Radiopacity and physical properties evaluation of infiltrants with Barium and Ytterbium addition

Abstract Radiopaque properties in the infiltrant should be interesting for clinicians to feel more confident to indicate this treatment. Thus, the aim of this study was to evaluate the effect of the incorporation of barium and ytterbium particles on the physical properties of resin infiltrants. Groups were divided according to the addition of ytterbium oxide (Y) alone (30 or 40%) or Y with barium (YB) (15/15% or 20/20% respectively) in the Icon commercial infiltrant and in the experimental infiltrant base. Digital radiography (n=5), Microradiography (n=5), Microtomography (n=3), degree of conversion (n=5), water sorption (n=16), solubility (n=16), contact angle (n=16), flexural strength (n=16), elastic modulus (n=16) and Energy dispersive X-ray Spectroscopy (n=10) were performed. Analyses were performed using the R program, with a significance level of 5%, and microradiography and Microtomography analyses were evaluated qualitatively. In groups with 30 or 40% of ytterbium, radiopacity was higher or equal to enamel. Microradiography and Microtomography appear to have more radiopacity in groups with 40% (Y). Among the groups with no particle addition, those of the experimental infiltrant presented a higher degree of conversion than those of Icon®. In most groups, there was solubility below the ISO-recommended levels. The addition of particles resulted in higher viscosity. Groups with Icon had higher flexural strength and elastic modulus than groups with experimental infiltrant. The addition of 40% (Y) improved polymerization, had low solubility, and had greater radiopacity than enamel, however negatively affected the viscosity increasing then. Experimental groups with the base showed a higher water sorption than Icon groups.

Resumo O objetivo desse estudo foi avaliar o efeito da incorporação de partículas de Bário e Itérbio nas propriedades físicas de infiltrantes resinosos. Os grupos foram divididos de acordo com a adição de Itérbio puro (30 ou 40%) ou Itérbio com Bário (15/15% ou 20/20% respectivamente) no infiltrante comercial Icon e no Infiltrante experimental base. Foram realizados os testes de: radiografia digital (n=5), microradiografia Transversa (n=5), microtomografia (n=3), grau de conversão (n=5), sorção (n=16), solubilidade (n=16), ângulo de contato (n=16), resistência flexural (n=16), modulo de elasticidade (n=16) e Espectroscopia por energia dispersiva (n=10). As análises foram realizadas utilizando o programa R, com nível de significância de 5%, e os testes de microradiografia e microtomografia foram analisados qualitativamente. Nos grupos com 30 ou 40% de Itérbio, a radiopacidade foi maior ou igual ao esmalte dentário. Na microradiografia e microtomografia parece ter maior radiopacidade nos grupos com 40% de itérbio. Dentre os grupos sem adição de partículas, os do infiltrante experimental apresentaram maior grau de conversão do que os do Icon e o grupo controle experimental e com 40% de itérbio apresentaram os melhores resultados. Na maioria dos grupos, a solubilidade foi abaixo dos níveis recomendados pela ISO. A adição de particulas resultou em maior viscosidade. Os grupos com Icon apresentaram maior resistência flexural e modulo de elasticidade do que os grupos com infiltrante experimental e a quantidade de partícula aumentou a resistência e o módulo de elasticidade. A adição de 40% de itérbio melhorou a polimerização, apresentou baixa solubilidade e maior radiopacidade do que o esmalte, porém afetou negativamente a viscosidade, aumentando-a.

Effect of experimental bleaching gels with polymers Natrosol and Aristoflex on the enamel surface properties

Abstract Natrosol and Aristoflex® AVC polymers are widely applied in the cosmetic industry and have recently been applied as a thickener option in the composition of dental bleaching gels, with the purpose to reduce the adverse effects on enamel mineral components. The aim of this study was to evaluate the color variation (ΔE* ab, ΔE00, ∆WID), surface roughness (Ra), and mineral content quantification (Raman Spectroscopy) of dental enamel after bleaching treatment with experimental gel-based on 10% carbamide peroxide (CP), containing Carbopol, Natrosol, and Aristoflex® AVC. Sixty bovine teeth were randomly divided into 6 groups (n=10): Negative Control (NC) - no treatment; Positive Control (PC) - Whiteness Perfect 10% - FGM; CP with Carbopol (CPc); CP with Natrosol (CPn); CP with Aristoflex® AVC (CPa); NCP - no thickener. Data were analyzed, and generalized linear models (∆WID -T0 x T1) were used for repeated measurements in time for Ra and with a study factor for ΔE* ab and ΔE00. For the evaluation of the mineral content, data were submitted to one-way ANOVA and Tukey tests. For enamel topographic surface analysis the Scanning Electron Microscope (SEM) was performed. A significance level of 5% was considered. ΔE* ab and ΔE00 were significantly higher for CPc, CPn, CPa, and NCP groups. (∆WID) showed a significantly lower mean than the other groups for NC in T1. After bleaching (4-hour daily application for 14 days), Ra was higher in the CPc, CPn, and PC groups. For CPa, Ra was not altered. No significant difference was found in the quantification of mineral content. CPa preserved the surface smoothness more effectively. Aristoflex® AVC is a viable option for application as a thickener in dental bleaching gels, presenting satisfactory performance, and maintaining the whitening efficacy of the gel, with the advantage of preserving the surface roughness of tooth enamel without significant loss of mineral content.

