Hydrogen peroxide induces cell proliferation and apoptosis in pulp of rats after dental bleaching in vivo: Effects of the dental bleaching in pulp

ObjectiveThis study provides an in vivo evaluation of the inflammatory response, levels of cell proliferation and apoptosis, and the presence of necrosis after dental bleaching with two concentrations of hydrogen peroxide (H₂O₂).DesignWistar rats were divided into Control (placebo gel), BLUE (20% H₂O₂, 1 × 50 min), and MAXX (35% H₂O₂, 3 × 15 min) groups. At 2 and 30 days, the rats were killed (n = 10). The jaws were processed for histology analysis and PCNA and Caspase-3-cleaved immunohistochemistry, and data were submitted to the Mann-Whitney or ANOVA test (P < 0.05).ResultsAt 2 days, the MAXX group showed necrosis and the BLUE group revealed moderate inflammation on the occlusal third of the crown (P < 0.05). At 30 days, tertiary dentin had formed and there was an absence of inflammation. The level of cell proliferation was higher in the middle third of the BLUE group (P < 0.05), and cervical of MAXX at 2 days (P < 0.05), decreasing at 30 days. The apoptosis was present at 2 days, particularly in the cervical third of the crown in the bleached groups (P < 0.05), with a decrease only at 30 days in the BLUE group (P < 0.05).ConclusionsThe concentration of H₂O₂ influences effects on the pulp tissue, where a higher concentration of H₂O₂ can cause necrosis in the pulp and a prolonged effect within the apoptotic process; lower concentrations of H₂O₂ provide moderate inflammation, cell proliferation and apoptosis with a reduction of these processes over time.     

Effect of Proanthocyanidin-enriched extracts on the inhibition of wear and degradation of dentin demineralized organic matrix

ObjectivesThe aim of this study was to evaluate the effect of Cranberry and Grape seed-enriched extract gels in inhibiting wear and degradation of demineralized organic matrix (DOM).Design225 dentin specimens obtained from bovine incisors were randomly allocated into 5 groups (n = 45): 10% Grape seed extract gel (GSE), 10% Cranberry extract gel (CE), 0.012% Chlorhexidine gel (CX), 1.23% NaF gel (F), and no active compound gel (P, placebo). Before the treatments, samples were demineralized by immersion in 0.87 M citric acid, pH 2.3 (36 h). Then, the studied gels were applied once over dentin for 1 min. Next, the samples were immersed in artificial saliva containing collagenase obtained from Clostridium histolyticum for 5 days. The response variable for dentin wear was depth of dentin loss measured by profilometry and for collagen degradation was hydroxyproline determination. Data were analyzed by ANOVA followed by Tukey's test and Pearson Correlation Test (p < 0.05).ResultsGrape seed extract significantly reduced dentin wear compared to the other groups (p < 0.05). Cranberry extract and Chlorhexidine did not differ statistically and were able to reduce wear when compared to NaF and placebo treatments. The hydroxyproline analysis showed that there was no significant difference among groups for all treatments (p < 0.05). Correlation analysis showed a significant correlation between the amount of degraded DOM evaluated by profilometry and the determination of hydroxyproline.ConclusionCranberry extract was able to reduce the dentin wear and collagen degradation, likely due to the proanthocyanidin content and its action. Therefore, Cranberry could be suggested as an interesting natural-based agent to prevent dentin erosion.     

In vitro enamel erosion and abrasion-inhibiting effect of different fluoride varnishes

