Tooth polishing: The current status

Ex vivo study of molecular changes of stained teeth following hydrogen peroxide and peroxymonosulfate treatments

White teeth can give confidence and tend to be associated with a healthier lifestyle in modern society. Therefore, tooth-bleaching strategies have been developed, including the use of hydrogen peroxide. Recently, peroxymonosulfate has been introduced as an alternative bleaching method to hydrogen peroxide. Although both chemicals are oxidizing agents, their effects on the molecular composition of the stained teeth are yet unknown. In this study, the molecular profiles of teeth bleached with hydrogen peroxide and peroxymonosulfate were compared using Liquid Chromatography-Tandem Mass Spectrometry. Statistical analyses were used to assess the samples. In addition, reference spectral libraries and in silico tools were used to perform metabolite annotation. Overall, principal component analysis showed a strong separation between control and hydrogen peroxide and peroxymonosulfate samples (p < 0.001). The analysis of molecular changes revealed amino acids and dipeptides in stained teeth samples after hydrogen peroxide and peroxymonosulfate treatments. Noteworthy, the two bleaching methods led to distinct molecular profiles. For example, diterpenoids were more prevalent after peroxymonosulfate treatment, while a greater abundance of alkaloids was detected after hydrogen peroxide treatment. Whereas non-bleached samples (controls) showed mainly lipids. Therefore, this study shows how two different tooth-whitening peroxides could affect the molecular profiles of human teeth.

The Evaluation of Different Polishing Techniques' Effects on the Post-operative External Staining of Enamel in Primary and Permanent Tooth

Objective This study aimed to examine patient complaints on recoloration development after polishing applications in primary and permanent teeth that differed in enamel composition and to determine the ideal polishing method. Methods A total of 30 permanent upper incisors and 30 primary molars were randomly divided into three groups of 10 using three different polishing techniques. Each polishing method (rubber, brush, and air polishing) was applied to the test surface of its own group. Milk and coffee were used in the coloring processes. A spectrophotometer was used for color measurements. Color change (∆E) was calculated between control and test surfaces and between the three measurement points. Results In the primary teeth's test surfaces, the rubber and brush groups were significantly more colored than the air-polishing group, when compared between after polishing and after coloration (p ˂ 0.05). Furthermore, the color difference of the permanent teeth between the initial measurements and after coloration was significantly higher in the rubber group's test surface compared to the air-polished group (p ˂ 0.05). The average ∆E values in both primary and permanent teeth were as follows: rubber > brush > air polishing. Conclusions Compared to rubber or brush polishing, air polishing seems safer to avoid predisposition to postoperative enamel discoloration. Primary teeth are more colored than permanent teeth. The effect of polishing on postoperative coloring should always be considered, and air polishing should be preferred whenever possible.

In Vitro Evaluation of the Different Supragingival Prophylaxis Tips on Enamel Surfaces

Objective: Periodontal instrumentation during supragingival prophylaxis may increase enamel surface roughness, which may lead to increased dental biofilm accumulation and demineralization of the enamel. The aim of this study was to evaluate the changes of the enamel surface profilometrically after the application of different scaler tips used for the professional supragingival prophylaxis. Materials and methods: Forty-eight enamel block samples obtained from extracted human maxillary premolar teeth were prepared and randomly assigned to four different treatment groups. Each treatment group was instrumented by the same clinician with different tools as Group 1: Er:YAG laser chisel tip, Group 2: scaler, Group 3: new generation universal curette; and Group 4: ultrasonic device. Sample surfaces were evaluated with a profilometer before and after instrumentations and after the polishing process. Results: Baseline roughness of the prepared enamel samples was similar between the groups. After instrumentation and polishing, the Er:YAG laser chisel tip revealed the most irregular surface morphology, whereas the new generation curette induced the smoothest surface. Conclusions: New generation universal curette is a promising tool, which can be used safely for supragingival calculus removal without the need for polishing on enamel surfaces.

Complicated Crown Fracture of Permanent Incisors: A Conservative Treatment Case Report and a Narrative Review

Dental trauma may have a severe impact on the social and psychological wellbeing of a patient. Most cases of dental injuries involve anterior teeth, especially the maxillary upper incisors. Crown fractures, with or without pulp exposure, are the most common trauma in permanent dentition. There are many methods of management, in which the initial state of the pulp, the time since the injury, and the presence of an accompanying injury play a key role. This case report aimed at showing a possible conservative treatment after complicated tooth fracture that consisted of partial pulpotomy followed by adhesive reattachment of the tooth fragment using a technique based on heated resin composite. Such a specific procedure represents a conservative approach to traumatic coronal lesions, providing a suitable opportunity to maintain the tooth vitality, aesthetics, and function. Indeed, reattachment of tooth fragment using a composite/adhesive is a simple technique to achieve excellent results in terms of aesthetic and function.

