Influence of leucite content on slow crack growth of dental porcelains

Objectives. To determine the stress corrosion susceptibility coefficient, n, of seven dental porcelains (A: Ceramco I; B: Ceramco-II; C: Ceramco-III; D: d.Sign; E: Cerabien; F: Vitadur-Alpha; and G: Ultropaline) after aging in air or artificial saliva, and correlate results with leucite content (LC). Methods. Bars were fired according to manufacturers` instructions and polished before induction of cracks by a Vickers indenter (19.6 N, 20 s). Four specimens were stored in air/room temperature, and three in saliva/37 degrees C. Five indentations were made per specimen and crack lengths measured at the following times: similar to 0; 1; 3; 10; 30; 100; 300; 1000 and 3000 h. The stress corrosion coefficient n was calculated by linear regression analysis after plotting crack length as a function of time, considering that the slope of the curve was (2/(3n + 2)]. Microstructural analysis was performed to determine LC. Results. LC of the porcelains were 22% (A and B); 6% (C); 15% (D); 0% (E and F); and 13% (G). Except for porcelains A and D, all materials showed a decrease in their n values when stored in artificial saliva. However, the decrease was more pronounced for porcelains B, F, and G. Ranking of materials varied according to storage media (in air, porcelain G showed higher n compared to A, while in saliva both showed similar coefficients). No correlation was found between n values and LC in air or saliva. Significance. Storage media influenced the n value obtained for most of the materials. LC did not affect resistance to slow crack growth regardless of the test environment. (c) 2008 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Influence of pH on slow crack growth of dental porcelains

Objectives. To evaluate the effect of pH of storage medium on slow crack growth (SCG) parameters of dental porcelains. Methods. Two porcelains were selected: with (UD) and without (VM7) leucite particles, in order to assess if the microstructure would affect the response of the material to the pH variation. Disc specimens were produced following manufacturers` instructions. Specimens were stored in artificial saliva in pHs 3.5, 7.0 or 10.0 for 10 days and after that the fatigue parameters (n: SCG susceptibility coefficient and sigma(0): scaling parameter) were obtained by the dynamic fatigue test using the same pH of storage. Microstructural analysis of the materials was also performed. Results. For VM7, the values of n obtained in the different pHs were similar and varied from 29.9 to 31.2. The sigma(0) value obtained in pH 7.0 for VM7 was higher than that obtained in the other pHs, which were similar. For porcelain UD, n values obtained in pHs 7.0 and 10.0 were similar (40.8 and 39.6, respectively), and higher than that obtained in pH 3.5 (26.5). With respect to sigma(0), the value obtained for porcelain UD in pH 10.0 was lower than those obtained in pHs 3.5 and 7.0, which were similar. Significance. The effect of pH on the stress corrosion susceptibility (n) depended on the porcelain studied. While the n value of VM7 was not affected by the pH, UD presented lower n value in acid pH. For both porcelains, storage in acid or basic pH resulted in strength degradation. (C) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Stress intensity factor threshold in dental porcelains

The stress intensity factor threshold (K(IO)) is related to the stress level at which cracks start to grow stably, causing the weakening of porcelain prostheses during their use. The values of K(IO) of seven dental porcelains (with and without reinforcing leucite crystal, KAlSi(2)O(6)) stored in air (22 degrees C, 60% relative humidity) and artificial saliva (37 degrees C) were determined by measuring the crack growth velocity of radial cracks generated at the corner of Vickers indentations. The results of K(IO) were correlated with the leucite content, fracture toughness (K(Ic)), and chemical composition of the porcelains. It was observed that K(IO) increased with the increase of leucite content (only for the leucite-based porcelains) and with the increase of K(Ic). The increase in Al(2)O(3) content or the decrease in the alkali oxide (K(2)O and Na(2)O) content of the material`s glassy matrix tended to increase the K(IO) values. Storage media (air and saliva) did not significantly affect the K(IO) of porcelains tested, indicating that the control parameter of K(IO) value was not the water content of the storage media.

Effect of Test Environment and Microstructure on the Flexural Strength of Dental Porcelains

Purpose: The objective of this study was to verify the influence of test environment on the flexural strength of dental porcelains with distinct microstructures. Material and Methods: Disk-shaped specimens from three dental porcelains with distinct leucite content (VM: zero; CE: 12; NS: 22 vol%) were manufactured and tested for biaxial flexural strength in air and immersed in artificial saliva. The results were analyzed by means of two-way ANOVA and Tukey`s test (alpha = 0.05). Results: The flexural strength (MPa) obtained for ambient air and artificial saliva environments, respectively, were: 110.0 +/- 16.0 and 81.5 +/- 10.8 for VM; 51.9 +/- 4.0 and 42.0 +/- 4.7 for CE; 72.0 +/- 11.5 and 63.6 +/- 5.8 for NS. A numerical decrease in the mean flexural strength was observed for all groups when specimens were tested under artificial saliva; however, the difference was only statistically significant for VM. Conclusions: The results indicate that the effect of water immersion on the flexural strength of dental porcelains varies according to their leucite content, as only the material without leucite in its microstructure (VM) showed significant strength degradation when tested under water.