ObjectiveTo investigate the erosion and abrasion inhibiting effect of CPP-ACP/NaF and xylitol/NaF varnishes.MethodsBovine enamel samples (n = 40) were exposed to the following treatments (n = 10): NaF varnish (Duraphat^®, positive control); CPP-ACP/NaF varnish (MI varnishTM); xylitol/NaF (Profluorid^®) or distilled and deionized water (MilliQ^®, negative control). The samples were submitted for 3 days to 4 cycles/day of erosion (5 min in Sprite Zero) and 2 cycles of abrasion/day after the first and last erosive challenge, with a toothbrush machine and slurries of a placebo toothpaste for 15 s (50 strokes/s). Among the cycles and after the last daily cycle, the specimens remained in artificial saliva. The change in the enamel surface was evaluated by using 3D non-contact optical profilometry with surface roughness (Ra and Sa values) and tooth structure loss (TSL) measurements. Scanning electron microscopy (SEM) assessed the enamel topographic characteristics. Differences in the Ra, Sa and TSL among treatments were tested using one-way ANOVA followed by the Tukey test.ResultsAll varnishes promoted better results for Ra and Sa values than the negative control (p = 0.0001), without difference among them (p > 0.05). However, CPP-ACP/NaF varnish stimulated fewer TSL (7.09 ± 0.70 μm) compared to NaF varnish (10.33 ± 1.36 μm, p = 0.002), xylitol/NaF varnish (9.96 ± 0.41 μm, p = 0.007) and the negative control (18.38 ± 3.32 μm, p = 0.0001).ConclusionA single-application of fluoride topical varnishes was effective in reducing enamel wear. The CPP-ACP/NaF varnish had the best effect against enamel loss from an erosion-abrasion challenge.     

Attività antibatterica di formulati a base di perossido di idrogeno e sali d’argento

ObjectivesThe purpose of this study was to examine the antibiofilm and the antibacterial activity efficacy of H₂O₂ alone and combined with silver salts.Materials and methodsWe used standard and innovative methods to assess the antibacterial effects of (i) H₂O₂ at 300 e 600 ppm (parts per million), and at 3%; (ii) the same H₂O₂ concentrations with the addition of Ag⁺ salts at 5 and 10 ppm, against a large number of microorganisms, in planctonic and sessile (biofilm) forms.ResultsAll of the microorganisms tested (including some nosocomial pathogens, such as Legionella pneumophila, Staphylococcus aureus, Pseudomonas aeruginosa) were inhibited at concentrations lower than those commonly used in dental unit waterlines (MIC < 600 ppm)ConclusionsH₂O₂ with silver salts displayed greater antibiofilm efficacy than the negative control (H₂O₂ without silver ions).     

Alternative model for cathepsin K activation in human dentin

ObjectiveTo evaluate the protease activity in dentin matrices subjected to lactic acid (LA) in comparison to polyacrylic acid (PAA) challenge model at cathepsin K (CT-K) optimum pH 5.5 to assess effectiveness of inhibitors in dentin collagen degradation.MethodsDentin disks measuring 0.5 mm prepared from human molars were completely demineralized in 10% H₃PO₄. Demineralized dentin disks were challenged with 0.1 M LA, 1.1 mM PAA, artificial saliva (AS), or deionized water (C) for 24 h or 7-days. Dentin collagen properties were tested by measurement of %dry mass change, and ultimate tensile strength (UTS). Degradation of dentin type I collagen was measured by telopeptide assays measuring the sub-product release of C-terminal cross-linked telopeptides (ICTP) and C-terminal peptide (CTX) in the incubation media in relation to total protein concentration, which correlates with matrix metalloproteinases (MMPs) and CT-K activities.ResultsGravimetric analysis showed statistically significant difference between C and other groups (p < 0.04) at 24 h. LA specimens showed significantly higher weight loss from 24 h to 7-days (p = 0.02). UTS revealed statistically significant difference between AS and LA at 24 h and 7-days. UTS at 24 h and 7-days for C and AS had significantly higher mean values compared to LA and PAA. Telopeptide assays reported that CTX_tp results showed that LA at 24 h had significantly higher mean values compared to C and AS.SignificanceLA has the ability to activate endogenous CT-K in dentin as measured by the release of CTX (CT-K specific telopeptide). This LA based model has the potential application for further investigations on the activity and possible inhibitors of CT-K in human dentin.     

Nano-structured hydroxyapatite and titanium dioxide enriching PENTA /UDMA adhesive as aesthetic coating for tooth enamel

