Assessment of the effect of experimental bleaching agent with nano-bioactive material on postoperative sensitivity: A randomized, triple blind clinical trial.

OBJECTIVES: This clinical study aimed to evaluate the effect of incorporating bioactive nanoparticles (n-Bm) inside an in-office bleaching gel on the risk and intensity of tooth sensitivity (TS) and on bleaching effectiveness. MATERIALS AND METHODS: Sixty-six participants were selected and randomly assigned into two groups: control-only in-office gel and experimental-in-office gel with n-Bm. Teeth were bleached in two sessions (3 × 15-min). TS was recorded using a VAS and NRS. The color change was evaluated by subjective (VITA Classical and VITA Bleachedguide) and objective (Easyshade spectrophotometer) methods at baseline and 30 days after the end of treatment. The TS was evaluated by McNemar, Wilcoxon Signed Rank, and paired t test. The color changes between groups were compared using paired t test (α = 0.05). RESULTS: No significant differences between the groups were observed in the risk (control = 27% [95%IC 18-39]; experimental = 21% [95%IC 13-32]) and intensity of TS, as well as in the color change (p >0.05) for any color measurement. CONCLUSION: The inclusion of n-Bm into the bleaching agents did not affect the whitening effectiveness, as well as the risk and intensity of TS between groups. However, the results of the absolute risk of TS were low for both in-office gels used. CLINICAL SIGNIFICANCE: Despite no significant differences between groups, both experimental bleaching agents present suitable results with low values for TS.

Bulk Fill flow resin contraction using 3D finite element model and calibration by Fiber Bragg Grating measurement.

Contraction due to polymerization of dental resin can cause failure on the adhesive interfaces, can lead to problems such as the appearance of gaps in the interfaces, postoperative sensitivity, pulp damage and the return of the caries. The objective of this work is the study of stresses on the dental adhesive that are generated by the process shrinkage of resin associated with biting forces. A laboratory experiment measured the strains and temperature inside the FiltekTM Bulk Fill Flow resin during the process of polymerization using Fiber Bragg Grating sensors in an ex vivo tooth. From tomographic images a three-dimensional geometric model of the tooth was reconstructed. A pre-tension was calibrated to simulate the residual contraction on the resin 3 D model. Finally, an Finite Element Method analysis was performed to access the adhesive stresses at the interface enamel/dentin with the adhesive, considering as loading the residual polymerization contraction of the dental resin and also biting loads. The model was able to represented the strain obtained in the laboratory experiment. The results of the stress analysis shows that the outer regions of adhesive are more prone to failure, as veried by dental surgeons in clinical practice.

Effect of Conditioning Protocols and Ultrasonic Application of an Infiltrant Resin in White Spot Lesions.

The aim of this study was to evaluate different conditioning protocols and sonic/ultrasonic application of an infiltrant resin (IR) in artificial white spot lesions (AWSL). the V/L surfaces of 48 molars were induced to an AWSL and divided in 6 groups, according to the conditioning protocols and application technique: 15% hydrochloric acid (HA) + manual application of the IR; HA + 37% phosphoric acid (PA) + manual application of the IR; HA + ultrasonic application (U) of the IR; HA + sonic application (S) of the IR; PA+HA+S; and PA+HA+U. For the Penetration Depth (PD), the crowns were etched with HA for 120s. The IR Icon® (DMG) was applied according to the manufacturer`s instructions. The crowns were dye penetrated (0.1% red fluorophore rhodamine B isothiocyanate for 12h) and bleached with 30% hydrogen peroxide for 12 h. The discs were immersed in a 50% ethanol solution, containing 100 µM of sodium fluorescein. The PD (in µm) was measured using confocal laser scanning microscopy (20x). The bond strength (BS) was performed by michoshear test (0.5 mm/min). Data were submitted to 2-way ANOVA and Tukey (α=0.05). For BS, the interaction was not significant (p>0.05). For PD, the main factors were significant (application - p<0.001; conditioning technique - p=0.003). The ultrasonic application showed the highest PD values. PA+HA presented higher results than HA. The sonic/ultrasonic applications and the use of phosphoric acid prior to hydrochloric acid improved PD of the infiltrant resin. Conditioning protocols or application techniques did not influence BS values.

