Flavonoids effects against bacteria associated to periodontal disease and dental caries: a scoping review.

This scoping review focused on exploring the efficacy of flavonoids against bacteria associated with dental caries and periodontal diseases. Inclusion criteria comprise studies investigating the antibacterial effects of flavonoids against bacteria linked to caries or periodontal diseases, both pure or diluted in vehicle forms. The search, conducted in August 2023, in databases including PubMed/MEDLINE, Scopus, Web of Science, Embase, LILACS, and Gray Literature. Out of the initial 1125 studies, 79 met the inclusion criteria, majority in vitro studies. Prominent flavonoids tested included epigallocatechin-gallate, apigenin, quercetin, and myricetin. Predominant findings consistently pointed to bacteriostatic, bactericidal, and antibiofilm activities. The study primarily investigated bacteria associated with dental caries, followed by periodontopathogens. A higher number of publications presented positive antibacterial results against Streptococcus mutans in comparison to Porphyromonas gingivalis. These encouraging findings underline the potential applicability of commercially available flavonoids in materials or therapies, underscoring the need for further exploration in this field.

The influence of the renewal or the single application of the peroxide gel on the efficacy and tooth sensitivity outcomes of in-office bleaching-A systematic review and meta-analysis.

OBJECTIVE: To answer the question: "Does the peroxide gel application regimen (single application vs. renewal) influence the efficacy and the tooth sensitivity outcomes of in-office tooth bleaching?" METHODS: The search was done in Pubmed, Cochrane, LILACS, Scopus, Web of Science, and EMBASE in February 2021 (updated in July 2021). Randomized clinical trials (RCT) comparing the single application vs. the renewal protocols of HP were included. The meta-analyses were performed for the objective (ΔEab ), subjective (ΔSGU) color changes, and absolute risk of tooth sensitivity (TS). Heterogeneity was evaluated using Q test (I2 ). Cochrane Collaboration tool assessed the risk of bias (RoB). The GRADE evaluated the certainty of evidence. RESULTS: Five RCT studies remained. Two studies showed high RoB, and three presented some concerns. No significant differences were observed between the protocols in terms of the ΔEab , ΔSGU, and TS. ΔEab exhibited substantial heterogeneity (I2  = 87%), while ΔSGU (I2  = 60%) and the TS (I2  = 62%) presented a moderate one. The certainty of evidence was considered low or very low, depending on the variable response and the evaluation time. CONCLUSION: The application regimen (single vs. renewal of HP) did not impact color change or the absolute risk of TS. CLINICAL SIGNIFICANCE: The renewal of bleaching gel during the in-office appointment may not be necessary. However, there is at least a low certainty of evidence. Because of this, further randomized clinical trials with appropriate methodology on this topic are encouraged.

Effect of zirconia decontamination protocols on bond strength and surface wettability.

OBJECTIVE: To evaluate the effects of human saliva decontamination protocols on bond strength of resin cement to zirconia (Y-PSZ), wettability, and microbial decontamination. MATERIALS AND METHODS: Zirconia plates were sandblasted and divided into (a) not contaminated, (b) contaminated with human saliva and: (c) not cleaned, (d) cleaned with air-water spray, (e) cleaned with 70% ethanol, (f) cleaned with Ivoclean, or (g) cleaned with nonthermal atmospheric plasma (NTAP). The wettability and microbial decontamination of the surfaces were determined after saliva contamination or cleaning. Monobond Plus (Ivoclar Vivadent) was applied after cleaning, followed by Variolink LC (Ivoclar Vivadent). The samples were stored 1 week before shear bond strength (SBS) testing, and data (SBS and wettability) were analyzed by one-way analysis of variance and Tukey test (α = .05). RESULTS: Saliva contamination reduced SBS to zirconia compared to not contaminated. Both Ivoclean and NTAP produced higher SBS compared to not cleaned and were not significantly different from the not contaminated. Ivoclean produced the highest contact angle, and NTAP the lowest. With the exception of using just water-spray, all cleaning protocols decontaminated the specimens. CONCLUSIONS: Both Ivoclean and NTAP overcame the effects of saliva contamination, producing an SBS to zirconia comparable to the positive control. CLINICAL SIGNIFICANCE: Dental ceramics should be cleaned prior to resin cementation to eliminate the effects of human saliva contamination, and Ivoclean and NTAP are considered suitable materials for this purpose.

