Preemptive use of ibuprofen and desensitizer decreases immediate tooth sensitivity after in-office bleaching: A triple-blind, randomized, placebo-controlled clinical trial.

BACKGROUND: The authors evaluated the synergistic analgesic effect of preemptive administration of 400 mg of ibuprofen (IBU) and potassium fluoride 2% (KF2), both in isolation or combination, on the painful perception of tooth sensitivity after tooth bleaching. METHODS: Fifteen patients participated in this triple-blind, randomized, placebo-controlled clinical trial. The study used a crossover design for drug administration and a split-mouth design for desensitizer agent. Four paired groups were formed: IBU plus KF2 (IBU + KF2); IBU (IBU + placebo KF); KF2 (placebo IBU + KF2), and placebo (placebo IBU + placebo KF). The outcome measure was the perception of tooth sensitivity, assessed using a visual analog scale. Data were collected at 4 different times: immediately after tooth bleaching (baseline) and after 6, 30, and 54 hours. Statistical analysis was performed using the Friedman test and relative risk. RESULTS: IBU plus KF2 was found to be more effective in reducing tooth sensitivity immediately after bleaching (baseline) compared with the placebo group (P < .05). The risk of experiencing moderate or severe tooth sensitivity was approximately 4 times higher in the placebo group than in the IBU plus KF2 group (relative risk, 4.00; 95% CI, 1.01 to 15.81; P = .025). CONCLUSIONS: The combined use of 400 mg of IBU and KF2 appears to be beneficial in managing postbleaching tooth sensitivity. It provides a superior analgesic effect compared with placebo. PRACTICAL IMPLICATIONS: The preemptive administration of IBU plus KF2 reduces tooth sensitivity after tooth whitening when compared with placebo. This clinical trial was registered in the Brazilian Clinical Trials Registry Platform. The registration number is U1111-1249-8191.

Chemical analysis of n-propyl gallate used as pre-treatment for resin-dentin bond strength: In vitro study.

This study aimed to evaluate the effect of n-propyl gallate as pre-treatment for resin-dentin bond strength. The dentin pre-treatments evaluated included propyl gallate of concentrations 0.1% (w/v), 1.0% (w/v), and 10.0% (w/v), as well as glutaraldehyde 5.0% (v/v), and distilled water as a control treatment. Dentin specimens were prepared for Fourier Transformed Infrared Spectroscopy (FT-IR) (n = 3/pre-treatment). Pre-treatments were actively applied to dentin blocks before performing the adhesive procedure to composite resin. Microtensile bond strength to dentin (µTBS) (n = 8/pre-treatment) was determined after 24 h and 6 months of storage. Data were submitted to a two-way ANOVA, followed by Tukey's post hoc test. As for FT-IR, propyl gallate 1%-treated specimens presented higher water, carbonate, collagen, and amide absorbance rates compared to other tested groups, while specimens pre-treated with glutaraldehyde and distilled water presented similar absorbance curves. Regarding µTBS, all concentrations of propyl gallate resulted in statistically significant higher bond strength values than distilled water at 24 h. After 6 months of storage, propyl gallate 0.1% was the only group that maintained µTBS over time. Propyl gallate 0.1% might be a suitable dentinal pre-treatment due to being able to present chemical bonds with demineralized dentin and providing resin-dentin bond stability after 6 months of storage.

Protective effect of green tea catechins on eroded human dentin: an in vitro/in situ study.

