Comparison of the abrasive properties of two different systems for interproximal enamel reduction: oscillating versus manual strips.

BACKGROUND: The aim of the present investigation was to evaluate enamel reduction efficiency, abrasive property decay, and enamel effects between oscillating mechanical and manual systems for interproximal enamel reduction (IPR). METHODS: Three oscillating strips and three manual strips were tested on twelve freshly extracted premolars blocked in an acrylic cylinder pot by means of a material testing machine. Each strip underwent one test of 8 cycles (30 s each). Both abrasive tracks and teeth surfaces were qualitative evaluated before and after IPR by means of SEM analysis. Efficiency and abrasive property decay of both IPR systems were investigated by the amount of enamel reduction within the eight-cycle testing. Independent t-test was used to evaluate differences in variables between the two systems. RESULTS: Mechanical IPR system showed higher efficiency in terms of enamel reduction (p < 0.005) when compared with manual IPR system (0.16 mm and 0.09 mm, respectively). Quantity of removed enamel decreased throughout the 8 cycles for both systems. Less presence of enamel debris and detachment of abrasive grains were observed on mechanical strips rather than manual strips. SEM analysis revealed more regular surface of teeth undergone mechanical IPR procedures. CONCLUSION: Oscillating diamond strips showed more controlled efficiency when compared with the manual IPR system leading to a more regular enamel surface.

An in vitro study on the effect of an oscillating stripping method on enamel roughness.

BACKGROUND: The aim of the present study was to assess the changes in enamel roughness parameters before and after stripping with an oscillating diamond strip system. METHODS: Sound premolars extracted for orthodontic reasons were embedded up to their cervical area in a polyvinylsiloxane putty, creating four groups of four teeth with three interproximal areas each (mesial/distal). The same regions of interproximal enamel surfaces were studied by 3D optical interferometric profilometry before and after stripping with the Ortho-Strips system (Intensiv Dental SA, Montagnola, Switzerland) (n teeth = 16, n contact points = 12, n sites measured = 24). The roughness parameters tested were the amplitude parameters Sa and Sz, the hybrid parameter Sdr, and the functional parameters Sci and Svi. The parameter differences (ΔSa, ΔSz, ΔSdr, ΔSci, ΔSvi) were calculated per region and statistically analyzed by one-sample Mann-Whitney rank sum test (a = 0.05). RESULTS: High statistically significant differences were found in ΔSa, ΔSz, and ΔSvi median values (0.453, 3.870, and 0.040 µm, respectively); a significant difference in ΔSdr median value (1.514%); and no statistically significant difference in ΔSci (0.110 median value). CONCLUSIONS: Under the conditions of the present study, the Ortho-Strips system seems to significantly increase the amplitude parameters Sa and Sz; the hybrid parameter Sdr, associated with the developed interfacial area ratio; and the functional parameter Svi, which depicts the volume of the deepest valleys. Under the conditions of the present study, the Ortho-Strips seems to significantly increase four of five measured roughness parameters.

The Ethics of Interproximal Reduction.

Interproximal reduction (IPR) has become particularly popular with the use of removable aligners. Clinical and ethical factors concerning the use of interproximal reduction to facilitate orthodontic alignment are discussed. CPD/Clinical Relevance: An understanding of the aetiological factors of a malocclusion is essential to enable full discussion of the risks and benefits, or the alternatives to IPR.

Microabrasión de esmalte dentario en odontología restauradora / Dental enamel microabrasion in restorative dentistry

La estética es el paradigma de la odontología restauradora. En la actualidad, se utilizan procedimientos combinados, por la exigencia sostenida de los pacientes por tener piezas dentarias blancas y brillantes. Es así que, para cumplir con esas expectativas, clínicas, en algunos casos se utilizan técnicas de blanqueamiento dentario, mientras que en otros se necesitan procedimientos como los de microabrasión o micro-macro abrasión, para remover manchas oscuras o blancas del esmalte dentario, buscando de esta manera, la satisfacción en lo que a estética se refiere. La microabrasión es un procedimiento muy utilizado en la actualidad por los profesionales odontólogos, por lo anteriormente expuesto o como técnica previa al uso de sistemas adhesivos. Por ello, se pretende con este documento, presentar una revisión sobre conceptos actuales, como así también los condicionantes al momento de seleccionar materiales o realizar el procedimiento de microabrasión.

