Search

Purpose: The aim of the present study was to perform a review of the effects of infiltrants and sealers on the inhibition of enamel demineralisation.Materials and Methods: The authors searched the Cochrane Library, Embase, PubMed and Web of Science (ISI) for papers published between January 1970 and September 2008. The main search terms were 'artificial caries' or 'caries treatment' or 'caries-like lesion' or 'white spot lesion' or 'enamel demineralisation' or 'natural caries' and 'enamel' and 'sealant' or 'resin infiltration'. The inclusion criteria were studies that produced artificial non-cavitated enamel lesions before the application of sealant in in vivo or in vitro studies. Studies excluded were those that had not produced artificial non-cavitated enamel lesions before the application of sealant; had evaluated the inhibition of enamel demineralisation around restorations, sealant and orthodontic bracket/bands; had not evaluated the inhibition of enamel demineralisation after the sealant application; and had not applied sealant materials. Selected papers were given scores, from A to C, according to predetermined criteria.Results: Eighteen studies were identified and included in the project critical appraisal. Two papers were classified as Grade A, nine as Grade B and seven as Grade C.Conclusions: It can be concluded that while fissure sealing acts as a diffusion barrier on the top of the lesion surface, the infiltration technique creates a barrier inside the lesion by replacing the mineral lost with a low-viscosity light-curing resin. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate the polishing procedures effect on color stability and surface roughness of composite resins. Methods. Specimens were distributed into 6 groups: G1: Filtek Supreme XT + PoGo; G2: Filtek Supreme XT + Sof-Lex; G3: Filtek Supreme XT + no polishing; G4: Amelogen + PoGo; G5: Amelogen + Sof-Lex.; G6: Amelogen + no polishing. Initial color values were evaluated using the CIELab scale. After polishing, surface roughness was evaluated and the specimens were stored in coffee solution at 37°C for 7 days. The final color measurement and roughness were determined. Results. Sof-Lex resulted in lower staining. Amelogen showed the highest roughness values than Filtek Supreme on baseline and final evaluations regardless of the polishing technique. Filtek Supreme polished with PoGo showed the lowest roughness values. All groups presented discoloration after storage in coffee solution, regardless of the polishing technique. Conclusion. Multiple-step polishing technique provided lower degree of discoloration for both composite resins. The final surface texture is material and technique dependent. [ABSTRACT FROM AUTHOR]

Background: Pulpectomy is used to treat primary teeth with irreversibly inflamed or necrotic pulp tissue. There is, however, a lack of consensus on clinical protocols for teaching pulpectomy at dental schools., Aim: To determine what faculty members at Brazilian dental schools are teaching about pulpectomy in primary teeth., Design: A cross-sectional, observational study was conducted using a 39-question survey available via the Google Forms® platform. A snowball sampling strategy was used for recruitment. Invitations to participate were sent via e-mail, WhatsApp® and Instagram®. The data were analysed descriptively., Results: A total of 177 (58.4%) responses were obtained. Most faculty members recommended the use of Kerr hand files (66.1%), and 1% sodium hypochlorite was the most common choice for the irrigating solution (35.3%). Iodoform pastes were the first choice of faculty members (41.6%), and 60.5% of the faculty members recommended composite resin as the definitive restoration., Conclusion: Similarities were found in the teaching of pulpectomy for primary teeth among faculty members at dental schools in Brazil., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)

Purpose: To assess the impact of transformations in pediatric dental clinics following reopening during the COVID-19 pandemic on pediatric dentistry procedures performed by dental students., Methods: Data were collected from electronic clinical records of Integrated Dental Clinical disciplines (I, II, III, and IV) from 2018 to 2023. The procedures were categorized into phases: prevention/stabilization, restorative/definitive, and maintenance. The data were analyzed descriptively and by t-test considering the pre-pandemic and pandemic periods (α = 5%)., Results: During the pandemic, Integrated Dental Clinics I and III saw increased prevention/stabilization procedures percentages (92.4% and 74.3%) compared to pre-pandemic (84.9% and 70%), while Integrated Dental Clinic II and IV saw a decline (76.6% and 66.1%) compared to pre-pandemic (79.1% and 67.9%). Restorative/definitive procedures decreased in Integrated Dental Clinic I and III (5.5% and 20.3%) from pre-pandemic period (10% and 24.1%) but increased in Integrated Dental Clinic II and IV (18.3% and 26.2%) from pre-pandemic (15.3% and 25%). Maintenance procedures decreased in Integrated Dental Clinic I, II, and III (2.1%, 5%, and 5.4%) compared to pre-pandemic (5.1%, 5.6%, and 6%), except for Integrated Dental Clinic IV, which saw an increase (7.8% from 7.2%). Despite the percentage changes, no significant differences were found between the periods analyzed (p > 0.05). However, when considering the total procedures across all disciplines and phases, there was a significant decrease during the pandemic in phases 1 and 3 (p < 0.05)., Conclusion: Despite the changes in pediatric dentistry procedures, the transformations within the dental clinic suggest tangible benefits for the teaching-learning process and safe patient care., (© 2024 American Dental Education Association.)

