Finite element stress analysis of composite resin veneers for diastema closure.

The fracture of restorations used for diastema closure is a clinical concern. The objective of this study was to perform a finite element-based comparative analysis of functional stress patterns in composite resin veneer restorations used for diastema closure to determine the influence of factors such as the preparation design, proximal extension, loading level, and vector of stress (loading angle). Three-dimensional finite element stress analysis was performed on a maxillary central incisor model to examine the stress distribution resulting from a nanofilled composite veneer restoration with 4 different extensions of unsupported composite (0.5, 1.0, 1.5, or 2.0 mm) and 2 different preparation designs (partial or full) under 3 loads (50, 150, or 250 N) and 3 loading angles (60°, 90°, or 125°). The maximum stress was found to be concentrated on the full-preparation design with a 0.5-mm mesial extension under a 250-N load and 60° loading angle. The minimum stress was found with the partial-preparation design with a 0.5-mm mesial extension under a 50-N load and 90° loading angle. Based on the results of the present study, a partial-preparation design is preferred when nanofilled composite resins are used for diastema closure.

Oral microbial biofilms: an update.

Human oral cavity (mouth) hosts a complex microbiome consisting of bacteria, archaea, protozoa, fungi and viruses. These bacteria are responsible for two common diseases of the human mouth including periodontal (gum) and dental caries (tooth decay). Dental caries is caused by plaques, which are a community of microorganisms in biofilm format. Genetic and peripheral factors lead to variations in the oral microbiome. It has known that, in commensalism and coexistence between microorganisms and the host, homeostasis in the oral microbiome is preserved. Nonetheless, under some conditions, a parasitic relationship dominates the existing situation and the rise of cariogenic microorganisms results in dental caries. Utilizing advanced molecular biology techniques, new cariogenic microorganisms species have been discovered. The oral microbiome of each person is quite distinct. Consequently, commonly taken measures for disease prevention cannot be exactly the same for other individuals. The chance for developing tooth decay in individuals is dependent on factors such as immune system and oral microbiome which itself is affected by the environmental and genetic determinants. Early detection of dental caries, assessment of risk factors and designing personalized measure let dentists control the disease and obtain desired results. It is necessary for a dentist to consider dental caries as a result of a biological process to be targeted than treating the consequences of decay cavities. In this research, we critically review the literature and discuss the role of microbial biofilms in dental caries.

Effect of Two Polishing Systems on Surface Roughness, Topography, and Flexural Strength of a Monolithic Lithium Disilicate Ceramic.

PURPOSE: To evaluate the effect of overglazing and two polishing procedures on flexural strength and quality and quantity of surface roughness of a monolithic lithium disilicate ceramic computer-aided design (CAD) after grinding. MATERIALS AND METHODS: This in vitro study was conducted on 52 partially crystalized bar-shaped specimens (16 × 4 × 1.6 mm) of monolithic lithium disilicate ceramic. The specimens were wet polished with 600-, 800-, and 1200-grit silicon carbide papers for 15 seconds using a grinding/polishing machine at a speed of 300 rpm. Then, the specimens were crystalized and glaze-fired in one step simultaneously and randomly divided into four groups of 13: (I) Glazing group (control); (II) Grinding-glazing group, subjected to grinding with red band finishing diamond bur (46 µm) followed by glazing; (III) Grinding-D+Z group, subjected to grinding and then polishing by coarse, medium, and fine diamond rubber points (D+Z); and (IV) Grinding-OptraFine group, subjected to grinding and then polishing with a two-step diamond rubber polishing system followed by a final polishing step with an OptraFine HP brush and diamond polishing paste. The surface roughness (Ra and Rz) values (µm) were measured by a profilometer, and the mean values were compared using one-way ANOVA and Tamhane's test (post hoc comparison). One specimen of each group was evaluated under a scanning electron microscope (SEM) for surface topography. The three-point flexural strength values of the bars were measured using a universal testing machine at a 0.5 mm/min crosshead speed and recorded. The data were analyzed using one-way ANOVA and Tamhane's test (α = 0.05). RESULTS: Statistically significant differences were noted among the experimental groups for Ra, Rz (p < 0.0001), and flexural strength values (p < 0.009). The lowest Ra and Rz values were found in the grinding-OptraFine group (0.465 ± 0.153), which were significantly lower than those in glazing (p < 0.03) and grinding-glazing (p < 0.001) groups. The Ra and Rz values were not significantly different between the two polishing systems (p = 0.23 and p = 0.25, respectively). The highest flexural strength was found in the glazing group (283.350 ± 49.854 MPa) without significant differences compared to grinding-glazing (p = 0.98) and grinding-OptraFine groups (p = 0.86). The lowest flexural strength was found in grinding-D+Z group (225.070 ± 17.299), which was significantly different from the value in glazing (p < 0.03) and grinding-glazing (p < 0.04) groups. SEM analysis of polished surfaces revealed regular morphology with some striations. CONCLUSIONS: The OptraFine system created smoother and more uniform surfaces in terms of quantity (p < 0.03 for Ra, p < 0.01 for Rz) and quality of roughness compared to glazing. The flexural strength of lithium disilicate ceramic after polishing with the OptraFine system was similar to that after glazing (p = 0.86). Despite similar surface roughness after polishing with the two systems, the D+Z system reduced the flexural strength of ceramic (p < 0.03).