Antibacterial-containing dental adhesives' effects on oral pathogens and on Streptococcus mutans biofilm: Current perspectives.

PURPOSE: To describe the literature findings regarding commercially available antibacterial-containing dental adhesives and the futures perspectives of this field. RESULTS: High-risk caries patients could yield benefits from restorative materials containing antibacterial properties in order to reduce the recurrent caries formation. Dental adhesives with antibacterial agents may reduce restoration replacement, as recurrent caries is still one of the major reasons for replacing a resin restoration. Literature results of three commercially available adhesives: Gluma 2Bond, Clearfil SE Protect and Peak Universal Bond, containing glutaraldehyde, MDPB and chlorhexidine, respectively indicates that Clearfil SE Protect seems to have better results against oral pathogens and on Streptococcus mutans biofilm. Besides the promising findings, clinical studies are still necessary in order to validate the clinical efficacy when exposed to a more complex environment and the long-term effect of either commercially available materials, experimental antibacterial monomers or antibacterial incorporations. As a suggestion of this article and according to the current scientific trends in this specific field, future directions should focus on restorative materials with therapeutic components targeting the virulence factors of cariogenic biofilm with minimal toxicity and side effects, and long-term action. CLINICAL SIGNIFICANCE: Antibacterial-containing dental adhesives may have therapeutic effects, working as an additional source to reduce recurrent caries development in patients with high-risk of caries, and consequently the reduction in restoration replacements.

Effect of experimental dentin etchants on dentin bond strength, metalloproteinase inhibition, and antibiofilm activity.

OBJECTIVE: this study evaluated dentin microtensile bond strength (µTBS) and failure modes (at 24 h and one year), bonding interface regarding hybridization, surface morphology regarding demineralization, in situ metalloproteinase (MMP) activity, and antibacterial effect of three dentin etchants compared to 35% phosphoric acid (PA). MATERIALS AND METHODS: The Adper Single Bond 2 adhesive (3 M Oral Care) was applied on moist dentin etched with PA (control) or on air-dried dentin etched with 3% aluminum nitrate + 2% oxalic acid (AN), 6.8% ferric oxalate + 10% citric acid (FO), or 10% citric acid (CA). The µTBS test used 40 human teeth (n = 10). Failure modes and surface morphology were analyzed by scanning electron microscopy (n = 3), while bonding interface morphology and MMP activity were evaluated by laser scanning confocal microscopy (n = 3). Antibacterial activity was evaluated against S. Mutans biofilm by means of viable cells count (CFU/mL). RESULTS: PA presented the highest bond strengths regardless of aging time. PA, AN, and CA showed stable bond strengths after one year of storage. Adhesive and mixed failures were predominant in all groups. Thin hybrid layers with short resin tags were observed for the experimental etchants. The AN-based etchant was able to inhibit MMP activity. All tested etchants presented antibacterial activity against S. Mutans biofilm. SIGNIFICANCE: This study suggests different dentin etchants capable of inhibiting MMP activity while also acting as cavity disinfectants.

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness.

This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Resistance of glaze application on indirect restorative CAD/CAM materials against abrasive toothbrushing wear.

PURPOSE: The aim of this study was to evaluate the effect of toothbrushing on the surface roughness (Sa), roughness profile (Rv), gloss units (GU) and surface morphology of three glazed ceramics. MATERIALS AND METHODS: Specimens (n=7) from different CAD/CAM materials 1- Lithium disilicate-based glass ceramic (IPS e.max CAD); 2- Zirconia-reinforced lithium silicate glass ceramic (Celtra Duo) and 3- 6 mol% yttria partially-stabilized zirconia (InCoris) were evaluated. IPS e.max CAD and InCoris specimens were sintered and all the groups were pre-polished and glazed according to the manufacturer's recommendations: IPS Ivocolor Glaze Paste (Ivoclar Vivadent) or Universal Overglaze High Flu (Dentsply/Sirona). Sa, Rv, GU and morphology were analyzed before and after brushing at 30.000, 120.000 and 180.000 cycles. The data of Sa and GU were analyzed by ANOVA two-way and post-hoc Tukey's test (α=0.05). Rv was analyzed by Kruskal-Wallis and Student-Newman-Keuls. The surface morphology was analyzed qualitatively. RESULTS: The Sa decreased significantly after 180.000 toothbrushing cycles for all materials tested. CE showed higher Rv than EM and IN, and IN showed the highest GU after 180.000 toothbrushing cycles, which promoted a polishing effect for all materials. CONCLUSION: Long-term toothbrushing was not able to jeopardize the glazed-surface of all tested materials compared to unbrushed.