Effect of conditioning protocols and ultrasonic application of an infiltrant resin in white spot lesions

Abstract The aim of this study was to evaluate different conditioning protocols and sonic/ultrasonic application of an infiltrant resin (IR) in artificial white spot lesions (AWSL). the V/L surfaces of 48 molars were induced to an AWSL and divided in 6 groups, according to the conditioning protocols and application technique: 15% hydrochloric acid (HA) + manual application of the IR; HA + 37% phosphoric acid (PA) + manual application of the IR; HA + ultrasonic application (U) of the IR; HA + sonic application (S) of the IR; PA+HA+S; and PA+HA+U. For the Penetration Depth (PD), the crowns were etched with HA for 120s. The IR Icon® (DMG) was applied according to the manufacturer`s instructions. The crowns were dye penetrated (0.1% red fluorophore rhodamine B isothiocyanate for 12h) and bleached with 30% hydrogen peroxide for 12 h. The discs were immersed in a 50% ethanol solution, containing 100 µM of sodium fluorescein. The PD (in µm) was measured using confocal laser scanning microscopy (20x). The bond strength (BS) was performed by michoshear test (0.5 mm/min). Data were submitted to 2-way ANOVA and Tukey (α=0.05). For BS, the interaction was not significant (p>0.05). For PD, the main factors were significant (application - p<0.001; conditioning technique - p=0.003). The ultrasonic application showed the highest PD values. PA+HA presented higher results than HA. The sonic/ultrasonic applications and the use of phosphoric acid prior to hydrochloric acid improved PD of the infiltrant resin. Conditioning protocols or application techniques did not influence BS values.

Resumo: O objetivo deste estudo foi avaliar diferentes protocolos de condicionamento e a aplicação sônica/ultrassônica de uma resina infiltrante (RI) em lesões de mancha branca produzidas artificialmente (LMBA). As superfícies vestibulares/linguais de 48 molares foram induzidas à formação de LMBA e divididas em 6 grupos, de acordo com os protocolos de condicionamento e técnica de aplicação da resina infiltrante: ácido hidroclorídrico 15% (AH) + aplicação manual da RI; AH + ácido fosfórico 37% (AF) + aplicação manual da RI; AH + aplicação ultrassônica da RI (U); AH + aplicação sônica da RI (S); AF + AH + S; e AF + AH + U. para o grau de penetração (GP), condicionou-se as coroas com AH por 120 s. A RI Icon® (DMG) foi aplicada de acordo com as instruções do fabricante. As coroas foram coradas (rodamina B 0,1% por 12 h) e clareadas com peróxido de hidrogênio 30% por 12 h. os discos foram imersos em solução de etanol 50%, contendo 100 µM de fluoresceína sódica. O GP (em µm) foi mensurado por meio de microscopia confocal a laser (20´). A resistência de união (RU) foi calculada pelo teste de microcisalhamento (0,5 mm/min). Os dados foram submetidos ao teste ANOVA 2 fatores e Tukey (α=0,05). Para RU, a interação não foi significante (p>0,05). Para GP, os fatores principais foram significantes (técnica de aplicação - p<0,001; protocolos de condicionamento - p=0,003). A aplicação U mostrou os maiores valores de GP. AF+AH demonstrou resultados superiores ao grupo AH. As aplicações sônica/ultrassônica e o uso do ácido fosfórico antes do ácido hidroclorídrico aumentaram o GP da resina infiltrante. Os protocolos de condicionamento ou as técnicas de aplicação não influenciaram os valores de RU.

Bond strength values of fiberglass post to flared root canals reinforced with different materials.

The aim of this study was to compare in vitro the bond strength (BS) between fiberglass posts and flared root canals reinforced with different materials. The roots of 48 premolars were endodontically treated. After one week, the root canals were prepared to simulate an oversized root canal, except for the positive control group (PCG), which was cemented with a prefabricated fiber post (PFP) compatible with the root canal size, simulating an ideal adaptation. The other samples (n=8/group) were used to test alternative restorative techniques for filling root canals: negative control group (NCG [PFP with a smaller diameter than of the root canal]), composite resin group - CRG, bulkfill group - BFG, self-adhesive cement group - SAG, and glass ionomer group - GIG. The posts were cemented and after 1 week, each root was sectioned transversely into six 1-mm thick discs and the push-out test was done to evaluate the BS. Data were analyzed by two-way repeated measures ANOVA and Tukey's tests (α=0.05). The highest BS value was observed for PCG. The NCG and the GIG groups showed the lowest BS values. Root reinforcement with conventional and bulk-fill composite resins showed the highest BS values; however, the bulk-fill resin was the only treatment able to maintain high BS values in all regions of the root canal. The self-adhesive cement showed intermediate results between CRG and GIG. Root reinforcement with bulk-fill composite resin is an effective option for flared root canals before cementation of a prefabricated fiber post.

