Case Reports of Enamel Microabrasion Associated with At-home Dental Bleaching After Orthodontic Bracket Removal.

Adequate removal of residual bonded materials from the enamel surface after orthodontic bracket debonding is critical, since any remaining composite may compromise enamel surface morphology and esthetics. The following clinical case reports present the association of at-home dental bleaching using 10% carbamide peroxide and the removal of residual bonded material using a super fine, tapered diamond bur followed by the use of an enamel microabrasion product after orthodontic bracket debonding. The proposed treatment considerably improved the esthetics and successfully removed the grooves created during the removal of the bonding composite, resulting in a smooth enamel surface.

Enamel Microabrasion and Dental Bleaching on Teeth Presenting Severe-pitted Enamel Fluorosis: A Case Report.

The present clinical case report describes the clinical steps of enamel microabrasion associated with dental bleaching to restore severely-pitted fluorosed teeth. The process of removing the fluorotic superficial stains started by using macroabrasion with a water-cooled fine tapered 3195 FF diamond bur. Rubber dam isolation of the operative field was used to remove the remaining enamel stains and superficial irregularities with the Opalustre microabrasive compound (6.6% hydrochloric acid associated with silicon carbide particles) followed by polishing using fluoridated paste and subsequent 2% neutral fluoride gel topical application. After one month, dental bleaching was performed using 10% carbamide peroxide in custom-formed acetate trays for two hours/day for 42 days. The association of enamel microabrasion with dental bleaching was effective for reestablishing the dental esthetics of a patient with severe dental fluorosis.

Home Dental Bleaching Monitored With Microelectronic Sensors to Record the Wearing Times of an Acetate Tray/Bleaching Product.

The present case study quantifies the clinical wearing time of an acetate tray/bleaching product during home dental bleaching. The patient was instructed to use a 10% carbamide peroxide gel for 6-8 hours each day for 20 days. The wearing time of the tray was measured by a microsensor from TheraMon microelectronic system (Sales Agency Gschladt, Hargelsberg, Austria) completely embedded in the tray so that the clinician would be informed as to the precise time the tray was placed in the mouth. Evaluation of the daily printout during dental bleaching demonstrated that the patient did not correctly follow the clinician's instructions as to the wearing time of the tray. Recording the wearing time of dental bleaching agents can be beneficial for both dental professional and patient to obtain a more effective treatment according to the patient's needs and expectations.

Clinical/Photographic/Scanning Electron Microscopy Analysis of Pit and Fissure Sealants After 22 Years: A Case Series.

Pit and fissure sealant is a clinical technique adopted to prevent caries lesion development. Ionomeric and/or resin-based materials are commonly used for this purpose. This article presents a case series of sealed teeth with 22-year follow-up evaluated by clinical, photographic, and microscopic analysis. In 1992, sixteen patients (9-14 years of age) had at least three teeth sealed with one of the following materials: resin-modified glass ionomer cement (RMGIC, Vitrebond or Fuji II LC) or polyacid-modified resin composite (PMRC, VariGlass VLC), totaling 86 sealed permanent teeth. After 22 years, 10 patients were recalled, representing 41 teeth. The retention of sealants was assessed by three methods: clinical analysis by visual inspection; photography; and scanning electron microscope (SEM) images and classified as retained (pits and fissures filled by sealant material); partially retained (pits and fissures partially filled by sealant material); or totally lost (no material was found in pits and fissures). The SEM images provided a higher number of retained sealants when compared with the clinical and photographic evaluations. Also, no totally lost scores were found with SEM analysis, regardless of the sealing material. No caries lesions were found. A fully or partially retained sealant in pits and fissures was capable of preventing caries lesions after 22 years within the patient pool analyzed.

Treatment of Enamel Surfaces After Bracket Debonding: Case Reports and Long-term Follow-ups.

After bracket debonding, residual bonded material may be observed on the enamel surface. When not properly removed, this residual material can interfere with the surface smoothness of the enamel, potentially resulting in staining at the resin/enamel interface and contributing to biofilm accumulation. Clinical case reports demonstrate clinical procedures to remove residual bonded material after bracket debonding. A water-cooled fine tapered 3195 FF diamond bur was used to remove the residual bonded material. Subsequently, the enamel surface was treated with Opalustre microabrasive compound. After one week, overnight dental bleaching was initiated using 10% carbamide peroxide in custom-formed trays for four weeks. The enamel microabrasion technique was found to be effective for polishing the enamel surface and for reestablishing the dental esthetics associated with dental bleaching. Longitudinal clinical controls of other clinical cases are presented.

Accomplishing esthetics using enamel microabrasion and bleaching-a case report.

