Comparative study of physical-chemical properties of bioactive glass ionomer cement.

This study analyzed the physical-chemical properties of bioactive ionomer materials. Cention N bioactive materials were evaluated chemically activated (CN) and light-cured (CN-LC), Equia Forte Fill (EQUI); conventional resin composite Filtek Z350 XT (Z350); resin glass ionomer cement Riva light Cure (RIVA) and flowable resin composite Filtek Bulk Fill Flow (BULK-F) were evaluated. Sixty specimens (n=10) were prepared for sorption (SR), solubility (SL), flexural strength (FS), shrinkage stress (SS), conversion degree (CD), microhardness (MI), and surface roughness (SR) tests. Non-cured and light-cured materials were assessed on FTIR. 30 human molar teeth were used in the bond strength test (BS). Data were subjected to ANOVA and post-hoc Tukey's test (5% of significance). EQUI showed more sorption in SR and no statistical difference from RIVA and CN-LC. CN group showed more solubility and EQUI presented less (p<0.05). BULK-F showed higher FS (MPa), without differences from CN and Z350, whereas EQUI presented the lowest FS not differing from RIVA. BULK-F and CN-LC showed more shrinkage stress differing from EQUI. CN-LC and CN showed higher CD differing from the other which showed no differences (p>0.05) between them. EQUI showed the highest hardness (p<0.05) in MI. There were no differences (p>0.05) in SR (µm). Z350 and BULK-F presented higher BS, whereas CN-LC showed the lowest, although not differing from EQUI and RIVA. Equia Forte's solubility and microhardness make it a good alternative as a restorative material. Cention N degree of conversion and flexural strength making it an esthetic option to amalgam.

Whitening efficacy of activated charcoal-based products: A single-blind randomized controlled clinical trial.

OBJECTIVE: This randomized controlled clinical trial evaluated the whitening efficacy, tooth sensitivity (TS), and volunteers' satisfaction following the use of activated charcoal powder and toothpaste. METHODS: Fifty-six volunteers were randomly allocated into 4 groups (n = 14) according to a 14-day toothbrushing or whitening treatment with activated charcoal powder (ACPW), activated charcoal toothpaste (ACT), regular fluoridated toothpaste (RT), and 10 % carbamide peroxide (CP). Objective (ΔE00) and subjective (ΔSGU) color and whiteness index (ΔWID) changes were calculated. Patients self-reported the risk and intensity of TS using a visual analogue scale and the volunteer's satisfaction was determined by a questionnaire. Color assessments were analyzed by Kruskal-Wallis followed by Dwas-Steel-Crithlow-Fligner, and absolute TS risk and volunteer's satisfaction by Fisher exact test (p < 0.05). RESULTS: ACPW and ACT promoted similar effects in ΔE00, ΔSGU, and ΔWID to that observed for RT. No significant difference was found in terms of TS risk intensity. TS risk became high after 7 and 14 days, with higher TS prevalence in CP. Volunteers reported that ACPW exhibited the lowest ease-of-use, comfort, and whitening satisfaction among groups (p < 0.05). CONCLUSION: Activated charcoal-based products presented a minor and unsatisfactory whitening effect while CP resulted in optimal tooth whitening and the highest level of satisfaction among volunteers. Risk was higher from 7 days onwards and was more pronounced in the CP. CLINICAL RELEVANCE: Based on the whitening effect and patient satisfaction, this controlled-randomized clinical evidence supports that the use of activated charcoal-based products should be discouraged.

Comparative study of physical-chemical properties of bioactive glass ionomer cement

Abstract This study analyzed the physical-chemical properties of bioactive ionomer materials. Cention N bioactive materials were evaluated chemically activated (CN) and light-cured (CN-LC), Equia Forte Fill (EQUI); conventional resin composite Filtek Z350 XT (Z350); resin glass ionomer cement Riva light Cure (RIVA) and flowable resin composite Filtek Bulk Fill Flow (BULK-F) were evaluated. Sixty specimens (n=10) were prepared for sorption (SR), solubility (SL), flexural strength (FS), shrinkage stress (SS), conversion degree (CD), microhardness (MI), and surface roughness (SR) tests. Non-cured and light-cured materials were assessed on FTIR. 30 human molar teeth were used in the bond strength test (BS). Data were subjected to ANOVA and post-hoc Tukey's test (5% of significance). EQUI showed more sorption in SR and no statistical difference from RIVA and CN-LC. CN group showed more solubility and EQUI presented less (p<0.05). BULK-F showed higher FS (MPa), without differences from CN and Z350, whereas EQUI presented the lowest FS not differing from RIVA. BULK-F and CN-LC showed more shrinkage stress differing from EQUI. CN-LC and CN showed higher CD differing from the other which showed no differences (p>0.05) between them. EQUI showed the highest hardness (p<0.05) in MI. There were no differences (p>0.05) in SR (µm). Z350 and BULK-F presented higher BS, whereas CN-LC showed the lowest, although not differing from EQUI and RIVA. Equia Forte's solubility and microhardness make it a good alternative as a restorative material. Cention N degree of conversion and flexural strength making it an esthetic option to amalgam.