Toothbrushing effects on the surface roughness and cement volume loss of bonded enamel-ceramic interface.

This study evaluated the effect of toothbrushing on enamel-cementing material-ceramic bonded interfaces, using different cementing materials. MATERIALS AND METHODS: Thirty enamel and thirty ceramic blocks were bonded with cementing materials to produce the samples that were bonded with three types of cementing materials: 1- RelyX Ultimate resin cement (REXU), 2- RelyX Unicem 2 self-adhesive resin cement (REU2) and 3- heated Z100 restorative composite (60°C). Bonded interfaces of the samples were toothbrushed and the surfaces of the 3 cementing materials were evaluated for roughness (RG, in µm), roughness profile (RP, in µm), and volume loss (VL, in µm3) (baseline and after 20,000 and 60,000 toothbrushing cycles). Data were evaluated by Generalized Linear Analysis (two factors: "material" and "toothbrushing cycle") and Bonferroni test (α=0.05). RESULTS: REXU and Z100 exhibited lower RG than that presented by REU2, except after 60,000 toothbrushing cycles when only Z100 differed from REU2. The increase in toothbrushing cycles increased the RG and RP for all materials. REU2 also showed higher RP than those showed by REXU and Z100 when it was analyzed regarding the enamel. The VL of Z100 was the lowest with 20,000 toothbrushing cycles, regarding the enamel and ceramic. For 60,000 cycles, REXU showed the lowest VL regarding the ceramic, and REU2 had the highest VL regarding the enamel and ceramic. CONCLUSION: In general, REXU and Z100 showed the best results regarding the evaluations performed and the REU2 exhibited the highest RG, RP, and VL.

Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research.

Objectives: This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells. Materials and Methods: Electronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed. Results: Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies. Conclusions: Few in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings. Trial Registration: PROSPERO Identifier: CRD42022337192.

Bonding interface and dentin enzymatic activity of two universal adhesives applied following different etching approaches.

OBJECTIVES: Etching approaches [37% phosphoric acid, self-etching, 10-3 solution (3% ferric chloride dissolved in 10% citric acid), or 1.4% nitric acid] were evaluated regarding enamel shear bond strength (24 h), dentin microtensile bond strength (24 h and 2 years), failure mode, enzymatic activity of the hybrid layer, and nanoleakage (24 h and 2 years) of Prime&Bond Universal (PBU, Dentsply-Sirona) and Gluma Bond Universal (GBU, Kulzer). METHODS: Adhesives were applied on blot-dried (wet-bonding, positive control) or air-dried (remaining groups) dentin after acid-etching (15 s) or in self-etch mode. Enamel and dentin bond strength tests used 160 human teeth (n = 10). Failure mode of tested samples and nanoleakage within the dentin-adhesive interface (n = 5) were analyzed by scanning electron microscopy. Dentin enzymatic activity was investigated by in situ zymography (n = 3). RESULTS: Enamel bond strengths did not differ statistically among groups. Wet-bonding with 37% phosphoric acid showed similar dentin bond strength compared to 10-3 solution or 1.4% nitric acid at 24 h for both adhesives. None of the etchants inhibited enzymatic activity, and all groups showed dentin bond strength reduction after 2-year storage. GBU showed higher nanoleakage. Experimental etchants did not affect enamel bond strength. Dentin bond strength was not stable after 2 years, despite promising 24-hour results. SIGNIFICANCE: This study suggests multiple etching approaches to optimize and achieve stable dentin bonding, while also offering in-depth information about the performance of recently released universal adhesive systems.

Development and Physicochemical Characterization of Eugenia brejoensis Essential Oil-Doped Dental Adhesives with Antimicrobial Action towards Streptococcus mutans.