The present study sought to evaluate the protective effect of Epigallocatechin-3-gallate (EGCG) and commercial green tea (GT) on eroded dentin using in vitro and in situ experimental models. For the in vitro experiment, matrix metalloproteinases (MMPs) were extracted from demineralized human coronary dentin powder (citric acid, pH 2.3) and assessed via a colorimetric assay and electrophoresis in gelatin. The gels were exposed to buffers with: control (no treatment), 0.05% sodium fluoride (NaF), 0.12% chlorhexidine digluconate (CHX), GT infusion, and 0.1% EGCG, and their respective activity was analyzed by zymography. For the in situ experiment, 20 healthy volunteers (aged 20-32 years) participated in this single-center, blind, crossover study. The subjects wore upper removable devices containing four human dentin blocks. Erosive challenge (coke-1 min) was performed four times/day/5 days. Blocks were treated for 1 min with: control (No treatment), 0.05% NaF, 0.1% EGCG, and GT. Thereafter, the specimens were subjected to stylus profilometry and SEM. ANOVA was used to evaluate dentin roughness and wear, with a significance level of 5%. In the zymography analysis, 0.12% CHX, GT, and 0.1% EGCG were found to inhibit the action of MMPs; however, in the colorimetric assay, only green tea inhibited the activity of MMPs. There were no significant differences observed in dentin roughness or wear (p > 0.05). Herein, EGCG and GT inhibited the activity of endogenous proteases, resulting in protection against erosion-induced dentin damage; however, they could not prevent tooth tissue loss in situ.

Hesperidin reduces dentin wear after erosion and erosion/abrasion cycling in vitro.

OBJECTIVE: To evaluate the action of hesperidin (HPN) at different concentrations to prevent dentin erosive wear, associated or not to abrasion. METHODS: A study with 6 experimental groups (n = 10) for erosion (experiment 1) and another 6 for erosion + abrasion (experiment 2). The treatments were: distilled water (DW), DW with collagenase (DW + Col), 0.46% epigallocatechin-3-gallate (EGCG) and 0.1%, 0.5% or 1% HPN. The specimens were submitted to a cycle (3x/day) for 5 days that consisted of immersion on 1% citric acid (5 min), artificial saliva (60 min), treatment (5 min), brushing (150 movements only in experiment 2), and artificial saliva (60 min / overnight). Collagenase was added in artificial saliva for all groups except DW-group. Dentin changes were assessed with optical profilometry and scanning electron microscopy. Data were submitted to one-way analysis of variance and Tukey tests (α = 0.05). RESULTS: For experiment 1, DW showed the lowest wear and did not significantly differ from EGCG. DW + Col showed the highest wear, being significantly different from HPN at 1%. In experiment 2, DW showed the lowest wear and DW + Col the highest. EGCG showed less wear than the three groups treated with HPN. In addition, for both cycling models, there were no significant differences among the three concentrations of HPN analyzed. In micrographs of HPN-treated groups, it could be observed the formation of a barrier on the dentin that promoted the obliteration of the tubules. CONCLUSIONS: HPN was able to preserve the demineralized organic matrix layer but did not overcome the effect of EGCG.

Protective effect of green tea catechins on eroded human dentin: an in vitro/in situ study

Abstract The present study sought to evaluate the protective effect of Epigallocatechin-3-gallate (EGCG) and commercial green tea (GT) on eroded dentin using in vitro and in situ experimental models. For the in vitro experiment, matrix metalloproteinases (MMPs) were extracted from demineralized human coronary dentin powder (citric acid, pH 2.3) and assessed via a colorimetric assay and electrophoresis in gelatin. The gels were exposed to buffers with: control (no treatment), 0.05% sodium fluoride (NaF), 0.12% chlorhexidine digluconate (CHX), GT infusion, and 0.1% EGCG, and their respective activity was analyzed by zymography. For the in situ experiment, 20 healthy volunteers (aged 20-32 years) participated in this single-center, blind, crossover study. The subjects wore upper removable devices containing four human dentin blocks. Erosive challenge (coke-1 min) was performed four times/day/5 days. Blocks were treated for 1 min with: control (No treatment), 0.05% NaF, 0.1% EGCG, and GT. Thereafter, the specimens were subjected to stylus profilometry and SEM. ANOVA was used to evaluate dentin roughness and wear, with a significance level of 5%. In the zymography analysis, 0.12% CHX, GT, and 0.1% EGCG were found to inhibit the action of MMPs; however, in the colorimetric assay, only green tea inhibited the activity of MMPs. There were no significant differences observed in dentin roughness or wear (p > 0.05). Herein, EGCG and GT inhibited the activity of endogenous proteases, resulting in protection against erosion-induced dentin damage; however, they could not prevent tooth tissue loss in situ.