Resumo Este estudo analisou as propriedades físico-químicas dos materiais de ionômero bioativo. Os materiais bioativos Cention N quimicamente ativados (CN) e fotopolimerizados (CN-LC), Equia Forte Fill (EQUI); resina composta convencional Filtek Z350 XT (Z350); resina de ionômero de vidro Riva light Cure (RIVA) e resina composta fluida Filtek Bulk Fill Flow (BULK-F) foram avaliados. Sessenta espécimes (n=10) foram preparados para testes de sorção (SR), solubilidade (SL), resistência à flexão (FS), tensão de contração (SS), grau de conversão (CD), microdureza (MI) e rugosidade da superfície (SR). Os materiais não curados e curados com luz foram avaliados por FTIR. 30 dentes molares humanos foram usados no teste de resistência de união (BS). Os dados foram submetidos a ANOVA e teste de post-hoc Tukey (5% de significância). O EQUI apresentou maior sorção no SR e não mostrou diferença estatística em relação aos grupos RIVA e CN-LC. O grupo CN apresentou maior solubilidade e o EQUI apresentou menor (p<0,05). O BULK-F apresentou maior FS (MPa), sem diferir do CN e do Z350, enquanto o EQUI apresentou o menor FS, não diferindo do RIVA. O BULK-F e o CN-LC apresentaram maior estresse de contração, diferindo do EQUI. O CN-LC e o CN apresentaram maior CD (%), diferindo dos demais, que não apresentaram diferenças (p>0,05) entre si. A EQUI apresentou a maior dureza (p<0,05) no MI. Não houve diferenças (p>0,05) na SR (µm). Z350 and BULK-F apresentaram BS, enquanto a CN-LC apresentou a menor, embora não diferindo da EQUI e da RIVA. A solubilidade e a microdureza do Equia Forte o tornam uma boa alternativa como material restaurador. O grau de conversão e a resistência à flexão do Cention N o tornam uma opção estética ao amálgama.

Dental aesthetic perception of patients submitted to activated charcoal-based bleaching agents: A randomized clinical trial.

OBJECTIVE: To evaluate the effects of activated charcoal-based products used in two presentation forms (powder or toothpaste), compared to 10 % carbamide peroxide and conventional toothpaste on aesthetic perception and psychosocial impact before and after treatment. METHODS: Fifty-six participants were divided into 4 experimental groups (n = 14). Activated charcoal-based powder (PW); Activated charcoal-based dentifrice (AC); Conventional fluoride toothpaste (CD) and 10 % carbamide peroxide (CP). All products were used for 14 days. Psychosocial impact on dental esthetics (PIDAQ), oral health impact profile (OHIP- Esthetics) and orofacial esthetics scale (OES) questionnaires were applied before and after treatment. Descriptive and exploratory data analyses were performed and analyzed using linear mixed models for repeated measures over time considering significance level of α = 0.05. RESULTS: For PIDAQ, the CP group showed significant decrease in psychological impact, aesthetic perception domains and overall score, while in the PW group, there was only a significant decrease in the psychological impact domain. Decrease in OHIP was observed for the functional limitation domain scores for treatments with CP and PW, in the psychological discomfort domain, decrease was observed for all groups, while for the OES questionnaire, significant increase in the color domain was observed for the CP group. CONCLUSION: Activated charcoal-based products showed lower scores in all questionnaires when compared with carbamide peroxide; thus, charcoal-based products promoted lower impact on quality of life and aesthetic perception. CLINICAL RELEVANCE: In this randomized clinical trial, charcoal-based OTC products had inferior quality of life and aesthetic perception results compared to conventional carbamide peroxide bleaching.

In vitro assessment of activated charcoal-based dental products.

