1
|
Mederos M, de León E, García A, Cuevas-Suárez CE, Hernández-Cabanillas JC, Rivera-Gonzaga JA, Grazioli G. In vitro characterization of a novel resin-based restorative material containing alkaline fillers. J Appl Oral Sci 2024; 32:e20230219. [PMID: 38232277 PMCID: PMC10984576 DOI: 10.1590/1678-7757-2023-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/26/2023] [Accepted: 12/02/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE In this study, a comparative evaluation of the physicochemical properties of Cention N and other direct restorative materials was performed. Three restorative materials-a resin-modified glass ionomer (Fuji II LC), an alkasite-based resinous material (Cention N), and a resin composite (Tetric N Ceram)-were characterized in terms of degree of conversion, Knoop hardness number (KHN) ratio, flexural strength, elastic modulus, water sorption, water solubility, microshear bond strength to dentin, immediate microleakage, and radiopacity. METHODOLOGY The microshear bond strength to dentin and microleakage of Cention N were evaluated with and without the application of an adhesive system (Tetric N Bond Universal). A one-way ANOVA test was used to analyze the data in terms of degree of conversion, KHN ratio, water sorption, water solubility, microshear bond strength to dentin, and radiopacity. A two-way ANOVA test (carried out considering the material type and ethanol aging as factors) was used to analyze the data in terms of flexural strength and elastic modulus. The Kruskal-Wallis test was used to statistically analyze the data on microleakage. A significance level of α=0.05 was used for all tests. RESULTS Fuji II LC was found to have the highest degree of conversion, water sorption, and microleakage, as well as the lowest flexural strength. Cention N had the highest solubility; when used with an adhesive system, it achieved bond strength and microleakage similar to those of the Tetric N Ceram composite. Tetric N Ceram had the highest degree of conversion, KHN ratio, and radiopacity. Conclusion: The properties of Cention N validate its efficacy as an alternative direct restorative material when used in conjunction with an adhesive system.
Collapse
Affiliation(s)
- Matias Mederos
- Universidad de la RepúbicaFacultad de OdontologíaDepartamento de Odontología Preventiva y RestauradoraMontevideoUruguayUniversidad de la Repúbica, Facultad de Odontología, Departamento de Odontología Preventiva y Restauradora, Area de Materiales Dentales, Montevideo, Uruguay
| | - Elisa de León
- Universidad de la RepúbicaFacultad de OdontologíaDepartamento de Odontología Preventiva y RestauradoraMontevideoUruguayUniversidad de la Repúbica, Facultad de Odontología, Departamento de Odontología Preventiva y Restauradora, Area de Materiales Dentales, Montevideo, Uruguay
| | - Andrés García
- Universidad de la RepúbicaFacultad de OdontologíaDepartamento de Odontología Preventiva y RestauradoraMontevideoUruguayUniversidad de la Repúbica, Facultad de Odontología, Departamento de Odontología Preventiva y Restauradora, Area de Materiales Dentales, Montevideo, Uruguay
| | - Carlos Enrique Cuevas-Suárez
- Universidad Autónoma del Estado de HidalgoÁrea académica de Odontología, Laboratorio de Materiales DentalesPachucaMéxicoUniversidad Autónoma del Estado de Hidalgo, Área académica de Odontología, Laboratorio de Materiales Dentales, Pachuca, México.
| | - Juan Carlos Hernández-Cabanillas
- Universidad Autónoma de Baja CaliforniaFacultad de Ciencias de la SaludTijuanaMéxicoUniversidad Autónoma de Baja California, Blvd Universitario, Facultad de Ciencias de la Salud, Tijuana, México.
| | - José Alejandro Rivera-Gonzaga
- Universidad Autónoma del Estado de HidalgoÁrea académica de Odontología, Laboratorio de Materiales DentalesPachucaMéxicoUniversidad Autónoma del Estado de Hidalgo, Área académica de Odontología, Laboratorio de Materiales Dentales, Pachuca, México.
| | - Guillermo Grazioli
- Universidad de la RepúbicaFacultad de OdontologíaDepartamento de Odontología Preventiva y RestauradoraMontevideoUruguayUniversidad de la Repúbica, Facultad de Odontología, Departamento de Odontología Preventiva y Restauradora, Area de Materiales Dentales, Montevideo, Uruguay
| |
Collapse
|
2
|
Yu J, Yi L, Guo R, Guo J, Yang H, Huang C. The Stability of Dentin Surface Biobarrier Consisting of Mesoporous Delivery System on Dentinal Tubule Occlusion and Streptococcus Mutans Biofilm Inhibition. Int J Nanomedicine 2021; 16:3041-3057. [PMID: 33948084 PMCID: PMC8088303 DOI: 10.2147/ijn.s290254] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/31/2021] [Indexed: 01/21/2023] Open
Abstract
Background The dentin exposure always leads to dentin hypersensitivity and/or caries. Given the dentin’s tubular structure and low mineralization degree, reestablishing an effective biobarrier to stably protect dentin remains significantly challenging. This study reports a versatile dentin surface biobarrier consisting of a mesoporous silica-based epigallocatechin-3-gallate (EGCG)/nanohydroxyapatite delivery system and evaluates its stability on the dentinal tubule occlusion and the Streptococcus mutans (S. mutans) biofilm inhibition. Materials and Methods The mesoporous delivery system was fabricated and characterized. Sensitive dentin discs were prepared and randomly allocated to three groups: 1, control group; 2, casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) group; and 3, the mesoporous delivery system group. The dentin permeability, dentinal tubule occlusion, acid and abrasion resistance, and S. mutans biofilm inhibition were determined for 1 week and 1 month. The in vitro release profiles of EGCG, Ca, and P were also monitored. Results The mesoporous delivery system held the ability to sustainably release EGCG, Ca, and P and could persistently occlude dentinal tubules with acid and abrasion resistance, reduce the dentin permeability, and inhibit the S. mutans biofilm formation for up to 1 month compared with the two other groups. The system provided prolonged stability to combat oral adverse challenges and served as an effective surface biobarrier to protect the exposed dentin. Conclusion The establishment of the dentin surface biobarrier consisting of a mesoporous delivery system indicates a promising strategy for the prevention and the management of dentin hypersensitivity and caries after enamel loss.
