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

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

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

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

Effects of age condition on the distribution and integrity of inorganic fillers in dental resin composites.

OBJECTIVES: The aim of this study is to evaluate the distribution of the filler size along with the zeta potential, and the integrity of silane-bonded filler surface in different types of restorative dental composites as a function of the material age condition. MATERIALS AND METHODS: Filtek P60 (hybrid composite), Filtek Z250 (small-particle filled composite), Filtek Z350XT (nanofilled composite), and Filtek Silorane (silorane composite) (3M ESPE) were tested at different stage condition (i.e., fresh/new, aged, and expired). Composites were submitted to an accelerated aging protocol (Arrhenius model). Specimens were obtained by first diluting each composite specimen in ethanol and then dispersed in potassium chloride solution (0.001 mol%). Composite fillers were characterized for their zeta potential, mean particle size, size distribution, via poly-dispersion dynamic light scattering. The integrity of the silane-bonded surface of the fillers was characterized by FTIR. RESULTS: The material age influenced significantly the outcomes; Zeta potential, filler characteristics, and silane integrity varied both after aging and expiration. Silorane presented the broadest filler distribution and lowest zeta potential. Nanofilled and silorane composites exhibited decreased peak intensities in the FTIR analysis, indicating a deficiency of the silane integrity after aging or expiry time. CONCLUSION: Regardless to the material condition, the hybrid and the small-particle-filled composites were more stable overtime as no significant alteration in filler size distribution, diameter, and zeta potential occurred. A deficiency in the silane integrity in the nanofilled and silorane composites seems to be affected by the material stage condition. CLINICAL SIGNIFICANCE: The materials conditions tested in this study influenced the filler size distribution, the zeta potential, and integrity of the silane adsorbed on fillers in the nanofilled and silorane composites. Thus, this may result in a decrease of the clinical performance of aforementioned composites, in particular, if these are used after inappropriate storage conditions.

Polymerization kinetics and polymerization stress in resin composites after accelerated aging as a function of the expiration date.

OBJECTIVES: To determine the effect of material condition (new, aged, and expired) on the polymerization kinetics and polymerization stress of different classifications of dental composites. MATERIALS AND METHODS: Specimens were obtained according to the following factors: Composites: (3M ESPE) Filtek P60, Filtek Z250, Filtek Z350XT, and Filtek Silorane; and Material conditions: new, aged, and expired. The syringe composites underwent an accelerated aging protocol (Arrhenius model) representing approximately 9 months of aging. Infrared (IR) spectra were obtained kinetically and were analyzed for: maximum conversion rate (%/s), time into exposure when maximum rate occurred (s), conversion at maximum rate (%), and total conversion (%) at 90 s by comparison of absorption IR peak ratios before and after polymerization. Polymerization was evaluated at the bottom surface of 2.0 mm-thick specimens. Polymerization stress was determined in a tensilometer, inserting the composite between acrylic rods fixed to clamps in a universal test machine and dividing the maximum load recorded by the rods cross-sectional area. Polymerization stress (MPa) was calculated at 300 s. Data were statistically analyzed by two-way ANOVA and Tukey's post hoc test (α=0.05). RESULTS: The majority of the polymerization kinetic parameters were not influenced by the material condition. Silorane composite presented significantly lower conversion rate and lower conversion at the maximum rate when expired (p<0.05). The nanofilled composite (Filtek Z350XT) presented a significantly higher total conversion when aged and expired compared to the new one (p>0.05). In all conditions, Filtek Z350XT and Filtek Silorane presented significantly lower conversion rates (p < 0.05). Filtek Silorane also exhibited the lowest stress, irrespective of the material condition (p<0.05). The polymerization stress was not influenced by the material condition (p>0.05). CONCLUSIONS: Most of the kinetic parameters are not influenced by the material condition. Filtek P60 and Filtek Z250 are more stable as both composites present similar polymerization kinetic results, irrespective of the material condition. Silorane composite presents lower stress values among the tested materials in all conditions. Aging does not affect stress development in restorative composites.

