Restoration of teeth with customized CAD/CAM glass fiber posts: report of 2 cases.

This article presents 2 cases in which computer-aided design/computer-aided manufacturing (CAD/CAM) was used to fabricate glass fiber posts to restore an anterior tooth and a posterior tooth with severe coronal destruction. In the past decade, CAD/CAM technology has improved, allowing high-precision milling of customized glass fiber posts. This can enhance the biomechanical behavior of the restoration, as the post and core are milled in a single unit, decreasing the risk of failure near the core junction or in the body of the core. The customized post also provides better adaptation and requires a thinner layer of cement, thus minimizing voids. In case 1, the patient had a severely damaged maxillary right canine with a ferrule from a previous restoration. In case 2, the patient presented with a mandibular left first molar exhibiting severe coronal destruction. In both cases, impressions of the root canal were scanned with a bench scanner, and the posts were fabricated using a glass fiber material designed for CAD/CAM technology. A self-adhesive resin cement was used to cement the posts in the root canals, and a metal-free crown (case 1) and overlay (case 2) were fabricated and placed. Satisfactory retention and esthetics were achieved, and both patients was pleased by the final results. These cases demonstrate the viability of CAD/CAM to restore endodontically treated teeth, and this technology can be an option for dentists interested in using a digital workflow. The longevity of the posts produced via this technique needs to be evaluated in clinical trials.

In vitro effects of hydrogen peroxide combined with different activators for the in-office bleaching technique on enamel.

OBJECTIVE: The aim of this study was to evaluate the alteration of human enamel bleached with high concentrations of hydrogen peroxide associated with different activators. MATERIALS AND METHODS: Fifty enamel/dentin blocks (4 × 4 mm) were obtained from human third molars and randomized divided according to the bleaching procedure (n = 10): G1 = 35% hydrogen peroxide (HP - Whiteness HP Maxx); G2 = HP + Halogen lamp (HL); G3 = HP + 7% sodium bicarbonate (SB); G4 = HP + 20% sodium hydroxide (SH); and G5 = 38% hydrogen peroxide (OXB - Opalescence Xtra Boost). The bleaching treatments were performed in three sessions with a 7-day interval between them. The enamel content, before (baseline) and after bleaching, was determined using an FT-Raman spectrometer and was based on the concentration of phosphate, carbonate, and organic matrix. Statistical analysis was performed using two-way ANOVA for repeated measures and Tukey's test. RESULTS: The results showed no significant differences between time of analysis (p = 0.5175) for most treatments and peak areas analyzed; and among bleaching treatments (p = 0.4184). The comparisons during and after bleaching revealed a significant difference in the HP group for the peak areas of carbonate and organic matrix, and for the organic matrix in OXB and HP+SH groups. Tukey's analysis determined that the difference, peak areas, and the interaction among treatment, time and peak was statistically significant (p < 0.05). CONCLUSION: The association of activators with hydrogen peroxide was effective in the alteration of enamel, mainly with regards to the organic matrix.

Influence of the combined effect of desensitizing dentifrices and universal adhesives on dentin bond strength under erosive conditions.

OBJECTIVE: This study aimed to evaluate whether the use of desensitizing dentifrices containing obliterating agents can affect bond strength of eroded/abraded dentin. METHODOLOGY: A total of 100 dentin samples were obtained from human molars. The teeth were cut into 3 mm-thickness discs and allocated in five groups (n=20), according to the toothpaste used: WoF - abrasion with fluoride-free toothpaste (Cocoricó); Arg - toothpaste containing arginine (Colgate Sensitive Pro-Relief); Nov - calcium sodium phosphosilicate toothpaste (Sensodyne Repair and Protect); SnF - fluoride-containing toothpaste (AmF/SnCl2/SnF2 - Elmex Erosion); and Control (no erosive/abrasive process). The erosive/abrasive cycle consisted of immersion in citric acid (1%, pH 2.6, 5 min, 4×/day) and abrasion (2×/day, 120-20 sec abrasion, 100 sec immersion) with each toothpaste. During intervals, samples were immersed in artificial saliva. This cycle was performed for five days. Two resin cylinders (2 mm in diameter) were constructed on each sample for the shear bond strength test using a universal adhesive system. The self-etch and etch-and-rinse (Scotchbond Universal) strategies were employed, each in half of the total sample (n=10). Bond strength (MPa) was measured in a shear test and failure modes were assessed with a stereomicroscope. Statistical analysis was performed using the two-way analysis of variance (ANOVA) and Tukey tests (p<0.05). RESULTS: A statistically significant difference was found between the adhesive strategies tested (p<0.001), with the self-etching form showing higher values than the etch-and-rinse. Moreover, no significant differences were observed between the tested toothpastes (p=0.750) and interactions (p=0.438). CONCLUSION: The use of toothpaste containing obliterating agents does not affect bond strength to dentin subjected to erosive/abrasive conditions when a universal adhesive is used. However, the self-etch strategy might be preferred for eroded/abraded dentin.

