Influence of in-office whitening on the color matching and surface characteristics of single-shade resin composites.

OBJECTIVE: The color matching of single-shade resin composites after in-office whitening was investigated. MATERIALS AND METHODS: Four single-shade resin composites were used. A total of 35% hydrogen peroxide was used as the whitening agent. The resin composite was placed in a cavity of an artificially discolored bovine tooth. The color differences between the restoration and surrounding enamel before and after whitening were determined based on ΔE*ab, ΔE00, and ΔWID. The color stability, surface roughness (Sa), and surface gloss (GU) of the resin composite alone were also evaluated. Statistical analyses were performed using repeated-measures analysis of variance with the Tukey-Kramer test. RESULTS: Based on the 50:50% of perceptibility and acceptability thresholds of ΔE*ab and ΔE00, none of the resin composite restorations were clinically acceptable before or after whitening. Regarding ΔWID, although all resin composites showed "acceptable match" in the baseline, they showed "mismatch" after the third session of whitening. Most of the resin composites alone were stable in color against whitening. CONCLUSIONS: Although the single-shade resin composites failed to achieve the expected color matching on discolored teeth either before or after the whitening, the impact of the whitening on the color of the resin composite alone may be negligible.

Effect of ion-releasing filler-containing gel application on dentin remineralization using optical coherent tomography.

PURPOSE: To examine the effects of an ion-releasing filler-containing gel on the remineralization of dentin using optical coherence tomography (OCT). METHODS: Dentin slabs of bovine teeth were sliced and shaped into a rectangular form. Specimens were treated with undersaturated 0.1 M lactic acid buffer solution (pH 4.75) for 10 minutes and then placed in artificial saliva (pH 7.0). This procedure was repeated three times a day for 28 days. The dentin remineralization effects of a fluoride/S-PRG filler-containing gel (PRG) and a 38% SDF solution (SDF) on dentin slabs of bovine teeth were compared. After treatment, the dentin slabs were immersed in a 0.1 M lactic acid buffer solution and then placed in artificial saliva. This procedure was repeated three times a day for 28 days. OCT imaging was conducted on the selected location of the dentin surface. The peak intensity and width at 1/e² were recorded in each of the six areas on the sample and averaged. Each group had a sample size of 10. Knoop hardness number (KHN) measurements and scanning electron microscopy (SEM) observations were also conducted. The data for each group were subjected to a one-way repeated-measures ANOVA and Tukey tests (α= 0.05). The samples were also observed using SEM. RESULTS: The peak signal intensities of SDF and PRG decreased on day 7 and then slightly increased during the experimental period for the one-off application groups and then decreased for frequent-time application groups. Although the width at 1/e² in the untreated specimens decreased over the test period, SDF and PRG for the one-off application groups exhibited an increase in widths on day 7 followed by a slight decrease, whereas it increased for the frequent-time application groups. The average KHN of the dentin samples exhibited the same tendency as the width at 1/e². Closure of the dentin tubules and crystal precipitation were detected on the surface of both SDF and PRG groups. CLINICAL SIGNIFICANCE: S-PRG filler-containing gel might have the ability to prevent dentin demineralization and could be useful for the prevention of hard-to-access lesions. This material achieved remineralization of the demineralized root dentin and had the same remineralization ability as SDF in vitro.

Ultrasonic measurement of dentin remineralization effects of dentifrices and silver diamine fluoride.

OBJECTIVE: This study investigated the dentin remineralization effect of the application of a functionalized tri-calcium phosphate (fTCP) dentifrice and a silver diamine fluoride (SDF) solution. MATERIAL AND METHODS: The materials used were: a fluoride-containing dentifrice with fTCP (fTCP＋), a fluoride-containing dentifrice without fTCP (fTCP-) and a 38% SDF solution. Following treatment, the dentin slabs were immersed in a 0.1-M lactic acid buffer solution and then placed in artificial saliva. This procedure was repeated three times daily for 28 days. The propagation time of longitudinal ultrasonic velocities (UV) and the Knoop hardness (KH) of the samples were measured. The samples were also observed using scanning electron microscopy. RESULTS: The SDF and fTCP＋ groups showed higher UV than the fTCP - group regardless of the application method. The F-SDF group at 28 days showed significantly higher UV (4121 ± 102 m/s) than the F-fTCP + group (3731 ± 65 m/s) (p < .05). The F-SDF group at 28 days showed significantly higher KH (47.4 ± 2.2) than the F-fTCP＋ group (43.3 ± 1.0) and the F-fTCP - group (42.9 ± 2.1) (p < .05). Closure of the dentinal tubules and crystal precipitation was detected on the surface of the fTCP＋ group to a greater extent than the fTCP - group. CONCLUSIONS: The fTCP-containing dentifrice and SDF solution effectively enhanced bovine dentin remineralization.