ObjectivesThe aim of this study was to investigate the effect of the nanostructured hydroxyapatite (NHAp) and titanium dioxide nanoparticles (NTiO₂) on dispersion in an adhesive containing monomers of Dipenta erythritol penta-acrylate monophosphate (PENTA) and Urethane dimethacrylate (UDMA), as well as evaluating the structural, optical and mechanical behavior of the composite material for dental aesthetic application.MethodsThe NHAp powders were synthesized through the wet chemical methods of hydrothermal and ultrasound-assisted precipitation. The microstructure, morphology and composition analysis of the powder of NHAp and NTiO₂ were performed by scanning and transmission electron microscopy. The optical microscopic identification of the different colors was obtained due to varying the amounts of NHAp and NTiO₂ in the adhesive. On the other hand, the diffuse reflectance spectra of the coatings were evaluated every 2 nm with the wavelength from 400 to 800 nm for combined specular and diffuse reflectance. The nanomechanical properties of the aesthetic coating such as (H), elastic modulus (E) and nanoscratching were evaluated by nanoindentation. The roughness of the composite coatings were evaluated by AFM.ResultsFrom different powders combinations, NHAP 75%Wt-NTiO₂ %25 Wt, at (10Wt %) into a dental adhesive, the resulting mixture manifested the optimum aesthetic white appearance. The scanning and transmission electron microscopy images confirmed that the HAp nanorods and TiO₂ nanoparticles sized were 55 nm and 20 nm respectively prepared by the high-energy ball mixed process. The values of nanomechanical properties of the optimum aesthetic coating were hardness, H = 3.2 ± 0.3 GPa, elastic modulus, E = 78 ± 3 GPa, Yield point, Y = 107 MPa ± 2 and scratching, maximum wear track deformation 3.7 ± 0.12 μm². The percentage of reflectance to optimum aesthetic white appearance was of 46.83% at 423 nm of wavelength.ConclusionsThe nanocomposite PENTA/UDMA with mixtures of Nanohydroxyapatite and titanium dioxide may be considerate as a mechanical toughened, also an option to modify shade qualities for dental aesthetic applications.     

Mold filling and dimensional accuracy of titanium castings in a spinel-based investment

ObjectivesAim of the study was to analyze the mold filling capacity and the dimensional accuracy of a spinel-based investment for titanium castings.MethodsExpansion of the investment in dependence of the preheating temperature was measured in a dilatometer. The degree of transformation of MgO and Al₂O₃ to spinel (MgAl₂O₄) was evaluated by means of X-ray powder diffraction. Mold filling capacity was assessed by casting a grid and calculating the percentage of completed segments. Dimensional accuracy was analyzed by casting a hollow cylinder and measuring the difference between the inner diameter of the resin pattern and the resulting titanium casting.ResultsSpinel formation starts at 819 °C. Diffraction patterns prove the formation of spinel from MgO and Al₂O₃. The amount of spinel increases with increasing preheating temperature. The final expansion of the investment at the end of the preheating cycle at 450 °C shows a linear correlation to the maximum preheating temperature. The degree of mold filling is reciprocal to the preheating temperature. The dimensional accuracy shows a linear correlation to the amount of spinel. Best dimensional accuracy was obtained at about 900 °C. After a preheating temperature of 884 °C, as recommended by the manufacturer, the cast specimens showed a slightly lower inner diameter as compared to the resin patterns.SignificanceThe results suggest that with the spinel investment analyzed an excellent accuracy of titanium castings may be obtained.     

Corrosive effects of fluoride on titanium under artificial biofilm

Purpose

This study aimed to investigate the effect of sodium fluoride (NaF) on titanium corrosion using a biofilm model, taking environmental pH into account.

Improved mechanical performance of self-adhesive resin cement filled with hybrid nanofibers-embedded with niobium pentoxide

ObjectivesIn this study hybrid nanofibers embedded with niobium pentoxide (Nb₂O₅) were synthesized, incorporated in self-adhesive resin cement, and their influence on physical-properties was evaluated.MethodsPoly(D,L-lactide), PDLLA cotton-wool-like nanofibers with and without silica-based sol–gel precursors were formulated and spun into submicron fibers via solution blow spinning, a rapid fiber forming technology. The morphology, chemical composition and thermal properties of the spun fibers were characterized by field emission scanning electron microscopy (FE-SEM), energy dispersive X-ray spectroscopy (EDS) and Fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC), respectively. Produced fibers were combined with a self-adhesive resin cement (RelyX U200, 3 M ESPE) in four formulations: (1) U200 resin cement (control); (2) U200 + 1 wt.% PDLLA fibers; (3) U200 + 1 wt.% Nb₂O₅-filled PDLLA composite fibers and (4) U200 + 1 wt.% Nb₂O₅/SiO₂-filled PDLLA inorganic–organic hybrid fibers. Physical properties were assessed in flexure by 3-point bending (n = 10), Knoop microhardness (n = 5) and degree of conversion (n = 3). Data were analyzed with One-way ANOVA and Tukey’s HSD (α = 5%).ResultsComposite fibers formed of PDLLA-Nb₂O₅ exhibited an average diameter of ∼250 nm, and hybrid PDLLA + Nb₂O₅/SiO₂ fibers were slightly larger, ∼300 nm in diameter. There were significant differences among formulations for hardness and flexural strength (p < 0.05). Degree of conversion of resin cement was not affected for all groups, except for Group 4 (p < 0.05).SignificanceHybrid reinforcement nanofibers are promising as fillers for dental materials. The self-adhesive resin cement with PDLLA + Nb₂O₅ and PDLLA + Nb₂O₅/SiO₂ presented superior mechanical performance than the control group.     

