In-vivo evaluation of the effects of short-term dehydration and rehydration on the color differences of immature permanent incisor teeth.

OBJECTIVE: It is aimed to evaluate the color changes of upper central incisor teeth with different root maturation levels after 15 min of dehydration and rehydration. MATERIALS AND METHODS: Using the Cvek classification, 60 participants were divided into five groups. A spectrophotometer, equipped with a specially designed jig, was utilized for color measurements. Following isolation, color measurements were conducted at the dehydration process intervals of baseline, 1st, 2nd, 3rd, 5th, 7th, 10th, and 15th minutes. After mouth rinsing, measurements were repeated at the same time intervals during the rehydration process. CIEDE2000 (ΔE00 ) values and the Whiteness Index (WID ) were obtained to compare the color changes between the initial readings and each interval. Friedman and Repeated Measures ANOVA were applied to compare classes by time during the dehydration and rehydration periods, as well as ANOVA and Kruskal-Wallis tests to compare by classes for each time (p < 0.05). RESULTS: Significant differences emerged in the mean ΔE00 values during dehydration and rehydration periods across all Cvek Classes (p < 0.05). While no statistically significant differences were observed among Classes at different minutes during the rehydration period (p > 0.05), it was particularly noted that the mean ΔE00 values of Classes 2, 3, and 5 at the 2nd minute of dehydration were statistically significantly higher than the mean of Class 1 (p < 0.05). However, when evaluating the starting and ending measurements of both dehydration and rehydration processes, and the overall change in ΔE00 and ΔWID , no significant variations were detected across the Classes (p > 0.05). CONCLUSIONS: In teeth that have just erupted and are still undergoing root development, dehydration in the initial minutes results in noticeable color changes. However, the change in ΔE00 and ΔWID of the teeth was found to be similar after the dehydration and rehydration processes. CLINICAL SIGNIFICANCE: According to the Cvek classification, the lower color change in Class 1 teeth within the first 2 min of dehydration and the need for more than 15 min of rehydration for immature teeth with an open apex to return to their initial state after a 15-min dehydration are crucial for clinicians in terms of color assessment timing.

Effects of staining and bleaching procedures on the optical and surface properties of CAD-CAM materials.

PURPOSE: To examine the effects of coffee staining and bleaching applications on the optical properties of CAD-CAM blocks, and to provide a three-dimensional visualization of surface changes with atomic force microscope (AFM). METHODS: 80 samples were prepared from four different CAD-CAM blocks: [Cerec (CR), Shofu (SH), Cerasmart (CRS), Lava Ultimate (LU)], and a microhybrid composite resin [Filtek Z250 (Z250)]. After staining, the samples were divided into two subgroups according to bleaching methods: 16% carbamide peroxide (HB), and 40% hydrogen peroxide (OB). Color measurements were performed at baseline (t0), after staining (t1), and after bleaching (t2) to obtain translucency parameters (TP00), color change (ΔE00), and whiteness index (WID) values. Surface roughness analysis (Ra) was performed with AFM after coffee staining and bleaching procedures (at t1 and t2). Data were analyzed with Generalized Linear Model, and Bonferroni correction (P< 0.05). RESULTS: TP00 values increased only in the CRS group after the bleaching application, and the effect of method was again observed only in CRS. While bleaching increased WID values of all groups except CRS, no difference was found between bleaching methods. Regardless of evaluation time, the roughest group is Z250, and the only difference between bleaching methods was observed in the CR group. In conclusion, the effects of staining and bleaching applications on the optical and surface properties of CAD-CAM blocks are material-dependent. CLINICAL SIGNIFICANCE: Effective bleaching of discolored CAD-CAM materials was achieved regardless of the bleaching method used, and without any significant adverse effect on the surface properties of the materials.

Investigation of the effect of indirect pulp capping materials on dentin mineral density

Aim: To evaluate the potential of inducing mineral density changes of indirect pulp capping materials applied to demineralized dentin. Methods: A total of 50 cavities were prepared, 5 in each tooth, in extracted ten molars without caries, impacted or semi-embedded. The cavities were scanned by microcomputed tomography (µ-CT) after creating artificial caries by microcosm method (pre-treatment). Each cavity was subjected to one of 5 different experimental conditions: control (dental wax), conventional glass ionomer cement (Fuji IX GP Extra), resin-modified calcium silicate (TheraCal LC), resin-modified calcium hydroxide (Ultra-Blend Plus), MTA (MM-MTA) and the samples were kept under intrapulpal pressure using simulated body fluid for 45 days. Then, the second µ-CT scan was performed (post-treatment), and the change in dentin mineral density was calculated. Afterward, elemental mapping was performed on the dentinal surfaces adjacent to the pulp capping agents of 5 randomly selected samples using energy dispersive X-ray spectroscopy (EDS) apparatus attached to a scanning electron microscope (SEM). The Ca/P ratio by weight was calculated. Friedman test and Wilcoxon Signed Ranks test were used to analyze the data. Results: There was a significant increase in mineral density values of demineralized dentin after treatment for all material groups (p<0.05). Resin-modified calcium silicate had similar efficacy to MTA and conventional glass ionomer cement, but was superior to resin-modified calcium hydroxide in increasing the mineral density values of demineralized dentin. Conclusions: Demineralized dentin tissue that is still repairable can be effectively preserved using materials with remineralization capability

The impact of remineralization agents on dental bleaching efficacy and mineral loss in bleached enamel.