Collapse
Affiliation(s)
- Jian Yu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Luyao Yi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Rui Guo
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Jingmei Guo
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Hongye Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Cui Huang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| |
Collapse
|
3
|
Bastos-Bitencourt N, Velo M, Nascimento T, Scotti C, da Fonseca MG, Goulart L, Castellano L, Ishikiriama S, Bombonatti J, Sauro S. In Vitro Evaluation of Desensitizing Agents Containing Bioactive Scaffolds of Nanofibers on Dentin Remineralization. MATERIALS 2021; 14:ma14051056. [PMID: 33668257 PMCID: PMC7956660 DOI: 10.3390/ma14051056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 01/02/2023]
Abstract
This study evaluated the effect of the incorporation of bioactive nanofibers in desensitizing agents on dentin permeability. Sixty disks of dentin were randomly distributed in four groups (n = 15). Distribution was based on the desensitizing agents, fluoride varnish and self-etching adhesive, and the presence of nanofibers: C (self-etching adhesive Clearfil SE Bond), CN (Clearfil SE Bond with 1% nanofiber), D (Duraphat varnish), and DN (Duraphat varnish with 1% nanofiber). Dentin permeability was determined using hydraulic conductivity. For a qualitative analysis, confocal laser microscopy and scanning electron microscopy were performed. The C group showed the lowest hydraulic conductance (Lp%) (89.33), while the DN group showed the highest Lp% (116.06). No statistical significance was observed in the Lp% values in all groups after the treatment and 6% citric acid challenge (p > 0.239). In the images, the CN group presented a higher superficial and intratubular deposition. In addition, this group presented a more homogeneous dentin surface and wide occlusion of dentinal tubules than the other treatments. Despite there being no statistical differences among the treatments employed, the images showed that the CN group presented a higher surface and intratubular deposition compared to the other treatments, even after the acid challenge.
Collapse
Affiliation(s)
- Natália Bastos-Bitencourt
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP 17011-220, Brazil; (N.B.-B.); (M.V.); (C.S.); (S.I.); (J.B.)
| | - Marilia Velo
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP 17011-220, Brazil; (N.B.-B.); (M.V.); (C.S.); (S.I.); (J.B.)
| | - Tatiana Nascimento
- Center for Fuels and Materials (NPE—LACOM), Program of Post-Graduation in Chemistry, Federal University of Paraíba (PPGQ-UFPB), João Pessoa, PB 58033-455, Brazil; (T.N.); (M.G.d.F.)
- Laboratory of Nanobiotechnology (NANOS), Institute of Biotechnology, Federal University of Uberlândia, Av. Pará, 1720, Uberlândia, MG 38400-902, Brazil;
| | - Cassiana Scotti
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP 17011-220, Brazil; (N.B.-B.); (M.V.); (C.S.); (S.I.); (J.B.)
| | - Maria Gardennia da Fonseca
- Center for Fuels and Materials (NPE—LACOM), Program of Post-Graduation in Chemistry, Federal University of Paraíba (PPGQ-UFPB), João Pessoa, PB 58033-455, Brazil; (T.N.); (M.G.d.F.)
| | - Luiz Goulart
- Laboratory of Nanobiotechnology (NANOS), Institute of Biotechnology, Federal University of Uberlândia, Av. Pará, 1720, Uberlândia, MG 38400-902, Brazil;
| | - Lucio Castellano
- Human Immunology Research and Education Group (GEPIH), Technical School of Health, Federal University of Paraíba, João Pessoa, PB 58059-900, Brazil;
| | - Sergio Ishikiriama
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP 17011-220, Brazil; (N.B.-B.); (M.V.); (C.S.); (S.I.); (J.B.)
| | - Juliana Bombonatti
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP 17011-220, Brazil; (N.B.-B.); (M.V.); (C.S.); (S.I.); (J.B.)
