PTH 1-34-functionalized bioactive glass improves peri-implant bone repair in orchiectomized rats: Microscale and ultrastructural evaluation.

The objective of this work was to investigate the use of Biogran® functionalized with parathyroid hormone (PTH) 1-34 by sonochemistry for the local delivery of this anabolic agent to the implant site. The effects of Biogran® and topical administration of PTH 1-34 on peri-implant bone regeneration were evaluated from the microscale to ultrastructural levels in healthy (SHAM) and orchiectomized (ORQ). While some animals only received a titanium implant in their tibial metaphyses (CLOT group), in others the peri-implant defect was first filled with Biogran® either without or with PTH 1-34 functionalization (BG and BGPTH groups, respectively) prior to implant installation. Osseointegration was characterized from a biomechanical perspective by measuring the removal torque with the counter-torque technique. Micro-CT was used to evaluate the percentage of bone volume, trabecular thickness, number and separation, and bone-implant contact (BIC). Dynamics of new bone formation were assessed by measuring fluorochrome area, daily mineral apposition rate, and neoformed bone area using confocal laser microscopy. RT-PCR was performed to evaluate ALP and osteocalcin expression. The interface between newly formed bone and Biogran® was examined using scanning electron microscopy (SEM) and scanning transmission electron microscopy (STEM) at the micro-and nanoscale, respectively, while elemental analyses were completed in SEM with energy-dispersive X-ray spectroscopy (EDS). STEM imaging demonstrated the intimate attachment of bone to Biogran® (nanoscale level). Overall, the results suggest that the effectiveness of the topical administration of PTH 1-34 at the implant site seems enhanced in osteoporotic bone, promoting peri-implant bone regeneration to comparable levels in healthy conditions.

Proanthocyanidin encapsulation for sustained bioactivity in dentin bioadhesion: A two-year study.

OBJECTIVES: To determine the long-term effect on the stability of dentin-resin interfaces after the addition of polylactide (PLA) capsules containing proanthocyanidin (PAC) to adhesive resin. METHODS: Sub-micron (SM) and micron (M) size capsules containing PACs were produced using a combination of emulsification and solvent evaporation techniques and characterized. Human dentin surfaces (n = 8) were etched (35% glycolic acid) and primed (15% enriched Vitis vinifera extract solution - VVe), followed by the application of an experimental adhesive containing 0 (control), 1.5 wt% of SM or M PAC-filled PLA capsules light cured for 40 s. A crown was built using commercial composite. After 24 h-immersion (37 °C) in simulated body fluid, specimens were serially sectioned into resin-dentin beams. Microtensile bond strength (TBS), micro-permeability and fracture pattern were assessed immediately and after 1 and 2 years. Data were statistically analyzed using two-way ANOVA and post-hoc test (α = 0.05). RESULTS: Polydisperse capsules were manufactured with average diameter of 0.36 µm and 1.08 µm for SM and M, respectively. The addition of capsules did not affect TBS (p = 0.889). After 2 years, TBS significantly decreased in SM (p = 0.006), whereas M showed similar initial values (p = 0.291). Overall, less micro-permeability was found in M than the control and SM group (p < 0.001). After 2 years, fractured surfaces from capsule-containing groups failed within the adhesive layer while control fractured at the bottom of the hybrid layer. SIGNIFICANCE: The addition of PAC-filled PLA microcapsules in a dental adhesive did not affect the bond strength while increased and sustained the protection against micro-permeability in the interface, likely due to release of PACs.

Biomimetic Growth of Metal-Organic Frameworks for the Stabilization of the Dentin Matrix and Control of Collagenolysis.

The dentin matrix is a collagenous scaffold structurally involved in anchoring resin-based materials to the tooth. Time-dependent degradation of this scaffold at the resin-dentin interface remains a core problem in adhesive dentistry, limiting the service life of dental fillings. This study explored the use of emergent materials termed metal-organic frameworks (MOFs)─formed by the self-assembly of metal ions and organic building blocks─to safeguard the collagen integrity in the functional dentin matrix. We demonstrate that collagen fibrils (from demineralized human dentin) can induce the biomimetic growth of MOF crystals as protective coatings to strengthen and stabilize the fibrils. Zeolitic imidazolate framework-8 (ZIF-8), a zinc-based microporous MOF, was used to fabricate the MOF composites via a "one-pot" reaction in water. The ZIF-modified dentin matrix presented superior mechanical strength and resistance to proteolysis, which can positively affect the longevity of collagen as an anchoring substrate. This work identifies a potential biomedical application of biomimetically synthesized MOFs in repairing dental tissues critical to restorative therapies.

