RESUMO
OBJECTIVES: To conduct a systematic review and meta-analysis to evaluate the risk and intensity of tooth sensitivity (TS) after topical application of desensitizers containing potassium nitrate before dental bleaching. METHODS: We searched PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE. We also surveyed gray literature without restrictions. We meta-analyzed the data using the random-effects model to compare potassium nitrate and placebo in terms of risk and intensity of TS and color change (∆SGU or ∆E). The quality of the evidence was rated using the GRADE approach. The risk of bias (RoB) of the included studies was analyzed using the Cochrane RoB tool. RESULTS: After the database screening, 24 articles remained. A significant 12% lower risk for the groups where desensitizing agents were applied (p = 0.02), with a risk ratio of 0.88 (95% CI 0.78 to 0.98). About the intensity of TS, a significant average mean difference of - 0.77 units of VAS units (95%CI - 1.34 to - 0.19; p = 0.01) in favor of the desensitizer group. In the NRS scale, a significant average mean difference of - 0.36 (95% CI - 0.61 to - 0.12; p value = 0.004) in favor of the desensitizer group. No significant difference was observed in color change (p > 0.28) in ∆SGU and ∆E. CONCLUSIONS: Although a significant reduction in the risk and intensity of TS was observed in groups treated with a potassium nitrate at some point during the bleaching, the clinical significance of this reduction is subtle and clinically questionable. Color change is not affected by the use of agents. CLINICAL RELEVANCE: The reduction in the risk and intensity of TS with the topical application of potassium nitrate-based desensitizing agents in dental bleaching is subtle and maybe clinically questionable.
Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Sensibilidade da Dentina/tratamento farmacológico , Sensibilidade da Dentina/prevenção & controle , Humanos , Peróxido de Hidrogênio , Nitratos , Compostos de PotássioRESUMO
OBJECTIVES: This randomized triple-blind clinical trial, split-mouth design, evaluated the application effect of the desensitizing gel before and after in-office bleaching on tooth sensitivity. MATERIALS AND METHODS: In one group, the desensitizing gel was applied for 10 min before the bleaching with 35% hydrogen peroxide, and then application of placebo gel after (n = 90). In the other group, the desensitizing gel was applied before and after the bleaching procedure for 10 min (n = 90). The primary outcome was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a shade guides. RESULTS: The proportion of patients that experienced pain in the side of before application was 90% (95% CI 82 to 94.6%), while the side of before and after was 93% (95% CI 86.2 to 96.9%), without significant difference between groups (OR = 0.25; 95% CI 0.005 to 2.52; p = 0.37). Pain was correlated in both groups, for the NRS scale (p < 0.0001) and the VAS scale (p < 0.0001) in all assessment periods. Significant whitening was detected, and no significant difference of color change was observed between groups (p > 0.45). CONCLUSIONS: The application of the desensitizing agent did not influence the effectiveness of bleaching, but it was not efficient in reducing the sensitivity, when applied before the procedure, or before and after. CLINICAL RELEVANCE: The use of a desensitizing gel before or after in-office bleaching does not reduce incidence or intensity of tooth sensitivity.
Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Sensibilidade da Dentina/etiologia , Sensibilidade da Dentina/prevenção & controle , Feminino , Humanos , Peróxido de Hidrogênio , Clareamento Dental/efeitos adversos , Resultado do TratamentoRESUMO
BACKGROUND: The aim of this systematic review was to evaluate the frequency of micronuclei or other DNA damage in the oral mucosa of adults that have smokeless tobacco habits compared to adults that not have these habits. MATERIAL AND METHODS: We searched PubMed, Scopus, Web of Science, LILACS, BBO and Cochrane Library and SIGLE. We also surveyed gray literature. We included only clinical trials that compare the frequency of micronuclei or other DNA damage in the oral mucosa of adults that have smokeless tobacco habits compared to adults that not have these habits. Quality assessments of the selected trials were evaluated by two independent reviewers, using the Effective Public Health Practice Project - (EPHPP) with modifications. RESULTS: After the database screening and removal of duplicates, 2574 studies were identified. After title screening, 172 studies remained, and this number was reduced to 25 after careful examination of the abstracts. The standardized mean difference of the frequency of micronuclei between groups was 1.88, with a 95% confidence interval of 1.40 to 2.36 (p < 0.00001). In all analyses heterogeneity was detected. CONCLUSIONS: Despite the heterogeneity of studies, the frequency of micronuclei was significant bigger in adults who have the smokeless tobacco habit when compared to those not have this habit. The same occurred with the frequency of binucleated cells, karyolisis and karyorrhexis.