Physical analysis of an acrylic resin modified by metal and ceramic nanoparticles.

BACKGROUND: Nanoparticles (NPs) have gained significant attention in various fields due to their unique properties and potential applications. Polymethyl methacrylate (PMMA) is an acrylic resin widely used in dentistry and medicine. However, the effect of different types of NP fillers on the physical properties of PMMA-based resins has not been thoroughly explored in the literature. OBJECTIVES: The present study aimed to evaluate the effects of 3 different types of NP fillers on the physical properties of an experimental PMMA-based resin as a function of the NP content and concentration. MATERIAL AND METHODS: Ten groups (n = 10) were designed. The specimens were composed of an acrylic resin, silicon dioxide (SiO2), cerium dioxide (CeO2), and titanium dioxide (TiO2) at the following ratios (wt%): group 1 (G1) - control; group 2 (G2) - 0.5% SiO2; group 3 (G3) - 1% SiO2; group 4 (G4) - 3% SiO2; group 5 (G5) - 0.5% CeO2; group 6 (G6) - 1% CeO2; group 7 (G7) - 3% CeO2; group 8 (G8) - 0.5% TiO2; group 9 (G9) - 1% TiO2; and group 10 (G10) - 3% TiO2. Transmission electron microscopy (TEM) was used to assess the quality of NP dispersion. Thermal stability was assessed with thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The effects of the abovementioned NPs on the properties of the resin were evaluated using the Archimedes principle for density, the Vickers hardness (VH) test and the impact strength (IS) test. Data analysis employed the oneand two-way analysis of variance (ANOVA), followed by Duncan's post hoc test at a significance level of 0.05. RESULTS: Transmission electron microscopy showed partial NP dispersion. All types of NPs enhanced the mechanical properties of the acrylic resin except for IS, which was similar to that of the control group. Among the types of NPs, irrespective of the weight percentage, CeO2 showed higher thermal stability and higher IS for 0.5 wt% and 1 wt% as compared to other groups, as well as the highest values of density at 0.5 wt%, 1 wt% and 3 wt%. Titanium oxide at 1 wt% presented a higher VH as compared to other groups. The fracture pattern was the same for all groups. CONCLUSIONS: Incorporating the tested NPs into the acrylic resin resulted in enhanced physical properties, primarily attributed to a lower NP content.

Secondary caries inhibition promoted by adhesive systems and bleaching agents with fluoride.

PURPOSE: To evaluate the initial caries development at adhesive/enamel interface after 10% carbamide peroxide bleaching (CP) with or without fluoride (F) under dynamic pH-cycling. METHODS: Standard cavities were prepared on the bucal surface of 60 bovine incisors, which were restored with two fluoride-containing adhesives: Optibond FL (FL) and Optibond Solo Plus (SP). The restored teeth were submitted to thermal cycling process in order to age the adhesive/enamel interface. Both SP and FL adhesive-restored teeth were divided into groups (n= 10) and bleached with 10% CP (CP) and 10% CP + F (CPF) or remained unbleached (Control). Bleaching was performed for 14 days simultaneously with pH-cycling. The specimens were prepared for cross-section microhardness evaluation and polarized light microscopy analysis to evaluate caries lesions at different depths around the bonded interface. RESULTS: Group FL (not bleached) presented the lowest mineral loss rate among groups, but secondary caries formation was observed for all groups around the bonded interface. An inhibition zone was observed for all groups, with caries lesion detected at 5 microm from the cavity wall.

