Microleakage of Silver-Modified Atraumatic Restorative Technique (SMART) Restorations Using Silver Diammine Fluoride and High-Viscosity Glass Ionomer.

Purpose: The purpose of this study was to investigate the microleakage of atraumatic glass ionomer restorations with and without silver diammine fluoride (SDF) application. Restorations with SDF are termed silver-modified atraumatic restorations (SMART). Methods: Sixty carious extracted permanent teeth were randomly allocated to two SMART groups and two control groups (n equals 15 per group) for a total of four groups. After selective caries removal, test specimens were treated with 38 percent SDF and polyacrylic acid conditioner was applied and rinsed; teeth were restored with Fuji IX GP® glass ionomer (n equals 15) or with SMART Advantage™ glass ionomer (SAGI; n equals 15). For control groups, specimens were restored with their respective GI material after selective caries removal, both without SDF. Restored teeth were placed in Dulbecco's Phosphate-Buffered Saline solution at 37 degrees Celsius for 24 hours. Teeth were thermocycled between five and 55 degrees Celsius for 1,000 cycles, stained with two percent basic fuchsin, sectioned, and visually inspected for microleakage utilizing stereomicroscopy on a four-point scale. Data were statistically analyzed using Kruskal-Wallis one-way analysis of variance on ranks using Dunn's method (P<0.05). Results: Microleakage between the two SMART restoration groups was insignificant. SAGI alone demonstrated significantly more microleakage than all other groups. There was no statistical significance between the Fuji IX GP® control group and the two SMART restoration groups. Conclusions: This in vitro study indicated that silver diammine fluoride placed before glass ionomer restoration does not increase microleakage. Polyacrylic acid may be used after SDF placement without increasing microleakage.

Influence of size-anatomy of the maxillary central incisor on the biomechanical performance of post-and-core restoration with different ferrule heights.

PURPOSE: The study aims to investigate the influence of the ferrule effect and types of posts on the stress distribution in three morphological types of the maxillary central incisor. MATERIALS AND METHODS: Nine models were created for 3 maxillary central incisor morphology types: "Fat" type - crown 12.5 mm, root 13 mm, and buccolingual cervical diameter 7.5 mm, "Medium" type - crown 11 mm, root 14 mm, and buccolingual cervical diameter 6.5 mm, and "Slim" type - crown 9.5 mm, root 15 mm, and buccolingual cervical diameter 5.5 mm. Each model received an anatomical castable post-and-core or glass-fiber post with resin composite core and three ferrule heights (nonexistent, 1 mm, and 2 mm). Then, a load of 14 N was applied at the cingulum with a 45° slope to the long axis of the tooth. The Maximum Principal Stress and the Minimum Principal Stress were calculated in the root dentin, crown, and core. RESULTS: Higher tensile and compression stress values were observed in root dentin using the metallic post compared to the fiber post, being higher in the slim type maxillary central incisor than in the medium and fat types. Concerning the three anatomical types of maxillary central incisors, the slim type without ferrule height in mm presented the highest tensile stress in the dentin, for both types of metal and fiber posts. CONCLUSION: Post system and tooth morphology were able to modify the biomechanical response of restored endodontically-treated incisors, showing the importance of personalized dental treatment for each case.

Effect of low power Er:YAG laser irradiation of CAD-CAM resin-based composites on resin bonding.

PURPOSE: To investigate the effect of painless low-power Er:YAG laser irradiation of conventional and polymer-infiltrated ceramic network (PICN) type CAD-CAM resin-based composites (RBCs) on resin bonding. METHODS: An Er:YAG laser system, phosphoric acid etchant, universal adhesive, RBC, and two types of CAD-CAM RBC block were used. Microtensile bond strength, fracture mode, scanning electron microscopy (SEM) observations of bonding interfaces and CAD-CAM surfaces, and surface roughness of ground and pretreated surfaces were investigated. As pretreatment methods, low-power Er:YAG laser irradiation and air-abrasion with alumina particles were used. RESULTS: The effect of low-power Er:YAG laser irradiation of CAD-CAM RBCs on bonding to repair resin varied depending on the type of CAD-CAM RBCs. CLINICAL SIGNIFICANCE: The low-power Er:YAG laser irradiation of the conventional CAD-CAM RBCs was shown to be effective as a surface pretreatment for resin bonding, while the laser irradiation of PICN-type CAD-CAM RBCs was not effective.