Resumo Os polímeros Natrosol e Aristoflex® AVC são amplamente utilizados na indústria cosmética e foram recentemente aplicados como uma opção de espessante na composição de géis de clareamento dental, com o objetivo de reduzir os efeitos adversos sobre os componentes minerais do esmalte. O objetivo deste estudo foi avaliar a variação de cor (ΔE*ab, ΔE00, ∆WID), rugosidade da superfície (Ra), e quantificação do conteúdo mineral (Raman Spectroscopy) do esmalte dentário após clareamento dental com gel experimental baseado em 10% de peróxido de carbamida (CP), contendo Carbopol, Natrosol e Aristoflex® AVC. Sessenta dentes bovinos foram divididos aleatoriamente em 6 grupos (n=10): Controle Negativo (CN) - sem tratamento; Controle Positivo (CP) - Brancura Perfeita 10% - FGM; CP com Carbopol (CPc); CP com Natrosol (CPn); CP com Aristoflex® AVC (CPa); NCP - sem espessante. Os dados foram analisados e modelos lineares generalizados (∆WID -T0 x T1) foram usados para medições repetidas no tempo para Ra e com um fator de estudo para ΔE*ab e ΔE00. Para a avaliação do conteúdo mineral, os dados foram submetidos a testes unidirecionais de ANOVA e Tukey. Para a análise da superfície topográfica do esmalte, o Microscópio Eletrônico de Varredura (SEM) foi realizado. Um nível de significância de 5% foi considerado. ΔE*ab e ΔE00 foram significativamente maiores para os grupos CPc, CPn, CPa e NCP. (∆WID) mostrou uma média significativamente menor do que os outros grupos para NC em T1. Após o clareamento (aplicação diária de 4 horas por 14 dias), Ra foi maior nos grupos CPc, CPn e PC. Para CPa, Ra não foi alterado. Nenhuma diferença significativa foi encontrada na quantificação do conteúdo mineral. O CPa preservou a suavidade da superfície de forma mais eficaz. Aristoflex® AVC é uma opção viável para aplicação como espessante em géis de clareamento dental, apresentando desempenho satisfatório e mantendo a eficácia clareadora do gel, com a vantagem de preservar a rugosidade da superfície do esmalte dentário sem perda significativa de conteúdo mineral.

Application of polyetheretherketone (PEEK) posts: evaluation of fracture resistance and stress distribution in the root: in vitro and finite element analyses

Abstract To evaluate the feasibility of using a milled polyetheretherketone (PEEK) post and core in endodontically treated teeth with or without a ferrule. Sixty bovine tooth roots were endodontically treated followed by cementation of intraradicular retainers (IR), according to each experimental group: a) non-ferrule glass fiber post (f0FP); b) 2-mm-ferrule glass fiber post (f2FP); c) non-ferrule resized glass fiber post (f0PR); d) 2-mm-ferrule resized glass fiber post (f2PR); e) non-ferrule PEEK post and core (f0PPC); and f) 2-mm-ferrule PEEK post and core (f2PPC). Metal crowns were made and cemented. A periodontal ligament was simulated using polyether. A force was applied to the palatine portion of each sample at 45°, until fracture. Fracture resistance data were submitted to two-way ANOVA and Tukey's test (α = 0.05). Three-dimensional digital models were developed to calculate the tensions formed in the root using finite element analysis. Models of glass fiber posts and PEEK posts and cores were evaluated with or without a ferrule. The results were analyzed by the Mohr-Coulomb criterion. The type of IR was not influenced by fracture strength (p = 0.243). There were significant statistical differences among the remaining factors. Ferrule groups had greater fracture resistance, and the failure mode of teeth with a ferrule was more catastrophic than the non-ferrule group. A ferrule increases fracture resistance and influences failure mode; the PEEK post and core did not modify the biomechanics of endodontically treated teeth, and resembled the glass fiber post results. The crack initiation point differed between the ferrule and non-ferrule groups.

Characterization of whitening toothpastes and their effect on the physical properties of bulk-fill composites

Abstract Objective To characterize activated charcoal and 2% hydrogen peroxide-based toothpastes and investigate their effects on roughness, color change, and gloss of bulk-fill composite resin. Methodology Composite resin specimens (Aura Bulk Fill, SDI) were subjected to 5,000 brushing cycles with regular toothpaste (Colgate Total 12, [RT]), activated charcoal toothpaste (Bianco Dental Carbon, [AC]), or hydrogen peroxide-containing toothpaste (Colgate Luminous White Advanced, [HP]), with or without coffee exposure. The pH, particle characterization by scanning electron microscopy (SEM), and weight% of solid particles in the toothpaste were assessed. Roughness (Ra) was evaluated using a surface profile-measuring device, color change (∆Eab/∆E00) by reflectance spectrophotometer, and gloss unit (GU) by glossmeter. Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests were used, and the correlation coefficient test was performed between Ra and GU (α=0.05). Results RT presented a higher Ra after brushing and did not change after staining with coffee; moreover, the ∆Eab/∆E00 values were higher for RT than HP. Regarding gloss, AC and HP obtained higher values compared to RT. A significant negative correlation between gloss and Ra was found for RT exposed to coffee. All toothpastes had a neutral pH; however, RT had the largest percentage of solids by weight. SEM images showed particles of many sizes: irregular shape (RT), more regular particles (AC), and spherical clusters (HP). Although surface roughness, color change, and gloss may compromise the longevity of restorations, the whitening toothpastes tested did not promote more morphology changes than regular toothpastes.

