Marta Maria Martins Giamatei Contente

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.

Thermal alteration and morphological changes of sound and demineralized primary dentin after Er:YAG laser ablation

The purpose of this study was to assess the influence of Er:YAG laser pulse repetition rate on the thermal alterations occurring during laser ablation of sound and demineralized primary dentin. The morphological changes at the lased areas were examined by scanning electronic microscopy (SEM). To this end, 60 fragments of 30 sound primary molars were selected and randomly assigned to two groups (n = 30); namely A sound dentin (control) and B demineralized dentin. Each group was divided into three subgroups (n = 10) according to the employed laser frequencies: I–4 Hz; II–6 Hz, and III–10 Hz. Specimens in group B were submitted to a pH‐cycling regimen for 21 consecutive days. The irradiation was performed with a 250 mJ pulse energy in the noncontact and focused mode, in the presence of a fine water mist at 1.5 mL/min, for 15 s. The measured temperature was recorded by type K thermocouples adapted to the dentin wall relative to the pulp chamber. Three samples of each group were analyzed by SEM. The data were submitted to the nonparametric Kruskal‐Wallis test and to qualitative SEM analysis. The results revealed that the temperature increase did not promote any damage to the dental structure. Data analysis demonstrated that in group A, there was a statistically significant difference among all the subgroups and the temperature rise was directly proportional to the increase in frequency. In group B, there was no difference between subgroup I and II in terms of temperature. The superficial dentin observed by SEM displayed irregularities that augmented with rising frequency, both in sound and demineralized tissues. In conclusion, temperature rise and morphological alterations are directly related to frequency increment in both demineralized and sound dentin. Microsc. Res. Tech., 2011.

Bond Durability of Er:YAG Laser-Prepared Primary Tooth Enamel

This study evaluated in vitro the influence of thermocycling and water storage (WS) on the shear bond strength (SBS) of composite resin in cavities prepared in primary tooth enamel with conventional bur or Er:YAG laser. The test surfaces were obtained from 48 primary molars and randomly assigned to 2 groups (n=24), according to cavity preparation: A: bur-preparation and B: Er:YAG laser irradiation. The specimens were restored with an etch-and-rinse adhesive system and composite resin. Each group was divided into 4 subgroups (n=6) according to WS duration and number of thermal cycles (TCs): I: 24 h WS/no thermocycling; II: 7 days WS/500 TCs; III: 1 month WS/2,000 TCs; IV: 6 months WS/12,000 TCs. The specimens were tested to failure in shear strength at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by two-way ANOVA and Tukeys test. SBS means (S.D.) in MPa were: AI: 17.45 (2.03), AII:16.38 (1.49), AIII: 6.88 (0.66), AIV: 7.77 (1.53), BI: 12.32 (0.99), BII: 15.37 (2.24), BIII: 15.05 (2.01) and BIV-5.51 (1.01). WS duration and number of TCs influenced significantly the SBS values only for BIV (p<0.05). AI presented the highest SBS value, which was statistically similar to those of AII, BII and BIII. In conclusion, the adhesion of an etch-and-rinse adhesive to Er:YAG laser-irradiated primary tooth enamel was affected by the methods used to simulate degradation of the adhesive interface only when 6 months WS/12,000 TCs were employed.

Effect of Polishing and Brushing on Removal of Cigarette Smoke Stains from Artificial Teeth

