Minimal alterations on the enamel surface by micro-abrasion: in vitro roughness and wear assessments

Objective: To evaluate the in vitro changes on the enamel surface after a micro-abrasion treatment promoted by different products. Material and Methods: Fifty (50) fragments of bovine enamel (15 mm × 5 mm) were randomly assigned to five groups (n=10) according to the product utilized: G1 (control)= silicone polisher (TDV), G2= 37% phosphoric acid (3M/ESPE) + pumice stone (SS White), G3= Micropol (DMC Equipment), G4= Opalustre (Ultradent) and G5= Whiteness RM (FGM Dental Products). Roughness and wear were the responsible variables used to analyze these surfaces in four stages: baseline, 60 s and 120 s after the micro-abrasion and after polishing, using a Hommel Tester T1000 device. After the tests, a normal distribution of data was verified, with repeated ANOVA analyses (p?0.05) which were used to compare each product in different stages. One-way ANOVA and Tukey tests were applied for individual comparisons between the products in each stage (p?0.05). Results: Means and standard deviations of roughness and wear (µm) after all the promoted stages were: G1=7.26(1.81)/13.16(2.67), G2=2.02(0.62)/37.44(3.33), G3=1.81(0.91)/34.93(6.92), G4=1.92(0.29)/38.42(0.65) and G5=1.98(0.53)/33.45(2.66). At 60 seconds, all products tended to produce less surface roughness with a variable gradual decrease over time. After polishing, there were no statistically significant differences between the groups, except for G1. Independent of the product utilized, the enamel wear occurred after the micro-abrasion. Conclusions: In this in vitro study, enamel micro-abrasion presented itself as a conservative approach, regardless of the type of the paste compound utilized. These products promoted minor roughness alterations and minimal wear. The use of phosphoric acid and pumice stone showed similar results to commercial products for the micro-abrasion with regard to the surface roughness and wear

Effect of Xylitol Varnishes on the Inhibition of Demineralization in Vitro

Objective: To evaluate the efficacy of xylitol varnishes in the inhibition of enamel demineralization in vitro. Material and Methods: Bovine enamel blocks (n=120) were randomly allocated to four groups (n = 30), and the surface hardness (SH) was measured at baseline. The blocks were treated with the following varnishes: 20% xylitol, 20% xylitol plus F (5% NaF), Duraphat™ (5% NaF, positive control), and placebo (no-F/xylitol, negative control). The varnishes were applied and removed after 6 h of immersion in artificial saliva. The blocks were subjected to pH cycles (demineralization and remineralization for 2 and 22h/day, respectively, for 8 days). Surface and cross-sectional hardnesses were measured to calculate the percentage of SH loss (%SHL) and the integrated loss of the subsurface hardness (ΔKHN). Data were statistically analyzed using Kruskal-Wallis and Tukey’s tests (p<0.05). Results: %SHL was significantly decreased by 20% xylitol plus F, Duraphat™, and 20% xylitol varnishes compared to placebo. The use of 20% xylitol plus F varnish led to a significantly lower percentage of SH loss compared to the use of 20% xylitol varnish without F. However, the experimental and commercial varnishes led to significantly lower subsurface demineralization compared to placebo and did not differ from each other. Conclusion: Xylitol varnishes, especially when combined with F, effectively prevent enamel demineralization

Impact of filler size and distribution on roughness and wear of composite resin after simulated toothbrushing

Objectives: Nanofilled composite resins are claimed to provide superior mechanical properties compared with microhybrid resins. Thus, the aim of this study was to compare nanofilled with microhybrid composite resins. The null hypothesis was that the size and the distribution of fillers do not influence the mechanical properties of surface roughness and wear after simulated toothbrushing test. Material and methods: Ten rectangular specimens (15 mm x 5 mm x 4 mm) of Filtek Z250 (FZ2), Admira (A), TPH3 (T), Esthet-X (EX), Estelite Sigma (ES), Concept Advanced (C), Grandio (G) and Filtek Z350 (F) were prepared according to manufacturer's instructions. Half of each top surface was protected with nail polish as control surface (not brushed) while the other half was assessed with five random readings using a roughness tester (Ra). Following, the specimens were abraded by simulated toothbrushing with soft toothbrushes and slurry comprised of 2: 1 water and dentifrice (w/w). 100,000 strokes were performed and the brushed surfaces were re-analyzed. Nail polish layers were removed from the specimens so that the roughness (Ra) and the wear could be assessed with three random readings (mu m). Data were analyzed by ANOVA and Tukey's multiple-comparison test (alpha = 0.05). Results: Overall outcomes indicated that composite resins showed a significant increase in roughness after simulated toothbrushing, except for Grandio, which presented a smoother surface. Generally, wear of nanofilled resins was significantly lower compared with microhybrid resins. Conclusions: As restorative materials suffer alterations under mechanical challenges, such as toothbrushing, the use of nanofilled materials seem to be more resistant than microhybrid composite resins, being less prone to be rougher and worn.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq), BrazilCNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico), Brazil [136375/2006-5

