Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups

Superficial irregularities and certain intrinsic stains on the dental enamel surfaces can be resolved by enamel microabrasion, however, treatment for such defects need to be confined to the outermost regions of the enamel surface. Dental bleaching and resin-based composite repair are also often useful for certain situations for tooth color corrections. This article presented and discussed the indications and limitations of enamel microabrasion treatment. Three case reports treated by enamel microabrasion were also presented after 11, 20 and 23 years of follow-ups224347354sem informaçã

Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups

Superficial irregularities and certain intrinsic stains on the dental enamel surfaces can be resolved by enamel microabrasion, however, treatment for such defects need to be confined to the outermost regions of the enamel surface. Dental bleaching and resin-based composite repair are also often useful for certain situations for tooth color corrections. This article presented and discussed the indications and limitations of enamel microabrasion treatment. Three case reports treated by enamel microabrasion were also presented after 11, 20 and 23 years of follow-ups

Conservative reconstruction of the smile by orthodontic, bleaching, and restorative procedures

The following is a clinical case report of a patient whose chief complaint was the presence of generalized spacing in the maxillary anterior segment following orthodontic treatment. After meticulous clinical analyses and discussions of the clinical procedures to be adopted, dental bleaching was performed in both arches with 10% hydrogen peroxide (Opalescence Trèswhite Supreme 10% Hydrogen Peroxide - Ultradent Products, Inc., South Jordan, USA) after the conclusion and stabilization of orthodontic treatment. Then, the orthodontic appliance was removed and the diastemas in the maxillary anterior teeth were closed with Amelogen Plus (Ultradent Products, Inc., South Jordan, USA) resin composite. It was observed that the association of orthodontic, bleaching, and restorative procedures was capable of restoring dental shape, function, and esthetics, allowing the patient to smile without hesitation

The Effect Of Hydrofluoric Acid Concentration And Heat On The Bonding To Lithium Disilicate Glass Ceramic

The aim of this study was to evaluate the effects of hydrofluoric acid (HF) concentration and previous heat treatment (PHT) on the surface morphology and micro-shear bond strength (mSBS) of a lithium disilicate glass ceramic (EMX) to resin cement. One hundred four EMX specimens were randomly assigned to two groups (n=52) according to the HF concentration: 5% and 10%. A new random distribution was made according to the PHTs (n=13): control (no PHT); previously heated HF (70 °C); previously heated EMX surface (85 °C); the combination of heated HF + heated EMX surface. The etching time was set at 20 s. All EMX blocks were silanated and received a thin layer of an unfilled resin. Five resin cement cylinders were made on each EMX surface using Tygon tubes as matrices, and then stored for 24 h at 37 °C. One random etched EMX sample from each group was analyzed using field-emission scanning electron microscopy (FE-SEM). The data were subjected to two-way ANOVA and multiple comparisons were performed using the Tukey post hoc test (a=0.05). For the control groups, 5% HF showed statistically lower mSBS values when compared to 10% HF (p<0.05). PHT increased the mSBS values for 5% HF, yielding statistically similar results to non-PHT 10% HF (p<0.05). FE-SEM images showed increased glassy matrix removal when PHT was applied to HF 5%, but not to the same degree as for 10% HF. PHT has the potential to improve the bond strength of 5% HF concentration on lithium disilicate glass ceramic.27672773

Influence of daily usage times on patients’ compliance during at-home bleaching : a randomized clinical trial

