Alkasite restorative material for endodontically treated teeth: a randomized controlled pilot study.

Objectives: This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment. Materials and Methods: The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05). Results: After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05). Conclusions: The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period. Trial Registration: Brazilian Registry of Clinical Trials (ReBEC) Identifier: RBR-97kx5jv.

Influence of using different toothpaste during bleaching with violet LED light (405 nm) on the colour and roughness of dental enamel: an in vitro study.

This in vitro study aimed to investigate potential changes in the color and roughness of dental enamel resulting from the use of different toothpaste formulations during bleaching with violet LED light (405 nm). Sixty specimens of bovine incisors, each measuring 6 × 6 × 3 mm, were segregated into six distinct experimental groups based on their respective treatments (n = 10): C + VL: Brushing with Colgate® Total 12 + bleaching with violet LED; LB + VL: Brushing with Colgate® Luminous White Brilliant + bleaching with violet LED; LI + VL: Brushing with Colgate® Luminous White Instant + violet LED bleaching; C: Brushing with Colgate® Total 12; LB: Brushing with Colgate® Luminous White Brilliant; LI: Brushing with Colgate® Luminous White Instant. The examined variables included alterations in color (∆L*, ∆a*, ∆b*, ∆Eab, and ∆E00), surface roughness (Ra), and scanning electron microscopy observations. No statistically significant distinctions emerged in total color variations (∆E00 and ∆E) among the groups under scrutiny. Notably, the groups that employed Colgate® Luminous White Instant displayed elevated roughness values, irrespective of their association with violet LED, as corroborated by scanning electron microscopy examinations. It can be concluded that whitening toothpastes associated to violet LED do not influence the color change of dental enamel in fifteen days of treatment. Toothpastes with a higher number of abrasive particles showed greater changes in enamel roughness, regardless of the use of violet LED.

Biomodification of eroded and abraded dentin with epigallocatechin-3-gallate (EGCG).

This study aimed to evaluate in vitro the effects of epigallocatechin-3-gallate (EGCG) as a biomodifier of eroded and abraded dentin. Forty dentin specimens were obtained from the buccal surface of bovine teeth. The specimens were randomly distributed in 4 groups according to dentin substrate: sound or eroded/abraded and dentin biomodification: with 0.5% EGCG and no biomodification (control group). Specimens were subdivided according to aging time: 24 h and 3 months for the analysis of microtensile bond strength (n = 10), morphology of the adhesive interface by SEM (n = 3) and dentin micropermeability by fluorescence microscope (n = 8). Statistical analysis was performed using SPSS system version 20.0 with a significance level of 5%. The results revealed that the control group with eroded-abraded dentin exhibited the lowest bond strength values at 24 h and 3 months. However, the application of 0.5% EGCG as a biomodifier significantly increased bond strength on both sound and eroded-abraded substrates. After 3 months, all groups exhibited an adhesive interface with a more intense fluorescence in the adhesive layer, indicating an increase in porosity at the interface. In conclusion, the EGCG application as a biomodifier enhanced bond strength on both sound and eroded-abraded dentin substrates, however, adhesive interfaces are more regular when restorations are performed on sound dentin, regardless of the biomodification with EGCG.

Impact of combined at-home bleaching and whitening toothpaste use on the surface and color of a composite resin.

Objective: This in vitro study aimed to evaluate the effects of different whitening toothpastes on a composite resin during at-home bleaching with 10% carbamide peroxide. Materials and Methods: Sixty samples (7 mm × 2 mm) were used for color and roughness analyses, while another 60 samples (3 mm × 2 mm) were utilized to assess microhardness. The factors analyzed included toothpaste, for which 5 options with varying active agents were tested (distilled water; conventional toothpaste; whitening toothpaste with abrasive agents; whitening toothpaste with abrasive and chemical agents; and whitening toothpaste with abrasive, chemical, and bleaching agents). Brushing and application of whitening gel were performed for 14 days. Surface microhardness (SMH), surface roughness (Ra), and color (∆L*, ∆a*, ∆b, ∆E*ab, and ∆E00) were analyzed. The Ra and SMH data were analyzed using mixed generalized linear models for repeated measures, while the color results were assessed using the Kruskal-Wallis and Dunn tests. Results: Between the initial and final time points, all groups demonstrated significant increases in Ra and reductions in SMH. No significant differences were found between groups for SMH at the final time point, at which all groups differed from the distilled water group. Conventional toothpaste exhibited the lowest Ra, while whitening toothpaste with abrasive agent had the highest value. No significant differences were observed in ∆L*, ∆a*, and ∆b. Conclusions: While toothpaste composition did not affect the color stability and microhardness of resin composite, combining toothbrushing with whitening toothpaste and at-home bleaching enhanced the change in Ra.