OBJECTIVE: Assess the effects of activated charcoal-based products on whitening and changes on dental enamel surface. MATERIAL AND METHODS: Fifty-two blocks of bovine dental enamel were randomly distributed in four groups (n = 13): brushing with activated charcoal-based powder (PW); brushing with activated charcoal-based dentifrice (AC); brushing with a conventional dentifrice containing 1450 ppm of fluoride (CD); and whitening with 10% carbamide peroxide (CP). Color, microhardness, and surface alteration were analyzed at baseline and after 14 days of treatment. Three samples per group were randomly selected and examined using scanning electron microscopy (SEM) to analyze the morphology. RESULTS: PW exhibited greater color change for the ΔE00 , ΔWID, Δb* and ΔL* parameters than other groups (p < 0.05). After treatment, microhardness decreased in AC and CP groups (p < 0.05). Also, PW and AC groups showed more surface alteration than CD and CP (p < 0.001). Changes in the morphology of dental enamel were observed by SEM in PW and AC groups. CONCLUSION: Activated charcoal-based products showed a lower whitening effect than 10% carbamide peroxide. These products also influenced dental enamel microhardness, resulting in greater surface alteration. CLINICAL SIGNIFICANCE: Activated charcoal-based products promoted minimum whitening effects with significant enamel surface alteration. The 10% carbamide peroxide was more effective for whitening and caused slight enamel surface alteration.

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.

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

Abstract 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.

Resumo Os objetivos deste estudo clínico foram avaliar a alteração de cor - ΔE (baseada em espectrofotometria e análise visual) e luminosidade - L* (baseada em espectrofotometria) da superfície do esmalte dentário (após tratamento ortodôntico) ao redor da área onde os braquetes ortodônticos foram fixados, com base em diferentes materiais de cimentação, como resina (grupo R) e cimento de ionômero de vidro modificado por resina (grupo RMGIC). Estudo boca dividida foi inicialmente composto por 14 pacientes. Os braquetes ortodônticos foram fixados nos incisivos centrais superiores com resina ou RMGIC. A cor da superfície vestibular de cada dente foi mensurada por espectrofotometria e avaliada por exame visual antes do processo de fixação dos braquetes. Quatro indivíduos foram excluídos durante o acompanhamento; assim, 10 pacientes foram avaliados (n=10). Os braquetes foram removidos após 12 meses de tratamento ortodôntico, a mensuração da cor do dente e o exame visual foram realizados novamente, e o Índice de Remanescente do Adesivo (IRA) também foi mensurado. Os resultados ΔE e L* foram submetidos ao teste t de Student e à análise de variância para medidas repetidas, respectivamente (α=0.05). Os dados do ARI foram analisados em porcentagens. Houve diferença estatisticamente significativa no ΔE entre os grupos; o grupo R apresentou valores estatisticamente maiores de L* após o tratamento ortodôntico. O IRA 2 e 3 prevaleceu no grupo RMGIC, enquanto o grupo R apresentou 0 e 1. Após o tratamento ortodôntico, o grupo RMGIC apresentou menores alterações no ΔE e o aumento da escala branca foi observado na superfície do esmalte ao redor da área onde os braquetes foram fixados no grupo R. A análise visual não mostrou mudança de cor nos dentes avaliados.

Assessing the bleaching effect of an experimental stabilized chlorine dioxide agent used for internal bleaching purposes

Aim Assessing the intracoronal bleaching effectiveness of an experimental chlorine dioxide product, based on the walking bleach technique. Methods Extracted bovine incisors were artificially stained with bovine blood and filled with zinc phosphate cement at cementoenamel junction level. Teeth were divided into 3 groups (n=10): (SP) sodium perborate added with distilled water, (CD) chlorine dioxide and (C) control - dry cotton inserted into the pulp chamber. Bleaching agents were used at 0, 7 and 14 days. VITA Easyshadetm (∆Eab) was used to analyze tooth color at the 7th, 14th and 21st days, based on the CIE2000 system. Data were analyzed through ANOVA and Tukey's test. Results There were no statistically significant differences in Δb, ΔE, ΔE00 and ΔWID between CD and the control group. These parameters have shown significant differences between CD and SP, which differed from the control. However, they did not show significant differences either in the control group or in CD at the 7th, 14th and 21st days. Values recorded for SP at the 7th day differed from those recorded at the 14th and 21st days. Δa has shown differences within the same group at the 7th, 14th and 21st days. There was no difference between groups, when they were compared at the same day (7th and 14th). The control group differed from SP at the 21st day. CD did not differ from the other two groups. ΔL did not show differences between groups and times. Conclusion Stabilized chlorine dioxide (0.07%, at pH 3.5) should not be used as intracoronal bleaching agent along with the walking bleach technique.

Evaluation of Removal Force in Prosthetic Components of Morse Taper Dental Implants.