Micro-Raman spectroscopic analysis of TiO2 phases on the root surfaces of commercial dental implants

ObjectivesTo identify the TiO₂ phases of the root surface of commercially available titanium dental implants, subjected to various surface treatments.MethodsThe titanium implants studied were: Allfit (ALF), Ice (ICE), IMZ TPS (TPS), Laser Lok (LLK), Prima Connex (PRC), Ospol (OSP), Osseospeed TX (OSS), Osseotite Full (OTF), Replace Select (RPS), SLA (SLA) and Trilobe (TRB). The root parts of the implants (n:2) were analyzed by Raman microspectroscopy employing argon ion laser excitation (514.5 nm wavelength) and a 100 μm × 100 μm sampling area at two randomly selected sites.ResultsThe spectra of OSP and RPS showed the characteristic peaks of anatase, with traces of rutile (RPS). Complex phases composed of anatase, rutile and amorphous TiO₂ were identified in ALF, ICE and LLK. Rutile and amorphous TiO₂ were found in PRC, OSS, OTF, TPS and TRB, whereas rutile and possibly brookite were traced in SLA. In all implants, except OSP and RPS, peaks assigned to organic impurities (CH₂, CH₃) and carbonates were recorded. Ti₂O₃ was identified in OTF, PRC and Al₂O₃ in TRB.SignificanceGreat variations in the TiO₂ polymorphs were registered among the implant root surfaces tested. Considering the important differences in the biological activity of these polymorphs, it can be concluded that provision of information regarding the TiO₂ state on implant surfaces should be a mandatory task for implant manufacturers.     

Optimization of calcium concentration of saliva with phosphoryl oligosaccharides of calcium (POs-Ca) for enamel remineralization in vitro

ObjectivePhosphoryl oligosaccharides of calcium (POs-Ca) are highly soluble calcium source made from potato starch. The aim of this study was to investigate the optimal concentrations of POs-Ca for the remineralization of subsurface enamel lesions in vitro.DesignDemineralized bovine enamel slabs (n = 5) were remineralized in vitro for 24 h at 37 °C with artificial saliva (AS) containing 0–0.74% POs-Ca to adjust the Ca/P ratio to 0.4–3.0, then sectioned and analysed by transversal microradiography (TMR). The data were analysed by Scheffe's post hoc test. The Ca/P ratio with most remineralization was used to investigate the effect of calcium on enamel remineralization (n = 11). The demineralized slabs were treated with AS with calcium-chloride- (CaCl₂-) or POs-Ca with an identical calcium content, and sectioned for TMR and wide-angle X-ray diffraction (WAXRD) analyses to evaluate the local changes in hydroxyapatite (HAp) crystal content. The data were analysed using the Mann–Whitney U-test.ResultsThe highest mineral recovery rate resulted from addition of POs-Ca to adjust the Ca/P to 1.67. At this ratio, the mineral recovery rate for AS containing POs-Ca (24.2 ± 7.4%) was significantly higher than that for AS containing CaCl₂ (12.5 ± 11.3%) (mean ± SD, p < 0.05). The recovery rate of HAp crystallites for AS containing POs-Ca (35.7 ± 10.9%) was also significantly higher than that for AS containing CaCl₂ (23.1 ± 13.5%) (p < 0.05). The restored crystallites were oriented in the same directions as in sound enamel.ConclusionsPOs-Ca effectively enhances enamel remineralization with ordered HAp at a Ca/P ratio of 1.67.     

