Regenerative and Protective Effects on Dental Tissues of a Fluoride-Silicon-Rich Toothpaste Associated with a Calcium Booster: An In Vitro Study.

Calcium boosters have been used as a supplement for fluoride toothpastes to repair the dental tissues and reduce dentin permeability. This in vitro study aimed to characterize the regenerative and protective effects of the treatment of dental tissues with a fluoride-silicon-rich toothpaste associated with a calcium booster. Bovine enamel and dentin blocks (n = 5) were obtained (4 × 4 × 6 mm). A fluoride-silicon-rich toothpaste and a calcium booster were used to brush the enamel and dentin both immediately and five days afterwards. The outcomes were then compared to those of the untreated control group. After that, the specimens were cross-sectioned. SEM was used to evaluate the micromorphology of the surface and cross-section. Energy-dispersive X-ray spectroscopy (EDS) was used to determine the elemental analyses (weight%). After treatment for 5 days with a booster/silicon-rich toothpaste, EDS analysis demonstrated that it induced a significant mineral change. It was also able to form a protective silicon-enriched mineral layer on both enamel and dentin surfaces. It was demonstrated in vitro that a fluoride-silicon-rich toothpaste associated with a calcium booster regenerates the dental tissues, remineralizing the enamel structure and occluding the dentin tubules.

Evaluating changes in the color and luminosity of dental enamel after orthodontic treatment: A clinical study.

The aims of this clinical study were to evaluate the Color change - ΔE (based on spectrophotometry and visual analysis) and luminosity - L* (based on spectrophotometry) of dental enamel surface (after orthodontic treatment) around the area where orthodontic brackets were fixed, based on different cementing materials such as a resin (R group) and resin-modified glass ionomer cement (RMGIC group). The split-mouth study initially comprised 14 patients. Orthodontic brackets were fixed to the upper central incisors with resin or RMGIC. The color of the buccal surface of each tooth was measured through spectrophotometry and visual examination before the bracket-fixation process. Four individuals were excluded during the follow-up; thus 10 patients were evaluated (n=10). Brackets were removed after 12 months of orthodontic treatment, tooth color measurement and visual examination were performed again, and Adhesive Remaining Index (ARI) was also measured. ΔE and L* results were subjected to Student's t-test and by repeated-measures analysis of variance, respectively (α=0.05). ARI data were analyzed in percentages. There was statistically significant difference in ΔE between groups; the R group showed statistically higher values of L* after orthodontic treatment. ARI of 2 and 3 prevailed in the RMGIC group, whereas the R group presented 0 and 1. After orthodontic treatment, the RMGIC group presented smaller changes in ΔE, and the increase in the white scale was observed on the enamel surface around the area where brackets were fixed in the R group. The visual analysis did not show color change on the evaluated teeth.

Effectiveness of fluoride-containing toothpastes associated with different technologies to remineralize enamel after pH cycling: an in vitro study.

BACKGROUND: To evaluate the efficacy of fluoride-containing toothpastes with different technologies to remineralize artificial caries lesions in enamel. METHODS: Bovine enamel blocks were divided into three thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling with dentifrices). Enamel blocks were randomly distributed into five groups (n = 12): Fluoride-free toothpaste, Colgate Oral Care (NC); Arginine-containing toothpaste, Colgate Total Daily Repair (PC); Silicate-based fluoride toothpaste: REFIX technology, regenerador + sensitive (RDC), NR-5 technology, Regenerate Enamel Science (RES), and NOVAMIN technology, Sensodyne Repair and Protect (SRP). The specimens were submitted to a pH cycling model for 6 days. The efficacy of the toothpastes was estimated by calculating the surface microhardness recovery (%SMHR) and the fluorescence recovery (ΔFRE) with quantitative light-induced fluorescence. The cross-sectional micromorphology of the enamel surface was also assessed using scanning electron microscopy. Elemental analyses (weight%) were determined with an energy-dispersive X-ray spectrometer (EDS). The results were compared to that of the control (NC). Data were statistically analyzed (5%). RESULTS: %SMHR could be ranked as follows: RDC = PC = RES = SRP > NC. Significantly higher %SMHR and ΔFRE means were observed after enamel treatment with RDC (22.7 and 46.9, respectively). PC (%SMHR = 18.8) was as efficacious as RDC to recover the surface microhardness with a significantly lower mean of ΔFRE (19.5). Only RDC was able to promote the formation of a mineralized layer on the surface of enamel enriched with silicon on the surface. CONCLUSIONS: The silicate-based fluoride toothpaste containing REFIX technology demonstrated greater efficacy in the remineralizing artificial caries than the other products.

