Digital
plaque imaging evaluation of a stabilized stannous fluoride dentifrice compared
with a triclosan/copolymer dentifrice
Tao He, dds, phd, Matthew L. Barker, phd, Aaron R. Biesbrock, dmd, phd,
ms, Holly Eynon,
Jeffery L. Milleman, dds, mpa, Kimberly R. Milleman, rdh, bsed, Mark S. Putt, msd, phd
& Ana MarÍa Wintergerst, ms, phd
Abstract: Purpose: To compare the relative plaque
control efficacy of a marketed 0.454% stabilized stannous fluoride (SnF2)
dentifrice relative to a triclosan/copolymer
dentifrice using digital plaque imaging analysis (DPIA). Methods: This was a randomized, two-treatment, double-blind,
parallel group design study that compared SnF2 and triclosan/copolymer dentifrices over a period of 3 weeks.
DPIA was used to capture a digital image of the maxillary and mandibular anterior facial surfaces of 12 teeth and to
calculate plaque area coverage. Overnight DPIA images were taken at a baseline
visit after which subjects were randomly assigned to one of the two treatment
groups and were required to brush with their assigned dentifrice according to
each manufacturer’s instructions. Subjects had DPIA assessments on two separate
days at the end of Week 3. Results: 96
subjects were randomized to treatment. Plaque area data for 47 subjects per
treatment group were compared at Week 3 using ANCOVA. The SnF2 group
demonstrated a statistically significant reduction in overnight plaque at Week
3 compared to baseline (P= 0.002). The reduction for the triclosan group at Week 3 compared to baseline was not statistically significant (P= 0.24).
At Week 3, the SnF2 group demonstrated a 17% lower adjusted mean for
overnight plaque relative to the triclosan group with
a mean difference that was statistically significant (P< 0.05). The Week 3
adjusted mean change from baseline in overnight plaque for the SnF2 group was 3 times greater versus that of the triclosan group (P< 0.05). (Am J Dent 2013;26:303-306).
Clinical significance: This comparison between marketed
dentifrices indicates that a stabilized stannous fluoride dentifrice provided
significantly greater overnight plaque inhibition versus a triclosan/copolymer
dentifrice.
Mail: Dr. Tao He, Procter &
Gamble, Mason Business Center, 8700 Mason-Montgomery Road, Mason, OH 45040 USA.
E-mail: he.t@pg.com
Effect of fluoride varnish supplemented
with sodium trimetaphosphate
Michele Maurício Manarelli, dds, msc, Marcelo Juliano Moretto, dds, msc, phd,
Kikue Takebayashi Sassaki, phd, Cleide Cristina Rodrigues Martinhon, dds, msc, phd,
Juliano Pelim Pessan, dds, msc, phd & Alberto
Carlos Botazzo Delbem, dds, msc, phd
Abstract: Purpose: To assess
in vitro the effect on enamel erosion (ERO) and erosion followed by abrasion
(ERO+ABR) of varnishes with different fluoride concentrations, supplemented or
not with sodium trimetaphosphate (TMP). Methods: Bovine enamel blocks were
randomly divided into six groups according to the type of varnish used: placebo
(no F), NaF 5%, NaF 2.5%, NaF 2.5% plus TMP 3.5%, NaF 2.5%
plus TMP 5%, NaF 2.5% plus TMP 10%. Varnishes were
tested for ERO and ERO+ABR, separately for 3 and 5 days. ERO was done by
immersion in Sprite Zero (5 minutes, 4x/day), while ERO+ABR was performed by
brushing for 15 seconds after each erosive challenge. Enamel wear (µm) and
cross-sectional hardness (ΔKHN) were assessed after the experimental
periods. Data were analyzed by ANOVA, Tukey’s test
and Pearson’s correlation coefficient (P< 0.05). Results: Varnishes supplemented with TMP promoted significantly
lower wear and hardness loss when compared to the other treatments in all
conditions studied (P< 0.05). Similar wear rates were observed for the
placebo, NaF 2.5% and NaF 5% varnishes (P> 0.05). Greater wear was observed after 5 days of ERO and
ERO+ABR when compared with 3 days (P< 0.05). Positive and significant
correlations were found between enamel wear and ΔKHN. No dose-response
relationship was found between TMP concentration and wear and hardness. It was
concluded that fluoride varnishes supplemented with TMP had a higher protective
effect against ERO and ERO+ABR, which was associated with a reduction in enamel
softening. (Am J Dent 2013;26:307-312).
