Effect of Phytic Acid Etching and Airborne-Particle Abrasion Treatment on the Resin Bond Strength.

Objective: This study aimed to evaluate the bond strength of a universal adhesive to dentin (µTBS) using different time periods of airborne particle abrasion (APA) and two types of acid etching. Methods: Seventy-two human third molars were divided into 9 groups (n=8) according to dentin pretreatment: APA duration (0, 5, or 10s) and acid etching (no acid - NA, 37% phosphoric acid - PhoA, or 1% phytic acid - PhyA). APA was performed at a 0.5 cm distance and air pressure of 60 psi using 50 µm aluminum oxide particles. Afterwards, two coats of Single Bond Universal adhesive (3M) were applied to the dentin surface. Composite blocks were built using the incremental technique, sectioned into 1×1 mm slices and subjected to microtensile bond strength (µTBS) testing. Fracture patterns and surface topography of each dentinal pretreatment were evaluated using a Scanning electron microscope (SEM). Bond strength data were analyzed using two-way ANOVA and Bonferroni post-hoc tests. Results: The group that received pretreatment with 5s APA and PhoA presented higher µTBS values among all groups, which was statistically different when compared with the PhoA, 10APA+PhoA, and 5APA+PhyA groups. PhyA did not significantly influence the bond strength of the air-abraded groups. Finally, adhesive failure was considered the predominant failure in all groups. Conclusion: Dentin pretreated by airborne particle abrasion using aluminum oxide demonstrated an increase in bond strength when abraded for 5 seconds and conditioned with phosphoric acid in a universal adhesive system.

Remineralizing effect of the association of nano-hydroxyapatite and fluoride in the treatment of initial lesions of the enamel: A systematic review.

OBJECTIVE: Assessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ. METHODS: Seven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies' methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study. RESULTS: The included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings. CONCLUSION: Even with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found. CLINICAL SIGNIFICANCE: Due to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.

Effects of the Incorporation of Bioactive Particles on Physical Properties, Bioactivity and Penetration of Resin Enamel Infiltrant.

Purpose: The resinous infiltrant lacks remineralizing activity. This research aimed to develop and evaluate bioactivity, physico-mechanical properties and penetration of resin infiltrants containing Biosilicate or nanohydroxyapatite. Methods: Experimental resin infiltrant (ERI; 75/25 wt.% TEGDMA/BisEMA) was divided among the groups Pure Experimental (PE); ERI + Biosilicate 5 or 10% (Bio5; Bio10), ERI + 10% nanohydroxyapatite (Hap10), and Icon (DMG, Germany). Bioactivity was analyzed by SEM, EDS and FT-IR/ATR after soaking in SBF. Degree of conversion (DC), sorption and solubility (SO; SOL), flexural strength, modulus of elasticity (FS; E-modulus), contact angle (CA) and penetration were characterized. Extent of penetration was analyzed by treating white spot lesions (WSL) in human dental enamel samples with the infiltrants and subsequently analyzing specimens by confocal laser scanning microscopy. Data from each test were submitted to ANOVA and Tukey's tests (p < 0.01). Results: SEM, EDS and FT-IR showed the formation of precipitates and increase in the rates of Ca and P in the groups with bioactive particles, after storage in SBF. Hap10 showed higher DC and CA values than all the other groups. Groups Bio5 and Bio10 showed CA values similar to those of Icon, higher SO and SOL values, and reduction in other properties. All infiltrants were capable of penetrating into the WSLs. Conclusion: The incorporation of Biosilicate (5 or 10%) or nanohydroxyapatite (10%) into ERI induced mineral deposition on the surface and did not compromise infiltration and penetration into WSLs, however, compromising their physico-mechanical properties.

Effect of Different Bleaching Gels Thickeners on Cytotoxicity to Human Gingival Fibroblasts and Enamel Physical Properties: an in Situ Study.

Objective: This study evaluated in vitro, the effects of carbamide peroxide 10% (CP) associated with Carbopol® (CP-ct) and Aristoflex® (CP-at) thickeners on human gingival fibroblasts (HGF) cytotoxicity and assessed in situ their effects on dental enamel. Material and methods: The cytotoxicity was analyzed using MTT - Vybrant® proliferation test. For in situ stage, 144 bovine enamel/dentin blocks were randomized into seven groups (n=12). Samples were stained, fixed in intraoral palatal devices and bleached for 4 h, during 14 days, with: Carbopol thickener (ct), Aristoflex thickener (at), CP-ct, CP-at, CP without thickener (CP-wot), Commercial CP (CP-com). The samples had their microhardness (SMH), roughness (Ra) and color analyzed using a microdurometer, a rugosimeter and a spectrophotometer, respectively. The analyses were performed at baseline and 24-h after completion of tooth bleaching. Results: Different thickeners were similar regarding their cytotoxicity. The experimental gels with Carbopol exhibited lower SMH values, while the groups treated with CP exhibited higher Ra values. For the color change results, the groups treated with CP had values above the acceptability and perceptibility limits. Conclusion: CP-at was able to promote an effective bleaching with less alterations of the tooth surface compared to the CP-ct. Hence, Aristoflex stands as a promising thickener in conjunction with CP in order to preserve the physical properties of dental enamel after home bleaching.

Bioinspired catechol chemistry for dentin remineralization: A new approach for the treatment of dentin hypersensitivity.