Change in the pulp chamber temperature with different stripping techniques.

BACKGROUND: The aim of this study is to evaluate the change in pulp chamber temperature during the stripping technique. METHODS: Seventy-eight proximal surfaces of 39 extracted human teeth were stripped by two techniques: double-sided perforated stripping disk (PSD) and handheld stripper (HS). The teeth were divided into three groups: incisors (group 1), premolars (2), and molars (3). A J type thermocouple was inserted into the pulp chamber for temperature evaluation during the stripping procedure. RESULTS: Temperature rise was observed in all groups. The average temperature increase for the incisors was 2.58°C (±0.27°C) with PSD and 1.24°C (±0.3°C) with HS; for the premolars, 2.64°C (±0.29°C) with PSD and 0.96°C (±0.39°C) with HS; and for the molars, 2.48°C (±0.38°C) with PSD and 0.92°C (±0.18°C) with HS. There was significant difference (p<0.001) in pulp temperature variation among the stripping techniques evaluated. Greater variations in the temperature were observed for the stripping technique with PSD for all groups (3.1°C in incisors and premolars, 3.2°C in molars). Stripping performed with HS had minor differences in pulp temperature (1.7°C in incisors, 1.9°C in premolars, and 1.2°C in molars) than those in PSD group. However, the temperature variation was less than the critical threshold (5.5°C) in all groups. The results for teeth group comparison showed no significant difference in the temperature variation. CONCLUSIONS: The stripping technique with PSD produced significant increase in pulp temperature, with no differences between the types of teeth. However, it may not be clinically relevant, and both stripping techniques can be used safely.

Integrating techniques to re-establish dentogingival esthetics.

The aim of this article was to report the clinical case of a male patient of 20 years with hyperpigmented gingiva and moderate fluorosis, whose smile was reestablished by the use of a laser assisted depigmentation procedure, an enamel microabrasion technique, followed by at-home bleaching and subsequent remineralization therapy. The association of these techniques presented excellent results and the patient was satisfied. All techniques are painless, fast and easy to perform, in addition to preserving the hard and soft dental structure. Treatment showed immediate and permanent results; these techniques must be divulged among professionals and their patients.

Interproximal enamel reduction as a part of orthodontic treatment.

OBJECTIVE: Interproximal enamel reduction is a part of orthodontic treatment for gaining a modest amount of space in the treatment of crowding. Today interproximal enamel reduction has become a viable alternative to the extraction of permanent teeth, and helps to adjust the Bolton Index discrepancy. The aim of the study is to evaluate various interproximal enamel reduction techniques, its indications, contraindications and complications presented in recent scientific studies. MATERIAL AND METHODS: Papers published in English language between 2003 and 2012 were searched in PubMed, ScienceDirect and The Cochrane Library databases, as well as the Web search Google Scholar. Initial searches were made to find peer-reviewed systematic reviews, meta-analyses, literature reviews, clinical trials, which analysed at least one interproximal enamel reduction method. 31 published data fulfilled the inclusion criteria. RESULTS: According to the study, abrasive metal strips, diamond-coated stripping disks, and air-rotor stripping are the main interproximal enamel reduction techniques. Indications for use are mild or moderate crowding in dental arches, Bolton Index discrepancy, changes in tooth shape and dental esthetics within the enamel, enhancement of retention and stability after orthodontic treatment, normalization of gingival contour, elimination of black gingival triangles, and correction of the Curve of Spee. Complications of interproximal enamel reduction are hypersensitivity, irreversible damage of dental pulp, increased formation of plaque, the risk of caries in the stripped enamel areas and periodontal diseases. CONCLUSION: Interproximal enamel reduction is an important part of orthodontic treatment for gaining space in the dental arch, and for the correction of the Bolton index discrepancy.

Comparison of six different methods of cleaning and preparing occlusal fissure surface before placement of pit and fissure sealant: an in vitro study.