A clinical evaluation of zirconia reinforced lithium silicate glass-ceramic CAD/CAM onlay: a two-year case report / Avaliação clínica de onlay cerâmica do tipo CAD / CAM de silicato de lítio reforçado com zircônia: um relato de caso de dois anos

ABSTRACT The CAD/CAM technology arose from the need to develop materials with better mechanical and optical properties that could be used for making monolithic restorations. Several materials have been used for milling indirect restorations in prefabricated blocks. Among them, lithium silicate reinforced with zirconia. Due to its recent introduction in the market, this case report aimed to present a detailed clinical protocol for the execution of a ceramic onlay of this material using CAD/CAM technology. A 57-year-old female patient sought care with extensive restoration in composite resin (BOMD) of tooth 15 maintained for almost two years. However, due to bruxism, constant dental tightening, the extension of the direct restoration and the need for improved esthetics, it was proposed to replace it with an indirect ceramic onlay restoration. Prophylaxis and choice of the color of the patient's dental substrate were performed. Afterwards, the dental preparation was made and polished. Subsequently, the molding was made with addition silicone and the provisional restoration confectioned. Once the stone model was obtained, it was scanned and the ceramic onlay restoration was milled using CAD/CAM technology. Finally, the restoration was stained and cemented over the preparation. After 2 years, the restoration remained stable, with no evidence of color mismatch, marginal discoloration, marginal cleft, caries or fracture, proving the effectiveness of the treatment in this time interval. The correct indication of the ceramic material combined with the use of CAD/CAM technology facilitated the restorative process, restoring function and the esthetics desired by the patient.

RESUMO A tecnologia CAD/CAM surgiu da necessidade de desenvolvimento de materiais com melhores propriedades mecânicas e ópticas que pudessem ser utilizados para confecção de restaurações monolíticas. Diversos materiais têm sido utilizados para fresagem de restaurações indiretas em blocos pré-fabricados. Dentre eles, o silicato de lítio reforçado com zircônia. Devido a sua recente introdução no mercado, este relato de caso objetivou apresentar um protocolo clínico detalhado para a execução de uma onlay cerâmica desse material utilizando a tecnologia CAD/CAM. Paciente, 57 anos, sexo feminino, procurou atendimento com extensa restauração em resina composta envolvendo as faces (MODV) do dente 15 mantida por quase dois anos. Contudo, em virtude do bruxismo, do apertamento dental constante, da extensão da restauração direta e da necessidade de melhora na estética, foi proposto a substituição por uma restauração indireta em cerâmica do tipo onlay. Foi realizada a profilaxia e escolha da cor do substrato dental da paciente. Em seguida o preparo dental foi confeccionado e polido. Posteriormente foi feita a moldagem com silicone de adição e a confecção do provisório. Com a obtenção do modelo, este foi escaneado e fresada a onlay cerâmica pela tecnologia CAD/CAM, que posteriormente foi maquiada e cimentada sobre o preparo. Após 2 anos, a restauração permaneceu estável, sem evidência de incompatibilidade de cor, descoloração marginal, fenda marginal, cárie ou fratura, comprovando a eficácia do tratamento neste intervalo de tempo. A correta indicação do material cerâmico aliada ao uso da tecnologia CAD-CAM facilitou o processo restaurador devolvendo função e a estética desejada pela paciente.

Assessment of influence of LED curing units used on microhardness of resin-modified glass ionomer sealants

Aim: Resin modified glass ionomer (RMGI) is class of material that can be used as sealant for preventing and arresting the progression of caries in pits and fissures. As these are hybrid materials, their properties can be affected by factors related to the polymerization process. Therefore, this study aimed to evaluate the influence of different generations of LED curing units (Elipar DeepCure-L and VALO Grand) on Knoop microhardness values (KHN) of RMGI sealants (Clinpro XT and Vitremer). Methods: Forty cylindrical specimens (6mm ø x 1 mm high) were prepared according to the manufacturer's instructions and divided into four groups (n=10) according to the type of RMGI and LED used. The KHN of the top surface of each sample was calculated 7 days after light-curing. Data were submitted to two-way ANOVA (α = 0.05). Results: Vitremer had higher KHN values than Clinpro XT after using both LEDs (p<0.0001), but especially when light-cured with the use of VALO Grand (p<0.0001). Whereas the KHN value of Clinpro was not influenced by the LED device (p>0.05). Conclusions: Top surface microhardness values of RGMI sealants were affected by both material composition and generations of LED curing units used. Third generation LED curing units seemed to be more efficient for the polymerization of RMGI-based sealants

Surface roughness evaluation and whitening efficiency on tooth enamel after using whitening toothpaste: a randomized double-blinded study