Tunable polymer-peptide hybrids for dentin tissue repair.

OBJECTIVES: This study targets to assess the remineralization capability of conditioned dentin infiltrated with polymeric nanoparticles (NPs) doped with tideglusib (TDg) (TDg-NPs). METHODS: Dentin conditioned surfaces were infiltrated with NPs and TDg-NPs. Bonded interfaces were created, stored for 24 h and submitted to mechanical and thermal challenging. Resin-dentin interfaces were evaluated through nanohardness, Masson's trichrome staining microscopy, and Raman analysis. RESULTS: Dentin surfaces treated with TDg-NPs and load cycled produced higher nanohardness than the rest of the groups at the hybrid layer. At the bottom of the hybrid layer, all samples treated with TDg-NPs showed higher nanohardness than the rest of the groups. Active remineralization underneath the hybrid layer was detected in all groups after TDg application and load cycling, inducting new dentinal tubuli formation. After thermocycling, remineralization at the hybrid layer was not evidenced in the absence of NPs. Raman analysis showed increase mineralization, enriched carbonate apatite formation, and improved crosslinking and scaffolding of the collagen. CONCLUSIONS: Mechanical loading on the specimens obtained after TDg-NPs dentin infiltration inducts an increase of mineralization at the resin/dentin interface, indicating remineralization of peritubular and intertubular dentin with augmented crystallographic maturity in crystals. Enriched collagen quality was produced, generating an adequate matrix organization to promote apatite nucleation, after tideglusib infiltration. CLINICAL SIGNIFICANCE: At the present research, it has been proved the creation of reparative dentin, at the resin-dentin interface, after tideglusib dentin infiltration. Chemical stability, to favor integrity of the resin-dentin interface, is warranted in the presence of the TDg-NPs in the demineralized dentin collagen.

Effect of group and individual education on shade matching competency of dental students.

PURPOSE: To evaluate the influence of group and individual education on shade matching quality using a visual color competency test to match shade tab pairs from two Vita classical A1-D4 shade guides. METHODS: 60 dental students, 21-25 years old (39 females, 21 males) participated in the study. All participants passed a color deficiency test before the experiment. The examination was voluntary and approved by the corresponding Ethics Committee. Students were randomly divided into three groups (n=20): one control group, NE (no education) and two experimental groups - GE (group education) and IE (individual education). The study was performed in three phases. In the "before" (B - Phase 1) and "after" (A - Phase 3) phase, all groups had to match 16 pairs of tabs from two Vita classical A1-D4 shade guides, with the shade designations hidden by custom letter markings. All tabs were mixed on a gray surface illuminated by color-correcting light. In Phase 2 (between B and A), GE had only group education, while IE received additional individual education and training. The control group did not participate in Phase 2. Means and standard deviations were calculated, and differences were compared using the one-way ANOVA, ANCOVA test, and Student t-test for dependent samples (α= 0.05). RESULTS: The NE group matched 10.3 (3.2) and 10.4 (2.9) tab pairs in the before and after phases, respectively. Corresponding results for GE were 11.1 (2.2) and 14.4 (1.9) and 9.5 (3.6) and 15.0 (1.5) for IE, respectively. In Phase 1 (B), no statistically significant difference was recorded among the groups (P= 0.260). The experimental groups achieved a statistically significant improvement compared with the control group in Phase 3 (A) (P< 0.001). Both experimental groups achieved statistically significant improvement within the group after education, GE (P< 0.001) and IE (P< 0.001). Within the limitations of this study, it was concluded that both experimental groups had statistically significant progress in shade matching. The group that received individual education (IE) made statistically significant progress compared with the group that received group education (GE). No statistically significant difference was found in the results of the control group between Phase 1 and Phase 3 of the study. CLINICAL SIGNIFICANCE: Improving the shade matching ability facilitates the work of dentists and dental technicians and enhances the esthetics of dental restorations.

