Micro-computed tomography for assessing the internal and external voids of bulk-fill composite restorations: A technical report

none6noopenTosco, Vincenzo; Monterubbianesi, Riccardo; Furlani, Michele; Giuliani, Alessandra; Putignano, Angelo; Orsini, GiovannaTosco, Vincenzo; Monterubbianesi, Riccardo; Furlani, Michele; Giuliani, Alessandra; Putignano, Angelo; Orsini, Giovann

A Comparative Evaluation of Nanohydroxyapatite-Enriched Hydrogen Peroxide Home Bleaching System on Color, Hardness and Microstructure of Dental Enamel

none7siThis study aimed to evaluate two hydrogen peroxide (HP)-based at-home bleaching systems in order to analyze whether nano-hydroxyapatite (nHA) addition may represent a reliable and safe solution for tooth whitening without altering dental microstructure and hardness. Human third molars (N = 15) were treated with two bleaching agents, one containing 6%HP (6HP) and the other 6% HP nHA-enriched (6HP-nHA) with average particle diameter ranging from 5–20 nm. Their effects on enamel were assessed using a spectrophotometer, Vickers microhardness (VMH) test and Scanning Electron Microscopy (SEM), comparing the treated groups with the non-treated control group (CTR). Color analysis revealed improvement in whiteness in both groups compared to CTR. VMH test results showed no differences among the groups. SEM analysis highlighted no evident changes in the enamel microstructure of tested groups compared to CTR. At high magnification, in 6HP group, a slight increase in irregularities of enamel surface morphology was observed, while 6HP-nHA group displayed removal of the aprismatic layer but preservation of the intact prismatic structure. These results suggest that the 6HP-nHA agent may be recommended to provide reliable whitening treatment, without damaging the enamel micromorphology and hardnessopenMonterubbianesi, Riccardo; Tosco, Vincenzo; Bellezze, Tiziano; Giuliani, Giampaolo; Özcan, Mutlu; Putignano, Angelo; Orsini, GiovannaMonterubbianesi, Riccardo; Tosco, Vincenzo; Bellezze, Tiziano; Giuliani, Giampaolo; Özcan, Mutlu; Putignano, Angelo; Orsini, Giovann

Microleakage Analysis of Different Bulk-Filling Techniques for Class II Restorations: µ-CT, SEM and EDS Evaluations

none8This study aimed to compare two different bulk-filling techniques, evaluating the internal and external adaptation of class II resin-composite restorations, by analysing the gap formation using microcomputed tomography (µ-CT) and scanning electronic microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Two standardized mesio/disto-occlusal (MO/DO) cavities were prepared in eight extracted human third molars that were divided, according to the filling technique used, in the following two groups (n = 4): BG (Bulk&Go group) and BT (Bulk Traditional group). After universal bonding application, followed by the light curing, all teeth were restored using a bulk-fill composite. Specimens were scanned with µ-CT to evaluate 3D interfacial gaps. Acquired µ-CT data were analysed to quantify the gap formation. Complementary information to the µ-CT analysis were obtained by SEM. Thereafter, the chemical composition of tooth-restoration interface was analysed using EDS. The µ-CT analysis revealed gaps formation at the tooth-restoration interface for both the BG and BT groups, while within the restoration, only in the BT group there was evidence of microleakage formation. The scanning electron micrographs of both groups showed that the external marginal integrity of the restoration was preserved, while EDS showed the three different structures (tooth surface, adhesive layer and resin composite) of the tooth-restoration interface, highlighting the absence of gap formation. In both BG and BT, the two filling techniques did not show significant differences regarding the internal and external marginal adaptation of the restoration. To achieve a successful restoration, the clinician could be advised to restore a class II cavity using a single increment bulk-filling technique (BG), thus treating it as a class I cavity.openTosco, Vincenzo; Vitiello, Flavia; Furlani, Michele; Gatto, Maria Laura; Monterubbianesi, Riccardo; Giuliani, Alessandra; Orsini, Giovanna; Putignano, AngeloTosco, Vincenzo; Vitiello, Flavia; Furlani, Michele; Gatto, Maria Laura; Monterubbianesi, Riccardo; Giuliani, Alessandra; Orsini, Giovanna; Putignano, Angel