Influence of saliva contamination on the shear bond strength of orthodontic brackets bonded with self-etching adhesive systems.

INTRODUCTION: Our objective was to evaluate the influence of saliva contamination on the shear bond strength of orthodontic brackets bonded with self-etching primers. METHODS: One hundred thirty-five bovine incisors were randomly divided into 3 groups, and exposed enamel surfaces were bonded with Transbond Plus Self Etching Primer (TB) (3M Unitek, Monrovia, Calif), Adhese Single Bottle (AD) (Ivoclar, Vivadent, Schaan, Liechtenstein), and Self Etch Bond (SE) (Vigodent, Rio de Janeiro, Brazil). Each group was subdivided into 3 treatments (n = 15): saliva contamination (S), saliva contamination and deionized water rinsing (SW), and no salivary contamination (C). Resin composite (Z-100, 3M/ESPE, Salt Lake City, Utah) was applied to all samples to bond the orthodontic brackets. Shear bond strength testing was carried out in a universal testing machine operating at 1.0 mm per minute. RESULTS: The results were statistically analyzed with 2-way analysis of variance (ANOVA) and Tukey tests (P <0.05). Saliva contamination caused a significant decrease of enamel strength in the groups bonded with TB and SE compared with the SW and C groups. Enamel bond strengths of the C and SW groups were higher than those of the TB group, followed by the AD and SE groups. Enamel bond strength after S was higher than AD, followed by TB and SE. CONCLUSIONS: The shear bond strengths of orthodontic brackets to enamel and the performance of the adhesive systems were influenced by contamination with saliva.

Evaluation of surface roughness of microhybrid and nanofilled composites after pH-cycling and simulated toothbrushing.

AIM: This study evaluated the surface roughness patterns of two resin-based composite restorative materials, a microhybrid (Filtek Z250, 3M ESPE) and a nanofilled (Filtek Supreme, 3M ESPE), subjected to a regimen that simulated dynamic pH-cycling and toothbrushing. METHODS AND MATERIALS: Twelve standardized cylindrical specimens of each resin-based composite material were prepared, finished, and mechanically polished. The experimental units were submitted to a pH-cycling regimen followed by 50,000 toothbrushing cycles, after which the surface roughness was measured using an atomic force microscope (AFM). AFM surface roughness was evaluated at three intervals: (1) immediately after specimen preparation (baseline), (2) after pH-cycling, and (3) after simulated toothbrushing. The results were then analyzed using a split-plot design and followed by linear regression and a Tukey's test at a significance level of p<0.05. RESULTS: The results obtained indicated that simulated toothbrushing provoked a remarkable increase in surface roughness for both types of composite resins tested (p=0.0031). However, pH-cycling did not alter the surface of the composite under the conditions of this experiment. CONCLUSION: Based on the results obtained, it was concluded that simulated toothbrushing was capable of increasing the surface roughness of the microhybrid (Filtek Z250) and the nanofilled (Filtek Supreme) composites tested. CLINICAL SIGNIFICANCE: Surface roughness of nanofilled and microhybrid composites is significantly increased after toothbrushing, although pH-cycling, as tested in this study, does not appear to affect the morphology of either composite material.

Influence of Erosion/Abrasion and the Dentifrice Abrasiveness Concomitant with Bleaching Procedures.