The aim of this randomized double-blinded study was to evaluate the enamel surface roughness and color change after one month of whitening toothpaste use and the color stability obtained 1 month after its interruption. 30 volunteers were divided into 3 groups (n = 10) corresponding to the dentifrices: 1) Colgate Total 12 Clean Mint (TD) (Control), 2) Colgate Luminous White (LW) and 3) Sensodyne Whitening Extra Fresh (SB). The volunteers were impression with addition silicone to obtain an epoxy resin replica of the upper central incisor for the initial surface roughness evaluation using a profilometer and the initial color of the incisors and canines was evaluated with a spectrophotometer after one week of wash-out. After 1 month, the color of the central incisors and canines was measured again, and the volunteers were molded to obtain a second replica to the final roughness analysis. Data were submitted to ANOVA-one way (p≤0.05). The results showed that there was no statistical difference between the dentifrices for color difference and surface roughness for all the studied conditions. It was possible to conclude that the whitening dentifrices used in this study were not able to alter the initial color of the teeth and did not cause changes in the surface roughness of enamel.

Conservative treatment of interproximal incipient caries lesions by resin infiltration

Minimally invasive dentistry is based on conservative techniques for the treatment of initial caries lesions, the so-called white spot lesions. One of the conservative maneuvers includes the use of enamel resin infiltrant: a low viscosity material that penetrates the enamel pores to stop lesion progression. Aim: Therefore, this case report aimed to describe the clinical case of a 28-year-old female patient under routine consultation, in which a radiographic examination showed the presence of two incipient caries lesions in the left upper premolars. Methods: The application of a resin infiltrating agent (Icon®, DMG ­ Hamburg, Germany) was chosen as treatment to stop caries lesions progression. Conclusion: The use of this conservative technique can be considered a promising approach for the prevention of dental tissue wear, and the resin infiltrant is considered an effective material

Repair Adhesive Strength of Conventional and Bulk Fill Resins Using Different Bonding Techniques / Resistência Adesiva de Reparo em Resinas Compostas Convencionais e 'Bulk-Fill' Utilizando Diferentes Técnicas de Adesão

This research aimed to evaluate the bond strength by micro tensile strength (µTBS), elastic modulus (EM) and flexural strength (FS) by the three-point test using three types of composite resins: Charisma Diamond, Filtek Z350 and Tetric N-Ceram Bulk Fill; and three adhesion techniques: adhesive, silane, silane and adhesive. The combinations of each resin with the adhesive technique resulted in nine groups (n = 12). Initially, with the composites, EM and FS tests were performed. Sequentially, each fragment was repaired with the different adhesive systems. All samples were subjected to µTBS testing on a universal assay machine. Data were subjected to the normality test and the parametric ANOVA test. Charisma resin showed the highest values in EM and RF compared to the other composite resins (p <0.05). The highest µTBS value was for silane + adhesive repaired Charisma resin. The lowest µTBS values were in Bulk Fill resin, regardless of adhesive system. The EM and FS results showed that Filtek Z350 resins had the best results, while bulk fill resins had lower results. It was concluded that Charisma and Filtek Z350 resins presented better results. However, in the bulk fill group, the lowest mean values of µTBS, FS and EM were obtained, as well as the lowest value in EM. (AU)

Esta pesquisa teve como objetivo avaliar a resistência de união (RU) por resistência à microtração, módulo de elasticidade (ME) e resistência à flexão (RF) pelo teste de três pontos, utilizando três tipos de resinas compostas: Charisma Diamond, Filtek Z350 e Tetric N-Ceram Bulk Fill; e três técnicas de adesão: adesivo, silano, silano e adesivo. As combinações de cada resina com a técnica adesiva resultaram nove grupos (n = 12). Inicialmente, com os compósitos foram realizados testes de ME e RF. Sequencialmente, cada fragmento foi reparado com os diferentes sistemas adesivos. Todas as amostras foram submetidas ao teste de RU por microtração em uma máquina de ensaio universal. Os dados foram submetidos ao teste de normalidade e ao teste paramétrico ANOVA. A resina Charisma apresentou os maiores valores no ME e RF em relação às demais resinas compostas (p <0,05). O maior valor de RU foi para a resina Charisma reparada com silano + adesivo. Os menores valores de RU foram na resina Bulk Fill, independentemente do sistema adesivo. Os resultados no ME e RF mostraram que as resinas Filtek Z350 obtiveram os melhores resultados, enquanto as resinas bulk fill obtiveram resultados inferiores. Conclui-se que as resinas Charisma e Filtek Z350 apresentaram melhores resultados. Entretanto, no grupo de bulk fill obteve-se as menores médias de RU, RF e ME, bem como o menor valor no ME. (AU)

Combination of at-home and in-office bleaching techniques: case series / Combinação das técnicas de clareamento dental caseira e de consultório: relato de casos

ABSTRACT Tooth bleaching is one of the most conservative aesthetic techniques. At-home and in-office bleaching may be performed, as well as the combination of both techniques. As this combination may be done in different manners, distinct orders of combinations were proposed in this report. A 24 years-old man, whose upper central incisor and canine shades were A2 and A3 respectively, was initially treated by chair-side with 40-min application of 40% hydrogen peroxide (HP) for two sessions. Afterwards, an two-week overnight at-home bleaching was performed with 10% carbamide peroxide (CP). The shade of upper central incisors changed to 1M1 and canine was B1. Conversely, a 30 years-old woman was firstly conducted with at-home bleaching (overnight 4-weeks 10% CP) and, subsequently, with a single appointment of in-office bleaching for 45 minutes (35% HP). The shade of her upper central incisor changed from A1 to 0.5M1 and the upper canine from A3 to B1. The VITA classical (A1-D4) shade guide and VITA Bleached guide 3D-MASTER were used to determine the tooth color during the treatments. In both bleaching treatments, patients reported no significant tooth sensitivity and the final outcomes met their expectation.

