Microhardness assessment of different commercial brands of resin composites with different degrees of translucence

Owing to improvements in its mechanical properties and to the availability of shade and translucence resources, resin composite has become one of the most widely used restorative materials in present day Dentistry. The aim of this study was to assess the relation between the surface hardness of seven different commercial brands of resin composites (Charisma, Fill Magic, Master Fill, Natural Look, Opallis, Tetric Ceram, and Z250) and the different degrees of translucence (translucid, enamel and dentin). Vickers microhardness testing revealed significant differences among the groups. Z250 was the commercial brand that showed the best performance in the hardness test. When comparing the three groups assessed within the same brand, only Master Fill and Fill Magic presented statistically significant differences among all of the different translucencies. Natural Look was the only one that showed no significant difference among any of the three groups. Charisma, Opallis, Tetric Ceram and Z250 showed significant differences among some of the tested groups. Based on the results found in this study, it was not possible to establish a relation between translucence and the microhardness of the resin composites assessed. Depending on the material assessed, however, translucence variation did affect the microhardness values of the resin composites.

Scientific article in vitro evaluation of the influence of air abrasion on detection of occlusal caries lesions in primary teeth

The purpose of this study was to assess the influence of cleaning pits and fissures with an aluminum oxide air abrasion system on the detection of occlusal caries in primary teeth using laser fluorescence (LF) and visual examination. Methods: The sample comprised 65 pit and fissure sites on extracted primary teeth suspected to be carious. The sites were submitted to 2 visual examinations (examiner JAR) and 2 LF readings (examiner TMV). Next, the occlusal surfaces were air-abraded and re-examined thereafter using both methods. The teeth were sectioned, and the histological analysis of the sites with a stereoscopic magnifying lens at X32 magnifi cation was used as the gold standard. Results: Cohen's kappa statistic for LF and visual examination were, respectively, 0.282/0.884 before and 0.896/0.905 after air abrasion. LF showed a sensitivity of 0.28 increasing to 0.49 and a specifi city of 0.50 increasing to 0.92. Visual examination showed sensitivity of 0.78 and specifi city of 0.73. Both increased after air abrasion. Conclusion: The findings suggest that cleaning pits and fissures with aluminum oxide air abrasion increased the accuracy of LF and visual examination for detection of occlusal caries in primary teeth.

Regional odontodysplasia in early childhood: A clinical and histological study

Regional odontodysplasia (RO) is a rare disorder of dental development. The affected teeth are clinically hypoplastic and hypocalcified, presenting a ghost-like appearance radiographically. The aim of this work was to report a clinical case of a child with both primary and permanent dentition affected by RO. The conducted therapy was based on a conservative approach, which consisted of follow-up clinical evaluations of the anomalous teeth. However, the endodontic treatment of the primary incisors failed. Then, the chosen option for patient rehabilitation became extraction followed by removable of prosthesis confection. The extracted teeth were processed for histological analysis. In spite of the uncertain prognosis, but taking into account the psychological aspects of the patient, a conservative approach in an attempt to maintain those viable teeth in the oral cavity should be established.

Short Communication: In vitro evaluation of the abrasiveness of acidic dentifrices.

AIM: This in vitro study evaluated the abrasiveness of acidic fluoride (F) dentifrices with different F concentrations on bovine enamel. METHODS: Enamel blocks (4.0 x 4.0 mm2, n=120) were selected according to their surface microhardness and divided into 12 groups. Slurries of dentifrices were used containing 0 (placebo), 275, 412, 550 and 1,100 ppm F (pH 4.5 or 7.0), as well as testing two commercial dentifrices (Crest, positive control, 1,100 ppm F and Colgate Baby, 500 ppm F). Enamel blocks were partially protected with an adhesive tape (control area) and then brushed by an automated toothbrushing machine (16,000 strokes). During this process, 0.4 ml of the slurries were injected every 2 mins on the enamel blocks. After toothbrushing, enamel wear was determined by profilometry. STATISTICS: Results were analyzed by ANOVA and Tukey's test (p<0.05). RESULTS: The mean values for pH in the suspensions during treatment were 6.93, 4.32, 7.56 and 8.19 for neutral experimental dentifrices, acidic experimental dentifrices, Crest and Colgate baby, respectively. The abrasiveness of the acidic dentifrices was similar (p<0.05) to the neutral ones, whereas commercial dentifrices yielded lower abrasion (p<0.05). CONCLUSION: It was concluded that a reduction of the pH of dentifrices does not increase their abrasiveness.

