Effect of coffee staining and simulated oral hygiene methods on the color and translucency of a nanoceramic resin.

OBJECTIVE: Evaluate the color and translucency of a nanoceramic resin subjected to hygiene practices and immersion in coffee over time. MATERIALS AND METHODS: Specimens (n = 80, HT and LT, 0.5-mm thick) of a nanoceramic resin were obtained and were divided in groups according to the simulated oral hygiene: no intervention (NT), brushing with an electric brush and water (BN), brushing with an electric brush and toothpaste for 10 s (BT), and immersion in mouthwash for 30 s (MW). Oral hygiene practices were repeated after staining in coffee solution for 15, 48, 336, 1440, 8640, and 35,040 min. Spectral wavelengths were recorded with a spectrophotometer at each time. ∆E00 , ∆L', ∆C', ∆H', and TP00 were calculated by CIEDE2000 and were evaluated by 2-way ANOVA, repeated measures ANOVA, and Tukey's HSD test (α = 0.05). RESULTS: ANOVA showed significance among factors for ΔE00 (p < 0.05), with higher ΔE00 for NT-HT (11.7) and NT-LT (11.2). After T6 (2-year simulation), the lowest values were found for BT-HT (5.3) and BT-LT (4.9). All groups showed a reduction in lightness and translucency and increased chroma and hue. However, the smallest variations were found in the BT groups (p < 0.05). CONCLUSIONS: Brushing with toothpaste effectively minimized the color change of NCRs caused by coffee staining. CLINICAL SIGNIFICANCE: Oral hygiene practices, such as brushing with toothpaste, might be important to minimize staining of nanoceramic resin restorations, especially in patients who frequently consume coffee.

Dental and composite resin discoloration induced by different hydraulic calcium silicate-based cements: two-year in vitro assessment.

Few long-term studies assess the discoloration induced by hydraulic calcium silicate-based cement on dental structures. In addition, as far as we know, no long-term study has assessed the discoloration induced by these cement on composite resin. This in vitro study aimed to assess, during a period of two years, the discoloration potential of different hydraulic calcium silicate-based cements (hCSCs) on the enamel/dentin structure and composite resin restoration. A total of 40 enamel/dentin discs were obtained from bovine incisors, and 40 composite resin discs (10 mm in diameter × 2 mm thick) were fabricated. A 0.8 mm-deep cavity was made in the center of each disc and filled with the following hCSCs (n=10): Original MTA (Angelus); MTA Repair HP (Angelus); NeoMTA Plus (Avalon); and Biodentine (Septodont). An initial color measurement was performed (T0 - baseline). After 7, 15, 30, 45, 90, 300 days, and two years, new color measurements were performed to determine the color (ΔE00), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and whiteness index (WID). For enamel/dentin, the ΔE00 was significant among groups and periods (p<0.05). NeoMTA Plus had the greatest ΔE00. The NeoMTA Plus group had the greatest ΔE00 after two years for composite resin. Significant reduction in lightness was observed for all groups after two years (p<0.05). The most significant WID values were observed after 30 days for Biodentine (enamel/dentin) and MTA Repair HP groups (composite resin) (p<0.05). The hCSCs changed the colorimetric behavior of both substrates, leading to greater darkening over time. The Bi2O3 in the Original MTA seems relevant in the short periods of color change assessment.

Dental and composite resin discoloration induced by different hydraulic calcium silicate-based cements: two-year in vitro assessment