RESUMO O clareamento dental é uma das técnicas estéticas mais conservadoras no âmbito odontológico. Técnicas de clareamento caseira ou de consultório, ou a combinação de ambas, podem ser realizadas para alcançar o prognóstico desejado. Esta combinação das técnicas pode ser realizada por meio de diferentes abordagens, como apresentado neste relato de casos. Um paciente do gênero masculino, 24 anos de idade, cujos incisivo central superior e caninos apresentaram cor A2 e A3, respectivamente, foi inicialmente submetido à técnica de clareamento de consultório de duração por sessão de 40 mim com gel de peróxido de hidrogênio (PH) 40%, em duas sessões. Posteriormente, a técnica de clareamento caseira foi realizada durante duas semanas com gel de peróxido de carbamida (PC) a uma concentração de 10%.A cor final dos incisivos centrais superiores foi alterada para 1M1, enquanto a dos caninos para B1. Por outro lado, uma paciente do gênero feminino, 30 anos de idade, foi inicialmente submetida ao clareamento caseiro (durante a noite, por 4 semanas- PC 10%), e subsequentemente, com aplicação pontual de agente clareador (PH 35%) em consultório, em sessão de 45 min. A cor do incisivo central superior da paciente, mudou de A1 para 0,5M1 e do canino superior de A3 para B1. As escalas de cor VITA Classic (A1-D4), e VITA Bleachedguided 3D-MASTER foram utilizadas nesta série de casos para determinar a coloração dos dentes durante os tratamentos. Em ambos os tratamentos, os pacientes não reportaram sensibilidade dental significante, e suas expectativas finais foram atendidas.

Effect of erosive challenge and cigarette smoke on dentin microhardness, surface morphology and bond strength / Efeito de desafios erosivos e fumaça de cigarro na microdureza, morfologia de superfície e resistência de união à dentina

Objective: This study aimed to evaluate the surface microhardness and morphology, as well as the microshear bond strength of a self-etching adhesive (Clearfil SE, Kuraray) to eroded dentin, exposed or not to cigarette smoke. Forty dental crowns were divided into 4 groups (n = 10): no treatment (control) (C); erosion (E); erosion + cigarette smoke exposure (ES); cigarette smoke exposure (S). Samples were prepared through third molars polishing until dentin exposure, followed by crown section. Erosive cycles were performed 5 times/day for 30 s at 60 min intervals. Cigarette smoke was produced with twenty cigarettes/day, during 5 days. Microhardness was evaluated initially and after the treatments. Microshear bond strength was tested after the treatments and dentin restoration with flow composite. Failure patterns and dentin morphology was evaluated by Scanning Electron Microscopy. Microshear bond strength data was submitted to two-way ANOVA, microharness test was adjusted by gamma distribution to be a non-parametric analyses (p=0.05), and surface morphology as qualitative analyses. Loss percentage of microhardness was observed only in groups submitted to erosion. Bond strength was statistically similar between all groups. The most prevalent failure pattern was of adhesive type. Morphological analysis of dentin showed obliterated tubules in groups submitted to cigarette smoke exposure. Cigarette smoke exposure did not promote any effect in the percentage of microhardness loss, as in sound dentin as in eroded dentin. Cigarette smoke, erosion, and association of both, did not alter the bond strength of self-etching adhesives to dentin. (AU)

Objetivo: Este estudo teve como objetivo avaliar a microdureza (% perda de dureza) e morfologia de superfície (MS), assim como a resistência de união (RU) de um adesivo autocondicionante (Clearfil SE, Kuraray) à uma dentina erodida, exposta ou não à fumaça de cigarro. Material e Métodos: Quarenta coroas dentais de terceiros molares foram seccionadas da raiz e polidas até a exposição dentinária, sendo aleatoriamente divididas em 4 grupos (n=10): sem tratamento (controle), erosão (E), erosão+ exposição a fumaça de cigarro (ES); exposição a fumaça de cigarro (S).O ciclo erosivo foi realizado 5 vezes/dia por 30s, com 60 minutos de intervalo entre eles. Os grupos ES e S foram exposto à fumaça de cigarro produzida por 20 cigarros/dia, durante 5 dias. A avaliação da microdureza foi realizada antes e após os tratamentos, enquanto a resistência da união por microcisalhamento foi realizada após os tratamentos Os padrões de fratura representativos e a MS dentinária foram avaliados por microscopia eletrônica de varredura (MEV). Os dados de RU foram analisados por ANOVA dois fatores, enquanto a análise de microdureza foi ajustada por distribuição gama por ser uma análise não-paramétrica (p=0.05). A MS foi analisada qualitativamente. Resultados: Os grupos expostos aos ciclos erosivos (E e ES) apresentaram % de perda de dureza significativamente menor que os grupos não expostos (Controle e S. aos ciclos erosivos (E e ES). Para RU, não houve diferença estatística significativa entre os grupos. O padrão de fratura mais observado foi do tipo adesivo, e através das imagens obtidas por MEV, observou-se a obliteração de túbulos dentinários no grupo exposto à fumaça de cigarro, enquanto os grupos submetidos aos ciclos erosivos (E e ES) apresentaram maior exposição e diâmetro de túbulos dentinários. Conclusão: A exposição à fumaça de cigarro não promove nenhum efeito quanto a perda de porcentagem de dureza dentinária, assim como em dentina erodida e saudável. A fumaça de cigarro, o processo erosivo, e a associação de ambos, não altera a resistência da união de adesivos autocondicionantes à dentina. (AU)

