Composite resin color stability: influence of light sources and immersion media

Objective: This study evaluated the influence of light sources and immersion media on the color stability of a nanofilled composite resin. Material and Methods: Conventional halogen, high-power-density halogen and high-power-density light-emitting diode (LED) units were used. There were 4 immersion media: coffee, tea, Coke (R) and artificial saliva. A total of 180 specimens (10 mm x 2 mm) were prepared, immersed in artificial saliva for 24 h at 37 +/- 1 degrees C, and had their initial color measured with a spectrophotometer according to the CIELab system. Then, the specimens were immersed in the 4 media during 60 days. Data from the color change and luminosity were collected and subjected to statistical analysis by the Kruskall-Wallis test (p<0.05). For immersion time, the data were subjected to two-way ANOVA test and Fisher's test (p<0.05). Results: High-power-density LED (Delta E=1.91) promoted similar color stability of the composite resin to that of the tested halogen curing units (Jet Lite 4000 plus - Delta E=2.05; XL 3000 - Delta E=2.28). Coffee (Delta E=8.40; Delta L=-5.21) showed the highest influence on color stability of the studied composite resin. Conclusion: There was no significant difference in color stability regardless of the light sources, and coffee was the immersion medium that promoted the highest color changes on the tested composite resin.

Intrusion of teeth with class III furcation: a clinical, histologic and histometric study in dogs

Aim: To assess orthodontic intrusion effects on periodontal tissues in dogs' pre-molars with class III furcations treated with open flap debridement (OFD) or with guided tissue regeneration (GTR) associated to bone autograft (BA).Material and Methods: Class III furcations were created in the pre-molars of seven mongrel dogs. After 75 days, teeth were randomly treated with OFD or GTR/BA. After 1 month, metallic crowns were assembled on pre-molars and connected apically to mini-implants by nickel-titanium springs. Teeth were randomly assigned to orthodontic intrusion (OFD+I and GTR/BA+I) groups or no movement (OFD and GTR/BA) groups. Dogs were sacrificed after 3 months of movement and 1 month retention.Results: All class III furcations were closed or reduced to class II or I in the intrusion groups, while 50% of the lesions in non-moved teeth remained unchanged. Intruded teeth presented higher probing depth and lower gingival marginal level than non-moved teeth (p < 0.01). Clinical attachment gain was reduced in the intrusion groups by the end of retention (p < 0.05). OFD+I presented smaller soft tissue area and larger bone tissue area than other groups (p < 0.05).Conclusion: Orthodontic intrusion with anchorage via mini-implants improved the healing of class III furcation defects after OFD in dogs. GTR/BA impaired those results.

Effect of diabetes mellitus and insulin therapy on bone density around osseointegrated dental implants: a digital subtraction radiography study in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The effect of implant design on insertion torque and immediate micromotion

Objectives: To evaluate the effect of insertion torque on micromotion to a lateral force in three different implant designs. Material and methods: Thirty-six implants with identical thread design, but different cutting groove design were divided in three groups: (1) non-fluted (no cutting groove, solid screw-form); (2) fluted (901 cut at the apex, tap design); and (3) Blossomt (Patent pending) (non-fluted with engineered trimmed thread design). The implants were screwed into polyurethane foam blocks and the insertion torque was recorded after each turn of 901 by a digital torque gauge. Controlled lateral loads of 10N followed by increments of 5 up to 100N were sequentially applied by a digital force gauge on a titanium abutment. Statistical comparison was performed with two-way mixed model ANOVA that evaluated implant design group, linear effects of turns and displacement loads, and their interaction. Results: While insertion torque increased as a function of number of turns for each design, the slope and final values increased (Po0.001) progressively from the Blossomt to the fluted to the non-fluted design (M +/- standard deviation [SD] = 64.1 +/- 26.8, 139.4 +/- 17.2, and 205.23 +/- 24.3 Ncm, respectively). While a linear relationship between horizontal displacement and lateral force was observed for each design, the slope and maximal displacement increased (Po0.001) progressively from the Blossomt to the fluted to the non-fluted design (M +/- SD 530 +/- 57.7, 585.9 +/- 82.4, and 782.33 +/- 269.4 mm, respectively). There was negligible to moderate levels of association between insertion torque and lateral displacement in the Blossomt, fluted and non-fluted design groups, respectively. Conclusion: Insertion torque was reduced in implant macrodesigns that incorporated cutting edges, and lesser insertion torque was generally associated with decreased micromovement. However, insertion torque and micromotion were unrelated within implant designs, particularly for those designs showing the least insertion torque.

