Do aesthetics dental needs interfere in the oral health-related quality of life and in the self-steem of patients seeking for treatment at University São Francisco Dental School ?

Aim: The objective was to evaluate oral health-related quality of life (OHRQOL) in patients aging 18 - 60 years, considering oral health, dental aesthetic impact and self-esteem. Methods: The sample comprised 81 patients, regardless gender/ethnicity, seeking for dental aesthetic treatment at University São Francisco, Bragança Paulista-SP. The instruments used to assess the OHRQOL were the questionnaires: 1. Rosenberg Self-Esteem Scale (RSS); 2. Oral Health Impact Profile-14 Brazil (OHIP) and 3. Psychosocial Impact and Aesthetic Dental Questionnaire-Brazil (PIADQ). Data were analyzed by Spearman correlation (α=5%) and descriptive statistics. Results: The older the patient the worse the oral and general health conditions found (p<0.05). Moreover, the age showed significant correlation with OIHP and PIADQ questionnaires scores (p=0.000). The three questionnaires showed moderate positive correlations (p<0.05 r=0.461­0.685) among them. In addition, OHIP and QIPED questionnaires correlated with general health and oral health (p<0.05 r=0.230­0.558). Conclusion: It could be concluded that aesthetic dental needs interfere, in fact, in the oral health-related quality of life and in the self-steem of patients seeking for treatment University São Francisco Dental School (AU)

Análise da sensibilidade após o uso prévio de dessensibilizantes em clareamento dental / Sensitivity analysis after using desensitizing before to the whitening tooth

O objetivo desse estudo foi avaliar a utilização de três diferentes dessensibilizantes dentais antes da aplicação do gel clareador contendo cálcio. Foram selecionados 32 voluntários e estes divididos, aleatoriamente, em 4 grupos (n = 8): G1) Gel de Peróxido de Hidrogênio a 35% contendo cálcio (Gel PH+Ca); G2) Desensibilize KF 2% + (Gel PH+Ca); G3) Desensibilize KF 0,2% + (Gel PH+Ca) e G4) Nano P + (Gel PH+Ca). Os materiais foram aplicados em 3 sessões e, posteriormente, foram realizadas mensurações da sensibilidade utilizando a escala visual analógica de dor, através de estímulos táteis e evaporativos. Não houve diferença estatística (p > 0,05) de sensibilidade entre os indivíduos de grupos diferentes, em nenhum dos períodos de avaliação.

The objective of this study was to evaluate the use of three different dental desensitizing before application of whitening gel with calcium. They selected 32 volunteers and these randomly divided into 4 groups (n = 8): G1) Hydrogen Peroxide 35% gel containing calcium (Ca + Gel PH) ; G2) Desensibilize KF + 2% (Gel PH + Ca) ; G3) Desensibilize KF + 0.2 % (Gel PH + Ca) and G4) P + Nano (Gel PH + Ca). The materials were applied in three sessions were held and after, sensitivity measurements using the visual analogue scale of pain through tactile and evaporative actuations. There was no statistical difference (p> 0.05) in sensitivity between individuals of different groups, in any period of assessment.

In situ antimicrobial activity and inhibition of secondary caries of self-etching adhesives containing an antibacterial agent and/or fluoride.

PURPOSE: To evaluate the in situ effect of fluoride and MDPB-containing adhesives on antibacterial activity around restorations in conditions of high caries risk. METHODS: Bovine enamel and dentin blocks were restored with a fluoride-containing (One-up Bond F Plus - OP) or a MDPB and fluoride-containing adhesive (Clearfil Protect Bond - PB). Volunteers (n = 17) wore an intra-oral appliance containing three enamel and three dentin blocks, aligned side-by-side and restored with OP or PB and one enamel and dentin block (controls). The cariogenic challenge was carried out in two phases of 14 days each. The counts of total streptococci (TM), mutans streptococci (MS) and lactobacilli (LB) were analyzed in the biofilm formed. Cross-sectional microhardness (CSM) and polarized light microscopy (PLM) evaluated caries lesions around the restorations and the demineralization extension. Data obtained by CSM testing was analyzed by Split-Split Plot ANOVA (P < 0.05). PLM and microbiota results were analyzed by Wilcoxon test (P < 0.05). RESULTS: TM and MS counts were highest for the OP enamel restorations, and these presented higher lesion depths than PB in both the enamel and dentin. The CSM in dentin was the lowest at 60 µm from the restoration wall. None of the adhesives prevented demineralization and bacteria growth, but PB reduced the amount of oral pathogens in enamel and demineralization around restorations in enamel and dentin.