Assuntos
Dano ao DNA/efeitos dos fármacos , Mucosa Bucal/efeitos dos fármacos , Fumar/efeitos adversos , Tabaco sem Fumaça/toxicidade , Adulto , Bases de Dados Factuais , Humanos , Testes para Micronúcleos/métodos , Saúde Pública , NicotianaRESUMO
BACKGROUND: This study compared the efficacy of ketorolac alone versus its combination with tramadol/acetaminophen for pain control after mandibular third molar surgery. MATERIAL AND METHODS: A randomized, triple-blind clinical trial was carried out with 52 patients divided into 2 groups: Group K+T+A (1 tablet of Ketorolac 10 mg plus and 1 capsule of Tramadol 37.5 mg/acetaminophen 325 mg) and Group K (1 tablet of Ketorolac 10 mg plus and 1 placebo capsule). The treatments were given 1 h before the surgery and was repeated 4 times per day, for 48 h. The difference in postoperative pain was assessed by 4 primary end-points: pain intensity (VAS 100mm, for 48 h), rescue medication, overall assessment and adverse effects. RESULTS: Significant differences in pain intensity were observed in the different times (p < 0.05). The comparison of groups in each time showed significant differences only of 9 h, with lower level of pain intensity for group K+T+A (p = 0.005). The need of analgesics was higher in Group K (p < 0.001), the need of antiemetic were greater in Group K+T+A (p < 0.0001). No significant difference between groups were observed in overall assessment. The adverse effects was higher in Group K+T+A. CONCLUSIONS: The current study showed that both ketorolac and the combination of ketorolac plus tramadol/acetaminophen showed good control of pain after the extraction of the lower third molars. Although the combination group showed lower pain at 9 h, the difference is small and not clinically relevant.
Assuntos
Acetaminofen/administração & dosagem , Analgesia , Analgésicos não Narcóticos/administração & dosagem , Analgésicos Opioides/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Cetorolaco/administração & dosagem , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Extração Dentária , Tramadol/administração & dosagem , Adolescente , Adulto , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: The study aimed to compare the tooth sensitivity (TS) and bleaching efficacy of two hydrogen peroxide gels with different pHs (acid pH [Pola Office, SDI] and the neutral pH [Pola Office+, SDI]) used for in-office bleaching. MATERIALS AND METHODS: Fifty-four patients from Brazil and Chile, with right superior incisor darker than A2, were selected for this double-blind, split-mouth randomized trial. Teeth were bleached in two sessions, with 1-week interval. Each session had three applications of 8 min each, according to the manufacturer's instructions. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easy shade spectrophotometer) methods. Participants recorded TS with 0-10 visual analog scale. Color change in shade guide units (SGU) and ΔE was analyzed by Student's t test (α = 0.05). The absolute risk and intensity of TS were evaluated by McNemar's test and Wilcoxon-paired test, respectively (α = 0.05). RESULTS: All groups achieved the same level of whitening after 30 days of clinical evaluation. The use of a neutral in-office bleaching gel significantly decreases the absolute risk of TS (28%, 95% CI 18-41) and intensity of TS when compared to the acid bleaching gel (absolute risk of 50%, 95% CI 37-63). CONCLUSION: The use of a neutral in-office bleaching agent gel produced the same whitening degree than an acid bleaching gel but with reduced risk and intensity of tooth sensitivity. CLINICAL SIGNIFICANCE: Clinicians should opt to use in-office bleaching with a neutral gel than an acid product because the former causes a significant lower risk and intensity of tooth sensitivity.
Assuntos
Sensibilidade da Dentina/induzido quimicamente , Peróxido de Hidrogênio/química , Clareadores Dentários/química , Descoloração de Dente/tratamento farmacológico , Brasil , Chile , Método Duplo-Cego , Feminino , Géis , Humanos , Concentração de Íons de Hidrogênio , Masculino , Resultado do TratamentoRESUMO
OBJECTIVE: This double-blind, split mouth randomized clinical trial aimed to assess the clinical performance of Clearfil Universal Bond Quick (CBUq) universal adhesive under different application times (no waiting and waiting) compared to Clearfil SE Bond adhesive in non-carious cervical lesions (NCCLs) over 18 months. METHODS: One hundred and eighty-three restorations were distributed randomly into three groups based on the adhesive system and waiting time: CUBq without waiting time (CUBq-NW), CUBq with a 20 s waiting time (CUBq-W), and CSE with a 20 s waiting time. After placement, restorations were evaluated after 18 months using the International Dental Federation (FDI) and United States Public Health Service (USPHS) criteria. Statistical analyses involved Friedman repeated measures analysis of variance and Wilcoxon tests, with a significance level set at 5 %. RESULTS: Over the 18-month period, no restorations were lost across the tested groups. Marginal adaptation evaluation indicated minor discrepancies in 21 restorations (8 CUBq-NW, 6 CUBq-W, and 7 CSE). There were no significant differences observed among the three groups following the 18-month clinical assessment (p > 0.05). Only two restorations showed marginal discoloration after 18 months (1 CUBq-NW and 1 CSE). CONCLUSIONS: The application of Clearfil Universal Bond Quick using either the "waiting" or "no-waiting" technique exhibited excellent clinical results in NCCLs during the 18-month follow-up period, demonstrating comparable performance to Clearfil SE Bond in all assessed outcomes. CLINICAL SIGNIFICANCE: The findings suggest that the new universal adhesive applied using the no-waiting technique demonstrates promising clinical performance when compared to conventional application methods. TRIAL REGISTRATION: ClinicalTrials.gov identifer RBR-69p7mpr.
