The effect of photobiomodulation therapy associated with casein phosphopeptide-amorphous calcium phosphate fluoride paste on the treatment of posthome whitening tooth sensitivity and color change: A randomized clinical trial.

OBJECTIVE: This study assessed whether combining photobiomodulation therapy (PBMT) with casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) paste can effectively reduce post-home whitening tooth sensitivity (TS) without compromising shade change. METHODS: Fifty participants were selected and assigned to one of four groups: (1) PLACEBO group-received a placebo paste and PBMT simulation; (2) PBMT group-received a placebo paste + PBMT; (3) CPP-ACPF group-received CPP-ACPF paste and PBMT simulation; (4) CPP-ACPF + PBMT group-received both CPP-ACPF paste and PBMT. The participants used whitening trays containing 22% carbamide peroxide for 2 h a day for 21 days. TS was measured daily using a visual analog scale, while shade change was assessed using a spectrophotometer: before bleaching treatment (T0), after the first (T1), second (T2), and third (T3) weeks of treatment, and 30 days (T4) after completing the whitening treatment. RESULTS: Intragroup analysis revealed that the PLACEBO group had the highest increase in sensitivity during the whitening treatment. The CPP-ACPF and PBMT groups showed no significant difference tooth whitening (TW) between weeks regarding aesthetic change. The CPP-ACPF and PBMT group exhibited a significant reduction in TS between the first and third and between the second and third weeks TW, but not between the first and second. Conversely, the PLACEBO group showed a higher sensitivity than the other groups (p < .05). The CPP-ACPF and PBMT groups did not differ from each other. Furthermore, the CPP-ACPF and PBMT group showed a greater decrease in sensitivity than the PLACEBO group at T1, T2, and T3 (p < .01), and was significantly differed from CPP-ACPF and PBMT groups only at T2 and T3. All groups confirmed TW effectiveness. Student's and paired t-test did not reveal any significant difference between groups (p > .05). CONCLUSION: Therefore, PBMT associated with CPP-ACPF paste can reduce TS without compromising the efficacy of TW.

Clinical evaluation of surface treatment on clinical performance of non-carious sclerotic cervical lesions: 18-month follow-up.

PURPOSE: To evaluate the influence of different surface treatments on the clinical behavior of non-carious cervical sclerotic lesions (NCCLs) over an 18-month follow-up period. METHODS: 128 NCCLs from 32 volunteers were randomized into four groups (n=32): G1-control, without preoperative treatment of the dentin surface; G2, dentin conditioning with 17% ethylenediaminetetracetic acid (EDTA) for 2 minutes; G3, increase in dentin surface roughness with diamond bur and G4, increase in dentin surface roughness with diamond bur + dentin conditioning with 17% EDTA for 2 minutes. RESULTS: Differences between groups were tested using the Friedman test (α= 0.05). A questionnaire was administered to volunteers about risk factors related to NCCLs. The relationship between the questionnaire data and the clinical performance of the restorations was analyzed using the multiple logistic regression test (α= 0.05). The variables related to parafunctional habits, anxiety and/or depression were significantly related to the manifestation of postoperative sensitivity. Roughening the sclerotic dentin with a diamond bur increased postoperative sensitivity within 12 months. The presence of parafunctional habits and anxiety/depression may lead to postoperative sensitivity. CLINICAL SIGNIFICANCE: Roughening the sclerotic dentin with a diamond bur increased postoperative sensitivity within 12 months.

Effect of LEDs with Different Wavelengths on the Microhardness and Nanohardness of Nanohybrid Composite Resins.

