Advertisements
February 2021 Abstracts
Research
Articles
Enamel staining with e-cigarettes,
tobacco heating products and modern
Annette
Dalrymple, bsc, phd, Emma-Jayne
Bean, bsc, msc, Thomas C. Badrock, Randy A. Weidman, ms,
Abstract: Purpose: To
evaluate the effect of cigarette smoke, smokeless tobacco (e.g. snus), tobacco heating products (THP), electronic
cigarettes (EC), and modern oral nicotine products on tooth staining. Methods: In this in vitro study, staining was assessed for 86 days following exposure of
bovine enamel samples to a scientific reference cigarette (1R6F), a THP (glo), an EC (ePen 3), a reference snus product (CRP1.1), and a modern oral product
(LYFT). Red wine and coffee were used as positive controls and DMSO and
complete artificial saliva as negative controls. Whether brushing could reduce
staining levels was also assessed. Changes in staining levels were assessed
using the Commission Internationale de L'éclairage L*a*b* method. Results: Enamel staining
increased with incubation time, and cigarette smoke, snus,
coffee and wine induced statistically higher staining levels. THP, EC and
modern oral exposure induced minimal staining levels that were also comparable
to negative control samples. At day 86, ΔE mean and SD values were 28.50 ±
3.14, 19.76 ± 1.26, 17.35 ± 3.44, 16.22 ± 2.07, 18.30 ± 3.82, 4.10 ± 1.99,
11.30 ± 2.60, 49.56 ± 2.44 for cigarette, glo, EC
with blended tobacco, EC with rich tobacco, reference snus product, modern oral product, coffee or wine. The control ΔE mean and SD
values at day 86 were 18.68 ± 3.89 for DMSO and 2.17± 0.78 for complete
artificial saliva. The ∆E values for all DMSO extracted samples and
control increased from day 1 to 86, which suggests that the DMSO used to
extract the samples contributes to the enamel sample staining levels. Staining
levels were reduced by brushing. (Am J Dent 2021;34:3-9).
Clinical significance: Cigarette smoke, red wine, snus and coffee stained enamel. Exposure to THP, EC or
modern oral product extracts for 86 days resulted in minimal enamel staining.
Further studies are required to assess the long-term impact on staining and the
oral cavity following consumer exclusive use of EC, THP or modern oral
products.
Mail: Dr. Annette Dalrymple, British
American Tobacco, R&D, Southampton, Hampshire, SO15 8TL, UK. E-mail: Annette_Dalrymple@bat.com
Influence of
calcium lactate and fluoride solution mouthrinses on
tooth
Isabella Spinardi Furlan, dds, Natália Russo Carlos, dds, Ana Victoria Dourado Pinto, dds,
Abstract: Purpose: To conduct a clinical evaluation of calcium lactate and
sodium fluoride mouthrinses in reducing sensitivity
and efficacy of color change during in-office bleaching. Methods: 75
participants were selected and divided into three groups (n= 25), according to
the type of desensitizing treatment tested: calcium lactate mouthrinse prior to sodium fluoride mouthrinse before each
bleaching session; daily mouthrinse with sodium
fluoride; control (absence of mouthrinse). Each mouthrinse was used for 1 minute. Bleaching was performed
following the same protocol in all groups, with 40% hydrogen peroxide (Opalescence
Boost), in three 40-minute sessions, with a 48-hour interval between sessions.
Clinical parameters such as sensitivity, gingival irritation and mouthrinse acceptability were assessed using Visual
Analogue Scale (VAS) and clinical examination at two timepoints:
baseline (before any treatment) and 48 hours after the end of treatment. The
color was evaluated with a spectrophotometer (VITA Classical scale guide, 3D
Master guide and CIEL*a*b*). The data were analyzed by generalized linear
models and by one-way ANOVA. Results: There was significant color change
in all groups according to the VITA Classical scale guide (P< 0.001). There
was no significant difference among the groups for ΔL*, Δa*, Δb* and ΔE
over time (P> 0.05). The control group presented a significant increase in
sensitivity (P= 0.008). The other groups showed no significant difference
between initial and final timepoints (P> 0.05). No
symptoms of gingival irritation were observed in any of the groups evaluated.