Assuntos
Cimentos Dentários , Adesivos Dentinários , Cimentos Dentários/uso terapêutico , Resinas Compostas/química , Restauração Dentária Permanente/métodos , Cimentos de Resina/química , Boca , Colo do Dente/patologia , Adaptação Marginal DentáriaRESUMO
PURPOSE: The objective of this double-blind, split-mouth, randomized clinical trial was to evaluate the color match of a single-shade composite resin Admira Fusion X-tra in comparison with a multi-shade composite resin Admira Fusion in non-carious cervical lesion restorations (NCCLs). METHODS AND MATERIALS: One hundred and twenty restorations were performed on NCCLs with two restorative materials (n=60). After prophylaxis, the teeth were isolated with a rubber dam, and one universal adhesive was applied in the selective enamel etching strategy. For both groups, the restorations were inserted incrementally and light-cured. The values of the coordinates L*, a*, and b* in the cervical third before vs after the restorations and cervical vs middle third after the restorations were evaluated using a digital spectrophotometer after the coordinate values were used to calculate the CIEDE (ΔE00). The restorations were evaluated at baseline and after 7 days of clinical performance according to the FDI criteria. Statistical analysis was performed using the Chi-square test for all parameters. Color change was analyzed by Student t-test for paired samples (α=0.05). RESULTS: All restorations were evaluated after 7 days. Regarding the color measurement, no significant difference was observed when Admira Fusion was compared to Admira Fusion X-tra for any of the comparisons performed (p>0.05). However, the values of ΔE00 in the cervical third before vs after the restorations were higher when compared with ΔE00 observed when the cervical vs middle third after restorations were compared. All restorations received the score "clinically very good" after 7 days for all outcomes, including the subjective color match, when evaluated for FDI criterion. CONCLUSIONS: The single-shade composite resin used achieves the same color match when compared to a multi-shade composite resin after 7 days in NCCLs.
Assuntos
Resinas Compostas , Restauração Dentária Permanente , Resinas Compostas/uso terapêutico , Restauração Dentária Permanente/métodos , Seguimentos , Materiais Dentários , Cimentos de Resina , Cor , Adaptação Marginal DentáriaRESUMO
OBJECTIVES: To evaluate the effect of the different radiant exposures from a multipeak light curing unit on the physical and mechanical properties of flowable and high-viscosity bulk-fill resin-based composites (RBC). METHODS: Five flowable bulk-fill RBCs (Tetric N-Flow Bulk-fill, Ivoclar Vivadent; Filtek Bulk Fill Flow, 3M Oral Care; Opus Bulk Fill Flow APS, FGM; Admira Fusion x-base, Voco and; and SDR Plus Bulk Fill Flowable, Dentsply Sirona) and five high-viscosity bulk-fill RBCs (Tetric N-Ceram Bulk-fill, Ivoclar Vivadent; Filtek One Bulk Fill, 3M Oral Care; Opus Bulk Fill APS, FGM; Admira Fusion x-tra, Voco; and SonicFill 2, Kerr) were photo-cured using a VALO Cordless light (Ultradent) for 10, 20, and 40 seconds at an irradiance of 1200, 800, or 400 mW/cm2, resulting in the delivery of 4, 8, 12, 16, 24, 32, or 48 J/cm2. Post-gel shrinkage (Shr) was calculated using strain-gauge test. The degree of conversion (DC, %) was calculated using FTIR. Knoop hardness (KH, N/mm2) and elastic modulus (E, MPa) were measured at the top and bottom surfaces. Logarithmic regressions between the radiant exposures and mechanical properties were calculated. Radiodensity was calculated using digital radiographs. Data of Shr and radiodensity were analyzed using two-way analysis of variance (ANOVA), and the DC, KH, and E data were analyzed with two-way ANOVA using split-plot repeated measurement tests followed by the Tukey test (a = 0.05). RESULTS: Delivering higher radiant exposures produced higher Shr values (p<0.001) and higher DC values (R2=0.808-0.922; R2=0.648-0.914, p<0.001), KH (R2=0.707-0.952; R2=0.738-0.919; p<0.001), and E (R2=0.501-0.925; R2=0.823-0.919; p<0.001) values for the flowable and high-viscosity RBCs respectively. Lower KH, E and Shr were observed for the flowable bulk-fill RBCs. All bulk-fill RBCs had a radiopacity level greater than the 4-mm thick aluminum step wedge. The radiant exposure did not affect the radiopacity. CONCLUSION: The Shr, DC, KH, and E values were highly correlated to the radiant exposure delivered to the RBCs. The combination of the higher irradiance for longer exposure time that resulted in radiant exposure between 24 J/cm2 to 48 J/cm2 produced better results than delivering 400 mW/cm2 for 40 s (16 J/cm2), and 800 mW/cm2 for 20 seconds (16 J/cm2) or 1200 mW/cm2 for 10 seconds (12 J/cm2). All the bulk-fill RBCs were sufficiently radiopaque compared to 4 mm of aluminum.
