Impact of tooth mineral tissues genes on dental caries: A birth-cohort study.

OBJECTIVE: We aimed to investigate whether Single Nucleotide Polymorphisms present in the genes of tooth mineral tissues influence dental caries trajectory across the life course, and if there is an epistatic (gene-gene) interaction between these SNPs. METHODS: A representative sample of all 5,914 births from the 1982 Pelotas birth cohort study was prospectively investigated. Dental caries trajectory across the life course was assessed at 15(n = 888), 24(n = 720), and 31 years old(n = 539). Group-based trajectory modeling was used to identify distinct subgroups of individuals whose caries measurements followed a similar pattern over time. Genetic material was collected, and individuals were genotyped [rs4970957(TUFT1), rs1711437(MMP20), rs1784418(MMP20), rs2252070(MMP13), rs243847(MMP2), rs2303466(DLX3), rs11656951(DLX3), rs7501477(TIMP2), rs388286(BMP7), and rs5997096(TFIP11)]. Analyzes were performed for allele and genotype using logistic regression and generalized multifactor dimensionality reduction for epistatic interactions. RESULTS: The analyses included 678 individuals, those with allele C (OR=0.74, CI95%[0.59-0.92]), genotype CC in the additive effect (OR=0.52, CI95%[0.31-0.89]), and the genotype TC/CC in dominant effect (OR=0.72, CI95%[0.53-0.98]) on the rs243847(MMP2) were associated with low caries trajectory. Individuals with the allele T (OR=0.79, CI95%[0.64-0.98]) and the genotype TC/CC in dominant effect (OR=0.66, CI95%[0.47-0.95]) on the rs5997096(TFIP11) were associated with low caries trajectory. Positive epistatic interactions were observed involving two (MMP2 and BMP7; p = 0.006) and three (TUFT1, MMP2, and TFIP11; p<0.001) loci and high caries trajectory. CONCLUSIONS: Some SNPs present in the genes of tooth mineral tissues were associated with caries trajectory and epistatic interactions increasing the network of SNPs involved in individual caries experience. CLINICAL SIGNIFICANCE: Single nucleotide polymorphisms in the pathway of tooth mineral tissues genes may contribute significantly to the individual caries experience across the life course.

Iodonium salt incorporation in dental adhesives and its relation with degree of conversion, ultimate tensile strength, cell viability, and oxidative stress.

OBJECTIVE: The aim of this study was to evaluate the degree of conversion, ultimate tensile strength, cell viability, and oxidative stress of two different ternary initiation systems, using two photoinitiation polymerization times. METHODS: The groups investigated were camphorquinone (CQ); CQ and diphenyleneiodonium hexafluorophosphate (DPI); CQ and ethyl 4-dimethylamine benzoate (EDAB); and CQ, EDAB, and DPI, with EDAB in high and low concentration. To assess the degree of conversion (DC) and the ultimate tensile strength (UTS), a real-time Fourier transform infrared spectroscopy and a universal test machine Emic DL-500 were used, respectively. Cell viability and oxidative stress were evaluated by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide), superoxide dismutase (SOD), total sulfhydryl (SH) content, and thiobarbituric acid reactive species (TBARS) formation assays. RESULTS: Slight lower cell viability was shown when DPI was associated with high concentrations of EDAB; this reduction seemed to be attenuated when lower concentrations of EDAB were used. When EDAB and DPI were associated, no oxidative damage was shown. The degree of conversion was increased in the ternary systems (CQ + EDAB lower concentration + DPI) group, which did not affect the UTS, cytotoxicity, and oxidative stress parameters. The polymerization time did not affect cell viability, total SH, and TBARS; however, a slight increase was shown in SOD levels. CLINICAL RELEVANCE: Our study emphasizes the relevance of incorporating the third element-iodonium salt-in a binary adhesive systems composed exclusively of CQ and EDAB.

Replacement of maxillary incisor crowns over discolored substrates in a single visit with a CAD-CAM system and lithium silicate ceramic.