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
- Correspondence: ; Tel.: +34-961-369-000
| |
Collapse
|
4
|
Comparing the Effectiveness of Different Dentinal Desensitizing Agents: In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6652250. [PMID: 33628801 PMCID: PMC7896870 DOI: 10.1155/2021/6652250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/29/2022]
Abstract
Objectives To evaluate the in vitro effectiveness of desensitizing agents in reducing dentine permeability. Methods The efficacy of desensitizing agents in reducing dentine permeability by occluding dentine tubules was evaluated using a fluid filtration device that conducts at 100 cmH2O (1.4 psi) pressure, and SEM/EDX analyses were evaluated and compared. Forty-two dentine discs (n = 42) of 1 ± 0.2 mm width were obtained from caries-free permanent human molars. Thirty dentine discs (n = 30) were randomly divided into 3 groups (n = 10): Group 1: 2.7% wt. monopotassium-monohydrogen oxalate (Mp-Mh oxalate), Group 2: RMGI XT VAR, and Group 3: LIQ SiO2. Dentine permeability was measured following treatment application after 10 minutes, storage in artificial saliva after 10 minutes and 7 days, and citric acid challenge for 3 minutes. Data were analysed with a repeated measures ANOVA test. Dentine discs (n = 12) were used for SEM/EDX analyses to acquire data on morphological changes on dentine surface and its mineral content after different stages of treatment. Results Desensitizing agents' application on the demineralized dentine discs exhibited significant reduction of permeability compared to its maximum acid permeability values. Mp-Mh oxalate showed a significant reduction in dentine permeability (p < 0.05) when compared to RMGI XT VAR and LIQ SiO2. On SEM/EDX analysis, all the agents formed mineral precipitates that occluded the dentine tubules. Conclusions 2.7% wt. monopotassium-monohydrogen oxalate was significantly effective in reducing dentine permeability compared to RMGI XT VAR and LIQ SiO2.
Collapse
|
5
|
Bhavsar BA, Vaz M, Neilalung K, Das T, Majumdar S, Talukdar J. Comparative Evaluation of Efficacy of Diode Laser and Clinpro XT Varnish for Treatment of Dentin Hypersensitivity: A Randomized Clinical Trial. J Int Soc Prev Community Dent 2021; 10:779-785. [PMID: 33437713 PMCID: PMC7791592 DOI: 10.4103/jispcd.jispcd_356_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 11/04/2022] Open
Abstract
Context Dentin hypersensitivity (DH) is a very common dilemma and often results in temporary relief by the conventional treatment method. An in vivo comparative study of various methods and materials helps in evaluation of a superior method to provide a long-lasting relief. Aim The aim of this study was to evaluate the efficacy of diode laser (DL) and Clinpro XT Varnish for managing DH. Materials and Methods This study was a randomized, single-blinded, clinical trial, designed, adhering to the CONSORT (Consolidated Standards of Reporting Trials) Guidelines using DL and fluoride-based varnish for managing DH. A total of 40 teeth were selected from eight patients and randomly divided into two groups. All patients received tactile and air syringe stimulus to assess for DH and a visual analog scale (VAS) was used to obtain readings at baseline, 15min, 1 week, and 3 weeks, posttreatment. Student's t test was used, paired t test was for the intragroups, and unpaired t test was for intergroups. Results This study showed that the effect of DL and Clinpro XT Varnish results in a significant decrease of DH. However, success decreased gradually over time. Conclusion Clinpro XT Varnish presented superior immediate effect and DL effect tends to become better with time. Hence, both had good results in the end.
Collapse
Affiliation(s)
- Bhavika Alpesh Bhavsar
- Department of Conservative Dentistry and Endodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Michelle Vaz
- Department of Conservative Dentistry and Endodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Kamei Neilalung
- Department of Conservative Dentistry and Endodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Tanisha Das
- Department of Leadership in Healthcare, Trinity Western University, Langley Township, British Columbia, Canada
| | - Swarnaditya Majumdar
- Department of Dentistry, Murshidabad Medical College and Hospital, Berhampore, West Bengal, India
| | - Jagriti Talukdar
- Department of Dentistry, Assam Medical College and Hospital, Dibrugarh, Assam, India
| |
Collapse
|
6
|
Hydraulic conductance of dentin after treatment with fluoride toothpaste containing sodium trimetaphosphate microparticles or nanoparticles. Clin Oral Investig 2020; 25:2069-2076. [PMID: 32808179 DOI: 10.1007/s00784-020-03516-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the hydraulic conductance of dentin after treatment with fluoride toothpastes containing sodium trimetaphosphate microparticles (TMPmicro) or nanoparticles (TMPnano). MATERIALS AND METHODS The dentinal tubules of bovine dentin blocks (4 × 4 × 1 mm) were unobstructed for determination of the maximum hydraulic conductance of the dentin. The dentin blocks were randomized into four groups (n = 15/group) of toothpastes (placebo, 1100 ppm F, and 1100 with 3% TMPmicro or 3% TMPnano) which were applied for 7 days (2×/day) using a brushing machine. The dentin surface (5/group) was analyzed by scanning electron microscopy. The hydraulic conductance post-treatment was measured in the other ten blocks. Thereafter, the same blocks were immersed in citric acid (pH 3.2) for 1 min, and the conductance was determined again. The data were submitted to 2-way ANOVA repeated measures, followed by the Student-Newman-Keuls test (p < 0.05). RESULTS The percentage conductance reduction post-treatment for the groups were placebo = 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). After acid attack, the percentage reduction was placebo < 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). The toothpastes containing TMP showed the highest obliteration of dentinal tubules. CONCLUSIONS The addition of TMPmicro to fluoride toothpaste produced a greater reduction in hydraulic conductance when compared with 1100 ppm F toothpaste. CLINICAL RELEVANCE The increased capacity of toothpastes containing TMP to reduce hydraulic conductance indicates their potential to reduce symptoms of dentinal hypersensitivity.
