Microhardness of different esthetic restorative materials: Evaluation and comparison after exposure to acidic drink.

BACKGROUND: Acidic beverages, such as soft drinks (orange juice and cola), can produce erosion of resin composites. The aim of this in vitro study was to evaluate the effect of immersion in acidic drink on the Vickers microhardness (VK) of different esthetic restorative materials (one nanohybrid Ormocer-based composite, one nanoceramic composite, one nanofilled composite, and one microfilled hybrid composite). MATERIALS AND METHODS: In this in vitro study, thirty specimens of each esthetic restorative material were divided into three subgroups (n = 10): specimens of group 1 were used as control, specimens of group 2 were immersed in 50 ml of acidic drink for 1 day, specimens of group 3 were immersed in 50 ml of acidic drink for 7 days. Data were analyzed by Shapiro-Wilk test to assess the normality of the distributions followed by nonparametric Kruskal-Wallis analysis of variance and Mann-Whitney U-test comparison test among groups. A significant level of α = 0.05 was set for comparison between the groups. RESULTS: Mann-Whitney U-test showed that each material showed lower microhardness values after immersion in acidic solution (P < 0.05). Paired t-test confirmed that microhardness for each composite did not change after immersion in distilled water (Control group) (P > 0.05). Significant changes were registered for all restorative materials after immersion in acidic solution for 1 day and 7 days (P < 0.05). CONCLUSION: The Filtek Supreme XTE, a nanofilled composite, and Admira Fusion, a nanohybrid ormocer-based composite, showed the best behavior. The Ceram X Universal (nanoceramic composite) although reached lower hardness values than the previous materials, but resisted well to the 1 week immersion in soft-drink. Finally, the Gradia Direct achieved the most disappointing results: Low microhardness values are justified by the nature of its filling (microfilled hybrid composite).

Remineralizing effect of a zinc-hydroxyapatite toothpaste on enamel erosion caused by soft drinks: Ultrastructural analysis.

BACKGROUND: The aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste on repairing enamel erosion produced by a soft drink (Coca-Cola) compared to toothpastes with and without fluoride using Scanning Electron Microscopy (SEM). MATERIAL AND METHODS: Fifty specimens were assigned to 5 groups of 10 specimens each. (Group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, 3: erosive challenge, toothpaste without fluoride, group 4: erosive challenge, fluoride toothpaste treatment, group 5: erosive challenge, zinc-hydroxyapatite toothpaste treatment). Repeated erosive challenges were provided by immersing bovine enamel specimens (10 per group) in a soft drink for 2 min (6mL, room temperature) at 0, 8, 24 and 32 h. After each erosive challenge, the toothpastes were applied neat onto the surface of specimens for 3 min without brushing and removed with distilled water. Between treatments the specimens were kept in artificial saliva. The surface of each specimen was imaged by SEM. RESULTS: Statistically significant differences were found between the samples used as control and those immersed in Coca-Cola (group 1 and 2): indeed among all groups the highest grade of damage was found in group 2. Instead the lowest grade was recorded in the samples of group 5 (Zinc hydroxyapatite toothpaste). CONCLUSIONS: The results of this study confirmed the potential benefit the Zn-HAP technology could provide in protecting enamel from erosive acid challenges. The treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect. Key words:Dental erosion, enamel, SEM, toothpaste.

Preventive effects of different protective agents on dentin erosion: An in vitro investigation.