Coffee-stained tooth enamel color restoration and surface abrasion with whitening and regular toothpaste.

PURPOSE: To evaluate the effectiveness of whitening toothpaste in restoring tooth color after coffee staining and its potential impact on enamel surfaces compared with regular toothpaste. METHODS: Bovine tooth enamel specimens were prepared and stained with coffee solutions before undergoing brushing simulation with different toothpaste slurries (whitening, regular, reference). For precise evaluation, spectrophotometric measurements were taken at intervals to assess color changes using the CIELAB (Commission Internationale de l'Éclairage Lab*) color space. Additionally, profilometric measurements were taken to determine the impact of toothpaste type on the roughness and abraded depth of the enamel surface. To understand the effects of toothpaste and brushing on color change, surface roughness, and abraded depth, while also considering correlations between these factors, the findings were analyzed using mixed-effects models. RESULTS: The whitening toothpaste group demonstrated the highest recovery rate (71%) after 10,000 brushstrokes, followed by the regular toothpaste group (48%) and the reference slurry group (43%). The mixed-effects model analysis revealed that the reference group had a smaller change in lightness (ΔL) than those in the regular toothpaste group. The whitening toothpaste group showed a greater change in lightness on average than those in the regular toothpaste group, with an increase in lightness as the number of brushstrokes increased. According to the roughness and abraded depth data, the whitening toothpaste group was least affected by brushing, while the reference and regular toothpaste groups showed higher levels of roughness and abraded depth at all intervals. CLINICAL SIGNIFICANCE: Gaining a thorough understanding of the effectiveness of whitening toothpaste and its impact on the enamel surface plays a crucial role in refining toothpaste formulations and advancing tooth whitening techniques in dental care.

Working viscosity and non-Newtonian behavior of silicone denture liners.

PURPOSE: To evaluate flow profile and non-Newtonian behavior of 10 different silicone lining materials. METHODS: Ten commercially available silicone lining materials were selected for evaluation. The flow profile and non-Newtonian behavior of each material was measured using a shark fin testing method. Fin height and resultant base thickness were measured with a digital caliper and compared with one-way ANOVA and Student-Newman-Keuls post hoc test and fin base by Kruskal-Wallis one-way ANOVA on ranks with Dunn post hoc test with significance at P< 0.05 for both. RESULTS: Shark fin heights ranged from 9.62 ± 0.86 mm [Reline II (Soft)] to 25.54 ± 0.43 mm [Sofreliner (Medium)]. Shark fin bases ranged from 2.57 ± 0.51 mm [Sofreliner (Medium)] to 10.31 ± 0.57 mm [Reline II (Soft)]. Statistically significant differences were found between certain samples' shark fin heights as well as resultant bases (P< 0.05) indicating different rheological properties. CLINICAL SIGNIFICANCE: Silicone liner materials differ significantly with respect to flow profile and non-Newtonian behavior. While a high flow profile (low viscosity) of an elastomeric impression material improves accuracy, it may be a detriment to a denture lining material that must achieve a critical minimum thickness to provide resilience. Likewise, a low flow profile (high viscosity) material may also pose a disadvantage, requiring excessive compression and possible tissue distortion to achieve the same critical thickness. The results of this study should be considered when selecting the appropriate material for clinical application. Additional studies are indicated to further quantify rheological properties as well as correlate them to physical properties after the complete cure of the material.