Er:YAG laser in selective caries removal and dentin treatment with chitosan: a randomized clinical trial in primary molars.

This study evaluated the effect of chitosan on dentin treatment after selective removal of caries lesions with Er:YAG laser in reducing Streptococcus mutans, as well as its effect on the performed restorations. The sample consisted of children (aged 7 to 9 years) with active carious lesions and dentin cavitation located on the occlusal surface of deciduous molars. Eighty teeth were randomly distributed into 4 groups according to the caries removal method: Er:YAG laser (250 mJ/4 Hz) or bur and dentin surface treatment: 2.5% chitosan solution or distilled water. The bacterial load of caries-affected dentin was quantified by counting CFU/mg (n = 10). The teeth were restored and evaluated at 7 days, 6 months, and 12 months using modified USPHS criteria (n = 20). Microbiological data was analyzed by Mann-Whitney and clinical analyses were done using Kruskal-Wallis and Dunn test (α = 0.05). The results showed that the Er:YAG laser significantly reduced the amount of Streptococcus mutans (p = 0.0068). After dentin treatment with chitosan, there was a significant reduction in the amount of Streptococcus mutans for both removal methods (p = 0.0424). For the retention and secondary caries criteria, no significant differences were observed along the evaluated time (p > 0.05). The laser-treated group was rated "bravo" for discoloration (p = 0.0089) and marginal adaptation (p = 0.0003) after 6 and 12 months compared to baseline. The Er:YAG laser reduced the amount of Streptococcus mutans and the chitosan showed an additional antibacterial effect. After 1 year, the Er:YAG laser-prepared teeth, regardless of the dentin treatment, showed greater discoloration and marginal adaptation of the restorations.

Evaluation of the efficacy of the use of violet LED light in the bleaching of damaged primary incisors darkened by trauma.

BACKGROUND: The aim of this study was to evaluate efficacy of violet LED light for the bleaching treatment of primary incisors darkened by trauma. METHODS: Twenty deciduous incisors with color change were selected, divided into two groups: control - no bleaching protocol was applied, and VL- treated with violet LED. The change color analysis was taken in each tooth, by spectrophotometer. In three different time: baseline - before treatment, after 4 treatment sessions and after 8 treatment sessions. RESULTS: The color change data were analyzed using ANOVA and a post- hoc Tukey tests (α=0.05). After 4 and 8 sessions no differences were observed between the groups (p<0.05). CONCLUSIONS: Thus, it can be concluded that violet LED light was not effective in bleaching primary incisors darkened by trauma after 8 sessions.

Bond strength of bulk fill composite to teeth prepared with Er: YAG laser

Aim: The present in vitro study aimed to evaluate the bond strength of a bulk fill composite on dentin surfaces prepared with the Er: YAG laser. Methods: Twenty-four permanent third molars were selected and divided into 2 groups: CP - Conventional preparation with high-speed handpiece (control) and LA (laser) - Preparation with Er: YAG laser. The occlusal surface was removed to expose coronal dentin, which was subsequently prepared with a high-speed handpiece or Er: YAG laser (350mJ, 4Hz, 1.5 ml/min water flow). Both groups were restored with Filtek One Bulk Fill (3M ESPE) composite resin. After 24 hours, the samples were evaluated for microtensile bond strength (µTBS), fracture pattern, and scanning electron microscopy (SEM). Results: The data obtained in the µTBS test were submitted to t-test (α=0.05). The results showed no difference in µTBS when the different types of cavity preparation were compared (ρ=0.091). Fracture patterns revealed the prevalence of cohesive fracture in composite resin in CP (83.3%) and adhesive fracture in LA (92.1%). In the SEM analysis, the LA group demonstrated the presence of gaps between the composite resin and the irradiated dentin surface. The hybrid layer exhibited more regularity with the presence of longer and uniform resin tags in the CP group. Conclusion: The type of cavity preparation did not influence the values of bulk fill composite resin µTBS to dentin. Fracture patterns and scanning electron microscopy analyses suggested less interference at the adhesive interface in preparations performed using CP