Assuntos
Resinas Acrílicas , Alumínio , Resinas Compostas , Metacrilatos , Poliuretanos , Siloxanas , Viscosidade , Teste de Materiais , Polimerização , Materiais Dentários , Propriedades de SuperfícieRESUMO
OBJECTIVES: This study aimed to evaluate the adhesive properties in dentine after the application of silver diamine fluoride (SDF) on carious dentine lesions immediately and after 2 years of water storage. METHODS: 96 human molars used were subjected to artificial dentine caries production, and then randomly divided into 12 experimental groups according to 1. application of an SDF solution (carious dentine lesion without SDF treatment [control], with 12 % silver diamine fluoride [SDF 12 %] or 38 % silver diamine fluoride [SDF 38 %]); 2. Universal adhesives (Clearfil Universal Bond Quick [CUQ] and Single Bond Universal [SBU]); 3. adhesive strategy (etch-and-rinse [ER] and self-etch [SE]). After restoration, the specimens were sectioned and submitted to the microtensile bond strength test (µTBS) and energy-dispersive X-ray spectrometry analysis (SEM/EDX). All tests were performed immediately and after 2 years of water storage. Data from the µTBS were analyzed using four-way ANOVA and Tukey's test (α = 0.05). RESULTS: Only the interaction of factors 'SDF' vs 'time' was significant (p = 0.03). After 2 years of storage, the groups where SDF was applied showed higher µTBS values compared to the control group. No significant decrease in µTBS values was observed for SBU when comparing immediate and 2-year results, but a significant reduction in µTBS values was observed after 2 years for CUQ. CONCLUSION: Independent of the adhesive strategy, the use of SDF may be a promising alternative to maintain the bonding of universal adhesives to carious dentinal lesions. CLINICAL SIGNIFICANCE: This study may clarify and support clinicians regarding the longevity of resin-based restoration in caries-affected dentine treated with silver diamine fluoride.
Assuntos
Bis-Fenol A-Glicidil Metacrilato , Colagem Dentária , Cárie Dentária , Compostos de Amônio Quaternário , Compostos de Prata , Humanos , Cimentos Dentários , Suscetibilidade à Cárie Dentária , Dentina , Água/química , Teste de Materiais , Resistência à Tração , Cimentos de Resina/farmacologia , Cimentos de Resina/química , Adesivos Dentinários/farmacologia , Adesivos Dentinários/química , Fluoretos TópicosRESUMO
PURPOSE: To evaluate the effect of bur roughness on bond strength values and conditioner pattern of two-step self-etch adhesives applied on sclerotic dentin. METHODS: The roots of 48 bovine incisors were removed and the crowns were divided into four groups: the control group (CO) teeth were left untreated or the teeth were slightly roughened with coarse-, medium-, or fine-grit diamond burs. Next, the teeth were subdivided and Clearfil SE Bond (CSE) and Adper SE Bond (ASE) were applied according to the manufacturers' instructions. Composite resin (Opallis) buildups were incrementally constructed on the bonded surfaces. After storage for 24 hours in distilled water at 37°C, the teeth were sectioned into sticks (area of 0.8 mm(2)). The sticks were stressed until failure by tensile forces (0.5 mm/min). Additionally, eight bovine teeth were treated as previously described, and after adhesive application, the surface was rinsed off and examined by scanning electron microscopy to measure the relative number of open tubules (OT). Data (MPa) were analyzed by two-way analysis of variance and Tukey test (p=0.05). RESULTS: CO showed the highest bond strength values (p<0.05). As regards OT, the lowest mean was observed for CO (p<0.05) and the highest was found after application of CSE or ASE (p<0.05).
