 0.05% sodium fluoride solution (1 min day/8 weeks); (B4) samples were treated with an infiltrant resin (Icon, DMG). The groups were treated with one of the following adhesives: Clearfil S3 Bond Plus (Kuraray) or Single Bond Universal (3M ESPE), followed by the resin composite application (Filtek Z 350 XT, 3M ESPE). The specimens were submitted to thermalcycling aging (10,000 ×; 2±5ºC, 50±55ºC and 37°± 2°C). The specimens were sectioned into prism shapes with ~1mm² of base and submitted to microtensile test. The collected data were submitted to ANOVA and Tukey´s test (?= 5%). Results: The Means (±SD) in MPa were: Clearfill S3 Bond Plus: Control (17.17±3.52); B1 (11.60±0.74); B2 (6.83±1.87); B3 (8.38±1.59) and B4 (27.00±1.76); Single Bond Universal: Control (26.26±3.19); B1 (10.94±2.00); B2 (11.05±1.74); B3 (15.63±1.25) and B4 (22.60±2.29). Conclusion: The surface infiltrated with an infiltrating resin (Icon) did not negatively affect the bond strength between resin composite and enamel. The demineralized and remineralized groups with sodium fluoride and artificial saliva presented statistically lower results when compared to the other groups.  

Effects of Different Surface Treatments on Composite Repairs

PURPOSE

To evaluate the influence of different surface treatments on roughness and bond strength of composite repairs.

MATERIALS AND METHODS

120 truncated conical specimens were prepared with composite Grandio SO (VOCO) and submitted to 5000 thermal cycles. Specimens were divided into 12 groups (n = 10) regarding the surface treatments: negative control (NC), without treatment; medium-grit diamond bur (MGD); coarse-grit diamond bur (CGD); conventional carbide bur (ConC); crosscut carbide bur (CutC); chemical vapor deposition diamond bur (CVD); sandblasting with aluminum oxide (AlO); Er:YAG laser 200 mJ/10 Hz (Er200); Er:YAG laser 60 mJ/10 Hz (Er50); Nd:YAG laser 120 mJ/15 Hz (Nd120); Nd:YAG laser 60 mJ/ 15Hz (Nd60); air abrasion with 110-μm silica modified aluminum oxide (Rocatec Plus-3M) (SIL). After the surface treatments, the surface roughness (Ra) was measured using a profilometer, and then the adhesive system Admira Bond (VOCO) was applied. Another truncated conical restoration was built up with the same composite over the bonded area of each specimen. In order to evaluate the cohesive strength, double-cone specimens were made and considered as a control group (CoheC). The specimens were submitted to tensile bond strength testing and the obtained data (MPa) were evaluated by one-way ANOVA, Tukey's and correlation tests.

RESULTS

ANOVA showed significant differences among experimental groups for roughness and adhesive strength (p < 0.00). The roughness values (Ra) were: NC (0.21 ± 0.19)(c); ConC (0.30 ± 0.08)(c); CutC (0.50 ± 0.22)(cd); CVD (0.74 ± 0.14)(bd); MGD (0.89 ± 0.39)(ab); Er50 (0.89 ± 0.14)(ab); AlO (0.90 ± 0.07)(ab); Nd60 (0.94 ± 0.33ab; SIL (0.98 ± 0.07)(ab); Nd120 (1.10 ± 0.19)(a); CGD (1.10 ± 0.32)(a); Er200 (1.12 ± 0.21)(a). The results of the tensile bond strength test in MPa were: CGD (11.58 ± 3.03)(a); MGD (12.66 ± 3.82)(ab); NC (13.51 ± 3.95(ab); Nd120 (14.11 ± 5.95)(ab); ConC (14.73 ± 6.12)(ab); Er200 (15.51 ± 1.45)(abc); CVD (15.61 ± 5.00(abc); Er50 (16.44 ± 2.75) (abc); CutC (16.79 ± 2.98)(abc); Nd60 (17.72 ± 2.45)(abcd); AlO (18.33 ± 3.19)(bcd); SIL (21.13 ± 4.48(cd); CoheC (23.50 ± 5.81)(d). The groups followed by the same letters were not statistically significantly different (Tukey's test). No correlation was found between bond strength and roughness (r = 0.007).

