Evaluation of material waste, dimensional stability, and detail reproduction of polyvinyl siloxane impression materials mixed with different mixing tips

STATEMENT OF PROBLEM

Redesigned mixing tips, promising less impression material waste, have been marketed. However, whether their use adversely affects the dimensional stability and detail reproduction of the impression material is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the dimensional stability, detail reproduction, and material waste of different polyvinyl siloxane impression materials (regular and light-body) mixed with 2 different mixing tips (MIXPAC T-Mixer mixing tip and MIXPAC helical mixing tip).

MATERIAL AND METHODS

Six different polyvinyl siloxane impression materials were used in 2 different consistencies: Virtual Monophase and Virtual Light Body (Ivoclar Vivadent AG), Express XT Regular and Express XT Light Body (3M ESPE), and Panasil initial contact Regular and Panasil initial contact Light (Kettenbach). The polyvinyl siloxane impression materials were mixed with 2 different mixing tips: conventional helical and T-Mixer (n=10). The specimens were prepared in a metal matrix as per specification #19 of the American National Standards Institute/American Dental Association (ANSI/ADA) and International Organization for Standardization (ISO) 4823:2015. The materials were mixed with both mixing tips as per the manufacturer's instructions, inserted into a perforated custom tray on the matrix, and allowed to polymerize completely. The dimensional stability was calculated based on the measurement of the reproduction of lines engraved in the metal matrix. Detail reproduction was evaluated through analysis of continuity and reproducibility of those lines, immediately, 7 days, and 14 days after polymerization. Material waste was assessed by the difference between the initial (before mixing) and final weight (after complete polymerization) of both mixing tips. The data on dimensional stability and detail reproduction among the materials were submitted to the Kruskal-Wallis test, followed by the Student-Newman-Keuls test (α=.05). Comparison between the mixing tips was carried out with the Mann-Whitney test (α=.05), while the comparison among the periods of analysis (immediate, 7 days, and 14 days) was carried out with the Friedman test (α=.05). The data on material waste between the mixing tips were submitted to 1-way ANOVA, followed by the Tukey honestly significant difference tests (α=.05).

RESULTS

The T-Mixer mixing tip resulted in reduced material waste. For dimensional stability, Virtual Light mixed with T-Mixer resulted in lower dimensional change (0.53 ±0.58%) compared with the helical mixing tip (1.09 ±0.43%). Among the materials, Panasil Light presented higher values of dimensional change at immediate and 7-day analysis when mixed with T-Mixer tip with a statistical difference compared with Express Light, Virtual Light, and Panasil Regular (P<.05). In general, both mixing tips provided similar results in all periods of analysis (P>.05) for qualitative analysis of detail reproduction.

CONCLUSIONS

The T-Mixer tip resulted in less material waste compared with the helical mixing tip. In general, light-body materials showed higher dimensional stability when the T-Mixer tip was used compared with the conventional tip. In general, reduced detail reproduction was observed after periods longer than 7 days after impression making.

Decomposition Rate, pH, and Enamel Color Alteration of At-Home and In-Office Bleaching Agents

Abstract This study evaluated the decomposition rate (DR), pH, enamel color alteration (DE) and whiteness index (DWI) promoted by at-home and in-office bleaching. Enamel surface was submitted to (n=10): at-home (10%, 15%, 20% carbamide peroxide - CP, 6% hydrogen peroxide -HP) and three 35% HP agents with light irradiation (LED, laser, and halogen) or no treatment (control). The DR and pH of agents were measured after 0, 2, 4, 6 and 8 h (at-home) or after 5, 15, 20, 30 and 40 min (in-office). Color parameters (L*, a*, b*, DE, DWI) were determined at baseline and after bleaching. DR, pH, L*, a*, b* data were analyzed by one-way (at-home) or two-way (in-office) repeated measures ANOVA and Tukey test. DE and DWI, by one-way (at-home) or two-way (in-office) ANOVA and Tukey test. DR of at-home agents was similar after 6 and 8 h (p>0.05), with pH close to neutral (6.5 to 6.9, CP) or acid 5.9 (6% HP). From 4 to 8 h, DE was higher for 15% and 20% CP compared with 10% CP (p<0.05). After 40 min, DR of 35% HP agents was similar and all exhibited significant DE in one application (p<0.05), regardless light irradiation. DWI indicated whitening effect with no differences among groups (p>0.05). One 35% HP showed alkaline pH, and the others, pH < 5.5. At-home agents could be applied for 2 h (15%, 20% CP, 6% HP) and 4 h (10% CP) and the in-office agents, up to 40 min in one application, without light.