The longevity of prosthetic rehabilitation is determined by the stability of the implant and abutment interfaces. True morse taper connections on dental restorations have been effective, however activation force still empirical. This work compared the activation strength and internal contact of Morse taper system according to the removal force. Eighty sets, composed of implants and prosthetic abutments, were evaluated with different internal contact areas; 15.12mm2 (G3.3) and 21.25mm2 (G4.3). The specimens were activated at 0° and 30°, with loads of 10, 20, 40 and 60N. The specimens were submitted to tensile test and the data to ANOVA and Tukey's tests (α=0.05). Representative specimens were examined under SEM. Removal force of G3.3 (2.15±1.33MPa) did not differed to G4.3 (1.99±1.03MPa). The activation at 0º (2.95±0.98MPa) statistically differed to 30º (1.19±0.54MPa). The 60N load was statistically superior for G3.3 and there was no statistical difference between 20N to 60N in G4.3. The values of 10N at 30o and 20N at the long axis of the morse taper implant, independent of the frictional contact area showed the best settlement.

Evaluation of Removal Force in Prosthetic Components of Morse Taper Dental Implants

Abstract The longevity of prosthetic rehabilitation is determined by the stability of the implant and abutment interfaces. True morse taper connections on dental restorations have been effective, however activation force still empirical. This work compared the activation strength and internal contact of Morse taper system according to the removal force. Eighty sets, composed of implants and prosthetic abutments, were evaluated with different internal contact areas; 15.12mm2 (G3.3) and 21.25mm2 (G4.3). The specimens were activated at 0° and 30°, with loads of 10, 20, 40 and 60N. The specimens were submitted to tensile test and the data to ANOVA and Tukey's tests (α=0.05). Representative specimens were examined under SEM. Removal force of G3.3 (2.15±1.33MPa) did not differed to G4.3 (1.99±1.03MPa). The activation at 0º (2.95±0.98MPa) statistically differed to 30º (1.19±0.54MPa). The 60N load was statistically superior for G3.3 and there was no statistical difference between 20N to 60N in G4.3. The values of 10N at 30o and 20N at the long axis of the morse taper implant, independent of the frictional contact area showed the best settlement.

Resumo A longevidade da reabilitação protética é determinada pela estabilidade das interfaces implante e pilar. Conexões de cone Morse em restaurações dentárias têm se mostrado eficazes, porém a força de ativação ainda é empírica. Este trabalho comparou a força de ativação e contato interno do sistema cone Morse de acordo com a força de remoção. Oitenta conjuntos, compostos por implantes e pilares protéticos, foram avaliados com diferentes áreas de contato interno; 15,12mm2 (G3.3) e 21,25mm2 (G4.3). Os corpos-de-prova foram ativados a 0° e 30°, com cargas de 10, 20, 40 e 60N. Os corpos de prova foram submetidos ao ensaio de tração e os dados aos testes ANOVA e Tukey (α=0,05). Espécimes representativos foram examinados em MEV. A força de deslocamento do G3.3 (2,15±1,33MPa) não diferiu do G4.3 (1,99±1,03MPa). A ativação a 0º (2,95±0,98MPa) diferiu estatisticamente para 30º (1,19±0,54MPa). A carga de 60N foi estatisticamente superior para G3.3 e não houve diferença estatística entre 20N a 60N no G4.3. Os valores de 10N em 30o e 20N no longo eixo do implante cone morse, independente da área de contato friccional apresentaram o melhor assentamento.

Brix-3000 as a Preventive Measure in Aerosol Production against Covid-19: Case Report / Utilização do gel Enzimático Brix-3000 Como Medida Preventiva na Produção de Aerossóis Frente à Covid-19: Relato de Caso

In 2020, the World Health Organization declared a pandemic due to a new virus, known as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). Faced with exposure to cross-contamination due to the use of aerosols from rotary instruments, saliva, and nasopharyngeal secretions, health professionals had to explore alternative methods for removing decayed tissue, such as BRIX-3000, a papain-based enzymatic gel used for the chemical-mechanical removal of infected decayed tissue using manual instruments, with the aim of reducing the risk of contamination for the dental team. Thus, this paper aims to report a clinical case, using the BRIX-3000 in the removal of carious tissue. An 8 year-old patient complained of sensitivity in teeth 55 and 65, and was proposed removal of decayed tissue by means of chemical-mechanical removal. The procedure was performed without anesthesia, under relative isolation. The enzymatic gel was taken to the cavity following the manufacturer's directions, and after 1 minute the infected tissue was removed by curettage. Then the cavity was prepared, using cotton for washing and drying, avoiding the triple syringe and the formation of aerosols. Glass ionomer was used as a provisional material. It can be concluded that the papain-based enzymatic gel had great efficacy in removing decayed tissue, besides reducing aerosolization and, thus, contamination, making clinical care safer against the spread of infectious and contagious diseases, before the Covid-19 pandemic. (AU)

