Effects of desensitizing dentifrices on the reduction of pain sensitivity caused by in-office dental whitening: a double-blind controlled clinical study

Objective: The purpose of this study was to clinically evaluate the influence of desensitizing dentifrices applied through a plastic tray on reducing the pain sensitivity and color variation caused by in-office dental whitening and to evaluate differences among such dentifrices through a controlled double-blind clinical study.

Materials and methods: A prospective study was conducted with 48 individuals between 18 and 30 years without gender distinction. For the dental whitening, 35% hydrogen peroxide was used in three clinical sessions. After each whitening session, the volunteers used a plastic tray containing one of the dentifrices (sucralose– S, sodium fluoride – SF, arginine and calcium carbonate – ACC, and 5% potassium nitrate – PN) for 4 hrs during the night. The evaluation of the sensitivity associated with the use of the plastic tray in each whitening session was performed using the analog numerical scale with scores from 0 to 10. The color variation (ΔE) was determined with a spectrophotometer. The pain sensitivity data were submitted to the multivariate analysis of variance with repeated measurements and a Lambda Wilks test (p<0.05). To analyze the color variation, a one-way ANOVA was applied (p<0.05).

Results: The ACC and 5% NP groups showed a reduction in sensitivity in relation to the other groups (p<0.05). There was a reduction in sensitivity after placement of the tray with dentifrice. The color evaluation associated with the dentifrice showed no difference (p=0.9186).

Conclusion: The use of desensitizing dentifrices with ACC or 5% NP in a plastic tray was effective for the reduction of pain sensitivity, and the use of a desensitizing dentifrice did not decrease the effectiveness of whitening.

Effect of Dentin Pretreatment with Arginine on Microshear Bond Strength of Etch-and-Rinse or Self-Etch Adhesive Systems

Objective The main purpose of this study was to evaluate the effect of dentin pretreatment with 8% arginine on the immediate and 6-month bond strength (BS) of adhesive systems and surface morphology of dentin.

Materials and Methods Dentin bovine specimens (5 × 5 mm) were allocated into following pretreatments: without pretreatment (conventional technique, C) or exposure to arginine solution (A) for 5 minutes prior to tooth restoration. The adhesive procedure was performed using ( n = 12): 3-step etch-and-rinse adhesive (Scotchbond Multipurpose—SBMP [C+SBMP and A+SBMP]); 2-step etch-and-rinse adhesive (Single Bond 2 - SB [C+SB and A+SB]); or 2-step self-etch adhesive (Clearfil SE Bond - CSEB [C+CSEB and A+CSEB]). After 24 hours, the composite resin restorations were evaluated immediately and after 6 months of water storage using a microshear test and fracture pattern. The dentin surface exposed to A was assessed by scanning electron microscopy (SEM). The immediate BS data were submitted to a two-way analysis of variance and Tukey's test, and the long-term BS results were analyzed using Kruskal–Wallis and Dunn tests (α = 0.05).

Results There was a significant decrease in immediate and 6-month BS for the A+SB and A+CSEB groups, which differed statistically from the C group. The fracture pattern was predominantly adhesive for SB and CSEB adhesive for C and A. The SEM images presented a different conditioning pattern of the dentin exposed to A.

Conclusion The dentin pretreatment with arginine interfered negatively in the immediate and long-term BS of the simplified adhesive system. However, the SBMP adhesive was not affected by arginine pretreatment presenting the most satisfactory results.

Evaluation of Bond Strength, Nanoleakage, and Marginal Adaptation of Bulk-fill Composites Submitted to Thermomechanical Aging

PURPOSE

To evaluate the bond strength (BS), nanoleakage, and marginal adaptation (MA) of three bulk-fill and one conventional composite, submitted or not to mechanical and thermal cycling.

MATERIALS AND METHODS

Ninety-six molars were selected and 4-mm-deep class I cavities were prepared and restored. Half of the teeth were submitted to mechanical and thermal cycling (MTC). Teeth were divided into 8 groups (n = 12), according to the composite used - Filtek Z350 XT (Z350), Tetric N-Ceram Bulk Fill (TET), Filtek Bulk Fill Posterior Restorative (FBF) and SonicFill (SF) - and aging, submitted or not to MTC. Fifty-six teeth (n = 7) were used for bond-strength testing, which was performed on stick-shaped specimens obtained from the restored area. Two sticks per tooth were selected to assess nanoleakage. For MA analysis, 40 teeth (n = 5) were sectioned parallel and perpendicular to the occlusal surface and resin-based replicas from the obtained surfaces were prepared. Fracture pattern, nanoleakage, and MA were evaluated using SEM. Quantitative analysis of nanoleakage and MA were performed with ImageJ software. Data obtained were submitted to two-way ANOVA and Tukey's test (ɑ = 0.05).