Enamel and dentin bond strength, interfacial ultramorphology and fluoride ion release of self-etching adhesives during a pH-cycling regime.

PURPOSE: This study evaluated the effects of pH cycling on fluoride release and bond strength of two self-etching adhesive systems to both enamel and dentin. The ultramorphology of the interfaces produced by the adhesive systems were also analyzed. MATERIALS AND METHODS: The buccal surfaces of bovine incisors were flattened to expose enamel and dentin, which were bonded with either Clearfil Protect Bond (CPB) or One-Up Bond F Plus (OBP). The bonded samples were prepared for microtensile bond strength (µTBS) testing, fluoride ion release, and transmission electron microscopy. pH cycling comprised demineralization (8 h/day) and remineralization (16 h/day) cycles for 8 days. The µTBS data were analyzed by two-way ANOVA, while fluoride release was analyzed using the Friedman and Wilcoxon tests. RESULTS: The adhesives presented similar bond strengths to enamel. However, the dentin bond strength of CPB was higher than that of OBP. pH cycling did not influence enamel or dentin µTBS. The amount of fluoride released from the bonded enamel and dentin was low and varied among the groups. The morphological evaluation showed that the thickness of the dentin hybrid layers was similar for both adhesives. CONCLUSION: The pH-cycling regime did not affect enamel or dentin bond strengths. In enamel, both the self-etching adhesives tested presented similar bond strengths, but in dentin, Clearfil Protect Bond showed higher dentin bonding than One-Up Bond F Plus.

Effect of fluoride-containing bleaching agents on bovine enamel microhardness

Aim: The purpose of this study was to evaluate the effect of 10% carbamide peroxide (10%CP) bleaching agents with different fluoride concentrations on enamel microhardness after induction of artificial caries lesions during pH-cycling model. Methods: Bovine dental enamel blocks with known surface microhardness were subjected to caries lesion induction and another surface microhardness was determined after a demineralization protocol. The enamel blocks were divided into four groups (n=17) and subjected to 12-day pH-cycling. The groups consisted of the following treatments: 1) artificial saliva (control group not subjected to bleaching treatment); 2) 10%CP; 3) 10%CP (with 0.11% fluoride); 4) 10%CP (with 0.5% fluoride). After treatments, the enamel was evaluated using surface microhardness, polarized light microscopy (PLM) and scanning electronic microscopy. The percentage of surface microhardness recovery was determined for each group and analyzed by the Kruskal Wallis and Dunn’s tests (a=0.05). The values of lesion depth by PLM were analyzed by ANOVA and Tukey’s test (a=0.05). Results: The enamel treated with bleaching gels containing or not fluoride presented lower mineral recovery and higher caries lesion depth than the control group. Conclusions: These data suggest that bleaching procedures on enamel with artificially induced caries lesions should be used with caution even in the presence of fluoride because there was no recovery in the microhardness.

In vitro secondary caries inhibition by adhesive systems in enamel around composite restorations.

This study compared the ability of adhesive systems to inhibit in vitro caries lesions in enamel under high cariogenic challenge. Bovine enamel blocks with cavity preparations were restored with AP-X resin composite (Kuraray Med) using four adhesives systems: Clearfil SE Bond (Kuraray Med); Clearfil Protect Bond (Kuraray Med); One-Up Bond F (Tokuyama) and Single Bond (3M ESPE). The specimens were submitted to an eight-day pH-cycling regimen. After cariogenic challenge, the enamel was evaluated to detect caries lesions using cross-sectional microhardness, polarized light microscopy and scanning electronic microscopy. Data from cross-sectional microhardness and polarized light microscopy evaluations were statistically analyzed by ANOVA and Tukey's test. The mineral % volume showed no statistical difference among adhesives (p > 0.05); however, polarized light microscopy analysis showed lower caries lesions with Clearfil Protect Bond (p < 0.05). The scanning electron microscopy images showed greater caries lesions and demineralization areas close to restorations for Clearfil SE Bond, One-Up Bond F and Single Bond compared to Clearfil Protect Bond. The pH-cycling regimen promoted subsurface enamel demineralization in all specimens treated. The polarized light microscopy and scanning electronic microscopy analyses showed that Clearfil Protect Bond seems to produce lower enamel demineralization around restorations; however, cross-sectional microhardness did not demonstrate differences among the adhesives.