Evaluation of structural coloration of experimental flowable resin composites.

OBJECTIVE: To examine the effect of filler contentTo examine the effect of filler content on structural coloration of experimental flowable resin composites. OVERVIEW: Experimental composites containing spherical fillers and different filler contents (30, 40, 50, 60 and 70 wt%), a structural colored resin composite (Omnichroma), and a nanohybrid flowable resin composite (Gracefil LoFlo) were used. The optical characteristics of the specimens were measured on standard black and white backgrounds using a spectrophotometer under CIE D65 illuminant and the L*a*b* values were determined. The color matching abilities to artificial teeth were evaluated using the ΔE*ab and ΔE00 color difference formulas. One-way analysis of variance and Tukey's post hoc test were used. The spectral reflectance of experimental composites showed different trends in different backgrounds, plate thickness, and filler contents. In particular, higher spectral reflectance was observed on the white background at wavelengths ranging from 450 to 700 nm in both 1.5 and 3.0 mm plates when compared to the black background. The percent reflectivity tended to decrease with a decrease of the filler contents. The color matching abilities of the experimental composites improved with the increase in the filler contents. CONCLUSIONS: Structural coloration of the flowable resin composites were affected by the filler contents. CLINICAL SIGNIFICANCE: Clinical Significance: Higher filler contents might be needed to achieve the optimal color properties of structural colored flowable resin composites, thereby improving the restoration esthetics.

Ultrasonic measurement of remaining dentin thickness using a pencil-type transducer.

PURPOSE: To evaluate the ability of a pencil-type transducer connected to a pulser-receiver to measure remaining dentin thickness (RDT). METHODS: A total of 24 freshly extracted bovine incisors were used to prepare dentin disks with certain thicknesses (0.5, 1.0, 1.5 and 2.0 mm). The thicknesses of the specimens were measured with an ultrasonic technique using a pencil-type transducer, and the data obtained were compared with the direct measurement obtained using a micrometer. The Bland-Altman comparison method and paired t-test were performed at a 0.05 significance level. RESULTS: The agreement between different measurement methods was analyzed to evaluate the inter-methodology variation. The Bland-Altman comparison method revealed a mean difference of 0.0098 ± 0.724 mm between the ultrasonic technique and the direct measurement, with the 95% Bland-Altman limits of agreement ranging from 0.1322 to 0.1517 mm. CLINICAL SIGNIFICANCE: Ultrasonic measurement using the pencil-type transducer may be a promising method to evaluate remaining dentin thickness.

Enamel remineralization effect of a dentifrice containing calcium sodium phosphosilicate: an optical coherence tomography observation.

OBJECTIVE: The purpose of this study was to examine the effects of a dentifrice containing 5% calcium sodium phosphosilicate (CSP) on the remineralization of the enamel using optical coherence tomography (OCT). MATERIALS AND METHODS: Bovine incisors were sliced and shaped in a rectangular form. One group of five specimens was treated with undersaturated 0.1 M lactic acid buffer solution (pH 4.75) for 10 min and then placed in artificial saliva (pH 7.0) (De group). Other specimens were stored in solutions of toothpaste containing CSP for 10 min, followed by 10-min immersion in the lactic acid buffer solution twice a day before storage in artificial saliva (CSP group). An additional group was stored in only artificial saliva (control group). OCT imaging on the selected location of the enamel surface was performed. The peak intensity and width at 1/e2 were recorded in each of the six areas on the sample and averaged, and the sample size of each group was six. The integrated value in units (dB × µm) was calculated in the area of peak intensity. The data for each group was subjected to one-way repeated-measures ANOVA and Tukey HSD tests (α = 0.05). RESULTS: The changes in integrated values of each group were different. A slight but significant increase in the integrated value was observed in the control group, whereas a slight but significant decrease in the value was observed the De group. Integrated values increased in the CSP group. CONCLUSIONS: Remineralization occurred upon immersion in the toothpaste containing CSP.