RESULTS

TET presented good MA and higher values of BS when compared to SF. Z350 and FBF presented poorer MA and lower BS, which was statically similar to the other groups. SF obtained the best MA values. Regarding nanoleakage, the highest values were obtained for TET, which differed significantly from the other groups, which presented similar results among themselves. Aging by MTC solely affected MA.

CONCLUSION

Bulk-fill composites presented similar performance to the conventional nanocomposite and remained stable when aged.

Evaluation of Finishing/Polishing Techniques on Low-Shrink Posterior Restorative After Mechanical Cycling

O objetivo deste estudo foi avaliar a rugosidade superficial de resinas compostas à base silorano e metacrilato submetidas a diferentes técnicas de acabamento/polimento. Foram preparadas 12 amostras de disco de cada resina composta: P90®, Z350® e Carisma, divididas em 12 grupos de acordo com a técnica de acabamento / polimento: sem acabamento / polimento (controle); acabamento com ponta diamantada 1112 FF; acabamento com ponta diamantada 1112 FF associada a Enhance / Pogo; acabamento com ponta diamantada 1112 FF associada a Enhance / Pogo / Polishing / Pastas Poli I e II / Fotogloss. Após as leituras iniciais da rugosidade da superfície, os espécimes foram submetidos a ciclos mecânicos (1.200.000 ciclos) e submetidos imediatamente a leituras de rugosidade final. As medias de rugosidade superfícial foram analisadas estatisticamente por ANOVA e teste de Tukey-Kramer (α = 0,05). As imagens de MEV foram realizadas após o acabamento / polimento e após a ciclagem mecânica. O compósito P90 mostrou valores de rugosidade superficial semelhantes a outros compósitos investigados. Tough, mostrou diferença significativa nas técnicas de acabamento / polimento. O grupo de pontas damantadas apresentou maior rugosidade superficial que diferiu das outras resinas compostas (α <0,05). Enance / Pogo mostrou os menores resultados, que não apresentaram diferença em relação ao grupo de pasta de polimento (α> 0,05). O material restaurador posterior de baixa contração apresentou rugosidade superficial semelhante quando comparado as resinas compostas de dimetacrilato e são restaurações adequadas para região posterior.Palavras-chave: Dente. Resinas de Silorano.  Propriedades de Superfície. AbstractThe aim of this study was to evaluate the surface roughness of a silorane and methacrylate-based composite resins subjected to different finishing/polishing techniques. Twelve disk specimens were prepared from each composite resin: P90®, Z350® and Charisma, divided into 12 groups according to the finishing/polishing technique: no finishing/polishing (control); finishing with 1112 FF diamond burs; finishing with 1112 FF diamond burs associated to Enhance/Pogo; finishing with 1112 FF diamond burs associated to Enhance/Pogo/Polishing/Poli I and II pastes/Fotogloss. After initial readouts of surface roughness, the specimens were subjected to mechanical cycling (1.200.000 cycles) and immediately subjected to final roughness readouts.  Surface roughness means was statistically analyzed by ANOVA and Tukey-Kramer test (α=0.05). SEM images were realized after finishing/polishing and after mechanical cycling. The P90 composite showed surface roughness values similar to other investigated composites. However, significant difference was observed in finishing/polishing techniques. The diamond burs group showed the highest surface roughness differing from the other composite resins (α < 0.05). Enance/Pogo showed the lowest results, which presented no difference compared to the polishing paste group (α > 0.05). The low-shrink posterior restorative showed similar surface roughness when compared to dimethacrylate composite resins and suitable to posterior restorations. Keywords: Tooth. Silorane Resins. Surface Properties. 

