Improving bonding to eroded dentin by using collagen cross-linking agents: 2 years of water storage.

OBJECTIVES: The aim of this study was to investigate the effects of collagen cross-linking agents on nanomechanical and bonding properties of eroded dentin (ED), 24 h and 2 years after water storage. MATERIALS AND METHODS: Human molar dentin surfaces, eroded by soft drinks or citric acid, were acid-etched and treated with primers containing proanthocyanidin (PA) and riboflavin (RI) or were untreated (control) and tested after 24 h and 2 years. After acid etching and adhesive application (Prime&Bond Elect (PBE); Scotchbond Universal (SBU); Tetric n-bond Universal (TEU)), specimens were sectioned into beams and tested for microtensile bond strength (µTBS) and silver nitrate deposition (NL) after 24 h and 2 years. The beams were used to evaluate the 24-h in situ conversion of degree (DC). Nanohardness (NH) and Young's modulus (YM) were evaluated via resin-bonded dentin slices after 24 h and 2 years. A three-way ANOVA and Tukey's test were used for statistical analysis (5%). RESULTS: For both storage times, ED with citric acid resulted in lower µTBS, NH, and YM and higher NL for each adhesive system than soft drink ED (p < 0.05). After 2 years of water storage, cross-linking primers maintained the µTBS, NH, and YM (p < 0.05) when compared with the control group. Althougth, the NL values decreased for all groups after 2 years of water storage, PA and RI treatments showed NI values lower than control group (p < 0.001). No significant differences were observed between PA and RI treatments (p > 0.05). Cross-linking primers maintain or improve DC (p < 0.03). In general, TEU and SBU yielded higher µTBS, DC, NH, and YM and lower NL than PBE. CONCLUSION: Cross-linking agents improved the results and maintained the resin-ED interface bonding and nanomechanical properties, without jeopardizing adhesive polymerization. CLINICAL RELEVANCE: Cross-linking agents are a viable alternative for improving and maintaining resin-ED interface bonding and nanomechanical properties.

Necrotizing Sialometaplasia and Bulimia: A Case Report.

Bulimia is an eating disorder with a great prevalence in young women. Due to its multifactor ethiology, bulimia has systemic consequences. In the literature, necrotising sialometaplasia is seldom associated with bulimia. Its etiopathogenesis is discussed by several authors; nevertheless, the consensus does not consider the relevance of local trauma associated with induced vomiting. A case of necrotising sialomethaplasia, presented with a single hard palatal ulcer in a bulimic woman is described in the present report. The patient did not present significant systemic laboratorial values, nor physical weight variations, which highlights the relevance of performing a complete medical clinical history when diagnosing this rare pathology.

Bonding properties of universal adhesives to root canals prepared with different rotary instruments.

STATEMENT OF PROBLEM: Preparation of coronal dentin by using a diamond rotary instrument usually results in higher bond strength values than preparation with tungsten carbide burs, but information is lacking about the influence of rotary instruments on root canals before the bonding of fiber posts. PURPOSE: The purpose of this in vitro study was to evaluate the influence of the rotary instrument used to prepare the root canal and bonding strategies on the adhesion of fiber posts to root dentin with universal adhesive systems. MATERIAL AND METHODS: Human premolars were used and divided into 8 groups according to the combination of the following factors: rotary instrument (tungsten carbide bur versus diamond rotary instrument), cementation system (single-bond versus prime and bond), and bonding method (etch-and-rinse versus self-etch). Eight teeth per group were evaluated by push-out bond strength, 4 teeth were evaluated for nanoleakage by using scanning electron microscopy (SEM), and 2 teeth were evaluated for shape by SEM. Data for bond strength and nanoleakage for each cementation system were subjected to 2-way ANOVA and Tukey honest significant differences tests (α=.05). RESULTS: The highest bond strength values were observed for preparation using a diamond rotary instrument for both cementation systems. For prime and bond, the highest bond strength values were observed with the self-etch adhesion strategy, and the self-etch strategy was better for the single-bond; and the self-etch strategy was better than etch-and-rinse just after the use of a diamond instrument. In relation to nanoleakage for the cementation system, the prime and bond had the lowest values for groups using a diamond instrument and self-etch strategy. For the single bond, the adhesion strategy did not influence nanoleakage, but the rotary instrument did, with diamond rotary instruments resulting in lower values. SEM analyses showed a greater number of unobliterated tubules in the self-etch mode and a more regular surface when prepared with a diamond rotary. CONCLUSIONS: To improve the adhesion of fiber posts to root canal, a diamond rotary instrument should be used, and generally, universal adhesive systems must be used in self-etch mode.

