Effects of light-, self-, and
tack-curing on degree of conversion and physical
Liang Chen, phd, Byoung In Suh, phd, Christine Gleave,
ms, Won
Jun Choi, Jihye Hyun & Jiyun Nam
Abstract: Purpose: To evaluate
the polymerization degree of conversion (DC) and physical strength of dual-cure
cements with tack-curing, and compare them to those with light-curing and
self-curing resins. Methods: Four
dual-cure resin cements were evaluated by DC and diametral tensile strength (DTS) tests with three different polymerization methods:
Light-cure (photo-polymerization 40 seconds, self-curing 30 minutes); Self-cure
(self-curing 30 minutes); and Tack-cure (photo-polymerization 3 seconds,
self-curing 30 minutes). Polymerization degree of conversion was determined
using Fourier transform infrared spectroscopy, and calculated based on the
ratio changes of aliphatic-to-aromatic C=C IR absorption peaks before and after
polymerized. Specimens for DTS (n = 10) were prepared using circular molds (6.0
mm in diameter and 3.0 mm in height) and tested after 24-hour water storage.
Data were analyzed by two-way ANOVA. Multiple post-hoc pairwise comparisons were performed by t-test when significant effects were found across
the factors (α = 0.05). Results: The Self-cure groups had slow initial curing rate, resulting in the lower DC
than both the Light-cure and Tack-cure groups. After 30 minutes of
polymerization, only in the RelyX Ultimate group,
light-curing resulted in higher DC than tack-curing, which resulted in higher
DC than self-curing (P< 0.05). The self-cure of resin cements resulted in a
significantly lower DTS only for RelyX Ultimate
cement (P< 0.05). There was no significantly different DTS between the
Tack-cure and Light-cure groups for all of the resin cements. For all of the
three curing modes, RelyX Ultimate cements had the
lowest DTS among the four cements tested in this study. (Am J Dent 2016;29:67-70).
Clinical
significance: This study suggests that dual-cure resin cements
provided either higher or equivalent values of both DC and DTS when tack-cured
rather than self-cured. They had the same DTS and either an equivalent or lower
DC when tack-cured rather than light-cured. In clinical applications, tack-cure
would not adversely affect the materials’ performance.
Mail: Dr. Liang Chen, BISCO, Inc., 1100 W Irving Park
Road, Schaumburg, IL 60193, USA. E-mail: lchenchem@yahoo.com
Effect of Biodentine on secondary caries formation: An in vitro study
Betül Memis Özgül, dds, phd, R. Ebru Tirali, dds, phd & S. Burcak Cehreli, dds, phd
Abstract: Purpose: To
compare the effects of two materials, Biodentine and
conventional glass-ionomer cement (CGIC), on secondary caries formation around
restorations when used as a dentin replacement material. Methods: 30 approximal cavities were
prepared on mesial and distal surfaces of 15 caries-free human premolar teeth
extracted for orthodontic or periodontal reasons. Cavities were filled with A: Biodentine as a base + Filtek Z250 composite (n= 15) or B: CGIC as a base + Filtek Z250 composite (n= 15). The materials were applied according to the
manufacturers’ instructions. Teeth were thermocycled,
and placed in a demineralizing solution for 5 weeks.
Secondary caries formation was assessed using the International Caries
Detection and Assessment System (ICDAS) II and quantitative computer-aided
image measurement of caries depth. Results: The computer-aided measurements showed that the Biodentine group had significantly lower lesion depth measurements than the CGIC group (P=
0.004). However, there was no significant difference among the groups based on
the ICDAS II scores (P> 0.05). (Am J
Dent 2016:29:71-74).
Clinical
significance: This
in vitro study showed favorable results for Biodentine when used as dentin replacement material under resin-based composites.
Mail:
Dr. Betül Memis Özgül, Department
of Pediatric Dentistry, Faculty of Dentistry, Baskent UniversityTaskent cad. No: 107 06450, Ankara, Turkey.
