The effects of acid erosion and remineralization on enamel and three different dental materials: FT-Raman spectroscopy and scanning electron microscopy analysis

Do effervescent vitamin tablets affect the surface roughness, microhardness, and color of human enamel and contemporary composite resins?

PURPOSE

To compare the impact of four effervescent vitamin tablets on the surface roughness, microhardness, and color of human enamel and contemporary composite resins.

MATERIAL AND METHODS

Sixty enamel and a total of 240 anterior (Gradia Direct Anterior), posterior (Gradia Direct Posterior), and universal composite resin (Filtek Ultimate) specimens (n = 60 per group) were fabricated. Each group was subdivided into five subgroups (n = 12, per subgroup). The specimens were subsequently immersed in YOUPLUS, Redoxon, Sunlife Immuvit, and Sambucol effervescent vitamin solutions for 2 min per day over 30 days. Distilled water was used as control. Subsequently, surface roughness (Ra) was detected using a profilometer, and microhardness (VHN) was measured using a microhardness tester. A spectrophotometer device was used to record the L,a,b color coordinates of the specimens after 24 h, 7 days, and 30 days, and the color changes (ΔE00) of the groups were calculated. The data were analyzed by ANOVA, two-way ANOVA, Kruskal-Wallis, Levene's, and Fisher's least significant difference (LSD) tests (p < 0.05). SEM analysis was conducted on one randomly selected specimen per group (×1000).

RESULTS

In terms of surface roughness, material X vitamin interactions were found significant (p < 0.05). The increase in Ra from 24 h to 30 days was found significant (p < 0.05) except for Gradia Direct Anterior X Redoxon, Sunlife Immuvit and Sambucol, Filtek Ultimate X Sunlife Immuvit and Sambucol, and all control groups. Ra changes were also concluded by SEM. Regarding VHNs, material X vitamin interactions were significant (p < 0.005), except for all Filtek Ultimate subgroups. The changes in VHNs of the groups from 24 h to 30 days were significant for all enamel and Gradia Direct Anterior X YOUPLUS, Gradia Posterior X YOUPLUS, Sunlife Immuvit, and Sambucol groups (p < 0.05). In terms of ΔE00, significant differences were observed between the 7 days and 30 days in the enamel (p = 0.047), Gradia Direct Anterior (p = 0.019), and Gradia Direct Posterior groups (p = 0.038).

CONCLUSIONS

Daily consumption of effervescent vitamin tablets can increase surface roughness, decrease microhardness, and influence the color of human enamel and contemporary anterior, posterior, and universal composite resins after a 30-day period.

Effect of an Effervescent Multivitamin on Color and Surface Roughness of Micro-Hybrid Dental Resin Composites

The use of multivitamins has become widespread globally, yet there is a scarcity of studies investigating their impact on resin composite restorations. This study aimed to evaluate the effect of an effervescent multivitamin tablet on micro-hybrid dental resin composites' surface roughness and color. Fifty disc-shaped samples (8 × 2 mm, shade A2; n = 10) were prepared and polished using five different micro-hybrid resin composites (Pergamon, Dentac, Turkey; Estelite Posterior, Tokuyama, Japan; Geanial Anterior, GC, Japan; Charisma Opal, Kulzer, Germany; Beautifil II, Shofu, USA). Samples were immersed in 200 mL water to one effervescent multivitamin tablet (Redoxon Triple Action, Bayer) at 24 °C for 2 min a day in 24 h intervals for 30 days. All samples' surface roughness (Ra) and ΔE(L*a*b) measurements were recorded at the beginning and end of the 30 days. The Wald chi-square and a two-way ANOVA were used for statistical analysis (significance level p < 0.05). The resin composite type and exposure to the multivitamin had a statistically significant effect on Ra values (p < 0.05). The resin composite type had a statistically significant effect on ΔE values, likely due to the higher mean value of BII (p = 0.040). The surface roughness and color of resin composites can be affected by multivitamins with a pH value of 3.0. Therefore, it is important to consider the patient's routine vitamin intake during resin composite selection. Additional research is required to explore the properties of different dental restorative materials.

Effect of Low pH Dietary Supplements on Discoloration of Resin Composites

AIM

This study aimed to evaluate the impact of the consumption of low pH dietary supplements on the color stability of different resin composites.

