Remineralization of caries-affected dentin and color stability of teeth restored after treatment with silver diamine fluoride and bioactive glass-ceramic.

OBJECTIVES: The aim of this study was to evaluate the microhardness of caries-affected dentin and color stability of teeth restored after treatments with silver diamine fluoride (SDF) associated to potassium iodide (KI) and Biosilicate. MATERIAL AND METHODS: Different samples from bovine teeth were obtained. For color readings, 80 cavities (6 mm × 6 mm × 2 mm) were prepared, and for microhardness, teeth were flattened into dentine to obtain 40 samples. All samples were submitted to cariogenic challenge and separated in 4 groups, according to the treatment used: 12% SDF + KI; 38% SDF; Biosilicate and control (no treatment). Cavities were restored with resin-modified glass-ionomer cement (RMGIC, Vitremer, 3 M ESPE) or composite resin (CR, Z350, 3 M ESPE). After restoration, the samples were submitted to thermo-mechanical cycling (TMC) for 1,200,000 cycles. Color readings (EasyShade, Vita) were performed after restorations, after TMC, and 30 days after TMC. Knoop microhardness was evaluated on the planned samples before and after cariogenic challenge, after treatments, and after 30 days. Scanning electron microscopy (SEM) evaluated the dentine surface after treatments. Data were analyzed (ANOVA, Bonferroni, p < .05). RESULTS: The results showed a higher color alteration for RMGIC than CR. The time of analysis was significant (p < .05) for the 12% SDF + KI and control group. There was no difference (p < .05) in microhardness between groups. However, there was evidence of dentin remineralization after treatments. CONCLUSIONS: It was concluded that the samples treated with Biosilicate resulted in a color alteration similar to control. The treatments presented dentin remineralizing potential for microhardness, below the demineralization level, caused by the cariogenic challenge. CLINICAL RELEVANCE: Considering the remineralizing potential presented by Biosilicate, this agent is a promising alternative that overcomes the SDF adverse effects such as tooth staining.

Over-the-counter bleaching agents can help with tooth whitening maintenance.

OBJECTIVE: This study evaluated the influence of over-the-counter agents on the maintenance of color and microhardness of the enamel after home bleaching protocol. MATERIALS AND METHODS: Specimens of bovine teeth (6 × 6 × 2 mm) were prepared, and color (Easyshade, VITA) and microhardness (HMV-2, Shimadzu) readings were performed. All the specimens were bleached using 22% carbamide peroxide (22%CP), except for the control group, and then separated into seven groups (n = 10) according to the interaction of toothpaste (whitening, conventional, and whitening with peroxide) and mouth rinse (whitening and conventional). The study simulated 1 year of toothbrushing (Pepsodent, MAVTEC) and mouth rinse by immersion. After that, final color and microhardness measurements were performed. Data were analyzed by one-way ANOVA, Tukey's test (P < .05). RESULTS: The group submitted to 22%CP + whitening toothpaste + whitening mouth rinse showed higher color maintenance (P < .05) than the control group. The perception of whitening of teeth (ΔWID ) was higher than the color change (ΔE00 ). There was a decrease in microhardness after treatment with 22%CP + conventional toothpaste + whitening mouth rinse. CONCLUSIONS: Over-the-counter products can help with the maintenance of tooth whitening after bleaching with carbamide peroxide; however, special attention should be given since the association of products can also reduce the microhardness of the dental enamel. CLINICAL SIGNIFICANCE: The association between whitening toothpastes and mouth rinses might be beneficial for maintaining color during 1 year after bleaching treatment.

Tooth discoloration induced by the different phases of a calcium aluminate cement: One-year assessment.

