Influence of surface treatment on the performance of silorane-based composite resin in class I restorations: a randomized clinical trial.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of silorane-based composite restorations applied after different surface treatments. MATERIALS AND METHODS: This controlled and randomized clinical trial included 26 patients with class I restoration indications. The teeth were randomly assigned to the following treatments: control 1/G1, silorane specific self-etching adhesive (P90 self-etch primer and bond) + silorane-based composite resin (Filtek™ P90 low shrink posterior restorative); G2, 37% phosphoric acid + silorane specific self-etching adhesive + silorane-based composite resin; G3, blasting with aluminum oxide + silorane specific self-etching adhesive + silorane-based composite resin; and control 2/G4, self-etching adhesive (Adper™ SE Plus self-etch adhesive) + dimethacrylate-based composite resin (Filtek™ P60 posterior restorative). The clinical performance was evaluated at baseline and after 1 year. RESULTS: A total of 141 restorations were made and evaluated. For all clinical criteria evaluated, no significant difference was found between the surface treatments at baseline and after 1 year (p > 0.05). After 1 year, only the group with 37% phosphoric acid + silorane specific self-etching adhesive (G2) showed a significant reduction in marginal adaptation (p < 0.05). CONCLUSION: In general, all surface treatments showed an adequate clinical performance for silorane-based composite resin in class I restorations. However, a reduction in the marginal adaptation after 1 year was found when additional phosphoric acid etching was used prior to silorane specific self-etching adhesive. CLINICAL RELEVANCE: The use of phosphoric acid etching prior to specific self-etching adhesive can adversely affect the marginal adaptation of silorane-based restorations.

Fatigue failure load of feldspathic ceramic crowns after hydrofluoric acid etching at different concentrations.

STATEMENT OF PROBLEM: Hydrofluoric acid etching modifies the cementation surface of ceramic restorations, which is the same surface where failure is initiated. Information regarding the influence of hydrofluoric acid etching on the cyclic loads to failure of ceramic crowns is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the influence of different hydrofluoric acid concentrations on the fatigue failure loads of feldspathic ceramic crowns. MATERIAL AND METHODS: Eighty feldspathic ceramic crowns were cemented with resin cement to identical simplified complete crown preparations machined in a dentin-like polymer. The preparations were etched with 10% hydrofluoric acid for 60 seconds and received a primer coating. Before cementation, the intaglio of the ceramic crowns was treated with 1 of 4 surface conditionings (n=20): nonconditioned (control, CTRL), or etched for 60 seconds with different hydrofluoric acid concentrations: 1% (HF1), 5% (HF5), and 10% (HF10). A silane coupling agent was applied on this surface of all crowns, which were cemented to the preparations. Each crown was cyclically loaded in water with a G10 epoxy-glass piston positioned in the center of the occlusal surface. Fatigue failure loads of ceramic crowns were obtained by the staircase approach after 500000 cycles at 20 Hz. Mean failure loads were analyzed by 1-way ANOVA and the Tukey test (α=.05). RESULTS: Mean failure loads of groups CTRL (245.0 ±15.1 N), HF1 (242.5 ±24.7 N), and HF10 (255.7 ±53.8 N) were statistically similar (P>.05), while that of the HF5 group (216.7 ±22.5 N) was significantly lower (P<.05). CONCLUSIONS: HF5 acid had a negative effect on the fatigue loads of the tested feldspathic ceramic crowns, while HF1 and HF10 acids did not change the fatigue resistance.

In-Vitro Comparison Of Micro-Leakage Between Nanocomposite And Microhybrid Composite In Class V Cavities Treated With The Self-Etch Technique.