Utilizing the optical properties of composite resins to improve esthetics: a layering technique for anterior restorations

A comprehensive knowledge of the optical properties of composite resins is essential to achieving optimal results in direct anterior restorations. This case report describes an anterior composite resin restoration fabricated with a layering technique and explains how to use a simple photographic method to verify that the desired optical effects are reproduced. A Class IV restoration was completed on a maxillary central incisor with the help of a silicone guide. An esthetic result was achieved through careful color examination as well as material selections that were based on knowledge of the translucency, opacity, and fluorescence of the chosen direct composite resins. The approach of combining a composite resin designed for bleached teeth with highly opalescent and translucent resins as well as matching the natural dental anatomy provided excellent esthetic results. The suitable reproduction of optical characteristics was confirmed by increasing the contrast of the final photograph, which highlighted the translucency achieved in the area of the mamelons.

Physical and photoelastic properties of bulk-fill and conventional composites

Purpose

This study evaluated the influence of thickness increment on degree of conversion (DC), Knoop microhardness (KHN), and polymerization-shrinkage stress (PSS) by photoelasticity of three dental composites.

Methods

For DC and KHN, 45 samples were prepared and divided into nine groups (n=5), according to composite (microhybrid [Filtek Z250 - Z250], bulk-fill flowable [SureFil SDR Flow - SDR], and nanohybrid composite [N’Durance - NDU]) and increment thickness (1, 1.5, and 3 mm). PSS was measured by photoelastic analysis. Composites were placed into a photo-elastic model cavity and light-cured. DC and KHN data were subjected to two-way ANOVA and Bonferroni post hoc test. PSS results were qualitatively evaluated through Kruskal–Wallis test.

Results

SDR showed the highest DC values. At top and bottom surfaces, the highest KHN was obtained by Z250. Z250 showed higher PSS than SDR in 1.5 mm increments. NDU showed higher PSS than SDR in 3 mm increments.

Conclusion

The bulk-fill composite demonstrated better DC and similar KHN and PSS in deeper layers compared to conventional composites. Bulk-fill composites may perform as well as conventional nanohybrid and microhybrid composites.

Influence of a hydrophobic monomer on the physical and mechanical properties of experimental surface sealants

This study evaluated the effect of adding the hydrophobic monomer 1,12 dodecanediol dimethacrylate (DDDMA) to experimental sealants with and without thermocycling on degree of conversion (DC), water sorption (WS), water solubility (WSB), color stability (ΔE), and micro-shear bond strength (μSBS). Five experimental and one commercially available sealant (Bisco - BIS) were tested. The experimental sealants were formulated by mixing different percentages of DDDMA monomers and urethane dimethacrylate (UDMA). The photoinitiator system was composed by camphorquinone (CQ) and tertiary amine 4-ethyl benzoate dimetilamiono (EDBA). Ethanol was used as a solvent. The experimental groups were named sequentially according to the monomeric content (DDDMA/UDMA): S40/40 (40/40), S50/30 (50/30), S60/20 (60/20), S70/10 (70/10) and S80/0 (80/0). Data were analyzed separately by one-way ANOVA, followed by Tukey's test (p<0.05). The values of DC ranged from 94.59% (S40/40) to 54.02% (S80/10). BIS showed the highest WS value (p<0.05) and S40/40, S50/30, S60/20 and S80/0 showed the lowest WS values of all tested sealants. WSB values ranged from 7.88 µg/mm3 (BIS) to 13.27 µg/mm3 (S70/10). The highest ΔE value was 11.05±2.88 for BIS and the highest μSBS value was found for S60/20. No significant difference was observed in bond strength between sealants and bovine enamel after thermocycling. Adding DDDMA to the composition of surface sealants can improve its performance, once the monomer increased the degree of conversion and the color stability.

Treatment of non-carious lesions: Diagnosis, restorative materials and techniques

Management of non-carious cervical lesions (NCCLs) still is a challenge in clinical practice. The diagnosis is the key to treat these lesions successfully. Aim/Case report: Therefore, the aim of this case report is to describe the diagnosis and treatment of generalized abfraction lesions associated to abrasion lesions of a 43 years old patient and to discuss considerations about the technique and materials to be used appropriately. After the diagnosis, a treatment plan with preventive and restorative approach was elaborated. The occlusal adjustment was performed to distribute the contact points and the patient was instructed in relation to tooth brushing habits. It was also recommended that the patient use a dentifrice with potassium nitrate for the control of sensitivity. For lesions over 1mm deep, the restorative treatment was performed using the self-etching adhesive system and nanohybrid composite by the stratification technique. Unsatisfactory restorations have been replaced. Occlusal splint was done and the patient was instructed to use the device every day overnight. One year after treatment, follow-up was performed. The appearance of new NCCLs was not observed. There was no progression of lesions smaller than 1 mm. There was no loss of restorations. All restorations were fully satisfactory and the patient reported absence of dentin hypersensitivity. Conclusion: The treatment performed besides being aesthetically satisfactory after 1 year resulted in the control of the disease, preventing the appearance of new lesions and guaranteeing a better quality of life to the patient.