AIM & OBJECTIVES: The purpose of this in vitro study was to evaluate and compare the microleakage of pit and fissure sealants after using six different preparation techniques: (a) brush, (b) pumice slurry application, (c) bur, (d) air polishing, (e) air abrasion, and (f) longer etching time. MATERIAL & METHOD: The study was conducted on 60 caries-free first premolars extracted for orthodontic purpose. These teeth were randomly assigned to six groups of 10 teeth each. Teeth were prepared using one of six occlusal surface treatments prior to placement of Clinpro" 3M ESPE light-cured sealant. The teeth were thermocycled for 500 cycles and stored in 0.9% normal saline. Teeth were sealed apically and coated with nail varnish 1 mm from the margin and stained in 1% methylene blue for 24 hours. Each tooth was divided buccolingually parallel to the long axis of the tooth, yielding two sections per tooth for analysis. The surfaces were scored from 0 to 2 for the extent of microleakage. STATISTICAL ANALYSIS: Results obtained for microleakage were analyzed by using t-tests at sectional level and chi-square test and analysis of variance (ANOVA) at the group level. RESULTS: The results of round bur group were significantly superior when compared to all other groups. The application of air polishing and air abrasion showed better results than pumice slurry, bristle brush, and longer etching time. Round bur group was the most successful cleaning and preparing technique. Air polishing and air abrasion produced significantly less microleakage than traditional pumice slurry, bristle brush, and longer etching time.

Conservative approach for a clinical resolution of enamel white spot lesions.

Enamel white spot lesions in anterior teeth that compromise esthetics are common. Microabrasion is indicated, since it affects enamel superficially. An acid-abrasive slurry with 37% phosphoric acid with pumice was used on the enamel for a controlled time period. Home bleaching with hydrogen peroxide was then used, further improving the final result. The method is safe, easy, and conservative and provides good esthetic results.

A minimally invasive procedure for esthetic achievement: enamel microabrasion of fluorosis stains.

Esthetic alterations (such as fluorosis) that result from intrinsic dental staining in enamel and dentin can be controlled or softened by noninvasive methods such as dental bleaching or enamel microabrasion. Part of the enamel is removed during microabrasion; however, this wear is clinically insignificant and does not harm the dental structure. This article presents a case in which the microabrasion technique was used to remove fluorosis staining. Based on the results of this case report, it can be concluded that this technique is efficient and can be considered a minimally invasive procedure.

Surface roughness of the restored enamel after orthodontic treatment.

INTRODUCTION: After fixed appliance treatment, one concern is to restore the enamel surface as closely to its original state as possible. A variety of cleanup processes are available, but all are time-consuming and carry some risk of enamel damage. The purpose of this study was to examine tooth surfaces restored with different cleanup protocols. METHODS: Ninety-nine premolars extracted for orthodontic purposes were used. The 2 materials tested were Sof-Lex disks (3 M ESPE AG, Seefeld, Germany) and fiberglass burs (Stain Buster, Carbotech, Ganges, France). These were used alone and in combination with high- and low-speed handpieces, with which they were also compared. Eight groups were ultimately tested. All groups were compared with intact enamel, which served as the control group. From each group, 10 samples were examined with profilometry and 1 with scanning electron microscopy. Adhesive remnant index scores were recorded to ensure equal distributions for the groups. The time required for the cleanup processes and profilometry test results were also recorded. RESULTS: The fastest procedure was performed with high-speed handpieces, followed by low-speed handpieces. Sof-Lex disks and fiberglass burs required more time than carbide burs but did not result in significantly longer times for the cleanup procedure when combined with tungsten carbide-driven low- or high-speed handpieces or when used alone with low-speed handpieces. Although Sof-Lex disks were the most successful for restoring the enamel, it was not necessary to restore the enamel to its original surface condition. Generally, all enamel surface-roughness parameters were increased when compared with the values of intact enamel. The average roughness and maximum roughness depth measurements with Sof-Lex disks were statistically similar to measurements of intact enamel. CONCLUSIONS: No cleanup procedure used in this study restored the enamel to its original roughness. The most successful was Sof-Lex disks, which restored the enamel closer to its original roughness.

Primary tooth enamel loss after manual and mechanical microabrasion.

