Influência da concentração de peróxido de hidrogênio nos agentes clareadores na cor e penetração através da estrutura dental

Pós-graduação em Odontologia Restauradora - ICT

Efeito da escovação dentária no manchamento de braquetes estéticos cerâmicos

Objective: this study aimed to analyze the in vitro effect of brushing on the color stability of ceramic brackets immersed in dye solutions. Materials and Methods: seven ceramic brackets of four commercial brands were tested: two monocrystalline and two polycrystalline. The parameters of color were obtained by spectrophotometer before and after 21 days of immersion of the brackets in coffee, red wine, Coca-Cola, black tea and artificial saliva. Another group of brackets of each brand were also immersed in the same solutions and for an equal time to the previous group, but with intervals of daily brushing performed by a toothbrushing machine (Mavtec). The data were evaluated by analysis of variance, multiple comparison tests for means and Student's t-test. Results: the mean color change of the brackets without brushing ranged from 0.46 to 7.61, while in the group with brushing these means ranged from 0.36 to 2.50. The staining still remained noticeable (change of color greater than 3.7) for all brackets when immersed in black tea. Conclusion: daily brushing helped significantly in the color stability of ceramic brackets, maintaining the color change to levels considered not visible to the human eye, except for the solution of black tea in which the staining remained relevant.

Correlación entre diferentes métodos de evaluación de color en el clareamiento dental. Correlation between different methods for co

The aim of this study was to evaluate the correlation of color change on bleaching tooth through delta E (ΔE) by the spectrophotometer Spectroshade (SS) and digital program Scanwhite (SW). Methods: 25 patient volunteers were recruited from Operative Dentistry at Universidad de Chile Dental School, between 18 to 30 years, with good oral hygiene. Exclusion criteria: Previous experienced tooth bleaching, anterior restorations, cervical lesions, pain dental, pregnant patient, stained teeth, malposition of the teeth and periodontal pathology. The bleaching was made in two sessions with three different bleaching systems which were randomly. The assessment of color change through ΔE was made on the two upper central incisors (N=50) by the SS and SW. The color in the same teeth were measured before (T0) and after (T1) of the bleaching treatment. Data were analyzed using test Spearman correlation coefficient (Rho) with a significant level of 95%. Results: The results showed a positive and significant correlation (0.676), with a statistically significant difference (p<0.05). Conclusion: There is correlation in the measurement of color change on bleaching tooth by SS and SW.

Effect of staining agents on color change of composites

Composite resins are materials that can present color changing when exposed to pigments. Objective: The aim of this study was to evaluate, in vitro, the color changing of composites after immersion in different substances for different periods. Material and methods: Two microhybrid composite resins: Charisma (Heraeus – Kulzer) and Opallis (FGM) were used. Red wine and acai pulp were also used as immersion medium. For this study, 32 specimens with 10 mm of diameter and 2 mm of thickness were used, divided into 4 groups: Group 1 – Opallis composite immersed in red wine solution; Group 2 – Opallis composite immersed in acai berry pulp solution; Group 3 – Charisma composite immersed in red wine solution; Group 4 – Charisma composite immersed in acai berry pulp solution. The specimens were evaluated in the following time periods: T0 – baseline, T1 – 24 hours, T2 – 48 hours, T3 – 72 hours and T4 – 96 hours. For the assessment of staining, a spectrophotometer for colorimetry was used (Color Guide 45 / 0, PCB 6807 BYK-Gardner Gerestsried GmBH, Germany), and the values obtained were transferred to a computer and recorded according to CIELAB system. Results: The data were evaluated using Kruskal- Wallis non-parametric tests with the following mean values for the immersion periods of 24, 48, 72 and 96 hours, respectively: G1 – 7.35, 7.84, 9.04,10.48; G2 – 2.92, 4.15, 4.30, 4.64; G3 – 3.14, 7.35, 8.13, 8.43, G4 – 4.49, 5.99, 6.92, 6.76. Conclusion: Red wine showed a higher tendency toward altering the composite color than acai berry pulp. In addition, no significant difference was found concerning to the behavior of the two composite resins. Concerning to the immersion time periods, significant differences were only observed among the groups in the 24 hour time period.

