Effect of toothbrushing on the toxicity of casting alloys

Effects of toothbrush abrasion on surface and antibacterial properties of hydroxyapatite-tryptophan complex with gray titania

Photocatalysts have attracted attention in the medical field for their antibacterial effects. However, typical photocatalysts are activated by ultraviolet rays, which may have adverse effects. Therefore, we focused on a new photocatalyst that is activated by visible light, hydroxyapatite (HAp), and amino acid complex with gray titania, and evaluated its antibacterial effects against Porphyromonas gingivalis and effect by toothbrushing. The test sample was a titanium alloy substrate, and four surface treatments were applied: (1) substrate only, (2) substrate with HAp complex, (3) substrate with HAp complex with gray titania, and (4) HAp-tryptophan complex with gray titania (TR). These surface treatments were evaluated with or without toothbrushing (8 total groups). Surface roughness (Sa), fluorescent X-ray analysis (XRF), and scanning electron microscopy (SEM) were used to evaluate surface properties. To investigate antibacterial effects, each sample was seeded with P. gingivalis, irradiated with red light, and total viable bacterial count was determined. For Sa measurement, TR showed no significant difference after toothbrushing. However, in XRF and SEM observation, TR exhibited peeling of the applied coating after toothbrushing. In the antibacterial test, TR showed a decrease in P. gingivalis under no toothbrushing condition. Conversely, with toothbrushing, the TR coating appeared to peel. However, no significant difference in P. gingivalis count was observed among all groups. HAp-tryptophan complex with gray titania coating showed an antibacterial effect against P. gingivalis when irradiated with visible light. However, toothbrushing can result in coat peeling and consequently reduce the antibacterial effect.

An innovative method for in-situ composition analysis of fixed metallic dental restorations

Dental restorations made from alloys corrode during their service time. In cases of suspected toxic or allergic reactions to the corrosion products, the composition of the intraoral dental restorations has to be determined. The sample materials can be obtained intra-orally in a non-destructive manner using the chipping test. Metallic shavings are extracted with the aid of a dental stone and graphite carrier platelet, which is then transferred to an electron microscope for electro dispersive X-ray (EDX) analysis. The chipping test suffers from a rather complicated and error-prone procedure of obtaining and transferring the samples.

OBJECTIVE

The objective of the present study was the validation of a simplified method for non-destructive in-situ extraction of dental alloy samples, using a newly developed dental bur made from carbon fiber reinforced polyether ether ketone (PEEK), which at the same time serves as an electrically conductive sample carrier for EDX analysis.

METHODS

Fifteen burs for dental hand pieces were manufactured from carbon fiber reinforced PEEK, using two formulations. The burs were passed over precious and non-precious dental alloys with different rotation speeds. The alloy samples embedded in the burs were analyzed using EDX and compared to a control.

RESULTS

The burs manufactured from PEEK containing 30% short carbon fibers proved sufficiently robust for sample extraction even from the harder non-precious metals. The results of EDX analysis were in accordance with the control,no statistical significant differences, free of contamination, and were not affected by rotation speed,higher as 20%.

SIGNIFICANCE

The proposed method is valid, practical and constitutes an improvement over the traditional chipping test.

Effect of Alkaline Peroxides on the Surface of Cobalt Chrome Alloy: An In Vitro Study

PURPOSE

Removable denture hygiene care is very important for the longevity of the rehabilitation treatment; however, it is necessary to analyze the effects that denture cleansers can cause on the surfaces of prostheses. Thus, this study evaluated the effect of alkaline peroxide-effervescent tablets on the surface of cobalt-chromium alloys (Co-Cr) used in removable partial dentures.

MATERIALS AND METHODS

Circular metallic specimens (12 × 3 mm) were fabricated and were immersed (n = 16) in: control, Polident 3 Minute (P3M), Steradent (S), Efferdent (E), Polident for Partials (PFP), and Corega Tabs (CT). The surface roughness (μm) (n = 10) was measured before and after periods of cleanser immersion corresponding to 0.5, 1, 2, 3, 4, and 5 years. Ion release was analyzed (n = 5) for Co, Cr, and molybdenum (Mo). Scanning electron microscopy (SEM) analysis and an Energy-dispersive X-ray spectroscopy (EDS) were conducted in one specimen. The surface roughness data were statistically analyzed (α = 0.05) with the Kruskal-Wallis test to compare the solutions, and the Friedman test compared the immersion durations. Ion release analysis was performed using 2-way ANOVA and Tukey's test.