Two-year clinical evaluation of a proanthocyanidins-based primer in non-carious cervical lesions: A double-blind randomized clinical trial.

OBJECTIVES: This double-blind randomized clinical trial evaluated the influence of pre-treatment with proanthocyanidins (PA) from grape seed extract on the clinical behavior of a simplified etch-and-rinse adhesive placed in non-carious cervical lesions (NCCLs) over 6- and 24-months. MATERIALS AND METHODS: A total of 135 restorations were randomly inserted in 45 subjects. The NCCLs were etched with 37 % phosphoric acid for 15 s and distributed into 3 groups: Control (PA0) - adhesive ExciTE F applied as per the manufacturer's recommendations; PA2 and PA5 groups - 2 wt% and 5 wt% PA solution, respectively, were applied for 60 s and washed for 30 s prior to application of the adhesive. The resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline, 6 months (6 m) and 24 months (24 m) using both the FDI and USPHS criteria. Statistical analyses were carried out using Friedman repeated-measures analysis of variance by rank and the Wilcoxon test (α = 0.05). RESULTS: The retention rates were 98 % (PA0), 98 % (PA2) and 83 % (PA5) after 6 m and 93 % (PA0), 89 % (PA2) and 70 % (PA5) after 24 m. Only PA5 resulted in a significant lower retention rate at 6 m and at 24 m compared with that of baseline (p = 0.03). All groups resulted in a significantly worse marginal adaptation and marginal staining for the FDI criteria when the baseline vs. the 24 m recall data were compared. These differences were considered clinically acceptable under the FDI criteria. CONCLUSIONS: The application of PA as a primer did not result in clinical advantages after 24 m of clinical service, regardless of the concentration used. CLINICAL RELEVANCE: It has been reported that PA, a collagen crosslinking agent, increases the durability of the dentin-resin interface. However, no effects were found clinically after 24 months.

Effect of Metalloproteinase Inhibitors on Bond Strength of a Self-etching Adhesive on Erosively Demineralized Dentin.

PURPOSE: To analyze the influence of epigallocatechin-3-gallate (EGCG) and chlorhexidine (CHX) on adhesive-dentin bond strength of a self-etch adhesive to sound dentin (SD) and eroded dentin (ED). MATERIALS AND METHODS: Thirty-six middle-dentin samples were assigned to six groups (n = 6) according to pretreatment (DW: distilled water, control; 0.1% EGCG; or 2% CHX) and erosive challenge (presence or absence). Specimens were subjected to 2-h acquired pellicle formation, then half of them were exposed to 1% citric acid three times a day for five days. SD and ED were treated with the tested solutions for 60 s, and then Clearfil SE Bond was applied before resin composite buildup. Bonded teeth were longitudinally sectioned into sticks and half were immediately tested, while the remaining specimens were tested after six months. The mode of fracture was examined and the microtensile bond strength (µTBS) measured. Statistical analysis was performed with ANOVA and Bonferroni tests. RESULTS: At both time periods, regardless of the dentin substrate, EGCG groups did not show bond strengths that were significantly different from those obtained with DW (p > 0.05), while CHX generated lower values than did DW (p < 0.05). On SD, there was a bond strength reduction only in the CHX groups after six months. However, for ED, the bond strength significantly decreased in all groups. CONCLUSION: CHX negatively affected both dentin substrates, while the pretreatment with EGCG did not affect µTBS over time on SD. µTBS may be influenced by the substrate over time and EGCG can be used as an alternative to CHX to maintain the bond strength of self-etching adhesives.