BACKGROUND: When a light cure composite resin is used to restore a class V lesion, certain stresses are generated at the tooth-restoration interface. If these stresses exceed the bond strength of the restorative material, microscopic gaps are formed which eventually cause micro-leakage at the tooth-restoration interface. The objective of the present study was to compare the micro-leakage values at the tooth-restoration interface using dye penetration method between a Nano filled and a Micro hybrid light cured composite resin in class V cavities using the self-etch technique. METHODS: Sixty class V cavities were made coronal to the cemento-enamel junction in the extracted premolars. These were then randomly divided into two study groups. Group A: Self-etch; filled with P-60 (microhybrid) n=30. Group B: Self-etch; filled with Z-350 (nano-filled) n=30. Specimens were subjected to thermo-cycling at 5-55 °C±2 °C with a 30 seconds dwell time. After which they were stained with 2% methylene blue. Later, sectioned bucco-lingually and examined using a stereo microscope (magnification X4) at the occlusal, axial and gingival surfaces. Micro-leakage around the toothrestoration interface was assessed by using the degree of dye penetration in millimetres. RESULTS: There was 100% micro leakage seen at both the occlusal and gingival surfaces when using the P-60 composite. With the Z-350 composite 84% occlusal and 88% of the gingival surfaces exhibited microleakage.. CONCLUSIONS: With respect to micro-leakage in class V cavities, Z-350 was found to be a superior restorative material compared to P-60 on the occlusal surface. Overall, there is no statistically significant difference in the micro-leakage exhibited by the two restorative materials in class V preparations subjected to self-etch protocol.

Enamel etching for bonding fixed orthodontic braces.

BACKGROUND: Acid etching of tooth surfaces to promote the bonding of orthodontic attachments to the enamel has been a routine procedure in orthodontic treatment since the 1960s. Various types of orthodontic etchants and etching techniques have been introduced in the past five decades. Although a large amount of information on this topic has been published, there is a significant lack of consensus regarding the clinical effects of different dental etchants and etching techniques. OBJECTIVES: To compare the effects of different dental etchants and different etching techniques for the bonding of fixed orthodontic appliances. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 8 March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 2), MEDLINE via OVID (to 8 March 2013), EMBASE via OVID (to 8 March 2013), Chinese Biomedical Literature Database (to 12 March 2011), the WHO International Clinical Trials Registry Platform (to 8 March 2013) and the National Institutes of Health Clinical Trials Registry (to 8 March 2013). A handsearching group updated the handsearching of journals, carried out as part of the Cochrane Worldwide Handsearching Programme, to the most current issue. There were no restrictions regarding language or date of publication. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing different etching materials, or different etching techniques using the same etchants, for the bonding of fixed orthodontic brackets to incisors, canines and premolars in children and adults. DATA COLLECTION AND ANALYSIS: Two review authors extracted data and assessed the risk of bias of included studies independently and in duplicate. We resolved disagreements by discussion among the review team. We contacted the corresponding authors of the included studies to obtain additional information, if necessary. MAIN RESULTS: We included 13 studies randomizing 417 participants with 7184 teeth/brackets. We assessed two studies (15%) as being at low risk of bias, 10 studies (77%) as being at high risk of bias and one study (8%) as being at unclear risk of bias. Self etching primers (SEPs) versus conventional etchantsEleven studies compared the effects of SEPs with conventional etchants. Only five of these studies (three of split-mouth design and two of parallel design) reported data at the participant level, with the remaining studies reporting at the tooth level, thus ignoring clustering/the paired nature of the data. A meta-analysis of these five studies, with follow-up ranging from 5 to 37 months, provided low-quality evidence that was insufficient to determine whether or not there is a difference in bond failure rate between SEPs and convention etchants (risk ratio 1.14; 95% confidence interval (CI) 0.75 to 1.73; 221 participants). The uncertainty in the CI includes both no effect and appreciable benefit and harm. Subgroup analysis did not show a difference between split-mouth and parallel studies.There were no data available to allow assessment of the outcomes: decalcification, participant satisfaction and cost-effectiveness. One study reported decalcification, but only at the tooth level. SEPs versus SEPsTwo studies compared two different SEPs. Both studies reported bond failure rate, with one of the studies also reporting decalcification. However, as both studies reported outcomes only at the tooth level, there were no data available to evaluate the superiority of any of the SEPs over the others investigated with regards to any of the outcomes of this review.We did not find any eligible studies evaluating different etching materials (e.g. phosphoric acid, polyacrylic acid, maleic acid), concentrations or etching times. AUTHORS' CONCLUSIONS: We found low-quality evidence that was insufficient to conclude whether or not there is a difference in bond failure rate between SEPs and conventional etching systems when bonding fixed orthodontic appliances over a 5- to 37-month follow-up. Insufficient data were also available to allow any conclusions to be formed regarding the superiority of SEPs or conventional etching for the outcomes: decalcification, participant satisfaction and cost-effectiveness, or regarding the superiority of different etching materials, concentrations or etching times, or of any one SEP over another. Further well-designed RCTs on this topic are needed to provide more evidence in order to answer these clinical questions.