Em 2020, a Organização Mundial da Saúde declarou uma pandemia devido a um novo vírus, conhecido como SARS-CoV-2 (Síndrome Respiratória Aguda Grave Coronavírus 2). Frente à exposição de uma contaminação cruzada, devido à utilização de aerossóis advindos dos instrumentos rotatórios, salivas e secreções da nasofaringe, os profissionais da saúde precisaram explorar métodos alternativos para remoção do tecido cariado, como no caso o BRIX-3000, um gel enzimático a base de papaína, utilizado na remoção químico-mecânica do tecido cariado infectado, por meio de instrumentos manuais, com o objetivo de diminuir o risco de contaminação da equipe odontológica. Posto isto, esse trabalho visa relatar um caso clínico, utilizando o BRIX-3000 na remoção do tecido cariado. Paciente, 8 anos, procurou atendimento queixando-se de sensibilidade nos elementos dentais 55 e 65. Foi proposto a remoção do tecido cariado por meio da remoção químico-mecânica. O procedimento foi realizado sem anestesia, sob isolamento relativo. O gel enzimático foi levado a cavidade seguindo as orientações do fabricante, decorridos 1 minuto iniciou-se a remoção do tecido infectado por meio de curetagem. Em seguida a cavidade foi preparada, utilizando algodão para lavagem e secagem, evitando a seringa tríplice e a formação de aerossóis. Como material provisório utilizou-se o ionômero de vidro. Diante do caso, pode-se concluir-se que o gel enzimático a base de papaína teve grande eficácia na retirada do tecido cariado, além de reduzir a aerossolização e, assim, a contaminação, tornando o atendimento clínico mais seguro contra a disseminação de doenças infectocontagiosas, frente a pandemia da Covid-19. (AU)

Anticaries Agent Based on Silver Nanoparticles and Fluoride: Characterization and Biological and Remineralizing Effects-An In Vitro Study.

Objective: The aim of the study was to characterize and evaluate the stability, antimicrobial activity, cytotoxicity, and remineralizing effects of silver nanoparticles and fluoride anticaries agent (AgF) on staining dental enamel. Materials and Methods: An experimental AgF solution was prepared and compared to silver diamine fluoride (SDF). First, the AgF was characterized and the stability was evaluated by transmission electron microscopy (TEM). Streptococcus mutans, Enterococcus faecalis, and Escherichia coli strains were used to evaluate the minimum inhibitory and bactericidal concentration and cytotoxicity performed using L929 fibroblastic cells by MTT test. Caries-like lesions induced by pH-cycling in human enamel were obtained, and then, the superficial microhardness, cross-sectional microhardness (CSMH), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS) were performed. Photographic images were taken to analyze the enamel staining. Results: The AgF showed stableness in long term with bacteriostatic and bactericidal actions without cytotoxicity. Enamel remineralization, in surface and in depth (CSMH), was observed when the AgF was used, and it was similar to SDF. SEM showed enamel precipitation, and EDS observed the presence of P, Ca, Au, Ag, and Cl elements. Contrary to SDF, AgF did not stain the enamel. Conclusion: The nano silver fluoride anticaries agent tested presented long-term stability, superficial and in-depth remineralizing capacity with antimicrobial potential and biocompatibility and did not stain the enamel.

Evaluation of enamel roughness after the removal of brackets bonded with different materials: In vivo study.

The aims of this in vivo study were to evaluate the effect of bonding with resin-modified glass ionomer cement (RMGIC) and to assess enamel surface roughness before and after the removal of brackets bonded with composite or RMGIC from the maxillary central incisors. Fifteen orthodontic patients were selected for the study. For each patient, the teeth were rinsed and dried, and brackets were bonded with composite (Transbond XT) and RMGIC (Vitremer Core Buildup/Restorative). At the conclusion of orthodontic treatment, their brackets were removed. Dental replicas were made of epoxy resin in initial conditions (before bonded) and after polishing with an aluminum oxide disc system. Adhesive remnant index (ARI) and surface roughness was measured on the dental replicas and data were evaluated statistically by Mann-Whitney and paired t-test, respectively. No bracket debonding occurred during patients' treatment periods. It was verified that the ARI values of the two maxillary central incisors were similar (p = 0.665). For both bonding materials, the ARI value of 3 was predominant. After polishing, surface roughness was similar in the composite and RMGIC groups (0.245 µm and 0.248 µm, respectively; p = 0.07). In both groups, enamel surface roughness values were significantly lower after polishing compared with the initial condition (p < 0.001). RMGIC promoted efficiency in cementing brackets without fail during treatment; the choice of composite or RMGIC materials was not a factor that influenced the roughness of the enamel surface, however, polishing led to smoother surfaces than those found at the beginning of the treatment.