This study evaluated the effect of remineralization agents on bleaching efficiency, enamel mineral changes, and post-bleaching color stability. A total of 112 enamel-dentin blocks were prepared from bovine teeth. Following initial color measurements, separate treatment regimens were carried out as follows: negative control (no treatment); positive control (bleaching only); bleaching, then NaF; bleaching + NaF (mix); bleaching, then CPP-ACPF; bleaching + CPP-ACPF (mix); bleaching, then nHAP+F; bleaching + nHAP+F (mix). Color measurements were repeated after immersion in distilled water for 7 days, and again after staining with coffee solution for 14 days. The CIELAB-based whiteness index was used to evaluate bleaching efficiency, and the CIEDE2000 color difference formula for color stability. Chemical investigation was performed using scanning electron microscopy with energy dispersive spectroscopy and X-ray diffraction analyses. The experimental groups showed significant increases in whiteness compared to the negative control, and the staining after bleaching did not result in statistically significant differences between the groups. Energy dispersive spectroscopic analysis revealed that bleaching protocols had no impact on elemental levels as well as the ratio of Ca/P. The combined use of bleaching agents with remineralization agents did not affect bleaching effectiveness but also did not provide an additional contribution.

Effects of radiotherapeutic X-ray irradiation on cervical enamel.

PURPOSE: Therapeutic radiation used for head and neck cancers mainly affects the cervical region of the tooth. To better understand the impact of therapeutic radiation on tooth, we aimed to examine the crystallinity, micro-morphology, and elemental composition of the cervical inner enamel located adjacent to the dento-enamel junction. MATERIALS AND METHODS: Ninety-one specimens obtained from 16 impacted third mandibular molars were randomly divided into seven groups (0, 10, 20, 30, 40, 50, and 60 Gy irradiation groups). Energy-dispersive X-ray spectroscopy (EDX) and scanning electron microscopy (SEM) were performed after the irradiation by 6 MV photon energy. The X-ray diffraction (XRD) were conducted in every group before and after irradiation. Elemental compositions, and Ca/P, P/N, Ca/N atomic ratios were subjected to the Shapiro-Wilk normality test. All of the elements except Mg showed a normal distribution and were compared by the one-way ANOVA. The non-normally distributed Mg data and Ca/P, P/N, and Ca/N ratios were compared by the Kruskal-Wallis test. RESULTS: The results showed that widening in the interprismatic spaces were observed in the experimental groups subjected to 30 Gy and the following increased doses. In addition, there were no significant differences in C, O, Ca, P, N percentages between irradiated and non-irradiated groups (p > .05). An increase in atomic ratio of the Mg was detected after samples conducted by 60 Gy radiation dose (p < .05). The stoichiometric Ca/P, Ca/N, and P/N atomic ratios did not change by irradiation (p > .05). The XRD peaks of the inner enamel crystalline phase showed a slight decline in the 60 Gy radiation dose group. CONCLUSION: Radiation effects begin to be seen after 30 Gy radiation dose groups. The widen interprismatic spaces seen obviously in 50 Gy and 60 Gy dose groups. Besides Mg ratio showed an increase in the 60 Gy dose group. But it should be thought that radiation caries is a multi-factorial disease that is in collaboration with various radiation-induced side effects.

Effects of high temperature on dental restorative materials for forensic purposes.

This study aimed to observe the effects of high temperature on different restorative dental materials by detecting changes in their microstructural and elemental composition. Disk shaped samples (10 mm diameter, 2 mm depth) were prepared from 8 dental materials (compomer, glass carbomer, ormocer, giomer, zinc reinforced glass ionomer (GI), silver-alloy reinforced GI, zirconia reinforced GI, and conventional GI). Scanning electron microscopy/Energy dispersive X-ray spectroscopy (SEM/EDS) was used to characterize sample surface structures and elemental composition. The same samples were also analyzed using X-ray fluorescence (XRF) to determine the trace element content. Each sample was placed in a porcelain furnace and exposed to 900 °C for 30 min. Observations of macroscopic changes in samples after exposure high temperature were recorded. The microstructural changes in sample surfaces after incineration were detected by SEM. The elemental compositions obtained before and after the incineration were compared after repeating the XRF and EDS analyses. Dental materials demonstrated specific macroscopic changes and microstructural deteriorations detected by SEM images after exposure to high temperature. While several changes occurred in the elemental content of materials in terms of amount, the original elemental composition was preserved. The ability to distinguish dental materials by elemental analyses has had an important impact on the identification process.