Discolored substrates constitute a challenge to the esthetics of the definitive restoration. Because of technique sensitivity, the generally prolonged treatment time is a drawback to both the patient and the dentist. The technique described presents the replacement of ceramic maxillary incisors crowns over discolored substrates in a single visit by using a milling machine. Translucent blocks of a lithium silicate ceramic reinforced with zirconium dioxide particles were used. Intraoral scans of the trial restorations and of the tooth preparations were performed. The crown parameters were defined in the software. Ceramic blocks were milled in the presintered phase and characterized. The crowns were cemented at the end of the appointment with excellent esthetics.

Development of a dual-cure mineral trioxide aggregate-based cement: Biological, physical, and mechanical properties.

PURPOSE: The purpose of this study is to compare the physical, mechanical, and biocompatibility properties of a new dual-cure white mineral trioxide aggregate (D-W-MTA) and a commercial W-MTA. MATERIALS AND METHODS: Diametral tensile strength (DTS), water sorption (WSp), and water solubility (WSl) tests were performed. Cytotoxicity was observed in primary culture of human pulp fibroblasts (HPFs) and mouse 3T3/NIH fibroblast lineage. Specimens of both materials were embedded in 1 mL of Dulbecco's modified essential medium for 24 h. Cells were incubated for 24 h with the eluates. Cytotoxicity was evaluated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and genotoxicity by micronucleus (MN) formation. Data were analyzed by ANOVA and Kruskal-Wallis tests considering P < 0.05. RESULTS: D-MTA and W-MTA not showed cytotoxic effect on the two cell lines. However, D-MTA stimulated HPF growth. The MN count was similar to that of the control group for D-MTA and W-MTA. D-MTA presented lower DTS and WSl. Nevertheless, WSp was similar in the two groups. CONCLUSION: The results suggest that D-MTA is a promising material for pulp capping. Thus, in vivo tests should be performed to evaluate the performance of this material.

Providing a harmonious smile with laminate veneers for a patient with peg-shaped lateral incisors.

The most common discrepancy concerning tooth size is the presence of peg-shaped lateral incisors, which can cause teeth with reduced size, anterior diastema, and consequently an unpleasant smile. The development of the adhesive dentistry and ceramic veneers allowed all ceramic-bonded restorations to become an esthetic and functional approach to reestablish the smile harmony. The purpose of this clinical report is to describe a conservative treatment approach to recover an esthetic disharmony caused by bilateral peg-shaped lateral incisors. A 30-year-old female patient was seeking treatment to solve an esthetic disharmony of her smile. Lithium disilicate veneers were planned and build-up with the help of diagnostic models, wax-up, mock-up, and silicone guides, to restore the morphology, size, function, and esthetic of upper lateral incisors and smile. The lithium disilicate veneers were able to provide the harmonization of the patient's smile, recovering the teeth size, shape, and anatomic characteristics.

Push-out bond strength of different translucent fiber posts cemented with self-adhesive resin cement.

PURPOSE: Evaluate the bond strength of different translucent fiber posts in the cervical, middle, and apical root thirds cemented with self-adhesive resin cement. MATERIALS AND METHODS: Sixty single-rooted teeth were randomly divided into five groups according to the fiber post used: Reforpost (opaque [control]), exacto, white post, radix, and Macro-Lock Illusion X-RO. The roots were subjected to chemomechanical preparation and cemented with self-adhesive resin cement. The teeth were sectioned into slices of the different root thirds and tested for bond strength (push-out). Two-way analysis of variance and Bonferroni test were used to verify statistical differences between groups (P < 0.05). RESULTS: No significant difference between the root thirds was detected (P > 0.05). However, the performance of the posts demonstrated a significant difference (P < 0.05). RDX had a lower performance in the apical third (P < 0.05). The other fiber posts had the same performance irrespective of the root third evaluated. The predominant failure pattern was adhesive between resin cement and root dentin. CONCLUSION: In general, the different translucent fiber posts showed the same performance. Yet, translucent fiber posts did not show superior bond strength compared with the opaque fiber post in any of the root thirds evaluated.

Experimental self-etching HEMA-free adhesive systems: cytotoxicity and degree of conversion.