E-mail:
dtbetulmemis@hotmail.com
Clinical and spectrophotometric evaluation after chlorhexidine use
Lorenzo Bevilacqua, dds, ms, Giuliana Liani, dh, Gaetano Castronovo, md, dds & Fulvia Costantinides, dds, ms
Abstract: Purpose: To
evaluate by a clinical spectrophotometric analysis
the staining side effect of a 0.2% chlorhexidine (CHX) mouthrinse containing an anti-discoloration
system (ADS) compared with a 0.12% and a 0.2% CHX mouthrinse,
after periodontal surgery. The efficacy of the products and the patient’s opinion
and acceptance were also assessed. Methods: The study was carried out on 60 subjects scheduled for periodontal flap surgery
at the Unit of Periodontology and Dental Hygiene
(University of Trieste, Italy). After surgery, the subjects were randomly prescribed
to rinse for 1 week with 10 ml of a 0.12% CHX (Group 1), 0.2% CHX (Group 2) or
0.2% ADS CHX (Group 3). Before surgery (T0), 7 days (T1) and 14 days (T2) after
surgery, following variables were recorded: gingival parameters at the
surgically treated sites (Full-Mouth Plaque Score, Full-Mouth Bleeding Score
and Modified Gingival Index), tooth pigmentation measured as ΔE, patient
perception and acceptance of the mouthrinses. Results: 53 subjects completed the
study. The difference among treatments related to gingival variables was not
statistically significant. No statistical differences were found for dental
pigmentation among the mouthrinses over time nor for discomfort at each follow-up examination. A slightly
less acceptance rate was observed for 0.2% CHX. The following conclusions were
drawn: (1) 0.2% CHX with ADS did not cause less brown pigmentation than the
0.2% CHX or than the 0.12% CHX; (2) 0.2% ADS CHX was as effective as CHX
without ADS in reducing gingival signs of inflammation in the post-surgical
early healing phase; (3) 0.2% CHX showed the lowest score in terms of taste
acceptance compared with 0.12% and ADS CHX. (Am J Dent 2016;29:75-80).
Clinical
significance: This randomized clinical trial demonstrated that no differences exists in terms of staining side effects, clinical efficacy
and acceptance among 0.2% chlorhexidine (CHX)
containing an anti-discoloration system (ADS), 0.2% CHX and 0.12% CHX at 7 and
14 days after periodontal flap surgery.
Mail:
Dr. Lorenzo Bevilacqua, School of Dental Sciences,
Piazza dell’Ospitale 1, 34129 Trieste, Italy. E-mail: l.bevilacqua@fmc.units.it
In situ anticariogenic activity of free fatty acids after sucrose exposure
Rodrigo
A. Giacaman, dds, phd, Ricardo Valenzuela-Ramos, dds & Cecilia
Muñoz-Sandoval, dds
Abstract: Purpose: To test
whether the effect of sucrose on enamel is hampered by immediate free fatty
acids exposure to the oral biofilm formed under a highly cariogenic environment, in situ. Methods: A
split-mouth, cross-over and double-blind in situ experiment was carried out
with 11 volunteers who wore palatal appliances containing bovine enamel slabs.
In two 15-day phases, volunteers dripped 20% sucrose onto the slabs eight times
per/day for 5 minutes followed by 5 additional minutes with suspensions of 10 mM oleic, linoleic or stearic acid or sucrose (caries-positive control), four
times/day. Biofilms were analyzed for biomass,
bacteria and polysaccharide formation and enamel demineralization was estimated
by surface microhardness. Results: Biofilms exposed to oleic and linoleic acids showed significantly lower biomass than the
control. S. mutans counts were reduced upon linoleic acid exposure (P<
0.05). All free fatty acids reduced polysaccharide formation (P< 0.05).
Slabs exposed to 20% sucrose followed by free fatty acids had significantly
lower demineralization than those exposed to sucrose alone, with reductions of
33%, 27% and 20% for linoleic, oleic and stearic acid, respectively. Data suggest that unsaturated
free fatty acids exposed after sucrose might potentially reduce cariogenicity of the oral biofilm formed on enamel in situ,
but further clinical confirmation is required. (Am J Dent 2016;29:81-86).
Clinical
significance: Data suggest that unsaturated free fatty acids exposed after sucrose might
potentially reduce cariogenicity of the oral biofilm
formed on enamel in situ, but further clinical confirmation is required.
Mail: Dr.