Objectives: The aim of this scoping review was to evaluate the available scientific evidence regarding the use of flavonoids in the treatment of caries-affected dentin focusing on bonding to dentin., Methods: A comprehensive literature search was performed in five databases from March 2022 and updated in April 2023: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Additionally, the references of included studies were manually searched. Gray literature was excluded from the review., Study Selection: Inclusion criteria included in vitro, in situ, and in vivo studies (animal or human) published in English. Abstracts, reviews, case reports, book chapters, doctoral dissertations, guidelines, and studies using pure plant extracts were excluded. Data collected from the selected studies were summarized and subjected to narrative and descriptive analysis. Out of the 91 studies identified, only 16 studies met the inclusion criteria., Results: The review analyzed eight different flavonoids (hesperidin, galardin, proanthocyanidin, genipin, quercetin, naringin, epigallocatechin-3-gallate, and other catechins subtypes) used as pretreatment or loaded into adhesive systems, primers, and phosphoric acid. The use of flavonoids improved the mechanical properties of the materials and modified the biological properties of the dentin, reducing collagen loss by the inhibition of proteolytic activity of matrix metalloproteinases (MMPs)., Conclusions: Based on the findings of this scoping review, it can be concluded that the use of flavonoids as pretreatment or incorporation into dental materials preserves collagen in the hybrid layer, inhibiting the MMPs activities, modifying the collagen fibrils of the dentin matrix and improving the mechanical properties of the dental adhesive systems. Therefore, it represents a promising approach for promoting dentin biomodification. This can result in more stable bonding of adhesive restorations to caries-affected dentin., Competing Interests: Declaration of Competing Interest none., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Evaluate molecularly the role of P 11 -4 self-assembly peptide in dentin remineralization and its interaction with collagen I., Methods: The calcium-responsive P 11 -4 peptide was analyzed by intrinsic fluorescence emission spectrum, circular dichroism spectrum (CD), and atomic force microscope (AFM). Differential light scattering was used to monitor the nucleation growth rate of calcium phosphate nanocrystals in the absence or in the presence of P 11 -4. AFM was used to analyze the radial size (nm) of calcium phosphate nanocrystals formed in the absence or in the presence of P 11 -4, as well as to verify the spatial structure of P 11 -4 in the absence or in the presence of Ca 2+ ., Results: The interaction of Ca 2+ with the P 11 -4 (K D = 0.58 ± 0.06 mM) promotes the formation of β-sheet antiparallel structure, leads to its precipitation in saturated solutions of Ca/P = 1.67 and induces the formation of parallel large fibrils (0.6 - 1.5 µm). P 11 -4 organized the HAP nucleation by reducing both the growth rate and size variability of nanocrystals, analyzed by the F test (p < 0.0001, N = 30). P 11 -4 interacts (K D = 0.75 ± 0.06 μM) with the KGHRGFSGL motif present at the C-terminal collagen telopeptide domain. P 11 -4 also increased the amount of HAP and collagen in the MDPC-23 cells., Significance: The presented data propose a mechanism that will help future clinical and/or basic research to better understand a molecule able to inhibit structural collagen loss and help the impaired tissue to remineralize., (Copyright © 2023 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the effect of P 11 -4 self-assembly peptide on cell viability and osteogenic capacity of SCAPs through mineral deposition and gene expression of osteogenic markers., Methods: SCAPs were seeded in contact with P 11 -4 (10 µg/ml, 100 µg/ml and 1 mg/ml) solution. Cell viability was evaluated using a colorimetric assay MTT: 3-(4,5-dimethyl-thiazolyl-2)-2,5- diphenyltetrazolium bromide) in an experimental time of 24, 48 and 72 h (n = 7). Mineral deposition and quantification provided by the cells was tested using the Alizarin Red staining and Cetylpyridinium Chloride (CPC), respectively, after 30 days (n = 4). Gene expression of Runt-related transcription factor 2 (RUNX2), Alkaline phosphatase (ALP) and Osteocalcin (OCN) was quantified using quantitative polymerase chain reaction (RT-qPCR), at 3 and 7 days with Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as the housekeeping gene, and relative gene expression was measured using the ΔΔCq method. Data were analyzed using Kruskall-Wallis followed by multiple comparisons, and T-test for gene expression with α=0.05., Results: All tested concentrations (10 µg/ml, 100 µg/ml and 1 mg/ml) were not cytotoxic at time 24 and 48 h. After 72 h, a slight decrease in cell viability was observed for the lowest concentration (10 µg/ml). The concentration of 100 µg/ml P 11 -4 showed the highest mineral deposition. However, qPCR analysis of P 11 -4 (10 µg/ml) showed upregulation of RUNX2 and OCN at 3 days, with downregulation of ALP at 3 and 7d CONCLUSION: P 11 -4 did not affect cell viability, induced mineral deposition in SCAPs, and upregulated the expression of RUNX2 and OCN genes at 3 days, while downregulating ALP expression at 3 and 7 days., Clinical Significance: Based on the results obtained in this study it can be stated that self-assembling peptide P 11 -4 is a potential candidate to induce mineralization on dental stem cells for regenerative purposes and also for a clinical use as a capping agent without compromising the cells health., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication., (Copyright © 2023. Published by Elsevier Ltd.)