Effects of desensitizing products on the reduction of pain sensitivity caused by in-office tooth bleaching: a 24-week follow-up

Abstract Objective To clinically assess the effect of desensitizing gels and dentifrices on the reduction in pain sensitivity and color variation during tooth bleaching. Methodology A total of 108 volunteers were randomly separated into the following groups of n=12: GT/S-glycerine and thickener/sucralose; NF/S-potassium nitrate and sodium fluoride/sucralose; NA/S-potassium nitrate and arginine/sucralose; GT/AC-glycerine and thickener/arginine and calcium carbonate; NF/AC-potassium nitrate and sodium fluoride/arginine and calcium carbonate; NA/AC-potassium nitrate and arginine/arginine and calcium carbonate; GT/PN-glycerine and thickener/potassium nitrate; NF/PN-potassium nitrate and sodium fluoride/potassium nitrate; and NA/PN-potassium nitrate and arginine/potassium nitrate. Sensitivity was assessed with the numerical analogue scale, and color variation (ΔE) was measured with a spectrophotometer. The sensitivity values obtained were subjected to a multivariate analysis of variance (MANOVA) and color variation values were subjected to a randomized analysis of variance (p<0.05). Results The NF/AC, NA/AC, NF/PN, and NA/PN groups presented lower sensitivity values and reduced sensitivity compared to those of the other groups throughout the clinical sessions. None of the groups showed sensitivity at the 24-week assessment. Statistically, no significant difference were observed in the color values among the groups four weeks after the beginning of bleaching (p=0.074). Additionally, the color assessment of all groups was statistically similar four weeks (p=0.084) and 24 weeks (p=0.118) after the beginning. Conclusion Our results indicate that adding NF/S, NA/S, NF/AC, and NA/AC desensitizers to tooth bleaching protocols reduces pain sensitivity without affecting its effectiveness.

Glass fiber posts: influence of cementation techniques on push-out bond strength

Aim: Glass fiber posts are indicated in the rehabilitation of extensively damaged teeth; their cementation represents a critical step in restorative dentistry. The aim of this study was to quantify and compare the push-out bond strength of glass fiber posts cemented by conventional technique, two-step technique with luting agent and two-step technique associating bulk-fill composite and luting agent. Methods: Eighty maxillary bovine incisors were endodontically treated and divided into eight groups (n = 10) according to the luting agent (Rely X ARC and Duo-link) and cementation technique (conventional technique; two-step technique with luting agent; and two-step technique associating bulk-fill composite ­ Filtek Bulk-fill flow or Surefil SDR flow ­ and luting agent). Samples were submitted to pushout bond strength test, and the fracture pattern was evaluated through scanning electron microscope. Data were submitted to two-way ANOVA and Tukey's test (α = 0.05). Results: When Rely X ARC was used, the conventional cementation technique obtained higher bond strength values than the twostep technique associated with Filtek Bulk-fill flow. When Duolink was used, the two-step technique associated with Filtek Bulk-fill flow presented higher bond strength values than the conventional technique. The most prevalent fracture patterns were adhesive between luting agent and dentin, and adhesive between bulk-fill composite and dentin. Conclusion: Two-step cementation technique associated with bulk-fill composite may be promising depending on the luting agent used

Effect of diphenyliodonium hexafluorphosphate in the yellowing and properties of experimental resin cements

Aim: The yellowing effect is undesirable and can occur in the dental restoration margins when light-cured resin cements containing camphorquinone as photoinitiator is used. This study aimed to evaluate the effect of diphenyliodonium hexafluorphosphate (DPI) in photoinitiator systems that contained different concentrations of camphorquinone (CQ) and dimethylamino ethyl benzoate (EDAB) on resin cements. Methods: A base (1:1) of bisphenol A diglycidyl methacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA) was obtained, and 60wt% of glass fillers was added. Eight formulations were obtained: RC1 (0.5mol% CQ / 1mol% EDAB), RC2 (0.5mol% CQ / 2mol% EDAB), RC3 (1mol% CQ / 1mol% EDAB), RC4 (1mol% CQ / 2mol% EDAB), and RC5 to RC8, which contained the same bases plus 0.5mol% DPI. Experimental resin cements were evaluated by the degree of conversion (DC), L*a*b* color analysis, water sorption (WS) and solubility (S), flexural strength, and Elastic Modulus. The data were analyzed by three-way ANOVA, Tukey's and Mann-Whitney tests (α = 0.05). Results: The combination of DPI and 0.5mol% CQ increased DC in RC6 and L* in RC5 without increasing the WS and a* b* values. CQ at 1mol% showed higher values of b* and lower values of a*, except for RC3. Groups with 2mol% EDAB showed higher DC. Conclusion: The addition of DPI reduces CQ, generating a decreased yellowing effect, while maintaining adequate properties in the resin cements, especially with 2mol% EDAB