Dental caries is a multifactorial, biofilm-dependent infectious disease that develops when detrimental changes occur in the oral cavity microenvironment. The antimicrobial and antivirulence properties of the essential oil obtained from the leaves of Eugenia brejoensis Mazine (EBEO) have been reported against Gram-positive and Gram-negative bacteria. Herein, the antimicrobial action of EBEO towards Streptococcus mutans is reported, along with the development and characterization of dental adhesives doped with. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of EBEO were determined against S. mutans, while its toxicity was analyze using Tenebrio molitor larvae. EBEO (MIC and 10×MIC) was incorporated into the Ambar Advanced Polymerization System® (Ambar APS), a two-step total-etch adhesive system (FGM Dental Group), and the antibiofilm action was evaluated. The reflective strength, modulus of elasticity, degree of conversion, and maximum rate of polymerization of each adhesive were also determined. The MIC and MBC values of EBEO against S. mutans were 62.5 µg/mL. The tested concentrations of EBEO were non-toxic to T. molitor larvae. The formation of S. mutans biofilms was significantly inhibited by EBEO and EBEO-coated resin discs (p < 0.05). Importantly, EBEO incorporation did not affect the mechanical and physicochemical properties in relation to oil-free adhesive version. EBEO showed strong antibacterial and antibiofilm activity against S. mutans, no toxicity effect against T. molitor larvae, and did not jeopardize the physical-chemical properties tested.

Microhardness homogeneity of RBCs light-cured with a multiple-peak LED and surface characterization after wear.

This in vitro study evaluated the effect of the beam homogeneity of a multiple-peak light-curing unit on the surface microhardness and the effect of toothbrushing wear on the microhardness, surface roughness, roughness profile, volume loss, and gloss retention of incremental and bulk-fill resin-based composites (RBCs). A LED light-curing unit (VALO) with four LEDs at the tip end (405, 445, 465A, and 465B nm emission peak) was used according to each manufacturer-recommended time to obtain disks (n=10) of six RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra, and Filtek Bulk Fill. Microhardness values were obtained according to each LED positioning of the light-curing unit on the top surface of the RBCs and were analyzed before and after toothbrushing regarding microhardness, surface roughness, roughness profile, volume loss, and gloss retention. Microhardness was considered homogeneous on the top surface regardless of the type of RBC or wavelength tested (p>0.05). Overall, toothbrushing did not reduce the microhardness of the RBCs but influenced the gloss values for most RBCs (p<0.001). Charisma Classic presented the greatest surface roughness and roughness profile after toothbrushing (p<0.05). Volume loss did not differ among RBCs (p>0.05). In conclusion, different wavelengths of the LED did not affect the top surface microhardness, regardless of the RBCs tested; and bulk-fill composites presented similar surface changes (microhardness, surface roughness, roughness profile, volume loss, and gloss retention) when compared to conventional composites after toothbrushing.

Incorporation of Apigenin and tt-Farnesol into dental composites to modulate the Streptococcus mutans virulence.

OBJECTIVES: The aim of this in vitro study was to incorporate two anti-caries agents, Apigenin and tt-Farnesol, to resin composite and resin cement to reduce the virulence of Streptococcus mutans around dental restorations. METHODS: Apigenin (Api, 5 mM) and tt-Farnesol (Far, 5 mM) were added alone, together, and combined with fluoride (F). Biofilm of S. mutans was grown on composite discs, and the dry-weight, bacterial viability, and the polysaccharides (alkali-soluble, intracellular and water-soluble) were quantified. CLSM images of the S. mutans biofilm were obtained after three years of water-storage. The effect of the additions on the physicochemical properties and the composite colorimetric parameters were also analyzed. RESULTS: The additions did not affect bacterial viability. Api alone and combined with Far or combined with Far and F decreased the bacterial dry-weight, alkali-soluble and intracellular polysaccharides. After three years, the composites containing the additions presented a greater EPS matrix on the top of biofilm. Statistical difference was obtained for the degree of conversion; however, the maximum polymerization rate and curing kinetics were unaffected by the additions. No difference was observed for the water-soluble polysaccharides, flexural strength, and elastic modulus. Api increased the yellowness of the composites. SIGNIFICANCE: Api, alone and combined, reduced the expression of virulence of S. mutans without jeopardizing the physicochemical properties of the composites.