Oral and Dental Abnormalities in Barber-Say Syndrome

A previously unreported case of Barber Say syndrome is described with special attention to dental manifestations. A 7-year-old female with multiple congenital anomalies such mammary gland hypoplasia, hypertrichosis, ectropion, and redundant skin was seen at the School of Dentistry of the University of Sao Paulo. Oral examination revealed macrostomia, broad alveolar ridges, gingival fibromatosis, taurodontism, delayed tooth eruption, and malocclusion. Dental treatment included gingivoplasty and orthodontic treatment. (C) 2010 Wiley-Liss, Inc.

Gels Containing MMP Inhibitors Prevent Dental Erosion in situ

Matrix metalloproteinase (MMP) inhibition has been shown to reduce dentin caries progression, but its role in dental erosion has not yet been assessed. This study tested the hypothesis that gels containing MMP inhibitors (epigallocatechin gallate-EGCG and chlorhexidine) can prevent dental erosion. Volunteers (n = 10) wore palatal devices containing bovine dentin blocks (n = 10/group) treated for 1 min with EGCG at 10 (EGCG10) or 400 mu M (EGCG400), chlorhexidine at 0.012%, F at 1.23% (NaF), and no vehicle (placebo). Erosion was performed with Coca-Cola (R) (5 min) 4X/day during 5 days. The wear, assessed by profilometry (mean +/- SD, mu m), was significantly reduced by the gels containing MMP inhibitors (0.05 +/- 0.02(a), 0.04 +/- 0.02(a), and 0.05 +/- 0.02(a) for EGCG10, EGCG400, and chlorhexidine, respectively) when compared with NaF (0.79 +/- 0.35(b)) and placebo gels (1.77 +/- 0.35(b)) (Friedman and Dunn`s tests, p < 0.01). The use of gels delivering MMP inhibitors was shown to prevent erosion and opens a new perspective for protection against dental erosion.

The Erosive Potential of 1% Citric Acid Supplemented by Different Minerals: An In Vitro Study

Purpose: The objective of the present in vitro study was to evaluate the effect of different minerals in combination with 1% citric acid on dental erosion. Materials and Methods: Ninety enamel samples were randomly allocated to nine groups (G1. pure 1% citric acid solution [control]. G2. with 1 mM Ca: G3 with 0 047 mM F, G4. with 1 mM Fe. G5. with 1 mM P, G6 with 1 mM Ca and 0 047 mM F. G7. with 1 mM Ca and 1 mM P: G8: with 1 mM Fe and 0.047 mM F, G9. with 1 mM Ca, 1 mM P. 0 047 rnM F and 1.0 mM Fe) The samples were subjected to six pH cycles, each consisting of immersion in pure or modified 1% citric acid (1 min) followed by storage in artificial saliva (59 min) Enamel wear was assessed using profilometry. Results: Data were analysed using analysis of variance and Tukey test (P < 0 05) Enamel loss (mean +/- SD) amounted to between 0 87 +/- 0 30 and 1 74 +/- 0 74 mu m but did not significantly differ among the groups Conclusions: The modification of 1% citric acid with different minerals did not have a protective effect on enamel erosion

Emerging technologies for the prevention of dental caries. Are current methods of prevention sufficient for the high risk patient?

Fluorides and chlorhexidine are technologies that are 65 and 40 years old, respectively. This overview argues that current methods of caries prevention are not effective for the high caries risk patient. In this review examples, arguments and recommendations are provided to address the high caries risk patient that include: failure of comprehensive chemical modalities treatments to address the high caries risk patient; ecological alteration - would this be an effective approach?; and biomaterials and oral microbiome research to address the high caries risk patient.

