Rosa Helena Miranda Grande

Mechanical characterization of proanthocyanidin-dentin matrix interaction

OBJECTIVES To characterize the properties of dentin matrix treated with two proanthocyanidin rich cross-linking agents and their effect on dentin bonded interfaces. METHODS Sound human molars were cut into 0.5 mm thick dentin slabs, demineralized and either treated with one of two cross-linking agents (grape seed-GSE and cocoa seed-COE extracts) or left untreated. The modulus of elasticity of demineralized dentin was assessed after 10 or 60 min and the swelling ratio after 60 min treatment. Bacterial collagenase was also used to assess resistance to enzymatic degradation of samples subjected to ultimate tensile strength. The effect of GSE or COE on the resin-dentin bond strength was evaluated after 10 or 60 min of exposure time. Data were statistically analyzed at a 95% confidence interval. RESULTS Both cross-linkers increased the elastic modulus of demineralized dentin as exposure time increased. Swelling ratio was lower for treated samples when compared to control groups. No statistically significant changes to the UTS indicate that collagenase had no effect on dentin matrix treated with either GSE or COE. Resin-dentin bonds significantly increased following treatment with GSE regardless of the application time or adhesive system used. SIGNIFICANCE Increased mechanical properties and stability of dentin matrix can be achieved by the use of PA-rich collagen cross-linkers most likely due to the formation of a PA-collagen complex. The short term resin-dentin bonds can be improved after 10 min dentin treatment.

Durability of Enamel Bonding Using Two-step Self-etch Systems on Ground and Unground Enamel

This study examined the early and long-term microtensile bond strengths (MTBS) and interfacial enamel gap formation (IGW) of two-step self-etch systems to unground and ground enamel. Resin composite (Filtek Z250) buildups were bonded to proximal enamel surfaces (unground, bur-cut or SiC-treated enamel) of third molars after the application of four self-etch adhesives: a mild (Clearfil SE Bond [SE]), two moderate (Optibond Solo Plus Self-Etch Primer [SO] and AdheSE [AD]) and a strong adhesive (Tyrian Self Priming Etchant + One Step Plus [TY]) and two etch-and-rinse adhesive systems (Single Bond [SB] and Scotchbond Multi-Purpose Plus [SBMP]). Ten tooth halves were assigned for each adhesive. After storage in water (24 hours/37 degrees C), the bonded specimens were sectioned into beams (0.9 mm2) and subjected to microTBS (0.5 mm/minute) or interfacial gap width measurement (stereomicroscope at 400x) either immediately (IM) or after 12 months (12M) of water storage. The data were analyzed by three-way repeated measures ANOVA and Tukeys test (alpha=0.05). No gap formation was observed in any experimental condition. The microTBS in the Si-C paper and diamond bur groups were similar and greater than the unground group only for the moderate self-etch systems (SO and AD). No reductions in bond strength values were observed after 12 months of water storage, regardless of the adhesive evaluated.

Antioxidant activity by DPPH assay of potential solutions to be applied on bleached teeth

The aim of this study was to assess, using the DPPH assay, the antioxidant activity of several substances that could be proposed to immediately revert the problems caused by bleaching procedures. The percentage of antioxidant activity (AA%) of 10% ascorbic acid solution (AAcidS), 10% ascorbic acid gel (AAcidG), 10% sodium ascorbate solution (SodAsS), 10% sodium ascorbate gel (SodAsG), 10% sodium bicarbonate (Bicarb), Neutralize(®) (NE), Desensibilize(®) (DES), catalase C-40 at 10 mg/mL (CAT), 10% alcohol solution of alpha-tocopherol (VitE), Listerine(®) (LIS), 0.12% chlorhexidine (CHX), Croton Lechleri (CL), 10 % aqueous solution of Uncaria Tomentosa (UT), artificial saliva (ArtS) and 0.05% sodium fluoride (NaF) was assessed in triplicate by 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) free radical assay. All substances exhibited antioxidant activity, except for CL. AAcidS, AAcidG and VitE exhibited the highest AA% (p<0.05). On the contrary, CHX, NE, LIS and NaF showed the lowest AA% (p<0.05). In conclusion, AAcidS, AAcidG, SodAsS, SodAsG and VitE presented the highest antioxidant activity among substances tested in this study. The DPPH assay provides an easy and rapid way to evaluate potential antioxidants.