MATERIALS AND METHODS

Three different restorative materials were used for this in vitro study: Filtek One Bulk-Fill (FOB), Filtek Z550 (Z550), and Fill-Up (FUP). Samples fabricated from each composite group were divided into four subgroups, and color measurements were performed at baseline. The control subgroup was stored in distilled water, and the other three subgroups were immersed in acidic dietary supplement solutions (Redoxon, Supradyn, and Voonka Collagen Shake) for 2 minutes daily for 28 days. Color measurements were obtained using a digital spectrophotometer. Color change values (ΔE1) were calculated after each color measurement. Next, all samples were immersed in a coffee solution for 7 days and repeat color measurements were taken to determine ΔE2 values. The study groups were compared using the Kruskal-Wallis test (α =0.05).

RESULTS

ΔE1 values were significantly different among the groups (P < 0.05). While Voonka Collagen Shake produced the greatest discoloration in FOB (1.67 ± 1.08) and Filtek Z550 (3.59 ± 1.90) materials, Fill-Up showed the highest discoloration (3.14 ± 0.37) with Supradyn. Analysis of ΔE2 values demonstrated a significant difference only for the Filtek Z550-Redoxon group versus the control group (P < 0.05).

CONCLUSION

Acidic dietary supplements not only produce color alterations in resin composites but also reduce the staining resistance of the composite further, depending on the type of composite and dietary supplement. Consumption of staining food after taking Redoxon effervescent tablets produces greater discoloration in Filtek Z550 restorations compared with other restorative materials.

Remineralizing Ability of Resin Modified Glass Ionomers (RMGICs): A Systematic Review

The selective caries removal approach leads to the need to use materials with the ability to remineralize remaining partially demineralized dentin. Among the materials proposed are resin-modified glass ionomer cements (RMGICs). The aim of this systematic review was to evaluate, based on in vitro experimental studies, whether RMGICs are suitable for remineralizing affected dentin. A systematic literature search was performed in four databases, followed by article selection, data extraction, and quality assessment. Studies assessing the remineralizing potential of RMGICs on dentin were included in our review. Studies which compared such properties between different RMGICs or with other materials were also eligible. The studies report the remineralizing ability of RMGICs, albeit with differences between different commercial products. RMGICs show a similar ability to conventional GICs to remineralize affected dentin, fulfilling the function for which they are designed. Moreover, the incorporation of additives, such as bioactive glass (BAG) or CCP-ACP, improves their remineralizing potential. The results of this review support the use of RMGICs as restorative materials after selective caries removal.

Acid Resistance of CAD/CAM Resin Composites

Acid resistance of CAD/CAM resin composites. Erosion-related tooth surface loss is closely related to acid exposure, such as contact with acidic beverages or disease-related reflux. As a result, dental restorations in affected patients are also exposed to acids, which indicates that the performance and longevity of a dental restoration is impacted by the acid resistance of the individually employed restorative materials. However, unlike for ceramic materials, the acid resistance of CAD/CAM resin composites is not commonly evaluated by the manufacturers, and no standardised test methods have yet been established. Against this background, the present in vitro study aimed to examine the long-term resistance of CAD/CAM resin composites (Brilliant Crios, Cerasmart, Grandio blocs, Lava Ultimate, Shofu Block HC) against three acidic media (tonic water, acetic acid, hydrochloric acid) as well as demineralized water and to investigate potential damage mechanisms. Changes in surface roughness (Sa) were detected by confocal laser scanning microscopy (CLSM), and changes in surface hardness were measured using Vickers hardness (HV). The damage mechanisms were analysed by scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDS) and micro X-ray computer tomography (µXCT). For each material, few changes in either Sa or HV were identified for at least one of the different media; for Cerasmart, the sharpest deterioration in surface properties was observed. SEM–EDS revealed leaching of barium, aluminium, and titanium from fillers in a 2 µm zone on the rough but not on the polished surface of the specimen. Within the limitations of the current study, it can be concluded that polished CAD/CAM resin composites can be recommended for clinical use in patients with erosive conditions.

Resin infiltrant protects deproteinized dentin against erosive and abrasive wear

Objectives

This study aimed to investigate the anti-erosive/abrasive effect of resin infiltration of previous deproteinized dentin.