Effectiveness of Experimental Whitening Toothpastes Containing Colorants on the Optical Properties of Enamel.

Objective: This in vitro study investigated the whitening potential of experimental toothpastes containing optical colorants in their formulations in comparison with commercial products. The chemical and physical characteristics of the toothpastes, the morphology, and elemental analysis of the enamel surface after treatment were also analyzed. Materials and Methods: One hundred twenty-five bovine incisor teeth were randomly divided into five groups according to the treatment: (i) experimental PHTALOX dental gel (PHT); (ii) experimental blue silica dental gel (SDG); (iii) Sensodyne Whitening Repair & Protect (WRP); (iv) Sensodyne True White (STW); (v) Snow White Toothpaste (SWS). The whiteness index differences (ΔWI D ) and color alteration (CIELab-ΔE, CIEDE2000-ΔE 00) were calculated after color change analysis using a spectrophotometer before and after the enamel treatment (n = 25). The surface and cross-sectional micromorphology were assessed using scanning electron microscopy. The elemental analyses were determined with energy-dispersive X-ray spectroscopy (EDS). The pH, particle size, zeta potential, and polydispersity index of toothpaste were evaluated. Data was statistically analyzed (ANOVA/Tukey, 5%). Results: Whitening toothpastes containing optical colorants were effective for whitening the enamel, as whiter teeth were observed following treatment (higher means of ΔWI D ). In addition, when the parameters ΔE ab and ΔE 00 were evaluated, these toothpastes were graded as very good effectiveness (grade 4). Other toothpastes were graded as 3 (good effectiveness). PHT had a neutral pH and a larger mean particle size (412.8 nm). Elemental analysis demonstrated enamel with a silicon-enriched mineral layer on the enamel surface treated with SDG. The Ca/P ratio after enamel treatment varied from 1.74 (SWS) to 2.04 (SDG and WRP). Conclusions: Experimental whitening toothpastes containing optical colorants are effective at bleaching the enamel. The synergism among the different parameters analyzed seems to positively affect the color change after brushing with whitening toothpastes containing optical colorants.

Longevity of bonded composite restorations after dentin biomodification with neolignans obtained from Nectandra leucantha / Longevidade de restaurações de resina composta após biomodificação de dentina com neolignanas obtidas de Nectandra leucantha

Objective: This in vitro study evaluated the effect of neolignan-containing solutions on dentin biomodification previously applied to the bonding procedure in adhesive restorations. Material and Methods: Neolignans, dehydrodieugenol B­CP1 and dehydrodieugenol B methyl ether­CP2, were isolated from Nectandra leucanthaand two aqueous solutions containing 0.13% neolignans, 0.2% propylene glycol and 3.0% ethanol were prepared. Bovine teeth were ground flat to obtain 2-mm thick specimens which received resin composite restorations (N=10). The neolignan solutions were applied before the bonding procedure (60 s). Experimental groups were: control, untreated group, 0.12% chlorhexidine gel, 0.13% CP1 solution, and 0.13% CP2 solution. A push-out bond strength test was conducted (0.5 mm/min). Bovine tooth sections (0.5×1.7×7.0 mm) were also obtained to assess the modulus of elasticity and mass change after treatment (N=15). A three-point bending test evaluated the elastic modulus of fully demineralized dentine beams after immersion in the solutions. The data were statistically analyzed (α = 0.05). Results: The bond strength of the restorations to dentin was significantly improved by the treatment with neolignan-containing solutions, irrespective of the evaluation time (p<0.05). After 6 months, a significant reduction in the bond strength was observed in the groups treated with the solutions (p>0.05), but the means were significantly higher than the control groups (p<0.05). The elastic modulus of demineralized dentin was significantly improved after the treatment with the solutions (p<0.05). All groups lost mass weight. Conclusion: The solutions improved the in vitro longevity of bonded restorations, possibly due to the dentin biomodification effect of the neolignans.(AU)

