Boniek Castillo Dutra Borges

Arrest of non-cavitated dentinal occlusal caries by sealing pits and fissures: a 36-month, randomised controlled clinical trial

OBJECTIVE This study aimed to evaluate the progression of sealed non-cavitated dentinal occlusal caries in a randomised controlled clinical trial. MATERIALS AND METHODS Sixty teeth with non-cavitated dentinal occlusal caries were selected in patients with a high risk for caries. Patients were randomly divided into two groups so that each group included 30 teeth. Patients in the experiment group were given oral hygiene instructions and a fissure sealant. Patients in the control group were given oral hygiene instructions only. Caries progression and sealant loss were monitored over a period of 36 months by clinical and radiographic examinations. RESULTS Clinical and radiographic progression of caries was significantly more frequent in the control group than in the experiment group. Three teeth lost their sealant and showed caries progression, but this was apparent only at the 12-month follow-up. At the 24- and 36-month recall appointments, neither sealant loss nor caries progression were observed. CONCLUSION The pit and fissure sealant utilised in this study was shown to be effective in arresting carious lesions at 36 months.

Impact of remineralizing agents on enamel microhardness recovery after in-office tooth bleaching therapies

OBJECTIVE It has been shown that bleaching with 35/38% hydrogen peroxides may alter both enamel morphology and mineral content. This study aimed to analyze the morphology and microhardness of enamel bleached with in-office hydrogen peroxides and exposed toremineralizing agents. MATERIALS AND METHODS After recording initial enamel morphology and microhardness, 60 bovine incisors were bleached using either a calcium-containing 35% hydrogen peroxide (Whiteness HP Blue) or a calcium-free 35% hydrogen peroxide (Whitegold Office) (n = 30). Then, the teeth were subjected to one of three post-bleaching remineralizing treatments (n = 10): storage in artificial saliva only, application of a sodium fluoride gel or application of a nanohydroxyapatite-based agent (Nano-P). After 24 h and 14 days of post-bleaching treatments, the enamel morphology and microhardness were re-evaluated. The microhardness data were analyzed by means of two-way ANOVA with repeated measurements and Tukey tests (p < 0.05), while the enamel morphology was analyzed descriptively. RESULTS Samples exposed to Nano-P presented statistically the highest microhardness 24 h after its application in comparison with other remineralizing agents. The microhardness recovery did not occur in any of the groups 14 days after treatment. The morphology of all samples 14 days after the application of all remineralizing agents presented a higher number of irregularities. CONCLUSION Although some remineralizing products provided microhardness recovery and a positive effect on enamel morphology at 24 h post-bleaching, none of them were able to maintain microhardness and enamel morphology at 14 days post-bleaching.

Efficacy of in-office bleaching techniques combined with the application of a casein phosphopeptide-amorphous calcium phosphate paste at different moments and its influence on enamel surface properties

OBJECTIVES: The aim of this in vitro study was to investigate the efficacy of in‐office bleaching technique combined with the application of a casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP) paste (MI Paste–MI) at different moments and its influence on enamel surface properties. METHODS: Eighty bovine dental crowns were randomly allocated into eight groups (n = 10), and bleached with either 35% hydrogen peroxide (HP) or 37% carbamide peroxide (CP). Four different protocols of application of MI were considered: without MI, MI applied before bleaching, MI applied after bleaching, and MI applied both before and after bleaching. Bleaching effectiveness was measured by the VITA EasyShade spectrophotometer utilizing the CIEL*a*b* system (ΔE, ΔL*, Δa*, and Δb*). Color readings were measured at baseline, 7, 14, and 21 days. Hardness and roughness were measured at baseline (T0) and immediately after bleaching (T14). Data were subjected to the two‐way ANOVA for repeated measurements and Tukeys test at 5%. RESULTS: HP groups achieved the greatest color change. The application of a CPP‐ACP paste did not reduce the efficacy of bleaching peroxides. Samples bleached with CP showed decreased hardness at T14. Samples bleached with HP that received the application of MI before and before/after bleaching did not present hardness decrease at T14. Samples bleached with peroxides only and received MI after bleaching showed increased roughness at T14. CONCLUSIONS: The use of CPP‐ACP was able to prevent negative changes in roughness and hardness of bovine enamel when associated to hydrogen peroxide, and might be applied before/after the bleaching protocol. Microsc. Res. Tech. 75:1019–1025, 2012.