Effect of different concentrations of nanohydroxyapatite on tooth bleaching effectiveness and enamel bond strength

Objective: To evaluate the effect of 35% hydrogen peroxide (35% HP) combined to different concentrations of nanohydroxyapatite (nHA) on the effectiveness of dental bleaching (superficial enamel and deep dentin) and enamel bond strength. Material and Methods: Fifty bovine dental specimens (5x5x2mm) were divided into 5 groups, according to the treatments (n = 10): no bleaching (negative control); 35% HP (positive control); 35% HP+ 5% nHA; 35% HP + 10% nHa; and 35% HP + 15% nHA. Three in-office bleaching sessions were made. The color analysis was performed on the enamel surface and the opposite dentin, using a spectrophotometer. The results were expressed in the CIE L*a*b* system. After this, the adhesive system was applied to the tooth structure, and the dental specimens received a composite restoration. The microshear bond strength test was performed 24 h after the restoration. Data were submitted to ANOVA and Tukey's test (?=0.05). Results: For the enamel color analysis, all bleached groups differed statistically from the unbleached group, with increasing L* values and decreasing b* values. The addition of different concentrations of nHA did not interfere with the bleaching effectiveness for the enamel and opposite dentin. For microshear bond strength, no statistically significant differences were presented between groups. The adhesive failure rate of the 35% HP + 10% nHA group was lower than the 35% HP group and similar to the negative control. Conclusion: The addition of different concentrations of nHA in 35% of hydrogen peroxide did not interfere with the bleaching efficacy of enamel and deep dentin and did not affect the enamel bond strength after bleaching KeywordsEnamel; Shear strength; Tooth bleaching. 

Effect of preheating and light-curing unit on physicochemical properties of a bulk fill composite

Objective

The aim of this study is to evaluate the effect of composite preheating and polymerization mode on degree of conversion (DC), microhardness (KHN), plasticization (P), and depth of polymerization (DP) of a bulk fill composite.

Methods

Forty disc-shaped samples (n = 5) of a bulk fill composite were prepared (5 × 4 mm thick) and randomly divided into 4 groups according to light-curing unit (quartz–tungsten–halogen [QTH] or light-emitting diode [LED]) and preheating temperature (23 or 54 °C). A control group was prepared with a flowable composite at room temperature. DC was determined using a Fourier transform infrared spectrometer, KHN was measured with a Knoop indenter, P was evaluated by percentage reduction of hardness after 24 h of ethanol storage, and DP was obtained by bottom/top ratio. Data were statistically analyzed by analysis of variance and Tukey’s test (α = 0.05).

Results

Regardless of light-curing, the highest preheating temperature increased DC compared to room temperature on bottom surface. LED showed a higher DC compared to QTH. Overall, DC was higher on top surface than bottom. KHN, P, and DP were not affected by curing mode and temperature, and flowable composite showed similar KHN, and lower DC and P, compared to bulk fill.

Conclusion

Composite preheating increased the polymerization degree of 4-mm-increment bulk fill, but it led to a higher plasticization compared to the conventional flowable composite evaluated.

Esthetic smile rehabilitation of anterior teeth by treatment with biomimetic restorative materials: a case report

BACKGROUND

In daily clinical practice, esthetics of anterior teeth is a common presenting complaint of patients.

OBJECTIVE

This case report discusses the management of asymmetric smile associated with unsatisfactory extensive composite restorations and describes a clinical protocol using the direct composite resin for smile enhancement to restore the dental harmony of anterior teeth.

METHODS

The treatment planning was based on a diagnostic wax-up and cosmetic mock-up. After clinical and patient approvals were obtained, the patient was subjected to direct and indirect restorative treatment.

CONCLUSION

Nanocomposites are an effective alternative for anterior teeth restorations. Additionally, good planning enables satisfactory esthetic results, leading to the correction of an inappropriate axial inclination of incisors.