This study investigated the influence of incorporating Biosilicate ® on the physico-mechanical and biological properties of glass ionomer cement (GIC). This bioactive glass ceramic (23.75% Na 2 O, 23.75% CaO, 48.5% SiO 2 , and 4% P 2 O 5 ) was incorporated by weight (5%, 10%, or 15%) into commercially available GICs (Maxxion R and Fuji IX GP). Surface characterization was made by SEM ( n = 3), EDS ( n = 3), and FTIR ( n = 1). The setting and working (S/W time) times ( n = 3) and compressive strength (CS) were analyzed ( n = 10) according to ISO 9917-1:2007. The ion release (n = 6) was determined and quantified by ICP OES and by UV-Vis for Ca, Na, Al, Si, P, and F. To verify cell cytotoxicity, stem cells from the apical papilla (SCAP) were exposed to eluates ( n = 3, at a ratio of 1.8 cm 2 /mL) and analyzed 24 h post-exposure. Antimicrobial activity against Streptococcus mutans (ATCC 25175, NCTC 10449) was analyzed by direct contact for 2 h ( n = 5). The data were submitted for normality and lognormality testing. One-way ANOVA and Tukey's test were applied for the working and setting time, compressive strength, and ion release data. Data from cytotoxicity and antimicrobial activity were submitted for Kruskal-Wallis' testing and Dunn's post hoc test (α = 0.05). Among all experimental groups, only those with 5% (wt) of Biosilicate ® showed better surface quality. Only M5% showed a comparable W/S time to the original material ( p = 0.7254 and p = 0.5912). CS was maintained for all Maxxion R groups ( p > 0.0001) and declined for Fuji IX experimental groups ( p < 0.0001). The Na, Si, P, and F ions released were significantly increased for all Maxxion R and Fuji IX groups ( p < 0.0001). Cytotoxicity was increased only for Maxxion R with 5% and 10% of Biosilicate ® . A higher inhibition of S. mutans growth was observed for Maxxion R with 5% of Biosilicate ® (less than 100 CFU/mL), followed by Maxxion R with 10% of Biosilicate ® ( p = 0.0053) and Maxxion R without the glass ceramic ( p = 0.0093). Maxxion R and Fuji IX presented different behaviors regarding Biosilicate ® incorporation. The impacts on physico-mechanical and biological properties were different depending on the GIC, but therapeutic ion release was increased for both materials.

Objectives: Electrospun scaffolds are a versatile biomaterial platform to mimic fibrillar structure of native tissues extracellular matrix, and facilitate the incorporation of biomolecules for regenerative therapies. Self-assembling peptide P 11 -4 has emerged as a promising strategy to induce mineralization; however, P 11 -4 application has been mostly addressed for early caries lesions repair on dental enamel. Here, to investigate P 11 -4's efficacy on bone regeneration, polymeric electrospun scaffolds were developed, and then distinct concentrations of P 11 -4 were physically adsorbed on the scaffolds., Methods: P 11 -4-laden and pristine (P 11 -4-free) electrospun scaffolds were immersed in simulated body fluid and mineral precipitation identified by SEM. Functional groups and crystalline phases were analyzed by FTIR and XRD, respectively. Cytocompatibility, mineralization, and gene expression assays were conducted using stem cells from human exfoliated deciduous teeth. To investigate P 11 -4-laden scaffolds potential to induce in vivo mineralization, an established rat calvaria critical-size defect model was used., Results: We successfully synthesized nanofibrous (∼ 500 nm fiber diameter) scaffolds and observed that functionalization with P 11 -4 did not affect the fibers' diameter. SEM images indicated mineral precipitation, while FTIR and XRD confirmed apatite-like formation and crystallization for P 11 -4-laden scaffolds. In addition, P 11 -4-laden scaffolds were cytocompatible, highly stimulated cell-mediated mineral deposition, and upregulated the expression of mineralization-related genes compared to pristine scaffolds. P 11 -4-laden scaffolds led to enhanced in vivo bone regeneration after 8 weeks compared to pristine PCL., Significance: Electrospun scaffolds functionalized with P 11 -4 are a promising strategy for inducing mineralized tissues regeneration in the craniomaxillofacial complex., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Titanium dioxide nanotubes (TiO2-nts) were incorporated into a glass ionomer cement (GIC) with improved mechanical properties and antibacterial activity. The aims of the present in vitro study were to define the elemental characterization, aluminum (Al) release rate, and initial working time for GIC reinforced with TiO2-nts, in an experimental caries model. TiO2-nts were incorporated into GIC powder components at 5% by weight, and compared with unblended GIC. Experimental approaches used energy-dispersive spectrometry (EDS), atomic absorption spectrophotometry (AAS), and brightness loss to define surface element properties, Al release rates, and initial working time, respectively. Statistical analysis was performed by 2-way ANOVA, Tukey's test, generalized linear models, and Student's t test (a = 0.05). EDS data analysis revealed that TiO2-nts incorporated into GIC had no significant impact on the typical elemental composition of GICs in an in vitro caries model. Regarding the demineralizing solution, GIC with TiO2-nt significantly decreased the Al release rate, compared with the control group (p < 0.0001). Moreover, TiO2-nt incorporated into GIC did not alter the initial working time of the material (p > 0.05). These findings add information to our scientific body of knowledge concerning the potential impact of TiO2-nt on the performance of conventional GICs.