Color alteration is still a disadvantage of acrylic resin teeth and this problem seems to be greater in smokers. The objective of this study was to evaluate the efficiency of polishing and brushing on removal of stains from artificial teeth submitted to cigarette smoke. Forty denture teeth of distinct shades (62 and 69) were selected. The teeth were divided into 4 groups (n= 10), according to the tooth shade and method of stain removal performed: Groups 1 and 2 were submitted to the smoke of 20 cigarettes, and after new color readouts, were submitted to polishing with pumice stone and Spanish white paste. Groups 3 and 4 were submitted to 4 cycles of 5 cigarettes interspersed with standardized manual brushing. The values of color stability (DE) were compared using 2-way ANOVA, Bonferroni test (p 3.3). After exposure to 20 cigarettes, the greatest degree of color change occurred for teeth in shade 62. Polishing significantly reduced the color change for groups 1 and 2, however, without significant difference between them. For Groups 3 and 4 there was no difference between the teeth of shade 62 and 69. When the treatments for each tooth shade were compared alone, there was similarity between polishing and brushing irrespective of the shade of samples. Routine manual brushing and common clinical polishing methods were capable of removing a large portion of staining caused by cigarettes, and there was no difference between the methods. ˚

Hardness and modulus of elasticity of primary and permanent teeth after wear against different dental materials

Objectives: The purpose of this study was to determine the Youngs modulus and the hardness of deciduous and permanent teeth following wear challenges using different dental materials. Materials and Methods: Wear challenges were performed against four dental materials: A resin-based fissure sealant (Fluoroshield®), a glass ionomer based fissure sealant (Vitremer®), and two microhybrid composite resins (Filtek Z250 and P90®). Using the pin-on-plate design, a deciduous or a permanent tooth was made into a pin (4 mm × 4 mm × 2 mm) working at a 3 N vertical load, 1 Hz frequency, and 900 cycles (15 min) with Fusayama artificial saliva as a lubricant. Before and after the tribological tests, the hardness and elasticity modulus of the tooth samples were measured by creating a nanoindentation at load forces up to 50 mN and 150 mN. All of the results were statistically analyzed using ANOVA and post-hoc Duncans tests (P < 0.05). Results: No difference in hardness was encountered between deciduous and permanent teeth (P < 0.05) or modulus of elasticity (P < 0.05) before or after the wear challenges for all of the dental materials tested. Conclusions: Wear challenges against the studied dental materials did not alter the properties of permanent or deciduous teeth after the application of a 3 N load.

Self-etch bonding agent beneath sealant: Bond strength for laser-irradiated enamel

Objectives: This study evaluated the in vitro 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 two-step self-etch adhesive system (Adper SE Plus [SE], 3M/ESPE) on Er: YAG laser-irradiated enamel. Materials and Methods: Seventeen sound third molar crowns were embedded in acrylic resin, and the mesial-distal enamel surfaces were flattened. The enamel sites were irradiated with a 2.94-μm wavelength Er: YAG laser (120 mJ, 4 Hz, noncontact mode/17 mm, 20 s). The specimens were randomly assigned to three groups according to the bonding technique: I - 37% phosphoric acid etching + SB + F; II - SE + F and III - F applied to acid-etched enamel, without an intermediate layer of bonding agent. In all of the groups, a 3-mm diameter enamel-bonding site was demarcated and the sealant cylinders were bonded. After 24 hours in distilled water, the shear bond strength was tested at a crosshead speed of 0.5 mm/minute. The data were analyzed by one-way ANOVA and Tukey′s test. The debonded specimens were examined with a stereomicroscope to assess the failure modes. Results: The mean SBS values in MPa were I = 6.39 (±1.44); II = 9.50 (±2.79); and III = 5.26 (±1.82). No statistically significant differences were observed between groups I and III; SE/F presented a significantly higher SBS than that of the other groups (P = 0.001). With regard to the failure mode, groups I (65%) and II (75%) presented adhesive failures, while group III showed 50% adhesive failure. Cohesive failure did not occur. Conclusion: The application of the two-step self-etch bonding agent (Adper SE Plus) beneath the resin pit-and-fissure sealant placement resulted in a significantly higher bond strength for the Er:YAG laser-irradiated enamel.