Efficacy of Stannous Ions on Enamel Demineralization under Normal and Hyposalivatory Conditions: A Controlled Randomized in situ Pilot Trial

The study aim was to investigate the effect of antierosive agents on enamel under normal and hyposalivatory conditions. This double-blind crossover in situ pilot study evaluated 4 toothpastes: placebo (0 ppm F), sodium fluoride (NaF, 1,450 ppm), stannous/sodium fluoride (SnF/NaF, 1,450 ppm F-, 1,090 ppm Sn2+), and sodium fluoride, stannous chloride and chitosan (NaF/Sn/Ch, 1,450 ppm F-, 3,500 ppm Sn2+, 0.5% Ch). Twenty participants were assigned to 2 groups (n = 10 each): normal and low salivary flow. Participants wore palatal appliances holding 4 bovine enamel specimens previously eroded in vitro (D1) for 20 min prior to an in situ phase after which they were eroded again (D2). Surface microhardness was determined at baseline (BL), after D1, in situ phase and D2 to assess hardness loss (%SMH), residual hardness loss (%RHL) and erosion resistance (%RER). Additional specimens were evaluated by scanning electron microscopy after the in situ phase. ANOVA and a factorial analysis for between-subject effects were performed. Sn-based toothpastes showed the best effects (p < 0.05). Under normal flow, SnF/NaF showed higher efficacy, with a significant difference compared to NaF/Sn/Ch, NaF, and placebo (p < 0.05). Under low flow, SnF/NaF and NaF/Sn/Ch were comparable (p > 0.05); NaF and placebo were statistically similar. Comparing salivary conditions, there were significant differences for SnF/NaF for %SMH after the in situ phase (%SMHtotal)), %RHL and for all toothpastes in case of %RER. Factorial analysis revealed interactions between toothpaste and saliva flow for %SMHtotal and %RHL. Salivary flow can influence the efficacy of the antierosive toothpastes; however, Sn2+ preparations show even under low salivary flow conditions the highest efficacy in the prevention of enamel erosion.

Influence of Enamel Thickness on Bleaching Efficacy: An In-Depth Color Analysis

This study evaluated the influence of different enamel thicknesses and bleaching agents on treatment efficacy in-depth by spectrophotometry color analysis. Eighty bovine dental fragments were previously stained in black tea solution and randomly assigned into eight groups (n=10), 1.75mm dentin thickness and different enamel thicknesses as follows: 0.5mm, 1.0mm planned, 1.0mm unplanned (aprismatic enamel), and absence of enamel. The 10% carbamide peroxide (CP) and 35% hydrogen peroxide (HP) bleaching gels were applied on the enamel surface following the manufacturer's recommendations. Color of underlying dentin was evaluated at four times: after staining with tea (baseline) and after each one of the three weeks of bleaching treatment, by CIE L*a*b* system using reflectance spectrophotometer (CM 700d, Konica Minolta). The ΔE, ΔL, Δa, and Δb values were recorded and subjected to repeated measures ANOVA and Tukey’s test (α=0.05). The results showed an increase on lightness (L*), with decreased redness (a*) and yellowness (b*). At first and second week, bleaching with CP showed higher whitening effectiveness compared to bleaching with HP and the presence of aprismatic enamel significantly reduced ΔE for bleaching with CP. After three weeks of bleaching, few differences were observed between CP and HP groups, and outer enamel layer caused no influence on bleaching effectiveness. Overall, both at-home and in-office bleaching treatments were effective and the presence of aprismatic enamel did not interfere on the whitening efficacy.

Effect of Cigarette Smoke on Resin Composite Bond Strength to Enamel and Dentin Using Different Adhesive Systems

Objective: To evaluate the microshear bond strength of composite resin restorations in dental blocks with or without exposure to cigarette smoke.

Method: Eighty bovine dental blocks were divided into eight groups (n=10) according to the type of adhesive (Scotchbond Multi-Purpose, 3M ESPE, St Paul, MN, USA [SBMP]; Single Bond 2, 3M ESPE [SB]; Clearfil SE Bond, Kuraray Medical Inc, Okayama, Japan [CSEB]; Single Bond Universal, 3M ESPE [SBU]) and exposure to smoke (no exposure; exposure for five days/20 cigarettes per day). The adhesive systems were applied to the tooth structure, and the blocks received a composite restoration made using a matrix of perforated pasta. Data were statistically analyzed using analysis of variance and Tukey test (α&lt;0.05).