Influence of different burs and acid ultrasonic agitation on the bonding of fiber posts to root dentin

Aim: The objective is to evaluate the influence of different burs used to prepare the root canal space and acid ultrasonic agitation on bond strength (BS) between glass fiber posts (GFP) and root dentin. Methods: After endodontic treatment, the root canal spaces of 36 extracted human canines were prepared, according to the rotary instrument used (n=18): carbide bur (CB), provided by the post manufacturer and a diamond bur (DB). In both groups, the fiber posts were cemented with the adhesive system Ambar and resin cement Allcem, following the manufacturer`s instructions. Previously to the cementation procedures, the groups were subdivided into 2 groups (n=9), according to the phosphoric acid application mode: conventional etching (CE) and active etching (AE), performed by ultrasonic tip, both for 15s. Before the cementation procedures and after the acid application, 1 root of each group was randomly selected for ultrastructural morphological evaluation by SEM. After 1 week of the cementation, 8 specimens per group were transversely sectioned into six 1-mm thick slices, the root canal regions (cervical, medium and apical) were identified and the push-out test was performed to evaluate BS. Data were analyzed by 3-way ANOVA and Tukey test (α=0.05). Results: The results showed that the cross-product interaction of all factors was significant (P=0.035). Higher bond strength values were obtained when a DB with conventional etching, instead of CB, was used to prepare the root post space. Conclusion: It may be concluded that the use of diamond burs with conventional etching yields high BS values in all root canal thirds

Bond strength values of fiberglass post to flared root canals reinforced with different materials

Abstract The aim of this study was to compare in vitro the bond strength (BS) between fiberglass posts and flared root canals reinforced with different materials. The roots of 48 premolars were endodontically treated. After one week, the root canals were prepared to simulate an oversized root canal, except for the positive control group (PCG), which was cemented with a prefabricated fiber post (PFP) compatible with the root canal size, simulating an ideal adaptation. The other samples (n=8/group) were used to test alternative restorative techniques for filling root canals: negative control group (NCG [PFP with a smaller diameter than of the root canal]), composite resin group - CRG, bulkfill group - BFG, self-adhesive cement group - SAG, and glass ionomer group - GIG. The posts were cemented and after 1 week, each root was sectioned transversely into six 1-mm thick discs and the push-out test was done to evaluate the BS. Data were analyzed by two-way repeated measures ANOVA and Tukey's tests (α=0.05). The highest BS value was observed for PCG. The NCG and the GIG groups showed the lowest BS values. Root reinforcement with conventional and bulk-fill composite resins showed the highest BS values; however, the bulk-fill resin was the only treatment able to maintain high BS values in all regions of the root canal. The self-adhesive cement showed intermediate results between CRG and GIG. Root reinforcement with bulk-fill composite resin is an effective option for flared root canals before cementation of a prefabricated fiber post.

Effect of the Bis-Dimethylamino Benzydrol Coinitiator on the Mechanical and Biological Properties of a Composite.

To examine the effect of the alternative coinitiator 4,4'bis dimethylamino benzydrol (BZN) in degree of conversion (DC), mechanical and biological properties of experimental composites. The coinitiator BZN was used in three concentrations (0.2, 0.5 and 1.2%), and the coinitiator DMAEMA was used as control at the same concentrations as above. The molar concentration of camphorquinone (CQ) and coinitiators was kept constant (1:1). The composites were manipulated and submitted to microhardness test (VHN), flexural and compressive strength (in MPa), elastic modulus (GPa), DC (FT-IR) and in vitro cytotoxicity (against 3T3 fibroblastic cells) of the experimental resins. Data were subjected to two-way ANOVA and Tukey post-test (α=0.05). The experimental composite resin with BZN showed higher DC values compared to control DMAEMA groups. For the mechanical properties, microhardness values were higher in BZN groups; flexural strength and elastic modulus were similar between all the groups. Compressive strength for groups BZN0.5 and DMAEMA0.5 were not statistically different, being the lowest values attributed to group BZN0.2. The experimental resins with BZN and DMAEMA were considered nontoxic against 3T3 fibroblasts. The inclusion of the coinitiator BZN in experimental composites was considered nontoxic against 3T3 fibroblast cells, without compromising DC and mechanical properties.

Effect of the Bis-Dimethylamino Benzydrol Coinitiator on the Mechanical and Biological Properties of a Composite

Abstract To examine the effect of the alternative coinitiator 4,4'bis dimethylamino benzydrol (BZN) in degree of conversion (DC), mechanical and biological properties of experimental composites. The coinitiator BZN was used in three concentrations (0.2, 0.5 and 1.2%), and the coinitiator DMAEMA was used as control at the same concentrations as above. The molar concentration of camphorquinone (CQ) and coinitiators was kept constant (1:1). The composites were manipulated and submitted to microhardness test (VHN), flexural and compressive strength (in MPa), elastic modulus (GPa), DC (FT-IR) and in vitro cytotoxicity (against 3T3 fibroblastic cells) of the experimental resins. Data were subjected to two-way ANOVA and Tukey post-test (α=0.05). The experimental composite resin with BZN showed higher DC values compared to control DMAEMA groups. For the mechanical properties, microhardness values were higher in BZN groups; flexural strength and elastic modulus were similar between all the groups. Compressive strength for groups BZN0.5 and DMAEMA0.5 were not statistically different, being the lowest values attributed to group BZN0.2. The experimental resins with BZN and DMAEMA were considered nontoxic against 3T3 fibroblasts. The inclusion of the coinitiator BZN in experimental composites was considered nontoxic against 3T3 fibroblast cells, without compromising DC and mechanical properties.

