Efficacy of ClinproTMXT Varnish surrounding brackets on the enamel surface of white spot lesion

Abstract Orthodontics patients usual develop demineralization and present cavity caries lesions after six months. Minimally invasive procedures have been the goal in modern dental practice. The aim of this study was to evaluate the effect of ClinproTMXT Varnish, on the enamel surface roughness and severity of white spot lesions. Twenty premolars were submitted to bond brackets and experimental induction of demineralization and randomly divided into 2 groups: GI - fluoride varnish (Colgate Duraphat®); GII - Ionomeric Sealant (ClinproTMXT Varnish). The treatment was applied around the brackets. The surface roughness of specimens was analyzed, before treatment and 12 weeks after treatment by laser confocal microscopy, and the severity of the white spot lesion was by laser fluorescence device. The data were analyzed by non-parametric Wilcoxon and Mann-Whitney Test, at 5% significance, roughness percentage reduction was performed. The severity of demineralization decreased in both, GI (p = 0.005) and GII (p = 0.019). Enamel superficial roughness levels decreased in GI and GII. As well as the roughness percentage, being more expressive in the ClinproTMXT Varnish group (85,09%). Colgate Duraphat® or Clinpro™ XT Varnish reduced the severity of the demineralization and decreased the superficial roughness on the enamel. The Clinpro™ XT Varnish was superior to superficial roughness on enamel.

Resumo Pacientes ortodônticos geralmente desenvolvem desmineralização e apresentam lesões de cárie após seis meses de tratamento. Procedimentos minimamente invasivos têm sido o objetivo na prática odontológica moderna. O objetivo deste estudo foi avaliar o efeito do ClinproTM XT selante ionomérico, ao redor do bráquete, com relação a rugosidade superficial do esmalte e a severidade da lesão induzida. Vinte pré-molares foram submetidos a colagem de bráquetes e indução experimental de desmineralização e divididos aleatoriamente em 2 grupos: GI - verniz fluoretado (Colgate Duraphat®); GII - Selante Ionomérico (ClinproTM XT). O tratamento foi aplicado ao redor dos bráquetes. A rugosidade da superfície dos espécimes foi analisada, antes do tratamento e 12 semanas após o tratamento por microscopia confocal a laser e severidade da lesão de mancha branca por dispositivo de fluorescência a laser. Os dados foram analisados pelo teste não paramétrico de Wilcoxon e Mann-Whitney, a 5% de significância. A taxa de redução da lesão foi calculada. A severidade da desmineralização diminuiu tanto no GI (p = 0,005) quanto no GII (p = 0,019). Os níveis de rugosidade superficial do esmalte diminuíram no GI e GII, assim como o percentual de rugosidade, sendo mais expressivo no grupo ClinproTMXT (85,09%). Colgate Duraphat® e Clinpro™ XT reduziram a severidade da desmineralização e diminuíram a rugosidade superficial do esmalte. O selante ionomérico Clinpro™ XT foi superior na redução percentual de rugosidade.

Acquired enamel pellicle protects gastroesophageal reflux disease patients against erosive tooth wear

Abstract The objective of this study was to compare the protein profile of the acquired enamel pellicle (AEP) formed in vivo in patients with or without gastroesophageal reflux disease (GERD), and with or without erosive tooth wear (ETW). Twenty-four volunteers were divided into 3 groups: 1) GERD and ETW; 2) GERD without ETW; and 3) control (without GERD). The AEP formed 120 min after prophylaxis was collected from the lingual/palatal surfaces. The samples were subjected to mass spectrometry (nLC-ESI-MS/MS) and label-free quantification by Protein Lynx Global Service software. A total of 213 proteins were identified, or 119, 92 and 106 from each group, respectively. Group 2 showed a high number of phosphorylated and calcium-binding proteins. Twenty-three proteins were found in all the groups, including 14-3-3 protein zeta/delta and 1-phosphatidylinositol. Several intracellular proteins that join saliva after the exfoliation of oral mucosa cells might have the potential to bind hydroxyapatite, or participate in forming supramolecular aggregates that bind to precursor proteins in the AEP. Proteins might play a central role in protecting the dental surface against acid dissolution.

Sports mouthguards: Contamination, roughness, and chlorhexidine for disinfection - A randomized clinical trial

Abstract The aim of the present in vivo study was to evaluate the bacterial contamination of sports mouthguards, surface roughness, and the efficacy of chlorhexidine gluconate spray in the disinfection of these devices. A randomized, blinded cross-over clinical trial was performed with twenty 9 to 13 years old children who practiced martial arts and participated in all phases of the study. They were instructed to wear mouthguards 3 alternated days a week for 1 hour and, after use, to spray sterile tap water or chlorhexidine 0.12%. The mouthguards were analyzed by MTT assay, Checkerboard DNA-DNA hybridization, and confocal laser microscopy prior and after use for 2 weeks. Data were analyzed by Wilcoxon and t-Student, and Pearson correlation tests, with 5% significance level. Were observed that mouthguards of the control group were more contaminated with cariogenic microorganisms than those of the chlorhexidine group (p<0.05). The mouthguards use of spray of chlorhexidine reduced significantly the bacteria contamination compared with control group (p = 0.007). The surface roughness of the mouthguards increased significantly after use, irrespective of application of chlorhexidine spray. A moderate correlation (r=0.59) was observed between surface roughness and the cariogenic microorganism's contamination only for control group. Sports mouthguards had intense microbial contamination and increased surface roughness after its use. The use of chlorhexidine spray was effective for reducing the mouthguards contamination used by children.