Bonding Performance of Universal Adhesives to Eroded Dentin.

PURPOSE: To evaluate the microtensile bond strength (µTBS) and nanoleakage (NL) of several universal adhesives to eroded dentin (ED), using etch-and-rinse (ER) or self-etch (SE) strategies, and to characterize the surface using two pH cycling models to erode dentin (citric acid and a soft drink). MATERIALS AND METHODS: Molars were eroded either by soft-drink or citric acid cycling, or were left untreated as control (SD). For each surface, the following adhesives were applied: 1. All-Bond Universal; 2. Ambar Universal; 3. Clearfil Universal; 4. Futurabond U; 5. One Coat 7 Universal; 6. Peak Universal Bond; 7. Prime&Bond Elect; 8. Scotchbond Universal; 9. Tetric n-bond Universal, and 10. Xeno Select. After application of the composite, specimens were sectioned into composite-dentin sticks and tested under tension (0.5 mm/min). Selected sticks from each tooth were used to assess NL. The occlusal dentin surfaces after erosive cycling were examined using SEM. Data were analyzed by three-way ANOVA and Tukey's post-hoc test (a = 0.05). RESULTS: In ED, there was no difference in µTBS and NL between ER and SE strategies (p > 0.61). Most µTBS and NL values obtained for ED were, respectively, lower and higher than those for SD (p < 0.01), being worse for citric acid ED (p < 0.001). Citric-acid-eroded dentin showed more enlarged tubules, with partial loss of peritubular dentin when compared to soft-drink eroded dentin. CONCLUSION: The different pH cycling models reduced µTBS and increased NL of the composite/eroded-dentin interface; however, in ED, the performance of the universal adhesives did not depend on the adhesive strategy used.

An in situ evaluation of the polymerization shrinkage, degree of conversion, and bond strength of resin cements used for luting fiber posts.

STATEMENT OF PROBLEM: The behavior and magnitude of the deformations that occur during polymerization and the behavior of the luting agents of glass fiber posts inside the root canal require quantification. PURPOSE: The purpose of this in vitro study was to investigate the in situ polymerization shrinkage, degree of conversion, and bond strength inside the root canal of resin cements used to lute fiber posts. MATERIAL AND METHODS: Thirty maxillary canines were prepared to lute fiber posts. The teeth were randomly divided into 2 groups (n=15) according to the cementation system used, which included ARC, the conventional dual-polymerized resin cement RelyX ARC, and the U200 system, a self-adhesive resin cement, RelyX U200. Two fiber optic sensors with recorded Bragg gratings (FBG) were attached to each post before inserting the resin cement inside the root canal to measure the polymerization shrinkage (PS) of the cements in the cervical and apical root regions (µÎµ). Specimens were sectioned (into cervical and apical regions) to evaluate bond strength (BS) with a push-out test and degree of conversion (DC) with micro-Raman spectroscopy. Data were statistically analyzed with 2-way ANOVA and the Tukey honestly significant difference post hoc test (α=.05). RESULTS: The ARC and U200 system showed similar PS values (-276.4 ±129.2 µÎµ and -252.1 ±119.2 µÎµ, respectively). DC values from ARC were higher (87.5 ±2.7%) than those of U200 (55.9 ±9.7%). The cervical region showed higher DC values (74.8 ±15.2%) and PS values (-381.6 ±53.0 µÎµ) than those of the apical region (68.5 ±20.1% and -146.9 ±43.5 µÎµ, respectively) for both of the resin cements. BS was only statistically different between the cervical and apical regions for ARC (P<.05). CONCLUSIONS: The ARC system showed the highest PS and DC values compared with U200; and for both of the resin cements, the PS and DC values were higher at the cervical region than at the apical region of the canal root. BS was higher in the cervical region only for ARC.