Collapse
|
7
|
The Effectiveness of Remineralizing Agents on Dentinal Permeability. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4072815. [PMID: 30276206 PMCID: PMC6157146 DOI: 10.1155/2018/4072815] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/07/2018] [Indexed: 11/29/2022]
Abstract
The effectiveness of remineralizing agents in reducing dentine permeability by tubule occlusion using fluid filtration device functioning at 100 cmH2O (1.4 psi) pressure and SEM/EDX analysis were evaluated and compared. Seventy (n = 70) dentine discs of 1±0.2 mm width were prepared from sound permanent human molars. Fifty (n = 50) dentine discs were randomly divided into 5 groups (n = 10): Group 1: GC Tooth Mousse Plus (Recaldent GC Corporation Tokyo, Japan), Group 2: Clinpro™ White Varnish (3M ESPE, USA), Group 3: Duraphat® Varnish (Pharbil Waltrop GmbH, Germany), Group 4: Colgate Sensitive Pro-Relief™ dentifrice (Colgate Palmolive, Thailand), and Group 5: Biodentine™ (Septodont/UK). Dentine permeability was measured after treatment application at 10 minutes, artificial saliva immersion at 7 days, and citric acid challenge for 3 minutes. Data were analyzed by two-way repeated measures ANOVA. Dentine specimens (n = 20) were used for SEM/EDX analyses to obtain qualitative results on dentine morphology and surface deposits. Each treatment agent significantly reduced dentine permeability immediately after treatment application and created precipitates on treated dentine surfaces. All agents increased permeability values after 7 days of artificial saliva immersion except Clinpro White Varnish and Biodentine. Clinpro White Varnish exhibited significant resistance to acid challenge compared to others. Colgate Sensitive Pro-Relief dentifrice has a dual mechanism of action in reducing the dentine sensitivity.
Collapse
|
8
|
Canali GD, Rached RN, Mazur RF, Souza EM. Effect of Erosion/Abrasion Challenge on the Dentin Tubule Occlusion Using Different Desensitizing Agents. Braz Dent J 2018; 28:216-224. [PMID: 28492753 DOI: 10.1590/0103-6440201700811] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 12/19/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to evaluate dentinal tubule occlusion, measuring the dentin permeability (Lp) and using different desensitizing agents before and after abrasive/erosive challenge. Dentin discs from 42 healthy human third molars were obtained. Minimum Lp was measured after a smear layer simulation using #600 SiC paper and maximum Lp after an immersion in 0.5 M EDTA. The specimens were treated with different desensitizers: two varnishes (Clinpro XT Varnish-CV, Fluor Protector-FP), a paste (Desensibilize Nano P-NP) and a gel (Oxa Gel-OG). The Lp of each specimen was measured immediately after the desensitizers' application. The discs were subjected to erosion/abrasion cycles for 7 days, with 0.5% citric acid solution (6x/day) and tooth brushing (3x/day). Lp was measured after the first, fourth and seventh day of the challenge. The data were analyzed by 3-way ANOVA with repeated measurements and by a Games-Howell test (α=5%). FP and CV did not show significant differences in Lp immediately after application until the 7th day (p<0.05). OG showed a significant increase in Lp after the 4th and 7th days. NP resulted in a significantly higher permeability compared to the other materials immediately after the application and after the 1st day of challenge. All the desensitizers reduced the dentin permeability immediately after application. However, only the varnishes were able to maintain the occlusive effect after the erosion/abrasion challenge.
