Abstract The efficacy of whitening toothpastes is questionable and controversial. Clinicians, patients and researchers have expressed concern with whitening toothpastes due to the risk of wearing the dental structure and the potential for disappointment if the advertised cosmetic results are not achieved. Objective: This study compared the whitening performance of toothpastes with different whitening technologies after initial and continued use. Material and Methods: Ninety bovine incisors were stained using a concentrated solution of black tea. They were randomly distributed into 6 groups, according to the toothpaste whitening technology: activated charcoal (B&W), blue covarine (WAD), hydrogen peroxide (LWA), microbeads (Oral B 3D White Perfection – 3DW) and optimized abrasives (XW4D). They were compared to a traditional toothpaste without a whitening agent (TA – control). Specimens underwent a brushing machine with controlled pressure, time and temperature. A calibrated examiner measured the color using a VITA-Classical scale before the first brushing cycle (T0), after the first brushing cycle (TI), and after a brushing cycle that simulates continuous use (TCU). Whitening performance was evaluated by the difference of shades (ΔSGU) between T0–TI and T0–TCU timepoints, using the Kruskal-Wallis and Dunn's non-parametric test. The Wilcoxon test was used to evaluate the cumulative effect (α=0.05). Results: Statistically significant differences were observed between toothpastes in both TI and TCU (p<0.05). The time of use also had a significant effect (p<0.05). Conclusion: Only WAD and 3DW showed whitening performance after the first use (TI). The greatest whitening performance after continuous use was obtained by WAD, followed by LWA and 3DW. The use of conventional toothpaste (TA) promotes no tooth whitening. Clinical relevance: Microbead abrasives (3DW) and blue covarine (WAD) were the active technology tested that presented the best global tooth whitening performance.

Abstract Objective To prepare nanocomposite cements based on the incorporation of bioactive glass nanoparticles (nBGs) into BiodentineTM (BD, Septodent, Saint-Maur-des-Fosses Cedex, France) and to assess their bioactive properties. Material and Methods nBGs were synthesised by the sol-gel method. BD nanocomposites (nBG/BD) were prepared with 1 and 2% nBGs by weight; unmodified BD and GC Fuji IX (GIC, GC Corporation, Tokyo, Japan) were used as references. The in vitro ability of the materials to induce apatite formation was assessed in SBF by X-ray diffraction (XRD), attenuated total reflectance with Fourier transform infrared spectroscopy (ATR-FTIR), and scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis. BD and nBG/BD were also applied to dentine discs for seven days; the morphology and elemental composition of the dentine-cement interface were analysed using SEM-EDX. Results One and two percent nBG/BD composites accelerated apatite formation on the disc surface after short-term immersion in SBF. Apatite was detected on the nBG/BD nanocomposites after three days, compared with seven days for unmodified BD. No apatite formation was detected on the GIC surface. nBG/BD formed a wider interfacial area with dentine than BD, showing blockage of dentine tubules and Si incorporation, suggesting intratubular precipitation. Conclusions The incorporation of nBGs into BD improves its in vitro bioactivity, accelerating the formation of a crystalline apatite layer on its surface after immersion in SBF. Compared with unmodified BD, nBG/BD showed a wider interfacial area with greater Si incorporation and intratubular precipitation of deposits when immersed in SBF.

Resumo Introdução A detecção de pequenas lesões de cárie ainda é um desafio para profissionais da Odontologia, que em sua prática clínica dispõem de uma grande variedade de métodos para detectar cáries nas superfícies oclusais. Objetivo Avaliar clinicamente a efetividade da câmera de fluorescência Vista Proof, da microcâmera intraoral digital Vista Cam e do critério visual ICDAS (International Caries Detection and Assessment System) para detecção de lesões de cárie nas superfícies oclusais. Material e método Cento e sete dentes posteriores de pacientes adultos foram examinados visualmente e por meio de radiografias digitais por um examinador que os classificou de acordo com a presença ou ausência de cárie. Os dentes foram então avaliados por outro examinador que utilizou o ICDAS, fluorescência e imagens digitais ampliadas. A efetividade dos métodos foi mensurada por meio da sensibilidade, especificidade, razão de verossimilhança positiva e negativa. Para cada método, a curva ROC (Receiver Operating Characteristic) e a área sob a mesma - AUROC (Area Under the ROC curve) foram estimadas. Resultado Houve excepcional capacidade discriminante para as imagens intraorais (AUROC=0,93) e para o ICDAS (AUROC=0,91), com diferença estatística não significativa entre eles (z=0,35, p=0,73). A fluorescência apresentou capacidade discriminante aceitável (AUROC=0,78), embora tenha sido menor que os outros. A razão de verossimilhança positiva para a fluorescência foi 2,32, comparado a 20,58 para a imagem intraoral e 58,11 para o ICDAS. Conclusão Ambos os métodos e o ICDAS exibiram um adequado desempenho clínico, sendo que o ICDAS e a imagem intraoral foram mais efetivos que a fluorescência.

