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Clinical comparison of Gluma and Er:YAG laser treatment of cervically exposed hypersensitive dentin


Vicky  Ehlers, dds,  Claus-Peter  Ernst, dds, phd,  Martina  Reich,  Philipp  KÄmmerer, dds

&  Brita  Willershausen, dds, phd


Abstract: Purpose: To compare the desensitizing effects of a glutaraldehyde-based desensitizing system (Gluma) and an Er:YAG laser treatment on cervically exposed hypersensitive dentin. Methods: A total of 22 subjects (mean age: 39±13.7 years; 15 females, 7 males) suffering from cervical dentin hypersensitivity was included in a prospective, split-mouth clinical study. The teeth were treated on one side of the mouth with the glutaraldehyde-based desensitizing system and on the other side with the Er:YAG laser. Sensitivity perception was recorded before treatment (baseline), during and immediately after treatment, after 1 week, 1 month, 3 months and 6 months. The subjects were asked to rate the sensitivity experienced during air stimulation by placing a mark on a visual analogue scale (VAS). Results: Both techniques showed an effective reduction of cervical dentin hypersensitivity. The subjects experienced equal improvements compared to their status before and 6 months after treatment with both methods (P< 0.001). (Am J Dent 2012;25:131-135).


Clinical significance: Glutaraldehyde-based desensitizing system and Er:YAG laser treatment were effective in the treatment of cervically exposed hypersensitive dentin.


Mail: Dr. Vicky Ehlers, Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Augustusplatz 2, D-55131 Mainz, Germany. E-mail:





Anti-gingivitis effects of a novel 0.454% stabilized stannous fluoride

dentifrice relative to a positive control


Tao  He, dds, phd,  Matthew  L.  Barker, phd,  C.  Ram  Goyal, dds  &  Aaron  R.  Biesbrock, dmd, phd, ms


Abstract: Purpose: To compare the anti-gingivitis efficacy of a novel 0.454% stannous fluoride dentifrice to a commercially available positive control triclosan-containing dentifrice in a population of adults with gingivitis. Methods: This single-center, randomized and controlled, double-blind, parallel group, 2-month trial enrolled 200 adults with mild-to-moderate gingivitis. At baseline, pre-treatment gingivitis levels were assessed with both the Lobene Modified Gingival Index (MGI) and the Gingival Bleeding Index (GBI). Subjects were randomly assigned to one of two test dentifrices: either 0.454% highly bioavailable stannous fluoride or the 0.30% triclosan positive control. Following at-home, unsupervised toothbrushing according to manufacturer’s instructions with their assigned test dentifrice for 2 months, subjects were re-evaluated for gingivitis again via the MGI and GBI examinations. Results: A total of 196 subjects completed the trial and were evaluable. At Month 2, both test dentifrices produced statistically significant reductions in number of bleeding sites, GBI, and MGI on average relative to pre-treatment (P< 0.0001). The Month 2 adjusted mean improvement from baseline for the stannous fluoride dentifrice group was 62% greater for number of bleeding sites, 60% greater for GBI, and 45% greater for MGI versus the triclosan/copolymer positive control group; groups differed significantly (P< 0.0001) for each gingivitis measure at Month 2. Both dentifrices were well-tolerated. (Am J Dent 2012;25:136-140).


Clinical significance: Toothbrushing for 2 months with an advanced stannous fluoride test dentifrice provided superior reductions in gingival bleeding and inflammation when compared to brushing with a marketed triclosan/ copolymer control dentifrice.


Mail: Dr. Tao He, Procter & Gamble Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA. E-mail:



Secondary caries inhibition promoted by adhesive systems

and bleaching agents with fluoride


Vanessa  Cavalli, dds, msc, phd,  Camila  de  Aquino  Cardoso, dds,   Francine  de  Almeida  Zandonadi, dds, Priscila  Christiane  Suzy  Liporoni, dds, msc, phd,  Sandrine  Bittencourt  Berger, dds, msc, PhD &  Marcelo  Giannini, dds, msc, phd