CONCLUSION

Air abrasion with silica coating (Rocatec) was the only method which resulted in significantly higher bond strength in relation to the negative control group. The increase in laser energy produced a rougher surface, but reduced the bond strength.

Artificial Saliva Formulations versus Human Saliva Pretreatment in Dental Erosion Experiments

The aim of this study was to evaluate the erosion-preventive effect of different artificial saliva formulations and human saliva in vitro compared to human saliva in situ. In the in vitro experiment, bovine enamel and dentin specimens were stored in artificial saliva (4 different formulations, each n = 20), deionized water (n = 20) or human saliva (n = 6 enamel and dentin specimens/volunteer) for 120 min. In the in situ experiment, each of the 6 enamel and dentin specimens was worn intraorally by 10 volunteers for 120 min. The specimens were then eroded (HCl, pH 2.6, 60 s). Half of the specimens were subjected to microhardness analysis (enamel) and the determination of calcium release into the acid (enamel and dentin), while the other half were again placed in the respective medium or worn intraorally, respectively, for 120 min before a second erosion was performed. Knoop microhardness of enamel and the calcium release of enamel and dentin into the acid were again determined. Statistical analysis was conducted by two-way repeated-measures ANOVA or two-way ANOVA (α = 0.05). Enamel microhardness was not significantly different between all test groups after the first and the second erosive challenge, respectively. Enamel calcium loss was significantly lower in situ compared to the in vitro experiment, where there was no significant difference between all test groups. Dentin calcium loss was significantly lower than deionized water only after the first and than all except one artificial saliva after the second erosion. Under the conditions of this experiment, the use of artificial saliva formulations and human saliva in vitro does not reflect the intraoral situation in dental erosion experiments adequately.

Adhesive Systems as an Alternative Material for Color Masking of White Spot Lesions: Do They Work?

PURPOSE

To evaluate the color masking effect of infiltration treatment of artificial white spot lesions (AWSL) using a dedicated resin in comparison to different adhesive systems.

MATERIALS AND METHODS

Enamel/dentin specimens were obtained from bovine incisors and baseline color was assessed using a reflectance spectrophotometer, according to the CIE L*a*b* system. AWSL were produced using a buffered acid solution and a new color evaluation was performed. The specimens were divided into 8 groups: control: artificial saliva changed daily for 7 days; IC: infiltrating resin Icon; EC: EquiaCoat; FU: Futurabond U; SBU: Single Bond U; SBMP: Scotchbond MP; OB: OptibondFL; BF: Bioforty. After the treatments, the color was evaluated again and the values for the parameters ΔL (change in lightness), Δa (change in chroma), Δb (change in hue), and ΔE (general color difference) were calculated in relation to baseline. Data were analyzed by one-way ANOVA and Tukey's tests.

RESULTS

After treatment, ANOVA showed significant differences for all parameters (p = 0.001). Tukey's test showed the greatest lightness reduction (ΔL) for the IC group, followed by EC, FU, and SBU. The SBMP, OB, and BF groups were similar to the control. For Δb values, all groups showed differences in relation to the control, with no differences between them. In relation to ΔE, all groups showed differences in relation to the control (ΔE = 5.24), with no significant differences between them. ΔE values after application of all resinous materials were lower than the threshold of 3.7, indicating effective color masking.

CONCLUSIONS

The Icon infiltrant produced a greater lightness reduction of white lesions (ΔL). For general color difference (ΔE), all the resinous materials tested were able to color mask artificial AWSL.

Effect of Nd:YAG laser in the bond strength of fiberglass posts

The aim of the present study was to compare the effects of Nd:YAG laser application in root canals on bond strengths of fiber posts. Thirty single-rooted bovines were randomly divided into three groups (n=10); root canal instrumentation was performed, and pretreatment was conducted as follows: C group: conventional treatment (without laser irradiation); ALC group: Nd:YAG laser was applied after adhesive; and LAC group: Nd:YAG laser was applied before adhesive. The fiber posts Rebilda 15 DC (Voco) were cemented with an adhesive system and resin cement, in accordance with the manufacturer’s instructions. Six slices with 1.0mm height was obtained for of each root and bond strength was measured by push-out test using a universal testing machine (0.5 mm/min). Data were analyzed using Kruskal-Wallis and Dunn’s tests (p <0.05). Push-out bond strengths to root canal dentin were affected by the type of treatment and root third. The use of Nd:YAG laser after the application of adhesive system had a higher bonding performance compared with the use of laser before the application. Also, cervical and medium third presented higher bond strength values than the apical third. It must be conclude that the laser irradiation over the non-cured adhesive system is more efficient for increase in bond strength than the irradiation after the application of the adhesive. However, the use of 60mJ of laser energy is not sufficient to improve the bonding performance.