After bleaching, enamel surfaces are damaged, contributing to erosion and tooth sensitivity. Although fluoride is used after bleaching to try and revert alterations, it is not capable of repairing tooth structure. This study compared the effect of a self-assembly peptide (P11-4), with and without fluoride, and sodium fluoride (NaF 2%) on the Knoop microhardness (KHN) and surface roughness (Ra (μm)) of bleached enamel with an in-office bleaching regimen. Enamel blocks of bovine teeth (5 × 5 × 2 mm) with standardized surface hardness were bleached with 35% carbamide peroxide, following the manufacturer’s instructions. The teeth were randomly divided into the following groups (n = 7) according to post-bleaching treatment: no treatment (negative control) (C-); 2% NaF (NaF); Curodont™ Repair (Repair); and Curodont™ Protect (Protect). Specimens were stored in artificial saliva at 37 °C. To evaluate the effect of the post-bleaching treatments, KHN and Ra were measured before bleaching (baseline) and 24 h and 7 days after bleaching. Data were submitted to repeated measures ANOVA and Bonferroni tests (α = 0.05). There were significant interactions between the study factors (p = 0.001). After 7 days, Repair (572.50 ± 79.04) and Protect (583.00 ± 74.76) specimens showed increased surface KHN, with values higher than the NaF (465.50 ± 41.50) and C- (475.22 ± 58.95) baseline values. There was no significant difference in KHN at 24 h among groups (p = 0.587). At 24 h after bleaching, Repair was significantly different from all groups (p < 0.05). Repair showed the lowest Ra (μm) values (0.133 ± 0.035). After seven days, there was no significant difference in Ra values among groups when compared to the baseline. The use of P11-4-based materials after bleaching resulted in the fastest recovery to baseline enamel properties.

Objectives: Self-assembling peptide P 11 -4 is amphiphilic and pH-triggered, effective on repairing early enamel carious lesions and dentin remineralization. However, P 11 -4 effects on dentin biomineralization and repair ability remain unexplored. Thus, cytocompatibility and effectiveness of P 11 -4 on inducing mineralization and migration of odontoblast-like cells (MDPC-23) were investigated., Methods: MDPC-23 were seeded in contact with P 11 -4 (0.5 and 1 µg/ml), Dentin Matrix Protein 1 (DMP1 0.5 and 1 µg/ml) or Calcium hydroxide (Ca(OH) 2 100 µg/ml) solutions. Cell viability was verified using MTT (n = 6/group). Mineral deposition was tested using Alizarin Red (n = 4/group). Cell migration was assessed by light microscopy (n = 2/group). MTT and Alizarin Red data were compared using Kruskal-Wallis and Mann-Whitney (α=0.01)., Results: P 11 -4 (0.5 and 1 µg/ml) and DMP1 (0.5 and 1 µg/ml) resulted the highest cell viability; Ca(OH) 2 presented the lowest. 1 µg/ml DMP1 and 1 µg/ml P 11 -4 promoted the highest mineral deposition. Ca(OH) 2 presented lower values of mineral deposits than DMP1 1 µg/ml (p < 0.01), but similar to P 11 -4 1 µg/ml. P 11 -4 and DMP1 at 0.5 µg/ml induced lesser mineral precipitation than P 11 -4 and DMP1 at 1 µg/ml (p < 0.01), with no difference to Ca(OH) 2 . All materials stimulated cell migration, however, lower concentrations of DMP1 and P 11 -4 demonstrated a higher migration potential., Conclusion: P 11 -4 did not affect cell viability, induces mineral deposition and MDPC-23 migration like DMP1., Clinical Significance: Self-assembling peptide P 11 -4 does not affect the cell viability and induces mineral deposition comparable to native protein involved in biomineralization. Combined with its ability to bind type I collagen, P 11 -4 is a promising bioinspired molecule that provides native-tissue conditions and foster further studies on its ability to form dentin bridges in pulp-capping strategies., (Copyright © 2022. Published by Elsevier Ltd.)

The treatment of high-risk patients still is a challenge. The understanding and development non-invasive, non-destructive, and non-ionizing techniques, can help to guide the treatment and the diagnosis of primary and recurrent caries. The present study evaluated the behavior of enamel/restoration interface after a cariogenic challenge by Fourier domain optical coherence tomography (FD-OCT), scanning electron microscopy (SEM) examination, and the fluoride release of the different restorative materials. Cavities (1.5 × 0.5 mm) were performed in enamel surface and divided into groups (n = 8): glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), and resin composite (RC). The samples were submitted to pH-cycling, and the solutions analyzed for cumulative fluoride by ion-analyzer. The morphology was analyzed by SEM through replicas. The optical attenuation coefficient (OAC) was calculated through exponential decay from the images generated by FD-OCT. Data were analyzed considering α = 0.05. OAC values increased for all groups after pH-cycling indicating demineralization (p < .05). Considering the remineralizing solution, RMGIC presented higher fluoride release rate, followed by GIC, while RC did not release any fluoride. Yet for the demineralizing solution, RMGIC and GIC released similar fluoride rates, overcoming RC (p < .05). Micrographs revealed no changes on the restorations margins, although enamel detachment was observed for RC and GIC after pH-cycling., (© 2021 Wiley Periodicals LLC.)