Rodrigo A. Giacaman, School of Dentistry, 2 Norte 685, Talca, Chile. E-mail:
giacaman@utalca.cl
The antimicrobial potential of stevia in an in vitro microbial caries model
Maryam Kishta-Derani, dds, ms, Gisele F. Neiva, dds,
ms, ms, James R. Boynton, dds, ms, Youngjoo E. Kim, dds
Abstract: Purpose: To determine the effect of stevia on caries
development when incorporated into a cariogenic diet
in a controlled microbial caries model. Methods: 56 bovine tooth specimens (4 × 4 mm) were divided into four groups, each
secured in a caries-forming vessel. All vessels were placed on an electric
stirrer inside a 37°C incubator. The specimens were inoculated with Streptococcus mutans,
and exposed for 4 days to circulating cycles of tryptic soy broth supplemented with 5% sucrose-TSBS (three ×/day), and a mineral wash
solution. Between TSBS cycles (three x/day), each
group received one of four experimental solutions: phosphate buffer
(PBS-negative control), 0.5% stevia solution, 5% stevia solution, or 5% xylitol solution. Development of caries lesions was analyzed using enamel surface
hardness. Difference in Vickers Hardness between pre and post-treatment was
calculated to determine caries development. Plaque was dislodged from six
specimens per group, and the CFU/ml calculated. Data were analyzed using ANOVA
at 95% confidence level, and individual group differences calculated using Tukey’s test. Results: 5% xylitol resulted in significantly less plaque
at the end of the study compared to PBS and 5% stevia,
but not significantly different than 0.5% stevia. 5% stevia had significantly softer lesions than the other
groups, while there was no significant difference in hardness scores between 5% xylitol, 0.5% stevia and
PBS. (Am J Dent 2016;29:87-92).
Clinical
significance: Under
the highly cariogenic conditions of this study,
although a 0.5% stevia and a 5% xylitol solution significantly reduced the amount of bacteria, none of the supplements
used in this study decreased the development of caries lesions.
Mail:
Dr. Margherita Fontana, Dept. Cariology,
Restorative Sciences and Endodontics, School of
Dentistry, University of Michigan, 1011 N. University Dr. 2393, Ann Arbor, MI
48109-1078, USA. E-mail: mfontan@umich.edu
Efficacy of an
experimental toothpaste containing 5% calcium sodium
Farzana Sufi, msc, Claire
Hall, msc, Stephen Mason, Phd, David
Shaw, msc, Liam Kennedy, msc, cstat
Abstract: Purpose: To evaluate
the efficacy of an experimental toothpaste containing 5% (w/w) calcium sodium phosphosilicate (CSPS) in relieving dentin hypersensitivity
(DH) compared with control toothpastes containing no known anti-sensitivity
ingredients. Methods: This was the
first of two exploratory, randomized, four-treatment, examiner-blind,
parallel-design, single-site, 8-week studies in healthy subjects with
self-reported and clinically diagnosed DH. The experimental toothpaste
contained 5% CSPS with a modified surfactant system, developed to enhance its organoleptic properties. Efficacy was evaluated against an abrasivity-matched placebo formulation (0% CSPS) with
additional abrasive silica replacing the CSPS, and two commercially available
fluoride toothpastes as controls. After an initial lead-in period, subjects
were randomized to one of the four study treatments and instructed to brush
twice daily for the next 8 weeks. DH was assessed at baseline and following 4
and 8 weeks of treatment by response to tactile and evaporative (air) stimuli,
and using a Dentine Hypersensitivity Experience Questionnaire (DHEQ; a
validated quality-of-life measure for DH). Results: A total of 134 subjects were randomized and completed the study. All treatments
demonstrated statistically significant reductions in sensitivity from baseline
at Week 4 and Week 8 for each clinical measure of sensitivity (all P≤
0.001). The 0% CSPS toothpaste demonstrated small but statistically significant
reductions in Schiff sensitivity score compared with the other study
toothpastes at Week 8 (all P< 0.05), whereas the experimental 5% CSPS
toothpaste significantly improved the tactile threshold at Week 4 compared with
the 0% CSPS toothpaste (P= 0.0467). The DHEQ responses did not reveal any
consistent statistically significant within-treatment changes from baseline or
between-treatment differences. Correlation analysis showed weak-to-moderate
associations between the DHEQ outcomes and clinical endpoints. Study treatments
were well tolerated. The treatment differences observed in this exploratory
study were small and inconsistent between measures. The reasons for the inconsistencies
are not clear but may be related to the properties of the abrasivity-matched
0% CSPS formulation, with the increased level of dental silica conferring an
advantage in terms of reducing DH. The ability of dental silicas to occlude exposed dentin tubules and thereby reduce DH has been demonstrated
in previous studies, and may warrant further clinical investigation. (Am J Dent 2016;29:93-100).
Clinical
significance: In
this exploratory study, all toothpastes were effective in reducing DH from baseline
with only occasional, but inconsistent, treatment differences. The observed
treatment differences were not consistent with other published data in this
area and their clinical significance is unclear. Further discussion of the
findings is included in the publication of a second, similar study.