Effect of coarse grinding, overglazing, and 2 polishing systems on the flexural strength, surface roughness, and phase transformation of yttrium-stabilized tetragonal zirconia.

STATEMENT OF PROBLEM: Limited information is available for the best polishing systems and methods to obtain minimally abrasive monolithic zirconia surfaces after contouring and occlusal adjustment. PURPOSE: The purpose of this in vitro study was to evaluate the effect of grinding and polishing procedures on the flexural strength, quality and quantity of surface roughness, topography, and phase transformation of a zirconia-based ceramic system. MATERIAL AND METHODS: Fifty bar-shaped yttrium-stabilized zirconium oxide specimens (20×4×2 mm) were cut from presintered zirconia blanks. The specimens were wet-polished and divided into 5 groups (n=10): standard polishing without any surface treatment (group SP); grinding with a diamond rotary instrument (group Gr); grinding with a diamond rotary instrument (DRI) and over-glazing (group Gl); grinding with a DRI and polishing with an intraoral zirconia polishing kit in a 2-step procedure (group BP); and grinding with a DRI and polishing with an intraoral polishing kit (group MP). The Ra and Rz surface roughness values (µm) were measured with a profilometer. One specimen of each group was subjected to x-ray diffraction (XRD) to estimate the monoclinic phase and evaluated using scanning electron microscopy (SEM) for surface topography. The 3-point flexural strength of the bars was measured in a universal testing machine at a crosshead speed of 0.5 mm/min. The mean flexural strength (MPa) and surface roughness values were calculated, and the results were analyzed using 1-way ANOVA and Tukey honest significant difference tests (α=.05). RESULTS: Statistically significant differences were noted among the experimental groups for Ra, Rz (P<.001), and flexural strength values (P<.001). The highest Ra and Rz values were found in group Gr (P<.001) and the lowest in group Gl, which were significantly lower than the values in group Gr (P<.001). The 2 polishing systems (BP and MP) were not significantly different in terms of Ra and Rz values (P=.755 for Ra and P=.319 for Rz). The highest flexural strength was found in group Gr (283.35 ±49.85 MPa) without significant differences from those of MP and BP (P=.958 for BP and P=.404 for MP). The lowest flexural strength was found in Gl, which had no significant differences from those of the control group (P=1.000). In XRD the monoclinic phase was observed in Gr (26%), BP (24%), and MP (23%) groups. However, groups Gl and SP did not have any monoclinic phase. SEM showed deep unidirectional scratches after grinding that were smoothened by glazing and polishing. CONCLUSIONS: Roughness increased significantly after grinding, but polishing and glazing similarly diminished it. Glazing after grinding significantly decreased the flexural strength values, but polishing did not.

