Effect of thickness of indirect restoration and distance from the light-curing unit tip on the hardness of a dual-cured resin cement

This study evaluated the Knoop hardness and polymerization depth of a dual-cured resin cement, light-activated at different distances through different thicknesses of composite resin. One bovine incisor was embedded in resin and its buccal surface was flattened. Dentin was covered with PVC film where a mold (0.8-mm-thick and 5 mm diameter) was filled with cement and covered with another PVC film. Light curing (40 s) was carried out through resin discs (2, 3, 4 or 5 mm) with a halogen light positioned 0, 1, 2 or 3 mm from the resin surface. After storage, specimens were sectioned for hardness measurements (top, center, and bottom). Data were subjected to split-plot ANOVA and Tukey's test (α=0.05). The increase in resin disc thickness decreased cement hardness. The increase in the distance of the light curing tip decreased hardness at the top region. Specimens showed the lowest hardness values at the bottom, and the highest at the center. Resin cement hardness was influenced by the thickness of the indirect restoration and by the distance between the light-curing unit tip and the resin cement surface.

Effect of an acid diet allied to sonic toothbrushing on root dentin permeability: An in vitro study

This study quantified alterations in root dentin permeability after exposure to different acid beverages. Twenty-five third molars were sectioned below the cementoenamel junction, the root segment was collected, and the pulp tissue was removed. The root segments were connected to a hydraulic pressure apparatus to measure the permeability of root dentin after the following sequential steps, with 5 specimens in each: 1) phosphoric acid etching for 30 s (maximum permeability), 2) root planning to create new smear layer, 3) exposure to different acid substances for 5 min (orange, cola drink, vinegar, white wine, lemon juice), 4) toothbrushing with sonic toothbrush for 3 min, 5) toothbrushing with sonic toothbrush plus dentifrice for 3 min. Considering step I as 100%, the data were converted into percentage and each specimen was its own control. Data were analyzed statistically by Kruskal-Wallis and Dunn's post test at 5% significance level. All acidic substances increased dentin permeability significantly after scraping (p<0.05). Toothbrushing after exposure to acid substances decreased dentin permeability and the association with dentifrice accentuated the decrease (p<0.05), except for the specimens treated with cola drink. Thus, it may be concluded that all tested acid fruit juices increased dentin permeability, and toothbrushing with or without dentifrice can decrease root dentin permeability after dentin exposure to acid diet.

Evaluating the bonding of two adhesive systems to enamel submitted to whitening dentifrices.

The aim of this study was to evaluate by micro-shear bond strength test, the bond strength of composite resin restoration to enamel submitted to whitening dentifrices. Forty bovine teeth were embedded in polystyrene resin and polished. The specimens were randomly divided into eight groups (n=5), according to the dentifrice (carbamide peroxide, hydrogen peroxide and conventional dentifrice) and the adhesive system (Prime & Bond 2.1 and Adper Single Bond 2). Dentifrice was applied for 15 minutes a day, for 21 days. Thirty minutes after the last exposure to dentifrice, the samples were submitted to a bonding procedure with the respective adhesive system. After that, four buttons of resin were bonded in each sample using transparent cylindrical molds. After 24 hours, the teeth were submitted to the micro-shear bond strength test and subsequent analysis of the fracture mode. Data were submitted to analysis of variance and Fisher's PLSD test (alpha = 0.05). The micro-shear bond strength showed no difference between adhesives systems but a significant reduction was found between the control and carbamide groups (p = 0.0145) and the control and hydrogen groups (p = 0.0370). The evaluation of the failures modes showed that adhesive failures were predominant. Cohesive failures were predominant in group IV The use of dentifrice with peroxides can decrease bonding strength in enamel.