Surface-Directed Mineralization of Fibrous Collagen Scaffolds in Simulated Body Fluid for Tissue Engineering Applications.

The use of polymer additives that stabilize fluidic amorphous calcium phosphate is key to obtaining intrafibrillar mineralization of collagen in vitro. On the other hand, this biomimetic approach inhibits the nucleation of mineral crystals in unconfined extrafibrillar spaces, that is, extrafibrillar mineralization. The extrafibrillar mineral content is a significant feature to replicate from hard connective tissues such as bone and dentin as it contributes to the final microarchitecture and mechanical stiffness of the biomineral composite. Herein, we report a straightforward route to produce densely mineralized collagenous composites via a surface-directed process devoid of the aid of polymer additives. Simulated body fluid (1×) is employed as a biomimetic crystallizing medium, following a preloading procedure on the collagen surface to quickly generate the amorphous precursor species required to initiate matrix mineralization. This approach consistently leads to the formation of extrafibrillar bioactive minerals in bulk collagen scaffolds, which may offer an advantage in the production of osteoconductive collagen-apatite materials for tissue engineering and repair purposes.

MOF-Based Erodible System for On-Demand Release of Bioactive Flavonoid at the Polymer-Tissue Interface.

Plant-derived compounds incite applications virtually on every biomedical field due to the expedient antioxidant, anti-inflammatory and antimicrobial properties in conjunction with a natural character. Here, quercetin (QCT), a flavonoid with therapeutic potentials relevant to the oral environment, was encapsulated within metal-organic frameworks (MOFs) to address the concept of on-demand release of phytochemicals at the biointerface. We verified the applicability of a microporous MOF (ZIF-8) as a controlled-release system for QCT, as well as investigated the incorporation of QCT@ZIF-8 microparticles into a dental adhesive resin for desirable therapeutic capabilities at the tooth-restoration interface. QCT was encapsulated within the frameworks through a water-based, one-step synthetic process. The resulting QCT@ZIF-8 microparticles were characterized with respect to chemical composition, crystal structure, thermal behavior, micromorphology, and release profile under acidic and physiological conditions. A model dental adhesive formulation was enriched with the bioactive microparticles; both the degree of conversion (DC) of methacrylic double bonds and the polymer thermal behavior were accounted for. The results confirm that crystalline QCT@ZIF-8 microparticles with attractive loading capacities, submicron sizes, high thermal stability and responsiveness to environmental pH change were successfully manufactured. The concentration of QCT@ZIF-8 in the resin system was a key factor to maintain an optimal DC plateau and rate of polymerization. Essentially, one-step encapsulation of QCT in biocompatible ZIF-8 matrices can be easily achieved, and QCT@ZIF-8 microparticles proved as smart platforms to carry bioactive compounds with potential use to prevent microbial and enzymatic degradation of hard tissues and extracellular matrix components.

Sonochemical time standardization for bioactive materials used in periimplantar defects filling.

The aim of this study was determinate the best sonochemical time in order to obtain better bone characteristics when a bioactive material (Biogran) is used in the filling periimplantar defects. In this study, 32 rats were submitted to surgical proceedings to create a periimplantar defect that was filled with Biogran receiving different sonochemical times: 15 (G1), 30 (G2), 45 (G3) or 90 min (G4). The biomaterial was characterized through X-ray diffraction and scanning electron microscopy (SEM). In vivo analysis was performed through micro CT, laser confocal microscopy, immunohistochemistry and evaluation of bone cytoarchitecture through hematoxylin and eosin (HE) staining. The data were submitted to statistical testing, considering a significance level of p < 0.05. Rx diffraction of pure bioglass showed that it is predominantly amorphous; otherwise, there are small peaks at 23° and 31°. SEM shows that the longer the sonochemical time, the less edges the biomaterial will present. Within the groups, G1 and G2 showed the best quantity and quality by micro CT (p > 0.05). The best bone turnover result was found in G1 and G2, otherwise the better results were related to neoformed bone area, bone mineral apposition rate and bone implant contact to G1 (p < 0.05). G1 had the best results in terms of bone cytoarchitectural evaluation and immunohistochemistry. It is possible to conclude that Biogran that received 15 min of sonochemical treatment (G1) presented periimplantar bone repair with the best extracellular matrix properties, including the best quality and quantity of vital bone.

Effect of ethanol-dissolved rhodamine B marker on mechanical properties of non-simplified adhesives.