Synthesis and characterization of calcium phosphate particles functionalized with TEGDMA and their application in the development of remineralizing resin-based materials

Os objetivos deste trabalho foram : 1) sintetizar e caracterizar partículas de fosfato di-cálcico di-hidratado (DCPD) funcionalizadas com dimetacrilato de trietileno glicol (TEGDMA), com o propósito de reduzir a aglomeração e melhorar a interação entre as partículas e a matriz orgânica dos materiais resinosos e 2) avaliar o efeito da adição de partículas funcionalizadas em uma matriz resinosa em relação a liberação de íons, propriedades ópticas, grau de conversão, propriedades mecânicas e microestrutura do material. Na primeira etapa do trabalho foram sintetizadas pelo método sol-gel dois tipos partículas de DCPD: funcionalizadas e puras. Além dessas, caracterizou-se nesta etapa partículas comerciais do mesmo composto. As partículas foram caracterizadas por difração de raio X (DRX), espectroscopia no infravermelho com transformada de Fourier (FTIR), análise elementar, análise termogravimétrica (TGA), isortermas de adsorção de nitrogênio e método BET, microscopia eletrônica de transmissão e espalhamento de luz dinâmico (DLS). Na segunda etapa do trabalho, um novo lote de partículas funcionalizadas foi sintetizado, e como controle, sintetizou-se partículas não funcionalizadas. Quatro materiais resinosos foram formulados, um deles contendo apenas BisGMA e TEGDMA (1:1 em mols) e os demais contendo, além da matriz resinosa, 20% (em volume) de partículas funcionalizadas, partículas não funcionalizadas ou sílica coloidal silanizada. Os materiais foram avaliados quanto à liberação de íons, propriedades ópticas (transmitância total e E em relação à resina sem carga), grau de conversão (GC), resistência à flexão biaxial (RFB), módulo de elasticidade e análise microestrutural. Os dados foram submetidos à análise de variância (ANOVA), complementada pelo teste de Tukey, com nível de significância de 5 %. A composição das partículas foi confirmada por DRX e a funcionalização das mesmas foi confirmada pelas análises de FTIR, análise elementar e TGA. As partículas funcionalizadas apresentaram área superficial até 3 vezes maior quando comparadas às partículas puras e comerciais. Esses dados foram confirmados pela análise de DLS, que encontrou aglomerados maiores para as partículas dos compostos puro e comercial. Na segunda etapa do estudo, observou-se que a funcionalização das partículas não afetou a liberação de íons Ca2+ dos materiais bioativos; entretanto, a liberação de íons HPO42- foi 51% menor para o material contendo partículas funcionalizadas. Todos os materiais apresentaram GC semelhantes. O compósito com sílica apresentou valores de transmitância significantemente menores e E superior ao obtido para os demais materiais. A funcionalização das partículas aumentou a RFB em 32%, porém ainda inferior à do compósito com sílica. A funcionalização não afetou o módulo de elasticidade dos materiais. A síntese de partículas de DCPD funcionalizadas com TEGDMA foi realizada com êxito. O monômero funcionalizante contribuiu para a diminuição do tamanho dos aglomerados. Além disso, a funcionalização favoreceu a interação entre as partículas de DCPD e a matriz orgânica dos materiais, evidenciado pelo aumento no valor de resistência à flexão, sem redução substancial na liberação de íons cálcio do material.The aims of this study were: 1) to synthesize and characterize dicalcium phosphate dihidrate (DCPD) particles functionalized with triethylene glycol dimethacrylate (TEGDMA), with the purpose of reducing agglomeration and improve the interaction between the particles and the organic matrix of resin-based materials and 2) evaluate the effect of the addition of functionalized particles in a resin matrix regarding ion release, optical properties, degree of conversion, mechanical properties and microstructure. In the first part of the study, two types of DCPD particles were synthesized by a sol-gel method: functionalized and bare. Additionally, proprietary DCPD particles were also characterized. Particles were characterized by X-ray diffraction (DRX), Fourier-transformed infrared spectroscopy (FTIR), elemental analysis, thermogravimetric analysis (TGA), Nitrogen adsorption isotherms and BET method, transmission electron microscopy and dynamic light scattering (DLS). In the second part, a new batch was synthesized and, as a control, non-functionalized nanoparticles were synthesized. Four resin-based materials were prepared, one containing only BisGMA and TEGDMA (1:1 in mols) and the other containing besides the resin, 20 % (in volume) of functionalized, non-functionalized or silanized colloidal silica particles. Materials were evaluated for ion release, optical properties (total transmittance and E, in relation to the unfilled resin), degree of conversion (DC), biaxial flexural strength (BFS), elastic modulus and microstructural analysis. Data were subjected to analysis of variance (ANOVA), complemented by Tukey test, with a global significance level of 5%. Particles composition was confirmed by DRX, while functionalization was confirmed by FTIR , elemental analysis and TGA. Functionalized particles presented surface area up to three times higher compared to bare and proprietary particles. These findings were confirmed by DLS, which found larger agglomerates for the bare and proprietary particles. In the second part of the study, it was observed that particle functionalization did not affect Ca2+ release from the bioactive materials; however, HPO42- release was 51% lower from the material containing functionalized particles. All materials presented similar DC. The silica composite presented transmittance values significantly lower and higher E than the other materials. Functionalization increased BFS in 32%, however, it remained lower than the silica-containing composite. Functionalization did not affect elastic modulus. The synthesis of functionalized particles was accomplished with success. The functionalized monomer contributed for reducing agglomerate size. Also, functionalization favored the interaction between DCPD particles and the resin matrix of the materials, evidenced by the increase in flexural strength, without substantially reducing calcium release from the material

