Effect of air-abrasion pre-treatment with bioactive glass 45S5 on enamel surface loss after erosion/abrasion challenge

Effect of air-abrasion pretreatment with three desensitizing agents on efficacy of in-office tooth bleaching

OBJECTIVE

To evaluate the influence of air-abrasion of enamel with three different desensitizing powders on the whitening effect of a bleaching gel containing 40% H2O2, which was used for in-office tooth bleaching.

MATERIALS AND METHODS

Forty human incisors, extracted and prepared, were acquired for this study and subsequently randomized into four groups (n = 10). The control group specimens underwent no pretreatment prior to the bleaching procedure, whereas the remaining three groups underwent air abrasion using distinct desensitizing powders; (a) Sylc, which contains bioglass 45S5; (b) BioMinF, which contains calcium phospho-fluoro-silicate glass; and (c) MI Pearls, which contains nano-hydroxyapatite, 1 h preceding the Opalescence Boost PF 40% bleaching procedure. Color measurements were conducted using a double-beam UV-Vis spectrophotometer at four distinct time points (prior to bleaching, 24 h, 15 days, and 30 days post-bleaching).

RESULTS

Tooth color change outcomes revealed that there were no statistically significant results with respect to the interaction of the two criteria (treatments and time) (p = 0.990). Additionally, there were no statistically significant results with respect to the main effects of treatments (p = 0.385), while there were statistically significant effects with respect to the time criterion (p = 0.013).

CONCLUSIONS

The use of the tested desensitizing powders prior the bleaching procedure did not affect the tooth color change induced by the tested bleaching agent.

CLINICAL SIGNIFICANCE

Tooth color change and whiteness are not affected by air-abrasion desensitizing treatments when applied prior to in-office bleaching procedures.

Development and effect of orodispersible film incorporated with Biosilicate for remineralization of dental enamel subjected to cariogenic and erosive challenge

OBJECTIVES

The objective of this in vitro study was to assess the efficiency of incorporating Biosilicate particles (30 and 50 mg) into an experimental orodispersible film and its efficacy in the remineralization process of bovine dental enamel under cariogenic and erosive challenges.

METHODS

Ninety-nine intact incisors, devoid of cracks or fractures, yielding 198 samples (6 × 6 × 2 mm) via vestibular sectioning using a low-speed diamond disc under water cooling. After flattening the enamel surface with 600, 1200, and 2000 grit sandpaper, the samples were divided into two groups based on the challenges they underwent: cariogenic (0.1 M lactic acid at pH 5.0) or erosive (0.05 M citric acid solution at pH 2.3). Samples from each challenge were further categorized into 11 groups (n = 9) according to the duration of cariogenic (3, 7, and 14 days) or erosive (3, 7, and 10 days) challenge, along with positive control groups (fragments untreated with challenges and treated with different Biosilicate concentrations) and negative controls (fragments treated with artificial saliva for the same periods established for cariogenic and erosive challenges). Treatments with orodispersible films containing Biosilicate (30 and 50 mg) were administered for 2 min per day for 15 days.

RESULTS

The highest remineralizing potential was observed in samples treated with Biosilicate after 14 days of cariogenic challenge, irrespective of the concentration tested. For samples subjected to erosive challenge, erosion time did not affect Biosilicate's remineralizing potential.

CONCLUSION

Biosilicate shows promise in terms of remineralizing potential in enamel subjected to cariogenic challenge due to its ability to form hydroxycarbonapatite in mineralized tissues.

Evaluation of repair bond strength of a dental CAD/CAM resin composite after surface treatment with two Er,Cr:YSGG laser protocols following artificial aging

