The Effect of Three Desensitizing Toothpastes on Dentinal Tubules Occlusion and on Dentin Hardness.

There are two main methods used for dentin hypersensitivity (DH) treatment: dentinal tubule occlusion and blockage of nerve activity. Dentifrices are the most common vehicles for active ingredients used for DH treatment. The aim of this study was to evaluate the efficacy of three toothpastes on dentinal tubule occlusion, mineral acquisition, and dentin hardness. Forty human dentin disks were submerged in 40% citric acid for 30 s and then exposed to tooth brushing for 2 min twice a day for 14 days using three toothpastes: Dontodent Sensitive (group 1), Dr. Wolff's Biorepair (group 2), and Sensodyne Repair and Protect (group 3). In the control group (group 4), the samples were brushed with water. All of the samples were evaluated using scanning electron microscopy (SEM), energy-dispersive X-ray (EDX), and Vickers dentin hardness determination. On SEM images, the degree of dentinal tubule occlusion was assessed using a five-grade scale. The mean score values in groups 1-4 were 3.60 ± 0.69, 2.20 ± 0.91, 2.30 ± 1.16, and 5.00 ± 0.00, significantly higher in study groups when compared to the control group (Kruskal Wallis test p < 0.05). EDX evaluation showed significantly higher calcium and phosphorus concentrations in groups 1 and 3 when compared to control group d. The mean values of Vickers dentin hardness numbers in groups 1-4 were 243.03 ± 10.014, 327.38 ± 56.65, 260.29 ± 37.69, and 225.83 ± 29.93, respectively. No statistically significant results were obtained when comparing the hardness mean values in groups (Kruskal-Wallis statistical test, p = 0.372 > 0.05). All three toothpastes tested demonstrated significant occlusion of dentinal tubules. Dontodent Sensitive and Sensodyne Repair and Protect toothpastes enhanced the calcium and phosphorus content of the dentin surface. None of the toothpastes increased dentin hardness as a result of mineral acquisition.

Influence of the Loading with Newly Green Silver Nanoparticles Synthesized Using Equisetum sylvaticum on the Antibacterial Activity and Surface Hardness of a Composite Resin.

The aim of the study was to evaluate the antibacterial activity and surface hardness of a light-activated microhybrid composite resin modified with green silver nanoparticles (AgNPs). AgNPs were synthesized using an Equisetum sylvaticum extract and characterized through different methods such as UV-Vis, EDX, and FTIR. The obtained AgNPs were mixed with a microhybrid composite resin (Herculite XRV, Kerr Corp., Orange, CA, USA) in different concentrations: 0% (group A-control); 0.5% (group B); 1% (group C); and 1.5% (group D). A total of 120 composite resin disk-shaped samples were obtained and divided into 4 groups (n = 30) according to AgNP concentration. Each group was then divided into 2 subgroups: subgroup 1-samples were not soaked in 0.01 M NaOH solution; and subgroup 2-samples were soaked in 0.01 M NaOH solution. The antibacterial activity against Streptococcus mutans was determined using a direct contact test. A digital electronic hardness tester was used to determine the composite resin's Vickers surface hardness (VH). Statistical analysis was performed using the Mann-Whitney U and Kruskal-Wallis nonparametric tests with a confidence level of 95%. Groups C and D showed higher antibacterial activity against S. mutans when compared to the control group (p < 0.05). No significant differences were recorded between VH values (p > 0.05). The use of AgNPs synthesized from Equisetum sylvaticum as a composite resin filler in 1% wt. and 1.5% wt. reduced the activity of Streptococcus mutans. Soaking of the experimental composite resin decreased the antibacterial efficacy. The loading of a microhybrid composite resin with AgNPs in concentrations of 0.5% wt., 1% wt., and 1.5% wt. did not influence the surface hardness.

The Influence of Chlorhexidine Gluconate Dentine Pre-Treatment on Adhesive Interface and Marginal Sealing.