Clinical
significance: The
fluoridated varnishes supplemented with TMP were more effective against erosive
challenges associated or not to abrasion when compared to conventional
formulations. This enhanced effect of the TMP-supplemented varnishes was
attained with half of the fluoride concentration used in the conventional
formulations, which is highly desirable especially for the treatment of
children.
Mail: Dr.
Alberto Carlos Botazzo Delbem, Department of Pediatric
Dentistry and Public Health, Araçatuba Dental School,
Univ. Estadual Paulista State University (UNESP), Rua Jose Bonifacio 1193, 16015-050 Araçatuba - SP – Brazil. E-mail: adelbem@foa.unesp.br
LED light attenuation through human dentin: A first
step toward pulp
Ana Paula S. Turrioni, dds, ms, Juliana R.
L. Alonso, Fernanda G. Basso, dds, phd, Lilian T. Moriyama, phd, Josimeri Hebling, dds, phd, Vanderlei S. Bagnato, phd & Carlos
A. de Souza Costa, dds, phd
Abstract: Purpose: To evaluate the transdentinal light attenuation of LED at three wavelengths
through different dentin thicknesses, simulating cavity preparations of
different depths. Methods: Forty-two
dentin discs of three thicknesses (0.2, 0.5 and 1 mm; n = 14) were prepared
from the coronal dentin of extracted sound human molars. The discs were
illuminated with a LED light at three wavelengths (450 ±10 nm, 630 ±10 nm and
850 ±10 nm) to determine light attenuation. Light transmittance was also
measured by spectrophotometry. Results: In terms of minimum (0.2 mm) and maximum (1.0 mm) dentin
thicknesses, the percentage of light attenuation varied from 49.3% to 69.9% for
blue light, 42.9% to 58.5% for red light and 39.3% to 46.8% for infrared. For
transmittance values, an increase was observed for all thicknesses according to
greater wavelengths, and the largest variation occurred for the 0.2 mm
thickness. All three wavelengths were able to pass through the dentin barrier
at different thicknesses. Furthermore, the LED power loss and transmittance
showed wide variations, depending on dentin thickness and wavelength. (Am J Dent 2013;26:319-323).
Clinical significance: Determining light attenuation
through the dentin barrier as a function of the wavelength is a first step
toward establishing the ideal window for the biostimulation of pulpal tissue previously injured by caries lesion
progression and cavity preparation.
Mail: Prof. Dr. Carlos Alberto de
Souza Costa, Department of Physiology and Pathology, School of Dentistry of Araraquara, Univ. Estadual Paulista, Rua Humaitá,
1680. Centro, Caixa Postal: 331 CEP: 14801903 Araraquara,
SP, Brazil. E-mail: casouzac@foar.unesp.br
Post-retentive ability of new flowable resin composites
Jelena Juloski, dds, Cecilia Goracci, dds, msc, phd, Ivana Radovic, dds, msc, phd, Nicoletta Chieffi, dds, msc, phd,
Abstract: Purpose: To
investigate the applicability of flowable composites as
post luting agents by assessing the push-out strength
of posts. Methods: 36 intact single
rooted human premolars were selected. The endodontic treatment was performed
and half of the specimens were restored with light transmitting posts (DT Light
Post Illusion) and the other half with opaque posts (Tech 21 X-OP). In both
groups the following combinations of adhesive/cement were tested: OptiBond Solo Plus/Nexus Third Generation (NX3), XP Bond/SureFil SDR Flow (SDR), and Vertise Flow (VF). Push-out test was used to assess the retentive strength of fiber
posts, which was expressed in megapascals (MPa). Specimens were analyzed under a stereomicroscope to
determine failure mode (adhesive between luting agent
and post, adhesive between luting agent and dentin or mixed failure). Push-out data and failure mode
distribution were analyzed by two-way ANOVA and Chi-square test, respectively (P<
0.05). Results: The statistical
analysis revealed that only the type of luting material significantly influenced push-out bond strength of the post (P< 0.001).