Influência da formação de película adquirida e aplicação tópica de flúor na microdureza do esmalte tratado com peróxido de hidrogênio a 35 por cento / Influence of acquired pellicle formation and topical fluoride application on microhardness of bleached enamel with 35 per cent hydrogen peroxide

O objetivo deste estudo foi avaliar a influência da formação da película adquirida (PEA) e da aplicação tópica de flúor (ATF) após o tratamento com peróxido de hidrogênio a 35% na microdureza Knoop do esmalte. Foram obtidas 120 amostras de esmalte (4x4x4 mm), a partir das superfícies vestibulares de 60 incisivos bovinos. As amostras foram preparadas para a leitura de microdureza de superfície (inicial) e aleatoriamente divididas em quatro grupos (n=30): (1) Esmalte sem formação de PEA e sem ATF pós-tratamento clareador (controle); (2) Esmalte sem formação de PEA e com ATF pós-tratamento clareador; (3) Esmalte com formação de PEA e sem ATF pós-tratamento clareador; (4) Esmalte com formação de PEA e com ATF pós-tratamento clareador. Os dentes foram submetidos a 12 dias de ciclagem de pH, concomitante com o clareamento (Pola Office, SDI, Bayswater, Victoria, Austrália), que foi realizado no 1º, 6º e 12º dia de ciclagem. Após a ciclagem de pH, foi realizada a leitura da microdureza superficial final e da microdureza longitudinal do esmalte tratado. Todos os grupos experimentais mostraram redução da microdureza superficial do esmalte após os tratamentos realizados. Os valores médios (iniciais e finais) foram semelhantes entre os grupos experimentais. Com relação à microdureza longitudinal, somente na primeira profundidade (10 μm) observou-se redução significativa da microdureza, com relação às demais profundidades analisadas. Esses valores médios, em 10 μm, não diferiram entre os grupos experimentais, assim como as outras profundidades analisadas também não diferiram entre os grupos. A microdureza do esmalte não foi afetada pela formação de PEA, tampouco pela ATF

The objective of this study was to evaluate the influence of acquired salivary pellicle formation (SPF) and the topical application of fluoride (TAF) post-bleaching with 35% hydrogen peroxide on the Knoop microhardness of enamel. Sixty bovine incisors were used. One hundred twenty enamel blocks (4x4x4 mm) were obtained from the buccal surfaces of these teeth. The enamel surfaces were prepared for microhardness measurements (baseline) and randomly divided into 4 groups (n=30): 1) enamel without SPF and TAF (control); 2) enamel without SPF and treated with ATF; 3) enamel with PEA and without ATF; and 4) enamel with PEA and treated with TAF. The enamel blocks were submitted to a 12-day pH-cycling, and the bleaching agent (Pola Office, SDI, Bayswater, Victoria, Australia) was applied at the 1st, 6th and 12th days of cycling. After the treatments, the surface microhardness and the internal microhardness were measured. All the groups showed a reduction in the enamel surface microhardness after the treatments. The mean values (baseline and final) were similar among the groups. The internal microhardness was lower at the first depth (10 μm). The mean values of microhardness at 10 μm were similar among the groups, and the other means did not differ among them. SPF and TAF did not affect enamel microhardness

Efeito da irradiação dos agentes clareadores no esmalte dental com lesão de cárie / Effect of bleaching agents irradiated on dental enamel with caries-like lesions

Analisar os efeitos do peróxido de hidrogênio (35%) irradiado ou não e do dentifrício fluoretado (DF) aplicados no esmalte dental com lesão de cárie. Foram analisados dois agentes clareadores (Whiteness HP Maxx e Easy White) e três modos de aplicação (sem irradiação, irradiação com aparelho de lâmpada halógena ou LED/laser de diodo). Os clareamentos foram realizados nos 1º, 6º e 12º dias de ciclagem de pH. Os resultados de microdureza mostraram que não houve diferença entre os grupos. A microscopia de luz polarizada mostrou desmineralização superficial e na subsuperfície do esmalte para todos os grupos. O DF não foi capaz de controlar a perda mineral provocada pelo clareamento, sugerindo cautela na indicação do clareamento em condições de atividade de cárie.