PURPOSE: The aim of this study was to evaluate the effect of erosive/abrasive cycles and two different levels of abrasiveness of dentifrices over enamel and dentin subjected to bleaching. METHODS: Enamel and dentin bovine specimens were prepared and submitted to an at-home bleaching treatment using 9.5% hydrogen peroxide gel, which was applied daily (30 min/14 days). Concomitant with bleaching, an erosive cycle was performed using citric acid (0.3%, pH 3.8, 5 mins, 3×/day), followed by immersions in artificial saliva for remineralization (30 mins). Abrasion was done with two (high and low abrasiveness) dentifrices (2×/day, 120 seconds) after the first and third erosive immersion each day. Enamel and dentin softening were assessed by microhardness and erosive tooth wear by optical profilometry. Data were submitted to repeated measures ANOVA, followed by the Tukey's test with a significance level of 5%. RESULTS: For the enamel and considering the erosive-abrasive cycle, significant differences were found between the groups tested, the bleaching, and the abrasiveness of the dentifrice tested; however, the final microhardness values were significantly lower than the initial ones. For dentin, differences were found between the eroded/abrasion and the non-eroded/abrasion groups, with the former presenting lower microhardness values compared with the latter. In addition, bleaching decreased the microhardness values only for the highly abrasive dentifrice, and the final values were lower than for the initial ones for all tested groups. CONCLUSION: The use of high and low abrasiveness dentifrices during bleaching and concomitant with erosion/abrasion cycles is more harmful to dentin than to enamel. CLINICAL RELEVANCE: Although bleaching is considered a conservative treatment, it can cause deleterious effects to dental hard tissue. The association of an at-home bleaching technique with erosion and high- or low- abrasive dentifrices harms dentin more than enamel.

Mechanical performance of experimental acrylic resins modified by nanoparticles after chemical and mechanical degradation.

BACKGROUND: Different materials have been incorporated into the polymethylmethacrylate matrix to improve its performance. The aim of this study was to evaluate the degree of conversion (DC), the flexural strength (FS), the elasticity modulus (EM), and the effect of exposure to food-simulating liquids prior to brushing simulation on the gloss loss (GL) of experimental acrylic resins modified by nanoparticles. MATERIAL AND METHODS: Three different types of nanoparticles; silicon oxide (SiO2), cerium oxide (CeO2) and titanium oxide (TiO2) were added to a poly (methylmethacrylate) matrix, in proportions of 0.5wt%, 1wt% and 3wt% each, forming nine experimental groups. The acrylic resin was also tested as a control group. DC was investigated using Fourier transform infrared spectroscopy (FTIR). A three-point bending test was used for FS and EM. GL after chemical degradation and simulated brushing was evaluated using a glossmeter. Data were submitted to one and two-way ANOVA followed by Duncan's post hoc test (α=0.05). RESULTS: All nanoparticle-modified groups showed higher values of DC. Ce1% showed higher values of FS and EM. All other groups showed similar or lower physical-mechanical properties (FS, EM, GL). Regarding type and wt%, CeO2 and TiO2 groups had better performances and were similar to each other. CONCLUSIONS: Incorporating metal nanoparticles, especially CeO2, could improve the physical properties of the dental materials. Key words:Polymethylmetacrylate, degree of conversion, flexural strength, elasticity modulus, gloss loss.

Effect of bleaching agents on hardness, surface roughness and color parameters of dental enamel.

BACKGROUND: In this study was evaluated the effect of carbamide peroxide (CP) and hydrogen peroxide (HP) in different concentrations on hardness, roughness, and color parameters (color change - ΔE, lightness - ΔL, and yellow-blue axis - Δb) of bovine teeth. MATERIAL AND METHODS: Fifty square dental blocks (7 x 7 x 2 mm) were submitted to initial readings of Knoop hardness, surface roughness (Ra), and color parameters. Specimens were divided into 5 groups (n = 10): control group was kept in artificial saliva during the experimental period; CP 20% was bleached for 2 h daily for 14 days, HP 9.5% was bleached for 30 min daily for 14 days, HP 38% the bleaching gel was applied for 15 min, gel was removed and it was reapplied for two more times, the bleaching session was repeated for another 2 times every 7 days, totaling three sessions, and in CP 45% three sessions of 30 min each were performed of 7 in 7 days. All groups after the bleaching procedures had the bleaching gel removed, washed, and kept in artificial saliva. At the end of bleaching treatment, the hardness, roughness, and color parameters (ΔE, ΔL, and Δb) were re-evaluated. Data were analyzed by ANOVA, Tukey, and Dunnett tests (α = 0.05). RESULTS: Bleaching promoted a reduction in hardness, the CP 45% showed the lowest hardness and the CP 20% the highest, the HP 9.5% and HP 38% showed intermediate values of hardness. Bleaching agents did not affect the roughness. CP 20% and HP 38% promoted the highest values of ΔE and higher reduction of yellowish tone of tooth. Lightness increase after bleaching treatment for all groups. CONCLUSIONS: All the bleaching agents tested showed effectiveness, but with reduced hardness. Key words:Carbamide peroxide, hydrogen peroxide, tooth whitening, hardness, roughness.