Influence of extended light exposure time on the degree of conversion and plasticization of materials used as pit and fissure sealants

AIM To evaluate the conversion and plasticization of fissure sealer materials, as influenced by extended curing time. METHODS Twenty specimens (n=5) of a pit and fissure sealant and a flowable composite at two curing times (20 and 60 sec) were photocured with the Bluephase 16i light-emitting diode. The conversion was determined by Fourier transform infrared/attenuated total reflection spectroscopy 24 h after polymerization. Hardness was measured, and samples were stored in absolute ethanol for 24 h. A second hardness measurement was executed after storage to assess plasticization by the percentage of hardness decrease. Data were analyzed by analysis of variance and Pearsons correlation (α=0.05). RESULTS The pit and fissure sealant showed lower degree of conversion than the flowable composite. The 60-sec curing time increased the conversion only for the flowable composite. Plasticization was lower for the flowable composite than for the pit and fissure sealant. The 60-sec light exposure time showed a similar percentage of hardness decrease of 20 sec. A low correlation between the conversion and plasticization was found. CONCLUSION Extended curing time improved the conversion only for the flowable composite. The pit and fissure sealant presented lower conversion and higher plasticization than the flowable composite.

Efficacy of a non-drilling approach to manage non-cavitated dentin occlusal caries in primary molars: a 12-month randomized controlled clinical trial.

BACKGROUND. Despite the efficacy of non-drilling approaches to manage non-cavitated dentin occlusal lesions (NCDOL) in permanent teeth, there is no data validating this type of therapy in the primary dentition. AIM. To compare the efficacy of a traditional fissure sealant in managing NCDOL in primary molars. DESIGN. This study is a randomized controlled clinical trial with a split-mouth design. Thirty schoolchildren with two NCDOL were selected and divided into two groups. The experimental group received a resin-based fissure sealant, whereas the control group was treated with a conventional composite resin. Treatment efficacy was evaluated after 1 year by means of clinical and radiographic examinations. RESULTS. The two treatment modalities were found to be similarly effective in managing DONCL in primary molars. CONCLUSION. For the management of non-cavitated dentin occlusal caries in primary teeth, the invasive approach can be replaced with non-drilling fissure sealing techniques.

Effect of irradiation times on the polymerization depth of contemporary fissure sealants with different opacities

The aim of this study was to evaluate the depth of curing of 10 contemporary blue light-activated dental flowable materials at several opacities, influenced by different irradiation times using FT-IR spectroscopy. Fifty-five specimens (n = 5) with a 5-mm diameter and 1-mm thickness of translucent (Opallis Flow T), yellowed (Master Flow A2; Opallis Flow A2; Natural Flow A2; Fluroshield Yellowed), and opaque materials (Master Flow OA2; Natural Flow O; Opallis Flow OA3.5; Opallis Flow OP; Fluroshield White) were obtained at six curing times (10s, 20s, 30s, 40s, 50s, and 60s) using a high-intensity LED (Coltolux, Coltène/Whaledent). The degree of conversion (DC) (%) was obtained using the Nexus 470 FTIR Spectrometer (Nicolet Instruments, USA). The FTIR-ATR spectra for uncured and cured samples were analyzed using a ZnSe crystal. The top and bottom surfaces of the cured specimens were analyzed to obtain the depth of curing. Two-way ANOVA was used to analyze the data. The highest curing depth was obtained by Natural Flow OA2, while the lowest was shown by Master Flow OA2. The shortest curing time generated similar depths of cure in comparison with the most extensive for Opallis Flow A2 and Fluroshield Yellowed. Therefore, depth of curing, influenced by the irradiation time, was dependent on the materials. Using the Natural Flow OA2 opaque sealant and the 10-s curing time for Opallis Flow A2 and Fluroshield Yellowed may represent alternative approaches to sealing tooth fissures.