Indirect cytotoxicity of a 35% hydrogen peroxide bleaching gel on cultured odontoblast-like cells

The aim of this study was to evaluate the trans-enamel and trans-dentinal effects of a 35% hydrogen peroxide (H2O2) bleaching gel on odontoblast-like cells. Enamel/dentin discs obtained from bovine incisors were mounted in artificial pulp chambers (APCs). Three groups were formed: G1- 35% H2O2; G2- 35% H2O2 + halogen light application; G3- control. The treatments were repeated 5 times and the APCs were incubated for 12 h. Then, the extract was collected and applied for 24 h on the cells. Cell metabolism, total protein dosage and cell morphology were evaluated. Cell metabolism decreased by 62.09% and 61.83% in G1 and G2, respectively. The depression of cell metabolism was statistically significant when G1 and G2 were compared to G3. Total protein dosage decreased by 93.13% and 91.80% in G1 and G2, respectively. The cells in G1 and G2 exhibited significant morphological alterations after contact with the extracts. Regardless of halogen light application, the extracts caused significantly more intense cytopathic effects compared to the control group. After 5 consecutive applications of a 35% H2O2 bleaching agent, either catalyzed or not by halogen light, products of gel degradation were capable to diffuse through enamel and dentin causing toxic effects to the cells.

A comparison of the film thickness of two adhesive luting agents and the effect of thermocycling on their microTBs to feldspathic ceramic.

The aim of the present study was to evaluate the effect of thermocycling (TC) on the microtensile bond strength (microTBS) of two luting agents to feldspathic ceramic and to measure their film thickness (FT). For the microTBS test, sixteen blocks (6.4 x 6.4 x 4.8 mm) were fabricated using a feldspathic ceramic, etched with 10% hydrofluoric acid, rinsed and treated with the silane agent. The ceramic blocks were divided into two groups (n= 8): Gr1: dual-cured resin cement and Gr2: flowable resin. The luting agents were applied on the treated surfaces. Microsticks (1 +/-0. 1mm2) were prepared and stored under two conditions: dry, specimens immediately submitted to the microTBS test, and TC (6,000 cycles; 5 degrees C-55 degrees C). The microTBS was evaluated using a universal testing machine (1 mm/min). The microTBS data (MPa) were submitted to two-way ANOVA and Tukey' test (5%). For the FT test (ISO 4049), 0.05 ml of each luting agent (n=8) was pressed between two Mylar-covered glass plates (150 N) for 180 seconds and light polymerized. FT was measured using a digital paquimeter (Model 727-2001). The data (mm) were submitted to one-way ANOVA. The luting cement did not influence the microTBS results (p= 0.4467). Higher microtensile bond values were found after TC (20.5 +/- 8.6 MPa) compared to the dry condition (13.9 +/- 4. 7MPa), for both luting agents. The luting agents presented similar film thicknesses: Gr1- 0.052 +/- 0.016 mm; Gr2-0.041 +/- 0.003 mm. The luting agents presented similar film thickness and microTBS values, in dry and TC conditions and TC increased the bond strength regardless of the luting agent.

SEM-EDS and biomechanical evaluation of implants with different surface treatments: An initial study

Aim: Alterations in implant surfaces can affect periimplant bone formation and shorten the healing time. The goal of the present study was a comparative scanning electron microscopy (SEM)/energy dispersive spectrometry (EDS) and biomechanical evaluation of implants subjected to different surface treatments. Materials and Methods: Four implant surfaces were analyzed in the present study: machined commercial implants (TU); porous-surfaced commercial implants blasted with Al2O3 microspheres and acid-etched (TJA); laser beam-irradiated experimental implants (Laser) and laser beam-irradiated experimental implants with hydroxyapatite coating (HA). One sample for each surface underwent pre-surgery SEM/EDS analysis. Thirty-two implants (8 for each surface treatment) were then inserted into the tibia of 4 rabbits. After 8 weeks, the animals were euthanized and the implants retrieved by reverse torque and processed for post-surgery SEM/EDS analysis. Results: HA implants presented higher removal torque values when compared to Laser, TJA and TU groups. Post-surgery SEM micrographs clearly showed bone formation on all the examined surfaces; however, in the TU group bone covered only some areas of the implant surface, while in TJA, Laser and HA groups the entire implant surfaces were overlaid by newly formed bone. EDS analysis supported the results obtained by SEM and removal torque, showing that concentration of Ca and P increased from TU to TJA, Laser and HA implants. Conclusions: Implants with surfaces modified by laser beam with or without apatite coating showed more promising results.