Results: For enamel, there was no difference between the presence or absence of cigarette smoke (p=0.1397); however, there were differences among the adhesive systems (p&lt;0.001). CSEB showed higher values and did not differ from SBU, but both were statistically different from SB. The SBMP showed intermediate values, while SB demonstrated lower values. For dentin, specimens subjected to cigarette smoke presented bond strength values that were lower when compared with those not exposed to smoke (p&lt;0.001). For the groups without exposure to cigarette smoke, CSEB showed higher values, differing from SBMP. SB and SBU showed intermediary values. For the groups with exposure to cigarette smoke, SBU showed values that were higher and statistically different from SB and CSEB, which presented lower values of bond strength. SBMP demonstrated an intermediate value of bond strength.

Conclusion: The exposure of dentin to cigarette smoke influenced the bonding strength of adhesives, but no differences were noted in enamel.

Effect of at-home bleaching with different thickeners and aging on physical properties of a nanocomposite

Objective:

To evaluate the influence of 16% carbamide peroxide (CP) containing different thickeners on the physical characteristics of a nanocomposite resin submitted or not to accelerated artificial aging (AAA).

Materials and Methods:

One hundred samples were randomly distributed into two groups (n = 50) according to AAA. Each group was divided into 5 subgroups (n = 10) depending on the bleaching/thickener treatment: CP + carbopol, CP + natrosol, carbopol, natrosol, and no treatment (control). The physical properties tested were color (ΔE), gloss (GU), mean roughness (Ra), and Knoop microhardness (KHN). The resin surface was performed with atomic force microscopy (AFM).

Statistical Analysis:

The color (variable Δ E) was assessed with two-way analysis of variance (ANOVA) and additionally with Tukey's and Dunnett's tests, the roughness values were submitted to Kruskal–Wallis, Dunn's, and Mann–Whitney's tests. Data on gloss and KHN were submitted to two-way ANOVA and Tukey's test (α = 0.05).

Results:

Among the physical properties evaluated, CP + carbopol promoted a reduction in composite microhardness only, thus differing statistically from the controls. As for CP + natrosol, such a change was not observed. The aging process reduced all the physical properties, thus differing statistically from the nonaging group. CP + carbopol increased the roughness and decreased the gloss of aged resins, whereas natrosol reduced gloss only, which differed statistically from the controls.

Conclusions:

AFM showed evidence of the loss of organic matrix and exposure to load particles in the aged samples. Therefore, the replacement of carbopol with natrosol provided maintenance of the composite microhardness following bleaching. The aging process reduced the physical properties evaluated, and some changes were enhanced by the application of bleaching.

Tooth enamel properties and morphology after microabrasion: an in situ study

AIM

This study evaluated the effect of saliva on enamel after microabrasion with different microabrasive compounds under in situ conditions.

METHODS

Enamel/dentin blocks (16 mm² ) from bovine incisors were divided into nine groups (n = 19): one control group (no treatment), four groups treated with microabrasion using 35% phosphoric acid (H₃ PO₄ ) + pumice, and the last four groups treated with microabrasion using 6.6% hydrochloric acid (HCl) + silica. The treated groups were subdivided according to the in situ regimen: without salivary exposure, 1 h, 24 h, or 7 days of saliva exposure. Surface microhardness (SMH) and cross-sectional microhardness (CSMH) were tested. Scanning electron microscopy (SEM) was used to evaluate enamel morphology. Microhardness data were tested by analysis of variance, and Tukey's and Dunnett's tests (α = 0.05).

RESULTS

The SMH analysis revealed that all the microabrasion-treated groups presented significantly-reduced SMH values when compared to the control group (P < 0.05). Treatment with HCl + silica was more prone to the effect of saliva than H₃ PO₄ + pumice, even for CSMH analysis, once the superficial layers reached the same microhardness of that of the control group (P > 0.05). These results were confirmed by SEM, which demonstrated the mineral recovery effect over time.

CONCLUSION

Saliva was effective in promoting the rehardening of enamel after microabrasion, mainly for the surfaces treated with HCl + silica.

In vitro evaluation of the effect of different polishing techniques on the surface roughness of composite resins submitted to at-home and in-office bleaching procedures

Objective:

Bleaching agents may affect the properties of dental materials. The aim of this study was to evaluate the effect of different polishing techniques on the surface roughness of composite resins submitted to the at-home and in-office bleaching treatment.

