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The aim of this clinical, prospective, randomized, and parallel study was to evaluate different in-office treatments for dentin hypersensitivity (DH). One hundred ninety-two teeth with non-cavitated root exposures were treated using different desensitizers: fluoride varnish (Duraphat - FLU); bioactive ceramic solution (Biosilicate - BIOS); universal self-etching adhesive (Single Bond Universal - SBU); bioactive photoactivated varnish (PRG filler - SPRG). The degree of DH was analyzed using a visual analog scale (VAS) and computerized visual scale (CoVAS), before treatments and after 7, 15, and 30 days from the first session. Comparisons among desensitizers were performed using the Kruskal-Wallis and Dunn's tests. Friedman test was used to compare between times (p ≤ 0.05). Comparing desensitizers FLU presented a higher value of DH than BIOS using VAS at 7 days, however, no differences were found using CoVAS analysis. Comparing times, BIOS and SBU showed a reduction in DH after 7 days and SBU showed a reduction at 30 days compared to 7 days using VAS. FLU and SPRG groups reduced DH from 15 days to 30 days using VAS. There was a reduction in DH for FLU, BIOS, and SBU after 7 days and for BIOS this reduction also occurred at 30 days when compared to 15 days using CoVAS. SPRG group showed a reduction from 15 to 30 days. All desensitizers tested were able to reduce the initial sensitivity. The bioactive ceramic solution reduced the DH gradually after 30 days using computerized analysis.
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Desensibilizantes Dentinarios , Sensibilidad de la Dentina , Humanos , Sensibilidad de la Dentina/tratamiento farmacológico , Desensibilizantes Dentinarios/uso terapéutico , Masculino , Femenino , Estudios Prospectivos , Adulto , Resultado del Tratamiento , Persona de Mediana Edad , Fluoruros TópicosRESUMEN
BACKGROUND: Although several studies indicate the harmful effects of bleaching on pulp tissue, the demand for this procedure using high concentrations of hydrogen peroxide (HP) is high. OBJECTIVES: To investigate the influence of bleaching on the pulp tissue. METHODS: Electronic searches were conducted (PubMed/MEDLINE, Scopus, Cochrane Library and grey literature) until February 2021. Only in vivo studies that evaluated the effects of HP and/or carbamide peroxide (CP) bleaching gels on the inflammatory response in the pulp tissue compared with a non-bleached group were included. Risk of bias was performed according to a modified Methodological Index for Non-Randomized Studies scale for human studies and the Systematic Review Centre for Laboratory Animal Experimentation's RoB tool for animal studies. Meta-analysis was unfeasible. RESULTS: Of the 1311 studies, 30 were eligible. Of these, 18 studies evaluated the inflammatory response in animal models. All these studies reported a moderate-to-strong inflammatory response in the superficial regions of pulp, characterized by cell disorganization and necrotic areas, particularly during the initial periods following exposure to 35%-38% HP, for 30-40 min. In the evaluation of human teeth across 11 studies, seven investigated inflammatory responses, with five observing significant inflammation in the pulp of bleached teeth. In terms of tertiary dentine deposition, 11 out of 12 studies noted its occurrence after bleaching with 35%-38% HP in long-term assessments. Additionally, three studies reported significant levels of osteocalcin/osteopontin at 2 or 10 days post-treatment. Other studies indicated an increase in pro-inflammatory cytokines ranging from immediately up to 10 days after bleaching. Studies using humans' teeth had a low risk of bias, whereas animal studies had a high risk of bias. DISCUSSION: Despite the heterogeneity in bleaching protocols among studies, High-concentrations of HP shows the potential to induce significant pulp damage. CONCLUSIONS: High-concentrations of bleaching gel increases inflammatory response and necrosis in the pulp tissue at short periods after bleaching, mainly in rat molars and in human incisors, in addition to greater hard tissue deposition over time. However, further well-described histological studies with long-term follow-up are encouraged due to the methodological limitations of these studies. REGISTRATION: PROSPERO (CRD42021230937).
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Peróxido de Carbamida , Pulpa Dental , Peróxido de Hidrógeno , Blanqueadores Dentales , Blanqueamiento de Dientes , Blanqueamiento de Dientes/métodos , Blanqueamiento de Dientes/efectos adversos , Pulpa Dental/efectos de los fármacos , Pulpa Dental/patología , Humanos , Animales , Peróxido de Carbamida/farmacologíaRESUMEN
OBJECTIVES: This laboratory study evaluated the influence of the fluorescence intensity of composite resins on additional tooth wear and the presence of restorative material in different dental thirds during the retreatment of direct veneers. MATERIALS AND METHODS: The crown dimensions of 60 bovine incisors were reduced to 10 × 8 mm. The teeth were classified according to the fluorescence intensity of the composites: low (LOW) (TPH Spectra), medium (MED) (Opallis), and high (HIGH) (Essentia) groups. The teeth were divided according to the removal methods: conventional (CON) and fluorescence-aided identification technique (FIT). The specimens were scanned (T0), received veneer preparation, and scanned again (T1). After restorations, the composites were removed and the teeth were scanned (T2). Measurement assessments between T1 and T2 were performed to determine additional wear, presence of residual areas, and the average between additional wear and the presence of residual areas. Kruskal Wallis, Mann-Whitney, Friedman, 2-way ANOVA, and post-Tukey tests were performed (α < 0.05). RESULTS: The comparison of composite resins indicated a smaller area of additional wear and greater residue presence in the HIGH group than the LOW group for both techniques in the cervical third. Regarding removal methods, the FIT produced greater additional wear than the CON method for the LOW and MED groups in the middle and cervical thirds. The incisal third exhibited greater additional wear than the other thirds. CONCLUSIONS: Composite resins with high fluorescence intensity removed using FIT had less tooth wear. The incisal third was the most affected area for direct veneer removal procedures. CLINICAL SIGNIFICANCE: A FIT has been proposed for composite resin removal; however, the different fluorescence intensities of composite resins can influence tooth wear caused during this procedure.