Abstract Few long-term studies assess the discoloration induced by hydraulic calcium silicate-based cement on dental structures. In addition, as far as we know, no long-term study has assessed the discoloration induced by these cement on composite resin. Objective This in vitro study aimed to assess, during a period of two years, the discoloration potential of different hydraulic calcium silicate-based cements (hCSCs) on the enamel/dentin structure and composite resin restoration. Methodology A total of 40 enamel/dentin discs were obtained from bovine incisors, and 40 composite resin discs (10 mm in diameter × 2 mm thick) were fabricated. A 0.8 mm-deep cavity was made in the center of each disc and filled with the following hCSCs (n=10): Original MTA (Angelus); MTA Repair HP (Angelus); NeoMTA Plus (Avalon); and Biodentine (Septodont). An initial color measurement was performed (T0 - baseline). After 7, 15, 30, 45, 90, 300 days, and two years, new color measurements were performed to determine the color (ΔE00), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and whiteness index (WID). Results For enamel/dentin, the ΔE00 was significant among groups and periods (p<0.05). NeoMTA Plus had the greatest ΔE00. The NeoMTA Plus group had the greatest ΔE00 after two years for composite resin. Significant reduction in lightness was observed for all groups after two years (p<0.05). The most significant WID values were observed after 30 days for Biodentine (enamel/dentin) and MTA Repair HP groups (composite resin) (p<0.05). Conclusions The hCSCs changed the colorimetric behavior of both substrates, leading to greater darkening over time. The Bi2O3 in the Original MTA seems relevant in the short periods of color change assessment.

Additive Manufacturing Technologies for Fabrication of Biomaterials for Surgical Procedures in Dentistry: A Narrative Review.

PURPOSE: To screen and critically appraise available literature regarding additive manufacturing technologies for bone graft material fabrication in dentistry. MATERIAL AND METHODS: PubMed and Scopus were searched up to May 2021. Studies reporting the additive manufacturing techniques to manufacture scaffolds for intraoral bone defect reconstruction were considered eligible. A narrative review was synthesized to discuss the techniques for bone graft material fabrication in dentistry and the biomaterials used. RESULTS: The databases search resulted in 933 articles. After removing duplicate articles (128 articles), the titles and abstracts of the remaining articles (805 articles) were evaluated. A total of 89 articles were included in this review. Reading these articles, 5 categories of additive manufacturing techniques were identified: material jetting, powder bed fusion, vat photopolymerization, binder jetting, and material extrusion. CONCLUSIONS: Additive manufacturing technologies for bone graft material fabrication in dentistry, especially 3D bioprinting approaches, have been successfully used to fabricate bone graft material with distinct compositions.

Challenging replacement of a maxillary canine with an implant-supported restoration: A surgical and prosthetic approach.

This clinical report describes the replacement of a traumatized maxillary canine that was extracted after unsuccessful orthodontic extrusion with an implant-supported restoration. Guided bone regeneration surgery was performed, followed by a second surgery with implant placement plus simultaneous bone and tissue regeneration. Esthetics and function were achieved with the placement of a veneered zirconia implant-supported restoration.

Tooth discoloration induced by the different phases of a calcium aluminate cement: One-year assessment.

OBJECTIVES: To assess the discoloration of teeth treated with the different phases of calcium aluminate cement (CAC), in comparison with the conventional CAC and mineral trioxide aggregate (MTA). MATERIALS AND METHODS: Fifty bovine incisors were prepared and filled. Two millimeters of the filling was removed to fabricate a cervical plug with the following cements (n=10): CA(CaO.Al2 O3 ); CA2 (CaO.2Al2 O3 ); C12 A7 (12CaO.7Al2 O3 ); CAC and MTA. The initial color measurement was performed and after 7, 15, 30, 45, 90, 180, and 365 days new color measurements were performed to determine the color (ΔE00 ), lightness (ΔL'), chroma (ΔC'), hue differences (ΔH'), and the whiteness index (WID ). RESULTS: ΔE00 was significant for groups (p = 0.036) and periods (p < 0.05). The greater ΔE00 was observed after 365 days for CAC (12.8). C12 A7 (7.2) had the smallest ΔE00 . ΔL' and ΔC' were significant for groups and periods (p < 0.05). ΔH' was significant for periods (p < 0.05). After 365 days, significant reduction in lightness was observed for all groups. For CA, CA2 , CAC, and MTA groups, the WID values decreased over time (p < 0.05). CONCLUSIONS: The tested cements changed the color behavior of the samples, resulting in greater teeth darkening over time. CLINICAL SIGNIFICANCE: There is no long-term study assessing the discoloration induced by the different phases of CAC.

Early Biofilm Formation on Rough and Smooth Titanium Specimens: a Systematic Review of Clinical Studies.