Background and Objectives: The aim of this in vitro study was to evaluate the combined effect of a 2% chlorhexidine aqueous solution and a universal adhesive system applied in self-etch and etch-and-rinse strategies on the composite resin-dentin interface. Materials and Methods: Class V cavities were prepared on the facial and lingual surfaces of forty caries-free molars extracted for orthodontic reasons. The samples were randomly divided into two groups corresponding to the used etching protocol: I-etch-and-rinse; II-self-etch. In each tooth, one cavity was assigned for the control subgroups -IA (n = 20) and IIA (n = 20)-adhesive only, and the opposite cavity was pretreated with a 2% chlorhexidine solution-Gluco CHeX Cerkamed-subgroups IB (n = 20) and IIB (n = 20). Both sets of groups were restored using a universal adhesive system (Single Bond Universal Adhesive, 3M-ESPE) and a bulk-fill composite resin (Filtek One Bulk Fill Restorative, 3M-ESPE). The roots and the pulp tissue were then removed, and a needle connected to a perfusor with 100 mL saline solution was used for pulp pressure simulation with a hydrostatic pressure of 20 cm H2O. Cariogenic attack was simulated using a demineralizing solution for 3 days at a constant temperature of 25 °C. The teeth were then sectioned in a facial-lingual direction and the microleakages at the occlusal and cervical margins were registered and scored using an optical Carl-Zeiss AXIO Imager A1m microscope (Carl-Zeiss). The composite resin-dentin interface was analyzed using a SEM Vega Tescan LMH II. Statistical analysis was performed using the Kruskal-Wallis test with a significance level of p < 0.05. Results: Microleakage evaluation showed no significant differences among the study groups (p > 0.05). In subgroup IA, significant differences were recorded between occlusal and cervical margins (p < 0.05). Conclusions: Application of chlorhexidine on tooth substrate before using a universal bonding system in total etch or self-etch mode has no influence on the adhesive interface in the condition of cariogenic attack. The thickness of the adhesive resin layer seems to be less uniform when using chlorhexidine, but the morphological differences at the adhesive interface have no influence on the sealing capacity of the universal bonding system, regardless of the etching strategy.

Effects of Acidic Challenge on Demineralized Root Surface Treated with Silver Diamine Fluoride and Potassium Iodide.

BACKGROUND: The aim of the study was to assess the protective effect of applying potassium iodide (KI) over silver diamine fluoride (SDF) on demineralized root dentin in the case of a sustained acidogenic attack. METHODS: Forty caries-free third molars were used in the study. A diamond disc was used to separate the roots and the tooth crowns from the roots. Each root fragment was randomly distributed in one of the four study groups: C-samples were not demineralized; DD-demineralized samples; RS1-demineralized samples covered with SDF+KI (RS-Riva Star product, SDI limited, Bayswater, Australia); RS2-demineralized samples covered with SDF+KI and submersed to another acidic challenge for 3 days. SEM and EDX were used for the morphological and elemental analysis. Vickers hardness assessment was performed using a tribometer CETR UMT-2 (Bruker Corporation, Berlin, Germany). One-way ANOVA and post hoc Bonferroni tests were used for the statistical analysis with a significance level of p < 0.05. RESULTS: Morphological and elemental changes were observed on the surface of the study samples. Significant differences were observed between the recorded hardness values of groups C and DD (p = 0.005), C and RS2 (p = 0.002), DD and RS1 (p = 0.011); RS1 and RS2 (p = 0.004). CONCLUSIONS: The application of SDF and KI (Riva Star product) on root dentin caries resulted in the formation of a heterogeneous outer layer that sealed the dentin and increased the microhardness of the treated surface. In the conditions of the present study, this layer did not provide enough protection for root dentin exposed to continuous attacks.

The Impact of Simulated Gastric Acid and Toothbrushing on Surface Characteristics of Resin-Modified Glass-Ionomer Cements.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of simulated gastric acid associated with toothbrushing on the surface condition of three resin-modified glass-ionomer cements (RMGIC). Materials and Methods: One hundred and sixty samples of each material were obtained and included in three study groups according to the tested material: Group I (Ionolux, VOCO GmbH, Cuxhaven, Germany); Group II (Vitremer, 3 M-ESPE, St. Paul, MN, USA); and Group III (Fuji II LC, GC Corporation, Tokyo, Japan). The samples were submersed in hydrochloric acid 0.01 M (pH 3.8) for 3 h and exposed to a toothbrushing procedure at a frequency of 10,000 cycles with medium and hard bristles immediately or 30 min after the acid attack. Profilometric measurements were performed by using a non-contact profilometer (Dektak XT, Bruker, Billerica, MA, USA) in order to assess the surface roughness. ANOVA and Bonferroni post hoc tests were used for the statistical analysis at a significance level of p < 0.05. Results: Exposure of RMGICs to the erosive effect of hydrochloric acid in association with toothbrushing 30 min after the chemical attack increased the surface roughness of all three RMGICs. Exposure of the three tested materials exclusively to the action of hydrochloric acid did not affect the surface roughness. Conclusions: One year of hydrochloric acid challenge associated with one year of toothbrushing with medium-hardness bristles performed 30 min after the acid attack increase the surface roughness of two of the three types of RMGIC tested (Ionolux and Fuji II LC).

Customized 3D-Printed Titanium Mesh Developed for an Aesthetic Zone to Regenerate a Complex Bone Defect Resulting after a Deficient Odontectomy: A Case Report.