Clinical evaluation of a low-shrinkage resin composite in endodontically treated premolars: 3-year follow-up.

OBJECTIVES: This study compared the 3-year clinical performance of a low-shrinkage silorane-based composite material with that of a methacrylate-based composite material in the restoration of endodontically treated premolar teeth. MATERIALS AND METHODS: A total of 70 patients requiring a Class II composite-resin restoration of a premolar tooth following root-canal treatment participated in the study. Cavities were restored with either a silorane-based restorative (Filtek Silorane + Silorane System Adhesive) or a methacrylate-based restorative (Filtek Z250 + Clearfil SE Bond) system applied according to the manufacturer's instructions. Restorations were evaluated by two blinded observers at five different time intervals (baseline; 6 months; 1, 2, and 3 years) according to modified USPHS criteria. Pearson's chi-square tests were used to examine differences in the clinical performance of the materials (retention, color match, marginal discoloration, secondary caries, anatomical form, marginal adaptation, and surface roughness), and Friedman and Wilcoxon tests were used to compare changes between baseline and each recall time, with a level of 0.05 considered statistically significant. RESULTS: After 3 years, no statistically significant differences in clinical performance were observed between the two materials (p > 0.05). Intra-system comparisons revealed a statistically significant deterioration in color match, marginal discoloration, anatomical form, marginal adaptation, and surface roughness scores after 3 years for both systems. Although the difference was not significant at 3 years of follow-up, the level of deterioration in marginal adaptation and surface roughness was greater for the Filtek Silorane restoration than for the Filtek Z250 restoration at the 1 year follow-up (p > 0.05). CONCLUSION: Restorations of both materials were clinically acceptable after 3 years. The Filtek Silorane system did not appear to offer any clinical advantages over the methacrylate-based system when used in the restoration of Class II cavities in endodontically treated premolars. CLINICAL RELEVANCE: The restoration of endodontically treated premolars with minor or moderate loss of tooth structure can be directly performed either with silorane or methacrylate-based composite resins.

Water sorption and solubility of bulk-fill composites polymerized with a third generation LED LCU.

The aim of this study was to compare the degree of water sorption and solubility in bulk-fills after curing with a polywave light source. A total of 120 disc-shaped specimens (8 mm diameter; 4 mm depth) were prepared from three regular bulk-fill materials (X-tra Fil, Tetric N-Ceram Bulk Fill, SonicFill), and a control material (Filtek Z250), cured in 3 different modes (standard: 1000 mW/cm2-20 s; high power: 1400 mW/cm2-12 s; xtra power: 3200 mW/cm2-6 s) using a third generation light-emitting diode light curing unit. Water sorption and solubility levels of the specimens were measured according to the ISO 4049:2009 specification after storing in distilled water for 30 days. Data were analyzed using two-way ANOVA and Tukey's post-hoc test (p < 0.05). The Z250 sample exposed to high power presented a higher sorption compared to the X-tra Fil and SonicFill samples. In xtra power mode, the values of Z250 and SonicFill were similar to each other and higher compared to those of X-tra Fil. Only SonicFill exhibited significantly different sorption values depending on the curing mode, the highest of which was achieved when using the xtra power mode. The highest solubility values were obtained for SonicFill. No statistically significant differences were found among other groups. No significant correlation was detected between water sorption and solubility. The traditional composite group exhibited a higher water sorption values than the bulk-fills. The reduction in polymerization time significantly increased the sorption of SonicFill. SonicFill showed the highest water solubility value among the composites tested.

Water sorption and solubility of bulk-fill composites polymerized with a third generation LED LCU

Abstract The aim of this study was to compare the degree of water sorption and solubility in bulk-fills after curing with a polywave light source. A total of 120 disc-shaped specimens (8 mm diameter; 4 mm depth) were prepared from three regular bulk-fill materials (X-tra Fil, Tetric N-Ceram Bulk Fill, SonicFill), and a control material (Filtek Z250), cured in 3 different modes (standard: 1000 mW/cm2-20 s; high power: 1400 mW/cm2-12 s; xtra power: 3200 mW/cm2-6 s) using a third generation light-emitting diode light curing unit. Water sorption and solubility levels of the specimens were measured according to the ISO 4049:2009 specification after storing in distilled water for 30 days. Data were analyzed using two-way ANOVA and Tukey's post-hoc test (p < 0.05). The Z250 sample exposed to high power presented a higher sorption compared to the X-tra Fil and SonicFill samples. In xtra power mode, the values of Z250 and SonicFill were similar to each other and higher compared to those of X-tra Fil. Only SonicFill exhibited significantly different sorption values depending on the curing mode, the highest of which was achieved when using the xtra power mode. The highest solubility values were obtained for SonicFill. No statistically significant differences were found among other groups. No significant correlation was detected between water sorption and solubility. The traditional composite group exhibited a higher water sorption values than the bulk-fills. The reduction in polymerization time significantly increased the sorption of SonicFill. SonicFill showed the highest water solubility value among the composites tested.