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Resinas Compuestas , Coronas con Frente Estético , Resinas Compuestas/química , Bovinos , Fluorescencia , AnimalesRESUMEN
This study aimed to evaluate the interface of universal adhesive (UA) with bulk-fill resin (BF) and dentin, after endodontic irrigation. The pulp chamber of 96 molars was irrigated with chlorhexidine 2% (CHX) or sodium hypochlorite 5.25% (NaOCl) and restored according to three restorative protocols. Microtensile bond strength (µTBS) and nanoleakage tests were performed after 24 h of thermocycling. Kruskal Wallis, Mann-Whitney and Wilcoxon were performed (p < 0.05). Comparing restorative systems, a difference was found only when irrigated with CHX after 24 h. CHX provided higher µTBS than NaOCl after 24 h for two restorative protocols; after thermocycling, NaOCl provided the greatest µTBS than CHX for one group. Decreased µTBS was observed for all restorative systems when CHX was used after thermocycling. NaOCl demonstrated the highest nanoleakage. The composition of UA influenced the immediate adhesion and sealing to BF when CHX was used; ageing has a deteriorating effect on adhesion and sealing for all restorative systems.
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Recubrimiento Dental Adhesivo , Humanos , Técnicas In Vitro , Recubrimiento Dental Adhesivo/métodos , Irrigantes del Conducto Radicular/química , Hipoclorito de Sodio/química , Resistencia a la Tracción , Filtración Dental , Resinas Compuestas/química , Clorhexidina/farmacología , Clorhexidina/química , Cementos de Resina/química , Ensayo de Materiales , Cementos Dentales/químicaRESUMEN
Abstract The aim of this clinical, prospective, randomized, and parallel study was to evaluate different in-office treatments for dentin hypersensitivity (DH). One hundred ninety-two teeth with non-cavitated root exposures were treated using different desensitizers: fluoride varnish (Duraphat - FLU); bioactive ceramic solution (Biosilicate - BIOS); universal self-etching adhesive (Single Bond Universal - SBU); bioactive photoactivated varnish (PRG filler - SPRG). The degree of DH was analyzed using a visual analog scale (VAS) and computerized visual scale (CoVAS), before treatments and after 7, 15, and 30 days from the first session. Comparisons among desensitizers were performed using the Kruskal-Wallis and Dunn's tests. Friedman test was used to compare between times (p ≤ 0.05). Comparing desensitizers FLU presented a higher value of DH than BIOS using VAS at 7 days, however, no differences were found using CoVAS analysis. Comparing times, BIOS and SBU showed a reduction in DH after 7 days and SBU showed a reduction at 30 days compared to 7 days using VAS. FLU and SPRG groups reduced DH from 15 days to 30 days using VAS. There was a reduction in DH for FLU, BIOS, and SBU after 7 days and for BIOS this reduction also occurred at 30 days when compared to 15 days using CoVAS. SPRG group showed a reduction from 15 to 30 days. All desensitizers tested were able to reduce the initial sensitivity. The bioactive ceramic solution reduced the DH gradually after 30 days using computerized analysis.
Resumo O objetivo deste estudo clínico, prospectivo, randomizado e paralelo foi avaliar diferentes tratamentos em consultório para hipersensibilidade dentinária (HD). Cento e noventa e dois dentes com exposições radiculares não cavitadas foram tratados com diferentes dessensibilizantes: verniz fluoretado (Duraphat - FLU); solução cerâmica bioativa (Biosilicato - BIOS); adesivo autocondicionante universal (Single Bond Universal - SBU); verniz fotoativado bioativo (PRG filler - SPRG). O grau de HD foi analisado por meio da escala visual analógica (VAS) e da escala visual computadorizada (CoVAS), antes dos tratamentos e após 7, 15 e 30 dias da primeira sessão. As comparações entre dessensibilizantes foram feitas pelos testes de Kruskal-Wallis e Dunn. O teste de Friedman foi utilizado para comparação entre os tempos (p ≤ 0,05). Comparando os dessensibilizantes, o FLU apresentou um valor de HD maior do que o BIOS usando VAS aos 7 dias, no entanto, nenhuma diferença foi encontrada usando a análise CoVAS. Comparando os tempos, BIOS e SBU apresentaram redução de HD após 7 dias e SBU apresentou redução aos 30 dias em comparação com 7 dias usando VAS. Os grupos FLU e SPRG reduziram a HD em 15 dias a 30 dias usando VAS. Houve redução de HD para FLU, BIOS e SBU após 7 dias e para BIOS essa redução também ocorreu aos 30 dias quando comparada a 15 dias usando CoVAS. O grupo SPRG apresentou redução de 15 para 30 dias. Todos os dessensibilizantes testados foram capazes de reduzir a sensibilidade inicial. A solução de cerâmica bioativa reduziu o HD gradualmente após 30 dias usando análise computadorizada.