Shear bond strength of orthodontic brackets bonded using halogen light and light-emitting diode at different debond times

The aim of this in vitro study was to compare the photoactivation effects of QTH (Quartz-Tungsten-Halogen) and LED (Light-Emitting Diode) on the SBS (Shear Bond Strength) of orthodontic brackets at different debond times. Seventy-two bovine lower incisors were randomly divided into two groups according to the photoactivation system used (QTH or LED). The enamel surfaces were conditioned with Transbond self-etching primer, and APC (Adhesive Pre-Coated) brackets were used in all specimens. Group I was cured with QTH for 20 s and Group II with LED for 10 s. Both groups were subdivided according to the different experimental times after bonding (immediately, 24 h and 7 days). The specimens were tested for SBS and the enamel surfaces were analyzed according to the Adhesive Remnant Index (ARI). The statistical analysis included the Tukey's test to evaluate the main effects of photoactivation and debond time on SBS. The Chi-square test was used to compare the ARI values found for each group, and no statistically significant difference was observed. The debond time of 7 days for QTH photoactivation showed statistically greater values of SBS when compared to the immediate and 24 h periods. There was no statistically significant difference between the QTH and LED groups immediately and after the 24 h period. In conclusion, bonding orthodontic brackets with LED photoactivation for 10 s is suggested because it requires a reduced clinical chair time.

Effect of thickness of indirect restoration and distance from the light-curing unit tip on the hardness of a dual-cured resin cement

This study evaluated the Knoop hardness and polymerization depth of a dual-cured resin cement, light-activated at different distances through different thicknesses of composite resin. One bovine incisor was embedded in resin and its buccal surface was flattened. Dentin was covered with PVC film where a mold (0.8-mm-thick and 5 mm diameter) was filled with cement and covered with another PVC film. Light curing (40 s) was carried out through resin discs (2, 3, 4 or 5 mm) with a halogen light positioned 0, 1, 2 or 3 mm from the resin surface. After storage, specimens were sectioned for hardness measurements (top, center, and bottom). Data were subjected to split-plot ANOVA and Tukey's test (α=0.05). The increase in resin disc thickness decreased cement hardness. The increase in the distance of the light curing tip decreased hardness at the top region. Specimens showed the lowest hardness values at the bottom, and the highest at the center. Resin cement hardness was influenced by the thickness of the indirect restoration and by the distance between the light-curing unit tip and the resin cement surface.

Assessment of color fidelity of several composite resins compared to their Vita Classical shade registration

This study compared the color fidelity of different composite resins with their registration in the Vita Classical Shade Guide. Using a prefabricated Teflon mold, 120 specimens were divided into four groups fn - 30), according to the resin tested. Three subgroups (a = 10) were prepared for each resin group; these subgroups tested enamel shade, dentin shade, and enamel and dentin shade. Three measurements were performed to verily whether the tooth shade matched that of the Vita Classical Shade Guide. The color was evaluated and the shade variations were calculated. The data were submitted to a three-way AN OVA test (time, color match, and composite type), followed by Tukey's test. It was concluded that all composite resins showed color differences in relation to the Vita Classical Shade Guide.

Developmental Disturbance of an Unerupted permanent incisor due to trauma to its predecessor

Developmental disturbances of permanent teeth can result from trauma to primary teeth because of the proximity of the root of the primary teeth to their permanent successors. We describe the case of a 14-month-old boy who was referred to the baby clinic of the School of Dentistry, Universidad Estadual Paulista, Araçatuba, Brazil, after sustaining a severe trauma that led to intrusion of the right primary central incisor. Radiographic examination 4 years after the trauma showed a developing morphological change in the germ of the permanent successor. On eruption of the permanent central incisor, a crown malformation along with enamel hypoplasia was observed. We concludethat radiographic follow-up is indicated after trauma to monitor possible sequelae in the permanent successors even before their eruption. © 2011 Canadian Dental Association.

The influence of grain size coating and shaft angulation of different diamond tips on dental cutting

Objectives: To evaluate the influence of the grain size coating and shaft angulation of ultrasonic and high-speed diamond burs on the dental cutting effectiveness. Materials and Methods: For the grain size evaluation, cavities were prepared on 40 incisors using high-speed (1092 and 1093F KG Sorensen®) and ultrasonic tips (8.2142 and 6.2142-CVDentus®). For the shaft angulation evaluation, cavities were prepared on 40 incisors using uniangulated (T1-CVDentus®) and biangulated (T1-A CVDentus®) ultrasonic tips. The cavities were bisected and examined at 50 magnification. The width and depth of cavities were measured by Leica QWin software. Kruskal-Wallis non-parametric test was used for analysis. Results: The grain size did not affect the cutting effectiveness, but the high-speed burs promoted deeper and wider cavities than the ultrasonic tips. The shaft angulation did not affect the cutting effectiveness; both the angulated and biangulated tips had greater cutting efficiency in dentin than in enamel. Conclusions: Ultrasonic tips promoted more conservative preparations and seemed promising for cavity preparation.