Effect of periodontal treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A dominant function of p38 mitogen-activated protein kinase signaling in receptor activator of nuclear factor-kappa B ligand expression and osteoclastogenesis induction by Aggregatibacter actinomycetemcomitans and Escherichia coli lipopolysaccharide

Background and Objective: Lipopolysaccharide from gram-negative bacteria is one of the microbial-associated molecular patterns that initiate the immune/inflammatory response, leading to the tissue destruction observed in periodontitis. The aim of this study was to evaluate the role of the p38 mitogen-activated protein kinase (MAPK) signaling pathway in lipopolysaccharide-induced receptor activator of nuclear factor-kappa B ligand (RANKL) expression by murine periodontal ligament cells.Material and Methods: Expression of RANKL and osteoprotegerin mRNA was studied by reverse transcription-polymerase chain reaction upon stimulation with lipopolysaccharide from Escherichia coli and Aggregatibacter actinomycetemcomitans. The biochemical inhibitor SB203580 was used to evaluate the contribution of the p38 MAPK signaling pathway to lipopolysaccharide-induced RANKL and osteoprotegerin expression. Stable cell lines expressing dominant-negative forms of MAPK kinase (MKK)-3 and MKK6 were generated to confirm the role of the p38 MAPK pathway. An osteoclastogenesis assay using a coculture model of the murine monocytic cell line RAW 264.7 was used to determine if osteoclast differentiation induced by lipopolysaccharide-stimulated periodontal ligament was correlated with RANKL expression.Results: Inhibiting p38 MAPK prior to lipopolysaccharide stimulation resulted in a significant decrease of RANKL mRNA expression. Osteoprotegerin mRNA expression was not affected by lipopolysaccharide or p38 MAPK. Lipopolysaccharide-stimulated periodontal ligament cells increased osteoclast differentiation, an effect that was completely blocked by osteoprotegerin and significantly decreased by inhibition of MKK3 and MKK6, upstream activators of p38 MAPK. Conditioned medium from murine periodontal ligament cultures did not increase osteoclast differentiation, indicating that periodontal ligament cells produced membrane-bound RANKL.Conclusion: Lipopolysaccharide resulted in a significant increase of RANKL in periodontal ligament cells. The p38 MAPK pathway is required for lipopolysaccharide-induced membrane-bound RANKL expression in these cells.

Biomechanical and histologic evaluation of non-washed resorbable blasting media and alumina-blasted/acid-etched surfaces

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Short-term induction of thrombocytopenia delays periodontal healing in rats with periodontal disease: participation of endostatin and vascular endothelial growth factor

Background and Objective:Platelets contain factors, including VEGF and endostatin, that can modulate the healing process. We evaluated the effects of severe thrombocytopenia on periodontal healing in rats and determined the contribution of VEGF and endostatin to the healing process.Material and Methods:Rats were distributed into three test groups and two control groups. Cotton ligatures were placed at the gingival margin level of the lower first molar in the test groups. Sham-operated rats and rats in one of the periodontitis groups were killed 15 days later. Rats in the remaining two periodontitis groups had the ligatures removed in order to study the spontaneous recovery from the periodontal disease 15 days later, and these rats were treated with rabbit antiplatelet serum, in order to induce thrombocytopenia, or normal rabbit serum. An additional group without ligatures received antiplatet serum in the same period.Results:After ligature removal, rats treated with normal rabbit serum showed reduced myeloperoxidase activity, decreased alveolar bone loss and increased numbers of blood vessels. Thrombocytopenia caused a delay in alveolar bone regeneration, a decrease in the number of vessels and a modest decrease in myeloperoxidase activity. In the rats with periodontitis, serum endostatin concentrations were slightly decreased and serum VEGF remained unchanged compared with sham-operated animals. After ligature removal, a significant VEGF increase and endostatin decrease were observed in the rats treated with normal rabbit serum. Thrombocytopenia led to a dramatic fall in both VEGF and endostatin concentrations.Conclusion:Thrombocytopenia leads to a delay of periodontal healing in the situation of experimental periodontitis, which might be mediated in part by a decrease in the serum concentration of VEGF and endostatin derived from the platelets. However, other factors derived from the platelets may also have contributed to a delay of periodontal healing in the rats with thrombocytopenia.