The aim of this study was to evaluate the effect of 2% chlorhexidine digluconate (CHX) on microtensile bond strength (µTBS) between an adhesive system and under 3 dentin conditions. For that, this study evaluated the adhesive interface at initial, after 6 months and 1 year of storage. Forty-eight human third molars were prepared and randomly divided into 3 groups, according to dentin substrates: sound dentin (Sd), caries-infected dentin (Ci) and caries-affected dentin (Ca). The groups were subdivided into two according to the dentin pre-treatment: application of 2% CHX or without pre-treatment (control). The dentin surfaces were etched with 35% phosphoric acid gel and bonded with Adper Single Bond 2 (3M ESPE) adhesive system according to manufacturer's instructions. Subsequently, the specimens were stored in deionized water at 37°C for 24h, 6 months and 1 year. Two additional teeth were used to analyze the bonding interfaces by SEM. Data was submitted to three-way ANOVA in a split plot design and Tukey's test (α = 0.05). The results showed that Ci decreased µTBS values when compared to Ca and Sd, regardless storages time or treatment. Stored samples for 6 months and 1 year decreased the µTBS for the control group, but no difference was found between storages time for the CHX group. As a conclusion, the 2% CHX application after etching showed improved dentin bond strength in the storage time, regardless of the substrates evaluated.

This in vitro study evaluated the impact of TiO2 nanotubes (n-TiO2) incorporated into glass ionomer cement (GIC) on Streptococcus mutans (S. mutans) characteristics at cellular and molecular levels. n-TiO2, synthesized by the alkaline method (20 nm in size), was added to Ketac Molar EasyMix® at 0%, 3%, 5%, and 7% by weight. S. mutans strains were cultured on GIC disks with addition or not of n-TiO2 for 1, 3, and 7 days and the following parameters were assessed: inhibition halo (mm) (n=3/group); cell viability (live/dead) (n=5/group); cell morphology (SEM) (n=3/group); and gene expression by real-time PCR (vicR, covR, gtfB, gtfC, and gtfD) (n=6/group). The data were analyzed by the Kruskal-Wallis test, repeated-measures ANOVA or two-way ANOVA, and Tukey's and Dunn's post-hoc tests (α=0.05). The agar diffusion test showed a higher antibacterial property for 5% n-TiO2 compared with 3% and 7% (p<0.05) with no effect of time (1, 3, and 7 days). The cell number was significantly affected by all n-TiO2 groups, while viability was mostly affected by 3% and 5% n-TiO2, which also affected cell morphology and organization. Real-time PCR demonstrated that n-TiO2 reduced the expression of covR when compared with GIC with no n-TiO2 (p<0.05), with no effect of time, except for 3% n-TiO2 on vicR expression. Within-group and between-group analyses revealed n-TiO2 did not affect mRNA levels of gtfB, gtfC, and gtfD (p>0.05). Incorporation of n-TiO2 at 3% and 5% potentially affected S. mutans viability and the expression of key genes for bacterial survival and growth, improving the anticariogenic properties of GIC.

This study evaluated the fluoride (F) release and remineralizing potential of varnishes containing sodium fluoride (5% NaF), 5% NaF with CPP-ACP and 5% NaF with TCP in early caries lesions in primary teeth. To determine the F release at 1, 4, 6, 24, 72, and 168 hr, strips were covered with the varnishes and immersed in purified water (n = 7). The varnishes and purified water (negative control) were applied on enamel blocks with early caries lesions (n = 16). Enamel blocks were stored in artificial saliva and submitted to a pH-cycling. The area of enamel hardness loss (ΔS) was analyzed by microhardness, lesion depth by polarized light microscopy (PLM) and the chemical analysis by Energy-dispersive X-ray spectroscopy. Data were submitted to Shapiro-Wilk, two-way and one-way ANOVA, Tukey and paired t-tests (α = 5%). All varnishes released F, but 5% NaF with CPP-ACP had the highest release at 4, 6, 24, and 72 hr (p < .05) followed by 5% NaF with TCP and 5% NaF. No significant difference in ΔS was observed among varnishes (5% NaF = 4,098.4 ± 1,407.9; 5% NaF with CPP-ACP = 4,164.0 ± 1,019.3; 5% NaF with TCP = 4,183.2 ± 1,527.2; p = .999), but all of them differed from the negative control group (6,757.8 ± 2,274.7; p < .001). Lesion depth was lower in varnishes groups compared to negative control (% reduction: 5% NaF = 41.8%, 5% NaF with CPP-ACP = 38.8%, and 5% NaF with TCP = 36.3%; p < .001). Similar Ca, P, and Ca/P ratio percentages among groups and F was not detected after the treatments. All fluoride varnishes showed potential to enhance remineralization of early caries lesions in primary teeth., (© 2020 Wiley Periodicals LLC.)