BACKGROUND: The purpose of this in vitro study was to evaluate the preventive effects of different protective agents on dentine erosion, measuring mean percentage weight loss. Dissolution of dentine under erosive challenges caused by soft drinks was analyzed: specimens were weighed following each immersion period, with mean percent weight losses calculated. MATERIAL AND METHODS: Extracted teeth were sectioned into uniform slabs. Seventy permanent enamel specimens were randomly distributed to seven groups. Initial weights of all dentin specimens were performed. The fluoride pastes Remin Pro, MI Paste Plus, Tooth Mousse, Biorepair, Biorepair Plus and Regenerate were used in this study. A control group was treated just with tap water. The specimens then were immersed in Coca-Cola for a total of 32 min at room temperature. Finally each specimen was dry and weighed. The mass loss was calculated as a percentage of that observed prior the fluoride pastes application. Weight loss data were subjected to Analysis of Variance (One-way ANOVA) followed by Bonferroni's post hoc tests. RESULTS: Percent weight loss of specimens exposed to early stages in Coca-Cola showed linear progression with time. Specimen's application of fluoridated varnishes such as Biorepair or Regenerate, prior immersion in Coca-Cola, significantly protect dentin from demineralization. Otherwise, application of Tooth Mousse or Biorepair Plus increased dentin demineralization starting from 24 min of immersion in Coca-Cola. CONCLUSIONS: Despite the limitations of this study, the protective pastes that showed the less weight loss due to the acidic challenge are Biorepair and Regenerate. Key words:Dentine, erosion, protective agents, soft drinks, toothpastes.

Protective effect of zinc-hydroxyapatite toothpastes on enamel erosion: An in vitro study.

BACKGROUND: The aim of the present study was to test the impact of different toothpastes with Zinc-Hydroxyapatite (Zn-HAP) on preventing and repairing enamel erosion compared to toothpastes with and without fluoride. MATERIAL AND METHODS: The following four toothpastes were tested: two toothpastes with Zn-HAP, one toothpaste with fluoride and one toothpaste without fluoride. An additional control group was used in which enamel specimens were not treated with toothpaste. Repeated erosive challenges were provided by immersing bovine enamel specimens (10 per group) in a soft drink for 2 min (6mL, room temperature) at 0, 8, 24 and 32 h. After each erosive challenge, the toothpastes were applied neat onto the surface of specimens for 3 min without brushing and removed with distilled water. Between treatments the specimens were kept in artificial saliva. Enamel hardness, after the erosive challenge and toothpaste treatment was monitored using surface micro-hardness measurements. RESULTS: As expected, repeated erosive challenge by a soft drink for total of 8 min significantly reduced enamel surface hardness (ANOVA, p < 0.05). No re-hardening of the surface softened enamel was observed in the group treated with fluoride-free toothpaste. Surface hardness of the softened enamel increased when the specimens were treated with the fluoride toothpaste and the two toothpastes with Zn-HAP (p < 0.05). CONCLUSIONS: Toothpaste with Zn-HAP resulted in significant enamel remineralisation of erosively challenged enamel, indicating that these toothpastes could provide enamel health benefits relevant to enamel erosion. Key words:Enamel, erosion, remineralization, surface hardness, toothpastes.

Color stability of esthetic restorative materials: a spectrophotometric analysis.

Objective: The aim of this in vitro study was to evaluate the color stability of different restorative materials (one microfilled composite, one nanofilled composite, one nanohybrid composite and one Ormocer-based composite) after exposure to different staining solutions (coffee, coca-cola and red wine). Material and methods: All materials were polymerized into silicon rings (2 mm ×6 mm ×8 mm) to obtain specimens identical in size. Thirty cylindrical specimens of each material were prepared. They were immersed in staining solutions over a 28-day test period. A colorimetric evaluation according to the CIE L*a*b* system was performed by a blind trained operator at 7, 14, 21, 28 days of the staining process. The Shapiro-Wilk test and Kruskal-Wallis ANOVA were applied to assess significant differences among restorative materials. The paired t-test was applied to test which CIE L*a*b* parameters significantly changed after immersion in staining solutions. Results: All restorative materials showed clinically perceptible color differences after immersion in coffee. L* and b* values showed the highest variability. Coca cola and red wine did not influence the color stability for all restorative materials except for Filtek Supreme XTE. Conclusions: Coffee caused a significant color change in all types of tested composite resins. Filtek Supreme XTE demonstrated alone a staining susceptibility to red wine; no other significant differences among the materials were demonstrated. Long-term exposure to some food dyes (coffee in particular) can significantly affect the color stability of modern esthetic restorative materials regardless of materials' different composition.