Clinical Effectiveness of Laser Fluorescence, Visual Inspection and Radiography in the Detection of Occlusal Caries

The aim of this in vivo study was to compare a laser fluorescence (LF) device with Ekstrand’s visual scoring system and radiographic assessment for detection of occlusal caries. Thirty-eight adults aged 19–35 years participated in the study; a total of 57 third molars with macroscopically intact occlusal surfaces were selected. Two examiners assessed 110 sites by visual inspection (VI), bitewing radiography (BW) and LF. Teeth were then extracted and caries extent assessed by histology. The detection methods were compared by means of sensitivity, specificity, inter-examiner reproducibility (kappa statistics) and area under the ROC curve. VI and LF had similar (p > 0.05) and superior sensitivities than BW (p < 0.05). VI and BW showed similar specificities, which was superior to LF. The inter-examiner reproducibility was good for VI and BW and moderate for LF. The area under ROC curves showed that VI was better than LF. It was concluded that Ekstrand’s visual scoring system is the most valid method for caries diagnosis. LF should be considered an adjunct to caries diagnosis.

Evaluation of two mineral trioxide aggregate compounds as pulp-capping agents in human teeth

AIM The present randomized, controlled prospective study evaluated the histomorphological response of human dental pulps capped with two grey mineral trioxide aggregate (MTA) compounds. METHODOLOGY Pulp exposures were performed on the occlusal floor of 40 human permanent pre-molars. The pulp was capped either with ProRoot (Dentsply) or MTA-Angelus (Angelus) and restored with zinc oxide eugenol cement. After 30 and 60 days, teeth were extracted and processed for histological examination and the effects on the pulp were scored. The data were subjected to Kruskal-Wallis and Conover tests (alpha = 0.05). RESULTS In five out of the 40 teeth bacteria were present in pulp tissue. No significant difference was observed between the two materials (P > 0.05) in terms of overall histological features (hard tissue bridge, inflammatory response, giant cells and particles of capping materials). Overall, 94% and 88% of the specimens capped with MTA-Angelus and ProRoot, respectively, showed either total or partial hard tissue bridge formation (P > 0.05). CONCLUSIONS Both commercial materials ProRoot (Dentsply) and MTA-Angelus (Angelus) produced similar responses in the pulp when used for pulp capping in intact, caries-free teeth.

Evaluating resin-enamel bonds by microshear and microtensile bond strength tests: effects of composite resin

Objectives The aims of this study were to evaluate the effect of resin composite (Filtek Z250 and Filtek Flow Z350) and adhesive system [(Solobond Plus, Futurabond NR (VOCO) and Adper Single Bond (3M ESPE)] on the microtensile (µTBS) and microshear bond strength (µSBS) tests on enamel, and to correlate the bond strength means between them. Material and methods Thirty-six extracted human molars were sectioned to obtain two tooth halves: one for µTBS and the other one for µSBS. Adhesive systems and resin composites were applied to the enamel ground surfaces and light-cured. After storage (37ºC/24 h) specimens were stressed (0.5 mm/ min). Fracture modes were analyzed under scanning electron microscopy. The data were analyzed using two-way ANOVA and Tukeys test (α=0.05). Results The correlation between tests was estimated with Pearsons product-moment correlation statistics (α =0.05). For both tests only the main factor resin composite was statistically significant (p<0.05). The correlation test detected a positive (r=0.91) and significant (p=0.01) correlation between the tests. Conclusions The results were more influenced by the resin type than by the adhesives. Both microbond tests seem to be positive and linearly correlated and can therefore lead to similar conclusions.

Bond strength and morphology of enamel using self-etching adhesive systems with different acidities

Objectives: To assess the bond strength and the morphology of enamel after application of self-etching adhesive systems with different acidities. The tested hypothesis was that the performance of the self-etching adhesive systems does not vary for the studied parameters. Material and methods: Composite resin (Filtek Z250) buildups were bonded to untreated (prophylaxis) and treated (burcut or SiC-paper) enamel surfaces of third molars after application of four self-etching and two etch-and-rinse adhesive systems (n=6/condition): Clearfil SE Bond (CSE); OptiBond Solo Plus Self-Etch (OP); AdheSe (AD); Tyrian Self Priming Etching (TY), Adper Scotchbond Multi-Purpose Plus (SBMP) and Adper Single Bond (SB). After storage in water (24 h/37°C), the bonded specimens were sectioned into sticks with 0.8 mm2 cross-sectional area and the microtensile bond strength was tested at a crosshead speed of 0.5 mm/min. The mean bond strength values (MPa) were subjected to two-way ANOVA and Tukeys test (α=0.05). The etching patterns of the adhesive systems were also observed with a scanning electron microscope. Results: The main factor adhesive system was statistically significant (p<0.05). The mean bond strength values (MPa) and standard deviations were: CSE (20.5±3.5), OP (11.3±2.3), AD (11.2±2.8), TY (11.1±3.0), SBMP (21.9±4.0) and SB (24.9±3.0). Different etching patterns were observed for the self-etching primers depending on the enamel treatment and the pH of the adhesive system. Conclusion: Although there is a tendency towards using adhesive systems with simplified application procedures, this may compromise the bonding performance of some systems to enamel, even when the prismless enamel is removed.

