Responses of dental pulp cells to a less invasive bleaching technique applied to adhesive restored teeth

To assess the cytotoxicity of 35% hydrogen peroxide (HP) bleaching gel applied for 15 min to sound or restored teeth with two-step self-etching adhesive systems and composite resin. Materials and Methods: Sound and restored enamel/dentin disks were stored in water for 24 h or 6 months + thermocycling. The disks were adapted to artificial pulp chambers and placed in compartments containing culture medium. Immediately after bleaching, the culture medium in contact with dentin was applied for 1 h to previously cultured odontoblast-like MDPC-23 cells. Thereafter, cell viability (MTT assay) and morphology (SEM) were assessed. Data were analyzed by two-way ANOVA and Tukey's test (a = 5%). Results: In comparison to the negative control group (no treatment), no significant cell viability reduction occurred in those groups in which sound teeth were bleached. However, a significant decrease in cell viability was observed in the adhesive-restored bleached groups compared to negative control. No significant difference among bleached groups was observed with respect to the presence of restoration and storage time. Conclusion: The application of 35% HP bleaching gel to sound teeth for 15 min does not cause toxic effects in pulp cells. When this bleaching protocol was performed in adhesive-restored teeth, a significant toxic effect occurred.

Immediate human pulp response to ethanol-wet bonding technique

To evaluate the short-term response of human pulps to ethanol-wet bonding technique. Methods Deep class V cavities were prepared on 17 sound premolars and divided into three groups. After acid-etching, the cavities from groups 1 (G1) and 2 (G2) were filled with 100% ethanol or distilled water, respectively, for 60 s before the application of Single Bond 2. In group 3 (G3, control), the cavity floor was lined with calcium hydroxide before etching and bonding. All cavities were restored with resin composite. Two teeth were used as intact control. The teeth were extracted 48 h after the clinical procedures. From each tooth serial sections were obtained and stained with haematoxylin and eosin (H/E) and Masson's trichrome. Bacteria microleakage was assessed using Brown & Brenn. All sections were blindly evaluated for five histological features. Results Mean remaining dentine thickness was 463 ± 65 μm (G1); 425 ± 184 μm (G2); and 348 ± 194 μm (G3). Similar pulp reactions followed ethanol- or water-wet bonding techniques. Slight inflammatory responses and disruption of the odontoblast layer related to the cavity floor were seen in all groups. Stained bacteria were not detected in any cavities. Normal pulp tissue was observed in G3 except for one case. Conclusions After 48 h, ethanol-wet bonding does not increase pulpal damage compared to water-wet bonding technique. Clinical significance Ethanol-wet bonding may increase resin-dentine bond durability. This study reported the in vivo response of human pulp tissue when 100% ethanol was applied previously to an etch-and-rinse simplified adhesive system.

Use of salivary biomarkers for diagnosis of periodontal disease activity: a literature review

Periodontal disease is an infectious disease characterized by the connective tissue destruction and consequent alveolar bone loss in response to plaque accumulation on the tooth surface. The clinical diagnosis of periodontal disease is based both on clinical examination involving the evaluation of probing depth and radiographic examination of alveolar bone loss but these examinations are not enough to determine the activity of the disease process. For that reason, it has been proposed to seek predictive disease markers in an attempt to assess the disease activity and so, evaluate the efficacy of the periodontal disease treatment. The aim of this review is to present recent advances in the development of proteomic, genomics and microbial biomarkers and potential clinical applications. It was concluded that periodontal treatment based on assessing the levels of salivary biomarkers emerges as a promising method in near future and will become an integral part of the evaluation of periodontal health.

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.

Dose-Response and Time-Course of a-Tocoferol Mediating the Cytoprotection Of Dental Pulp Cells Against Hydrogen Peroxide

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Responses of Dental Pulp Cells to a Less Invasive Bleaching Technique Applied to Adhesively Restored Teeth

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

Optimizing maxillary aesthetics of a severe compromised tooth through orthodontic movement and dental implants

Treatment of severe compromised tooth in the maxillary anterior area still poses great challenge to the clinicians. Several treatment modalities have been proposed to restore the function and aesthetics in teeth with advanced periodontal disease. The present study aims to report a case of traumatic injury of a left-maxillary central incisor with ridge preservation, orthodontic movement, and implant therapy. A 45-year-old woman underwent the proposed treatment for her left central incisor: basic periodontal therapy, xenogenous bone graft, and guided bone regeneration (GBR). Six months after the graft procedure, orthodontic movement by means of alignment and leveling was made and a coronal displacement of the gingival margin and vertical bone apposition could be observed after 13 months of active movement. Afterwards, a dental implant was placed followed by a connective tissue graft and immediate provisionalization of the crown. In conclusion, orthodontic movement was effective to improve the gingival tissue and alveolar bone prior to implant placement favoring the aesthetic results. Six years postoperatively, the results revealed height and width alveolar bone gain indicating that the treatment proposed was able to restore all the functional and aesthetic parameters.