OBJECTIVES: To assess the discoloration of teeth treated with the different phases of calcium aluminate cement (CAC), in comparison with the conventional CAC and mineral trioxide aggregate (MTA). MATERIALS AND METHODS: Fifty bovine incisors were prepared and filled. Two millimeters of the filling was removed to fabricate a cervical plug with the following cements (n=10): CA(CaO.Al2 O3 ); CA2 (CaO.2Al2 O3 ); C12 A7 (12CaO.7Al2 O3 ); CAC and MTA. The initial color measurement was performed and after 7, 15, 30, 45, 90, 180, and 365 days new color measurements were performed to determine the color (ΔE00 ), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and the whiteness index (WID ). RESULTS: ΔE00 was significant for groups (p = 0.036) and periods (p < 0.05). The greater ΔE00 was observed after 365 days for CAC (12.8). C12 A7 (7.2) had the smallest ΔE00 . ΔL' and ΔC' were significant for groups and periods (p < 0.05). ΔH' was significant for periods (p < 0.05). After 365 days, significant reduction in lightness was observed for all groups. For CA, CA2 , CAC, and MTA groups, the WID values decreased over time (p < 0.05). CONCLUSIONS: The tested cements changed the color behavior of the samples, resulting in greater teeth darkening over time. CLINICAL SIGNIFICANCE: There is no long-term study assessing the discoloration induced by the different phases of CAC.

Color stability and surface roughness of composite resins submitted to brushing with bleaching toothpastes: An in situ study.

OBJECTIVE: To evaluate, in situ, the color stability (CS) and surface roughness (SR) of composite resins after toothbrushing with whitening toothpaste. MATERIALS AND METHODS: Specimens (6 × 2 mm/) of composite resin (Tetric N-Ceram, Z250 and Z350) were randomly fixed on thirty participants' upper molars (buccal surface). For an initial standardization (7 days), participants used a soft toothbrush and nonwhitening toothpaste (SDB - Sorrisos Dentes Brancos). Initial CS (Easyshade) and SR (Surfcorder RS) measurements were performed. For SR, impressions of specimens were taken (Express, 3 M ESPE) to produce replicas in polyurethane resin (Axon F16, Abcol). Participants were randomly separated into three groups (n = 10) regarding used toothpaste (SDB; Close up White Now - CWN; Colgate Luminous White - CLW). After 90 days, CS and SR measurements were obtained, and data were analyzed (2-way ANOVA, repeated measures, Bonferroni, P < .05). RESULTS: Z250 showed higher (P < .05) color change than Z350. Tetric N-Ceram presented an intermediary value for ΔE, however, it also demonstrated higher SR (P < .05) after brushing with CLW, compared with SDB and CWN. CONCLUSIONS: The SR change of composite resin after toothbrushing with a whitening toothpaste is material dependent, but the toothpaste abrasiveness does not change the CS. CLINICAL SIGNIFICANCE: Whitening toothpaste do not change the color stability of composites; however, it can alter the restorative composite surface roughness.

Randomized clinical study of alterations in the color and surface roughness of dental enamel brushed with whitening toothpaste.

OBJECTIVES: This clinical study evaluated the influence of whitening toothpaste on color and surface roughness of dental enamel. MATERIALS AND METHODS: Initially, the abrasiveness of the toothpastes used (Sorriso Dentes Brancos [SDB]; Colgate Luminous White and Close up White Now) was tested on 30 (n = 10) plexiglass acrylic plates that were submitted to mechanical tooth brushing totalizing 29,200 cycles. Subsequently, 30 participants were selected, and received a toothbrush and nonwhitening toothpaste (SDB). The participants used these products for 7 days and initial color readouts (Spectrophotometer) and surface roughness of one maxillary central incisors was performed after this period of time. For surface roughness readouts, one replica of the maxillary central incisor was obtained by a polyvinyl siloxane impression material (Express) and polyurethane resin. After baseline measurements, participants were separated into three groups (n = 10), according to the toothpaste used. The participants returned after 7, 30, and 90 days when new color readouts and surface roughness were recorded. The measured values were statistically analyzed (2-way-ANOVA, repeated measures, Tukey, P < .05). RESULTS: Whitening toothpastes did not promote significant (P > .05) color alteration and nor increased the surface roughness of the dental enamel in brushing time of the study. CONCLUSIONS: The abrasiveness of whitening toothpaste and the brushing trial period did not affect the surface roughness of dental enamel. However, color changes observed on enamel were above the perceptibility and acceptability thresholds reported in the literature. CLINICAL SIGNIFICANCE: The over-the-counter toothpastes tested had an effect on dental enamel color above the perceptibility and acceptability thresholds but did not change the surface roughness of the teeth.