The aim of the present study was to evaluate the impact of two Er,Cr:YSGG laser surface treatments on the repair bond strength of a dental CAD/CAM resin composite (Brilliant Crios) after artificial aging. Twenty-four resin-based CAD/CAM blocks were cut and 48 rectangular slabs (3 x 12 x 14 mm) were prepared. Preliminary SEM observations indicated the most favorable laser settings regarding surface modification of the tested restorative material. The CAD/CAM specimens were then divided into 4 groups (n=12) based on their surface pretreatment: no treatment, air abraded with 50-μm Al2O3 particles, and laser irradiated with two different protocols using Er,Cr:YSGG laser with average power 3.5 and 4.5 W, pulse repetition rate 35 and 50 Hz, and pulse energy 100 and 90 mJ, respectively. After surface treatments each group followed a bonding protocol with silane and a flowable resin composite was used to prepare 48 microrods. Half of the microrods of each group were subjected on shear bond strength (SBS) test (chisel-shaped blade, load cell of 500 N, crosshead speed of 1 mm/min) after 24 h, while the other half underwent artificial aging (15,000 cycles, 5-55 °C) and then SBS test. The debonded specimens were examined under an optical microscope to determine the failure mode. All specimens were also evaluated using SEM to assess the surface topography after the treatments. The results showed that SBS significantly decreased after thermocycling in all the experimental groups (p<0.05). Control group presented much lower SBS values than the other groups after both 24 h and thermocycling (p<0.05). The highest values of SBS exhibited air-abrasion group (p<0.05), followed by the two laser groups, which did not differ to each other (p>0.05). The results of the current study indicated that Er,Cr:YSGG laser irradiation can be an alternative treatment for repairing the tested resin-based CAD/CAM restorative material.

Effect of Whitening Toothpastes with Different Active Agents on the Abrasive Wear of Dentin Following Tooth Brushing Simulation

The aim of this research was to evaluate the abrasive dentin wear that can be induced by three commercial whitening toothpastes following a tooth-brushing simulation (TBS) corresponding to a three-month period. Sixty human canines were selected, and the roots were separated from the crowns. Then the roots were randomly divided into six groups (n = 10) and were submitted to TBS using the following slurries: Group 1-deionized water (RDA = 5); Group 2-ISO dentifrice slurry (RDA = 100); Group 3-a regular toothpaste (RDA = 70); Group 4-a charcoal-containing whitening toothpaste; Group 5-a whitening toothpaste containing blue covasorb and hydrated silica; and Group 6-a whitening toothpaste containing microsilica. Following TBS, surface loss and surface roughness changes were evaluated using confocal microscopy. Additionally, surface morphology and mineral content changes were observed using scanning electron microscopy and energy-dispersive X-ray spectroscopy. The deionized water group presented the lowest surface loss (p < 0.05), while the charcoal-containing toothpaste presented the highest surface loss, followed by ISO dentifrice slurry (p < 0.001). Blue-covasorb-containing and regular toothpastes did not present statistically significant differences (p = 0.245), and neither didmicrosilica-containing toothpaste or ISO dentifrice slurry (p = 0.112). The surface height parameters and surface morphology changes of the experimental groups followed the surface loss patterns, while no differences were detected in mineral content after TBS.Although the charcoal-containing toothpaste exhibited the highest abrasive wear to dentin, according to ISO 11609, all the tested toothpastes exhibited appropriate abrasive behavior towards dentin.

Influence of violet LED and fluoride-containing carbamide peroxide bleaching gels on early-stage eroded/abraded teeth

PURPOSE

This study evaluated enamel with early-stage erosion/abrasion following bleaching with 20% and 45% carbamide peroxide (CP) gels containing fluoride (F) and irradiated with violet LED (LED).

METHODS

Enamel blocks were immersed in 1% citric acid (5 min) and artificial saliva (120 min) three times to produce early-stage enamel erosion. Simulated toothbrushing was performed only after the first saliva immersion, to provoke enamel abrasion. The erosive/abraded enamel samples were submitted to (n=10): LED/CP20, CP20, LED/CP20_F, CP20_F, LED/CP45, CP45, LED/CP45_F, CP45_F, LED, and control (without treatment). The pH of the gels was assessed, and color (ΔE₀₀) and whiteness index (ΔWI_D) changes were calculated after cycling (T₁), and 7 days from bleaching (T₂). Enamel surface roughness average (Ra) and Knoop microhardness (kg/mm², %SHR) were evaluated at baseline (T₀) at T₁ and T_2. Scanning electron microscopy evaluated the enamel surface morphology at T₂.

RESULTS

The gels' pH was neutral and CP20 and CP45 exhibited no differences in ΔE₀₀ and ΔWI_D (p>0.05) but LED increased these parameters for CP20_F and CP45. Erosion/abrasion significantly decreased mean kg/mm², and the LED group was the only one not increasing microhardness after bleaching (p>0.05). None of the groups fully recovered the initial microhardness. All groups exhibited %SHR similar to the control (p>0.05) and the increase in Ra was detected only after erosion/abrasion. CP20_F groups exhibited a more preserved enamel morphology.

CONCLUSION

Light irradiation combined with low-concentrated CP gel promoted a bleaching effect comparable to the high-concentrated CP. The bleaching protocols did not adversely impact the surface of early-stage eroded/abraded enamel.