Effect of a fluoride- and bromide-containing adhesive system on enamel around composite restorations under high cariogenic challenge in situ.

PURPOSE: To evaluate the effect of a novel antibacterial and fluoride-releasing adhesive formulation on enamel demineralization under sucrose exposure in situ (simulating high caries risk conditions). MATERIALS AND METHODS: This crossover, blind study was performed in two phases of 14 days. Volunteers (n = 14) wore an intraoral appliance containing four bovine enamel blocks with cavity preparations restored using self-etching primers/composite resin (Clearfil SE Bond or Clearfil Protect Bond/Clearfil AP-X). The volunteers dropped 20% sucrose solution 8x/day and used fluoridated dentifrice 3x/day. After 14 days, enamel mineral loss was assessed by cross-sectional microhardness (CSMH), and the demineralization areas in enamel adjacent to the restoration were examined by scanning electron microscopy (SEM) and polarizing light microscopy (PLM). The CSMH data were analyzed using ANOVA and Tukey's test (p < 0.05). RESULTS: Enamel blocks restored with Clearfil Protect Bond showed higher mineral content (%vol) adjacent to restorations than Clearfil SE Bond only for the first site of microhardness measurement and close to enamel surface (20 microm). SEM and PLM analysis suggested that the Clearfil Protect Bond adhesive promoted less enamel demineralization around restorations. CONCLUSION: After 14 days of cariogenic challenge, the findings suggested that Clearfil Protect Bond might help to control the demineralization around restorations in cases of high caries risk.

Effect of 10% carbamide peroxide bleaching on sound and artificial enamel carious lesions.

This study evaluated the effect of 10% carbamide peroxide (CP) bleaching on Knoop surface microhardness (KHN) and morphology of sound enamel and enamel with early artificial caries lesions (CL) after pH-cycling model (pHcm). Human dental enamel blocks were randomly divided into 6 groups (n=10): 1 - sound enamel bleached (S) with CP (Rembrandt/Den-Mat); 2 - S and submitted to pHcm; 3 - CL bleached with CP; 4 - CL stored in artificial saliva and submitted to pHcm; 5 - CL treated with placebo gel and submitted to pHcm; 6 - CL bleached with CP and submitted to pHcm. Enamel blocks with known initial KHN values were demineralized (groups 3 to 6) and submitted to 12 day pHcm (groups 2, 4, 5 and 6). After demineralization and treatments, KHN was determined and the specimens were examined using scanning electron microscopy (SEM). Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. The results showed that among CL groups (3 to 6) only the group 3 presented remineralization after treatments. S groups (1 and 2) showed higher KHN and presented less formation of porosities on enamel surface than CL groups after treatments. In conclusion, bleaching procedures on enamel with CL did not exacerbate the demineralization, but should be indicated with caution.

Effect of 10 percent carbamide peroxide bleaching on sound and artificial enamel carious lesions

This study evaluated the effect of 10 percent carbamide peroxide (CP) bleaching on Knoop surface microhardness (KHN) and morphology of sound enamel and enamel with early artificial caries lesions (CL) after pH-cycling model (pHcm). Human dental enamel blocks were randomly divided into 6 groups (n=10): 1 - sound enamel bleached (S) with CP (Rembrandt/Den-Mat); 2 - S and submitted to pHcm; 3 - CL bleached with CP; 4 - CL stored in artificial saliva and submitted to pHcm; 5 - CL treated with placebo gel and submitted to pHcm; 6 - CL bleached with CP and submitted to pHcm. Enamel blocks with known initial KHN values were demineralized (groups 3 to 6) and submitted to 12 day pHcm (groups 2, 4, 5 and 6). After demineralization and treatments, KHN was determined and the specimens were examined using scanning electron microscopy (SEM). Data were analyzed statistically by ANOVA and Tukey's test at 5 percent significance level. The results showed that among CL groups (3 to 6) only the group 3 presented remineralization after treatments. S groups (1 and 2) showed higher KHN and presented less formation of porosities on enamel surface than CL groups after treatments. In conclusion, bleaching procedures on enamel with CL did not exacerbate the demineralization, but should be indicated with caution.