Objetivo: Este estudo in vitro avaliou o efeito de soluções contendo neolignanas na biomodificação da dentina aplicadas previamente à restaurações adesivas. Material e Métodos: Neolignanas, desidrodieugenol B­CP1 e éter metílico de desidrodieugenol B-CP2, foram isolados da espécie Nectandra leucantha e duas soluções aquosas contendo 0,13% de neolignanos, 0,2% de propilenoglicol e 3,0% de etanol foram preparadas. Dentes bovinos foram lixados para obter espécimes de 2 mm de espessura e preparos cavitários restaurados com resina composta (N=10). As soluções foram aplicadas em dentina antes do procedimento adesivo (60 s). Os grupos experimentais foram: controle, grupo não tratado, gel de clorexidina 0,12%, solução de CP1 a 0,13% e solução de CP2 a 0,13%. Foi realizado o teste de resistência de união push-out (0,5 mm/min). O módulo de elasticidade e a alteração de massa após tratamento da dentina (0,5×1,7×7,0 mm) foram também avaliados em teste de flexão de três pontos (N=15). Os dados foram analisados estatisticamente (α=0,05). Resultados: A resistência de união das restaurações à dentina melhorou significativamente com o tratamento com as soluções, independentemente do tempo de avaliação (p<0,05). Após 6 meses, foi observada redução significativa da resistência de união nos grupos tratados com as soluções (p>0,05), com médias significativamente maiores do que nos grupos controle (p<0,05). O módulo de elasticidade da dentina desmineralizada aumentou significativamente após tratamento com as soluções (p<0,05). Todos os grupos perderam massa, independentemente do tratamento. Conclusão: As soluções melhoraram in vitroa longevidade das restaurações adesivas, possivelmente devido ao efeito biomodificador da dentina das neolignanas(AU)

Modified Synthesis and Physicochemical Characterization of a Bioglass-Based Composite for Guided Bone Regeneration.

OBJECTIVES: Bioglass composites and polymers are materials of great interest for the medical and dental areas due to their properties, combining the bioactivity of ceramic materials and the mechanical properties of polymers. The purpose of the present study was to develop and to characterize the physicochemical and morphological properties an experimental bioglass-based ternary composite composed associated with sodium carboxymethylcellulose (Na-CMC) and polyvinyl alcohol (PVA). The compatibility of functional groups with bioglass was previously evaluated. The composite was then synthesized and evaluated in terms of morphology, elemental composition, compressive strength, porosity, and bioactivity. MATERIALS AND METHODS: The bioglass was previously synthesized using a sol-gel route and characterized using FTIR analysis to identify the functional groups. The bone graft composite was then synthesized associating the bioglass with PVA, surfactant Triton X, and Na-CMC. The composite was then morphologically characterized using SEM/EDS. The porosity of the composite was analyzed using µCT, which also provided the composite compression strength. The composite was then evaluated in terms of its bioactivity using SEM/EDS analyses after immersion in SBF for 12, 24, 48, and 72 h. RESULTS: FTIR analysis confirmed, among other components, the presence of Si-O-Ca and Si-O-Si bonds, compatible with bioglass. SEM analysis exhibited a composite with a porous structure without spikes. The elemental mapping confirmed the presence of Si, Ca, and P in the composite. µCT analysis demonstrated a porous structure with 42.67% of open pores and an average compression strength of 124.7 MPa. It has also demonstrated ionic changes in the composite surface after immersion in SBF, with increasing detection of Ca and P as a function of time, highlighting its chemical bioactivity. CONCLUSIONS: It can be concluded that the proposed bioglass-based composite presents a three-dimensional, well-structured, chemically bioactive porous structure, mechanically resistant for being reinforced with polymeric phases, with promising results as a synthetic bone graft, which makes it suitable for guided bone regeneration.

Bonding Reactions of Dental Self-Adhesive Cements with Synthetic Hydroxyapatite as a Function of the Polymerization Protocol.

OBJECTIVES: This study evaluated the influence of the cement composition and different polymerization protocols on the bonding chemical interaction of self-adhesive cements with synthetic hydroxyapatite. MATERIALS AND METHODS: Two commercial self-adhesive resin cements (RelyX U200 and Maxcem Elite) were selected, manipulated, mixed with hydroxyapatite dry powder (HAp), dispensed into molds, and distributed into three groups according to polymerization protocols: immediate photoactivation (IP); delayed photoactivation, 10 min self-curing and light-curing (DP); and chemical activation (CA, no light exposure). The detailed chemical information, at atomic scale, on the surface and deeper into the bulk of self-adhesive cement/hydroxyapatite mixtures was evaluated with X-ray photoelectron spectroscopy (XPS). RESULTS: Chemical elements were detected in both cements, such as Na, O, Ca, C, P, and Si. Other elements were detected in minor concentrations. RelyX U200 exhibited the most intense formation of calcium salts products when the cement/HAp mixtures were photoactivated (immediate or delayed). RelyX U200/HAp mixture under delayed photoactivation (DP) also exhibited higher binding energy between calcium moieties of the HAp and methacrylates in the cement. A higher energy difference in the interaction of HAp with the cement comparing the bulk and surface areas was observed when RelyX U200 underwent the delayed photoactivation protocol. Maxcem Elite exhibited an increased chemical reactivity when either chemically activated or immediately photoactivated and a higher binding energy of the carboxyl groups bonded to the calcium of HAp when chemically activated. CONCLUSIONS: The interaction of cements with hydroxyapatite is chemical in nature and leads to the formation of calcium salts, which may favor better integrity and longevity of adhesive restorations. The polymerization protocol affects the chemical interaction in mixtures of self-adhesive cements and hydroxyapatite, influencing the formation of these salts and the establishment of intermolecular interactions between the HAp and the cements.