Resolution of a fluorosis case through the association of minimally invasive techniques: microabrasion and tooth bleaching

Color changes may interfere with smile balance and they represent a clinical challenge to dentists. Dental fluorosis originates from intrinsic factors and it is a disorder of enamel formation during the phase of teeth development, resulting in the change of enamel color. This clinical case report aimed to present the resolution of a case of dental fluorosis through the association of minimally invasive techniques, namely microabrasion and tooth bleaching. A 27-year-old male patient sought the dental clinic of the School of Dentistry of Piracicaba (FOP - UNICAMP, Brazil) presenting striped and symmetrical white stains and generalized chromogenic biofilm. After anamnesis and clinical examination, the patient was diagnosed with fluorosis stains. Initially, adequacy of the oral environment was performed with prophylaxis and supragingival scraping. Then, the enamel microabrasion technique was performed with 6% hydrochloric acid associated with silicon carbide (Whiteness RM - FGM) and supervised at-home bleaching was performed with 16% carbamide peroxide (Whiteness Simple 16% - FGM). In conclusion, the treatment performed reestablished the aesthetics and harmony of smile color with minimally invasive procedures without causing tooth sensitivity

Effect of iodonium salt and chitosan on the physical and antibacterial properties of experimental infiltrants

Abstract Resinous infiltrants are indicated in the treatment of incipient carious lesions, and further development of these materials may contribute to greater control of these lesions. The aim of this study was to analyze the physical and antibacterial properties of experimental infiltrants containing iodonium salt and chitosan. Nine experimental infiltrants were formulated by varying the concentration of the diphenyliodonium salt (DPI) at 0, 0.5 and 1 mol%; and chitosan at 0, 0.12 and 0.25 g%. The infiltrants contained the monomeric base of triethylene glycol dimethacrylate and bisphenol-A dimethacrylate ethoxylate in a 75 and 25% proportion by weight, respectively; 0.5 mol% camphorquinone and 1 mol% ethyl 4-dimethylaminobenzoate. The degree of conversion was evaluated using Fourier transformer infrared spectroscopy, and the flexural strength and elastic modulus using the three-point bending test. Sorption and solubility in water, and antibacterial analysis (minimum inhibitory concentration and minimum bactericidal concentration) were also analyzed. Data was analyzed statistically by two-way ANOVA and Tukey's test (p<0.05), with the exception of the antibacterial test, which was evaluated by visual inspection. In general, the infiltrant group containing 0.5% DPI and 0.12% chitosan showed high values of degree of conversion, higher values of elastic modulus and flexural strength, and lower sorption values in relation to the other groups. Antibacterial activity was observed in all the groups with DPI, regardless of the concentration of chitosan. The addition of DPI and chitosan to experimental infiltrants represents a valid option for producing infiltrants with desirable physical and antibacterial characteristics.

Effect of different concentrations of nanohydroxyapatite on tooth bleaching effectiveness and enamel bond strength / Efeito de diferentes concentrações de nanohidroxiapatita na efetividade clareadora e força de adesão ao esmalte

Objective: To evaluate the effect of 35% hydrogen peroxide (35% HP) combined to different concentrations of nanohydroxyapatite (nHA) on the effectiveness of dental bleaching (superficial enamel and deep dentin) and enamel bond strength. Material and Methods: Fifty bovine dental specimens (5x5x2mm) were divided into 5 groups, according to the treatments (n = 10): no bleaching (negative control); 35% HP (positive control); 35% HP+ 5% nHA; 35% HP + 10% nHa; and 35% HP + 15% nHA. Three in-office bleaching sessions were made. The color analysis was performed on the enamel surface and the opposite dentin, using a spectrophotometer. The results were expressed in the CIE L*a*b* system. After this, the adhesive system was applied to the tooth structure, and the dental specimens received a composite restoration. The microshear bond strength test was performed 24 h after the restoration. Data were submitted to ANOVA and Tukey's test (α=0.05). Results: For the enamel color analysis, all bleached groups differed statistically from the unbleached group, with increasing L* values and decreasing b* values. The addition of different concentrations of nHA did not interfere with the bleaching effectiveness for the enamel and opposite dentin. For microshear bond strength, no statistically significant differences were presented between groups. The adhesive failure rate of the 35% HP + 10% nHA group was lower than the 35% HP group and similar to the negative control. Conclusion: The addition of different concentrations of nHA in 35% of hydrogen peroxide did not interfere with the bleaching efficacy of enamel and deep dentin and did not affect the enamel bond strength after bleaching.(AU)