The effectiveness of at-home dental bleaching treatments depends on the time that bleaching products are in contact with the teeth surface and, consequently, on the adequate use of associated custom acetate trays. Objective: This randomized single-blinded trial aimed to analyze if the daily usage time of these products influences the patient’s compliance behavior when submitted to monitored at-home dental bleaching. Secondary outcomes were color change and tooth sensitivity. Methodology: Sixty-six volunteers were randomly distributed into three groups (n=22): patients were instructed to use the trays for 2 (G2), 4 (G4), and 8 (G8) hours daily. The daily dental bleaching compliance behavior was measured using a microsensor inserted into the trays. Subjective and objective color evaluation assessments were adopted at baseline (T0), one (T1), two (T2), and three weeks (T3) after the beginning of the bleaching treatment, as well as two weeks after the treatment (T4). Tooth sensitivity was analyzed using the VAS scale, ranging from T1 to T4. Results: G2 showed a greater degree of cooperation than G8 and cooperation was inversely proportional to the recommended usage time. Significantly higher color change was observed in the upper arch for G8 when compared to G2 in subjective analysis, from T1 to T4. There were no statistical differences between the groups in objective analysis. Conclusion: Shorter recommended usage time of the bleaching product may improve the patient's compliance with at-home dental bleaching treatments. However, increased daily usage time may promote better subjective color change. Bleaching sensitivity was more significant in the first week for a longer time of use

Localized mechanics of dentin self-etching adhesive system

The bond strength of composite resins (CRs) to dentin is influenced by the interfacial microstructure of the hybrid layer (HL) and the resin tags (TAG). The contemporary self-etching primer adhesive systems overcame the inconvenient of the etch-and-rinse protocol. Studies, however, have demonstrated that HL thickness and TAG length vary according to the wetting time and additional use of acid-etching prior to self-etching primers. This study investigated the localized stress distribution in the HL and the dentin/adhesive interface. Two HL thicknesses (3 or 6 µm), two TAG lengths (13 or 17 µm) and two loading conditions (perpendicular and oblique-25º) were investigated by the finite element (FE) analysis. Five two-dimensional FE models (M) of a dentin specimen restored with CR (38 x 64 µm) were constructed: M1 - no HL and no TAG; M2 - 3 µm of HL and 13 µm of TAG; M3 - 3 µm of HL and 17 µm of TAG; M4 - 6 µm of HL and 13 µm of TAG; and M5 - 6 µm of HL and 17 µm of TAG. Two distributed loadings (L) (20N) were applied on CR surface: L1 - perpendicular, and L2 - oblique (25º). Fixed interfacial conditions were assigned on the border of the dentin specimen. Ansys 10.0 (Ansys®, Houston, PA, USA) software was used to calculate the stress fields. The peak of von Mises (sigmavM) and maximum principal stress (sigmamax) was higher in L2 than in L1. Microstructures (HL and TAG) had no effect on local stresses for L1. Decreasing HL decreased sigmavM and sigmamax in all structures for L2, but the TAG length had influence only on the peributular dentin. The thickness of HL had more influence on the sigmavM and sigmamax than TAG length. The peritubular dentin and its adjacent structures showed the highest sigmavM and sigmamax, mainly in the oblique loading

Influência da fonte de luz polimerizadora na microdureza da resina composta de diferentes cores