PURPOSE: This study's purpose was to assess the amount of dental enamel loss on primary incisors after manual or mechanical microabrasion with a phosphoric acid/pumice paste. METHODS: Ten exfoliated primary maxillary incisors were bisected faciolingually and the resulting 20 halves were randomly assigned to 2 groups: group 1 (N = 10)-manual technique (plastic spatula); and group 2 (N = 10)-mechanical technique (rubber cup attached to a low-speed handpiece). Microabrasion was performed on the buccal surface using an abrasive paste prepared with 37% phosphoric acid and pumice. Ten 20-second applications alternated with 20-second risings were performed in each group. Enamel thickness measurements made under stereomicroscopy before and after microabrasion were analyzed statistically by analysis of variance and pairwise t test. RESULTS: There was a statistically significant difference (P = .003) between the manual and mechanical techniques. The mechanical technique produced a mean enamel loss of 274.16 microm (66% of total enamel thickness), while the mean enamel loss with the manual technique was 152.59 microm (39% of total enamel thickness). CONCLUSION: Manual microabrasion using a plastic spatula removed less enamel, but was sufficient to eliminate most superficial stains and defects, and may be a viable option for the microabrasive technique on primary teeth.

Operative dentistry and the abuse of dental hard tissues: confocal microscopical imaging of cutting.

We reviewed studies wherein the cutting of dental tissues, simulating interactions that would occur under clinical circumstances in the mouth, have been observed directly-first by real time, video rate, stereoscopic, three-dimensional scanning electron microscopy; and second and more conveniently, by video rate confocal optical microscopy. We have observed, directly, both the interactions of slow-moving cutting instruments emulating "chisels" and high-speed events, including the effects of rotary burs and air-propelled abrasive particles and soft powder slurries. The observational data contribute to our basic understanding of the functional behavior of dental tissues and formed a useful background for the practitioner of operative dentistry.

Association of enamel microabrasion and bleaching: a case report.

Enamel microabrasion may be indicated for certain clinical situations, since it is a proven method for removing superficial intrinsic enamel discoloration defects such as fluorosis-like stains; in addition, it is safe, conservative, and easy to perform. However, this method removes enamel structure, causing teeth to become yellowish. This yellowing can be treated with enamel microabrasion and bleaching. This article describes and documents how these two methods were utilized to correct tooth color for a young patient.

Severe enamel abrasion due to misuse of an air polishing device.

OBJECTIVES: In this case report, a 28-year-old male patient who severely injured the enamel tissue of his upper incisors due to excessive self-performed air polishing has been presented. Air polishing devices are frequently used in initial or supportive periodontal therapy to remove supragingival plaque and dental stains. Enamel tissue is minimally affected by air polishing when appropriately performed by a professional. However, excessive air polishing may have detrimental effects even on the intact enamel. The aim of this case report is to present a patient who severely injured the enamel surfaces of his upper incisors due to excessive self-performed air polishing. METHODS: A case of severe enamel abrasions in a 28-year-old male patient who injured the enamel surfaces of his upper incisors following several self-performed air polishing sessions has been presented. RESULTS: Severely abraded enamel surfaces of the upper incisors were present and during the course of therapy restored by composite restorations to establish a satisfactory clinical appearance. CONCLUSIONS: In clinical practice, air polishing can be performed rather safely on intact enamel and is a beneficial procedure in initial and supportive periodontal therapy when performed by a professional under recommended operating conditions. However, review of the literature reveals that air polishing may be harmful on tooth and surrounding structures unless carried out cautiously. Furthermore, excessive use of air polishing devices, especially by unauthorized personnel may be damaging and lead to severe abrasion of enamel tissue.

Improving esthetically objectionable human enamel fluorosis with a simple microabrasion technique.

Mild-to-moderately severe enamel fluorosis (EF) is an unsightly maturation-phase dental disorder. Despite extensive epidemiological studies on EF, little is known about individual treatment options. This study was carried out to determine whether a simple microabrasion technique is effective in improving the esthetics of EF. Patients with a variety of severities were treated using a water-cooled fine diamond polishing bur at high speed to remove the surface enamel layers. Photographs of the affected teeth before and after treatment were shown by computer to a panel of three judges (two lay and one experienced), who rated the appearance of the teeth using a newly developed visual analog scale. The severity of EF was rated randomly and blind for 52 individual teeth (26 before and 26 after treatment). Reteated-measures analysis of variance was used to analyze the results. The lay judges rated the appearance of the teeth with EF as significantly more objectionable before treatment. All judges found a significant improvement in the severity of EF after treatment. Using a newly developed visual analog scale, our study indicates that EF of an objectionable nature can be significantly improved with a simple microabrasion technique, thus conserving tooth structure and minimizing the cost of treating EF.