Substituição de restauração classe IV em resina composta: relato de caso clínico / Class IV restoration replacement in composite resin: clinical case report

Introdução: a estética é um fator decisivo para a substituição de restaurações anteriores que apresentam falhas, causadas principalmente por alterações na coloração ou fraturas. Objetivo: o presente relato de caso descreve a substituição de uma restauração classe IV insatisfatória, apresentando o protocolo clínico utilizado desde o planejamento até a reabilitação definitiva, com o propósito de difundir o conhecimento sobre a técnica adotada e auxiliar outros profissionais no seu cotidiano clínico. Relato do caso: paciente JPJ, 28 anos, sexo masculino, apresentou-se ao consultório odontológico queixando-se do aspecto estético de uma restauração em resina composta no seu dente anterior. Durante o exame físico intrabucal foi identificada a presença de uma restauração classe IV insatisfatória no elemento 21, apresentando degradação e manchamento superficial. Para uma análise estética completa e planejamento do caso, foram realizadas fotografias intrabucais e moldagem com alginato para confecção de modelos de gesso. Resultados: como tratamento, foi realizado profilaxia, isolamento absoluto e substituição da restauração do dente 21 pela técnica direta com o auxílio de uma guia de silicone. Foi utilizado um sistema adesivo convencional de 2 passos (Single Bond 2, 3M ESPE, St. Paul, MN, USA) e resinas compostas nanohíbridas (Empress Direct, Ivoclar-Vivadent, Barueri, SP, BRA), uma para reprodução do esmalte e outra para dentina. Por fim, foram realizados acabamento e polimento das restaurações. Conclusão: restaurações diretas com resinas compostas, quando bem indicadas e executadas, permitem a devolução da função de forma satisfatória e resultados altamente estéticos.

Introduction: aesthetics are a decisive factor in replacing anterior restorations that present failures, mainly caused by color changes or fractures. Objective: this case report describes the replacement of a class IV restoration with composite resin by the direct technique, presenting the clinical protocol used, from planning to definitive rehabilitation, with the purpose of spreading knowledge of the technique and helping other professionals in their daily clinical routine. Case report: patient JPJ, 28 years old, male, presented to the dental office complaining about the aesthetic aspect of a composite resin restoration on his anterior tooth. During the intraoral physical examination, the presence of a class IV restoration in element 21 was identified, which was unsatisfactory due to degradation and surface staining. For a complete and detailed esthetic analysis, intraoral photographs and molding with alginate were taken to make plaster models. Results: as a treatment, prophylaxis, absolute isolation and replacement of the restoration of tooth 21 were performed by the direct technique with the aid of a silicone guide. A conventional 2-step adhesive system (Single Bond 2, 3M ESPE, St. Paul, MN, USA) and nanohybrid composite resins (Empress Direct, Ivoclar-Vivadent, Barueri, SP, BRA) were used, one for enamel reproduction and another for dentine. Finally, finishing and polishing of the restorations were carried out. Conclusion: direct restorations with composite resins, when properly indicated and executed, allow the return of function in a satisfactory way and highly esthetic results.

Evaluation of mineral content of tooth enamel after application violet led associated with 35% hydrogen peroxide.