Materials and Methods:

Disc-shaped specimens were carried out of nanofilled and microhybrid composites (n = 10). Finishing step was performed after light curing (L1) and polishing after 24 h with two systems (L2). Then, specimens were submitted to the home or in-office bleaching procedures, and roughness was re-evaluated (L3). The surface roughness (Ra) readings were measured at L1, L2, and L3 times using a profilometer. Data were statistically analyzed by multiple-way analysis of variance and Tukey test (α = 0.05).

Results:

The polishing procedures decreased Ra for both composites compared to baseline values (L1). The roughness of specimens polished with jiffy did not present significant difference after polishing step (L2) and bleaching treatment (L3). However, the groups polished with Sof-Lex discs had increase on the Ra values after bleaching.

Conclusion:

The polishing is an important procedure to reduce the roughness of dental restorations and composite surface polished with jiffy system improved the degradation resistance to the bleaching agents compared to Sof-Lex discs.

Effect of Toothpaste Application Prior to Dental Bleaching on Whitening Effectiveness and Enamel Properties

OBJECTIVE

The purpose of this study was to investigate the effects on the enamel properties and effectiveness of bleaching using 35% hydrogen peroxide (HP) when applying toothpastes with different active agents prior to dental bleaching.

METHODS

Seventy enamel blocks (4 × 4 × 2 mm) were submitted to in vitro treatment protocols in a tooth-brushing machine (n=10): with distilled water and exposure to placebo gel (negative control [NC]) or HP bleaching (positive control [PC]); and brushing with differing toothpastes prior to HP bleaching, including potassium nitrate toothpaste (PN) containing NaF, conventional sodium monofluorophosphate toothpaste (FT), arginine-based toothpastes (PA and SAN), or a toothpaste containing bioactive glass (NM). Color changes were determined using the CIE L*a*b* system (ΔE, ΔL, Δa, and Δb), and a roughness (Ra) analysis was performed before and after treatments. Surface microhardness (SMH) and cross-sectional microhardness (CSMH) were analyzed after treatment. Data were analyzed with repeated measures ANOVA for Ra, one-way ANOVA (SMH, ΔE, ΔL, Δa, and Δb), split-plot ANOVA (CSMH), and Tukey post hoc test (α<0.05). The relationship between the physical surface properties and color properties was evaluated using a multivariate Canonical correlation analysis.

RESULTS

Color changes were statistically similar in the bleached groups. After treatments, SMH and CSMH decreased in PC. SMH increased significantly in the toothpaste groups vs the negative and positive control (NM > PA = SAN > all other groups) or decreased HP effects (CSMH). Ra increased in all bleached groups, with the exception of NM, which did not differ from the NC. The variation in the color variables (ΔL, Δa, and Δb) explained 21% of the variation in the physical surface variables (Ra and SMH).

CONCLUSION

The application of toothpaste prior to dental bleaching did not interfere with the effectiveness of treatment. The bioactive glass based toothpaste protected the enamel against the deleterious effects of dental bleaching.

Effect of 7.5% hydrogen peroxide containing remineralizing agents on hardness, color change, roughness and micromorphology of human enamel

PURPOSE

To determine the microhardness, color change, surface roughness, and micromorphology of tooth enamel submitted to bleaching treatment with 7.5% hydrogen peroxide (HP) with added calcium, amorphous calcium phosphate, sodium fluoride (NaF), and hydroxyapatite (HA).

METHODS

80 enamel slabs were used (n = 10). Three commercial agents [Pola Day 7.5%, Day White ACP 7.5% (DW-ACP), and White Class Calcium 7.5% (WC-Calcium)], three experimental (7.5% HP+NaF, 7.5% HP+HA, and 7.5% PH+NaF+HA), a positive control (with HP), and a negative control (without HP) groups were assessed. The commercial products were applied according to manufacturers' recommendations and the experimental ones were applied for 1.5 hours daily. During and after treatment, specimens were stored in artificial saliva. Tests were performed at baseline, 7, 14, 21, 28, and 35 days. Data were analyzed by ANOVA and Tukey's test (α = 0.05).