The aim of this study was to evaluate the effect of replacing 2-hydroxyethyl methacrylate (HEMA) by methacrylate surfactant monomers on the cytotoxicity and degree of conversion of two-step self-etching dentin adhesive systems. Five HEMA-free adhesive systems were tested: Bis-EMA 10, Bis-EMA 30, PEG400, PEG400UDMA, PEG1000, and a HEMA group was used as positive control. The cytotoxicity of the experimental primers, with different monomer concentrations (2 or 20 wt%), and bond resins, containing 25 wt% surfactant, was assessed using murine fibroblast cell line 3T3 and the tetrazolium assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)). The degree of conversion of the bond resins was analyzed using Fourier transform infrared spectroscopy. The data were submitted to statistical analysis using level of significance set at P < 0.05. The PEG 1000 group obtained higher cell viability in comparison with HEMA in the 2 % primer. The cell survival rate using 20 % primer showed that PEG1000 and BIS-EMA 10 were less cytotoxic than HEMA. With regard to the eluate from bond resin, the data showed that the groups BIS-EMA 10, BIS-EMA 30 and PEG400UDMA were less cytotoxic than HEMA. No statistically significant difference was found among degrees of conversion of the experimental groups and HEMA. PEG 1000, BIS-EMA 10 and 30 monomers showed the biological potential for use in new adhesive system formulations since they showed lower cytotoxicity and similar degree of conversion when compared with the HEMA-containing group.

Characterization of morphology and composition of inorganic fillers in dental alginates.

Energy dispersive X-ray spectroscopy microanalysis (EDX), scanning electron microscopy (SEM), and Archimedes' Principle were used to determine the characteristics of inorganic filler particles in five dental alginates, including Cavex ColorChange (C), Hydrogum 5 (H5), Hydrogum (H), Orthoprint (O), and Jeltrate Plus (JP). The different alginate powders (0.5 mg) were fixed on plastic stubs (n = 5) and sputter coated with carbon for EDX analysis, then coated with gold, and observed using SEM. Volume fractions were determined by weighing a sample of each material in water before and after calcining at 450(°)C for 3 h. The alginate materials were mainly composed of silicon (Si) by weight (C-81.59%, H-79.89%, O-78.87%, H5-77.95%, JP-66.88%, wt). The filler fractions in volume (vt) were as follows: H5-84.85%, JP-74.76%, H-70.03%, O-68.31%, and C-56.10%. The tested materials demonstrated important differences in the inorganic elemental composition, filler fraction, and particle morphology.

Preparation, modification, and characterization of alginate hydrogel with nano-/microfibers: a new perspective for tissue engineering.

We aimed to develop an alginate hydrogel (AH) modified with nano-/microfibers of titanium dioxide (nfTD) and hydroxyapatite (nfHY) and evaluated its biological and chemical properties. Nano-/microfibers of nfTD and nfHY were combined with AH, and its chemical properties were evaluated by FTIR spectroscopy, X-ray diffraction, energy dispersive X-Ray analysis, and the cytocompatibility by the WST-1 assay. The results demonstrate that the association of nfTD and nfHY nano-/microfibers to AH did not modified the chemical characteristics of the scaffold and that the association was not cytotoxic. In the first 3 h of culture with NIH/3T3 cells nfHY AH scaffolds showed a slight increase in cell viability when compared to AH alone or associated with nfTD. However, an increase in cell viability was observed in 24 h when nfTD was associated with AH scaffold. In conclusion our study demonstrates that the combination of nfHY and nfTD nano-/microfibers in AH scaffold maintains the chemical characteristics of alginate and that this association is cytocompatible. Additionally the combination of nfHY with AH favored cell viability in a short term, and the addition of nfTD increased cell viability in a long term.

Tetrahydrofuran as solvent in dental adhesives: cytotoxicity and dentin bond stability.