BACKGROUND: The aim of this study was to evaluate the microhardness and quantify the presence of minerals (Calcium and Phosphorous) of tooth enamel submitted to bleaching with violet LED light, either associated with 35% hydrogen peroxide gel, or not. METHODS: Bovine incisors were selected and divided into 4 Groups according to the bleaching technique used: C- Without bleaching (Control); VL- violet LED; HP- 35% Hydrogen Peroxide; HP+VL- 35% Hydrogen Peroxide + violet LED. The response variables were surface microhardness (n = 12), Energy Dispersive Spectroscopy (EDS) (n = 6) and scanning electron microscopy (SEM) (n = 3). RESULTS: The 2-way ANOVA test with repeated measures showed that there was difference in the microhardness values of enamel in the specimens in all of the Groups when the values measured in the initial and final time intervals were compared, however, without significant differences between the values of the different treatments in both time intervals. The results with reference to EDS were analyzed with the 1-way ANOVA test. There was difference among the Groups only in the Ca%, with Group HP obtaining the lowest values, with significant difference from those of the C Group. SEM images showed a smooth, homogeneous enamel surface and similarity among the Groups, irrespective of the treatment performed. CONCLUSIONS: Therefore, it was concluded that the changes caused in enamel by the use of violet LED Light, either associated with 35% hydrogen peroxide, or not, did not differ from those of non-bleached tooth enamel, showing absence of harm to the mineral content of tooth enamel resulting from the use of violet LED.

Color stability of dental enamel bleached with violet LED associated with or without Low concentration peroxide gels.

BACKGROUND: This study aimed to evaluate the in vitro color of dental enamel bleached with the violet LED, associated with or without low-concentration of peroxide; analyzed in two time intervals: 24 h later and 6 months after the treatment. METHODS: Ninety fragments of bovine teeth (6 × 6 mm and 3 mm thick) were randomly divided into 6 groups according to bleaching treatment: NB - no bleaching, VL - Violet LED, HP- 7.5 % hydrogen peroxide, HP + VL - 7.5 % hydrogen peroxide + violet LED, CP - 22 % carbamide peroxide, CP + VL - 22 % carbamide peroxide + violet LED. The color change was analyzed by using a spectrophotometer, at time intervals of 24 h and 6 months after performing the bleaching techniques (n = 12). Scanning electron microscopy (SEM) was performed to verify the enamel surface morphology after treatment (n = 3). RESULTS: The color change data were analyzed using ANOVA and a post-hoc Tukey tests (α = 0.05). The VL group showed chromatic changes after 24 h of treatment, however the groups submitted to bleaching gel treatments associated with or without violet LED (CP + VL, CP, HP, HP + VL) showed the highest color change values at all time intervals analyzed, with color stability after 6 months of treatment for the CP + VL group. Scanning electron microscopy analysis showed the greatest change in enamel surface for Groups CP and HP. CONCLUSIONS: It could be concluded that violet LED had immediate bleaching effect without promoting significant changes in enamel morphology, however the association with carbamide peroxide 22 % showed color stability and greater bleaching efficacy than the use of violet LED alone, after 6 months.

Durability of resin on bleached dentin treated with antioxidant solutions or lasers.

OBJECTIVE: To assess the influence of antioxidants (sodium ascorbate - SA, epigallocatechin-3-gallate (EGCG) from Camellia sinensis and punicalagin from Punica granatum) or lasers (Er:YAG and diode) on bleached dentin. METHODS: Four hundred and forty slabs of intracoronary dentin were prepared: 224 for bond strength (debonding test) (n = 14), 96 for chemical analysis (EDS) and morphology (SEM) (n = 6), 96 for interface analysis (n = 6) and 24 for atomic force microscopy (AFM). The slabs were distributed according to the post-treatment after bleaching (35% hydrogen peroxide): GI- no bleaching and no post-treatment, GII- only bleached, GIII- 10-days delay in restorative procedure, GIV- 10% SA (10 min), GV- 0.5% EGCG (10 min), GVI- 0.5% punicalagin (10 min), GVII- Er:YAG laser (0.80W, 20s) and GVIII- diode laser (1.5W, 20s). Restorative procedures were done. Half of the slabs were analyzed immediately and the others, after 12 months. Debonding and AFM data were analyzed by ANOVA and Tukey tests (α = 0.05). RESULTS: All the post-treatments, except for punicalagin, reestablished the immediate bond strength, similar to those restored after 10 days (p > 0.05). Following degradation, EGCG and punicalagin reestablished the bond strength (p < 0.05). Lasers were not effective in maintaining the bond strength after 12 months (p < 0.05). Higher O levels were found after bleaching but were reduced overtime. Ca and P remained stable. SEM and AFM showed residual granules of SA and irregular surface due to the laser action. After aging, tags and good interface were verified in GI, GIII, GV and GVI. CONCLUSION: Sodium ascorbate, EGCG or lasers restored the immediate bond strength, but only the natural extracts were effective in the long-term durability of resin. Thus, EGCG at 0.5% for 10 min seems to be the best pre-restorative treatment for bleached substrate.