Resumo O objetivo do presente estudo in vivo foi avaliar a contaminação bacteriana de protetores bucais esportivos, a rugosidade da superfície e a eficácia do spray de gluconato de clorexidina na desinfecção desses dispositivos. Um ensaio clínico randomizado, cego, cruzado foi realizado com vinte crianças de 9 a 13 anos, que praticavam artes marciais, participaram de todas as fases do estudo. As crianças foram orientadas a usar o protetor bucal por 3 dias alternados durante 1 hora e, após o uso, borrifar água de torneira estéril ou clorexidina 0,12%. Os protetores foram analisados por ensaio MTT, Hibridização DNA-DNA e microscopia confocal a laser antes e após o uso por 2 semanas. Os dados foram analisados pelos teste de Wilcoxon, teste t de Student, e correlação de Pearson, com nível de significância de 5%. Observou-se que os protetores bucais do grupo controle estavam mais contaminados com microrganismos cariogênicos do que os do grupo experimental (clorexidina) (p <0,05). O uso de protetores bucais com spray de clorexidina reduziu significativamente a contaminação bacteriana em relação ao grupo controle (p = 0,007). A rugosidade da superfície dos protetores bucais aumentou significativamente após o uso, independentemente da aplicação de spray de clorexidina. Uma correlação moderada (r = 0,59) foi observada entre a rugosidade da superfície e a contaminação do micro-organismo apenas para o grupo controle. Os protetores bucais esportivos apresentam intensa contaminação microbiana e aumento da rugosidade superficial após o uso. O uso de spray de clorexidina foi eficaz para reduzir a contaminação dos protetores bucais usados por crianças.

Microhardness homogeneity of RBCs light-cured with a multiple-peak LED and surface characterization after wear

Abstract This in vitro study evaluated the effect of the beam homogeneity of a multiple-peak light-curing unit on the surface microhardness and the effect of toothbrushing wear on the microhardness, surface roughness, roughness profile, volume loss, and gloss retention of incremental and bulk-fill resin-based composites (RBCs). A LED light-curing unit (VALO) with four LEDs at the tip end (405, 445, 465A, and 465B nm emission peak) was used according to each manufacturer-recommended time to obtain disks (n=10) of six RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra, and Filtek Bulk Fill. Microhardness values were obtained according to each LED positioning of the light-curing unit on the top surface of the RBCs and were analyzed before and after toothbrushing regarding microhardness, surface roughness, roughness profile, volume loss, and gloss retention. Microhardness was considered homogeneous on the top surface regardless of the type of RBC or wavelength tested (p>0.05). Overall, toothbrushing did not reduce the microhardness of the RBCs but influenced the gloss values for most RBCs (p<0.001). Charisma Classic presented the greatest surface roughness and roughness profile after toothbrushing (p<0.05). Volume loss did not differ among RBCs (p>0.05). In conclusion, different wavelengths of the LED did not affect the top surface microhardness, regardless of the RBCs tested; and bulk-fill composites presented similar surface changes (microhardness, surface roughness, roughness profile, volume loss, and gloss retention) when compared to conventional composites after toothbrushing.

Resumo Este estudo in vitro avaliou a homogeneidade do feixe de um fotopolimerizador de múltiplos picos na microdureza superficial e o efeito da escovação na microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e retenção do brilho de compósitos a base de resina (RBCs) incrementais ou bulk-fill. Um fotopolimerizador LED (VALO) com quatro LEDs na ponteira (405, 445, 465A e 465B nm de pico de emissão) foi usado de acordo com o tempo recomendado por cada fabricante para obtenção de discos (n=10) de seis RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra e Filtek Bulk Fill. Os valores de microdureza foram obtidos seguindo o posicionamento de cada LED na superfície superior das amostras e foram analisados antes e após a escovação quanto a microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e retenção do brilho. A microdureza foi considerada homogênea no topo da superfície, independentemente do tipo de RBCs ou comprimento de onda testados (p>0.05). No geral, a escovação não reduziu a microdureza das RBCs, mas influenciou o brilho para a maioria das RBCs (p<0.001). Charisma Classic apresentou os maiores valores de rugosidade superficial e perfil de rugosidade após a escovação (p<0.05). A perda de volume não diferiu entre as RBCs (p>0.05). Em conclusão, os diferentes comprimentos de onda do LED não alteraram a microdureza do topo da superfície, independentemente das RBCs testadas; e as resinas bulk-fill apresentaram alterações superficiais similares (microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e manutenção do brilho) quando comparadas às resinas convencionais após a escovação.

Color Stability and Surface Roughness of Hybrid and Nanofilled Composites Brushed with Abrasive Dentifrices / Estabilidade de Cor e Rugosidade Superficial de Resinas Compostas Micro-Híbridas e Nanoparticulada Submetidas à Escovação com Dentifrícios Abrasivos

The aim of this study was to evaluate the color stability and the surface roughness of different composites brushed with toothpastes presenting different levels of abrasivity. Thirty discs of each material were obtained using michohybrid composites (Brilliant NG and Charisma Diamond) and a nanocomposite (Filtek Z350XT). The initial color (CIELab) and surface roughness (confocal laser scanning microscopy) of resin discs were evaluated. Afterwards, 10 specimens per group were brushed with the following dentifrices: Maximum Cavity Protection, Sensodyne Repair & Protect and Colgate Sensitive Pro-Relief. Brushing was performed with an electric toothbrush equipped with soft bristle head, with standard power and weight, for 30 minutes. Every 30 seconds, 1.0 ml of the slurry was injected between the bristles of the brush and the specimen. After abrasive challenge, the samples had their color and roughness reevaluated. Data were submitted to the Kruskal-Wallis test (color change) or the t-test (surface roughness). The level of significance was 5%. Results: Brushing did not significantly change the color of the composites tested in the study herein . On the other hand, the surface roughness of the composites was significantly affected by the abrasive challenge, regardless of the toothpaste used. The surface roughness change was similar for all the composites. The abrasive challenge with the toothpastes Maximum Cavity protection, Sensodyne Repair & Protect and Colgate Sensitive Pro-Relief was not able to significantly change the color of the composite resins. Nevertheless, the abrasive challenges significantly altered the surface roughness of all the evaluated composites. However, the changes in surface roughness were statistically similar in the microhybrid and nanofilled composites. (AU)