RESULTS

DW-ACP presented lower microhardness and HP+HA presents the highest values (P < 0.05); only the experimental group presented color change similar to the commercial agents (P > 0.05). Overall, roughness increased with time (P < 0.05) and porosities, and deposition of crystalline structures in groups HP+HA and HP+NaF+HA were noted. The HP+HA agent was capable of reducing the loss of enamel microhardness due to bleaching and also present color change similar to the commercial products.

Adhesive Restorations as An Esthetic Solution in Dentinogenesis Imperfecta

Loss of tooth structure is the main sequela of dentinogenesis imperfecta (DI). Due to severe enamel attrition, patients with DI often present with esthetic, occlusal, endodontic, and speech complications. Therefore, an interdisciplinary approach, divided into separate clinical steps, should be developed to provide comprehensive dental rehabilitation. The purpose of this case report is to discuss the use of composite resin restorations as a transitional treatment step for the anterior teeth of an eight-year-old boy with DI until his bone and dental development permit orthodontic and orthognatic surgery.

Influence of Staining Solution and Bleaching on Color Stability of Resin Used for Caries Infiltration

OBJECTIVE

The objective of this study was to evaluate the color stability of Icon-infiltrated white spot lesions after staining and the bleaching effect on the infiltrated and stained surfaces.

METHODS AND MATERIALS

Enamel-dentin specimens (N=30, 5 × 5 × 3 mm, 1-mm enamel + 2-mm dentin thickness) were prepared from bovine incisors and randomly allocated into three groups (n=10): control, demineralized, and infiltrated. Artificial enamel subsurface lesions were created using 50 mL of 0.05 M acetate buffer solution. Specimens were produced by Icon application in enamel caries-like lesions, according to the manufacturer's instruction. Baseline color readings were assessed using a spectrophotometer, and CIE L*a*b* measurements of each specimen were performed using a white background. To simulate extrinsic dietary staining, specimens were placed into a 4-mL coffee infusion, three times daily for 15 minutes, for 14 days. After the staining procedure, color measurements were performed again. Then, bleaching procedures were performed using 16% carbamide peroxide gel for four hours daily for 21 days, and a final color assessment was performed. To compare the baseline and final measurements, t-test was used (α =0.05). The statistical comparison between the groups was performed using the one-way analysis of variance and Tukey tests (α =0.05).

RESULTS

Coffee staining provided a significant reduction of L* values and an increase of a* and b* in all groups (control, decayed, and infiltrated). The bleaching procedure provided a significant increase in L* and decrease of a* and b* values in all groups. There was no significant difference in ΔE values between decayed and infiltrated groups before bleaching, and after bleaching, the infiltrated group showed the lowest ΔE values.

CONCLUSION

It can be concluded that enamel infiltrated with Icon presents significant alteration of color after staining when compared with sound enamel. However, if there is discoloration of the infiltrant, the bleaching treatment can be used successfully.

Enamel morphology after microabrasion with experimental compounds

BACKGROUND

Enamel microabrasion is an esthetic treatment for removing superficial stains or defects of enamel.

AIM

This study evaluated the roughness after enamel microabrasion using experimental microabrasive systems.

MATERIALS AND METHODS

One hundred and ten samples (5 × 5 mm) were obtained from bovine incisors and divided into 11 groups (n = 10) in accordance with the treatment: Microabrasion using 6.6% hydrochloric acid (HCl) or 35% phosphoric acid (H3PO4) associated with aluminum oxide (AlO3) or pumice (Pum) with active application (using rubber cup coupled with a micro-motor of low rotation) or passive application (just placing the mixture on the enamel surface); just the use of acids in a passive application (negative control), and a group without treatment (positive control). Roughness analysis was performed before and after treatments. The statistical analysis used analysis of variance (PROC MIXED), Tukey-Kramer and Dunnet tests (P < 0.05). Representative specimens were evaluated using scanning electron microscopy (SEM).

RESULTS

There was no significant difference between the acids used (P = 0.0510) and the applications (P = 0.8989). All of the treated groups were statistically different from the positive control. When using passive application, the use of HCl + AlO3 resulted in higher roughness when compared with HCl + Pum. Additionally, this treatment was statistically different from the passive application of H3PO4 (negative control) (P < 0.05). However, SEM analysis showed that the treatment with AlO3 resulted in an enamel surface with a more polished aspect when compared with Pum.

CONCLUSION

AlO3 may be a suitable particle for use in microabrasive systems.