Oral Bacteria: Friends and Foes?

The oral cavity is an ideal niche for microbial prosperity due to its stable temperature, suitable pH, and continuous nutrient supply [...].

In vitro bleaching efficacy of violet LED associated with 10% hydrogen peroxide and 10% carbamide peroxide.

BACKGROUND: This in vitro study evaluated the efficacy and the effect over the dental enamel surface of violet LED dental bleaching associated to different concentrations of carbamide and hydrogen peroxide. METHODS: Human dental blocks (n = 100) were randomly distributed into 5 groups: 10% hydrogen peroxide (HP10), 10% carbamide peroxide (CP10), 10% hydrogen peroxide with violet LED (VHP10), 10% carbamide peroxide with violet LED (VCP10) and 35% hydrogen peroxide (HP35). The specimens were analyzed by Vickers microhardness test (n = 50) initially, immediately after and seven days after ending the bleaching protocol. For color analysis (n = 50), the specimens were evaluated for bleaching effectiveness (ΔE2000, ΔE1976) and whiteness index (ΔWID) with EasyShade spectrophotometer, before bleaching protocol and seven days after ending the bleaching protocol. The microhardness and color data were analyzed using one-way ANOVA with post-hoc Tukey test (α = 0.05). RESULTS: The microhardness values showed difference among the investigated groups only immediately after the end of the dental bleaching (p < 0.05), with reduction for the groups HP35 (p < 0.01) and HP10 (p < 0.05), however the microhardness values were reestablished after seven days. Regarding the color changes, a difference between VHP10 and the others groups evaluated for ΔE2000 and ΔE1976 index was observed (p < 0.05). For ΔWID, there was no difference between the studied groups. CONCLUSIONS: Violet LED associated with low concentration bleaching agents did not show a negative effect on dental enamel regarding the surface microhardness. All bleaching protocols were effective, therefore, perceptible to human eyes.

Oxygen Availability on the Application of Antimicrobial Photodynamic Therapy against Multi-Species Biofilms.

Methylene blue (MB)- or Curcumin (Cur)-based photodynamic therapy (PDT) has been used as an adjunctive treatment for periodontitis. Its actual clinical efficacy is still in question because the lack of oxygen in a deep periodontal pocket might reduce the PDT efficacy. We aim to investigate the effect of oxygen on PDT efficacy and to examine if the addition of hydrogen peroxide (HP) could improve PDT performance anaerobically. To this end, we cultured 48 h saliva-derived multi-species biofilms and treated the biofilms with 25 µM MB or 40 µM Cur, HP (0.001%, 0.01% and 0.1%), light (L-450 nm or L-660 nm), or combinations thereof under ambient air or strictly anaerobic conditions. MB- and Cur-PDTs significantly reduced biofilm viability in air but not under anaerobic conditions. HP at 0.1% significantly enhanced the killing efficacies of both MB- and Cur-PDTs anaerobically. The killing efficacy of Cur-PDT combined with 0.1% HP was higher anaerobically than in air. However, this was not the case for MB-PDT combined with 0.1% HP. In conclusion, this study demonstrated that the biofilm killing efficacies of MB- and Cur-PDTs diminished when there was no oxygen. HP at 0.1% can enhance the efficacy of PDT performed anaerobically, but the level of enhancement is photosensitizer-dependent.

Improving antimicrobial activity against endodontic biofilm after exposure to blue light-activated novel curcumin nanoparticle.