All desensitizing treatments presented high acceptability. Bleaching treatment
was effective, regardless of association with desensitizing treatments. No
treatment prevented bleaching sensitivity, but the absence of a combined
desensitizing treatment led to increased sensitivity. (Am J Dent 2021;34:10-16).
Clinical
significance: Although
bleaching sensitivity during in-office bleaching treatment cannot be avoided,
daily fluoridated mouthrinse or calcium lactate used
prior to fluoridated mouthrinse prevented its increase.
Mail: Profa. Dra. Roberta Tarkany Basting, Faculdade São Leopoldo Mandic/Operative
Dentistry Area, Faculty of Dentistry, Rua José Rocha Junqueira, 13. Bairro Swift,
Campinas – SP, 13045-755, Brazil. E-mail: rbasting@yahoo.com
Efficacy, longevity, and bleaching
sensitivity of carbamide and hydrogen
Priscila
Silva Abrantes, dds, Claudiana Menezes
Xavier, Ana Margarida dos Santos Melo, dds, msc,
Abstract: Purpose: To evaluate
the efficacy, longevity, and bleaching sensitivity of in-office bleaching with
37% carbamide (CP) and 35% hydrogen peroxides (HP). Methods: 45 volunteers were enrolled in this randomized, double blind, controlled,
split-mouth clinical trial with a 6-month follow-up. Left and right hemiarches were randomly selected to receive CP or HP
in-office bleaching. Three 40-minute applications of both bleaching agents were
performed once a week at the same time. Tooth shade and bleaching sensitivity
were recorded before and after bleaching sessions, 1 to 7 days after bleaching
sessions and up to 6 months after the last bleaching session using,
respectively, a shade guide and Visual Analogue Scale (VAS). Color change,
global immediate sensitivity - GIS (sum of sensitivity levels reported during
three bleaching sessions), trans- and post-bleaching sensitivity were obtained
and analyzed using paired Student t-test and two-way ANOVA/Tukey post-hoc tests (P< 0.05). Results: HP had statistically higher global
immediate sensitivity than CP. CP showed statistically lower sensitivity levels
during bleaching sessions and in two subsequent days than HP. CP and HP
provided statistically similar tooth shade at the end of the last bleaching
session and 3 and 6 months after the last bleaching session. (Am J Dent 2021;34:17-22).
Clinical significance: In-office
tooth bleaching using CP resulted in less bleaching sensitivity than HP,
without compromising efficacy and longevity over a 6-month follow-up period.
The use of 37% carbamide peroxide in substitution for
35% hydrogen peroxide can promote an effective, long-lasting, and more
comfortable in-office tooth bleaching for patients.
Mail: Dr.
Boniek Castillo Dutra Borges, Av. Senador Salgado Filho 1787, Lagoa Nova,
Natal, RN, 59151-250, Brazil. E-mail: boniek.castillo@gmail.com
Effectiveness of
in-office bleaching treatment with different
Ozge Parlar Oz, dds, phd & Nermin Demirkol, dds, phd
Abstract: Purpose: To
investigate the effectiveness of different light activation methods for
in-office bleaching agents in terms of color change durability and tooth
sensitivity (TS). Methods: 80 subjects were randomly divided into four
groups (n= 20). A bleaching agent (40% H2O2) was
activated using a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, an 810-nm diode laser, a light-emitting
diode (LED), and conventional (chemical) treatment. The CIE L*a*b* system and
ΔE* values were used to measure color changes in the teeth using a
spectrophotometer. TS was measured using the visual analogue scale (VAS). The
measurements were performed before the treatment, immediately afterwards, and 2
weeks, 1 month, and 6 months later. A P< 0.05 was accepted as statistically
significant. Results: The most statistically significant color change
occurred in the 2nd week (ΔE2) in all groups (P< 0.05).
However, the most color change in the 2nd week (ΔE2) occurred
in the Nd:YAG group, yet there was no statistically
significant result between Nd:YAG and LED (P>
0.05). After the procedure (VAS2), a statistically significant increase in TS
was observed in all groups (P< 0.05), with the highest sensitivity observed
in the LED group; significant differences were observed between the LED and the
other groups (P< 0.05). (Am J Dent 2021;34:23-30).