Bond strength of adhesive systems to sound and demineralized dentin treated with bioactive glass ceramic suspension.

OBJECTIVE: The objective of this study was to evaluate the effect of a Biosilicate®, associated with dentin adhesive system, on microtensile bond strength (µTBS) to sound and demineralized dentin. MATERIALS AND METHODS: Eighty sound-extracted molars had their middle occlusal dentin exposed. In forty teeth, dentin was artificially demineralized (pH cycling). Sound and demineralized dentin teeth were separated into four groups (n = 10), according to the substrate treatment before restoration: Group 1-total-etching adhesive Adper TM Single bond 2 (ASB) + Biosilicate®, Group 2-ASB (without Biosilicate®), Group 3-AdheSE self-etching adhesive system (AdSE) + Biosilicate®, and Group 4-AdSE (without Biosilicate®). Each tooth was restored with a hybrid composite and stored in water at 37 °C for 6 months. After water aging, teeth were cut in sticks (≈ 1 mm2 cross-sectional area) and all samples were submitted to µTBS test. The fracture modes of the samples were analyzed by stereomicroscopy. The representatively fractured samples were observed by scanning electron microscopy. Representative samples of each group were analyzed on energy dispersive X-ray spectrometry (EDX). The µTBS and Ca-P ratio values were analyzed by 2-way ANOVA, Bonferroni, and Tukey test, respectively, p < .05. RESULTS: ASB + Biosilicate® presented the highest µTBS values (p < .05), and lowest µTBS values (p < .05) were found in AdSE Group. There was no statistical difference (p < .05) on µTBS when substrates were compared, except for Group 2. The fracture pattern analysis showed prevalence of adhesive fractures in all groups. CONCLUSION: Biosilicate® enhanced bond strength of self-etching and etch-and-rinse adhesives to sound and demineralized dentin. CLINICAL RELEVANCE: Bioactive glass ceramic suspension could be recommended to be used to improve the dentin bond strengths of the total-etching and self-etching adhesives after acid-etching and priming.

The Effect of Different Bleaching Treatments and Thermal-Mechanical Cycling on the Shear Bond Strength of Orthodontic Brackets.

OBJECTIVE: The aim of the present study was to compare the shear bond strength (SBS) of orthodontic brackets bonded to the enamel after at-home and in-office bleaching treatments. METHODS: Sixty bovine incisors were subjected to initial color readings and then classified into three groups: CP (16% carbamide peroxide), HP (35% hydrogen peroxide), and C (control). After treatments, new color readout was obtained, and orthodontic brackets were bonded to the bleached area. Half of the samples of each group (n=10) were subjected to thermal-mechanical cycling (TMC) testing (1,200,000 cycles; 44.2 N; 2 Hz/s), whereas the other half were stored in distilled water at 37 °C for 24 h. Samples were subjected to the SBS test at a speed of 0.5 mm/min. The mean SBS was analyzed (two-way ANOVA, Bonferroni test, p<0.05), and the fracture patterns were classified as adhesive, cohesive, and mixed types. RESULTS: There was no difference (p>0.05) in SBS values between the samples subjected to TMC and the cycled samples in any group. Samples subjected to carbamide peroxide presented lower SBS (p<0.05) than the non-cycled ones. Enamel adhesive fractures were higher in the bleached groups than in the control group, which presented mixed fractures prevalence, regardless of whether it was subjected to TMC or not. CONCLUSION: Thermal-mechanical cycling was not significant for SBS of orthodontic brackets, but tooth bleaching was a factor.