New therapies involving natural products and nanobiotechnology open additional perspectives to reduce endodontic infections. Curcumin is a natural polyphenol extracted from the dry rhizome of curcuma long Linn with therapeutic properties for application in nanobiotechnology and as a photosensitizer for photodynamic therapy. This study aimed to synthesize a novel polymeric nanoparticle of poly (lactic-co-glycolic acid) (PLGA) loaded with curcumin (NP+Cur), and evaluate its antimicrobial activity against endodontic biofilms. Additionally, its biocompatibility using oral keratinocytes was assessed. The polymeric NP+Cur was prepared by the nanoprecipitation method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were calculated for the three endodontic bacteria (Enterococcus faecalis, Streptococcus oralis and Actinomyces viscosus). Antibacterial activity of NP+Cur against single- and multispecies biofilm pre-formed on the botton 24-well plate and into dentin tubules of bovine teeth were evaluated by colony forming units and confocal laser scanning microscopy. The pre-irradiation time was 5 min followed by exposure to blue light-emitting diode at 450 nm for the photodynamic treatment. Cell viability using oral keratinocytes was assessed by Alamar Blue assay. MIC and MBC showed antibacterial activity of NP+Cur against endodontic bacteria. A treatment of pre-formed biofilms of endodontic bacteria with NP+Cur also significantly decreased bacterial viability. The concentration of 325 µg/mL of photoactivated NP+Cur was the one that most reduced the viability of the endodontic bacteria evaluated. Regarding biocompatibility, NP+Cur 325 µg/mL and pure nanoparticles showed a cell viability greater than 80%. The novel polymeric nanoparticles loaded with curcumin may be a promising adjunct use to treatment of endodontic infections.

Antimicrobial photodynamic therapy mediated by methylene blue-loaded polymeric micelles against Streptococcus mutans and Candida albicans biofilms.

BACKGROUND: Streptococcus mutans and Candida albicans can colonize the teeth, the oral cavity as biofilm and can cause oral infections. Thus, strategies to prevent and control oral biofilms are requested. The present study aims the development and characterization of methylene blue (MB)-loaded polymeric micelles for antimicrobial photodynamic therapy (aPDT) against Streptococcus mutans and Candida albicans biofilms METHODS: MB-loaded polymeric micelles were produced and characterized by particle size, polydispersity index, morphology, zeta potential, stability, MB release profile, and antimicrobial effect against S. mutans and C. albicans biofilms. RESULTS: MB-loaded polymeric micelles showed a reduced particle size, moderate polydisperse profile, spherical and neutral shape, which demonstrated to be promising features to allow micelles penetration into biofilms. Antimicrobial effect against bacterial and yeast biofilms was demonstrated once MB was irradiated by light under 660 nm (aPDT). Furthermore, MB-loaded polymeric micelles showed significant inhibition of S. mutans and C. albicans biofilms. Furthermore, the treatment with MB-micelles incubated with high pre-incubation times (15 and 30 min) were more effective than 5 min. It can be explained by the time required for this nanosystem to penetrate the innermost layer of biofilms and release MB for aPDT. CONCLUSION: MB-loaded polymeric micelles can effectively decrease the bacteria and yeast viability and it may cause positive impacts in the clinical practice. Thus, the developed formulation showed potential in the treatment to remove oral biofilms, but clinical studies are needed to confirm its potential.

Ultrasound device as a minimally invasive approach for caries dentin removal.

The aim of this study was to evaluate the efficacy of an ultrasound device and the dentin surface morphology after removal of the caries dentin lesions by removal rate and scanning electron microscopy (SEM). The Knoop hardness test on the bovine dentin blocks (n = 20, 4x4x2mm) was performed to standardize the samples and only those with 38 ± 2 KHN were included. The dentin blocks were submitted to induction of artificial caries lesions, using the bacterial model. Strains of Streptococcus mutans and Lactobacillus acidophilus were used for 7 days. The caries dentin lesion was removed for 1 min, according to two methods: G1 - carbide bur under low-speed rotation (control group) and G2 - ultrasound device under refrigeration. For the removal rate, the samples were weighed 3 times: T0 (before induction), T1 (after induction) and T2 (after removal). Morphology evaluation of the residual dentin surface was performed by SEM. Data normality was verified by Shapiro-Wilk test (p ≥ 0.240). T-test for independent samples was applied to evaluate the removal rate. A significance level of 5% was adopted. G2 provided lower removal rate than G1 (G1: 3.68 mg and G2 = 2.26 mg). SEM images showed different morphological characteristics between the groups. G2 showed absent of smear layer, while G1 showed a visible smear layer over the surface. We concluded that ultrasound device provides minimally invasive removal with residual dentin exhibiting open dentin tubules and no smear layer formation and no bacteria, which infer the removal of the infected tissue.