Ácido tânico como agente biomodificador de dentina / Tanic acid as biomodificator of collagen dentin

Introdução: a utilização de diferentes polifenóis no aumento das propriedades mecânicas do colágeno dentinário tem sido bastante empregada, sendo o ácido tânico um polifenol com propriedade biológica bastante pronunciada. Objetivo: avaliar o potencial biomodificador do ácido tânico (AT) em diferentes concentrações em colágeno dentinário. Métodos: os fatores sob investigação foram módulo de elasticidade, mensurado por meio de um ensaio de flexão de três pontos (n=10) e variação de massa (n=10), aferidos com uma balança de precisão, sendo, para tanto, avaliados os seguintes elementos: ácido tânico (0,1; 1 e 10%), proantocianidina (6,5%) e água destilada (controle). Resultados: quanto ao módulo de elasticidade, os grupos tratados com ácido tânico apresentaram valores, estatisticamente, superiores (p<0,05) aos demais grupos, não sendo observadas diferenças entre suas diferentes concentrações. Para os valores de variação de massa, os grupos que foram imersos em agentes biomodificadores apresentaram valores estatisticamente (p<0,05) superiores ao grupo controle. Conclusão: o ácido tânico se apresenta como um potencial agente biomodificador do colágeno dentinário, independente da concentração utilizada, aumentando o seu módulo de elasticidade e gerando um ganho de massa após uma hora de imersão.

Introduction: The use of different polyphenols in the increase of the mechanical properties of dentin collagen has been widely used, thus, tannic acid being a polyphenol with very pronounced biological proprieties. Objective: to evaluate the biomodifying potential of tannic acid (AT) in different concentrations in dentin collagen. Methods: the factors under investigation were modulus of elasticity, measured by a three-point bending test (n = 10), and mass variation (n = 10), measured by means of a precision scale, being the following substances evaluated: tannic acid (0.1, 1 and 10%), proanthocyanidin (6.5%) and distilled water (control). Results: As for the modulus of elasticity, the groups treated with tannic acid presented statistically higher values (p <0.05) in relation to the other groups, and no differences were observed between the different concentrations. For the values of mass variation, the groups that were immersed in biomodifiers showed statistically (p <0.05) values higher than the control group. Conclusion: tannic acid presents as a potential biomodifying agent of dentin collagen, regardless of the concentration used, increasing its modulus of elasticity and generating a mass gain after one hour of immersion.

Avaliação do efeito de técnicas de acabamento e polimento na rugosidade superficial de resinas compostas / Evaluation of the effect of finishing and polishing techniques on surface roughness of composite resins

Introdução: o acabamento e o polimento das resinas compostas (RC) podem interferir diretamente na rugosidade desses materiais, estando relacionadas com a adesividade de placa bacteriana, manchamento, brilho e lisura. Objetivo: comparar a rugosidade superficial de duas RC, sendo uma micro-híbrida (Filtek Z250) e outra nanoparticulada (Filtek Z350), após a realização dos procedimentos de acabamento e polimento. Métodos: utilizando-se uma matriz metálica, confeccionaram-se quinze discos de cada RC. A lisura superficial proporcionada pela fita de poliéster foi avaliada por meio de um rugosímetro (Hommel Tech-T1000), obtendo-se dados iniciais. Realizou-se a mensuração em triplicata, obtendo-se o valor da rugosidade média (Ra). Lixaram-se as superfícies de topo dos espécimes e seguiu-se nova obtenção da Ra. Os espécimes foram, aleatoriamente, distribuídos em três grupos: GI ­ discos de óxido de alumínio; GII ­ pontas siliconadas e GIII ­ discos de diamante micronizado, sendo obtida a Ra final. Os dados foram analisados pelo teste de Kruskal-Wallis e Qui-quadrado (α=1%). Resultados: a média e o desvio-padrão expresso em µm foram: Z-250 GI - 0,16 (0,09), GII - 0,32 (0,06) e GIII - 0,06 (0,02) e para Z-350 GI - 0,06 (0,01), GII - 0,49 (0,14) e GIII - 0,07 (0,01). Para Z-250, o GIII apresentou melhor polimento, sendo, estatisticamente, diferente de GI e GII (p≤0,01). Para Z-350, não houve diferença estatística entre os GI e GIII, mas eles foram superiores ao GII (p≤0,01). Conclusão: o disco de diamante micronizado proporcionou melhores valores de lisura superficial independente do tipo de resina composta empregada.