OBJECTIVES: The aim of this study was to investigate the cytotoxicity and 1-year dentin bond stability of solvated etch-and-rinse dental adhesives based on tetrahydrofuran (THF), acetone, or ethanol, containing water or not. MATERIALS AND METHODS: Seven primers were prepared using the following solvents: THF, acetone, ethanol, water, THF/water, acetone/water, and ethanol/water. Bovine dentin was used, and specimens for microtensile bond strength (µTBS) test were prepared. Specimens were tested after storage in distilled water for 24 h or 1 year. Cytotoxicity of the solvents was evaluated in 3T3/NIH mouse fibroblasts using a colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay after exposure for 24 h. RESULTS: No significant differences were detected among solvents after storage for 24 h, except for the water-based group, which showed the lowest µTBS values. After storage for 1 year, the THF-based adhesive system resulted in more stable bonds. Yet, THF showed an intermediate cytotoxicity when compared with the other solvents, being less toxic than phosphate monomer and similar to 2-hydroxyethyl methacrylate. CONCLUSION: THF seems to be a suitable solvent for adhesive systems. CLINICAL RELEVANCE: THF is a promising solvent that can be used to improve dentin bond stability.

Effects of long-term water storage on the microtensile bond strength of five experimental self-etching adhesives based on surfactants rather than HEMA.

OBJECTIVES: The purpose of this study is to evaluate the hypothesis that replacing 2-hydroxyethyl methacrylate (HEMA) for surfactant dimethacrylates (SD) does not affect the immediate and long-term microtensile bond strength (µTBS) of experimental two-step self-etch HEMA-free adhesive systems applied on dentin. MATERIALS AND METHODS: Five experimental HEMA-free two-step self-etching systems containing different SD (ethoxylated bisphenol A diglycidyl dimethacrylate (Bis-EMA 10, B10), Bis-EMA 30 (B30), poly-ethyleneglycol (400) dimethacrylate (PEG 400, P400), PEG 1000 (P1000), and PEG 400 urethane dimethacrylate (UDMA) (UP400)) and a HEMA-containing system (control) (HA) were formulated. Specimens were subjected to the µTBS test after 24 h and 6 and 12 months of storage. Data (in megapascals) were analyzed by Kruskal-Wallis and Dunn tests (α = 0.05). RESULTS: Medians of the µTBS data after 24 h of storage are: HA = 57.2(A), B10 = 26.2(BC), B30 = 24.0(C), P400 = 32.6(BC), P1000 = 37.3(B), and UP400 = 57.9(A); after 6 months are: HA = 47.9(A), B10 = 18.5(B), B30 = 7.8(C), P400 = 16.1(B), P1000 = 14.6(BC), and UP400 = 51.6(A); and after 12 months are: HA = 31.2(A), B10 = 15.2(B), B30 = 9.0(B), P400 = 9.1(B), P1000 = 13.3(B), and UP400 = 35.7(A). Between the HEMA-free groups, the adhesive system formulated with PEG 400 UDMA produced similar µTBS to the HEMA-containing group. Also, the storage of specimens decreased the µTBS (p < 0.05). CONCLUSION: Replacing HEMA for PEG 400 UDMA in an adhesive system formulation generated a satisfactory µTBS to dentin. CLINICAL RELEVANCE: Surfactant dimethacrylates have a potential use in the development of HEMA-free self-etching adhesive systems, which are more chemically stable.

Nano-/microfiber scaffold for tissue engineering: physical and biological properties.

Alginate hydrogel (AH) has intrinsic physical and biological limitations that hinder its broader application in tissue engineering. We hypothesized that the inclusion of nanofibers in the hydrogel and the use of a biotemplate that mimics nature would enhance the translational potential of alginate hydrogels. In this study, we have shown a method to obtain nano-/microfibers of titanium (nfTD) and hydroxyapatite (nfHY) using cotton as a biotemplate. These fibers were incorporated in the alginate hydrogel and the mechanical characteristics and biological response to these reinforced materials were evaluated. We observed that these nanofibers resembled the structure of natural collagen and did not mediate cell toxicity. The incorporation of nfTD or nfHY to the AH has not increased the viscosity of the hydrogel. Therefore, this is a feasible method to produce a scaffold with improved physical characteristics, while at the same time generating an enhanced environment for cell adhesion and proliferation.

Addition of zinc methacrylate in dental polymers: MMP-2 inhibition and ultimate tensile strength evaluation.