Ultrasound device as a minimally invasive approach for caries dentin removal

Abstract The aim of this study was to evaluate the efficacy of an ultrasound device and the dentin surface morphology after removal of the caries dentin lesions by removal rate and scanning electron microscopy (SEM). The Knoop hardness test on the bovine dentin blocks (n = 20, 4x4x2mm) was performed to standardize the samples and only those with 38 ± 2 KHN were included. The dentin blocks were submitted to induction of artificial caries lesions, using the bacterial model. Strains of Streptococcus mutans and Lactobacillus acidophilus were used for 7 days. The caries dentin lesion was removed for 1 min, according to two methods: G1 - carbide bur under low-speed rotation (control group) and G2 - ultrasound device under refrigeration. For the removal rate, the samples were weighed 3 times: T0 (before induction), T1 (after induction) and T2 (after removal). Morphology evaluation of the residual dentin surface was performed by SEM. Data normality was verified by Shapiro-Wilk test (p ≥ 0.240). T-test for independent samples was applied to evaluate the removal rate. A significance level of 5% was adopted. G2 provided lower removal rate than G1 (G1: 3.68 mg and G2 = 2.26 mg). SEM images showed different morphological characteristics between the groups. G2 showed absent of smear layer, while G1 showed a visible smear layer over the surface. We concluded that ultrasound device provides minimally invasive removal with residual dentin exhibiting open dentin tubules and no smear layer formation and no bacteria, which infer the removal of the infected tissue.

Resumo O objetivo deste estudo foi avaliar a eficácia de um dispositivo ultrassônico e a morfologia da superfície dentinária após a remoção da dentina cariada por meio da taxa de remoção e imagens de microscopia eletrônica de varredura (MEV). Foi realizado o teste de dureza Knoop nas amostras de dentina bovina (n = 20, 4x4x2mm) afim de padronizar as amostras e foram incluídas apenas aquelas com 38 ± 2 KHN. As amostras de dentina foram submetidas à indução de lesões artificiais de cárie, utilizando-se modelo biológico contendo cepas de Streptococcus mutans e Lactobacillus acidophilus durante por 7 dias. As lesões foram removidas por 1 min, de acordo com dois métodos: G1 - fresa esférica sob baixa rotação (grupo controle) e G2 - dispositivo ultrassônico sob refrigeração. Para a taxa de remoção, as amostras foram pesadas em três tempos: T0 (antes da indução), T1 (após a indução) e T2 (após a remoção). A avaliação morfológica da superfície residual da dentina foi realizada por MEV. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk (p ≥ 0,240). Teste T para amostras independentes foi aplicado para avaliar a taxa de remoção. Foi adotado nível de significância de 5%. G2 apresentou menor taxa de remoção que G1 (G1: 3,68 mg e G2 = 2,26 mg). As imagens de MEV mostraram características morfológicas diferentes entre os grupos. G2 mostrou ausência de smear layer, enquanto G1 mostrou grande quantidade de smear layer sobre a superfície. Com base neste estudo in vitro, o dispositivo de ultrassom promoveu remoção minimamente invasiva e dentina residual exibindo túbulos dentinários abertos e mínima formação de smear layer.

How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2?

Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.

Curcumin-loaded Pluronic® F-127 Micelles as a Drug Delivery System for Curcumin-mediated Photodynamic Therapy for Oral Application.