Este estudo analisou o efeito do peróxido de carbamida a 10 por cento (PC) na microdureza Knoop de superfície (KHN) e morfologia do esmalte hígido e com lesões iniciais de cárie artificial (EC), após modelo de ciclagem de pH (cpH). Blocos de esmalte dental humano foram divididos aleatoriamente em 6 grupos (n=10): 1- esmalte hígido clareado (EHC) com PC (Rembrandt/Den-Mat); 2- EHC e submetido a cpH; 3- EC clareado com PC; 4- EC armazenado em saliva artificial e submetido a cpH; 5- EC tratado com gel placebo e submetido a cpH; 6- EC clareado com PC e submetido a cpH. Blocos de esmalte com a KHN conhecida eram desmineralizados (grupos 3 a 6) e submetidos a cpH (grupos 2, 4, 5 e 6). KHN foi determinada após a desmineralização e os tratamentos. Os espécimes foram examinados através de Microscopia Eletrônica de Varredura (MEV). Os dados foram analisados através de ANOVA e teste de Tukey (p<0,05). Os resultados indicaram que entre os grupos com EC (3 a 6) somente o grupo 3 apresentou remineralização após os tratamentos. Os grupos EHC (1 e 2) mostraram maior KHN e menor formação porosidades quando comparados aos grupos EC após os tratamentos. Os procedimentos clareadores no esmalte com lesão de cárie não exacerbaram a desmineralização, entretanto precisam ser indicados com cautela.

Peroxide bleaching agent effects on enamel surface microhardness, roughness and morphology

O objetivo deste estudo foi avaliar a rugosidade, microdureza e morfologia superficial do esmalte dental humano tratado com seis agentes clareadores (antes e depois do tratamento). Amostras de esmalte dental humano foram obtidas de terceiros molares e aleatoriamente distribuídas em sete grupos (n = 11): controle, Whiteness Perfect - peróxido de carbamida a 10% (PC 10%), Colgate Platinum - PC 10%, Day White 2Z - peróxido de hidrogênio a 7,5% (PH 7,5%), Whiteness Super - PC 37%, Opalescence Quick - PC 35% e Whiteness HP - PH 35%. Os agentes clareadores foram aplicados de acordo com as instruções dos fabricantes. O grupo controle permaneceu sem tratamento e armazenado em saliva artificial. O teste de microdureza foi realizado com o indentador Knoop, e a rugosidade superficial foi verificada através do rugosímetro. Observações morfológicas foram realizadas através de microscopia eletrônica de varredura (MEV). Os resultados foram estatisticamente analisados com ANOVA (dois fatores) e teste Tukey (5%) e revelaram uma redução significante nos valores de microdureza e um aumento significante da rugosidade de superfície após o clareamento. Alterações na morfologia do esmalte após o clareamento foram observadas através de MEV. Concluiu-se que os agentes clareadores podem alterar a microdureza, rugosidade e morfologia superficial do esmalte dental.

Peroxide bleaching agent effects on enamel surface microhardness, roughness and morphology.

The aim of this study was to evaluate the surface roughness, microhardness and morphology of human enamel exposed to six bleaching agents (at baseline and post-treatment). Human dental enamel samples were obtained from human third molars and randomly divided into seven groups (n = 11): control, Whiteness Perfect--10% carbamide peroxide (10% CP), Colgate Platinum--10% CP, Day White 2Z--7.5% hydrogen peroxide (7.5% HP), Whiteness Super--3% CP, Opalescence Quick--35% CP and Whiteness HP--35% HP. Bleaching agents were applied according to manufacturers' instructions. The control group remained not treated and stored in artificial saliva. Microhardness testing was performed with a Knoop indentor and surface roughness was analyzed with a profilometer. Morphologic observations were carried out with scanning electron microscopy (SEM). Results were statistically analyzed by two-way analysis of variance and Tukey's test (5%), and revealed a significant decrease in microhardness values and a significant increase in surface roughness post-bleaching. Changes in enamel morphology after bleaching were observed under SEM. It was concluded that bleaching agents can alter the microhardness, roughness and morphology of dental enamel surface.