Resumo Analisar o efeito do co-iniciador alternativo 4,4'bisdimetilaminobenzidrol (BZN) no grau de conversão (GC) e nas propriedades mecânicas e biológicas de resinas compostas experimentais. O co-iniciador BZN foi utilizado em três concentrações (0,2, 0,5 e 1,2), e o co-iniciador DMAEMA como controle, nas mesmas concentrações acima. A concentração molar entre canforoquinona (CQ) e os co-iniciadores foi mantida constante (1:1). As resinas compostas foram manipuladas e submetidas aos testes de microdureza (VHN), resistência à compressão e flexural (em MPa), módulo de elasticidade (em GPa), GC (em %, por meio de espectroscopia micro-Raman e FTIR com KBr), citotoxicidade in vitro (frente às células fibroblásticas 3T3) das resinas experimentais. Os resultados foram submetidos ao teste ANOVA 1 fator e pós-teste de Tukey (α=0,05). As resinas compostas experimentais com o BZN apresentaram GC e propriedades mecânicas satisfatórias, além de serem consideradas atóxicas a fibroblastos 3T3. A inclusão do co-iniciador BZN à resina composta foi considerada não tóxica frente a células fibroblásticas 3T3 e sem comprometer o grau de conversão e as propriedades mecânicas da mesma.

Is the bonding of self-adhesive cement sensitive to root region and curing mode?

OBJECTIVES: To evaluate the influence of two curing techniques on the degree of conversion (DC) of resin cements and on bond strength (BS) of fiber posts in different regions of root dentin. MATERIAL AND METHODS: Twenty single-rooted premolars were endodontically treated, and the post spaces were prepared. The roots were randomly divided into two groups (n=10), according to the activation mode of the resin cement RelyX™ U200 (3M ESPE Saint Paul, MN, USA): conventional (continuous activation mode) and soft-start activation mode (Ramp). The posts (WhitePost DC/FGM) were cemented according to the manufacturer's recommendations and, after one week, the roots were cross-sectioned into six discs each of 1-mm thickness, and the cervical, medium, and apical thirds of the root canals were identified. The DC was evaluated under micro-Raman spectroscopy and the BS was evaluated by the push-out test. The data were analyzed by two-way ANOVA and Tukey's test (α=0.05). RESULTS: Neither the activation mode nor the root regions affected the DC of the resin cement. Higher BS was achieved in the soft-start group (p=0.036); lower BS was observed in the apical third compared to the other root regions (p<0.001). Irrespective of the activation mode and root region, the mixed failure mode was the most prevalent. CONCLUSION: The BS of fiber posts to root canals can be improved by soft-started polymerization. The DC was not affected by the curing mode.

Is the bonding of self-adhesive cement sensitive to root region and curing mode?

Abstract Objectives To evaluate the influence of two curing techniques on the degree of conversion (DC) of resin cements and on bond strength (BS) of fiber posts in different regions of root dentin. Material and Methods Twenty single-rooted premolars were endodontically treated, and the post spaces were prepared. The roots were randomly divided into two groups (n=10), according to the activation mode of the resin cement RelyX™ U200 (3M ESPE Saint Paul, MN, USA): conventional (continuous activation mode) and soft-start activation mode (Ramp). The posts (WhitePost DC/FGM) were cemented according to the manufacturer’s recommendations and, after one week, the roots were cross-sectioned into six discs each of 1-mm thickness, and the cervical, medium, and apical thirds of the root canals were identified. The DC was evaluated under micro-Raman spectroscopy and the BS was evaluated by the push-out test. The data were analyzed by two-way ANOVA and Tukey’s test (α=0.05). Results Neither the activation mode nor the root regions affected the DC of the resin cement. Higher BS was achieved in the soft-start group (p=0.036); lower BS was observed in the apical third compared to the other root regions (p<0.001). Irrespective of the activation mode and root region, the mixed failure mode was the most prevalent. Conclusion The BS of fiber posts to root canals can be improved by soft-started polymerization. The DC was not affected by the curing mode.

