Transenamel and Transdentinal Penetration of Hydrogen Peroxide Applied to Cracked or Microabrasioned Enamel

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

Effect of fluoride gels supplemented with sodium trimetaphosphate on enamel erosion and abrasion: In vitro study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

In situ protocol for the detemination of dose-response effect of low-fluoride dentifrices on enamel remineralization

No in situ protocol has assessed the dose-response effects of fluoride dentifrices involving low-fluoride formulations. Objective: To assess the ability of an in situ remineralization model in determining dose-response effects of dentifrices containing low fluoride concentrations ([F]) on bovine enamel. Material and Methods: Volunteers wore palatal appliances containing demineralized enamel blocks and brushed their teeth and devices with the dentifrices supplied (double-blind, crossover protocol) separately for 3 and 7 days. Surface hardness (SH), integrated subsurface hardness (AKHN) and [F] in enamel were determined. Data were analyzed by ANOVA, Tukey's test and Pearson's correlation (p<0.05). Results: Dose-response relationships were verified between [F] in dentifrices and SH, AKHN and enamel [F]. Higher correlation coefficients between enamel [F] and SH and AKHN were obtained for the 3-day period. Significant differences in SH and AKHN were observed among all groups for the 3-day period, but not between 0-275, 275-550, and 550-1,100 mu g F/g dentifrices for the 7-day period, nor between 3- and 7-day periods for the 1,100 mu g F/g groups. Conclusions: Considering that the peak remineralization capacity of the conventional dentifrice (1,100 mu g F/g) was achieved in 3 days, this experimental period could be used in future studies assessing new dentifrice formulations, especially at low-fluoride concentrations.

Inhibition of tooth erosion by milk containing different fluoride concentrations: An in vitro study

Objectives: This in vitro study assessed the effect of milk containing different fluoride concentrations on tooth erosion.Methods: Bovine enamel and root dentine specimens were treated with: (1) bovine whole milk with 0 ppmF; (2) 2.5 ppm F; (3) 5 ppmF;(4) 10 ppmF (all after erosion); (5) whole milk with 0 ppm F (before erosion); (6) NaF (0.05% F, positive control, after erosion) or (7) 0.9% NaCl (negative control, after erosion). The specimens were submitted to pH cycles (4 x 90 s in soft drink) and treatments for 5 days. The specimens were immersed in the treatment solutions for 1 min(only at the first cycle each day) with further exposition to 1: 1 milk: saliva slurry for 10 min. The tooth loss was measured using a contact profilometer and statistically analysed (p < 0.05).Results: Rinsing with milk before erosive challenge significantly reduced tooth loss compared to negative control (67% and 24% reduction in dentine and enamel loss, respectively) and to milk after erosive challenge, only for dentine. The addition of fluoride to milk also reduced tooth loss compared to negative control, but with no significant differences among fluoride concentrations for enamel and dentine (mu m), respectively: 0 ppm (3.63 +/- 0.04 and 2.51 +/- 0.53), 2.5 ppm F (2.86 +/- 0.42 and 1.96 +/- 0.47), 5 ppm F (2.81 +/- 0.27 and 1.77 +/- 0.44), 10 ppm F (2.03 +/- 0.49 and 1.68 +/- 0.59). There was a negative and significant correlation between [F] and the tooth loss.Conclusions: Daily rinse with milk containing F is able to reduce both enamel and dentine erosion in vitro.Clinical significance: Since the prevalence of dental erosion is steadily increasing, rinse with milk or its derivate might be an important strategy to reduce the progression of tooth erosion. (C) 2013 Elsevier Ltd. All rights reserved.

The effect of chronic treatment with fluoride on salivary activity, tooth, and bone in spontaneously hypertensive rats (SHR)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

In situ evaluation of low-fluoride toothpastes associated to calcium glycerophosphate on enamel remineralization

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Proteins, Pathogens, and Failure at the Composite-Tooth Interface

In the United States, composites accounted for nearly 70% of the 173.2 million composite and amalgam restorations placed in 2006 (Kingman et al., 2012), and it is likely that the use of composite will continue to increase as dentists phase out dental amalgam. This trend is not, however, without consequences. The failure rate of composite restorations is double that of amalgam (Ferracane, 2013). Composite restorations accumulate more biofilm, experience more secondary decay, and require more frequent replacement. In vivo biodegradation of the adhesive bond at the composite-tooth interface is a major contributor to the cascade of events leading to restoration failure. Binding by proteins, particularly gp340, from the salivary pellicle leads to biofilm attachment, which accelerates degradation of the interfacial bond and demineralization of the tooth by recruiting the pioneer bacterium Streptococcus mutans to the surface. Bacterial production of lactic acid lowers the pH of the oral microenvironment, erodes hydroxyapatite in enamel and dentin, and promotes hydrolysis of the adhesive. Secreted esterases further hydrolyze the adhesive polymer, exposing the soft underlying collagenous dentinal matrix and allowing further infiltration by the pathogenic biofilm. Manifold approaches are being pursued to increase the longevity of composite dental restorations based on the major contributing factors responsible for degradation. The key material and biological components and the interactions involved in the destructive processes, including recent advances in understanding the structural and molecular basis of biofilm recruitment, are described in this review. Innovative strategies to mitigate these pathogenic effects and slow deterioration are discussed.