The effect of coffee solution on tooth color during home bleaching applications.

PURPOSE: To quantify the change in color of human and bovine teeth exposed to a coffee solution during a 16% carbamide peroxide (16% CP) home application bleaching treatment using photoreflectance analysis. METHODS: 40 enamel slabs (4 x 4 x 2 mm) were obtained from seven unerupted third human molars and seven bovine incisors, which were allocated into four groups: G1: human control group whitened and not exposed to a coffee solution; G2: bovine control group whitened and not exposed to a coffee solution; G3: human teeth whitened and exposed to a coffee solution; G4: bovine teeth whitened and exposed to a coffee solution. The home bleaching procedure was performed using 16% CP gel applied in a 1 mm-thick layer on the tooth surface over a period of 6 hours per day, for 28 days. Tooth color was evaluated using photoreflectance analysis throughout the bleaching procedure at intervals of 7, 14, 21 and 28 days, and posttreatment at 7, 15 and 30 days. Results were statistically analyzed using ANOVA and Tukey-Kramer tests. RESULTS: After 28 days of bleaching treatment, no significant difference was detected between photoreflectance analysis of specimens exposed to coffee solution and specimens not exposed to coffee solution (P < 0.05). However, when the teeth were exposed to a coffee solution during home bleaching treatment, the whitening effect was observed to be less stable (P < 0.05). Bovine and human enamel substrates behaved similarly in terms of staining and bleaching effects, although they presented inherent differences in color (P < 0.05).

In vitro evaluation of the effectiveness of bleaching agents activated by different light sources.

PURPOSE: This study evaluated the efficacy of tooth whitening and color stability at different time periods after treatment. MATERIALS AND METHODS: Blocks obtained from human molars were divided into 15 groups (n = 5) by bleaching agents: 35% hydrogen peroxide (Whiteness HP and Opalescence Xtra) and 37% carbamide peroxide (Whiteness Super); and light sources: halogen lamp and plasma arc lamp (bleach mode), LED/diode laser, argon laser, and no light source. The efficacy of bleaching was measured using a spectrophotometer. Six bleaching sessions were performed (times 1 to 6). The specimens were submitted to another reading 7, 15, and 30 days after the end of bleaching (times 7, 8, and 9). The results were submitted to ANOVA followed by Tukey test and polynomial regression (p < 0.05). RESULTS: Carbamide peroxide significantly differed from hydrogen peroxide, presenting low reflectance values. Activated versus non-activated bleaching did not differ significantly for any gel tested, except for Whiteness HP activated by argon laser, which presented the lowest mean reflectance values. The results obtained with hydrogen peroxide revealed a decrease in reflectance values one month after the end of treatment. For carbamide peroxide, this decrease was not observed. CONCLUSION: The halogen lamp presented the same or higher efficacy than non-activated bleaching, which had a longer gel contact period. When hydrogen peroxide was used, a decrease in reflectance values was observed 30 days after the end of bleaching.

Chemical composition and roughness of enamel and composite after bleaching, acidic beverages and toothbrushing.