Antimicrobial photodynamic therapy (aPDT) is promising for oral decontamination. Curcumin has been used as photosensitizer; however, the hydrophobic properties can negatively affect aPDT. This study evaluated the aPDT efficacy using Cur-loaded Pluronic® F-127 micelles against Streptococcus mutans and Candida albicans biofilms. Micelles characterization was performed by zeta potential, dynamic light scattering, transmission electron microscopy, absorption and fluorescence spectroscopy. Cur concentrations, cell viability by CFU mL-1 and confocal microscopy were determined. Data were analyzed by parametric and nonparametric tests under 5%. Cur-loaded Pluronic® F-127 exhibited spherical shape, suitable particle size (≤100 nm), adequate polydispersity index, best stability, lower photodegradation and autoaggregation compared to unloaded-Cur. Both microorganisms were sensitive to Cur-loaded Pluronic® F-127 micelles aPDT, with minimum inhibitory concentration (MIC) of 270 µm and 2.1093 µm for S. mutans and C. albicans suspended culture, respectively. Cur-loaded Pluronic® F-127 aPDT exhibited antibacterial/antifungal effect against the biofilms (~3 log10 reduction; P ≤ 0.05); however, similar to unloaded (P ≥ 0.05). Confocal images confirmed these results. Cur-loaded Pluronic® F-127 micelles exhibited good photo-chemical properties and may be a viable alternative to deliver Cur and to improve aPDT effect during the treatment of dental caries. Moreover, Pluronic® micelles can enhance the solubility, stability, permeability and control the release of Cur.

Current applications of drug delivery nanosystems associated with antimicrobial photodynamic therapy for oral infections.

The oral cavity is colonized by several species of microorganisms that can cause dental caries, periodontal diseases, candidiasis, endodontic infections, and, among other diseases related to the dental field. Conventional treatment consists of mechanical removal associated with systemic administration of antimicrobials, which can cause various side effects and microbial resistance. In this context, alternative therapies have been developed, including Antimicrobial Photodynamic Therapy (aPDT). For the improvement of therapy, the implementation of nanotechnology is very important to optimize the delivery system of the dyes or photosensitizers on biological targets. Besides, this combination provides a non-invasive treatment, better solubility and bioavailability, delivery to the target site, controlled release and protection against external and physical-chemical factors, low side effects, and, unlikely resistant species. Although, there are numerous researches on aPDT and nanotechnology, few review articles based on the combination of these three aspects: nanosystems, aPDT and oral infections are available. For this reason, this article aims to discuss the advances and advantages of this combination. Therefore, this article was divided into different types of nanosystems (organic and inorganic nanoparticles) associated with aPDT bringing a description of it is definitions, properties, and, applications in oral infections.

Photodynamic inactivation mediated by methylene blue or chlorin e6 against Streptococcus mutans biofilm.

BACKGROUND: An appropriate photosensitizer (PS) for photodynamic inactivation should have a pronounced antimicrobial efficacy but low dark toxicity. The aim of this study is to investigate the concentration-dependent antimicrobial efficacies of methylene blue (MB) and chlorin e6 (Ce6), against Streptococcus mutans biofilms and to compare the efficacies of these two PSs. METHODS: The 48-h S. mutans UA159 biofilms, grown on glass coverslips, were subjected to MB or Ce6 at 25, 50, 100 and 200 µM with or without irradiation by 660 nM LED light (L). Control groups (-PS-L and -PS + L) were also included. Viability of the biofilm was analyzed by CFU/biofilm and biofilm lactic acid production was quantified by an enzymatic assay. RESULTS: With irradiation, MB under 25 µM resulted in 2-log reduction in biofilm viability and 30-fold reduction in biofilm lactic acid production. However, this biofilm killing efficacy did not change with increasing MB concentration. The biofilm killing efficacy of Ce6 increased with increasing Ce6 concentrations and resulted in 5-log reduction in biofilm viability. The lactic acid inhibitory effect of Ce6 was significantly lower than MB at 25 µM (p<0.01) but higher than MB at 200 µM (p=0.05), although the difference at 200 µM did not reach statistical significance. No dark toxicity could be observed for MB whereas low dark toxicity could be seen for Ce6 when the concentration is above 50 µM. CONCLUSION: Ce6 under 200 µM showed to be a more powerful PS for photodynamic inactivation than MB. Both Ce6- and MB-based photodynamic inactivation are useful methods for biofilm control in caries prevention.

Microstructural effect of a laser-activated bleaching agent containing titanium dioxide on human enamel.