SDR (9.00 ± 2.17 MPa) performed similarly to the
control group NX3 (7.15 ± 1.74 MPa), while VF (4.81 ±
1.51 MPa) should significantly lower bond strength.
Failure modes differed significantly among groups. (Am J Dent 2013;26:324-328).
Clinical
significance: The
new low-shrinkage flowable composite for bulk filling
of posterior restorations (SureFil SDR Flow) may also
be considered for fiber post luting, as in this
investigation it provided post retention comparable to that of a dual-cure resin cement tested as a control.
Mail:
Dr. Jelena Juloski, Department of Dental Materials and Fixed Prosthodontics of Siena, Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy. E-mail: jelenajuloski@gmail.com
Clinical investigation of oral malodor during
long-term
Deyu Hu, dds, ms, Xue Li, dds, phd, Wei Yin, dds, phd, William DeVizio, dmd, Luis R. Mateo,
ma,
Serge Dibart, dds & Yun-Po Zhang, phd, dds (hon)
Abstract: Purpose: To investigate whether the long term use of two
dentifrices containing arginine, an insoluble calcium
compound, and fluoride: (1) 1.5% arginine and 1450 ppm F as sodium monofluorophosphate (NaMFP) in a dicalcium phosphate dihydrate (dical)
base, and (2) 8.0% arginine and 1450 ppm F as NaMFP in a calcium
carbonate base, results in an increase in oral malodor potentially associated
with increased ammonia production from breakdown of arginine,
as compared to a commercially available fluoride dentifrice without arginine (1450 ppm F as NaMFP in a dical base), after 6
months of product use. Methods: A
6-month clinical study, with 119 subjects, was conducted in Chengdu, China,
using a double blind, randomized, parallel, three-treatment design. A panel of
four expert judges used a nine-point hedonic scale to evaluate breath odor
using a protocol designed in concordance with the ADA Acceptance Program
Guidelines for Product Used in the Management of Oral Malodor. After a baseline
evaluation, study subjects who scored above the threshold value for unpleasant
breath odor were stratified by score and randomized into one of three treatment
groups. Subjects were provided with a soft-bristled manual toothbrush (Colgate
Classic Clean Toothbrush) and brushed their teeth thoroughly in their regular
and customary manner for 1 minute with their assigned dentifrice, twice daily.
Before breath-odor evaluations, the subjects refrained from eating odorigenic foods and did not use dental hygiene procedures,
breath mints, or mouth rinses for 48 hours and 12 hours, respectively. Results: There was no statistically
significant difference in oral malodor levels among subjects using the three
dentifrices after 1, 3 and 6 months of product use. (Am J Dent 2013;26:329-334).
Clinical significance: The long term use of the two
dentifrices containing arginine and fluoride did not
increase oral malodor potentially associated with increased ammonia production
from breakdown of arginine, as compared to the
commercially available fluoride dentifrice.
Mail: Dr Yun-Po
Zhang, Colgate-Palmolive Technology Center, 909 River Road, Piscataway, NJ
08855-1343, USA; E-mail: yun_po_zhang@colpal.com
Analysis of interfacial structure and
bond strength of self-etch adhesives
Lilliam M. Pinzon, dds, ms, mph, Larry G. Watanabe, bs,
ms, Andre F. Reis, dds, ms, phd, John M. Powers, phd,
Abstract: Purpose: To
determine the bond strength, nanoleakage and
interfacial morphology of four self-etch adhesives bonded to superficial
dentin. Methods: Microtensile (MT) (n= 15) and single plane shear (SP) (n= 8) bond tests were performed using
human dentin polished through 320-grit SiC paper. Clearfil Protect Bond (PB), Clearfil S3 Bond (S3), Prompt L-Pop (PLP) and G-Bond (GB) were used according to their manufacturers’
instructions. Composite was applied as cylinders with a thickness of 4 mm with
a 1 mm diameter and stored in water at 37°C for 24 hours. Specimens were debonded with a testing machine at a cross-head speed of 1
mm/minute. Means and standard deviations of bond strength were calculated. Data
were analyzed using ANOVA. Fisher’s PLSD intervals were calculated at the 0.05
level of significance. Failure modes were determined at ×100. The hybrid layer
was revealed by treatment with 5N HCl/5% NaOCl or
fractured perpendicular to the interface and sputter coated with gold.