Background and Objectives: Alveolar ridge augmentation in the complex bone defect is a popular topic in implantology. Guided bone regeneration (GBR) is one of the most commonly applied methods to reconstruct alveolar bone. The application of a membrane is the fundamental principle of GBR. There are many membrane types used in oral surgery, but the advantage of the titanium mesh is the rigidity which provides space maintenance and prevents contour collapse. The smooth surface also reduces bacterial contamination. Using computer-aided design (CAD) and computer-aided manufacturing (CAM) in dentistry allows us to obtain the perfect architecture form of the mesh, which covers and protects the bone reconstruction. Case presentation: We present a surgical case of a 27-year-old female patient with severe aesthetic bone atrophy after a deficient odontectomy. Based on the GBR clinical applications, the technique consists of bone reconstruction and a customized titanium mesh application. Using mesh titanium in this case presentation was a reliable alternative to perform a lateral alveolar bone augmentation and reconstruct ridge deformities before reaching an ideal implant placement. Conclusions: According to our case report, the customized titanium mesh could be a valuable option for guided bone regeneration in aesthetic maxillary defects.

In Vitro Evaluation of Gastric Acid and Toothbrushing Effect on the Surface State of Different Types of Composite Resins.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of gastric acid associated with the effect of toothbrushing on the surface roughness of different types of composite resin used for direct restorations. Materials and Methods: The materials used in this study were two microhybrid (Filtek Z250, Herculite XRV) and two nanohybrid (Filtek Z550, Herculite XRV Ultra) composite resins. Two hundred and forty cylindrical samples with a height of 2 mm and a diameter of 6 mm were divided into four groups (groups A, B, C and D) corresponding to each tested material (n = 60). Each group was divided in two subgroups: subgroup I-the samples were submersed in hydrochloric acid and immediately submitted to toothbrushing; subgroup II-the samples were submitted only to toothbrushing. The simulation of the acid attack was performed by immersing the samples in a 0.01 M hydrochloric acid solution for 90 min. This procedure was followed immediately by toothbrushing simulation with 10,000 cycles. The acid attack and toothbrushing simulation were performed for two times. The surface roughness evaluation was performed with a Proscan 2100 profilometer. Repeated Measures ANOVA and Bonferroni post-hoc tests were used to perform the statistical analysis. Results: Simulation of one year of toothbrushing associated or not to hydrochloric acid exposure increases the surface roughness of microhybrid and nanohybrid composite resins. Six months of toothbrushing associated to six months of hydrochloric acid exposure increase the surface roughness of nanohybrid composite resins. Conclusions: Microhybrid composite resins surface becomes rougher after toothbrush and acid submersion when comparing to nanohybrid composite resins.

Conventional and Resin-Modified Glass Ionomer Cement Surface Characteristics after Acidic Challenges.

The aim of the present study was to assess by atomic force microscopy (AFM) the surface roughness of a traditional glass ionomer cement- GIC (Fuji IX GP, GC Corporation, Tokyo, Japan) and a resin modified glass ionomer cement- RMGIC (Vitremer, 3M ESPE, St. Paul, MN, USA) after different immersion regimes on some acidic drinks. Sixteen cylindrical samples having the height of 5 mm and the thickness of 2 mm were obtained from each material and they were divided into two groups: Group I (Fuji IX samples) and Group II (Vitremer samples). Specimens of each group were then randomly divided into 4 subgroups: subgroup A (control)-15 samples were kept in artificial saliva and in the other three subgroups, each having 15 samples the samples were immersed in Coca-Cola (subgroup B), Cappy lemonade and mint (subgroup C) and Fuzetea (subgroup D) for 7 days (subgroups A1-D1), 14 days (subgroups A2-D2), and 21 days (subgroups A3-D3). AFM qualitative and quantitative surface evaluation (mean value of surface roughness parameter, Sa) of each sample was performed. The highest surface roughness was determined when both materials were submerged 14 days in acidic drinks. Traditional GIC was more affected by acidic environment when comparing to RMGIC.

Evaluation of the Surface Roughness of Bulk-Fill Composite Resins after Submission to Acidic and Abrasive Aggressions.

This in vitro study aimed to assess the erosive effect of hydrochloric acid in association with toothbrushing procedure on the surface condition of three bulk-fill composite resins used for direct restoration. A total of 480 samples (160 from each composite resin): X-tra Fil (VOCO, Germany)­group A, Filtek Bulk-fill Posterior (3M-ESPE, St. Paul, MN, USA)­group B, G-aenial Posterior (GC Japan)­group C were prepared, submitted to chemical attack for 60 min with hydrochloric acid 30% and, subsequently, submitted to the abrasive effect of toothbrushing using 10,000 cycles with medium and hard bristles, at three different times (immediately and after 30 min after acid attack or without any chemical attack). The surface roughness of the samples was measured using a noncontact profilometer (Dektak XT, Bruker, Billerica, MA, USA). The values were analyzed using ANOVA and post hoc Bonferroni tests, with a p < 0.05. Chemical attack for 60 min associated with one year of toothbrushing with toothbrushes having medium or hard bristles increase the surface roughness of tested bulk-fill composite resins. No differences were recorded between toothbrushing with medium or firm bristles immediately or 30 min after acidic challenge for each of the three bulk-fill composite resins. Exposure to hydrochloric acid determines no effect on surface roughness of bulk-fill composite resins.