Effect of Hydrothermal, Chemical, and Mechanical Degradation on Flexural Strength and Phase Transformation of Ground, Glazed, and Polished Zirconia.

Objectives: Evaluation of the effect of grinding on flexural strength of zirconia after low temperature degradation (LTD) and pH-cycling. Materials and Methods: Sixty-four bar-shaped specimens of yttria-stabilized tetragonal polycrystalline zirconia were milled, sintered, wet-polished, and divided into 8 groups (N=8). The four control groups were not aged while artificial aging was performed in the 4 experimental groups in three steps including LTD in steam for 40h, pH-cycling, and tooth brushing for artificial aging. All groups underwent surface preparations as follows: standard polishing without surface treatment (Sp), grinding with a blue-yellow band diamond instrument (Gr); grinding with a diamond rotary instrument (DRI) and then over-glazing (Gl); grinding with a DRI followed by two-step intraoral polishing (Po); standard polishing and aging (Sp-Ag); grinding and aging (Gr-Ag), grinding, over-glazing and aging (Gl-Ag); and grinding, polishing and aging (Po-Ag). Monoclinic content was assessed in one specimen of each group by X-ray diffraction (XRD). The 3-point flexural strength test was performed in a universal testing machine. The results were analyzed with two-way ANOVA and Tukey's test (α=0.05). Results: Mean flexural strength (Mpa) was significantly higher in groups Gr and Po compared to group Sp (both, P<0.0001) and group Gl (both, P<0.0001). In XRD analyses, the highest monoclinic phase before aging was observed in group Gr (12.6%), and after aging in group Gr-Ag (51.2%). Conclusion: Grinding and polishing increased the flexural strength, while glazing did not exhibit any significant effect on this parameter. Furthermore, aging did not adversely affect flexural strength.

Effects of Dental Pulp Stem Cell Preconditioning on Osteogenesis using Conditioned Media of Probiotics Bacteria.

Background: Stem cells are used to treat numerous diseases; however, their lifespan is rather short. Factors such as probiotics affect and improve various cell lineage efficacies. The aim of this study was to investigate the effects of probiotics-conditioned media on dental pulp stem cell potentials in osteogenesis. Methods: The experiment was initiated by culturing Lactobacillus casei and Lactobacillus acidophilus probiotics as well as DPS-7 cells. Bacterial supernatants were separated and concentrated as the conditioned media. The DPS-7 cells were treated with various concentrations of the conditioned media. Furthermore, MTT assay and alkaline phosphatase activity were used. The mRNA expression of three genes (bFGF, EGF-ß and BMP-2) involved in osteogenesis was analyzed using a real-time polymerase chain reaction. Results: The response of dental pulp stem cells to probiotics preconditioning promoted cell proliferation, increased alkaline phosphatase activity and upregulated bFGF and BMP-2 gene expression. Increased expression was significant for BMP-2 and moderate for bFGF; however, it was non-significant for EGF-ß. The use of the two probiotics was the most effective. Conclusion: In general, synergism of the combined probiotics preconditioning induces differentiation of DPS-7 cells into osteoblasts most effectively.

Evaluation of the Effect of NovaMin and Er,Cr:YSGG Laser on Remineralization of Erosive Lesions of Primary Enamel Teeth: An In Vitro Study.

Introduction: The purpose of this in vitro study is to ascertain how NovaMin and Er,Cr:YSGG laser radiation affect the remineralization of primary tooth enamel lesions. Methods: 40 main teeth served as the study's sample size. These teeth were allocated into five groups at random. The first group served as a negative control (artificial saliva); the second group served as a positive control (APF gel 1.23%); the third group NovaMin, the fourth group Er,Cr:YSGG laser, the fifth group Er,Cr:YSGG laser and finally, the application of NovaMin. For the purpose of measuring microhardness, all samples were submitted to the dental materials laboratory three times. Results: The collected data were compared using the SPSS 28 program between the baseline measurement, after demineralization, and after remineralization. The data were analyzed using ANCOVA and Bonferroni tests. All groups demonstrated a considerable increase in microhardness as compared to the negative control group (P<0.05). With the exception of the third and fourth groups, there was no discernible difference in the rise in microhardness between the other groups. The third and fourth groups were compared, and the results revealed that NovaMin had a greater impact than laser therapy alone (P=0.023). Scanning electron microscopy (SEM) analysis backed up the findings. Conclusion: In comparison to using the Er,Cr:YSGG laser alone, using NovaMin alone can speed up the remineralization of erosion lesions on the surface of primary teeth.