Physicochemical properties, metalloproteinases inhibition, and antibiofilm activity of doxycycline-doped dental adhesive.

OBJECTIVES: To evaluate the incorporation of doxycycline (DOX) into a commercial dental adhesive regarding physicochemical properties, microtensile bond strength (µTBS), nanoleakage (NL), nanohardness (NH) and Young's modulus (YM), metalloproteinases (MMP) inhibition, and antibiofilm activity. METHODS: DOX was incorporated into the adhesive at 0.05, 0.1, 0.5, and 1 wt%. Restored teeth were evaluated for µTBS, NL, NH, and YM after 24 -hs and 1-year of water storage. Biofilms of Streptococcus mutans were grown on top of these adhesives and determined for bacterial viability and amount of biomass. The inhibitory effect on MMP was analyzed by in situ zymography under confocal microscopy. RESULTS: Adhesives with 0.5 and 1 wt% of DOX presented reduced pH and degree of conversion. The incorporation of DOX did not affect µTBS and hybrid layer YM. The control group (no DOX) had a decrease in µTBS and the densest silver nitrate areas after 1-year storage. Hybrid layer NH values increased with 0.1 wt% DOX compared to control and 1 wt% DOX groups, at 24 -hs. After 1-year storage, NH of 1 wt% DOX adhesive decreased compared to the control group. The 0.5 and 1 wt% concentrations of DOX decreased the bacterial viability and the biofilm biomass. Confocal images suggest an increased MMP inhibition proportional to the percentage of DOX. CONCLUSION: At any concentration, DOX-doped dental adhesives were able to inhibit MMP activity, diminish nanoleakage, and maintain the resin-dentin bond-strength after 1 year of artificial aging. CLINICAL SIGNIFICANCE: Doxycycline-doped dental adhesive inhibited metalloproteinases activity and preserved interface bond strength. This formulation has a potential to improve adhesive restorations clinical longevity.

Flowable and Regular Bulk-Fill Composites: A Comprehensive Report on Restorative Treatment.

This article reports a comprehensive restorative treatment using bulk-fill composites and discusses their properties and clinical performance. A 20-year-old man sought dental treatment due to the dark shade of his smile and multiple old amalgam fillings. Based on clinical and radiographic findings, and the patient's demand for tooth-colored fillings, treatment comprised enamel microabrasion and in-office dental bleaching, followed by the replacement of amalgam fillings by bulk-fill composites. Bulk-fill composites exhibit modifications in the filler size and shape or in the chemistry of monomers that allow them to be applied in thicker layers (4 to 5 mm), creating opportunities for simpler, faster, and more-efficient clinical procedures, as seen in the present report.

Dry-bonding to dentin using alternative conditioners based on iron-containing solutions or nitric acid.

OBJECTIVES: To evaluate the effect of experimental conditioners (10-3 solution - 10-3, 6.8% ferric oxalate - FOX, and 1.4% nitric acid - NI) on dentin elastic modulus, flexural strength, bond strength, failure mode, and adhesive interface morphology of two etch-and-rinse adhesives (XP Bond, Dentsply or One-Step, Bisco) applied on etched dry dentin. METHODS: Sound human third molars were used for the microtensile bond strength test (n = 8), performed at 24 h and after one year of water storage. Failure modes were evaluated by scanning electron microscopy. Dentin bonding interface was analyzed by confocal laser scanning microscopy (n = 3). Adhesive systems were applied on phosphoric acid-etched, wet (positive control) and dry (negative control) dentin, and on etched and dry dentin previously treated with 10-3 (15s), FOX (60s), or NI (15s). Bovine dentin bars (n = 15) were immersed into the conditioning solutions and subjected to a three-point bending test. RESULTS: XP Bond + 10-3 or NI resulted in lower bond strength than phosphoric acid. One-Step + 10-3 or NI resulted in bond strengths equivalent to the positive control. Experimental conditioners presented no bond strength reduction after one year, regardless of the bonding agent tested. One-Step resulted in more adhesive failures than XP Bond at 24 h, and mixed failures increased after storage. All experimental conditioners promoted hybridization and resin tags formation, except FOX. Dentin elastic modulus was not affected by the conditioners, whereas flexural strength was significantly reduced by FOX. CONCLUSIONS: Adequate and stable dentin bonds were achieved when the bonding agents were applied on 10-3 or NI-treated dentin. None of the experimental conditioners reduced dentin elastic modulus, but dentin flexural strength was significantly reduced by FOX-conditioning.

