Influence of Erosion/Abrasion and the Dentifrice Abrasiveness Concomitant with Bleaching Procedures.

PURPOSE: The aim of this study was to evaluate the effect of erosive/abrasive cycles and two different levels of abrasiveness of dentifrices over enamel and dentin subjected to bleaching. METHODS: Enamel and dentin bovine specimens were prepared and submitted to an at-home bleaching treatment using 9.5% hydrogen peroxide gel, which was applied daily (30 min/14 days). Concomitant with bleaching, an erosive cycle was performed using citric acid (0.3%, pH 3.8, 5 mins, 3×/day), followed by immersions in artificial saliva for remineralization (30 mins). Abrasion was done with two (high and low abrasiveness) dentifrices (2×/day, 120 seconds) after the first and third erosive immersion each day. Enamel and dentin softening were assessed by microhardness and erosive tooth wear by optical profilometry. Data were submitted to repeated measures ANOVA, followed by the Tukey's test with a significance level of 5%. RESULTS: For the enamel and considering the erosive-abrasive cycle, significant differences were found between the groups tested, the bleaching, and the abrasiveness of the dentifrice tested; however, the final microhardness values were significantly lower than the initial ones. For dentin, differences were found between the eroded/abrasion and the non-eroded/abrasion groups, with the former presenting lower microhardness values compared with the latter. In addition, bleaching decreased the microhardness values only for the highly abrasive dentifrice, and the final values were lower than for the initial ones for all tested groups. CONCLUSION: The use of high and low abrasiveness dentifrices during bleaching and concomitant with erosion/abrasion cycles is more harmful to dentin than to enamel. CLINICAL RELEVANCE: Although bleaching is considered a conservative treatment, it can cause deleterious effects to dental hard tissue. The association of an at-home bleaching technique with erosion and high- or low- abrasive dentifrices harms dentin more than enamel.

Marginal Gap Evaluation of Metal Onlays and Resin Nanoceramic Computer-Aided Design and Computer-Aided Manufacturing Blocks Onlays.

OBJECTIVE: This study was carried out to assess and compare the marginal gap of conventionally used metal onlays and new resin nanoceramic (RNC) (Lava Ultimate block) onlays. MATERIALS AND METHODS: This is an in vitro study using two extracted sound human mandibular molars. One tooth was prepared to receive the metal onlays and another one for the RNC onlays which were fabricated using the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. Twelve metals and 12 ceramic onlays were fabricated before they were placed at their respective preparation and examined under the Leica stereomicroscope, M125C (Leica Microsystems, Wetzlar, Germany) for a marginal analysis. The gap width was measured at 10 predefined landmarks which included 3 points on the buccal and lingual surfaces each and 2 points each on the mesial and distal surfaces, respectively. STATISTICAL ANALYSIS: Mann-Whitney post hoc test was used for statistical analysis (P ≤ 0.05). RESULTS: Overall, the RNC onlays showed significant lower marginal gap with the exception of the landmarks 5 and 6 (on distolingual) and no significant difference at landmark 7 (on midlingual). It was observed that the marginal gap were all within the clinically acceptable limit of 120 µm. CONCLUSIONS: Based on the results obtained, it can be concluded that the RNC CAD/CAM onlays are a promising alternative to the metal onlays.

Comparison of composite resin and porcelain inlays for restoration of noncarious cervical lesions: An In vitro study.

BACKGROUND: Composite resin (CR) currently is one of the most commonly used material in restoring noncarious cervical lesions (NCCL) due to its strength and esthetics color but has microleakage problem. The aim of this study is to compare in vitro the microleakage depth between CR and porcelain in restoring NCCL. MATERIALS AND METHODS: This an in vitro study was done by preparing cavities on the buccocervical surface of 62 extracted premolar teeth which randomly assigned to two groups (n = 31) where Group 1 was restored with nanocomposite and Group 2 was cemented with porcelain cervical inlays. They were then subjected to thermocycling before immersion in 2% methylene blue dye for 24 h. Dye penetration depths were measured using Leica imaging system For statistical analysis, independent t-test was used to analyze the results (P < 0.05). RESULTS: Porcelain cervical inlay restorations demonstrated statistically lesser microleakage depth for the cervical margins (P = 0.018) when compared to CR. Deeper microleakage depth at the cervical compared to coronal margins of CR (P = 0.006) but no significant difference of both margins for porcelain cervical inlays (P = 0.600). CONCLUSION: Porcelain cervical inlays show lesser microleakage than CR which could be alternative treatment option in restoring NCCL with better marginal seal and esthetics.