Evaluating the Effect of Sumac Extract on Dentine Micro-Hardness during pH Cycling.

Statement of the Problem: Although sumac extract (SE) is reported as a collagen cross linker, the available data regarding its effect on the dentine micro-hardness is quite sparse. Purpose: Therefore, the aim of this study includes evaluating the effect of different concentrations of SE on dentine micro-hardness comparing to grape seed extract (GSE). Materials and Method: In this experimental study, the GSE was purchased from available market and convert to 5% solution. Meanwhile the 5, 10, and 20% of SE solutions were prepared experimentally. The base line micro-hardness of 60 samples (30 premolars divided to buccal and lingual segments) was recorded triplicate for each specimen and they were randomly divided into 5 groups (four abovementioned experimental solutions and de-ionized water as negative control). For 35 consecutive days, each sample was twice pH cycled and treated by solutions. Ultimately, the final micro-hardness was recorded triplicate again for each sample and the numerical data was compared with each other using one-way ANOVA and Tukey HSD Post Hoc tests (α=0.05). Results: The meanSD values of micro-hardness for the groups was recorded as 54.45 13.4, 65.6518.5, 39.572.26, 41.131.66 and 43.794.96 at base line and 10.40.99, 11.85 0.75, 10.161.84, 8.481.16 and 6.311.01 at final stage for control, GSE 5%, SE 5%, SE 10% and SE 20% respectively. There was no significant difference among the micro-hardness of the groups before treatment (p= 0.369). However, after experimental treatment, there was significant difference between the groups (p= 0.024) while in pairwise comparison just two groups (GSE 5% and SE 20%) had significant difference with each other (p= 0.017). Conclusion: The efficacy of SE was reversely related to its concentration. Moreover, neither GSE nor SE had significant effect on dentine micro-hardness after 35 day pH cycling.

Effect of Low-Temperature Degradation, Ph-Cycling and Simulated Tooth Brushing on Surface Roughness, Topography, and Polish Retention of Yttrium-Stabilized Tetragonal Zirconia.

Statement of the Problem: Surface roughness of zirconia is an important parameter that determines the success of zirconia restorations. When zirconia surfaces are left rough, higher susceptibility to hydrothermal aging, plaque accumulation and color changes would occur. Therefore, polish retention of these restorations is considered as a challenge. Purpose: The purpose of this in vitro study was to determine the effect of hydrothermal degradation, pH- cycling, and simulated tooth brushing on surface roughness, topography, and polish retention of an yttrium-stabilized monolithic zirconia. Materials and Method: In this experimental study, 64 specimens of yttria-stabilized tetragonal zirconium oxide (20×4×2mm) were prepared (ZirKonzahn, Steger, Ahrntal). The specimens were wet- polished (standard polishing), and divided into 8 groups (n=8). Four control groups were assessed in non-aged condition while in 4 experimental groups the artificially ageing was done. Different finishing and polishing procedures were performed in 8 groups. The surface roughness values including mean surface roughness (Ra) and mean height of surface roughness (Rz) was measured by a profilometer. The results were analyzed using two-way ANOVA and Tukey's HSD test (α=0.05). One representative specimen of each group was inspected under a scanning electron microscope (SEM) for assessment of surface topography. Results: The effects of surface treatments on Ra (p<.001) and Rz (p<.001) parameters were significant. Ageing had no significant effect on Ra (p=.086) and Rz (p=.067) values. Maximum Ra and Rz parameters were recorded following grinding (p<.001) and minimum values were recorded after glazing, which were significantly lower than the values in grinding group (p<.001). Polishing and glazing diminished the surface roughness (Ra) of ground zirconia similarly (p=.995). Conclusion: Aging had no significant effect on surface roughness of zirconia, irrespective of surface treatment type. Grinding yielded maximum surface roughness. Intra oral polishing yielded a surface roughness comparable to standard polishing and glazing.