Influence of acid-etching after grit-blasted on osseointegration of titanium dental implants: in vitro and in vivo studies.

Rough implant surfaces have shown improved osseointegration rates. In a majority of dental implants, the microrough surfaces are obtained by grit blasting and/or acid-etching. The aim of this contribution was to evaluate the effects of acid-etching, after the grit-blasted treatment in titanium dental implants, on surface wettability, surface energy, osteoblast responses and its osseointegration behavior. Four surfaces were studied: as-machined, acid-etched, micro-rough by grit-blasting and the combination grit-blasted surface with acid-etched. The surfaces with increasing roughness show more osteoblastic adhered cells. This effect was most pronounced on samples blasted and blasted with acid-etching. The roughness obtained by grit-blasting is the main factor in comparison with the acid etching treatment in the biological response. These results were confirmed in vivo tests and histological analysis. The results demonstrated that the combination of the grit-blasted and acid-etched accelerated lightly bone regeneration at the different periods of implantation in comparison with the grit-blasted implants.

Reconsidering the double etching of enamel: do self-etching primers contaminate phosphoric acid-etched enamel?

PURPOSE: To evaluate the composite-to-enamel bond following double etching of the enamel using phosphoric acid and different self-etching (SE) bonding systems with and without the application of their respective acidic primers. MATERIALS AND METHODS: The enamel surfaces of 90 human molars were ground (600 grit) flat and randomly divided into nine groups (n = 10). Three two-step SE systems (AdheSE, ASE; Clearfil SE Bond, CSE; OptiBond Solo Plus SE, OSE) were tested, both with and without primer application on enamel pre-etched with phosphoric acid under dry bonding conditions. As the controls, the SE systems were applied according to their original directions without pre-etching. All the specimens were built up with a microhybrid composite resin (Arabesk Top). After water storage for 24 h at 37°C, the bonded specimens were sheared to failure in the Zwicki 1120. Etching and failure patterns were evaluated using a scanning electron microscope (SEM). Shear bond strength was analyzed with two-way ANOVA and Tukey's test. Failure modes were analyzed with Fisher's exact test. RESULTS: Without pre-etching, CSE showed significantly higher bond strengths than ASE and OSE (p < 0.05). Enamel etching prior to the application of the SE systems tended to result in higher bond strengths, but significantly increased the values only for ASE (p < 0.05). Contamination of the pre-etched enamel with the SE primer decreased the bond strength by values of 19% for ASE (p > 0.05), 36% for CSE (p < 0.05), and 75% for OSE (p < 0.05). SEM analysis showed that omission of the priming step significantly increased the number of cohesive failures within the resin for OSE (p < 0.0001). CONCLUSION: Additional etching with phosphoric acid before the application of SE systems does not necessarily result in better enamel bonding, since unavoidable primer contamination of the pre-etched enamel was shown to significantly reduce the bond strength for two of the three systems tested.

Possible hazardous effects of hydrofluoric acid and recommendations for treatment approach: a review.

Hydrofluoric acid (HF) is commonly used for conditioning the glass ceramics either prior to cementation or for intraoral repair in prosthetic and restorative dentistry. The present study offers a review of chemical properties of HF used, highlight the possible hazardous effects of this agent, and to recommend the treatment approach for potential risks. Available published information documented in PubMed, Medline, and Picarta literature databases was reviewed. Additional information was derived from scientific reports, medical and chemical textbooks, handbooks, product information, manufacturers' instructions, Internet web sites of the HF manufacturers. No report was found on the incidence of the hazardous effects of HF in dentistry. Reports from other fields presented incidences of acute and chronic symptoms in exposure to HF. While acute symptoms include skin or nail burns, chronic ones involve systemic toxicity, eye injuries, inhalation and ingestion-related symptoms that can be even fatal. HF can be harmful and particularly aggressive to soft tissues, but symptoms may not be apparent immediately after exposure. The hazardous effects are not based on the pH value, but on the toxicity of HF. Potential hazards of HF known from other applications than dentistry should be considered also in dental applications. Especially the clinicians, who often deal with adhesive cementation or repair of glass ceramics, should take necessary precautions for possible hazards of HF.

