Marginal adaptation and performance of bioactive dental restorative materials in deciduous and young permanent teeth

Objective: The aim of this study was to investigate the adaptation of different types of restorations towards deciduous and young permanent teeth. Materials and Methods: Class V cavities were prepared in deciduous and young permanent teeth and filled with different materials (a conventional glass-ionomer, a resin-modified glass-ionomer, a poly-acid-modified composite resin and a conventional composite resin). Specimens were aged in artificial saliva for 1, 6, 12 and 18 months, then examined by SEM. Results: The composite resin and the polyacid-modified composite had better marginal adaptation than the glass-ionomers,though microcracks developed in the enamel of the tooth. The glass-ionomers showed inferior marginal quality and durability, but no microcracking of the enamel. The margins of the resin-modified glass-ionomer were slightly superior to the conventional glass-ionomer. Conditioning improved the adaptation of the composite resin, but the type of tooth made little or no difference to the performance of the restorative material. All materials were associated with the formation of crystals in the gaps between the filling and the tooth; the quantity and shape of these crystals varied with the material. Conclusions: Resin-based materials are generally better at forming sound, durable margins in deciduous and young permanent teeth than cements, but are associated with microcracks in the enamel. All fluoride-releasing materials give rise to crystalline deposits.

Background interference on the color of dental composite materials with different thickness by digital contrast

In this work the color dependence of resin composites with the background color was evaluated. The objective was to measure since what thickness the color of the sample stops being influenced by the color of the background over which the resin is placed and the methodology used in experiment was based in analyzing the contrast of digital images of the sample over a black background. The results shown that since 0.8 mm the images contrast becomes almost constant; it prove that since this thickness the color of resin composite depends on the optical resin properties only. The experiment was repeated under three conditions of luminosity to evaluate the influence of it on the image contrast and the results obtained were identical.

The applicability of using different energy levels in CT imaging for differentiation or identification of dental restorative materials.

PURPOSE The goal of this study was to investigate whether different computed tomography (CT) energy levels could supply additional information for the differentiation of dental materials for forensic investigations. METHODS Nine different commonly used restorative dental materials were investigated in this study. A total of 75 human third molars were filled with the restorative dental materials and then scanned using the forensic reference phantom in singlesource mode. The mean Hounsfield unit values and standard deviations (SDs) of each material were calculated at 120, 80 and 140 kVp. RESULTS Most of the dental materials could be differentiated at 120 kVp. We found that greater X-ray density of a material resulted in higher SDs and that the material volume could influence the measurements. CONCLUSION Differentiation of dental materials in CT was possible in many cases using single-energy CT scans at 120 kVp. Because of the number of dental restorative materials available and scanner and scan parameter dependence, as well as the CT imaging artifacts, the identification (in contrast to differentiation) was problematic.

Changes on transmittance mode of different composite resins

The purpose of this study was to evaluate the transmittance of seven different composite resins. Ten specimens were prepared (10 mm diameter, 2 mm thickness) for each experimental group, as follows: G1- Charisma® A 2 (Heraeus-Kulzer); G2- Filtek™ Supreme A 2E (3M/ESPE); G3- Filtek™ Supreme A2B (3M/ESPE); G4-Filtek™ Supreme YT (3M/ESPE); G5- Esthet-X® A2 (Dentsply); G6- Esthet-X® YE (Dentsply); G7- Durafill® A 2 (Heraeus-Kulzer) and G8- Filtek™ Z-100 A2 (3M/ESPE). The transmittance mode was measured using a UV-visible spectrophotometer (Cary Instruments) at 400-760 nm. The specimens were evaluated at three different times: zero hour (initial), 24 hours and 10 days after immersion in artificial saliva. The differences in transmittance were determined by two-way analysis of variance (ANOVA) and Tukey's test. The various composite resins showed significant differences in the wavelength dependence of transmittance. The mean values of transmittance increased significantly, with wavelengths increasing from 400 to 760 nm. The performance of the experimental groups was similar in terms of immersion time, considering that at time zero and after 10 days, all the groups showed similar results, which were statistically higher than the values obtained after 24 hours of immersion. The Filtek™ Supreme YT composite resin presented the highest mean transmittance values along the wavelengths at the three measured times. Esthet-X® YE and Durafill® yielded similar mean transmittance values, which were higher than those of the other groups. This study shows that the transmittance values of composite resins are directly related with the type, size and amount of inorganic filler particles.