Effect of violet led associated with low-concentration hydrogen peroxide on enamel surface roughness

Aim: The present study aimed to assess in vitro the effect ofviolet LED in tooth bleaching techniques associated or not withlow-concentration hydrogen peroxide gel on enamel surfaceroughness. Methods: Fifty-two enamel fragments of bovineteeth were flattened and polished (4x4x3 mm) and dividedinto four groups according to bleaching treatment: VL- VioletLED; HP- 7.5% hydrogen peroxide; HP+VL- 7.5% hydrogenperoxide + violet LED; C- No bleaching (control). Before thetreatments, all specimens were immersed in 20 mL of blacktea for six days, changing solutions every 24 h to simulatethe staining of specimens. Forty fragments were used toanalyze surface roughness (n=10) and 12 fragments wereused for the morphological analysis (SEM) (n=3). Results:The data were submitted to one-way ANOVA and a post-hocTukey test. The lower roughness values was observed for thegroup that did not receive bleaching treatment (C), differingsignificantly only from the group bleached with 7.5% hydrogenperoxide + violet LED (HP+VL) (p=0.0077). The remaininggroups did not show significant differences in roughnessvalues (p>0.05). The scanning electron microscopy analysisshowed irregularities on the enamel surface regardless ofthe treatment received. Conclusion: The results showedthat bleaching treatments with violet LED associated withlow-concentration hydrogen peroxide gels (7.5%) increasethe surface roughness of tooth enamel

Effect of grape seed extract on bond strength of restorative material to bleached enamel

Objective: The aim of this study was to evaluate the effect of different concentrations of a natural antioxidant (grape seed extract) on the bond strength of the restorative material to the bleached enamel. Methods: Forty fragments of healthy bovine incisors were randomly divided into four groups (n = 10): Group I: no bleaching; Group II: Bleaching with 35% hydrogen peroxide (HP) and without post-treatment; Group III: Bleaching with 35% HP + 5% grape seed extract; and Group IV: Bleaching with 35% HP + 10% grape seed extract. The bond strength at the adhesive interface was evaluated using the shear test (MPa). The data were analyzed by the analysis of variance (ANOVA) and Tukey test ( =0.05%). The fracture types were also analyzed and classified into: adhesive, cohesive or mixed. Results: Only Group III (bleached + 5% grape seed extract) had a significant increase (p<0.001) in bond strength values when compared to Group II bleached, without post- reatment). All groups showed a predominance of the adhesive type of fracture. Conclusion: It could be concluded that tooth bleaching decreases the bond strength to bleached enamel and 5% grape seed extract applied after dental bleaching improves the bond strength between the restorative material and the bleached enamel.

Objetivo: Este trabalho teve por objetivo avaliar in vitro o efeito de um antioxidante natural (extrato de semente de uva) em diferentes concentrações, na resistência de união do material restaurador ao esmalte clareado. Métodos: Quarenta fragmentos de incisivos bovinos hígidos, foram divididos aleatoriamente em quatro grupos (n=10): Grupo I: sem clareamento; Grupo II: clareado com peróxido de hidrogênio 35% (PH) e sem pós-tratamento; GIII: clareado PH 35% + extrato de semente de uva 5%; e Grupo IV: clareado com PH 35% + extrato de semente de uva 10%. A resistência de união da interface esmalte/material restaurador foi avaliada por meio do teste de cisalhamento (MPa). Os dados foram analisados pela análise de variância (ANOVA) e testes de Tukey ( =0,05%). Os tipos de fratura também foram analisados e classificados em: adesiva, coesiva ou mista. Resultados: Apenas o Grupo III (clareado + extrato de semente de uva 5%) apresentou aumento estatisticamente significante (p<0,001). dos valores de resistência de união comparado ao Grupo II (clareado e sem pós-tratamento). Todos os grupos mostraram um predomínio do tipo de fratura adesiva. Conclusão: O clareamento dental diminui significativamente a força de adesão ao esmalte dental clareado, e o extrato de semente de uva 5% aplicado após o clareamento dental melhora a resistência de união entre o material restaurador e o esmalte clareado.