Hypoxia inhibits mineralization ability of human dental pulp cells treated with TEGDMA but increases cell survival in accordance with the culture time

ObjectiveTo evaluate the cytotoxicity and mineralization effects of TEGDMA in human dental pulp cells (hDPCs) under hypoxic and normoxic culture conditions.DesignCell viability was evaluated using XTT assay after incubation periods of 24, 48, or 72 h. The expression of mineralization-related genes (osteonectin, osteopontin, dentin sialophosphoprotein, collagen type 1) and heme oxygenase 1 (HO-1) was assessed by quantitative real-time polymerase chain reaction at 24 and 72 h.ResultsIn XTT assay, viability was higher in 0.3, 1, 2, 4, and 5 mM groups in the presence of 21% O₂ after 24 h (p < 0.05). Additionally, while 0.3, 1, 2 mM groups had higher cell viability in the presence of 21% O₂ after 48 h (p < 0.05), in 3 mM groups cell viability was higher under 3% O₂ than 21% O₂ after both 24 and 48 h (p < 0.05). 1–3 mM groups had higher cell viability under 3% O₂ after 72 h (p < 0.05). There was no difference between 4 and 5 mM groups with regards to cell viability after 48 or 72 h (p > 0.05). In the gene expression study, TEGDMA-treated hDPCs showed lower mineralization potential in the presence of 3% than with 21% O₂ (p < 0.05). hDPCs revealed higher HO 1 expression in 0.3 and 1 mM groups under hypoxic than under normoxic conditions after a 72-h time period (p < 0.001).ConclusionsHypoxic conditions increased cell survival in accordance with the culture period but inhibited the odontoblastic differentiation of hDPCs treated with TEGDMA.     

Color change of some aesthetic dental materials: Effect of immersion solutions and finishing of their surfaces

ObjectivesThe purpose of this research was to evaluate the color change of five aesthetic dental materials, before and after immersion in distilled water and blue food color solution for 7 and 21 days, and to study the effect of finishing the surfaces on any color change.MethodsDisc shaped samples of five types of light curing composite (A2) (n = 10 samples/composite) were prepared and all samples were light-cured with a Plasma Arc light cure unit for ten seconds. One side of each sample disc was finished and polished with a Super-Snap system all samples. After 24 h, color measurements of each sample were conducted using a digital spectrophotometer. Five sample discs from each composite group were immersed in 30 ml of food color solution for 7 and 21 days, while the remaining five sample discs were immersed in 30 ml of distilled water as a control. Color measurements were repeated for all samples at 7 and 21 days after immersion. The color changes were statistically analyzed using t-tests within the same group. A result was considered statistically significant at α = 0.05.ResultsThe color differences (ΔE) ranged from 0.4 to 4.66 and statistically significant differences on the finished and unfinished surfaces were observed after immersion in the food color solution for 7 days. No significant differences were found in any group after immersion in the food color solution for 21 days. The Tetric EvoCeram and Arabesk groups showed less color differences after 7 and 21 days than other composites.ConclusionFinished composite surfaces showed less coloration than unfinished surfaces after 7 days, but all surfaces (finished and unfinished) were highly colored for all composite types after 21 days.     

Effect of pulpal pressure on the microtensile bond strength of luting resin cements to human dentin

ObjectivesThe objectives of this study were to examine the effect of pulpal pressure on the microtensile bond strength (mTBS) of luting resin cements to human dentin and the permeability of dentin surfaces pre-treated with an adhesive and a self-etching primer.MethodsCylindrical composite blocks were luted with resin cements (RelyX ARC, 3M ESPE: ARC; Panavia F, Kuraray Medical Inc.: PF; RelyX Unicem, 3M ESPE: UN) in the absence or presence of simulated pulpal pressure. The application of Adper Single Bond 2 (3M ESPE) and ED primer 2.0 (Kuraray) was performed under 0 cm H₂O. After each resin cement was applied, the pulpal pressure group was subjected to 20 cm H₂O of hydrostatic pressure for 10 min during the initial setting period. Testing for mTBS was performed on 0.9 mm × 0.9 mm sectioned beams after 24 h water-storage. Scanning electron microscopy was performed to investigate the fractured surfaces after mTBS testing and additional dentin surfaces that were treated by an etchant, ED primer 2.0 and UN. Fluid permeability was measured on dentin surfaces that were applied with Adper Single Bond 2 and ED primer 2.0.ResultsApplication of pulpal pressure reduced mTBS significantly in groups ARC and PF. Porous bonding interfaces due to water permeability through the cured adhesive were observed on fractured surfaces. Dentin surfaces that were applied with the adhesive and the primer were more permeable than smear layer-covered dentin. The mTBS of UN was significantly lower than ARC and PF regardless of the absence/presence of pulpal pressure.SignificanceFluid permeation during the initial setting period deteriorated the bonding quality of resin cements.     