AIM: This study aimed to evaluate the effect of a laser-activated bleaching agent containing titanium dioxide (TiO2) nanoparticles on enamel roughness and hardness. MATERIALS AND METHODS: Twenty human premolars were randomized into two groups according to the bleaching treatments performed: HP - 35% hydrogen peroxide and HP + TiO2 - 30% hydrogen peroxide containing TiO2 light-activated by diode laser (980 nm). It was performed two bleaching sessions with an interval of 7 days. Microhardness and roughness of the enamel were assessed at three times: T0 - Before 1st appointment, T1 - after 2nd appointment, and T2-7 days after 2nd appointment. RESULTS: The HP + TiO2 did not cause changes on enamel roughness and hardness and presented the same effects of the HP. CONCLUSIONS: Both bleaching agents showed no difference between them. Then, it is possible to conclude that both are viable for clinical use during in-office dental bleaching technique regarding the microstructural changes that they might cause.

Photodynamic inactivation of planktonic cultures of Streptococcus mutans using erythrosine irradiated by LED / Inativação fotodinâmica de culturas planctônicas de Streptococcus mutans usando eritrosina irradiada por LED

Objective: The aim of this in vitro study was to evaluate the efficacy of photodynamic inactivation (PDI) with erythrosine (E), using a light-emitting diode (LED) on planktonic cultures of Streptococcus mutans. Material and Methods: A Streptococcus mutans strain (UA 159) was used to prepare the suspensions containing 107 cells/mL, which was tested under different experimental conditions: a) LED irradiation in the presence of erythrosine as a photosensitizer (E+L+); b) LED irradiation only (P-L+); c) treatment with erythrosine only (E+L-); and d) no LED irradiation or photosensitizer (P) treatment, which served as a control group (P-L-). After treatment, strains were seeded onto MSBS agar for determination of the number of colony-forming units (CFU/mL). Results: The results were submitted to analysis of variance and the Tukey test (p < 0.05). No reduction in the number of CFU/mL was observed in the treatment group with erythrosine (E+L+) when compared to the control (P-L-). Conclusion: PDI using erythrosine did not reduce the number of CFUs per millimeter within the parameters in this study. (AU)

Objetivo: o objetivo deste estudo in vitro foi avaliar a eficácia da inativação fotodinâmica (PDI) com a eritrosina (E), usando diodo de emissão de luz azul (LED) em culturas planctônicas de Streptococcus mutans. Material e métodos: a cepa de Streptococcus mutans (UA 159) foi usada para o preparo das suspensões padrões contendo 107 células/mL, as quais foram testadas em diferentes condições experimentais a) irradiação com LED em presença da eritrosina como fotossensibilizador (E+L+); b) irradiação com LED apenas (F-L+); c) tratamento com eritrosina apenas (E+L-); e d) tratamento sem irradiação com LED ou fotossensibilizador (F), que serviu como grupo controle (F-L-). Após o tratamento, as cepas foram semeadas em ágar MSBS para determinação do número de unidades formadoras de colônias (UFC/mL). Resultados: os resultados foram submetidos à análise de variância e teste de Tukey (p < 0.05). Não foi observada redução no número de UFC/mL no grupo de tratamento com eritrosina (E+L+) quando comparado ao grupo controle (F-L-). Conclusão: a PDI usando etritrosina e LED não reduziu o número de UFCs por milímetro com os parâmetros utilizados neste estudo.(AU)

Violet LED with low concentration carbamide peroxide for dental bleaching: A case report.

The use of violet LED was recently introduced as a new alternative technique to perform tooth bleaching, associated or not with bleaching agents. This paper shows a tooth bleaching clinical case report performed in a 26-year-old woman, using a violet LED with 10% carbamide peroxide (CP). The tooth bleaching protocol was performed in 3 sessions. Fifteen irradiations using a violet light system (BMW, MMoptics, São Carlos, SP, Brazil) were done during 30 s (on) and 60 s (off) without bleaching gel, and more 5 irradiations associated to 10% CP. Upper and lower arches were irradiated separately. The total procedure time was 30 min. Subjective and objective color assessments were performed using Vitapan Classical shade guide and VITA Easyshade spectrophotometer, respectively. Dentin sensitivity was measured using a visual analogue scale. The use of violet LED associated to a low concentration carbamide peroxide successfully promoted tooth bleaching and no side effects i.e. dentin sensitivity during and post treatment was observed.

