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This double-blind randomized clinical trial evaluated the efficacy and safety of two carbamide peroxide concentrations used in at-home vital bleaching. Ninety-two volunteers with a shade mean of C1 or darker for the six maxillary anterior teeth were randomized into two balanced groups (n=46) according to bleaching agent concentration: 10% (CP10) or 16% (CP16) carbamide peroxide. The patients were instructed to use the whitening agent in a tray for two hours once a day for three weeks. Shade evaluations were done with a value-oriented shade guide mad a spectrophotometer at baseline and one week post-bleaching (four-week evaluation). Tooth sensitivity was measured daily using a scale ranging from 0 (no sensitivity) to 4 (severe sensitivity). At the end of the study, the volunteers filled out a questionnaire with seven questions aimed to give their opinion about the adopted treatment regimen. Both carbamide peroxide concentrations resulted in significantly lighter teeth at the four-week evaluation compared to the baseline for all color parameters (p<0.0001) and shade median (p<0.001). There was no significant difference between the two groups in terms of shade change difference with either the spectrophotometer (p=0.1) or the shade guide (p=0.7). Also, no statistically significant difference was found in relation to ΔL* (p=0.7), Δa* and ΔE* (p=0.5). A significant reduction in yellowness (Δb*) was observed for CP16 compared to CP10 (p=0.05) in crude analysis, which disappeared after controlling for b* parameter at baseline. The group treated with CP16 experienced more tooth sensitivity during the first (p=0.02) and third (p=0.01) weeks of treatment compared to the CP10 group. However, no major difference was observed (p=0.09) when the degree of tooth sensitivity between groups was compared. Both 10% and 16% carbamide peroxide concentrations were equally effective and safe for a three-week at-home tooth-bleaching treatment. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study tested tensile bond strength to enamel and dentin and the flexural modulus of three resin cements. It also determined the influence of these properties on the fracture resistance of teeth restored with ceramic inlays. Materials and Methods: Initially, 10 standard ceramic discs were bonded to enamel using the following resin cements: Enforce (E), RelyX ARC (RX) and Fill Magic Dual Cement (FM). After seven days of storage, the specimens were subjected to tensile forces at a crosshead speed of 0.5 mm/minute until fracture. The enamel was then ground and the ceramic disks were bonded to dentin. The flexural modulus of each type of resin cement was calculated based on the straight-line tension-deformation curve using the three-point flexure method. For resistance to fracture, 40 sound maxillary premolars were randomly divided into four groups (n=10). Three groups were submitted to preparations and restored with ceramic inlays bonded with the same resin cements used during the tensile test (n=10). Intact teeth were used as the control group. The specimens were subjected to compressive axial loading at 0.5 mm/minute using a 10-mm steel ball until fracture. Results: Statistical analysis revealed that, for all cements, the bond strength to enamel was significantly higher (p<0.05) than that obtained in dentin, in both substrates, RX and FM showed higher bond strengths than that obtained for E (p<0.05). In relation to flexural modulus, FM had the lowest and E the highest flexural modulus; whereas, RX differed from the other two (p<0.05). The teeth with inlays that were bonded using RX, and E had a significantly higher (p<0.05) fracture resistance than those where the inlays were bonded with FM but without recovering the resistance observed for the control group (intact teeth). Conclusion: The three resin cements had different mechanical properties. A higher flexural modulus usually resulted in improved resistance to fracture for the ceramically restored teeth. [ABSTRACT FROM AUTHOR]

This study evaluated in vitro and in situ the potential adverse effects of 10% carbamide per oxide on human enamel using microhardness calcium loss and surface morphology analysis. Twenty-four enamel slices (4 mm2) were obtained from recently extracted premolars. The specimens were polished under water-cooling down to 1,200-grade sandpaper. After initial microhardness readings (100g), the specimens were randomly divided into two groups for in situ and in vitro specimens were stored in deionized water and the in situ specimens, included in an intra-oral appliance, were placed in the oral cavity of four volunteers. these cycling sequences took place for 14 days. Upon conclusion of the bleaching treatment, new microhardness readings were performed on all specimens. Calcium dosage was assessed from the bleaching gel collected after initial exposure on day one, then from gel collected between days two and seven and gel collected between day eight and 14 using an atomic absorption spectrophotometer. Surface morphology was observed from two non-treated control specimens and two specimens of each experimental bleached group under SEM evaluation. Statistical analysis (ANOVA and Tukey test) disclosed that specimens bleached in situ showed similar microhardness to unbleached specimens and had statistically higher (p<0.01)hardness than in vitru bleached specimens. The loss if calcium in the vitru conditions. SEM micrographs demonstrated that surface alterations were more pronounced in the in vitro condition. The adverse effects of carbamide peroxide on enamel were evident in specimens bleached in vitro but were not seen in situ. The presence of saliva could prevent the demiralizing effects of bleaching gel in situ. [ABSTRACT FROM AUTHOR]