Acupuncture in the treatment of temporo-mandibular disorders in Sydenham’s chorea patient: a case report

A case report for a woman with Sydenham’s chorea is presented, and suggests that this treatment may be worth trying in other patients with this condition. A 33-year-old woman, a housewife with two daughters, initially presented at the acupuncture clinic with rapid, irregular and aimless involuntary movements of the arms and legs, trunk and facial muscles. The medical history revealed that at age of four the patient developed her first episode of rheumatic fever, without obsessive-compulsive behaviour. However, the patient showed symptoms compatible with Sydenham’s chorea such as choreiform movements, hypotonia, motor agitation, loss of coordination, gait disturbances and impediment of speech, associated with joint pain, most prominent in at the temporo-mandibular joint. The patient has been treated since then with haloperidol. Therefore, during the two pregnancies she presented an exacerbation of her previous symptoms of Sydenham’s chorea, which is a very common finding, reporting mainly limitation in the opening of mouth associated with pain and clicks in the temporo-mandibular joint. It is important to emphasise that she did not stopped taking the medication during the pregnancies. Additionally, the pregnancy proceeds normally with any recurrence of the chorea and complications, and her daughters are not affected by any disease. The conventional treatment for temporo-mandibular joint pain (occlusal splint) was not able to reduce these symptoms exacerbated during the pregnancies so five years after the second pregnancy the dental department referred her to the acupuncture treatment. An evaluation of the patient’s disease history revealed that the …

Wear of two pit and fissure sealants in contact with primary teeth

Objectives: Wear simulations may provide an indication of the clinical performance of pit-and-fissure sealants when associated with primary teeth as counterbody, restricting the involved variables. The aim of this study was to evaluate wear of dental materials used as pit-and-fissure sealants in contact with primary teeth. Materials and Methods: A resinous sealant (Fluroshield® ) and a resin-modified glass ionomer cement (Vitremer® ) were selected in a post-plate design, using as counterbody primary tooth pins (4 × 4 × 2 mm) at 3 and 10 N vertical load, 1 Hz frequency, 900 wear cycles in artificial saliva (n = 15). Attrition coefficient values were obtained and the material and primary tooth volumes were analyzed. Data were analyzed statistically by ANOVA and Duncan′s test (P < 0.05). Results: Fluroshield® presented the highest attrition coefficient values for the 3 N but these values decreased significantly for the 10 N load. The means for volume loss (3 mm) of the different samples after the wear test were not statistically different for the materials. The volume loss values for the primary teeth were statistically different and there was an increase in volume loss with the increase of the load applied in the wear tests. Conclusions: Differences were also observed with regard to the surface deformation characteristics. The wear rates of primary tooth enamel vary according to the type of material and the load applied during mastication.

Efetividade inicial e após 15 dias de clareamento exógeno variando-se a técnica e os agentes clareadores

The objective of this study is to evaluate in vitro the effectiveness of two techniques of exogenous dental bleaching in association to two bleaching agents (at home + carbamide peroxide at 10% and activated by LED + hydrogen peroxide at 35%). Twenty crowns of human premolar, split up in the mesio-distal sense, were divided into two groups (n =10). Initially, digital standardized photographs were taken, following coordinated x and y of the teeth, in the pre-staining period (IR - initial reading). Next, the specimens were stored for 30 days in artificial saliva at 37 _C with tea kills, Coke, Periogard and Gatorade. After this period, new photographs were taken (RAICS - reading after immersion in coloring solutions) and the teeth were divided into groups, according to the bleaching process they were submitted: GI - daily application of carbamide peroxide at 10% for four weeks; GII - three consecutive applications of hydrogen peroxide at 35% activated by LED. After that stage, the specimens were again submitted to photographic takings, one being accomplished immediately after bleaching (R0 - reading after bleaching) and the other one 15 days after (R15 - reading 15 days after bleaching). After definition of the coordinate x and y which corresponds to the center of the dental element, the photographic images of the teeth were analyzed in Software Adobe Photoshop® in which the color readings were achieved according to the scale R, G, B and K. The results showed that the coloring substances used were able to promote the staining of the teeth in significant levels, and just the home technique bleaching associated to the carbamide peroxide at 10% was able to promote the bleaching of the specimens in significant levels in the initial (R0) period as well as after a period of 15 days.