Cláudia Cristina Brainer de Oliveira Mota

Marginal analysis of resin composite restorative systems using optical coherence tomography

OBJECTIVES To analyze marginal integrity of resin composites dental restorations using optical coherence tomography (OCT). METHODS Thirty extracted human premolars had occlusal cavities prepared and were randomly divided according to the restorative systems evaluated: Filtek P90™/P90 Adhesive System™, Filtek Z350™, and Filtek Z250™/Single Bond™ (3M/ESPE). The teeth were then stored in the dark for 24h in 0.9% saline solution. Restorations were finished and polished and stored again for 24h before thermocycling (500 cycles, 5-55°C). A commercially available OCT system was used (SR-OCT: OCP930SR/Thorlabs) with 930nm central wavelength. Cross-sectional images were obtained every 250μm and evaluated using Image J. A-scans were analyzed using the Origin 8.0 program, after a filter treatment using Matlab. RESULTS The qualitative analysis of the internal margins did not observe gaps even after A-scan examination, although distinctive patterns were found for each restorative system. Penetration of Single Bond and Filtek P90 self-etch primer into dentin was also observed. A thick adhesive layer was found for Filtek P90 bonding agent. SIGNIFICANCE Considering the characteristics of the OCT system, the setup used in this study was capable of evaluating the marginal integrity of resin composite restorations and detecting some interaction between dental bonding agents and dental substrates. OCT can be considered a promising method for the evaluation of the internal margins of restorations in vivo.

Alternative methods for determining shrinkage in restorative resin composites

OBJECTIVES The purpose of this study was to evaluate polymerization shrinkage of resin composites using a coordinate measuring machine, optical coherence tomography and a more widely known method, such as Archimedes Principle. Two null hypothesis were tested: (1) there are no differences between the materials tested; (2) there are no differences between the methods used for polymerization shrinkage measurements. METHODS Polymerization shrinkage of seven resin-based dental composites (Filtek Z250™, Filtek Z350™, Filtek P90™/3M ESPE, Esthet-X™, TPH Spectrum™/Dentsply 4 Seasons™, Tetric Ceram™/Ivoclar-Vivadent) was measured. For coordinate measuring machine measurements, composites were applied to a cylindrical Teflon mold (7 mm × 2 mm), polymerized and removed from the mold. The difference between the volume of the mold and the volume of the specimen was calculated as a percentage. Optical coherence tomography was also used for linear shrinkage evaluations. The thickness of the specimens was measured before and after photoactivation. Polymerization shrinkage was also measured using Archimedes Principle of buoyancy (n=5). Statistical analysis of the data was performed with ANOVA and the Games-Howell test. RESULTS The results show that polymerization shrinkage values vary with the method used. Despite numerical differences the ranking of the resins was very similar with Filtek P90 presenting the lowest shrinkage values. SIGNIFICANCE Because of the variations in the results, reported values could only be used to compare materials within the same method. However, it is possible rank composites for polymerization shrinkage and to relate these data from different test methods. Independently of the method used, reduced polymerization shrinkage was found for silorane resin-based composite.

Non-Invasive Periodontal Probing Through Fourier-Domain Optical Coherence Tomography.

BACKGROUND Periodontitis is a multifactorial and infectious disease that may result in significant debilitation. The aim of this study is to exploit two optical coherence tomography (OCT) systems operating in the Fourier domain at different wavelengths, 930 and 1,325 nm, for structural analysis of periodontal tissue in porcine jaws. METHODS Five fresh porcine jaws were sectioned and stored in formalin before OCT analysis. Two- and three-dimensional OCT images of the tooth/gingiva interface were performed, and measurements of the gingival structures were obtained. The 930-nm OCT system operates in the spectral domain, whereas the 1,325-nm system is a swept-source model. Stereomicroscope images, the gold standard, were used for direct comparison. RESULTS Through image analysis, it is possible to identify the free gingiva and the attached gingiva, the calculus deposition over tooth surfaces, and the subgingival calculus that enables the enlargement of the gingival sulcus. In addition, the gingival thickness and the gingival sulcus depth can be non-invasively measured, varying from 0.8 to 4 mm. CONCLUSIONS Regarding the ability of the two OCT systems to visualize periodontal structures, the system operating at 1,325 nm shows a better performance, owing to a longer central wavelength that allows deeper tissue penetration. The results with the system at 930 nm can also be used, but some features could not be observed due to its lower penetration depth in the tissue.

