Concurrent Effects of Bleaching Materials and the Size of Root Canal Preparation on Cervical Dentin Microhardness

Introduction: The aim of the present study was to evaluate the concurrent effect of root canal preparation size and intra coronal bleaching on dentin microhardness. Methods and Materials: Seventy-two intact anterior teeth were root canal treated and randomly divided into two groups (n=36) according to the size of coronal root canal preparation. The coronal portions of the canals were then enlarged with #2 and 4 Peeso reamers, respectively. Following root canal obturation, teeth were assigned into three groups (n=12) to be treated with bleaching agents containing 35% hydrogen peroxide (HP), sodium perborate (SP) and distilled water as control group. The teeth were stored at 37ºC and 100% humidity for 7 days. Dentinal blocks with 3 mm thickness were obtained from the cervical region and Vickers microhardness number (VHN) were measured for outer and inner dentin in each tooth sample. Data were analyzed using two-way ANOVA and Tukey’s HSD tests. Results: In the outer dentin, the mean VHN in the HP and control groups showed statistically significant differences (P=0.047). The mean VHN of inner dentin for the large preparation size was statistically higher in comparison to the small preparation size (P=0.042). There was a statistically significant difference in the mean VHN of inner dentin with small preparation size between HP and SP groups (P=0.029) and HP and control groups (P=0.021). Conclusion: Intra coronal bleaching with 35% hydrogen peroxide, affects the inner and outer dentin significantly. Excessive removal of cervical dentin, following root canal preparation, alongside the adverse effect of bleaching materials on dentin could result in the tooth fracture.Keywords: Hardness Test; Hydrogen Peroxide; Sodium Perborate; Tooth Bleachin

Effect of Various Finishing and Polishing Systems on Surface Roughness of Nanohybrid and Microhybrid Composites

Objectives Finishing and polishing systems may affect the surface properties of composite resins. In this in vitro study, we evaluated the surface roughness of two composite resins after polishing with three different polishing systems. Methods Thirty-six specimens (8 mm diameter × 2 mm thickness) were fabricated from Kalore nanohybrid and Gradia Direct microhybrid composite in a Teflon mold and divided into four groups according to the polishing protocol (n=9): control group, Sof-Lex, Super Snap, and Jiffy. The mean surface roughness (Ra) values were determined using a profilometer and the surface of two samples in each group was observed under a scanning electron microscope (SEM). Data were analyzed using one-way and two-way ANOVA. The significance level was set at 5%. Results Profilometric evaluation showed that in both composite resins, the smoothest surfaces were obtained with Mylar strip; also Jiffy showed significantly higher Ra values than other polishing systems. Type of composite and polishing technique had significant effects on surface roughness (P=0.0001). SEM observations also showed that surface roughness of Jiffy was more than that of three other groups. Conclusion After the use of finishing and polishing systems, the surface roughness of Gradia was higher than Kalore in all polishing systems. Sof-Lex and Super Snap were effective on Gradia, and jiffy created the roughest surface

Evaluation of the effect of nanohydroxyapatite-containing toothpaste and mouthwash on remineralization of early enamel caries and occluding of dentinal tubules