Evaluation of the dentin-pulp complex after cavity preparation with ultrasonic diamond tip

The aim of this paper was to compare the dentin-pulp complex response to cavity preparation in human teeth using ultrasonic chemical vapor deposition (CVD) diamond tip and high-speed diamond bur. Class V buccal cavities were randomly prepared in 40 premolars from 14 patients aged 11 to 15 years. The cutting time was recorded and the cavities had the axial walls protected with gutta-percha and were filled with glass ionomer cement. The teeth were extracted at intervals of 0, 5, 10 and 20 days, and were decalcified, sectioned and stained by Hematoxylin & Eosin, Masson's Trichrome and Brown & Brenn techniques. The inflammatory response and cell disorganization were blindly evaluated by two examiners. The remaining dentin thickness (RDT) was measured by a linear scale using computer software. Statistical analysis by one-way ANOVA showed no statistically significant difference (P≤0.05) among the cavities prepared with either type of instrument, with mean RDT of 1132.50 mm. Cutting time and the pulp-dentin complex responses were analyzed statistically by Kruskal-Wallis and Dunn tests (P≤0.05). The ultrasonic CVD diamond tip took 5 times longer to prepare the cavities and there were no typical inflammatory pulp responses in cavities prepared with either type of cutting instrument, only mild to moderate cell disorganization was present. Even taking longer to cut the dental substrate, the ultrasonic CVD diamond tip produced similar pulp response compared to the conventional high-speed diamond bur.

In vitro study of shear bond strength in direct bonding of orthodontic molar tubes

Objective: Although direct bonding takes up less clinical time and ensures increased preservation of gingival health, the banding of molar teeth is still widespread nowadays. It would therefore be convenient to devise methods capable of increasing the efficiency of this procedure, notably for teeth subjected to substantial masticatory impact, such as molars. This study was conducted with the purpose of evaluating whether direct bonding would benefit from the application of an additional layer of resin to the occlusal surfaces of the tube/tooth interface. Methods: A sample of 40 mandibular third molars was selected and randomly divided into two groups: Group 1 - Conventional direct bonding, followed by the application of a layer of resin to the occlusal surfaces of the tube/tooth interface, and Group 2 - Conventional direct bonding. Shear bond strength was tested 24 hours after bonding with the aid of a universal testing machine operating at a speed of 0.5mm/min. The results were analyzed using the independent t-test. Results: The shear bond strength tests yielded the following mean values: 17.08 MPa for Group 1 and 12.60 MPa for Group 2. Group 1 showed higher statistically significant shear bond strength than Group 2. Conclusions: The application of an additional layer of resin to the occlusal surfaces of the tube/tooth interface was found to enhance bond strength quality of orthodontic buccal tubes bonded directly to molar teeth.

Laminate veneers - a review and clinical case

The laminate veneers are great choice for rehabilitation for anterior segment of the mouth. Actually, due the employment of dental cements and bonding to dentin, the uses of laminate veneers is an effective and conservative treatment, showing a high rate success rate. This paper presents a clinical case of 50 years old male, J.C.H, who have a chief complaint of an unattractive smile. After the diagnosis and planning, 10 laminate veneers were placed from the second bicuspid (15) to the second bicuspid (25). The correct indication of laminate veneers allows restorations with appropriate esthetic and patient's satisfaction with immediate effect on quality of life. © 2011 Nova Science Publishers, Inc.

Micromechanics of dentin/adhesive interface in function of dentin depth: 3d finite element analysis

Objectives: The aim of this study was to analyze the stress distribution on dentin/adhesive interface (d/a) through a 3-D finite element analysis (FEA) varying the number and diameter of the dentin tubules orifice according to dentin depth, keeping hybrid layer (HL) thickness and TAǴs length constant. Materials and Methods: 3 models were built through the SolidWorks software: SD - specimen simulating superficial dentin (41 x 41 x 82 μm), with a 3 μm thick HL, a 17 μm length Tag, and 8 tubules with a 0.9 μm diameter restored with composite resin. MD - similar to M1 with 12 tubules with a 1.2 μm diameter, simulating medium dentin. DD - similar to M1 with 16 tubules with a 2.5 μm diameter, simulating deep dentin. Other two models were built in order to keep the diameter constant in 2.5 μm: MS - similar to SD with 8 tubules; and MM - similar to MD with 12 tubules. The boundary condition was applied to the base surface of each specimen. Tensile load (0.03N) was performed on the composite resin top surface. Stress field (maximum principal stress in tension - σMAX) was performed using Ansys Wokbench 10.0. Results: The peak of σMAX (MPa) were similar between SD (110) and MD (106), and higher for DD (134). The stress distribution pathway was similar for all models, starting from peritubular dentin to adhesive layer, intertubular dentin and hybrid layer. The peak of σMAX (MPa) for those structures was, respectively: 134 (DD), 56.9 (SD), 45.5 (DD), and 36.7 (MD). Conclusions: The number of dentin tubules had no influence in the σMAX at the dentin/adhesive interface. Peritubular and intertubular dentin showed higher stress with the bigger dentin tubules orifice condition. The σMAX in the hybrid layer and adhesive layer were going down from superficial dentin to deeper dentin. In a failure scenario, the hybrid layer in contact with peritubular dentin and adhesive layer is the first region for breaking the adhesion. © 2011 Nova Science Publishers, Inc.