Mail:
Ms. Farzana Sufi, Oral Care Medical Affairs, Research & Development, GSK
Consumer Healthcare, St George’s Avenue, Weybridge,
Surrey, KT13 0DE, UK. E-mail: farzana.x.sufi@gsk.com
Efficacy of an experimental toothpaste containing 5% calcium sodium
Farzana Sufi, msc, Claire Hall, msc, Stephen Mason, phd, David Shaw, msc, Jeffery Milleman, dds, mpa
Abstract: Purpose: To compare the efficacy of an experimental toothpaste
containing 5% (w/w) calcium sodium phosphosilicate (CSPS) in relieving dentin hypersensitivity (DH) with that of control
toothpastes containing no known anti-sensitivity ingredients. Methods: This was the second of two
exploratory, randomized, four-treatment, examiner-blind, parallel-design,
single-site, 8-week studies in healthy subjects with self-reported and
clinically diagnosed DH. After an initial lead-in period, subjects were
randomized to one of four study treatments: the experimental toothpaste
containing 5% CSPS with a modified surfactant system, developed to enhance its organoleptic properties; an abrasivity-matched
placebo formulation (0% CSPS) with additional abrasive silica replacing the
CSPS; or one of two commercially available fluoride toothpastes as controls.
Subjects were instructed to brush twice daily for the next 8 weeks. DH was
assessed at baseline and following 4 and 8 weeks of treatment by response to
tactile and evaporative (air) stimuli, and using a Dentine Hypersensitivity
Experience Questionnaire (DHEQ; a validated quality of life measure for DH). Results: A total of 137 subjects were
included in the efficacy analysis. The experimental 5% CSPS toothpaste
demonstrated statistically significant reductions from baseline in sensitivity
at Week 4 and Week 8 for each clinical measure (all P< 0.01). It also demonstrated
significantly greater improvements in DH compared with the two control
toothpastes for the majority of clinical measures at Week 4 (P≤ 0.01) and
for all clinical measures at Week 8 (all P < 0.01). The abrasivity-matched
0% CSPS toothpaste was associated with similar outcomes to the 5% CSPS
toothpaste. The DHEQ responses did not reveal any consistent statistically
significant within-treatment changes from baseline or between-treatment
differences. Strong correlations with DHEQ outcomes were only observed for the
subjects’ sensitivity rating in response to evaporative (air) stimuli at Week
8. Study treatments were well tolerated. (Am
J Dent 2016;29:101-109).
Clinical significance: In this proof-of-concept study,
the 5% CSPS toothpaste and the abrasivity-matched
placebo provided similar performance in reducing DH from baseline and in
comparison with the negative controls. The efficacy of the abrasivity-matched
0% CSPS formulation in reducing DH may be related to the increased dental
silica content. Previous studies have demonstrated the ability of dental silicas to occlude exposed dentin tubules and thereby
reduce DH. Further clinical investigation of the properties of dental silicas is warranted.
Mail: Ms. Farzana Sufi, Oral Care
Medical Affairs, Research & Development, GSK Consumer Healthcare, St
George’s Avenue, Weybridge, Surrey, KT13 0DE, UK. E-mail: farzana.x.sufi@gsk.com
Chemical and mechanical degradation of nano-ionomer after two different
Iman Ibrahim ElSayad, msc, phd & Eman Aly Abou Auf, msc, phd
Abstract: Purpose: To evaluate the effect of food-simulating liquids prior
to brushing on surface roughness of a nano-ionomer
restorative protected with two surface protection agents. Methods: 90 specimens were divided into three groups according to
surface protection; the first group: no surface protection; the second group:
copal varnish; the third group: light cure Ketac Glaze. Each group was subdivided into three subgroups relative to the immersion
solution: artificial saliva; citric acid 0.02 M; or 50% ethanol. Specimens were
stored for 7 days in one of the solutions in an incubator. One surface of each
specimen was subjected to brushing with a sonic electric toothbrush while the
other surface was not brushed. Surface roughness was measured with a
stereo-microscope. Data were analyzed using one way ANOVA followed by paired
t-test (P< 0.05). Results: The
surface roughness of the nano-ionomer specimens
immersed in ethanol was significantly higher than those immersed in citric
acid. No significant differences were found between surface protection agents
or between brushed and un-brushed specimens. The highest surface roughness mean
value was recorded with brushed unprotected specimens immersed in ethanol.
While the lowest surface roughness mean value was recorded with un-brushed
copal varnish protected specimens immersed in ethanol. (Am J Dent 2016;29:110-114).
Clinical significance: The surface
roughness of the nano-ionomer tested was differently
affected by the food-simulating solutions, depending on the immersion solution.
Tested surface protection agents did not provide optimal protection. Brushing
did not induce an increase in surface roughness.
Mail: Dr.
