12-Month color stability of enamel, dentine, and enamel-dentine samples after bleaching

The study aimed to quantify the color regression of enamel (E), dentine (D), and combined enamel-dentine (ED) of differently bleached ED specimens over a period of 12 months in vitro. Two ED samples were obtained from the labial surfaces of bovine teeth and prepared to a standardized thickness with the enamel and dentine layer each 1 mm. The ED samples were distributed on four groups (each n=80), in which the different bleaching products were applied on enamel (1, Whitestrips; 2, Illumine 15%; 3, Opalescence Xtra Boost) or dentine surfaces (4, mixture of sodium perborate/distilled water). Eighty ED samples were not bleached (control). Color (L*a*b*) of ED was assessed at baseline, subsequently after bleaching and at 3, 6, and 12 months of storage after bleaching (each 20 samples/group). E and D samples were prepared by removing the dentine or enamel layer of ED samples to allow for separate color analysis. Bleaching resulted in a significant color change (Delta E) of ED specimens. Within the observation period, Delta L but not Delta b declined to baseline. L* values of E and D samples also declined and were not significantly different from control samples after 12 months, while b* values did not decrease to baseline. Generally, no differences between the bleaching agents could be observed. Color change of enamel, dentine, and combined ED of in vitro bleached tooth samples is not stable over time with regard to lightness. However, yellowness did not return to baseline within 1 year.

Enamel microabrasion followed by dental bleaching for patients after orthodontic treatment - Case reports

This article reports clinical procedures used to remove residual bonded resin and enamel stains following bracket debonding at the conclusion of orthodontic treatment. A water-cooled fine-tapered diamond bur was used for resin removal, followed by enamel surface finishing using a commercially available microabrasion paste. It was noted that residual tooth coloration remained yellowish because of enamel translucency; the yellow dentin shade showed through. Additional tooth shade lightening was achieved using carbamide peroxide dental bleaching solution in custom-formed trays. This report describes a safe and effective technique that optimizes tooth appearance at the conclusion of orthodontic therapy. Mechanical resin removal, enamel microabrasion, and tooth bleaching are employed.

Increase in severity of molar-incisor hypomineralization and its relationship with the colour of enamel opacity: a prospective cohort study

Background. Predicting risk of posteruptive enamel breakdown (PEB) of molar-incisor hypomineralization (MIH) opacity is a difficult but important clinical task. Therefore, there is a need to evaluate these aspects through longitudinal studies.Objective. The aim of this longitudinal study was to analyse the relationship between colours of MIH opacity of children aged 6-12 (baseline) and other clinical and demographic variables involved in the increase in severity of MIH.Materials and methods. A blinded prospective 18-month follow-up was conducted with 147 individuals presenting mild MIH. Tooth-based incidence of increase in severity of MIH (PEB or atypical restorations) was used as dependent measurement. Enamel opacities were recorded according to colour shades of white, yellow and brown, allowing assessment of susceptibility to structural loss over time, according to colour of MIH opacity. Poisson regression models were used to adjust the results for demographic and clinical variables.Results. Brown and yellow MIH opacities were at higher risk for PEB and atypical restorations than those of white ones, even after adjustment for clinical and demographic variables.Conclusion. Teeth presenting mild MIH severity associated with yellow and brown enamel opacities were at high risk for increase in severity of MIH than lighter ones. This result could help clinicians determine a risk-based treatment for children with MIH.