RESULTS

There was no significant surface roughness difference when comparing the solutions (p > 0.05) and the immersion durations (p = 0.137). Regarding ion release (μg/L), CT, E, and control produced a greater release of Co ions than S (p < 0.05). CT produced a greater release of Cr ions than control, S, and P3M (p < 0.05). Finally, E caused the greatest release of Mo ions (p < 0.05). SEM confirmed that the solutions did not damage the surfaces and EDS confirmed that there were no signs of oxidation.

CONCLUSION

The various solutions tested did not have any deleterious effects on the Co-Cr alloy surface. Steradent, however, presented the smallest ionic release.

Effect of toothbrushing on shade and surface roughness of extrinsically stained pressable ceramics

STATEMENT OF PROBLEM

The effect of toothbrushing on extrinsically stained pressable ceramic materials is unknown.

PURPOSE

The purpose of this in vitro study was to investigate the effects of toothbrushing on the shade and surface roughness of extrinsically stained, pressable ceramics.

MATERIAL AND METHODS

Two materials, leucite-based (IPS Empress Esthetic [EE]; Ivoclar Vivadent AG) and lithium disilicate-based ceramic (IPS e.max Press [EP]; Ivoclar Vivadent AG), were studied. For each material, 24 disk-shaped specimens, 10 mm (diameter)×3 mm (height) were fabricated. Three different methods (n=8) of applying extrinsic stains were performed on each material: glazed only (G, control group); stained then glazed (SG); and stained and glazed together (T). The specimens were brushed with a multistation brushing machine under a load of 1.96 N at a rate of 90 strokes per minute with a soft and straight toothbrush (Oral-B #35) and a 1:1 toothpaste and distilled water slurry. Shade and roughness were measured at baseline and at 72, 144, 216, and 288 hours, which is equivalent to 3, 6, 9, and 12 years of simulated toothbrushing for 2 minutes twice a day. A repeated measures ANOVA with staining technique as a fixed factor was used to evaluate shade and roughness (α=.05).

RESULTS

For EE groups, no significant change was found after 12 years of simulated toothbrushing regarding shade and surface roughness, irrespective of staining techniques (P>.05). However, EP groups demonstrated a significant shade change and an increase in surface roughness after 12 years of simulated toothbrushing. Shade change was found to depend on the method of applying stain. For the EP-SG technique, a significant shade change was observed only at the 9- to 12-year interval (P=.047). However, the EP-T technique demonstrated a significant difference in shade between baseline and 3 years (P=.005) and in the 6- to 9-year interval (P=.005). Surface roughness was only significantly affected at baseline and 3 years for the EP-T group (P=.005).

CONCLUSIONS

For the shade and surface roughness of the EE groups, no statistically significant difference was found after 12 years of toothbrushing, irrespective of the staining technique. The shade and surface roughness of the EP groups were significantly statistically affected by toothbrushing time; only shade changes were found to depend on technique.

Nickel alloys in the oral environment

The use of nickel casting alloys for long-term restorations in dentistry has long been controversial. A 'tug-of-war' between economic, engineering and biological considerations is central to this controversy; nickel-casting alloys have low costs and favorable physical properties, but are corrosion-prone in the oral environment. Clinicians and researchers have questioned the safety of nickel-containing dental alloys because several nickel compounds are known to cause adverse biological effects in vivo and in vitro in contexts outside of dentistry. The debate revolves around the extent to which corrosion products from oral restorations cause intraoral or systemic biological problems. Current evidence suggests that nickel alloys may be used successfully and safely in dentistry if clinical risks are taken into account. However, these alloys may cause significant clinical problems, primarily allergenic and inflammatory, if the risks are ignored.

Predicting clinical biological responses to dental materials

OBJECTIVES

Methods used to measure and predict clinical biological responses to dental materials remain controversial, confusing, and to some extent, unsuccessful. The current paper reviews significant issues surrounding how we assess the biological safety of materials, with a historical summary and critical look at the biocompatibility literature. The review frames these issues from a U.S. perspective to some degree, but emphasizes their global nature and universal importance.

METHODS

The PubMed database and information from the U.S. Food and Drug Administration, International Standards Organization, and American National Standards Institute were searched for prominent literature addressing the definition of biocompatibility, types of biological tests employed, regulatory and standardization issues, and how biological tests are used together to establish the biological safety of materials. The search encompassed articles published in English from approximately 1965-2011. The review does not comprehensively review the literature, but highlights significant issues that confront the field.