Influence of variation of power density on polymerization shrinkage and pigmentation of photosensitive resins

O presente estudo, in vitro, teve como objetivo avaliar a influência da variação da densidade de potência (300, 600, 1000 e 1550 mW/cm2) na contração de polimerização e na pigmentação de duas resinas compostas, Filtek Z250 e Filtek Z350XT (3M/ESPE). Para avaliação das forças geradas durante a contração de polimerização foram utilizadas duas bases de aço, em forma retangular (6 X 2 mm), posicionadas paralelamente na máquina de ensaios (Emic - DL 500), uma conectada à célula de carga de 100 Kg e, a outra, ao braço fixo. As resinas compostas foram introduzidas entre as bases metálicas, com altura de 1mm, volume de 12mm3 e fator C de 1,5. Para fotoativação foi utilizado o aparelho LED Blue Star 3 (Microdont Micro Usinagem de Precisão LTDA), determinando-se o tempo de 20 s para as diferentes densidades de potência. As bases ficaram fixas durante o ensaio (120 s) e as forças geradas durante a polimerização foram registradas numericamente e por meio de gráficos [força (N) x tempo (s)], num total de dez ensaios para cada grupo. Para os testes de pigmentação foram confeccionados, em uma matriz pré-fabricada, cinco espécimes circulares (6 mm X 2 mm) para cada grupo. As avaliações das alterações de cor (_E) foram realizadas com o Espectrofotômetro Easyshade com o sistema CIE-Lab, em diferentes períodos (inicial, após 6 e 12hs, 1, 2, 3, 4 e 5 dias de imersão em café). Os resultados obtidos foram submetidos à análise estatística ANOVA a dois critérios e teste Tukey para comparações individuais (p<0,05). Os resultados evidenciaram que a variação da densidade de potência influenciou diretamente na indução da contração de polimerização, com geração de forças significantemente maiores à medida que se aumentou os valores de irradiância, independente da resina composta utilizada. De forma semelhante, as alterações de cor apresentaram uma relação com a variação da densidade de potência, porém de forma indireta, evidenciando-se que o aumento progressivo da irradiância inferiu em menores valores de _E, assim como uma pigmentação mais acentuada para a resina composta nanoparticulada em relação à resina micro-híbrida. Considerando a observação de efeitos distintos com emprego de diferentes densidades de potência, dentro de um mesmo tempo de fotoativação das resinas compostas analisadas, tanto em relação à indução da contração de polimerização quanto de alteração de cor, deve ser concebido que o fator densidade de potência não pode ser estabelecido de forma independente aos demais parâmetros técnicos relacionados à dose de irradiância, à sequência de energia necessária e ao espectro de luz requerido para efetivação da polimerização das diferentes formulações de compósitos disponíveis.The aim of this in vitro study was to evaluate the influence of the power density (300, 600, 1000 and 1550 mW/cm2) on polymerization shrinkage and pigmentation of two composite resins, Filtek Z250 and Filtek Z350XT (3M/ESPE). The experimental groups were set based on different combinations of the influencing factors. For the polymerization shrinkage test two steel bases with a parallel disposition were used, the movable one was connected to a 100 kg load cell and the other one was fixed using a universal testing machine (EMIC - DL 500). The resin composite was inserted between the bases and light-cured for 20 s with a LED unit (Blue Star 3, Microdont) The bases stayed fixed during the test (120 s) and the polymerization stresses generated were recorded in graphs [curves force (N) x time (s)]. A total of ten tests for each group were made. For the pigmentation tests five circular specimens (6 mm X 2 mm) for each group were made using a prefabricated mold. Using the color-measuring device Easyshade with the CIE-Lab system, evaluations were made at different times (baseline, after 6 hours, 12 hours, 1, 2, 3, 4 and 5 days of coffee immersion). Statistical analysis was performed with two-way ANOVA and Tukey test for individual comparisons (p <0.05). The results showed that the power density variation directly influenced the induction of polymerization shrinkage, with significantly greater generation force as it increased the values of irradiance, independent of the resin used. Similarly, color changes showed a relation with the power density variation, however demonstrating indirectly that the gradual increase in irradiance inferred at lower values of _E, as pigmentation was more pronounced for the composite with nanoparticles compared to a micro-hybrid resin. Considering the observation of various effects when using different power densities within the same light-curing time of the composite resins analyzed, in relation to the induction of polymerization shrinkage and color change, should be understood that the power density factor can not be established independently of other technical parameters related to the irradiation dosage, the sequence of necessary energy and light spectrum required to effecting the polymerization of composites with different available formulations