This case report describes the sequential steps that were used to treat unesthetic, white, hard-texture enamel stains of unknown etiology. A tapered fine diamond bur was used to remove superficial enamel followed by the use of an enamel microabrasion compound Opalustre (Ultradent Products Inc). This technique removed the stains and was followed by polishing with a fluoride paste to restore the enamel to a smooth finish. The teeth were subsequently bleached with carbamide peroxide (Opalescence 10%, Ultradent Products), which achieved the patient's desired esthetic results.

Effect of sodium ascorbate on dentin bonding after two bleaching techniques.

The purpose of this study was to analyze the influence of 10% sodium ascorbate (SA) on the hybrid layer, resin tag length, and bond strength to dentin after bleaching. Six groups were tested: G C, control; G SA, sodium ascorbate (SA) + restoration; G CP, bleaching with carbamide peroxide (CP) + restoration; G CP+SA, bleaching with CP + SA+ restoration; G HP, bleaching with 35% hydrogen peroxide (HP) + restoration; and G HP+SA, HP + SA + restoration. After dental bleaching, the dentin was exposed and the antioxidant solution was applied to groups G SA, G CP+SA, and G HP+SA, before bonding procedures. The teeth were sectioned in the mesiodistal direction. One section was decalcified, and the specimens were embedded in paraffin and sectioned in the longitudinal direction with a thickness of 6 µm. Fifteen slices of each specimen were selected according to a systematic sample of slices with an interval proportional to the total number of slices obtained for each tooth. The specimens were stained using the Brown & Brenn method, and an optic microscope was used to analyze the hybrid layer thickness and resin tag length. The remaining tooth segment was sectioned into stick-shaped specimens and used for microtensile bond strength testing (0.5 mm/min). Statistical analysis was performed using two-way analysis of variance and Fisher test. The results for hybrid layer + tag formation (in micrometers) were G C, 13.27 Aa; G SA, 11.85 Ba; G CP, 6.84 Bb; G CP+SA, 9.02 Ab; G HP, 7.28 Bb; and G HP+SA, 9.22 Ab; bond strength results (in MPa) were G C, 49.5 Aa; G SA, 51.7 Aa; G CP, 37.16 Bb; G CP+SA, 47.69 Aa; G HP, 32.39 Ab; and G HP+SA, 39.67 Ab. Tooth bleaching with CP or HP impairs the formation of the hybrid layer and resin tags and reduces the microtensile bond strength. Statistically, the use of SA significantly increases the hybrid layer thickness and resin tag length. The microtensile bond strength values for carbamide peroxide increased, but the microtensile bond strength for hydrogen peroxide was not affected.

One-year clinical evaluation of composite restorations in posterior teeth: effect of adhesive systems.

This clinical study assessed the performance of posterior composite resins applied with the Adper™ Single Bond Plus (SB) and Adper™ Scotchbond SE (SE) adhesive systems and Filtek™ Supreme Plus composite resin, using modified US Public Health Service criteria. A total of 97 restorations were placed in posterior teeth by two calibrated operators. Application of the materials followed manufacturers' instructions. The restorations were evaluated by two examiners at baseline and after one year. Statistical analyses were conducted using the proportion test at a significance level of 5% (p<0.05). All the restorations evaluated (ie, 100%) received an alpha rating for the criteria of marginal discoloration and marginal integrity at baseline. At one year, for marginal discoloration, 64.6% of SB and 61.2% of SE received an alpha rating. For marginal integrity, 72.9% of SB and 77.6% of SE received an alpha rating. The other restorations received bravo ratings for both criteria. None of the teeth that received the restorative systems presented caries lesions around the restorations. A total of eight teeth presented postoperative sensitivity one week after baseline, five with SB and three with SE; the symptom had disappeared one year later. One year later, composite resin restorations using either adhesive system showed satisfactory clinical performance.

Effect of hydrogen peroxide at 35% on the morphology of enamel and interference in the de-remineralization process: an in situ study.

This study evaluated the microhardness and histomorphology of bovine enamel when 35% hydrogen peroxide is used. A total of 44 specimens were adapted to removable devices used by 11 individuals subjected to dental caries challenge. A decrease in microhardness was observed for all groups after the cariogenic challenge. Microscopic analysis revealed that fragments subjected to cariogenic challenge associated with bleaching had more intense superficial histologic changes, but the depth of the lesions remained unchanged. It was concluded that 35% hydrogen peroxide enhanced the reduction in hardness and histomorphologic changes in the enamel surface exposed to cariogenic challenge.

Observation of tags and hybrid layer of a single bottle conventional adhesive system and a self-etching adhesive system, on sound dentin.