Non-contact profilometry of eroded and abraded enamel irradiated with an Er:YAG laser.

Literature has reported positive results regarding the use of lasers in the control of erosive lesions; however, evaluating whether they are effective in the control of the progression of erosive/abrasive lesions is important. Objectives This study aimed to evaluate the effect of the Er:YAG laser irradiation in controlling the progression of erosion associated with abrasive lesions in enamel. Material and methods Bovine incisors were sectioned, flattened and polished. Forty-eight enamel slabs were subjected to treatment in an intraoral phase. Twelve volunteers used an intraoral appliance containing one slab that was irradiated with an Er:YAG laser (5.2 J/cm2, 85 mJ, 2 Hz) and another non-irradiated slab on each side of the appliance, during one phase of 5 d, under a split-mouth design. Devices were subjected to erosive challenges (1% citric acid, 5 min, 3 times a day) and abrasive challenges one h after (brushing force of 1.5 N for 15 s) randomly and independently on each side of the device. Measurements of enamel loss were performed via 3D optical profilometry (µm). We analyzed data using the Kruskal-Wallis and Mann-Whitney tests and morphological characteristics via scanning electron microscopy. Results Following erosive and abrasive challenges, the group that was irradiated with the Er:YAG laser presented less loss of structure than the non-irradiated group. The group that underwent erosion and irradiation did not exhibit a significant difference from the non-irradiated group. Conclusion Irradiation with the Er:YAG laser did not control the loss of structure of enamel subjected to erosion but did control abrasion after erosion.

Protocols for sodium ascorbate application on intracoronary dentin bleached with high-concentrated agent.

PURPOSE: Composite resin restorations are normally replaced after the internal bleaching of endodontically treated-teeth because the bleaching agent does not alter the color of the restorative material. This study evaluated the effect of 10% sodium ascorbate (SA) applied at different protocols on bleached dentin. MATERIALS AND METHODS: One-hundred slabs of intracoronary bovine dentin were divided into 5 groups: 2 controls-GI without bleaching (positive), GII bleached with 35% hydrogen peroxide (HP) (negative); and 3 experimentals - GIII. 35% HP + SA at protocol 1 (dripping, washing and drying the solution), GIV. 35% HP + SA at protocol 2 (dripping and aspirating the solution) and GV. 35% HP + SA at protocol 3 (dripping, rubbing and aspirating the solution). Sixty fragments were restored and subjected to shear bond strength test (n = 12). Forty fragments (n = 8) were prepared for chemical analysis (energy dispersive X-ray spectrometry) and surface morphology (scanning electron microscopy). Data were analyzed by ANOVA and Tukey test (P < 0.05). RESULTS: GI (3.169 ± 1.510a) had the highest means values, similar to GIV (2.752 ± 0.961a) and GV (2.981 ± 1.185a) (P < 0.05). Inferior values were obtained in GII (1.472 ± 0.342b) and GIII (2.037 ± 0.742ab) had intermediate values (P > 0.05). Oxygen concentration was reduced in groups treated with SA, and the surface exhibited residual granules of the solution. CONCLUSION: The 10% SA solution reestablishes the bond strength of restorative material to bleached dentin, especially if active protocols of application and aspiration were used.

Effects of EDTA gel and chlorhexidine gel on root dentin permeability.

The aim of this study was to evaluate the effect of 24% ethylenediaminetetraacetic acid (EDTA) gel and 2% chlorhexidine gel (CHX) in dentin permeability and smear layer removal from root canals instrumented with NiTi rotary system using histochemical staining and scanning electron microscopy (SEM) analysis. Overall, 43 premolars were classified into two experimental groups, EDTA (n = 20) and CHX (n = 20), and a negative control (NC) (n = 3). All specimens were instrumented and the irrigant solutions were used after each file change. The EDTA group received a final rinse with 5-ml 1% NaOCl followed by a 5-ml 0.9% saline solution; the CHX group received a final rinse with 10-ml 0.9% saline solution; and the negative control group received a final rinse with only 0.9% saline solution. Fifteen teeth from each group were prepared for histochemical staining and evaluation of dentin permeability using the image-scanning software Axion Vision (v.4.8.2). Five remaining teeth were prepared for analysis using SEM for morphological analysis. The study found that 24% EDTA gel increased the permeability of dentin in all thirds evaluated and also demonstrated an increased cleaning ability, with dentinal walls free of smear layer and open dentinal tubules, as compared to 2% CHX gel. It was concluded that EDTA was efficient in cleaning the dentinal tubules and increased dentin permeability.