Assuntos
Colagem Dentária , Dentina Secundária/ultraestrutura , Adesivos Dentinários/química , Diamante/química , Preparo do Dente/instrumentação , Condicionamento Ácido do Dente/métodos , Adesividade , Animais , Bovinos , Resinas Compostas/química , Análise do Estresse Dentário/instrumentação , Desenho de Equipamento , Teste de Materiais , Metacrilatos/química , Microscopia Eletrônica de Varredura , Polietilenoglicóis/química , Ácidos Polimetacrílicos/química , Poliuretanos/química , Distribuição Aleatória , Cimentos de Resina/química , Estresse Mecânico , Propriedades de Superfície , Temperatura , Resistência à Tração , Fatores de Tempo , Água/químicaRESUMO
Laboratory investigations are essential models responsible for science development. However, laboratory discoveries must be confirmed in a clinical environment where many known and unknown variables and complex mechanisms are involved. Using conclusions from laboratory studies to make clinical recommendations can lead to widespread "unreliable truths" or so-called myths in any field of knowledge. These myths may increase the costs (financial and time) or even cause harm (side effects) that would be unnecessary, given that the current protocol or conduct was previously evaluated in a more complex and complete clinical setting. This article will discuss certain myths in dentin bonding that may influence clinical decision-making, bringing some principles of evidence-based practice to allow a more critical evaluation of the literature findings.
Assuntos
Dentina , Projetos de PesquisaRESUMO
OBJECTIVES: This study compared the bonding properties of dentin of three 2-step etch-and-rinse adhesives (2-ERAs) to those of three universal adhesives (UAs) applied with an etch-and-rinse strategy (ER), immediately and after 1 year of water storage. METHODS: Sixty caries-free molars were divided into 6 groups according to the adhesive systems used (n = 10). The 2-ERA systems included were: 1) Adper Single Bond 2 (SB), 2) Tetric N-Bond (TB), and 3) Ambar (AM); and the UAs systems were: 4) Single Bond Universal (SBU) 5) Tetric N-Bond Universal (TBU), and 6) Ambar Universal (AMU). The occlusal third of each tooth was removed and the adhesives were applied. After the composite build-up, specimens were sectioned and tested for microtensile bond strength (µTBS) and nanoleakage (NL) immediately and after 1 year of water storage. In situ degree of conversion (DC) was only evaluated in the immediate time. For water sorption (WS), solubility (SO), and mass change (MC) tests, 48 disk-shaped specimens were prepared (n = 8) and assessed according to ISO 4049:2009. RESULTS: UAs showed higher µTBS and lower NL values than 2-ERAs did after 1 year of water storage (p = 0.001). Regarding DC, 2-ERAs showed higher DC values than UAs (p = 0.001). Regarding WS, 2-ERAs showed higher WS values than those of UAs (p = 0.00001), except for AM and AMU. Lower WS was observed for AM than for other 2-ERAs (p = 0.00001). CONCLUSION: The use of UAs applied with the ER strategy seems to be a more effective technique for maintaining adhesion to dentin substrate than 2-ERAS. CLINICAL SIGNIFICANCE: This study may support clinicians in selecting the most adequate adhesive system to be used in ER strategy in dentin, demonstrating that UAs were more effective, considering the longevity of the resin restorations.
Assuntos
Colagem Dentária , Cimentos Dentários , Cimentos Dentários/química , Adesivos Dentinários/química , Cimentos de Resina/química , Dentina , Água/química , Resistência à Tração , Teste de Materiais , AdesivosRESUMO
OBJECTIVES: To compare the bleaching efficacy and tooth sensitivity (TS) of 4% hydrogen peroxide (HP) in adults using a continuous or fractioned protocol. METHODS AND MATERIALS: A single-blind randomized controlled trial with a parallel design was conducted. Eighty-six patients with upper canines A2 or darker were submitted to bleaching with 4% HP gel for three weeks after random allocation into the fractioned protocol (two 30-minute daily applications) or continuous protocol (single one-hour application). We evaluated the color change at baseline, weekly, and 30 days after the bleaching using Vita Classical and Vita Bleachedguide using the units of shade guides (SGU) and by spectrophotometer using CIELab 1976 (ΔEab) and CIEDE 2000 formulas (ΔE00), as well as Whiteness Index (ΔWID). We assessed the absolute risk of TS with a visual analog scale (VAS) and numeric rating scale (NRS). Color changes in each recall were compared with the Student t-test. The risk of TS was evaluated by the Chi-square test, and the intensity by Mann-Whitney test (NRS) and Student t-test (VAS). RESULTS: The mean difference for the ΔSGU Vita Classical (0.5; 95% CI: -0.5 to 1.5), ΔSGU Vita Bleachedguide (-0.4; 95% CI: -1.5 to 0.7), ΔEab (1.4; 95% CI: -0.1 to 2.9), ΔE00 (0.6; 95% CI: -0.4 to 1.6), and ΔWID (-3.2; 95% CI: -7.3 to 0.9) after three weeks of bleaching was not clinically or statistically significant (p>0.10). The absolute risk of TS was 44% (95% CI: 30-58%) and 46% (95% CI: 32-61%) in the fractioned and continuous protocols, respectively (RR=1.0; 95% CI: 0.6 to 1.5; p>0.91). CONCLUSION: A fractioned bleaching protocol with 4% HP (30 minutes twice daily) did not increase the whitening degree nor affect the risk and intensity of TS when compared with the one-hour continuous protocol.
Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Humanos , Peróxido de Hidrogênio/uso terapêutico , Clareamento Dental/métodos , Clareadores Dentários/uso terapêutico , Sensibilidade da Dentina/induzido quimicamente , Método Simples-Cego , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
PURPOSE: The objective of this study was to evaluate if the application method (tip with brush or tip without brush) and hydrogen peroxide (HP) concentration (6% or 35% self-mixing) of in-office bleaching gel influences the penetration of HP into the pulp chamber, color change, and the amount of bleaching gel used. METHODS: Forty healthy premolars were randomly divided into the following five groups (n=8): no treatment; HP6% using a tip with a brush, HP6% using a tip without a brush, HP35% using a tip with a brush, and HP35% using a tip without a brush. After treatments, the HP concentration (µg/mL) within the pulp chamber was determined using UV-Vis spectrophotometry. The color change (ΔEab, ΔE00, and ΔWID) was evaluated using a digital spectrophotometer. The amount of gel used (g) in each group was measured using a precision analytical balance. Data from each test were submitted to parametric tests (α=0.05). RESULTS: The tip with a brush resulted in a lower amount of HP inside the pulp chamber and less gel used when compared with the tip without a brush, regardless of HP concentration (p<0.05). However, regarding the tip used, although no significant difference was observed when HP35% was used (p>0.05), a higher whitening effect was observed when the 6% HP was applied without a brush as opposed to with a tip brush (p<0.05). CONCLUSIONS: The use of a tip with a brush, regardless of the in-office bleaching gel concentration (6% or 35% self-mixing), presented a lower penetration and lower volume of spent gel when compared to a tip without brush. However, the whitening effect depended on the concentration of HP used.
Assuntos
Peróxido de Hidrogênio , Clareadores Dentários , Clareamento Dental , Cor , Cavidade Pulpar , Peróxido de Hidrogênio/administração & dosagem , Espectrofotometria/métodos , Clareamento Dental/métodos , Clareadores Dentários/administração & dosagem , Dente Pré-Molar , HumanosRESUMO
OBJECTIVES: This in vitro study aimed to evaluate the bleaching efficacy (BE), hydrogen peroxide penetration into the pulp chamber (HPP), and physical-chemical properties (concentration, pH, and viscosity) of in-office bleaching gels immediately and after 1 week of mixing. METHODS AND MATERIALS: We randomly divided 49 premolars into seven groups: control (no bleaching) and the following in-office bleaching (Opalescence Boost 40%, Total Blanc One Step 35%, and Whiteness HP Blue 35%) applied at two storage times: immediately and after 1 week. We evaluated the BE using a digital spectrophotometer and the HPP through UV-Vis spectroscopy. We measured the initial concentration, pH, and viscosity using titration, a Digital pH meter and Rheometer, respectively. For statistical analysis, we used a twoway analysis of variance and Tukey and Dunnet tests (α=0.05). RESULTS: We observed higher BE and HPP for Opalescence Boost and Total Blanc One Step after 1 week of mixing than for Whiteness HP Blue (p<0.001). We observed a significantly lower initial concentration for Whiteness HP Blue 1 week after mixing compared to immediately (p=0.00001). All bleaching gels showed a decrease in pH after 1 week of mixing (p=0.00003). However, Total Blanc One Step had a lower pH at both evaluation times (p<0.001). Only Opalescence Boost maintained viscosity 1 week after mixing. CONCLUSIONS: Opalescence Boost was the only bleaching gel able to keep bleaching efficacy, with the same characteristics of permeability and physical- chemical properties after 1 week of mixing.
