Dentin microhardness during and after whitening treatments

Objective: This in vitro study aimed to evaluate the effect of bleaching agents on dentin microhardness during and after bleaching. Method and materials: Specimens were randomly assigned to seven groups (n = 15): Nite White Excel 2 Z [NW] 10% and 22%; Rembrandt [REM] 10% and 22%; Opalescence [OPA] 10% and 20%; and a placebo agent. The 42-day whitening treatment consisted of daily application of the agents to the dentin surfaces for 8 hours, followed by immersion in artificial saliva for 16 hours. After the bleaching treatment, specimens were kept immersed in artificial saliva for 14 days. Microhardness was measured at baseline, 8 hours, and 7, 14, 21, 28, 35, and 42 days of bleaching and during the posttreatment period (7 and 14 days). Results: The analysis of variance for split-plot showed a significant effect on the interaction between bleaching agent and time. Tukey's test and regression analyses revealed that during the bleaching period, the agents NW 10%, NW 22%, and OPA 20%, which did not differ from each other, did not alter dentin microhardness, showing constant microhardness values. There were no differences among REM 10%, REM 22%, and OPA 10%, which showed significant reductions in microhardness after day 14 compared to other agents. After bleaching procedures, there was an increase in dentin microhardness for all groups. Conclusion: Throughout the bleaching treatment, depending on the agent applied, dentin showed a transitory decrease in microhardness values. In the posttreatment period, artificial saliva presented a remineralizing effect on the bleached surfaces.

Effect of surface and heat treatments on the biaxial flexural strength and phase transformation of a Y-TZP ceramic

To evaluate the effect of grinding and airborne-particle abrasion on the biaxial flexural strength (BFS) and phase transformation of a Y-TZP ceramic, and examine whether sintering the veneering porcelain renders the previous heat treatment recommended by the manufacturer unnecessary. Materials and Methods: Lava zirconia specimens (N = 108) were obtained with the following dimensions: 14.0 mm diameter × 1.3 mm thickness (n = 36) and 14.0 mm × 1.6 mm (n = 72). The thicker specimens were ground with diamond burs under irrigation and received (heat-treated groups) or not (non-heat-treated groups) a heat treatment (1000°C for 30 min) prior to the four firing cycles applied to simulate the sintering of the veneering porcelain. All specimens were air abraded as follows (n = 12): 1) 30-μm silica-modified Al2O3 particles (Rocatec Soft); 2) 110-μm silica-modified Al2O3 particles (Rocatec Plus); and 3) 120-μm Al2O3 particles, followed by Rocatec Plus. Three specimens of each group were analyzed by x-ray diffraction (XRD) to assess the monoclinic phase content (%). The BFS test was performed in a mechanical testing machine (Instron 8874). Data (MPa) were analyzed by two-way ANOVA (grinding × airborne-particle abrasion and heat treatment × airborne-particle abrasion) and Tukey's post-hoc test (α = 0.05). The strength reliability was analyzed using the Weibull distribution. Results: Grinding significantly decreased the BFS of the non-heat-treated groups (p < 0.01). Within the ground groups, the previous heat treatment did not influence the BFS (p > 0.05). Air abrasion only influenced the BFS of the ground/heat-treated groups (p < 0.01). For the non-heat-treated groups, the grinding did not decrease the Weibull modulus (m), but it did decrease the characteristic strength (σ0). For Rocatec Soft and 120-μm Al2O3 particles + Rocatec Plus, the heat-treated groups presented lower m and higher σ0 than the ground/non-heat-treated groups. The independent variables did not seem to influence phase transformation. Air-abraded surfaces presented higher monoclinic zirconia content than the as-sintered and ground surfaces, which exhibited similar content. Conclusion: Even under irrigation, grinding compromised the Y-TZP ceramic strength. The sintering of the veneering porcelain rendered the previous heat treatment recommended by the manufacturer unnecessary. Airborneparticle abrasion influenced the strength of heat-treated zirconia.