Specimens were viewed at ×1,000, ×2,500, and ×5,000 in a field emission SEM at
15 kV. Teeth (n=2) sectioned into 0.9 mm-thick slabs were immersed in ammoniacal silver nitrate solution for 24 hours, rinsed and
immersed in photo-developing solution for 8 hours. Specimens were sectioned (90
nm-thick) and observed under TEM. Results: Means ranged from 25.0 to 73.1 MPa for MT and from
15.5 to 56.4 MPa for SP. MT values were greater than
SP, but were highly correlated (R2 = 0.99, P= 0.003) and provided
the same order for the systems studied. Fisher’s PLSD intervals (P< 0.05)
for bond strength techniques and adhesives results were 1.7 and 2.3 MPa, respectively. Failures sites were mixed. TEM showed
that hybrid layers were ~0.5 μm for PB, GB and
S3 and ~5 μm for PLP. SEM showed morphologic
differences among adhesives. Silver nitrate deposits were observed within the
interfaces for all adhesive systems. (Am
J Dent 2013;26:335-340).
Clinical
significance: Simplification of application procedures appears to induce loss of adhesion
capabilities. The microtensile bond strengths ranged
from 25-73 MPa. None of the adhesive systems tested
was able to totally prevent nanoleakage, but there
were differences among systems. No relationship was observed between thickness
of the hybrid layer and bond strength.
Mail:
Dr. Lilliam M. Pinzon, Department of Preventive and
Restorative Dental Sciences, University of California San Francisco, 707
Parnassus Avenue, D-2244. San Francisco, CA 94143, USA. E-mail: lilliam.pinzon@ucsf.edu
Adhesion to primary dentin: Microshear bond strength and scanning
electron microscopic observation
Daniele Scaminaci Russo, dds, Valentina Iuliano, dds, Lorenzo Franchi, dds, Marco Ferrari, md, dmd, phd
Abstract: Purpose: To
compare the bond strength to human primary dentin of a self-adhesive
light-curing resin composite, a self-etch adhesive and a glass-ionomer cement
by means of microshear bond strength (µSBS) test and scanning
electron microscopic (SEM) observations. Methods: 75 human primary molars were sectioned to obtain a 2 mm-thick slab of
mid-coronal dentin, randomly divided into three groups (n=25). Nine conical
frustum-shaped build-ups were constructed on the occlusal surface of each dentin slab using a self-adhesive light-curing resin composite
(Vertise Flow; Group 1), bonding agent (Optibond All-in-One; Group 2) combined with resin composite
(Premise Flow) and a glass-ionomer cement (Ketac-Fil;
Group 3). After thermocycling, specimens were
subjected to µSBS test. All debonded specimens were
observed at SEM. Data were analyzed by a mixed model and chi-square test. Results: The bond strength measured in
Group 1 (9.0±4.5 MPa) was significantly lower than
that one recorded in Group 2 (20.2±12.5 MPa) although
it was significantly higher than the one recorded in Group 3 (4.8±2.3 MPa). Failures were mainly adhesive in all groups. (Am J Dent 2013;26:341-346).
Clinical
significance: Self-adhesive light-curing resin composites may be a viable alternative to
conventional materials used for the restoration of primary teeth especially in
young or noncompliant children.