Abstract Introduction The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Objective To clinically assess the effectiveness of the Vista Proof fluorescence camera, the Vista Cam digital intraoral micro camera and the International Caries Detection and Assessment System (ICDAS) visual criterion for detecting caries lesions on occlusal surfaces of permanent teeth. Material and method One hundred and seven posterior teeth from adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. The teeth were then assessed by the other examiner using ICDAS, fluorescence and magnified digital images. The effectiveness of the methods was measured based on sensitivity, specificity, positive and negative likelihood ratio. For each method, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC curve (AUROC) were estimated. Result There was exceptional discrimination capacity for the intraoral images (AUROC=.93) and the ICDAS (AUROC=.91), with no significant statistical difference between them (z=.35, p=.73). The fluorescence exhibited an acceptable discrimination capacity (AUROC=0.78), although it was lower than the others. The positive likelihood ratio for the fluorescence was only 2.32, compared to 20.58 for the intraoral image and 58.11 for the ICDAS. Conclusion Both methods and the ICDAS exhibited an adequate clinical performance, although the ICDAS and intraoral image were more effective than the fluorescence.

Abstract The objective of this study was to analyze the effect of bleaching toothpastes, both conventional and those containing the new whitening agent Blue Covarine, on teeth previously bleached by conventional techniques (in-office and at-home). Squared bovine enamel/dentin blocks (6.0 x 6.0 x 2.0 mm) were randomly distributed in 6 groups (n = 15), according to the technique used to bleach them (in-office: HP35%; at-home: PC10%) and the type of bleaching toothpaste (none: control; Blue Covarine containing: BC; and without Blue Covarine: NBC). Experimental groups denominated HP35%, HP35%BC and HP35%NBC received in-office tooth bleaching before toothbrushing, and groups PC10%, PC10%BC and PC10%NBC were subjected to at-home tooth bleaching prior to toothbrushing. After bleaching treatment, groups HP35%BC, PC10%BC, HP35%NBC and PC10%NBC underwent daily tooth brushing in a brushing machine for 3 minutes (150 strokes/min, with a load of 375 g). Tooth color alteration was measured by reflectance spectroscopy (Vita EasyShade, Vident, Brea, CA, USA) at: T0 (baseline) – after in-office or at-home bleaching treatment; T1 – immediately after tooth brushing; T2 - 7 days and T3 - 14 days after tooth brushing. Data was analyzed by repeated measures mixed ANOVA and the Bonferroni post hoc test, with a significance level of 5%. Statistically significant differences were found between different experimental groups, evaluation times and for the interaction between them (p < 0.001). Tooth brushing using either bleaching toothpaste (conventional or with Blue Covarine) showed no color alteration on teeth previously bleached by in-office and at-home tooth bleaching. The use of bleaching toothpastes on previously bleached teeth did not produce a color alteration.

ABSTRACT Objective The purpose of this in vitro study was to compare the efficacy of a bleaching toothpaste containing Blue Covarine vs. conventional tooth bleaching techniques using peroxides (both in-office and at-home). Material and Methods Samples were randomly distributed into five experimental groups (n=15): C - Control; BC – Bleaching toothpaste containing Blue Covarine; WBC – Bleaching toothpaste without Blue Covarine; HP35 - In-office bleaching using 35% hydrogen peroxide; and CP10 – At-home bleaching with 10% carbamide peroxide. The dental bleaching efficacy was determined by the color difference (ΔE), luminosity (ΔL), green-red axis (Δa), and blue-yellow axis (Δb). The CIELab coordinates were recorded with reflectance spectroscopy at different times: T0 - baseline, T1 – immediately after bleaching, T2 - 7 days, T3 - 14 days, and T4 - 21 days after the end of treatments. Data were analyzed by a repeated measures mixed ANOVA and post hoc Bonferroni test, with a significance level of 5%. Results No significant differences were found between the treatment groups C, BC, and WBC. The groups HP35 and CP10 showed significantly higher whitening efficacy than groups C, BC, and WBC. Conclusions There were no significant differences in the whitening efficacy between a Blue Covarine containing toothpaste, a standard whitening toothpaste, and a control. Neither of the whitening toothpastes tested were as effective as in-office or at-home bleaching treatments.