Trans-enamel and trans-dentinal cytotoxic effects of a 35% H2O2 bleaching gel on cultured odontoblast cell lines after consecutive applications

To evaluate the trans-enamel and trans-dentinal cytotoxic effects of a 35% H2O2 bleaching gel on an odontoblast-like cell lines (MDPC-23) after consecutive applications.Fifteen enamel/dentine discs were obtained from bovine central incisor teeth and placed individually in artificial pulp chambers. Three groups (n = 5 discs) were formed according to the following enamel treatments: G1: 35% H2O2 bleaching gel (15 min); G2: 35% H2O2 bleaching gel (15 min) + halogen light (20 s); G3: control (no treatment). After repeating the treatments three consecutive times, the extracts (culture medium + gel components that had diffused through enamel/dentine discs) in contact with the dentine were collected and applied to previously cultured MDPC-23 cells (50 000 cells cm(-2)) for 24 h. Cell metabolism was evaluated by the MTT assay and data were analysed statistically (alpha = 5%; Kruskal-Wallis and Mann-Whitney U-test). Cell morphology was analysed by scanning electron microscopy.Cell metabolism decreased by 92.03% and 82.47% in G1 and G2 respectively. G1 and G2 differed significantly (P < 0.05) from G3. Regardless of halogen light activation, the application of the bleaching gel on the cultured odontoblast-like cells caused significantly more severe cytotoxic effects than those observed in the nontreated control group. In addition, significant morphological cell alterations were observed in G1 and G2.After three consecutive applications of a 35% H2O2 bleaching agent, the diffusion of the gel components through enamel and dentine caused severe toxic effects to cultured pulp cells.

Disinfection of Bovine Enamel by Microwave Irradiation: Effect on the Surface Microhardness and Demineralization/Remineralization Processes

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

Morphology and bacterial colonisation of tooth/ceramic restoration interface after different cement excess removal techniques

Objectives: To evaluate the influence of different protocols for resin cement removal during cementation on biofilm formation.Methods: Twenty-eight ceramic blocks, which were injected under pressure, were placed over enamel blocks obtained from freshly extracted bovine incisors. The ceramic blocks were cemented to the enamel blocks using a dual-cured resin cement and the excess resin was removed according to the experimental group: TS: Teflon spatula; BR: brush; BR+: brush and polishing; SB+: scalpel blade and polishing. After autoclaving, the samples were colonised by incubation in a sucrose broth suspension standardised with Streptococcus mutans in microaerophilic stove. Specimens were quantitatively analysed for bacterial adherence at the adhesive interface using confocal laser scanning microscopy and counting the colony forming units, and qualitatively analysed using SEM. The roughness (Ra/Rz/RSm) was also analysed. Data were analysed by 1-way ANOVA and Tukey's test (5%).Results: The roughness values ranged from 0.96 to 1.69 mu m for Ra (p > 0.05), from 11.59 to 22.80 mu m for Rz (p = 0.02 < 0.05) and from 293.2 to 534.3 mu m for RSm (p = 0.00). Bacterial adhesion varied between 1,974,000 and 2,814,000 CFU/ml (p = 0.00). Biofilm mean thickness ranged from 0.477 and 0.556 mu m (p > 0.05), whilst the biovolume values were between 0.388 and 0.547 mu m(3)/mu m(2) (p = 0.04). Lower values for roughness, bacterial adhesion, biofilm thickness and biovolume were found with BR, whilst TS presented the highest values for most of the parameters. SEM images confirmed the quantitative values.Conclusions: The restoration margin morphology and interface roughness affects bacterial accumulation. The brush technique promoted less bacterial colonisation at the adhesive interface than did the other removal methods.Clinical significance: The brush technique seems to be a good option for removing the excess resin cement after adhesive cementation in clinical practice, as indicated by its better results with lower bacterial colonisation. (C) 2012 Elsevier Ltd. All rights reserved.