Optical Coherence Tomography as an Auxiliary Tool for the Screening of Radiation-Related Caries

OBJECTIVE The aim of this study was to evaluate the morphological alterations of radiation-related caries using optical coherence tomography. METHODS Thirty-six extracted teeth from 11 patients who had undergone radiotherapy were sectioned in the sagittal axis in the center of the carious lesion, and 100 μm thick sections were obtained from each specimen. One sample from each tooth was investigated by an optical coherence tomography (OCT) system, and the results were compared with histological images from polarized light microscopy. RESULTS In OCT dentin caries images, the demineralized area appeared as a white region, whereas the translucent zone appeared as a dark area, a similar pattern also seen in coronal caries. In noncavitated enamel lesions clinically observed as brown discoloration, the area of high porosity, and also the dark color, absorbs part of the light, resulting in a dark pattern. Finally, the involvement of dentin-enamel junction (DEJ) or cement-enamel junction (CEJ) could be clearly observed, when present and marked alterations along the CEJ could be noted, as junction continuity loss, gap formation, and mineral loss tissue. CONCLUSIONS The OCT technique was able to characterize radiation-related caries, from a morphological point of view. Also demonstrated was its potential benefit for use in the clinical monitoring of radiation-related carious process.

Fracture process characterization of fiber-reinforced dental composites evaluated by optical coherence tomography, SEM and optical microscopy

This study used optical coherence tomography (OCT) compared to scanning electron microscopy (SEM) and optical microscopy (OM) to evaluate qualitatively crack propagation and final fracture in restorative composite materials - Filtek Z250 and Filtek Z350 (3M ESPE) - with fiber reinforcement after cyclic loading. Samples were made using a split mold. Initially, 3-point bending tests were performed to determine the maximum force and tension at the fracture moment using samples without fiber reinforcement. Then, mechanical cycling tests were performed using samples with glass fiber embedded internally. The failures were analyzed using the 3 methods described before. OCT permitted good characterization of internal crack propagation of the dental composites, which, however, could not be visualized by either SEM or OM. OCT was proven to be laboratory research tool that is easy to use, does not require any specific preparation of the samples, and is less expensive than SEM.

Optical coherence tomography applied to the evaluation of wear of composite resin for posterior teeth

Resin composites are widely used as restorative materials due to their excellent aesthetical and mechanical properties. Posterior teeth are constantly submitted to occlusal stress and upon restoration require more resistant resins. The aim of this study was to analyze in vitro the wear suffered over time by restorations in resin composite in posterior teeth, by Optical Coherence Tomography (OCT). 30 molars had occlusal cavities prepared and were randomly divided into three groups (n=10) and restored with resin composite: G1: Filtek P90 (3M/ESPE), G2: Tetric N-Ceram (Ivoclar Vivadent); G3: Filtek P60 (3M/ESPE). Specimens were subjected to initial analysis by OCT (OCP930SR, Thorlabs, axial resolution 6.2 μm) and stereoscopic microscope. Specimens were submitted to thermocycling (500 cycles, 5-55 °C) and subjected to simulated wear through a machine chewing movements (Wear Machine WM001), projecting four years of use. After mechanical cycles, the specimens were submitted to a second evaluation by the OCT and stereoscopic microscopy. As a result, it was observed that 90% of the restorations of both groups had fractures and/or points of stress concentration, considered niches for early dissemination of new fracture lines. It was also found that G1 and G2 had more points of stress concentration, whereas G3 had a higher incidence of fracture lines already propagated. It was concluded that the G3 showed more brittle behavior at the masticatory wear when compared to G1 and G2.

