R. Banu Ermis

Radiopacity evaluation of contemporary resin composites by digitization of images

Objective: The aim of this study was to evaluate the radiopacity of different composite resins and compare the values to those of human enamel and dentine. Materials and Methods: Five specimens of each material with thicknesses of 2 mm were prepared and radiographed alongside aluminum step wedge and human enamel and dentin. Three occlusal radiographs for each material were taken and digitized using a desktop scanner. Mean gray values of the test materials were measured using Image J software. Then a conversion was performed according to establish the radiopacity of the test materials, in millimeters of equivalent Al. Data were analyzed using one-way analysis of variance and Duncan multiple range tests (P < 0.05). Results: The radiopacity values varied among the restorative materials (P < 0.05). The radiopacity values of the materials tested were, in decreasing order: Enamel Plus HRI > Z250 > Filtek Ultimate ≥ Z550 > Nexcomp ≥ Nanoceram Bright > enamel ≥ Estelite Sigma Quick > Clearfil Majesty Esthetic ≥ Reflexions XLS ≥ Aelite LS Posterior ≥ dentin ≥ 2 mm Al. Conclusion: All resin composite materials investigated in this study presented different radiopacity values. However, all materials had radiopacity values greater than dentin and had sufficient radiopacity to meet International Organization for Standardization 4049 standard.

A case report on fluorosed teeth whitening without microabrasion - Is it possible?

Whitening of fluorosis stains ranging from yellow to dark brown presents a great challenge to the dentists. The aim of this study was to report the clinical case of a 32-year-old female patient with moderate fluorosis, who was treated using the combination of light-assisted in-office and at-home whitening system. The in-office whitening was performed using 25% hydrogen peroxide (Zoom DayWhite, Discus Dental, Stamford, USA) for four 15-min sessions with supplemental light (Philips Zoom, Stamford, USA) immediately followed by home whitening with a take-home custom tray using 22% carbamide peroxide (Zoom NiteWhite, Discus Dental, Stamford, USA) worn for 6 h a day for 1 week. Color measurements using a dental spectrophotometer (Spectroshade, MHT Optic Research AG, Niederhasli, Switzerland) after the first week showed that the suggested combination technique provided a fast whitening result with a high degree of patient satisfaction. The in-office whitening with light exhibited to be an efficient method for removing yellow and brown fluorosis stains, while the at-home whitening was useful for obtaining a uniform tooth shade. At the 6-month and 1-year recall, the teeth shade and appearance were evaluated. The results of this case report clearly show an effective esthetic result in the long term; however, the question of whether appropriate color stability would be provided by the technique still remains to be answered.

Effect of tooth discoloration severity on the efficacy and color stability of two different trayless at-home bleaching systems

Background. The use of trayless at-home bleaching agents in darker teeth is raising some concerns due to their unknown efficacy. The purpose of this in vitro study was to evaluate the effect of tooth discolouration severity on the efficacy and colour stability of two different trayless at-home bleaching systems. Methods. Ninety enamel-dentin samples were divided into two groups: lighter tand darker teeth. The teeth in each group were further divided into three groups (n=15): (1) tray-based system with 10% carbamide peroxide (Opalescence Oh) (control group); (2) a tray applied whitening membrane with 10% hydrogen peroxide (Treswhite Supreme); and (3) a whitening pen with 22% carbamide peroxide (Hollywood Smiles). After bleaching, the teeth were stained for 9 days using red wine. Colour readings before bleaching treatment were determined using a dental spectrophotometer and were repeated 24 h after bleaching treatment and 24 h after staining process. Analysis of variance, Bonferroni and Dunnett C tests were used at 5% significance level. Results. No differences were observed between the bleaching efficacy of Treswhite Supreme and Opalescence Oh in the lighter teeth, while Opalescence Oh had the best bleaching efficacy in the darker teeth (p<0.05). Hollywood Smiles had the worst bleaching efficay but the best color stability in both lighter and darker teeth (p<0.05). No differences were observed between the color stability values of Treswhite Supreme and Opalescence Oh. Conclusion. This study suggested that both the tooth discolouration severity and the type of trayless system used affected the bleaching efficacy, whereas only the type of trayless system affected the color stability.