Materials and Methods

Dentin slabs were randomly assigned to 3 groups (n = 15): Control (no deproteinization; no resin infiltrant applied), RI (no deproteinization; resin infiltrant applied), and DRI (deproteinization; resin infiltrant applied). After undergoing the assigned treatment, all slabs were subjected to an in vitro cycling model for 5 days. The specimens were immersed in citric acid (0.05 M, pH = 3.75; 60 seconds; 3 times/day) and brushed (150 strokes). Between the challenges, the specimens were exposed to a remineralizing solution (60 minutes). The morphological alterations were analyzed by mechanical profilometry (µm) and scanning electron microscopy (SEM). Data were submitted to one-way analysis of variance (ANOVA) and Tukey tests (p < 0.05).

Results

Control and RI groups presented mineral wear and did not significantly differ from each other (p = 0.063). DRI maintained a protective layer preserving the dentin (p < 0.001). After erosive/abrasive cycles, it was observed that in group RI, only 25% of the slabs partially evidenced the presence of the infiltrating, while, in the DRI group, 80% of the slabs presented the treated surface entirely covered by a resin-component layer protecting the dentin surface as observed in SEM images.

Conclusions

The removal of the organic content allows the resin infiltrant to efficiently protect the dentin surface against erosive/abrasive lesions.

Do whey protein beverages affect the microhardness of composites? A laboratory study

Background:

Whey protein supplements might be a potential risk factor for the restoration surface due to its pH and lactose content.

Aim:

The study aimed to evaluate the effect of whey protein beverages on the microhardness of four restorative composites with different microstructures (Filtek Z 350XT, Filtek Z 250XT, Filtek Bulk Fill (FBF), and Filtek P 60).

Materials and Methodology:

Forty disc-shaped samples from each material (in total 160) were prepared and wet polished. The samples of each group were randomly divided into four subgroups and subjected to four immersion media namely, whey protein Concentrate (WPC), whey protein Isolate (WPI), whey protein water (WPW), and distilled water (DW). The immersion protocol was performed twice for 10 min daily for 30 days followed by immersion in artificial saliva for another 10 min and stored in DW till the next cycle. The pre immersion and post immersion microhardness of all the samples were recorded with a Microhardness Tester FM-800. Data obtained were statistically analyzed using SPSS 25 software.

Results and Conclusions:

All composites exhibited decline in microhardness, except for FBF. P 60 composites which showed the highest decline in microhardness. WPC and WPI caused the greatest reduction in microhardness compared to WPW.

Improved bond performances of self-etch adhesives to enamel through increased MDP-Ca salt formation via phosphoric acid pre-etching

OBJECTIVES

The chemical affinity between 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and hydroxyapatite (HAp) is an important factor in the enamel bonding provided by MDP-based self-etch (SE) adhesives, besides microinterlocking mechanisms. This study aimed to investigate how phosphoric acid pre-etching affects MDP-Ca salt formation in the application of MDP-based SE adhesives.

METHODS

Single Bond Universal (SBU), All Bond Universal (ABU), Clearfil Universal Bond Quick (CBQ), and a MDP-based all-in-one adhesive (EXP) were used in both SE and etch-and-rinse (ER) modes, along with Clearfil SE Bond and untreated enamel (UE) as controls. The MDP-Ca salts produced with or without etching were examined by nuclear magnetic resonance, Raman spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, and Fourier-transform infrared spectroscopy. Zeta potential, contact angle, and scanning electron microscopy measurements were employed to elucidate the mechanism behind the changes in MDP/HAp chemical affinity upon pre-etching.

RESULTS

The percentage of MDP-Ca salt in EXP_ER (73.13%) was higher than that in EXP_SE (43.27%). Characteristic CH₂ (1130, 1441, 2853, and 2909 cm^-1), CC (1641 cm^-1), and CO (1718 cm^-1) bands were observed in the Raman spectra of EXP_ER. Pre-etching increased the negative zeta potential of the enamel surface compared to that of UE (P < 0.001). The contact angles of MDP-based adhesives applied to pre-etched enamel were significantly lower than those of the self-etched surface (P < 0.05).

SIGNIFICANCE

The increased MDP-Ca salt formation is a significant advantage of phosphoric acid pre-etching, improving the MDP/HAp chemical affinity in addition to increasing surface wettability.