Enamel remineralization and surface roughness after treatment with herbal-containing toothpastes.

BACKGROUND: Oral care products containing bioactive agents obtained from extracts of plant drugs were launched. This in vitro study investigated the effects of herbal-containing toothpastes associated or not with fluoride to remineralize the enamel after cariogenic challenge with pH cycling. The chemical and physical factors of toothpastes and the enamel surface roughness after brushing were also analyzed. MATERIAL AND METHODS: Sixty bovine enamel blocks were obtained and divided into 3 thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling, and brushing with toothpastes). Toothpastes containing herbal compounds contained no fluoride [Galla chinensis (GCH)], low-F concentration [D'Or (DOR); Herbal Bliss (HBL)], or a different fluoride type [Elmex Anticaries (EAC)]. The results were compared to NaF-containing toothpastes: 1450 and 5000 ppm. Enamel blocks were brushed with the toothpastes using a pH-cycling model (7 days). The Knoop hardness (25g/10s) of the surface and the longitudinal sections were then evaluated. The percentage of surface hardness recovery (%SHR) was calculated. The enamel surface roughness, pH, particle size, zeta potential, and polydispersity index of toothpaste slurries were also evaluated. Data were statistically analyzed (α=5%). RESULTS: No significance was observed when %SHR was compared (p>0.05). DOR, GCH, and HBL were more effective in remineralizing the enamel subsurface. Significantly higher surface roughness was observed when treated with EAC and GCH (p<0.05). CONCLUSIONS: All toothpastes were able to remineralize the enamel, especially the subsurface, with results equal or better than that of standard toothpastes. Key words:Enamel, hardness, roughness, toothpaste, tooth remineralization.

Influence of Dentin Priming with Tannin-Rich Plant Extracts on the Longevity of Bonded Composite Restorations.

OBJECTIVE: This in vitro study evaluated the influence of bioactive plant extracts as dentin biomodifying agents to improve the longevity of bonded restorations. For that, plant extracts were applied to the dentin surface prior to the adhesive system. MATERIALS AND METHODS: Bovine incisors were ground flat to obtain 2 mm thick slices in which conical preparations were made (N = 10). Tannin-containing plant extracts were applied to dentin before the application of the restorative system, as follows: control group (untreated, CTL), chlorhexidine 0.12% (CHX), mastruz (Dysphania ambrosioides, MTZ), cat's claw (Uncaria tomentosa, CTC), guarana (Paullinia cupana, GUA), galla chinensis (Rhus chinensis, GCH), and tannic acid (extracted from Acacia decurrens, TNA). The push-out bond strength test was conducted (0.5 mm/min). Dentin biomodification was assessed by the modulus of elasticity and mass change in bovine tooth sections (0.5 × 1.7 × 7.0 mm). The dentin staining after extract treatments of dentin slices was compared. The dentin surface wettability was also evaluated by means of the contact angles of the adhesive system with the dentin surface and compared with the untreated control group. Data were subjected to ANOVA/Tukey's test (α = 0.05). RESULTS: The bond strength of the restoratives to dentin was not significantly improved by the plant extracts, irrespective of the evaluation time (p > 0.05). Except for TNA, the elastic modulus of demineralized dentin significantly reduced after treatment with the plant extracts (p < 0.05). The dentin staining correlated with the tannin content of the extracts. The contact angle was significantly reduced when treated with CTC, GCH, and TNA. CONCLUSIONS: The tannin-containing extracts had a questionable effect on the longevity of bonded restorations. The dentin modulus was negatively affected by the extract treatments. Although some of the extracts changed the contact angle, which seems to improve the adhesive monomer permeation, the tannin-rich plant extract application prior to adhesive application was proven to be clinically unfeasible due to dentin staining.

Biomimetic Mechanism of Action of Fluoridated Toothpaste Containing Proprietary REFIX Technology on the Remineralization and Repair of Demineralized Dental Tissues: An In Vitro Study.