This study evaluated the effect of zinc methacrylate (ZM) on the inhibition of matrix metalloproteinase 2 (MMP-2) and the ultimate tensile strength (UTS) of an experimental polymer. Enzymes secreted from mouse gingival tissues were analyzed by gelatin zymography in buffers containing 5 mM CaCl(2) (Tris-CaCl(2)) in 50 mM Tris-HCl buffer with various concentrations of ZM (0.5, 1, 2, 4, 8, and 16 mM). The matrix metalloproteinases present in the conditioned media were characterized by immunoprecipitation. The polymer UTS evaluation was performed in eight groups with various concentrations of ZM (0, 0.5, 1, 2.5, 5, 10, 20, and 30 wt.%), in a mechanical testing machine. MMP-2 (62 kDa) was detected in the zymographic assays and inhibited by ZM in all tested concentrations. UTS data were submitted to one-way ANOVA and Tukey's test (α = 0.05), and no significant differences were observed among groups, except in the polymer containing 30% ZM, presenting a significantly lower value when compared with the control group (p < 0.05). The results suggest that ZM inhibits MMP-2 expression in all concentrations tested, while small concentrations did not affect the ultimate tensile strength of the polymer. Zinc methacrylate is a metalloproteinase inhibitor that can be copolymerized with other methacrylate monomers. Yet, the addition of ZM did not affect the resin bond strength. Thus, in vivo tests should be performed to evaluate the performance of this material.

Bond strength of HEMA-containing versus HEMA-free self-etch adhesive systems to dentin.

This study analyzed the bond strength (BS) of HEMA versus HEMA-free self-etch adhesive systems to dentin. The occlusal surface of 20 third molars was removed and the dentin was abraded with 600-grit silicon carbide paper. The teeth were randomly assigned to 4 groups (n = 5) and restored with GO, Adper SE Plus, OptiBond All-In-One, and Clearfil 3S Bond adhesive systems and Filtek Z350 composite. After light curing (600 mW/cm²), the teeth were stored in distilled water at 37 ºC for 24 h and were sectioned in the mesiodistal and buccolingual directions to obtain sticks (0.8 mm²). The sticks were subjected to tensile force using a universal testing machine (0.5 mm/min), and the modes of failure were analyzed by scanning electron microscopy and classified as adhesive, cohesive, or mixed. The BS data (in MPa) were treated using one-way ANOVA and Tukey's tests at 5% significance. GO presented the lowest mean bond strength value (10.57 ± 3.72) and differed significantly from the other materials (p = 0.001), which, in turn, presented statistically similar results (p>0.05) among themselves: Adper SE Plus (29.08 ± 8.93), OptiBond All-In-One (28.36 ± 6.49), and Clearfil 3S Bond (28.62 ± 6.97). Mixed fractures were the most prevalent. It was concluded that the influence of HEMA on BS to dentin was material dependent.

Characterization of an antimicrobial dental resin adhesive containing zinc methacrylate.

This study evaluates the effect of zinc methacrylate (ZM) on the degree of conversion (DC), cytotoxicity and antimicrobial activity (AA) of an experimental resin. Tetraethyleneglycol dimethacrylate was used as the experimental resin and it was photo activated using camphoroquinone and ethyl 4-dimethylamine benzoate. Additionally, 1.0, 2.5, 5.0, 10, 20 and 30 wt% of ZM was added to the various experimental resins. The DC was accessed by Fourier Transform infrared spectroscopy. For cytotoxicity, immortalized mouse fibroblasts were exposed to the experimental resin extracts. An MTT assay was used to access the cytotoxicity. The AA against Streptococcus mutans UA159 was accessed by the agar diffusion method. An improvement in the DC in all concentrations of ZM was observed. The greater the amount of ZM on the experimental resin, the less the cytotoxicity was provoked. Three ZM concentrations showed AA that exhibited various inhibition growth zones with 10, 20 (10 mm) and 30 wt% (15 mm).

A new approach in self-etching adhesive formulations: replacing HEMA for surfactant dimethacrylate monomers.