Mail:
Dr. Luca Giachetti, Department of Surgery and Translational Medicine, Unit of
Dentistry, University of Florence, Via del Ponte di Mezzo 48, 50127 Florence, Italy. E-mail: luca.giachetti@unifi.it
Plaque fluoride concentrations associated to the use
of conventional
and low-fluoride dentifrices
Juliano Pelim Pessan, dds, msc, phd, Michele
Mauricio Manarelli, dds,msc, Karina
Yuri Kondo, dds, msc,
Gary Milton Whitford, dmd, phd, Alberto Carlos Botazzo Delbem, dds, msc, phd
& MarÍlia Afonso Rabelo Buzalaf, dds, msc, phd
Abstract: Purpose: This
double-blind, crossover study evaluated whole plaque fluoride concentration
(F), as well as whole plaque calcium concentrations (Ca) after brushing with a
placebo (PD – fluoride free), low-fluoride (LFD, 513 µg F/g) and conventional
(CD, 1,072 µg F/g) dentifrices. Methods: Children (n=20) were randomly assigned to brush twice daily with one of the
dentifrices, during 7 days. On the 7th day, samples were collected at 1 and 12
hours after brushing. F and Ca were analyzed with an ion-selective electrode
and with the Arsenazo III method, respectively. Data
were analyzed by ANOVA, Tukey’s test and by Pearson
correlation coefficient (P< 0.05). Results: The use of the fluoridated dentifrices significantly increased plaque [F]s 1
hour after brushing when compared to PD, returning to baseline levels 12 hours after.
Positive and significant correlations were found between plaque [F] and (Ca)
under most of the conditions evaluated. The mean increase in plaque [F]
observed 1 hour after brushing with the CD were only about 47% higher than
those obtained for the LFD. The use of a LFD promotes proportionally higher
increases in plaque [F] when compared to a CD. Plaque F concentrations were
also shown to be dependent on plaque Ca concentrations. (Am J Dent 2013;26:347-350).
Clinical significance: The similarity of plaque F
levels 1 hour after brushing with the low-fluoride and conventional dentifrices
suggest that low-fluoride dentifrices could be a valid alternative of
dentifrice use, especially by caries-inactive children residents in an
optimally fluoridated area.
Mail: Dr. Juliano Pelim Pessan, Department of
Pediatric Dentistry and Public Health, Araçatuba Dental School, Paulista State University (UNESP), Rua Jose Bonifacio 1193,
16015-050 Araçatuba - SP – Brazil. E-mail:
jpessan@foa.unesp.br
Randomized clinical trial of adhesive restorations
in primary molars.
18-month results
Luciano Casagrande, dds,
ms, phd, DÉbora Martini Dalpian, dds, ms, Thiago Machado Ardenghi, dds, ms, phd,
Abstract: Purpose: To evaluate the clinical performance of adhesive
restorations of resin composite and resin-modified glass-ionomer cements in
primary molars. Methods: This
randomized clinical trial included subjects (5-9 year-old children) selected at
two university centers (UFRGS and UNIFRA). The sample consisted of 132 primary
molars presenting active cavitated carious lesions
(with radiographic involvement of the inner half of the dentin), located on the occlusal and occlusal-proximal
surface. The sample was randomly divided into three groups, according to the
restorative material: (G1) universal restorative system (Adper Single Bond 2 system and Filtek Z350); (G2):
Resin-modified glass-ionomer cement (Vitremer); and (G3): Low shrink restorative system (Filtek P90). The restorations were clinically and radiographically followed every 6 months for up to 18
months using the USPHS modified criteria for clinical evaluation. Survival
estimates for restoration longevity were evaluated using the Kaplan-Meier
method. Log-rank test (P< 0.05) was used to compare the differences in the
success rate according to the type of the restorative material. Results: The type of restorative
material used did not influence the longevity of the restorations. After
clinical follow-up, there was no statistical difference in the rates of success
for the three materials used to restore active cavitated carious lesions in primary molars. The survival rates for the follow-up were
similar regarding the number of restored surfaces and the caries removal
technique (partial or complete). Mean estimated time of survival was 17.2
months (95% CI: 16.7-17.7). Estimated survival rates of the restorations were
100%, 98%, 88% and 65% at 1, 6, 12 and 18 months of clinical evaluations,
respectively.(Am
J Dent 2013;26:351-355).
Clinical significance: Primary molars
with active cavitated carious lesion restored with
resin-modified glass-ionomer cement and resin composite presented satisfactory
levels of clinical success at the 18-month follow-up period.
Mail: Dr.