AIM: The aim of this study is to compare the effectiveness of polymerization of nanohybrid composite resins with different colors and thicknesses, photocured by units of different wavelengths through Knoop microhardness (KHN) and Berkovich nanohardness (DUH). MATERIALS AND METHODS: One hundred twenty specimens of Tetric N-Ceram (Ivoclar/Vivadent) were divided into groups (n = 5) according to the experimental test, the color of the composite resin (A2 and Bleach-M/BM), the light source: monowave (Elipar™ FreeLight DeepCure-3M/ESPE), dental products-1200 mW/cm2/15 seconds (FL); or polywave (Bluephase-Ivoclar/Vivadent 1200 mW/cm2/15 and 30 seconds (BP), and thickness (irradiated surface,1, 2, and 3 mm). The specimens were stored dry for 24 hours at 37°C and received five indentations on the top and button surfaces. Analysis of variance (ANOVA), Tukey, and Pearson correlation (p < 0.01%) tests were used. RESULTS: A direct correlation was found between KHN and DUH. The higher values of KHN and DUH were observed with Elipar™ FreeLight DeepCure unit in irradiated surface and 1-mm-thick specimens at A2 color. CONCLUSION: That Elipar™ FreeLight DeepCure unit showed better effectiveness in curing nanohybrid composite resins, used in this work, in different colors and depths as compared to Bluephase in both experimental tests, and that DUH can substitute KHN test when comparing the effectiveness of polymerization. CLINICAL SIGNIFICANCE: The evaluation of the mechanical properties of composite resins is essential to verify their possible clinical performance.

Effect of nanohydroxyapatite associated with photobiomodulation in the control of dentin hypersensitivity: A randomized, double-blind, placebo-controlled clinical trial.

PURPOSE: To evaluate the effect of nanohydroxyapatite ( nHAP) associated with photobiomodulation (PBM) in the control of dentin hypersensitivity (DH). (C-Shape It). METHODS: 32 subjects with 83 hypersensitive teeth were randomized into four groups (N =8) : GPlacebo - simulated PBM (without light emission) followed by the application of nHAP-free toothpaste; GLaser - PBM followed by the application of nHAP-free toothpaste; GnHAP - simulated PBM followed by the application of nHAP; GLasernHAP - PBM followed by the application of nHAP. A visual analogue scale (VAS) was used to measure DH after a tactile and evaporative stimulus. DH evaluations were performed at four times: baseline, 1st, and 2nd treatment sessions, and 1 month. A questionnaire was used to evaluate the risk factors associated with DH intensity. Mixed-design ANOVA followed by Tukey test and logistic regression were used. RESULTS: The mechanical stimulus showed a significant reduction in DH in all experimental groups (P< 0.05) at the 2nd treatment session. For the evaporative stimulus, the GLasernHAP group presented a significant reduction in DH at the 1st treatment session (P< 0.05). Intragroup analysis showed that only the GnHAP group showed regression of DH at 1 month for the two applied stimuli. The variables of parafunctional habits, diets rich in acidic drinks and anxiety had significant relationships with the intensity of DH (P< 0.05). CLINICAL SIGNIFICANCE: The use of nHAP and application of PBM to laser are effective in the control of dentin hypersensitivity. However, their association did not enhance the desensitizing effect.

Chemical and Mechanical Properties of Experimental Dental Composites as a Function of Formulation and Postcuring Thermal Treatment.

This study evaluated the influence of formulation and thermal treatment on the degree of conversion, fracture toughness, flexural strength, and elastic modulus of experimental composites. Six composites were analyzed at BisGMA : TEGDMA molar ratios of 1 : 1 and 7 : 3 with filler at 30, 50, and 70 wt%. The degree of conversion was analyzed by Fourier transform infrared spectroscopy, fracture toughness was measured using the single-edge notched beam, and flexural strength and elastic modulus were measured with the 3-point bend test. For all tests, one-half of the specimens received thermal treatment at 170°C for 10 min. Data were analyzed by the Kruskal-Wallis or ANOVA/Tukey's test (α = 5%). The 1 : 1 BisGMA : TEGDMA ratio showed higher properties than the 7 : 3 ratio. Although the material with 70% filler had a conversion lower than the one with 50%, it showed higher mechanical properties. The thermal treatment improved all properties in all materials. Therefore, the use of an equimolar ratio of BisGMA : TEGDMA can be paired with 70 wt% filler to design dental composites that possess increased advantageous physical and chemical properties. Furthermore, the simple and low-cost method of thermal treatment proposed for use in clinical dentistry has been shown to effectively improve the properties of all evaluated materials.