Influence of microwave disinfection on the dimensional stability of intact and relined acrylic resin denture bases

Statement of problem. Microwave irradiation has been suggested as a method to disinfect denture bases. However, the effect of microwave heating on the dimensional stability of the relined denture bases is unknown.Purpose. The purpose of this study was to evaluate the dimensional stability of intact and relined acrylic resin denture bases after microwave disinfection.Material and methods. A standard brass cast simulating an edentulous maxillary arch was machined and used to fabricate 2- and 4-mm-thick denture bases (n=200), which were processed with heat-polymerized acrylic resin (Lucitone 550). The 2-mm thick-specimens (n=160) were relined with 2 mm of autopolymerizing resin (Tokuso Rebase Fast, Ufi Gel Hard, Kooliner, or New Truliner). Distances between 5 removable pins on the standard brass cast were measured with a Nikon optical comparator, and the area (mm(2)) formed by the distance between 5 pins was calculated and served as baseline. During fabrication, the pins were transferred to the intaglio surface of the specimens. Differences between the baseline area and those subsequently determined for the specimens were used to calculate the percent dimensional changes. The intact and relined denture bases were divided into 4 groups (n=10) and evaluated after: polymerization (control group P); 1 cycle of microwave disinfection (MW); daily microwave disinfection for 7 days (control group MW7); water storage for 7 days (WS7). Microwave irradiation was performed for 6 minutes at 650 W. Data were analyzed using 2-way ANOVA followed by Tukey's test (alpha=.05).Results. Intact specimens and those relined with Kooliner and New Truliner showed increased shrinkage after 1 (P=.05, .018, and .001, respectively) and 7 (P <.001, .003, and <.001, respectively) cycles of microwave disinfection. With the exception of specimens relined with Kooliner, intact specimens showed greater shrinkage than the relined specimens after 7 cycles of microwave disinfection.Conclusions. Microwave disinfection produced increased shrinkage of intact specimens and those relined with New Truliner and Kooliner.

Effect of microwave disinfection on the hardness and adhesion of two resilient liners

Statement of problem. Microwave irradiation has been suggested for denture disinfection. However, the effect of this procedure on the hardness and bond strength between resilient liners and denture base acrylic resin is not known.Purpose. This study evaluated the effect of water storage time and microwave disinfection on the hardness and peel bond strength of 2 silicone resilient lining materials to a heat-polymerized acrylic resin.Material and methods. Acrylic resin (Lucitone 199) specimens (75 X 10 X 3 mm) were stored in water at 37 degrees C (2 or 30 days) before bonding (n = 160). The resilient lining materials (GC Reline Extra Soft and Dentusil) were bonded to the denture base and divided into the following 4 groups (n = 10): Tests performed immediately after bonding (control); specimens immersed in water (200 mL) and irradiated twice, with 650 W for 6 minutes; specimens irradiated daily for 7 total cycles of disinfection; specimens immersed in water (37 degrees C) for 7 days. Specimens were submitted to a 180-degree peel test (at a crosshead speed of 10 mm/min) and the failure values (MPa) and mode of failure were recorded. Pretreatment and posttreatment hardness measurements (Shore A) of the resilient materials were also performed. Three-way analysis of variance, followed by the Tukey HSD test, was performed (alpha=.05).Results. The analysis revealed that, for all conditions, the mean failure strengths of GC Reline Extra Soft (0.95-1.19 MPa) were significantly higher (P<.001) than those of Dentusil (0.45-0.50 MPa). The adhesion of the liners was not adversely affected by water storage time of Lucitone 199 or microwave disinfection. All peel test failures were cohesive. There was a small but significant difference (P<.001) between the pretreatment (34.33 Shore A) and posttreatment (38.69 Shore A) hardness measurements.Conclusion. Microwave disinfection did not compromise the hardness of either resilient liners or their adhesion to the denture base resin Lucitone 199.