Objetivo: Avaliar a resistência à fratura de dentes tratados endodonticamente após tratamento clareador usando peroxido de hidrogênio a 15% com nanopartículas de dióxido de titânio (15HPTiO2) fotoativado por LED-laser, em comparação aos protocolos usando peróxido de hidrogênio 35% (35HP), peróxido de carbamida 37% (37CP) ou perborato de sódio (SP).Material e método:Após tratamento endodôntico, 50 incisivos bovinos extraídos foram divididos em 5 grupos (n = 10): G1- sem clareamento; G2- 35HP; G3- 37CP; G4- 15HPTiO2fotoativado por LED-laser e G5- SP. Nos grupos G2 e G4, o protocolo de clareamento foi aplicado em 4 sessões, com 7 dias de intervalo entre cada sessão. Nos grupos G3 e G5, os materiais foram inseridos na câmara pulpar por 21 dias e trocados a cada 7 dias. Após 21 dias, as coroas foram submetidas à força de compressão com velocidade de 0,5 mm/min, aplicada a 135º em relação ao longo eixo da raiz. empregando máquina de ensaios mecânicos, até a fratura. Os dados foram submetidos aos testes de ANOVA e Tukey (p = 0.05).Resultado:O tratamento clareador em dentes tratados endodonticamente com 15HP e nanopartículas de TiO2fotoativado por LED-laser proporcionou redução da resistência à fratura semelhante ao 35HP, 37CP ou SP (p>0,05). Todos os tratamentos clareadores reduziram a resistência coronária à fratura quando comparados aos dentes sem tratamento (p<0,05).Conclusão:Todos os protocolos de clareamento reduziram a resistência à fratura dos dentes tratados endodonticamente, sem diferenças estatisticamente significantes entre os grupos.

Objective: The aim of this study was evaluate the fracture resistance of endodontically-treated teeth after bleaching treatment using 15% hydrogen peroxide plus titanium dioxide nanoparticles (15HPTiO2) photoactivated by LED-laser, in comparison with protocols using 35% hydrogen peroxide (35HP), 37% carbamide peroxide (37CP) or sodium perborate (SP).Material and method: After endodontic treatment, fifty bovine extracted incisors were divided into five groups (n =10): G1- without bleaching; G2- 35HP; G3- 37CP; G4- 15HPTiO2 photoactivated by LED-laser and G5- SP. In G2 and G4, the bleaching protocol was applied in 4 sessions, with a 7 day interval between each session. In G3 and G5, the materials were kept in the pulp chamber for 21 days, but replaced every 7 days. After 21 days, the crowns were subjected to compressive load at a cross head speed of 0.5 mm/min, applied at 135° to the long axis of the root using an eletromechanical testing machine, until fracture. The data were submitted to ANOVA and Tukey tests (p = 0.05).Result:The bleaching treatment in endodontically-treated teeth with 15HP plus TiO2 nanoparticles and photoactivated by LED-laser caused reduction of the fracture resistance similarly provided by 35HP, 37CP or SP (p>0.05). All bleaching treatments reduced the fracture resistance compared to unbleached teeth (p<0.05).Conclusion: All bleaching protocols reduced the fracture resistance of endodontically-treated teeth, but there were no differences between each other.

AIM: To correlate the tray technique for isolation and counting of Streptococcus mutans over dental restoration with the toothpick technique. METHODS: Forty 18-50-year-old patients of both genders with high cariogenic risk were selected. Inclusion criteria were: occlusal restoration evaluated as alpha, according to the Ryge's criteria (examiner' Cohen-Kappa 0.8) and 2 years old maximum age. Each patient provided a saliva sample (control group S) and two samples of dental biofilm from amalgam or resin-based composite restorations in the same patient, one obtained with the toothpick technique (group TT), and the other from homologous tooth restoration with the tray technique (group TR). This method involves only a direct impression on the occlusal surfaces by a section of a fluoride tray with trypticase yeast extract cysteine sucrose with bacitracin (TYCSB) agar previously prepared and solidified. The samples were incubated at 37 ºC for 48 h and the colony-forming units (CFU) were counted. The results were statistically analyzed with SPSS software using the linear regression method at 95% confidence level. RESULTS: TR was able to isolate S. mutans, and there was a significant positive correlation (r=0.95) with TT. There was no significant correlation between TR and control group S (r=0.47). CONCLUSIONS: TR was able to isolate and count S. mutans from the dental biofilm of dental restorations with a significant correlation with the TT group.