Effect of Chemical Challenges on the Properties of Composite Resins.

OBJECTIVE: To evaluate the chemical degradation effect on microhardness and roughness of composite resins after aging. MATERIALS AND METHODS: Specimens (n = 10) were used for Filtek Z350 XT (Z350), Filtek Bulk Fill (BULK), Micerium HRI (HRI), Micerium BIOFUNCION (BIO), and Vittra APS (VITTRA). Microhardness and roughness were performed before and after degradation with the followed solutions: citric acid, phosphoric acid, 75% alcohol, and distilled water. Samples were to a 180-day chemical cycling protocol. After degradation, one sample of each group was selected for scanning electron microscope evaluation. The data were analyzed with normal distribution (Kolmogorov-Smirnov) and similarities of variations for the Bartlett test. ANOVA (two-way) followed by Tukey's test was performed considering treatment and composite resin (P < 0.05). RESULTS: For microhardness and roughness, variations were noted to different solution and resin formulations. Z350 and HRI showed higher microhardness percentage loss, and it was more evident after storage in alcohol (-48.49 ± 20.16 and -25.02 ± 14.04, respectively) and citric acid (-65.05 ± 28.97 and 16.12 ± 8.35, respectively). For roughness, Z350 and VITTRA showed less delta values after alcohol storage (-0.047 ± 0.007 and -0.022 ± 0.009, respectively). HRI had the worst roughness for citric acid (-0.090 ± 0.025). All resins were not statistically different between each other in water and phosphoric acid. CONCLUSION: The formulations of restorative resin materials influenced in degree of surface degradation after 180 days of chemical degradation. Water was considered the solution that causes less degradation for microhardness and roughness evaluations. For microhardness, alcohol was considered the worst solution for Z350 and HRI. For superficial roughness, Z350 and VITTRA showed less degradation in alcohol and citric and phosphoric acid solutions.

Effect of Amelogenin Solution in the Microhardness of Remineralized Enamel and Shear Bond Strength of Orthodontic Brackets.

OBJECTIVES: To evaluate the microhardness of tooth enamel remineralized with enamel matrix protein solution as well as the shear bond strength of orthodontic brackets bonded to this surface. MATERIALS AND METHODS: In total, 24 human premolars were selected and divided into 3 experimental groups (n = 8): SE-sound enamel, DE-demineralized enamel, and TE-demineralized enamel treated with amelogenin solution. Samples from DE and TE groups were subjected to pH cycling to induce initial artificial caries lesion. TE group was treated with amelogenin solution. Samples were placed in artificial saliva for 7 days. Knoop microhardness was measured before any intervention (T0), after pH cycling (T1) and after amelogenin solution treatment application (T2). Twenty-four hours after ceramic orthodontic brackets were bonded, samples were subjected to shear test in a universal testing machine. Microhardness and shear measurement distributions were subjected to Kolmogorov-Smirnov normality test, which was followed by parametric tests (α = 0.05): 2-way analysis of variance (factors: enamel condition × treatment) and Tukey posttest for all three groups (SE, DE, and TE) in T0 and T2 for microhardness; analysis of variance and Tukey's test, for shear bond strength test. RESULTS: Means recorded for Knoop microhardness in T2, for the SE (366.7 KHN) and TE (342.8 KHN) groups, were significantly higher than those recorded for the DE group (263.5 KHN). The shear bond strength of the SE (15.44 MPa) and TE (14.84 MPa) groups statistically differed from that of the DE group (11.95 MPa). CONCLUSION: In vitro demineralized enamel treatment with amelogenin solution was capable of taking samples' hardness back to levels similar to those observed for sound enamel. The shear bond strength on the enamel subjected to this treatment was similar to that observed for healthy enamel and higher than that observed for demineralized enamel.

Evaluation of enamel roughness after the removal of brackets bonded with different materials: In vivo study