OBJECTIVES: Rhodamine B (RB) is commonly used to evaluate dental polymers, including dental bonding systems (DBS). For reliability assessments, its effect should not only allow visualization of the dentin-polymer interface but also must not interfere with the bonding of the DBS to dentin as measured by the microtensile bond strength and hardness tests. MATERIAL AND METHODS: Flat human dentin surfaces were prepared and randomly distributed (n = 10) into six groups: Adper Scotchbond Multi-Purpose (MP) or Clearfil SE Bond (SE) in concentrations of none/control, 0.02 or 0.1 mg/mL. These combinations were prepared through ethanol dissolution to improve their penetration into the dentin. All specimens were fabricated with Filtek Z250 (n = 10) and prepared for a microtensile bond test (µTBS) (0.5 mm/min) after 7 days and 6 months. The failure modes were determined using a stereomicroscope (×40). For the hardness test, flat human dentin blocks were prepared and treated as previously described (n = 6). The specimens were stored at 37 °C/48 h and were tested (Knoop indenter - 25 gF/10 s). Data were analyzed with two-way ANOVA and Tukey tests for multiple comparisons (α = 0.05). The effect of time was evaluated using the Student t-test. RESULTS: For 7-day µTBS, both the DBS and RB concentrations were significant factors (p < 0.01). After 6 months, only the RB concentration was significantly different. Adhesive failures were prevalent for all groups. Regarding hardness, the DBS differed only with the use of 0.10 mg/mL of RB. CONCLUSIONS: Ethanol-dissolved rhodamine B in concentrations of 0.02 and 0.10 mg/mL in non-simplified adhesives can affect the physical-mechanical properties of functional monomer-based systems rather more than those of BisGMA systems.

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.

Determining Optimal Fluorescent Agent Concentrations in Dental Adhesive Resins for Imaging the Tooth/Restoration Interface.

Fluorescent dyes like Rhodamine B (RB) have been used to identify the spatial distribution of adhesive restorative materials in the tooth/restoration interface. Potential effects of the addition of RB to dental adhesives were addressed in the past, but no further information is available on how to determine suitable concentrations of RB in these bonding agents for imaging in the confocal laser scanning microscope. This study provides systematical strategies for adding RB to viscous dental adhesive resins, focusing on the determination of the lowest range of dye concentrations necessary to achieve an acceptable image of the dentin/adhesive interface. It was demonstrated that optimized images of the resin distribution in dentin can be produced with 0.1-0.02 mg/mL of RB in the (tested) adhesives. Our approaches took into account aspects related to the dye concentration, photophysical parameters in different host media, specimen composition and morphology to develop a rational use of the fluorescent agent with the resin-based materials. Information gained from this work can help optimize labeling methods using dispersions of low-molecular-weight dyes in different monomer blend systems.

Efeito de adição de rodamina B e fluoresceína sódica a sistemas adesivos não simplificados: aspectos fotofísicos e físico-químicos / Effect of addition of rhodamine B and fluorescein to conventional etch-and-rinse and self-etching adhesive systems: photophysical and physical-chemical aspects

A adição de corantes fluorescentes a adesivos odontológicos possibilita a investigação da distribuição espacial desses materiais na interface dente-restauração, utilizando-se a microscopia confocal de varredura a laser (MCVL). A literatura indica falta de padronização na aplicação de agentes fluorescentes com tal finalidade. Esse estudo sistematizou estratégias para a adição de rodamina B (RB) e fluoresceína sódica (FS) a um sistema adesivo convencional de três passos, Adper Scotchbond Multi-Purpose (MP), e um autocondicionante de dois passos, Clearfil SE Bond (SE), considerados "padrão-ouro" na Odontologia. Os objetivos principais foram (a) determinar a menor faixa de concentrações de RB e FS necessária para produzir imagens satisfatórias da interface dentina-adesivo e (b) avaliar o efeito da adição desses corantes sobre algumas propriedades das resinas. Os adesivos foram marcados com RB ou FS em concentrações decrescentes (0,5, 0,1, 0,02 e 0,004 mg/mL) por meio de um método de dispersão semidireto. O comportamento fotofísico/ fluorescente dos adesivos marcados foi investigado por espectroscopia de fotoluminescência e MCVL. Paralelamente, avaliaram-se os adesivos quanto ao grau de conversão (GC) e ao ângulo de contato (AC). Tanto os resultados de GC como os de AC foram submetidos à análise de variância com dois fatores (adesivo e tratamento) com α = 0,05, seguida de teste post-hoc de Tukey. Os máximos comprimentos de onda de emissão e de excitação da RB e da FS foram influenciados pelo meio polimérico e pela concentração de corante de modo geral. A MCVL preliminar de amostras de adesivo polimerizado, realizada sob condições experimentais padronizadas, mostrou que o comportamento fluorescente da RB em MP e SE foi muito semelhante na mesma concentração de corante, mas o mesmo não pôde ser dito do comportamento da FS, que foi notavelmente inferior no adesivo autocondicionante, SE, na concentração mais alta. Em dentina, os adesivos preparados com RB nas concentrações-alvo de 0,1 e 0,02 mg/mL apresentaram fluorescência ótima; já aqueles preparados com 0,004 mg/mL produziram fraco sinal. Adesivos preparados com FS a 0,5 mg/mL apresentaram ótima fluorescência na interface de adesão, enquanto que concentração menor desse corante não produziu sinal suficiente. Padrões morfológicos aparentemente atípicos foram observados na interface de adesão, quando da associação do adesivo SE com o corante FS. A adição de RB e FS nas quatro concentrações indicadas aos adesivos MP e SE não afetou o GC nem o AC em comparação com os grupos de controle correspondentes. Em suma, a RB mostra-se um corante mais versátil que a FS na avaliação morfológica das interfaces dentina-MP e dentina-SE via MCVL. A menor faixa de concentrações de RB nos adesivos MP e SE, na qual é possível produzir imagens satisfatórias das interfaces, situa-se entre 0,1­0,02 mg/mL. Já o corante FS deve ser adicionado a esses adesivos a pelo menos 0,5 mg/mL para produzir níveis de fluorescência satisfatórios na interface de adesão. A não ocorrência de efeitos deletérios sobre a polimerização e a molhabilidade das resinas estabelece uma margem de segurança para a incorporação desses agentes fluorescentes (em concentração ≤ 0,5 mg/mL) nesses sistemas monoméricos.(AU)