Influence of the curing mode on the degree of conversion of a dual-cured self-adhesive resin luting cement beneath ceramic

Abstract Objective. To evaluate the effect of the delayed photoactivation and ceramic barrier on the degree of conversion (DC) of self-adhesive resin cement. Materials and methods. Circular specimens (5 mm in diameter × 1 mm in thickness) of the RelyX U-100 resin cement were made using the following curing protocols (n = 10): (G1) 40 s beneath a IPS Empress II ceramic; (G2) 40 s of direct photocuring; (G3) 80 s beneath the ceramic; (G4) 80 s of direct photocuring; (G5) self-curing; (G6) 5 min in the absence of light (self-curing) followed by transceramic photocuring for 40 s; (G7) 5 min in the absence of light (self-curing) followed by transceramic photocuring for 80 s. All the specimens were photoactivated by LED (800 mW/cm2). After 24 h of dry storage, the DC was measured by FTIR, on the top surface of the specimens. Data were submitted to one-way ANOVA and Tukey test (p ≤ 0.05). Results. Direct photocuring with no ceramic interposition, regardless of the curing time (40 s and 80 s) promoted the highest conversion mean (56.79 ± 1.19 and 59.98 ± 2.93, respectively) and the 5 min delay time for the transceramic photocuring presented a similar mean compared to the immediate transceramic photocuring. The DC was influenced by the ceramic barrier, decreasing the conversion values (49.72 ± 1.91 for 40 s and 52.36 ± 2.50 for 80 s), with no statistical difference from the groups with the previous 5 min of photoactivation delay. The self-cure only showed the worst DC values. Conclusion. Direct photocuring provided a higher degree of conversion for the self-adhesive resin cement. The delayed light activation did not influence the degree of conversion for the resin cement tested.

Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

OBJECTIVE: To determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10%) combined with estriol (0.1%) + estradiol (0.25%) for relieving postmenopausal symptoms. METHODS: A total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512. RESULTS: An improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05) after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04±4.9 to 57.12±4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol. CONCLUSION: The nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women.

EFFECTS OF A NEW TESTOSTERONE TRANSDERMAL DELIVERY SYSTEM, BIOLIPID B2®-TESTOSTERONE IN HEALTHY MIDDLE AGED MEN: A CONFOCAL RAMAN SPECTROSCOPY STUDY

The Transdermal Delivery System (BIOLIPID B2®) is a nanoemulsion that can be a pplied directly to the skin by a metered pump to deliver hormones into the systemic circulation. The ai ms of this study were to assess the efficacy of BIOLIPID B2 ® to deliver testosterone systemically and evaluate the short - term effects on Thyroid - Stimulating Hormone (TSH), C - reactive protein (CRP) serum levels and blood pressure in middle aged men with tes tosterone deficiency . An open label randomized prospective study enrolled 14 Brazilian middle aged men with testosterone deficiency . The volunteers received in the forearm 50mg of transdermal BIOLIPID B2® - testosterone nanostructured formulation daily for 3 months. Confocal Raman Spectroscopy (CRS) was used to determine depth and concentration of testosterone on skin layers. Clinical parameters and serum concentrations were compared between the base line and 3 months after treatment. Serum concentrations of t estosterone, CPR and TSH changed significantly (p 0.05) and no changes were observed in the blood pressure . N o adverse events were attribu ted to this transdermal hormone replacement therapy protocol. The BIOLIPID B2 ® nanoemulsion formulation is safe and effective in reestabli shing testosterone and Thyroid - Stimulating Hormone (T SH) serum levels. This transdermal protocol may serve as a strate gy for hormone replacement therapy in middle aged men.

Preliminary study of a novel in-office bleaching therapy modified with a casein phosphopeptide-amorphous calcium phosphate.

Although in‐office bleaching has been proven successful for bleaching teeth, controversy exists from morphological alterations in enamel morphology due to mineral loss and tooth sensitivity. This preliminary study aimed to evaluate the efficacy of a novel in‐office tooth bleaching technique modified with a casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP) paste (MI paste—MI) and its effect on the enamel morphology and tooth sensitivity. Three patients received a 35% hydrogen peroxide (Whiteness HP—HP) dental bleaching system. HP was prepared and applied on the teeth on one of the hemiarches, whilst teeth on the other hemiarch were bleached with a mixture of HP and MI. Tooth color, epoxy resin replicas, and sensitivity levels were evaluated in the upper incisors. The results were analyzed descriptively. Right and left incisors showed similar color change after bleaching. Incisors bleached with the mixture of HP and MI presented unaltered enamel surfaces and lower sensitivity levels. The currently tested tooth bleaching technique did not reduce the gel effectiveness while decreasing hypersensitivity levels and protecting the enamel against surface alterations caused by the high‐concentration bleaching peroxide tested. The concomitant use of MI Paste and high‐concentration hydrogen peroxide might be a successful method for decreasing tooth sensitivity and limiting changes in the enamel morphology during in‐office bleaching. Microsc. Res. Tech. 2012.