Introduction: finishing and polishing of composite resins (CR) can directly interfere with the roughness of these materials, being related to bacterial plaque adhesion, staining, gloss and smoothness. Objective: to compare the surface roughness of two CR, a micro-hybrid (Filtek Z250) and a nanoparticulate (Filtek Z350) after finishing and polishing. Methods: using a metal matrix, fifteen disks of each CR were made. The surface smoothness provided by the polyester tape was evaluated by a rugosimeter (Hommel Tech-T1000) obtaining initial data. Measurements were made in triplicate, and the mean roughness value (Ra) was obtained. The top surfaces of the specimens were sieved and re-obtained the Ra. The specimens were randomly distributed into three groups: GI - aluminum oxide discs; GII - silicone tips and GIII - micronized diamond discs, obtaining the final Ra. Data were analyzed by the Kruskal-Wallis test and chi-square test (α = 1%). Results: the mean and standard deviation expressed in µm were: Z-250 GI - 0.16 (0.09), GII - 0.32 (0.06) and GIII - 0.06 (0.02) and for Z -350 GI - 0.06 (0.01), GII - 0.49 (0.14) and GIII - 0.07 (0.01). For Z-250, the GIII presented better polishing, being statistically different from GI and GII (p≤0.01). For Z-350, there was no statistical difference between GI and GIII, but these were higher than GII (p≤0.01). Conclusion: the micronized diamond disk provided better surface smoothness values independent on the type of composite resin used.

Dentin bonding and physicochemical properties of adhesives incorporated with epigallocatechin-3-gallate.

The aim was to assess dentin adhesion and physicochemical properties of experimental etch-and-rinse and self-etch adhesives doped with epigallocatechin-3-gallate (EGCG), a well-known collagen crosslinker obtained from green tea (Camellia sinensis). Experimental adhesives were prepared without (0 wt%), with 0.1 or 0.5 wt% EGCG addition. Their degree of conversion was surveyed by FTIR, and bar-shaped specimens were tested to obtain flexural strength and modulus initially and after 1-week ethanol storage. Extracted human molars were prepared, bonded, and cut into resin-dentin sticks for microtensile bond strength test, which was conducted after 24 h or 6-month water storage. Statistical analyses were performed with two-way ANOVA and Tukey's test (p < 0.05). Degree of conversion outcomes depicted a significant polymerization reduction by the addition of EGCG in self-etch adhesive in both concentrations. However, only 0.1% reduced the conversion of etch-and-rinse adhesive. Flexural modulus and strength were significantly diminished (p < 0.05) by the addition of both concentrations of EGCG for the two model adhesives. Dentin-bond strength was reduced after aging with the addition of EGCG to self-etch adhesive. Nevertheless, 0.5% EGCG increased the bond strength of etch-and-rinse adhesive after aging, conversely to the significant reduction for EGCG-free control adhesive. In conclusion, EGCG at 0.5% provides optimal improvements on dentin bonding without altering final polymerization of a model etch-and-rinse adhesive.

Two-year clinical evaluation of proanthocyanidins added to a two-step etch-and-rinse adhesive.

OBJECTIVE: To compare the clinical behavior of Proanthocyanidins (PA)-free and PA-containing two-step etch-and-rinse adhesive used underneath resin composite restorations in non-carious cervical lesions (NCCLs) over a 6- (6 M) and 24-month (24 M) period. METHODS: 135 restorations were randomly placed in 45 subjects. The NCCLs were conditioned (37% phosphoric acid for 15 s) and distributed into 3 groups: Control (EX0) - ExciTE F (Ivoclar Vivadent) adhesive applied following the manufacturer's recommendations; EX2 and EX5 - 2 wt% and 5 wt% of PA were added to ExciTE F, respectively, and applied as in EX0. Resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline, 6 M and 24 M, using FDI and USPHS criteria. Statistical analyses were performed using Friedman and Wilcoxon tests (α = 0.05). RESULTS: The retention rates were 98% (95% confidence interval 88-99%) for EX0, 92% (80-97%) for EX2; and 85% (72-93%) for EX5 at 6 M. A significant difference was found only for EX5 at 6 M when compared with the respective baseline findings (p = 0.03) and when compared with EX0 and EX2 (p = 0.001) at 6 M. After 24 M, the retention rates were 98% (88-99%) for EX0, 73% (59-84%) for EX2, and 71% (56-82%) for EX5. Only EX0 did not result in significant difference in retention rate at 24 M when compared with baseline but showed a significant higher retention rate when compared with those of EX2 and EX5 (p = 0.001). CONCLUSION: Adding proanthocyanidins to the adhesive solution jeopardized the retention of composite resins restorations in non-carious cervical lesions after 24 months. CLINICAL RELEVANCE: In spite of being user-friendlier than when used separately, the incorporation of proanthocyanidins into the adhesive solution impairs the longevity of composite restorations.