Effect of immersion time of restorative glass ionomer cements and immersion duration in calcium chloride solution on surface hardness

ObjectivesThe objective of this study was to evaluate the effect of immersion time of restorative glass ionomer cements (GICs) and immersion duration in calcium chloride (CaCl₂) solution on the surface hardness.MethodsTwo high-viscosity GICs, Fuji IX GP and GlasIonomer FX-II, were selected. Forty-eight specimens were randomly divided into two groups. Sixty minutes after being mixed, half of them were immersed in a 42.7 wt% CaCl₂ solution for 10, 30, or 60 min (Group 1); the remaining specimens were immersed after an additional 1-week of storage (Group 2). The surface hardness of the specimens was measured and analyzed with two-way ANOVA and the Tukey HSD test (α = 0.05). The surface compositions were examined using energy-dispersive X-ray spectroscopy and X-ray photoelectron spectroscopy.ResultsThe surface hardness of Group 1 significantly increased as the immersion duration in CaCl₂ increased; that of Group 2 significantly increased only after 60-minute CaCl₂ immersion. After CaCl₂ immersion, the amounts of Ca increased as the immersion duration increased. The surface hardness after CaCl₂ immersion significantly correlated with the amount of Ca in Group 1, but not in Group 2. The binding energy of the Ca2p peak was similar to that of calcium polyalkenoate. These findings indicated that the Ca ions from the CaCl₂ solution created chemical bonds with the carboxylic acid groups in the cement matrix.SignificanceImmersion of GICs in CaCl₂ solution at the early stage of setting was considered to enhance the formation of the polyacid salt matrix; as a result, the surface hardness increased.     

Effect of water aging on microtensile bond strength of dual-cured resin cements to pre-treated sintered zirconium-oxide ceramics

ObjectivesTo evaluate the hydrolytic stability of different dual-cure resin cements when luted to zirconia ceramic.MethodsEighteen cylinder-shaped zirconia blocks (Cercon Zirconia, Dentsply) were conditioned with: Group 1, no treatment; Group 2, sandblasting (125 μm alumina–Al₂O₃-particles); Group 3, tribochemical silica coating (50 μm silica-modified Al₂O₃ particles). Ceramic blocks were duplicated in composite resin (Tetric Evo Ceram, Ivoclar-Vivadent). Composite disks were luted to pre-treated ceramic surfaces using: (1) Clearfil Esthetic Cement (CEC; Kuraray); (2) Rely X Unicem (RXU; 3M ESPE); (3) Calibra (CAL; Dentsply Caulk). After 24 h, bonded samples were cut into microtensile sticks (1 mm²). Half of the sticks were loaded in tension until failure (cross-head speed of 0.5 mm/min). The remaining half was tested after 6 months of water storage at 37 °C. Data was analyzed with three-way ANOVA and Tukey’s test (P <0.05). Fractographic analysis was performed by SEM.ResultsAfter 24 h, bond strength of CEC to zirconia was significantly higher than that of RXU and CAL, independently from the ceramic pre-treatment (P <0.001). Using CAL, all samples failed prematurely except when luting to sandblasted surfaces. After 6 months of water aging, bond strength of CEC significantly decreased. RXU did not significantly alter bond strengths. Adhesion of sandblasted specimens luted with CAL fell over time. Micromorphological alterations were evident after water storage.SignificanceResin–ceramic interfacial longevity depended on cement selection rather than on surface pre-treatments. CEC and RXU were both suitable for luting zirconia. Water aging played an important role in the durability of zirconia-to-composite chemical bonds.     