The addition of fluorescent dyes to dental adhesives makes it possible to investigate the spatial distribution of such resin-based materials in the tooth-restoration interface, using confocal laser scanning microscopy (CLSM). Literature indicates a lack of standardization on the application of fluorescent agents for this purpose. This work presents strategies for adding rhodamine B (RB) and fluorescein sodium salt (FS) to a three-step etch-and-rinse adhesive system, Adper Scotchbond Multi-Purpose (MP), and a two-step self-etching one, Clearfil SE Bond (SE), both regarded as "gold standard" in restorative dentistry. The main objectives were (a) to determine the lowest range of RB and FS concentrations required to produce suitable images of the dentin-adhesive interface via CLSM and (b) to investigate potential effects of addition of these dyes on some resin properties. The adhesives were labeled with RB or FS at decreasing concentrations (0.5, 0.1, 0.02 and 0.004 mg/mL) by means of a semi-direct dispersion method. The photophysical/fluorescent behavior of the labeled resins was investigated by photoluminescence spectroscopy and by CLSM. The adhesives were also investigated with regards to the degree of conversion (DC) and contact angle (CA). A two-way ANOVA of "adhesive" and "treatment" was conducted on DC and CA separately, followed by Tukey's test. The maximum emission and excitation wavelengths of RB and FS were influenced by the host polymer and the dye concentration in general. The preliminary CLSM of cured adhesive samples, performed with standardized settings, showed that the fluorescent behavior of RB in MP and SE was very similar in the same dye concentration, unlike the behavior of FS, which was lower in the self-etching adhesive for the highest dye concentration. In dentin, the adhesives prepared with RB at the target concentrations of 0.1 and 0.02 mg/mL presented optimal fluorescence; those with 0.004 mg/mL produced poor signal. Adhesives prepared with FS at 0.5 mg/mL presented optimal fluorescence at the bonding interface, whereas lower concentrations of FS did not produce sufficient signal. Atypical morphological features were observed at the bonding interface, when adhesive SE was used with FS. The addition of RB and FS at the four decreasing concentrations to adhesives MP and SE did not affect DC or CA compared to the corresponding controls. In short, RB is more versatile than FS for the morphological characterization of dentin-MP and dentin-SE interfaces via MCVL. The lowest range of RB concentrations in adhesives MP and SE that can produce suitable images of the bonding interface lies between 0.1­0.02 mg/mL. The dye FS should be added to these adhesives at 0.5 mg/mL at least to produce satisfactory fluorescence levels at the bonding interface. Since negative effects on polymerization and wettability of the resins were not observed, the use of RB and FS (in concentration ≤ 0.5 mg/mL) together with MP and SE should be reliable in terms of resin properties.(AU)

Water interaction and bond strength to dentin of dye-labelled adhesive as a function of the addition of rhodamine B