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This study aimed to evaluate the influence of dental adhesive color on the chromatic stability and fluorescence intensity of composite resin restorations of different thicknesses. Ninety bovine enamel samples were obtained and restored with resin composite varying thicknesses of restorative material and enamel (1.0 mm enamel and 1.0 mm composite; 1.5 mm enamel and 0.5 mm composite; 0.5 mm enamel and 1.5 mm composite). The restorations were made of composite resin (Opallis E-bleach H) using different types of dental adhesives: Ambar, Ambar APS, and Single Bond Universal (n=10). The samples were subjected to color measurement tests in a spectrophotometer using CIEDE2000 and fluorescence intensity measurements before and after aging in a red wine coloring solution. Data were subjected to analysis of variance (ANOVA) and Tukey's test (α = 0.05). There were no statistically significant changes in color stability or fluorescence intensity for restorations made of different materials or thicknesses (p>0.05). Single Bond Universal showed greater color stability at 0.5 mm thickness (ΔE00 = 4.4 ± 1.6) compared to other thicknesses of the same material (p=0.003), as well as a greater difference in fluorescence intensity after aging at 1.5 mm thickness (-414.9 ± 103.8) compared to other materials (p=0.0002). Overall, it was concluded that the different adhesive systems did not influence the color stability and fluorescence of restorations of different thicknesses.
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Cementos Dentales , Cementos de Resina , Animales , Bovinos , Cementos Dentales/química , Cementos de Resina/química , Resinas Compuestas/química , Color , Ensayo de MaterialesRESUMEN
OBJECTIVE: To assess whether bleaching gel volume influences chromatic changes, hydrogen peroxide (HP) diffusion, inflammation, and oxidative stress in the pulp tissue. METHODOLOGY: A total of 60 bovine teeth were divided into four groups, according to bleaching gel volume (n=15): without gel (WG); V30 (30 µL of 35% HP); V60 (60 µL); and V120 (120 µL). HP diffusion analysis was performed in the first session (T1). Chromatic changes (ΔE, ΔE00, and WID) were assessed after the first (T1), second (T2), third (T3) sessions, and 15 d (T4) after the end of treatment. Moreover, 20 rats were randomly divided into four groups (n=10) and their upper first molars were treated with different gel volumes: control (no treatment); V2 (2 µL of 17.5% HP); V4 (4 µL); and V8 (8 µL). After 24 h, rats were euthanized and the specimens processed for histological and immunohistochemical (nitric oxide synthase) evaluation. Data were analyzed using the Wilcoxon and Mann-Whitney tests (p<0.05). RESULTS: In vitro (bovine teeth), chromatic changes were not influenced by bleaching gel volume, showing similar values in all groups and sessions, except for the control group (p<0.05). The V120 group had the highest HP diffusion values (p<0.05). In vivo (pulp tissue), the V4 and V8 groups showed the highest inflammatory infiltrate in the pulp and significant oxidative stress (p<0.05). CONCLUSION: The adverse effects on the dental pulp related to HP diffusion, pulp inflammation, and oxidative stress depend on bleaching gel volume, while the bleaching effect is not proportional to the volume used.
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Antiinfecciosos , Blanqueadores Dentales , Blanqueamiento de Dientes , Animales , Bovinos , Ratas , Peróxido de Hidrógeno/efectos adversos , Óxido Nítrico , Blanqueadores Dentales/efectos adversos , InflamaciónRESUMEN
OBJECTIVES: To evaluate in vitro the effects of sodium fluoride (F) and nano-sized sodium trimetaphosphate (TMPnano) added to a 35% hydrogen peroxide (H2O2) bleaching gel on the color alteration, enamel mechanical and morphological properties, and H2O2 transamelodentinal diffusion. MATERIALS AND METHODS: Bovine enamel/dentin discs (n = 180) were divided according to the bleaching gel: 35% H2O2 (HP); 35% H2O2 + 0.1% F (HP/F); 35% H2O2 + 1% TMPnano (HP/TMPnano); 35% H2O2 + 0.1% F + 1% TMPnano (HP/F/TMPnano) and 35% H2O2 + 2% calcium gluconate (HP/Ca). The gels were applied 3 times by 40 min; once each 7-day. The Commission Internationale de l'Eclairage (CIE) L*a*b* total color alteration (ΔE), color alteration by CIEDE2000 (ΔE00), whitening index (ΔWID), surface (SH) and cross-sectional hardness (ΔKHN), surface roughness (Ra), and transamelodentinal diffusion were determined. Enamel surfaces were evaluated by Scanning Electron Microscopy (SEM) and X-ray Dispersive Energy (EDX). Data were submitted to ANOVA, followed by the Student-Newman-Keuls test (p <0.05). RESULTS: ΔE, ΔE00, and ΔWID were similar among the gels that promoted a bleaching effect after treatment (p <0.001). Mineral loss (SH and ΔKHN), Ra, and H2O2 diffusion were lower for HP/F/TMPnano; the HP and HP/Ca groups presented the highest values (p <0.001). For SEM/EDX, surface changes were observed in all bleached groups, but less intense with TMPnano. CONCLUSIONS: Gels containing F/TMPnano do not interfere with the bleaching effect and reduce enamel demineralization, roughness, H2O2 diffusion, and morphological changes. CLINICAL RELEVANCE: Whitening gels containing F/TMPnano can be used as a new strategy to increase safety and maintain clinical performance.