BACKGROUND: In this study was assessed the surface roughness and chemical composition of tooth enamel and composite resin after bleaching treatment, immersion in acidic beverages, and simulated toothbrushing. MATERIAL AND METHODS: One hundred and twenty dental blocks (10 x 10 x 3 mm) were randomly assigned (n = 10) according to surface treatment [none (N), bleaching (B), toothbrushing (T), and B+T] and storage medium [saliva (S), whiskey (W), and orange juice (O)]: experimental groups - N+S, N+W, N+O, B+S, B+W, B+O, S+T, W+T, O+T, B+S+T, B+W+T, and B+O+T. Two bleaching sessions were conducted using 38% hydrogen peroxide (3 applications). Surface roughness was measured using a roughness tester and composition was determined by micro energy-dispersive X-ray fluorescence spectrometry (µ-EDXRF) before and after treatments. Calcium/phosphorus (Ca/P) ratio in enamel and silica (Si) content in composite were evaluated. Data were statistically analyzed by ANOVA and Tukey's test (α = 0.05). RESULTS: Overall, increased values of surface roughness for enamel and composite were observed mainly after immersion in orange juice and bleaching/toothbrushing association. Moreover, this association and immersion in whiskey resulted in lower Ca/P ratio and after aging methods, bleached and bleached/toothbrushed groups showed decreased in Ca/P ratio compared to initial values. All groups showed Si content decrease at the end, except the group without surface treatment and immersed in saliva, and bleaching followed by immersion in orange juice and toothbrushing caused the highest Si reduction. CONCLUSIONS: Bleaching and toothbrushing combination strengthened the effects caused by acidic drinks on roughness and chemical composition of enamel and composite. Key words:Tooth bleaching, toothbrushing, physical properties, chemical properties.

Bonding performance of universal adhesives with concomitant use of silanes to CAD/CAM blocks / Associação de adesivos universais com silanos na adesão em blocos de CAD/CAM

ABSTRACT Objective: This study assessed whether the use of a silane coupling agent influence the bond strength of two universal adhesives to ceramic or resin CAD/CAM blocks. Methods: Forty-eight samples were obtained from each resin nano-ceramic hybrid block (RCBs) and lithium disilicate ceramic blocks (LD). Samples were treated with silane with MDP (Monobond - S-MDP), silane without MDP (Prosil - PS), and no silane application (Control - Ctr) followed by universal adhesive with silane (UAS) and without silane (UA) (n=8). Three polyurethane tubes (1.5 mm of internal diameter) were positioned in each sample treated surface and filled with a dual cured resin cement. Bond strength was assessed by microshear bond strength test and failure analysis was performed for all samples. Results: For the RCBs, UAS presented the highest bond strength values (p=0.004). Silane application was not significant in bond strength values (p=0.444). For LD, silane application was significant in bond strength values (p<0.001), but the adhesive was not (p=0.066). Failure analysis showed high prevalence of adhesive failures for both substrates. Conclusion: A silane-containing universal adhesive promoted the best bond strength results to the resin nano-ceramic hybrid block. For bonding to a glass-ceramic CAD/CAM material, additional silane (without MDP) application presented the best results.

RESUMO Objetivo: Este estudo avaliou se o uso de um agente de união silano influencia na resistência de união de dois adesivos universais a blocos CAD/CAM cerâmicos ou resinosos. Métodos: Quarenta e oito amostras foram obtidas de blocos resinosos (RCBs) e cerâmicos de dissilicato de lítio (LD). As amostras foram tratadas com silano contendo: MDP (Monobond - S-MDP), silano sem MDP (Prosil - PS) ou sem aplicação de silano (Control - Ctr) seguido de adesivo universal com silano (UAS) ou sem silano (UA) (n=8). Três tubos de poliuretano (1,5 mm de diâmetro interno) foram posicionados em cada superfície tratada da amostra e preenchidos com um cimento resinoso dual. A resistência de união foi avaliada pelo teste de microcisalhamento e a análise de falha foi realizada para todas as amostras. Resultados: Para os RCBs, UAS apresentou os maiores valores de resistência de união (p=0,004). A aplicação de silano não foi significativa nos valores de resistência adesiva (p=0,444). Para LD, a aplicação de silano foi significativa nos valores de resistência de união (p<0,001), mas o adesivo não (p=0,066). A análise de falhas mostrou alta prevalência de falhas adesivas para ambos os substratos. Conclusão: O adesivo universal contendo silano promoveu os melhores valores de resistência adesiva ao bloco de resina. Para o bloco cerâmico, a aplicação adicional de silano (sem MDP) apresentou melhores resultados.