This experimental light microscopy study investigated the formation of a hybrid layer and resin tags on sound dentin, after utilization of conventional and self-etching adhesive systems. After restorative procedures, the specimens were decalcified in a formic acid and sodium citrate solution, embedded in paraffin, sectioned at 6-microm thickness and stained by the Brown & Brenn method for analysis and measurement by light microscopy (AXIOPHOT) (400x). The results were statistically analyzed by analysis of variance, at a significance level of 5%. Based on the results, it could be concluded that the conventional adhesive allowed the formation of a thicker hybrid layer than the self-etching adhesive, with similar penetration into the dentinal tubules (resin tags).

Observation of tags and hybrid layer of a single bottle conventional adhesive system and a self-etching adhesive system, on sound dentin / Avaliaþ§es em microscopia óptica comum da camada hibrida de adesÒo e dos prolongamentos resinosos (tags) em tecido dentinário hígido: efeitos de um sistema adesivo resinoso frasco único e de um autocondicionante

This experimental light microscopy study investigated the formation of a hybrid layer and resin tags on sound dentin, after utilization of conventional and self-etching adhesive systems. Afterrestorative procedures, the specimens were decalcified in a formic acid and sodium citrate solution, embedded in paraffin, sectioned at 6-ým thickness and stained by the Brown & Brenn method for analysis and measurement by light microscopy (AXIOPHOT) (400x). The results were statistically analyzed by analysis of variance, at a significance level of 5%. Based on the results, it could be concluded that the conventional adhesive allowed the formation of a thicker hybrid layer than the self-etching adhesive, with similar penetration into the dentinal tubules (resin tags).(AU)

Analisamos nesta pesquisa laboratorial/microscópica, o poder deformaþÒo da camada híbrida de adesÒo e dos prolongamentos resinosos (tags) em tecido dentinário hígido, empregando, para tanto, nesse substrato dental, um sistema adesivo convencional e outro autocondicionante. Após a realizaþÒo dos procedimentosrestauradores; os espécimes foram descalcificados em soluþÒo de ácido fórmico/citrato de sódio, incluídos em parafina, cortados a uma espessura de 6 micrometros, corados pelo método Brown & Brenn, para posteriormente, serem analisados e mensurados emmicroscopia óptica comum (AXIOPHOT) (400X). Após a coleta dos resultados, estes foram submetidos O análise estatística ANOVA, ao nível de 5%. De acordo com os resultados obtidospudemos concluir que o adesivo convencional possibilitou a formaþÒode uma camada híbrida de adesÒo mais espessa do que o adesivo autocondicionante e um mesmo nível penetraþÒo no interior do túbulo dentinário (Tags).(AU)

Observation of tags and hybrid layer of a single bottle conventional adhesive system and a self-etching adhesive system, on sound dentin / Avaliações em microscopia óptica comum da camada hibrida de adesão e dos prolongamentos resinosos (tags) em tecido dentinário hígido: efeitos de um sistema adesivo resinoso frasco único e de um autocondicionante

This experimental light microscopy study investigated the formation of a hybrid layer and resin tags on sound dentin, after utilization of conventional and self-etching adhesive systems. Afterrestorative procedures, the specimens were decalcified in a formic acid and sodium citrate solution, embedded in paraffin, sectioned at 6-ìm thickness and stained by the Brown & Brenn method for analysis and measurement by light microscopy (AXIOPHOT) (400x). The results were statistically analyzed by analysis of variance, at a significance level of 5%. Based on the results, it could be concluded that the conventional adhesive allowed the formation of a thicker hybrid layer than the self-etching adhesive, with similar penetration into the dentinal tubules (resin tags).

Analisamos nesta pesquisa laboratorial/microscópica, o poder deformação da camada híbrida de adesão e dos prolongamentos resinosos (tags) em tecido dentinário hígido, empregando, para tanto, nesse substrato dental, um sistema adesivo convencional e outro autocondicionante. Após a realização dos procedimentosrestauradores; os espécimes foram descalcificados em solução de ácido fórmico/citrato de sódio, incluídos em parafina, cortados a uma espessura de 6 micrometros, corados pelo método Brown & Brenn, para posteriormente, serem analisados e mensurados emmicroscopia óptica comum (AXIOPHOT) (400X). Após a coleta dos resultados, estes foram submetidos à análise estatística ANOVA, ao nível de 5%. De acordo com os resultados obtidospudemos concluir que o adesivo convencional possibilitou a formaçãode uma camada híbrida de adesão mais espessa do que o adesivo autocondicionante e um mesmo nível penetração no interior do túbulo dentinário (Tags).

Resin-based composite reinforced sealant.

PURPOSE: To describe and picture a technique for using a resin-bonded sealant reinforced by inclusion of resin-based composite, before polymerization. METHOD: Using an extracted mandibular molar, embedded in plaster and isolated with a rubber dam, a step-by-step depiction of the technique is shown. RESULTS: A picture of a six-year-old sealant in a first permanent molar, still in perfect condition, is shown. CONCLUSION: This technique offers a reliable method for treating pits and fissures.