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Blanqueadores Dentales , Blanqueamiento de Dientes , Humanos , Animales , Bovinos , Fluoruros/farmacología , Peróxido de Hidrógeno/farmacología , Peróxido de Hidrógeno/química , Estudios Transversales , Esmalte Dental , Fluoruro de Sodio/farmacología , Geles/farmacología , Blanqueamiento de Dientes/efectos adversos , Blanqueadores Dentales/efectos adversosRESUMEN
PURPOSE: This study evaluates the effects of different toothpastes on the nanohardness and chemical compositions of restorative materials and dental surfaces. METHODS: Bovine enamel (n = 72) and dentin (n = 72) blocks were obtained and restored using RMGIC (n = 36) or CR (n = 36) to create the following surfaces: dentin adjacent to RMGIC (DRMGIC), enamel adjacent to RMGIC (ERMGIC), dentin adjacent to CR (DCR), and enamel adjacent to CR (ECR). After restoration, one hemiface of each specimen was coated with an acid-resistant varnish to facilitate the creation of control (C) and eroded (E) sides; the latter were achieved by erosion-abrasion cycles as follows: erosion with 1% citric acid: 5 days, four times for 2 min each day; 1% citric acid/abrasion, two times for 15 s, followed by immersion in a toothpaste slurry for 2 min. Toothpastes without fluoride (WF; n = 12), with sodium fluoride (NaF; n = 12), and with stannous fluoride (SnF2; n = 12) were used for RMGIC or CR. The specimens were analyzed for nanohardness (H), and chemical composition using energy-dispersive X-ray spectroscopy and Raman microscopy. The data were statistically analyzed using two-way repeated measures ANOVA and Tukey's test (α = 0.05). RESULTS: Lower H values were obtained with NaF for DRMGIC-C, with a statistically significant difference from the H value obtained with WF (p < 0.05). The calcium and phosphorus concentrations in DCR-E were significantly lower with WF than with the other types of toothpaste (p < 0.05). Fluoride-containing toothpastes are capable of preserving the main chemical components of the dentin adjacent to the restorative materials under erosive-abrasive conditions.
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PURPOSE: This in vitro study aimed to evaluate the aesthetic compromise generated in adhesive interface of ceramic laminate veneer luted after tooth bleaching and the use of antioxidant agents. Thus, the chromatic coordinates and whitening index (WID) were evaluated, comparing whiteness changes (ΔWID) results to perceptibility and acceptability thresholds. MATERIAL AND METHODS: In total, 88 bovine enamel samples (7 × 8 × 4 mm; n = 8) were submitted to the ceramic laminate veneer luting protocol according to surface treatment (unbleached and bleached enamel), antioxidant agents (control; 10% ascorbic acid and 10% α-tocopherol), and luting periods (after 24 h and after 14 days). To lute IPS e.max ceramic restorations (7 × 8 × 0.6 mm), Tetric N-Bond Universal adhesive system and Variolink Aesthetic LC resin cement were used. An ultraviolet-visible spectrophotometer (UV-VIS) was utilized to measure CIE L*a*b* coordinates prior to and after UV-B artificial accelerated aging for 252, 504, and 756 h. L*, a*, and b* axes were evaluated separately, and the whitening stability (ΔWID) effect was assessed by varying the whiteness index for dentistry (WID). The 50:50% visual threshold was used to evaluate ΔWID values (whiteness perceptibility [WPT] and whiteness acceptability [WAT]). Color parameters changes (ΔL*Δa*Δb*), WID, and ΔWID data were subjected to 2-way repeated measures ANOVA followed by Tukey's test (α = 0.05). RESULTS: Different UV-aging periods influenced the chromatic coordinates, WID, and ΔWID of the ceramic restorations regardless of the bleaching treatment, antioxidant solutions and luting periods (P < .05). In general, ΔWID values after UV-aging periods were above perceptibility and acceptability thresholds (WPT = 0.72 and WAT = 2.62, respectively) for all experimental groups (P < .05). Unbleached and 10% ascorbic acid-treated enamels luted after 14 days of the antioxidant action exhibited lower ΔL* and Δb* values, while control group showed lower Δa* values. All experimental groups showed similar performance on ΔWID compared to the control group, regardless of the UV-aging period analyzed (P > .05). CONCLUSION: α-tocopherol is a suitable antioxidant solution to be used 24 h post enamel bleaching not compromising clinical acceptability of ceramic laminate veneers. CLINICAL RELEVANCE: The adhesive interface of ceramic laminate veneers may appear darker after the use of antioxidant agents affecting the clinical acceptability of the restorations.
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Antioxidantes , alfa-Tocoferol , Animales , Bovinos , Antioxidantes/farmacología , Color , Ensayo de Materiales , Cerámica , Ácido AscórbicoRESUMEN
PURPOSE: The structural integrity of the resin cement layer, the bond strength, and the biomechanical behavior of different fiberglass post cementation techniques were evaluated. METHODS: Thirty-three bovine incisors were divided into three groups (n = 11): conventional fiberglass post (CFP), conventional fiberglass post in flared root canals (CFL), and relined fiberglass post (RFP). Six specimens from each group were submitted for high-resolution microcomputed tomography (µCT) to evaluate the integrity and presence/volume of voids at the resin cement layer. Finite element analysis (FEA) of two three-dimensional (3D) models of each group were conducted, one considered ideal (without interface defects) and another containing the conditions identified in the µCT analysis. Push-out bond strength tests were conducted for all specimens. RESULTS: The CFL group had the greatest mean values of void (Thirds cervical: 73.67; middle: 95.67; apical: 47.33) and gap concentration (Thirds cervical: 14.67; middle: 15.83; apical: 8.33) compared with CFP and RFP. A significant difference in bond strength was observed between the cervical (1.33 MPa) and middle thirds (1.85 MPa) compared with the apical third (4.85 MPa) of the CFL. A significant difference was observed in the bond strength in the CFL (1.33 MPa) and RFP (3.29 MPa) in the cervical third, which were statistically similar to the bond strength of the CFP. The tensile stress distributions were similar in most structures, localized in the cervical region on the lingual surface. CONCLUSIONS: Structural defects in the interface layer might influence the bond strength and biomechanical behavior under the different fiberglass post cementations.
