Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents.

Bonding to demineralized dentin of a diseased tooth has shown to be a significant clinical issue. This study evaluated the effect of 0.2% NaF-(NaF), MI Paste™-(CPP-ACP) and the self-assembling peptide 'P11-4' (Ace-QQRFEWEFEQQ-NH2) contained in Curodont™ Repair, have on microtensile bond strength-(µTBS) of two different adhesive systems (Adper™ Single Bond-(SB) or Clearfil™ SE Bond (CSE)) and wettability of demineralized dentin slices after remineralising agents were applied. The highest µTBS were found for the demineralized dentin-(DD) treated with CPP-ACP; both adhesives systems (p < 0.05) did not significantly difference from P11-4 treatment associated with SB, and also presented higher values than sound dentin-(SD/SB) (p < 0.01). DD treated with P11-4 associated with CSE did not differ from DD/CSE (p > 0.05). The NaF treatment associated with CSE recovered the bond strength values of SD/CSE and associated with CSE demonstrated lower µTBS than other groups, although significantly higher than DD (p < 0.05). P11-4 and CPP-ACP increased significantly the wettability of demineralized dentin (p < 0.05); etching acid improved wettability for all groups (p < 0.05), whilst NaF did not affect the wettability of demineralized dentin (p > 0.05). Morphological analysis of the dentin surface and dentin-resin interface revealed unique features of the applied remineralizing agent. The results indicated that self-assembling peptide P11-4 associated with SB and CPP-ACP associated with SB or CSE significantly enhanced the bond strength to demineralized dentin (p < 0.05). We conclude that by modifying the dentine surface and restoring conditions found on sound dentin, this can enhance the interfacial bonding.

Efecto de agentes blanqueadores libres de peróxido sobre el color dental. Revisión sistemática / Effect of Peroxide-Free Dental Bleaching Agents on Dental Color. Systematic Review

Antecedentes: Los agentes blanqueadores oxidantes tales como los peróxidos generan daños irreversibles en el esmalte dental y afectan químicamente el componente orgánico e inorgánico del esmalte. Se reportan en la literatura sustancias alternativas que pueden mejorar el color del esmalte, sin causarle daño. Objetivo: Identificar las sustancias blanqueadoras tipo remineralizante reportadas en la literatura y su efecto en el color del esmalte dental. Métodos: Se consultaron las bases de datos PubMed, ScienceDirect, Embase, Scielo, Lilacs y Scopus, las palabras clave empleadas para la búsqueda fueron dental enamel, tooth bleaching, bleaching, calcium phosphate, hidroxyapatite, apatite, biomimetic, biomimetics, conectadas por el operador booleano AND y OR de diferentes maneras. Los criterios de elegibilidad de los artículos que harían parte de la revisión fueron que no incluyeran peróxidos de hidrógeno y carbamida con adición fluoruros y fosfatos de calcio y adicionalmente que emplearan un método de medición de color. Resultados: El resultado de la búsqueda arrojó 7 artículos, las sustancias encontradas de tipo remineralizante fueron hidroxiapatita sintética, fosfatos de calcio y el hexametafosfato de sodio. Según los criterios de evaluación definidos solo 4 de ellos tuvieron un nivel de evidencia alto, uno nivel medio y dos bajos. Todos los estudios reportan con los tratamientos probados, la capacidad de generar cambios en el color del esmalte dental. Conclusión: Las sustancias blanqueadoras remineralizantes encontradas, tienen la capacidad de producir cambios en el color del esmalte dental, lo cual se evidencia con modificación en las diferentes escalas de medición empleadas.

Background: Oxidizing bleaching agents such as peroxides generate irreversible damage to dental enamel and chemically affect the organic and inorganic component of the enamel. Alternative substances that can improve the color of the enamel without damaging it are reported in the literature. Purpose: To identify the remineralizing bleaching substances reported in the literature and their effect on the color of the dental enamel. Methods: The databases PubMed, ScienceDirect, Embase, SciELO, Lilacs and Scopus were consulted, the keywords used for the search were dental enamel, tooth bleaching, bleaching, calcium phosphate, hydroxyapatite, apatite, biomimetic, biomimetics, connected by the Boolean operator AND and OR in different ways. The eligibility criteria of the articles that would be part of the review were not to include hydrogen peroxide and carbamide peroxides with addition of fluorides and calcium phosphates and additionally using a color measurement method. Results: The result of the search yielded 7 articles, the substances found of remineralizing type were synthetic hydroxyapatite, calcium phosphates and sodium hexametaphosphate. According to the evaluation criteria defined, only 4 of them had a high level of evidence, one medium level and two low. All studies report with proven treatments the ability to generate changes in tooth enamel color. Conclusions: The remineralizing whitening substances found have the ability to produce changes in the color of the dental enamel, which is evidenced with modification in the different measurement scales used.

Effect of rewetting solutions on micropush-out dentin bond strength of new bioceramic endodontic material

Abstract To evaluate the influence of rewetting solutions on bond strength to root dentin of conventional gutta-percha (GP) or niobium phosphate glass-based gutta-percha (GNb) associated with a bioceramic sealer. The root canals of 80 human mandibular premolars were prepared using nickel-titanium instruments and irrigation with sodium hypochlorite and EDTA. The teeth were randomly divided into four groups according to the gutta-percha used: GNb or GP associated with EndoSequence BC Sealer (BC) and the solution for rewetting dentin before filling (distilled water; phosphate buffer saline solution - PBS; simulated body fluid - SBF; or no solution). The root canals were filled with a single cone using warm vertical condensation. Micropush-out bond strengths associated with the filling materials in slices from middle root thirds was determined 30 days after root filling. The failure mode was analyzed with stereoscopic lens. The data were statistically analyzed by two-way ANOVA and Holm-Sidak test (p < 0.05). There was significant difference in the types of gutta-percha (p < 0.001) and in the different rewetting solutions (p = 0.003). The interaction between gutta-percha and rewetting solutions was not significant (p = 0.53). The SBF solution provided an increase in bond strength for both gutta-percha solutions. The GNb+BC (3.42 MPa) association increased bond strength when compared with GP+BC (2.0 MPa). The use of SBF as a dentin rewetting solution increased bond strength in the groups studied. Association of GNb with bioceramic sealer was beneficial, increasing the bond strength to dentin when compared with the association with GP.