Effect of surface and heat treatments on the biaxial flexural strength and phase transformation of a y-tzp ceramic

To evaluate the effect of grinding and airborne-particle abrasion on the biaxial flexural strength (BFS) and phase transformation of a Y-TZP ceramic, and examine whether sintering the veneering porcelain renders the previous heat treatment recommended by the manufacturer unnecessary. Materials and Methods: Lava zirconia specimens (N = 108) were obtained with the following dimensions: 14.0 mm diameter × 1.3 mm thickness (n = 36) and 14.0 mm × 1.6 mm (n = 72). The thicker specimens were ground with diamond burs under irrigation and received (heat-treated groups) or not (non-heat-treated groups) a heat treatment (1000°C for 30 min) prior to the four firing cycles applied to simulate the sintering of the veneering porcelain. All specimens were air abraded as follows (n = 12): 1) 30-μm silica-modified Al2O3 particles (Rocatec Soft); 2) 110-μm silica-modified Al2O3 particles (Rocatec Plus); and 3) 120-μm Al2O3 particles, followed by Rocatec Plus. Three specimens of each group were analyzed by x-ray diffraction (XRD) to assess the monoclinic phase content (%). The BFS test was performed in a mechanical testing machine (Instron 8874). Data (MPa) were analyzed by two-way ANOVA (grinding × airborne-particle abrasion and heat treatment × airborne-particle abrasion) and Tukey's post-hoc test (α = 0.05). The strength reliability was analyzed using the Weibull distribution. Results: Grinding significantly decreased the BFS of the non-heat-treated groups (p < 0.01). Within the ground groups, the previous heat treatment did not influence the BFS (p > 0.05). Air abrasion only influenced the BFS of the ground/heat-treated groups (p < 0.01). For the non-heat-treated groups, the grinding did not decrease the Weibull modulus (m), but it did decrease the characteristic strength (σ0). For Rocatec Soft and 120-μm Al2O3 particles + Rocatec Plus, the heat-treated groups presented lower m and higher σ0 than the ground/non-heat-treated groups. The independent variables did not seem to influence phase transformation. Air-abraded surfaces presented higher monoclinic zirconia content than the as-sintered and ground surfaces, which exhibited similar content. Conclusion: Even under irrigation, grinding compromised the Y-TZP ceramic strength. The sintering of the veneering porcelain rendered the previous heat treatment recommended by the manufacturer unnecessary. Airborneparticle abrasion influenced the strength of heat-treated zirconia.

Effect of surface treatments on the shear bond strength of luting cements to Y-TZP ceramic

Statement of problem Because zirconia is a glass-free material, alternative surface treatments such as airborne-particle abrasion or silica coating should be used for long-term bonding. However, these surface treatments in combination with different bonding agents and luting cements have not yet been studied. Purpose The purpose of the study was to evaluate the effect of surface treatments on the shear bond strength (SBS) of luting cements to Y-TZP ceramic. Material and methods Zirconia disks (N=240) were airborne-particle abraded with the following particles (n=48): 50 μm Al2O3; 120 μm Al2O3; 30 μm silica-coated Al2O3 (Rocatec Soft); 120 μm Al2O3+110 μm silica-coated Al2O3 (Rocatec Plus); and Rocatec Plus. After silanization of the zirconia surface, composite resin disks were bonded with (n=12) RelyX Luting 2; RelyX ARC; RelyX U100; and Panavia F. The bonded specimens were thermocycled (10 000 cycles) and tested for SBS. Failure mode was determined with a stereomicroscope (×20). The morphology and elemental composition of airborne-particle abraded surfaces were evaluated with scanning electron microscopy (×500) and energy-dispersive x-ray spectroscopy (×50). Results Surface treatments, cements, and their interaction were significant (P<.001). For RelyX ARC, Rocatec Soft and Rocatec Plus provided the highest SBS. In general, surface treatments did not influence the SBS of RelyX U100 and Panavia F. Regardless of the cement, no significant difference was found between 50 μm and 120 μm Al2O3 particles, between Rocatec Soft and Rocatec Plus, or between Rocatec Plus and 120 μm Al2O3 particles+Rocatec Plus. All groups showed adhesive failures. Different particle sizes provided differences in morphological patterns. The elemental composition comprised Al and Al/Si for alumina and silica-abraded zirconia. Conclusions Particle size did not influence the SBS of the groups abraded exclusively with alumina or silica-coated particles. RelyX ARC was more surface-treatment dependent than RelyX U100 or Panavia F.

Influence of standard load micro and nanopatterned in surface roughness of bleached teeth and submitted to different surface treatments?