Influence of Different Types and Concentrations of Chemical Catalysts on Dental Bleaching Efficiency

The objective of this study was to evaluate the effects of different types and concentrations of chemical catalysts on the efficiency of 35% hydrogen peroxide gel on dental bleaching. Enamel-dentin disks were obtained from bovine incisors and the initial color was assessed. The groups were divided according to the type and concentration of catalyst added to an experimental gel: ferrous sulphate (FS) (0.001, 0.002 and 0.003%); ferrous gluconate (Fg) (0.01, 0.02 and 0.03%); ferric chloride (FC) (0.01, 0.02 and 0.03%); manganese gluconate (MG) (0.01, 0.02 and 0.03%); and manganese chloride (MC) (0.01, 0.02 and 0.03%). The positive control (PC) group received the bleaching gel without any catalyst, while in the negative control (NC) the specimens remained in artificial saliva. Three applications of the bleaching gels were performed for 10 minutes each, repeated after 7 days. Color assessments were performed 7 days after the first session and 7 days after the second. The specimens were stored in artificial saliva and assessed again after 1 year. The data were analyzed by parametric analysis of variance and Tukey's test. Some of the chemical catalysts tested were effective in reducing the yellowish color of the samples in relation to the positive control group after 1 and 2 applications and diminished the color relapse over time. After 1 year, the FS was the most effective catalyst tested. We concluded that some chemical catalysts increased the efficiency of dental bleaching.

Analysis of the Color and Fluorescence Alterations of Enamel and Dentin Treated With Hydrogen Peroxide

Abstract: The aim of this study was to evaluate the effect of hydrogen peroxide whitening on fluorescence and color of bovine enamel and dentin. Twenty five dentin discs and 25 enamel discs, with 6 mm diameter and 1 mm thick, were obtained. Direct fluorescence (spectrofluorophotometry) and color (spectrophotometry) were assessed. After fluorescence and color baseline measurements, specimens were immersed in a 35% hydrogen peroxide (HP) solution for 1 h. This procedure was repeated after 7 days. Final fluorescence and color measurements were performed after the second immersion. Chemical characterization of 5 additional specimens was also performed. Data were submitted to repeated analysis of variance and Tukey´s test for fluorescence and unpaired t-test for color and chemical components (p<0.05). Fluorescence decreased significantly in dentin specimens after whitening. Enamel presented lower fluorescence than dentin at baseline, but this parameter did not decrease after whitening. Color changes were observed for both substrates, with significantly greater whitening effect in dentin (ΔE=10.37) (p<0.001). Whitening by hydrogen peroxide induced significant decrease in fluorescence of tooth dentin and promoted significant color changes in dentin and enamel with more accentuated outcomes in dentin.

Effect of home-bleaching gels modified by calcium and/or fluoride and the application of nano-hydroxyapatite paste on in vitro enamel erosion susceptibility

OBJECTIVE

This in vitro study compared the effect of bleaching agents modified by the addition of calcium and/or fluoride and the application of a nano-hydroxyapatite paste after bleaching, on the susceptibility of enamel to erosion.

MATERIALS AND METHODS

Bovine enamel cylindrical samples (3 mm diameter) were assigned to six groups (n = 20 specimens/group) according to the bleaching agent: no bleaching (C-control), 7.5% hydrogen peroxide gel (HP), HP with 0.5% calcium gluconate (HP+Ca), HP with 0.2% sodium fluoride (HP+F), HP with calcium and fluoride (HP+Ca+F) and HP followed by the application of a nano-hydroxyapatite agent (HP+NanoP). The gels were applied on the enamel surface (1 h) followed by cyclic erosive challenges (Sprite Zero®-2 min), for 14 days. The paste was applied after bleaching for 5 min (HP+NanoP). The enamel surface alteration was measured by contact profilometry (µm) (after 7 and 14 days).