Effect of Chemical and Mechanical Degradation on Surface Roughness, Topography, Gloss, and Polish Retention of Three Composites Polished with Five Polishing Systems.

Objective: Finishing and polishing (F/P) of composites is a fundamental step influencing the clinical service of restorations. The aim of this study was to evaluate the effect of different F/P systems on surface roughness, gloss, and polish retention of composite resins. Materials and Methods: One-hundred and five disc-shaped specimens (4×4 mm) were made from nanofilled, microhybrid, and microfilled composites (n=35). The specimens were divided into five subgroups (n=7) for F/P with Sof-Lex (4-step), Shofu (4-step), Cosmedent (3-step), Diacomp Composite-Pro (2-step), and Opti1Step systems. The surface roughness values (Ra and Rz) were measured before and after pH-cycling and simulated toothbrushing. Surface topography was assessed by using a scanning electron microscope (SEM) at three magnifications. For assessment of surface gloss, 45 rectangular specimens (10×8×2 mm) were fabricated from three composites (n=15) and randomly allocated to five subgroups (n=3). Surface gloss was measured before and after aging. The mean values were calculated and analyzed by two-way ANOVA, Tukey, and t-test. Level of significance was set at 0.05. Results: The composite type had no significant effect on surface roughness (P>0.05); however, the type of F/P system significantly affected it (P<0.05). The pH-cycling and simulated toothbrushing had no significant effect on gloss or polish retention of the three composites (P>0.05). Conclusion: Type of F/P system had a greater effect on surface roughness and gloss of composite resins than the type of composite.

Effect of zinc oxide nanoparticles on physical and antimicrobial properties of resin-modified glass ionomer cement.

BACKGROUND: To improve the limitations, many modifications in the resin-modified glass ionomer (RMGI) composition have been proposed. In this study, we evaluated the effect of different concentrations of zinc oxide (ZnO) nanoparticles incorporated into RMGI cement on its physical and antimicrobial properties. MATERIALS AND METHODS: In this in vitro study, ZnO nanoparticles with 0-4 wt.% concentrations were incorporated into RMGI. The following tests were carried out: (a) Antibacterial activity against Streptococcus mutans tested by disc diffusion method, (b) mechanical behavior assessment by measuring flexural strength (FS) and flexural modulus (FM), (c) micro-shear bond strength (µ-SBS), and (d) fluoride and zinc release. Data were analyzed using the statistical tests of ANOVA, t-test, and Tukey's HSD post hoc in SPSS V22. The level of significancy was 0.05. RESULTS: In the disc diffusion method, specimens with 2 wt.% ZnO nanoparticles showed the highest antimicrobial efficacy (P < 0.05). After 1 month of water storage, no significant difference was observed in FS and FM of the samples (P > 0.05). In 2 wt.% ZnO nanoparticles group, µSBS increased in the first 7 days but decreased by 17% after one month, which showed a significant difference with that of the control group. The fluoride release did no change in the ZnO nanoparticle-containing group compared with the control group at all time intervals. CONCLUSION: Incorporation of 2 wt.% ZnO nanoparticles into the RMGI cement adds antimicrobial activity to the cement without sacrificing FS and fluoride release properties, while decreased µSBS.

Effect of Er: YAG Laser on Microtensile Bond Strength of Bleached Dentin to Composite.