ABSTRACT Objective This study investigated the effect of the fluorescent dye rhodamine B (RB) for interfacial micromorphology analysis of dental composite restorations on water sorption/solubility (WS/WSL) and microtensile bond strength to dentin (µTBS) of a 3-step total etch and a 2-step self-etch adhesive system. Material and Methods The adhesives Adper Scotchbond Multi-Purpose (MP) and Clearfil SE Bond (SE) were mixed with 0.1 mg/mL of RB. For the WS/WSL tests, cured resin disks (5.0 mm in diameter x 0.8 mm thick) were prepared and assigned into four groups (n=10): MP, MP-RB, SE, and SE-RB. For µTBS assessment, extracted human third molars (n=40) had the flat occlusal dentin prepared and assigned into the same experimental groups (n=10). After the bonding and restoration procedures, specimens were sectioned in rectangular beams, stored in water and tested after seven days or after 12 months. The failure mode of fractured specimens was qualitatively evaluated under optical microscope (x40). Data from WS/WSL and µTBS were assessed by one-way and three-way ANOVA, respectively, and Tukey’s test (α=5%). Results RB increased the WSL of MP and SE. On the other hand, WS of both MP and SE was not affected by the addition of RB. No significance in µTBS between MP and MP-RB for seven days or one year was observed, whereas for SE a decrease in the µTBS means occurred in both storage times. Conclusions RB should be incorporated into non-simplified DBSs with caution, as it can interfere with their physical-mechanical properties, leading to a possible misinterpretation of bonded interface.

Effects of age condition on the distribution and integrity of inorganic fillers in dental resin composites.

OBJECTIVES: The aim of this study is to evaluate the distribution of the filler size along with the zeta potential, and the integrity of silane-bonded filler surface in different types of restorative dental composites as a function of the material age condition. MATERIALS AND METHODS: Filtek P60 (hybrid composite), Filtek Z250 (small-particle filled composite), Filtek Z350XT (nanofilled composite), and Filtek Silorane (silorane composite) (3M ESPE) were tested at different stage condition (i.e., fresh/new, aged, and expired). Composites were submitted to an accelerated aging protocol (Arrhenius model). Specimens were obtained by first diluting each composite specimen in ethanol and then dispersed in potassium chloride solution (0.001 mol%). Composite fillers were characterized for their zeta potential, mean particle size, size distribution, via poly-dispersion dynamic light scattering. The integrity of the silane-bonded surface of the fillers was characterized by FTIR. RESULTS: The material age influenced significantly the outcomes; Zeta potential, filler characteristics, and silane integrity varied both after aging and expiration. Silorane presented the broadest filler distribution and lowest zeta potential. Nanofilled and silorane composites exhibited decreased peak intensities in the FTIR analysis, indicating a deficiency of the silane integrity after aging or expiry time. CONCLUSION: Regardless to the material condition, the hybrid and the small-particle-filled composites were more stable overtime as no significant alteration in filler size distribution, diameter, and zeta potential occurred. A deficiency in the silane integrity in the nanofilled and silorane composites seems to be affected by the material stage condition. CLINICAL SIGNIFICANCE: The materials conditions tested in this study influenced the filler size distribution, the zeta potential, and integrity of the silane adsorbed on fillers in the nanofilled and silorane composites. Thus, this may result in a decrease of the clinical performance of aforementioned composites, in particular, if these are used after inappropriate storage conditions.

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.

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.

Effect of simulated intraoral erosion and/or abrasion effects on etch-and-rinse bonding to enamel.

PURPOSE: To assess the influence of simulated oral erosive/abrasive challenges on the bond strength of an etch-and-rinse two-step bonding system to enamel using an in situ/ex vivo protocol. METHODS: Bovine enamel blocks were prepared and randomly assigned to four groups: CONT - control (no challenge), ABR - 3x/day-1 minute toothbrushing; ERO - 3x/day - 5 minutes extraoral immersion into regular Coca Cola; and ERO+ABR - erosive protocol followed by a 1-minute toothbrushing. Eight blocks were placed into an acrylic palatal appliance for each volunteer (n = 13), who wore the appliance for 5 days. Two blocks were subjected to each of the four challenges. Subsequently, all the blocks were washed with tap water and Adper Single Bond 2/Filtek Z350 were placed. After 24 hours, 1 mm2 beams were obtained from each block to be tested with the microtensile bond strength test (50 N load at 0.5 mm/minute). The data were statistically analyzed by one-way RM-ANOVA and Tukey's tests (alpha = 0.05). RESULTS: No difference was detected among the ABR, ERO, and CONT groups (P > 0.05). ERO+ABR group yielded lower bond strengths than either the ABR and ERO groups (P < 0.0113).