Abstract: Purpose: To evaluate the initial caries development at adhesive/enamel interface after 10% carbamide peroxide bleaching (CP) with or without fluoride (F) under dynamic pH-cycling. Methods: Standard cavities were prepared on the bucal surface of 60 bovine incisors, which were restored with two fluoride-containing adhesives: Optibond FL (FL) and Optibond Solo Plus (SP). The restored teeth were submitted to thermal cycling process in order to age the adhesive/enamel interface. Both SP and FL adhesive-restored teeth were divided into groups (n= 10) and bleached with 10% CP (CP) and 10% CP + F (CPF) or remained unbleached (Control). Bleaching was performed for 14 days simultaneously with pH-cycling. The specimens were prepared for cross-section microhardness evaluation and polarized light microscopy analysis to evaluate caries lesions at different depths around the bonded interface. Results: Group FL (not bleached) presented the lowest mineral loss rate among groups, but secondary caries formation was observed for all groups around the bonded interface. An inhibition zone was observed for all groups, with caries lesion detected at 5 µm from the cavity wall. (Am J Dent 2012;25:141-145000).


Clinical significance: The presence of fluoride in the three- and two-step etch-and-rinse adhesives and bleaching agents did not prevent secondary caries formation at the bonded interface.


Mail: Prof. Dr. Vanessa Cavalli, Department of Dentistry, University of Taubaté, R. Expedicionário Ernesto Pereira, 110, Taubaté – SP 12020-330 Brazil.  E-mail:



Comparative efficacy of two treatment regimens combining in-office and at-home programs for dentin hypersensitivity relief: A 24-week clinical study


David Hamlin, dmd,  Luis R. Mateo, ma,  Serge Dibart, dmd,  Evaristo Delgado, dds, msc,

Yun Po Zhang, msc, phd  &  William DeVizio, dmd


Abstract: Purpose: Dentin hypersensitivity is a significant clinical problem that affects numerous individuals. This sharp pain, arising from exposed dentin in response to external stimuli, can be a particularly uncomfortable and unpleasant sensation for patients, because it interferes with their quality of life. The objective of this 24-week, single-center, parallel group, double-blind, stratified and randomized clinical study was to evaluate the clinical efficacy of a single professional treatment with an in-office desensitizing paste followed by twice daily brushing with a desensitizing toothpaste and toothbrush for 24 weeks. Methods: 100 adults with confirmed dentin hypersensitivity were randomly assigned into two groups. One group received a single in-office treatment with a desensitizing paste containing 8% arginine and calcium carbonate (marketed as Colgate Sensitive Pro-Relief Desensitizing Paste and Elmex Sensitive Professional desensitizing paste), after dental scaling, followed by 24 weeks of brushing twice daily with a desensitizing toothpaste containing 8% arginine, calcium carbonate with 1450 ppm fluoride as MFP (marketed as Colgate Sensitive Pro-Relief toothpaste and Elmex Sensitive Professional toothpaste) and using the Colgate Sensitive Pro-Relief toothbrush (Test Group). The other group received a single in-office treatment with Nupro-M pumice prophylaxis paste, after dental scaling, followed by 24 weeks of brushing twice daily with a non-desensitizing toothpaste containing 1450 ppm fluoride as MFP and with the Oral-B Indicator toothbrush (Negative Control Group).  Hypersensitivity was re-examined immediately after in-office product application and after 8 and 24 weeks of twice daily brushing. Results: Immediately after professional product application, and after 8 and 24 weeks, subjects assigned to the Test Group demonstrated statistically significant improvements in dentin hypersensitivity compared to subjects assigned to the Negative Control Group in tactile (49.8%, 57.5% and 32.9%, respectively) and air blast (26.0%, 38.4% and 34.3%, respectively) sensitivity scores. The instant reductions in dentin hypersensitivity provided by the single professional application of a desensitizing paste for in-office use, containing 8% arginine and calcium carbonate were maintained by twice daily brushing with the 8% arginine, calcium carbonate toothpaste with 1450 ppm fluoride as MFP and the Colgate Sensitive Pro-Relief toothbrush for at least 24 weeks. (Am J Dent 2012;25:146-152).


Clinical significance: Based on these clinical results, this novel strategy that uses a two prong regimen to treat dentin hypersensitivity could be a new tool for the dental team  in the effective management of this painful condition.