In vitro Analysis of Surface Roughness Produced by an Air Polishing Device and Conventional Root Planing on Cementum: A Profilometric Study

Context:

Tooth surface polishing is an integral part of periodontal therapy. Enamel and cementum show a smooth surface clinically after debridement with the naked eye, but numerous surface irregularities can be detected microscopically. Air polishing is safe and effective when used by trained professionals.

Aims:

The aim of the study is to evaluate and compare the surface roughness of cementum by using an air polishing device and conventional root planing with hand instruments.

Materials and Methods:

A total of 45 extracted teeth stored in saline were divided into three groups randomly – Group A (conventional root planing), Group B (hand instrumentation and air polishing), and Group C (air polishing alone) – with 15 samples each. Samples were evaluated for surface roughness by using profilometer. Six parameters were checked for surface roughness.

Statistical Analysis Used:

The data were collected, charted, and analyzed using one-way ANOVA with post hoc LSD method for pairwise comparisons.

Results:

Least amount of surface roughness was achieved with Group C when compared with Group A and Group B. These differences were statistical significant (P < 0.0001).

Conclusions:

Air polishing can effectively smoothen the root surface by removing surface irregularities which are produced hand/ultrasonic instruments. Profilometer can be effectively used to measure the surface roughness.

Effects of preoperative air-powder polishing and rubber-cup prophylaxis on tooth bleaching: randomized controlled split-mouth clinical study

OBJECTIVE

This clinical study aimed to compare the effects of preoperative air-powder polishing and rubber-cup prophylaxis on tooth bleaching.

MATERIALS AND METHODS

Twenty-three patients with tooth discoloration were enrolled in this randomized controlled split-mouth experimental study. Before bleaching, air-powder polishing (APP) and rubber-cup polishing (RCP) techniques were applied on either side of the mouth. A 40% hydrogen peroxide bleaching agent was applied twice for 15 min for the in-office bleaching treatment. The tooth bleaching effects were assessed immediately and 1 week after bleaching.

RESULTS

There were no significant differences between the prophylaxis groups with respect to all color parameters (ΔL, Δa, Δb, ΔSGU, and ΔE00) immediately after bleaching (p > 0.05). At 1-week assessment period, there were no significant differences between the prophylaxis groups with respect to all color parameters (p > 0.05), except ΔE00 (p < 0.05).

CONCLUSION

Immediately after the bleaching treatment, the two prophylactic techniques produced similar efficacy. One week after the bleaching treatment, the APP technique produced higher levels of color changes.

CLINICAL RELEVANCE

APP prophylaxis before bleaching treatment may reduce the application time and the number of sessions to achieve the desired color.

TRIAL REGISTRATION

ClinicalTrial.gov ID: NCT04407910.

Efficacy evaluation of rubber cup and air polishing techniques using glycine in plaque and stain removal - A clinical trial

Background:

Researchers have proved Glycine to be safe, less abrasive, sweet and comfortable for patients. It is beneficial in removing plaque as well as stains. The present study aims to compare the plaque and extrinsic stain removal efficacy of the air-polishing device and rubber cup prophylaxis technique along with a comparative evaluation of the gingival trauma caused by both the techniques.

Method:

This split-mouth randomized clinical trial was conducted on a total of 60 subjects in half of whom, left side was assigned to Glycine powder air polishing and the right side to rubber cup prophylaxis with (Glycine powder) and vice versa in the other half. All the subjects had their calculus removed one month prior to the intervention. Plaque index, Stain index and Trauma index were recorded and statistical analysis was done.

Results:

Both the techniques (RCP and AP) demonstrated a significant reduction in plaque and stains within their respective groups, but revealed non-significant differences between the study groups. Gingival trauma was found to be significantly higher in case of AP group. Rubber cup technique was preferred over air polishing by the subjects.

Conclusion

The data indicates that both the techniques were equally beneficial for plaque and stain removal, but rubber cup polishing technique has an advantage over the air polishing technique.

Research on dental plaque removal methods for efficient oral prophylaxis: With a focus on air polishing and rubber cup polishing

OBJECTIVES

This study was conducted to compare the plaque control effectiveness of rubber cup polishing with that of air polishing during oral prophylaxis procedures and to investigate the effect of the order of air-polishing application on the efficiency of oral prophylaxis.