Evaluation of Antimicrobial Photodynamic Therapy against Streptococcus mutans Biofilm in situ.

AIM: This study investigated the effect of antimicrobial photo-dynamic therapy (aPDT) over Streptococcus mutans biofilm. MATERIALS AND METHODS: Eighteen (n = 18) patients were selected and one palatine device with dental blocks was used. The biofilm was treated by curcumin and Photogem® with a LED and the effect was analyzed by CFU/ml. RESULTS: Although, statistical analysis showed significant reductions for aPDT mainly with Photogem® (p = 0.02), these were low. CONCLUSION: The results suggest a low antimicrobial effect of aPDT over S. mutans biofilm. Some parameters used need to be improved. CLINICAL SIGNIFICANCE: This technique can be a promising in Dentistry.

Reabilitação protética de um paciente portador de Síndrome da Combinação ­ relato de caso / Prosthetic rehabilitation of a patient with Combination Syndrome ­ case report

Estima-se que aproximadamente 26% dos pacientes reabilitados proteticamente são pacientes edentados no arco superior e portadores de extremidades livres posteriores no arco inferior. Esses pacientes podem apresentar perda de osso na porção anterior da maxila, aumento das tuberosidades, hiperplasia papilar do palato duro, extrusão dos dentes anteriores mandibulares e perda de osso alveolar sob a base da PPR mandibular, caracterizando a Síndrome da Combinação. O tratamento mais indicado é a reabilitação com uso de implantes para promover suporte funcional, mas por razões médicas ou financeiras, o tratamento convencional com próteses ainda é considerado uma boa indicação. O tratamento visa ao restabelecimento do equilíbrio oclusal, da estética facial e dentária, da função mastigatória, do conforto e aumento da autoestima do paciente. Esse relato de caso apresenta o tratamento reabilitador convencional, com prótese total superior e PPR inferior Classe I de Kennedy, em um paciente do gênero masculino, 51 anos, portador da Síndrome da Combinação. O conhecimento pelo cirurgião dentista das alterações dessa síndrome e de seus fatores predisponentes proporciona ao profissional a aplicação de condutas adequadas no tratamento reabilitador destes pacientes e na prevenção dos sinais e sintomas deste distúrbio (AU).

It is estimated that approximately 26% of patients treated with prosthesis present total edentulous maxilla opposed by natural anterior teeth. These patients might experience loss of bone in the anterior part of the maxilla, increased tuberosity, papillary hyperplasia of the hard palate, extrusion of the mandibular anterior teeth, and loss of alveolar bone under the lower PPR base, featuring Syndrome Combination. The treatment of choice was the rehabilitation using implants to promote functional support, however, for medical or financial reasons, conventional treatment with prosthesis is still considered a good indication. The aim of the treatment is to restablish the occlusal balance, facial and dental aesthetics, masticatory function, comfort, and increase of self-esteem. This current case report presents a conventional prosthetic rehabilitation using a maxillary complete denture and a Class I Kennedy mandibular removable partial denture, in a 51-year-old male patient with Combination Syndrome. The knowing of the characteristics of this syndrome and its predisposing factors results on an appropriate approach in prosthetic rehabilitation of these patients, leading to prevention of signs and symptoms of this disorder (AU).

Effect of different light-curing techniques on hardness of a microhybrid dental composite resin / Efeito de diferentes técnicas de fotoativação na dureza de uma resina composta dental microhíbrida