Histological and immunohistochemical evaluation of the peri-implant soft tissues around machined and acid-etched titanium healing abutments: a prospective randomised study.

A close spatial correlation has been described between the roughness of intraoral materials and the rate of bacterial colonisation. The aim of the present study in man was to conduct a comparative immunohistochemical evaluation of the inflammatory infiltrate, microvessel density, the nitric oxide synthases 1 and 3 and the vascular endothelial growth factor expression, the proliferative activity, and the B and T lymphocyte and histiocyte positivity in the peri-implant soft tissues around machined and acid-etched titanium healing caps. Ten patients participated in this study. The patients were enrolled consecutively. All patients received dental implants left to heal in a non-submerged mode. Healing caps were inserted in all implants. Half of the implants were supplied randomly with machined caps of titanium (control), while the other half were provided randomly with acid-etched titanium caps (test). After a 6-month healing period, a gingival biopsy was performed with a circular scalpel around the healing caps of both groups. The inflammatory infiltrate was mostly present in test specimens. Their extension was much larger than that of the control samples. A higher number of T and B lymphocytes were observed in test specimens. Higher values of microvessel density and a higher expression of vascular endothelial growth factor intensity were observed in the test samples. Furthermore, the Ki-67, NOS1 and NOS3 expression was significantly higher in the test specimens. All these results showed that the tissues around test healing caps underwent a higher rate of restorative processes, most probably correlated to the higher inflammation processes observed in these tissues.

Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area.

INTRODUCTION: There is a paucity of information with regard to the susceptibility of iatrogenic white spot lesion formation after inattentive, surplus orthodontic etching with 30% phosphoric acid and the subsequent provision or absence of adequate oral hygiene. METHODS: Ninety sound enamel specimens were randomly allocated to 6 trial groups (n = 15 each) for etching with 30% phosphoric acid for either 15 seconds and standardized daily enamel brushing or no brushing, etching for 30 seconds with daily brushing or no brushing, or nonetched controls with brushing or no brushing. Nutritive acidic assaults were simulated by demineralization cycles 3 times per day for 1 hour with interim storage in artificial saliva. Lesion depths in terms of percentage of fluorescence loss (delta F, delta Q) and lesion extension compared with the baseline were assessed by using quantitative light-induced fluorescence after 2, 7, 14, 21, and 42 days. Etching duration, trial time elapse, and oral hygiene, as well as the significance of factor interactions, were analyzed with 3-way analysis of variance (α = 5%). RESULTS: The impact of the factors of enamel brushing, trial time elapse, and etching each had a comparably significant effect on lesion progression. The effect of surplus etching on white spot lesion formation was significantly enhanced by the simultaneous absence of enamel brushing and also the progression of trial time. The combination of 30 seconds of surplus etching with inadequate oral hygiene was especially detrimental. CONCLUSIONS: Excessive surplus orthodontic etching of the complete labial enamel surface, instead of the bracket bases only, must be avoided to prevent iatrogenic white spot lesions. Etching times not exceeding 15 seconds are favorable.

How to increase the durability of resin-dentin bonds.