Non-contact profilometry of eroded and abraded enamel irradiated with an Er: YAG laser

Abstract Literature has reported positive results regarding the use of lasers in the control of erosive lesions; however, evaluating whether they are effective in the control of the progression of erosive/abrasive lesions is important. Objectives This study aimed to evaluate the effect of the Er:YAG laser irradiation in controlling the progression of erosion associated with abrasive lesions in enamel. Material and methods Bovine incisors were sectioned, flattened and polished. Forty-eight enamel slabs were subjected to treatment in an intraoral phase. Twelve volunteers used an intraoral appliance containing one slab that was irradiated with an Er:YAG laser (5.2 J/cm2, 85 mJ, 2 Hz) and another non-irradiated slab on each side of the appliance, during one phase of 5 d, under a split-mouth design. Devices were subjected to erosive challenges (1% citric acid, 5 min, 3 times a day) and abrasive challenges one h after (brushing force of 1.5 N for 15 s) randomly and independently on each side of the device. Measurements of enamel loss were performed via 3D optical profilometry (μm). We analyzed data using the Kruskal-Wallis and Mann-Whitney tests and morphological characteristics via scanning electron microscopy. Results Following erosive and abrasive challenges, the group that was irradiated with the Er:YAG laser presented less loss of structure than the non-irradiated group. The group that underwent erosion and irradiation did not exhibit a significant difference from the non-irradiated group. Conclusion Irradiation with the Er:YAG laser did not control the loss of structure of enamel subjected to erosion but did control abrasion after erosion.

Impact of hydrogen peroxide activated by lighting-emitting diode/laser system on enamel color and microhardness: An in situ design.

BACKGROUND: Hydrogen peroxide (HP) at lower concentration can provide less alteration on enamel surface and when combined with laser therapy, could decrease tooth sensitivity. This in situ study evaluated the influence of 15% and 35% HP gel activated by lighting-emitting diode (LED)/laser light for in-office tooth bleaching. MATERIALS AND METHODS: Forty-four bovine enamel slabs were polished and subjected to surface microhardness (load of 25 g for 5 s). The specimens were placed in intraoral palatal devices of 11 volunteers (n = 11). Sample was randomly distributed into four groups according to the bleaching protocol: 15% HP, 15% HP activated by LED/laser, 35% HP, and 35% HP activated by LED/laser. The experimental phase comprised 15 days and bleaching protocols were performed on the 2(nd) and 9(th) days. Surface microhardness (KHN) and color changes were measured and data were analyzed by ANOVA (α = 0.05). RESULTS: There were no significant differences in microhardness values neither in color alteration of enamel treated with 15% HP and 35% HP activated or not by LED/laser system (P > 0.05). CONCLUSIONS: Both concentrations of HP (15 or 35%), regardless of activated by an LED/laser light, did not affect the surface microhardness and had the same effectiveness in enamel bleaching.

Effect of Fluoride Varnish Combined with Er:YAG Laser on the Permeability of Eroded Dentin: An In Situ Study

This study evaluated the combined effect of fluoride varnish and Er:YAG laser on the permeability of eroded bovine root dentin. After initial erosive challenge followed by a remineralization period, the specimens were divided in two groups according to the treatment - fluoride varnish and non-fluoride varnish - and were subdivided according to the irradiation protocol: Er:YAG laser (100 mJ, 3 Hz, 12.8 J/cm2per pulse, non-contact and defocus mode) and non-irradiated. After a lead-in period, 7 volunteers wore a palatal device containing 4 specimens that were subjected to erosive challenges. At the first experimental phase, 4 volunteers used specimens treated with fluoride varnish and fluoride varnish+Er:YAG laser and 3 volunteers used specimens treated with non-fluoride varnish and non-fluoride varnish+Er:YAG laser. After a washout period, volunteers were crossed to treatments, characterizing a 2x2 crossover experiment. At the end of the experimental phase, the quantitative response variable was obtained by permeability analysis and the qualitative response by scanning electron microscopy (SEM). Two-way ANOVA and Tukey-Kramer's test revealed that specimens treated with fluoride varnish+Er:YAG laser showed the lowest permeability and a significant difference was found between this group and the others. When varnish (fluoride/non-fluoride) was applied in the absence of Er:YAG laser, higher permeability was found when compared to the laser-treated groups. SEM evaluations showed partially or completely obliterated dentinal tubules when specimens were treated with fluoride varnish+Er:YAG laser. It may be concluded that Er:YAG laser was able to control the permeability of eroded root dentin and the combination with fluoride varnish increased laser action.