OBJECTIVES: This in vitro study aimed to characterize the mineral content and surface and cross-sectional morphology of enamel and dentin tissues treated with a 1450 ppm fluoride-containing toothpaste with REFIX technology. MATERIALS AND METHODS: Bovine enamel blocks (n = 5) were obtained (4 × 4 × 6 mm), demineralized (artificial caries lesion), and treated (pH cycling and brushing with the toothpaste). During the pH cycling, which lasted for 7 days (demineralization and remineralization took 6 and 18 hours, respectively), the enamel was brushed for 5 minutes using an electric toothbrush before being immersed in a remineralizing solution. The dentin blocks were acid-etched for 2 minutes (0.05 M citric acid, pH 1.8) to expose the dentinal tubules (n = 5). Morphological analysis of the dentin was performed immediately and after 7 days of brushing with the dentifrice, and compared with the control group. The specimens were then cross-sectioned. The surface and cross-sectional micromorphology were assessed using scanning electron microscopy (SEM). The elemental analyses (weight%) were determined with an energy-dispersive X-ray spectroscopy (EDS). RESULTS: The toothpaste with REFIX technology remineralized and repaired the surface enamel effectively. The elemental analysis also demonstrated that treating the enamel with the toothpaste formed a silicon-enriched mineral layer on the enamel surface. Elemental analysis of the enamel cross-sections showed that the toothpaste induced a mineral change. The results were also consistent in the dentin, where the dentinal tubules were progressively occluded until there was complete occlusion after 7 days. CONCLUSIONS: We prove the biomimetic mechanism of action of fluoridated toothpaste containing proprietary REFIX technology for obtaining silicon-enriched, remineralized and repaired dental tissues.

Silicon-enriched hydroxyapatite formed induced by REFIX-based toothpaste on the enamel surface / Formação de hidroxiapatita enriquecida com silício induzida por dentifrício à base de REFIX na superfície do esmalte

Objetivo: Este estudo in vitro objetivou caracterizar o teor de minerais e a morfologia das partículas de um dentifrício fluoretado contendo tecnologia REFIX e o teor de minerais e a morfologia da superfície do esmalte tratada com este produto. Material e Métodos: Blocos de esmalte bovino (n=5) foram obtidos (4×4×6 mm), desmineralizados (lesão de cárie artificial) e tratados (ciclagem de pH e escovação com dentifrício). Durante a ciclagem de pH de 7 dias (desmineralização e remineralização levaram 6 h e 18 h, respectivamente), o esmalte foi escovado por 5 min com uma escova dental elétrica antes de ser imerso em uma solução de remineralização. Avaliou-se a micromorfologia e os níveis elementares (% em peso) dos íons presentes no dentifrício e na camada formada sobre o esmalte após o tratamento. A morfologia da superfície foi avaliada por meio de microscopia eletrônica de varredura (MEV). As análises elementares foram realizadas usando um espectrômetro de energia dispersiva de raios-X (EDS). Resultados: A análise por MEV do dentifrício demonstrou uma distribuição de tamanho uniforme de partículas de forma regular que foram organizados esparsamente em "nanoclusters". A análise elementar da formulação do dentifrício demonstrou a presença de Si (silício), Na (sódio), P (fósforo) e F (flúor), entre outros. Observou-se também uma camada mineral na superfície de esmalte com espessura uniforme consistente em torno de 14 µm. Conclusão: De acordo com os resultados, conclui-se que a tecnologia REFIX modifica a superfície e subsuperfície da estrutura do esmalte, formando uma camada mineral rica em silício. (AU)

Objective: This in vitro study aimed at characterizing the mineral content and filler particle morphology of a fluoridated toothpaste containing REFIX technology and the mineral content and the morphology of the enamel surface treated with this product. Material and Methods: Bovine enamel blocks (n=5) were obtained (4×4×6 mm), demineralized (artificial caries lesion), and treated (pH cycling and brushing with the toothpaste). During the pH cycling, which lasted for 7 days (demineralization and remineralization took 6 h and 18 h, respectively), the enamel was brushed for 5 min using an electric toothbrush before being immersed in a remineralization solution. We evaluated the micromorphology and elemental levels (wt%) of ions present in the toothpaste and on the layer formed over the enamel following the treatment. The surface morphology was assessed using scanning electron microscopy (SEM). The elemental analyses were performed using an energy-dispersive X-ray spectrometer (EDS). Results: Scanning electron micrographs of the toothpaste demonstrated a uniform size distribution of regular-shaped fillers sparsely organized in nanoclusters. Elemental analysis of the toothpaste's formulation demonstrated the presence of Si (silicon), Na (sodium), P (phosphorus), and F (fluorine), among others. We also detected a mineral layer that had formed on the treated enamel surface; the layer had a consistent uniform thickness of ~14 µm. Conclusion: Based on the results, it can be stated that REFIX technology modifies the surface and subsurface of the enamel structure, forming a Si-rich mineral layer. (AU)

The interaction of sodium trimetaphosphate with collagen I induces conformational change and mineralization that prevents collagenase proteolytic attack.