INTRODUCTION: The evolution of light curing units can be noticed by the different systems recently introduced. The technology of LED units promises longer lifetime, without heating and with production of specific light for activation of camphorquinone. However, further studies are still required to check the real curing effectiveness of these units. PURPOSE: This study evaluated the microhardness of 4 shades (B-0.5, B-1, B-2 and B-3) of composite resin Filtek Z-250 (3M ESPE) after light curing with 4 light sources, being one halogen (Ultralux - Dabi Atlante) and three LED (Ultraled - Dabi Atlante, Ultrablue - DMC and Elipar Freelight - 3M ESPE). METHODS: 192 specimens were distributed into 16 groups, and materials were inserted in a single increment in cylindrical templates measuring 4mm x 4mm and light cured as recommended by the manufacturer. Then, they were submitted to microhardness test on the top and bottom aspects of the cylinders. RESULTS: The hardness values achieved were submitted to analysis of variance and to Tukey test at 5% confidence level. It was observed that microhardness of specimens varied according to the shade of the material and light sources employed. The LED appliance emitting greater light intensity provided the highest hardness values with shade B-0.5, allowing the best curing. On the other hand, appliances with low light intensity were the least effective. It was also observed that the bottom of specimens was more sensitive to changes in shade. CONCLUSION: Light intensity of LED light curing units is fundamental for their good functioning, especially when applied in resins with darker shades.INTRODUCTION: A evolução dos aparelhos fotopolimerizadores pode ser notada nos diferentes sistemas introduzidos recentemente no mercado. A tecnologia apresentada pelos aparelhos LED promete maior tempo de vida útil, não gerar aquecimento e produzir luz específica para a ativação da canforoquinona. No entanto, ainda são necessários estudos complementares para se conhecer a real efetividade destes aparelhos na polimerização dos materiais. PROPOSTA: Neste trabalho foi verificada a microdureza de 4 cores (B-0,5, B-1, B-2 e B-3) da resina composta Filtek Z-250 (3M ESPE) quando polimerizadas com 4 fontes de luz, sendo uma halógena (Ultralux - Dabi Atlante) e três LED (Ultraled - Dabi Atlante, Ultrablue - DMC e Elipar Freelight - 3M ESPE). MÉTODOS: Os 192 corpos-de-prova foram distribuídos em 16 grupos e os materiais foram inseridos em único incremento em matrizes cilíndricas de 4mm X 4mm, sendo polimerizados pelo tempo preconizado pelo fabricante. Em seguida, foram submetidos ao teste de microdureza na superfície superior e inferior dos cilindros. RESULTADOS: Os valores de dureza obtidos foram submetidos à análise de variância e ao teste de Tukey ao nível de 5%. Foi observado que a dureza dos corpos-de-prova variou conforme a cor do material e aparelhos utilizados. O aparelho LED que emite maior intensidade luminosa proporcionou a obtenção dos maiores valores de dureza, com o croma B-0,5 possibilitando a melhor polimerização. Por outro lado aparelhos com baixa intensidade luminosa foram os menos efetivos. Também foi observado que a região do fundo dos corpos-de-prova foi mais sensível à mudança das cores. CONCLUSÕES: A intensidade de luz dos fotopolimerizadores LED é fundamental para seu bom funcionamento, principalmente quando empregadas resinas com croma mais acentuado

Longitudinal photographic observation of the occurrence of bubbles in pit and fissure sealants

The purpose of this study was to employ photographic evaluation to observe the presence or absence of bubbles in pit and fissure sealants Concise and Prisma Shield, at 7 days, 18 months, 36 months and 11 years after accomplishment of treatment. METHODS: A hematoxylin-based staining solution was applied to the occlusal surface at the study periods, which allowed assessment of the sealing material on the surface. All occlusal surfaces were photographed and the photographs corresponding to each period were subjected to photographic evaluation. RESULTS: There was statistically significant difference only at 18 months, with a significantly higher number of specimens with bubbles for the Prisma Shield sealant compared to the Concise, whereas the groups were similar at all other study periods. On the other hand, separate analysis of subsequent periods of the sealants did not reveal any significant difference. CONCLUSIONS: According to the results of the present longitudinal investigation, it may be concluded that the sealing materials showed that bubbles came into and went out with time. However, this fact did not interfere with its clinical purpose, provided the remaining material covers the expected region of pits and fissures.Avaliação fotográfica para observar a presença ou a ausência de bolhas nos selantes de fóssula e fissuras Concise e Prisma Shield aos 7 dias, 18 meses, 36 meses e 11 anos, após a realização dos selamentos. METODOLOGIA: Foi aplicado na superfície oclusal, em todos os períodos de análise, uma solução corante a base de hematoxilina, que possibilitou a verificação e a avaliação dos materiais seladores presentes nesta superfície. Todas as superfícies oclusais foram fotografadas e as fotografias, correspondentes a cada período em análise, foram submetidas à avaliação fotográfica. RESULTADOS: Verificou-se diferença estatisticamente significativa somente aos 18 meses de análise, com o selante Prisma Shield apresentando um número significativamente maior de bolhas superficiais, que o selante Concise; enquanto que os demais grupos apresentaram-se estatisticamente semelhantes entre si, em todos os outros períodos de análise. Por outro lado, quando os selantes foram analisados isoladamente, nos períodos subseqüentes, não foi observada a presença de diferença estatisticamente significativa. CONCLUSÃO: De acordo com os resultados observados, pudemos verificar que os materiais seladores apresentaram o aparecimento e o desaparecimento de bolhas, fato que não interferiu na finalidade clínica do selamento realizado