Edemogenic test and hydrogen peroxide degradation rate of bleaching gels with different desensitizing agents

Objective: The at-home bleaching technique leads to the intimate contact of the bleaching gel with gingival tissues, so this study evaluated the immediate inflammatory response, through the edemogenic test, induced by at-home bleaching gels of 10% carbamide peroxide with different desensitizing agents, the quantification of hydrogen peroxide released and bleaching gels pH. Material and Methods: Forty-eight rats were divided into groups (n=12): CTRL-control group, WP-Whiteness Perfect 10% (FGM Produtos Odontológicos, Joinville, SC, Brazil), OPA-Opalescence 10% (Ultradent Products Inc., South Jordan, IT, USA), and PB-Power Bleaching (BM4, Palhoça, SC, Brazil). For the edemogenic test, all rats received an intravenous injection of Evan's Blue; after 30 min, 0.2 mL of each bleaching gels was injected into the subcutaneous tissue of the rats, and the results of the vascular permeability were assessed after 3 and 6h. The amount of HP released and pH of each product was also determined. Data were submitted to statistical test (p<0.05). Results: At 3h, the PB showed higher vascular permeability than the other groups. At 6h, the PB produced similar vascular permeability than WHI, and higher than OPA and CTRL groups. The OPA group had a higher vascular permeability at 6h compared to 3h; there is no difference in other groups. The PB group had higher HP concentrations than the other groups. Conclusion: In general, the PB caused a more considerable amount of inflammatory edema and higher amount of HP released. This results suggesting that these bleaching gels cause greater aggression in soft gingival tissues that eventually ends up in contact with bleaching products KeywordsTooth bleaching; Carbamide peroxide; Hydrogen peroxide; Capillary permeability.

Effect of Adhesive Restoration and Bleaching Technique on the Concentration of Hydrogen Peroxide In the Pulp Chamber

This study aimed to quantify the concentration of hydrogen peroxide into the pulp chamber in the presence or absence of adhesive enamel restorations and to analyze the resin-dentin interface of bleached groups. Bovine incisors (120) were randomly divided into three groups according to enamel treatment (n=40 each): (1) enamel without restoration (control); (2) enamel cavities (3 mm diameter × 1.5 mm depth) restored with a silorane-based (SB) system; or (3) enamel cavities (3 mm diameter × 1.5 mm depth) restored with a dimethacrylate-based (DB) system. Restorations were thermocycled, and all groups were submitted to one application of 35% hydrogen peroxide (HP) agent for 45 minutes and subjected to four light activation methods (n=10 each): without light, light-emitting diode (LED), LED/diode laser, or halogen light. Acetate buffer solution was placed into the pulp chamber before bleaching, and this solution was collected to spectrophotometrically determine the concentration of HP that reached the pulp chamber after bleaching. Rhodamine B was added to the HP agent and applied on additional enamel samples of each group for 24 hours. Samples were sectioned mesiodistally, and the bleaching agent was traced using confocal microscopy. According to two-way analysis of variance and Tukey test (α=0.05), the HP concentration in the pulp chamber of the control group was significantly lower than that of the SB group (p&lt;0.05), regardless of light activation. No differences were observed between DB and SB groups and between control and DB groups, except for the DB halogen light activated group, which exhibited higher HP intrapulpal concentration (p&lt;0.05). Confocal microscopy exhibited HP diffusion through the interface of the SB and DB restored groups as well as enamel prisms in the control group. The SB restorative system increased the HP diffusion into the pulp chamber, but HP was able to diffuse even in the absence of enamel restorations.

Use of modified lip repositioning technique associated with esthetic crown lengthening for treatment of excessive gingival display: A case report of multiple etiologies

Excessive gingival display during smile can result in compromised esthetics. This study aims to report a case of excessive gingival display with multiple etiologies treated by means of modified lip repositioning technique associated with esthetic crown lengthening. A 23-year-old female patient, with 5-mm gingival display during smile caused by altered passive eruption and hypermobility of the upper lip, underwent the modified lip repositioning technique associated with gingivectomy followed by flap elevation and ostectomy/osteoplasty. Seven months after the second procedure, the patient had her esthetic complaint solved appearing stable in the observation period. The modified lip repositioning technique is an effective procedure employed to reduce gingival display and when associated with esthetic clinical crown lengthening, can appropriately treat cases of gummy smile.

Giant complex odontoma in maxillary sinus

In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination.

Penetration of hydrogen peroxide and degradation rate of different bleaching products

This study's aim was to evaluate the degradation rate of hydrogen peroxide (H2O2) and to quantify its penetration in tooth structure, considering the residence time of bleaching products on the dental enamel. For this study, bovine teeth were randomly divided according to the bleaching product received: Opalescence Xtra Boost 38%, White Gold Office 35%, Whiteness HP Blue 35%, Whiteness HP Maxx 35%, and Lase Peroxide Sensy 35%. To analyze the degradation of H2O2, the titration of bleaching agents with potassium permanganate was used, while the penetration of H2O2 was measured via spectrophotometric analysis of the acetate buffer solution, collected from the artificial pulp chamber. The analyses were performed immediately as well as 15 minutes, 30 minutes, and 45 minutes after product application. The data of degradation rate of H2O2 were submitted to analysis of variance (ANOVA) and Tukey tests, while ANOVA and Fisher tests were used for the quantification of H2O2, at the 5% level. The results showed that all products significantly reduced the concentration of H2O2 activates at the end of 45 minutes. It was also verified that the penetration of H2O2 was enhanced by increasing the residence time of the product on the tooth surface. It was concluded that the bleaching gels retained substantial concentrations of H2O2 after 45 minutes of application, and penetration of H2O2 in the dental structure is time-dependent.