Resin-dentin bonds are not as durable as was previously thought. Microtensile bond strengths often fall 30% to 40% in 6 to 12 months. The cause of this poor durability is a combination of the activation of matrix metalloproteinases (MMPs) by weak acids such as lactic acid released by caries-producing bacteria, and acid-etchants used in adhesive bonding systems. These acids uncover and activate matrix-bound MMPs. The other contributing factor is incomplete resin infiltration. If all exposed collagen fibrils were enveloped by resin, the MMPs would not have free access to water, an obligatory requirement of these enzymes. Recently, several inhibitors of MMPs have been added to adhesive primers. Examples include chlorhexidine (CHX), benzalkonium chloride (BAC), and MDPB, an antibacterial monomer used in a two-step self-etching primer adhesive. The advantage of MDPB over CHX and BAC is that it polymerizes with adhesive resins and cannot leach from the hybrid layer. This is an example of what can be termed a "therapeutic adhesive system" that provides anti-MMP activity along with antibacterial qualities.

In vitro evaluation of microleakage under orthodontic brackets using two different laser etching, self etching and acid etching methods.

This study evaluated the microleakage of brackets bonded by four different enamel etching techniques. Forty freshly extracted human premolars were divided randomly into four equal groups and received the following treatment: group 1, acid etching; group 2, self-etching primer (SEP); group 3, erbium:yttrium-aluminum-garnet (Er:YAG) laser etching; and group 4, erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching. After photopolymerization, the teeth were kept in distilled water for 1 month and then subjected to 500 thermal cycles. Then, the specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 h, sectioned, and examined under a stereomicroscope. In addition, they were scored for marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces from the incisal and gingival margins. Statistical analyses consisted of the Kruskal-Wallis test and the Mann-Whitney U test with Bonferroni correction. Microleakage occurred between the adhesive-enamel and bracket-adhesive interfaces in all groups. For the adhesive-enamel surface, a significant difference was observed between group 1 and groups 2 (P = 0.011), 3 (P = 0.002), and 4 (P = 0.000) on the gingival side. Overall, significant differences were observed between group 1 and groups 3 (P = 0.003) and 4 (P = 0.000). In dental bonding procedures, acid etching was found to result in the least microleakage. Since etching with a laser decreases the risk of caries and is time-saving, it may serve as an alternative to acid etching.

Nanoleakage and microtensile bond strength at the adhesive-dentin interface after different etching times.

PURPOSE: To evaluate the effect of etching time on the nanoleakage and microtensile bond strength (microTBS) at the interface between etch-and-rise adhesives and dentin. METHODS: Eighty molars were sectioned to expose the superficial dentin and randomly divided into four groups according to the adhesives used: OptiBond Solo (OB), Single Bond (SB), One-Step (OS), and Prime&Bond NT (PB). Within each group, a total-etching technique was applied, and the dentin surfaces were etched for 0, 15, 30 or 60 seconds. Each treated tooth was then sectioned into sticks. A non-trimming microTBS test and TEM observation for nanoleakage were sequentially performed. RESULTS: The degree of nanoleakage increased as etching time increased (P < 0.05). For the OS and PB groups, the highest microTBS values were achieved with 15 seconds of etching, followed by 30, 60 and 0 seconds. For the OB and SB groups, the microTBS values for 15- and 30-second etching times were similar and were both significantly higher than those of 0 and 60 seconds (P < 0.05).

The early osseointegration of the laser-treated and acid-etched dental implants surface: an experimental study in rabbits.

The aim of the study was to evaluate early osseointegration of the laser-treated and acid-etched implant surface after the installation in rabbit tibias for 4 weeks. A total of 56 screw-shaped implants were grouped as follows: group A: implants were turned surface; group B: implants were laser-treated surface; group C: implants were acid-etched; group D: Implants were laser-treated and acid-etched surface. After 4 weeks, the removal torques were: group A: 13.21 +/- 11.30 Ncm; group B: 29.73 +/- 8.32 Ncm; group C: 30.31 +/- 9.45 Ncm; group D: 35.76 +/- 7.58 Ncm; The averages of bone-to-implant contact (BIC) were as follows: group A: 27.30 +/- 6.55%; group B: 38.00 +/- 8.56%; group C: 42.71 +/- 8.48%; group D: 49.71 +/- 9.21%. The removal torque and bone-to-implant contact measurements yielded statistically significant differences between the treated groups and turned group (P < 0.05); The laser-treated and acid-etched surface achieved higher Bone-to-Implant Contact than the laser-treated surface (P < 0.05), but there was no statistically significant difference between the laser-treated and acid-etched surface and the acid-etched surface in bone-to-implant contact (P > 0.05). In the present study, it was concluded that the laser-treated and acid-etched implants had good osteoconductivity and was a potential material for dental implantation.