OBJECTIVES: There is a concern whether the enhancement on implant surface roughness is responsible for higher biofilm formation, which acts as an aetiological factor for peri-implant diseases. The aim of the present systematic review was to answer the following question: "Are rough surfaces more susceptible to early biofilm formation when compared to smoother surfaces on titanium specimens?". MATERIAL AND METHODS: The research was performed on PubMed, Web of Science and Scopus, up to August 2021. Eligibility criteria included studies that analysed human biofilm formation on titanium specimens with distinct surface roughness (smooth vs minimally, moderate, or rough) over the experimental times of 1 or 3 days. Roughness average (Ra) and biofilm analysis parameters were extracted from selected articles. Risk of bias was evaluated using the Checklist for Quasi-Experimental Studies. RESULTS: Of 5286 papers, 5 were included and analysed. Smooth titanium surfaces included machined and anodized titanium/Ti-6Al-4V; machined and acid etched TiZr. Minimally, moderately, or rough surfaces comprised titanium and titanium alloys (TiZr, Ti-6Al-4V), that received surface treatments (anodization, acid-etching, blasting, hydroxyapatite-coating). No statistically significant difference on biofilm formation on rough and smooth titanium surfaces was reported by 3 studies, while more contamination on rough titanium surfaces was stated by 2 investigations. An isolated smooth surface has also been associated to higher contamination. Moderate to high quality methodological assessment of studies were identified. CONCLUSIONS: It is not possible to assume that rough surfaces are more susceptible to early biofilm formation than smooth titanium surfaces. Additional studies are required to study this multifarious interaction.

Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry-A Comprehensive Review.

Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were Escherichia coli and Staphylococcus aureus. Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.

Current perspectives on dental adhesion: (3) Adhesion to intraradicular dentin: Concepts and applications.

Adhesion science is one of the greatest contributions to restorative dentistry. Adhesion not only established the current principles of tissue preservation, but also allowed for the production of more hermetic and long-lasting restorations. Although adhesive strategies are routinely used in most clinical situations, adhesion to root dentin is still a major challenge. The presence of humidity together with less intertubular dentin are factors that limit the adhesive potential of root dentin. This situation is more unfavorable in endodontically treated teeth prepared for prefabricated or custom-made intraradicular posts; these procedures may alter the mechanical properties of teeth by modifying the viable dentin surface for adhesion. Also, contaminants deposited on the dentin surface are difficult to remove through conventional techniques. Moreover, root canal morphology has a very unfavorable C-factor, bringing undesirable effects resulting from polymerization contraction of resin-based materials. However, the differences between coronal and root dentin are not a barrier for dentin adhesion. Standardization of procedures and care during clinical steps are fundamental to the success of adhesion to coronal or intraradicular dentin. Thus, it is essential to know the anatomy of the root structure, the factors that interfere with intraradicular adhesion, as well as the current adhesive materials and techniques.

Evaluation of the color and translucency of glass-infiltrated zirconia based on the concept of functionally graded materials.

STATEMENT OF PROBLEM: Infiltrated zirconia has promising mechanical properties. However, information about its optical behavior is scarce. PURPOSE: The purpose of this in vitro study was to evaluate the color and translucency of zirconia submitted to infiltration and aging. MATERIAL AND METHODS: Sixty zirconia disks were machined. Ten disks received no treatment (NT group), 10 disks were immersed in a coloring liquid (A2 group), and 10 disks were immersed in a fluorescent liquid (F group). The other 30 disks were submitted to the same treatments plus glass infiltration (NT+I, A2+I, and F+I groups). The coordinates L*, a*, and b* and the Y tristimulus values were obtained to calculate the color (ΔE00), lightness, chroma, and hue differences; the translucency parameter (TP); and the contrast ratio (CR) associated with the specimens. After aging in an autoclave for 4 hours (T1), new measurements were made. Two- and 3-way ANOVAs were used to analyze color differences, TP, and CR. The lightness, chroma, and hue differences were evaluated by a repeated measures ANOVA. Multiple comparisons were made with the Tukey honestly significant difference (HSD) test (α=.05). RESULTS: The greatest color differences were observed in the A2+I group (11.23 ΔE00) (P<.001). Aging affected the chroma of the colored groups (P=.013 and P=.001) but did not affect their translucency (P=.347 for TP and P=.132 for CR). The greatest TP values were found in the NT and NT+I groups (2.54 and 2.34, respectively), whereas the CR was equal to or close to 1 in all groups. CONCLUSIONS: Color differences were observed in the glass-infiltrated groups. The TP and CR were affected by infiltration. Aging did not influence the optical behavior of the specimens.