Effects of a non-rinse conditioner on the enamel of primary teeth

O objetivo deste estudo in vitro foi de avaliar ao microscópio eletrônico de varredura os aspectos morfológicos do esmalte de dentes decíduos após condicionamento com ácido fosfórico a 36% ou com um agente condicionador não lavável. Foram selecionados 10 dentes decíduos anteriores esfoliados naturalmente. As amostras sofreram limpeza coronária com pasta de pedra-pomes e água, em baixa-velocidade. O condicionamento foi realizado no esmalte da face vestibular. Os espécimes foram divididos em dois grupos: G1 (n=10): condicionamento com ácido fosfórico a 36% na forma de gel - Conditioner 36 (Dentsply) durante 20 segundos, seguidos de lavagem com água durante 15 segundos; G2 (n=10): condicionamento com NRC - Non Rinse Conditioner (Dentsply) durante 20 segundos, seguidos de secagem com ar durante 15 segundos. As amostras foram desidratadas, montadas em bases metálicas e cobertas com ouro para análise ao microscópio eletrônico de varredura (Jeol JSM 6.100). A análise da eletromicrografias revelou que ambos os agentes condicionadores foram efetivos para condicionar o esmalte de dentes decíduos, causando microporosidades mas com melhor resultado quando utilizou-se o ácido fosfórico a 36% na forma de gel.

Influence of fluoride dentifrice on brushing abrasion of eroded human enamel: An in situ/ex vivo study

This in situ/ex vivo study assessed the effect of fluoride dentifrice on eroded enamel subjected to brushing abrasion. In a crossover study performed in 2 phases, 10 volunteers wore acrylic palatal appliances, each containing 3 human enamel blocks. Dentifrice was used to brush the volunteers' teeth and the specimens subjected to abrasion. In phases A and B the dentifrices used had the same formulation, except for the absence or presence of fluoride, respectively. The blocks were subjected to erosion by immersion of the appliances in a cola drink for 5 min, 4 times a day. Then the blocks were brushed, and the appliance was replaced into the mouth. Enamel alterations were determined using profilometry and percentage change in surface microhardness (%SMHC) tests. The data were tested using the paired t test. The mean wear values (+/- SD, mu m) were: group A 6.84 +/- 1.72 and group B 5.38 +/- 1.21 (p = 0.04). The mean %SMHC values (+/- SD) were: group A 54.6 +/- 16.2 and group B 45.7 +/- 6.8 (p = 0.04). Fluoride dentifrice had a protective effect on eroded enamel subjected to brushing abrasion. Copyright (c) 2007 S. Karger AG, Basel.

Effect of an iron mouthrinse on enamel and dentine erosion subjected or not to abrasion: An in situ/ex vivo study

Objectives: This in situ/ex vivo study evaluated whether a rinse with an iron solution could reduce wear and the percentage of microhardness change of human enamel and dentine submitted to erosion followed by brushing after 1 or 30 min.Design: During 2 experimental 5-day crossover phases (wash-out period of 10 days), 10 volunteers wore intraoral palatal devices, with 12 specimens (6 of enamel and 6 of dentine) arranged in 3 horizontal rows (4 specimens each). In one phase, the volunteers immersed the device for 5 min in 150 mL of cola drink, 4 times a day. Immediately after immersion, no treatment was performed in one row. The other row was brushed after 1 min using a fluoride dentifrice and the device was replaced into mouth. After 30 min, the remaining row was brushed. In the other phase, the procedures were repeated, but after immersion the volunteers rinsed for 1 min with 10 mL of a 10 mM ferrous sulphate solution. Changes in surface microhardness (%SMH) and wear (profilometry) of enamel and dentine were measured. Data were tested using ANOVA and Tukey's tests (p < 0.05).Results: the enamel presented more wear than dentine, under all experimental conditions. The iron solution caused a significant reduction on the %SMH in enamel, and a significant reduction on the wear in dentine, regardless the other conditions.Conclusions: Rinsing with an iron solution after an erosive attack, followed or not by an abrasive episode, may be a viable alternative to reduce the loss of dental structure. (c) 2006 Elsevier Ltd. All rights reserved.