Accuracy of Irradiance and Power of Light-Curing Units Measured With Handheld or Laboratory Grade Radiometers.

This study measured and compared exitance irradiance and power of 4 commercial dental light-curing units (LCU) (Elipar S10, Elipar DeepCure-S, Corded VALO and Bluephase Style) using different types of radiometers. The devices used to analyze the LCU were classified as either handheld analog (Henry Schein, Spring, Demetron 100A, Demetron 100B and Demetron 200), handheld digital (Bluephase 1, Bluephase II, Coltolux, CureRite and Hilux), or laboratory instruments (Thermopile and Integrating Sphere). The laboratory instruments and the Bluephase II radiometer were also used to measure the LCU's power (mW). The LCU's were activated for 20 s (n=5). Data were analyzed using Kruskal-Wallis and Student-Newman-Keuls multiple comparison test (a=0.05). Among the LCU, the laboratory instruments presented different irradiance values, except for Corded VALO. The Coltolux and Hilux radiometers measured greater irradiance values compared to the laboratory instruments for the four LCUs tested. Within a given LCU, handheld analog units measured lower irradiance values, compared to handheld digital and laboratory instruments, except using the Spring radiometer for the Elipar S10 LCU. None of the handheld radiometers were able to measure similar irradiance values compared to laboratory instruments, except for Elipar S10 when comparing Bluephase 1 and Thermopile. Regarding power measurement, Bluephase II always presented the lowest values compared to the laboratory instruments. These findings suggest that the handheld radiometers utilized by practitioners (analog or digital) exhibit a wide range of irradiance values and may show lower outcomes compared to laboratory based instruments.

Effect of indirect restorative material and thickness on light transmission at different wavelengths.

PURPOSE: The aim of this study was to evaluate the influence of indirect restorative material type and thickness on the transmission of different wavelengths from a broad-banded dental curing light. METHODS: Four dental indirect restorative materials for computer-aided design and computer-aided manufacturing (CAD/CAM) were evaluated: [RC] resin/ceramic hybrid material (Lava Ultimate), [FC] feldspathic ceramic (VitaBlocs), and two zirconia-based ceramics ([ZK] Katana; and [ZL] Lava). Total loss of irradiance (TL) was measured for blue (WB, 425-490nm) and violet (WV, 350-425nm) wavelengths. Specimens of 15×15mm with varying thicknesses (0.5, 1.0, 1.5, and 2.0mm) were fabricated (n=5). A plasma-arc dental light-curing unit was used (Arc Light-II). To assess TL as a function of wavelength, a software (Spectra Suite v5.1) connected to a spectroradiometer (USB2000) and an integrating sphere (CTSM-LSM-60-SF) was used. Data was subjected to statistical analysis (two-way ANOVA and post-hoc Tukey test, α=0.05). RESULTS: A 0.5mm interposition resulted in TL from 50.5 to 67.2%, depending on material. Increased thickness resulted in higher TL for all materials. FC showed less TL compared to ZK. In general, WV showed higher TL than did WB, and WV/WB proportion decreased with increasing thickness. CONCLUSIONS: Indirect materials significantly reduced TL, and this effect is greater with increasing thickness. WV showed lower penetration compared to WB.

Evaluation of three different decontamination techniques on biofilm formation, and on physical and chemical properties of resin composites.