Morphological alterations on human radicular dentin after exposure to different fruit juice drinks

Purpose: This in vitro study aimed to evaluate the effect of different fruit juice drinks available in the Brazilian market on smear layer removal and dentinal tubules opening, as well as to verify the effect of toothbrushing subsequently to the juices exposure. Methods: Dentin specimens were prepared and randomly distributed into the control group (distilled water) and twelve types of fruit juice drinks (cashew, orange, mandarin, apple, passion fruit, guava, strawberry, grape, mango, pear, peach, pineapple). The following treatments were applied: immersion or immersion + brushing. After preparation for SEM, photomicrographs were assessed using an index of smear layer removal. Results: No significant differences regarding smear layer removal and dentinal tubules exposure could be observed between the groups after both treatments (Kruskal-Wallis, post-hoc paired comparisons, P>0.05). The control solution and the fruit juice drinks were not able to remove smear layer and to open dentinal tubules. Significant difference between the applied treatments was detected only for the mango juice group (Mann-Whitney, P<0.05). Conclusion: Under the experimental conditions, the different fruit juice drinks did not promote significant alterations on human radicular dentin morphology regardless of the subsequent application of brushing procedures. Copyright: © 2011 Zandim et al.

Adhesion of real seal to human root dentin treated with different solutions

The aim of this study was to evaluate the effects of different irrigants on sealer-dentin bond strength when using Real Seal. Thirty single-rooted teeth were divided into 3 groups. In one group, the teeth were irrigated with 3 mL of 2.5% NaOCl after each file change, flushed with 17% EDTA for 3 min and finally rinsed with 3 mL of 2.5% NaOCl. In the other two groups, rinse with NaOCl was replaced with 2% chlorhexidine gluconate (CHX) and 0.9% saline, respectively. Each root was sectioned transversally into apical, middle and coronal thirds to obtain 2-mm-thick slices. Each slice was filled with Real Seal and Resilon. Push-out test was used to analyze bond strength and failure modes were classified as adhesive, cohesive or mixed, according to SEM observations. The push-out test did not reveal any statistically significant difference (p>0.05) between the irrigants. However, the groups exhibited significantly different (p<0.05) bond strengths in terms of the root canal third. Higher bond strength was observed at the apical third when compared with coronal third, while middle third presented intermediary values. Fifteen specimens were analyzed by SEM (5 per group). Eleven specimens exhibited adhesive failures (5 in saline, 4 in NaOCl and 2 in CHX group); 2 cohesive failures were observed in the CHX group, and 1 mixed failure each was observed in the CHX and NaOCl groups. The tested irrigants did not influence the bond strength of Resilon and Real Seal to dentin. The apical third exhibited higher mean bond strengths and adhesive failures were predominant.

Effect of acid fruit juices combined with electric or sonic toothbrushing on root dentin permeability - An in vitro study

The purpose of this in vitro study was to quantify the alterations on human root dentin permeability after exposure to different acid fruit juices and to evaluate the effect of toothbrushing with electric or sonic toothbrush after acid exposure. The root dentin of 50 extracted third molars was exposed with a high speed bur. Crowns were sectioned above the cementoenamel junction and root fragments were used to prepare dentin specimens. Specimens were randomly assigned to 5 groups according to the fruit juice (kiwifruit, starfruit, green apple, pineapple and acerolla). Each specimen was connected to a hydraulic pressure apparatus to measure root dentin permeability using fluid filtration method after the following sequential steps: I) conditioning with 37% phosphoric acid for 30 s, II) root scaling, III) exposure to acid fruit juices for 5 min and IV) electric or sonic toothbrushing without dentifrice for 3 min. Data were analyzed statistically by the Wilcoxon and Mann-Whitney tests at 5% significance level. All fruit juices promoted a significant increase of dentin permeability while toothbrushing decreased it significantly (p<0.05). It may be concluded that all acid fruit juices increased root dentin permeability, while toothbrushing without dentifrice after acid exposure decreased the permeability. The toothbrush mechanism (electric or sonic) had no influence on the decrease of root dentin permeability.