Effect of different bleaching protocols on dental enamel and composite resin

To evaluate changes in microhardness, roughness and surface morphology of dental enamel and composite resin after different tooth bleaching techniques. Material and Methods: Dental fragments from bovine incisors with composite resin restorations were submitted to different bleaching protocols: G1 – daily 8 hours application of a 10% carbamide peroxide (CP) gel during 21 days; G2: 3 applications of 15 minutes of a 38% hydrogen peroxide (H2O2) gel; G3: 38% H2O2 gel associated to irradiation with LED (470nm) during 6 minutes. The Knoop micro hardness of enamel and composite resin were evaluated at 1, 7, 14 and 21 days for G1, and after 1, 2 and 3 sessions for G2 and G3. The roughness and superficial morphology (atomic force microscopy) were evaluated before and at the end of the bleaching treatment. The data were analyzed by Mann-Whitney and Wilcoxon tests (=5%). Results: Significant reduction on enamel hardness was observed after 2 and 3 sessions for G2 and G3. For composite, the reduction occurred after 21 days for G1, and after 3 sessions for G2 and G3 (p<0.05). Significant reduction on roughness and superficial morphology were observed only for enamel of G1 group (p<0.05). Conclusion: The 10% CP gel promoted only superficial alterations on dental enamel, while the 38% H2O2 gel promoted mineral reduction of this dental tissue. All the bleaching protocols promoted reduction on hardness of composite resin.

Effect of two formulations of 10% sodium ascorbate on fracture resistance of endodontically treated tooth submitted to dental bleaching with hydrogen peroxide associated titanium dioxide nanoparticles

Purpose: This study evaluated the effect of 10% sodium ascorbate (10SA), in gel (10SAg) or aqueous solution (10SAs) formulations, on fracture resistance of endodontically treated tooth submitted to dental bleaching procedures with 15% hydrogen peroxide associated with titanium dioxide (15HP-TiO2) nanoparticles and photoactivated by LED-laser. Material and methods: Forty maxillary premolars were endodontically-treated and embedded in acrylic resin up to the cement-enamel junction. The specimens were divided into four groups (n=10): G1 (negative control): no bleaching, coronal access restored with composite resin; G2 (positive control): three dental bleaching sessions using 15HP-TiO2 and LED-laser photoactivation and restored with composite resin (positive control); G3 (10SAg): similar procedures to G2, but applied 10SA, in gel formulation, for 24 hours before restoration; G4 (10SAs): similar procedures to G3, but applied 10SA, in aqueous solution formulation. The 15HP-TiO2 was applied on buccal and lingual surfaces of the crown tooth and inside the pulp chamber and photoactivated by LED-laser. Between each bleaching session, the teeth were maintained in artificial saliva, at 37oC, for 7 days. In sequence, the teeth were submitted to fracture resistance testing using an eletromechanical machine test. The data was analyzed using Kruskal Wallis test (p = 0.05) Results: There are no differences significant among the groups in relation to fracture resistance of endodontically treated teeth (p>0.05). Conclusions: The use of 10% sodium ascorbate, in gel or aqueous solution formulations, did not interfered on the fracture resistance teeth after dental bleaching using 15HP-TiO2 and LED-laser photoactivation.

Spectrophotometric evaluation of dental bleaching under orthodontic bracket in enamel and dentin

Aware of the diffusion capacity of bleaching in the dental tissues, many orthodontists are subjecting their patients to dental bleaching during orthodontic treatment for esthetic purposes or to anticipate the exchange of esthetic restorations after the orthodontic treatment. For this purpose specific products have been developed in pre-loaded whitening trays designed to fit over and around brackets and wires, with clinical efficacy proven. Objective: The objective of this study was to evaluate, through spectrophotometric reflectance, the effectiveness of dental bleaching under orthodontic bracket. Material and Methods: Thirty-two bovine incisors crown blocks of 8 mm x 8 mm height lengths were used. Staining of tooth blocks with black tea was performed for six days. They were distributed randomly into 4 groups (1-home bleaching with bracket, 2- home bleaching without bracket, 3- office bleaching with bracket, 4 office bleaching without bracket). The color evaluation was performed (CIE L * a * b *) using color reflectance spectrophotometer. Metal brackets were bonded in groups 1 and 3. The groups 1 and 2 samples were subjected to the carbamide peroxide at 15%, 4 hours daily for 21 days. Groups 3 and 4 were subjected to 3 in-office bleaching treatment sessions, hydrogen peroxide 38%. After removal of the brackets, the second color evaluation was performed in tooth block, difference between the area under the bracket and around it, and after 7 days to verified color stability. Data analysis was performed using the paired t-test and two-way variance analysis and Tukey’s. Results: The home bleaching technique proved to be more effective compared to the office bleaching. There was a significant difference between the margin and center color values of the specimens that were subjected to bracket bonding. Conclusions: The bracket bond presence affected the effectiveness of both the home and office bleaching treatments.