OBJECTIVES: This study evaluated the cell viability and expression of different major genes involved in mineralization in odontoblast-like cells exposed to sodium trimetaphosphate (STMP). It was also investigated the influence of STMP on the rate of calcium phosphate crystal growth, its anti-proteolytic action against the enzymatic degradation of type I collagen, the binding mechanism of STMP to collagen fibrils, and the potential mechanism to induce collagen stabilization. METHODS: Immortalized rat odontoblast MDPC-23 cells were cultured. Cell viability was assessed by trypan blue staining, and the changes in gene expression balance induced by STMP were assessed by quantitative reverse transcription (qRT) PCR assays. Crystalline particle formation was monitored by light-scattering detectors to estimate pH variation and the radial size of the crystalline particles as a function of reaction time (pH 7.4, 25°C) in the presence of STMP in supersaturated calcium phosphate solution (Ca/P=1.67). Images were obtained under atomic force microscopy (AFM) to measure the particle size in the presence of STMP. A three-point bending test was used to obtain the elastic modulus of fully demineralized dentin beams after immersion in STMP solution. The binding mechanism of STMP to collagen fibrils and potential stabilization mechanism was assessed with circular dichroism spectrometry (CD). The data were analyzed statistically (α=0.05). RESULTS: STMP had no significant influence on the cell viability and gene expression of the MDPC-23 cells. STMP greatly increased the rate of crystal growth, significantly increasing the average radial crystal size. AFM corroborated the significant increase of STPM-treated crystal size. Mineralized collagen I fibrils exhibited less collagenase degradation with lower STMP concentration. CD analysis demonstrated changes in the conformational stability after STMP binding to type I collagen. SIGNIFICANCE: The increased resistance of collagen against the proteolytic activity of collagenases appears to be related to the conformational change induced by STMP binding in collagen I and the STMP capacity for promoting biomimetic mineralization in type I collagen fibrils.

Influence of a propolis-based irrigant solution on gap formation and bond strength of posts bonded to root canal dentin using different resin cements.

This study evaluated the influence of an aqueous propolis-based solution (PROP) on gap formation and bond strength of posts bonded to root canal dentin using resin cements. Endodontically-treated bovine incisors received different irrigation protocols: 1) 2.5% sodium hypochlorite (NaOCl)/17% EDTA/NaOCl; 2) saline solution (NaCl)/EDTA/0.12% chlorhexidine (CHX); 3) NaOCl/PROP/NaOCl; 4) NaCl/PROP/CHX; 5) NaCl/PROP/NaCl. Posts were then bonded with cements: RelyX ARC; Panavia F2.0; or RelyX U200 (n=10). The specimens were cross-sectioned. Gaps were assessed and performed the push-out bond strength test. Surface roughness of dentin fragments was also evaluated. Statistical analysis was performed (5%). RelyX U200 exhibited greater gap-free interfaces. Bond strength varied as a function of cements and irrigation protocols. PROP irrigation had no negative effect on the bond strength (p>0.05). Roughness increased significantly after NaOCl/EDTA/NaOCl, but remained unaltered after PROP irrigation protocols. Propolis-based irrigation protocols do not interfere in the bonding performance of posts cemented to root canal dentin.

Effects of 1450-ppm Fluoride-containing Toothpastes Associated with Boosters on the Enamel Remineralization and Surface Roughness after Cariogenic Challenge.