O objetivo deste estudo foi avaliar a estabilidade de cor e a rugosidade superficial de diferentes resinas compostas escovadas com dentifrícios de diferentes níveis de abrasividade. Trinta discos de cada material foram obtidos utilizando compósitos micro-híbridos (Brilliant NG e Charisma Diamond) e um nanocompósito (Filtek Z350XT). A cor inicial (CIELab) e a rugosidade superficial (microscopia confocal de varredura a laser) dos discos de resina foram avaliadas. Em seguida, 10 amostras por grupo foram escovadas com os dentifrícios Máxima Proteção Anticáries, Sensodyne Repair & Protect e Colgate Sensitive Pro-Alívio. A escovação foi realizada com uma escova elétrica com cabeça de cerdas macias, com potência e peso padronizados, durante 30 minutos. A cada 30 segundos, 1,0 ml da pasta era injetada entre as cerdas da escova e a amostra. Após o desafio abrasivo, as amostras tiveram sua cor e rugosidade reavaliadas. Os dados foram submetidos ao teste de Kruskal-Wallis (alteração de cor) ou ao teste t (rugosidade da superfície) (α=5%). A escovação não alterou significativamente a cor dos compósitos. Por outro lado, a rugosidade superficial dos compósitos foi significativamente afetada pelo desafio abrasivo, independentemente do dentifrício utilizado. A alteração da rugosidade superficial foi semelhante para todos os compósitos. O desafio abrasivo com a Máxima Proteção Anticáries, o Sensodyne Repair & Protect e o Colgate Sensitive Pro-Alívio não foi capaz de alterar significativamente a cor das resinas. Diferentemente, os desafios abrasivos alteraram significativamente a rugosidade superficial de todos os compósitos avaliados. No entanto, as mudanças na rugosidade foram estatisticamente semelhantes nos compósitos micro-híbridos e nanoparticulado. (AU)

Different approaches for aesthetic rehabilitation of discolored nonvital anterior teeth / Diferentes abordagens para reabilitação estética de dentes anteriores escurecidos não-vitais

ABSTRACT An ideal aesthetic standard consists of facial and smile harmony. Discolored teeth generally cause an imbalance in facial aesthetics, leading to low self-esteem and disturbance in social relationships. Causes of teeth discoloration are classified as intrinsic or extrinsic. Bleaching is considered a safe and effective treatment for discolored nonvital teeth and can be associated with restorative treatment to properly correct the dental color and maximize the aesthetic results. This paper aims to present two case reports of single discolored nonvital anterior teeth and the protocol used to reestablish the dental harmony of these patients by bleaching and direct composite resin restoration. To exert minimally invasive dentistry is very important to preserve tooth structure and reduce the risk of fracture. Internal bleaching, although may not be sufficient to reestablish the aesthetic in some cases, it is important to minimize dental preparation to perform an indirect or direct restoration. Dentists must take into account the patients expectations, dominate the restorative technique and know the dental materials to properly be able to restore function and aesthetics and consequently improve life quality and social relationships.

RESUMO Um padrão estético ideal consiste na harmonia facial e do sorriso. Dentes descoloridos geralmente causam um desequilíbrio na estética facial, levando a baixa auto-estima e interferência nas relações sociais. As causas da descoloração dos dentes são classificadas como intrínsecas ou extrínsecas. O clareamento é considerado um tratamento seguro e eficaz para os dentes não vitais escurecidos e pode ser associado ao tratamento restaurador para corrigir adequadamente a cor dental e maximizar os resultados estéticos. O objetivo deste trabalho é apresentar dois relatos de casos de dentes anteriores não vitais escurecidos e o protocolo utilizado para restabelecer a harmonia dentária desses pacientes por meio de clareamento e restauração direta em resina composta. Para exercer uma Odontologia minimamente invasiva é muito importante preservar a estrutura dentária e reduzir o risco de fratura. O clareamento interno, embora possa não ser suficiente para restabelecer a estética em alguns casos, é importante para minimizar o preparo dental para realizar uma restauração indireta ou direta. Os dentistas devem levar em consideração as expectativas dos pacientes, dominar a técnica restauradora e conhecer os materiais dentários para poder restaurar adequadamente a função e a estética e, consequentemente, melhorar a qualidade de vida e as relações sociais.

Color stability of nanohybrid composite resins in drinks

Aim: The objective of this study was to evaluate the effects of solutions on the color stability of nanohybrid composite resins. Methods: The experimental sample consisted of 90 composite specimens (Beautifil II; Z350XT; Premisa), divided into three subgroups (n=10) according to the solutions (matte tea; lemon flavor isotonic drink; artificial saliva). The specimens were immersed in the solutions (5 mL/specimen) while stirring for 5 minutes, four times a day, with 1-hour intervals, repeated for 15 days. The color of the specimens was analyzed before (baseline) and after the 15th day of cycling using the CIELAB system. Data were analyzed using the two-way analysis of variance (ANOVA) and Tukey's test (α=5%). Results: Different behaviors were observed among resins. Beautifil II presented the highest color change (∆E=4.18) and less color stability, statistically different from the others (p<.05). The solutions also presented different behaviors. The lemon flavor isotonic drink (∆E=3.95) promoted the highest color change, statistically different from saliva (∆E=2.75; p<.05). The interaction between Beautifil II and isotonic drink became even more evident and significant (p<.05). Conclusion: The isotonic drink is the solution that most affected the resins, and Beautifil II presents the worst color stability

Effect of diode laser irradiation on the bond strength of polymerized non-simplified adhesive systems after 12 months of water storage