Mail: Dr. Evaristo Delgado, Colgate-Palmolive Technology Center, 909 River Road, Piscataway, NJ 08854, USA. E-mail:



Laboratory bonding ability of a multi-purpose dentin adhesive


Jorge  PerdigÃo, dmd, ms, phd,  Ana  Sezinando, dmd, ms  &  Paulo  C.  Monteiro, dmd, msd


Abstract: Purpose: To evaluate the laboratory dentin and enamel microtensile bond strengths (μTBS) and interfacial ultra-morphology of a new multi-purpose dental adhesive applied under different bonding strategies. Methods: μTBS - 36 extracted caries-free human molars were assigned to six groups: Group CSE – Clearfil SE Bond, a 2-step self-etch adhesive (self-etch control); Group SBU-SE - Scotchbond Universal Adhesive (SBU), applied as a one-step self-etch adhesive; Group OSLmOptiBond SOLO Plus (OSL), a 2-step etch-and-rinse adhesive applied on moist dentin (etch-and-rinse control); Group OSLd – OSL applied on air-dried dentin; Group SBU-ERm – SBU applied as a 2-step etch-and-rinse adhesive on moist dentin; Group SBU-ERd - SBU applied as a 2-step etch-and-rinse adhesive on air-dried dentin. Build-ups were constructed with Filtek Z250 and cured in three increments of 2 mm each. Specimens were sectioned with a slow-speed diamond saw under water in X and Y directions to obtain bonded beams that were tested to failure in tension at a crosshead speed of 1 mm/minute. Statistical analyses were computed using one-way ANOVA followed by post-hoc tests at P< 0.05. Ultra-morphologic evaluation - dentin-resin interfaces were prepared for each of the six groups, processed, and observed under a FESEM. Results: μTBSOSLm resulted in significantly higher mean μTBS (63.0 MPa) than the other five groups. All SBU groups ranked in the same statistical subset regardless of the dentin treatment. The lowest mean μTBS were obtained with CSE (47.2 MPa) and OSLd (50.2 MPa), which were ranked in the same statistical subset. Ultra-morphologic evaluation – The two self-etch adhesives resulted in a similar ultra-morphology. Dried dentin did not preclude the formation of a hybrid layer with SBU-ERd, as opposed to OSLd. (Am J Dent 2012:25:153-158).


Clinical significance: Scotchbond Universal Adhesive was not affected by the adhesion strategy or by the degree of dentin moisture.




Mail: Dr. Jorge Perdigão, School of Dentistry, University of Minnesota, 515 SE Delaware St., 8-450 Moos Tower, Minneapolis, MN 55455, USA. E-mail:



Effects of post surface treatments on the bond strength

of self-adhesive cements


Claudia Mazzitelli, dds, msc, phd,  Federica Papacchini, dds, msc, phd,  Francesca Monticelli, dds, msc, phd, Manuel Toledano, md, dds, phd   &   Marco Ferrari, md, dds, phd


Abstract: Purpose: To evaluate whether fiber post surface conditioning techniques would influence the ultimate retentive strength of self-adhesive resin cements into the root canal. Methods: 50 single-rooted premolars with one root canal were endodontically treated and prepared to receive a fiber post. Five groups were formed (n=10) according to the post surface pre-treatment performed: (1) Silane application (Monobond S) for 60 seconds; (2) 10% hydrogen peroxide application for 20 minutes; (3) Rocatec Pre; (4) Silicate/silane coating (DT Light SL Post); (5) No treatment (DT Light Post). Two self-adhesive resin cements (RelyX Unicem and MaxCem) were used as luting agents. The bonded specimens were stored up to 1 month (37°C and 100% humidity). The force required to dislodge the post (MPa) via an apical-coronal direction was measured with the push-out bond strength test (cross-head speed: 0.5 mm/minute until failure). Failure patterns were evaluated under SEM. Data was statistically analyzed with one-way ANOVA and Tukey tests (P< 0.05). Results: No increase in the push-out bond strength values were observed for RelyX Unicem, independently from the post surface treatment performed. MaxCem attained higher bond strengths when luted to silanated posts. (Am J Dent 2012;25:159-164).


Clinical significance: The benefit of fiber post surface treatments in the luting procedure depends on the selected luting agents. The dispensing modality and the viscosity of the material may influence their ultimate adhesion mechanism.