Abstract The aims of this in vivo study were to evaluate the effect of bonding with resin-modified glass ionomer cement (RMGIC) and to assess enamel surface roughness before and after the removal of brackets bonded with composite or RMGIC from the maxillary central incisors. Fifteen orthodontic patients were selected for the study. For each patient, the teeth were rinsed and dried, and brackets were bonded with composite (Transbond XT) and RMGIC (Vitremer Core Buildup/Restorative). At the conclusion of orthodontic treatment, their brackets were removed. Dental replicas were made of epoxy resin in initial conditions (before bonded) and after polishing with an aluminum oxide disc system. Adhesive remnant index (ARI) and surface roughness was measured on the dental replicas and data were evaluated statistically by Mann-Whitney and paired t-test, respectively. No bracket debonding occurred during patients' treatment periods. It was verified that the ARI values of the two maxillary central incisors were similar (p = 0.665). For both bonding materials, the ARI value of 3 was predominant. After polishing, surface roughness was similar in the composite and RMGIC groups (0.245 μm and 0.248 μm, respectively; p = 0.07). In both groups, enamel surface roughness values were significantly lower after polishing compared with the initial condition (p < 0.001). RMGIC promoted efficiency in cementing brackets without fail during treatment; the choice of composite or RMGIC materials was not a factor that influenced the roughness of the enamel surface, however, polishing led to smoother surfaces than those found at the beginning of the treatment.

Resumo Os objetivos deste estudo in vivo foram avaliar o efeito da colagem com cimento de ionômero de vidro modificado por resina (CIVMR) e a rugosidade da superfície do esmalte antes e após a remoção dos braquetes colados com compósito ou CIVMR em incisivos centrais superiores. Quinze pacientes ortodônticos foram selecionados para o estudo. Para cada paciente, os dentes foram lavados e secos, e os braquetes colados com compósito (Transbond XT) e CIVMR (Vitremer Core Buildup / Restorative). Ao término do tratamento ortodôntico, os braquetes foram removidos. As réplicas dentais foram confeccionadas em resina epóxica nas condições iniciais (antes da colagem) e após o polimento com sistema de discos de óxido de alumínio. O índice de remanescente adesivo (IRA) e a rugosidade da superfície foram mensurados nas réplicas dentais e os dados foram avaliados estatisticamente por Mann-Whitney e teste t pareado, respectivamente. Não ocorreu descolagem de braquetes durante os períodos de tratamento dos pacientes. Verificou-se que os valores do IRA dos dois incisivos centrais superiores foram semelhantes (p = 0,665). Para ambos os materiais de colagem, o valor de IRA predominante foi 3. Após o polimento, a rugosidade da superfície do esmalte foi semelhante nos grupos compósito (0,245 μm) e CIVMR (0,248 μm) (p = 0,07). Em ambos os grupos, os valores de rugosidade da superfície do esmalte foram significativamente menores após o polimento em comparação com a condição inicial (p <0,001). CIVMR promoveu eficiência na colagem de braquetes sem falhas durante o tratamento; a escolha dos materiais compósito ou CIVMR não foi um fator que influenciou na rugosidade da superfície do esmalte, porém, o polimento levou a superfícies mais lisas do que as encontradas no início do tratamento.

Effect of application time and concentration of silver diamine fluoride on the enamel remineralization.

BACKGROUND: Silver diamine fluoride has attracted attention because of its clinical success in arresting dental caries. Thus, the aim of this study was to evaluate the effect of different application times and concentrations of silver diamine fluoride (SDF) on deciduous tooth enamel remineralization. MATERIAL AND METHODS: Blocks of deciduous tooth enamel were categorized into six groups of 11 each: 2 control groups: intact enamel, and demineralized enamel; 38% SDF and 30% SDF which were subdivided according to application times (1 and 3 min). The microhardness of samples was determined, and all groups except the intact enamel group were subjected to pH cycling to produce initial carious lesions. The 38% and 30% SDF solutions were applied to the enamel for 1 or 3 min. After pH cycling and SDF treatments, the microhardness was again determined. Samples were sectioned to evaluate the cross-sectional microhardness. Furthermore, internal porosity of the samples was examined using micro-CT. Data were statistically analyzed by analysis of variance followed by Tukey's test, and linear regression analyses were performed. RESULTS: There was no difference in enamel remineralization based on surface and cross-sectional microhardness. The 30% SDF solution applied for 3 min promoted significantly less pores than the other groups. CONCLUSIONS: The 1-min application time promoted enamel remineralization regardless of the SDF concentration (30% or 38%). Key words:Cariostatic agents, dental caries, primary tooth, tooth remineralization.

Effect of Protein-Based Treatment on Chemical Composition, Hardness and Bond Strength of Remineralized Enamel.