Influence of desensitizing agents on the microshear bond strength of adhesive systems to dentin.

The aim of this study was to evaluate the effect of desensitizing agents on the micro-shear bond strength of adhesive systems to dentin. Forty bovine teeth were divided into 8 groups (n=5): G1--Single Bond (SB); G2--GH.F + SB; G3-- Desensibilize + SB; G4--essensiv + SB; G5 --ingle Bond 2 (SB2); G6--H.E + SB2; G7--esensibilize + SB2; G8--Dessensiv + SB2. In all of the groups, the desensitizing agents were applied after phosphoric acid etching and before the dentin adhesive application. Z250 composite resin tubes were bonded on the treated surface. After 24 hours, the teeth were tested in a universal machine. Data were submitted to ANOVA and Tukey's test (5%). The results showed that the groups where Desensibilize and Dessensiv were applied exhibited smaller bond strength values.

Effects of phosphoric acid on bovine enamel bleached with carbamide peroxide.

The aim of this study was to measure the demineralization capacity of 37% phosphoric acid on bovine enamel at different time-points after bleaching with 30% carbamide peroxide. Five, 4 x 4-mm sections were obtained from the enamel of 10 bovine incisors. After applying 30% carbamide peroxide (Vivastyle) for 90 min, specimens were stored in artificial saliva for 0, 24, 72 h, or 7 d and then immersed in 37% phosphoric solution. At 15, 30, 60, 90, and 120 s, 5-ml aliquots were extracted. A control group of specimens was not bleached. Ca(2+) concentrations were measured by atomic absorption spectrophotometry. A larger amount of Ca(2+) was extracted from enamel by phosphoric acid after the application of 30% carbamide peroxide. Twenty-four hours after bleaching, significantly more Ca(2+) was extracted from bleached than from control specimens at all time-points, and this greater susceptibility to the action of the acid persisted for at least 1 wk after bleaching.

Influence of different etching times on dentin surface morphology.

The aim of this study is to investigate the influence of different etching times on demineralized dentin surface morphology using scanning electron microscopy and qualitative line microanalysis of chemical structure. Two sample groups, consisting of 30 first premolar teeth in each group, were established. Teeth were cut at the half-distance between the enamel-dentin junction and the pulp. The first group of specimens was etched for 10 seconds and the second group for 30 seconds. 37% ortophosphoric acid was used. SEM (scanning electron microscopy) was utilized to observe the following parameters: number and diameter of dentinal tubules, dentinal and intertubular dentinal surface percentage, appearance of the dentin surface porous zone containing smear layer and demineralized residual collagen particles with dentin demineralization products in acid globules, and dissolved peritubular dentin cuff. After calculating measurements of central tendency (X,C, Mo, SD), Kolmogorov-Smirnov and Student t-test were performed to confirm the quantitative results, and the chi2-test was run to produce qualitative data. In contrast to the 10-second etching time, the increased etching time of 30 seconds resulted in the following findings: (1) an increased number of dentinal tubules (p < 0.05), (2) an increase in dentinal tubule diameter (p < 0.05), (3) an increase in dentinal tubule surface percentage (p < 0.001), (4) a decrease in intertubular dentinal surface percentage (p < 0.001), (5) appearance of dentin surface porous zone containing smear layer and demineralized residual collagen particles with dentin demineralization products in acid globules (p < 0.001), and (6) completely dissolved peritubular dentin cuff (p <0.001). Therefore, different etching times using the same phosphoric acid concentration result in different morphological changes in demineralized dentin surface. Moreover, based on a comparison with current studies, prolonged etching time causes morphological changes to dentin surface. Such changes, have, in turn, negative effects on the dentin hybridization process.

Tooth color change due to different etching and debonding procedures.