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Recubrimiento Dental Adhesivo , Técnica de Perno Muñón , Animales , Bovinos , Cementación/métodos , Cementos de Resina/química , Microtomografía por Rayos X , Vidrio/química , Dentina , Ensayo de MaterialesRESUMEN
Introduction: fluoride toothpaste is widely used by the population. Objective: dentifrices with a high concentration of sodium fluoride and the presence of tricalcium phosphate were developed, providing additional protection to patients vulnerable to the development of caries. This study aimed to evaluate the influence of different dentifrices on the surface and internal hardness and enamel wear after artificial caries, pH cycling, and toothbrushing. Material and method: enamel blocks (4x4 mm) were obtained from 20 bovine teeth. The specimens were submitted to artificial caries lesion and then to pH cycling and brushing according to the dentifrice: Colgate Total 12 and Clinpro + Tricalcium Phosphate. Result: after this period, they were submitted to analysis of superficial and internal hardness and profilometry. Scanning Electron Microscopy (SEM) was performed. The data obtained were evaluated by one-way Analysis of Variance (ANOVA) to evaluate the mineral recovery and profilometry, and two-way repeated measures ANOVA to evaluate the superficial and internal hardness. Conclusion: analyzing the surface hardness, after caries induction, there was a significant reduction in hardness that was partially recovered regardless of the dentifrice used. For internal hardness, Clinpro obtained lower values on the control side and up to 90 micrometers on the test side. As for profilometry, Colgate Total 12 showed greater wear when compared to Clinpro. It was concluded that Clinpro promoted lower internal hardness, however, Colgate Total 12 resulted in greater surface wear of tooth enamel.
Introdução: dentifrícios fluoretados são amplamente utilizados pela população. Foram desenvolvidos dentifrícios com alta concentração de fluoreto de sódio e presença de tricálcio fosfato, fornecendo proteção adicional a pacientes vulneráveis ao desenvolvimento da cárie. Objetivo: o objetivo deste estudo foi avaliar a influência de diferentes dentifrícios na dureza superficial, interna e desgaste do esmalte após cárie artificial, ciclagem de pH e escovação. Material e método: blocos de esmalte (4x4 mm) foram obtidos a partir de 20 dentes bovinos. Os espécimes foram submetidos à lesão de cárie artificial e, em seguida, à ciclagem de pH e escovação de acordo com o dentifrício: Colgate Total 12 e Clinpro + Tricálcio Fosfato. Após este período, foram submetidos à análise de dureza superficial e interna e perfilometria. Foi realizada microscopia eletrônica de varredura. Resultado: os dados obtidos foram avaliados por ANOVA um critério para avaliar a recuperação mineral e perfilometria, ANOVA dois critérios medidas repetidas para avaliar a dureza superficial e interna. Conclusão: analisando a dureza superficial, após a indução da cárie houve uma redução significativa na dureza que foi parcialmente recuperada independente do dentifrício utilizado. Para dureza interna, Clinpro obteve valores menores no lado controle e até 90 micrômetros no lado teste. Quanto à perfilometria, o Colgate Total 12 apresentou maior desgaste quando comparado ao Clinpro. Concluiu-se que Clinpro promoveu menor dureza interna, porém, o Colgate Total 12 resultou em maior desgaste superficial do esmalte dentário.
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Animales , Bovinos , Remineralización Dental , Pastas de Dientes , Microscopía Electrónica de Rastreo , Análisis de Varianza , Esmalte Dental , Flúor , Caries Dental , DentífricosRESUMEN
Abstract This study aimed to evaluate the influence of dental adhesive color on the chromatic stability and fluorescence intensity of composite resin restorations of different thicknesses. Ninety bovine enamel samples were obtained and restored with resin composite varying thicknesses of restorative material and enamel (1.0 mm enamel and 1.0 mm composite; 1.5 mm enamel and 0.5 mm composite; 0.5 mm enamel and 1.5 mm composite). The restorations were made of composite resin (Opallis E-bleach H) using different types of dental adhesives: Ambar, Ambar APS, and Single Bond Universal (n=10). The samples were subjected to color measurement tests in a spectrophotometer using CIEDE2000 and fluorescence intensity measurements before and after aging in a red wine coloring solution. Data were subjected to analysis of variance (ANOVA) and Tukey's test (α = 0.05). There were no statistically significant changes in color stability or fluorescence intensity for restorations made of different materials or thicknesses (p>0.05). Single Bond Universal showed greater color stability at 0.5 mm thickness (ΔE00 = 4.4 ± 1.6) compared to other thicknesses of the same material (p=0.003), as well as a greater difference in fluorescence intensity after aging at 1.5 mm thickness (-414.9 ± 103.8) compared to other materials (p=0.0002). Overall, it was concluded that the different adhesive systems did not influence the color stability and fluorescence of restorations of different thicknesses.