OBJECTIVES: This study evaluated three different sterilization/disinfection techniques for resin composites on bacterial growth and surface modification after decontamination. METHODS: Two resin composites were sterilized/disinfected with three different techniques: UV light, 1% chloramine T, and 70% ethanol. Four different times were used for each technique to determine the shortest time that the solution or UV light was effective. The influence of sterilization/disinfection technique on bacterial growth was evaluated by analyzing the metabolic activity, using the AlamarBlue™ assay, bacterial viability, and SEM images from biofilms of Streptococcus mutans. The surface change, after the process, was analyzed with ATR/FTIR and SEM images. The solutions used for decontamination (1% chloramine-T and 70% ethanol) were analyzed with 1 H-NMR to identify any resin compounds leached during the process. RESULTS: One minute of decontamination was efficient for all three methods tested. Chloramine-T increased the surface porosity on resin composites, no changes were observed for UV light and 70% ethanol, however, 1 H-NMR identified leached monomers only when 70% ethanol was used. No chemical change of the materials was found under ATR/FTIR analyses after the decontamination process. Chloramine-T, with no previous wash, increased the bacterial viability for both resin composites and increased the bacterial metabolism for the resin composite without fluoride. CONCLUSION: UV light had no interference on the resin composites properties tested using 1 min of exposure compared to the other decontamination methods. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 945-953, 2018.

Toothbrushing effects on the surface roughness and cement volume loss of bonded enamel-ceramic interface

Abstract This study evaluated the effect of toothbrushing on enamel-cementing material-ceramic bonded interfaces, using different cementing materials. Materials and Methods: Thirty enamel and thirty ceramic blocks were bonded with cementing materials to produce the samples that were bonded with three types of cementing materials: 1- RelyX Ultimate resin cement (REXU), 2- RelyX Unicem 2 self-adhesive resin cement (REU2) and 3- heated Z100 restorative composite (60°C). Bonded interfaces of the samples were toothbrushed and the surfaces of the 3 cementing materials were evaluated for roughness (RG, in µm), roughness profile (RP, in µm), and volume loss (VL, in µm3) (baseline and after 20,000 and 60,000 toothbrushing cycles). Data were evaluated by Generalized Linear Analysis (two factors: "material" and "toothbrushing cycle") and Bonferroni test (α=0.05). Results: REXU and Z100 exhibited lower RG than that presented by REU2, except after 60,000 toothbrushing cycles when only Z100 differed from REU2. The increase in toothbrushing cycles increased the RG and RP for all materials. REU2 also showed higher RP than those showed by REXU and Z100 when it was analyzed regarding the enamel. The VL of Z100 was the lowest with 20,000 toothbrushing cycles, regarding the enamel and ceramic. For 60,000 cycles, REXU showed the lowest VL regarding the ceramic, and REU2 had the highest VL regarding the enamel and ceramic. Conclusion: In general, REXU and Z100 showed the best results regarding the evaluations performed and the REU2 exhibited the highest RG, RP, and VL.

Resumo Este estudo avaliou o efeito da escovação nas interfaces de união esmalte-material cimentante-cerâmica, utilizando diferentes materiais cimentantes. Materiais e Métodos: Trinta esmaltes e trinta blocos cerâmicos foram unidos com materiais de cimentação para produzir as amostras que foram unidas com três tipos de materiais de cimentação: 1- cimento resinoso RelyX Ultimate (REXU), 2- cimento resinoso autoadesivo RelyX Unicem 2 (REU2) e 3-compósito restaurador aquecido Z100 (60°C). As interfaces coladas das amostras foram escovadas e as superfícies dos 3 materiais cimentantes foram avaliadas quanto à rugosidade (RG, em µm), perfil de rugosidade (RP, em µm) e perda de volume (VL, em µm3) (baseline e após 20.000 e 60.000 ciclos de escovação). Os dados foram avaliados por Análise Linear Generalizada (dois fatores: "material" e "ciclo de escovação") e teste de Bonferroni (α=0,05). Resultados: REXU e Z100 apresentaram menor RG do que REU2, exceto após 60.000 ciclos de escovação, quando Z100 diferiu apenas de REU2. O aumento dos ciclos de escovação aumentou o RG e RP para todos os materiais. O REU2 também apresentou PR maior que o REXU e Z100, quando analisado em relação ao esmalte. O VL de Z100 foi o menor com 20.000 ciclos de escovação em relação ao esmalte e cerâmica. Para 60.000 ciclos, o REXU apresentou o menor VL em relação à cerâmica e o REU2 o maior VL em relação ao esmalte e à cerâmica. Conclusão: De maneira geral, REXU e Z100 apresentaram os melhores resultados nas avaliações realizadas e o REU2 apresentou os maiores RG, RP e VL..