Clinical evaluation of in-office dental bleaching treatments with and without the use of light-activation sources

This study clinically evaluated the alteration of color, color stability, dental sensitivity and gingival irritation on patients undergoing dental bleaching using varying bleaching methods and light-activation sources. According to pre-established criteria, 40 patients were selected and randomly divided into four groups (n=10): Group 1--35% Hydrogen Peroxide (HP); Group 2--35% HP plus Halogen Curing Light XL 3000 (3M/ESPE); Group 3--35% HP plus Demetron LED (Kerr) and Group 4--35% HP plus LED/LASER (Bio-art). For all groups, there were two sessions of bleaching with 35% HP, with a one week break between sessions. At each bleaching session, three applications of the bleaching gel were used. Two methods of shade evaluation were performed before and after the first week, second week, first month and after six months of the bleaching treatment. These methods were VITA Easyshade Spectrophotometer and Vita Classical Shade Guide. Statistical analysis using ANOVA demonstrated equality between the participating groups when evaluating the group and time variables. The In-Office dental bleaching treatments of vital teeth with 35% HP did not prove to be more effective when light sources were used. There was no difference in color stability between groups until the sixth month of evaluation.

Effect of placement techniques on the marginal adaptation of Class V composite restorations

STATEMENT OF THE PROBLEM

Several techniques are proposed for the restoration of Class V cavities but there is no agreement in the literature as to which technique is more effective.

PURPOSE

To evaluate the effect of different techniques of composite increment placement on the marginal adaptation of Class V restorations.

METHODS AND MATERIALS

Twenty-four human molars were selected and prepared with standardized saucer-shaped cavity dimensions of 3.0 mm (occlusal-gingival), 2.0 mm (mesial-distal), and 2.0 mm (depth). The margins are in reference to the cemento-enamel junction with 1.5 mm being located on enamel and 1.5 mm on dentin. The cavities were randomly assigned into three groups (n=8) and restored with composites as follows: Group 1, the occlusal increment was placed and cured first followed by the gingival increment; Group 2, the gingival increment was placed and cured first followed by the occlusal increment; and Group 3, the cavities were restored with one bulk increment. Restorations were immediately finished and stored for 24 h in tap water. Specimens were subjected to thermocycling (1000 cycles, 5 degrees C to 55 degrees C, 30 s dwell time) and immersed in 0.5% basic fuchsin solution for 24 h in room temperature. After rinsing with running water, the restorations were sectioned longitudinally and enamel and dentin margins were evaluated and scored according to the microleakage on a 0-3 scale. Data were subjected to Kruskal-Wallis test at p<0.05.

RESULTS

Median of microleakage scores for all evaluated groups was zero. No statistical difference was observed among the three groups both in enamel (p = 0.5929) and dentin (p = 0.3679) margins

CONCLUSION

The placement technique did not influence the marginal adaptation of moderate Class V restorations.

CLINICAL SIGNIFICANCE

No differences on marginal adaptation were observed when restoring conservative Class V cavities using incremental or bulk placement techniques.

Flowable composites as "filled adhesives:" a microleakage study

OBJECTIVE

The purpose of this in vitro study was to investigate the microleakage at dentin margins of a flowable resin composite associated with an adhesive, either light cured separately or co-cured, in Class V cavities.

MATERIALS AND METHODS

Twenty four recently extracted human molars were prepared with standardized box-shaped Class V cavities of 3.0 mm (mesial-distal), 2.0 mm (occlusal-gingival), and 2.0 mm depth with margins located on enamel and dentin/cementum on the buccal or lingual surfaces. The cavities were randomly assigned into three groups (n=8): Group I - Single Bond + Filtek Z250 (control); Group II - Single Bond + Filtek Flow (light cured separately) + Filtek Z250; and Group III - Single Bond + Filtek Flow co-cured (light cured simultaneously) + Filtek Z250. After being immersed in tap water for 24 h, the specimens were thermocycled (1000x, 5 degrees -55 degrees C, 30 sec dwell time) and immersed in a 0.5% basic fuchsine solution for 24 h. The restorations were sectioned longitudinally and gingival margins were evaluated for microleakage using a 0-4 scale. Data were subjected to the Kruskal-Wallis test at p<0.05.

RESULTS

A statistically significant difference at p = 0.0044 between Groups 1 and 3 and Groups 2 and 3 was observed. Although Group 2 performed slightly better than Group 1, no significant difference was observed.

CONCLUSION

The use of a flowable resin composite cured simultaneously with an adhesive yielded the worst results in this study. As no statistical differences were seen between Groups 1 and 2, the use of a flowable composite as a means of minimizing microleakage at dentin margins may be questioned.