Clinical significance: Although all light activation
techniques showed noticeable color changes, the conventional technique showed
appreciable color change at the 6-month follow-up. Nd:YAG and diode laser activation can be preferable alternatives to LED and
conventional activation in clinical practice as they bleach more and faster,
decrease the number of sessions and chair time, and cause minimum sensitivity.
Mail: Dr. Ozge Parlar Oz, Department of Prosthodontics, Faculty of
Dentistry, University of Gaziantep, Gaziantep, 27310, Turkey. E-mail:
ozgeparlar@gmail.com
Influence of 9.3
µm CO2 and Er:YAG laser preparations
Clara
Isabel Anton y Otero, dr med dent, Tissiana
Bortolotto, dr med dent, msc, phd, Enrico Di Bella, phd
Abstract: Purpose: To examine
the marginal adaptation in enamel and dentin of mixed Class V saucer shaped
restorations where cavities were prepared by two different lasers. Methods: A handpiece-integrated Er:YAG laser @ 4.5 W, 300 mJ, 15 Hz (LiteTouch III) and a novel CO2 laser @ 12.95 W, 19.3 mJ,
671 Hz (Solea 9.3 µm). Diamond bur preparation with a
25 µm diamond bur (Intensiv) in a red contra angle at
high speed under water spray cooling served as the control. Eight cavities per
group were readied and restored under simulation of dentin fluid with a one
bottle universal adhesive (One Coat 7 Universal) and a nanohybrid resin composite (Everglow), applied in two layers.
For every preparation technique, the adhesive system was applied in the selective-etch
and the self-etch mode, resulting in six experimental groups. Marginal analysis
was performed immediately after polishing and after simultaneous thermal
(5-50°C, 2 minutes each) and mechanical (max. 49 N; 200,000 cycles) loading by
using a SEM (´200 magnification). Results: Significant differences were found for all groups - except groups 2 and 5 -
between initial and terminal results and between the groups as well (P< 0.05,
2-way ANOVA with Fisher’s post-hoc test). The bur prepared group with
selective-etch technique showed the best overall results after loading,
followed by Er:YAG prepared self-etch group and CO2-prepared
selective-etch group. (Am J Dent 2021;34:31-38).
Clinical significance: By using a universal one-component
adhesive system, marginal adaptation in enamel and in dentin depended on the
preparation method and on the adhesive’s application technique as well. When
using lasers, Er:YAG in self-etch mode and CO2 9.3 µm in selective-etch mode total marginal adaptation showed results which
were comparable to conventional bur preparation with selective-etch technique.
Mail: Prof.
Dr. Ivo Krejci, University of Geneva, Faculty of Medicine, CUMD - University
Clinics of Dental Medicine, Division of Cariology and Endodontology, 1, rue Michel-Servet,
1211 Genève 4, Switzerland. E-mail: ivo.krejci@unige.ch
Influence of
anodized titanium abutment backgrounds
Kubra DeGirmenci, dds & Serkan Saridag, dds, phd
Abstract: Purpose: To
characterize the color outcome on different zirconia types of various colored titanium backgrounds produced with a newly developed
anodized technique. Methods: Blue, green, pink and gold-colored titanium
backgrounds were produced via different anodization voltage values. Non-anodized grey colored titanium was used as a control. A
total of 40 disc-shaped zirconia specimens were
prepared from four different zirconia types (Cercon HT, Noritake Alliance, Prettau,
and Ice Zirkon). The zirconia specimens were placed on different titanium backgrounds to evaluate color
differences (∆E) by recording the L, a and b values. ∆E, ∆L,
∆a and ∆b values were compared for different titanium backgrounds
and zirconia types. To analyze the results, repeated
measures ANOVA and Bonferroni adjustments for pairwise comparison were used (α= 0.05). Results: The Cercon HT group had the highest ∆E value,
while the Noritake group showed the lowest ∆E value (P< 0.05).
∆L, ∆a and ∆b values showed significant color changes depending
on the color of the titanium background, the sintering procedure of zirconia and the zirconia ingredients (P< 0.05). (Am J Dent 2021:34:39-43).