Introduction: In non-vital tooth bleaching, dentin is in direct contact with the bleaching agent, 1 to 3-week delay is needed to eliminate free radicals from tooth structure. The present study aimed to evaluate the effect of irradiation of Er: YAG laser on immediate microtensile bond strength of bleached dentin to composite. Methods: Sixty sounds human teeth were collected and randomly divided into 4 groups (n=15): no bleaching (NB), opalescence endo hydrogen peroxide (HP) gel bleaching, sodium perborate (SP) bleaching and laser bleaching with heydent gel (LB). The groups were divided into 3 subgroups (n=5): no surface treatment, Er: YAG laser irradiation and 10% sodium ascorbate (SA). All samples were restored and underwent microtensile bond strength testing. Statistical analysis was carried out using one-way and two-way ANOVA. Results: Bond strength in NB-SA group had a significant difference with the NB group (P<0.05) while no significant difference was noted between NB and NB-Er groups (P=0.55). Application of SA and Er: YAG laser after bleaching with SP did not enhance the bond strength (P=0.07). Conclusion: Application of SA and Er: YAG laser after HP gel bleaching significantly enhanced the bond strength. Application of Er: YAG laser after internal bleaching with HP gel could enhance the bond strength.

The Effect of Incorporation of 0.5 %wt. Silica Nanoparticles on the Micro Shear Bond Strength of a Resin Modified Glass Ionomer Cement.

STATEMENT OF THE PROBLEM: The clinical success of glass ionomer restorations depends on the strength of resin-modified glass ionomer (RMGI) cement bonding to dentin and there is limited information available regarding the bond strength of resin modified glass ionomers containing silica nanoparticles to dental structures. PURPOSE: The aim of this study was to compare the microshear bond strength (µSBS) of RMGI with and without silica (SiO2) nanoparticles to dentin of permanent teeth. MATERIALS AND METHOD: In this experimental study, the occlusal surfaces of 30 freshly extracted intact third molars were ground to expose the flat dentin and after conditioning with 20% poly acrylic acid, were randomly assigned to two main groups (n=15). The first group was filled with RMGI (Fuji II LC, GC) and the second group was filled with RMGI plus 0.5%wt. silica nanoparticles. Then, each main group was divided into three subgroups, and then stored in an incubator at 37 oC with 100% humidity for 1, 7, and 30 days. The µSBS test was performed using a universal testing machine (1 mm/min). The data were analyzed by t-test, repeated measures ANOVA and Tukey test (p< 0.05). RESULTS: There were no statistically significant differences between the mean µSBS of the groups with and without nanoparticles along the different storage periods (p> 0.05). There was significant difference in µSBS values among the three different storage periods in all the tested materials (p< 0.05). CONCLUSION: Incorporation of 0.5 %wt. silica nanoparticles did not compromise the µSBS of Fuji II LC RMGI to dentin.

Dual function of proanthocyanidins as both MMP inhibitor and crosslinker in dentin biomodification: A literature review.

Proanthocyanidin, a natural phytochemical bioactive agent, simultaneously can silence the activity of dentinal proteases and crosslink the collagen matrix; both of these phenomena would be the fundamentals for bio-stability of resin-dentin interface which is essential for a promising adhesive dentistry. This review provides an overview of the data developed by different groups of researchers and highlighted topics are proanthocyanidin chemistry, natural resources and the unique interactions between proanthocyanidincollagen and proanthocyanidin-MMPs in dentin. Besides, clinical applications of proanthocyanidin in the form of proanthocyanidin-containing adhesives, preconditioners and etchants have been reviewed. One hundred and twelve studies have been published in peer-reviewed journals from 1981 to 2017, all were comprised in this review, some of them have been actually proven to be promising from clinical point of view and others need further assessment before their adoption as clinically practicable protocols.

The effect of silica nanoparticles on the mechanical properties of fiber-reinforced composite resins.

Background. Nanotechnology has introduced many nanoparticles in recent years, which can be incorporated for mechanical improvement of dental materials. However, the existing data are widely sparse. This study investigated the reinforcing effect of silica nanoparticles when incorporated into the matrix phase of an experimental dental fiber-reinforced compositeresin (FRC) through evaluation of its flexural properties. Methods. In this experimental study FRC samples were divided into two main groups (containing two or three bundles),either of whic consisted of five subgroups with 0, 0.2, 0.5, 2 and 5 wt% of silica nanoparticles in the matrix resin (n=10 in each subgroup); a commercial FRC (Angelus, Brazil) was used as the control group (n=10). Three-point bending test was performed to evaluate the flexural strength and modulus. Thereafter, the microstructure of the fractured samples was evalu-ated using scanning electron microscopy (SEM). The results were analyzed with one-way ANOVA and HSD Tukey tests (α = 0.05). Results. The results revealed that the silica nanoparticles had a significant and positive effect on the flexural strength and modulus of FRCs (P<0.05), with no significant differences from 0.2 to 5 wt% of nanoparticles (P > 0.05) in either group with two or three bundles of fibers. Conclusion. Incorporating silica nanoparticles into the FRC resin phase resulted in improved flexural strength and modulus of the final product.