Micro-sized erosions in a nanofilled composite after repeated acidic beverage exposures: consequences of clusters dislodgments

Objective: To evaluate the hardness (KHN), color stability (DE), and superficial micromorphology of two categories of composites after immersion in either distilled water or grape juice for up to 45 days. MATERIAL AND METHODS: Cylindrical specimens (6 mm diameter x 2 mm thick) were obtained according to the factors: composite [Opallis (FGM) and Filtek Z350XT (3M ESPE)]; immersion solution (distilled water and grape juice); and evaluation time: 24 h and 7, 14, 21, 28, and 45 days. After photoactivation, the specimens were stored at 37ºC for 24 h. KHN (50 g/15 s) and ΔE were then repeatedly assessed according to the immersion solutions. Data were analyzed (three-way ANOVA/Tukey's test). Scanning electron microscopy (SEM) topographic analysis was also performed. RESULTS: In general, KHN of both composites reduced after 24 h, irrespective of the immersion solution and time. A significantly lower KHN was noted for Opallis compared with Filtek Z350XT in all parameters. An increase in ΔE over time was noted for both composites, irrespective of the immersion solution. Significantly higher ΔE was noted for Filtek Z350XT immersed in grape juice compared with Opallis, regardless of the evaluation time. The grape juice caused significantly higher DE compared with water in all periods. SEM analysis showed eroded areas for Filtek Z350XT but not for Opallis. CONCLUSIONS: The compositions and immersion solutions influence the composite hardness and the color stability. In spite of the higher hardness, the nanofilled composite is more susceptible to color change than the microhybrid when immersed in an acidic dyed solution. .

Micro-sized erosions in a nanofilled composite after repeated acidic beverage exposures: consequences of clusters dislodgments.

OBJECTIVE: To evaluate the hardness (KHN), color stability (DE), and superficial micromorphology of two categories of composites after immersion in either distilled water or grape juice for up to 45 days. MATERIAL AND METHODS: Cylindrical specimens (6 mm diameter x 2 mm thick) were obtained according to the factors: composite [Opallis (FGM) and Filtek Z350XT (3M ESPE)]; immersion solution (distilled water and grape juice); and evaluation time: 24 h and 7, 14, 21, 28, and 45 days. After photoactivation, the specimens were stored at 37 ºC for 24 h. KHN (50 g/15 s) and ΔE were then repeatedly assessed according to the immersion solutions. Data were analyzed (three-way ANOVA/Tukey's test). Scanning electron microscopy (SEM) topographic analysis was also performed. RESULTS: In general, KHN of both composites reduced after 24 h, irrespective of the immersion solution and time. A significantly lower KHN was noted for Opallis compared with Filtek Z350XT in all parameters. An increase in ΔE over time was noted for both composites, irrespective of the immersion solution. Significantly higher ΔE was noted for Filtek Z350XT immersed in grape juice compared with Opallis, regardless of the evaluation time. The grape juice caused significantly higher DE compared with water in all periods. SEM analysis showed eroded areas for Filtek Z350XT but not for Opallis. CONCLUSIONS: The compositions and immersion solutions influence the composite hardness and the color stability. In spite of the higher hardness, the nanofilled composite is more susceptible to color change than the microhybrid when immersed in an acidic dyed solution.

Effects of curing protocols on fluid kinetics and hardness of resin cements.

The effects of polymerization protocols on water sorption/solubility, the diffusion coefficient (D), the flux (J), and the hardness (KH) of two resin cements were evaluated. The materials were manipulated and divided into three groups (n=6) according to the curing protocol: PA=photoactivation (40 s); DP=delayed photoactivation (10 min self-curing plus 40 s photoactivated); CA=chemical activation. After desiccation, the specimens were weighed, stored in water (37ºC), evaluated over 28-days, and hardness recorded. Chemical activation resulted in lower net water uptake, D, and J for RelyX ARC (RX). For Variolink II (VL), CA yielded equivalent D and lower J; however, photoactivation resulted in lower net water uptake. Hardness of VL was less affected by the water storage, irrespective of the polymerization protocol. Considering the water diffusion parameters, VL demonstrated immediate photoactivation dependence; for RX, a chemical activation. Different polymerization protocols affect the fluid kinetics and the hardness of the resin cements tested.