Prevalence of dental wear among 12-year-old Brazilian adolescents using a modification of the tooth wear index

Objective. This study investigated the prevalence of dental wear in 12-year-old adolescents using a modification of the tooth wear index (TWI). The modifications were proposed in order to fit with the World Health Organization standard, thus allowing application of the index in broad epidemiological surveys. Study design: An epidemiological cross-sectional survey was performed by trained, calibrated examiners, using a modified version of the TWI. Methods: Urban elementary schools were chosen because they provide a fair representation of the city`s population in terms of socio-economic status. The sample included 295 adolescents, selected randomly and systematically. Dental wear was assessed by calibrated examiners (kappa > 0.85), using a modified version of the TWI. This modified version includes a code for teeth restored due to wear, and another code for teeth that cannot be assessed. In addition, it does not differentiate the depth of dentine involvement. Proportions and confidence intervals were used to describe the prevalence of dental wear. Mann-Whitney test was used to detect differences in the degree of dental wear between mates and females. The level of statistical significance was set at 5%. Results: In total, 24,780 dental surfaces were evaluated. Among these surfaces, 73.10% did not present dental wear, 24.10% had incipient lesions, 2.46% had moderate lesions and 0.34% had been restored. No severe lesions were detected. Tooth wear was mainly seen on the occlusal/incisal surfaces (26.55%), involving enamel or enamel-dentine, but not the secondary dentine or pulp. The prevalence of dental wear was 26.90%. Considering the different teeth, wear was present in 53.22% of incisors, 50.51% of canines, 10.17% of premolars and 10.85% of molars. The prevalence of the different degrees of dental wear was similar in mates and females (P > 0.05). Conclusion: The modified TWI seems to bean effective toot for use in broad epidemiological surveys, due to easier calibration and high reproducibility rates. (C) 2008 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.

Effect of 4% titanium tetrafluoride solution on dental erosion by a soft drink: An in situ/ex vivo study

Objective: This in situ/ex vivo study assessed the effect of titanium tetrafluoride (TiF4) on permanent human enamel subjected to erosion. Design: Ten volunteers took part in this study performed in two phases. In the first phase (ERO), they wore acrylic palatal appliances containing two enamel blocks, divided into two rows: TiF4 (F) and no-TiF4 (no-F). During the 1st day, the formation of a salivary pellicle was allowed. In the 2nd day, the TiF4 solution was applied on one row (ERO + F), whereas on the other row no treatment was performed (ERO + no-F). From 3rd until 7th day, the blocks were subjected to erosion, 4x per day. In the 2nd phase (no-ERO), the volunteers wore acrylic palatal appliances containing one enamel block, during 2 days, to assess the effect of TiF4 only (no-ERO + F). Enamel alterations were determined using profilometry (wear), microhardness (%SMHC) tests, scanning electron microscope and microprobe analysis. The %SMHC and wear were tested using ANOVA and Tukey`s post hoc tests (p < 0.05). Results: The mean of %SMHC and wear ( mu m) values ( +/- S.D.) were, respectively: ERO + F -73.32 +/- 5.16(A)/2.40 +/- 0.60(a); ERO + no-F -83.49 +/- 4.59B/1.17 +/- 0.48(b) and no-ERO + F -67.92 +/- 6.16(A)/0.21:E 0.09(c). In microscope analysis, the no-F group showed enamel with honeycomb appearance. For F groups, it was observed a surface coating with microcracks. The microprobe analysis revealed the presence of the following elements (%) in groups ERO + F, ERO + no-F and no-ERO + F, respectively: Ca (69.9, 72.5, 66.25); P (25.9, 26.5, 26.06); Ti (3.0, 0, 5.93). Conclusions: The TiF4 was unable to reduce dental erosion. (c) 2007 Elsevier Ltd. All rights reserved.

The effect of an experimental 4% TiF(4) varnish compared to NaF varnishes and 4% TiF(4) solution on dental erosion in vitro

This in vitro study assessed the effect of an experimental 4% TiF(4) varnish compared to commercial NaF and NaF/CaF(2) varnishes and 4% TiF(4) solution on enamel erosion. For this, 72 bovine enamel specimens were randomly allocated to the following treatments: NaF varnish (2.26% F), NaF/CaF(2) varnish (5.63% F), 4% TiF(4) varnish (2.45% F), F-free placebo varnish, 4% TiF(4) solution (2.45% F) and control (not treated). The varnishes were applied in a thin layer and removed after 6 h. The solution was applied to the enamel surface for 1 min. Then, the specimens were alternately de- and remineralized (6 times/day) in an artificial mouth for 5 days at 37 degrees C. Demineralization was performed with the beverage Sprite (1 min, 3 ml/min) and remineralization with artificial saliva (day: 59 min, 0.5 ml/min; during the night: 0.1 ml/min). The mean daily increment of erosion and the cumulative erosion data were tested using ANOVA and ANCOVA, respectively, followed by Tukey`s test (alpha = 0.05). The mean daily erosion increments and cumulative erosion (micrometers) were significantly less for the TiF(4) varnish (0.30 +/- 0.11/0.65 +/- 0.75) than for the NaF varnish (0.58 +/- 0.11/1.47 +/- 1.07) or the NaF/CaF(2) varnish (0.62 +/- 0.10/1.68 +/- 1.17), which in turn showed significantly less erosion than the placebo varnish (0.78 +/- 0.12/2.05 +/- 1.43), TiF(4) solution (0.86 +/- 0.11/2.05 +/- 1.49) and control (0.77 +/- 0.16/2.06 +/- 1.49). In conclusion, the TiF(4) varnish seems to be a promising treatment to reduce enamel loss under mild erosive conditions. Copyright (C) 2008 S. Karger AG, Basel.