Objectives: To determine the impact of treating caries-affected dentin (CAD) with: 0.2% sodium fluoride (NaF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP/MI Paste™) or peptide P 11 -4 (Curodont™ Repair) on the longevity of resin/CAD interface at storage times of 24 -h, 6- and 18-month., Methods: 255 caries-free third molars were used, and CAD was produced by a biological method. The teeth were randomly distributed into: G1- Sound dentin (SD); G2- CAD; G3- CAD + 0.2% NaF (CAD/NaF); G4- CAD + CPP-ACP (CAD/ACP); G5- CAD + Curodont™ Repair (CAD/P 11 -4). The Filtek Z350 composite resin block was bonded to dentin using Adper™ Single 2 (4 mm/height). Resin/dentin blocks were stored in a solution of Simulated Body Fluid at 37 °C, pressures were modified to simulate natural pulpal pressures. Specimens were investigated by microtensile bond strength (μTBS) (n = 8), Scanning Electron Microscopy (to assess the failure mode) (n = 8), nanoinfiltration (to assess the interface sealing) (n = 3), in situ zymography (to assess the gelatinolytic activity) (n = 3) and micro-computed microtomography (μ-CT) (to assess the mineralization) (n = 3). Data from μTBS, μ-CT and, nanoinfiltration and hybrid layer formation/degradation were submitted to two-way ANOVA and Tukey tests, and failure patterns and in situ zymography to Kruskal-Wallis and Dunn tests (α = 5%)., Results: The highest mineral density change by μ-CT, smallest silver nitrate infiltration and proteolytic activity in the adhesive layer were obtained significantly for the groups SD, CAD/ACP and CAD/P 11 -4, with most mixed fractures at 18-month (p < 0.001). CAD/NaF showed significantly similar values to CAD, CAD and CAD/NaF which presented a high percentage of adhesive fracture (p < 0.001) at all time periods., Significance: Treating caries-affected dentin with remineralizing agents CPP-ACP and Curodont™ Repair, has the potential to be a clinically relevant treatment protocol to increase the longevity of adhesive restorations., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this paper is to present the results of a consensus meeting on the threshold property requirements for the clinical use of conventional glass-ionomer cements (GICs) for restorative indications., Methods: Twenty-one experts on GICs evaluated the results of tests on mechanical and optical properties of 18 different brands of restorative GICs: Bioglass R [B], Chemfil Rock [CR], Equia Forte [EF], Gold Label 2 [GL2], Gold Label 9 [GL9], Glass Ionomer Cement II [GI], Ionglass [IG], Ion Z [IZ], Ionomaster [IM], Ionofil Plus [IP], Ionostar Plus [IS], Ketac Molar Easymix [KM], Magic Glass [MG], Maxxion R [MA], Riva Self Cure [R], Vidrion R [V], Vitro Fil [VF] and Vitro Molar [VM]. All experiments were carried out by a team of researchers from Brazil and England following strict protocols, under the same laboratory conditions throughout, and maintaining data integrity., Results: There was consensus on: determining as primary properties of the material: compressive strength, microhardness, acid erosion and fluoride release, and as secondary properties: contrast ratio and translucency parameter, in order to rank the materials. Seven brands were below the thresholds for restorative indications: IZ, IM, IG, MA, VF, B and MG., Conclusions: Based on the primary properties adopted as being essential for restorative indications, the conventional restorative GICs that met the thresholds and could be considered suitable as long-term restorative materials were: EF, GI, GL9, KM, IP, GL2, IS, CR, V, VM and R. A decision-making process to select the best GIC must also include results from clinical trials., Clinical Significance: This study provides a ranking of GICs that could be considered suitable as long-term restorative materials based on their main properties., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background and Objectives: Dental cementum (DC) is a mineralized tissue covering tooth roots that plays a critical role in dental attachment. Differences in deciduous vs. permanent tooth DC have not been explored. We hypothesized that proteomic analysis of DC matrix would identify compositional differences in deciduous (DecDC) vs. permanent (PermDC) cementum that might reflect physiological or pathological differences, such as root resorption that is physiological in deciduous teeth but can be pathological in the permanent dentition., Methods: Protein extracts from deciduous (n = 25) and permanent (n = 12) teeth were pooled (five pools of DecDC, five teeth each; four pools of PermDC, three teeth each). Samples were denatured, and proteins were extracted, reduced, alkylated, digested, and analyzed by liquid chromatography-mass spectrometry (LC-MS/MS). The beta-binomial statistical test was applied to normalized spectrum counts with 5% significance level to determine differentially expressed proteins. Immunohistochemistry was used to validate selected proteins., Results: A total of 510 proteins were identified: 123 (24.1%) exclusive to DecDC; 128 (25.1%) exclusive to PermDC; 259 (50.8%) commonly expressed in both DecDC and PermDC. Out of 60 differentially expressed proteins, 17 (28.3%) were detected in DecDC, including myeloperoxidase (MPO), whereas 43 (71.7%) were detected in PermDC, including decorin (DCN) and osteocalcin (BGLAP). Overall, Gene Ontology (GO) analysis indicated that all expressed proteins were related to GO biological processes that included localization and response to stress, and the GO molecular function of differentially expressed proteins was enriched in cell adhesion, molecular binding, cytoskeletal protein binding, structural molecular activity, and macromolecular complex binding. Immunohistochemistry confirmed the trends for selected differentially expressed proteins in human teeth., Conclusions: Clear differences were found between the proteomes of DecDC and PermDC. These findings may lead to new insights into developmental differences between DecDC and PermDC, as well as to a better understanding of physiological/pathological events such as root resorption., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: This study aimed to evaluate (1) the effect of irrigating solutions and intracanal medicaments on the release of transforming growth factor beta 1 (TGF-β1) and vascular endothelial growth factor (VEGF) from cervical root dentin and (2) the effect of associating triple antibiotic paste (TAP) and calcium hydroxide paste (CH) with 2% chlorhexidine (CHX) on TGF-β1 release., Methods: First, 119 specimens from roots (cervical thirds) were obtained and were distributed into 5 groups: 2% CHX, 2.5% sodium hypochlorite, TAP, CH, and 10% EDTA by each growth factor (TGF-β1 [n = 8] and VEGF [n = 8]). Then, specimens were distributed as follows (n = 13): TAP + 2% CHX, CH + 2% CHX, and 10% EDTA and treated with irrigating solutions and intracanal medicaments. After the treatments, the specimens were immersed in 10% EDTA (20 minutes), and the solution was analyzed using the enzyme-linked immunosorbent assay. The data were submitted to normality, homogeneity of variance, and Mann-Whitney tests (P < .05)., Results: Significant differences were found between the irrigating solutions (P < .05) and intracanal medicaments for TGF-β1 (P < .05). No VEGF release was detected for any group. Our results showed no significant differences among the TAP + 2% CHX and EDTA groups for TGF-β1 but a significant difference between CH + 2% CHX and the other groups (P < .05)., Conclusions: The use of 2% CHX as the irrigating solution, CH as the intracanal medicament, and 10% EDTA as the final irrigation provides higher TGF-β1 release from the cervical root dentin, whereas VEGF was not detected. Moreover, TAP and 2% CHX with 10% EDTA as the final irrigation resulted in greater TGF-β1 release from cervical root dentin than CH + 2% CHX., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the effect of glass-ionomer cement (GIC) on gene expression (gtfC, gtfD, covR, and vicR) of Streptococcus mutans (S. mutans) biofilms at 2, 4 and 24 hours., Methods: Six groups were tested according to the materials and time observation, as follows: ceramic (IPS Empress Esthetic), as the control group, and GIC (Ketac Molar Easymix); and time points of S. mutans biofilm formation (2, 4, and 24 hours). Round-shaped samples (10 x 2 mm) of each material were prepared according to the manufacturers' specifications. GIC discs were handled in a laminar flow hood under aseptic conditions and stored at 100% relative humidity at 37°C for 24 hours to complete setting reaction. The samples were placed in a 24-well plate and immersed in 1.5 ml BHI + 1% sucrose with an inoculum of S. mutans UA159 to allow biofilm growth during 2, 4, and 24 hours. Next, the samples were removed, vortexed and centrifuged to collect cell pellets (n=5) for each material and time point. Pellets were stored at -80°C. Then, RNA was purified using the RNeasy Mini Kit protocol. The RNA was converted in cDNA using iScript cDNA Synthesis according to the manufacturer's recommendations. Analysis of gtfC, gtfD, vicR, and covR expressions was performed using Step One Real-Time qPCR device with specific primers for each gene and the analysis normalized by 16S reference gene expression. Data from gtfC, gtfD, and vicR were analyzed by t-test to compare between groups while Mann-Whitney was used to analyze covR expression (α= 0.05)., Results: No significant differences at 2 and 4 hours between materials for all analyzed genes were noted. However, in the 24-hour period, a significant decrease in gtfC and vicR expressions were observed, while covR expression increased when GIC was compared to ceramic., Clinical Significance: The use of glass-ionomer cement decreased the virulence of S. mutans biofilms, which may imply a reduced bacterial cariogenic potential., Competing Interests: The authors declared no conflict of interest. The Coordination of Superior Level Staff Improvement (AUX/PROEX/CAPES 0878/2018) financially supported this project., (Copyright©American Journal of Dentistry.)