The aim of this study was evaluate the dental enamel after whitening treatment with Opalescence Boost PF® 38%, correlating the structural alterations in the surface of the enamel with its respective pH and verify if whitened teeth submitted to different finishing and polishing techniques show similar surface texture to healthy teeth (control group). Sixty premolars were divided in 6 groups (n = 10), which had been immersed in artificial saliva during all the experiment. Protocol whitening was performed according to the manufacturer recommendations, and then the specimens were submitted to different polishing technique with Sof-Lex Pop On® disks, Flex Diamond® felt disks using two different micrometric polishing pastes (Enamelize® and Diamond Polish®) and two nanometric polishing pastes (Lummina-E Diamond and Lummina-E Alumina), according to the groups. Representative specimens were analyzed in scanning electronic microscopy (SEM). Whitening gel used in this experiment had modified the morphologic aspect of the enamel surface. It was found that two nanometric polishing pastes (G5 and G6) promoted a less rough surface compared to control group even after the whitening process.

Marginal adaptation of Class V restorations with current generation dentin-bonding agents: effect of different dentin surface treatments.

This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with FiltekTM Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

Filling of simulated lateral canals with gutta percha or resilon when using thermomechanical compaction

Aims: To evaluate the filling of simulated lateral canals with gutta-percha or Resilon when using thermomechanical compaction. Setting and Design: Forty-five human single-rooted teeth were subjected to tooth decalcification and clearing. Materials and Methods: After root canal preparation, artificial lateral canals were made at 2, 5, and 8 mm from the working length (WL), corresponding to the apical, middle, and cervical thirds, respectively. The specimens were divided (n = 15) according to the filling material: Dentsply gutta-percha (GD), Odous gutta-percha (GO), and Resilon cones (RE). Root canals were obturated by thermomechanical compaction using a #45 compactor and no sealer. Lateral canals were analyzed by digital radiography and digital images after tooth decalcification and clearing using the Image Tool software. Statistical Analysis Used: Data were subjected to the Kruskal-Wallis and Dunn tests at 5% significance. Results: In the coronal third, RE and GO presented more filling ability than GD (P < 0.05). In the middle and apical thirds, RE presented the best results. Conclusions: Resilon demonstrated filling ability as material for root canal obturation by using thermomechanical compaction.

Effectiveness of gutta-percha and Resilon in filling lateral root canals using thermomechanical technique

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Impact of chemical agents for surface treatments on microhardness and flexural strength of root dentin

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Fracture resistance of simulated immature teeth after different intra-radicular treatments

The aim of this study was to evaluate the fracture resistance of simulated immature teeth after different intra-radicular treatments. Crowns and roots of bovine incisors were cut transversally and removed to simulate immature teeth. Root canal preparation and flaring were performed using a bur in crown-apex and apex-crown direction. The samples were distributed into 5 groups (n=10): Positive control (PoC) - no root canal flaring or filling; Negative control (NeC) - teeth were sectioned and their root canals were flared; Direct anatomical glass fiber post (RaP) - #2 Reforpost main glass fiber post relined with composite resin; Double tapered conical glass fiber posts (ExP) - #3 Exacto glass fiber post; and #2 Reforpost main glass fiber + Reforpin accessory glass fiber posts (RrP). In RaP, ExP and RrP, 4.0-mm apical plugs were done with MTA Angelus. The specimens were embedded in polystyrene resin inside cylinders and the periodontal ligament was simulated with a polyether-based impression material. The specimens were submitted to compressive fracture strength test (0.5 mm/min at 135° relative to the long axis of the tooth) in a servo-hydraulic mechanical testing machine MTS 810. Data were subjected to one-way ANOVA and Dunnett's C or Tukey's tests (α=0.05). The control groups (PoC and NeC) showed lower fracture strength than the experimental groups. NeC presented the lowest resistance and ExP presented the highest resistance among the experimental groups. The flaring procedures produced a detrimental effect on the fracture resistance of the bovine teeth. Glass fiber intra-radicular posts increased significantly the fracture resistance of simulated immature teeth.

Repair of composites: Effect of laser and different surface treatments

Objectives: This study investigated the repairs of resin composite restorations after using different surface treatments.Design: Eighty four truncated cones of Filtek Z350 were prepared and thermo-cycled (20,000 cycles). Surfaces were roughened with diamond bur and etched with 37% phosphoric acid. Those cones were divided into 7 groups (N=12): 1) Prime&Bond 2.1; 2) aluminum oxide sandblasting+Prime&Bond 2.1; 3) Er:YAG laser treatment+Prime&Bond 2.1; 4) 9.6% hydrofluoric acid for 2 min-Fsilane coupling agent.; 5) silane coupling agent; 6) auto-polymerized acrylic monomer+Prime&Bond 2.1; 7) Adper Scothbond SE. Teflon device was used to fabricate inverted truncated cones of repair composite over the surface-treated. The bonded specimens were stressed to failure under tension. The data were analyzed with oneway ANOVA and Tukey tests.Results: Mean repair strengths (SD, in MPa) were, Group-2: 18.8a; Group-1: 18.7a; Group-6: 13.4ab; Group-7: 9.5bc; Group-3: 7.5bcd; Group-4: 5.2cd; Group-5: 2.6d.Conclusions: The use of diamond bur and a conventional adhesive and the use of aluminum oxide sandblasting prior to adhesive provided a simple and cost-effective solutions to composite repair. Er:YAG laser, silane alone, 9.6% hydrofluoric acid plus silane or a self-etching adhesive results in inferior composite repair strengths. (C) 2015 Elsevier Ltd. All rights reserved.