Quantification of Peroxide Ion Passage in Dentin, Enamel, and Cementum After Internal Bleaching With Hydrogen Peroxide

The aim of this study was to evaluate the amount of peroxide passage from the pulp chamber to the external enamel surface during the internal bleaching technique. Fifty bovine teeth were sectioned transversally 5 mm below the cemento-enamel junction (CEJ), and the remaining part of the root was sealed with a 2-mm layer of glass ionomer cement. The external surface of the samples was coated with nail varnish, with the exception of standardized circular areas (6-mm diameter) located on the enamel, exposed dentin, or cementum surface of the tooth. The teeth were divided into three experimental groups according to exposed areas close to the CEJ and into two control groups (n=10/group), as follows: GE, enamel exposure area; GC, cementum exposed area; GD, dentin exposed area; Negative control, no presence of internal bleaching agent and uncoated surface; and Positive control, pulp chamber filled with bleaching agent and external surface totally coated with nail varnish. The pulp chamber was filled with 35% hydrogen peroxide (Opalescence Endo, Ultradent). Each sample was placed inside of individual flasks with 1000 mu L of acetate buffer solution, 2 M (pH 4.5). After seven days, the buffer solution was transferred to a glass tube, in which 100 mu L of leuco-crystal violet and 50 mu L of horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined by spectrophotometer and converted into microgram equivalents of hydrogen peroxide. Data were submitted to Kruskal-Wallis and Dunn-Bonferroni tests (alpha=0.05). All experimental groups presented passage of peroxide to the external surface that was statistically different from that observed in the control groups. It was verified that the passage of peroxide was higher in GD than in GE (p<0.01). The GC group presented a significantly lower peroxide passage than did GD and GE (p<0.01). It can be concluded that the hydrogen peroxide placed into the pulp chamber passed through the dental hard tissues, reaching the external surface and the periodontal tissue. The cementum surface was less permeable than were the dentin and enamel surfaces.

Enamel Defects in Maxillary Central Incisors of Infants With Unilateral Cleft Lip

Objective: To evaluate the presence of enamel alterations in deciduous maxillary central incisors of infants with unilateral cleft lip and alveolar ridge, with or without cleft palate, and to compare the occurrence and location of these alterations between the central incisor adjacent to the cleft and the contralateral incisor.Design: Intraoral clinical examination was performed after tooth cleaning and drying by a single examiner with the aid of a dental mirror, dental probe, and artificial light, with the child positioned on a dental chair. The defects were recorded in a standardized manner according to the criteria of the Modified Developmental Defects of Enamel Index.Setting: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC) at Bauru, São Paulo, Brazil.Patients: One hundred one infants were evaluated. All were white, of both genders, aged 12 to 36 months and had at least two thirds of the crowns of maxillary incisors erupted.Results: Demarcated opacity was the most common defect at both cleft and noncleft sides, followed by diffuse opacity. The occurrence of hypoplasia at the cleft side was 11.8%. Most defects affected less than one third of the crown.Conclusion: The occurrence of enamel defects in deciduous maxillary central incisors of patients with unilateral cleft lip was 42.6%, mainly affecting the cleft side as to both number and severity.

In vitro evaluation of the microhardness of bovine enamel exposed to acid solutions after bleaching

Acid erosion is a superficial loss of enamel caused by chemical processes that do not involve bacteria. Intrinsic and extrinsic factors, such as the presence of acid substances in the oral cavity, may cause a pH reduction, thus potentially increasing acid erosion. The aim of this study was to evaluate the microhardness of bleached and unbleached bovine enamel after immersion in a soda beverage, artificial powder juice and hydrochloric acid. The results obtained for the variables of exposure time, acid solution and substrate condition (bleached or unbleached enamel) were statistically analyzed by the ANOVA and Tukey tests. It was concluded that a decrease in microhardness renders dental structures more susceptible to erosion and mineral loss, and that teeth left unbleached show higher values of microhardness compared to bleached teeth.

Morphology of the dental carinae in Mariliasuchus amarali (Crocodylomorpha, Notosuchia) and the pattern of tooth serration among basal Mesoeucrocodylia.