Abstract Objectives: The aim of this in vitro study was to evaluate the bonding strength of non-simplified dentin bonding systems (DBS) to dentin irradiated with a diode laser (970 nm) immediately and after 12 months of water storage following either primer or bond application. Material and methods: The experimental design included three different factors: DBS type [AdperTM Scotchbond Multipurpose (MP) and Clearfil™ SE Bond (CSE)], irradiation [without irradiation - control (C), irradiation after primer application (AP), and irradiation after bond application (AB)], and time [initial (I) and after 12 months of water storage (12 m)]. Sixty sound human third molars (n = 10) were obtained, and their flat occlusal dentin areas were prepared and standardized. Laser irradiation was performed in the contact mode perpendicular to the dental surface over an automatically selected scanning area at a pulse energy of 0.8 W, frequency of 10 Hz, and energy density of 66.67 J/cm2. After 7 days of treatment, the specimens were cut, and half of them were subjected to microtensile testing (500 N/0.05 mm/min), whereas the remaining sticks were examined after 12 months of water storage. The obtained data were analyzed by three-way analysis of variance (ANOVA) followed by a Tukey test (p<0.05). The observed fracture modes were investigated using a portable digital microscope with a magnification of 40x. Results: Among the utilized DBS, MP generally exhibited higher bond strengths, but did not always differ from CSE under similar conditions. The irradiation factor was statistically significant only for the MP/AB groups. After 12 months of storage, all groups demonstrated a significant reduction in the bond strength, whereas the results of fracture analysis showed a predominance of the adhesive type. Conclusions: The laser treatment of non-simplified DBS was not able to stabilize their bonding characteristics after 12 months.

Efeito da Degradação Química sobre a Rugosidade Superficial e Estabilidade de Cor de Resinas Compostas Micro-híbrida e Nanoparticulada / Effect of Chemical Degradation on Surface Roughness and on Color Stability of Micro hybrid and Nanofilled Composites

A resina composta é o material restaurador mais utilizado atualmente. Apesar de seu sucesso clínico, o material está sujeito a alterações em suas propriedades físicas, quando exposto ao meio bucal. O objetivo foi avaliar a influência da degradação química na estabilidade de cor e na rugosidade superficial de resinas micro-híbrida e nanoparticulada. Foram confeccionados 40 discos (6,0mm x 2,0mm) da resina composta micro-híbrida (Z250XT) e 40 da resina nanoparticulada (Z350XT). Após a análise da cor inicial e da rugosidade inicial, 10 discos de cada resina foram imersos em saliva artificial (Controle, pH=6,4), suco de laranja (pH= 3,4), refrigerante de limão (pH=2,9) e vinho tinto (pH=3,1), por 4 horas por dia (37ºC) durante 30 dias. Após, foram realizadas as leituras finais de cor e rugosidade. Os dados obtidos para a estabilidade de cor foram analisados pelo Teste de Kruskal-Wallis, seguido pelo Teste de Dunn (α=5%). Para a análise da rugosidade foi utilizado o Teste t para amostras pareadas (α=5%). O manchamento provocado pela saliva artificial, suco de laranja e refrigerante foi similar, mas foi estatisticamente diferente do manchamento produzido pelo vinho, em ambas as resinas testadas. O vinho produziu o mesmo grau de manchamento nas resinas micro-híbrida e nanoparticulada. Foi observado que o suco de laranja, o refrigerante e o vinho promoveram aumento da rugosidade superficial dos discos de resina. Diante disso, concluiu-se que o vinho alterou a cor de resinas compostas micro-híbrida e nanoparticulada, e que a rugosidade superficial dos discos de resina foi alterada por todas as bebidas utilizadas. (AU).

Composite resin is the most used restorative material. Despite its clinical success, it is susceptible to changes in its physical properties when exposed to the oral environment. The aim was to evaluate the influence of acidic beverages on the color stability and on the surface roughness of the nanofilled and micro hybrid composite. Forty discs (6.0mm x 2.0mm) of the micro hybrid composite (Z250XT) and 40 of the nanofilled composite (Z350XT) were manufactured. After the measurement of the initial color and the initial roughness, 10 discs of each composite were individually immersed in artificial saliva (control, pH = 6.4), orange juice (pH=3.4), lime soda (pH = 2.9) and red wine (pH = 3.1) during 4 hours per day at 37°C for 30 days. At the end of the experiment, the final analysis of color and surface roughness were performed. The data obtained for the color stability were analyzed by Kruskal-Wallis and Dunn's test (α= 5%). For the analysis of the surface roughness, the t test for related samples was used (α= 5%). The color changes promoted by artificial saliva, orange juice and soda were similar, but they were statistically different from staining produced by wine, in both tested composites. Wine produced the same degree of staining in both composites. Orange juice, soda and red wine increased the surface roughness of the composite discs. It was concluded that red wine significantly changes the color of micro hybrid and nanofilled composites. Furthermore, all beverages increased the surface roughness of the composites tested in the study herein. (AU).

Alteração de Cor de Resinas Compostas Imersas em Diferentes Bebidas / Colors Change of Composite Resins Immersed in Different Beverages

O presente estudo analisou resinas compostas imersas em diferentes bebidas (café, vinho tinto, refrigerante a base de cola e água destilada) nos diferentes tempos de polimento. Avaliou-se também a estabilidade de cor após o repolimento. As resinas compostas utilizadas foram: Resina Filtek Z350 XT e Resina Brilliant NG; as bebidas para o experimento foram: café, refrigerante à base de cola, vinho tinto e água destilada, que corresponde ao grupo controle. Foram confeccionados 160 corpos de prova: 80 de cada resina composta. Vinte corpos de prova receberam polimento imediato, vinte receberam polimento após 24 horas, vinte o polimento após 7 dias e os outros vinte não receberam polimento. As análises de cor foram feitas utilizando o aparelho espectrocolorímetro, que utiliza o sistema CIELab. Foi avaliado o ΔE dos grupos após 30 dias (ΔE= 30d ­ baseline). Os dados foram submetidos à ANOVA e teste de Tukey (α=5%). Os corpos-de-prova passaram por processo de repolimento com discos de Sof-Lex Pop On e, posteriormente, foram analisados em busca de identificar se houve aproximação equivalente à cor inicial. As bebidas testadas possuem capacidade de manchamento, sendo o café e o vinho tinto os grupos com maiores valores de alteração de cor, seguido do refrigerante à base de cola. As resinas compostas polidas apresentaram valores menores de alteração de cor, independentemente, do tempo de polimento. Com o repolimento, a água destilada e o refrigerante à base de cola tiveram seus valores considerados clinicamente aceitáveis ΔE<3,3. Já o café e o vinho tinto tiveram seus valores de manchamento reduzidos, porém perceptíveis ao olho humano. (AU)