Resumo Esse estudo avaliou o feito combinado do verniz fluoretado ao laser de Er:YAG na permeabilidade da dentina radicular erodida. Fragmentos de dentina radicular bovina, foram submetidos a um desafio erosivo inicial com ácido cítrico, que foi seguido por um período de remineralização. Posteriormente, os espécimes foram divididos em relação aos tratamentos: verniz (fluoretado e não fluoretado) e subdivididos de acordo com a irradiação: laser de Er:YAG (100 mJ, 3 Hz, 12.8 J/cm2 por pulso, sem contato e modo não focado) e não irradiado. Após um período de lead in, 7 voluntários utilizaram um dispositivo palatino contendo 4 espécimes que foram submetidos a desafios erosivos. Na primeira fase do experimento, 4 voluntários utilizaram dispositivos com fragmentos tratados com verniz fluoretado e verniz fluoretado+laser de Er:YAG e 3 voluntários utilizaram espécimes tratados com verniz não fluoretado e verniz não fluoretado+laser de Er:YAG. Depois de um período de wash-out, os voluntários foram cruzados em relação aos tratamentos, caracterizando um experimento cross-over 2x2. Ao final de cada fase experimental, a variável resposta quantitativa foi obtida através da análise de permeabilidade e a qualitativa por microscopia eletrônica de varredura (MEV). A ANOVA dois critérios e teste de Tukey-Kramer revelou que as amostras tratadas com verniz fluoretado+laser de Er:YAG mostraram menor permeabilidade e uma diferença significativa foi encontrada entre este grupo, quando comparado aos demais grupos. Quando o verniz (fluoretado/não fluoretado) foram aplicados na ausência do laser de Er:YAG maiores valores de permeabilidade foram encontrados quando comparados com os grupos irradiados com o laser. A MEV demostrou túbulos dentinários parcialmente ou completamente ocluídos quando as amostras foram tratadas com verniz fluoretado+laser de Er: YAG. Pode-se concluir que o laser de Er:YAG foi capaz de controlar a permeabilidade da dentina radicular erodida e essa ação é aumentada quando o laser está associado ao verniz fluoretado.

CO2 laser emission modes to control enamel erosion.

Considering the importance and prevalence of dental erosion, the aim of this in vitro study was to evaluate the influence of different modes of pulse emission of CO2 laser associated or not to acidulated phosphate fluoride (APF) 1.23% gel, in controlling enamel erosion by profilometry. Ninety-six fragments of bovine enamel were flattened and polished, and the specimens were subjected to initial erosive challenge with hydrochloric acid (pH = 2). Specimens were randomly assigned according to surface treatment: APF 1.23% gel and gel without fluoride (control), and subdivided according to the modes of pulse CO2 laser irradiation: no irradiation (control), continuous, ultrapulse, and repeated pulse (n = 12). After surface treatment, further erosive challenges were performed for 5 days, 4 × 2 min/day. Enamel structure loss was quantitatively determined by a profilometer, after surface treatment and after 5 days of erosive challenges. Two-away ANOVA revealed a significant difference between the pulse emission mode of the CO2 laser and the presence of fluoride (P ≤ 0.05). The Duncan's test showed that CO2 laser irradiation in continuous mode and the specimens only received fluoride, promoted lower enamel loss than that other treatments. A lower dissolution of the enamel prisms was observed when it was irradiated with CO2 laser in continuous mode compared other groups. It can be concluded that CO2 laser irradiation in continuous mode was the most effective to control the enamel structure loss submitted to erosive challenges with hydrochloric acid.