Influence of thermal and mechanical stresses on the strength of intact and relined denture bases

Statement of problem. Denture bases may become increasingly weaker as a result of thermal stress and flexural cyclic loading. Information regarding this potential problem and its relationship to the denture base reline is limited.Purpose. This study evaluated the influence of thermal and mechanical stresses on the strength of intact and relined denture bases.Material and methods. Twenty-eight microwave-polymerized (Acron MC) intact denture bases were prepared in the shape of a 3-mm-thick maxillary denture. Additionally, fifty-six 2-mm-thick denture bases were relined with 1 mm of autopolymerizing resin (Tokuyama Rebase Fast II or New Truliner) (n = 28). Intact and relined specimens were divided into 4 groups (n = 7) as follows: without stress (control); a mechanical stress at 0.8 Hz for 10,000 cycles; 5000 thermal cycles between 5 degrees C and 55 degrees C; or a combination thermo-mechanical stress. The specimens were vertically loaded in compression with a rounded rod at 5 mm/min until failure, using a universal testing machine. Data on maximum fracture load (N), deflection at fracture (%), and fracture energy (N-mm) were analyzed by 2-way analysis of variance and Student-Newman-Keuls tests (alpha = .05).Results. The strength of the denture bases relined with New Truliner was not significantly affected by any of the experimental conditions, but comparing the control groups, New Truliner exhibited the lowest maximum fracture load values. The maximum fracture load of intact denture bases (P = .002) and those relined with Tokuyama Rebase Fast II (P = .01) showed a significant decrease after thermal stress. Additionally, cyclic loading significantly decreased the maximum fracture load (P < .001), deflection at fracture (P = .025), and fracture energy (P < .001) of intact denture bases and those relined with Tokuyama Rebase (P values of .002, .039, and .001, respectively).Conclusion. Thermal and mechanical stresses exert deleterious effects on the strength of intact and/or relined denture bases, which vary according to the relining material used.

Comparison of the occlusal vertical dimension after processing complete dentures made with lingualized balanced occlusion and conventional balanced occlusion

Statement of problem. An increase in occlusal vertical dimension (OVD) may occur after processing complete dentures. Although many factors that generate this change are known, no information is available in the dental literature regarding the effect that the occlusal scheme may have on the change in OVD.Purpose. This in vitro study compared the increase in OVD, after processing, between complete dentures with teeth arranged in lingualized balanced occlusion and conventional balanced occlusion.Material and methods. Thirty sets of complete dentures were evaluated as follows: 15 sets of complete dentures were arranged in conventional balanced occlusion (control) and 15 sets of complete dentures were arranged in lingualized balanced occlusion. All dentures were compression molded with a long polymerization cycle. The occlusal vertical dimension was measured with a micrometer (mm) before and after processing each set of dentures. Data were analyzed using an independent t test (alpha=.05).Results. The mean increase in the OVD, after processing, was 0.87 +/- 0.21 mm for the control group and 0.90 +/- 0.27 mm for the experimental group. There was no significant difference between the groups.Conclusion. After processing, dentures set in lingualized balanced occlusion showed an increase in OVD similar to those set in conventional balanced occlusion.

Hardness of heat-polymerized acrylic resins after disinfection and long-term water immersion

Statement of the problem. In selecting a disinfectant for dental prostheses, compatibility between the disinfectant and the type of denture base material must be considered to avoid adverse effects on the hardness of the acrylic resin.Purpose. This study investigated the hardness of 2 denture base resins after disinfection and long-term water immersion.Material and methods. Thirty-two disk-shaped specimens (13 mm in diameter and 8 mm thick) were fabricated from each resin (Lucitone 550 and QC-20), polished, stored in water at 37degreesC for 48 hours, and submitted to hardness tests (Vickers hardness number [VHN]) before disinfection. Disinfection methods included scrubbing with 4% chlorhexidine gluconate for 1 minute, immersion for 10 minutes in I of the tested disinfectant Solutions (n=8) (3.78% sodium perborate, 4% chlorhexidine gluconate, or 1% sodium hypochorite), and immersion in water for 3 minutes. The disinfection procedures were repeated 4 times, and 12 hardness measurements were made on each specimen. Control specimens (not disinfected) were stored in water for 56 minutes. Hardness tests (VHN) were also performed after 15, 30, 60, 90, and 120 days of storage in water. Statistical analyses of data were conducted with a repeated measures 3-way analysis of variance (ANOVA) and Tukey post-hoc test (alpha=.05).Results. Mean values +/- SD for Lucitone 550 (16.52 +/- 0.94 VHN) and QC-20 (9.61 +/- 0.62 VHN) demonstrated a significant (P<.05) decrease in hardness after disinfection, regardless of material and disinfectant solutions used (Lucitone 550: 15.25 +/- 0.74; QC-20: 8.09 +/- 0.39). However, this effect was reversed after 15 days of storage in water. Both materials exhibited a continuous increase (P<.05) in hardness values for up to 60 days of water storage, after which no significant change was observed.Conclusion. Within the limitations of this in vitro study, QC-20 and Lucitone 550 specimens exhibited significantly lower hardness values after disinfection regardless of the disinfectant solution used.

