Clinical assessment of a manual toothbrush with CrissCross and tapered bristle technology on gingivitis and plaque reduction
ZHIPENG XU, MDS, XIN CHENG, BE, ERINN CONDE, BS, YUANSHU ZOU, PHD, JULIE GRENDER, PHD & RENZO ALBERTO CCAHUANA-VASQUEZ, DDS, PHD
ABSTRACT: Purpose: The primary aim of this study was to evaluate the gingivitis-reduction efficacy of an experimental manual toothbrush with CrissCross and tapered bristle technology in comparison with a marketed control manual toothbrush with traditional design and non-tapered bristles. In addition, the study compared the two toothbrushes for plaque-reduction efficacy. Methods: This was a randomized, controlled, parallel group, examinerblind, single-center, 4-week clinical trial with adult subjects in good general health. All subjects had presence of gingivitis (at least 10 bleeding sites). The subjects were randomly assigned to one of two treatment groups: a manual toothbrush having CrissCross and tapered bristle technology (tapered group: Oral-B CrossAction Ultrathin manual toothbrush); or a traditional flat-trim design and regular non-tapered bristles (control group: Oral-B Indicator Soft 35 manual toothbrush). Subjects were instructed to brush twice-daily for 4 weeks with their assigned brush and a standard sodium fluoride dentifrice. At baseline, Week 2, and Week 4, gingivitis was assessed using the Mazza Modification of the Gingival Bleeding Index (Mazza GI) and pre-brushing whole-mouth plaque was measured using the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI). Results: 100 subjects (50 per group) were randomized to treatment and assessed at baseline, and 97 subjects (48 in the tapered group and 49 in the control group) completed the study. At both Weeks 2 and 4, both groups showed a significant (P< 0.005) reduction versus baseline in Mazza GI and number of bleeding sites, and the tapered group showed a significantly (P< 0.001) greater reduction from baseline for both these assessments compared to the control group. By Week 4 the tapered group showed a reduction from baseline of 17.9% in Mazza GI and 38.5% in the number of bleeding sites; the corresponding figures for the control group were 7.5% and 12.6%, respectively. Both groups showed a significant (P< 0.001) reduction versus baseline in TMQHPI by Week 4, with no significant (P=0.06) between-group difference. (Am J Dent 2019;32:107-112).
CLINICAL SIGNIFICANCE: The twice-daily use of a manual toothbrush with CrissCross design and tapered
bristles had a statistically significantly greater gingivitis reduction
compared to a manual toothbrush of traditional flat-trim design and regular
non-tapered bristles, which could be a clinical advantage.
Mail: Dr. Zhipeng Xu, Shaanxi Provincial People’s Hospital No. 256 Youyi West Road, 710068 Xi'an, Shaanxi, China. E-mail: sxkq88@163.com
Surface treatment effects on bond strength of
CAD/CAM fabricated posts
Serra Oguz Ahmet, dds, phd, Ferhan
Egilmez, dds, phd, Gulfem
Ergun, dds, phd & Isil
Cekic-Nagas, dds, phd
Abstract: Purpose: To compare the effect of different surface treatments on
the bond strength of CAD/CAM fabricated resin-based and prefabricated fiber
posts to root canal dentin. Methods: 160 single-rooted human teeth were selected and received endodontic treatment.
The teeth were divided into four groups according to the post material used:
(1) Prefabricated fiber-reinforced composite post (Snowpost), (2) CAD/CAM
nanoceramic (Cerasmart), (3) CAD/CAM polymer infiltrated ceramic (Vita Enamic)
and (4) CAD/CAM resin nanoceramic (Lava Ultimate). Then the posts were randomly
assigned into four sub-groups according to the surface treatment method used:
(1) Control (no treatment), (2) Laser (Er,Cr:YSGG laser device, Waterlase), (3)
Hydrofluoric acid treatment [9.6% HF (Pulpdent) for 2 minutes], and (4)
Sandblasting (50 μm Al2O3). Following post space
preparation, posts were cemented with dual-cure resin cement (Panavia SA cement
plus). From each root, five 1 mm-thick slices were obtained. The micropush-out
bond strength test was performed for each slice. Data were analyzed by using
two-way ANOVA and Tukey HSD tests. The fracture modes were evaluated under a
stereomicroscope. Representative specimens were analyzed with SEM following
surface treatments. Results: Micropush-out
bond strength of posts to dentin was significantly affected by the type of post
material (P< 0.05), but not by the surface treatment (P= 0.397). (Am J Dent 2019;32:113-117).
Clinical significance: Posts
manufactured by CAD/CAM could be suitable options for restoration of severely
affected endodontically-treated teeth.
Mail: Dr.