Objective: This study assessed the Vickers hardness (VHN) provided by two LCUs when using (1) direct and indirect light-curing techniques, (2) 40 and 60 s and (3) top and bottom surfaces. Material & Methods: One halogen Curing Light 2500 (3M Espe) and one LED (MM Optics) were used by direct and indirect (0,1.0, 2.0 and 3.0 mm of dental structure) techniques during 40 and 60 s. The samples were made with FiltekTM Z250 in a metallic mould with a central orifice (4 mm in diameter, 2 mm in thickness). The samples were stored in dry mean by ± 24 h and the hardness measurements were performed in a testing machine (Buehler MMT-3 digital microhardness tester Lake Bluff, Illinois USA). A 50 gf load was used and the indenter with a dwell time of 30 s. The data were submitted to multiple ANOVA and Newman-Keuls‘s test (p < 0.05). Results: Halogen LCU exhibited higher Vickers hardness values than LED mainly because of the power density used. Hardness values were influenced by LCUs, lightcuring techniques, irradiation times and surfaces. For both LCUs, hardness values were found to decrease with indirect light-curing technique, mainly for the bottom surface. Samples irradiated for 60 s exhibited higher hardness values when the halogen LCU was used. For 60 s, the VHN values were statistically significant greater than 40 s. Significant differences in top and bottom surfaces Vickers hardness number (VHN) values were observed among different LCUs used 40 and 60 s. Conclusion: The LCUs, lightcuring techniques, variations of irradiation times, and surfaces (top and bottom) influence the composite resin hardness.

Objetivo: Este estudo avaliou a dureza Vickers (VHN) em função de duas fontes de luz quando utilizadas diferentes (1) técnicas de fotoativação, direta e indireta, (2) 40 e 60 s, e (3) superfícies de topo e base. Material e Métodos: Uma fonte de luz halógena Curing Light 2500 (3M Espe) e um LED (MM Optics) foram utilizados nas técnicas de fotoativação direta e indireta (0 , 1,0, 2,0 e 3,0 milímetros de estrutura dental), durante 40 e 60 s. As amostras foram feitas utilizando-se FiltekTM Z250 em matriz metálica com orifício central (4 mm de diâmetro, com 2 mm de espessura). As amostras foram armazenadas em meio seco por ± 24 h e as medidas de dureza foram realizadas em microdurômetro (Buehler MMT-3 digital microhardness tester Lake Bluff, Illinois USA). Uma carga de 50 gf durante 30 s foi utilizada. Os dados foram submetidos à análise de variância múltipla e teste de Newman-Keuls (p < 0,05). Resultados: A fonte de luz halógena promoveu os maiores valores de dureza Vickers, principalmente, em função da densidade de potência utilizada. Os valores de dureza foram influenciados pelas fontes de luz, técnicas de fotoativação, tempos de irradiação e superfícies, topo e base. Para ambas as fontes de luz, os valores de dureza diminuíram com a técnica de fotoativação indireta, principalmente para a superfície de base. Amostras irradiadas por 60 s apresentaram valores de dureza maiores quando a fonte de luz halógena foi utilizada. Durante 60 s , os valores de VHN foram estatisticamente significativos maior do que 40 s. Diferenças significativas foram observadas nos valores dureza Vickers (VHN) para as superfícies de topo e base utilizando 40 e 60 s. Conclusão: As fontes de luz, técnicas de fotoativação direta e indireta, tempos de irradiação e superfícies (topo e base) influenciam na dureza da resina composta.

Evaluation of bond strength and thickness of adhesive layer according to the techniques of applying adhesives in composite resin restorations.

Adhesive restorations have increasingly been used in dentistry, and the adhesive system application technique may determine the success of the restorative procedure. The aim of this study was to evaluate the influence of the application technique of two adhesive systems (Clearfil SE Bond and Adper Scotchbond MultiPurpose) on the bond strength and adhesive layer of composite resin restorations. Eight human third molars were selected and prepared with Class I occlusal cavities. The teeth were restored with composite using various application techniques for both adhesives, according to the following groups (n = 10): group 1 (control), systems were applied and adhesive was immediately light activated for 20 seconds without removing excesses; group 2, excess adhesive was removed with a gentle jet of air for 5 seconds; group 3, excess was removed with a dry microbrushtype device; and group 4, a gentle jet of air was applied after the microbrush and then light activation was performed. After this, the teeth were submitted to microtensile testing. For the two systems tested, no statistical differences were observed between groups 1 and 2. Groups 3 and 4 presented higher bond strength values compared with the other studied groups, allowing the conclusion that excess adhesive removal with a dry microbrush could improve bond strength in composite restorations. Predominance of adhesive fracture and thicker adhesive layer were observed via scanning electron microscopy (SEM) in groups 1 and 2. For groups 3 and 4, a mixed failure pattern and thinner adhesive layer were verified. Clinicians should be aware that excess adhesive may negatively affect bond strength, whereas a thin, uniform adhesive layer appears to be favorable.