Influence of the combined effect of desensitizing dentifrices and universal adhesives on dentin bond strength under erosive conditions

Abstract Objective This study aimed to evaluate whether the use of desensitizing dentifrices containing obliterating agents can affect bond strength of eroded/abraded dentin. Methodology A total of 100 dentin samples were obtained from human molars. The teeth were cut into 3 mm-thickness discs and allocated in five groups (n=20), according to the toothpaste used: WoF - abrasion with fluoride-free toothpaste (Cocoricó); Arg - toothpaste containing arginine (Colgate Sensitive Pro-Relief); Nov - calcium sodium phosphosilicate toothpaste (Sensodyne Repair and Protect); SnF - fluoride-containing toothpaste (AmF/SnCl2/SnF2 - Elmex Erosion); and Control (no erosive/abrasive process). The erosive/abrasive cycle consisted of immersion in citric acid (1%, pH 2.6, 5 min, 4×/day) and abrasion (2×/day, 120-20 sec abrasion, 100 sec immersion) with each toothpaste. During intervals, samples were immersed in artificial saliva. This cycle was performed for five days. Two resin cylinders (2 mm in diameter) were constructed on each sample for the shear bond strength test using a universal adhesive system. The self-etch and etch-and-rinse (Scotchbond Universal) strategies were employed, each in half of the total sample (n=10). Bond strength (MPa) was measured in a shear test and failure modes were assessed with a stereomicroscope. Statistical analysis was performed using the two-way analysis of variance (ANOVA) and Tukey tests (p<0.05). Results A statistically significant difference was found between the adhesive strategies tested (p<0.001), with the self-etching form showing higher values than the etch-and-rinse. Moreover, no significant differences were observed between the tested toothpastes (p=0.750) and interactions (p=0.438). Conclusion The use of toothpaste containing obliterating agents does not affect bond strength to dentin subjected to erosive/abrasive conditions when a universal adhesive is used. However, the self-etch strategy might be preferred for eroded/abraded dentin.

Physicochemical changes in enamel submitted to pH cycling and bleaching treatment.

OBJECTIVE: The purpose of this study was to assess the hardness, mineral content, surface roughness, and micromorphology of sound and slightly demineralized enamels, before and after bleaching procedure using 10% carbamide peroxide. METHODS: Sixty bovine dental blocks were randomly divided into the following two groups: 30 slabs were submitted to three cycles of pH and 30 slabs were noncycled. Hardness (n=10) was measured using the microhardness tester with Knoop indenter under a 50 g load for 5 seconds. The calcium/phosphate (Ca/P) ratio (n=10) was obtained using a micro-energy-dispersive X-ray fluorescence (µ-EDXRF) spectrometer. The measurement of roughness average (n=10) was performed using a surface roughness tester. Specimens were bleached 6 hours/day during 21 days, and then, physicochemical properties were re-evaluated. Two additional specimens were carried out to evaluate surface micromorphology using the scanning electron microscopy. Data were statistically analyzed by ANOVA and Tukey's test (α=0.05). RESULTS: Sound and slightly demineralized enamels showed no difference in Ca/P ratio after dental bleaching according to the µ-EDXRF analysis, but the Ca/P ratio decreased after bleaching for slightly demineralized enamel. Bleaching treatment decreased the hardness and increased the surface roughness, causing micromorphology alterations. CONCLUSION: Therefore, bleaching procedure promoted change in bovine enamel surface and increased the demineralization of slightly demineralized enamel but not affected the mineral content of sound enamel.

Influence of coffee on reflectance and chemistry of resin composite protected by surface sealant.

PURPOSE: To assess the influence of the light-curing unit type and whether or not it was worth using surface sealant protection on resin composite restorative materials stained by coffee. Another objective was to propose the monitoring of coffee staining by FT-Raman spectroscopy using carbon-hydrogen (C-H) bonds as reference to the composite matrix degradation. METHODS: Sixty cylindrical specimens of resin composite were prepared and divided into six groups: HC (control)--cured with a halogen light; LC (control) cured with a LED; HF--cured with a halogen light + Fortify Plus; LF--cured with a LED + Fortify Plus; HP--cured with a halogen light + PermaSeal; LP--cured with a LED + PermaSeal. After storage for 24 hours at 37% and 100% of relative humidity, the top surface was protected, and the other surfaces isolated. Polishing with paper discs was performed after 24 hours of curing and prior to FT-Raman spectroscopy and reflectance measurements. All specimens were submitted to coffee staining for 14 days and evaluated by both systems. Results were statistically analyzed by ANOVA and Tukey tests. RESULTS: FT-Raman spectrum only showed significant changes in groups LC and LP (P< 0.05). Reflectance demonstrated that staining was present in all specimens protected by sealants. Sealant staining was larger in the HF (P < 0.001) group.