The aim of this study was to evaluate the Streptococcus mutans biofilm influence on the roughness (Ra), gloss (GU), surface hardness (KHN) and flexural strength (FS) of high viscosity bulk fill composites. Filtek Bulk Fill (FBF), Tetric N Ceram Bulk Fill (TNC), X-tra fil Bulk Fill (XF) and Filtek Z350 (FZ) were used. Ten discs of each composite were prepared for Ra, KHN and GU and 20 bars for the FS. After 24 h, specimens were polished and initial analyzes performed. Samples were sterilized and subjected to biodegradation for 7 days and final analyzes performed. Representative samples of each group were evaluated in Scanning Electron Microscope. Data were submitted to ANOVA two factors and Tukey test. XF presented the highest values (p<0.05) of Ra before and after biodegradation (0.1251; 0.3100), and FZ (0.1443) the lowest after biodegradation (p<0.05). The highest GU values (p<0.05) were observed for FZ (71.7; 62) and FBF (69.0; 64.6), and the lowest (p<0.05) for TNC (61.4; 53.3) and XF (58.5; 53.5), both before and after biodegradation. For KHN the highest values were obtained by XF (151.7; 106), and the (p< 0.05) lowest values for TNC (62.2; 51.8), both before and after biodegradation. The highest values (p<0.05) of FS were observed for FZ (127.6) and the lowest (p<0.05) for TNC (86.9); after biodegradation, XF (117.7) presented the highest (p<0.05) values compared to TNC and FZ." In conclusion, biodegradation increased Ra and decreased GU and KHN for all. Concerning FS, degradation provided a significant decreased value only for FZ.