Active compounds and derivatives of camellia sinensis responding to erosive attacks on dentin.

This research explored the potential of Camellia sinensis-derived teas and active compounds to be used as treatments to prevent dentin wear. Human root dentin slabs were randomly assigned to 5 groups (n = 10) as follows: distilled water (DW, control), epigallocatechin-3-gallate (EGCG), theaflavin gallate derivatives (TF), commercial green tea (GT), and commercial black tea (BT). The samples were submitted to a pellicle formation and an erosive cycling model (5x/day, demineralization using 0.01 M hydrochloric acid/60 s) followed by remineralization (human stimulated saliva/60 min) for three days. The samples were treated for 5 min using the test group solutions between the erosive cycles. Dentin changes were assessed with profilometry analysis and FT-Raman spectroscopy. The data regarding wear were analyzed by ANOVA followed by Tukey's test (p < 0.05). EGCG, TF derivatives, and both regular teas significantly suppressed erosive dentin loss (38-47%, p < 0.05). No obvious changes in the Raman spectra were detected in the specimens; however, the DW group had a minor relationship of 2880/2940 cm-1. The phenolic contents in both green and black tea and the important catechins appear to have protective effects on dentin loss.

Synthesis and characterization of a new methacrylate monomer derived from the cashew nut shell liquid (CNSL) and its effect on dentinal tubular occlusion.

OBJECTIVE: The aim of this study was to synthesize, to characterize and to evaluate the effects on tubular occlusion of new monomer derived from cashew nut shell liquid (CNSL), also studying the effects of acid challenge (AC) on dentin surfaces treated with desensitizers. METHODS: The intermediary cardanol-epoxy (CNE) was synthesized through epoxidation of CNSL, followed by synthesis of cardanol-methacrylate-epoxy (CNME) through methacryloyl chloride esterification. Products were purified through chromatography column and characterized by Fourier transform infrared spectrometry and nuclear magnetic resonance. Resinous dentin desensitizers were formulated containing either unsaturated cardanol (CNU), CNE or CNME. Dentin disks were divided into seven groups: SL - Smear-layer, EDTA - EDTA-treated only, GLUMA - Gluma Desensitizer, OCB - One Coat Bond, CNU - CNU desensitizer, CNE - CNE desensitizer and CNME - CNME desensitizer. Dentinal fluid rate (DFF) was obtained using a Flodec equipment and tubular occlusion employing a scanning electron microscope (SEM), before and after AC. Data of DFF were submitted to two-way ANOVA and Tukey's test (p<0.05). RESULTS: GLUMA showed the lower reduction in DFF when compared to the other products, which were statistically similar. Even after AC, CNME presented the most homogenous and occluded surface, while CNE and CNU were partially removed, GLUMA was completely removed and OCB keep an occluded, but irregular surface. SIGNIFICANCE: CNME showed a great reduction of DFF and a homogenous occluded surface, suggesting that it may be a suitable and acid-resistant treatment option for dentine hypersensitivity.

The effect of magnesium hydroxide-containing dentifrice using an extrinsic and intrinsic erosion cycling model.