Background and Aims: Different factors play a role in causing tooth decay. Modern dentistry is looking for a way to prevent tooth decay and suggests different ways to increase remineralization. The aim of this study was to evaluate the effect of nanohydroxyapatite toothpaste and mouthwash on remineralization of primary enamel lesions and obstruction of tubules. Materials and Methods: In this study, 90 human extracted central teeth were used. Artificial decay was induced by placing the specimens for 72 hrs in a demineralization solution in an incubator at 37 °C. Hardness of the specimens was determined by a microhardness test before any surface treatment. The specimens were then divided randomly into 6 groups of 15. For 1-6 groups, the specimens were subjected to a pH cycling for 14 days, which included 3 hrs of demineralization and 21 hrs of remineralization. At the same time, 1-3 groups were in contact with diluted toothpaste in a ratio of 1:3 with deionized water at a rate of 5 ml twice a day for two min. Eac specimen of 4-6 groups was exposed to 5 ml of three types of mouthwashes for one min. Then, the specimens were cut in the buccolingual direction in order to simultaneously evaluate the dentinal tubules and Vickers microhardness test was performed again and the before and after microhardness values were compared. Then, the percentage of deposition on the surface and tubule obstruction were analyzed using SEM (Scanning electron microscope) (P=0.006). Data were analyzed using SPSS24 software bu the descriptive statistics, ANOVA analysis of variance, and multiple Tukey comparisons. Results: The results of analysis of variance test showed that there was a statistically significant difference in the microhardness changes between study groups (P=0.006). Also, in-group analysis of microhardness changes, there was a significant difference (P<0.0001). Besides, only in the group containing 0.5% nanohydroxyapatite toothpaste, more than 50% tubule deposition and obstraction was observed (P<0.05). Conclusion: According to the present study, nanohydroxyapatite can be one of the treatment strategies to repair incipient lesions of teeth and the addition of nanohydroxyapatite, preferably to toothpaste, increases the dental microhardness

Evaluation of Yazd Dentist’s Knowledge, Attitude and Performance of Aesthetic Management of Anterior Composite Restorations in 2020

Introduction: Nowadays, due to the rapid development of new resin restorative materials and extensive media advertising concerning the importance and impact of a beautiful smile, there is an increased demand for the restoration of anterior teeth; thus, the beauty of smile is rendered as a major concern for patients and dentists. Methods: In this cross-sectional descriptive study, 165 general dentists in Yazd City, Iran were selected by random sampling. Of these, 158 dentists completed the study questionnaire, including 5 demographic items and 38 more items in three parts: knowledge, attitude and performance. Gleaned data were analyzed with SPSS 16 using T-test, one-way ANOVA, descriptive statistics (frequency/percentage). Results: In this study, 39.9% of dentists were male and 60.1% were female. There was no statistically significant correlation between the scores of attitude and knowledge with gender, age, history of activity, and the university of dentists' study (P>0.05). Yet, a statistically significant correlation was observed between the average attitude scores of dentists who participated in training courses and the dentists who did not participate in training courses (P<0.05). Conclusion: Based on the results of the present study, dentists had average knowledge and poor attitude regarding the aesthetic management of anterior composite restorations. However, participation in courses and workshops on aesthetic management of anterior composite restorations had a great impact on dentists' attitudes. Moreover, most dentists were not satisfied with the Dental School's training regarding anterior composite restorations

Evaluation of Microhardness of Mineral Trioxide Aggregate after Immediate Placement of Different Coronal Restorations: An In Vitro Study

Objectives: The purpose of this research was to evaluate the effect of immediate placement of different restorative materials in comparison with a temporary restoration on the surface microhardness of mineral trioxide aggregate (MTA). Materials and Methods: Access cavities were prepared in 40 extracted human molars, and a 3-mm layer of MTA was placed in the pulp chamber. The samples were divided into eight groups (n=5). Ten minutes after the MTA placement, two groups were restored with Zonalin temporary restoration, while the other six groups were restored with glass-ionomer cement (GIC), resin-modified glass-ionomer (RMGI), or resin-based composite. In each group, the Vickers microhardness (VMH) of MTA was determined after 7 and 21 days. Data were entered into SPSS 17 software program and were analyzed by two-way analysis of variance (ANOVA). The significance level was set at 5%. Results: The type of restorative materials had a statistically significant effect on the microhardness of MTA (P=0.002). However, the microhardness of MTA was neither significantly influenced by the timing of final restoration (P=0.246) nor by the time-material interaction (P=0.116). Conclusions: Based on the results of the present study and by considering the limitations of laboratory studies, it is recommended to postpone the placement of final restorations until the underlying MTA is completely set. Otherwise, in the clinical conditions in which early covering of MTA is recommended, sufficient moist-curing and hydration should be guaranteed by selecting a restorative material with the lowest hydrophilic interaction energy

Evaluation of shear bond strength of bioactive glass ionomer containing titanium and conventional glass ionomer particles to dentin treated with Er-YAG laser and conventional methods