Comparative analysis of the effect of Bioactive Glass 45S5 on enamel erosion progression in human dentitions (in vitro study)

OBJECTIVES

The aim of the present study was to compare the surface morphology alterations, mineral content, and surface roughness of eroded enamel surface versus eroded enamel surface which was preceded by Bioactive Glass 45S5 (BAG45S5) application in both primary and permanent human dentitions.

MATERIALS AND METHODS

Fifty-two primary teeth and fifty-two permanent teeth were selected. Teeth were randomly divided into 4 groups of twenty-six teeth each. Groups A1 and B1 underwent erosion with 1% citric acid, while groups A2 and B2 were subjected to application of BAG45S5 powder followed by the same erosive conditions as A1 and B1. Measurements were performed by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and surface profilometry. They were used to examine the surface morphology alterations, mineral content, and surface roughness, respectively.

RESULTS

SEM of enamel which received BAG45S5 showed smoother surface in primary teeth post erosion. EDX analysis showed that enamel exhibited crucial resistance to mineral loss in the group which received BAG45S5 prior to inducing erosion as compared to the induced erosion-only group. This was significant (p < 0.005) in both human dentitions. Erosion-only groups showed significantly less surface roughness in permanent teeth (p < 0.045). A marked decrease in surface roughness was observed in surfaces receiving BAG45S5, primary teeth (p < 0.001), and permanent teeth (p < 0.001).

CONCLUSIONS

Bioactive Glass 45S5 proved successful against erosive conditions in both primary and permanent teeth with better performance in the permanent teeth so it can be regarded as a means of prevention.

CLINICAL RELEVANCE

Bioactive Glass 45S5 powder could be used not only to remove stains but also as a prophylactic preventive measure against the multiple episodes of acidic food and beverage consumption in children.

Effect of air-abrasion pretreatment with three bioactive materials on enamel susceptibility to erosion by artificial gastric juice

OBJECTIVE

The purpose of the study was to investigate the protective effect of three in-office preventive treatments with bioactive materials against enamel erosion induced by artificial gastric juice similar to that found in gastroesophageal reflux disease (GERD) patients. The treatments included air-abrasion of enamel with a fluoride-containing bioactive glass (BioMinF®), Bioglass 45S5 (ProSylc) and nano-hydroxyapatite (MI Pearls) to test enamel susceptibility following an erosive challenge.

METHODS

Enamel surface loss was evaluated using confocal microscopy, while changes in enamel surface roughness and morphology were also investigated after the treatments. SEM and EDS were used to observe formation of apatite crystals on enamel and to detect alterations in mineral composition. In Group 1 (negative control) the specimens did not receive any treatment; Group 2 specimens (positive control) treated with 0.4 % SnF₂, while in Groups 3-5 enamel was air-abraded with BioMinF®, ProSylc and MI Pearls, respectively.

RESULTS

All the experimental groups reduced significantly enamel surface loss compared to the negative control group (p < 0.05), except for the MI Pearls treatment (p > 0.05). The most protective behavior against erosion presented the treatment with SnF₂. BioMinF induced the larger amount of apatite crystals on the enamel surface, followed by ProSylc.

SIGNIFICANCE

BioMinF and ProSylc treatments may be beneficial against dental erosion induced by gastric juice in GERD patients, while MI Pearls treatment may not suitable for this indication. Both materials promote formation of apatite crystals on enamel in acidic conditions protecting the surface from the erosion. The tested treatments may be useful in GERD patients who cannot comply with at-home therapies with SnF₂.

Evaluation of the effect of soft drinks on the surface roughness of dental enamel in natural human teeth

Background: Exposing enamel to soft drinks and beverages causes changes in the microscopical morphology. Changes in the physical characteristics, like hardness and surface roughness, were studied with various parameters. Factors such as pH, exposed duration, and other content of the soft drinks have different effects on the enamel. Methods: Thirty-six human premolar teeth were randomly divided into three groups (n=12). Group 1 consisted of teeth which were immersed in artificial saliva (control), group 2 consisted of teeth which were immersed in Pepsi, and group 3 consisted of teeth which were immersed in Mirinda. After the preparation of samples and necessary measures, surface roughness was measured using the profilometer. Baseline measurements were taken. Reading two and reading three were taken after exposing the specimens for three days and 15 days, respectively. All of the collected data were compared statistically using SPSS and presented in tables and graphs. Results: At the baseline, the surface roughness value was the same for all three groups. On the 3 rd day, the Mirinda group showed more surface roughness compared to that of the test and Pepsi groups, which was statistically significant. On the 15 th day, both the Pepsi and Mirinda groups showed increased surface roughness compared to that of the control, which was statistically significant. Conclusions: Within the limitation of this study, it can be concluded that surface roughness increased when teeth were exposed to both soft drinks.