Analysis of photoreflectance and microhardness of the enamel in primary teeth submitted to different bleaching agents.

Treatment of darkened teeth in children is of great importance from an esthetic-functional point of view and for the psychoemotional development of the child. The objective of the present study was to determine the in vitro efficacy of three bleaching agents for whitening of artificially stained primary teeth. Fifty anterior primary teeth were artificially stained and then divided into three experimental groups (n = 15) submitted to bleaching treatment with 35% hydrogen peroxide gel, 35% carbamide peroxide gel, and 35% carbamide peroxide gel mixed with sodium perborate powder. The control group (n = 5) was not submitted to any bleaching treatment. Color changes were evaluated with a reflectance spectrophotometer and possible alterations in the enamel surface after bleaching were measured by Vickers microhardness testing. The data were assessed using the Student's t test. The results confirmed the bleaching action of the three agents tested. No significant difference in mean microhardness was observed between the three bleaching agents when compared to the control group.

Analyses by photoreflectance spectroscopy and Vickers hardness of conventional and laser-assisted tooth bleaching.

PURPOSE: To evaluate the in vitro effects of two bleaching products developed to be used with halogen or argon laser lights. METHODS: 20 human embedded third molars were cut into four parts resulting in 75 useful specimens. The specimens were divided at random into five groups and submitted to the traditional power bleaching procedure for enamel. Group C was separated as a control group. Group 37L was exposed to a 37% carbamide peroxide bleaching solution and exposed to 488 nm argon laser radiation. The same solution was used in Group 37H but the bleaching was exposed to a halogen lamp-based unit. The 35% carbamide peroxide was used in Groups 35L and 35H. One was treated as in Group 37L and the other as in Group 37H. The samples were analyzed for Vickers hardness and also by photoreflectance. RESULTS: Group 37L presented more white spectra than Group 37H. However, Groups 35L and 35H showed similar results. Comparing both bleaching products, the 35% carbamide peroxide was more effective as a bleaching agent than the 37% formulation. No significant difference in Vickers hardness was noted between the two bleaching products.

Effects of Bleaching Agents Combined with Regular and Whitening Toothpastes on Surface Roughness and Mineral Content of Enamel.

OBJECTIVE: The purpose of this study was to evaluate surface roughness and changes in the composition of enamel submitted to different bleaching protocols and toothbrushing with regular and whitening toothpastes. BACKGROUND DATA: Bleaching treatment could promote morphological and chemical changes in enamel surface. METHODS: Enamel blocks were randomized into nine groups (n=10) according to the bleaching treatment (no bleaching, control group; 6% hydrogen peroxide, HP; or 10% carbamide peroxide, CP) and toothpaste used (placebo, PL; regular, R; or whitening dentifrice, W). Bleaching was performed according to manufacturers' instructions and all groups were submitted to 30,000 cycles of simulated toothbrushing with toothpaste (PL, R, or W). Mineral content evaluation and enamel roughness were evaluated initially (T1), after bleaching (T2), and after toothbrushing (T3), using an energy-dispersive micro X-ray fluorescence spectrometer and profilometry, respectively. Data were statistically analyzed with two way ANOVA, Tukey, and Dunnett tests (5%). RESULTS: Enamel surface roughness was influenced by bleaching and toothbrushing. Surface roughness increased for the groups that brushed with the placebo dentifrice (CP+PL, HP+PL, C+PL) and for the control group that brushed with whitening dentifrice (C+W). Enamel Ca/P ratio decreased after bleaching, but toothbrushing, regardless of the dentifrice used, did not reduce the enamel mineral content. CONCLUSIONS: The bleaching treatment resulted in a decrease of enamel mineral content, but the studied dentifrices did not contribute to surface mineral loss.