Maria Cristina Borsatto

Microstructure and mineral composition of dental enamel of permanent and deciduous teeth

Purpose: This study evaluated and compared in vitro the microstructure and mineral composition of permanent and deciduous teeths dental enamel. Methods: Sound third molars (n = 12) and second primary molars (n = 12) were selected and randomly assigned to the following groups, according to the analysis method performed (n = 4): Scanning electron microscopy (SEM), X‐Ray diffraction (XRD) and Energy dispersive X‐ray spectrometer (EDS). Qualitative and quantitative comparisons of the dental enamel were done. The microscopic findings were analyzed statistically by a nonparametric test (Kruskal‐Wallis). The measurements of the prisms number and thickness were done in SEM photomicrographs. The relative amounts of calcium (Ca) and phosphorus (P) were determined by EDS investigation. Chemical phases present in both types of teeth were observed by the XRD analysis. Results: The mean thickness measurements observed in the deciduous teeth enamel was 1.14 mm and in the permanent teeth enamel was 2.58 mm. The mean rod head diameter in deciduous teeth was statistically similar to that of permanent teeth enamel, and a slightly decrease from the outer enamel surface to the region next to the enamel‐dentine junction was assessed. The numerical density of enamel rods was higher in the deciduous teeth, mainly near EDJ, that showed statistically significant difference. The percentage of Ca and P was higher in the permanent teeth enamel. Conclusions: The primary enamel structure showed a lower level of Ca and P, thinner thickness and higher numerical density of rods. Microsc. Res. Tech., 2010.

Microleakage of a resin sealant after acid-etching, Er:YAG laser irradiation and air-abrasion of pits and fissures.

OBJECTIVE The aim of this in vitro study was to assess microleakage underneath a filled pit-and-fissure sealant bonded to occlusal surfaces treated by four enamel etching techniques. SUMMARY BACKGROUND DATA There has been no report of a study assessing microleakage of a pit-and-fissure sealant, comparing acid-etching, Er:YAG laser and air-abrasion for treating enamel surface. METHODS Forty extracted human third molars were selected and randomly assigned into four groups of ten teeth: group I, the occlusal surfaces were acid-etched; group II, a very short pulsed Er:YAG laser was used to treat the surfaces; group III, aluminum oxide air-abrasion was associated with acid-etching; group IV, Er:YAG laser was associated with acid-conditioning. The surfaces were sealed and the teeth were stored for 7 days in distilled water. Then, specimens were thermocycled, immersed in a 0.2% rhodamine solution, sectioned, and analyzed for leakage using an optical microscope connected to a video camera. The images were digitized and analyzed by software that allowed microleakage assessment in millimeters. RESULTS Statistical analysis showed that occlusal surfaces treated exclusively by the Er:YAG laser (group II) provided the poorest marginal sealing and that acid-etching (group I) was statistically similar to aluminum oxide air-abrasion + acid etching (group III) and to Er:YAG laser + acid-etching (group IV). CONCLUSIONS The results suggest that complementing either air-abrasion or Er:YAG laser irradiation with a subsequent acid-conditioning did not lessen microleakage at the enamel-sealant interface when compared with an acid-etched group. It was also observed that treating the enamel surface exclusively by Er:YAG laser resulted in the highest degree of leakage.

Assessing Microleakage on Class V Composite Resin Restorations after Er:YAG Laser Preparation Varying the Adhesive Systems

OBJECTIVE The aim of this study was to assess the performance of three bonding agents in preventing microleakage of class V cavities prepared and treated by Er:YAG laser associating with acid etching. BACKGROUND DATA There has been very little research comparing the efficiency of single-component and self-etching adhesive systems in preventing microleakage of cavities prepared and conditioned with Er:YAG laser. MATERIALS AND METHODS Thirty cavities - with occlusal margin in enamel and cervical in dentin/cementum - were prepared in sound human third molars using a short pulsed Er:YAG laser (500 mJ/5 Hz) The enamel and dentin surfaces were conditioned for 30 sec using lower dosimetries (120 mJ/4 Hz), and the samples were randomly assigned into three groups, according to the adhesive system: (I) Bond-1; (II) Prime & Bond NT; and (III) Etch & Prime 3.0. Groups I and II were acid-etched for 15 sec, and group III did not receive any acid treatment once a self-etching system was employed. Cavities were restored with a light-cured composite resin (JEK-Z250 Filtek-250), and after finishing, the samples were thermocycled, isolated with epoxy resin and nail varnish, immersed in a 0.2% Rhodamine B solution for 24 h, and sectioned longitudinally. The sections obtained were analyzed for leakage using an optical microscope connected to a computer and a video camera. We digitized the images using a special software program that allowed a quantitative evaluation of microleakage in millimeters. RESULTS Statistical analysis using the Kruskal-Wallis test showed statistically significant difference between both margins, and the occlusal region presented better marginal sealing. Comparing the three resin bonding systems, Prime & Bond NT entirely sealed both margins, while Etch & Prime 3.0 provided the poorest overall results, showing a statistically significant difference (p < 0.01). CONCLUSION It may be concluded that, for all the tested materials, microleakage values were higher in cervical (dentin/cementum) margins. Additionally, Prime & Bond NT provided a complete elimination of marginal infiltration at both margins, after treating the dental surface with laser irradiation associated with a sequent acid-etching.