The present study examined composite resins in different beverages (coffee, red wine, cola-based soda and distilled water) in the different times of polishing and after the re-polishing. The composite resins used were: resin Filtek Z350 XT and resin Brilliant NG; the tested beverages were: coffee, red wine, soft-drink and distilled water corresponding to the control group. 160 specimens were made, 80 of each composite. Twenty specimens were given immediate polishing, twenty were polished after 24 hours, twenty were polished after 7 days and the other twenty had no polishing. Color analysis was made using the spectrophotometer device that uses CIELab system. ΔE was evaluated after 30 days immersion period (ΔE = 30-days - baseline). The data were submitted to ANOVA and Tukey tests (α=5%). Then, specimens were re-polished with Sof- Lex Pop On and subsequently analyzed if there was approach equivalent to the initial color. All the tested beverages had ability to staining, and coffee and red wine groups showed higher values of color change, followed by soft-drink. The composite resins polished showed lower values of color change, regardless of the polishing time. After re-polishing, distilled water and soft-drink had their values considered clinically acceptable ΔE<3.3; coffee and red wine had their staining values reduced, but perceptible to the human eye. (AU)

Does laser diode irradiation improve the degree of conversion of simplified dentin bonding systems?

Abstract Simplified dentin-bonding systems are clinically employed for most adhesive procedures, and they are prone to hydrolytic degradation. Objective This study aimed to investigate the effect of laser diode irradiation on the degree of conversion (DC), water sorption (WS), and water solubility (WSB) of these bonding systems in an attempt to improve their physico-mechanical resistance. Material and Methods Two bonding agents were tested: a two-step total-etch system [Adper™ Single Bond 2, 3M ESPE (SB)] and a universal system [Adper™ Single Bond Universal, 3M ESPE (SU)]. Square-shaped specimens were prepared and assigned into 4 groups (n=5): SB and SU (control groups - no laser irradiation) and SB-L and SU-L [SB and SU laser (L) - irradiated groups]. DC was assessed using Fourier transform infrared spectroscopy with attenuated total reflectance. Additional uncured resin samples (≈3.0 µL, n=5) of each adhesive were also scanned for final DC calculation. For WS/WSB tests, similar specimens (n=10) were prepared and measured by monitoring the mass changes after dehydration/water storage cycles. For both tests, adhesive fluids were dropped into standardized Teflon molds (6.0×6.0×1.0 mm), irradiated with a 970-nm laser diode, and then polymerized with an LED-curing unit (1 W/cm2). Results Laser irradiation immediately before photopolymerization increased the DC (%) of the tested adhesives: SB-L>SB>SU-L>SU. For WS/WSB (μg/mm3), only the dentin bonding system (DBS) was a significant factor (p<0.05): SB>SU. Conclusion Irradiation with a laser diode improved the degree of conversion of all tested simplified dentin bonding systems, with no impact on water sorption and solubility.

Evaluation of Surface Roughness and Bacterial Adhesion on Tooth Enamel Irradiated With High Intensity Lasers

Abstract The aim was to evaluate the surface roughness and bacterial adhesion on enamel irradiated with high intensity lasers, associated or not to a fluoride varnish. Eighty fragments of bovine enamel were equally divided in 8 groups (n=10). Group 1 was not treated and Group 2 received only a 5% fluoride varnish application. The other groups were irradiated with an Er:Cr:YSGG (8.92 J/cm2), an Nd:YAG (84.9 J/cm2) and a diode laser (199.04 J/cm2), associated or not to a 5% fluoride varnish. The surface roughness was measured before and after treatments. Afterward, all samples were incubated in a suspension of S. mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted by a stereoscope and the results were expressed in CFU/mm2. One-way ANOVA and the Tukey´s test compared the roughness data and the Student´s test compared the results obtained in the bacterial adhesion test (a=5%). The results showed that the irradiated samples without varnish presented the same roughness and the same bacterial adhesion that the non-irradiated samples. However, samples irradiated in the presence of fluoride varnish showed higher surface roughness and higher bacterial adhesion than the non-irradiated samples and those irradiated without varnish. Presence of pigments in the varnish increased the lasers’ action on the enamel surface, which produced ablation in this hard tissue and significantly increased its surface roughness. For this reason, the enamel’s susceptibility to bacterial adhesion was higher when the irradiation of the samples was made in presence of fluoride varnish.

Resumo O objetivo foi avaliar a rugosidade superficial e adesão bacteriana no esmalte dental irradiado com lasers de alta intensidade, associados ou não a um verniz fluoretado. Oitenta fragmentos de esmalte foram igualmente divididos em 8 grupos (n= 10). O grupo 1 não recebeu tratamento e o grupo 2 recebeu aplicação de verniz fluoretado a 5%. Os outros grupos foram irradiados com os lasers Er,Cr:YSGG (8,92 J/cm2), Nd:YAG (84,9 J/cm2) e um laser de diodo (199,04 J/cm2), associados ou não ao verniz fluoretado. A rugosidade superficial foi medida antes e após os tratamentos. Depois, todas as amostras foram imersas em suspensão de S. mutans a 37 °C durante 24 h. As unidades formadoras de colônia (UFC) foram contadas utilizando uma lupa estereoscópica, e os resultados foram expressos em UFC/mm2. Os resultados de rugosidade foram analisados por ANOVA e pelo teste de Tukey, e a adesão bacteriana foi analisada pelo teste de Student (a=5%). As amostras irradiadas sem verniz apresentaram a mesma rugosidade superficial e a mesma adesão bacteriana que as amostras não irradiadas. No entanto, as amostras irradiadas na presença do verniz fluoretado apresentaram maior rugosidade superficial e aderência bacteriana do que as amostras não irradiadas e daquelas irradiadas sem o verniz. A presença de pigmentos no verniz aumentou a ação dos lasers na superfície do esmalte, promovendo a ablação do tecido duro e aumentando significativamente a sua rugosidade superficial. Por isso, a adesão bacteriana no esmalte foi maior quando a irradiação foi realizada na presença do verniz fluoretado.