Cytotoxic Effects of 5-Azacytidine on Primary Tumour Cells and Cancer Stem Cells from Oral Squamous Cell Carcinoma: An In Vitro FTIRM Analysis

In the present study, the cytotoxic effects of 5-azacytidine on primary Oral Squamous Cell Carcinoma cells (OSCCs) from human biopsies, and on Cancer Stem Cells (CSCs) from the same samples, were investigated by an in vitro Fourier Transform InfraRed Microscospectroscopy (FTIRM) approach coupled with multivariate analysis. OSCC is an aggressive tumoral lesion of the epithelium, accounting for ~90% of all oral cancers. It is usually diagnosed in advanced stages, and this causes a poor prognosis with low success rates of surgical, as well as radiation and chemotherapy treatments. OSCC is frequently characterised by recurrence after chemotherapy and by the development of a refractoriness to some employed drugs, which is probably ascribable to the presence of CSCs niches, responsible for cancer growth, chemoresistance and metastasis. The spectral information from FTIRM was correlated with the outcomes of cytotoxicity tests and image-based cytometry, and specific spectral signatures attributable to 5-azacytidine treatment were identified, allowing us to hypothesise the demethylation of DNA and, hence, an increase in the transcriptional activity, together with a conformational transition of DNA, and a triggering of cell death by an apoptosis mechanism. Moreover, a different mechanism of action between OSSC and CSC cells was highlighted, probably due to possible differences between OSCCs and CSCs response

Multidisciplinary evaluation of the remineralization potential of three fluoride-based toothpastes on natural white spot lesions.

OBJECTIVES This in vitro study aimed assessing the remineralization potential of three commercial fluoride-based toothpastes in permanent teeth with natural white spot lesions (WSLs). A multidisciplinary approach based on Raman microspectroscopy (RMS), Scanning electron microscopy (SEM), Energy-dispersive x-ray spectroscopy (EDS), and Vickers microhardness (VMH) was exploited. METHODS N = 12 human molars with natural WSLs in the proximal-vestibular zone were selected and divided into 4 groups (n = 3) according to the different treatments: HAF (hydroxyapatite with fluoride ions); SMF (sodium monofluorophosphate with arginine); SF (sodium fluoride with enzymes), and CTRL (untreated group). All toothpastes tested contained 1450 ppm of fluoride. Teeth samples were submitted to the following protocol: a 7-day pH cycling treatment, with two daily exposures (2 min each time) to the commercial toothpastes described above. The surface micromorphology (SEM), the chemical/elemental composition (RMS and EDS), and the Vickers microhardness (VMH) were evaluated. Statistical analysis was performed. RESULTS A remarkable remineralization of WSLs in SEM images was observed in all treated groups compared to CTRL. In particular, HAF and SF displayed higher values of VMH, phosphates amount (I960), crystallinity (FWHM960), and lower ones of C/P (I1070/I960) with respect to CTRL. Intermediate values were found in SMF, higher than CTRL but lower with respect to HAF and SF. As regards the Ca/P ratio, statistically significant differences (p < 0.05) were found between SF and the other groups. CONCLUSIONS All the tested dentifrices have shown to remineralize the WSLs. SF and HAF have comparable capability in hardness recovery and crystallinity; however, SF shows the best remineralizing potential according to both micromorphological and chemical analyses. Clinical relevance The daily use of toothpastes containing hydroxyapatite partially replaced with fluoride, sodium monofluorophosphate with arginine and sodium fluoride toothpaste associated with enzymes represents a preventive, therapeutic, effective, and non-invasive tool for remineralize WSLs

Efficacy of an All-Natural Polyherbal Mouthwash in Patients With Periodontitis: A Single-Blind Randomized Controlled Trial