OBJECTIVE: To evaluate, in vitro, the effect of Mg(OH)2 dentifrice, and the influence of the number of experimental days, on the extrinsic (citric acid -CA) and intrinsic (hydrochloric acid -HCl) enamel erosion models. DESIGN: Human enamel slabs were selected according to surface hardness and randomly assigned to 3 groups (n=9) as follows: non-fluoridated (negative control), NaF (1450ppm F- positive control) and Mg(OH)2 (2%) dentifrices. The slabs were daily submitted to a 2-h period of pellicle formation and, over a period of 5days, submitted to cycles (3×/day) of erosive challenge (CA 0.05M, pH=3.75 or HCl 0.01M, pH=2 for 30s), treatment (1min -1:3w/w of dentifrice/distilled water) and remineralization (artificial saliva/120min). Enamel changes were determined by surface hardness loss (SHL) for each day and mechanical profilometry analysis. Data were analyzed by two-way ANOVA followed by Tukey's test to % SHL and one-way ANOVA to profilometry (p<0.05). RESULTS: The number of experimental days influenced the erosion process for the two types of erosion models (p<0.001). Mg(OH)2-containing dentifrices were effective in reducing enamel extrinsic acid erosion as determined by % SHL (p<0.001) when compared to the control group, being better than positive control (p<0.001); however, the dentifrices were not effective for the intrinsic model (p=0.295). With regards to surface wear, no statistically significant differences were found among the groups for CA (p=0.225) and HCl (p=0.526). CONCLUSION: The findings suggest that Mg(OH)2 dentifrices might protect enamel against slight erosion, but protection was not effective for stronger acid erosion.

Active compounds and derivatives of camellia sinensis responding to erosive attacks on dentin

Abstract This research explored the potential of Camellia sinensis-derived teas and active compounds to be used as treatments to prevent dentin wear. Human root dentin slabs were randomly assigned to 5 groups (n = 10) as follows: distilled water (DW, control), epigallocatechin-3-gallate (EGCG), theaflavin gallate derivatives (TF), commercial green tea (GT), and commercial black tea (BT). The samples were submitted to a pellicle formation and an erosive cycling model (5x/day, demineralization using 0.01 M hydrochloric acid/60 s) followed by remineralization (human stimulated saliva/60 min) for three days. The samples were treated for 5 min using the test group solutions between the erosive cycles. Dentin changes were assessed with profilometry analysis and FT-Raman spectroscopy. The data regarding wear were analyzed by ANOVA followed by Tukey's test (p < 0.05). EGCG, TF derivatives, and both regular teas significantly suppressed erosive dentin loss (38-47%, p < 0.05). No obvious changes in the Raman spectra were detected in the specimens; however, the DW group had a minor relationship of 2880/2940 cm−1. The phenolic contents in both green and black tea and the important catechins appear to have protective effects on dentin loss.

Pretreatment with Sodium Fluoride Maintains Dentin Bond Strength of a Two-Step Self-Etch Adhesive after Thermal Stressing.

PURPOSE: To evaluate the effect of sodium fluoride and chlorhexidine digluconate on the composite-dentin bond strength of a self-etch adhesive after thermocycling. MATERIALS AND METHODS: Eighteen human third molars were prepared to expose a flat dentin surface and were divided into 3 groups (n = 6) according to the 3 cavity cleaning solutions: distilled water, 2% chlorhexidine digluconate (CHX), or 1.23% sodium fluoride (NaF). Solutions were rubbed onto dentin surfaces for 60 s, followed by bonding with Clearfil SE Bond, and a 5-mm-thick composite crown buildup. Bonded teeth were stored in distilled water for 24 h and then longitudinally sectioned to obtain bonded sticks. Half of the specimens were immediately tested in tension at 0.5 mm/min, while the remaining specimens were tested after 60,000 thermal cycles. Data were analyzed using two-way ANOVA and the Holm-Sidak method. RESULTS: There was no significant difference between the groups after 24 h (p > 0.05). Thermocycling resulted in significant bond strength reduction for distilled water and CHX (p < 0.05). When 24 h bond strengths were compared to the thermocycling group, NaF maintained its bond strength (p > 0.05), while significant reductions were observed for distilled water and CHX (p < 0.05). CONCLUSIONS: Pretreatment with NaF maintained the bond strength of Clearfil SE Bond to dentin after 60,000 thermal cycles, but pretreatment with CHX did not.

Randomized Two-year Clinical Evaluation of Oxalic Acid in Restorations of Noncarious Cervical Lesions.