Comparative analysis of gingival phenotype in animal and human experimental models using optical coherence tomography in a non-invasive approach

Imaging methods are widely used in diagnostic and among the diversity of modalities, optical coherence tomography (OCT) is nowadays commercially available and considered the most innovative technique used for imaging applications, in both medical and non-medical applications. In this study, we exploit the OCT technique in the oral cavity for identification and differentiation between free and attached gingiva, as well as determining the gingival phenotype, an important factor to determination of periodontal prognosis in patients. For the animal studies, five porcine jaws were analyzed using a Swept Source SS-OCT system operating at 1325nm and stereomicroscope, as gold pattern. The SSOCT at 1325nm was chosen due to the longer central wavelength, that allows to deeper penetration imaging, and the faster image acquisition, an essential factor for clinical setting. For the patient studies, a total of 30 males and female were examined using the SS-OCT at 1325nm and computer controlled periodontal probing. 2D and 3D images of tooth/gingiva interface were performed, and quantitative measurements of the gingival sulcus could be noninvasively obtained. Through the image analysis of the animals jaws, it was possible to quantify the free gingiva and the attached gingiva, the calculus deposition over teeth surface and also the subgingival calculus. For the patient’s studies, we demonstrated that the gingival phenotype could be measured without the periodontal probe introduction at the gingival sulcus, confirming that OCT can be potentially useful in clinic for direct observation and quantification of gingival phenotype in a non-invasive approach.

Evaluation of the polymerization shrinkage of experimental flowable composite resins through optical coherence tomography

This study evaluated the polymerization shrinkage of two experimental flowable composite resins (CR) with different proportions of Urethane dimethacrylate (UDMA)/triethylene glycol dimethacrylate (TEGDMA) monomers in the organic matrix (50:50 and 60:40, respectively). A commercially available flowable CR, Tetric N-Flow (Ivoclair Vivadent, Liechtenstein, Germany), was employed as the control group. The resins were inserted in a cylindrical teflon mold (7 mm diameter, 0.6 mm height) and scanned with OCT before photoactivation, immediately after and 15 minutes after light-curing (Radii-Cal, SDI, Australia, 1,200 mW/cm2 ) exposure. A Callisto SD-OCT system (Thorlabs Inc, USA), operating at 930 nm central wavelength was employed for imaging acquisition. Cross-sectional OCT images were captured with 8 mm transverse scanning (2000x512 matrix), and processed by the ImageJ software, for comparison between the scanning times and between groups. Pearson correlation showed significant shrinkage for all groups in each time analyzed. Kruskal-Wallis test showed greater polymerization shrinkage for the 50:50 UDMA/TEGDMA group (p=0.001), followed by the control group (p=0.018). TEGDMA concentration was proportionally related to the polymerization shrinkage of the flowable composite resins.

Optical coherence tomography follow‐up of patients treated from periodontal disease

Optical coherence tomography (OCT) is one of the most important imaging modalities for biophotonics applications. In this work, an important step towards the clinical use of OCT in dental practice is reported, by following-up patients treated from periodontal disease (PD). A total of 147 vestibular dental sites from 14 patients diagnosed with PD were evaluated prior and after treatment, using a swept-source OCT and two periodontal probes (Florida probe and North Carolina) for comparison. The evaluation was performed at four stages: day 0, day 30, day 60 and day 90. Exceptionally one patient was evaluated 1-year after treatment. It was possible to visualize in the two-dimensional images the architectural components that compose the periodontal anatomy, and identify the improvements in biofilm and dental calculus upon treatment. In the follow-up after the treatment, it was observed in some cases decrease of the gingival thickness associated with extinction of gingival calculus. In some cases, the improvement of both depth of probing with the traditional probes and the evidence in the images of the region was emphasized. The study evidenced the ability of OCT in the identification of periodontal structures and alterations, being an important noninvasive complement or even alternative for periodontal probes for treatment follow-up. OCT system being used in a clinical environment. Above OCT image (left) prior treatment and (right) 30 days after treatment.

Potential of nano-silver fluoride for tooth enamel caries prevention

This ex vivo study evaluated the efficiency of nano-silver fluoride (NSF) to enamel remineralization of deciduous teeth submitted to a high cariogenic challenge. 33 specimens of sound enamel were distributed into three groups: treated with sodium fluoride, with NSF, and deionized water. All specimens were submitted to microhardness test before chemical caries induction; post-induction of caries; and post-cariogenic challenge. The high cariogenic challenge was carried out in 14 daily cycles. There was no significant statistical difference (p=0.958) of enamel microhardness between NSFtreated and NaF-treated specimens. However, it presented significant difference between water-treated specimens and both NSF-treated and NaF-treated specimens (p=0.003).Furthermore, optical coherence tomography was employed for caries diagnosis, as it can be used in clinical environment.