Investigação das propriedades mecânicas de cimentos resinosos duais convencionais e autoadesivos em macro e nanoescala / Investigation of mechanical properties of conventional and self-adhesive resin cements in macro and nanoscale

Objetivo: O objetivo desse estudo foi avaliar e comparar as propriedades mecânicas dos cimentos resinosos duais convencionais e autoadesivos em macro e nanoescala. Métodos: Foram confeccionados 15 espécimes de cada marca de cimentos resinosos, AllCem (FGM), RelyX ARC (3M/ESPE) e RelyX U200 (3M/ESPE), para cada teste realizado (flexão de três pontos, compressão e nanoindentação) de acordo com as instruções dos fabricantes. Os espécimes foram fotoativados com aparelho Optilux Demetron (Kerr) por 40 segundos e armazenados em frascos escuros a 37ºC por 24 horas. Foram obtidos os resultados de resistência flexural, resistência à compressão, dureza e de módulo de Young para os diferentes testes mecânicos. Os dados foram avaliados pelos testes ANOVA, múltiplas comparações de Tukey HSD para análise dos valores de resistência, dureza e módulo de elasticidade entre os diferentes cimentos resinosos e ANOVA dois critérios e múltiplas comparações de Games Howell para análise dos módulos de Young entre os diferentes experimentos. Resultados: Os resultados revelaram que o AllCem obteve os maiores valores de resistência flexural e compressão axial (129±22,01 MPa; 243,71±29,75, respectivamente) e o RelyX U200 os menores valores (82,35±19,83 MPa; 134,57±48,93 MPa, respectivamente). Os valores de dureza não diferiram entre os cimentos estudados. No teste de flexão os valores de módulo de Young não diferiram entre os cimentos resinosos. No teste de compressão axial o AllCem apresentou módulo de Young estatisticamente maiores que dos demais cimentos. Para nanoindentação AllCem e RelyX U200 apresentaram maiores valores de módulo de Young que RelyX ARC. Os valores de módulo de Young diferiram significativamente entre todos os experimentos (p<0.05). Conclusão: Os valores das propriedades dos cimentos resinosos podem ser influenciados pelo tipo de experimento (macro- ou nanoescala) realizado.(AU)

Aim: The aim of this study was to evaluate and compare the mechanical properties of conventional and self-adhesive dual resin cements in macroscale and nanoscale. Methods: Fifteen specimens of each brand of resin cement ­ AllCem (FGM), RelyX ARC (3M/ ESPE), and RelyX U200 (3M/ESPE) ­ were made for each test performed in this study (three point bending, compression, and nanoindentation) according to the manufacturer's instructions. The specimens were photoactivated with Optilux Demetron (Kerr) for 40 seconds and stored in the dark at 37°C for 24 hours. Subsequently, they were submitted to flexural strength and axial compression tests at a speed of 1 mm/min, as well as to the Berkovich nanoindentation test. The results of flexural strength, compressive strength, hardness, and Young's modulus were obtained for the different mechanical tests. Data were evaluated by ANOVA tests; multiple comparisons of Tukey HSD to analyze the values of strength, hardness, and Young's modulus among the different resin cements; and ANOVA two criteria and multiple comparisons of Games Howell to analyze the Young's modulus within the different experiments. Results: The results showed that AllCem obtained the highest values of flexural strength and axial compression (129±22.01, 243.71±29.75 MPa, respectively), while RelyX U200 presented the lowest values (82.35 ± 19.83, 134.57 ± 48.93 MPa, respectively). The hardness values did not differ among the studied cements. In the flexural test, the Young's modulus values did not differ between the resin cements. In the axial compression test, AllCem presented a Young's modulus that was statistically higher than the other cements. In the nanoindentation test, AllCem and RelyX U200 presented higher values for Young's modulus than RelyX ARC. Young's modulus values differed significantly among all experiments (p <0.05). Conclusion: The values of resin cement properties can be influenced by the type of experiment (macroscale and nanoscale) performed.(AU)

Active and Passive Application of the Phosphoric Acid on the Bond Strength of Lithium Disilicate.

The objective of this study was to evaluate the effect of passive or active phosphoric acid (PA) application after hydrofluoric acid (HA) treatment on the microshear bond strength of lithium disilicate. Thirty ceramic discs were made with IPS Emax 2 (10 mm thick and 10 mm diameter). The specimens were divided into 3 groups, A: 9.6% HA application; AF: 9.6% HA application + cleaning with 37% PA in passive mode and AFF: 9.6% HA application + cleaning with 37% PA in active mode. For the microshear test, four tygons (0.9 mm diameter and 0.2 mm high) were filled with resin cement (RelyX Ultimate) and placed on the ceramic disks. After testing, the fracture modes were examined under scanning electron microscopy. Data were analyzed by one-way ANOVA and Tukey's post test (α=0.05). The bond strength values were significantly higher in Group AFF (11.0±2.5 MPa) compared with group A (8.1±2.6 MPa) (p<0.002). AF group was not statistically different (9.4±2.5 MPa) from Group A. It was concluded that the active application of 37% PA after 9.6% HA increases the microshear bond strength values between the resin cement and lithium disilicate ceramic.