Isil Cekic-Nagas, Department of Prosthodontics, Faculty of Dentistry, Gazi
University, Bişkek Cd.(8.Cd.) 82.Sk. No:4 06510 Emek, Ankara, Turkey. E-mail:
isilcekic@gmail.com
Functionalized silk dental floss as a vehicle for
delivery of bioactive
Grigoriy Sereda, phd, Khaled Rashwan, phd, Shahaboddin
Saeedi, bs, David Christianson, bs,
Abstract: Purpose: To enable the commercially available silk dental floss
to carry a series of desensitizing, alkalizing, and tooth strengthening
pharmacons. Methods: The
hydroxy-groups of the serine and tyrosine residues of the commercial silk
dental floss were exposed by degumming, and employed as the chemical anchors
for the introduction of carboxy-groups to the surface. The affinity of the silk
dental floss to a set of bioactive species was studied by SEM, EDS, and XFS.
The acetylated silk was used as a control sample for the experiments
elucidating the effect of the surface carboxy-groups on its affinity to a
series of pharmacons. Results: While
unmodified silk has affinity to microcrystals of sodium carbonate, some
affinity to hydroxyapatite particles and Sr2+, its carboxylation
drastically increased the affinity to hydroxyapatite, Sr2+, Ca2+ and K+. The unmodified silk had some affinity to existing
hydroxyapatite particles, but did not initiate the growth of hydroxyapatite on
the surface. Carboxylation of silk enabled the growth of hydroxyapatite on its
surface, and significantly increased its affinity to the existing
hydroxyapatite particles. The unmodified silk had significant affinity to Zn2+,
which exceeded its acylated derivatives. (Am
J Dent 2019;32:118-123).
Clinical significance: The ability
of the commercial and modified silk floss to carry a series of pharmacons makes
them precursors for a series of new versatile materials with a potential for
delivering small doses of bioactive agents in a targeted manner.
Mail: Dr. Grigoriy Sereda, Department of Chemistry,
University of South Dakota, 414 East Clark Street, Vermillion, SD 57069,
USA. E-mail: Grigoriy.Sereda@usd.edu
At-home,
in-office and combined dental bleaching techniques using
Ana Victoria Dourado Pinto, dds, Natália Russo Carlos, dds, Flávia
Lucisano Botelho do Amaral, dds, msc, phd,
Abstract: Purpose: To conduct a clinical evaluation of dental bleaching
techniques using hydrogen peroxide (HP), regarding tooth sensitivity, gingival
irritation, subject’s perception of color change, and calcium (Ca) and
phosphorous (P) concentrations in enamel. Methods: 75 volunteers were
distributed according to the bleaching technique (n=25): (a) at-home: 10%HP
(Opalescence GO) for 15 days of continuous use (1 hour per day); (b) in-office:
40%HP (Opalescence Boost) in three clinical sessions (40 minutes each session);
(c) combined: one initial session with 40%HP, and the rest with 10%HP for 15
days of continuous use. Clinical evaluations and Ca and P concentration
collections were obtained before, during bleaching treatment, and 15 days after
conclusion of treatment. The generalized linear models were used to evaluate
the data for VITA Classical scale, CIELAB, tooth sensitivity, degree of
acceptability of the technique, Ca and P concentrations and to determine the
ΔE variables and color change perception. Gingival irritation was analyzed
by Fisher’s Exact test. The total frequencies for each time interval
(regardless of bleaching technique) were compared at 50% by the chi-square
test. Results: The in-office technique presented the lowest tooth
sensitivity, but all techniques caused an increase in sensitivity over time
(P< 0.0001). All techniques resulted in lower Ca and P concentrations in
enamel at each time point, compared with the baseline concentrations. Calcium
concentrations did not differ significantly among the treatments (P= 0.9360).
Phosphorus concentration at the 8th day was higher for the in-office
technique group (P< 0.05). All the bleaching techniques were effective in
altering color, with ΔE values higher than 3.3, without any significant
differences (P= 0.3255). Higher occurrence of gingival irritation was observed
for at-home and combined techniques. The combined technique seemed to promote a
color change faster than the other techniques. (Am J Dent 2019;32:124-132).
Clinical
significance: All the
dental bleaching techniques proved equally effective in promoting tooth color
change. These techniques may reduce calcium and phosphorous content in enamel.
The at-home and the combined techniques may cause greater dental sensitivity
than the in-office technique, and led to a higher prevalence of gingival
irritation.
Mail: Profa.