Effect of Different Surface Treatments on Microtensile Bond Strength of Composite Resin to Normal and Fluorotic Enamel After Microabrasion.

OBJECTIVES: This study aimed to determine the effect of surface treatments such as tooth reduction and extending the etching time on microtensile bond strength (µTBS) of composite resin to normal and fluorotic enamel after microabrasion. MATERIALS AND METHODS: Fifty non-carious anterior teeth were classified into two groups of normal and fluorotic (n=25) using Thylstrup and Fejerskov index (TFI=4-6). Teeth in each group were treated with five modalities as follows and restored with OptiBond FL and Z350 composite resin: 1-Etching (30 seconds), bonding, filling (B); 2-Tooth reduction (0.3mm), etching, bonding, filling (R-B); 3-Microabrasion (120 seconds), etching, bonding, filling (MB); 4- Microabrasion, tooth reduction, etching, bonding, filling (M-R-B); and 5- Microabrasion, etching (60 seconds), bonding, filling (M-2E-B). Ten experimental groups (n=5) were designed; 150 rectangular samples (10 in each group) with a cross-sectional area of 1×1mm2 were prepared for µTBS test. Failure mode was determined under a stereomicroscope and one specimen was selected from each group for scanning electron microscopy (SEM) analysis. Data were analyzed using two-way ANOVA and Tukey's test. RESULTS: The µTBS to normal enamel was higher than to fluorotic enamel in all groups except for group (R-B). The Maximum and minimum µTBS were noted in the group (normal, reduction, bonding) and (fluorosed, microabrasion, bonding), respectively. Tooth reduction increased µTBS more effectively than extended etching time after microabrasion. CONCLUSIONS: Fluorosis may reduce µTBS of composite resin to enamel. Microabrasion reduced the bond strength. Tooth reduction and extended etching time increased µTBS of composite resin to both normal and fluorotic enamel.

Effect of CO2, Nd:YAG and Er:YAG Lasers on Microtensile Bond Strength of Composite to Bleached-Enamel.

BACKGROUND: Tooth restoration immediately after bleaching is challenging due to the potential problems in achieving adequate bond strength. OBJECTIVE: The aim of this study was to evaluate the effect of surface treatment with ER:YAG, ND:YAG, CO2 lasers and 10% sodium ascorbate solution on immediate microtensile bond strength of composite resin to recently bleached enamel. MATERIALS & METHODS: Ninety sound molar teeth were randomly divided into three main groups (n:30) : NB (without bleaching), HB (bleached with 38% carbamide peroxide) and OB (bleached with Heydent bleaching gel assisted by diode laser). Each group was divided into five subgroups (n:6) : Si (without surface treatment), Er (Er:YAG laser), CO2 (CO2 laser), Nd (Nd:YAG laser) and As (Immersion in 10% sodium ascorbate solution). The bonding system was then applied and composite build-ups were constructed. The teeth were sectioned by low speed saw to obtain enamel- resin sticks and submitted to microtensile bond testing. Statistical analyses were done using two- way ANOVA, Tukey and Tamhane tests. RESULTS: µTBS of bleached teeth irradiated with ND:YAG laser was not significantly different from NB-Nd group. Microtensile bond strength of OB-Er group was higher than NB-Er and HB-Er groups. The mean µTBS of HB-CO2 group was higher than NB-CO2 group; the average µTBS of HB-As and OB-As groups was also higher than NB-As group. CONCLUSION: Use of Nd:YAG, CO2 lasers and 10% sodium ascorbate solution could improve the bond strength in home-bleached specimens. Application of ND:YAG laser on nonbleached specimens and Er:YAG laser on office-bleached specimens led to the highest µTBS in comparison to other surface treatments in each main group.