Long-term surface hardness and monomer conversion of a nonofilled and a microhybrid composite resin

Objective: This study aims to evaluate the degree of conversion (DC) and hydrolytic degradation through the Vickers hardness test (HV) of a nanofilled (Filtek™ Z-250, 3M) and a microhybrid (Filtek™Supreme-XT, 3M) composite resin. Materials and methods: Eight disk-shaped specimens (4 mm diameter × 2 mm thick, ISO 4049) of each material were prepared for each test. Composites were inserted into single increment in a metallic matrix and light-cured for 40 seconds. VH readings were performed for each specimen at predetermined intervals: immediately after polymerization (control), 1, 2, 3, 7, 14, 21, 30 and 180 days. After curing, initial hardness measurements were performed and the specimens were immersed in artificial saliva at 37°C. For DC (%), specimens were ground, pressed with KBr and analyzed by FT-IR spectrophotometer. Results: Student t-test showed that there was no difference between the resins for DC (p = 0.252). ANOVA analysis revealed that Z-250 VH means were all greater than S-XT, for both top and bottom surfaces, whatever the storage-period in artificial saliva (p < 0.001). After 180 days of storage, the hardness obtained for S-XT was similar with that at the baseline, for both top and bottom surfaces. While for Z-250 hardness was not significantly different from baseline only for top surface, but there was a significant decrease observed in hardness for bottom surface. Conclusion: The materials tested showed no evidence of hydrolytic degradation in a significant way, in a 6-month storagetime in artificial saliva. Nanofilled resin presents a monomer conversion comparable to the conventional microhybrid.

In-Office dental bleaching efficacy assessment in function of the light exposure regime by digital colometric reflectance spectroscopy

In-office dental bleaching has been subject of several studies. Generally those studies quantify through visual analysis, the shade reduction of the teeth submitted to different bleaching protocols (light sources, bleaching agent concentrations and irradiation time). The objective of this work is the determination of the influence of four irradiation protocols on the obtainment of better aesthetic results using a colorimetric spectrophotometer that quantifies color changes in each situation imposed. Forty bovine incisors were selected in function of similar anatomic characteristics; a concentrated coffee solution was used to stain the teeth. A commercial spectrophotometer was used to measure the color changes during evolution of the experiment (stain and bleaching phases) and the obtained data was analyzed by the ANOVA test. The obtained data showed the evolution of teeth color during the staining period, as well as, the color reduction that each bleaching protocol achieved. Based on our findings it is possible to conclude that bleaching protocols with larger irradiation periods did not showed significant differences when compared with shorter irradiation protocols, in that way the use of protocols with 30 min or more of consecutive irradiation are not clinically justified and also can cause several side effects.

Instrumentación para el registro del color en odontología

Color is an important variable in cosmetic dentistry, and it has traditionally been measured by a visual method, comparing teeth with standard color guides. In recent decades, electronic instruments have been developed to eliminate the subjective factor of visual measurement. This objective method has mainly been performed with colorimeters, spectrophotometers and the analysis of images obtained with digital cameras. These instruments have proven to be reliable with a high degree of precision and accuracy. Its use is recommended as an adjunctive tool to assess color in direct and indirect restorations, in aesthetic treatments like bleaching, and to facilitate communication with the dental laboratory. The spectrophotometer is the device that has reported better “in- vitro “ and “in -vivo” performance, being the “Vita Easyshade “ the one with more reliable results.

Correspondência de cor de diferentes marcas e sistemas de resina c omposta em relação à escala vita classical

The objective of this study was to compare different resins and determine their matching color with Vita shade, also investigating the possibility of substitution among them and the correlation between the visual and spectrophotometry methods of color selection. The composite resin Tetric N-Ceram® shade A1 was used as light-control and color A4 as dark-control. For each material were prepared five 10 x 2 mm disks. Analyses were performed in a metamerism box by volunteers who ordered the specimens from the lightest to the darkest. The spectrophotometry was carried out using the spectrophotometer Vita Easyshade®. ∆E values were subjected to analysis of variance with 5% significance level. The Fisher exact test showed that there was no color match among the materials and the reference Vita shade. The possibility of substitution among the composites could not be established. The two methods are able to correctly differentiate the control resin A4 as distinct from the other resins shade A2.