Heat-killed Enterococcus faecalis Alters Nitric Oxide and CXCL12 Production but not CXCL8 and CCL3 Production by Cultured Human Dental Pulp Fibroblasts

Introduction: Fibroblasts are the most abundant cells in dental pulp. To investigate their capacity to produce the chemokines CCL3, CXCL8, and CXCL12 as well as nitric oxide (NO), we evaluated the production of these mediators in supernatants of cultured human dental pulp fibroblasts (HDPF) stimulated by heat-killed Enterococcus faecalis (HKEF). Methods: Primary cultures of HDPF were stimulated with medium alone or HKEF (1:1, 10:1, or 100:1 bacteria:fibroblast) for 1, 6, and 24 hours. Chemokines and NO were assessed through enzyme-linked immunosorbent assay and Griess reaction, respectively. Statistical analysis was performed by using analysis of variance and Tukey post test. Results: CCL3 was not detected, whereas constitutive CXCL8 was not affected. Production of CXCL12 was increased at 1 and 6 hours, and NO was increased at the concentration of 1:1 bacteria:fibroblast at 24 hours. Viability and proliferation assays did not reveal cell number differences. Conclusions: These findings demonstrate that heat-killed E. faecalis is able to increase production of CXCL12 and NO by HDPF. (J Endod 2010;36:91-94)

Chronic maxillary sinusitis associated with dental impression material

A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body located in the posterior lower part of the sinus and an abnormal soft tissue mass in the entire right maxillary sinus. When asked about sinusitis, the patient mentioned occasional episodes of pus taste and intermittent crises of headache lasting for one week. The patient has been edentulous for 20 years. Sinus debridement was performed and the oroantral fistula was closed. The clinical suspicion of the presence of zinc oxide-eugenol paste was confirmed by microscopical and chemical analysis. After 6 months of follow-up, the fistula continued to be closed and sinusitis did not recur. This clinical case of maxillary chronic sinusitis illustrates a different odontogenic origin.

Odontogenic keratocyst and multiple supernumerary teeth in a patient with Ehlers-Danlos syndrome - A case report and review of the literature

Ehlers-Danlos syndrome (EDS) is a hereditary disorder of the connective tissue related to collagen metabolism. Deficiency or alteration of the collagen present in the tissues results in some classic signs such as skin hyperelasticity, articular hypermobility, and vascular fragility, among others. In addition, EDS oral manifestations are rarely cited in the literature. The aim of this article is to report a rare case of a young female patient with EDS who presented supernumerary teeth and an odontogenic keratocyst. There is no report in the literature of the simultaneous occurrence of these alterations. The article further highlights the importance of EDS diagnosis in patients who need dental treatment and the due care for their assistance.

The Drop Technique: a Method to Control the Amount of Fluoride Dentifrice Used by Young Children

Purpose: The purpose of this study was to evaluate the amount of dentifrice applied to the toothbrush by school children using a liquid dentifrice (drop technique), when compared to toothpaste. Materials and Methods: A total of 178 school children (4-8 years old) from two cities in Brazil (Bauru and Bariri) participated in the present two-part crossover study. Children from Bauru received training regarding tooth-brushing techniques and use of dentifrice before data collection. In each phase, the amount of toothpaste or liquid dentifrice applied by the children to the toothbrush was measured, using a portable analytical balance (+/- 0.01 g). Data were tested by analysis of covariance (Ancova) and linear regression (p < 0.05). Results: The mean (+/- standard deviation) amounts of toothpaste and liquid dentifrice applied to the toothbrushes for children from Bauru were 0.41 +/- 0.20 g and 0.15 +/- 0.06 g, respectively. For children from Bariri, the amounts applied were and 0.48 +/- 0.24 g and 0.14 +/- 0.05 g, respectively. The amount of toothpaste applied was significantly larger than the amount of liquid dentifrice for both cities. Children from Bariri applied a significantly larger amount of toothpaste, when compared to those from Bauru. However, for the liquid dentifrice, there was no statistically significant difference between the cities. A significant correlation between the amount of toothpaste applied and the age of the children was verified, but the same was not found for the liquid dentifrice. Conclusion: The use of the drop technique reduced and standardised the amount of dentifrice applied to the toothbrush, which could reduce the risk of dental fluorosis for young children.