Correlation between hybrid layer thickness, resin tag length and microtensile bond strength of a self-etching adhesive system

The purpose of this study was to evaluate the correlation between the hybrid layer thickness, resin tag length and resin bond strength of a self-etching adhesive system to sound dentin tissue in vivo. After performing restorative procedures and tooth extractions, ten specimens were sectioned in a mesiodistal direction. One dental section was used for light microscope analysis, in which both the resin tag length and hybrid layer thickness were measured, while the other section was analyzed using a microtensile test (0.5 mm/min). The fractured surface of the latter section was characterized using a stereoscopic magnifying glass (40x magnifcation). The results were subject to statistical analysis using the Pearson Correlation Test (a = 0.05). The hybrid layer thickness, resin tag length and resin bond strength mean values were 2.19 microm (0.34), 4.34 microm (0.28) and 9.73 MPa (5,55), respectively. In addition, correlation tests between the resin tag length and the resin bond strength (r=0.014) and also between the hybrid layer thickness and bond strength (r=0.43), showed no statistically significant correlation. The microtensile bond strength of Adper Prompt L Pop self-etching adhesive system does not depend on hybrid layer thickness or resin tag length.

In vitro assessment of dentin erosion after immersion in acidic beverages: Surface profile analysis and energy-dispersive X-ray fluorescence spectrometry study

The aim of this study was to investigate the effects of some acidic drinks on dentin erosion, using methods of surface profile (SP) analysis and energy-dispersive X-ray fluorescence spectrometry (EDXRF). One hundred standardized dentin slabs obtained from bovine incisor roots were used. Dentin slabs measuring 5x5 mm were ground flat, polished and half of each specimen surface was protected with nail polish. For 60 min, the dentin surfaces were immersed in 50 mL of 5 different drinks (Gatorade®, Del Valle Mais orange juice®, Coca-Cola®, Red Bull® and white wine), 20 blocks in each drink. The pH of each beverage was measured. After the erosive challenge, the nail polish was removed and SP was analyzed. The mineral concentration of dentin surfaces was determined by means of EDXRF. Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). SP analysis showed that Red-Bull had the highest erosive potential (p<0.05). EDXRF results exhibited a decrease in phosphate in the groups immersed in Red-Bull, orange juice and white wine (p<0.05), and no significant difference in calcium content between the reference surface and eroded surface. In conclusion, this study demonstrated that all studied beverages promoted erosion on root dentin and Red Bull had the highest erosive potential. There was no correlation between pH of beverages and their erosive potential and only the P content changed after erosive challenge.

Persistence of epoxy-based sealer residues in dentin treated with different chemical removal protocols

The presence of residual endodontic sealer in the pulp chamber may cause discoloration of the dental crown and interfere with the adhesion of restorative materials. The aim of this study was to compare the efficacy of different solvents in removing residues of an epoxy resin-based sealer (AH Plus) from the dentin walls of the pulp chamber, by scanning electron microscopy (SEM). Forty-four bovine incisor dental crown fragments were treated with 17% EDTA and 2.5% NaOCl. Specimens received a coating of AH Plus and were left undisturbed for 5 min. Then, specimens were divided in four groups (n = 10) and cleaned with one of the following solutions: isopropyl alcohol, 95% ethanol, acetone solution, or amyl acetate solution. Negative controls (n = 2) did not receive AH Plus, while in positive controls (n = 2) the sealer was not removed. AH Plus removal was evaluated by SEM, and a score system was applied. Data were analyzed by Kruskal-Wallis and Dunn tests. None of the solutions tested was able to completely remove AH Plus from the dentin of the pulp chamber. Amyl acetate performed better than 95% ethanol and isopropyl alcohol (p < 0.05), but not better than acetone (p > 0.05) in removing the sealer from dentin. No significant differences were observed between acetone, 95% ethanol, and isopropyl alcohol (p > 0.05). It was concluded that amyl acetate and acetone may be good options for cleaning the pulp chamber after obturation with AH Plus. SCANNING 35:17-21, 2013. © 2012 Wiley Periodicals, Inc. © Wiley Periodicals, Inc.