A quantitative and qualitative evaluation of reports of clinical trials published in six Brazilian dental journals indexed in the Scientific Electronic Library Online (SciELO)

Introduction: Open access publishing is becoming increasingly popular within the biomedical sciences. SciELO, the Scientific Electronic Library Online, is a digital library covering a selected collection of Brazilian scientific journals many of which provide open access to full-text articles. This library includes a number of dental journals some of which may include reports of clinical trials in English, Portuguese and/or Spanish. Thus, SciELO could play an important role as a source of evidence for dental healthcare interventions especially if it yields a sizeable number of high quality reports. Objective: The aim of this study was to identify reports of clinical trials by handsearching of dental journals that are accessible through SciELO, and to assess the overall quality of these reports. Material and methods: Electronic versions of six Brazilian dental Journals indexed in SciELO were handsearched at www.scielo.br in September 2008. Reports of clinical trials were identified and classified as controlled clinical trials (CCTs - prospective, experimental studies comparing 2 or more healthcare interventions in human beings) or randomized controlled trials (RCTs - a random allocation method is clearly reported), according to Cochrane eligibility criteria. Criteria to assess methodological quality included: method of randomization, concealment of treatment allocation, blinded outcome assessment, handling of withdrawals and losses and whether an intention-to-treat analysis had been carried out. Results: The search retrieved 33 CCTs and 43 RCTs. A majority of the reports provided no description of either the method of randomization (75.3%) or concealment of the allocation sequence (84.2%). Participants and outcome assessors were reported as blinded in only 31.2% of the reports. Withdrawals and losses were only clearly described in 6.5% of the reports and none mentioned an intention-to-treat analysis or any similar procedure. Conclusions: The results of this study indicate that a substantial number of reports of trials and systematic reviews are available in the dental journals listed in SciELO, and that these could provide valuable evidence for clinical decision making. However, it is clear that the quality of a number of these reports is of some concern and that improvement in the conduct and reporting of these trials could be achieved if authors adhered to internationally accepted guidelines, e. g. the CONSORT statement.

Effect of thermal cycling on microleakage between hard chairside relines and denture base acrylic resins

Objectives:Microleakage is a pre-stage of debonding between hard chairside relines and denture base acrylic resins. Therefore, it is important to assess them with regard to the longevity of the relined denture. This study investigated the effect of thermal cycling on the microleakage at the interface of three hard chairside reline resins and three denture base resins.Material and methods:Rectangular bars (12 mm x 3 mm x 3 mm) of Lucitone 550, Acron MC and QC 20 were made and relined with Kooliner, Tokuyama Rebase Fast II and Ufi Gel Hard, Lucitone 550, Acron MC and QC 20 resins. Specimens were divided into one control and two test groups (n = 10). In specimens of the control group, the microleakage was performed after the reline procedure. In Test Group 1, the specimens were stored for 24 h in distilled water at room temperature and in Test Group 2; the specimens were thermal cycled from 5 to 55 degrees C for 5000 cycles with a 30-s dwell time. Subsequently, all specimens were immersed in 50% silver nitrate solutions for 24 h. All specimens were sectioned longitudinally into three fractions and the lateral sections were examined (n = 20). Silver nitrate stain penetration was examined under a stereoscopic lens with x30 magnification, and the images were captured. Leica Qwin image analysis software was used to determine microleakage at the interface of the materials. Data were analysed using the Kruskal-Wallis test at a 95% level of significance.Results:For all cycles, there were no statistically significant differences between thermal cycled and non-thermal cycled groups (p > 0.05).Conclusion:It can be concluded that thermal cycling had no effect on the microleakage.