Resumo O objetivo deste estudo foi avaliar a influência da cor do adesivo dental na estabilidade cromática e intensidade de fluorescência das restaurações de resina composta de diferentes espessuras. Foram obtidos noventa amostras de esmalte bovino que foram restaurados com resina composta, variando a espessura do material restaurador e do esmalte (1,0 mm de esmalte e 1,0 mm de compósito; 1,5 mm de esmalte e 0,5 mm de compósito; 0,5 mm de esmalte e 1,5 mm de compósito). As restaurações foram feitas de resina composta (Opallis E-bleach H) utilizando diferentes tipos de adesivos odontológicos: Ambar, Ambar APS, e Single Bond Universal (n=10). As amostras foram submetidas a testes de medição de cor em um espectrofotômetro usando CIEDE2000 e medições de intensidade de fluorescência antes e depois do envelhecimento em uma solução de coloração de vinho tinto. Os dados foram submetidos à análise de variância (ANOVA) e ao teste de Tukey (α = 0,05). Não houve mudanças estatisticamente significativas na estabilidade da cor ou intensidade de fluorescência para restaurações feitas de diferentes materiais ou espessuras (p>0,05). O Single Bond Universal mostrou maior estabilidade de cor a 0,5 mm de espessura (ΔE00 = 4,4 ± 1,6) em comparação com outras espessuras do mesmo material (p=0,03), bem como uma maior diferença na intensidade de fluorescência após o envelhecimento a 1,5 mm de espessura (-414,9 ± 103,8) em comparação com outros materiais (p=0,0002). Em geral, concluiu-se que os diferentes sistemas adesivos não influenciaram a estabilidade de cor e a intensidade de fluorescência das restaurações de diferentes espessuras.
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Abstract Objective To assess whether bleaching gel volume influences chromatic changes, hydrogen peroxide (HP) diffusion, inflammation, and oxidative stress in the pulp tissue. Methodology A total of 60 bovine teeth were divided into four groups, according to bleaching gel volume (n=15): without gel (WG); V30 (30 µL of 35% HP); V60 (60 µL); and V120 (120 μL). HP diffusion analysis was performed in the first session (T1). Chromatic changes (ΔE, ΔE00, and WID) were assessed after the first (T1), second (T2), third (T3) sessions, and 15 d (T4) after the end of treatment. Moreover, 20 rats were randomly divided into four groups (n=10) and their upper first molars were treated with different gel volumes: control (no treatment); V2 (2 μL of 17.5% HP); V4 (4 μL); and V8 (8 μL). After 24 h, rats were euthanized and the specimens processed for histological and immunohistochemical (nitric oxide synthase) evaluation. Data were analyzed using the Wilcoxon and Mann-Whitney tests (p<0.05). Results In vitro (bovine teeth), chromatic changes were not influenced by bleaching gel volume, showing similar values in all groups and sessions, except for the control group (p<0.05). The V120 group had the highest HP diffusion values (p<0.05). In vivo (pulp tissue), the V4 and V8 groups showed the highest inflammatory infiltrate in the pulp and significant oxidative stress (p<0.05). Conclusion The adverse effects on the dental pulp related to HP diffusion, pulp inflammation, and oxidative stress depend on bleaching gel volume, while the bleaching effect is not proportional to the volume used.
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OBJECTIVES: This in vitro study aimed to evaluate the effect of different times and concentrations of hydrofluoric acid etching on the surface of indirect restorative materials obtained from blocks used in CAD-CAM technology. METHODS: Specimens (4 mm × 4 mm × 0.8 mm) were obtained for each indirect restorative material: zirconia-reinforced lithium monosilicate ceramic (Celtra Duo), nanoceramic resin (Lava Ultimate), and polymer-infiltrated ceramic network material (Vita Enamic). The materials were submitted to etching with 5% or 10% hydrofluoric acid for 20, 40, 60, or 90 s. A control group for each material was evaluated without any surface treatment, totaling nine experimental groups for each material (n = 10). The specimens were evaluated for surface roughness (Ra and Rz), confocal optical microscopy, the contact angle (θ), surface free energy (γs), total free interaction energy (∆G) using a goniometer, and microshear bond strength to resin cement. Specimen images were obtained using scanning electron microscopy, confocal optical microscopy, and atomic force microscopy. Data on the surface roughness, the contact angle, surface free energy, total free interaction energy, and bond strength were subjected to two-way ANOVA and Tukey´s test (α=0.05). RESULTS: In general, Celtra Duo showed better results after etching with 10% hydrofluoric acid for 40 or 60 s. Lava Ultimate showed better performance after etching with 10% hydrofluoric acid for 20 or 40 s, whereas Vita Enamic showed better results after etching with 5% hydrofluoric acid for 90 s. CONCLUSION: Each material showed different characteristics after etching with hydrofluoric acid. Knowledge of the proper protocol for each material is essential to ensure improvements in the adhesion process and durability of indirect restorations. In general, Celtra Duo presented mechanical properties superior to those of Lava Ultimate and Vita Enamic. CLINICAL SIGNIFICANCE: Specific etching protocols must be recommended for each indirect material because longer exposure to hydrofluoric acid can jeopardize the surface, thus affecting the mechanical and bond strength properties.