Color and opacity of composites protected with surface sealants and submitted to artificial accelerated aging.

OBJECTIVES: To evaluate the color similarity, stability and opacity of composites (TPH, Charisma, and Concept, shade A2) protected with surface sealants (Fortify Plus and Biscover) and cyanoacrylate (Super Bonder). METHODS: Forty specimens of each composite were made and separated into 4 groups (n=10) according to the surface protection: GI - without sealant; GII - cyanoacrylate; GIII - Fortify Plus; GIV - Biscover. Color and opacity readings were taken before and after Artificial Acelerated Aging (AAA) and the values obtained for color stability were submitted to statistical analysis by 2-way ANOVA and Bonferroni's test (P<.05). The values acquired for color similarity were submitted to 1-way ANOVA and Tukey's test (P<.05). The specimen sufaces were compared before and after AAA using Scanning Electronic Microscopy (SEM). RESULTS: Studied composites did not present the same values for the coordinates L*, a* and b * before AAA, indicating that there was no color similarity among them. All composites presented color alteration after AAA with clinically unacceptable values. Protected groups presented lower opacity variation after AAA, in comparison with the control goup. SEM evaluation demonstrated that AAA increased the surface irregularities in all of the studied groups. CONCLUSION: Surface sealants were not effective in maintaining composite color, but were able to maintain opacity.

Bleaching agent action on color stability, surface roughness and microhardness of composites submitted to accelerated artificial aging.

OBJECTIVES: The purpose of this study was to evaluate the bleaching agent action on color stability, surface roughness and microhardness of composites (Charisma, Filtek Supreme and Heliomolar - A2) submitted to accelerated artificial aging (AAA). METHODS: A Teflon matrix (12 x 2 mm) was used to fabricate 18 specimens (n=6) which, after polishing (Sof-Lex), were submitted to initial color reading (ΔE), Knoop microhardness (KHN) (50 g/15 s load) and roughness (R(a)) (cut-off 0.25 mm) tests. Afterwards, the samples were submitted to AAA for 384 hours and new color, microhardness and roughness readings were performed. After this, the samples were submitted to daily application (4 weeks) of 16% Carbamide Peroxide (NiteWhite ACP) for 8 hours and kept in artificial saliva for 16 hours. New color, microhardness and roughness readings were made at the end of the cycle, and 15 days after bleaching. RESULTS: Comparison of the ΔE means (2-way ANOVA, Bonferroni, P<.05) indicated clinically unacceptable color alteration for all composites after AAA, but without significant difference. Statistically significant increase in the KHN values after AAA was observed, but without significant alterations 15 days after bleaching. For R(a) there was no statistically significant difference after AAA and 15 days after bleaching. CONCLUSIONS: The alterations promoted by the bleaching agent and AAA are material dependent.

Composites associated with pulp-protection material: color-stability analysis after accelerated artificial aging.

OBJECTIVES: This study assessed the color stability of two composites associated with two pulp protectors submitted to accelerated artificial aging (AAA). METHODS: 60 test specimens were made with 0.5 mm of protection material (calcium hydroxide - CH or glass ionomer cement - GIC) and 2.5 mm of restoration material (Concept or QuixFil) and divided into 3 groups (n=10) according to the type of protection material/composite, and the control group (no protection). After polishing, color readings were obtained with a spectrophotometer (PCB 6807 Byk Gardner) before and after AAA for 384 hours, and L*, a*, and b* coordinates and total color variation (DeltaE) were analyzed (2-way ANOVA, Bonferroni, alpha=05). RESULTS: Composites placed on CH presented lower L* levels than those on GIC, which presented higher L* values than the control group and lower b* values than those of the CH group. The Concept composite presented higher DeltaE levels for all groups, differing statistically from QuixFil, except when placed on GIC. CONCLUSIONS: It was concluded that the protection material could affect the color stability and AAA is a factor that enhances this effect, depending on the type of composite used.