Luciano Casagrande, Department of Pediatric Dentistry, School of Dentistry,
Federal University of Rio Grande do Sul (UFRGS),
Ramiro Barcelos 2492, Porto Alegre,
RS; ZIP: 90035-003, Brazil. E-mail: luciano.casagrande@ufrgs.br
Evaluation of bleaching efficacy and erosion
potential of four different
So Ran Kwon, dds, ms, phd,
ms, Juan Wang, dds,
ms, phd, Udochukwu Oyoyo, mph & Yiming Li, dds, msd, phd
Abstract: Purpose: To evaluate the bleaching
efficacy and erosion potential of various over-the-counter bleaching products
following a test method specified in ISO 28399. Methods: Specimens were prepared from bovine molars, stained in tea
solution, embedded and randomly assigned to six groups of 10 enamel and dentin
specimens each. Color was assessed at baseline, 1 day and 1 month
post-bleaching with the Vita Bleachedguide 3D Master
shade guide. Surface roughness changes (∆Ra), determined by baseline and
post-treatment values were measured with a profilometer.
The negative (NC) and positive control (PC) was treated with grade 3 water and
1.0% citric acid, respectively. Over-the-counter products were used according
to manufacturer’s instructions. Brite Teeth Pro (BT),
Natural White 5-Minute Whitening (NW), Luster Premium White (LP), and Crest 3D Whitestrips (WS) represented a brush-on-paint system, tray
system, light-activated system and adhesive-strip system, respectively. Kruskal-Wallis procedure was used to compare surface
roughness changes among groups. Color change was assessed with Friedman-test
and stratified by hard tissue type with α= 0.05. Results: WS was the only group demonstrating color changes in
enamel and dentin (P< 0.05). There were no differences in ∆Ra for
enamel and dentin among NC, BT, LP, and WS. NW showed increase in ∆Ra in
dentin (P< 0.05), while PC demonstrated an increase in ∆Ra regardless
of hard tissue type (P< 0.05). (Am J
Dent 2013;26:356-360).
Clinical significance: Proper selection of
over-the-counter bleaching products is advised to achieve desirable bleaching
efficacy without affecting surface roughness.
Mail: Dr. So Ran Kwon, Department
of Operative Dentistry, University of Iowa College of Dentistry, 801 Newton
Road #45, S235 DSB, Iowa City, IA 52242-1001, USA. E-mail: soran-kwon@uiowa.edu
Treatment modalities for peri-implant mucositis and peri-implantitis
Stefan Renvert, dds, phd, Ioannis Polyzois, dmd, phd & G. Rutger Persson, dds, phd
Abstract: Purpose: To review treatment modalities
used for peri-implant mucositis and peri-implantitis. Methods: A literature search was performed in PubMed for articles published until May 2013 using peri-implantitis and peri-implant mucositis and different modalities of treatment as search terms. The search was limited
to the English literature. Titles and abstracts were searched in order to find
studies eligible for the review. Results: The present review reported that treatment of peri-implant mucositis lesions using mechanical therapy is
possible. The additional use of professionally delivered antimicrobials has
commonly failed to show additional benefits as compared to mechanical
debridement alone. The scientific evidence on the efficacy of non-surgical and
surgical therapies in the treatment of peri-implantitis is limited. Complete resolution of peri-implantitis using mechanical, laser, or photodynamic therapy does not seem to result in a
predictable outcome. Following surgical interventions around implants diagnosed
with peri-implantitis, clinical improvements as
judged by reductions of probing depths and bleeding on probing have been
reported. Bone or bone substitutes have been used in attempts to regenerate
bone loss around implants. When regenerative modalities have been employed,
radiographic evidence of defect fill has been reported. Few long term follow up studies on the
treatment of peri-implantitis are available. Positive
treatment results can be maintained over a period of 3-5 years. Regardless of
the treatment performed, adequate plaque control by the patient is fundamental
to treatment success. If the patient cannot obtain an adequate level of oral
hygiene, the infection around the implants will reoccur. (Am J Dent 2013;26:313-318).
Clinical significance: Patient risk assessment and a
proper maintenance program seem to be fundamental for obtaining good treatment
results of peri-implantitis.
Mail: Dr. Stefan Renvert,
Department of Oral Sciences, School of Health and Society, Kristianstad University, Kristianstad, Sweden. E-mail:
stefan.renvert@hkr.se