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Recubrimiento Dental Adhesivo , Ácido Fluorhídrico , Ácido Fluorhídrico/química , Porcelana Dental/química , Ensayo de Materiales , Propiedades de Superficie , Materiales Dentales/química , Cementos de Resina/química , Cerámica/química , Diseño Asistido por ComputadoraRESUMEN
This study aims to evaluate in vitro the effect of violet LED when applied directly to dentin tissue pigmented by different substances. We analyzed the chromatic alteration, the bleaching effect and the temperature variation. Hence, 60 bovine dentin tissue discs were divided into five groups: NNatural Pigmentation; T-Black Tea; C-Soluble Coffee; W-Red Wine; B-Equine Blood. Individualized pigmentation protocols were performed and all groups reached the same chromatic change value. Subsequently, we simultaneously performed a bleaching session and measured temperature variation using a K-type thermocouple device. Data on chromatic change (∆E, ∆E00, ∆a, ∆b and ∆L), whitening effect (WID) and temperature variation were subjected to one-way Anova and Tukey's post-test at a 5% significance level. The C group showed the most relevant chromatic change values, similar to the N group, responding positively to the treatment. However, the B group differed from the control group, which showed difficulty to respond to the treatment. Regarding the whitening index, only the W group showed lower results than the others. The B group showed the greatest temperature changes. We conclude that the violet LED offered chromatic change, which generated a bleaching effect. Pigmentations with red wine and blood showed the greatest difficulty to respond to treatment, also promoting a higher temperature rise in teeth pigmented with blood.
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Fotoquimioterapia , Blanqueamiento de Dientes , Animales , Bovinos , Caballos , Blanqueamiento de Dientes/métodos , Fotoquimioterapia/métodos , Temperatura , Calor , DentinaRESUMEN
OBJECTIVE: The study aims to assess the effects of a 10% H2O2 bleaching gel with different MnO2 concentrations on the bleaching efficacy (BE), degradation kinetics (DK) of H2O2, and trans-amelodentinal cytotoxicity (TC). MATERIALS AND METHODS: Standardized bovine enamel/dentin disks (n = 96) were placed in artificial pulp chambers, and the bleaching gels were applied for 45 min. Thus, the following groups were established: (G1) no treatment (negative control/NC); (G2) 35% H2O2 (positive control/PC); (G3) 10% H2O2; (G4) 10% H2O2 + 2 mg/mL MnO2; (G5) 10% H2O2 + 6 mg/mL MnO2; and (G6) 10% H2O2 + 10 mg/mL MnO2. After analyzing bleaching efficacy (ΔE00 and ΔWI), the degradation kinetics of H2O2 and trans-amelodentinal cytotoxicity were determined (n = 8, ANOVA/Tukey; p < 0.05). RESULTS: G6 presented BE (ΔE00 and ΔWI) statistically similar to G2, which represented conventional in-office bleaching (p = 0.6795; p > 0.9999). A significant reduction in the diffusion of H2O2 occurred in G3, G4, G5, and G6 compared to G2 (p < 0.0001). The highest DK of H2O2 occurred in G6 (p < 0.0001), which had the lowest TC in comparison with all other bleached groups (p ≤ 0.0186). CONCLUSION: The addition of 10 mg/mL of MnO2 in a 10% H2O2 bleaching gel potentiates the degradation of this reactive molecule, which increases the BE of the product and decreases TC. CLINICAL SIGNIFICANCE: Replacing a 35% H2O2 gel commonly used for conventional in-office dental bleaching by a 10% H2O2 gel containing 10 mg/mL of MnO2 reduces the cytotoxicity of this professional therapy, maintaining its excellent esthetic efficacy.
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Blanqueadores Dentales , Blanqueamiento de Dientes , Bovinos , Animales , Peróxido de Hidrógeno , Blanqueadores Dentales/toxicidad , Compuestos de Manganeso , Óxidos/toxicidad , Estética Dental , GelesRESUMEN
PURPOSE: This in vitro study aimed to determine the effect of antioxidant solutions used after dental bleaching on the shear bond strength and adhesive interface sealing of ceramic laminate veneer luting. Additionally, effects on the enamel surface characteristics of hydrogen peroxide neutralization, surface energy, total free interaction energy, morphology, and chemical composition of enamel were assessed. MATERIAL AND METHODS: Total 127 bovine incisors were divided into experimental groups, according to the surface treatment (unbleached and bleached enamel), antioxidant types (control; 10% ascorbic acid and 10% α-tocopherol), and periods of luting of ceramic laminates (24 h and after 14 days). Shear bond strength was assessed using microtensile test before and after thermal cycling (5760 cycles, 5-55 °C) (n = 6). The sealing of the adhesive interface was assessed using a confocal laser scanning microscope (n = 3). Hydrogen peroxide neutralization analysis was performed using a spectrophotometer (n = 5). The surface energy and total free interaction energy (n = 10) were measured using an automatic goniometer, while enamel morphology and chemical composition were assessed by scanning eletron microscopy (n = 3). Shear bond strength and enamel surface properties data were subjected to ANOVA followed by Tukey's test (α = 0.05). Adhesive interface micrographs were evaluated by the inter-examiner Kappa test and subjected to Kruskal-Wallis and Dunn's tests (α = 0.05). RESULTS: In general, thermal aging decreased the shear bond strength values of the luting agents to enamel (P < .05). The α-tocopherol solution was able to reverse the oxidizing effect from dental bleaching, increasing the shear bond strength values and preserving the integrity of the adhesive interface sealing (P < .05). Moreover, the α-tocopherol antioxidant agent promoted higher hydrogen peroxide neutralization after dental bleaching (P < .05). Dental bleaching influenced the enamel surface, decreasing the surface energy and total free interaction energy values (P < .05). CONCLUSION: α-tocopherol was able to reverse the oxidizing effects of dental bleaching, improving the enamel surface properties, as well as the adhesion and interface sealing of ceramic laminate veneer restorations.