Active and Passive Application of the Phosphoric Acid on the Bond Strength of Lithium Disilicate

Abstract The objective of this study was to evaluate the effect of passive or active phosphoric acid (PA) application after hydrofluoric acid (HA) treatment on the microshear bond strength of lithium disilicate. Thirty ceramic discs were made with IPS Emax 2 (10 mm thick and 10 mm diameter). The specimens were divided into 3 groups, A: 9.6% HA application; AF: 9.6% HA application + cleaning with 37% PA in passive mode and AFF: 9.6% HA application + cleaning with 37% PA in active mode. For the microshear test, four tygons (0.9 mm diameter and 0.2 mm high) were filled with resin cement (RelyX Ultimate) and placed on the ceramic disks. After testing, the fracture modes were examined under scanning electron microscopy. Data were analyzed by one-way ANOVA and Tukey's post test (α=0.05). The bond strength values were significantly higher in Group AFF (11.0±2.5 MPa) compared with group A (8.1±2.6 MPa) (p<0.002). AF group was not statistically different (9.4±2.5 MPa) from Group A. It was concluded that the active application of 37% PA after 9.6% HA increases the microshear bond strength values between the resin cement and lithium disilicate ceramic.

Resumo O objetivo desse estudo foi avaliar o efeito da aplicação passiva ou ativa do ácido fosfórico após o tratamento com ácido hidrofluorídrico na resistência de união ao microcisalhamento entre cimento resinoso e dissilicato de lítio. Trinta discos foram confeccionados com IPS Emax 2 (10 mm de espessura e 10 mm de diâmetro). Os espécimes foram divididos em três grupos (A: aplicação do ácido hidrofluorídrico 9,6%; AF: aplicação do ácido hidrofluorídrico 9,6% + limpeza com ácido fosfórico 37% em modo passivo; AFF: aplicação do ácido hidrofluorídrico 9,6% + limpeza com ácido fosfórico 37% no modo ativo). Para o teste de microcisalhamento, quatro tygons (0,9 de diâmetro e 0,2 mm de altura) foram preenchidos com cimento resinoso (RelyX Ultimate) e dispostos sobre os discos de cerâmica. Após o teste, os modos de fratura foram examinados por microscopia eletrônica de varredura. Os dados foram analisados estatisticamente por ANOVA e pós-teste de Tukey (α=0,05). Os valores de resistência de união foram significativamente superiores para o grupo AFF (11,0±2,5 MPa), comparado ao grupo A (8,1±2,6 MPa) (p<0,002), mas este não estatisticamente diferente do grupo AF (9,4±2,5 MPa). Concluiu-se que a aplicação ativa do ácido fosfórico 37% após o uso do ácido hidrofluorídrico 9,6% aumenta a resistência de união entre o cimento resinoso e a cerâmica de dissilicato de lítio.

Effect of bleaching agents containing fluoride or calcium on enamel microhardness, roughness and permeability

To evaluate the effect of different in-office bleaching agents on the permeability, roughness and surface microhardness of human enamel. Methods: For evaluation of roughness and microhardness, 40 hemi-faces of 20 premolars were subjected to initial roughness (Ra parameter) and microhardness (VHN) measurements. Thirty-two premolar's crowns were used for permeability test. Then, all specimens were randomly divided into four groups: C - without bleaching (control), HP35 - bleaching with 35% hydrogen peroxide (HP), HPF38 - 38% HP+fluoride, HPC35 - 35% HP+calcium. Final roughness (FR) and microhardness (FM) measurements were evaluated. For permeability, the 32 crowns were immersed in 1% sodium hypochlorite (20 min) and silver nitrate solutions (2 h) and subjected to developing solution under fluorescent light (16 h). Three sections from the crowns were analyzed in light microscope (100x) to evaluate the scores of permeability: Score 0 - no tracer agent penetration; Score 1 - less than half the thickness of enamel penetration; Score 2 - tracer agent reaching half the enamel thickness; Score 3 - entire enamel depth penetration, without reaching dentin and Score 4 - tracer agent reaching dentin. For roughness and microhardness evaluation were used one-way ANOVA and Dunnet post-test for independent samples, and t test for paired samples. For permeability, the data were analyzed by Kruskal Wallis and Dunn tests. Results: A significantly higher permeability and surface roughness were observed in groups HP35, HPF38 and HPC35 compared to the C group, as well as decreased microhardness (p<0.05). Conclusions: All bleaching agents increased permeability and surface roughness, and decreased microhardness of human enamel; thus, the addition of fluoride or calcium was not beneficial...