Enamel erosion control by strontium-containing TiO2- and/or MgO-doped phosphate bioactive glass

OBJECTIVES

To evaluate the effect of strontium-containing titanium- and/or magnesium-doped phosphate bioactive glass on the control of dental erosion.

MATERIALS AND METHODS

Fifty fragments of human enamel were divided into five groups: negative control, 45S5 bioglass, strontium-containing Ti-doped phosphate bioactive glass (PBG-Ti), strontium-containing Mg-doped phosphate bioactive glass (PBG-Mg), and strontium-containing Ti- and Mg-doped phosphate bioactive glass (PBG-TiMg). The specimens underwent cycles of erosive challenge twice daily for 5 days with 1 mL of citric acid for 2 min followed by 1 mL of the suspension with bioactive substances for 3 min. After the cycles, profilometry, roughness and microhardness testing, and scanning electron microscopy (SEM) were performed. The following statistical tests were used: one-way ANOVA (profile, roughness, and surface microhardness (%VMS) data variation), Tukey's HSD (%VMS), Games-Howell test (profilometry), Student's t test (roughness), and Pearson's correlation between the variables.

RESULTS

The lower loss of enamel surface and lower %VMS was observed in the PBG-Mg and PBG-TiMg groups, and only the PBG-Mg group showed similar roughness between baseline and eroded areas (p > 0.05). On SEM micrographs, PBG-Ti and PBG-Mg groups showed lower apparent demineralization.

CONCLUSION

All bioactive materials protected the enamel against erosion. However, strontium-containing phosphate bioactive glasses showed lower enamel loss, and the presence of Mg in these bioactive glasses provided a greater protective effect.

CLINICAL RELEVANCE

Experimental strontium-containing phosphate bioactive glasses are effective in controlling enamel erosion. The results obtained in this study will guide the development of new dental products.

Baseline Specimens of Erosion and Abrasion Studies

The difficulty in obtaining human teeth that are caries-free that have similar environmental exposure, e.g., diet intake and water fluoridation has lead researchers to opt for bovine teeth as a substitute for erosion studies. Bovine mandibular incisors are readily available at abattoirs and often originate from the same region and are likely to consume similar dietary intake. The bovine teeth for erosion or abrasion studies usually undergo specimen preparation to produce a "flat surface" baseline specimen. Among other terms used to define baseline specimens for erosion and abrasion studies include phrases like "optically flat" and "flat and smooth surface." However, these terms might have no quantitative value as it does not justify the actual surface characteristics of the prepared flattened surface. In dentistry, roughness average (Ra) is the most commonly used parameter when reporting the roughness of specimens Reporting Ra alone might not be sufficient as it does not provide information regarding the surface texture as there is no distinction between valleys and peaks, nor does it provide information about the core structure of a material unlike the bearing area curve. The incorporation of Ra and BAP values in baseline specimens has the potential in predicting the wear or lubricating potential of these specimens. Furthermore, standardization of baseline specimens by acknowledging its surface roughness values ensures comparability of erosion and abrasion studies as different specimen preparation technique might influence the outcome or results of research.

Effect of novel charcoal-containing whitening toothpaste and mouthwash on color change and surface morphology of enamel

Purpose:

The aim of this in vitro study was to investigate the effectiveness of a novel charcoal-containing whitening toothpaste and a mouthwash on tooth color change and the alterations of enamel that may be induced after toothbrushing, corresponding to a 90-day period.

Materials and Methods:

Forty human canines were used, stained with coffee, and divided into four groups (n = 10) as follows: Group 1 (control) submitted to toothbrushing with deionized water, Group 2 with a regular toothpaste, Group 3 with a whitening toothpaste (1% charcoal), and Group 4 with the same whitening toothpaste in combination with a mouthwash (1% charcoal and 0.5% H₂O₂). After the treatments, ΔΕ of the teeth was evaluated using an ultraviolet/Vis spectrophotometer, whereas the changes in surface morphology were observed by means of a confocal microscope.