OBJECTIVES: This in vitro study investigated the remineralization potential of 1450 ppm, fluoride-containing toothpastes containing different active remineralization agents after cariogenic challenge with pH cycling. The enamel surface roughness after brushing and the chemical and physical characteristics of the toothpastes tested were also analyzed. MATERIALS AND METHODS: Fifty-six bovine enamel blocks were obtained (4 × 4 × 6 mm) and divided into three thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling, and brushing with dentifrices). Seven commercially available fluoride toothpastes (1450 ppm F): three with anti-erosion claims (Candida Professional [CPP], Colgate Total 12 Daily Repair [CDR], Regenerate Enamel Science [RES]); three with desensitizing claims (Bianco Pro Clinical [BPP], Elmex Sensitive [ESS], and Regenerador Diário DentalClean [RDC]); and one standard regular-fluoride toothpaste Colgate Total 12 (CTT) were selected. During pH cycling (demineralization 6 h/remineralization 18 h) for 7 days, the treated third was brushed with the different dentifrices for 10 minutes in a brushing machine before immersion in a remineralizing solution. The Knoop hardness (25 g, 10 second of the surface, and longitudinal section were then evaluated at eight depths (10 to 330 µm). Mean and percentage of surface hardness recovery (% SHR) were calculated. Surface enamel roughness (Ra) was also evaluated. The pH, %weight of particles, zeta potential, and polydispersity index of toothpaste slurries were also evaluated. STATISTICAL ANALYSIS: Data were statistically analyzed (ANOVA/Tukey, 5%). RESULTS: The %SHR of CPP was significantly lower than the others (p < 0.05). The enamel subsurface was more effectively remineralized when treated with BPP, ESS, and RDC. The surface roughness was higher when the demineralized third was treated with CTT, RDC, and RES and after the cariogenic challenge (p < 0.05). For some of the products tested, there was no relationship between surface remineralization and subsurface remineralization. Although toothpastes CPP and RDC present the lowest %SHR means, both products effectively remineralize within the subsurface carious lesion. Regression analysis demonstrated no strong correlations of the enamel surface roughness with the chemical and physical parameters. CONCLUSIONS: Most but not all the fluoride toothpastes were able to remineralize the enamel surface. No specific chemical or physical parameter alone correlated with the surface roughness.

Evidence-Based Studies and Perspectives of the Use of Brazilian Green and Red Propolis in Dentistry.

This review analyzes the evidence and perspectives of dental use of the green and red propolis produced in Brazil by Apis mellifera L. Multiple applications of propolis were found considering its antibacterial, antifungal, anti-inflammatory, immunomodulatory, antiviral, and healing properties. Its therapeutic effects are mainly due to the presence of alcohols, aldehydes, aliphatic acids, aliphatic esters, amino acids, aromatic acids, aromatic esters, flavonoids, hydrocarbyl esters, ethers, fatty acids, ketones, terpenes, steroids, and sugars. Propolis has been mainly used in dentistry in the composition of dentifrices and mouthwashes. Studies have also demonstrated promising use against dentin hypersensitivity, root canal treatment, Candida albicans, and other microorganisms. Overall review of the literature presented here demonstrated that both Brazilian green and red propolis are effective for the problems of multiple etiologies that affect the oral cavity in different dental specialties.

Oxidative stress induced by self-adhesive resin cements affects gene expression, cellular proliferation and mineralization potential of the MDPC-23 odontoblast-like cells.

OBJECTIVE: Clinical issues have been raised about problems related to cytotoxic effects caused when applying self-adhesive cement. It was hypothesized that byproducts eluted from self-adhesive cements modulate oxidative stress response, the gene expression of signaling pathways of inflammatory process/transcriptional activators, and the expression and activity of interstitial collagenases, and modify the phenotypic characteristics of cellular proliferation and mineral deposition in odontoblastic-like cells. METHODS: Cements (MaxCem Elite [MAX] and RelyX U200 [U200)]) were mixed, dispensed into moulds, and photoactivated according to the manufacturers' instructions. Immortalized rat odontoblast-like cells (MDPC-23) were cultured and exposed to polymerized specimens of cements for 4 h. Reactive oxidative specimen production and quantification of gene expression were evaluated. Cell proliferation assay and alizarin red staining were also performed to evaluate the disturbance induced by the cements on cellular proliferation and mineralization. RESULTS: Despite their cytotoxic effects, both self-adhesive cements influenced the metabolism in the odontoblast cells on different scales. MAX induced significantly higher oxidative stress in odontoblast cells than U200. Gene expression varied as a function of exposure to self-adhesive cements; MAX induced the expression of pro-inflammatory cytokines such as TNF-α, whereas U200 downregulated, virtually depleted TNF-α expression, also inducing overexpression of the transcriptional factor Runx2. Overexpression of heme oxygenase-1 (HO-1) and thioredoxin reductase 1 (TRXR1) occurred after exposure to both cements, antioxidant genes that are downstream of Keap1-Nrf2-ARE system. MAX significantly induced the overexpression of collagenase MMP-1, and U200 induced the expression of gelatinase MMP-2. MAX significantly inhibited cell proliferation whereas U200 significantly activated cell proliferation. Alizarin red staining revealed significantly decreased mineral deposition especially when exposed to MAX. SIGNIFICANCE: These results support the hypothesis that byproducts of different self-adhesive cements play important roles in the highly orchestrated process which ultimately affect the cellular proliferation and the mineral deposition in odontoblastic-like cells, possibly delaying the reparative dentin formation after cementation of indirect restorations, especially on recently exposed dentin preparations.