RESULTS

C-control (mean ± SD: 2.29 ± 0.37 at 7 days/4.86 ± 0.72 at 14 days) showed significantly lower loss compared to the experimental groups. HP+Ca (3.34 ± 0.37/6.75 ± 1.09) and HP+F (4.49 ± 0.92/7.61 ± 0.90) presented significantly lower enamel loss than HP (4.18 ± 0.50/10.30 ± 1.58) only for 14 days and HP+Ca+F (4.92 ± 1.03/8.12 ± 1.52) showed values similar to the HP+F group. The HP+NanoP (5.51 ± 1.04/9.61 ± 1.21) resulted in enamel loss similar to the HP after 14 days.

CONCLUSIONS

It was found that 7.5% hydrogen peroxide increased the susceptibility of enamel to erosion. The addition of calcium or fluoride to the bleaching gel reduced the erosion effect, while the nano-hydroxyapatite agent did not provide any protective effect.

Influence of whitening gel application protocol on dental color change

OBJECTIVES

To evaluate the influence of different whitening protocols on the efficacy of 35% hydrogen peroxide (HP) tooth whitening and gel pH and concentration.

MATERIAL AND METHODS

Eighty-four enamel/dentin discs from bovine incisors were used. The baseline color was measured with a spectrophotometer. Two sessions of in-office whitening with 35% HP were performed under different protocols: G1: 3 applications of HP (10 min each) per session; G2: 1 application of 30 min per session; G3: 1 application of 40 min per session, with no gel replenishment within session for groups 2 and 3. HP titration and pH evaluation at baseline, after 10, 30, and 40 min were also performed. The final color was measured 24 h after the 1st and 2nd whitening sessions. Data were submitted to Repeated Measures ANOVA and Tukey's test.

RESULTS

For color evaluation, no differences were observed among groups after two sessions. HP titration showed no drop on concentration after 10, 30, or 40 min. The pH was 5.54 at baseline and 5.41 after 40 min.

CONCLUSION

Replenishment or extended application time of in-office whitening gel does not affect gel pH and concentration, a fact that supports the similar effectiveness of whitening observed among the tested protocols.

Longitudinal Evaluation of Bond Strength to Enamel of Dental Adhesive Systems Associated with Nd:YAG Laser

OBJECTIVES

This study evaluated the durability of bond strength to enamel using total-etch (Single Bond/SB) and self-etch (Clearfil SE Bond/CSEB) adhesives associated with neodymium:yttrium-aluminu-garnet (Nd:YAG) laser irradiation through the uncured adhesives.

METHODS

Bovine incisors were worn to expose an area of enamel and were divided into four groups: group 1 (control) SB + polymerization; group 2 (control) CSEB + polymerization; group 3 (laser) - SB + Nd:YAG laser (174.16 J/cm(2)) + polymerization; and group 4 (laser) CSEB + Nd:YAG (174.16 J/cm(2)) + polymerization. Blocks of composite were fabricated and stored for 24 hours or 12 months, sectioned into beams, and submitted to microtensile tests. Results were analyzed by three-way analysis of variance (ANOVA) (adhesive, technique, and storage time) and Tukey tests.

RESULTS

ANOVA revealed significant differences for adhesive × technique and technique × storage time (p<0.05). The mean values (MPa) for interaction adhesive × technique (standard deviation) were as follows: SB/control = 35.78 (6.04)a; SB/laser = 26.40 (7.25)b, CSEB/control = 26.32 (5.71)b, CSEB/laser = 23.90 (7.49)b. For interaction technique × storage time the mean values were as follows: control/24 hours = 32.58 (6.49)a; control/12 months = 29.52 (8.38)a; laser/24 hours = 29.37 (5.71)a; laser/12 months = 20.92 (6.5)b. Groups with the same letters showed no statistically significant differences.

CONCLUSION

Scanning electron microscope analysis showed evident areas of micromorphological alterations in lased samples after 12 months of water storage. Nd:YAG laser irradiation of enamel through unpolymerized total-etch adhesive significantly reduced bond strength compared with the control. Bond strength decreased when enamel samples irradiated with Nd:YAG laser through unpolymerized adhesives were stored in water for 12 months.