Comparing the Effects of Whey Extract and Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on Enamel Microhardness.

STATEMENT OF THE PROBLEM: With the recent focus of researches on the development of non-invasive treatment modalities, the non-invasive treatment of early carious lesions by remineralization would bring a major advance in the clinical management of these dental defects. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is considered to be effective in tooth remineralization. PURPOSE: The aim of this in-vitro study was to compare the effects of whey and CPP-ACP in increasing the enamel microhardness. MATERIALS AND METHOD: Microhardness of 30 sound human permanent premolars was measured before and after 8-minute immersion of samples in Coca-Cola. The teeth were then randomly divided into 3 groups and were immersed in artificial saliva, whey, and tooth mousse for 10 minutes. The changes of microhardness within each group and among the groups were recorded and analyzed using paired t-test. RESULTS: The microhardness increased in each group and between the groups; this increase was statistically significant (p= 0.009). CONCLUSION: The effect of whey on increasing the enamel microhardness was more than that of tooth mousse.

Effect of Nano-Tricalcium Phosphate and Nanohydroxyapatite on the Staining Susceptibility of Bleached Enamel.

Objective. This study was designed to evaluate the effect of nano-tricalcium phosphate (n-TCP) and nanohydroxyapatite (n-HAP) on prevention of restaining of enamel after dental bleaching. Methods. Forty bovine incisors were bleached with 20% carbamide peroxide for two weeks. Afterward, they were divided into five groups based on remineralization solution: no treatment (control), 10% n-TCP, 5% n-TCP, 10% n-HAP, and 5% n-HAP. Each group was daily immersed for 10 minutes in the restaining solution (tea) and for 3 minutes in the remineralization agent, respectively. This protocol was repeated for five days. Subsequently, three digital photographs (baseline, after bleaching, and after restaining) were analyzed by Adobe Photoshop software. The obtained L (∗) , a (∗) , b (∗) , and ΔE parameters were compared using ANOVA and Wilcoxon and Bonferroni tests. Results. After bleaching, there were significant changes in tooth colors (P < 0.001) while, after restaining and immersion in remineralization solutions, there were no significant differences in L (∗) , a (∗) , and b (∗) values of different groups (P > 0.05). However, ΔE of 10% TCP was significantly lower than the control (P = 0.02) while there were no significant differences between the other groups (P > 0.05). Conclusion. 10% n-TCP could significantly maintain the resultant color and reconstruct the enamel structure after bleaching.

Comparison of nano-hydroxyapatite and sodium fluoride mouthrinse for remineralization of incipient carious lesions.

OBJECTIVE: Dental caries is an infectious disease that can be prevented in several ways. The aim of this study was to compare the efficacy of sodium fluoride mouthrinse and nano- hydroxyapatite (nano-HA) for the remineralization of incipient caries. MATERIALS AND METHODS: After obtaining different concentrations of nano-HA (0-2-5-10%), 60 sound premolars fixed in acrylic blocks were coated with nail polish except for one surface. Ten teeth (control group) were stored in distilled water and the remaining 50 samples were demineralized by immersion in 13 ml of 0.1 M lactic acid and 0.2% poly acrylic acid for 48 hours. Their microhardness was then measured and compared to that of the control group. Next, the 50 test teeth were randomly divided into 5 groups of group1 (negative), group 2 (2% nano-HA), group 3 (5% nano-HA), group 4(10% nano-HA) and group 5 (0.2 NAF mouthrinse). The microhardness of the teeth was measured after 12 hours of immersion in the above-mentioned solutions. Data were analyzed using repeated measures analysis of variance (ANOVA). RESULTS: Microhardness of all samples decreased significantly after immersion in the demineralization solution and increased following immersion in nano-HA and NAF mouthrinses; however, this increase was not statistically significant (P=0.711). CONCLUSION: Nano-HA and NAF mouthrinses can greatly enhance remineralization and increase tooth microhardness.