In situ Effect of Nanohydroxyapatite Paste in Enamel Teeth Bleaching.

AIM: Evaluate in situ the effect of nanohydroxyapatite paste (nano-HAP) before bleaching with hydrogen peroxide 35% (HP35%) by ion chromatography (IC) Knoop hardness number (KHN) and tristimulus colorimetry (TC). MATERIALS AND METHODS: A total of 60 fragments were obtained from third molars included (3 mm × 3 mm × 3 mm) and the specimens were divided into three groups (n = 20): Gas chromatography (CG) (negative control group) = no bleaching; HP35% (positive control group) = HP35% whitening (whiteness HP35%); nano-HAP = application for 10 minutes before bleaching treatment + HP35%. The specimens were fixed to the volunteers' molars. The KHN and TC were measured before and after bleaching. For IC, the dentin layer was removed, leaving the enamel that was crushed, and autoclaved for chemical quantification (calcium, fluorine, and phosphorus). The results of KHN and TC were analyzed statistically by analysis of variance (ANOVA) followed by Tukey test (p < 0.05). RESULTS: The HP35% group showed reduction of the Ca, F, and P ions. The initial and final KHN mean of the CG and nano-HAP did not differ statistically; however, the group of HP35% did differ statistically. The mean ΔE of the HP35% and nano-HAP groups did not differ statistically from each other. However, they differed from the CG. CONCLUSION: The nano-HAP paste preserved the KHN, promoted the lower loss of Ca and P ions and an increase of F ions when compared with the CG, but did not influence the effectiveness of the bleaching treatment. CLINICAL SIGNIFICANCE: Nano-HA is a biomaterial that has shown positive results in the prevention of deleterious effects on the enamel by the action of the office bleaching treatment.

Effects of Internal Bleaching on the Adhesion of Glass-Fiber Posts.

OBJECTIVE: We evaluated the effects of internal bleaching on the adhesion of glass-fiber posts (GFPs) luted with different resin cements. METHODS: Forty extracted human single-root teeth were endodontically treated and divided into four groups (n=10): G1- conventional resin cement (CRC); G2- self-adhesive resin cement (SARC); G3- bleaching + CRC; and G4- bleaching + SARC. Specimens were sectioned transversally into three slices to perform the push-out test at the coronal, middle and apical regions of the root canals. Data were analyzed using analysis of variance and Tukey's test (p<0.05). RESULTS: The push-out bond strength of GFPs luted with SARC after bleaching (G4) was significantly lower than that of the other groups (p<0.001). We found no statistically significant differences in push-out bond strength among the other groups. SIGNIFICANCE: Internal bleaching reduced the adhesion of GFPs luted with SARC. The adhesion of GFPs luted with CRC was not decreased after bleaching.

Effect of fluoride gels on microhardness and surface roughness of bleached enamel.

The effect of bleaching treatments containing added calcium and combined with neutral or acidic fluoride gels on tooth enamel was investigated in vitro through Knoop microhardness (KHN) and surface roughness (SR) measurements. A total of 60 bovine incisors were tested, including 30 for SR measurements and 30 for KHN measurements. The specimens were divided into 12 groups and subjected to a bleaching agent with hydrogen peroxide 35% (Whiteness HP 35% Maxx, FGM) or hydrogen peroxide 35% with calcium (Whiteness HP 35% Blue Calcium, FGM) and a fluoride treatment flugel acidulated phosphate fluoride (APF) or flugel neutral fluoride (NF). Control specimens were submitted to bleaching treatments without fluoride. Microhardness tests were performed using a Knoop indentor. Roughness measurements were obtained using a roughness analyzer. Measurements were obtained before and after treatment. The specimens were stored in distilled water at 37 °C between treatments. The results were analyzed using descriptive and inferential statistics. Treatments using APF combined with 35% HP caused a decrease in microhardness, while NF combined with HP 35% Ca increased the enamel hardness. Fluoride gels did not alter the SR of the bleached enamel.