New Single-bottle Ceramic Primer: 6-month Case Report and Laboratory Performance.

INTRODUCTION: This article presents a 6-month case report and an in vitro evaluation of the performance of the new self-etching glass-ceramic monobond etch and prime (MEP) when applied in a lithium disilicate (LD). The MEP contains in the same bottle, along with acid conditioner and silanes. This simplifies the bonding procedures by reducing not only the number of steps, but also the working time. A 42-year-old female patient sought for esthetic treatment, and the main complaint was the darkened appearance of the upper lateral incisor. The esthetic treatment includes dental bleaching and gingivectomy, all-ceramic zirco-nia crowns, and all-ceramic crown and laminate veneer LD. After 6 months of esthetic treatment, marginal staining, gap, or chip fracturing damaging margins after sharp explorer in the margins was not observed. Furthermore, the inferior etching pattern of MEP was compared with traditional hydrofluoric acid (HF) conditioning. The microshear bond strength to the intaglio surface of LD was statistically similar when HF was compared with MEP. This new self-etching glass-ceramic showed good in vitro and 6 months clinical results in this case report. Future long-term clinical studies with more clinical case need to be done to confirm the performance of the use of this new conditioner. CLINICAL SIGNIFICANCE: The use of a new self-etching glass-ceramic showed a good in vitro and 6 months clinical results. This new product can be an easy, simple, and alternative approach for esthetics bonding procedure.

Influence of the resin cement thickness on bond strength and gap formation of fiber posts bonded to root dentin.

PURPOSE: To evaluate the effect of the resin cement thickness (RCT) on bond strength (BS) and gap formation (GF) of fiber posts bonded to root dentin. MATERIALS AND METHODS: The roots of 24 extracted human mandibular premolars were treated endodontically and the post spaces were prepared using drills with different diameters according to the following groups (n = 8): well adapted (WA), moderately well adapted (MA) and poorly adapted (PA). The fiber glass posts were cemented (Excite DSC and Variolink II) in accordance with the manufacturer's instructions. After 1 week, the roots were transversely sectioned into six 1-mm-thick disks and photographed using an optical microscope to determine the RCT. After this, epoxy resin replicas of each sample were observed using SEM, and the mean length and width of the gaps formed in the cement/dentin/post interface were measured. Finally, each sample was subjected to the push-out test (0.5 mm/min), and the data were statistically analyzed using one-way ANOVA and Tukey's tests at the 5% level of significance. RESULTS: The lowest RCT (µm) was observed for WA and the highest for PA. The group MA showed an intermediate value. Significantly higher push-out BS values were observed for WA compared to the other groups. The MA and PA groups were statistically similar. The highest mean gap length (%) and width (µm) were observed for PA. The groups MA and WA were statistically similar. CONCLUSION: Lower resin cement thickness resulted in better fiber post adhesion, that is, in higher bond strength and less gap formation.

Effects of adding barium-borosilicate glass to a simplified etch-and-rinse adhesive on radiopacity and selected properties.