Effects of probiotic fermented milk on biofilms, oral microbiota, and enamel

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Color masking of developmental enamel defects: a case series

Developmental defects involving color alteration of enamel frequently compromise the esthetic appearance of the tooth. The resin infiltration technique represents an alternative treatment for color masking of these lesions and uniformization of tooth color. This technique is considered relatively simple and microinvasive, since only a minimal portion of enamel is removed. This article illustrates the color-masking effect with resin infiltration of fluorosis and traumatic hypomineralization lesions with a case series. The final esthetic outcomes demonstrated the ability of the resin infiltrant to mask the color of white developmental defect lesions, resulting in satisfactory clinical esthetic improvements. However, in more severe cases, the color-masking effect was not complete.

Erosive cola-based drinks affect the bonding to enamel surface: an in vitro study

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

Effects of copper vapor laser irradiation (λ = 510.6 nm) on the enamel and dentine of human teeth: An ultra-structural morphologic study

Objective: A morphological and ultra-structural study of copper vapor laser (λ = 510.6 nm) effects on enamel and dentine was performed to show the effects of this radiation. Methods: A total of 15 human molars were cut in half; 15 pieces were separated for irradiation on enamel and 15 for dentine. These two groups were further divided into five experimental groups, including a control group, comprised of three half-sections each, irradiated by a CVL laser with a power of 7 W, a repetition rate of 15,000 pulses/sec and exposed at 500, 600, and 800 msec and 1 sec irradiation times with a 5-sec interval between irradiations. Results: In an ultra-structural SEM exam, we observed that on the enamel surfaces irradiated for 1 sec there was morphological alteration that consisted of catering, flaking, and melting on the surfaces. There was no alteration for the other exposure times. On the dentine teeth irradiated for 1 sec, we observed an evident ultra-structural alteration of melted tissue and loss of morphological characteristics. In the dentine group irradiated by 800 msec, we observed ablation and a partial loss of morphological characteristics. In the dentine groups irradiated by 500 and 600 msec, no alteration was observed. Conclusions: The results showed that irradiation with CVL promoted morphologic changes in the enamel as well as in the dentine and demonstrated a need for future studies in order to establish a safe protocol for further use in the odontological practice.

Evaluation of the bleached human enamel by scanning electron microscopy

Since bleaching has become a popular procedure, the effect of peroxides on dental hard tissues is of great interest in research. Purpose: The aim of this in vitro study was to perform a qualitative analysis of the human enamel after the application of in-office bleaching agents, using Scanning Electron Microscopy (SEM). Materials and Methods: Twenty intact human third molars extracted for orthodontic reasons were randomly divided into four groups (n=5) treated as follows: G1- storage in artificial saliva (control group); G2- four 30-minute applications of 35% carbamide peroxide (total exposure: 2h); G3- four 2-hour exposures to 35% carbamide peroxide (total exposure: 8h); G4- two applications of 35% hydrogen peroxide, which was light-activated with halogen lamp at 700mW/cm2 during 7min and remained in contact with enamel for 20min (total exposure: 40min). All bleaching treatments adopted in this study followed the application protocols advised by manufacturers. Evaluation of groups submitted to 35% carbamide peroxide was carried out after two time intervals (30 minutes and 2 hours per session), following the extreme situations recommended by the manufacturer. Specimens were prepared for SEM analysis performing gold sputter coating under vacuum and were examined using 15kV at 500x and 2000x magnification. Results: Morphological alterations on the enamel surface were similarly detected after bleaching with either 35% carbamide peroxide or 35% hydrogen peroxide. Surface porosities were characteristic of an erosive process that took place on human enamel. Depression areas, including the formation of craters, and exposure of enamel rods could also be detected. Conclusion: Bleaching effects on enamel morphology were randomly distributed throughout enamel surface and various degrees of enamel damage could be noticed. Clinical significance: In-office bleaching materials may adversely affect enamel morphology and therefore should be used with caution.