Effect of different storage media on elemental analysis and microhardness of cervical cavity margins restored with a bioactive material.

Objectives: This study aimed to investigate the elemental analysis and microhardness of a bioactive material (Activa) and marginal tooth structure after storage in different media. Materials and Methods: Fifteen teeth received cervical restorations with occlusal enamel and gingival dentin margins using the tested material bonded with a universal adhesive, 5 of them on the 4 axial surfaces and the other 10 on only the 2 proximal surfaces. The first 5 teeth were sectioned into 4 restorations each, then stored in 4 different media; deionized water, Dulbecco's phosphate buffered saline (DPBS), Tris buffer, and saliva. The storage period for deionized water was 24 hours while it was 3 months for the other media. Each part was analyzed by scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) analysis for different substrates/distances and the wt% of calcium, phosphorus, silica, and fluoride were calculated. The other 10 teeth were sectioned across the restoration, stored in either Tris buffer or saliva for 24 hours or 3 months, and were evaluated for microhardness of different substrates/areas. Data were analyzed using analysis of variance and Tukey's post hoc test. Results: Enamel and dentin interfaces in the DPBS group exhibited a significant increase in calcium and phosphorus wt%. Both silica and fluoride significantly increased in tooth structure up to a distance of 75 µm in the 3-month-media groups than the immediate group. Storage media did not affect the microhardness values. Conclusions: SEM-EDS analysis suggests an ion movement between Activa and tooth structure through a universal adhesive while stored in DPBS.

Clinical evaluation of subgingival open sandwich restorations: 3-year results of a randomized double-blind trial.

OBJECTIVES: To provide a 3-year follow-up of previously treated patients to assess and compare the periodontal responses and clinical performance of proximal subgingival open sandwich restorations. MATERIALS AND METHODS: Ninety-five adults participated in the study, with a combined total of 120 compound Class II cavities. These cavities had gingival margins located below the CEJ. Four different restorative materials were used to elevate the dentin/cementum gingival margins of the cavities: resin-modified glass ionomer, glass hybrid, flowable bulk-fill composite, or ion-releasing material, which were then completed with the same overlaying composite. Different periodontal and clinical evaluations, based on the criteria set by the World Dental Federation (FDI) criteria, were performed at different time intervals, including baseline, 6 months, 1, 2, and 3 years. RESULTS: The type of base material did not affect the periodontal evaluations. There were no statistically significant differences between different time intervals or base material groups in any of the evaluated FDI parameters. However, the ion-releasing material scored significantly worse in the radiographic evaluation than any of the other groups. CONCLUSIONS: All tested materials are suitable for proximal subgingival open sandwich restorations, as long as the restoration/tooth margin is at least 2-mm away from the bone crest. CLINICAL SIGNIFICANCE: Clinicians can confidently choose any of the tested materials for proximal subgingival open sandwich restorations, as they have shown good outcomes from both periodontal and clinical perspectives.

Periodontal Evaluation of Subgingival Open Sandwich Restorations: 2-Year Results of a Randomized Double-Blind Trial.

This study aimed to evaluate the periodontal responses of subgingival proximal margins elevated using different restorative materials. A total of 120 proximal cavities with dentin/cementum gingival margins were elevated using one of four materials (resin-modified glass ionomer, glass hybrid, flowable bulk-fill resin composite, or bioactive ionic resin) and completed with the same overlaying resin composite. At 2 weeks (baseline), 6 months, 1 year, and 2 years postrestoration, periodontal parameters and the radiographic distance between the restoration margin and bone crest were evaluated. Appropriate statistical analyses were performed. The values of all periodontal parameters increased with time, although only the increases in Plaque Index and probing depth within each material group were statistically significant. There were no statistically significant differences in any of the periodontal parameters between the different materials within the same evaluation period, nor between different time points or material groups in the radiographic distances. Both glass ionomer-based and resin-based materials were periodontally safe as subgingival open sandwich restorations.