Clinical significance: Anodized titanium abutments may
improve color in esthetic regions when a ceramic abutment cannot be used. The
study showed that the gold-colored titanium produced via anodization was better than other colors at producing a tooth-like color for
implant-supported zirconia restorations. Also, by
adjusting the color of zirconia restorations, the
effect of the background could be altered using the zirconia sintering protocol.
Mail: Dr. Kubra Degirmenci, Department of Prosthodontics,
Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey.
E-mail: dtkubradegirmenci@outlook.com
Effect of
surface preparation and light curing on penetration
Lorraine
Lau, dmd, msd, Ryan
L. Quock, dds, Di I. Wu, dds, ms, phd, Daniel A. Harrington, phd,
Abstract: Purpose: To evaluate
the effect of light cure, as well as various dentin surface treatment approaches,
on the penetration depth of silver precipitating from 38% silver diamine fluoride into primary dentin tubules. Methods: The occlusal dentin surfaces of 42 non-carious
primary molars were exposed and then sectioned into halves bucco-lingually.
The halves from each tooth pair were randomly split in two mega-groups, and
each mega-group was divided randomly as follows into six experimental groups:
prepared by either carbide bur (G1, G2), ceramic bur (G3, G4), or erbium laser
(G5, G6). SDF was then applied to all prepared surfaces, and finally
even-numbered groups (G2, G4, G6) were light cured. One mega-group was assigned
to quantitative evaluation of silver penetration depth along the axial wall,
and the other mega-group was reserved for qualitative observation of relative
silver distribution on the occlusal surface, both via
scanning electron microscope. Results: No significant difference was
observed in silver penetration depth between light cure and non-light cure
groups (P= 0.8908). There was a statistically significant association between
tooth preparation method and depth of silver penetration (P< 0.000001);
laser-treated groups had significantly deeper silver penetration (1,148.9 µm
G5, 1160.4 µm G6) than carbide bur (P< 0.05; 184.7 µm G1, 301.8 µm G2) or
ceramic bur (P< 0.05; 184.1 µm G3, 131.0 µm G4) groups. A significant
difference (P< 0.05) was noted in percentage occlusal surface coverage of particles between laser (51.4% G5, 35.8% G6) and carbide
groups (21.1% G1, 19.3% G2). Light cure had no significant effect on the depth
of silver penetration from 38% SDF in the dentin of primary teeth. Laser
preparation resulted in deeper silver penetration than carbide or ceramic bur.
(Am J Dent 2021;34:44-48).
Clinical significance: Exposure of 38% silver diamine fluoride-treated dentin to light cure did not affect
the depth of penetration of silver particles into the dentin tubules of primary
teeth. Rather, tooth preparation approaches that reduce the smear layer, like
laser ablation, resulted in the deepest penetration of silver into the tubules.
Clinical application of these findings will depend on scenario and treatment
aim.
Mail: Dr. Ryan Quock, Department
of Restorative Dentistry & Prosthodontics, University
of Texas School of Dentistry, 7500 Cambridge, Houston, TX 77054, USA. E-mail: Ryan.Quock@uth.tmc.edu
Antimicrobial
effects of silver diamine fluoride: An in vivo study
Érica Torres de Almeida Piovesan, dds, ms, Marly Vale Soares Silva, dds,
Abstract: Purpose: To
compare the antimicrobial effect of treating dentin caries lesions with silver diamine fluoride (SDF) in different concentrations and chlorhexidine (CHX). Methods: Children aged 7-10
years presenting one occlusal dentin carious lesion
in primary molars were selected, totaling 40 teeth. The sample was randomly
divided into four groups: (G1) 38%-SDF + potassium iodide (KI); (G2) 30%-SDF;
(G3) 2%-CHX; and (G4) control group. After cleaning the cavity up to firm
dentin, a sample of dentin from the pulp wall was collected; the cavity was
then treated with the antimicrobial agent tested and, immediately after,
another dentin sample was collected. Cavities were restored with high viscosity
glass ionomer cement. Microorganisms were counted,
and species from the Streptococcus genus were analyzed for susceptibility to
antimicrobial agents. Shapiro-Wilk and Levene’s tests were used to assess normality and
homogeneity, respectively. Student’s t-test, two-way ANOVA, and Bonferroni post-test were applied for multiple comparisons. Results: For the overall microorganisms count, it was observed that G1
and G2 presented a statistically lower number of microorganisms following
treatment in comparison to G3 and G4 (P< 0.05). When analyzing the
Streptococcus spp. and Enterococcus sp. separately, a
statistical reduction in the microorganism count before and after the treatment
was observed for all groups (P< 0.05), excluding the control group. Among
the species tested, S. mutans were the least
susceptible to SDF treatments compared to the other species. The treatments
with SDF were more effective in reducing microorganisms when compared to CHX.