Aim: This study aimed to evaluate the anti-inflammatory effect and the incidence of adverse effects of an all-natural polyherbal mouthwash in patients with periodontitis, after 3 months of use. These aims were accomplished by using full mouth bleeding score (FMBS), full mouth plaque score (FMPS), probing depth (PD) clinical attachment level (CAL) and a questionnaire recording any adverse events.Methods: The present randomized controlled clinical study considered 40 patients with moderate or severe periodontitis, randomized in two groups: a test group (TG) and a control group (CG). TG was instructed to use a polyherbal mouthwash composed of Propolis resin extract, Plantago lanceolata, Salvia officinalis leaves extract, and 1.75% of essential oils and the CG was given a placebo mouthwash. Both groups were instructed to rinse for 2 min, twice daily after their routine oral home care with the different mouthwashes. Clinical measurements of FMBS, FMPS, PD and CAL were recorded at baseline (T0) and after 3 months (T1). The incidence of adverse outcomes was recorded at every follow-up. Mann–Whitney U test and Wilcoxon signed-rank test were used for the statistical analysis (p &lt; 0.05).Results: The final study sample consisted of 34 healthy individuals, 17 individuals in each of the two groups. TG and CG showed a statistically significant reduction in FMBS (p = 0.001 TG; p = 0.002 CG), FMPS (p = 0.001 TG; p = 0.003 CG), PD (p = 0.001 TG; p = 0.011 CG) and CAL (p &lt; 0.001 TG; p = 0.020 CG) values from baseline to 3 months. The TG showed a statistically significant decrease in FMBS and FMPS compared with the CG. No adverse events or side effects were reported or observed in both groups.Conclusion: The use of polyherbal mouthwash in patients with moderate or severe periodontitis has proved safe and effective in reducing bleeding score and plaque accumulation, after 3 months, compared with placebo, although no difference between the two groups were reported on PD and CAL (both improving at T1)

An Overview on Current Non-invasive Diagnostic Devices in Oral Oncology

Oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy, and despite advances in cancer therapies, the overall 5-year survival rate has remained below 50% over the past decades. OSCC is typically preceded by potentially malignant disorders (PMD), but distinguishing high-risk from low-risk PMD is challenging. In the last years, several diagnostic methods as light-based detection systems (LBDS) have been proposed to facilitate the detection of OSCC and PMD. Furthermore, the recent evolution of nanotechnology may provide new opportunities to detect PMD and OSCC at an early stage. Indeed, several preclinical studies showed the potential of nanotechnology to enhance diagnostic accuracy. For these reasons, it is fundamental to conduct studies to evaluate the efficacy of nanotechnology implementation in LBDS. The aim of this article is to review the current literature on LBDS and to provide a summary of the sensitivity and specificity of each technique, and possible future applications of nanotechnologies. The LBDS showed great potential for screening and monitoring oral lesions, but there are several factors that hinder an extensive use of these devices. These devices seem to be useful in assessing lesion margins that must be biopsied. However, to date, conventional oral examination, and tissue biopsy remain the gold standard for OSCC diagnosis. The use of nanotechnologies could be the next step in the evolution of LBDS, thus providing devices that can help clinicians to detect and better monitor oral lesions

Can Desensitizing Toothpastes Also Have an Effect on Gingival Inflammation? A Double-Blind, Three-Treatment Crossover Clinical Trial