Ultrasonic assessment of the effects of self-assembling peptide scaffolds on preventing enamel demineralization.

OBJECTIVES: This study evaluates the effect of self-assembling peptide P11-4 (Curodont Repair, CDR) on bovine enamel remineralization by measuring changes in ultrasonic propagation velocity. METHODS: Six specimens per group were prepared by sectioning bovine teeth into enamel blocks. These blocks were then immersed in lactic acid buffer solution (pH = 4.75) for 10 min twice a day and stored in artificial saliva. Other specimens were first treated with CDR, followed by a 10-min immersion in the lactic acid buffer solution twice a day, before storage in artificial saliva. The propagation time of longitudinal ultrasonic waves was measured using a pulser/receiver. Six specimens were used for each treatment protocol. The obtained data were statistically analyzed using ANOVA followed by Tukey's honestly significant difference tests (α = 0.05). Specimens were observed using laser scanning microscopy and scanning electron microscopy. RESULTS: Sonic velocity was found to decrease with time for specimens stored in the demineralizing solution. On the other hand, increases in sonic velocity were found for specimens treated with CDR. These specimens also exhibited signs of mineral deposition. CONCLUSIONS: By measuring the ultrasonic propagation velocity, it can be concluded that CDR application has an ability to promote bovine enamel remineralization.

Ultrasonic measurement of the effects of light irradiation and presence of water on the polymerization of self-adhesive resin cement.

Self-adhesive resin cements are useful in restorations because they reduce the number of clinical steps involved in the restoration process. This study evaluated, using ultrasonic measurements, the influence of light irradiation and the presence of water on the polymerization behavior and elastic modulus of a self-adhesive resin cement. A self-adhesive resin cement (RelyX Unicem 2 Automix) or a resin cement (RelyX ARC) was inserted into a transparent mold on a sample stage, and the presence of water and effect of light-irradiation were evaluated. The transit time of a sonic wave through the cement disk was divided by the specimen thickness to obtain the sonic velocity, and longitudinal and shear waves were used to determine the elastic modulus. When the resin cements were light-irradiated, the sonic velocity rapidly increased and plateaued at 2,500-2,700 m s-1 . When the cements were not irradiated, the rates of increase in the sonic velocity were reduced. When water was applied to the sample stage, the sonic velocity was reduced. The elastic modulus values of the specimens ranged from 9.9 to 15.9 GPa after 24 h. The polymerization behavior of self-adhesive resin cements is affected by the polymerization mode and the presence of water.

Influence of warm air-drying on enamel bond strength and surface free-energy of self-etch adhesives.

We examined the effect of warm air-drying on the enamel bond strengths and the surface free-energy of three single-step self-etch adhesives. Bovine mandibular incisors were mounted in self-curing resin and then wet ground with #600 silicon carbide (SiC) paper. The adhesives were applied according to the instructions of the respective manufacturers and then dried in a stream of normal (23°C) or warm (37°C) air for 5, 10, and 20 s. After visible-light irradiation of the adhesives, resin composites were condensed into a mold and polymerized. Ten samples per test group were stored in distilled water at 37°C for 24 h and then the bond strengths were measured. The surface free-energies were determined by measuring the contact angles of three test liquids placed on the cured adhesives. The enamel bond strengths varied according to the air-drying time and ranged from 15.8 to 19.1 MPa. The trends for the bond strengths were different among the materials. The value of the γS⁺ component increased slightly when drying was performed with a stream of warm air, whereas that of the γS⁻ component decreased significantly. These data suggest that warm air-drying is essential to obtain adequate enamel bond strengths, although increasing the drying time did not significantly influence the bond strength.

Ultrasonic measurement of the effects of adhesive application and power density on the polymerization behavior of core build-up resins.