Dra. Roberta Tarkany Basting, Department of Restorative Dentistry, Faculty of
Dentistry and Institute of Research, Rua José Rocha Junqueira, 13, Bairro
Swift, Campinas, SP CEP: 13045-755, Brazil. E-mail: rbasting@yahoo.com
In vitro
dentin tubule occlusion by an arginine-containing dentifrice
Peiyan
Yuan, dds, msc, Weiying Lu, dds, msc, Haoyan Xu, dds, msc, Jianzhen Yang, dds, msc, phd,
Abstract: Purpose: To evaluate the ability of an arginine-containing dentifrice to occlude dentin
tubules. Methods: Dentin discs were
divided equally into premolar and molar groups, which were then utilized in
three treatment groups: a blank control group (distilled water treatment), a
negative control group (common dentifrice with calcium carbonate) and an
experimental group [dentifrice with 8% (w/w) arginine]. Each dentin disk was
brushed with the dentifrice twice daily for 7 consecutive days. After this
period, each disc was separated into two equal halves. One half was used for
scanning electron microscopy (SEM) and energy-dispersive spectrometer (EDS)
examinations, while the other half was brushed with distilled water twice daily
for another 7 days prior to SEM observation. Results: The plugging rate in the arginine dentifrice group was
significantly higher and more sustainable than in the negative control group.
The surface deposition of calcium and phosphorus on the dentin discs in the
arginine dentifrice group was also significantly higher. (Am J Dent 2019;32:133-137).
Clinical significance: This study provided evidence that using arginine as an active ingredient in dentifrice can improve its ability to occlude dentin tubules, thus supporting future efforts to improve dentin hypersensitivity.
Mail: Dr. Pingping Xu, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, 366 Jiangnandadao Road, Guangzhou, China. E-mail: pingpingxukqyy@163.com
The erosion protection efficacy of a stabilized
stannous fluoride dentifrice:
Nicola X. West, bds, fds rcs phd, fds (rest dent), Nikki
Hellin, rdn, Rachelle Eusebio,
mas & Tao He,
dds, phd
Abstract: Purpose: To compare the enamel protection
efficacy of a stabilized stannous fluoride dentifrice to a triclosan-containing
sodium fluoride dentifrice using a 10-day in situ erosion model, in accordance
with the American Dental Association Seal of Acceptance guidelines for enamel
erosion control. Methods: In this
single-center, double-blind, randomized, supervised-usage, two-treatment, four-period,
crossover study, healthy adult subjects were randomized to a treatment sequence
involving the following products: a 0.454% stannous fluoride (1,100 ppm F)
dentifrice (Procter & Gamble) and a control dentifrice containing 0.243%
sodium fluoride (1,100 ppm F) and 0.3% triclosan (Colgate-Palmolive). Each
study period consisted of 10 treatment days. Subjects wore an intra-oral appliance
fitted with two polished human enamel samples for 6 hours per treatment day.
While wearing the appliance, subjects swished with their assigned dentifrice
slurry for 60 seconds twice daily and with 250 ml orange juice over a 10-minute
period four times daily. After 10 days, enamel specimens were removed and
measured for surface loss using contact profilometry. Results: 36 subjects were enrolled and 33 completed the study (mean
age = 41.8 years). The stannous fluoride dentifrice demonstrated 90.3% less
enamel loss than the NaF/triclosan dentifrice (P < 0.001) at Day 10, with
median enamel loss of 0.279 µm and 2.877 µm, respectively. Both products were
well tolerated. (Am J Dent 2019;32:138-142).
Clinical significance: The stannous fluoride dentifrice
provided significantly greater protection against dental erosion relative to
the NaF/triclosan dentifrice.
Mail: Professor Nicola West, Periodontology Clinical
Trials Unit, Bristol Dental School, Lower Maudlin Street, Bristol, BS1 2LY, United
Kingdom. E-mail: n.x.west@bristol.ac.uk
Effect of silver diamine fluoride and potassium iodide on bonding to demineralized dentin
MARK VAN DUKER, BA, JURI HAYASHI, DDS, PHD, DANIEL C. CHAN, DMD, MS, DDS, JUNJI TAGAMI, DDS, PHD & ALIREZA SADR, DDS, PHD
ABSTRACT: Purpose: To evaluate the microtensile bond strength (MTBS) of resin composite to demineralized dentin treated with SDF or SDF-KI. Methods: Occlusal enamel of 30 caries-free extracted human molars was removed to expose flat dentin surfaces. Specimens were immersed in demineralizing solution (pH 4.5) for 7 days. A standard smear layer was created using 600-grit silicon carbide paper. Specimens were distributed into three groups (n=10). Control: Dentin rinsed with deionized water; SDF: Dentin treated with 38% SDF; and SDF-KI: Dentin treated with SDF and KI. Specimens were bonded with composite using Scotchbond Universal in etch-and-rinse mode. MTBS beams were prepared from each specimen after 24 hours and tested. Data was analyzed by one-way ANOVA with Tukey HSD post-hoc test. Results: MTBS test results ranged from 0 to 40 MPa. The highest values were obtained in the Control and lowest in SDF-KI, where pre-test failures were frequently observed. One-way ANOVA showed a significant difference among groups (P< 0.005); post-hoc analysis suggested no statistical difference between Control and SDF, but both groups showed higher MTBS compared with SDF-KI. (Am J Dent 2019;32:143-146).