The effect of magnesium hydroxide-containing dentifrice using an extrinsic and intrinsic erosion cycling model

ObjectiveTo evaluate, in vitro, the effect of Mg(OH)₂ dentifrice, and the influence of the number of experimental days, on the extrinsic (citric acid –CA) and intrinsic (hydrochloric acid –HCl) enamel erosion models.DesignHuman enamel slabs were selected according to surface hardness and randomly assigned to 3 groups (n = 9) as follows: non-fluoridated (negative control), NaF (1450 ppm F- positive control) and Mg(OH)₂ (2%) dentifrices. The slabs were daily submitted to a 2-h period of pellicle formation and, over a period of 5 days, submitted to cycles (3×/day) of erosive challenge (CA 0.05 M, pH = 3.75 or HCl 0.01 M, pH = 2 for 30 s), treatment (1 min −1:3 w/w of dentifrice/distilled water) and remineralization (artificial saliva/120 min). Enamel changes were determined by surface hardness loss (SHL) for each day and mechanical profilometry analysis. Data were analyzed by two-way ANOVA followed by Tukey’s test to % SHL and one-way ANOVA to profilometry (p < 0.05).ResultsThe number of experimental days influenced the erosion process for the two types of erosion models (p < 0.001). Mg(OH)₂-containing dentifrices were effective in reducing enamel extrinsic acid erosion as determined by % SHL (p < 0.001) when compared to the control group, being better than positive control (p < 0.001); however, the dentifrices were not effective for the intrinsic model (p = 0.295). With regards to surface wear, no statistically significant differences were found among the groups for CA (p = 0.225) and HCl (p = 0.526).ConclusionThe findings suggest that Mg(OH)₂ dentifrices might protect enamel against slight erosion, but protection was not effective for stronger acid erosion.     

Influence of surface treatments and resin cement selection on bonding to densely-sintered zirconium-oxide ceramic

ObjectivesTo evaluate the effect of surface conditioning on the microtensile bond strength of zirconium-oxide ceramic to dual-cured resin cements.MethodsEighteen cylinder-shaped zirconium-oxide ceramic blocks (Cercon^® Zirconia, Dentsply) were treated as follows: (1) Sandblasting with 125 μm aluminum-oxide (Al₂O₃) particles; (2) tribochemical silica coating using 50 μm Al₂O₃ particles modified by silica; (3) no treatment. Each ceramic cylinder was duplicated in composite resin (Tetric Evo Ceram, Ivoclar-Vivadent) using a silicon mold. Composite cylinders were bonded to conditioned ceramics using: (1) Calibra (Densply Caulk); (2) Clearfil Esthetic Cement (Kuraray); (3) Rely × Unicem (3 M ESPE). After 24 h bonded specimens were cut into microtensile sticks that were loaded in tension until failure. Data were analyzed using two-way ANOVA and Student–Newman–Keuls test for multiple comparisons (p < 0.05). Failure mode was recorded and the interfacial morphology of debonded specimens was observed using a scanning electron microscope (SEM). Surface topography and ceramic average surface roughness were analyzed under an atomic force microscope (AFM).ResultsSignificant changes in zirconia surface roughness occurred after sandblasting (p < 0.001). Bond strength of Clearfil cement to zirconia was significantly higher than that of Rely × Unicem and Calibra, regardless of the surface treatment (p < 0.001). When using Calibra, premature failures occurred in non-treated and silica coated zirconia surfaces.SignificanceThe phosphate monomer-containing luting system (Clearfil Esthetic Cement) is recommended to bond zirconia ceramics and surface treatments are not necessary.     

Promotion of enamel caries remineralization by an amelogenin-derived peptide in a rat model