PURPOSE: To evaluate the radiopacity, ultimate tensile strength (UTS), microhardness (KHN), degree of conversion (DC), water sorption (WS) and solubility (SL) of experimental adhesives. MATERIALS AND METHODS: Five experimental adhesives with different concentrations of barium-borosilicate oxide microfillers [0% (R0), 30% (R30), 40% (R40), 50% (R50), 60% (R60)] were formulated based on the adhesive system Ambar (FGM). The adhesive Adper Single Bond 2 (SB, 3M ESPE) was used as commercial reference. For the radiopacity (n = 5), KHN (n = 5), WS (n = 10), and SL (n = 10) tests, adhesive disks were constructed (5.0 mm in diameter and 1.0 mm thick), while for UTS (n = 5), hourglass-shaped specimens with a cross-sectional area of 0.8 mm2 were used. The FTIR spectra of unpolymerized and polymerized adhesives were used to determine the DC. Data were submitted to a one-way ANOVA and Tukey's test (α = 0.05). RESULTS: All experimental adhesives showed radiopacity similar to enamel, except those of R0 and SB. Filler addition did not jeopardize the UTS, KHN, or WS of the filled adhesives in comparison with the unfilled version. Except for R40, filler addition reduced the SL. The filled adhesives showed lower DC when compared with R0, but the DC was similar or higher when compared with SB. CONCLUSIONS: The addition of barium-borosilicate glass up to 50% did not jeopardize the mechanical properties of the adhesive layer and seems to reduce its solubility.

Evaluation of different restorative techniques for filling flared root canals: fracture resistance and bond strength after mechanical fatigue.

PURPOSE: To evaluate the fracture resistance (FR) and bond strength (BS) after mechanical fatigue (MF) of flared root canals restored with different restorative techniques for fiber post cementation. MATERIALS AND METHODS: The root canals of 84 single-rooted premolars were endodontically treated and prepared in order to simulate an oversized root canal, except for the positive control group (PC), in which a prefabricated fiber post (PFP) with a diameter compatible with the post cavity was cemented. In the oversized root canals, alternative restorative techniques for post cementation were tested, as follows: NC: negative control (PFP with a diameter smaller than that of the root canal); AP: PFP + accessory posts; RR: root reinforcement with composite resin; DAP: direct anatomical post; IAP: indirect anatomical post. After the luting procedures using Excite DSC and Variolink II, indirect composite crowns were cemented on composite resin cores and the specimens were mechanically fatigued (1.2 x 106 cycles, 40 N). From each group, 8 specimens were subjected to the push-out BS test and the others 6 specimens to the FR test. For both tests, the data were subjected to ANOVA and Scheffe's tests (α = 0.05). RESULTS: In terms of FR, all alternative techniques showed intermediate performance, being similar to both control groups. In terms of BS, only the groups DAP and IAP were similar to the well-adapted condition (positive control group). CONCLUSION: The use of DAP and IAP should be the first choice for fiber post cementation in oversized root canals.

Effect of a novel quaternary ammonium methacrylate polymer (QAMP) on adhesion and antibacterial properties of dental adhesives.

This study investigated the resin-dentin bond strength (µTBS), degree of conversion (DC), and antibacterial potential of an innovative adhesive system containing a quaternary ammonium methacrylate polymer (QAMP) using in situ and in vitro assays. Forty-two human third molars were flattened until the dentin was exposed and were randomly distributed into three groups of self-etching adhesive systems: Clearfil™ SE Bond containing 5% QAMP (experimental group), Clearfil™ Protect Bond (positive control) and Clearfil™ SE Bond (negative control). After light curing, three 1 mm-increments of composite resin were bonded to each dentin surface. A total of thirty of these bonded teeth (10 teeth per group) was sectioned to obtain stick-shaped specimens and tested under tensile stress immediately, and after 6 and 12 months of storage in distilled water. Twelve bonded teeth (4 teeth per group) were longitudinally sectioned in a mesio-to-distal direction to obtain resin-bonded dentin slabs. In situ DC was evaluated by micro-Raman spectroscopy. In vitro DC of thin films of each adhesive system was measured using Fourier transform infrared spectroscopy. In vitro susceptibility tests of these three adhesive systems were performed by the minimum inhibitory/minimum bactericidal concentration (MIC/MBC) assays against Streptococcus mutans, Lactobacillus casei, and Actinomyces naeslundii. No statistically significant difference in µTBS was observed between Clearfil™ SE Bond containing 5% QAMP and Clearfil™ SE Bond (p>0.05) immediately, and after 6 and 12 months of water storage. However Clearfil™ Protect Bond showed a significant reduction of µTBS after 12 months of storage (p=0.039). In addition, QAMP provided no significant change in DC after incorporating into Clearfil™ SE Bond (p>0.05). Clearfil™ SE Bond containing 5% QAMP demonstrated MIC/MBC values similar to the positive control against L. casei and A. naeslundii and higher than the negative control for all evaluated bacterial strains. The use of QAMP in an adhesive system demonstrated effective bond strength, a suitable degree of conversion, and adequate antibacterial effects against oral bacteria, and may be useful as a new approach to provide long-lasting results for dental adhesives.