CLINICAL SIGNIFICANCE: Silver diamine fluoride can be applied precisely and regionally on
demineralized dentin before bonding without compromising the bond strength of a
universal adhesive used with phosphoric acid etching. Addition of potassium
iodide to reduce discoloration will dramatically weaken the bond.
Mail: Dr. Alireza
Sadr, Biomimetics Biomaterials Biophotonics Biomechanics & Technology (B4T)
Laboratory, Department of Restorative Dentistry, University of Washington, 1959
NE Pacific St. Box 357456, Seattle, WA 98195, USA. E-mail: arsadr@uw.edu
Effect of endodontic retreatment on the bond
strength of resin cements
Kamila de F. Pereira, dds,
msc, Ana Carolina
Venção, dds, msc, Miriam G.
Magro, dds, msc,
Abstract: Purpose: To evaluate the effect of
endodontic retreatment on the bond strength of different cementation techniques
(self-adhesive and conventional resin cement) through the push-out mechanical
testing and the penetrability of resin cements to root dentin. Methods: 60 human teeth with single
oval-shaped canals were used (n=15): G1 - Endodontic treatment and cementation
with RelyX ARC (ETA); G2 - Endodontic treatment and cementation with U200
(ETU); G3 - Endodontic retreatment and cementation with RelyX ARC (ERA); G4 - Endodontic
retreatment and cementation with U200 (ERU). The groups with conventional
endodontic treatment were filled with AH plus (ETA and ETU), while the groups
that were submitted to endodontic retreatment were initially filled with Endofill
and afterwards with AH Plus. Each radicular third (cervical, middle, and
apical, of each tooth) was submitted to push-out bond strength testing,
followed by evaluation with confocal laser microscopy to determine the
penetration of the resin cements, and scanning electron microscopy was used to
evaluate the failure mode. The parametric data were evaluated by two-way ANOVA
and Tukey tests, and non-parametric data by Kruskal-Wallis and Dunn tests
(α< 0.05). Results: The ETA
group had higher bond strength values to intra-radicular dentin than the other
groups in all root thirds (P< 0.05). Endodontic retreatment had a negative
impact on the penetration and push-out bond strength of RelyX ARC and U200
cement, regardless of the analyzed radicular third. (Am J Dent 2019;32:147-151).
Clinical significance: The bond strength between fiber
post and root dentin can be affected by several factors, such as technical
failure, cementation technique, pretreatment of the dentin, type of post and
adaptation. The endodontic retreatment interferes negatively on the bond
strength and penetrability of RelyX ARC and U200 cements to dentin, regardless
of the analyzed radicular third. Therefore, the endodontic retreatment might have
an adverse effect due to over preparation and aggression to the root canal.
Mail: Dr Thiago S. Porto, Department
of Comprehensive Care, CWRU School of Dental Medicine, 2124 Cornell Rd,
Cleveland, OH, 44106, USA. E-mail: txp209@case.edu
Cytotoxic effects of silver diamine fluoride
Mary E. Fancher, dds, ms, Suzanne
Fournier, dds, Janice Townsend, dds, ms & Thomas E. Lallier, phd
Abstract: Purpose: To investigate the effect of
silver diamine fluoride (SDF) and fluoride varnish (FV) on human gingival
fibroblasts (HGF) and bacteria. Methods: HGF cell viability was assessed after exposure to various dilutions of SDF
or FV. Hydroxyapatite (HA) discs treated with SDF, FV, or saline were rinsed in
artificial saliva for 84 days. HGF were exposed to treated discs and viability
assessed fluorescently. Oral bacteria were exposed to treated discs and
survival quantified. Results: At
0.01%, SDF was almost 100% cytotoxic to HGF. SDF and FV treated HA discs,
induced near-complete cell death after 24 hours of contact. After rinsing FV
discs for 21 days, cell survival exceeded 95%. SDF treated discs were toxic to
HGF and bacteria after 9 weeks of rinsing. (Am
J Dent 2019;32:152-156).
Clinical significance: SDF and FV can induce cell
death. FV lost its cytotoxicity within 3 weeks, while SDF remained cytotoxic
even after 9 weeks of rinsing. This research confirms that SDF has long lasting
antimicrobial effects at very low concentrations although it does raise
concerns regarding cytotoxicity. However, HGF cells are exposed to other
cytotoxic substances in dentistry with little, if any, long-term effects.
Mail: Dr. Janice Townsend,
Department of Pediatric Dentistry, College of Dentistry, The Ohio State
University, 4126 Postle Hall, 305 W. 12th Ave., Columbus, OH 43210-1267,
USA. E-mail: townsend.661@osu.edu