Degree of conversion of nanofilled and microhybrid composite resins photo-activated by different generations of LEDs.

OBJECTIVE: This study aimed at evaluating the degree of conversion (DC) of four composite resins, being one nanofilled and 3 microhybrid resins, photo-activated with second- and third-generation light-emitting diodes (LEDs). MATERIAL AND METHODS: Filtek™ Z350 nanofilled composite resins and Amelogen® Plus, Vit-l-escence™ and Opallis microhybrid resins were photo-activated with two second-generation LEDs (Radii-cal and Elipar Free Light™ 2) and one third-generation LED (Ultra-Lume LED 5) by continuous light mode, and a quartz halogen-tungsten bulb (QHT, control). After 24 h of storage, the samples were pulverized into fine powder and 5 mg of each material were mixed with 100 mg of potassium bromide (KBr). After homogenization, they were pressed, which resulted in a pellet that was evaluated using an infrared spectromer (Nexus 470, Thermo Nicolet) equipped with TGS detector using diffuse reflectance (32 scans, resolution of 4 cm(-1)) coupled to a computer. The percentage of unreacted carbon-carbon double bonds (% C=C) was determined from the ratio of absorbance intensities of aliphatic C=C (peak at 1637 cm-1) against internal standard before and after curing of the specimen: aromatic C-C (peak at 1610 cm-1). RESULTS: The ANOVA showed a significant effect on the interaction between the light-curing units (LCUs) and the composite resins (p<0.001). The Tukey’s test showed that the nanofilled resin (Filtek™ Z350) and Opallis when photo-activated by the halogen lamp (QTH) had the lowest DC compared with the other microhybrid composite resins. The DC of the nanofilled resin (Filtek™ Z350) was also lower using LEDs. The highest degrees of conversion were obtained using the third-generation LED and one of second-generation LEDs (Elipar Free Light™ 2). CONCLUSIONS: The nanofilled resin showed the lowest DC, and the Vit-l-escence™ microhybrid composite resin showed the highest DC. Among the LCUs, it was not possible to establish an order, even though the second-generation LED Radii-cal provided the lowest DC.

Associação de microabrasão e fechamento de distemas com resina composta: relato de caso clínico / Association of microabrasion and diastema closure with composite resin: a case report

Com o avanço das técnicas e materiais restauradores, o cirurgião-dentista tornou-se capaz de solucionar problemas estéticos de forma conservadora. Esse relato de caso descreve a associação das técnicas de microabrasão e fechamento de diastemas com resinas compostas diretas. A paciente do sexo feminino, 16 anos de idade, foi encaminhada pelo ortodontista à clínica de Dentística Restauradora para o fechamento de diastema. Após anamnese e exame clínico detalhado, constatou-se, também, a presença de manchas brancas de fluorose na face vestibular dos dentes anterossuperiores, sendo também proposto o procedimento de microabrasão. Por meio de modelos de estudo da paciente, foi realizado o enceramento diagnóstico, de forma a simular o fechamento dos diastemas. O modelo encerado foi moldado com silicona de condensação para servir como guia de orientação durante os procedimentos restauradores. O tratamento resultou na elevação da autoestima da paciente,pela obtenção de um sorriso mais harmonioso por meio da associação de técnicas estéticas conservadoras.

With the improvements in restorative techniques and materials, the dentist is able to conservatively solve esthetic problems. This case report describes the association of techniques for microabrasion and closure of diastema with direct composite resins. The patient, aged 16, was referred to the restorative dental clinic by the orthodontist for diastema closure. After a detailed clinical examination, it was also noticed the presence of fluorosis white stains on the buccal surface of anterior-superior teeth, and microabrasion treatment was proposed. Through the study cast models of the patient, diagnostic waxing was performed to simulate the closure of diastema. The wax model was cast with condensation silicone to serve as a guideline during the restorative procedures. The treatment resulted in patient's improved self-esteem by obtaining a more harmonious smile through the association of conservative esthetic techniques