Mail:  Dr. Claudia Mazzitelli, Department of Fixed Prosthodontics and Dental Materials, School of Dental Medicine, Policlinico “Le Scotte”, University of Siena, viale Bracci 1, Siena, 53100, Italy.  E-mail:



Clinical evaluation of an in-office desensitizing paste containing 8% arginine and calcium carbonate for relief of dentin hypersensitivity prior to dental prophylaxis


Wellington  S.  Tsai, dmd , ms ,  Sally-Jo  Placa, dmd, mpa  &  Fotinos  S.  Panagakos, dmd, phd


Abstract: Purpose: To evaluate the clinical efficacy of a professional prophylaxis paste containing 8% arginine-calcium carbonate in the reduction of dentin hypersensitivity used as a pre-procedural application compared to a commercially-available prophylaxis paste. Methods: This study was conducted at Jersey Shore University Medical Center in Neptune , New Jersey , USA . A mixed population of adult males and females between the ages of 18-70 were included in the study. Baseline air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale) were mandatory for inclusion in this study. Subjects were randomly assigned to either: (1) Control paste, Nupro non-fluoridated pumice based prophylaxis paste (Dentsply Professional) or (2) Test paste, a desensitizing paste containing 8% arginine and calcium carbonate (Colgate-Palmolive Company). Either the Control or Test paste was applied to subjects prior to their receiving a routine dental prophylaxis. After completion of the dental cleaning procedure, a final post-cleaning air blast examination was performed on each subject following identical methods as at the baseline exam. Paired t-tests and ANCOVA were used. Results: 66 subjects were enrolled in the study. Following the post-cleaning air blast hypersensitivity examination, there was a significant decrease of 83.94% in the hypersensitivity of subjects using the Test paste. The group using the Control paste showed a 13.43% desensitization. There was a statistically significant difference of 79.65% between the two groups. Subjects in the age groups 41-50, 51-60, and 61-70 years of age showed the most reduction in dentin hypersensitivity. (Am J Dent 2012;25:165-170).


Clinical significance: The results of this study support the conclusion that (1) the application of the 8% arginine/ calcium carbonate paste provided a statistically significant reduction in the sensitivity of patients when compared to the control paste; and (2) the use of the 8% arginine/calcium carbonate paste prior to prophylaxis is beneficial as part of a dental cleaning regimen for patients with complaints of dentin hypersensitivity.



Mail: Dr. Wellington S. Tsai, Department of Dentistry, Jersey Shore University Medical Center, 1945 Highway 33, Neptune, NJ 07753, USA. E-mail:



Quantification and identification of bacteria in acrylic resin dentures

and dento-maxillary obturator-prostheses


Yasuhisa  Takeuchi, dds, phd, Kazuko  Nakajo, dds, phd, Takuichi  Sato, dds, phd, Shigeto  Koyama, dds, phd, Keiichi  Sasaki, dds, phd  &  Nobuhiro  Takahashi, dds, phd


Abstract: Purpose: To quantify and identify bacteria detected in acrylic resin dentures and dento-maxillary obturator-prostheses after long-term use. Methods: The internal layer of denture bases from 13 daily-use removable acrylic resin dentures was sampled, while the inner fluid samples/no-fluid samples of obturators were collected from 11 in-use acrylic resin dento-maxillary obturator-prostheses. Samples were cultured, and isolated bacteria were counted and identified by molecular biological methods. Results: Bacteria were detected in five (38.5%) acrylic resin dentures and six (54.5%) acrylic resin obturators. Four Lactobacillus species and one Propionibacterium species were isolated from three repaired denture bases, and from two non-repaired dentures, two Actinomyces species and Streptococcus mutanswere isolated. On the other hand, 17 bacterial species, belonging to the family and genera of Olsenella, Bacillus, Citrobacter, Enterobacteriaceae, Lactobacillus, Pantoea, Peptoniphilus, Klebsiella and Pseudomonas, were isolated from obturators. Several species of viable bacteria were detected in acrylic resin denture bases and obturators. (Am J Dent 2012;25:171-175).


Clinical significance: The findings of this study suggest that not only the surfaces of acrylic resin prostheses, but also the internal areas can act as microbial reservoirs. The bacteria inside the acrylic resin prostheses may be associated with oral malodor and oral/respiratory infections in individuals wearing prostheses.