ObjectiveAn amelogenin-derived peptide has been shown to promote remineralization of demineralized enamel in an in vitro model of initial caries induced by pH cycling. The present study examines whether the peptide exerts similar effects within the complex oral environment in vivo.DesignSpecific pathogen-free Sprague-Dawley rats (n = 36) were infected with Streptococcus mutans, given ad libitum access to Diet 2000 and drinking water supplemented with sucrose (10%, w/v), and then randomly divided into three groups treated with 25 μM peptide solution, 1 g/L NaF or deionized water. Molar teeth were swabbed twice daily with the respective solutions for 24 days. Then animals were killed, their jaws were removed and caries lesions were analyzed using the quantitative light-induced fluorescence-digital (QLF-D) technique to measure changes in mineral content. To verify QLF-D results, caries were scored for lesion depth and size using the Keyes method, and analyzed using polarized light microscopy (PLM).ResultsMineral gain was significantly higher in teeth treated with peptide or NaF than in teeth treated with water (p < 0.05), based on the QLF-D results (ΔF and ΔQ). Incidence of smooth-surface and sulcal caries based on Keyes scores was similar in rats treated with peptide or NaF, and significantly lower in these groups than in rats treated with water (p < 0.05). Lesions on teeth treated with peptide or NaF were shallower, based on PLM. No significant differences were observed between molar enamel caries treated with peptide or NaF.ConclusionsThis amelogenin-derived peptide can promote remineralization in a rat caries model, indicating strong potential for clinical use.     

Evaluation of interface characterization and adhesion of glass ceramics to commercially pure titanium and gold alloy after thermal- and mechanical-loading

ObjectivesThis study evaluated the effect of thermal- and mechanical-cycling on the shear bond strength of three low-fusing glassy matrix dental ceramics to commercial pure titanium (cpTi) when compared to conventional feldspathic ceramic fused to gold alloy.MethodsMetallic frameworks (diameter: 5 mm, thickness: 4 mm) (N = 96, n = 12 per group) were cast in cpTi and gold alloy, airborne particle abraded with 150 μm aluminum oxide. Low-fusing glassy matrix ceramics and a conventional feldspathic ceramic were fired onto the alloys (thickness: 4 mm). Four experimental groups were formed; Gr1 (control group): Vita Omega 900–Au–Pd alloy; Gr2: Triceram–cpTi; Gr3: Super Porcelain Ti-22–cpTi and G4: Vita Titankeramik–cpTi. While half of the specimens from each ceramic–metal combination were randomly tested without aging (water storage at 37 °C for 24 h only), the other half were first thermocycled (6000 cycles, between 5 and 55 °C, dwell time: 13 s) and then mechanically loaded (20,000 cycles under 50 N load, immersion in distilled water at 37 °C). The ceramic–alloy interfaces were loaded under shear in a universal test machine (crosshead speed: 0.5 mm/min) until failure occurred. Failure types were noted and the interfaces of the representative fractured specimens from each group were examined with stereomicroscope and scanning electron microscope (SEM). In an additional study (N = 16, n = 2 per group), energy dispersive X-ray spectroscopy (EDS) analysis was performed from ceramic–alloy interfaces. Data were analyzed using ANOVA and Tukey's test.ResultsBoth ceramic–metal combinations (p < 0.001) and aging conditions (p < 0.001) significantly affected the mean bond strength values. Thermal- and mechanical-cycling decreased the bond strength (MPa) results significantly for Gr3 (33.4 ± 4.2) and Gr4 (32.1 ± 4.8) when compared to the non-aged groups (42.9 ± 8.9, 42.4 ± 5.2, respectively). Gr1 was not affected significantly from aging conditions (61.3 ± 8.4 for control, 60.7 ± 13.7 after aging) (p > 0.05). Stereomicroscope images showed exclusively adhesive failure types at the opaque ceramic–cpTi interfacial zone with no presence of ceramic on the substrate surface but with a visible dark titanium oxide layer in Groups 2–4 except Gr1 where remnants of bonder ceramic was visible. EDS analysis from the interfacial zone for cpTi–ceramic groups showed predominantly 34.5–85.1% O₂ followed by 1.1–36.7% Al and 0–36.3% Si except for Super Porcelain Ti-22 where a small quantity of Ba (1.4–8.3%), S (0.7%) and Sn (35.3%) was found. In the Au–Pd alloy–ceramic interface, 56.4–69.9% O₂ followed by 15.6–26.2% Si, 3.9–10.9% K, 2.8–6% Na, 4.4–9.6% Al and 0–0.04% Mg was observed.SignificanceAfter thermal-cycling for 6000 times and mechanical-cycling for 20,000 times, Triceram–cpTi combination presented the least decrease among other ceramic–alloy combinations when compared to the mean bond strength results with Au–Pd alloy–Vita Omega 900 combination.