Surface and subsurface erosion of primary enamel by acid beverages over time

This study evaluated the influence of a cola-type soft drink and a soy-based orange juice on the surface and subsurface erosion of primary enamel, as a function of the exposure time. Seventy-five primary incisors were divided for microhardness test (n=45) or scanning electron microscopy (SEM) analysis (n=30). The specimens were randomly assigned to 3 groups: 1 - artificial saliva (control); 2 - cola-type soft drink; and 3 - soy-based orange juice. Immersion cycles in the beverages were undertaken under agitation for 5 min, 3 times a day, during 60 days. Surface microhardness was measured at 7, 15, 30, 45 and 60 days. After 60 days, specimens were bisected and subsurface microhardness was measured at 30, 60, 90, 120, 150 and 200 µm from the surface exposed. Data were analyzed by ANOVA and Tukeys test (a=0.05). Groups 2 and 3 presented similar decrease of surface microhardness. Regarding subsurface microhardness, group 2 presented the lowest values. SEM images revealed that after 60 days the surfaces clearly exhibited structural loss, unlike those immersed in artificial saliva. It may be concluded that erosion of the surfaces exposed to the cola-type soft drink was more accentuated and directly proportional to the exposure time.

Tensile Bond Strength of Dentin-Resinous System Interfaces Conditioned with Er:YAG Laser Irradiation

OBJECTIVE The aim of this in vitro study was to assess tensile bond strength of dentin-resinous system interfaces conditioned with Er:YAG laser irradiation. BACKGROUND DATA There are different results reported in the literature which relate to laser Er:YAG effects on dentin surface as a pretreatment during adhesives procedures. MATERIALS AND METHODS Forty-two surfaces of human dentin from third upper molar were used after being extracted and kept in the refrigerator in 0.5% chloramines aqueous solution and then divided into three experimental groups and three control groups. The chosen restorative systems were Alert (Jeneric/Penton), Prodigy (Kerr Co.), and Z-100 (3M Co.), with correspondent dental adhesives Bond 1, Optibond Solo, and Single Bond, respectively. To conduct tensile tests, a special system of pairs of rods aligned in a specific apparatus was used, in accordance with ISO/TR 11405 standard (1994). RESULTS By means of statistical analysis, the Kruskal Wallis test, it was noticed that group IE (laser + acid + Alert), 18.89 MPa, differed considerably from group IC (acid + Alert), 8.03 MPa (p < 0.10), but did not differ from the other groups. Group IIC (acid + Prodigy), 19.88 MPa, differed from group IIE (laser + acid + Prodigy), 12.57 MPa (p < 0.05), but did not differ from groups IIIE (laser + acid + Z-100), 14.11 MPa, and IIIC (acid + Z-100), 19.58 MPa. Group IIIE did not differ statistically from group IIIC. CONCLUSION It was concluded that previous Er:YAG laser treatment on the dentinal structure only improved the tensile bond resistance of the Alert restorative system.

Electro-acupuncture efficacy on pain control after mandibular third molar surgery

The aim of this study was to evaluate the efficacy of electro-acupuncture (EAC) on postoperative pain control after mandibular third molar surgery. Twenty four young patients (12 male and 12 female) with symmetrically impacted mandibular third molars were selected. Each patient was submitted to two separate surgical procedures under local anesthesia. At one side, extraction was carried out employing both prior (24h) and immediately postoperative application of EAC, while on the contralateral side surgery was carried out without any treatment. EAC was applied on 6 bilateral systemic and 2 auricular points with a WQ10Dl appliance using 40-60Hz frequency for 20 min and individually adjusted intensity. Postoperative pain intensity was rated on a 100 mm visual analog scale (VAS) between 2 and 72 h and recording the amount of analgesics intake after surgery. Statistical analysis was performed using theWilcoxon test. Postoperative pain VAS scores were significantly lower for the EAC group (p<0.05) and analgesic intake decreased (p<0.05) for all evaluated periods (p<0.05). Under the tested conditions EAC therapy is efficient was proved controlling postoperative pain following mandibular third molar surgical removal.