OBJECTIVE: Dentin remineralization is of considerable clinical interest for dentin hypersensitivity and developing biomimetic analogs that can regulate hydroxyapatite (HAp) nucleation and growth remains a challenge. This study aimed to evaluate in vitro the potential for dentin remineralization using the following biomimetic in situ prepared poly(catechols): poly(dopamine), poly(DOPA), poly(caffeic acid) and a synthesized DOPA-peptide possessing collagen and calcium-binding domains (DOPA-Ahx-(Gly)3-(Glu)5). METHODS: Dentin samples were immersed in a freshly prepared phosphate-buffered saline (PBS) containing the respective catechol and laccase. After the reaction, they were immersed in calcium and phosphate remineralization solution, which was changed every day for 10 days. Samples of intact and demineralized dentin were used as control groups and kept in deionized water under the same experimental conditions. The remineralized dentin was characterized by scanning electron microscopy (SEM), Micro-energy dispersion X-ray fluorescence spectroscopy (µEDX) and X-ray diffraction (XRD). RESULTS: The application of different poly(catechols) and DOPA-peptide promoted crystal nucleation and the formation of HAp, which partially covered both the dentin surface and dentinal tubules walls. SIGNIFICANCE: By mimicking the role of charged non-collagenous proteins in vivo, polymers consisting of catechol groups showed the ability to modify demineralized dentin surface properties, promoting mineral formation. The use of poly(catechols) may be encouraged for the development of a therapeutic technique for dentin hypersensitivity.

Utilizing the optical properties of composite resins to improve esthetics: a layering technique for anterior restorations.

A comprehensive knowledge of the optical properties of composite resins is essential to achieving optimal results in direct anterior restorations. This case report describes an anterior composite resin restoration fabricated with a layering technique and explains how to use a simple photographic method to verify that the desired optical effects are reproduced. A Class IV restoration was completed on a maxillary central incisor with the help of a silicone guide. An esthetic result was achieved through careful color examination as well as material selections that were based on knowledge of the translucency, opacity, and fluorescence of the chosen direct composite resins. The approach of combining a composite resin designed for bleached teeth with highly opalescent and translucent resins as well as matching the natural dental anatomy provided excellent esthetic results. The suitable reproduction of optical characteristics was confirmed by increasing the contrast of the final photograph, which highlighted the translucency achieved in the area of the mamelons.

Shade changing effectiveness of plasdone and blue covarine-based whitening toothpaste on teeth stained with chlorhexidine and black tea.

OBJECTIVE: This study evaluated the effectiveness of toothbrushing with whitening toothpaste in altering the shade of stained human enamel. MATERIALS AND METHODS: Thirty fragments of human enamel, stained with chlorhexidine/black tea underwent 1000 and 5000 brushing cycles (BC) with (n = 10): PLS (Gel Dental Day, Bitufo), Close Up White Now, Unilever (COVB) and regular (Gel Dental Night, Bitufo) toothpaste. Images were taken before staining (baseline), after staining (STN) and following 1000 and 5000 BC and were analyzed using the CIELAB parameters (ΔE, Δb and ΔL). STATISTICAL ANALYSIS USED: Data were submitted to two-way ANOVA (α = 0.05). RESULTS: ΔE was higher from STN to baseline; 1000 BC to STN and 5000 BC to STN (P < 0.001). Significant differences in Δb values were found from 1000 BC to STN and 5000 BC to STN. For COVB, greater ΔL was observed from 1000 BC to STN, what differed statistically from the regular toothpaste (P < 0.05). There was no difference between toothpaste when ΔL was calculated from 5000 CB to STN. CONCLUSIONS: Toothpaste containing COVB or PLS in association with 5000 BCs showed similar effectiveness in changing enamel shade; but after the first 1000 toothbrushing cycles, the use of COVB toothpaste promoted higher lightness in stained enamel.

Influence of previous acid etching on interface morphology and bond strength of self-etching adhesive to cavosurface enamel.

OBJECTIVES: The aim of this study was to evaluate the (1) bond strength of a etch-and-rinse and self-etching adhesive systems to cavosurface enamel, (2) influence of the previous acid etching with phosphoric acid 35% to the self-etching adhesive application on bond strength values, and (3) analysis of the cavosurface enamel morphology submitted to different types of conditioning, with the use of a scanning electronic microscope (SEM). METHODS: Twenty four human third molars were sectioned on mesio-distal direction, resulting in two slices. The specimens were ground flat with 600-grit aluminum oxide papers, and were randomly divided into three groups: Group 1 (etch-and-rinse adhesive system (control group)), Group 2 (self-etching adhesive), and Group 3 (self-etching adhesive with previous 35% phosphoric acid-etching for 15 s). Four cylinders (0.75 mm of diameter, 1 mm height) were confectioned prior to the microshear test. Four samples for each group were prepared according the cavosurface enamel treatment and were analyzed in an SEM. RESULTS: Group 3 had the highest values on bond strength to cavosurface enamel compared to the other two groups, which presented statistically similar values. The performance of acid etching before the application of the self-etching adhesive results in an etching pattern that is different than the other groups, favoring the adhesion to the cavosurface enamel. CONCLUSIONS: Acid etching increases the bond strength values of the self-etching adhesive to cavosurface enamel, promoting a conditioning pattern that favors the adhesion to this substrate.