Influence of Chemical Degradation and Toothbrushing on Surface of Composites

Objective

The aim of this study was to evaluate the effect of chemical degradation media associated with brushing on surface roughness (Ra) and Knoop microhardness (KHN) analyses of different composites.

Materials and methods

Eighty specimens were prepared for each composite: GrandioSO (Voco), Amaris (Voco), Filtek Supreme (3M ESPE), Filtek LS (3M ESPE). The specimens were divided into four groups according to the immersion in chemical degradation media for 7 days: artificial saliva (control), heptane, 0.02 M citric acid, 70% ethanol. The surface of specimens was submitted to 10950 brushing cycles (200 gm load) in an automatic toothbrushing machine with abrasive slurry. Surface roughness and microhardness measurements were obtained at baseline, after immersion in chemical degradation media and after brushing. Data were submitted to three-way repeated measures ANOVA and Tukey's test (p < 0.05).

Results

The KHN means for composites were: Grandio (153.5 ± 35.9)a, Filtek Supreme (87.0 ± 24.9)b, Amaris (64.5 ± 24.5)c, LS (69.0 ± 15.3)c; for storage media: artificial saliva (97.3 ± 46.7)a, ethanol (93.3 ± 49.9)a, citric acid (95.8 ± 42.1)a, heptane (87.6 ± 36.7)b; and after treatments: after chemical degradation (104.8 ± 49.7)a, baseline (93.8 ± 42.5)b, after brushing (81.9 ± 36.5)c. The Ra results for composites were: LS (0.15 ± 0.25)a, GrandioSO (0.19 ± 0.24)ab, Filtek Supreme (0.20 ± 0.22)ab, Amaris (0.23 ± 0.37)b; for storage media: artificial saliva (0.18 ± 0.31)a, heptane (0.18 ± 0.25)a, ethanol (0.20 ± 0.26)a, citric acid (0.21 ± 0.28)a, and after treatments: brushing (0.11 ± 0.14)a, after chemical degradation (0.23 ± 0.32)b, baseline (0.24 ± 0.32)b.

Conclusion

Brushing after chemical degradation reduced surface roughness values. In general, chemical degradation did not affect composites roughness, but microhardness was significantly reduced. Heptane produced the biggest reduction in composites microhardness.

Clinical relevance

The food-simulating solutions and brushing simulating alter the composites properties, and these alterations are material-dependent.

How to cite this article

Torres CRG, Da Silva TM, Sales ALLS, Pucci CR, Borges AB. Influence of Chemical Degradation and Toothbrushing on Surface of Composites. World J Dent 2015;6(2):65-70.

Effect of Nd:YAG laser on the solvent evaporation of adhesive systems

OBJECTIVE

This study evaluated the influence of Nd:YAG laser on the evaporation degree (ED) of the solvent components in total-etch and self-etch adhesives.

MATERIALS AND METHODS

The ED of Gluma Comfort Bond (Heraeus-Kulzer) one-step self-etch adhesive, and Adper Single Bond 2 (3M ESPE), and XP Bond (Dentsply) total-etch adhesives was determined by weight alterations using two techniques: Control--spontaneous evaporation of the solvent for 5 min; Experimental--Nd:YAG laser irradiation for 1 min, followed by spontaneous evaporation for 4 min. The weight loss due to evaporation of the volatile components was measured at baseline and after 10 s, 20 s, 30 s, 40 s, 50 s, 60 s, 70 s, 80 s, 90 s, 100 s, 110 s, 2 min, 3 min, 4 min, and 5 min.

RESULTS

Evaporation of solvent components significantly increased with Nd:YAG laser irradiation for all adhesives investigated. Gluma Comfort Bond showed significantly higher evaporation of solvent components than Adper Single Bond 2 and XP Bond. All the adhesives lost weight quickly during the first min of Nd:YAG laser irradiation.

CONCLUSION

The application of Nd:YAG laser on adhesives before light curing had a significant effect on the evaporation of the solvent components, and the ED of Gluma Comfort Bond one-step self-etch adhesive was significantly higher than with Adper Single Bond 2 and XP Bond total-etch adhesives.

CLINICAL RELEVANCE

The use of the Nd:YAG laser on the uncured adhesive technique can promote a greater ED of solvents, optimizing the longevity of the adhesive restorations.