METHODS

The study included adult patients (≥20 years of age) who had visited the dental clinic for oral prophylaxis. A total of 173 subjects were divided into three groups (scaling followed by rubber cup polishing, SR; scaling followed by air polishing, SA; and air polishing followed by scaling, AS) based on sex, age, oral health status, oral hygiene status, and indications and contraindications according to the oral prophylaxis method. The analysis of variance (ANOVA) was used to determine the difference in oral prophylaxis time, residual deposits rate, subjects and dental hygienist satisfaction.

RESULTS

The total scaling time was shorter in the AS group (15.4 ± 6.9 minutes) than in the SA (18.7 ± 5.5 minutes) and SR groups (19.9 ± 6.2 minutes) (p < 0.05). The rate of residual deposits was significantly higher in the SR group than in the AS or SA groups (p < 0.05). The satisfaction level of dental hygienists was higher in the AS group (8.8 ± 1.0 points) and the SA group (8.4 ± 1.0 points) than in the SR group (6.2 ± 1.3 points).

CONCLUSION

During oral prophylaxis, dental plaque removal using air polishing requires a relatively longer time when compared to rubber cup polishing, but it can better eliminate dental plaque. In addition, we found that dental plaque removal using air polishing prior to scaling reduced the total scaling time.

CBD-supplemented Polishing Powder Enhances Tooth Polishing by Inhibiting Dental Plaque Bacteria

OBJECTIVE

Air polishing is a safe tooth polishing technique used by dental professionals for stain and plaque removal and as a preventive procedure for dental health. We previously reported the antibacterial properties of cannabinoids against dental plaque bacteria. The objective of this study was to analyze the possibilities to improvise the existing air-polishing technique by supplementing cannabinoid powder into the classic polishing powder for effective removal of supragingival and subgingival plaque and for inhibition of plaque-forming bacteria.

MATERIALS AND METHODS

The cannabidiol (CBD) powder was added to the tooth polishing powder (AIR-N-GO, classic) at a 1% (wt/wt) ratio. The study was conducted on 12 patients, of whom six received regular polishing treatment and six received CBD-supplemented polishing treatment. The dental plaque samples were collected before and after each treatment and subjected to in vitro microbiological analysis, and the colony forming units (CFU) were analyzed by using an automated colony counter.

RESULTS

Based on in vitro microbiological analysis, the average CFU of interdental space samples collected from post-CBD-supplemented polishing treatment was significantly reduced (linear fold change between 3.9 and 18.4) compared with that of postregular polishing (linear fold change between 1.0 and 2.6) treatment.

CONCLUSIONS

The CBD-supplemented polishing powder can help in effective removal and killing of dental plaque bacteria during the polishing treatment; it can also be added as an enhancing supplement to the existing polishing powders.

Cervicofacial Emphysema Complicating a Dental Procedure

BACKGROUND

Cervicofacial subcutaneous emphysema can occur rarely after a dental procedure, especially tooth extraction, and can be misdiagnosed as an allergic reaction or post-procedure swelling.

CASE REPORT

We report a rare case of a 29-year-old man who developed extensive cervicofacial subcutaneous emphysema after a dental hygiene procedure. A review of the relevant literature is presented in our report. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Early identification and management of this potentially life-threatening condition is particularly important and can prevent serious complications, leading to improved patient outcomes.

Parenting styles and preschool children's behaviour in a Saudi Arabian postgraduate dental setting

BACKGROUND

The parenting style is shifting universally. Children lack the skills needed to deal with life stressful situations like those present in dental setting. Previous studies showed a correlation between parenting style and the child's dental behaviour. No studies have been performed in the Kingdom of Saudi Arabia (KSA) to relate parenting style to child's dental behaviour. The purpose of this study is to correlate parenting styles with the dental behaviour of their children, in Riyadh, KSA.

METHODOLOGY

Two hundred and eighty-two healthy preschool children aged 3-6 years were recruited in their first dental visit, to a postgraduate Paediatric Dentistry Clinics of the Dental University Hospital at KSU, Riyadh, KSA. The Parenting Styles and Dimensions Questionnaire was completed by the primary caregiver/parents. The behaviour of the children was evaluated after dental prophylaxis and fluoride application in the dental chair using Frankl behavior rating scale. Family and child demographic data were evaluated through a questionnaire.