Carinated teeth are common in Mesoeucrocodylia, and the occurrence of denticles over the carinae is related to high predacious species, often referred as ziphodont. This characteristic is broadly recognized as homoplastic. Carinae morphology is cryptic, difficult to be studied under common techniques, and Scanning Electronic Microscopy (SEM) allows the access to detailed information, offering a higher degree of confidence. Previous SEM study allowed the recognition of true/false ziphodont patterns, according to the morphology of the denticles, but such studies on gondwanan mesoeucrocodyles are uncommon. Mariliasuchus amarali is an Upper Cretaceous notosuchian mesoeucrocodyle from South America (Bauru Group, Brazil), with carinated teeth and specialized dentition. Its geological and biochronological distribution are reappraised. SEM study of two teeth shows carinae composed of isolated tuberous anisomorphic true denticles, supporting previous study. Enamel ornamentation does not develop over the carinae, and fabric becomes anastomosed in middle and posterior teeth. Carinae only occur in posterior molariform teeth, related to food processing. Morphological variability of Mariliasuchus is commented, focusing on dentition. Overall characteristics, molariform morphology and wear planes support a non-predacious habit for Matiliasuchus. Matiliasuchus pattern could not be related to true/false ziphodont patterns, either by morphology or function, and is defined as ziphomorph. Ziphomorph pattern is evaluated within the range of mesoeucrocodyles. The detailed study of homoplastic characteristics, such as dental carinae, may provide useful apomorphic information for cladistic analysis.

Penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel.

PURPOSE: To evaluate the penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel. MATERIALS AND METHODS: Forty-eight maxillary and mandibular caries-free premolars scheduled for extraction for orthodontic reasons were isolated, the occlusal surfaces subjected to prophylaxis and acid-etched with orthophosphoric acid prior to the application of the VariGlass VLC glass ionomer and Concise resin sealants. The teeth were extracted, two longitudinal median sectiors from each tooth were ground to a thickness of 80-100 microns, and the sealant penetration into the fissures evaluated. The sections were placed in nitric acid to dissolve the enamel so the lengths of the tags which had penetrated into the etched enamel could be measured at different sites on the walls of the fissures. RESULTS: Both sealants adapted well to the fissures but penetrated deeper into shallow, open fissures than into deep, constricted fissures. The VariGlass VLC tags into etched enamel were generally longer than the Concise projections.

Use of one-bottle adhesive as an intermediate bonding layer to reduce sealant microleakage on saliva-contaminated enamel

Purpose: To evaluate the influence of three different adhesives, each used as an intermediary layer, on microleakage of sealants applied under condition of salivary contamination. Materials and Methods: Six different experimental conditions were compared, 3 with adhesives and 3 without. After prophylaxis and acid etching of enamel, salivary contamination was placed for 10 s. In Group SC the sealant was applied after saliva without bonding agent and then light-cured. In Group SCA, after saliva, the surface was air dried, and then the sealant was applied and cured. In Groups ScB, SB and PB, a bonding agent (Scotchbond Dual Cure/3M, Single Bond/3M and Prime & Bond 2.1/Dentsply, respectively) was applied after the saliva and prior to the sealant application and curing. After storage in distilled water at 37°C for 24 hrs, the teeth were submitted to 500 thermal cycles (5°C and 55°C), and silver nitrate was used as a leakage tracer. Leakage data were collected on cross sections as percentage of total enamel-sealant interface length. Representative samples were evaluated under SEM. Results: Sealants placed on contaminated enamel with no bonding agent showed extensive microleakage (94.27% in SC; 42.65% in SCA). The SEM revealed gaps as wide as 20 μm in areas where silver nitrate leakage could be visualized. In contrast, all bonding agent groups showed leakage less than 6.9%. Placement of sealant with a dentin-bonding agent on contaminated enamel significantly reduced microleakage (P< 0.0001). The use of a bonding agent as an intermediary layer between enamel and sealant significantly reduced saliva's effect on sealant microleakage.