Inflammatory bowel disease: an overview of immune mechanisms and biological treatments

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

Evidence-based medicine: an update on treatments for peritoneal dialysis-related peritonitis

Peritonitis continues to be a major complication of peritoneal dialysis (PD), and adequate treatment is crucial for a favorable outcome. There is no consensus regarding the optimal therapeutic regimen, and few prospective controlled studies have been published. The objective of this manuscript is to review the results of PD peritonitis treatment reported in narrative reviews, systematic reviews, and proportional meta-analyses. Two narrative reviews, the only existing systematic review and its update published between 1991 and 2014 were included. In addition, we reported the results of a proportional meta-analysis published by our group. Results from systematic reviews of randomized control trials (RCT) and quasi-RCT were not able to identify any optimal antimicrobial treatment, but glycopeptide regimens were more likely to achieve a complete cure than a first generation cephalosporin. Compared to urokinase, simultaneous catheter removal and replacement resulted in better outcomes. Continuous and intermittent IP antibiotic use had similar outcomes. Intraperitoneal antibiotics were superior to intravenous antibiotics in reducing treatment failure. In the proportional meta-analysis of RCTs and the case series, the resolution rate (86%) of ceftazidime plus glycopeptide as initial treatment was significantly higher than first generation cephalosporin plus aminoglycosides (66%) and glycopeptides plus aminoglycosides (75%). Other comparisons of regimens used for either initial treatment or treatment of gram-positive rods or gram-negative rods did not show statistically significant differences. The superiority of a combination of a glycopeptide and a third generation cephalosporin was also reported by a narrative review study published in 1991, which reported an 88% resolution rate.

Speech-language therapy for treatment of dysphagia and dysphonia in systemic granulomatous diseases: granulomatous diseases: dysphagia and dysphonia treatments

The granulomatous lesions are frequently founded in infectious diseases and can involve the larynx and pharynx and can cause varying degrees of dysphonia and dysphagia. There is still no systematic review that analyzes effectiveness of speech therapy in systemic granulomatous diseases. Research strategy: A systematic review was performed according to Cochrane guideline considering the inclusion of RCTs and quasi-RCTs about the effectiveness of speech-language therapy to treat dysphagia and dysphonia symptoms in systemic granulomatous diseases of the larynx and pharynx. Selection criteria: The outcome planned to be measured in this review were: swallowing impairment, frequency of chest infections and voice and swallowing symptoms. Data analysis: We identified 1,140 citations from all electronic databases. After an initial shift we only selected 9 titles to be retrieved in full-text. After full reading, there was no RCT found in this review and therefore, we only described the existing 2 case series studies. Results: There were no randomized controlled trials found in the literature. Therefore, two studies were selected to be included only for narratively analysis as they were case series. Conclusion: There is no evidence from high quality studies about the effectiveness of speech-language therapy in patients with granulomatous diseases of the larynx and pharynx. The investigators could rely in the outcomes suggested in this review to design their own clinical trials.

Análise microestrutural e caracterização mecânica do aço AISI 4350 submetido a diferentes tratamentos térmicos

The multiphase steels are gaining increasing attention in scientific studies because of the different mechanical and microstructural properties that the material can achieve under different thermomechanical and heat treatments that can be submitted. In the present study, it was made a microstructural study thru the triple attack technic associated with optical microscopy and mechanical characterization of medium carbon AISI 4350 steel thru a tensile strength test, subjected to three routes of heat treatment: annealing, quenching and tempering and isothermal annealing. It was verified the predominance of ferrite-perlite constituent in the specimen annealed, martensitic in the quenched and tempered specimen and bainitic in the annealed isothermally specimen. The annealed material showed a higher ductility, while the hardened and tempered specimen showed the highest hardness and ultimately the bainitic specimen showed a combination of the two abovementioned mechanical properties. Thus, we proved that the multiphase steel SAE 4350 can be a versatile material with great potential for various industrial applications