This study evaluated the influence of surfactant dimethacrylates (SD) on the resin-to-dentin microtensile bond strength (µTBS) and characterized the interfacial micromorphology of the hybrid layer of the experimental HEMA-free self-etching systems. Five experimental HEMA-free two-step self-etching systems containing different SD (Bis-EMA 10, Bis-EMA 30, PEG 400, PEG 1000, and PEG 400 UDMA) and a HEMA-containing system (control) were compared. Each experimental adhesive system was applied and resin composite restorations were incrementally built up in bovine incisors. After 24 h, restored teeth were sectioned to obtain 24 sticks per group. Thereafter, the specimens were subjected to the µTBS test. Data (MPa) were analyzed by One-way ANOVA and Tukey's test. Adhesive-dentin interfaces were analyzed through Scanning Electron Microscopy (SEM). The adhesive system formulated with PEG 400 UDMA produced µTBS similar to the HEMA-containing group and statistically higher than the HEMA-free groups. Similar failure percentages were observed in the PEG 400 UDMA and the control group. In the SEM analysis, all the adhesive systems presented similar partially demineralized hybrid layer (1.5-3.0 µm thickness) with well-formed resin tags. All SD presented reasonable initial µTBS, with the PEG 400 UDMA being a promising monomer to be considered as a HEMA substitute in adhesive systems compositions.

Inhibition of the activity of matrix metalloproteinase 2 by triethylene glycol dimethacrylate.

The aim of this study was to evaluate the effect of different concentrations of triethylene glycol dimethacrylate (TEGDMA) on the inhibition of matrix metalloproteinase 2 (MMP-2). Mouse gingival explants were cultured overnight in DMEM and the expression of secreted enzymes was analyzed by gelatin zymography in buffers containing 5 mM CaCl(2) (Tris-CaCl(2)) in 50 mM Tris-HCl buffer with the addition of TEGDMA at different concentrations (0.62%, 1.25%, 2.5%, or 5.0% (v/v)). The gelatinolytic proteinase present in the conditioned media was characterized as matrix metalloproteinase by means of specific chemical inhibition. The matrix metalloproteinases present in the conditioned media were characterized as MMP-2 by immunoprecipitation. The eletrophoretic bands were scanned and the transmittance values were analyzed. Data was plotted and submitted to linear regression to investigate MMP-2 inhibition as a function of TEGDMA concentration. Three major bands were detected in the zymographic assays. These bands were characterized as MMP-2. Zymogene (72 kDa), intermediate (66 kDa) and active forms of MMP-2 (62 kDa) were inhibited by TEGDMA in a dose-dependent way. These findings suggest that TEGDMA could inhibit MMP-2 expression even at small concentrations.

Shrinkage stress of three composites under different polymerization methods.

The aim of this study was to evaluate the shrinkage stress of three composites under different polymerization methods: halogen conventional polymerization (G1), halogen "soft-start" polymerization (G2) and LED polymerization (G3). The composites tested were Filtek Z-100 (3M/ESPE), Filtek Z-250 (3M/ESPE) and Solitaire 2 (Heraeus Kulzer). For G1, an XL-3000 (3M/ESPE) curing unit with light intensity of 507 mW/cm2 was employed. In G2, the same light unit was used, but with a reduced light intensity in the first 20 s (166 mW/cm2). In G3, an Ultrablue I (DMC) LED curing unit with light intensity of 125 mW/cm2 was used. The test was performed with a DL 2000 (EMIC) universal testing machine and two metallic molds with a 1 mm space between them. The composites were inserted in the space between the molds and light cured according to the protocols mentioned above. Stress was registered in different periods of time: 10, 20, 40, 60, 90 and 120 s. A significant linear increase of the shrinkage stress over time was observed, except for Z-100 in G2. Generally, LED polymerization (G3) reduced the generated stress when compared to conventional halogen polymerization (G1). In G3, the composite with the additional co-initiator presented lower stress when compared to the other composites tested. The combination between composite and polymerization method produced different patterns of stress behavior. LED polymerization reduced the initial shrinkage stress of the three materials and was influenced by the presence of co-initiators in the composites.