Avaliação da liberação de flúor e da capacidade de recarga em diferentes cimentos de ionômero de vidro / Evaluation of the fluoride release and ability to recharge in different glass ionomer cements

Objetivo: Avaliar a liberação e a capacidade de recarga de flúor de diferentes cimentos de ionômero de vidro, durante a simulação de desafio cariogênico. Material e método: Foram confeccionados 12 corpos de prova para cada grupo experimental, com cimentos de ionômero de vidro convencionais - Maxxion R (FGM), Ketac Molar EasyMix (3M ESPE); cimento de ionômero de vidro modificado por resina - Vitrebond (3M ESPE), e resina composta, Filtek™ Z350XT (3M ESPE), como controle negativo. Os corpos de prova foram imersos alternadamente em sistema de ciclagem de pH, permanecendo 6 horas na solução de desmineralização e 18 horas na de remineralização, sendo mantidos em estufa a 37°C. Liberação de flúor foi verificada 1, 2, 7 e 14 dias antes e após a recarga com flúor, com eletrodo específico acoplado ao aparelho analisador de pH/fluoretos, calibrado a cada medição com soluções de fluoreto de sódio a 1 e 10 ppm, preparadas com TISAB II. Para leitura, foi adicionado 0,5 mL da amostra a igual volume de TISAB II. Recarga foi realizada com flúor neutro 2% por 4 minutos nas amostras, lavadas e imersas novamente nas soluções do sistema de ciclagem de pH. Os dados foram submetidos à análise de variância e ao teste de Tukey (α=0,05). Resultado: A liberação inicial de fluoreto (µgF/cm2) foi de 45,36; 37,49, e 26,35 para Maxxion R, Vitrebond e Ketac Molar EasyMix, respectivamente. Diferenças estatísticas significativas entre os materiais foram verificadas antes e após a recarga (p=0,001). Após a aplicação tópica de flúor, os cimentos de ionômero de vidro apresentaram capacidade de recarga de flúor. Conclusão: Cimentos de ionômero de vidro avaliados foram capazes de liberar flúor em soluções de ciclagem de pH e podem recarregar flúor através da aplicação tópica.

Objective: To evaluated the ability to fluoride release and recharge in the different glass ionomer cements during simulation of cariogenic challenge. Material and method: Twelve samples were made for each experimental group: conventional glass ionomer cements, Maxxion R (FGM), Ketac Molar EasyMix (3M ESPE); resin modified glass ionomer cement, Vitrebond (3M ESPE); and composite resin n Filtek™Z350XT (3M ESPE), negative control. The samples were immersed alternately in pH cycling method, remaining 6 hours in demineralization solution and 18 hours in remineralization solution and maintained at 37 °C. Fluoride release was measured 1, 2, 7, and 14 days before and after recharging with specific electrode coupled to the analyzer apparatus pH/fluoride, each measurement with calibrated solutions of sodium fluoride to 1 and 10 ppm, prepared with TISAB II. For reading was added 0.5 mL of sample to an equal volume of TISAB II. Recharging was made with neutral sodium fluoride to 2% for 4 minutes in the samples, washed and again immersed pH cycling solutions. Data were subjected to two-way ANOVA and Tukey's post-hoc test (α=0.05). Result: The initial fluoride release (µgF/cm2) was 45.36 ; 37.49 and 26.35 for Maxxion R, Vitrebond and Ketac Molar EasyMix, respectively. Significant differences between the materials before and after recharging were observed (p=0.001). After topical application of fluoride, both showed ability to recharge. Conclusion: The glass ionomer cements evaluated were capable of releasing fluoride in pH cycling solutions and may recharge through of a topical application.

In vivo temperature rise in anesthetized human pulp during exposure to a polywave LED light curing unit.

OBJECTIVES: This in vivo study evaluated pulp temperature (PT) rise in human premolars during exposure to a light curing unit (LCU) using selected exposure modes (EMs). METHODS: After local Ethics Committee approval, intact first upper premolars, requiring extraction for orthodontic reasons, from 8 volunteers, received infiltrative and intraligamental anesthesia. The teeth (n=15) were isolated using rubber dam and a minute pulp exposure was attained. A sterile probe from a wireless, NIST-traceable, temperature acquisition system was inserted directly into the coronal pulp chamber, and real time PT (°C) was continuously monitored while the buccal surface was exposed to polywave light from a LED LCU (Bluephase 20i, Ivoclar Vivadent) using selected EMs allowing a 7-min span between each exposure: 10-s either in low (10-s/L) or high (10-s/H); 5-s-turbo (5-s/T); and 60-s-high (60-s/H) intensities. Peak PT values and PT increases from baseline (ΔT) after exposure were subjected to one-way, repeated measures ANOVAs, and Bonferroni's post hoc tests (α=0.05). Linear regression analysis was performed to establish the relationship between applied radiant exposure and ΔT. RESULTS: All EMs produced higher peak PT than the baseline temperature (p<0.001). The 60-s/H mode generated the highest peak PT and ΔT (p<0.001), with some teeth exhibiting ΔT higher than 5.5°C. A significant, positive relationship between applied radiant exposure and ΔT (r(2)=0.916; p<0.001) was noted. SIGNIFICANCE: Exposing intact, in vivo anesthetized human upper premolars to a polywave LED LCU increases PT, and depending on EM and the tooth, PT increase can be higher than the critical ΔT, thought to be associated with pulpal necrosis.