Proximal caries lesion detection using the Canary Caries Detection System: an in vitro study.

OBJECTIVE: This study investigated the accuracy of the Canary System (CS) to detect proximal caries lesions in vitro, and compared it with conventional methods: International Caries Detection and Assessment System (ICDAS) II and bitewing radiography (BW). METHODS: Visible proximal surfaces of extracted human teeth were assessed by ICDAS-II before setting them in five manikin mouth models. Then contacting proximal surfaces in mouth models were assessed by BW and CS. Histological validation with polarized-light microscopy served as a gold standard. Pairwise comparisons were performed on area under the curve (AUC), sensitivity, and specificity of the three methods, and corrected using Bonferroni's method. Sensitivities and specificities were compared using a test of proportions and AUC values were compared using DeLong's method. RESULTS: The CS presented significantly higher sensitivity (0.933) than ICDAS-II (0.733, P = 0.01) and BW (0.267, P < 0.001), and ICDAS-II higher sensitivity than BW (P < 0.001). There were no significant differences between their specificity values: 0.825 (CS), 0.65 (ICDAS-II), and 0.875 (BW). The AUC of CS (0.862) was significantly higher than of ICDAS-II (0.681, P < 0.001) and BW (0.577, P < 0.001). CONCLUSION: The CS demonstrated greater accuracy in detecting proximal lesions than ICDAS-II and BW, although without significantly higher specificity.

Validity and reliability of the Malay version of Sleep Apnea Quality of Life Index--preliminary results.

BACKGROUND: The objective of this study was to determine the validity and reliability of the Malay translated Sleep Apnea Quality of Life Index (SAQLI) in patients with obstructive sleep apnea (OSA). METHODS: In this cross sectional study, the Malay version of SAQLI was administered to 82 OSA patients seen at the OSA Clinic, Hospital Universiti Sains Malaysia prior to their treatment. Additionally, the patients were asked to complete the Malay version of Medical Outcomes Study Short Form (SF-36). Twenty-three patients completed the Malay version of SAQLI again after 1-2 weeks to assess its reliability. RESULTS: Initial factor analysis of the 40-item Malay version of SAQLI resulted in four factors with eigenvalues >1. All items had factor loadings >0.5 but one of the factors was unstable with only two items. However, both items were maintained due to their high communalities and the analysis was repeated with a forced three factor solution. Variance accounted by the three factors was 78.17% with 9-18 items per factor. All items had primary loadings over 0.5 although the loadings were inconsistent with the proposed construct. The Cronbach's alpha values were very high for all domains, >0.90. The instrument was able to discriminate between patients with mild or moderate and severe OSA. The Malay version of SAQLI correlated positively with the SF-36. The intraclass correlation coefficients for all domains were >0.90. CONCLUSIONS: In light of these preliminary observations, we concluded that the Malay version of SAQLI has a high degree of internal consistency and concurrent validity albeit demonstrating a slightly different construct than the original version. The responsiveness of the questionnaire to changes in health-related quality of life following OSA treatment is yet to be determined.

Apical microleakage evaluation of system B compared with cold lateral technique: In vitro study.

The aim of this study was to evaluate in vitro the apical sealing ability of cold lateral and system B root filling techniques using dye penetration. Eighty-six extracted single-rooted human teeth were prepared and randomly divided into two experimental groups to be obturated by cold lateral condensation (n = 33) and system B (n = 33). The remaining 20 teeth served as positive and negative controls. The roots were embedded for 72 h in methylene blue dye solution and sectioned transversely for dye penetration evaluation using stereomicroscope. The results of this study showed that cold lateral condensation leaked significantly more (P < 0.001) than system B technique.