RESUMO
OBJECTIVE: Controversy exists regarding the effectiveness of delayed toothbrushing in decreasing erosive tooth wear (ETW). The purpose of this systematic review and meta-analysis was to assess the effects of delayed toothbrushing on ETW. MATERIALS AND METHODS: This systematic review and meta-analysis was conducted according to the PRISMA statement and registered in PROSPERO (CRD42020200463). PubMed, Embase, and Web of Science databases were systematically searched with no publication year limits. Screening and data extraction were performed independently by two reviewers. In situ and in vitro studies comparing ETW after delayed and immediate toothbrushing following an erosive attack were included. Review Manager software 5.3 (The Cochrane Collaboration, Oxford, UK) was used for statistical analyses. Heterogeneity was assessed with the Cochran Q test and I2 statistics. RESULTS: Of the 565 potentially relevant studies, 26 full-text articles were assessed for eligibility. Twelve articles were included in the systematic review, and 11 were included in the qualitative analyses. No significant difference in the ETW of human enamel was observed between delayed and immediate toothbrushing (P = 0.13), whereas significantly less ETW of bovine enamel was observed after delayed toothbrushing (P < 0.001). No significant difference in the ETW of bovine dentin was observed between delayed and immediate toothbrushing (P = 0.34). Studies on human dentin were not available. Subgroup analyses revealed a significant contribution of the use of fluoridated toothpaste to decreasing the ETW of human enamel after erosion and toothbrush abrasion (P = 0.02). CONCLUSIONS: Bovine and human teeth behaved differently in response to erosion and toothbrush abrasion. Delayed toothbrushing after an erosive attack was not effective at decreasing the ETW of human enamel compared to immediate toothbrushing, whereas it was effective at decreasing the ETW of bovine enamel. CLINICAL RELEVANCE: Delayed toothbrushing alone after the consumption of erosive foodstuffs or beverages is not capable of preventing erosive enamel wear.
Assuntos
Abrasão Dentária , Erosão Dentária , Desgaste dos Dentes , Animais , Bebidas , Bovinos , Esmalte Dentário , Humanos , Abrasão Dentária/etiologia , Abrasão Dentária/prevenção & controle , Erosão Dentária/prevenção & controle , Desgaste dos Dentes/prevenção & controle , Escovação DentáriaRESUMO
BACKGROUND: To assess the knowledge of and attitudes towards erosive tooth wear among dental, medical, and non-medical university students of two Chinese universities. METHODS: A questionnaire containing 15 questions on knowledge of erosive tooth wear and 10 questions on attitudes towards erosive tooth wear was designed, and its psychometric properties (reliability and validity) were analysed in a pilot study (n = 120 students). The following 3 groups of university students (n = 635) were recruited based on a convenience sampling technique and were distributed the questionnaire via an online survey system: dental students (DSs), medical students (MSs), and non-medical students (NSs). Differences in the scores between groups and genders were analysed by one-way analysis of variance (ANOVA). The Pearson correlation coefficient was used to determine the association between the knowledge and attitude scores (P < 0.05). RESULTS: The questionnaire was found to be reliable, valid and reproducible. A total of 435 students participated in this study (response rate: 69.6%). The knowledge score of the DSs (11.5 ± 3.4) was significantly higher than those of the NSs (5.5 ± 4.0) and MSs (6.1 ± 4.0) (P < 0.001). The attitude score of the DSs (45.2 ± 6.5) was significantly higher than those of the NSs (41.1 ± 6.9) and MSs (41.8 ± 6.4) (P < 0.001). The majority of DSs expressed attitudes that were more accurate and positive than those expressed by the other 2 groups. The attitude score was positively correlated with the knowledge score (r = 0.237, P < 0.001). CONCLUSIONS: Dental students had more accurate knowledge of and more positive attitudes towards erosive tooth wear than medical and non-medical students. In this population, a positive correlation was established between knowledge of and attitudes towards erosive tooth wear.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Estudantes/psicologia , Erosão Dentária , Desgaste dos Dentes , Adolescente , Adulto , Povo Asiático , Estudos Transversais , Feminino , Humanos , Masculino , Projetos Piloto , Reprodutibilidade dos Testes , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , UniversidadesRESUMO
OBJECTIVES: The present study aimed to evaluate the effectiveness of bioactive glass (BAG) in preventing dental erosion in primary teeth. METHODS: Enamel and dentin specimens (2 × 2 × 2 mm) were obtained from extracted primary teeth, which were randomly divided into the following groups based on the pretreatments (n = 12): DW (deionized water), NaF (2 % sodium fluoride), 2BAG (2 % BAG), 4BAG (4 % BAG), 6BAG (6 % BAG), and 8BAG (8 % BAG). The specimens were immersed in the respective solutions for 2 min and subjected to in vitro erosive challenges (4 × 5 min/d) for 5 d. The erosive enamel loss (EEL), erosive dentin loss (EDL), and the thickness of the demineralized organic matrix (DOM) were measured using a contact profilometer. The surface microhardness (SMH) was measured, and the percentage of SMH loss (%SMHL) was calculated. The surface morphology and mineral composition were evaluated by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS), respectively. RESULTS: After the erosive challenges, the EEL, EDL, and%SMHL of the 2BAG, 4BAG, 6BAG, and 8BAG groups significantly reduced, with the greatest reduction was observed in the 6BAG (EEL: 6.5 ± 0.2 µm;%SMHL in enamel: 12.8 ± 2.6; EDL: 7.9 ± 0.3 µm; %SMHL in dentin: 22.1 ± 2.7) and 8BAG groups (EEL: 6.4 ± 0.4 µm;%SMHL in enamel: 11.0 ± 1.9; EDL: 7.8 ± 0.5 µm; %SMHL in dentin: 22.0 ± 2.5) (P < 0.05). With increasing BAG concentrations, the number of surface deposits containing Ca, P, and Si increased. CONCLUSIONS: 6BAG was the most effective for preventing dental erosion in primary teeth and showed a particularly strong potential for dentin erosion prevention. CLINICAL SIGNIFICANCE: Bioactive glass, especially at a 6 % concentration, has proven effective in reducing erosive tooth wear and surface microhardness loss while also protecting demineralized organic matrix in primary dentin.
Assuntos
Esmalte Dentário , Dentina , Vidro , Dureza , Microscopia Eletrônica de Varredura , Fluoreto de Sódio , Espectrometria por Raios X , Erosão Dentária , Dente Decíduo , Erosão Dentária/prevenção & controle , Humanos , Vidro/química , Fluoreto de Sódio/uso terapêutico , Propriedades de Superfície , Cerâmica/química , Desmineralização do Dente/prevenção & controle , Teste de MateriaisRESUMO
PURPOSE: This study systematically reviewed the literature to compare the bond strength of resin composites with that of zirconia-reinforced lithium silicate (ZLS) and lithium disilicate (LD). STUDY SELECTION: This review was structured based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. This study was registered at the International Prospective Register of Systematic Reviews (CRD42021256900). Studies were searched via PubMed, Web of Science, and Google Scholar databases without language or publication year limits. In vitro studies that evaluated the bond strength of the resin composites to ZLS and LD were included. The risk of bias in all the included articles was evaluated. Statistical analyses were performed using the Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK). RESULTS: Of the 90 potentially related articles, the full texts of 16 articles were evaluated after screening. Finally, seven studies were included in the qualitative synthesis and meta-analysis. All the studies presented a medium risk of bias. The results showed no significant difference in bond strength between the ZLS and LD groups (P = 0.94, mean difference=0.08, and 95% confidence interval=-1.93 to 2.10). However, a significant difference was found in the subgroup analysis considering different types of aging treatments (P = 0.0008) and different types of bond strength tests (P < 0.00001). CONCLUSION: The bond strength of resin composites was found to be similar to that of ZLS and LD, but different aging treatments and bond strength tests exhibited varying effects on the bond strength.