RESULTS

Two hundred and eighty-two healthy Saudi children participated in the study with their parents. Two parenting styles were identified among Saudi parents including authoritative (94%, n = 265) and permissive parenting styles (6%, n = 17). Most of the children behaved positively (n = 205, 72.7%). Significant correlations were detected between parenting style and parent's dental anxiety (P value 0.02) but not significantly correlated to a child's dental behaviuor.

CONCLUSION

In the KSU sample studied, two parenting styles were identified among Saudi parents, authoritative and permissive parenting styles. Parenting style was correlated to parental dental anxiety and had an influence on a child's dental behaviour. Clinically, interesting correlations were identified regarding factors affecting child/s first dental visit behaviour.

The Effect of Thermocycling and Surface Treatments on the Surface Roughness and Microhardness of Three Heat-Pressed Ceramics Systems

Dental ceramic restorations are widely used in restorative dentistry. However, these restorations can be affected once cemented in the oral cavity by several factors. How can conventional surface treatments, such as glazing and mechanical polishing, diminish the effects of aging? The purpose of this in vitro study was to evaluate the effect of thermocycling and conventional surface treatments on the surface roughness and microhardness of three types of glass-ceramics by using a profilometer, scanning electron microscopy (SEM), atomic force microscopy (AFM), and a microhardness tester. Three types of ceramic systems (zirconia reinforced lithium silicate glass-ceramic, lithium disilicate glass-ceramic, and feldspathic glass-ceramic) (n = 48) were prepared. The samples were subjected to thermocycling for 10,000 cycles. Surface roughness was evaluated numerically using a profilometer and visually by using SEM and AFM. Microhardness was performed using a microhardness tester. The data were interpreted using the ANOVA test, and the results were correlated using Pearson’s correlation formula (r). Significant differences were found before and after thermocycling for the Ra (p < 0.01) and Rz (p < 0.05) parameters. As well, differences between glazed and polished surfaces were significant before and after thermocycling for surface roughness and microhardness (p < 0.05). A correlation was made between average surface roughness and microhardness (r = −460) and for the maximum surface roughness and microhardness (r = −606). Aging increases the roughness and decreases in time the microhardness. The tested ceramic systems behaved differently to the aging and surface treatments. Surface treatments had a significant impact on the microhardness and surface characteristics. The glazed groups were reported with higher surface roughness and lower microhardness when compared to the polished groups before and after thermocycling. The measuring roughness techniques determine the scale-dependent values for the Ra (Sa) and Rz (Sq) parameters. Thermocycling almost doubled the surface roughness for all the tested samples. Microhardness decreased only for the Celtra glazed samples. Nano-roughness increased the values for Vita and slightly for Emax. Thermocycling had little effect on Emax ceramic and a more significant impact on Celtra Press ceramic.

Advanced inorganic nanocomposite for decontaminating titanium dental implants

Oral hygiene and regular maintenance are crucial for preserving good peri-implant health. However, available prophylaxis products and toothpastes, which are optimized for cleaning teeth, tend to contaminate and abrade implant surfaces due to their organic components and silica microparticles, respectively. This study aims to develop an organic-free implant-paste based on two-dimensional nanocrystalline magnesium phosphate gel and hydrated silica nanoparticles (20-30% w/w) for cleaning oral biofilm on titanium dental implants. The surface chemistry, morphology, and bacterial load of contaminated Ti disks before and after decontamination using prophylaxis brushing with toothpaste and implant-paste were characterized by X-ray photoelectron spectroscopy (XPS), scanning electron microscopy, and fluorescence spectroscopy. Both commercial toothpastes and implant-paste remove bacteria, however, only implant-paste protects Ti metal from abrasion and removes organic contaminants. XPS showed a significant decrease of carbon contamination from 73% ± 2 to 20% ± 2 after mechanical brushing with implant-paste compared to 41% ± 11 when brushing with commercial toothpastes (p < 0.05). Fluorescence microscopy revealed that bacteria load on biofilm contaminated Ti (44 × 10³  ± 27 × 10³ /µm² ) was significantly reduced with the implant-paste to 2 × 10³  ± 1 × 10² /µm² and with a commercial toothpaste to 2.9 × 10³  ± 7·10² /µm² . This decay is relatively higher than the removal achieved using rotary prophylaxis brush alone (5 × 10³  ± 1 × 10³ /µm² , p < 0.05). Accordingly, this novel implant-paste shows a great promise as an efficient decontamination approach. © 2018 Wiley Periodicals, Inc. J. Biomed. Mater. Res. Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 761-772, 2019.