Effect of self-assembling peptide P11 -4 on enamel erosion: AFM and SEM studies.

The aim of the present in vitro study was to evaluate the protective effect of self-assembling peptide P11 -4 (Curodont™ Protect/Credentis) on enamel erosion produced by a soft-drink, by using Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM). Thirty human incisors were equally and randomly assigned to 6 groups. Group 1: intact enamel, group 2: soft drink, group 3: Curodont(™) Protect applied, group 4: Curodont(™) Protect applied + soft drink, group 5: soft drink + Curodont(™) Protect applied, group 6: soft drink + Curodont(™) Protect applied + soft drink. Specimens were observed through atomic force microscopy (AFM). The root mean-square roughness (Rrms) was obtained from the AFM images and the differences in the averaged values among the groups were analyzed by Shapiro-Wilk test in order to assess the normality of the distribution. Parametric ANOVA and post hoc Tuckey test were performed to assess the differences between the different groups. After demineralization process, enamel demonstrated a high degree of surface porosity. This morphological aspect was reflected in the increase of Rrms values. No significant differences (p > 0.05) were reported between intact enamel and enamel only treated with P11 -4 and between eroded enamel and enamel treated with P11 -4 and then demineralized. However significant differences (p < 0.05) were recorded when comparing softened enamel with softened enamel further remineralized with biomimetic self-assembling peptides and enamel treated with the protective paste between two acid attacks. The use of P11 -4 remineralizing may offer a degree of protection from enamel erosion. SCANNING 38:344-351, 2016. © 2015 Wiley Periodicals, Inc.

Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study.

AIM: The aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste against an erosive challenge produced by a soft drink (Coca-Cola) using Scanning Electron Microscopy (SEM). METHODS: Forty specimens were assigned to 4 groups of 10 specimens each (group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, group 3: erosive challenge, fluoride toothpaste treatment, group 4: erosive challenge, zinc-hydroxyapatite toothpaste treatment). The surface of each specimen was imaged by SEM. A visual rating system was used to evaluate the condition of the enamel surface; results were analyzed by nonparametric statistical methods. RESULTS: Statistically significant differences were found between the samples untreated and those immersed in Coca-Cola (group 1, 2); the highest grade of damage was found in group 2, while the lowest grade was recorded in the samples of group 4. Comparing the groups, the two analyzed toothpaste tended to protect in different extend. CONCLUSIONS: In this study treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect. This was greater than the effect observed for a normal fluoride toothpaste and confirmed the potential benefit the Zn-HAP technology can provide in protecting enamel from erosive acid challenges.

Protective effect of casein phosphopeptide-amorphous calcium phosphate on enamel erosion: Atomic force microscopy studies.

The aim of this study was to investigate the in vitro effect of a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (GC Tooth Mousse- TM, GC Corporation, Tokyo, Japan) on preventing enamel erosion, by using Atomic Force Microscopy (AFM). 30 human incisors, were equally assigned to 6 groups: intact enamel, enamel + soft drink, enamel + TM, enamel + TM + soft drink, enamel + soft drink + TM, enamel + soft drink + TM + soft drink. Specimens were observed through atomic force microscopy (AFM). The most common topographical parameters were determined, such as the surface roughness (Rrms ). The use of soft drink on intact enamel has roughened the surface of the sample. The application of the CPP-ACP paste on non-treated enamel made the surface smoother. A significant decrease in roughness was seen after remineralization with CPP-ACP paste. Significant differences were recorded when comparing softened enamel with softened enamel remineralized with CPP-ACP paste. Comparing eroded enamel with demineralized/remineralized specimens, the application of a CPP-ACP paste leads to a significant reduction in roughness values. AFM images of enamel surface treated with CPP-ACP resulted in less morphological changes of the tooth substrate when compared with the only eroded enamel surface morphology; thus, indicating that CPP-ACP paste promoted remineralization. Specimens' surface roughness remained similar regardless that the protective agent is used before or after exposure to coke or between two demineralizing cycles. The results confirmed the effectiveness of the CPP-ACP paste on preventing enamel erosion produced by soft drinks.