Os princípios gerais dos preparos cavitários para restaurações diretas podem ser considerados após 100 anos? / Do biomechanical principles of cavity preparation to direct restorations should be considered atfer 100 years?

O avanço da Odontologia rumo à ciência foi iniciado por Black³ que, há mais de 100 anos, desenvolveu e classificou os preparos cavitários de forma compatível com as lesões cariosas e com os materiais restauradores existentes na época. Naquele período, o amálgama predominava como material restaurador, o que exigia um maior envolvimento da estrutura dentária sadia e a confecção de preparos cavitários retentivos para a adaptação desse material. Com o conhecimento do mecanismo de ação do flúor no processo de remineralização das lesões cariosas e o advento dos materiais adesivos, os preparos cavitários passaram a ser mais conservadores, preservando a estrutura dentária hígida. Contudo, esse novo conceito da Dentística Contemporânea ainda requer a obediência de uma série de princípios biológicos e mecânicos durante a confecção dos preparos cavitários, tornando-se necessário adequá-los às condições atuais

Shear bond strength of resin composite to enamel treated with Er: YAG laser and phosphoric acid

The purpose of this work was to evaluate the shear bond strength of resin composite to enamel treated with Er:YAGlaser. It was used 33 human third molars. After the dental crowns cutting, the mesial and distal surfaces were embeddedperpendicularly to the PVC cylinders long axis. Enamel was ground and the samples were randomly divided into 6 groups:G1- phosphoric acid (control), G2- Er:YAG laser (60mJ/10Hz), G3- Er:YAG (100mJ/10Hz), G4- Er:YAG (60mJ/10Hz+ acid), G5- Er:YAG (100mJ/ 10Hz + acid), G6- Er:YAG (80mJ/2Hz). In all groups, Single Bond was used and resincomposite cylinders (Z100) were prepared. The samples were stored in distilled water at 37oC for 24 hours and submittedto shearing test. G1 presented bond strength values significantly higher than G2, G3 and G6. The groups irradiated onlywith Er:YAG laser, in different intensities and frequencies, were equivalent as for the bond strength values. The groupstreated with laser + acid presented strength values statistically equal to those of the control group. The enamel treatmentwith phosphoric acid, or its association with laser, is important to obtain good bond. The use of Er: YAG laser alone isnot recommended, considering the conditions tested in this study.

Objetivou-se avaliar a resistência adesiva da resina composta ao esmalte condicionado com Er:YAG laser, através do teste de cisalhamento. Foram utilizados 33 terceiros molares humanos. Após o seccionamento das coroas dentárias, as faces mesial e distal foram incluídas perpendiculares ao longo eixo de cilindros de PVC. O esmalte foi planificado com lixa 600 e os espécimes aleatoriamente divididos em 6 grupos: G1- ácido fosfórico (controle), G2- Er:YAG laser(60mJ/10Hz), G3- Er:YAG (100mJ/10Hz), G4- Er:YAG (60mJ/10Hz + ácido), G5- Er:YAG (100mJ/ 10Hz + ácido), G6-Er:YAG (80mJ/2Hz). Em todos os grupos, o sistema adesivo Single Bond foi aplicado e os cilindros de resina composta (Z100) confeccionados. Os espécimes foram armazenados em água destilada a 37°C por 24h e submetidos ao teste de cisalhamento. O G1 apresentou valores de resistência adesiva significantemente superiores aos grupos G2, G3 e G6.Os grupos irradiados apenas com Er: YAG laser, nas diferentes intensidades e freqüências, equivaleram-se quanto aos valores de resistência adesiva. Os grupos tratados com laser + ácido apresentaram valores de resistência estatisticamente iguais ao grupo controle. O tratamento do esmalte com ácido fosfórico, ou a sua associação com laser, é importante para a obtenção de uma boa adesão. A utilização somente do Er: YAG laser não é recomendada, considerando-se as condições testadas neste estudo.