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Antioxidantes , Recubrimiento Dental Adhesivo , Animales , Antioxidantes/farmacología , Bovinos , Cerámica/química , Resinas Compuestas/química , Esmalte Dental , Análisis del Estrés Dental , Peróxido de Hidrógeno , Ensayo de Materiales , Cementos de Resina/química , Resistencia al Corte , alfa-Tocoferol/farmacologíaRESUMEN
OBJECTIVES: To evaluate the influence of violet LED, associated or not with a 17.5% hydrogen peroxide (HP) bleaching gel, on inflammation, mineralization in pulp tissue, and collagen fiber maturation in dentin and pulp tissue. MATERIALS AND METHODS: The maxillary molars of eighty Wistar rats were distributed into four groups (n = 10): CONT - without treatment; HP - 30 min application of 17.5% HP; LED - 20 min application of violet LED; and HP+LED - application of PH and violet LED. Rats were euthanized and jaws were processed for histologic and immunohistochemical evaluation (IL-17, IL-23, and osteocalcin) and picrosirius red immediately after (T0), and at 7 (T1), 15 (T2), and 30 days (T3) post-treatment, with Wilcoxon, Mann-Whitney, paired T-test, and T-test (α = 0.05). RESULTS: HP and HP+LED presented necrosis and severe inflammatory infiltrate. When compared to CONT group, LED presented severe osteocalcin (OCN) immunostaining in T2 and less immature fibers in T2 and T3. CONCLUSION: The violet LED caused no severe damage to the pulp tissue, increased IL-17 and IL-23 expression in T0 when associated with HP, and had no influence on pulp tissue mineralization, besides accelerating the maturation of collagen fibers of dentin. CLINICAL RELEVANCE: Violet LED therapy induced no inflammation in the pulp tissue of rats and played no role in pulp tissue fibrosis, besides accelerating the maturation of dentin collagen fibers.
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Luces de Curación Dental , Pulpa Dental , Dentina , Peróxido de Hidrógeno , Inflamación , Fotoquimioterapia , Blanqueadores Dentales , Blanqueamiento de Dientes , Calcificación de Dientes , Animales , Colágeno/metabolismo , Pulpa Dental/efectos de los fármacos , Pulpa Dental/efectos de la radiación , Dentina/efectos de los fármacos , Dentina/efectos de la radiación , Geles , Peróxido de Hidrógeno/farmacología , Peróxido de Hidrógeno/uso terapéutico , Inflamación/tratamiento farmacológico , Inflamación/radioterapia , Interleucina-17/metabolismo , Interleucina-23/metabolismo , Osteocalcina/metabolismo , Fotoquimioterapia/métodos , Ratas , Ratas Wistar , Blanqueamiento de Dientes/métodos , Blanqueadores Dentales/farmacología , Blanqueadores Dentales/uso terapéutico , Calcificación de Dientes/efectos de los fármacos , Calcificación de Dientes/efectos de la radiaciónRESUMEN
OBJECTIVES: To evaluate the influence of photobiomodulation with infrared laser (IRL) in the rat pulp tissue after bleaching, considering the immunolabeling of interleukin (IL)-23 and hypoxia-inducible factor (HIF)-1α. METHODOLOGY: The right and left molars of forty rats were divided into groups: Control - with placebo gel and Bleached - with 35% hydrogen peroxide (H2O2). Half of the rats received one IRL application on both sides, establishing a split-mouth design, which resulted in 4 groups with 20 hemi-maxillae each: Control, Bleach, IRL, and Bleached-IRL. Rats (n=10) from each group were euthanized, at 2- and 30-days mark, and the pulp tissue was evaluated using inflammation and immunolabeling scores. Wilcoxon and Mann-Whitney statistical tests were performed (p<0.05). RESULTS: At the 2-days mark, the Bleached group had severe inflammation and necrosis in the occlusal thirds of the pulp, and moderate to severe inflammation in cervical third, whereas the Bleached-IRL had mild to moderate inflammation (p<0.05). At the 30-days mark, there was no inflammation, but tertiary dentine formation in the bleached groups. Regarding IL-23, severe immunolabeling was observed in the Bleached group (p<0.05) at the 2-days mark; at the 30-days mark, there was a reduction in immunolabeling, in which the Bleached group had moderate and the Bleached-IRL group had mild immunolabeling (p>0.05). HIF-1α was more evident at the 2-days mark in the Bleached group, without significant difference with the Bleached-IRL (p>0.05). The difference was observed between the bleached and control groups, without immunolabeling (p<0.05); at the 30-days mark, the Bleached group had reduction in HIF-1α immunolabeling, while the Bleached-IRL had an increase; the difference remained between the bleached and the controls groups (p<0.05). CONCLUSION: Photobiomodulation using IRL minimized the inflammation and IL-23 immunolabeling in the pulp tissue of rats after dental bleaching, but did not influence significantly the HIF-1α immunolabeling.