Effect of different dental composite resins on the polymerization process

Dental composite resins possess good esthetic properties, and are currently among the most popular dental restorative materials. Both organic and inorganic phases might influence the material behavior, the filler particle features and rate are the most important factors related to improvement of the mechanical properties of resin composites. Thus, the objective of this study was to evaluate the effect of three different composite resins on the polymerization process by Vickers hardness test. The samples were prepared using three different composite resins, as follow: group I-P-60 (3M/ESPE); group II-Herculite XRV (Kerr), and group III-Durafill (Heraeus-Kulzer). The samples were made in a polytetrafluoroethylene mould, with a rectangular cavity measuring 7 mm in length, 4 mm in width, and 3 mm in thickness. The samples were photo-activated by one light-curing unit based on blue LEDs (Ultrablue III-DMC/Brazil) for 20 and 40 s of irradiation times. The Vickers hardness test was performed 24 h after the photo-activation until the standardized depth of 3 mm. The Vickers hardness mean values varied from 158.9 (+/- 0.81) to 81.4 (+/- 1.94) for P-60, from 138.7 (+/- 0.37) to 61.7 (+/- 0.24) for Herculite XRV, and from 107. 5 (+/- 0.81) to 44.5 (+/- 1.36) for Durafill composite resins photo-activated during 20 s for the 1st and 2nd mm, respectively. During 40 s of photo-activation, the Vickers hardness mean values were: from 181.0 (+/- 0.70) to 15.6 (+/- 0.29) for P-60, and from 161.8 (+/- 0.41) to 11.2 (+/- 0.17) for Herculite XRV composite resins, for the 1st and 3th mm, respectively. For Durafill composite resin the mean values varied from 120.1 (+/- 0.66) to 61.7 (+/- 0.20), for the 1st and 2nd mm, respectively. The variation coefficient (CV) was in the most of the groups lower than 1%, then the descriptive statistic analysis was used. The Vickers hardness mean values for Durafill were lower than P-60 and Herculite XRV composite resins for 20 and 40 s of irradiation time. The polymerization process was greatly affected by the composition of the composite resins.

Effect of different dental composite resins on the polymerization process

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

The Effectiveness of Low-Intensity Red Laser for Activating a Bleaching Gel and Its Effect in Temperature of the Bleaching Gel and the Dental Pulp

Statement of the Problem: The effectiveness of low-intensity red laser for activating a bleaching gel and its effect in pulp temperature was not investigated in dental literature. Purpose: The objective of this study was to assess the effectiveness of low-intensity red laser for activating a bleaching gel, as well as its effect in temperature of the bleaching gel and the dental pulp. Materials and Methods: Forty extracted bovine teeth were immersed in a solution of coffee 14 days for darkening. The initial colors were recorded by spectrophotometric analysis. The specimens were randomly distributed into two groups (N = 20): the control, which did not receive light and the experimental group that received light from an appliance fitted with three red light-emitting laser diodes (? = 660 nm). A green-colored, 35% H2O2based bleaching gel was applied for 30 minutes, and changed three times. After bleaching, the colors were again measured to obtain the L*a*b* values. Color variation was calculated (?E) and the data submitted to the non-paired t-test (5%). To assess temperature, 10 human incisors were prepared, in which one thermocouple was placed on the bleaching gel applied on the surface of the teeth and another inside the pulp chamber. Results: There was a significant difference between the groups (p = 0.016), and the experimental group presented a significantly higher mean variation (7.21 +/- 2.76) in comparison with the control group (5.37 +/- 1.76). There was an increase in pulp temperature, but it was not sufficient to cause damage to the pulp. Conclusion: Bleaching gel activation with low-intensity red laser was capable of increasing the effectiveness of bleaching treatment and did not increase pulp temperature to levels deleterious to the pulp. CLINICAL SIGNIFICANCE The application of a low-intensity red laser was effective for activating a bleaching gel with green dye, without any deleterious increases in pulpal temperature. (J Esthet Restor Dent 24:126134, 2012)

Efficacy and cytotoxicity of a bleaching gel after short application times on dental enamel