Results:

The whitening toothpaste increased significantly ΔΕ (40.5%) compared to the control group (P < 0.001). In addition, the tested whitening toothpaste also increased ΔΕ (17.7%) compared to the regular toothpaste (P = 0.023). The whitening toothpaste presented smoother surfaces after toothbrushing, but more heterogeneous with numerous large craters, whereas the whitening mouthwash did not influence surface morphology changes.

Conclusions:

Charcoal-containing toothpastes may enhance the whitening of the teeth, but they should be used carefully due to changes that may induce on enamel. The patients should consult a dental professional for proper use. A charcoal-containing mouthwash in combination with whitening toothpastes probably cannot offer additional whitening effect.

Preparation of a toothpaste containing theobromine and fluoridated bioactive glass and its effect on surface micro-hardness and roughness of enamel

The aim was to synthesize a toothpaste and analyze its effect on surface micro-hardness and roughness of enamel. Basic paste was prepared by using basic ingredients. Theobromine (0.2 wt%) and laboratory synthesized fluoridated-bioactive glass (F-BG, 4 wt%) were added to it. Post-demineralization, 36 enamel blocks were divided into six groups that were brushed with their respective toothpaste+artificial saliva (AS): group 1 (control): basic paste; group 2: basic paste+theobromine; group 3: commercial theobromine toothpaste; group 4: commercial BG toothpaste; group 5: basic paste+F-BG; and group 6: basic paste+theobromine+F-BG. On micro-hardness analysis, group 6 performed best, followed by group 4. Surface roughness results showed the maximum decrease in roughness values for group 6, followed by group 5. Treatment with toothpaste composition containing theobromine+F-BG resulted in the enamel's increased micro-hardness and decreased surface roughness.

Bioactivity assessment of bioactive glasses for dental applications: A critical review

OBJECTIVE

In the context of minimally invasive dentistry and tissue conservation, bioactive products are valuable. The aim of this review was to identify, clarify, and classify the methodologies used to quantify the bioactive glasses bioactivity.

METHODS

Specific search strategies were performed in electronic databases: PubMed, Embase, Cochrane Library, and Scopus. Papers were selected after a review of their title, abstract, and full text. The following data were then examined for final selection: BAG investigated, objectives, criteria, methods, and outcomes.

RESULTS

Sixty-one studies published from 2001 to 2019, were included. The bioactivity of BAG can be evaluated in vitro in contact with solutions, enamel, dentin, or cells. Other studies have conducted in vivo evaluation by BAG contact with dentin and dental pulp. Studies have used various analysis techniques: evaluation of apatite with or without characterization or assessment of mechanical properties. Reprecipitation mechanisms and pulp cell stimulation are treated together through the term 'bioactivity'.

SIGNIFICANCE

Based on these results, we suggested a classification of methodologies for a better understanding of the bioactive properties of BAG. According to all in vitro studies, BAG appear to be bioactive materials. No consensus has been reached on the results of in vivo studies, and no comparison has been conducted between protocols to assess the bioactivity of other bioactive competitor products.

Tooth surface loss: A review of literature

Objectives

Tooth surface loss (TSL) or tooth wear (TW) is an irreversible loss of hard tooth structure caused by factors other than those responsible for dental caries. TSL is observed clinically as attrition, abrasion, abfraction, and erosion. It may be associated with symptoms such as tooth hypersensitivity and function impairment, and may lead to change in the morphology of the affected tooth. However, it may also be asymptomatic, meaning the patient may not be aware of it. In this instance, the dentist is encouraged to make the patient aware of this issue.

The aim of this review is to provide an overview of the classification and management of TSL.

Material and methods

The PubMed (MEDLINE) search engine was used to gather the most recent information on TSL. The search was restricted to a five year period (1 September 2014–31 August 2019), and only English-language studies were included. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: (Tooth surface loss OR tooth wear) AND (tooth attrition OR tooth Abrasion OR tooth erosion OR tooth abfraction OR non-carious cervical lesions) AND (humans). Studies were also obtained by manual searches and from Google Scholar.

Results

By this process, 560 articles and studies were obtained. More studies were also obtained by manual searches and from Google Scholar. The most relevant published studies were chosen and used in the current review. The selected articles are included in the reference list.

Conclusion

TSL is a clinical problem that dentists face on a daily basis. Therefore, a sound clinical approach by which TSL can be prevented and managed is essential. While this approach requires that dentists are knowledgeable about the issue, increasing public awareness of TSL is also vital.