Collapse
Affiliation(s)
- Gabriela D Canali
- Graduate Program in Dentistry, School of Life Sciences, PUCPR - Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Rodrigo N Rached
- Graduate Program in Dentistry, School of Life Sciences, PUCPR - Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Rui F Mazur
- Graduate Program in Dentistry, School of Life Sciences, PUCPR - Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Evelise M Souza
- Graduate Program in Dentistry, School of Life Sciences, PUCPR - Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.,Operative Dentistry, Department of Restorative Dentistry, UFPR - Universidade Federal do Paraná, Curitiba, PR, Brazil
| |
Collapse
|
9
|
Dentinal tubule obliteration using toothpastes containing sodium trimetaphosphate microparticles or nanoparticles. Clin Oral Investig 2018; 22:3021-3029. [PMID: 29464359 DOI: 10.1007/s00784-018-2384-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 02/07/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This in vitro study evaluated the effect of microparticles (TMPmicro) or nanoparticles (TMPnano) TMP associated with fluoride (F) in toothpaste formulations on the obliteration of dentinal tubules (DT). MATERIALS AND METHODS The dentinal tubules of bovine dentin blocks were unobstructed by immersion in 37% phosphoric acid solution. Blocks (n = 20/group) underwent mechanical brushing (2×/day) during 7 days with toothpastes: placebo, 1100 ppm F, and 1100 with 3% TMPmicro or 3% TMPnano. After that, ten blocks of each group were immersed in citric acid (pH 3.2) for 1 min. The number, diameter and area of unobstructed DT, atomic % of chemical elements from precipitates, and the mineral concentration were quantified. Data were submitted to two-way ANOVA, followed by Student-Newman-Keuls test (P < 0.05). RESULTS Toothpastes containing TMPmicro and TMPnano promoted greater obliteration of DT and greater mineral concentration compared to other groups (P < 0.05). Placebo and 1100 ppm F group presented similar obliteration but 1100 ppm F group promoted higher mineral concentration. Higher Ca/P ratios were observed in groups treated with TMP; the acid challenge reduced Ca/P ratio for all groups. The atomic % of C and N was significantly lower for TMP toothpastes before acid challenge, but increased afterwards. CONCLUSIONS It was concluded that the addition of TMPmicro or TMPnano to F toothpastes produced greater obliteration of dentinal tubules and higher mineral concentration when compared with 1100 ppm F. CLINICAL RELEVANCE By the addition of TMP, fluoride toothpastes may occlude the dentinal tubules, with potential to reduce dentin hypersensitivity.
Collapse
|
10
|
Bacelar-Sá R, Giannini M, Ambrosano GMB, Bedran-Russo AK. Dentin Sealing and Bond Strength Evaluation of Hema-Free and Multi-Mode Adhesives to Biomodified Dentin. Braz Dent J 2017; 28:731-737. [PMID: 29211130 DOI: 10.1590/0103-6440201701522] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 08/08/2017] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the effect of dentin biomodification on the bond strength (BS) and sealing ability (SA) of HEMA-free and multi-mode adhesives after 24 h and 6 months of water storage. Four adhesives were tested: two multi-mode (Scotchbond Universal - SU, and Prime & Bond Elect - PB) and two HEMA-free (All-Bond 3 - AB, and G-Aenial - GA). Human third molars were selected and dentin was treated with two cross-linking agents (5% glutaraldehyde and 6.5% proanthocyanidin-rich grape seed extract - PACs) for 10 min or kept untreated (control group) (n=6). Teeth were sectioned and prepared for BS test and SA analysis. The SA measurements were taken with the presence of smear layer (minimum permeability), EDTA treatment (maximum permeability), PACs application, adhesive application and after 6 months of water storage. BS data were analyzed by Proc Mixed and Tukey-Kramer test (α=5%). PACs application increased the BS for all adhesives tested at 24 h. However, BS decreased for SU and AB after six months. In general, multi-mode adhesives (SU and PB) did not differ from AB HEMA-free. GA presented the lowest BS values at both times of evaluation. Dentin permeability was reduced after PACs application and remained the same after 6 months, regardless adhesive application. PACs can increase the BS regardless the type of adhesive, however only for PB and GA the BS kept stable after 6-months of water storage. PACs was able to seal the dentin as the minimum permeability and also remained stable after 6 months.
Collapse
Affiliation(s)
- Renata Bacelar-Sá
- Department of Restorative Dentistry, Dental Materials Division, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Marcelo Giannini
- Department of Restorative Dentistry, Dental Materials Division, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Glaucia Maria Bovi Ambrosano
- Department of Social Dentistry, Biostatistics Division, Piracicaba Dental School, UNICAMP - State University of Campinas, Piracicaba, SP, Brazil
| | - Ana Karina Bedran-Russo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
11
|
Yilmaz NA, Ertas E, Orucoğlu H. Evaluation of Five Different Desensitizers: A Comparative Dentin Permeability and SEM Investigation In Vitro. Open Dent J 2017; 11:15-33. [PMID: 28484578 PMCID: PMC5396078 DOI: 10.2174/1874210601711010015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/28/2016] [Accepted: 01/03/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND/OBJECTIVE The purpose of this study was to evaluate the efficacy and durability of five different dentin desensitizers (Gluma Desensitizer Powergel, Bifluorid 12, Gluma Self Etch Bond, D/Sense Crystal, Nupro Sensodyne Prophylaxis Paste with Novamin) on tubule occlusion and dentin permeability reduction in vitro. METHOD The quantitative changes in permeability of 100 dentin discs were measured after desensitizer treatments and following post-treatments of 6% citric acid challenge for 1 min or immersion in artificial saliva for 24 hours under hydrostatic pressure generated by a computerised fluid filtration meter. Qualitative SEM analyses were also carried out. RESULTS Dentin permeability decreased after desensitizer application in all groups. Nevertheless, only the difference between 'Gluma Self Etch Bond' and 'Nupro Sensodyne Prophylaxis Paste with Novamin' groups was significantly different (p<0.05). Dentin permeability increased significantly after post-treatments (p<0.05). There was no statistically difference among the citric acid-subgroups (p>0.05). Of all the artificial saliva-subgroups, only the difference between 'D/Sense Crystal' and 'Bifluorid 12' was significantly different (p<0.05). In SEM analysis, morphological changes were detected on the dentin surface and within the tubules following desensitizer treatments and post-treatments. CONCLUSION All the desensitizers significantly reduced dentin permeability by changing the morphology of the dentin surface and/or dentinal tubules. Following post-treatments, there was some reduction in the efficacy of the desensitizers which was represented by the reduction in permeability values. SEM analysis revealed some physical changes in the dentin structure which can partly give an explanation to the reduced efficacy of tested desensitizers.