This study evaluated the chemical composition and microhardness of human enamel treated with an Enamel Matrix Derivative (EMD) solution, and the bond strength between composite resin and this enamel. Thirty human enamel samples were randomly divided into three groups: Untouched Enamel (UE), Demineralized Enamel (DE) and Demineralized Enamel Treated with EMD (ET). DE and ET groups were subjected to acid challenge and ET treated with EMD (EMD was directly applied over conditioned enamel and left for 15 min). Samples from each group (n=4) had chemical composition assessed through to attenuated total reflectance Fourier transform infrared (ATR-FTIR). Knoop microhardness of enamel samples from each group (n=10) was measured. For the microshear bond strength, the samples were etched for 30 s, and the adhesive was applied and cured for 10 s. Two matrixes were placed on the samples, filled with Filtek Z350 XT composite and cured for 20 s, each. The matrix was removed, and the microshear bond strength of each group (n=10) was tested. Data were subjected to Kruskal-Wallis test (for microhardness), to analysis of variance and to Tukey's test (for microshear bond strength); (α=0.05). FTIR results have shown phosphate (hydroxyapatite indicator) in 900-1200 cm-1 bands in the UE and ET groups, which were different from the DE group. Microhardness and microshear analyses recorded higher statistical values for the UE and ET groups than for DE. EMD application to demineralized enamel seems to have remineralized the enamel; thus, the microhardness and bond strength was similar between UE and ET groups.

Can silver diamine fluoride or silver nanoparticle-based anticaries agents to affect enamel bond strength?

OBJECTIVES: The aim of the current study is to investigate the effect of different anticaries agents, such as experimental agents based on silver nanoparticles (SNPs) and silver diamine fluoride (SDF), on the micro-shear bond strength (µ-SBS) of composite resin applied to intact enamel (IE) or demineralized enamel (DE). MATERIALS AND METHODS: Sixty dental enamel fragments were collected from human third molars and categorized into 6 groups (n = 10): positive control (IE), negative control (DE), IE + SDF, DE + SDF, IE + SNP and DE + SNP. Samples from DE, DE + SDF and DE + SNP groups were subjected to pH cycling; superficial microhardness test was performed to confirm demineralization. Resin composite build-ups were applied to the samples (0.75-mm diameter and 1-mm height) after the treatments (except for IE and DE groups); µ-SBS was also evaluated. Samples were analyzed under a stereomicroscope at 40× magnification to identify failure patterns. Data were subjected to one-way analysis of variance, followed by Tukey's and Dunnett's tests (p < 0.05). RESULTS: There was no significant difference among the IE, IE + SNP, DE + SDF, and DE + SNP groups. The IE + SDF and DE groups recorded the highest and the lowest µ-SBS values, respectively. Adhesive-type failures were the most frequent for all treatments. CONCLUSIONS: Anticaries agents did not have a negative effect on the µ-SBS of composite resin when it was used on IE or DE.

Reabilitação estética anterior associando cirurgia periodontal com laminados cerâmicos: relato de caso / Anterior aesthetic rehabilitation associating periodontal surgery with ceramic laminates: case report

Objetivo: Este trabalho teve como objetivo relatar um caso de reabilitação estética através de laminados cerâmicos e cirurgia periodontal como forma de tratamento para a agenesia do elemento dental 22 e sorriso gengival associado à retração labial. Relato do Caso: Paciente, gênero feminino procurou a Clínica Multidisciplinar da Unipar (Sede/Umuarama) relatando insatisfação com a harmonia estética do sorriso, apresentando coroas curtas e agenesia do elemento dental 22. Com base na anatomia do contorno gengival, foi indicada cirurgia de gengivectomia (bisel interno com osteotomia) para a região ântero-superior. Através do enceramento diagnóstico projetou-se o aumento de coroa clínica, obtendo-se assim uma guia, que foi utilizado para a realização do ensaio diagnóstico intrabucal, mock-up, e auxílio na cirurgia periodontal. Após 60 dias a paciente foi encaminhada para a realização dos procedimentos restauradores com a confecção de laminados cerâmicos. Conclusão: Pôde-se concluir através dos resultados clínicos obtidos, que a atuação multidisciplinar devolveu a harmonia estética do sorriso e melhora na qualidade de vida da paciente(AU)

Objective: The aim of this study was to report a case of aesthetic rehabilitation through laminates and periodontal surgery as a form of treatment for the dental element agenesis 22 and gummy smile associated with lip retraction. Case Report: Patient, female gender, came to the Clinic Multidisciplinary of Unipar (head office/Umuarama) reporting dissatisfaction with the smile aesthetic harmony, with short crown and dental element agenesis. Based on gingival contour anatomy, a gingivectomy surgery (inner bevel with osteotomy) was indicated for the anterossuperior region. The increase in clinical crown was projected by the termination of diagnosis, thereby a guide, that it was used for the realization of the intra-oral diagnostic test mock-up, and support at the periodontal surgery. After 60 days the patient referred for the performance of restorative procedures with the making of laminates. Conclusion: It was concluded through clinical results obtained, that the multidisciplinary action gave her the smile aesthetic harmony back and improvement in quality of life(AU)