RESULTS

Years ago, tests for biological safety sought to establish material inertness as the measure of safety, a criterion that is now deemed naive; the definition of biocompatibility has broadened along with the roles for materials in patient oral health care. Controversies persist about how in vitro or animal tests should be used to evaluate the biological safety of materials for clinical use. Controlled clinical trials remain the single best measure of the clinical response to materials, but even these tests have significant limitations and are less useful to identify mechanisms that shape material performance. Practice-based research networks and practitioner databases are emerging as important supplements to controlled clinical trials, but their final utility remains to be determined.

SIGNIFICANCE

Today we ask materials to play increasingly sophisticated structural and therapeutic roles in patient treatment. To accommodate these roles, strategies to assess, predict, and monitor material safety need to evolve. This evolution will be driven not only by researchers and manufacturers, but also by patients and practitioners, who want to use novel materials in new ways to treat oral disease.

Titanium surface topography after brushing with fluoride and fluoride-free toothpaste simulating 10 years of use

OBJECTIVES

To conduct a controlled study contrasting titanium surface topography after procedures that simulated 10 years of brushing using toothpastes with or without fluoride.

METHODS

Commercially pure titanium (cp Ti) and Ti-6Al-4V disks (6 mm Ø×4 mm) were mirror-polished and treated according to 6 groups (n=6) as a function of immersion (I) or brushing (B) using deionised water (W), fluoride-free toothpaste (T) and fluoride toothpaste (FT). Surface topography was evaluated at baseline (pretreatment) and post-treatment, using atomic force microscope in order to obtain three-dimensional images and mean roughness. Specimens submitted to immersion were submerged in the vehicles without brushing. For brushed specimens, procedures were conducted using a linear brushing machine with a soft-bristled toothbrush. Immersion and brushing were performed for 244 h. IFT and BFT samples were analysed under scanning electron microscope with Energy-Dispersive X-ray Spectroscopy (EDS). Pre and post-treatment values were compared using the paired Student T-test (α=.05). Intergroup comparisons were conducted using one-way ANOVA with Tukey post-test (α=.05).

RESULTS

cp Ti mean roughness (in nanometers) comparing pre and post-treatment were: IW, 2.29±0.55/2.33±0.17; IT, 2.24±0.46/2.02±0.38; IFT, 2.22±0.53/1.95±0.36; BW, 2.22±0.42/3.76±0.45; BT, 2.27±0.55/16.05±3.25; BFT, 2.27±0.51/22.39±5.07. Mean roughness (in nanometers) measured in Ti-6Al-4V disks (pre/post-treatment) were: IW, 1.79±0.25/2.01±0.25; IT, 1.61±0.13/1.74±0.19; IFT, 1.92±0.39/2.29±0.51; BW, 2.00±0.71/2.05±0.43; BT, 2.37±0.86/11.17±2.29; BFT, 1.83±0.50/15.73±1.78. No significant differences were seen after immersions (p>.05). Brushing increased the roughness of cp Ti and of Ti-6Al-4V (p<.01); cp Ti had topographic changes after BW, BT and BFT treatments whilst Ti-6Al-4V was significantly different only after BT and BTF. EDS has not detected fluoride or sodium ions on metal surfaces.

CONCLUSIONS

Exposure to toothpastes (immersion) does not affect titanium per se; their use during brushing affects titanium topography and roughness. The associated effects of toothpaste abrasives and fluorides seem to increase roughness on titanium brushed surfaces.

Biocompatibilidade dos materiais em Ortodontia: mito ou realidade?

O objetivo deste trabalho é apresentar uma revisão sobre os conceitos relacionados à biocompatibilidade dos materiais empregados em Ortodontia. Fatos relacionados às reações de hipersensibilidade aos diversos materiais ortodônticos são discutidos, sendo apresentadas as condutas recomendáveis nestas situações.

Dental casting alloys behaviour during power toothbrushing with toothpastes with various abrasivities. Part I: wear behavior

The purpose of this study was to evaluate the long term effect of abrasivity of toothpastes normally used over the surface and mechanical properties of dental casting alloys. Three dental casting alloys (Ni-Cr, Co-Cr, c.p. Ti) and one ceramic were chosen. Four specimens of each material were immersed in artificial saliva, brushed without or with one of four toothpastes of different Relative Dentine Abrasivity (RDA 50, 52, 80, and 114). An electric toothbrush with a load of 250 g was used for 420 min. Mass loss was determined by difference in weight, microhardness and surface roughness were also measured. Two-way ANOVA and non-parametric tests were used to detect significant differences. Titanium specimens (478 microg/cm(2)) exhibited the most mass loss, whereas ceramic (282 microg/cm(2)) and Co-Cr (262 microg/cm(2)) exhibited the least. However, ceramic demonstrated the most volume loss (0.239 mm(3)). The abrasivity effect of the toothpaste correlated with the RDA values. Slight variations in microhardness were observed after toothbrushing and depended on the material but not on the toothpaste used. Material surfaces were slightly smoothed by toothbrushing but no significant differences were detected. Dental casting alloys and ceramic are susceptible to abrasion by brushing with an electric toothbrush depending on the RDA value of the toothpaste. Variations in microhardness and surface roughness were not clinically relevant.