Direct measurement of time-dependent anesthetized in vivo human pulp temperature.

OBJECTIVES: Human intrapupal tooth temperature is considered to be similar to that of the body (≈37 °C), although the actual temperature has never been measured. This study evaluated the in vivo, human, basal, coronal intrapulpal temperature of anesthetized upper first premolars. METHODS: After approval of the local Ethics Committee was obtained (protocol no. 255,945), upper right and left first premolars requiring extraction for orthodontic reasons from 8 volunteers, ranging from 12 to 30 years old, received infiltrative and intraligamental anesthesia. The teeth (n=15) were isolated using rubber dam and a small, occlusal preparation was made using high-speed handpiece, under constant air-water spray, until a minute pulp exposure was attained. The sterile probe from a wireless, NIST-traceable, temperature acquisition system (Thermes WFI) was inserted directly into the coronal pulp. Once the probe was properly positioned and stable, real-time temperature data were continuously acquired for approximately 25 min. Data (°C) were subjected to 2-tailed, paired t-test (α=0.05), and the 95% confidence intervals for the initial and 25-min mean temperatures were also determined. RESULTS: The initial pulp temperature value (31.8±1.5 °C) was significantly lower than after 25-min (35.3±0.7 °C) (p<0.05). The 95% confidence interval for the initial temperature ranged from 31.0 to 32.6 °C and from 35.0 to 35.7 °C after 25 min. A slow, gradual temperature increase was observed after probe insertion until the pulp temperature reached a plateau, usually after 15 min. SIGNIFICANCE: Consistent coronal, human, in vivo temperature values were observed and were slightly, but significantly below that of body core temperature.

Clinical evaluation of the whitening effect of over-the-counter dentifrices on vital teeth.

This randomized clinical trial evaluated the whitening potential of commercially available toothpastes. Sixty patients were selected and randomly divided into 4 groups (n=15), according to the dentifrice used: GI (control) - Colgate Total 12, GII - Close-up White Now, GIII: Oral-B 3D White, GIV: Colgate Luminous White. Three daily brushings were performed for 2 to 3 min each, during a period of 15 days. Patients had the color of their teeth evaluated before and after the treatment by means of a spectrophotometer (Vita EasyShade - CIE L*a*b*). Data obtained from L values were analyzed by one-way ANOVA and t test. ∆E was also evaluated to calculate color alteration, by NBS criteria. Mean (standard deviation) of initial values were GI: 82.9 (4.9); GII: 83.9 (5.8); GIII: 83.9 (7.2); GIV: 86.4 (3.4) and final values were GI: 84.1 (6.3); GII: 84.6 (6.1); GIII: 84.2 (7.1); GIV: 88.2 (2.8). In conclusion, the dentifrices showed no lightening action on vital teeth, except for Colgate Luminous White; but according to NBS criteria, there was no noticeable visible change to the patients in any group.

Evaluation of the efficacy of LED-laser treatment and control of tooth sensitivity during in-office bleaching procedures.

OBJECTIVE: This study determined the efficacy of LED-laser treatment and the control of sensitivity caused by in-office bleaching. BACKGROUND DATA: Auxiliary power sources (halogen light, arc plasma, LED, LED-laser, and laser) are used in in-office teeth bleaching techniques to accelerate the redox reaction of the whitening gel to increase ease of use, to improve comfort and safety, and to decrease the procedure time. METHODS: Sixteen volunteers participated in this randomized, blinded and split-mouth clinical study. The volunteers were divided into two groups: GL, activation with LED; and GLL, activation with LED-laser (300 mW/cm2). The upper and lower arches were bleached in accordance with each treatment. Tooth sensitivity was recorded by a verbal pain scale and the color analysis was evaluated by the VITA scale, up to 6 months after bleaching. Tooth sensitivity and color change were compared between groups at each time period using the Wilcoxon and NcNemar tests. The sensitivity and color within the same group at different periods were analyzed using the Friedman test or Cochran's Q test. RESULTS: The intensity of sensitivity was similar for both groups at different periods, with no statistical difference between them (p>0.05). There were no significant differences in the color change comparing the two techniques (p>0.05); however, it was significant within each group at the different evaluation periods between the groups (p<0.05). CONCLUSIONS: LED-laser treatment was not able to prevent or reduce the sensitivity of teeth and did not improve the efficacy of bleaching.