The association of chlorhexidine digluconate and calcium chloride to use as vehicle of a silicate calcium-based cement

Objective: The purpose of this study was to evaluate the influence of the addition of 2% chlorhexidine digluconate (CHX) associated with 5% calcium chloride (CaCl2 ) on antimicrobial activity, setting time, pH and calcium release of gray mineral trioxide aggregate (GMTA). Materials and Methods: GMTA powder was mixed with water, 2% CHX alone or 2% CHX combined with 5% CaCl2 . Antimicrobial activity was determined against Enterococcus faecalis (ATCC 29212) strains by agar diffusion test. Data obtained were submitted to kruskal wallis tests. Analysis of the setting time was evaluated by American society for testing and materials C266-03 requirements. The pH and calcium release analysis were evaluated, in 24 h, 7, 14 and 28 days using pH meter equipment and atomic absorption spectrophotometer, respectively. Data obtained were analyzed by ANOVA, in 5% significance level. Results: Significant differences were seen (P < 0.01) among the zones of bacterial growth inhibition produced by 5% CaCl2 + 2% CHX combination against E. faecalis when compared with water (P < 0.05). Regarding the setting time, that combination had the shortest setting time (P < 0.05). All associations were alkaline and released calcium. No statistical difference was observed between the experimental groups at the different periods of analysis (P > 0.05). Conclusion: Combination of 5% CaCl2 + 2% CHX reduced the setting time and enhanced the antimicrobial activity of GMTA without changing the pH and calcium release.

Laboratory testes with quality data in Dentistry

In laboratory tests, just following the manufacturer’s instructions of materials or equipments may not be enough to obtain reliable data. Thus, intra and inter-examiners studies may be required. The aim of this study was to illustrate the application of the Intraclass Correlation Coefficient (r) in a study related to the color changing and hardness of composite resin conducted by two examiners. The color and hardness of 10 specimens of composite resin were evaluated by a colorimetric spectrophotometer and hardness tester, respectively, at two different times. Two trained examiners performed two measurements with an interval of one week. Specimens were stored in artificial saliva at 37±1ºC for 7 days. The Intraclass Correlation was used for analysis of intra and inter-examiner reproducibility. The intra-examiner reproducibility was 0.79, 0.44 and 0.76 for L, a and b color coordinates for the examiner 1 and 0.84, 0.23, 0.21 for examiner 2. For hardness, r-values were 0.00 and 0.23 for the examiner 1 and 2, respectively, showing unsatisfactory agreement on color and hardness evaluation for both examiners. It was noted that only the observation of protocol for use of equipment and examiners training were not sufficient to collect reliable information. Thus, adjustments in the experimental protocol were made and devices were produced to standardize the measurements. The reproducibility study was performed again. For examiner 1, values as 0.90, 0.59 and 0.79 were verified for L, a and b coordinates and, for examiner 2 were obtained values of 0.90, 0.75, 0.95. In relation to hardness, r-values of 0.75 and 0.71 were obtained for examiners 1 and 2, respectively. The inter-examiner reproducibility was 0.86, 0.87, 0.91 for L, a and b coordinates and 0.79 for hardness. It was concluded that intra and inter-examiner calibration is essential for obtaining quality measurements in laboratory tests.

Color stability of a nanofilled resin: influence of polishing and finishing and fluoride solutions according to time

Aim: The aim of the study was evaluate the finishing and polishing effect of the color stability of the composite resin Filtek Supreme XT, according to different fluoride solutions and time. Material and Methods: Specimens were prepared (n=140) with half of the samples finished and polished. The experimental groups were divided according to the presence or absence of finishing and polishing and immersion solutions (artificial saliva, sodium fluoride solution at 0.05% - manipulated, Fluordent Reach, Oral B, Fluorgard). The specimens remained in artificial saliva for 24 hours and were subjected to an initial color analysis using a spectrophotometer CIELab system. Then, they were immersed in the experimental solutions for 1 minute a day. The readings of the color change were made after 24 and 48 hours, 7, 14, 21, 30 and 60 days after the first immersion. The three-way mixed Analysis of Variance (ANOVA) ("finishing/polishing", "immersion medium" and “time”) were performed. For multiple comparisons, the Sidak test for repeated measure was used, with a 5% level of significance. Results: The finishing and polishing factor showed significant variability, independently of the immersion media (p<0.001). Cconclusion: Finishing and polishing procedures yielded better color stability to composite resin over time, regardless of the immersion media.