Background and Aims: Recently, the addition of nanoparticles into the restorative materials and tooth preparation by laser for improving the bond strength have been concidered by researchers. The aim of this study was to investigate the shear bond strength of the bioactive glass ionomer containing titanium particles and a conventional glass ionomer with two surface treatments by Er-YAG laser and conventional methods. Materials and Methods: In this in-vitro study, 64 sound extracted premolars were collected. For conventional method, the specimens were prepared in such a way that dentin surfaces with a depth of 0.5 millimeter created at distance of 2 mm from the joint of CEJ at the root or crown.  In the laser group, after preparing the teeth, the surface area was prepared by Er-YAG laser. Then, in the middle part of the buccal surface, a cylindrical mold with dimensions of 3.5 mm in diameter and 4 mm in height was placed and for each group was filled with its own glass ionomers. The  specimens  were divided into 8 groups by simple random sampling (n=8): A (laser, conventional glass ionomer, coronal dentin)/ B (laser, glass ionomer containing titanium nanoparticle, coronal dentin)/C (conventional, conventional glass ionomer, coronal dentin)/ D (conventional, glass ionomer containing titanium nanoparticle, coronal dentin)/ E (laser, conventional glass ionomer, root dentin)/ F (laser, glass ionomer containing titanium nanoparticle, root dentin)/ G (conventional, conventional glass ionomer, root dentin)/ H (conventional, glass ionomer containing titanium nanoparticle, coronal dentin). Finally, the shear bong strength by a universal testing machine was measured at a cross-head speed of 1 mm/min. For data analysis, Two-way ANOVA test was used to evaluate the effect of each variable and their interaction on the shear bond strength and Tukey test was used to compare the two groups. Results: There was significant difference only between groups B with C (P=0.002), E (P=0.007), G (P=0.001) and H (P=0.01). The highest bond strength was found for group B (laser, glass ionomer containing titanium nanoparticle, coronal dentin) and the lowest bond strength for group G (conventional, conventional glass ionomer, root dentin). Conclusion: All three factors of Er-YAG laser, glass ionomer containing titanium nanoparticle and coronal dentin had a positive effect on the improvement of the bond strength

Comparision between laser and sandblasting surface treatments on push-out bond strength of fiber posts to root canals

Background and Aims: Insufficient adhesion between fiber post and root canal is the main reason for the failure of the restoration and the fiber post surface treatment can imprive the bond strength. Additionally, there is disagreement about the ideal method of preparation to achieve the desired bond. The aim of this study was to compare the effect of two surface treatment methods on push-out bond strength of fiber posts to root canals. Materials and Methods: In this study, 45 healthy incisor teeth underwent root canal treatment. After preparing the post space, they were divided into 3 groups of 15, based on the surface treatment methods of the fiber post. In the first group as control group, no surface treatment was done on the fiber post. In the second and third groups, sandblasting with Cojet sand particles and 810 nm diode laser were used for surface treatment, respectively. Then, fiber posts were placed in all root channels by a self-adhesive resin cement. Then, the roots were cut in such a way that from each, 3 pieces with a thickness of 1.5 mm were obtained. Finally, the push-out bond strengths were measured using a universal testing machine. Data were analyzed by ANOVA using SPSS software. The level of significance was considered at P<0.05. Results: The average bond strengths in three groups were as follows: control group, 2.877 ±1.430, sandblast group 6.318±3.444, and laser 4.224 ±1.890 MPa ± SD. The difference in the bond strength between the sandblast group and the control group was significant (P=0.001). However, the average of the bond strength of laser group was not significantly different from the control group. (P=0.03). Conclusion: The findings of this study showed that unlike diode laser radiation, the use of Cojet sand particles for sandblasting the fiber post surfaces significanlty improved the bond strength

Comparison of the efficacy of calcium versus acetaminophen on reduction of orthodontic pain