This study evaluated in vitro the influence of five solutions used to treat cavity preparations on microleakage of amalgam restorations. Seventy-two standard Class V cavities were prepared in buccal and lingual surfaces of 36 recently extracted human third molars. The cervical wall was located in cementum and the occlusal wall was located in enamel. Specimens were randomly divided into six groups (n=12) according to the solution employed to treat the cavities: Group I-2.5% sodium hypochlorite; Group II-Calcium hydroxide solution; Group III-1.23% Acidulated phosphate fluoride; Group IV-2% digluconate of chlorhexidine; Group V-anionic detergent solution (1.25% sodium lauryl sulfate) and Group VI-control group. The solutions were applied for one minute, followed by washing and drying. Two coats of copal varnish were applied in each cavity. The cavities were filled with capsuled amalgam GS-80 (SDI). After finishing and polishing, the specimens were submitted for thermal cycling followed by immersion in methylene blue. Then, the specimens were sectioned and microleakage was evaluated based on a standard ranking under magnification (40x). Data were subjected to statistical analysis using non-parametric tests. Results of the study concluded that leakage was higher in cementum than enamel (p<0.01). The substances employed have no influence on microleakage except for sodium hypochlorite, which increased leakage values in enamel (p<0.05). [ABSTRACT FROM AUTHOR]

This study compared marginal leakage of Class II cavities with gingival margin in cementum using different technique~ Twenty-four recently extracted third molars were used. Proximal standard box cavities were prepared in both mesial and distal surfaces. The gingival margin was located apical to the cemento-enamel junction. All the preparations and restorations were performed by the same operator. Standard cavities were randomly divided into three groups (n=16) and restored as follows: Group 1-light-cured composite resin; Group 2--self-cured composite resin + light-cured composite resin and Group 3-amalgam + light-cured composite resin. After polishing, the teeth were thermocycled and their gingival margins exposed to dye. Specimens were sectioned and leakage scores observed in accordance with a standard ranking. Data were subjected to statistical analysis (Kruskal-Wallis). Results showed that the amalgam/resin composite combination demonstrated the least leakage. [ABSTRACT FROM AUTHOR]

This study evaluated the influence of caries-detection dyes on the in vitro tensile bond strength of adhesive materials to sound dentin. Caries-free human molars were ground to expose superficial dentin. Two dyes (a commercial 0.5% basic fuchsin in propylene glycol and Cari-D-Tect) were applied to sound dentin and rinsed. Subsequently, the dentin was etched with phosphoric acid (35%) and rinsed, leaving a moist dentin surface. The adhesive (Prime & Bond 2.0) was applied in two layers and light cured. A composite (TPH Spectrum), a compomer (Dyract), and a hybrid ionomer (Advance) were used to prepare the bond-strength specimens with a 3-mm-in-diameter bonding area. Control groups were made without use of dyes. Six specimens were prepared for each group. After 24 hours in distilled water, tensile bond strength (MPa) was measured using a testing machine. Analysis of variance was used to evaluate the data. Without dyes, bond strengths of TPH Spectrum and Dyract with Prime and Bond 2.0 were similar and both values were significantly (P < 0.05) higher than that of Advance with Prime & Bond 2.0. Dyes for caries detection reduced the bond strength of TPH Spectrum and Dyract but not Advance when used with Prime and Bond 2.0. [ABSTRACT FROM AUTHOR]

A literature review was conducted to investigate the influence of patient-related factors on restoration survival in posterior permanent teeth as well as to report the methods used to collect these factors. The selection of articles on longitudinal clinical studies investigating the survival of posterior restorations (except full crowns and temporary fillings) and including patient-related factors was performed by applying predefined criteria. The review was organized into two parts, the first describing how patient factors were assessed in the studies (n=45) and the second presenting the statistical significance (n=27) and size of the effect (n=11) of these factors on restoration survival. Patient-related factors mentioned in the studies included age; gender; caries risk; caries activity/severity; decayed, missing, filled teeth; number of restorations; oral hygiene; and bruxism, among others. Sixteen studies included the patient age or age range in the analysis, which was found to be significant in 47% of the studies. Regarding gender, four of 17 reports found a significant effect on survival, showing more failures for men in three studies. The caries risk profile or related variables were included in the analysis of 15 studies, and a significant effect on survival was reported for high-caries-risk individuals (or related variables) in 67% of these studies. Bruxism was also found to influence restoration survival in three of six studies where this variable was investigated. Some issues were found regarding the reporting of methods used to classify patients according to risk and were thoroughly discussed. In view of the information gathered in this review, the assessment of patient factors along with other variables should become part of clinical studies investigating restoration survival, since several of these factors were shown to influence the failure of restorations, regardless of the material type. [ABSTRACT FROM AUTHOR]

This study evaluated the histological response and the expression of tenascin (TN) and fibronectin (FN) after pulp capping with mineral trioxide aggregate (MTA) or calcium hydroxide (CH). Class V cavities and pulp exposure were performed in 40 primary pig teeth. The pulps were capped with either MTA or CH, and the cavities were sealed with resin-modified glass ionomer cement. CH was used as a control. Seven and 70 days posttreatment, the animals were sacrificed and teeth were prepared for histological evaluation. TN and FN were detected by immunostaining. A severe inflammatory response was observed after 7 days in the CH group (p<0.043), while in the MTA group, a mild response was observed. Similar reparative dentin deposition was observed after 70 days for both groups (p<0.005). The expression of FN and TN was similar for both groups in the two periods evaluated. TN and FN were expressed during pulp reparative events, independently of the capping material.