Mail: Dr. Takuichi Sato, Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan . E-mail:




Effect of adhesive resin application on the progression of cavitated and non-cavitated incipient carious lesions



Ibrahim  H.  El-Kalla, bchd, ms, ddsc,  Hussein  I.A.  Saudi, bchd, ms , ddsc  &  Rizk  A.I.  El-Agamy, bchd, ms


Abstract: Purpose: To evaluate the penetration of two different adhesive resin systems into cavitated and non-cavitated artificial carious lesions and the behavior of treated carious lesions under further acid attack. Methods: Artificial caries-like lesions were created on the proximal surface of 100 human primary molars by a demineralizing gel. The teeth were assigned to three groups according to the adhesive resin used. Group 1 (G1) was for Single Bond adhesive resin, Group 2 (G2) for Xeno V adhesive resin, and Group 3 (G3) was without any adhesive application. Each group was randomly and equally subdivided into subgroups a and b. In subgroup a, the teeth were kept with intact artificial caries-like lesion surfaces while in the subgroup b, a minute cavity was made at the center of artificial caries-like lesions using a sharp explorer. Each tooth was sectioned occluso-cervically into two halves through the center of the lesion; the sectioned surface was polished and examined under a reflected light microscope for estimating the depth of the carious lesion or penetration of the adhesive resin. All tooth halves were coated at the sectioned surface with two layers of acid resistant nail varnish and returned again to the demineralizing solution to assess the progression or arrest of the carious lesion after the second acid attack. Results: The penetration depth of adhesive resins did not differ significantly between subgroups (P > 0.05). After the second acid attack, the infiltrated carious lesions showed no lesion progression while the non-infiltrated lesions showed advanced caries progression. (Am J Dent 2012;25:176-180).




Clinical significance: Further demineralization of artificial cavitated and non-cavitated enamel carious lesions in primary teeth can be inhibited with adhesive resins.




Mail: Prof. Dr. Ibrahim H. El-Kalla, Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.  E-mail:



Contemporary adhesives: Marginal adaptation and microtensile bond strength of class II composite restorations


Rena  Takahashi, dds, phd,  Toru  Nikaido, dds, phd,  Junji  Tagami, dds, phd,  Reinhard  Hickel, dds, md, phd &  Karl-Heinz  Kunzelmann, dds, phd


Abstract: Purpose: To evaluate the marginal adaptation (in terms of % continuous margin) and microtensile bond strength (µTBS) of the enamel and dentin of direct class II composite restorations. Methods: 32 standardized class II cavities were prepared with the gingival margin of one box occlusal to the cementum-enamel junction (CEJ) and one gingival floor extended beyond the CEJ. The teeth (n= 8) were restored using one of four adhesive systems [Adper Scotchbond Multi Purpose (SMPP), Adper Scotchbond 1 XT (S1XT), Clearfil SE Bond (CSEB), or Clearfil Tri-S Bond (CTSB)] with incrementally placed composite restorations before being stored in water (24 hours), thermocycled (2,000 cycles, 5 to 55°C) and mechanically loaded (50,000 cycles, 50 N). Marginal adaptation was evaluated by SEM. Additionally, the teeth were sectioned and trimmed to obtain specimens for µTBS testing. Results: All adhesive systems exhibited “continuous margins” in enamel over 95.4%, whereas “continuous margins” in dentin ranged from 60.2 to 84.8%. CSEB and CTSB yielded significantly more “continuous margins” between the adhesive restoration and dentin than SMPP or S1XT (P< 0.05). The mean μTBSs (MPa) for enamel were 40.5 (SMPP), 37.3 (S1XT), 30.8 (CSEB) and 23.2 (CTSB), and for dentin, they were 37.7 (SMPP), 33.0 (S1XT), 37.3 (CSEB) and 29.0 (CTSB). (Am J Dent 2012;25:181-188).


Clinical significance: Although the choice of adhesive system had no influence on marginal adaptation to enamel, the self-etch adhesive systems showed excellent short-term marginal adaptation to dentin when compared to the etch-and-rinse adhesive systems. SMPP provided the highest bond strength to both enamel and dentin, whereas CSEB was the most predictable adhesive for dentin and a short-term acceptable adhesive for enamel.


Mail: Dr. Rena Takahashi, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan. E-mail:





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