Evaluation of the protective effect on enamel demineralization of CPP-ACP paste and ROCS by vibrational spectroscopy and SAXS: An in vitro study

The aim of this study was to investigate human dental enamel surfaces using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), Raman spectroscopy, and small angle X-ray scattering (SAXS) techniques concerning differences between the demineralized enamel surface and remineralized enamel surface by casein phosphopeptide amorphous calcium phosphate, Tooth mousse® (CPP-ACP) and remineralizing oral care systems (ROCS®) agents within the same tooth. For this purpose, 20 freshly extracted human maxillary central incisors without caries and defects were used. Labial surfaces of each of the teeth were divided into four sections, which were marked as follows: Group 1, normal enamel; Group 2, demineralized enamel with demineralization solution; Group 3, demineralized enamel + remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth); and Group 4, remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth). To describe the changes in tooth enamel, the phosphate group concentration within enamel was used as an indicator of the degree of mineralization. The phosphate and carbonate bands in the FTIR and Raman spectra were used to investigate the structural changes in the demineralized and remineralized enamel. Spectroscopic data were statistically analyzed in terms of CPP-ACP and ROCS using one-way analysis of variance. The carbonate content of demineralized enamel was higher than the carbonate content in the other groups (p < .03). The apatite carbonate-phosphate balance in the samples with only remineralizing agent-especially ROCS applied-changed significantly (p < .05) compared to the normal group. The average FTIR spectra of the groups were subjected to multivariate hierarchical cluster analysis (HCA) conducted with the use of the OPUS 5.5 software. Nanosized surface morphologies of the samples were compared using pair distance distributions obtained through SAXS analyses. According to the SAXS analyses, applications of CCP + ACP and ROCS agents were effective on nanostructures for all groups.

Effect of acidic beverages on surface roughness and color stability of artificial teeth and acrylic resin

PURPOSE

The aim was to evaluate the effect of four acidic beverages on the roughness (Ra) and color change (ΔE_ab) of two brands of artificial teeth and a heat-polymerized acrylic resin (HPAR) for use in a prosthetic base.

MATERIALS AND METHODS

All materials were divided into 5 groups, according to the used acidic beverage (artificial saliva - control, red wine, orange juice, coke-based, and lemon juice-based soft drink). The immersion process was divided into two stages: T1 - immersion in the acidic solutions for 10 minutes for 14 days; T2 - after T1, the samples were immersed in grape juice for 14 days. The Ra of the samples was evaluated in a rugosimeter and the ΔE_ab in a spectrophotometer, before and after the immersions. The analysis of variance of one (ΔE_ab) and two factors (Ra) and Tukey were performed (α=.05).

RESULTS

There was a statistical difference for roughness after immersion (T1) for Trilux and Tritone teeth, regardless of the acid solution. For Trilux teeth, all acid solutions increased Ra (P<.05). For Tritone teeth, only the coke-based soft drink did not statistically change Ra. Grape juice (T2) altered Ra only of artificial teeth (P<.05). The color was changed for all materials, after T1 and T2.

CONCLUSION

In general, the acidic solutions changed the Ra and ΔE_ab of HPAR and artificial teeth after T1. The grape juice altered the roughness only of the artificial teeth, promoting a clinically acceptable color change in the materials.

Effect of pediatric multivitamin syrups and effervescent tablets on the surface microhardness and roughness of restorative materials: An in vitro study

Background/purpose

Multivitamin syrups and effervescent tablets are commonly used for dietary support in children; however, these preparations may have detrimental effects on the surface of restorative materials. The aim of this study was to evaluate the effect of two multivitamin syrups and two effervescent tablets taken daily on the surface microhardness and roughness of two different restorative materials.

Materials and methods

The study groups were comprised of a conventional glass ionomer cement, Ketac Molar, and a giomer, Beautifil II. A total of 140 disc-shaped specimens were prepared and randomly assigned to 5 subgroups. The samples were immersed in 4 multivitamins (Supradyne syrup, Supradyne effervescent, Sambucol syrup, Sambucol effervescent) and deionized water (control group) for 2 min once a day for 28 days. Surface microhardness and roughness measurements were recorded at baseline and on the 7th, 14th, 21st and 28th days. Surface microhardness was measured using a Vickers hardness tester and surface roughness was determined using a profilometer.