Objectives: This study aimed to evaluate and correlate the efficacy and cytotoxicity of a 35 % hydrogen peroxide (HP) bleaching gel after different application times on dental enamel. Materials and methods: Enamel/dentin disks in artificial pulp chambers were placed in wells containing culture medium. The following groups were formed: G1, control (no bleaching); G2 and G3, three or one 15-min bleaching applications, respectively; and G4 and G5, three or one 5-min bleaching applications, respectively. Extracts (culture medium with bleaching gel components) were applied for 60 min on cultured odontoblast-like MDPC-23 cells. Cell metabolism (methyl tetrazolium assay) (Kruskal-Wallis/Mann-Whitney; α = 5 %) and cell morphology (scanning electron microscopy) were analyzed immediately after the bleaching procedures and the trans-enamel and trans-dentinal HP diffusion quantified (one-way analysis of variance/Tukey's test; α = 5 %). The alkaline phosphatase (ALP) activity was evaluated 24 h after the contact time of the extracts with the cells (Kruskal-Wallis/Mann-Whitney; α = 5 %). Tooth color was analyzed before and 24 h after bleaching using a spectrophotometer according to the Commission Internationale de l'Eclairage L*a*b* system (Kruskal-Wallis/Mann-Whitney; α = 0.05). Results: Significant difference (p < 0.05) in cell metabolism occurred only between G1 (control, 100 %) and G2 (60.6 %). A significant decrease (p < 0.05) in ALP activity was observed between G2, G3, and G4 in comparison with G1. Alterations on cell morphology were observed in all bleached groups. The highest values of HP diffusion and color alterations were observed for G2, with significant difference among all experimental groups (p < 0.05). G3 and G4 presented intermediate color change and HP diffusion values with no statistically significant differences between them (p > 0.05). The lowest amount of HP diffusion was observed in G5 (p < 0.05), which also exhibited no significant color alteration compared to the control group (p > 0.05). Conclusions: HP diffusion through dental tissues and its cytotoxic effects were proportional to the contact time of the bleaching gel with enamel. However, shorter bleaching times reduced bleaching efficacy. Clinical relevance: Shortening the in-office tooth bleaching time could be an alternative to minimize the cytotoxic effects of this clinical procedure to pulp tissue. However, the reduced time of bleaching agent application on enamel may not provide adequate esthetic outcome. © 2012 Springer-Verlag Berlin Heidelberg.

Bacterial Cellulose/Chondroitin Sulfate for Dental Materials Scaffolds

Bacterial cellulose (BC) has become established as a remarkably versatile biomaterial and can be used in a wide variety of scientific applications, especially for medical devices. In this work, the bacterial cellulose fermentation process is modified by the addition of chondroitin sulfate (1% w/w) to the culture medium before the bacteria are inoculated. Besides, biomimetic precipitation of calcium phosphate of biological interest from simulated body fluid on bacterial cellulose was studied. Chondroitin sulfate influences in bacterial cellulose were analyzed using transmission infrared spectroscopy (FTIR), XRD (X-ray diffraction) and scanning electron microscopy (SEM). FTIR analysis showed interaction between chondroitin sulfate, bacterial cellulose and calcium phosphate and XRD demonstrated amorphous calcium phosphate and carbonated apatite on bacterial cellulose nanocomposites. SEM images confirmed incorporation of calcium phosphate in bacterial celluloe nanocomposite surface and uniform spherical calcium phosphate particles. Future experiments with cells adhesion and viability are in course.

Esthetic dental anomalies as motive for bullying in schoolchildren

Facial esthetics, including oral esthetics, can severely affect children's quality-of-life, causing physical, social and psychological impairment. Children and adolescents with esthetic-related dental malformations are potential targets for bullies. This study was aimed to present and discuss patients who suffered from bullying at school and family environment due to esthetic-related teeth anomalies. Providing an adequate esthetic dental treatment is an important step in their rehabilitation when the lack of esthetic is the main source of bullying. After dental treatment, we noted significant improvement in self-esteem, self-confidence, socialization and academic performance of all patients and improvement in parental satisfaction regarding the appearance of their children. It is imperative that both family and school care providers be constantly alert about bullying in order to prevent or interrupt aggressive and discriminatory practices against children and adolescents. Clearly, dental anomalies may be a motive for bullying.

Flapless dental implant surgery : a retrospective study of 1,241 consecutive implants

Purpose: The purpose of this study was to identify retrospectively the predictors of implant survival when the flapless protocol was used in two private dental practices. Materials and Methods: The collected data were initially computer searched to identify the patients; later, a hand search of patient records was carried out to identify all flapless implants consecutively inserted over the last 10 years. The demographic information gathered on statistical predictors included age, sex, periodontal and peri-implantitis status, smoking, details of implants inserted, implant locations, placement time after extraction, use of simultaneous guided hard and soft tissue regeneration procedures, loading protocols, type of prosthesis, and treatment outcomes (implant survival and complications). Excluded were any implants that required flaps or simultaneous guided hard and soft tissue regeneration procedures, and implants narrower than 3.25 mm. Results: A total of 1,241 implants had been placed in 472 patients. Life table analysis indicated cumulative 5-year and 10-year implant survival rates of 97.9% and 96.5%, respectively. Most of the failed implants occurred in the posterior maxilla (54%) in type 4 bone (74.0%), and 55.0% of failed implants had been placed in smokers. Conclusion: Flapless dental implant surgery can yield an implant survival rate comparable to that reported in other studies using traditional flap techniques.