New intracanal formulations containing doxycycline or chlorhexidine against Enterococcus faecalis.

The present study aims to evaluate the antimicrobial effect of two new intracanal preparations against E. faecalis. Thirty single-rooted human canine teeth were used. The crowns were removed and the roots were instrumented using a conventional technique. Three groups of ten teeth each were infected with 108 CFU/ ml of E. faecalis for 21 days. The root canals were flled with new intracanal medications containing 3% doxycycline hydrochloride (DX) or 2% chlorhexidine digluconate (CHX). Ten teeth received no medication (NM)-negative control. Microbial samples were obtained 21 days after contamination: 14 days under the effect of the intracanal medications and 7 days after replacing the medications by BHI broth. The samples were homogenized, diluted, seeded on BHI agar and incubated for 48h/36°C. The number of colony forming units (CFU/ml) was obtained and analyzed statistically. All intracanal dressings significantly reduced the number of bacterial cells in the root canal after 14 days with medication. After the period with 7 days with BHI broth, the CFU counts of E. faecalis remained at low values. However, the NM group showed a significant increase of CFU in this period to similar values of the initial contamination. 3% doxycycline hydrochloride gel and 2% CHX gel were effective to eliminate E. faecalis from the root canal system.

Effect of topical application of ibuprofen/arginine on the in-office bleaching-induced tooth sensitivity: A randomized, triple-blind controlled trial.

OBJECTIVE: The application of anti-inflammatories as topical desensitizers before dental bleaching is an approach to reduce bleaching-induced tooth sensitivity (TS). This randomized controlled trial compared the risk and intensity of TS and the color change resulting from in-office dental bleaching after using an experimental desensitizing gel containing ibuprofen and arginine. METHODS: Sixty-two participants with upper canine shades A2 or darker were randomly assigned to either the ibuprofen-arginine desensitizing group or the placebo group. The desensitizing gel was applied for 15 min before in-office bleaching with 35 % hydrogen peroxide gel for 50 min (2 sessions). To assess the absolute risk and intensity of TS, visual (0-10) and numeric rating (0-5) scales were used, and group comparisons were made using the McNemar test, Wilcoxon test, and paired Student t-test (α = 0.05). Color change was evaluated using Vita Classical, Vita Bleachedguide (ΔSGU), and Vita EasyShade (ΔEab, ΔE00, and ΔWID) before and one month after the bleaching procedure. Group comparisons for color change were done using a paired t-test (α = 0.05). RESULTS: The odds ratio for TS was 0.14 [95 % CI 0.02 to 0.6], meaning lower odds of TS for the desensitizing gel. A lower intensity of TS was also observed for the experimental group (p < 0.005) up to 48 h after bleaching. All color evaluation tools demonstrated effective and similar whitening for both groups (p > 0.05). CONCLUSIONS: Using the experimental desensitizing gel containing ibuprofen and arginine effectively reduced the risk and intensity of TS without compromising the bleaching efficacy. CLINICAL RELEVANCE: The topical application of ibuprofen/arginine on the in-office bleaching reduced risk and intensity of bleaching-induced tooth sensitivity.

Micro-osteoperforation for enhancement of orthodontic movement: A mechanical analysis using the finite element method.