Assuntos
Cavidade Pulpar , Peróxido de Hidrogênio , Peróxido de Hidrogênio/uso terapêutico , Géis , ViscosidadeRESUMO
OBJECTIVES: To evaluate the absence of 2-hydroxyethyl methacrylate (HEMA) on the adhesive properties with enamel and dentin of universal adhesive systems containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP). METHODS AND MATERIALS: One hundred and twelve caries-free third molars were used to test adhesion to dentin (n=64) and enamel (n=48). For each substrate, teeth were divided into eight experimental groups: four different adhesives each using two adhesive strategies. The adhesives used were: (1) Scotchbond Universal (SBU, 3M Oral Care, St Paul, MN, USA) as a HEMA-containing universal adhesive; (2) Gluma Bond Universal (GBU, Kulzer, Hanau, Germany); (3) Solare Universal Bond (SUB, GC, Tokyo, Japan); and (4) Zipbond Universal (ZIP, SDI, Victoria, Australia) as HEMA-free universal adhesives. The adhesive strategies used were etch-and-rinse (ER) and self-etch (SE). For dentin tests, the occlusal third of the crown of all teeth was removed and an adhesive protocol was applied. After completing the restoration, specimens were sectioned into bonded sticks (0.8 mm 2) and tested for microtensile bond strength (µTBS), in situ degree of conversion (DC), and nanoleakage (NL) by scanning electron microscopy. For enamel tests, teeth were sectioned into four parts (buccal, lingual, and proximal), and an adhesive protocol was applied. After completing the restoration, the specimens were tested for their microshear bond strength (µSBS). For in situ degree of conversion (DC) and nanoleakage (NL) evaluation of enamel, the specimens were sectioned in slices to be evaluated. The data for each substrate were subjected to two-way ANOVA and Tukey's test (α=0.05) for each property evaluated. RESULTS: The SBU and ZIP adhesives showed the highest µSBS, and DC (dentin and enamel) and lower NL (dentin) values compared to GBU and SUB (p=0.001). However, SBU showed better results in terms of µTBS and µSBS (SE strategy), and DC (dentin and enamel) than ZIP. Strategy ER presented higher values of µTBS and µSBS when compared to strategy SE (p=0.001), except for SBU. CONCLUSION: The effect of the absence of HEMA in commercial universal adhesive systems on enamel and dentin adhesive properties appears to be material-dependent.
Assuntos
Colagem Dentária , Cimentos Dentários , Cimentos Dentários/uso terapêutico , Cimentos Dentários/química , Dentina , Cimentos de Resina/uso terapêutico , Cimentos de Resina/química , Metacrilatos/química , Resinas Compostas/química , Teste de Materiais , Resistência à Tração , Adesivos Dentinários/químicaRESUMO
OBJECTIVES: To evaluate the 5-year clinical performance of two-step etch-and-rinse adhesives in noncarious cervical lesions (NCCL). METHODS AND MATERIALS: The sample comprised 35 adults with at least two similar-sized NCCL. Seventy restorations were placed, according to one of the following groups: Adper Single Bond 2 (SB) and Ambar (AM). The restorations were placed incrementally using a resin composite (Opallis). The restorations were evaluated at baseline and after 6 and 18 months and 5 years using some items of the FDI criteria. The differences in the ratings of the two materials after 6 months, 18 months, and 5 years were performed with Friedman repeated measures ANOVA by rank and McNemar test for significance in each pair (α=0.05). RESULTS: Five patients did not attend the 60-month recall. No significant differences were observed between the materials for any criteria evaluated. Twenty-one restorations failed (12 for SB and 9 for AM) after 60 months. Thus, the retention rate for SB at 60 months were 55.6% for SB and 71% for AM (p=0.32). After 60 months, 12 restorations (6 for SB and 6 AM) showed some loss of marginal adaptation (p=1.0). Slight marginal discoloration was observed in 10 restorations (6 for SB and 4 AM; p=0.91). Five restorations (2 for SB and 3 for AM) showed recurrences of caries (p=1.0). CONCLUSIONS: Both two-step etch-and-rinse adhesives-Adper Single Bond 2, a polyalkenoic acid-containing adhesive, and Ambar, a 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing adhesive-showed acceptable clinical performance after 60 months.
Assuntos
Cárie Dentária , Adesivos Dentinários , Adesivos , Adulto , Cor , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Cárie Dentária/patologia , Adaptação Marginal Dentária , Restauração Dentária Permanente/métodos , Adesivos Dentinários/química , Adesivos Dentinários/uso terapêutico , Humanos , Cimentos de Resina/química , Cimentos de Resina/uso terapêutico , Colo do Dente/patologiaRESUMO
PURPOSE: To evaluate the effect of application time and viscosity of meta-phosphoric acid (MPA) and ortho-phosphoric acid (OPA) on the push-out resin-dentin bond strength (PBS) and nanoleakage (NL) at the adhesive-root dentin interface. METHODS AND MATERIALS: Ninety-six roots of premolars were endodontically prepared and randomly assigned into groups according to the (i) acid (OPA and MPA), (ii) viscosity (gel and liquid), and (iii) application time (7 and 15 seconds). Fiber posts were cemented to the roots, which were then transversally sectioned into serial slices. The slices (cervical, medium, and apical) were subjected to PBS or NL. Analysis of the dentin etching pattern was performed using scanning electron microscopy (SEM). The PBS (MPa) and NL (%) data were subjected to three-way repeated-measures analysis of variance (ANOVA) and Tukey's test (α=0.05). RESULTS: The cross-product interaction was significant for both PBS and NL (p<0.001). No significant difference in the PBS was observed with the use of OPA compared to MPA (p>0.05). Higher PBS values were observed in the groups etched for 15 seconds compared to 7 seconds, regardless of the acid, viscosity, or root third (p<0.05). Lower NL was observed for MPA etching when compared to OPA etching (p<0.05), and these values were not affected by increasing the application time or acid viscosity (p>0.05). A more pronounced etching pattern was observed with OPA than MPA regardless of the acid viscosity. CONCLUSION: The use of 40% meta-phosphoric acid promoted adequate bond strength without increasing dentin demineralization or void spaces in the hybrid layer.