Assuntos
Lítio , Cimentos de Resina , Cerâmica/química , Resinas Compostas , Porcelana Dentária/química , Análise do Estresse Dentário , Teste de Materiais , Silicatos , Propriedades de Superfície , Zircônio/químicaRESUMO
This in vitro study aimed to investigate the effect of quercetin pretreatment on the bond strength of bleached dentin. Human dentin blocks (2 × 2 × 1 mm) were prepared and randomly divided into 5 groups (n = 16): deionized water pretreatment + no bleaching treatment (DNB); deionized water pretreatment + bleaching treatment (DYB); 75 µg/mL quercetin pretreatment + bleaching (Q75B); 150 µg/mL quercetin pretreatment + bleaching (Q150B); and 300 µg/mL quercetin pretreatment + bleaching (Q300B). The surfaces of superficial dentin (bonding surfaces) were treated with the respective solutions for 2 min, and then the surfaces opposite to the bonding surfaces (near pulp, bleaching surfaces) were subjected to bleaching treatment with 40% hydrogen peroxide (Ultradent, USA) for two 15-min sessions (groups DYB, Q75B, Q150B, and Q300B). After the bleaching procedure, the bonding surfaces were bonded with resin cements (Panavia V5, Kuraray, Japan). The bonded specimens were then divided into 2 subgroups (n = 8): the aging group (subgroup T), which was subjected to 10,000 thermocycles, and the nonaging group (subgroup N), which was not subjected to thermocycling. The microshear bond strength (µSBS) was obtained using a universal testing machine (AGS-X, Shimadzu, Tokyo, Japan). Additional dentin blocks (5 × 5 × 1 mm) were prepared and treated the same as the groups DYB, Q75B, Q150B, and Q300B (n = 8) to evaluate the color change, defined as groups CCDYB, CCQ75B, CCQ150B, and CCQ300B, respectively. Color evaluation was performed using a spectrophotometer (Vita Easyshade Advance 4.0, Vident, USA) to obtain a baseline and again at the end of the bleaching treatment. The data were analyzed via two-way analysis of variance (ANOVA) and Tukey's post-hoc test (α = 0.05). For the immediate bond strength, the specimens in the groups Q75B, Q150B, and Q300B showed significantly higher µSBS values than those in the group DYB (all P < 0.05). No significant differences in the µSBS values were found among the groups Q75B, Q150B, Q300B, and DNB, respectively (all P > 0.05). For the aged bond strength, both the groups Q150B and Q300B exhibited significantly higher µSBS values than groups DYB and DNB (all P < 0.05), whereas no significance differences were found between groups Q150B and Q300B (P = 1.00) or between the groups DYB and DNB (P = 1.00). No significant differences were observed in the â³E values among all the groups tested (P = 0.80). Therefore, the application of quercetin for 2 min prior to the bleaching procedure preserved the immediate bond strength and improved the aged bond strength of bleached dentin while maintaining the effectiveness of bleaching.
Assuntos
Colagem Dentária , Cimentos de Resina , Resinas Compostas/análise , Análise do Estresse Dentário , Dentina/química , Humanos , Peróxido de Hidrogênio , Quercetina/análise , Quercetina/farmacologia , Cimentos de Resina/análise , Resistência ao Cisalhamento , Água/farmacologiaRESUMO
OBJECTIVE: The aim of the present study was to evaluate the in situ/in vivo effect of quercetin on dentin erosion and abrasion. METHODS: Human dentin blocks (2 × 2 × 2 mm) were embedded and assigned to 6 groups: 75 µg/mL, 150 µg/mL and 300 µg/mL quercetin (Q75, Q150, Q300); 120 µg/mL chlorhexidine (CHX, positive control); and deionized water and ethanol (the negative controls). The specimens were treated with the respective solutions for 2 min and then subjected to in situ/in vivo erosive/abrasive challenge for 7 d as follows: in vivo erosion 4 times a day and then in vivo toothbrush abrasion after the first and last erosive challenges of each day. Dentin loss was assessed by profilometry. An additional dentin specimen was used to evaluate the penetration depth of quercetin into dentin by tracking the spatial distribution of its characteristic Raman peak. Moreover, dentin blocks (7 × 1.7 × 0.7 mm) were used to detect the impact of quercetin on dentin-derived matrix metalloproteinase (MMP) inhibition by in situ zymography, and the inhibition percentage (%) was calculated. Additionally, the potential collagen crosslinking interactions with quercetin were detected by Raman spectroscopy, and the crosslinking degree was determined with a ninhydrin assay. Fully demineralized dentin beams (0.5 × 0.5 × 10 mm) were used to evaluate the impact of quercetin on the mechanical properties of dentin collagen fibre by the ultimate micro-tensile strength test (µUTS). The data were analysed by one-way analysis of variance and Tukey's test (α = 0.05). RESULTS: Compared to the negative controls, all treatment solutions significantly reduced dentin loss. The dentin loss of Q150 and Q300 was significantly less than that of CHX (all P < 0.05). The amount of quercetin decreased with increasing dentin depth, and the maximum penetration depth was approximately 25-30 µm. In situ zymography showed that quercetin significantly inhibited the activities of dentin-derived MMPs. The inhibitory percentages of Q75 and Q150 were significantly lower than that of CHX (all P < 0.05), but no significant difference was found between Q300 and CHX (P = 0.58). The collagen crosslinking interactions with quercetin primarily involved hydrogen bonding and the degree of crosslinking increased in a concentration-dependent manner. Statistically significant increases in µUTS values were observed for demineralized dentin beams after quercetin treatment compared with those of the control treatments (all P < 0.05). SIGNIFICANCE: This study provides the first direct evidence that quercetin could penetrate approximately 25-30 µm into dentin and further prevent dentin erosion and abrasion by inhibiting dentin-derived MMP activity as well as crosslinking collagen of the demineralized organic matrix.