Colour stability of acrylic resin denture teeth after immersion in different beverages

The colour stability of acrylic resin denture teeth in beverages was investigated. A spectrophotometer measured the colour (CIE-L*a*b* system) of all specimens after storage in distilled water for 24 h at 37°C (T0). Specimens were then immersed in various beverages. After 15 days (T1) and 30 days (T2), for each material, the mean ∆E values were calculated and compared by two-way ANOVA and Tukey intervals (α=0.05). In the ∆T0T1 period, specimens stored in red wine were significantly discoloured, compared to distilled water (P=0.003). There was no difference between immersion solutions in ∆ET0T2 (P=0.772) and in ∆ET1T2 (P=0.058), and no difference between materials in all immersion periods.

Chemical characterization and bioactivity of epoxy resin and Portland cement-based sealers with niobium and zirconium oxide radiopacifiers

The purpose of this study was to characterize and to evaluate the bioactivity potential of experimental root canal sealers (ES) based on Portland cement, epoxy resin with nano- and micro-particles of niobium or zirconium oxide used as radiopacifiers in comparison to AH Plus and MTA Fillapex. Methods Specimens of the sealers (10 mm in diameter × 1 mm thick) were prepared and the radiopacity was evaluated according to ISO 6876 (2012) specifications. Characterization of the sealers was performed under the scanning electron microscope (SEM) immediately after setting and after immersion for 28 days in Hank's balanced salt solution (HBSS). In addition X-ray energy dispersive spectroscopy (EDS), X-ray diffraction (XRD) and Fourier transform infrared (FT-IR) spectroscopy were also performed. The pH and calcium ion release were measured after 1, 7, 14, 21 and 28 days after completion of seating using a digital pH meter and an atomic absorption spectrophotometer, respectively. Results The experimental sealers exhibited an average radiopacity of 2.5 mm thickness of aluminum, which was similar to MTA Fillapex (P > 0.05) and inferior to AH Plus (P < 0.05). AH Plus did not show bioactivity. Although the experimental sealers did not exhibit the formation of hydration product, they encouraged the deposition of crystalline spherical structures of calcium deficient phosphate. The highest pH and calcium release values were observed with the experimental sealers (P < 0.01). ES-Nb-micro was the only sealer to present hexagonal shaped crystal deposition. Significance Novel root canal sealers based on a mixture of Portland cement, epoxy resin and radiopacifier exhibited a degree of bioactivity although no evidence of cement hydration was demonstrated on material characterization. The radiopacifier particle size had limited effect on the sealer microstructure and chemical properties.

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.

Cell membrane integrity of candida albicans after different protocols of microwave irradiation

To evaluate the ability of low time microwaveexposureto inactivate and damage cell membrane integrity of C. albicans. Materials and Methods: Two 200ml C. albicans suspensions were obtained. Sterile dentures were placed in a beaker containing Experimental (ES) or Control suspensions (CS). ES was microwaved at 650 W for 1, 2, 3, 4 or 5 min. Suspensions were optically counted using Methylene blue dye as indicative of membrane-damaged cells; spread on Agar Sabouraud dextrose (ASD) for viability assay; or spectrophotometrically measured at 550nm. Cell-free solutions were submitted to content analyses of protein (Bradford and Pyrogallol red methods); Ca++ (Cresolphthalein Complexone method); DNA (spectrophotometer measurements at 260nm) and K+ (selective electrode technique). Data were analyzed by Student-t test and linear regression (α=0.05). In addition, flowcytometry analysis of Candida cells in suspensionwas performed using propidium iodide. Results: All ES cells demonstrated cell membrane damage at 3, 4 and 5 min,viable cells were nonexistent at 3, 4 and 5 min ES ASD plates and optical density of ES and CS was not significantly differentfor all exposition times. ES cells released highcontents of protein, K+ , Ca++ and DNA after 2 min exposition when compared to that of the CSs. Similar results were observed with flow cytometry analysiswith regard to the periodsof microwave exposure. Conclusions: Microwave irradiation inactivated C. albicansafter 3min and damaged cell membrane integrity after 2 min exposition.