Similarly, the susceptibility of Streptococcus to CHX was lower than that
observed for SDF. (Am J Dent 2021;34:49-53).
Clinical significance: In cases where the dental professional
decides to apply an antimicrobial agent prior to the placement of a
restoration, silver diamine fluoride proved to be
more effective than chlorhexidine, slowing the
progression of carious lesions, and possibly preventing future restorative
interventions thus improving children's quality of life. It is important to
note that clinicians should consider the type of restorative material that will
be used due to the possibility that the use of SDF may influence adhesion of
the subsequent restoration.
Mail: Dr. Érica Torres de Almeida Piovesan,
Department of Dentistry, Faculty of Health Science, University of Brasilia - UnB, Campus Universitário Darcy Ribeiro, 70910-900, Brasilia - DF, Brazil. E-mail: ericatorresa@hotmail.com
A 6-month
randomized controlled trial evaluating a novel smart-connected
C. Ram Goyal, dds, Ralf Adam, phd, Hans Timm, phd, Julie Grender, phd & Jimmy Qaqish, bsc
Abstract: Purpose: This
6-month study compared the effects of a smart-connected oscillating-rotating
(O-R) electric rechargeable toothbrush with micro-vibrations with those of a
marketed smart-connected sonic rechargeable toothbrush for the reduction of
gingivitis and plaque. Methods: In this single-center, examiner-blind,
two-treatment, open-label, parallel-group, randomized study, 110 adult subjects
with evidence of gingivitis and plaque were randomized to use either the O-R
brush (Oral-B iO) or the sonic brush (Philips Sonicare DiamondClean). Both
groups were instructed to brush twice daily with a standard sodium fluoride
dentifrice. Gingivitis and plaque were assessed at baseline, week 1, and week
24 using the Modified Gingival Index (MGI), Gingival Bleeding Index (GBI), and
the Rustogi Modification of the Navy Plaque Index
(RMNPI). Designation of gingivitis case status as “healthy” or “not healthy”
was made according to the World Workshop on the Classification of Periodontal
and Peri-Implant Diseases and Conditions. Results: A significantly
greater percentage of subjects in the O-R brush group versus the sonic brush
group transitioned from “not healthy” to “healthy” gingivitis case status at
week 24 (96.4% vs. 81.8%; P= 0.029). The O-R toothbrush produced a
significantly greater reduction in adjusted mean MGI score, adjusted mean GBI
score, and adjusted mean number of bleeding sites than did the sonic brush
(week 24, by 32.6% for MGI score, by 23.7% for GBI score, and by 26.1% for
number of bleeding sites, P< 0.001). After a single use on day 1, plaque
removal was statistically significantly greater for the O-R brush compared to
the sonic brush (P< 0.001); by week 24, the O-R brush demonstrated greater reductions
in whole mouth plaque (24.6%), gingival margin plaque (61.9%) and approximal region plaque 25.8% (P≤ 0.007 for all)
compared to the sonic brush. (Am J Dent 2021;34:54-60).
Clinical significance: This 6-month study provides
evidence supporting use of a smart-connected O-R electric toothbrush with
micro-vibrations for plaque removal and gingivitis reductions, resulting in
transitions to a healthy gingival state.
Mail: Dr. Ralf Adam, Procter
& Gamble German Innovation Center, Frankfurter Straße 145, 61476 Kronberg, Germany. E-mail: adam.r@pg.com