Effect of resin infiltration and microabrasion on the microhardness, surface roughness and morphology of incipient carious lesions

Abstract Objective: The effects of resin infiltration and microabrasion on incipient carious lesions by surface microhardness, roughness and morphological assessments, and resistance to further acid attack of treated lesions were evaluated. Material and methods: Eighty artificially-induced incipient lesions were randomly divided into five groups (n = 16): resin infiltration with an adhesive resin (Excite F, Ivoclar Vivadent, Schaan, Liechtenstein), resin infiltration with a resin infiltrant (Icon, DMG, Hamburg, Germany), microabrasion without polishing (Opalustre, Ultradent, South Jordan, UT, USA), microabrasion with polishing (Opalustre, Ultradent, Diamond Excel, FGM, Joinville, SC, Brazil), and distilled water (control group). All specimens were exposed to demineralization for another 10 d. Microhardness, roughness and morphological assessments were done at baseline, following initial demineralization, treatment and further demineralization. Data were analysed by the Kruskal–Wallis, Friedman’s and Bonferroni tests (p < .05). Results: Enamel lesions treated with resin infiltrant and microabrasion demonstrated similar hardness values, with a nonsignificant difference compared with sound enamel. Resin infiltration demonstrated lower roughness values than those of microabrasion, and the values did not reach the values of sound enamel. Further demineralization for 10 d did not affect the hardness but increased the roughness of infiltrated and microabraded enamel surfaces. Polishing did not influence the roughness of microabraded enamel surfaces. After resin infiltration, porosities on enamel were sealed completely. The surface structure was similar to that of the enamel conditioning pattern for microabraded enamel lesions. Conclusions: Within the limitations of this study, the icon infiltration and microabrasion technique appeared to be effective for improving microhardness. Icon appeared to provide reduced roughness, although not equal to sound enamel. Further research is needed to elucidate their clinical relevance.

Kemomekanik Çürük Uzaklaştırma Yöntemleri ve Etkinliklerinin Değerlendirilmesi

Ozet Gunumuzde curuk dokusunun uzaklastirilmasi icin kullanilan yontemler; doner aletler (frezler) veya ekskavator, air abrazyon, ultrasonikler ve sonoabrazyon ile yapilan mekanik curuk uzaklastirma yontemleri, kemomekanik ve fotoablasyon (lazerler) curuk uzaklastirma yontemleri olmak uzere farkli kategorilerde siniflandirilmaktadir. Konvansiyonel curuk uzaklastirma yontemleri etkin olmakla birlikte mevcut olan bazi dezavantajlarini onlemek amaciyla kemomekanik curuk uzaklastirma yontemleri gelistirilmistir. Kemomekanik curuk uzaklastirma yonteminin calisma mekanizmasi, curuk dokusunun kimyasal yapisini degistiren ve dokunun yumusatilarak uzaklastirilmasini saglayan bir ajanin kullanilmasi ve yumusayarak yapisi degisen dentin dokusunun mekanik olarak el aletleri ile uzaklastirilmasi esasina dayanmaktadir. Kemomekanik curuk uzaklastirma yonteminin, curuk dokusunu agrisiz bir sekilde saglam dis sert dokularinin kaybina yol acmadan sadece enfekte dentin tabakasini ve selektif olarak uzaklastirdigi iddia edilmektedir. Ayrica yontemin bakterisit ve bakteriostatik etkilerinin bulunmasi, kullanimi sirasinda isi ve basinc olusturmayarak pulpa uzerinde olumsuz etkiler meydana getirmemesi de alternatif bir curuk uzaklastirma yontemi olarak degerlendirilmesini saglamaktadir. Bu calismanin amaci, sodyum hipoklorit ve enzim esasli kemomekanik curuk uzaklastirma ajanlari hakkinda bilgi verilmesidir. Yontemin avantaj ve dezavantajlari ve ayrica curuk uzaklastirma etkinligi; reziduel curuk ve bakteri varligi, dentinin mikrosertligi ve kimyasal yapisi acisindan laboratuvar ve klinik arastirmalardan elde edilen bulgular esliginde incelenecektir.