Longterm abrasive and erosive effect of whitening toothpaste on dentin surface.

PURPOSE: To evaluate the amount of dentin loss following immersion in or toothbrushing with whitening toothpaste (WT) containing hydrogen peroxide (HP) and citric acid (CA). Additionally, the amount of dentin loss after brushing with a WT alone or in combination with a conventional toothpaste was assessed, and the effects of HP and CA solutions on the dentin surface were investigated. METHODS: Bovine dentin specimens (n= 350) were randomly assigned to seven solutions of various compositions as toothpaste: The specimens assigned to each solution were then further divided into five treatment groups (n=10 each) : Group A = 1-hour immersion in each solution (ES); Group B = 10,000 brushing in ES; Group C = 1-hour immersion in ES + 10,000 brushing in ES; Group D = 1-hour immersion in ES + 10,000 brushing in reference slurry (RS); Group E = 10,000 brushing in ES + 10,000 brushing in RS. The amount and pattern of dentin loss were determined, and the surfaces were observed using noncontact profilometry. RESULTS: The WT (pH 5.0) caused lower dentin loss than RS after a single brushing cycle; however, the extent of dentin loss after 1 hour of immersion in the WT was significantly greater than that in the RS. Among the specimens treated with WT, a significant difference in dentin loss was observed between Group C and Groups D and E (P< 0.05) but not between Groups D and E. The surfaces exposed to CAS1, CAPB, and WT exhibited U-shaped patterns of dentin loss after brushing or immersion, whereas a wedge-shaped pattern was observed in those that underwent brushing with the RS. CLINICAL SIGNIFICANCE: The effects (dentin abrasion) of a whitening toothpaste containing hydrogen peroxide and citric acid when used in combination with a conventional toothpaste were similar to those seen with the continuous use of a conventional toothpaste alone.

Microhardness of different thicknesses of bulk fill composites.

PURPOSE: To compare the microhardness values and bottom/top hardness ratios of different composites after being cured in 2 or 4 mm increments. METHODS: Two bulk fill composites, methacrylate-based and ormocer-based, and one conventional composite were tested. 36 cylindrical discs were prepared (n=12/composite, with six for 2 mm, and six for 4 mm thickness) by pressing each composite into a mold between two glass slides covered by Mylar strips. The top and bottom surfaces of each sample were evaluated using a Buehler hardness tester for Knoop microhardness, with a 50 g static load applied for 10 seconds at three different locations of the central part of each sample. The bottom/top hardness ratio was calculated for each sample. The Knoop microhardness data and bottom/top ratio percentages were analyzed using two-way repeated measures ANOVA and Holm-Sidak post hoc test, with significance at P< 0.05. RESULTS: The tested methacrylate-based bulk fill had the highest overall microhardness among the three tested composites. All three composite types showed a significant difference in microhardness between the top and bottom of the 4 mm discs. The bottom/top ratio percentages differed significantly for both tested bulk fill composites across different thicknesses. Both tested bulk fill materials had a bottom/top ratio of ≥ 80% at the deepest level of a 4 mm increment. CLINICAL SIGNIFICANCE: The type of material significantly affected both the bottom and top microhardness values under the experimental conditions used. While both tested bulk fill composites showed a decline in microhardness at the bottom of the 4 mm depth, they had clinically acceptable microhardness ratios at greater depths.

Effect of open windows on airborne contamination and its topographical distribution in the dental operatory.

