Anatomical characteristics of different tooth groups. Effect on in-office bleaching treatment

AIM: The objective of the present study was to investigate the association between the anatomical characteristics of different tooth groups and the diffusion and bleaching effect of hydrogen peroxide (H2O2). MATERIALS AND METHODS: Computed tomography (CT) images from five patients were used to assess the hard tissue thickness and pulp volume (PV) of four tooth groups: lower (mandibular) incisors (LI), upper (maxillary) incisors (UI), canines (C), and premolars (PM). Additionally, 80 bovine tooth disks were divided into four groups (n = 20) to match the thickness of each tooth group studied. All the specimens were exposed to a 35% H2O2 bleaching gel, with 50 µL applied for 45 min during the first, second, and third sessions. Diffusion was evaluated using the peroxidase enzyme method. Color change analyses (∆E, ∆E00, and ∆WID) were performed after the three application sessions and 7 days after the bleaching treatment using a spectrophotometer. RESULTS: The PM group showed greater thickness and PV, followed by the C, UI, and LI groups (P 0.001). The LI group had six times greater H2O2 diffusion compared with the PM group (P 0.001), while the PM group exhibited a PV nine times larger than the LI group. Furthermore, the LI and UI groups achieved color saturation with one fewer session than the C and PM groups. CONCLUSIONS: Specific tooth groups have anatomical characteristics that interfere with bleaching treatment in terms of the diffusion and whitening effect of H2O2. Furthermore, the diffusion capacity of H2O2 was inversely proportional to the thickness of the tooth groups.

Randomized prospective clinical trial of class II restorations using flowable bulk-fill resin composites: 4-year follow-up.

OBJECTIVES: This randomized, prospective, and split-mouth study aimed to evaluate flowable bulk-fill resin composites in class II restorations, comparing it with a conventional layering technique after 4-year follow-up. MATERIALS AND METHODS: Fifty-three subjects received three class II restorations according to the restorative systems: conventional microhybrid composite resin (PA - Peak Universal + Amelogen Plus, Ultradent); flowable bulk-fill and nanoparticulate composite resins (ABF - Adper Single Bond 2 + Filtek Bulk Fill Flow + Filtek Z350XT, 3M/Espe); and flowable bulk-fill and microhybrid composite resins, (XST - XP Bond + SDR + TPH3, Dentsply). The clinical performance and interproximal contacts were evaluated. Statistical analyses were performed using the Kaplan-Meier, equality test of two proportions, Friedman, Wilcoxon, Kruskal-Wallis, Mann-Whitney, and Logistic regression analysis tests (alpha = 0.05). RESULTS: In total, 106 restorations were evaluated at 4 years. Both systems with bulk-fill composites presented higher marginal discoloration than PA. About surface texture, ABF restorative system showed superior bravo scores being statistically similar to XST. Better performance for wear and surface staining was found for XST restorative system. All restorative systems resulted in the decreased interproximal contacts, occurring early for XST. CONCLUSIONS: The restorative systems that used flowable bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 4 years. All restorative systems had decreased proximal contact after 4 years. CLINICAL RELEVANCE: Initial marginal discoloration was observed in more than 50% of class II restorations performed with restorative systems that used flowable bulk-fill resin composite. All restorative systems had decreased proximal contact strength over time.

Evaluation of the aesthetic effect, enamel microhardness and trans-amelodentinal cytotoxicity of a new bleaching agent for professional use containing trimetaphosphate and fluoride.

This study evaluated the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium trimetaphosphate (TMP), and NaF/TMP when added to a 35% hydrogen peroxide (H2O2) bleaching gel on the color change, enamel hardness, penetration and cytotoxicity trans-amelodentinal. Bovine enamel/dentin disks (n = 288) were divided according to the bleaching gel: 35% H2O2; 35% H2O2 + 0.05% NaF; 35% H2O2 + 0.25% TMP; 35% H2O2 + 0.05% NaF + 0.25% TMP; 35% H2O2 + 0.1% NaF + 1% TMP and 35% H2O2 + 2% CaGlu. The bleaching gels were applied thrice (40 min/session) at 7-day intervals between each application. Then, the color change, percentage of surface hardness loss (%SH), cross-sectional hardness (ΔKHN), trans-amelodentinal penetration of H2O2, cell viability and morphology (MDPC-23 odontoblast-like cells), alkaline phosphatase activity (ALP) and deposition of mineralization nodules were determined. The data were submitted to ANOVA, followed by the Student-Newman-Keuls test (p < 0.05). All bleaching gels showed significant color changes after treatment (p < 0.001). Mineral loss (%SH and ΔKHN) and H2O2 penetration were lower for 35% H2O2/0.1% NaF/1% TMP; 35% H2O2/2% CaGlu, meanwhile, showed higher values, compared to the other groups (p < 0.001). Cell viability was around 9%, except for the bleaching gel containing 35% H2O2/0.1% NaF/1% TMP with 12.8% (p < 0.05). ALP was higher for groups containing TMP compared to other whitening gels (p < 0.05). The formation of mineralization nodules was greater for gels containing NaF/TMP or CaGlu (p < 0.05). The alterations of cell morphology were intense for all bleaching gels. It was concluded that the addition of NaF/TMP in-office bleaching did not interfere in bleaching efficacy, reduced enamel demineralization, H2O2 penetration and cytotoxicity.