BACKGROUND: Micro-osteoperforation is a minimally invasive technique aimed at accelerating tooth movement. The goal of this novel experimental study was to assess tooth movement and stress distribution produced by the force of orthodontic movement on the tooth structure, periodontal ligament, and maxillary bone structure, with and without micro-osteoperforation, using the finite element method. MATERIALS AND METHODS: Cone-beam computed tomography was used to obtain a virtual model of the maxilla and simulate the extraction of right and left first premolars. Three micro-osteoperforations (1.5 x 5 mm) were made in the hemiarch on the distal and mesial surfaces of upper canines, according to the power tip geometry of the Propel device (Propel Orthodontics, Ossining, New York, USA). An isotropic model of the maxilla was fabricated according to the finite element method by insertion of mechanical properties of the tooth structures, with orthodontic force (1.5 N) simulation in the distal movement on the upper canine of a hemiarch. RESULTS: Initial movement was larger when micro-osteoperforations were performed on the dental crown (24%) and on the periodontal ligament (29%). In addition, stress distribution was higher on the bone structure (31%) when micro-osteoperforations were used. CONCLUSIONS: Micro-osteoperforations considerably increased the movement of both the dental crown and periodontal ligament, which highlights their importance in the improvement of orthodontic movement, as well as in stress distribution across the bone structure. Important stress absorption regions were identified within micro-osteoperforations.

Effect of odontoplasty on intake, nutrient digestibility, and intake time of tifton hay in ponies.

We aimed to evaluate the effects of dental correction on voluntary nutrient intake, time of intake, apparent digestibility and fecal particle size in Brazilian ponies. Twelve mares, with no history of previous dental treatments, housed in individual pens and fed a diet based on tifton 85 were used. The study comprised two consecutive experimental phases, pre and post dental treatment. Each phase consisted of 15 days for adaptation to the pen and treatment and 5 days for data collection, totaling 20 days. To calculate nutrient intake and digestibility coefficients, samples of diets, leftovers, and feces were analyzed for dry matter (DM), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), crude fat (CF), mineral matter (MM), organic matter (OM), and non-fiber carbohydrates (NFC). Food intake time was recorded using a digital video recorder. Fecal particles were analyzed by wet sieving. Dental correction did not influence the intake of DM, CP, NDF, CF, and OM by the animals. However, there was an increase in NFC intake from 0.12 kg to 0.14 kg and in food intake time from 654.50 ± 138.98 to 774.95 ± 167.14. There was a decrease in the digestibility of CP from 0.08 kg to 0.04 kg and an increase in the digestibility of NDF from 0.65 kg to 0.82 kg. Although odontoplasty increased the time of hay intake and the digestibility of the fibrous fractions of the feed of ponies, it did not influence the intake of nutrients and the size of the fecal particles.

Temporomandibular disorders and chronic daily headaches in the community and in specialty care.

BACKGROUND: Chronic daily headaches (CDHs) are often associated with temporomandibular disorders (TMDs). However, large studies assessing the relationship were conducted in general, and not clinical, populations. Thus, clinical exams were not completed. Clinic-based studies with expert diagnosis are, in turn, often small and may not be representative. OBJECTIVE: To contrast the demographic and clinical symptoms of CDH and TMD in participants within the general population relative to patients seen in a headache clinic. METHODS: All inhabitants 10 years and older of a small city in Brazil were interviewed. Those with more than 15 days of headache per month were examined by a team consisting of a neurologist, a dentist, and a physical therapist. Headaches were classified as per the Second Edition of the International Classification of Headache Disorders and TMD as per the Research Diagnostic Criteria. The procedure was repeated (by the same team) with CDH sufferers consecutively seen in a headache center. RESULTS: Of 1605 inhabitants interviewed, 57 (3.6%) had CDH, and 43 completed all physical assessments. For specialty care group, of 289 patients, 92 had CDH, and 85 completed all assessments. No significant differences were seen for gender and age, but education level was significantly higher among those recruited at specialty care. Muscular TMD happened in 30.2% of CDH patients from the community vs 55.3% in the headache center (difference of -25.1%, 95% confidence interval of difference=-40.8% to -9.4%). No TMD happened in 41.9% of those recruited from the population relative to 20% of those in the headache center (21.9%, 95% confidence interval=6.7-37.1%). CONCLUSION: Individuals with CDH recruited from the general population are significantly less likely to have CDH relative to those selected from the headache center. Issues of generalizability are of concern when conducting clinic-based studies on the topic.