The Influence of Abrasive and Acidic Aggressions on the Surface Condition of Flowable Composite Resin.

The aim of this in vitro study was to evaluate the effect of hydrochloric acid associated with the abrasive effect of toothbrushing on the surface condition of three flowable composite resins used for direct restoration. Seventy samples of each composite resin: Grandio Flow (VOCO, Germany)-group A, Filtek Ultimate Flow (3M-ESPE, MN, USA)-group B, G-aenial Flo X (GC Europe)-group C were prepared, submersed in hydrochloric acid 30% for 60 min and then submitted to simulated toothbrushing procedure using 5000 cycles with toothbrushes with medium and hard bristles, immediately after the chemical attack, after 30 min or without any chemical attack. The sample's surface roughness was analyzed using a noncontact profilometer (Dektak XT, Bruker, USA). ANOVA and post hoc Bonferroni tests, with a p < 0.05, were used to analyze the values. Hydrochloric acid action for 60 min and six months of toothbrushing using toothbrushes having medium hardness or firm bristles affects the surface roughness of tested flowable composite resins. Toothbrushing with firm bristles immediately after acidic challenge determines increased surface roughness for two of the three flowable composite resins (Grandio Flow and Filtek Ultimate Flow). Toothbrushing with medium or firm bristles thirty minutes after the acidic aggression determine no effect on surface condition of flowable composite resins.

Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis.

Dental pulp represents a specialized connective tissue enclosed by dentin and enamel, the most highly mineralized tissues of the body. Consequently, the direct examination as well as pathological evaluation of dental pulp is difficult. Within this anatomical context, our study aimed to evaluate the correlation between dental pulp lesions and clinical diagnosis. Pulpectomies were performed for 54 patients with acute and chronic irreversible pulpitides and for 5 patients (control group) with orthodontic extractions. The morphological features were semiquantitatively assessed by specific score values. The clinical and morphological correspondence was noted for 35 cases (68.62%), whereas inconsistency was recorded for 16 cases (31.38%). The results of the statistical analysis revealed the correlations between clinically and pathologically diagnosed acute/chronic pulpitides. No significant differences were established between the score values for inflammatory infiltrate intensity, collagen depositions, calcifications and necrosis, and acute, respectively chronic pulpitides. We also obtained significant differences between acute pulpitides and inflammatory infiltrate and calcifications and between chronic pulpitides and inflammatory infiltrate, collagen deposition, and calcifications. On the basis of the predominant pathological aspects, namely, acute and chronic pulpitis, we consider that the classification schemes can be simplified by adequately reducing the number of clinical entities.

[The influence of hygroscopic expansion on nanohybrid composite restorations]. / Influenta expansiunii higroscopice asupra restaurarilor realizate cu un compozit nanohibrid.

UNLABELLED: Hygroscopic expansion of resin materials is a common phenomena due to water adsorption into the resin matrix. This expansion is dependent upon the chemical structure of the material. Water sorption of resin dental material may contribute to stress release immediately after polymerization shrinkage has occurred. The aim of this study was to evaluate the influence of water storage on nanohybrid composite by assessment of marginal enamel sealing of restorations. MATERIAL AND METHOD: 30 human teeth extracted for periodontal or orthodontic reasons were used in these study. Cavities were prepared and restored using a nanohybrid composite (Ceramix Mono, Dentsply DeTrey) and a total-etch adhesive system (Prime&Bond NT, Dentsply DeTrey). The teeth were then randomly divided in three groups which were stored for various times in deionized water (one hour, 24 hours and 7 days). After the storage period, the teeth were immersed in methylen blue 1% for 24 h. Then specimens were axially cut and the dye penetration within the occlusal enamel interface was evaluated using optic microscope. RESULTS: Kruskal-Wallis test showed significant differences of dye penetration between the long-term hydrated groups and the group hydrated for only one hour (p < 0.05). The mean value of dye penetration decreased from 0.04 mm to 0.1 mm after water storage for both 24 hours and 7 days. However, good sealing in enamel margins of restorations was observed even without hydration. CONCLUSION: Our results confirm that nanohybrid composites used with total etch adhesives systems have good ability to seal the enamel margins and water sorption can improve this sealing.