Differential cytotoxic effects on odontoblastic cells induced by self-adhesive resin cements as a function of the activation protocol.

OBJECTIVES: To evaluate the cytotoxic effects of exposing odontoblast cells to a variety of commercial self-adhesive cements polymerized using different activation modes. METHODS: Five cements: MaxCem Elite (MAX), Bifix SE (BSE), G-Cem LinkAce (GCE), Clearfil SA Luting (CAS), and RelyX U200 (U200) were mixed, dispensed into molds, and distributed in groups, according to polymerization protocols: immediate photoactivation; delayed photoactivation (10min self-curing plus light-activation); and chemical activation (no light exposure). Immortalized rat odontoblast cells (MDPC-23) were cultured. Cell viability was assessed by Trypan Blue staining and total cell death was assessed by annexin V-APC/7-AAD double staining and flow cytometry. Volatilized compounds from polymerized specimens of cements were evaluated by gas chromatography/mass spectrometry (GC-MS). Data was analyzed with 2-way ANOVA/Tukey tests (α=0.05). RESULTS: Exposure to all of the cements tested significantly reduced the cell viability, irrespective of the activation protocol (p<0.05). The least harmful cements were CSA and U200. Total death of cells significantly increased when exposed to BSE, GCE, and MAX, especially when chemically activated (p<0.05). Characteristic apoptotic cells increased after exposure to cements, mainly for MAX, regardless of the activation mode. Chemical activation of MAX also induced necrosis. Moreover, GCE and MAX exhibited higher percentages of late apoptotic/dead cells. Chromatograms revealed 28 compounds released from the cements tested, some of them with known carcinogenic effects. Selection of self-adhesive cements and polymerization protocols affect the cytotoxicity and cell viability of odontoblastic cells. CLINICAL SIGNIFICANCE: Despite the simplified cementation protocol, care is needed when cementing indirect restorations with self-adhesive cements, especially on recently exposed dentin. This category of material may cause differential cytotoxic effects and should be considered when selecting a cement. This is particularly true in clinical cases of light attenuation, where the polymerization depends on chemical activation, inducing higher cytotoxic damages when using some of the cements tested.

Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial.

OBJECTIVES: To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. MATERIAL AND METHODS: This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a "rather low" to "very high" caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. RESULTS: Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. CONCLUSIONS: The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial

Abstract Objectives To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. Material and Methods This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a "rather low" to "very high" caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. Results Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. Conclusions The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Comparative bonding ability to dentin of a universal adhesive system and monomer conversion as functions of extended light curing times and storage.

OBJECTIVES: The purpose of this in vitro study was to evaluate the bonding ability and monomer conversion of a universal adhesive system applied to dentin as functions of different curing times and storage. The results were compared among a variety of commercial adhesives. MATERIALS AND METHODS: Flat superficial dentin surfaces were exposed on human molars and assigned into one of the following adhesives (n = 15): total-etch Adper Single Bond 2 (SB) and Optibond Solo Plus (OS), self-etch Optibond All in One (OA) and Clearfil SE Bond (CSE), and Scotchbond Universal Adhesive in self-etch mode (SU). The adhesives were applied following the manufacturers' instructions and cured for 10, 20, or 40s. Specimens were processed for the microtensile bond strength (µTBS) test in accordance with the non-trimming technique and tested after 24h and 2 years. The fractured specimens were classified under scanning electron microscopy (SEM). Infrared (IR) spectra were obtained and monomer conversion (%) was calculated by comparing the aliphatic-to-aromatic IR absorption peak ratio before and after polymerization (n=5). Data were analyzed by 2-way ANOVA/Tukey's tests (α = 0.05). RESULTS: At 24-h evaluation, OA and CSE presented similar bond strength means irrespective of the curing time, whereas SB and SU exhibited significantly higher means when cured for 40s as did OS when cured for 20 or 40s (p < 0.05). At 2-year evaluation, only OA exhibited significantly higher bond strength when cured for 20 and 40s (p < 0.05). When the evaluation times were compared, OA also exhibited the same bonding ability when cured for longer periods of time (20 and 40s). All of the adhesives tested exhibited significantly lower monomer conversion when photoactivated according to the manufacturers' instructions (10s). CONCLUSIONS: Higher monomer conversions obtained with longer light exposure allow only higher immediate bond strength for most of the adhesives tested. After 2-year storage, only the self-etching adhesive Optibond All-In-One exhibited the same bonding ability when cured for longer periods of time.