OBJECTIVE: To use ultrasonic measurements to monitor the effects of adhesive application and power density on the polymerization behavior of dual-cured core build-up resins. METHODS: Ultrasonic measurements were carried out using a pulser-receiver, transducers and an oscilloscope. The core build-up resins were mixed, inserted into a transparent mold and then placed onto a sample stage with or without self-etch adhesive. Power densities of 0 (no light irradiation), 200 and 600 mW/cm(2) were used for curing. The transit time through the core build-up resin disk was divided by the specimen thickness to obtain the longitudinal sound velocity (V). RESULTS: Light irradiation of the core build-up resins at a power density of 600 mW/cm(2) caused V values to rise to an initial plateau of 1550-1650 m/s, then to rise rapidly to a second plateau of 2800-3200 m/s. The rate of V increase was slower when the resin cements were light-irradiated and became faster when irradiated at a higher power density. There were no significant differences between the groups with or without adhesive. CONCLUSIONS: The polymerization behavior of the core build-up resins was affected by the power density of the curing unit. The influence of adhesive application differed among the core build-up resins tested.

Influence of surface roughness of universal shade resin composites on color adjustment potential.

This study aimed to determine the influence of surface roughness of the color adjustment potential restoration of universal resin composites. A structural colored resin composite (Omnichroma, OC) and a pigment-employed universal shade resin composite (Beautifil Unishade, BU) were used. Each resin composite was placed in a cavity to determine its ability to match the color of artificial teeth. The surface of the resin composites was polished with #800- or #2000-grit SiC paper before performing color measurements. One-way analysis of variance and Tukey post hoc tests were performed (α=0.05). The color difference (ΔE*ab) ranged from 2.5-3.9 for OC and 1.8-8.7 for BU. OC has a more stable color adjustment than BU. The color adjustment potential of universal resin composites was affected by the surface roughness of the restorations.

Bonding ability of resin cements to different types of CAD/CAM composite blocks.

This study investigated the bonding performance of two different types of resin cements to computer-aided design/computer-aided manufacturing (CAD/CAM) composite blocks based on the shear bond strength (SBS) test. A silane-containing self-adhesive resin cement (Panavia SA Cement Universal) and resin luting cement (Block HC Cem) with a primer, were used. Specimens were fabricated from three different types of CAD/CAM composite blocks, and their surfaces were blasted with alumina. Resin cements were bonded to the specimens, and their SBSs were measured after 15 min, 24 h, and after being subjected to thermal cycling for 10,000 and 30,000 cycles. Three-way ANOVA for bond strength revealed that CAD/CAM composite block, resin cement and storage time significantly influenced the SBS values, and the three-way interactions between the evaluated factors, and all the interactions were significant. It was concluded that the bonding performance of resin cements to CAD/CAM composite blocks were material and storage period dependent.

Evaluation of the effect of a glass ionomer cement containing fluoro-zinc-silicate glass on dentin remineralization using the ultrasonic pulse-echo method.

The purpose of this study was to investigate the protective effect of a glass ionomer cement (GIC) consisting of fluoro-zinc-silicate glass on the demineralization of bovine dentin using the ultrasonic pulse-echo method. The findings were compared with those obtained using a conventional GIC. Slabs of dentin from bovine teeth were sliced, shaped into a rectangular form, and immersed in 0.5 M ethylenediaminetetraacetic acid solution at 25ºC for 6 days, followed by storage in distilled water for 3 days. After demineralization, they were immersed in artificial saliva with and without the GIC specimens. The propagation times of the longitudinal ultrasonic waves in the samples were measured. The ultrasonic velocities of the fluoro-zinc-silicate glass-containing GICs were significantly increased 2-3 days after the start of the experiment and showed an upward trend thereafter. These findings indicate that the GICs containing fluoro-zinc-silicate glass might exhibit the potential to promote remineralization in the dentin.

Prevention of acidic attack on tooth enamel surfaces using polishing paste containing ion-releasing filler.