Fotoativação: estágio atual LED: classificação e características / Photoactivation: an update LED: classification and characteristics

Os aparelhos fotoativadores com lâmpada halógena têm sido amplamente utilizados para polimerizar materiais resinosos. No final dos anos 90 surgiram aparelhos LED (1ª geração) que se mostraram pouco efetivos. Posteriormente surgiram os 2ª geração com alta densidade de potência (alguns em torno de 1.000 mW/cm2). Mas, apesar desta evolução, eram necessários aparelhos capazes de fotoativar materiais que contivessem diferentes fotoiniciadores, já que o espectro de irradiância destes primeiros aparelhos era estreito, embora coincidente com a absorvância da canforoquinona. Desta forma, a recém-lançada 3ª geração apresenta, além de LEDs que emitem luz azul, LEDs que emitem luz violeta. Os aparelhos a serem lançados devem ser mais efetivos na polimerização dos materiais restauradores, independente do fotoiniciador contido nos materiais.

Quartz-tungsten halogen lights have been used to polymerize resin materials. A new technology was developed to polymerize these materials, called first-generation LED lights. These lights were found to be less effective and a new generation came on the market (second-generation). These lights provided a very high power density (around 1.000mW/cm2). Despite this evolving technology, it was necessary to produce LED units able to polymerize all materials, irrespective of the photoiniciator, due to the narrow spectrum provided by these lights, similar to camphorquinone absorbance. Third-generation LED light was developed and included, not only blue LED’s, but also LED’s providing violet light, thus curing all materials. Light sources to be launched might be more effective to polymerize composites, regardless the photoiniciator molecule.

Liner and light exposure: effect on in-vitro Class V microleakage.

This in vitro study evaluated the influence of different glass ionomer liners and curing methods on microleakage of resin composite restorations. Class V root preparations were made in 120 bovine incisors randomly divided into 12 groups according to liner and curing method. The resin composite system (Single Bond + Z100) was inserted and polymerized in one increment in all groups. Cavity preparations were either not lined (control), lined with a resin modified glass-ionomer cement (Vitrebond) or a conventional glass-ionomer cement (Ketac Bond). The restorations were light-cured using one of four curing methods. The teeth were thermocycled and immersed in 0.5% basic fuchsin, sectioned, and dye penetration was measured (Image Tool). No significant difference in leakage among conventional, ramp or pulse-delay methods was seen. High intensity light groups showed significantly greater penetration compared to other curing methods. No significant difference existed in marginal leakage between liners, but microleakage was significantly higher in groups restored using no liner. No relationship between lining technique and light curing method was observed. The use of glass ionomer liners reduced microleakage, while high intensity light curing produced the greatest dye penetration.

Partial pulpotomy and tooth reconstruction of a crown-fractured permanent incisor: a case report.

Pulp exposure due to traumatic injuries in the anterior permanent teeth of adolescents is a common occurrence. A vital permanent maxillary incisor with complex crown fracture and pulp exposure was treated by partial pulpotomy and assessed clinically through pulpal sensitivity tests and radiographically for periapical healing. Partial pulpotomy consisted of pulp tissue removal to a depth of only 1 to 2 mm, then capping the pulpal wound with calcium hydroxide, lining with resin-modified glass-ionomer cement, and restoration with resin composite. At each recall (7, 15, 21, 50, 90, 150, and 250 days), no spontaneous pain was observed; the pulp showed signs of vitality and absence of periapical radiolucency after 90 days. For long-term success, partial pulpotomy is recommended as an option for cases of traumatic pulp exposure in permanent incisors with crown fractures.