OBJECTIVES:: To compare the effects of different etching techniques, 12-, 24-bladed tungsten carbide burs, and polishing discs on tooth color changes during orthodontic treatment. MATERIALS AND METHODS:: 59 individuals (mean age: 15.20 ± 1.59 years) were divided into four groups: 37% phosphoric acid and adhesive primer was used in Groups I and II whereas self-etch primer was used in Groups III and IV for enamel preparation. After orthodontic treatment, residual adhesives were cleaned with 12-bladed tungsten carbide burs in Groups I and III, while 24-bladed tungsten carbide burs were used in Groups II and IV. All teeth were polished with medium and fine Sof-Lex XT discs (3M ESPE, St Paul, Minnesota). Color measurements were taken from upper incisors and canines at pretreatment (T0), after cleaning with tungsten carbide burs (T1) and polishing with discs (T2). Wilcoxon test was used for evaluation of L*, a*, b* changes and Kruskal-Wallis for intergroup comparison of color changes. RESULTS:: L*, a*, b* values, except a* at Groups I, II, IV, and b* at Group III, changed significantly ( P < .05). Groups III and IV showed significantly different color alterations from T0 to T1 ( P < .05). After polishing, tooth color alterations were not significantly different among the groups. CONCLUSIONS:: In self-etch bonding groups, a 12-bladed tungsten carbide bur caused less color change than the 24-bladed tungsten carbide bur. Orthodontic treatment resulted with visible and clinically unacceptable tooth color alterations regardless of the enamel preparation and clean-up techniques. Polishing reduced the effect of tungsten carbide burs, but did not affect the total influence of orthodontic treatment on the tooth color.

White spot lesions: Does etching really matter?

AIM: The clinical significance of acid etching prior to orthodontic bonding is controversial. In the present study, we evaluated the effect of 15 seconds of acid etching on enamel demineralization. METHODS: Twenty-seven human molars were sectioned and assigned to two groups. Under standardized conditions, the enamel surfaces were imaged using FluoreCam to obtain baseline data. Group 1 was etched using 37% phosphoric acid for 15 seconds, rinsed with water, and then imaged again; group 2 was only rinsed with water. Water rinse was collected for calcium chemical analysis using inductively-coupled plasma auger electron spectrometry. Both groups were subjected to 9 days of pH cycling, after which final FluoreCam images were obtained. RESULTS: Group 1 showed a significant increase in lesion area (P=.012), decrease in light intensity (P=.009), and decrease in impact (P=.007) after acid etching. The amount of calcium that leached out over the 15 seconds was 14 ppm ±2.4 (0.35 mmol/L±0.06). Following pH cycling, there was no statistically-significant between-group difference in overall enamel demineralization. CONCLUSION: Initial demineralization caused by 15 seconds of acid etching does not increase enamel susceptibility to further demineralization. This suggests that acid etching does not increase the risk of developing white spot lesions during orthodontics.

Effect of etching on bonding of a self-etch adhesive to dentine affected by amelogenesis imperfecta.

AIM: Dentine affected by amelogenesis imperfecta (AI) is histologically altered due to loss of hypoplastic enamel and becomes hypermineralized. In the present study, we examined the effect of additional acid etching on microtensile bond strength of a self-etch adhesive to AI-affected dentine. METHODS: Flat coronal dentine obtained from extracted AI-affected and non-carious permanent molars were allocated to two groups: (a) Clearfil SE Bond (control); and (b) Clearfil SE Bond and additional etching with 34% phosphoric acid for 15 seconds. The bonded teeth were sectioned into .8-mm2 beams for microtensile bond strength testing, and stressed to failure under tension. The bond strength data were analyzed using two-way analysis of variance (dentine type and etching step) and Student-Newman-Keuls multiple comparison test (P<.05). Representative fractured beams from each group were examined under scanning electron microscopy. RESULTS: Both factors, dentine substrate (P<.001) and etching step (P<.05), and their interactions (P<.001), were statistically significant. Additional etching had an adverse effect on the bond strength of Clearfil SE Bond to normal dentine (P<.005), and no significant improvement was found for AI-affected dentine (P=.479). CONCLUSION: Additional acid etching does not improve the bond strength of a self-etch adhesive to AI-affected dentine.