The purpose of this study was to investigate the ability of polishing paste containing surface pre-reacted glass-ionomer (S-PRG) filler to prevent acidic attack on tooth enamel surfaces. Resin composites were filled in the standardized cavities and finished with silicon carbide paper. These specimens were divided into three groups: the unpolished "control" group, the "PRG" group polished with S-PRG paste, and the "DDP" group polished with diamond-containing polishing paste. Following polishing, the specimens were immersed in a lactic acid buffer solution for 28 days. Optical coherence tomography (OCT) signals were measured to obtain the signal intensity and width at 1/e2 at selected locations on the enamel surface adjacent to the restoration. Although signal intensity significantly increased in all groups, widths at 1/e2 did not change significantly in the PRG group. For both the control and DDP groups, signal intensity and width at 1/e2 increased and decreased over time, respectively.

Influence of power density and primer application on polymerization of dual-cured resin cements monitored by ultrasonic measurement.

We used ultrasonic measurements to monitor the influence of power density and primer application on the polymerization reaction of dual-cured resin cements. The ultrasonic equipment comprised a pulser-receiver, transducers, and an oscilloscope. Resin cements were mixed and inserted into a transparent mould, and specimens were placed on the sample stage, onto which the primer, if used, was also applied. Power densities of 0 (no irradiation), 200, or 600 mW cm(-2) were used for curing. The transit time through the cement disk was divided by the specimen thickness to obtain the longitudinal sound velocity. When resin cements were light-irradiated, each curve displayed an initial plateau of approximately 1,500 m s(-1), which rapidly increased to a second plateau of 2,300-2,900 m s(-1). The rate of sound velocity increase was retarded when the cements were light-irradiated at lower power densities, and increased when the primer was applied. The polymerization behaviour of dual-cured resin cements was therefore shown to be affected by the power density of the curing unit and the application of self-etching primer.

Influence of surface treatment on bonding of resin luting cement to CAD/CAM composite blocks.

The aim of this study was to determine the influence of different surface treatments of CAD/CAM composite blocks on bonding effectiveness of resin cements, based on the shear bond strength test and the surface science examination. Specimens were fabricated from two types of CAD/CAM composite blocks (Cerasmart and VITA Enamic), and the specimen surfaces were alumina sandblasted. Specimen surfaces were treated with i) silane, ii) primer, and iii) silane+primer, then two types of cements (Block HC Cem and Super Bond) were bonded. After 24 h storage, bond strengths were measured. Surface free energy measurements were performed of the treated CAD/CAM composite blocks surfaces. The groups ii) and iii) showed significantly higher bond strengths than the group i), apart from VITA Enamic with Block HC Cem. Although the total surface free energy showed different trends in different surface treatments, a similar trend was found in both CAD/CAM composite blocks.

Influence of power density on polymerization behavior and bond strengths of dual-cured resin direct core foundation systems.

This study examined the influence of power density on dentin bond strength and polymerization behavior of dual-cured direct core foundation resin systems. Two commercially available dual-cured direct core foundation resin systems, Clearfil DC Core Automix with Clearfil DC Bond and UniFil Core with Self-Etching Bond, were studied. Bovine mandibular incisors were mounted in autopolymerizing resin and the facial dentin surfaces were ground wet on 600-grit SiC paper. Dentin surfaces were treated according to manufacturer's recommendations. The resin pastes were condensed into the mold and cured with the power densities of 0 (no irradiation), 100, 200, 400 and 600 mW/cm2. Ten specimens per group were stored in 37 degrees C water for 24 hours, then shear tested at a crosshead speed of 1.0 mm/minute in a universal testing machine. An ultrasonic measurement device was used to measure the ultrasonic velocities through the core foundation resins. The power densities selected were 0 (no irradiation), 200, and 600 mW/cm2, and ultrasonic velocity was calculated. ANOVA and Tukey HSD tests were performed at a level of 0.05. The highest bond strengths were obtained when the resin pastes were cured with the highest power density for both core foundation systems (16.8 +/- 1.9 MPa for Clearfil DC Core Automix, 15.6 +/- 2.9 MPa for UniFil Core). When polymerized with the power densities under 200 mW/cm2, significantly lower bond strengths were observed compared to those obtained with the power density of 600 mW/cm2. As the core foundation resins hardened, the sonic velocities increased and this tendency differed among the power density of the curing unit. When the sonic velocities at three minutes after the start of measurements were compared, there were no significant differences among different irradiation modes for UniFil Core, while a significant decrease in sonic velocity was obtained when the resin paste was chemically polymerized compared with dual-polymerization for Clearfil DC Core Automix. The data suggests that the dentin bond strengths and polymerization behavior of the dual-cured, direct core foundation systems are still affected by the power density of the curing unit. With a careful choice of the core foundation systems and power density of the curing unit, the benefit of using resin composites to endodontically-treated teeth might be acceptable.