Morphological Study and Analysis of Microhardness and Permeability of the Furcation of Maxillary Premolars

Abstract The morphology, microhardness and dentin permeability of the furcation region of maxillary premolars were evaluated. Ten premolars were cut lengthwise and the furcation region was delimited. In one group (n=10) microhardness was measured in the buccal, central and palatal regions, in the outer middle and inner layers of the furcation, and in the buccal and palatal regions adjacent to the furcation. Knoop hardness was tested with 10 g load for 15 s. Data were analyzed statistically by ANOVA and Tukey-Kramer test (a=0.05). In the other group (n=10) confocal microscopy was used to study dentin morphology. Other 10 specimens were instrumented with ProTaper and immersed in 10% copper sulfate for analysis of permeability under light microscopy. About microhardness, there was no significant difference (p>0.05) among the buccal (39.9±3.1), central (39.5±4.4) and palatal (39.7±5.0) regions of the furcation, or between these regions and the adjacent buccal (39.1±5.8) and palatal (39.7±5.8) regions (p>0.05). The inner layer (42.3±3.7) had significantly higher microhardness (p<0.05) than the outer layer (37.1±3.9). There was a tendency of calcification of the dentinal tubules from the outer towards the inner layer. The percentage of stained area was 12.45±2.0%, restricted to the outer layer. The buccal, central and palatal regions of the furcation as well as the buccal and palatal adjacent regions had similar microhardness values. In conclusion, the inner dentin layer is harder than the outer dentin layer. The dentinal tubules are sinuous and intertwine towards the middle layer. Dye penetration is restricted to the outer layer.

Resumo Estudou-se a morfologia, microdureza e permeabilidade dentinária da furca de pré-molares superiores. Dez pré-molares tiveram a porção oclusal da coroa e os terços radiculares médio e apical removidos. Cortou-se longitudinalmente o remanescente e delimitou-se a furca. As hemi-secções foram distribuídas em dois grupos. Num (n=10), mediu-se a microdureza nas regiões vestibular, central e palatina, nas camadas externa, média e interna e nas porções vestibular e palatina adjacentes à furca. Utilizou-se dureza Knoop, carga de 10 g por 15 s. Os dados foram analisados pelo teste ANOVA e Tukey-Kramer (a=0.05). No outro grupo (n=10) utilizou-se microscopia confocal para estudo da morfologia da dentina. Outros 10 espécimes foram instrumentados com Protaper e NaOCl a 1% e imersos em sulfato de cobre a 10% para análise da permeabilidade. Após preparo histológico os espécimes foram analisados em fotomicroscópio. Não houve diferença significante (p>0,05) entre a microdureza das regiões vestibular (39,9±3,1), central (39,5±4,4) e palatina (39,7±5,0), nem entre essas regiões e as adjacentes vestibular (39,1±5,8) e palatina (39,7±5,8) (p>0,05). A camada interna (42,3±3,7) é mais dura que a externa (37,1±3,9) (p<0,05). Há uma tendência dos canalículos calcificarem no sentido da camada externa para a interna. A porcentagem de área corada foi de 12,45±2.0 e restrita à camada externa. As regiões vestibular, central e palatina da furca, bem como as adjacentes vestibular e palatina apresentaram microdureza semelhante entre si. A camada interna apresentou-se mais dura que a externa. Os canalículos dentinários eram sinuosos e se entrelaçaram em direção à camada média. A penetração de corantes se restringiu à camada externa.

Analysis of the Early Stages and Evolution of Dental Enamel Erosion

Abstract The aim of this study was to evaluate by atomic force microscopy (AFM) the early phases and evolution of dental enamel erosion caused by hydrochloric acid exposure, simulating gastroesophageal reflux episodes. Polished bovine enamel slabs (4x4x2 mm) were selected and exposed to 0.1 mL of 0.01 M hydrochloric acid (pH=2) at 37 ?#61472;?#61616;C using five different exposure intervals (n=1): no acid exposure (control), 10 s, 20 s, 30 s and 40 s. The exposed area was analyzed by AFM in 3 regions to measure the roughness, surface area and morphological surface. The data were analyzed qualitatively. Roughness started as low as that of the control sample, Rrms=3.5 nm, and gradually increased at a rate of 0.3 nm/s, until reaching Rrms=12.5 nm at 30 s. After 40 s, the roughness presented increment of 0.40 nm only. Surface area (SA) increased until 20 s, and for longer exposures, the surface area was constant (at 30 s, SA=4.40 μm2 and at 40 s, SA=4.43 μm2). As regards surface morphology, the control sample presented smaller hydroxyapatite crystals (22 nm) and after 40 s the crystal size was approximately 60 nm. Short periods of exposure were sufficient to produce enamel demineralization in different patterns and the morphological structure was less affected by exposure to hydrochloric acid over 30 s.