Bond strength of a pit-and-fissure sealant associated to etch-and-rinse and self-etching adhesive systems to saliva-contaminated enamel: individual vs. simultaneous light curing

This study evaluated in vitro the shear bond strength (SBS) of a resin-based pit-and-fissure sealant [Fluroshield (F), Dentsply/Caulk] associated with either an etch-and-rinse [Adper Single Bond 2 (SB), 3M/ESPE] or a self-etching adhesive system [Clearfil S3 Bond (S3), Kuraray Co., Ltd.] to saliva-contaminated enamel, comparing two curing protocols: individual light curing of the adhesive system and the sealant or simultaneous curing of both materials. Mesial and distal enamel surfaces from 45 sound third molars were randomly assigned to 6 groups (n=15), according to the bonding technique: I - F was applied to 37% phosphoric acid etched enamel. The other groups were contaminated with fresh human saliva (0.01 mL; 10 s) after acid etching: II - SB and F were light cured separately; III - SB and F were light cured together; IV - S3 and F were light cured separately; V - S3 and F were light cured simultaneously; VI - F was applied to saliva-contaminated, acid-etched enamel without an intermediate bonding agent layer. SBS was tested to failure in a universal testing machine at 0.5 mm/min. Data were analyzed by one-way ANOVA and Fishers test (alpha=0.05).The debonded specimens were examined with a stereomicroscope to assess the failure modes. Three representative specimens from each group were observed under scanning electron microscopy for a qualitative analysis. Mean SBS in MPa were: I-12.28 (+/-4.29); II-8.57 (+/-3.19); III-7.97 (+/-2.16); IV-12.56 (+/-3.11); V-11.45 (+/-3.77); and VI-7.47 (+/-1.99). In conclusion, individual or simultaneous curing of the intermediate bonding agent layer and the resin sealant did not seem to affect bond strength to saliva-contaminated enamel. S3/F presented significantly higher SBS than the that of the groups treated with SB etch-and-rinse adhesive system and similar SBS to that of the control group, in which the sealant was applied under ideal dry, noncontaminated conditions.

SEM Analysis of Enamel Surface Treated by Er:YAG Laser: Influence of Irradiation Distance

Depending on the distance of laser tip to dental surface a specific morphological pattern should be expected. However, there have been limited reports that correlate the Er:YAG irradiation distance with dental morphology.

Shear bond strength of enamel surface treated with air-abrasive system

The aim of this study was to evaluate the shear bond strength of a composite resin to dental enamel, using three different surface treatments. Fifteen sound third molars were randomly assigned to three groups. The mesial and distal surfaces were flattened and covered using adhesive tape with a central orifice delimiting the adhesion area (7.07 mm2). Group I, the enamel surface was conditioned with 37% phosphoric acid for 15 s; group II, the surface was treated using air abrasion with aluminum oxide; group III, the enamel surface was treated using an association of air abrasion with aluminum oxide and 37% phosphoric acid. The Single Bond (3M) adhesive system was applied and a Teflon matrix was placed and filled with composite resin Z-100 (3M) and light-cured. The shear bond strength test was performed with a universal testing machine. The acid etching technique and air abrasion with aluminum oxide associated with acid etching had the highest shear bond strength values. Data were subjected to statistical analysis using ANOVA and the Turkey test, and no statistically significant difference in shear bond strength was observed between group I (12.49 +/- 2.85 MPa) and group III (12.59 +/- 2.68 MPa). In contrast, both groups had statistically better shear bond strengths compared to group II (0.29 +/- 0.56 MPa; p < 0.05). Air abrasion with aluminum oxide does not substitute acid etching. The association of these methods to obtain adequate adhesion to the substrate is necessary.

FTIR and SEM analysis of CO2 laser irradiated human enamel

OBJECTIVES Considering the enamel chemical structure, especially carbonate band, which has a major role in the caries prevention, the objective of the present study was to assess the chemical alterations on the enamel irradiated with CO(2) laser by means of FTIR spectroscopy and SEM analysis. DESIGN The enamel surfaces were analysed on a spectrometer for acquisition of the absorption spectrum relative to the chemical composition of the control sample. The irradiation was conducted with a 10.6-μm CO(2) laser (0.55W, 660W/cm(2)). The carbonate absorption band at 1600-1291cm(-1) as well as the water absorption band at 3793-2652cm(-1) was measured in each sample after the irradiation. The water band was measured again 24-h after the irradiation. The band area of each chemical compound was delimited, the background was subtracted, and the area under each band was integrated. Each area was normalized by the phosphate band (1190-702cm(-1)). RESULTS There was a statistically significant decrease (p<0.05) in the water content after irradiation (control: 0.184±0.04; irradiated: 0.078±0.026), which increased again after rehydration (0.145±0.038). The carbonate/phosphate ratio was measured initially (0.112±0.029) and its reduction after irradiation indicated the carbonate loss (0.088±0.014) (p<0.05). CONCLUSION The 10.6-μm CO(2) laser irradiation diminishes the carbonate and water contents in the enamel after irradiation.