Esthetic and functional rehabilitation of bilateral congenital absence of maxillary lateral incisors: Minimally invasive surgical and prosthetic approach.

OBJECTIVE: Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an esthetic and functional restorative treatment. Noninvasive treatments, that are in accordance with the patients' expectations, should be the first therapeutic alternative. If the deciduous tooth is present, minimally invasive dental extraction followed by immediate dental implant placement and provisional restoration is indicated. In this restorative treatment, an adequate emergency profile can be achieved by peri-implant soft-tissue-conditioning techniques. Moreover, the association of restorative materials, such as composite resins and dental ceramics, provides more predictable esthetic results. CLINICAL CONSIDERATIONS: The present case report presents a rehabilitation of bilateral congenital absence of maxillary lateral incisors through a multidisciplinary approach. Dental implants, long-term provisional restoration, tooth bleaching, minimally veneered high-translucent monolithic zirconia crowns, feldspathic veneers, and composite restorations were used by the dental team to achieve the expected functional and esthetic outcomes. CONCLUSIONS: Different treatment modalities are available for the rehabilitation of congenital absence of teeth. However, it is important that a dental team consider performing minimally invasive treatments, as many of these treatments are done on young patients. CLINICAL SIGNIFICANCE: Patient-centered treatments involving minimally invasive approaches in a multidisciplinary environment would be appropriate in order to achieve predictable results.

Fluorescence of natural teeth and restorative materials, methods for analysis and quantification: A literature review.

OBJECTIVE: This review integrates published scientific information about the fluorescence of natural teeth, dental resins and ceramics, and the main methods of analysis and quantification presented in the literature. OVERVIEW: Fluorescence is an emission of light (photons) by a substance that has absorbed light of higher energy. In natural teeth, it is more intense in the dentin than in the enamel and presents a bluish-white color. In dental resins and ceramics, fluorescence is obtained by the incorporation of materials that contain rare-earth luminescence centers (more precisely lanthanide luminescence centers), which allows these artificial materials to simulate natural teeth in a more beautiful and vital-looking way. However, the lack of knowledge about this optical phenomenon on the part of professionals indicates the need for more scientific studies and dissemination on this topic. CONCLUSIONS: Aesthetic materials have variable spectral compositions and fluorescence intensities, which are not always compatible with natural teeth. The fluorescence of teeth and restorative materials can be influenced by several factors, such as aging, temperature, and bleaching. Several devices for fluorescence evaluation and quantification are used in studies under different methodologies, but the small number of studies on the subject make it difficult to compare their results. CLINICAL SIGNIFICANCE: Fluorescence is a fundamental optical property for aesthetic rehabilitations since its presence and intensity in the restorative materials allows achieving an aesthetic result much closer to reality. However, the fluorescent behavior of natural teeth and aesthetic restorative materials is not yet fully understood by researchers and clinicians. Greater understanding of this phenomenon will contribute to the selection, indication, and clinical use of these materials.

Effect of different irrigations on the bond strength of self-adhesive resin cement to root dentin.

BACKGROUND: Different disinfectant solutions or medications are indicated prior fiber post bonding procedures.The aim was to evaluate the effect of different pretreatments of root canal on the bond strength of a fiber post luted to dentin with self-adhesive resin cement. MATERIAL AND METHODS: Forty-eight single-rooted mandibular premolars were endodontically treated and prepared to receive fiber posts. Teeth were assigned to four groups (n=12). Root canal walls were subjected to no pretreatment (G1 - control); irrigation with 10 mL of 5% sodium hypochlorite (NaOCl) (G2); 10 mL of 17% ethylenediaminetetraacetic acid (EDTA) associated with 10 mL of 5% NaOCl (G3); or 10 mL of 17% EDTA (G4). Fiber posts were bonded with self-adhesive cement. After the roots were sectioned into slices, a push-out bond strength test was performed using a universal testing machine at crosshead speed of 0.5 mm/min. Bond strength data were recorded and expressed in MPa and analyzed by Anova (5%) and Tukey Test (5%). RESULTS: It was found that G2 (9.36 MPa) and G4 (6.33 MPa) were significantly different among themselves and statistically inferior to G1 (13.93 MPa) while G3 (14.31 MPa) was statistically similar to G1 (control) and superior to G2 and G4. CONCLUSIONS: Irrigation with 17% EDTA associated with 5% NaOCl showed increased bond strength compared with the same solutions used alone. Key words:Self-adhesive, Dentin, Push-out, Bonding.