Assuntos
Inibidores de Metaloproteinases de Matriz , Erosão Dentária , Humanos , Inibidores de Metaloproteinases de Matriz/farmacologia , Erosão Dentária/prevenção & controle , Quercetina/farmacologia , Dentina , Metaloproteinases da Matriz , ColágenoRESUMO
OBJECTIVE: The aim of the present study was to evaluate the effect of quercetin on the acid resistance of human dentin through both laboratory and clinical studies. METHODS: Two hundred and twelve dentin blocks (2 mm × 2 mm × 2 mm) were prepared and used. For the laboratory study, dentin specimens were randomly divided into 8 groups (n = 12): deionized water, ethanol, 1.23 × 104 µg/ml sodium fluoride (NaF), 120 µg/ml chlorhexidine, 183.2 µg/ml epigallocatechin gallate (EGCG), and 75 µg/ml, 150 µg/ml, and 300 µg/ml quercetin (Q75, Q150, and Q300). The specimens were treated with the respective solutions for 2 min and then subjected to in vitro erosion (4 cycles/d for 7 d). The surface microhardness loss (%SMHl), erosive dentin wear, and surface morphology were evaluated and compared. For the impact on MMP inhibition, the release of crosslinked carboxyterminal telopeptide of type I collagen (ICTP) and the thickness of the demineralized organic matrix (DOM) were measured using additional dentin specimens. For the clinical study, the specimens were treated with NaF or Q300 for 2 min and then subjected to in vivo erosion (4 cycles/d for 7 d). The %SMHl and erosive dentin wear of the specimens were measured to determine whether quercetin similarly inhibits erosion in situ. RESULTS: The quercetin-treated group had a significantly lower %SMHl and erosive dentin wear than any other group, and the effect was concentration-dependent in vitro (P < 0.05). Dentin treated with quercetin produced significantly less ICTP and had a thicker DOM than the control dentin (P < 0.05). After in vivo erosion, the %SMHl and erosive dentin wear of the Q300 group were significantly lower than those of the control group (P < 0.05). SIGNIFICANCE: The application of quercetin was shown, for the first time, to increase the acid resistance of human dentin, possibly through MMP inhibition and DOM preservation.
Assuntos
Erosão Dentária , Dentina , Fluoretos , Humanos , Laboratórios , QuercetinaRESUMO
OBJECTIVES: To evaluate the short-term effects of stain-causing beverages on the effectiveness of in-office tooth bleaching. METHODS: Participants were recruited and randomly divided into 3 groups based on beverages used for rinsing during and after the bleaching procedure: group N (tap water, control group), group C (coffee), and group T (tea). Participants were instructed to rinse with the respective solutions for 30â¯s, 4 times daily for 4 weeks. All participants received two in-office bleaching treatment sessions with 40 % hydrogen peroxide (Opalescence BOOST PF 40 %, Ultradent); the sessions were separated by a 1-week interval. Tooth colour was assessed using a spectrophotometer (Easyshade, Vita ZahnFabrik) before the bleaching procedure (T0), immediately after the first session of bleaching (T1), immediately after the second session of bleaching (T2), as well as one week (T3) and three weeks after (T4) the end of bleaching. Tooth sensitivity (TS) was ranked using a numerical rating scale (NRS) and a visual analogue scale (VAS) at different time points. RESULTS: No significant difference in the whiteness index (W), â³E, â³a* and â³b* values among the 3 groups was observed at any time interval (P for all > 0.05). At T4, the â³L* value in group C was significantly lower than that in groups T and N (Pâ¯=â¯0.022 and Pâ¯=â¯0.001, respectively), though no significant difference in â³L* values was observed among the 3 groups at T1 (Pâ¯=â¯0.402), T2 (Pâ¯=â¯0.643) and T3 (Pâ¯=â¯0.177). Additionally, no significant difference was found in the TS values among the 3 groups at any of the evaluation time points (P for all > 0.05). CONCLUSIONS: Exposure to coffee or tea during the bleaching treatment period did not affect the effectiveness of the treatment. However, exposure to coffee after the bleaching treatment did affect the effectiveness of the treatment. Exposure to stain-causing beverages did not affect the bleaching-induced TS (ClinicalTrials.gov Identifier: NCT03933527). CLINICAL SIGNIFICANCE: The consumption of coffee or tea during tooth bleaching may not interfere with the colour change produced by the treatment. However, clinicians should advise their patients to refrain from, at least to some extent, consuming coffee after the bleaching procedure to maintain the effectiveness of the treatment.