Effect of Pulp Protection Technique on the Clinical Performance of Amalgam Restorations: Three-Year Results

This study evaluated the influence of the pulp protection technique on clinical performance of amalgam restorations after three years, with particular reference to post-operative sensitivity and secondary caries. One hundred and twenty (120) Class II amalgam restorations (68 premolars, 52 molars; 78 MOD, 42 OD/MO) were placed in 30 participants (four restorations per participant).The restorations were divided into four groups according to the pulp protection technique used: copal varnish; 2% neutral sodium fluoride; adhesive resin and no pulp protection. The parameters evaluated were post-operative sensitivity, staining of the dental structure, tooth vitality, partial or total loss of the restoration and secondary caries. One hundred and eight (108)restorations were available for evaluation after three years. No partial or total loss of restorations had occurred; all teeth were vital, no tooth structure staining or secondary caries was detected in any of the restored teeth. Post-operative sensitivity was observed only in two restorations at baseline and at seven-days. The three year clinical performance of teeth restored with a high copper dispersed phase amalgam was not affected by the choice of pulp protection technique

Carbamide peroxide gel stability under different temperature conditions: is manipulated formulation an option?

Nowadays the use of gel containing carbamide peroxide (CP) prepared in Pharmacy is a normal practice in the population. However, the quality of this product is questionable concerning its stability. The aim of this study is was to synthesize and to analyze this drug alone or associated to Carbopol gel through analytical methodology compatible with the routine of the Pharmacies. The reaction between urea and hydrogen peroxide was carried out at different resting times: 24 hours (CP 24 powder) and 48 hours (CP48 powder) after the mixture. Both products were associated with Carbopol 940® gel 1.5% (G) generating G24 and G48 samples. The stability of powders (CP24 e CP48) and the formulations (G24 and G48) were evaluated as a function of time (15, 40 and 45 days) and thermal variation (refrigeration: 8 °C±1; thermal shock 32 °C±1 /8 °C±1; stove: 32 °C±1), using a standard titration method. As a result, only under refrigeration the CP24 and CP48 contents remained stable during the period of 45 days. An interesting finding was that G24 and G48 presented greater stability for at least 45-days under refrigeration and thermal shock conditions, and up to 30 days under stove conditions. The results for the G24 and G48 were slightly higher than those obtained for the control. Therefore, we were able to conclude that association with Carbopol 940® Gel 1.5 % provided greater CP stability and that manipulated formulations containing CP may be viable for use in a period of 45 days under refrigeration conditions. The titration proved to be an effective technique for the analysis of CP with or without Carbopol 940® gel 1.5%.Atualmente, a utilização de gel contendo peróxido de carbamida manipulado em Farmácia é uma prática comum na população. No entanto, a qualidade deste produto é questionada, sobretudo no que se refere à estabilidade deste fármaco. O objetivo deste trabalho consiste na avaliação da viabilidade de sintetizar e analisar quantitativamente este fármaco associado ou não a um gel de Carbopol através de metodologia analítica compatível com a rotina das Farmácias. A reação entre a uréia e o peróxido de hidrogênio foi realizada em tempos diferentes de repouso após a mistura, 24 h para sintetizar o pó PC 24 e 48 h para o pó CP 48. Estes pós foram associados a um gel (G) de Carbopol 940® 1,5 %, originando as amostras G24 e G48. A estabilidade dos pós (PC 24 e PC 48) e das formulações (G 24 e G 48) foi avaliada em função do tempo (15, 40 e 45 dias) e da variação térmica (refrigeração: 8 °C±1; choque térmico: 32 °C±1/8 °C±1 e estufa: 32 °C±1), através da técnica de titulometria. Os resultados indicam que unicamente sob refrigeração o CP24 e o CP 48 mantiveram-se estáveis no período de 45 dias. O G24 e o G48 apresentaram estáveis por pelo menos 45 dias nas condições de refrigeração e choque térmico e por 30 dias na condição estufa. Os resultados obtidos para o G24 e G48 foram ligeiramente superiores aos obtidos para o controle. Além disso, é possível concluir que a associação do PC com o gel de Carbopol 940® 1,5 % promoveu um aumento na estabilidade do PC e que as preparações manipuladas contendo PC são viáveis para uso durante um período de 45 sob refrigeração. A titulometria mostrou-se uma técnica eficaz para a análise do PC associado ou não ao gel de Carbopol 940® 1,5%

Wear and morphology of infiltrated white spot lesions

Objectives: To evaluate the toothbrush wear resistance of infiltrated artificial white spot lesions following two infiltration strategies, and to assess their ultramorphology. Methods: Flat enamel surfaces from freshly extracted bovine teeth were polished and immersed in a Buskes demineralising solution for 30 days to create incipient caries-like lesions (white spots). Two experimental regions on the surface of each tooth were infiltrated with an infiltrant and a commercial etch-and-rinse adhesive. Toothbrush abrasion was applied for 20,000 cycles. Vertical wear loss of the infiltrated areas was measured after 10,000 and 20,000 cycles against unabraded and abraded enamel using confocal laser scanning microscopy (CLSM; multiple t-tests, α = 0.05). Each lesion's surface and cross-section were evaluated under CLSM and scanning electron microscopy after etching and infiltration to assess ultramorphology. Results: After 20,000 abrasion cycles, a statistically non-significant difference in vertical wear loss was measured for the infiltrant versus the adhesive compared with the original enamel (42.6 ± 20.7 μm vs. 40.4 ± 18.5 μm, p > 0.05). Irregular surface profiles were common for the adhesive-infiltrated group as a result of peeling and blistering of the resin-covering layer. Ultramorphology of the infiltrated lesions revealed different patterns of penetration regarding density and depth. Conclusions: Although both infiltration strategies had equivalent wear resistance to toothbrush abrasion, surface and morphological aspects pointed to improved surface stability and infiltration quality for the infiltrant material. © 2011 Elsevier Ltd. All rights reserved