Ultrasonic monitoring of the setting of glass-ionomer luting cements.

This study used ultrasonic measurements to monitor the setting behaviour, and changes in the elastic modulus, of glass-ionomer cements. The ultrasonic equipment comprised a pulser-receiver, transducers, and an oscilloscope. The two-way transit time through the mixing cement disk was divided by two, in order to account for the down-and-back travel path, and then multiplied by the sonic velocity within the material. The sonic velocities of the longitudinal and shear waves were used to determine the elastic modulus. In the earliest stages of the setting process, most of the ultrasound energy was absorbed by the cements and the second echoes were relatively weak. As the cements hardened, the sound velocities increased until they reached a plateau. The changes in sound velocities differed among the glass-ionomer cements tested. The mean elastic moduli of the specimens ranged from 2.6 to 6.2 GPa after 15 min, from 13.4 to 20.4 GPa after 24 h, and from 11.4 to 22.4 GPa after 1 month. The ultrasonic method used in this study has considerable potential for determining the setting processes of luting cements.

Change in elastic modulus of bovine dentine with exposure to a calcium hydroxide paste.

OBJECTIVE: To determine the effect of calcium hydroxide [Ca(OH)(2)] paste exposure on the elastic modulus of bovine dentine. METHODS: Dentine sections (4 mm x 4 mm x 1 mm) were obtained from freshly extracted bovine incisors and placed in dishes containing a 1-mm deep layer of Ca(OH)(2) paste or physiological saline as a control. An ultrasonic device was used to measure the sonic velocities of the longitudinal and shear waves, and the elastic modulus was calculated. Data were examined by analysis of variance followed by the Tukey H.S.D. test in order to compare different storage times. RESULTS: Exposure to Ca(OH)(2) paste significantly increased the mean elastic modulus of the dentine from 16.3 to 22.1 GPa. By contrast, the elastic modulus of the control dentine, which was exposed to physiological saline, remained constant. CONCLUSION: These results demonstrate that exposure to Ca(OH)(2) paste increases the elastic modulus of dentine, thereby making it more prone to fracture.

Effect of prior acid etching on bonding durability of single-step adhesives.

This study investigated the effect of prior phosphoric acid etching on the enamel bond strength of five single-step self-etch adhesive systems: Absolute, Clearfil tri-S Bond, Fluoro Bond Shake One, G-Bond and One-Up Bond F Plus. Bovine mandibular incisors were mounted in self-curing resin, and the facial surfaces were wet ground with #600 silicon carbide paper. Adhesives were applied to the enamel surfaces with or without prior phosphoric-acid etching and light irradiated. The resin composites were condensed into a mold and light irradiated. In total, 40 specimens were tested per adhesive system with and without prior acid etching and were further divided into two groups: those stored in water at 37 degrees C for 24 hours without cycling and those stored in water at 37 degrees C for 24 hours followed by thermal cycling between 5 degrees C and 55 degrees C with 10,000 repeats. After storage under each set of conditions, the specimens were tested in shear mode at a crosshead speed of 1.0 mm/minute. Two-way analysis of variance, the Student's t-test and the Tukey HSD test were used to analyze the data at a significance level of 0.05. For the specimens without prior acid etching, the mean bond strengths to enamel ranged from 11.0 to 14.6 MPa after 24-hour storage in water, while the corresponding values for specimens with prior acid etching ranged from 15.2 to 19.3 MPa. When these specimens were subjected to thermal cycling, the mean bond strengths ranged from 11.3 to 17.0 MPa without prior acid etching and from 12.3 to 23.2 MPa with prior acid etching. The changes in enamel bond strengths differed among the adhesive systems tested. After 24-hour storage in water, the most common failure modes were adhesive failure and mixed failure for specimens with and without prior acid etching, respectively. Thus, through a careful choice of adhesive system, prior acid etching can increase the bond strengths of single-step self-etch adhesive systems.