Influence of different light-curing units in surface roughness and gloss of resin composites for bleached teeth after challenges.

The aim of this study evaluates the surface roughness and gloss of resin composites for bleached teeth, using different modes of light curing and photoinitiators after challenges. Eighty discs were made with Filtek Z350XT (camphorquinone) and Vit-l-escence (camphorquinone, amine and lucerin-TPO). Forty disks were light cured by a monowave LED and forty with a polywave LED. Roughness and gloss analysis were made. The specimens were exposed to brushing and hydrochloric acid (HCl) and analyzed again. The data were analyzed by two-way ANOVA analysis of variance for repeated measures, considering each challenge separately. Afterwards, Tukey test was applied for multiple comparisons (p ≤ 0.05). All resins had a significant increase in roughness after brushing with polywave device and only Vit-l-escence presented significant increased after HCl. Regarding the surface gloss, no influence on light-curing units was found for all resins after toothbrushing and after HCl for Vit-l-escence. All resins showed significant decrease in gloss after the challenges. The type of LED device did not influence the roughness and surface gloss of resin composites for bleached teeth after the challenges.

Influence of the depth of intraradicular dentin on the pushout bond strength of resin materials.

AIM: The aim of the present study was to evaluate the pushout bond strength between glass-fiber posts to different regions of intraradicular dentin with different materials for adhesive cementation. METHODS: After endodontic filling, 40 teeth were divided into five groups according to adhesive cementation: Adper Single Bond 2 + RelyX ARC, Excite DSC + RelyX ARC (EXC), Adper SE Plus + RelyX ARC (SEP), RelyX Unicem, and Set. After the bonding process, roots were sectioned obtaining slices to be analyzed from each third. The bond strength was measured using the pushout test in a universal testing machine (Emic DL 3000) at a cross-head speed of .5 mm/minutes in different areas of the post space (cervical, middle, and apical). Data were subjected to analysis of variance and Fisher's test (α = .05). RESULTS: The highest values for the pushout bond strength were found for the SEP group in all experimental conditions, without a significant difference for the EXC group in the middle and apical regions. There was a decrease in pushout bond strength in the cervical-apical direction for all groups, except the EXC group, which did not show a difference among the different regions. CONCLUSIONS: The different interactions of the resin materials and the intraradicular depth influenced the bond strength of adhesives materials to dentin substrate.

Mechanical properties of components of the bonding interface in different regions of radicular dentin surfaces.

STATEMENT OF PROBLEM: The mechanical properties of the adhesive materials used in intraradicular treatments could vary according to the interaction between the restorative material and dentin substrate. An evaluation of these properties is essential to determine the success of the luting procedures performed on glass-fiber posts. PURPOSE: The purpose of this study was to evaluate the mechanical properties of dentin adhesives, resin cements, and the dentin that underlies the bonding interface in different thirds of intraradicular dentin. MATERIAL AND METHODS: Forty extracted, single-rooted human teeth were used in this study. After the endodontic treatment of the post spaces, the teeth were divided into 5 groups (n=8): Adper Single Bond 2 + RelyX ARC, Excite DSC + RelyX ARC, Adper SE Plus + RelyX ARC, RelyX Unicem, and Set. The hardness and elastic modulus values were measured at the adhesive interface in different thirds of the radicular dentin by using an ultramicrohardness tester. The data were subjected to 2-way ANOVA and the Fisher protected least significant difference test (α=.05). RESULTS: In the underlying dentin, the highest Martens hardness values were found in the apical region for all groups; the exceptions were the groups with the self-etching adhesive. In the adhesive layer, the highest Martens hardness values were obtained for the Adper SE Plus + RelyX ARC group; further, no statistical differences were found among the different regions for this group. RelyX ARC had the lowest Martens hardness and elastic modulus values in the apical regions when used with Adper Single Bond 2 and Adper SE Plus. No differences were found in the Martens hardness and elastic modulus values for the self-adhesive resin cement in the regions investigated. CONCLUSION: The mechanical properties of adhesive materials and the underlying dentin are influenced by the interaction between the two as well as by the depth of the analyzed intraradicular area.

Effect of thermocycling on roughness of nanofill, microfill and microhybrid composites.