Aerosols produced by dental handpieces represent a permanent risk of disease transmission in the dental environment. The current study evaluated the effects of natural ventilation (open windows) on Streptococcus mutans airborne contamination by dental handpieces in simulated clinical conditions. A dental phantom was placed on a dental chair at a standard university dental clinic operatory. An S. mutans suspension was infused into the phantom's mouth while an operator performed standardized dental procedures using low (contra-angle) and high speed (turbine) dental handpieces or an ultrasonic scaler, with windows open or closed. Selective medium Petri dishes were placed in 18 sites of the operatory environment to evaluate contamination topographically. Sites were clustered as: wall, floor, ceiling, dental chair, and cabinet. Contamination was expressed as log10 CFU/cm2 . A linear mixed model analysis was used, nesting the sites within each ventilation and handpiece combination. Open windows significantly reduced contamination. The high-speed handpiece provided the highest contamination, followed by the ultrasonic scaler and the low-speed handpiece. Contamination values were much smaller at the ceiling, and much larger at the chair. Opening windows produced more homogeneous contamination of the operatory compared to closed windows. Natural ventilation during dental procedures decreases contamination and affects its topographical distribution.

Comparative evaluation of subgingival scaling and polishing techniques on dental material surface roughness.

PURPOSE: To evaluate and compare the effects of different scaling and polishing techniques on the surface roughness of four different restorative materials. METHODS: 72 specimens were prepared, molded to a size of 8.0 by 2.0 mm, and cured according to the manufacturers' instructions. The specimens were stored at 37°C for 24 hours and then thermocycled for 5,000 cycles (from 55°C to 5°C) to simulate 6 months of clinical use. Surface roughness (Ra/average and Rz/max-overall heights) was calculated using a stylus profilometer by subtracting the simulated treatments of hand scaling, ultrasonic scaling, and air polishing from the baseline measurements. The difference in Ra and Rz data were compared independently for each measurement using a two-way ANOVA on Ranks and the Holm-Sidak test, with α< 0.05 used to determine significance. RESULTS: Irrespective of the scaling or polishing technique employed, flowable bulk fill demonstrated the lowest Ra and Rz values. Hand scaling exhibited the highest roughness and variability among the other techniques, regardless of the materials tested (P< 0.001). Air polishing with glycine resulted in the lowest roughness values across all tested materials, with the exception of the tested bioactive restorative material group. CLINICAL SIGNIFICANCE: Regarding surface roughness, air polishing with glycine may be an effective and safe intervention for periodontal maintenance of subgingival restorations compared to the other tested scaling methods.

Effect of doxycycline doped nanoparticles on osteogenic/cementogenic and anti-inflammatory responses of human cells derived from the periodontal ligament.

OBJECTIVES: This work aimed to evaluate if doxycycline-doped polymeric nanoparticles possessed any anti-inflammatory effect and promote osteogenic/cementogenic differentiation of stem cells from human periodontal ligament (PDLSCs). METHODS: The polymeric nanoparticles (NPs) were produced by a polymerization/precipitation process and doped with doxycycline (Dox-NPs). PDLSCs were cultured in the presence or absence of the NPs under osteogenic medium or IL-1ß treatment. Cells' differentiation was assessed by gene expression analysis of osteogenic/cementogenic markers alkaline phosphatase (ALP) and Runt-related transcription factor 2 (RUNX2). An anti-inflammatory effect was also ascertained by analyzing IL-1ß gene expression. Adipogenic and chondrogenic differentiation was used to confirm the multipotency of PDLSCs. RESULTS: Gene expression of ALP and RUNX2 in PDLSCs was significantly upregulated by the osteogenic medium (ALP: p<0.001; RUNX2: p = 0.005) while Dox-NPs further enhanced ALP gene expression of PDLSCs treated with the osteogenic medium. Furthermore, Dox-NPs suppressed the up-regulation of IL-1ß when cells were subjected to an inflammatory challenge. CONCLUSIONS: Dox-NPs enhanced PDLSCs differentiation into osteoblasts/cementoblasts lineages while providing an anti-inflammatory effect. CLINICAL SIGNIFICANCE: Due to their biocompatibility as well as anti-inflammatory and osteogenic/cementogenic effects, Dox-NPs are potential candidates for being used in periodontal regeneration.

Botox for the prevention of radiation-induced Sialadenitis and xerostomia in head and neck cancer patients: A pilot study.