Background: Pain and discomfort are common during orthodontic treatment. Aim: The aim of this single blind clinical trial was to compare the effectiveness of oral calcium versus acetaminophen in pain reduction. Materials and Methods: In this study, the patients recorded their pain on a 100-mm visual analogue scale (VAS). Forty female patients (14-19 years old) who had passed at least 2 months of their first orthodontic archwire placement and their pain intensity was 40-100 mm (VAS) were selected and randomly assigned to two groups. Psychotic status was measured using Hospital Anxiety and Depression Scale (HADS). In group 1 calcium forte tablets (500 mg) and in group 2 acetaminophen (325 mg) tablets were prescribed to be taken one tablet per day. After consumption of all tablets (n=60), pain intensity was measured and compared with that before drug therapy. Results: The results indicated that the difference in pain intensity before and after drug administration in the calcium group was statistically significant (P<0.001), but not significant in the acetaminophen group (P=0.468). The difference between the pain reduction in the two groups were also statistically significant (P<0.001). In the calcium group 9.5% and in the acetaminophen group 15.8% had anxiety that was not statistically significant (P=0.631). In both groups, no subject had depression. Conclusion: Calcium is more effective than acetaminophen in long-term pain reduction during orthodontic treatment

Effect of Mechanical Loads and Surface Roughness on Wear of Silorane and Methacrylate-Based Posterior Composites

Objectives: Dental composite wear in posterior restorations is a concern and is affected by different factors. This study was conducted to evaluate the effect of polishing and mechanical loads on wear of silorane-based and methyl methacrylate-based composites resins. Materials and Methods: Of each dental composite (Filtek P90 and Filtek P60), 40 samples were fabricated in a polyethylene mold (4mm diameter, 10mm height). According to the finishing and/or polishing protocols (180-grit or 2500-grit silicon carbide papers), the samples of each composite were divided into two groups. Surface roughness (Rₔ) was measured and recorded using a contact profilometer. The weight of each sample was also measured in grams. The wear test was performed in a pin-on-disc device under two different loads (70N, 150N). Afterwards, samples were subjected to profilometry and their weight was measured again. Data were analyzed using t-test and univariate ANOVA. P <0.05 was considered statistically significant. Results: Higher mechanical load resulted in greater weight loss (P<0.001). Samples polished with 2500-grit papers showed significantly lower Ra changes compared to those polished with 180-grit papers (P<0.001). Filtek P90 had greater weight loss than Filtek P60 except in one condition (180-grit, 70N). Conclusions: Results showed that wear of posterior composite restorations depends on mechanical load, type of composite resin and surface properties.

Comparison the effect of chlorhexidine 2%, ethanol 70%, sodium ascorbate 10% and delayed bonding usage on the shear bond strength of composite resin to bleached enamel

Background and Aims: The purpose of this study was to compare the effect of chlorhexidine 2%, ethanol 70% and sodium ascorbate 10% and delayed bonding for 1 week on the shear bond strength of composite resin to enamel after bleaching.   Materials and Methods: 90 human central incisors were divided into 6 equal groups: Group 1: no bleaching; Group 2: bleaching with carbamide peroxide 45% for 45 minutes; Group 3: bleaching + restoring specimens in distilled water for 1 week. In group 4, 5 and 6, after bleaching, 1 cc of chlorhexidine 2%, ethanol 70% and sodium ascorbate 10% were applied for 15 minutes. Composite cylinders were bonded on the buccal surfaces. Specimens were thermocycled for 1000 cycles and the shear bond strength test was done. Specimens were examined under stereomicroscope and SEM. Data were analyzed a sign ANOVA and Bonferroni test.   Results: The shear bond strength values were not significantly lower in the bleached teeth (group 3, 4, 5 and 6) than that of negative control group (group 1) (P=1.000, P=0.069, P=0.081, P=1.000) Bonferroni test results show significant difference between test groups (3, 4, 5 and 6) and group 2 (P<1.000, P=0.007, P=0.008, P<1.000) Under SEM, resin tags in group 2 was thinner and lesser than group 3, 4, 5 and 6. The most adhesive failures were in group 2.   Conclusion: Bleaching with carbamide peroxide and immediate bonding of composite decreased the shear bond strength. Sodium ascorbate 10% and delayed bonding for 1 week were the most effective way