OBJECTIVE: This study aimed to investigate the surface roughness of composite resins subjected to thermal cycles procedure. MATERIALS AND METHODS: Two microfill, four microhybrid and four nanofill composites were used. The surface roughness (Ra) was initially measured in a profilometer using a cut-off 0f 0.25 mm, after 3000 and 10,000 thermal cycles. Data were subjected to ANOVA and Fischer's test (α = 0.05). RESULTS: Overall, 3000 thermal cycles increased the surface roughness values for all materials and there was a trend in all groups to decrease the roughness after 10,000 thermal cycles. CONCLUSIONS: The composition of material, including the type of organic matrix, could be more relevant to roughness maintenance over time than the general behavior of composites based on particles fillers. The maintenance of smooth surface in resin-based composite restorations is totally dependent of organic composition of the material.

Mineral loss and color change of enamel after bleaching and staining solutions combination.

Pigments of food and beverages could affect dental bleaching efficacy. The aim of this investigation was to evaluate color change and mineral loss of tooth enamel as well as the influence of staining solutions normally used by adolescent patients undergoing home bleaching. Initial hardness and baseline color were measured on enamel blocks. Specimens were divided into five groups (n=5): G1 (control) specimens were kept in artificial saliva throughout the experiment (3 weeks); G2 enamel was exposed to 10% carbamide peroxide for 6 h daily, and after this period, the teeth were cleaned and stored in artificial saliva until the next bleaching session; and G3, G4, and G5 received the same treatments as G2, but after bleaching, they were stored for 1 h in cola soft drink, melted chocolate, or red wine, respectively. Mineral loss was obtained by the percentage of hardness reduction, and color change was determined by the difference between the data obtained before and after treatments. Data were subjected to analysis of variance and Fisher's test (α=0.05). G3 and G5 showed higher mineral loss (92.96 ± 5.50 and 94.46 ± 1.00, respectively) compared to the other groups (p ≤ 0.05). G5 showed high-color change (9.34 ± 2.90), whereas G1 presented lower color change (2.22 ± 0.44) (p ≤ 0.05). Acidic drinks cause mineral loss of the enamel, which could modify the surface and reduce staining resistance after bleaching.

Evaluating the bonding of two adhesive systems to enamel submitted to whitening dentifrices

The aim of this study was to evaluate by micro-shear bond strength test, the bond strength of composite resin restoration to enamel submitted to whitening dentifrices. Forty bovine teeth were embedded in polystyrene resin and polished. The specimens were randomly divided into eight groups (n= 5), according to the dentifrice (carbamide peroxide, hydrogen peroxide and conventional dentifrice) and the adhesive system (Prime & Bond 2.1 and Adper Single Bond 2). Dentifrice was applied for 15 minutes a day, for 21 days. Thirty minutes after the last exposure to dentifrice, the samples were submitted to a bonding procedure with the respective adhesive system. After that, four buttons of resin were bonded in each sample using transparent cylindrical molds. After 24 hours, the teeth were submitted to the micro-shear bond strength test and subsequent analysis of the fracture mode. Data were submitted to analysis of variance and Fisher's PLSD test (α=0.05). The micro-shear bond strength showed no difference between adhesives systems but a significant reduction was found between the control and carbamide groups (p=0.0145) and the control and hydrogen groups (p=0.0370). The evaluation of the failures modes showed that adhesive failures were predominant. Cohesive failures were predominant in group IV. The use of dentifrice with peroxides can decrease bonding strength in enamel.

O objetivo deste trabalho foi avaliar, pelo metodo de microcisalhamento, a resistencia adesiva obtida em restauracoes de resina composta realizadas sobre o esmalte dental previamente exposto a diferentes dentifricios. Para isso, quarenta dentes bovinos foram incluidos em resina de poliestireno e polidos. Os dentes foram divididos aleatoriamente em 8 grupos (n=5) de acordo com o dentifricio utilizado (cremes contendo peroxido de hidrogenio, peroxido de carbamida ou dentifricio convencional) e sistema adesivo (Prime & Bond 2.1 ou Adper single Bond 2). Os dentes foram expostos por 15 minutos por dia durante 21 dias as suspensoes dos respectivos cremes dentais. Trinta minutos apos a ultima exposicao ao dentifricio, os dentes foram restaurados empregando os 2 diferentes sistemas adesivos e resina composta. Apos 24 horas os dentes foram submetidos ao teste de microcisalhamento e posterior analise do padrao de fratura. Os resultados obtidos foram submetidos a analise de variancia e teste de Fisher's PLSD (α=0.05). Nao foi detectada diferenca estatistica entre os adesivos, porem entre os tratamentos com dentifricios, houve reducao estatisticamente significante entre os grupos controle x carbamida (p=0.0145) e entre o grupo controle x hidrogenio (p=0.0370). Na avaliacao do tipo de fratura houve predominancia de falhas adesivas, com excecao do grupo IV que apresentou maior fratura coesiva em esmalte. Assim, a utilizacao de cremes dentais, contendo peroxidos em suas formulacoes, pode provocar uma reducao na resistencia de uniao ao esmalte.