BACKGROUND: To determine the safety of Botox and its potential effect on alleviating radiation therapy (RT)-induced sialadenitis in head and neck cancer patients. METHODS: Twenty patients with stage III/IV head and neck cancer were randomized to receive Botox or saline injections into both submandibular glands (SMG). There were three visits: one before RT (V1); 1 week after RT (V2); and 6 weeks after RT (V3), each of which included saliva collection, a 24-h dietary recall, and a quality-of-life survey. RESULTS: No adverse events were observed. While the control group was much older, the Botox group more commonly underwent induction chemotherapy compared with controls. From V1 to V2, salivary flow decreased in both groups, but only in the control group from V1 to V3. CXCL-1 (GRO), a neutrophil chemoattractant, was lower in the Botox group compared with the control group at V3. CONCLUSION: Botox can be safely administered to the salivary glands prior to external beam radiation without observed complications or side-effects. After an initial reduction in salivary flow following RT, the Botox group showed lack of further flow reduction compared with controls. The inflammatory marker CXCL 1, which was reduced in the in Botox group at V3, may be a candidate for further studies of radiation-induced sialadenitis.

Secondary caries adjacent to bulk fill resin composite restorations lined with fluoride agents.

PURPOSE: To evaluate the potential secondary caries reduction of bulk-fill resin composite restorations treated with different fluoride (F)-based agents prior to restoration placement. METHODS: 25 upper extracted molars received Class V cavities on both buccal and lingual surfaces with an enamel margin and root surface margin. The teeth were randomly assigned into five groups with five teeth per group (n=10). The treatment groups were: control group, with no treatment; the other groups received treatment using different F-based agents prior to bonding. All teeth were restored using a selective etch bonding technique and bulk fill resin composite. All teeth received 10,000 thermal cycles followed by immersion in demineralizing solution to produce artificial caries-like lesions. Polarized light microscope evaluation was performed on longitudinal sections (30 enamel lesions and 30 root surface lesions per group). Lesion depth and wall lesions for both enamel and root surface adjacent to the restorations were evaluated. RESULTS: Both lesion depths and frequency of wall lesions in the enamel and root surfaces in all treatment groups were significantly reduced compared with the control group. Among the different F-based agents, no significant difference was seen on the enamel or root surface lesion depth, showing a similar presence of enamel and root cavosurface wall lesions. CLINICAL SIGNIFICANCE: F-based agent treatment of adjacent enamel and root surfaces prior to placement of restorative materials provided resistance to the development of secondary caries during an in vitro caries model.

Effect of toothpaste tablets on gloss and surface roughness of resin-based composite materials.

PURPOSE: To evaluate the effects of toothpaste tablets on the gloss and surface roughness of resin-based composite materials and determine the relationship between gloss and roughness. METHODS: Rectangular jigs were designed and printed. Wells (2 mm deep x 7 mm diameter) were filled with Filtek Supreme Ultra A2B, light-cured and polished. A small-area glossmeter was used for gloss (GU) measurements and a profilometer for roughness measurements (Ra) at baseline and after challenge with each toothpaste. An automated tooth-brushing machine was set at 120 strokes/minute for a total of 10,000 strokes to evaluate four test groups with 16 specimens in each group. NC: Brushing with distilled water; TABS: Colgate Anywhere Travel Tooth Tabs; CP: Colgate Cavity Protection Toothpaste and AW: Colgate Whitening Advanced Toothpaste. Kruskal-Wallis test was used to test the difference in gloss and surface roughness among the groups and Pearson correlation was used to compare the relationship between gloss and roughness. RESULTS: There was no statistically significant difference in gloss and roughness among the four groups at baseline. At post-brushing, there was a statistically significant difference among the groups (P< 0.001) with increased roughness and decreased gloss for CP and AW when compared to TABS. There was a statistically significant correlation between post-brushing roughness and post-brushing gloss (P< 0.001, rho: -0.815). Thus, the higher the surface roughness the lower the gloss. CLINICAL SIGNIFICANCE: Toothpaste tablets retain better gloss and roughness of resin-based composite materials when compared to conventional toothpastes.