Trends in restorative composites research:what is in the future?

Abstract Clinical trials have identified secondary caries and bulk fracture as the main causes for composite restoration failure. As a measure to avoid frequent reinterventions for restoration replacement, composites with some sort of defense mechanism against biofilm formation and demineralization, as well as materials with lower susceptibility to crack propagation are necessary. Also, the restorative procedure with composites are very time-consuming and technically demanding, particularly concerning the application of the adhesive system. Therefore, together with bulk-fill composites, self-adhesive restorative composites could reduce operator error and chairside time. This literature review describes the current stage of development of remineralizing, antibacterial and self-healing composites. Also, an overview of the research on fiber-reinforced composites and self-adhesive composites, both introduced for clinical use in recent years, is presented

Preventive effect of chitosan gel containing CaneCPI-5 against enamel erosive wear in situ.

OBJECTIVE This study evaluated the preventive effect of a chitosan gel containing CaneCPI-5 against enamel erosion and erosion + abrasion in situ. METHODS Sixteen volunteers participated in a crossover, double-blind protocol, comprising 4 phases: (1) no treatment (Nt); (2) chitosan gel (Cg); (3) chitosan gel + 12,300 ppm NaF (Cg + NaF); and (4) chitosan gel + 0.1 mg/mL CaneCPI-5 (Cg + Cane). Volunteers wore an appliance containing 4 specimens. Once/day, they applied the gel (except for Nt) (4 min/specimen). Erosive challenges were performed extra-orally (0.1% citric acid, 90 s, 4 × /day; ERO). Specimens were also abraded (toothbrush, 15 s/specimen, 2 × /day; ERO + ABR). Enamel wear was assessed by profilometry and relative surface reflection intensity (%SRI). Two-way RM-ANOVA/Sidak's tests and Spearman's correlation were used (p < 0.05). RESULTS For profilometry, ERO + ABR promoted significantly greater wear when compared with ERO. There was a significant difference among all treatments. The lowest enamel loss occurred for Cg + Cane, followed by Cg + NaF, Cg, and Nt (p < 0.05). The %SRI was significantly lower for ERO + ABR when compared to ERO, only for the Nt group. The greatest %SRI was found for the Cg + NaF and Cg + Cane groups, which did not differ significantly, regardless of the conditions. The lowest %SRI was found for the Nt and Cg groups, which did not differ from each other, regardless of the conditions. The Nt group did not differ significantly from the Cg + NaF (ERO). There was a significant correlation between both analyses. CONCLUSION The incorporation of CaneCPI-5 in the chitosan gel prevented erosive wear in situ. CLINICAL RELEVANCE These results open a new perspective for the use of CaneCPI-5 in other application vehicles, such as chitosan gel