Objetivo: avaliar o efeito do peróxido de hidrogênio a 35% (HP 35%) associado a diferentes concentrações de nanohidroxiapatita (nHA) sobre a efetividade clareadora do esmalte superficial, dentina profunda e da força de adesão ao esmalte. Material e Métodos: Cinquenta espécimes bovinos (5x5x2mm) foram divididos 5 grupos (n = 10): sem clareamento (controle negativo); HP 35% (controle positivo); HP 35% + nHA 5%; HP 35% + nHA 10%; e HP 35% + nHA 15%. Três sessões de clareamento de consultório foram realizadas. A análise de cor foi realizada na superfície do esmalte e na dentina oposta e os resultados expressos no sistema CIE L*a*b*. Depois disso, os sistemas adesivos foram aplicados no esmalte, e os blocos receberam uma restauração em resina composta. O teste microcisalhamento foi realizado 24 h após a restauração. Os dados foram submetidos à ANOVA e ao teste de Tukey (α = 0,05). Resultados: Para a análise de cor do esmalte, todos os grupos clareados diferiram estatisticamente do grupo não clareado. A adição de diferentes concentrações de nHA não interferiu com a eficácia clareadora para o esmalte e dentina. Para o microcisalhamento, não houve diferença entre os grupos. A taxa de falha adesiva do grupo HP 35% + nHA 10% foi menor do que o grupo HP 35% e similar ao controle negativo. Conclusão: a adição de diferentes concentrações de nHA em PH 35% não interferiu na eficácia clareadora do esmalte e da dentina e não afetou a força de adesão do esmalte após o clareamento (AU)

Influence of a hydrophobic monomer on the physical and mechanical properties of experimental surface sealants

Abstract This study evaluated the effect of adding the hydrophobic monomer 1,12 dodecanediol dimethacrylate (DDDMA) to experimental sealants with and without thermocycling on degree of conversion (DC), water sorption (WS), water solubility (WSB), color stability (ΔE), and micro-shear bond strength (μSBS). Five experimental and one commercially available sealant (Bisco - BIS) were tested. The experimental sealants were formulated by mixing different percentages of DDDMA monomers and urethane dimethacrylate (UDMA). The photoinitiator system was composed by camphorquinone (CQ) and tertiary amine 4-ethyl benzoate dimetilamiono (EDBA). Ethanol was used as a solvent. The experimental groups were named sequentially according to the monomeric content (DDDMA/UDMA): S40/40 (40/40), S50/30 (50/30), S60/20 (60/20), S70/10 (70/10) and S80/0 (80/0). Data were analyzed separately by one-way ANOVA, followed by Tukey's test (p<0.05). The values of DC ranged from 94.59% (S40/40) to 54.02% (S80/10). BIS showed the highest WS value (p<0.05) and S40/40, S50/30, S60/20 and S80/0 showed the lowest WS values of all tested sealants. WSB values ranged from 7.88 µg/mm3 (BIS) to 13.27 µg/mm3 (S70/10). The highest ΔE value was 11.05±2.88 for BIS and the highest μSBS value was found for S60/20. No significant difference was observed in bond strength between sealants and bovine enamel after thermocycling. Adding DDDMA to the composition of surface sealants can improve its performance, once the monomer increased the degree of conversion and the color stability.

Effect of pre- heating on hardness of methacrylate- and silorane- based composites

AIM: To evaluate the effect of composite pre-heating on the microhardness of different monomer resin-based. MATERIALS AND METHOD: Circular specimens of methacrylate- and silorane-based composite resins pre-heated at 23, 39, and 55˚ C were carried out, and cured using a halogen light-curing unit at 650 mW/cm². After 24 h, the specimens were polished and Knoop hardness number (KHN) was measured using a microhardness tester with 50-g load for 15 s. The data were analyzed with ANOVA and Tukey's tests (α = 0.05). RESULTS: Top surface presented higher KHN than bottom, methacrylate-based composite showed higher KHN compared to silorane, and pre-heating increased the KHN of the composites tested. CONCLUSION: Pre-heating can be used to improve the microhardness of methracrylate- and silorane-based composites.

Radiant exposure effects on physical properties of methacrylate - and silorane-composites

AIM: To evaluate the effect of different radiant exposures on the degree of conversion (DC), Knoop hardness number (KHN), plasticization (P), water sorption (WS), and solubility (S) of different monomer resin-based composites. METHODS: Circular specimens (5 x 2 mm) were manufactured from methacrylate and silorane composite resins, and light-cured at 19.8, 27.8, 39.6, and 55.6 J/cm2, using second-generation LED at 1,390 mW/cm2. After 24 h, DC was obtained using a FT-Raman spectrometer equipped with a Nd:YAG laser, KHN was measured with 50-g load for 15 s, and P was evaluated on the top and bottom surfaces by the percentage of hardness reduction after 24 h immersed in absolute alcohol. WS and S were determined according to ISO 4049. Data were subjected to statistical analysis (α=0.05). RESULTS: Methacrylate material presented higher DC, KHN, P, and WS than silorane (p<0.05). There was no difference in the S values (p>0.05). The increased radiant exposures improved only the KHN (p<0.05). In general, top surfaces showed higher DC and KHN than bottom, for both materials (p<0.05). The increase of the radiant exposure did not improve most physical properties of the composites and were monomer-base dependent. CONCLUSIONS: Chemical composition of the composite resins resulted in different physical properties behavior and could affect the clinical longevity of dental restorations, but overall these properties were not influenced by the different radiant exposures evaluated in the study...