Effect of crown stiffness and prosthetic screw absence on the stress distribution in implant-supported restoration: A 3D finite element analysis.

This in-silico investigation evaluated the mechanical impact of Morse tape implant-abutment interface and retention system (with and without screw) and restorative materials (composite block and monolithic zirconia) by means of a three-dimensional finite element analysis (3D-FEA). Four 3D models were designed for the lower first molar. A dental implant (4.5 × 10 mm B&B Dental Implant Company) was digitized (micro CT) and exported to computer-aided design (CAD) software. Non-uniform rational B-spline surfaces were reconstructed, generating a 3D volumetric model. Four different models were generated with the same Morse-type connection, but with a different locking system (with and without active screw) and a different crown material made of composite block and zirconia. The D2 bone type, which contains cortical and trabecular tissues, was designed using data from the database. The implants were juxtaposed inside the model after Boolean subtraction. Implant placement depth was simulated for the implant model precisely at crestal bone level. Each acquired model was then imported into the finite element analysis (FEA) software as STEP files. The Von Mises equivalent strains were calculated for the peri-implant bone and the Von Mises stress for the prosthetic structures. The highest strain values in bone tissue occurred in the peri-implant bone interface and were comparable in the four implant models (8.2918e-004-8.6622e-004 mm/mm). The stress peak in the zirconia crown (64.4 MPa) was higher than in the composite crown (52.2 MPa) regardless of the presence of the prosthetic screw. The abutment showed the lowest stress peaks (99.71-92.28 MPa) when the screw was present (126.63-114.25 MPa). Based on this linear analysis, it is suggested that the absence of prosthetic screw increases the stress inside the abutment and implant, without effect on the crown and around the bone tissue. Stiffer crowns concentrate more stress on its structure, reducing the amount of stress on the abutment.

Dentin abrasion using whitening toothpaste with various hydrogen peroxide concentrations.

PURPOSE: To compare the amount of abrasion of four whitening toothpastes, two conventional toothpastes, and seven experimental toothpastes with varying concentrations of hydrogen peroxide. METHODS: Bovine dentin specimens were treated with the four whitening toothpastes (containing three different concentrations of hydrogen peroxide: 0.75%, 1.50%, and 2.80%), two conventional toothpastes without hydrogen peroxide, seven experimental toothpastes (concentrations of hydrogen peroxide: 0.75%, 1.50%, 3.0%, 4.50%, 6.0%, 7.50%, and 9.0%), and distilled water. After 10,000 strokes of toothbrushing, the amount of abrasion on the dentin surface was measured with a contactless 3D surface profiler (n= 8). The pH of all solutions, the weight percentages of the particles, and the component of particles in the toothpaste were analyzed. The correlations between the dentin abrasion, pH, and weight percentages of the particles in the toothpastes were investigated. RESULTS: The amount of abrasion of the two conventional toothpastes were 1.1-3.6 times higher than those of the four whitening toothpastes. Likewise, the pH of the conventional toothpaste was higher than those of the other whitening toothpastes. No significant differences were found among the four whitening toothpastes. The four whitening toothpastes consisted of a relatively lower weight percentage of particles compared to the two conventional toothpastes. A strong positive correlation was observed between the dentin abrasion and the weight percentages of the particles (r= 0.913; P< 0.05). Furthermore, no significant differences in the amount of abrasion were observed between the specimens treated with seven experimental toothpastes and those treated with distilled water. CLINICAL SIGNIFICANCE: The whitening toothpastes containing less than 9% hydrogen peroxide did not seem to harm the dentin surface significantly. These findings can serve as a reference for consumers, patients, and dental professionals.