Uso de guias no planejamento de próteses sobre implantes / Use of guides in planning for implant-supported prostheses

O planejamento é fundamental na Implantodontia. Com um correto planejamento, tornam-se muito maiores as chances de obtenção do sucesso clínico, que hoje vai muito além de somente alcançar a osseointegração dos implantes, mas sim, de posicionar o implante idealmente para a confecção de uma prótese que venha a contemplar saúde, função e estética. O objetivo desse artigo foi de reforçar a importância das etapas de planejamento e da utilização de meios para transferir as informações obtidas para a situação clínica através do uso de guias. A busca pelas publicações foi realizada nas bases de dados Pubmed (Medline) e Periódicos CAPES, durante o segundo semestre de 2013. Também foi realizada busca manual de referências. A seleção final após a leitura de títulos, abstracts e textos completos chegou a 30 artigos. Concluiu-se que os guias auxiliam em todas as fases do tratamento e permitem maior previsibilidade dos resultados, aumentando substancialmente a qualidade e longevidade das reabilitações protéticas implantossuportadas.

Planning is essential in oral Implantology. With correct planning there are greater chances of obtaining clinical success, which currently means more than the osseointegration of implants, and includes ideal positioning of the implant for making a prosthesis that contemplates health, function and aesthetics. The aim of this article was to reinforce the importance of planning steps and the use of means to transfer the information obtained to the clinical situation using the guides. The search was conducted in the databases Pubmed (Medline) and CAPES journals during the second half of 2013. It was also performed manual search of references. The final selection after reading titles, abstracts and full texts reached 30 articles. It can be concluded that the guides help at all stages of treatment and allow greater predictability of the results, thereby greatly enhancing the quality and longevity of the prosthetic implant restorations.

Nasal Floor Elevation with Simultaneous Implant Placement: A Case Report.

OBJECTIVE: The aim of this paper is to report a clinical case of nasal floor elevation and simultaneous dental implant placement. CASE REPORT: The patient presented to the clinic of the Center of Education and Research on Dental Implants (CEPID) in the Department of Dentistry at the Federal University of Santa Catarina (UFSC, Florianópolis, Brazil), for follow-up for peri-implantitis control. After clinical and radiographic assessment, two of three implants on anterior maxilla were removed. A cone beam computed tomography (CBCT) scan revealed no bone height for conventional length implant insertion. Nasal floor elevation and simultaneous implant placement were performed, with nasal cavity augmentation carried out with bovine bone graft. After six months, the implants were reopened successfully. CONCLUSIONS: Nasal floor elevation proved to be a reliable method for dental implants insertion on the anterior atrophic maxilla when bone height reconstruction was necessary. The use of bovine bone substitutes for nasal cavity augmentation showed predictable results as well as simultaneous implant placement.

Partial-prep bonded restorations in the anterior dentition: Long-term gingival health and predictability. A case report.

Bonded porcelain restorations are a predictable and durable treatment option that can restore not only the strength and function of the teeth but also the esthetic appearance. One important issue in adhesive dentistry is the preservation of sound enamel. Following biomimetic principles, employing minimally invasive applications and adhesive technologies is of paramount importance for successful restorations. While it is widely accepted that minimally invasive restorative techniques should be favored, there is still some controversy over the noninvasive approaches. The purpose of this article is to question the complete "no-prep veneer" concept due to the possible negative effects on periodontal health caused by excessive contour and overhangs of the ceramic restoration, and to propose a new method to assess the quality and longevity of veneers with a partial-prep concept.