Direct restorative treatment of dental erosion caused by gastroesophageal reflux disease associated with bruxism: a case report

Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder in which stomach acids are chronically regurgitated into the esophagus and oral cavity. Continual exposure of the teeth to these acids can cause severe tooth wear. Dentists are often the first healthcare professionals to diagnose dental erosion in patients with GERD. This article presents a case report of a 27-year-old male smoker with tooth wear and dentin sensitivity caused by GERD associated with bruxism. After diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow-up with counseling on dietary and smoking habits, as well as management of the gastric disorders with medication. GERD management and the dental treatment performed for the eroded dentition are described, including diagnosis, treatment planning, and restorative therapy.

Prosthetic rehabilitation of a patient with gastroesophageal reflux disease: 4-year followup

The gastroesophageal reflux disease (GERD) is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics) was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment.

Responses of human dental pulp cells after application of a low-concentration bleaching gel to enamel

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

Delayed tooth replantation following root canal filling with calcium hydroxide and MTA: Histomorphometric study in rats

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

Delayed tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline

Systemic antibiotic therapy (SAT) has usually been recommended after tooth replantation, but its actual value has been questioned. As there are no reports in the literature about its influence on tooth replantation, the aim of this study was to evaluate the influence of systemic administration of antibiotics (amoxicillin and tetracycline) at the different phases of the repair process (7, 15, 30 days) in delayed rat tooth replantation. Ninety Wistar rats (Rattus norvegicus albinus) had their maxillary right incisors extracted and bench-dried for 60 min. The dental papilla, enamel organ, pulp tissue, and root surface-adhered periodontal ligament were removed, and the teeth were replanted. The animals received no antibiotics (n = 30) or were medicated systemically with amoxicillin (n = 30) and tetracycline (n = 30), and were euthanized after 7, 15, and 30 days. Regardless of the evaluation period, the acute inflammatory infiltrate was less intense and root resorption presented smaller extent and depth in the group treated with amoxicillin. The results suggest that SAT has a positive influence on the repair process in delayed tooth replantation and that amoxicillin is an excellent treatment option.

Localized periodontal disease induced by bacterial plaque and palatal radicular groove: treatment and considerations

The palatal radicular groove is a morphological tooth defect, which act as local predisposing risk factor favoring accumulation of the bacterial plaque, permitting microbial invasion via root groove way, directly into periodontal structures. A patient diagnosed with palatal radicular groove and a localized periodontal disease was treated by procedures to control bacterial action and procedures to eliminate local predisposing risk factor. To treat the periodontal bone defect a sequelae of periodontal disease, a guided tissue regeneration technique was applied by using allograft and xenograft materials associated with a resorbable demineralized bovine cortical bone membrane. The objective of surgical regenerative procedure was to recover the periodontal tissues nearly as they were before periodontal disease destruction.

Cytogenetic instability of dental pulp stem cell lines

Human adult stem cells (hASCs) offer a potentially renewable source of cell types that are easily isolated and rapidly expanded for use in regenerative medicine and cell therapies without the complicating ethical problems that are associated with embryonic stem cells. However, the eventual therapeutic use of hASCs requires that these cells and their derivatives maintain their genomic stability. There is currently a lack of systematic studies that are aimed at characterising aberrant chromosomal changes in cultured ASCs over time. However, the presence of mosaicism and accumulation of karyotypic abnormalities within cultured cell subpopulations have been reported. To investigate cytogenetic integrity of cultured human dental stem cell (hDSC) lines, we analysed four expanded hDSC cultures using classical G banding and fluorescent in situ hybridisation (FISH) with X chromosome specific probe. Our preliminary results revealed that about 70% of the cells exhibited karyotypic abnormalities including polyploidy, aneuploidy and ring chromosomes. The heterogeneous spectrum of abnormalities indicates a high frequency of chromosomal mutations that continuously arise upon extended culture. These findings emphasise the need for the careful analysis of the cytogenetic stability of cultured hDSCs before they can be used in clinical therapies.

Influence of pulp condition on the accuracy of an electronic foramen locator in posterior teeth: an in vivo study

The aim of this study was to assess, in vivo, the accuracy of the NovApex (R) electronic foramen locator in determining working length (WL) in vital and necrotic posterior teeth. The NovApex (R) was used in 144 canals: 35 teeth with vital pulps (68 canals) and 42 teeth with necrotic pulps (76 canals). WL was measured with the NovApex (R) locator and confirmed using the radiographic method. Differences between electronic and radiographic measurements ranging between 0.0 and 0.4 millimeters were classified as acceptable; differences equal to or greater than 0.5 millimeter were considered unacceptable. Pearson's chi-square test was used to assess the influence of pulp condition on the accuracy of NovApex (R) (alpha = 0.05). Regardless of pulp condition, differences between electronic and radiographic WL measurements were acceptable in 73.61% of the canals. No statistically significant differences in accuracy were observed when comparing vital and necrotic canals (p > 0.05). There were 38 unacceptable measurements. In none of these cases was the file tip located beyond the radiographic apex; in 32, it was located short of the NovApex (R) measurement. Pulp condition had no significant effect on the accuracy of NovApex (R).