Collapse
Affiliation(s)
- Nasibe Aycan Yilmaz
- Department of Restorative Dentistry, Faculty of Dentistry,
University of Adnan Menderes, Aydin, Turkey
| | - Ertan Ertas
- Department of Restorative Dentistry, Faculty of Dentistry,
University of Ondokuz Mayis, Samsun, Turkey
| | - Hasan Orucoğlu
- Department of Endodontics, Faculty of Dentistry, University of
Abant Izzet Baysal, Bolu, Turkey
| |
Collapse
|
12
|
Rizzante FAP, Maenosono RM, Duarte MAH, Furuse AY, Palma-Dibb RG, Ishikiriama SK. In Vitro Evaluation of Dentin Hydraulic Conductance After 980 nm Diode Laser Irradiation. J Periodontol 2015; 87:320-6. [PMID: 26643221 DOI: 10.1902/jop.2015.150444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Dentin hypersensitivity treatments are based on the physical obliteration of the dentinal tubules to reduce hydraulic conductance. The aim of the present study is to evaluate the hydraulic conductance of bovine root dentin after irradiation with a 980-nm diode laser, with or without associated fluoride varnish. METHODS Sixty bovine root dentin specimens were divided into six groups (n = 10 in each group): G1, G3, and G5 (0.5 W, 0.7 W, and 1 W diode laser, respectively); G2, G4, and G6 (fluoride varnish application + 0.5 W, 0.7 W, and 1 W diode laser, respectively). The dentin hydraulic conductance was evaluated at four time periods with a fluxmeter: 1) with smear layer, 2) after 37% phosphoric acid etching, 3) after the treatments, and 4) after 6% citric acid challenge. After the dentinal fluid flow measurements, specimens were also evaluated for mineral composition using energy dispersive X-ray spectroscopy (EDS). RESULTS Analysis demonstrated a better result with increased irradiation power (P < 0.001), especially if the diode laser irradiation was associated with the application of fluoride varnish (P < 0.001), ensuring a greater reduction in permeability. Considering the groups treated only with laser irradiation, the 1 W group was superior when compared with the 0.5 W and 0.7 W irradiated groups immediately after treatment (P < 0.001). After citric acid testing, all groups showed similar results, except when comparing the 1 W groups with the 0.5 W groups (P = 0.04). EDS results of the irradiated groups showed an increase in the proportion of calcium and phosphorus ions, which demonstrates a superficial composition modification after laser treatments. CONCLUSION Laser irradiation of exposed dentin promoted significant reduction in the dentin hydraulic conductance, mainly with higher energy densities and association with fluoride varnish.
Collapse
Affiliation(s)
- Fabio A P Rizzante
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Rafael M Maenosono
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marco A H Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Adilson Y Furuse
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Regina G Palma-Dibb
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo
| | - Sérgio K Ishikiriama
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
13
|
Lee HO, Park JY. Antibacterial Effect and Cytotoxicity of Desensitizer Containing Antimicrobial. ACTA ACUST UNITED AC 2015. [DOI: 10.17135/jdhs.2015.15.2.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
14
|
Chiang YC, Lin HP, Chang HH, Cheng YW, Tang HY, Yen WC, Lin PY, Chang KW, Lin CP. A mesoporous silica biomaterial for dental biomimetic crystallization. ACS NANO 2014; 8:12502-12513. [PMID: 25482513 DOI: 10.1021/nn5053487] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The loss of overlying enamel or cementum exposes dentinal tubules and increases the risk of several dental diseases, such as dentin hypersensitivity (causing sharp pain and anxiety), caries, and pulp inflammation. This paper presents a fast-reacting, more reliable and biocompatible biomaterial that effectively occludes exposed dentinal tubules by forming a biomimetic crystalline dentin barrier. To generate this biomaterial, a gelatin-templated mesoporous silica biomaterial (CaCO3@mesoporous silica, CCMS) containing nanosized calcium carbonate particles is mixed with 30% H3PO4 at a 1/1 molar ratio of Ca/P (denoted as CCMS-HP), which enables Ca2+ and PO4(3-)/HPO4(2-) ions to permeate the dentinal tubules and form dicalcium phosphate dihydrate (DCPD), tricalcium phosphate (TCP) or hydroxyapatite (HAp) crystals at a depth of approximately 40 μm (sub-μ-CT and nano-SEM/EDS examinations). In vitro biocompatibility tests (WST-1 and lactate dehydrogenase) and ALP assays show high cell viability and mineralization ability in a transwell dentin disc model treated with CCMS-HP (p<0.05). The in vivo efficacy and biocompatibility analyses of the biomaterial in an animal model reveal significant crystal growth (DCPD, TCP or HAp-like) and no pulp irritation after 70 days (p<0.05). The developed CCMS-HP holds great promise for treating exposed dentin by growing biomimetic crystals within dentinal tubules. These findings demonstrate that the mesoporous silica biomaterials presented here have great potential for serving as both a catalyst and carrier in the repair or regeneration of dental hard tissue.