Influence of two different methods of delivering fluoride on bond strength and degree of conversion of an adhesive after bleaching.

PURPOSE: To evaluate the influence of fluoride delivery and restoration time point on the microshear bond strength (mSBS) and degree of conversion (DC) values of an adhesive applied on bleached enamel. MATERIALS AND METHODS: Fifty-four enamel specimens were submitted to bleaching and divided into 3 groups of n = 18: group HP: 35% hydrogen peroxide (HP); group HPF: HP + 1.23% sodium fluoride application (F); group PF: 38% HP with F. A control group of n = 6 was neither bleached nor fluoridated. Subsequently, each group except the control was subdivided into 3 subgroups (n = 6) to be restored immediately, or at 7 or 14 days. Tygon tubes were filled with composite resin and placed on enamel surfaces, then the mSBS test was performed. The DC of the interface was observed with Raman spectroscopy. The data were submitted to two-way ANOVA and Tukey's and Dunnet's post-hoc test (α = 0.05). RESULTS: The mSBS results showed higher values for groups HP and HPF at 14 days compared with immediate and 7 days (p < 0.05). Lower DC values were obtained in the immediately restored groups HP and HPF, which were significantly different from 7 and 14 days (p < 0.05). mSBS and DC for group PF was similar at all restoration time points and to the control group (p > 0.05). CONCLUSION: Only the use of a fluoridated in-office bleaching agent (Opalescence Boost PF) proved to be effective for immediately reversing the side effects of low mSBS and DC values when in-office bleaching is used.

Effect of irrigation protocols on smear layer removal, bond strength and nanoleakage of fiber posts using a self-adhesive resin cement.

Objectives: This study aimed to investigate the effect of the application method of 2% chlorhexidine (CHX) and its influence on the adhesion of fiberglass posts cemented with a self-adhesive resin cement. Materials and Methods: Sixty human mandibular premolars were endodontically treated and divided into 5 groups (n = 12), according to the canal irrigant and its application method: 2 groups with conventional syringe irrigation (CSI)-2.5% sodium hypochlorite (NaOCl) (control) and 2% CHX- and 3 groups with 2% CHX irrigation/activation-by passive ultrasonic irrigation (PUI), Easy Clean file, and XP-Endo Finisher file. Two roots per group were evaluated for smear layer (SL) removal by scanning electron microscopy. For other roots, fiber posts were luted using a self-adhesive resin cement. The roots were sectioned into 6 slices for push-out bond strength (BS) (7/group) and nanoleakage (NL) (3/group). Data from SL removal were submitted to Kruskal-Wallis and Student-Newman-Keuls tests (α = 0.05). Data from BS and NL were evaluated by 2-way analysis of variance and Tukey's test (α = 0.05). Results: For SL removal and BS, the CHX irrigation/activation promoted better values than CSI with CHX (p < 0.05), but it was not significantly different from CSI with NaOCl (p > 0.05). For NL, the lowest values were obtained by the chlorhexidine irrigation/activation groups (p < 0.05). Conclusions: Active 2% CHX irrigation can be used to improve the post space cleaning and adhesion before fiber post cementation with self-adhesive resin cements.

Effect of dentin moisture on the adhesive properties of luting fiber posts using adhesive strategies.