Bonding to bleached enamel treated with 10% sodium bicarbonate: a one-year follow-up / Restaurações adesivas em esmalte clareado tratado com solução de bicarbonato de sódio a 10% - 1 ano de avaliação clínica

Objective: The aim of this case report is to present the 1-year follow-up of composite resin restorations performed on imediate bleached enamel. Clinical considerations: The presence of residual oxygen after bleaching may be responsible for inhibiting the polymerization of the monomers present in the adhesive systems, leading to the failure of the restorative procedure. The use of antioxidants, especially the 10% sodium bicarbonate solution (SB), could be a fast and practical alternative to improve the bond strength of these restorations. Patient with high aesthetic demands submitted to the office bleaching with hydrogen peroxide 35% received restorative procedure performed immediately after bleaching. After unsatisfactory resin composite restorations removal, the antioxidant SB was applied and the restorative procedure performed.After one year, the clinical performance of the restorations were successful, showing no signs of failure nor infiltration. Conclusions: The use of the 10% sodium bicarbonate in bleached enamel seems to be a viable alternative for clinical practice, however a large number of restorations of longitudinal researches will be need for corroborate this technique...

Objetivo: O objetivo desse relato de caso clínico é apresentar o acompanhamento de 1 ano de restaurações de resina composta realizadas em esmalte dentário recém-clareado. Considerações clínicas: A presença de oxigénio residual após o clareamento dentário pode ser responsável pela inibição da polimerização dos monômeros presentes nos sistemas adesivos, que pode acarretar em falha do processo restaurador. A utilização de antioxidantes, especialmente a solução de bicarbonato de sódio a 10% (SB), pode ser uma alternativa rápida e prática para melhorar a resistência de união destas restaurações. Em um paciente com alta exigência estética submetido ao clareamento de consultório com peróxido de hidrogénio a 35% foi realizado o procedimento restaurador imediatamente após o clareamento dentário. Após a remoção das restaurações insatisfatórias de resina composta, o antioxidante SB foi aplicado e o procedimento restaurador realizado imediatamente. Após um ano, o desempenho clínico das restaurações de resina composta foram adequadas, não mostrando sinais de falhas nem de infiltração marginal. Conclusões: O uso da solução de bicarbonato de sódio a 10% no esmalte clareado se mostrou uma alternativa viável e prática, contudo um maior número de estudos longitudinais é necessário afim de corroborar com a técnica utilizada neste caso clínico...

Soluções estéticas para alterações intrínsecas do esmalte dentário / Aesthetic solution for intrinsic alterations of dental enamel

A alta expectativa por tratamentos estéticos gerada pelos pacientes, associada a uma Odontologia cada vez menos invasiva, torna o tratamento das lesões intrínsecas de esmalte um desafio para o clínico. Desta forma, existe a necessidade da constante atualização e discussão sobre o tema para oferecer o tratamento mais conservador e, ao mesmo tempo, de excelência. Neste artigo serão apresentados e discutidos alguns casos clínicos representativos de situações mais frequentes de alterações do esmalte dentário, em que foram empregados diferentes tratamentos, desde os mais conservadores até os que envolvem algum desgaste dentário, visando o restabelecimento estético e funcional do esmalte.

The high expectations of the patients for aesthetic treatments associated to a less invasive Dentistry turns treatment of intrinsic lesions of enamel a challenge for clinicians. Thus constant update and discussion are needed in order to offer a more conservative approach and, at the same time, an excellent treatment. The present paper will present and discuss some clinical cases representing the most frequent situations of tooth enamel alterations, in which different treatments have been used, from the most conservative to those involving some tooth drilling, aiming at aesthetic and functional restoration of the enamel.

Microabrasion technique for enamel with fluorosis: a case report utilizing two distinct pastes / Técnicas de microabrasão no esmalte com fluorose: relato de caso clínico utilizando duas diferentes pastas

A técnica de microabrasão do esmalte é considerada uma alternativa conservadora e efetiva para remoção de manchas e irregularidades superficiais do esmalte e diferentes pastas podem ser usadas para essa finalidade. Objetivo: O objetivo desse estudo foi comparar a eficácia da técnica de microabrasão do esmalte com fluorose utilizando duas diferentes pastas. Material e Métodos: Paciente, gênero feminino, 18 anos de idade, foi submetida ao tratamento de microabrasão do esmalte, sendo que na arcada superior direita foi manipulada e aplicada a pasta à base de pedra-pomes (SSWhite) e ácido fosfórico a 37% (Alpha Etch, DFL) na proporção de 1:1 e na arcada superior esquerda uma pasta à base de ácido hidroclorídrico a 6,6% e óxido de silício (Micropol, DMC Equipamentos Ltda). Nas duas hemi-arcadas foi realizado o mesmo protocolo clínico por três vezes, sendo que a aplicação da pasta foi de 1 mm de espessura e a realização da microabrasão se deu por fricção mecânica com taça de borracha acoplada em baixa rotação por 10 s. Em seguida os dentes foram polidos com disco de feltro e pasta diamantada e aplicado flúor tópico APF 1,23% por 3 min. Resultados: Os resultados clínicos foram similares em ambas arcadas, independente da pasta utilizada. O sucesso na remoção de manchas no esmalte está dieretamente relacionada com o correto diagnóstico e a precisa indicação da técnica de microabrasão. Conclusões: Foi possível concluir que a as duas diferentes pastas utilizadas para a microabrasão do esmalte foram efetivas na remoção de machas intrínsecas por fluorose com resultados similares e com o restabelecimento estético dos dentes envolvidos.