Collapse
Affiliation(s)
- Yu-Chih Chiang
- School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University and National Taiwan University Hospital , No. 1, Chang-Te Street, Taipei 10016, Taiwan
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Calabria M, Porfirio R, Fernandes S, Wang L, Buzalaf M, Pereira JC, Magalhães AC. Comparative In Vitro Effect of TiF4 to NaF and Potassium Oxalate on Reduction of Dentin Hydraulic Conductance. Oper Dent 2014; 39:427-32. [DOI: 10.2341/13-156-l] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Dentin hypersensitivity (DH) is related to an increase in dentin permeability. This study tested the effect of titanium tetrafluoride (TiF4) compared with sodium fluoride (NaF) and potassium oxalate gel on reducing hydraulic conductance (Lp) from the perspective of diminishing dentin permeability. The Lp of the dentin disks (1.0 ± 0.2 mm) was evaluated using Flodec. The maximum Lp values of each disk were taken after phosphoric acid etching (15 seconds) and randomly allocated to seven groups (n=8) according to the treatments. The minimum (smear layer) and the maximum (after acid etching) Lp values were recorded. Treatments were performed for 4 minutes as follows: 1) NaF varnish 2) and solution (2.45% F, pH 5.0), 3) TiF4 varnish and 4) solution (2.45% F, pH 1.0), 5) 3% potassium oxalate gel, 6) free fluoride varnish (placebo, pH 5.0), 7) and no treatment (control). The Lp after each treatment was assessed. Samples were exposed to an erosive challenge (6% citric acid, pH 2.1, 1 minute), and the final Lp was recorded. The data were statistically analyzed using repeated measures two-way analysis of variance (p<0.05). All treatments were effective in reducing dentin Lp compared with the control immediately after the application. However, only potassium oxalate and NaF varnish significantly differed from placebo varnish (p<0.0001). The same results were found after the erosive challenge. Therefore, the TiF4 was less effective than the NaF varnish and potassium oxalate gel in reducing dentin permeability. Using this experimental model, both NaF varnish and potassium oxalate gel reduced the Lp similarly to the presence of smear layer.
Collapse
Affiliation(s)
- M Calabria
- Marcela Calabria, PhD, Bauru School of Dentistry, Operative Dentistry, Endodontics and Dental Materials, Bauru, Brazil
| | - R Porfirio
- Raphaelli Porfirio, DDS, Bauru School of Dentistry, Biological Sciences, Bauru, Brazil
| | - S Fernandes
- Samuel Fernandes, DDS, Bauru School of Dentistry, Biological Sciences, Bauru, Brazil
| | - L Wang
- Linda Wang, PhD, Bauru School of Dentistry, Operative Dentistry, Endodontics and Dental Materials, Bauru, Brazil
| | - M Buzalaf
- Marília Buzalaf, PhD, Bauru School of Dentistry, Biological Sciences, Bauru, Brazil
| | - JC Pereira
- José Carlos Pereira, PhD, Bauru School of Dentistry, Operative Dentistry, Endodontics and Dental Materials, Bauru, Brazil
| | - AC Magalhães
- Ana Carolina Magalhães, PhD, Bauru School of Dentistry, Biological Sciences, Bauru, Brazil
| |
Collapse
|
16
|
Wegehaupt FJ, Tauböck TT, Attin T. Influence of prophylaxis paste treatment on the abrasive wear of surface sealants. Acta Odontol Scand 2013; 71:744-50. [PMID: 22900836 DOI: 10.3109/00016357.2012.715201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the abrasive wear of surface sealants (Seal&Protect and K-0184 (experimental sealant)) and the influence of pre-treatment with mineral deposit forming prophylaxis pastes (NUPRO Sensodyne and NUPRO) on this wear. METHODS One hundred and eight bovine dentine samples were randomly allocated to nine groups (1-9). Pre-treatment (10 s): groups 1-3: untreated, groups 4-6: NUPRO, groups 7-9: NUPRO Sensodyne. Sealing: groups 1, 4 and 7: unsealed, groups 2, 5 and 8: Seal&Protect, groups 3, 6 and 9: K-0184 (experimental sealer). Samples were then brushed with 12 000 brushing strokes (BS) with toothpaste slurry in an automatic brushing machine (120 BS/min; F = 2.5 N). Surface profiles were recorded at baseline, after pre-treatment and sealing and after each 2000 BS. RESULTS Total profile change (wear or gain due to pre-treatment, treatment and 12 000 BS): groups 1, 4 and 7 (no surface sealant) showed a not significantly different wear of 18.48 ± 2.63 µm, 24.98 ± 3.02 µm and 21.50 ± 5.47 µm, respectively. Remaining groups (sealed) showed a gain in height with no significant difference among each other. Wear in sealed groups (2, 3, 5, 6, 8 and 9) were not significantly different at all numbers of brushing strokes. Starting with 4000 BS, the wear in unsealed groups (1, 4 and 7) was statistically significantly higher compared to all other groups. CONCLUSION Stability and wear resistance of surface sealants are not affected by pre-treatment of dentine with NUPRO Sensodyne. The surface sealants tested provide a stable protective surface layer on dentine, which lasts for at least 12 000 brushing strokes.