Iman Ibrahim ElSayad, Department of Operative
Dentistry, Faculty of Oral and Dental Medicine, Cairo University, 39 Wezarat Al Zeraa, Doki, Giza 12311, Egypt. E-mail: imsayad@gmail.com
Demineralization of resin-sealed enamel by soft
drinks
Agata A. Bartels, dmd,
ms, Carla A. Evans, dds, msc, Grace Viana, msc & Ana K. Bedran-Russo, dds,
ms, phd
Abstract: Purpose: To compare the in vitro
protective effect of orthodontic sealants on the enamel demineralization under
a soft drink-induced erosive challenge. Methods: The facial surfaces of bovine incisors were sectioned into 5 mm × 4 mm × 4 mm
enamel blocks. Specimens were randomly assigned to three surface protection
measures: control (exposed enamel), coating with Transbond XT (unfilled resin primer), or coating with Opal Seal (filled and fluoride
releasing primer). Thermocycling was used to simulate
aging. The specimens were pH cycled through an acidic buffer, test beverage and
a neutral buffer for a total of 7 days. Test beverages included water, Diet
Mountain Dew, and Coke Classic. Quantitative light-induced fluorescence (QLF)
images were taken at baseline and after aging. Final QLF images were taken to
evaluate the demineralization of enamel. Data were analyzed statistically using
a two-way ANOVA to compare the interaction between enamel surface protection
and beverages as well as one-way ANOVA to compare surface protection and the
test beverage levels. Results: A
statistically significant interaction was found between the surface protected
groups and the test beverage groups (P< 0.05). Statistically significant
differences were found among the test beverage groups (P< 0.05) and among
the surface protection groups (P< 0.05). Coke Classic went through the
sealant layer resulting in high enamel demineralization. Enamel coating with
Opal Seal significantly reduced the erosive attack of beverages. (Am J Dent 2016;29:115-119).
Clinical significance: Enamel surface protection using
a highly filled and fluoride releasing primer may be a beneficial technique
during orthodontic treatment to prevent enamel demineralization.
Mail: Dr. Ana Bedran-Russo, Department
of Restorative Dentistry, Room 531, College of Dentistry, University of
Illinois at Chicago, 801 S. Paulina Street, Chicago, IL 60612, USA. E-mail: bedran@uic.edu
A randomized clinical trial to assess
anti-plaque effects of an oral hygiene
Xiping Feng, dds, phd, Tao He, dds, phd, Michelle Cao, bs, Yanyan He, ms & Nelson Ji, bs
Abstract: Purpose: To assess
the anti-plaque efficacy of an oral hygiene regimen comprised of a
stannous-containing sodium fluoride dentifrice, advanced manual toothbrush, and
a cetylpyridinium chloride (CPC) rinse compared to a
negative control regimen. Methods: This
was a 4-week randomized and controlled, parallel group, single-center,
single-blind, clinical trial in generally healthy Chinese adults with existing
dental plaque. Following a 1-week acclimation period and cessation of overnight
oral hygiene prior to the baseline examination, overnight pre-brushing plaque
levels were assessed via digital plaque imaging analysis (DPIA). Subjects were
randomly assigned to either: (1) the test regimen of a stannous-containing sodium
fluoride dentifrice (Crest Pro-Health Expert), an advanced manual toothbrush
with CrissCross bristles (Crest Pro-Health manual
toothbrush), and a 0.07% CPC rinse (Crest Pro-Health Multi-Protection); or (2)
the negative control regimen group, a 0.243% sodium fluoride dentifrice (Crest
Cavity Protection) and a soft flat trim manual toothbrush (Crest MeiLiLiangJie). Subjects returned at Week 2 and Week 4
following twice daily use of their assigned products, again following pre-visit
cessation of overnight oral hygiene, for DPIA evaluation of overnight plaque
levels. Results: 35 fully evaluable
subjects completed the trial. At Week 2,
the pre-brushing overnight average DPIA plaque scores for the advanced products
regimen group were 72.4% statistically significantly lower relative to the
control group (P< 0.0001). At Week 4, the mean plaque inhibition benefit
provided by the regimen group was 76.8% greater than the control group (P< 0.0001).
All products were well-tolerated. (Am J
Dent 2016;29:120-124)
Clinical
significance: Twice daily use of a combination oral products regimen consisting of a
stannous-containing sodium fluoride dentifrice, CPC mouthrinse,
and advanced design manual toothbrush can provide greater plaque inhibition
than a control regimen with a regular fluoride dentifrice and manual
toothbrush.
Mail: Dr.
X. Feng, Department of Preventive and Pediatric
Dentistry, Ninth People’s Hospital, Shanghai Jiao Tong University School of
Medicine, PR China. E-mail: fxiping1808@qq.com