Dentin hypersensitivity after teeth bleaching with in-office systems. randomized clinical trial

Purpose: To comparatively and prospectively compare in a randomized clinical trial, dentin hypersensitivity after treatment with three in-office bleaching systems, based on hydrogen peroxide at different concentrations, with and without light source activation. Methods: 88 individuals were included according to inclusion and exclusion criteria. Subjects were randomly divided into the following three treatment groups: Group 1 was treated with three 15-minute applications of hydrogen peroxide at 15% with titanium dioxide (Lase Peroxide Lite) that was light-activated (Light Plus Whitening Lase) with five cycles of 1 minute and 30 seconds each cycle, giving a total treatment time of 45 minutes; Group 2 was treated with three 10-minute applications of hydrogen peroxide at 35% (Lase Peroxide Sensy), activated by light (LPWL) same activation cycles than Group 1, with a total treatment time of 30 minutes; Group 3 was treated with only one application for 45 minutes of hydrogen peroxide at 35% (Whitegold Office) without light activation. Each subject underwent one session of bleaching on the anterior teeth according to the manufacturers' instructions. Dentin sensitivity was recorded with a visual analogue scale (VAS) at baseline, immediately after, and at 7 and 30 days after treatment using a stimulus of an evaporative blowing triple syringe for 3 seconds on the upper central incisors from a distance of 1 cm. A Kruskal-Wallis test followed by Mann-Whitney test was performed for statistical analysis. Results: All groups showed increased sensitivity immediately after treatment. Group 1 displayed less changes relative to baseline with no significant differences (P= 0.104). At 7 and 30 days after treatment, a comparison of VAS values indicated no significant differences between all groups (P= 0.598 and 0.489, respectively).

Effects of dentin dry/moist condition on the immediate adhesive performance of different solvent-based etch-and-rinse adhesivesystems

Purpose: The purpose of this research was to analyze and measure, under optical microscopy, the hybrid layer thickness and resin tags length, as well as the microtensile bond strength of two conventional adhesive systems when applied to dry and moist dentinal substrate. Methods: Thirty-two extracted human molars were randomly distributed into four groups according to the adhesive systems (XP Bond and Prime&Bond 2.1) and moisture condition (dry and moist). In Groups I and II, XP adhesive system was applied on dry and moist dentin, respectively; while Groups III and IV received PB adhesive system, in the same way as was done in Groups I and II, respectively. After adhesive and restorative procedures, all specimens were sectioned along their long axes; one hemi-tooth sample was subjected to the microtensile bond strength test while the other was decalcified and serially sectioned into six micron thick slices and sequentially mounted on glass slides. These sections were stained by the Brown and Brenn method for posterior analysis and measurement of the hybrid layer and resin tags under a light microscope with a micrometric ocular 40/075. Results: Data were analyzed using two-way ANOVA and Tukey's test (α=0.05). For the variable hybrid layer thickness, XP showed no significant differences between dry and moist dentin (5.2 μm and 5.5 μm, respectively), but for PB, hybrid layer was significantly thicker for moist (4.0 μm) than for dry dentin (3.0 μm). For the variable resin tags length XP showed 17.9 μm length for dry dentin and 20.8 μm for moist dentin; PB 11.7 μm for dry and 12.69 μm for moist dentin;there was no significant differences between them, independent of the moisture condition. For the variable microtensile bond strength, XP showed 38.0 MPa for dry dentin and 44.5 MPa for moist dentin; and PB showed 22.7 MPa for dry dentin and 20.8 MPa for dry dentin no significant difference was observed between moist and dry dentin for XP (p=0.2) and PB (p=0.7), but XP was presented significantly higher bond strength values than PB in both moisture conditions (p=0.003 for dry and p=0.002 for moist). Conclusion: The two-step butanol-based etch-and-rinse adhesive XP Bond presented a superior behavior with regard to the hybrid layer thickness, length of resin tags and bond strength to dry and moist dentin substrates when compared with two-step acetone-based adhesive system Prime&Bond2.1. © 2013 Elsevier Ltd.