Assuntos
Colagem Dentária , Técnica para Retentor Intrarradicular , Cavidade Pulpar , Dentina , Adesivos Dentinários/química , Teste de Materiais , Ácidos Fosfóricos/farmacologia , Cimentos de Resina/química , ViscosidadeRESUMO
OBJECTIVE: To compare the efficacy, color stability, and tooth sensitivity (TS) of combined bleaching, using a modified protocol with at-home bleaching. METHODS: Eighty participants were randomized into two groups. In the combined group, a desensitizing gel was applied (10 minutes) prior to in-office bleaching (35% hydrogen peroxide (H2O2), 2×15 minute applications) and at-home bleaching (4% H2O2, 2×30 minutes for 21 days) started the next day. In the at-home group, only the at-home bleaching was performed. Color was recorded at the beginning and postbleaching with two scales (VITA Classical and Bleachedguide) and Easyshade spectrophotometer. The TS was recorded daily with a 0-10 visual analogue scale (VAS) and five-point numeric rating scale (NRS). RESULTS: A 40% lower risk (RR=1.4; 95% CI 1.1-1.9) was observed in the at-home group. Higher color change and intensity of TS [mean difference 2.3 (95% CI 1.3-3.3) in the VAS] was observed in the first week for the combined group. After the end of the protocol, a bleaching degree was detected for both groups, with no significant difference between both groups (p>0.05). CONCLUSION: The combined group produced a slightly higher degree of color change than at-home bleaching but with a higher risk and intensity of TS.
Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Humanos , Peróxido de Hidrogênio/uso terapêutico , Método Simples-Cego , Clareamento Dental/métodos , Clareadores Dentários/uso terapêutico , Resultado do TratamentoRESUMO
OBJECTIVES: This study evaluated the influence of irradiance/exposure time on the Knoop hardness (KHN) and polymer cross-linking density (PCLD), as well as microtensile bond strength (µTBS), nanoleakage (NL), and in situ degree of conversion (DC) of universal adhesives. METHODS AND MATERIALS: Two universal adhesive systems, Clearfil Universal Bond Quick (CUQ) and Scotchbond Universal Adhesive (SBU), were light-cured using various irradiance/exposure times: 1400 mW/cm2 for 5 s (1400*5); 1400 mW/cm2 for 10 s (1400*10); 3200 mW/cm2 for 5 s (3200*5); and 3200 mW/cm2 for 10 s (3200*10). Adhesive disks from each group were used to measure PCLD by KHN. One hundred and twenty-eight human molars were randomly assigned to 16 groups according to the following variables: adhesive system vs adhesive strategies vs radiance/exposure times. After restoration, specimens were sectioned into resin-dentin sticks and tested for µTBS, NL, and DC. The data from PCLD (%), KHN, µTBS (MPa), NL (%), and DC (%) data were subjected to ANOVA and Tukey's test (α=0.05). RESULTS: Significant reductions in KHN, µTBS, and DC (p=0.00001) values and an increase in NL and PCLD (p=0.00001) values were observed for 3200*10 when compared with other groups. Higher KHN, µTBS, and DC (p=0.000001) values were observed for 3200*5 in comparison with the other groups. The 1400*5 (7 J/cm2) and 1400*10 (14 J/cm2) groups showed intermediate values (p=0.000001). CONCLUSION: Although similar results in terms of hardness, polymer cross-linking density and nanoleakage were observed when 5 seconds at 3200 mW/cm2 and 10 seconds at 1400 mW/cm2 groups were compared, the use of higher irradiance (3200 mW/cm2) for only 5 seconds showed better results in terms of bond strength and degree of conversion for both universal adhesives to dentin. The prolonged exposure time (10 seconds) at the higher irradiance (3200 mW/cm2) showed the worst results.