Surface texture and composition of titanium brushed with toothpaste slurries of different pHs

OBJECTIVES

This in vitro study characterized the surface texture and composition of titanium brushed with toothpaste slurries of different pHs, and thereby elucidated mechanochemical interactions between the metal and abrasive material in dentifrice.

METHODS

Two fluoride-free toothpastes, which contained crystalline CaHPO(4).2H(2)O and amorphous SiO(2) particles as abrasive, were mixed with acidic buffers to provide slurries of pH 6.8 and 4.8. Specimens were cast from CP Ti, mirror-polished, and then toothbrushed at 120strokes/min for 350,400 strokes under a load of 2.45N. Specimen surfaces were characterized by means of SPM and EPMA. The obtained data were compared with the already reported results of water-diluted alkaline slurries. SPM data of each paste were analyzed using one-way ANOVA, followed by post hoc Tukey test.

RESULTS

Irrespective of toothpaste, neutral slurries, as with alkaline slurries, yielded a chemically altered surface with rough texture, whereas acidic slurries formed a chemically clean surface with relatively smooth texture. Mechanochemical polishing effect might be mainly responsible for the cleanness and smoothness.

SIGNIFICANCE

Acidic slurry-induced smooth surface may minimize plaque formation. However, the augmentation of released titanium ions may be adverse to the human body. For evaluation of toothpaste abrasion effects on titanium, paste slurry pH should be taken into account.

Ion release from gold/platinum dental alloy: could release of other elements be accountable in the contact allergy attributed to the gold?

OBJECTIVES

The release of metal ions (Al, Ag, Au, Ca, Cd, Co, Cr, Cu, Mg, Mo, Ni, Pd, Pt, Ti, and Zn) from the commercial gold/platinum (Au/Pt) dental alloy of declared composition was studied.

METHODS

Au/Pt was soaked in pH 6.0 phosphate buffer, 3.5 pH phosphate buffer and pH 3.5 mixture of lactic, formic and acetic acid, and incubated at 37 degrees C for 1, 2, 3, 4, 5, 6, 7, 14, 21, and 30 days. Six samples (n = 6) of every solution were prepared for any time period. Inductively coupled plasma atomic emission spectroscopy was used for analysis of the released elements.

RESULTS

Results demonstrated release of only Cr, Cu, Fe, and Zn from the tested Au/Pt dental alloy (ANOVA, p < 0.001 for buffer, time, and interaction, respectively); however, only Cu and Zn were declared.

CONCLUSIONS

The undeclared chromium from Au/Pt dental alloy, or some other element might be responsible for the contact allergy thus far attributed to the gold.

Effect of toothbrushing on titanium surface: An approach to understanding surface properties of brushed titanium

OBJECTIVES

This in vitro study aimed to characterize the surface morphology and composition of tooth-brushed titanium casting and thereby to elucidate interactions between the metal and abrasive material in dentifrice.

METHODS

Specimens were cast from CP Ti ingots and then mirror-finished. Two fluoride-free toothpastes containing crystalline CaHPO4.2H2O and amorphous SiO2 particles as abrasive were slurried with distilled water (15 g/30 mL). While toothbrushes were reciprocated at 120 strokes/min for 350,400 strokes, the specimens were brushed with the respective slurries under a load of 2.45 N. The brushed and non-brushed surfaces were characterized by means of SPM, EPMA, and XPS. SPM data were analyzed using one-way ANOVA, followed by post hoc Tukey test (p<0.01).

RESULTS

Irrespective of toothpastes, toothbrushing had a significant influence on surface roughness. The CaHPO4.2H2O-containing paste produced much rougher surface than the SiO2-containing paste. Both the surfaces were chemically altered due to reactions with the respective abrasive materials. Abrading chips had dimensions of micron to submicron order. A number of chips were attached to abrasive particles.

SIGNIFICANCE

The alterations of surface morphology and composition may affect biological responses of titanium in the oral environment. Dentifrice with lower abrasivity might be advisable for daily oral hygiene practice of patients with dental titanium devices.