Background: Many desensitizing toothpastes exist commercially; however, few clinical trials have investigated their anti-inflammatory effects. This study aimed to evaluate the anti-inflammatory effect and patient appreciation of two toothpastes containing desensitizing agents: (1) a zinc-carbonate-hydroxyapatite nanoparticle (CHA) and (2) a calcium sodium phosphosilicate bioactive glass (CSPS). Methods: CHA and CSPS were compared with an anti-inflammatory and antibacterial herbal based toothpaste (HB). The aims were accomplished by comparing the following outcomes: (1) the reduction in plaque and bleeding score (Full Mouth Plaque Score (FMPS) and Full Mouth Bleeding Score (FMBS), respectively); (2) the antibacterial activity (AbA) of the toothpaste by saliva samples; (3) the patient appreciation score (Visual Analogue Scale; VAS). Clinical parameters were assessed at baseline and 14 days post-treatment. Results: The final sample consisted of 25 subjects, aged between 20 and 58 years. Although no differences in FMPS were reported (p &gt; 0.05), both desensitizing toothpastes showed an improvement in FMBS. CSPS and HB recorded more AbA compared to CHA (p &lt; 0.05). Moreover, HB resulted in a higher VAS score than both desensitizing toothpastes (p &lt; 0.05). Conclusion: In conclusion, only CSPS displayed a similar anti-inflammatory effect compared to HB. Despite the low VAS score, CSPS could be considered as a valid and effective toothpaste in subjects with both dentin hypersensitivity and inflamed gums, highlighting its utility in clinical practice

New Frontiers in Conservative Dentistry: From Resin-Based Materials to Stem Cells

“Save the teeth” should be the final aim of every dentist. In the era of implantology, the attempt to maintain the tooth is critical; sometimes removing the whole tooth is easier than saving it. When the tooth is decayed, the clinician should remove the damaged tissue and try to reconstruct it. In this phase, decision making is an important task and the knowledge of all possible treatments and materials is essential in helping the clinician to take the right decision. Dentistry has recently gone through a technological revolution: important innovations have involved all dental disciplines, including Conservative dentistry, which is devoted to the care and maximum preservation of the tooth tissues. Preventive dentistry represents the initial and the most conservative method to accomplish the mission of preserving the teeth, therefore evaluations of new devices for dental care and oral disease were my first aim. If the tooth is decayed or traumatically injured, clinicians have a vast variety of dental materials to repair it. Nowadays, resin-based materials have become the gold standard replacements for damaged dental tissues, that can be restored using direct or indirect techniques. Recent developments and potential applications of some new resin-based materials were the second aim of the present thesis. In particular, physical and chemical properties of bulk fill composites and their behaviour after polishing procedures have been investigated. Furthermore, the cementation of indirect restoration has been evaluated by studying the kinetics of degree of conversion of luting resin agents and the effects on them of two different curing protocols. Finally, the third aim went a bit further into the future, in order to evaluate potential approaches of regenerating dental tissues or even completely reforming the whole tooth. Every day stem cells become closer to the reality and their clinical application could be a great challenge for regenerative and conservative dentistry. Novel potential strategies for regenerating damaged tissues have been studied. Particularly, a comparative study on the differentiation potential of human gingival, foreskin fibroblasts and dental pulp stem cells was performed

New Trends of Colour and Background Effect in Restorative Dentistry

Abstract: Evaluation of the right colour is an important step in restorative dentistry. In history, clinicians started to take the colour with subjective methods. For instance, shade guides were used to compare the teeth with their colour tabs and choose the right one. However, this method presents some issues related to the clinician: everyone perceives colours in different ways, not only because humans differ from each other, but also because they can be affected by local, physiological, physical and psychologically uncontrolled factors, such as fatigue, aging, emotions and lighting conditions. All these factors together contribute to make the subjective method unpredictable. For this reason, new instruments need to be exploited by clinicians in order to describe teeth colour in a more accurate and objective manner, thus applying the objective method. The digital camera, the colorimeter and the spectrophotometer are some of the instruments that can be used to reach this purpose. In both the subjective and objective methods, during determination of the colour, the clinician often focuses on teeth and forgets what surrounds it, like the black background of the mouth or the environmental light. These elements may influence the perception of the colour and, mainly in clinicians with a low level of experience, they could lead to a wrong evaluation of right shades. In order to solve these issues, different strategies can be applied by clinicians, such as making their own shade guide, mixing the objective and subjective methods, or use new devices