The technique of enamel microabrasion is considered an aesthetic alternative conservative and effective for stain removal or surface irregularities of the enamel and different materials or pastes can be used for this purpose Objetives: The objective of this study was to compare the efficiency of the technique of enamel microabrasion using two different pastes at removing hypoplastic stains by fluorosis. Methods: The female patient, 18 years, was submitted to enamel microabrasion, and in the right half of the maxilla was manipulated in the proportion of 1:1 by volume a paste of pumice (SSWhite) and 37% phosphoric acid (Etch Alpha, DFL), and in the left half of the maxilla used paste based on hydrochloric acid and 6.6% silicon carbide (Micropol, DMC Equipment Ltd.). In both hemi-arches was performed the same clinical protocol and repeated three times, by the application of 1.0 mm thickness of paste and realized the enamel microabrasion through mechanical friction with rubber cup at low speed for 10 s. Then, the teeth were polished with felt disc and diamond paste, and topical fluoride APF 1.23% for 3 min was applied. Results: The clinical outcome was similar for both hemi-arches, regardless of the used technique. The success in removing stains on tooth enamel is directly related to a correct diagnosis and accurate indication of microabrasion technique. Conclusions: It can be concluded that the two pastes used in the enamel microabrasion were effective for removing intrinsic stains from fluorosis, with similar results and with the re-establishment of aesthetics of the teeth involved.

Estratégias para adição de rodamina B em sistemas adesivos / Strategies for adding rhodamine B to bonding agents

A rodamina B e outros marcadores fluorescentes vêm sendo empregados na avaliação morfológica da interface de adesão com o auxílio de microscopia confocal de varredura a laser. Acrescentando-se rodamina B a sistemas adesivos, é possível observar as características de espessura da camada de adesivo, micromorfologia da camada híbrida, extensão e quantidade de tags, bem como diagnosticar defeitos ou alterações na interface de adesão. A literatura revela, entretanto, uma falta de precedentes sobre as quantidades de marcadores nos componentes resinosos. Além disso, ainda não se avaliou o efeito da concentração de rodamina B sobre a qualidade da análise da interface de adesão, bem como sobre o comportamento fotofísico dos marcadores nos sistemas adesivos. Este estudo foi realizado com o propósito de sistematizar um método de adição de rodamina B a sistemas adesivos, incluindo-se estratégias para a determinação de concentrações mínimas de rodamina nos componentes resinosos, porém, ainda viáveis para a realização da análise morfológica da interface de adesão através de microscopia confocal de varredura a laser. Para tal, os sistemas adesivos não simplificados e considerados padrão-ouro em suas categorias Adper™ Scotchbond™ Multi-Purpose (convencional de três passos) e Clearfil™ SE Bond (auto-condicionante de dois passos) foram modificados com rodamina B em cinco diferentes concentrações: C1 (0,5 mg/mL), C2 (0,10 mg/mL), C3 (0,02 mg/mL), C4 (0,004 mg/mL) e C5 (0,0008mg/mL) e o comportamento fluorescente da rodamina nos adesivos foi avaliado tanto no âmbito espectroscópico (espectroscopia de fotoluminescência), como no âmbito microscópico (microscopia confocal de varredura a laser). Para a modificação dos adesivos, utilizou-se uma técnica precisa de proporcionamento na qual o marcador fluorescente foi incorporado às resinas fluidas a partir de soluções de rodamina B em etanol. Os espectros de fluorescência mostraram diferenças nos máximos das bandas de emissão...