Resumo O objetivo deste estudo foi avaliar os estágios iniciais e a evolução da erosão do esmalte dental causado pela exposição ao ácido clorídrico, simulando assim episódios de refluxo gastroesofágico, usando um microscópio de força atômica (AFM). Fragmentos de esmalte bovino planificados e polidos (4x4x2 mm) foram selecionados e exposto a 0,1 mL de ácido clorídrico 0,01 M (pH = 2) a 37 ?#61616;C, utilizando cinco intervalos diferentes de exposição: sem exposição ao ácido (controle) e 10 s, 20 s, 30 s e 40 s. Então, a área exposta foi analisada com AFM em 3 regiões diferentes para mensurar a rugosidade, a área da superfície e a morfologia superficial. Os dados foram analisados qualitativamente. Inicialmente, a rugosidade apresentou valor baixo como a amostra controle, Rrms=3,5 nm, e aumentou gradualmente a uma taxa de 0,3 nm/s, até Rrms= 12,5 nm a 30 s. Após 40 s, a rugosidade apresentou um incremento de apenas 0,40 nm. Área de superfície (SA) aumentou até 20 s, e para exposições mais longas, a área de superfície manteve-se constante (30 s, o SA=4,40 μm2, e em 40 s, a SA=4,43 μm2). Em relação à morfologia superficial, a amostra controle apresentou cristais de hidroxiapatita menores (22 nm), e após 40s o tamanho do cristal era de aproximadamente 60 nm. Períodos curtos de exposição foram suficientes para produzir a desmineralização do esmalte em diferentes padrões e a estrutura morfológica foi menos afetada pela exposição ao ácido clorídrico acima de 30 s.

Diode laser irradiation increases microtensile bond strength of dentin

Laser irradiation after the immediate application of dentin bonding systems (DBSs) and prior to their polymerization has been proposed to increase bond strength. The objective of this study was to evaluate the effect of diode laser irradiation (λ = 970 nm) on simplified DBSs through microtensile bond strength tests. Forty healthy human molars were randomly distributed among four groups (n = 10) according to DBSs used [Adper™ SingleBond 2 (SB) and Adper™ EasyOne (EO)], and the respective groups were irradiated with a diode laser (SB-L and EO-L). After bonding procedures and composite resin build-ups, teeth were stored in deionized water for 7 days and then sectioned to obtain stick-shaped specimens (1.0 mm2). The microtensile test was performed at 0.5 mm/min, yielding bond strength values in MPa, which were evaluated by two-way ANOVA followed by Tukey’s test (p < 0.05) for individual comparisons. For both adhesive systems, diode laser irradiation promoted significant increases in bond strength values (SB: 33.49 ± 6.77; SB-L: 43.69 ± 8.15; EO: 19.67 ± 5.86; EO-L: 29.87 ± 6.98). These results suggest that diode laser irradiation is a promising technique for achieving better performance of adhesive systems on dentin.

The combined use of Er, Cr: YSGG laser and fluoride to prevent root dentin demineralization

The use of erbium lasers to prevent caries in enamel has shown positive results. However, it is not known if Er,Cr:YSGG laser can also be used to increase acid resistance of root dentine, which is another dental tissue susceptible to the action of cariogenic bacteria. Objective: To analyze the effects of the Er,Cr:YSGG laser (λ=2.78 μm, 20 Hz) irradiation associated with 2% neutral sodium fluoride (NaF) to prevent root dentin demineralization. Material and Methods: One hundred human root dentin samples were divided into 10 groups (G) and treated as follows: G1: no treatment; G2: NaF; G3: laser (4.64 J/cm2) with water cooling (WC=5.4 mL/min); G4: laser (4.64 J/cm2) without WC; G5: laser (8.92 J/cm2) with WC; G6: laser (8.92 J/cm2) without WC; G7: laser (4.64 J/cm2) with WC and NaF; G8: laser (4.64 J/cm2) without WC and NaF; G9: laser (8.92 J/cm2) with WC and NaF; G10: laser (8.92 J/cm2) without WC and NaF. The NaF gel was applied alone or after 4 min of irradiation. After 14 days of acid challenge, the samples were sectioned and the Knoop microhardness (KHN) test was done at different depths (30, 60, 90 and 120 μm) from the outer dentin surface. Data were analyzed by one-way ANOVA and Fisher’s test (α=5%). Results: The results showed that G8 and G10 presented higher KHN than the G1 for the depths of 30 and 60 μm, indicating an increase of the acid resistance of the dentin in up to 35% (p<0.05). Conclusions: The use of Er,Cr:YSGG laser irradiation at 4.64 J/ cm2 and 8.92 J/cm2 without water cooling and associated with 2% NaF can increase the acid resistance of human root dentin. .

Evaluation of dentinal permeability reduction provided by different desensitizing treatments

problem at dental offices and new approaches may be developed. Objectives: The authors studied different desensitizing treatments and their efficacy in reducing dentinal permeability and dentinal tubules opening. Material and methods: One hundred bovine incisors roots had their buccal surface flattened and treated by 3 applications of each desensitizing agent, following the respective groups (n = 10). After treated, 7 specimens of each group were prepared for a 0.5% basic fuchsin permeability test and the other 3 specimens were prepared to SEM qualitative analysis. The permeability test specimens were sectioned with a diamond saw in order to evaluate the stained and unstained areas. Kruskall Wallis statistical analysis was performed (p < 0.05). Results: Colgate Pró-Alívio paste and toothpaste, diode and Nd:YAG Lasers, GHF, Sensi Active, Oxagel and 2% Desensibilize promoted a significant permeability reduction when compared with the respective control groups (p < 0.05). Comparing the mean permeability differences between the different groups after the treatments, Oxagel and Nd:YAG were better than 0.2% Desensibilize group. Conclusion: None of the treatments may be considered 100% effective in treating dentinal hypersensitivity since a partial reduction of the permeability was observed.

Morphologic assessment of dental surface/ glass ionomer cement interface: influence of Er:YAG laser pretreatment

Introduction and objective: The aim of this study was to assess the surface and the substrate/glass ionomer cement (GIC) interface after Er:YAG laser irradiation by means of scanning electron microcopy. Material and methods: Thirty human third molars were selected and had their roots removed. Crowns were sectioned to obtain discs that were randomly assigned to three groups according to the surface pretreatment: 40% polyacrylic acid (control); Er:YAG laser irradiation (80mJ/2Hz) or Er:YAG laser followed by 40% polyacrylic acid. Two discs of each group were put aside to the surface analysis and the others were bisected. One half received Ketac-Fil and the other received Fuji II LC. Specimens were prepared for SEM and were analyzed under different magnifications. Results: Er:YAG laser group showed no adhesive interface for both enamel and dentin, but strongly damaged the interface build-up for dentin/Fuji II LC. The application of laser irradiation followed by the polyacrylic acid exhibited gaps and irregularities for both substrates. Conclusion: Er:YAG laser irradiation combined or not with 40% polyacrylic acid produced a surface unfavorable for GIC interaction, especially for the resin-modified ones.

Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization

Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm² area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher’s LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period.

A maioria dos estudos que utilizam o laser Nd:YAG com ação preventiva são em dentes permanentes, e são escassos os estudos em dentes decíduos. Desta forma, o objetivo do presente estudo foi avaliar in vitro o efeito do laser Nd: YAG combinado ou não com flúor na resistência ácida do esmalte decíduo após a indução de cárie artificial, através da avaliação de microdureza longitudinal e profundidade da desmineralização. Para tanto, foram selecionados 60 fragmentos de esmalte obtidos a partir da superfície bucal / lingual de molares decíduos irrompidos, os quais foram isolados com esmalte de unha e cera, deixando uma área exposta de 9 mm² na superfície do esmalte. Os espécimes foram divididos aleatoriamente em 6 grupos (n = 10) de acordo com o tipo de tratamento: C- Controle: sem tratamento; APF: aplicação de gel flúor fosfato acidulado 1,23%; FV: aplicação de verniz fluoretado 5%; L: aplicação do Laser Nd:YAG 0,5 W/10 Hz no modo contato; APFL: aplicação de gel flúor fosfato acidulado + Laser Nd:YAG; FVL: aplicação de verniz fluoretado 5% + Laser Nd:YAG. Após os tratamentos, os espécimes foram submetidos a um ciclo de desremineralização para a indução de lesão de cárie artificial. Os dados de microdureza longitudinal (%LMC) foram avaliados pelo teste de Kruskal-Wallis e os dados de profundidade da desmineralização foram avaliados pelos testes ANOVA e Fisher’s LSD (α=5%). Observou-se que os grupos APFL e APF apresentaram menor percentual de perda de dureza (p<0,05). A profundidade de desmineralização foi menor em todos os grupos tratados em comparação com o controle. Em conclusão, o laser Nd: YAG associado ou não com flúor/verniz não foi mais efetivo do que o flúor sozinho para prevenir a desmineralização do esmalte durante o período experimental.

Evaluation of translucency of a nanofilled and a microhybrid resin composites / Avaliação da translucência de resinas compostas nanoparticuladas e microhíbridas

Objectives: Color selection is a relevant issue to determine clinical success of esthetic restorations. However as multiple layer technique have been applied, opalescence and translucency parameters are also significant to allow resin composite to match tooth structure. Thus, the aim of this study was to compare different resin composites commonly launched in market to provide enamel translucency effect. Material and Methods: Four resin composites of shade A1 for enamel were tested: nanotechnology composites Filtek Z350 (F) and Grandio (G) were compared to microhybrid composites Filtek Z250 (Z) and Master Fill (M). Eight cylindrical specimens of each resin composite were prepared (6 mm x 2.5 mm), finished and individually stored in distilled water. The color analysis was performed following Cielab system parameters using a spectophotometer (Esfera -X-Rite-SP62 and X-Riteccolor Master CM2). Readings were processed using standard white and black backgrounds. Translucency parameter (TP) of these materials were calculated through the formula TP= [(Lw- Lb)2+ (aw-ab)2 + (bw-bb)2]1/2. Data were statistically analyzed and as a normal distribution was verified, they were submitted to one-way ANOVA and Tukey tests with α= 0.05 preset. Results: Mean and standard deviations were: F= 35.54+0.34; Z= 39.11+0.39; G= 40.93+0.38 e M= 41.41+0.34. Greater values of translucency were observed to G and M without significant differences between them, and the lower values were attributed to F and Z. Conclusion: The translucency of each material was material dependent. It is suggested that small particle size provokes reduction of translucency of resin composites when enamel shade materials are compared.

Objetivos: A seleção de cor é um aspecto relevante na determinação do sucesso clínico de restaurações estéticas. Entretanto, como a técnica laminada múltipla tem sido aplicada, parâmetros de opalescência e translucência também são significantes para permitir que a resina composta se mimetize à estrutura dentária. Desta forma, o objetivo deste estudo foi comparar diferentes resinas compostas comumente disponíveis comercialmente para oferecer o efeito de translucência do esmalte. Material e Metódos: Quatro resinas compostas da cor A1 para esmalte foram testadas: resinas nanoparticuladas Filtek Z350 (F) e Grandio (G) foram comparadas às resinas microhíbridas Filtek Z250 (Z) e Master Fill (M). Oito espécimes cilindricos de cada resina composta foram preparadas (6 mm x 2.5 mm), polidas e individualmente armazenadas em água destilada. A análise da cor foi realizada seguindo os parâmetros do sistema Cielab, utiizando um espectofotômetro (Esfera -X-Rite-SP62 and X-Riteccolor Master CM2). As leituras foram processadas usando fundos padronizados branco e preto. O parâmetro de translucência (TP) desses materiais foi calculado através da fórmula TP = [(Lw- Lb)2+ (aw-ab)2 + (bw-bb)2]1/2. Os dados foram analisados estatisticamente e como foi verificada uma distribuição normal, estes foram submetidos ao teste de ANOVA e Tukey α= 0􀀏05. Resultados: Médias e desvios-padrão foram: F = 35,54 + 0,34; Z= 39,11 + 0,39; G= 40,93 + 0,38 e M = 41,41+0,34. Maiores valores de translucência foram observados para G e M sem diferenças entre eles, e os menores valores foram atribuídos para F e Z. Conclusão: A translucência de cada resina é dependente do material. É sugerido que tamanho pequeno de partículas provoca uma redução da translucência das resinas compostas quando as cores de esmalte são comparadas.