PURPOSE: To evaluate the use of oxalic acid in restorations of noncarious cervical lesions. MATERIALS AND METHODS: Twenty volunteers of both sexes between 24 and 55 years old, with at least two lesions that were restored with the techniques to be evaluated, were selected. Ninety teeth were randomly divided into two groups: group 1, two-step etch-and-rinse adhesive technique (control) and group 2, pretreatment with oxalic acid followed by the application of a two-step etch-and-rinse adhesive system. The adhesive system used was XP Bond (Dentsply) and the restorative composite resin was Durafill (Heraeus Kulzer). A modified USPHS method was employed for the clinical evaluation, taking into account the following criteria: retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). Clinical assessments were conducted by two examiners at baseline and after 6 months, 1 and 2 years. RESULTS: After two years, the results of clinically satisfactory restorations (Alpha and Bravo) obtained for the control and experimental groups were: R (90.9%/93.33%), MI (100%/100%), MD (100%/100%), S (100%/100%), C (100%/100%), AF (100%/100%). CONCLUSION: Over a 2-year period, the use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in noncarious cervical lesions.

Carbohydrate-electrolyte drinks exhibit risks for human enamel surface loss.

OBJECTIVES: The aim of this investigation was to give insights into the impact of carbohydrate-electrolyte drinks on the likely capacity of enamel surface dissolution and the influence of human saliva exposure as a biological protective factor. MATERIALS AND METHODS: The pH, titratable acidity (TA) to pH 7.0, and buffer capacity (ß) of common beverages ingested by patients under physical activity were analyzed. Then, we randomly distributed 50 specimens of human enamel into 5 groups. Processed and natural coconut water served as controls for testing three carbohydrate-electrolyte drinks. In all specimens, we measured surface microhardness (Knoop hardness numbers) and enamel loss (profilometry, µm) for baseline and after simulated intake cycling exposure model. We also prepared areas of specimens to be exposed to human saliva overnight prior to the simulated intake cycling exposure. The cycles were performed by alternated immersions in beverages and artificial saliva. ANOVA two-way and Tukey HDS tests were used. RESULTS: The range of pH, TA, and ß were 2.85 - 4.81, 8.33 - 46.66 mM/L and 3.48 - 10.25 mM/L × pH, respectively. The highest capacity of enamel surface dissolution was found for commercially available sports drinks for all variables. Single time human saliva exposure failed to significantly promote protective effect for the acidic attack of beverages. CONCLUSIONS: In this study, carbohydrate-electrolyte drinks usually consumed during endurance training may have a greater capacity of dissolution of enamel surface depending on their physicochemical proprieties associated with pH and titratable acidity.

Two-year clinical evaluation of resin composite in posterior teeth: A randomized controlled study.

BACKGROUND: Clinical evaluations as fundamental method to prove the efficiency of restorative materials. AIM: This study evaluated the clinical performance of restorative systems during 2 years of clinical service. MATERIALS AND METHODS: This study assessed the clinical performance of restorative systems (Filtek Z250 and P60), during 2 years of clinical service, using the US Public Health Service system. The randomized and double-blind study comprising thirty volunteers. The restorations were evaluated at baseline, 6, 12, and 24 months. It was used the following criteria: marginal discoloration (MD), marginal integrity (MI), superficial texture (ST), wear (W), postoperative sensitivity (PS) and recurrent caries (RC). RESULTS: Statistic analysis was performed using Fisher's and McNemar's exact tests and Pearsons's Chi-square in a significance level of 5%. The results at baseline and 24 months for Group I were: MD - 100, 100%; MI - 100, 88.6%; ST - 100, 94.3%; W - 100, 94.3%; PS - 100, 100%; RC - 100, 100%, of alpha scores; Group II: MD - 100, 97.1%; MI - 100, 91.4%; ST - 100, 94.3%; W - 100, 91.4%; PS - 100, 100%; RC - 100, 100%, of alpha scores. It was observed no statistical difference in the evaluated criteria and period. CONCLUSIONS: After 24 months of evaluation, both restorative systems exhibited acceptable clinical performance.