Rhodamine B and other fluorescent markers have been used for the assessment of the bonding interface via confocal laser scanning microscopy. By adding rhodamine into adhesive systems, it is possible to study morphological characteristics of the hybrid layer, the extent and amount of resin tags and the adhesive layer thickness, as well as detecting potential defects or alterations at bonding interface. Meantime the literature reveals lack of standards among the quantities of fluorescent markers in resin-based polymers. The effects of rhodamine B concentration on the quality of the microscopic analysis, as well as on the photophysics of labeled adhesive systems were not assessed up to now. This study aimed to systematize methodologies for adding rhodamine B into adhesive systems, including suitable strategies for determining the minimum serviceable rhodamine concentrations to perform the morphological analysis of the bonding interface. Two non-simplified adhesive system considered gold standard categories Adper™ Scotchbond™ Multi-Purpose (3 steps conventional) and Clearfil™ SE Bond (2 steps self-etching) were modified with rhodamine B at five concentrations: C1 (0.5 mg/ml), C2 (0.10 mg/ml), C3 (0.02 mg/ml), C4 (0.004 mg/ml) and C5 (0.0008 mg/ml ) and the fluorescent behavior of the labeled resins was assessed both by photoluminescence spectroscopy and by confocal laser microscopy The preparation of the labeled resins was proceed by means of a precise proportioning technique in which the fluorescent marker was incorporated into the bonding agents from solutions of rhodamine B in ethanol. The fluorescence spectra showed differences in the intensity and wavelength fluorescence according to the rhodamine B concentration. Microscopic analysis of the dentin specimens confirmed adhesive systems can be modified with rhodamine B at far lower concentrations than those mentioned in the literature. Both evaluated systems were microscopically visualized while...

Water interaction with dental luting cements by means of sorption and solubility / Interação da água com cimentos dentais de acordo com a sorção e solubilidade

Water contributes to the setting reaction of self-adhesive luting cements, however, it can also accelerate their degradation. Objectives: The aim of this study was to compare a self-adhesive resin luting cement to other resin-based and glass-ionomer luting materials with regards to water sorption (WS) and solubility (WSB). The tested null hypothesis was that there is no difference in respect to these properties among the materials. Material and methods: Eight specimens from each group (15 mm x 0.5 mm) were prepared from self-adhesive luting cements Biscem (BC) and RelyX Unicem (R), dual-cure cements Bifix (BF), Allcem (A) and Enforce (E), chemical-cure cements C&B (CB) and Cement Post (CP) and a glass-ionomer luting cement Meron C (M) as the control group. The dual-cure products were light-cured beneath an IPS Empress Esthetic ceramic disk (20 mm x 1.5 mm) and for the chemical reaction materials, a 15 min-interval was respected for removal from the mould. The WS and WSB were respectively calculated as (m2-m3/V) and (m1-m3/V). Mass values of m1, m2 and m3 were determined by cycles of desiccation, water-immersion and a new desiccation. For each property, the data was analyzed by one-criteria ANOVA and Tukey tests (p < 0.05). Results: The glass-ionomer cement presented the highest WS, followed by the self-adhesive luting cements. Other resin cements were less susceptible to WS. No materials differed from each other when the WSB was considered, except for the M, which presented the lowest WSB. Conclusions: Self-adhesive luting cements were more prone to WS since water is essential to their setting reaction. However, their WSB was similar to the other resin-based cements.

A água contribui para a reação de presa dos cimentos auto adesivos, entretanto pode acelerar a sua degradação. Objetivos: O objetivo deste estudo foi comparar cimentos auto adesivos a outros cimentos resinosos e material ionomérico em relação à sorção de água (WS) e solubilidade (WSB). A hipótese nula foi de que não há diferença em relação a essas propriedades entre os materiais. Material e métodos: Oito espécimes de cada grupo (15 mm x 0,5 mm) foram preparados dos cimentos auto adesivos Biscem (BC) e RelyX Unicem (R), cimentos duais Bifix (BF), Allcem (A) e Enforce (E), cimentos químicos C&B (CB) e Cement Post (CP) e um cimento ionomérico Meron C (M) como grupo controle. Os produtos duais foram fotoativados sob um disco cerâmico de IPS Empress Esthetic (20 mm x 1,5 mm) e para os materiais de reação química, um intervalo de 15 min foi respeitado para a remoção do molde. A WS e WSB foram respectivamente calculadas como (m2-m3/V) e (m1-m3/V). Valores de massa m1, m2 and m3 foram determinadas pelos ciclos de dessecação, imersão em água e nova dessecação. Para cada propriedade, os dados foram analisados pelos testes de ANOVA a um critério e Tukey (p < 0.05). Resultados: O cimento ionomérico apresentou a maior WS, seguido dos cimentos auto adesivos. Os demais cimentos resinosos foram menos suscetíveis a WS. Nenhum material diferiu do outro quanto a WSB foi considerada, exceto por M, que apresentou a menor WSB. Conclusões: Cimentos auto adesivos foram mais suscetíveis a WS, uma vez que a água é essencial para sua reação de presa. Entretanto, seu WSB foi similar aos demais cimentos resinosos.