Results

For all subgroups; the surface microhardness values of the Ketac Molar and Beautifil II demonstrated a statistically significant decrease from the baseline to the 28th day measurements (p < 0.05), while the surface roughness displayed increased values that were found to be statistically significant (p < 0.05). The Ketac Molar surface roughness values were significantly higher than Beautifil II in all subgroups for all measurement days (p = 0.0001).

Conclusion

The prolonged use of multivitamin syrups and effervescent tablets may have negative effects on the physical properties of restorative materials.

Glass Fiber Reinforced Composite Orthodontic Retainer: In Vitro Effect of Tooth Brushing on the Surface Wear and Mechanical Properties

Fiber reinforced composites (FRCs) are metal free materials that have many applications in dentistry. In clinical orthodontics, they are used as retainers after active treatment in order to avoid relapse. However, although the modulus of the elasticity of FRCs is low, the rigidity of the material in the form of a relatively thick retainer with a surface cover of a flowable resin composite is known to have higher structural rigidity than stainless steel splints. The aim of the present study is to measure load and bending stress of stainless steel wires, as well as flowable resin composite covered and spot‑bonded FRC retainer materials after tooth brushing. These materials were tested with a three point bending test for three different conditions: no brushing, 26 min of brushing, and 60 min of brushing. SEM images were taken before and after different times of tooth brushing. Results showed that stainless steel was not significantly affected by tooth brushing. On the other hand, a significant reduction of values at maximum load at fracture was reported for both FRC groups, and uncovered FRCs were most affected. Concerning maximum bending stress, no significant reduction by pretreatment conditions was reported for the materials tested. SEM images showed no evident wear for stainless steel. Flowable resin composite covered FRCs showed some signs of composite wear, whereas spot‑bonded FRCs, i.e., without the surface cover of a flowable resin composite, showed signs of wear on the FRC and exposed glass fibers from the FRC's polymer matrix. Because of the significant changes of the reduction of maximum load values and the wear for spot‑bonded FRCs, this technique needs further in vitro and in vivo tests before it can be performed routinely in clinical practice.

The effects of intrinsic and extrinsic acids on nanofilled and bulk fill resin composites: Roughness, surface hardness, and scanning electron microscopy analysis

The objective of this study was to examine the effects of extrinsic or intrinsic acids on nanofilled and bulk fill resin materials in vitro. A total of 90 disks were prepared using dental restorative material (Filtek Z350XT, GrandioSO, Filtek Bulk Fill, X-tra fil). Thirty disks of each material were sub-divided into three groups (n = 10) that were immersed for 7 days in deionized water (DW), 5% citric acid (CA-pH 2.1), or 0.1% hydrochloric acid (HCl-pH = 1.2). Surface hardness and roughness (stylus profilometer by R_a parameter) analysis were performed before and after immersion. Morphological changes were evaluated by scanning electron microscopy. The data were analyzed by two-way ANOVA and Tukey's test (α = 0.05). All tested materials did not show significant differences in the effects of the DW, CA, or HCl solutions on surface roughness (p = .368). Likewise, the hardness loss was not affected by the solutions tested (p = .646), but there was a difference in the resin type (p = .002). Filtek Bulk Fill resin hardness was less affected, while Filtek Z350XT and GrandioSO presented the most hardness loss after 7 days of solution immersion. In terms of this experimental study, the results demonstrate the effectiveness of the mechanical properties (roughness and hardness surface) of nanofilled and bulk fill resin materials to resist erosion from extrinsic and intrinsic acids, therefore being potential candidates for dental applications.

Performance of Adhesives and Restorative Materials After Selective Removal of Carious Lesions: Restorative Materials with Anticaries Properties

Selective carious tissue-removal strategies require specific considerations in selection of restorative materials. A tight marginal seal placed over hard dentin and sound enamel is essential. For selective removal of carious tissue with permanent restoration, bioactive materials, such as high-viscosity glass-ionomer cement (HV-GIC) or calcium silicates, may be preferred over caries-affected firm or leathery dentin to improve remineralization. HV-GICs have the best clinical evidence of caries-arresting effect and demonstrate sufficient longevity as long-term provisional restorations that can later be used in open or closed sandwich restorations. As with any material, oral health maintenance remains important for long-term survival of restorations.