Collapse
Affiliation(s)
- Florian J Wegehaupt
- Department for Preventive Dentistry, Periodontology and Cariology University of Zurich, Plattenstrasse 11, CH-8032 Zürich, Switzerland.
| | | | | |
Collapse
|
17
|
Milia E, Castelli G, Bortone A, Sotgiu G, Manunta A, Pinna R, Gallina G. Short-term response of three resin-based materials as desensitizing agents under oral environmental exposure. Acta Odontol Scand 2013; 71:599-609. [PMID: 22891890 DOI: 10.3109/00016357.2012.700063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This paper focuses on clinical responses after 7 days of oral exposure to two resin-based materials as desensitizing agents compared to a fluoride varnish and on morphological and analytical study as a means to elucidate the mechanism of action. MATERIALS AND METHODS The elemental composition of Vertise™ Flow (VF), Universal Dentine Sealant (UDS) and Flor-Opal® Varnish (FOV) were investigated by using an X-ray energy dispersive spectrometer (EDX) in conjunction with a scanning electron microscope (SEM). SEM morphology of the material-treated dentine surfaces and pain reduction ability according to the Visual Analogue Scale (VAS) were evaluated in selected hypersensitive teeth. Post treatments and 7 day controls were recorded with SEM and VAS measurements. Clinical data was analysed with the Student's t-test for paired data, with a 5% significance level. RESULTS Silicon, ytterbium and alumina were the most present elements in VF, whilst calcium, chloride, silicon and alumina were highest in UDS. Within a 7 day oral environment all the tested materials modified the treated-dentine surfaces showing tubular occlusion of different morphology. Clinically, the efficacy of all materials was similar after a 7-day examination. However, VAS scores were significantly reduced if compared with the baseline (p < 0.05). CONCLUSIONS Within the limits of this study, data indicate that both resins are effective in sealing tubules and reducing VAS. A resin-related effect on the dentine's morphology was observed, which may influence the long-term response of the resins in the treatment of dental hypersensitivity, which requires further investigation.
Collapse
Affiliation(s)
- Egle Milia
- Department of Surgery, Microsurgery and Medicine, University of Sassari, Italy.
| | | | | | | | | | | | | |
Collapse
|
18
|
Evaluation of an Experimental Gel Containing Euclea natalensis: An In Vitro Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:184346. [PMID: 23243432 PMCID: PMC3517253 DOI: 10.1155/2012/184346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 09/27/2012] [Indexed: 11/30/2022]
Abstract
Objective. To evaluate the effect of an experimental gel containing Euclea natalensis extract on dentin permeability. Methods. Thirty-six dentin discs, 1-mm-thick. The discs were prepared from the coronal dentin of extracted human third molars that were divided into 3 groups (n = 10). The dentin discs in each group were treated with the groups following experimental materials: (FG): 1.23% fluoride gel, pH 4.1; (EG): Euclea natalensis extract gel, pH 4.1; (CG): control gel, pH 4.1. The gels were applied to the occlusal slide of the dentin under the following conditions: after 37% phosphoric acid and before 6% citric acid. The hydraulic conductance (HC) of each condition was determined four times using a fluid flow apparatus (Flodec). The data were analyzed using Two-way ANOVA and Tukey's test (P < 0.05). Results. The greatest mean reduction in HC was produced in group EG dentin discs (61.2%; P < 0.05). Even after acid challenge with 6% citric acid the great reduction occurred in group EG (66.0%; P < 0.05) than other groups (CG-77.1%, FG-90.8%). Conclusion. E. natalensis gel not only reduced dentin permeability, but also resisted posttreatment citric acid challenge without changing its permeability. Further research has to confirm this promising result in the clinical situation.
Collapse
|
19
|
Abstract
Dentinal hypersensitivity is exemplified by brief, sharp, well-localized pain in response to thermal, evaporative, tactile, osmotic, or chemical stimuli that cannot be ascribed to any other form of dental defect or pathology. Pulpal pain is usually more prolonged, dull, aching, and poorly localized and lasts longer than the applied stimulus. Up to 30% of adults have dentinal hypersensitivity at some time. Current techniques for treatment may be only transient in nature and results are not always predictable. Two methods of treatment of dentin hypersensitivity are tubular occlusion and blockage of nerve activity. A differential diagnosis needs to be accomplished before any treatment.
Collapse
Affiliation(s)
- Richard D Trushkowsky
- Advanced Program for International Dentists in Aesthetic Dentistry, Department of Cariology and Comprehensive Care, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA.
| | | |
Collapse
|