Effects of adhesive temperature on the early and 6-month dentin bonding

OBJECTIVES The aim of this study was to test the effect of adhesive temperature on the bond strength to dentin (muTBS) and silver nitrate uptake (SNU) of an ethanol/water (Adper Single Bond 2 [SB]) and an acetone-based (Prime&Bond 2.1 [PB]) etch-and-rinse adhesive system. METHODS The bottles of each adhesive were kept in various temperatures (5 degrees C, 20 degrees C, 37 degrees C and 50 degrees C) for 1h previously to its application in the occlusal demineralized dentin of 40 molars. Bonded sticks (0.8 mm(2)) were tested in tension (0.5 mm/min) immediately (IM) or after 6 months (6 M) of water storage. Two bonded sticks from each hemi-tooth were immersed in silver nitrate and analyzed by SEM. Data were analyzed by two-way repeated measures ANOVA and Tukeys test (alpha=0.05). RESULTS No significant difference in muTBS was detected for both adhesives at 5 degrees C and 20 degrees C. The highest bond strength for PB was observed in the 37 degrees C group while for SB it was in the 50 degrees C. Significant reductions of bond strengths were observed for PB at 37 degrees C and SB at 50 degrees C after 6 M of water storage. Silver nitrate deposition was seen in all hybrid layers, irrespective of the group. Lower silver nitrate deposition (water trees) in the adhesive layer was seen for PB and SB at higher temperatures. CONCLUSIONS The heating or refrigeration of the adhesives did not improve their resin-dentin bond resistance to water degradation over time.

The effect of specimen dimensions on the flexural strength of a composite resin

UNLABELLED PUORPOSE: The aim of this study was to evaluate the effect of specimen dimensions on the flexural strength of a composite resin (Heliomolar RO). METHODS The different dimensions tested - length x width x height (mm) were: 25x2x4; 25x2x2 (ISO 4049); 15x2x2; 10x2x2 and 10x2x1. Light-curing was performed at 600 mW/cm² for 40s, three times along the 25mm specimens, twice along 15mm specimen and once for the 10mm specimens. Specimens of all dimensions were light-cured on both surfaces, or only on one side. In the latter, the load was applied on the irradiated side or on the opposite one. RESULTS It was shown that the flexural strength was not affected by specimen length. When light-curing was performed on both surfaces, similar flexural strength values were obtained for any dimension. Despite the number of irradiated surfaces, specimens with a height of 1mm also obtained similar values. On the contrary, specimens with a height of 4mm, exposed only on one surface, reached the lowest strength. CONCLUSION The use of specimens with lower dimensions can lead to flexural strength values similar to the ones obtained with standardized specimen (ISO 4049), with the advantage of demanding less amount of material and being less time consuming.

Occlusal caries diagnosis in permanent teeth: an in vitro study

The reduction in caries prevalence has not occurred uniformly for all dental surfaces. As the occlusal surfaces are still the most likely sites for the development of lesions, new methods of diagnosis are still being evaluated. This study compared a laser fluorescence (LF) system (DIAGNOdent) with the Ekstrands visual system for in vitro detection of occlusal caries. A total of 57 extracted molars with macroscopically intact occlusal surfaces were selected. Two-examiners assessed 110 sites by visual inspection (VI) and LF. After ten days from the first measurement, all teeth were re-evaluated through the same methods by each examiner. Caries extension was histologically assessed (X 40). The methods were compared by means of sensitivity, specificity, intra- and inter-examiner reproducibility and area under the ROC curve. The kappas test showed good intra- and inter-examiner reproducibility for both methods. VI and LF showed similar sensitivities for both examiners, however, VI showed higher specificities than LF. The overall analysis, as demonstrated by the area under the ROC curve, showed that VI had a better performance than the LF device. It was concluded that the Ekstrands visual system is more reliable than the LF device. LF should be considered only as an adjuvant for occlusal caries diagnosis.