The purpose of this study was to evaluate the effect of dentin moisture (moist and dry) on the bonding of fiber posts to root dentin with different adhesive strategies (etch-and-rinse, self-etch, and self-adhesive). Seventy-two extracted single-rooted human teeth were endodontically treated and divided into six groups (n = 12) according to the moisture of dentin surface and adhesive systems as follows: a) etch-and-rinse/moist, b) etch-and-rinse/dry, c) self-etch/moist, d) self-etch/dry, e) self-adhesive/moist, and 6) self-adhesive/dry. The specimens were sectioned into six slices for push-out bond strength (BS), nanoleakage (NL) by SEM, and Vickers microhardness (VHN) of the resin cement. A universal testing machine (AG-I, Shimadzu Autograph) was used at a crosshead speed of 0.5 mm/min until post extrusion, with a load cell of 50 kg for evaluation of the push-out strength. Data on BS, NL, and VHN were evaluated by two-way ANOVA and Tukey's test (α = 0.05). Dentin moisture as the main factor was not significantly different for the push-out test. However, higher BS values can be observed for the etch-and-rinse group. A lower percentage of NL was found in the dry dentin groups. The moisture pattern was not significant in the hardness values for the pre-etching groups. Additional moisture did not increase the evaluated properties.

In vitro bleaching efficacy of violet LED associated with 10% hydrogen peroxide and 10% carbamide peroxide.

BACKGROUND: This in vitro study evaluated the efficacy and the effect over the dental enamel surface of violet LED dental bleaching associated to different concentrations of carbamide and hydrogen peroxide. METHODS: Human dental blocks (n = 100) were randomly distributed into 5 groups: 10% hydrogen peroxide (HP10), 10% carbamide peroxide (CP10), 10% hydrogen peroxide with violet LED (VHP10), 10% carbamide peroxide with violet LED (VCP10) and 35% hydrogen peroxide (HP35). The specimens were analyzed by Vickers microhardness test (n = 50) initially, immediately after and seven days after ending the bleaching protocol. For color analysis (n = 50), the specimens were evaluated for bleaching effectiveness (ΔE2000, ΔE1976) and whiteness index (ΔWID) with EasyShade spectrophotometer, before bleaching protocol and seven days after ending the bleaching protocol. The microhardness and color data were analyzed using one-way ANOVA with post-hoc Tukey test (α = 0.05). RESULTS: The microhardness values showed difference among the investigated groups only immediately after the end of the dental bleaching (p < 0.05), with reduction for the groups HP35 (p < 0.01) and HP10 (p < 0.05), however the microhardness values were reestablished after seven days. Regarding the color changes, a difference between VHP10 and the others groups evaluated for ΔE2000 and ΔE1976 index was observed (p < 0.05). For ΔWID, there was no difference between the studied groups. CONCLUSIONS: Violet LED associated with low concentration bleaching agents did not show a negative effect on dental enamel regarding the surface microhardness. All bleaching protocols were effective, therefore, perceptible to human eyes.

Magnetic resonance imaging evaluation of the disc morphology of temporomandibular joint in patients with severe hemophilia.

OBJECTIVES: This study aimed to assess the morphological differences in the articular disc (AD) between hemophilic patients and healthy individuals of the control group for further association with signs and symptoms. METHODS: Fourteen severe hemophilic patients had their AD evaluated by magnetic resonance imaging (MRI). The morphological findings were compared to those of a control group consisting of 14 healthy individuals. MRI was used to evaluate all the components of the temporomandibular (TMJ), including the AD, resulting in sequential T1-weighted parasagittal images. All the images were acquired with teeth in maximum intercuspation position. RESULTS: Morphological alterations showed significant statistical differences (P-value = 0.0068), whereas no statistical differences were found in the other variables, including TMJ pain, headache, bruxism and mouth opening limitation. In the group of non-hemophilic individuals, only two (14.29%) presented AD with non-biconcave features, whereas in the group of hemophilic patients, nine (64.29%) presented AD with a morphology other than biconcave. CONCLUSIONS: In patients with severe hemophilia, there seems to be a pattern of morphological alterations in the articular disc over time. The standard biconcave morphology of AD tends to change into other ones, particularly biplanar, hemiconvex and folded.