Observação fotográfica da ocorrência de bolhas em selantes de fóssulas e fissuras

The purpose of this study was to employ photographic evaluation to observe the presence or absence of bubbles in pit and fissure sealants Concise and Prisma Shield, at 7 days, 18 months, 36 months and 11 years after accomplishment of treatment. METHODS: A hematoxylin-based staining solution was applied to the occlusal surface at the study periods, which allowed assessment of the sealing material on the surface. All occlusal surfaces were photographed and the photographs corresponding to each period were subjected to photographic evaluation. RESULTS: There was statistically significant difference only at 18 months, with a significantly higher number of specimens with bubbles for the Prisma Shield sealant compared to the Concise, whereas the groups were similar at all other study periods. On the other hand, separate analysis of subsequent periods of the sealants did not reveal any significant difference. CONCLUSIONS: According to the results of the present longitudinal investigation, it may be concluded that the sealing materials showed that bubbles came into and went out with time. However, this fact did not interfere with its clinical purpose, provided the remaining material covers the expected region of pits and fissures.Avaliação fotográfica para observar a presença ou a ausência de bolhas nos selantes de fóssula e fissuras Concise e Prisma Shield aos 7 dias, 18 meses, 36 meses e 11 anos, após a realização dos selamentos. METODOLOGIA: Foi aplicado na superfície oclusal, em todos os períodos de análise, uma solução corante a base de hematoxilina, que possibilitou a verificação e a avaliação dos materiais seladores presentes nesta superfície. Todas as superfícies oclusais foram fotografadas e as fotografias, correspondentes a cada período em análise, foram submetidas à avaliação fotográfica. RESULTADOS: Verificou-se diferença estatisticamente significativa somente aos 18 meses de análise, com o selante Prisma Shield apresentando um número significativamente maior de bolhas superficiais, que o selante Concise; enquanto que os demais grupos apresentaram-se estatisticamente semelhantes entre si, em todos os outros períodos de análise. Por outro lado, quando os selantes foram analisados isoladamente, nos períodos subseqüentes, não foi observada a presença de diferença estatisticamente significativa. CONCLUSÃO: De acordo com os resultados observados, pudemos verificar que os materiais seladores apresentaram o aparecimento e o desaparecimento de bolhas, fato que não interferiu na finalidade clínica do selamento realizado.2732Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

In situ assessment of the saliva effect on enamel morphology after microabrasion technique

AIM: This study evaluated saliva effects on enamel morphology surface after microabrasion technique. METHODS: Enamel blocks (16 mm2) obtained from bovine incisors were divided into 9 groups as follows: one control group (no treatment), four groups with microabrasion treatment using 35% phosphoric acid and pumice (H3PO4+Pum) and other four groups treated with 6.6% hydrochloric acid and silica (HCl+Sil). One group of each treatment was submitted to 4 frames of saliva exposure: without exposure, 1-h exposure, 24-h exposure, and 7-days exposure on in situ regimen. Nineteen volunteers (n=19), considered as statistical blocks, used an intraoral appliance containing the specimens, for 7 days. Enamel roughness (Ra) was tested before and after treatment, and after saliva exposure. Confocal laser scanning microscopy (CLSM) was used to evaluate qualitatively the enamel morphology. RESULTS: All groups exhibited increased Ra after microabrasion. With regards to saliva exposure, the treatment with HCl+Sil presented more susceptibility to the saliva action, but no period of time was efficient in re-establishing this characteristic compared with the control group. CLSM analysis showed reduction of the micro-abrasive damages during the experimental times. CONCLUSIONS: Seven days of saliva exposure were not sufficient for the treated enamel to reach its normal characteristics compared with the control group133187192FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2011/004067-