OBJECTIVE: The aim of this study was to evaluate the fracture strength and failure mode of flared bovine roots restored with different intraradicular posts. MATERIAL AND METHODS: Fifty bovine incisors with similar dimensions were selected and their roots were flared until 1.0 mm of dentin wall remained. Next, the roots were allocated into five groups (n=10): GI- cast metal post-and-core; GII- fiber posts plus accessory fiber posts; GIII- direct anatomic post; GIV- indirect anatomic post and GV- control (specimens without intraradicular post). A polyether impression material was used to simulate the periodontal ligament. After periodontal ligament simulation, the specimens were subjected to a compressive load at a crosshead speed of 0.5 mm/min in a servo-hydraulic testing machine (MTS 810) applied at 135º to the long axis of the tooth until failure. The data (N) were subjected to ANOVA and Tukey's post-hoc test (α=0.05). RESULTS: GI and GIV presented higher fracture strength (p<0.05) than GII. GIII presented intermediate values without statistically significant differences (p>0.05) from GI, GII and GIV. Control specimens (GV) produced the lowest fracture strength mean values (p<0.05). Despite obtaining the highest mean value, GI presented 100% of unfavorable failures. GII presented 20% of unfavorable failures. GIII, GIV and GV presented only favorable failures. CONCLUSIONS: Although further in vitro and in vivo studies are necessary, the results of this study showed that the use of direct and indirect anatomic posts in flared roots could be an alternative to cast metal post-and-core.

O uso de condicionadores ácidos para desmineralizar a superfície dental e expor a rede de fibras colágenas para interdifusão dos monômeros adesivos e conseqüente formação da camada híbrida tem sido considerado o mais eficiente mecanismo de adesão dos agentes de união. O objetivo deste estudo foi comparar a resistência de união à dentina de três sistemas adesivos, dois autocondicionantes (Clearfil SE Bond - CSEB e One Up Bond F - OUBF) e um de condicionamento total (Single Bond - SB), sob três diferentes condições de substrato dentinário (úmido, seco e reidratado). Noventa terceiros molares humanos recém-extraídos foram cortados na superfície oclusal, para se remover o esmalte e formar uma parede plana de dentina. Os espécimes foram restaurados com resina composta (Filtek Z250) e submetidos ao teste de resistência de união à tração (TBS) em uma MTS 810. As médias foram submetidas à ANOVA a dois critérios e ao teste de Tukey (p = 0,05). A dentina úmida apresentou os maiores valores de TBS para os sistemas adesivos SB e CSEB. A dentina seca e a reidratada apresentaram TBS significativamente menor quando foi empregado SB. OUBF não apresentou resultados influenciados pela condição do substrato dentinário, tendo produzido TBS similares para os diferentes tratamentos de superfície.

The use of acid etchants to produce surface demineralization and collagen network exposure, allowing adhesive monomers interdiffusion and consequently the formation of a hybrid layer, has been considered the most efficient mechanism of dentin bonding. The aim of this study was to compare the tensile bond strength to dentin of three adhesive systems, two self-etching ones (Clearfil SE Bond - CSEB and One Up Bond F - OUBF) and one total-etching one (Single Bond - SB), under three dentinal substrate conditions (wet, dry and re-wet). Ninety human, freshly extracted third molars were sectioned at the occlusal surface to remove enamel and to form a flat dentin wall. The specimens were restored with composite resin (Filtek Z250) and submitted to tensile bond strength testing (TBS) in an MTS 810. The data were submitted to two-way ANOVA and Tukey's test (p = 0.05). Wet dentin presented the highest TBS values for SB and CSEB. Dry dentin and re-wet produced significantly lower TBS values when using SB. OUBF was not affected by the different conditions of the dentin substrate, producing similar TBS values regardless of the surface pretreatments.