Effect of hydrofluoric acid etching duration on the roughness and flexural strength of a lithium disilicate-based glass ceramic

The aim of this study was to examine the effect of different acid etching times on the surface roughness and flexural strength of a lithium disilicate-based glass ceramic. Ceramic bar-shaped specimens (16 mm x 2 mm x 2 mm) were produced from ceramic blocks. All specimens were polished and sonically cleaned in distilled water. Specimens were randomly divided into 5 groups (n=15). Group A (control) no treatment. Groups B-E were etched with 4.9% hydrofluoric acid (HF) for 4 different etching periods: 20 s, 60 s, 90 s and 180 s, respectively. Etched surfaces were observed under scanning electron microscopy. Surface profilometry was used to examine the roughness of the etched ceramic surfaces, and the specimens were loaded to failure using a 3-point bending test to determine the flexural strength. Data were analyzed using one-way ANOVA and Tukey's test (α=0.05). All etching periods produced significantly rougher surfaces than the control group (p<0.05). Roughness values increased with the increase of the etching time. The mean flexural strength values were (MPa): A=417 ± 55; B=367 ± 68; C=363 ± 84; D=329 ± 70; and E=314 ± 62. HF etching significantly reduced the mean flexural strength as the etching time increased (p=0.003). In conclusion, the findings of this study showed that the increase of HF etching time affected the surface roughness and the flexural strength of a lithium disilicate-based glass ceramic, confirming the study hypothesis.

Mechanisms of action of fluoride for caries control

Fluoride was introduced into dentistry over 70 years ago, and it is now recognized as the main factor responsible for the dramatic decline in caries prevalence that has been observed worldwide. However, excessive fluoride intake during the period of tooth development can cause dental fluorosis. In order that the maximum benefits of fluoride for caries control can be achieved with the minimum risk of side effects, it is necessary to have a profound understanding of the mechanisms by which fluoride promotes caries control. In the 1980s, it was established that fluoride controls caries mainly through its topical effect. Fluoride present in low, sustained concentrations (sub-ppm range) in the oral fluids during an acidic challenge is able to absorb to the surface of the apatite crystals, inhibiting demineralization. When the pH is re-established, traces of fluoride in solution will make it highly supersaturated with respect to fluorhydroxyapatite, which will speed up the process of remineralization. The mineral formed under the nucleating action of the partially dissolved minerals will then preferentially include fluoride and exclude carbonate, rendering the enamel more resistant to future acidic challenges. Topical fluoride can also provide antimicrobial action. Fluoride concentrations as found in dental plaque have biological activity on critical virulence factors of S. mutans in vitro, such as acid production and glucan synthesis, but the in vivo implications of this are still not clear. Evidence also supports fluoride's systemic mechanism of caries inhibition in pit and fissure surfaces of permanent first molars when it is incorporated into these teeth pre-eruptively. © 2011 S. Karger AG, Basel.

Bonding all-ceramic restorations with two resins cement techniques: A clinical report of three-year follow-up

Ceramics have been widely used for esthetic and functional improvements. The resin cement is the material of choice for bonding ceramics to dental substrate and it can also dictate the final esthetic appearance and strength of the restoration. The correct use of the wide spectrum of resin luting agents available depends on the dental tooth substrate. This article presents three-year clinical results of a 41 years old female patient B.H.C complaining about her unattractive smile. Two all-ceramic crowns and two laminates veneers were placed in the maxillary incisors and cemented with a self-adhesive resin luting cement and conventional resin luting cement, respectively. After a three-year follow-up, the restorations and cement/teeth interface were clinically perfect with no chipping, fractures or discoloration. Proper use of different resin luting cements shows clinical appropriate behavior after a three-year follow-up. Self-adhesive resin luting cement may be used for cementing all-ceramic crowns with high predictability of success, mainly if there is a large dentin surface available for bonding and no enamel at the finish line. Otherwise, conventional resin luting agent should be used for achieving an adequate bonding strength to enamel.