Purpose: To evaluate the association of dental caries with behavioural, socioeconomic and cultural factors; and Streptococcus mutans (SM) levels in the saliva and oral hygiene index of children aged 4 and 6 years old placed in an oral health programme., Materials and Methods: This study was an analytic cross-sectional oral health survey conducted over a 9-month period. A total of 466 children aged 4 and 6 years old were included for evaluation of SM levels in saliva, simplified oral hygiene index and dental caries activity., Results: High SM levels were associated with dmft index, toothbrushing without parental assistance, deficient oral hygiene and ingestion of sweet foods. Deficient oral hygiene was found in children aged 4 years old and with three or more siblings. Dental caries was associated with low family income, deficient oral hygiene, sucrose ingestion by children younger than three years old, bottle-feeding habit and low parental compliance., Conclusions: High SM levels in saliva, deficient oral hygiene and high frequency of sucrose ingestion had association with dental caries in children. Cultural, socioeconomic and behaviour factors indirectly influenced the onset of dental caries.

This study evaluates the effects of resin infiltrant composition and caries histological zone on the hydrolytic degradation of resininfiltrated artificial bovine enamel caries (RI-AEC). Different resin infiltrants were tested (n=26 per group): Icon (G1); TEGDMA 60%, UDMA 20%, and HEMA 20% (TUH); TEGDMA 80% and HEMA 20% (TH); and TEGDMA 75% and Bis-EMA 25% (TB). Following caries infiltration, samples were cut perpendicularly, and transverse microhardness were analyzed (at two histological zones: surface layer and lesion body) before and after 21 days of water immersion. TB presented lower decrease in microhardness (due to hydrolytic degradation) than the other groups, with a large effect size (Hedge's G from 0.83 to 1.19) and high power (84 to 99%). Neither histological zone nor its interaction with resin infiltrant composition significantly affected the outcome. In conclusion, resin composition affected microhardness of RI-AEC upon water immersion, and TB was the least affected.

Objective: Dentin remineralization is of considerable clinical interest for dentin hypersensitivity and developing biomimetic analogs that can regulate hydroxyapatite (HAp) nucleation and growth remains a challenge. This study aimed to evaluate in vitro the potential for dentin remineralization using the following biomimetic in situ prepared poly(catechols): poly(dopamine), poly(DOPA), poly(caffeic acid) and a synthesized DOPA-peptide possessing collagen and calcium-binding domains (DOPA-Ahx-(Gly) 3 -(Glu) 5 )., Methods: Dentin samples were immersed in a freshly prepared phosphate-buffered saline (PBS) containing the respective catechol and laccase. After the reaction, they were immersed in calcium and phosphate remineralization solution, which was changed every day for 10 days. Samples of intact and demineralized dentin were used as control groups and kept in deionized water under the same experimental conditions. The remineralized dentin was characterized by scanning electron microscopy (SEM), Micro-energy dispersion X-ray fluorescence spectroscopy (μEDX) and X-ray diffraction (XRD)., Results: The application of different poly(catechols) and DOPA-peptide promoted crystal nucleation and the formation of HAp, which partially covered both the dentin surface and dentinal tubules walls., Significance: By mimicking the role of charged non-collagenous proteins in vivo, polymers consisting of catechol groups showed the ability to modify demineralized dentin surface properties, promoting mineral formation. The use of poly(catechols) may be encouraged for the development of a therapeutic technique for dentin hypersensitivity., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to determine the physico-mechanical properties of a high viscosity glass ionomer cement (GIC) reinforced with TiO 2 nanotubes (TiO 2 -nt)., Methods: TiO 2 -nt was incorporated into the GIC powder components (Ketac Molar EasyMix™) in concentrations of 0% (control group), 3%, 5%, 7% by weight. Compressive strength (n = 10/group), three point bending for flexural strength (n = 18/group), microshear bond strength to dentin and failure mode (n = 20/group), and surface roughness and weight loss before and after brushing simulation (30,000 cycles) (n = 8/group) were evaluated. Data were submitted to Shapiro-Wilk, ANOVA, Tukey and Chi-square tests (α ≤ 0.05)., Results: Addition of 5% of TiO 2 -nt into GIC presented the highest values for compressive strength and differed from the control, 3% and 7% groups (p = 0.023). There were no significant differences in flexural strength (p = 0.107) and surface roughness before and after the dental brushing (p = 0.287) among the groups. GIC added with 5% TiO 2 -nt showed the lowest weight loss values (p = 0.01), whereas the control, 3% or 5% TiO 2 -nt groups presented similar microshear bond strength values (p ≥ 0.05). The 5% TiO 2 -nt group featured higher microshear bond strength than the 7% TiO 2 -nt group (p = 0.034). Cohesive in material was the most representative failure mode for all groups., Significance: The incorporation of TiO 2 -nt did not affect GIC's adhesiveness to dentin, but improved its compressive strength at 5%. Furthermore, TiO 2 -nt decreased the percentage of weight loss after GIC's surface wear., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

The tooth has a unique configuration with respect to biomaterials that are used for its treatment. Cells inside of the dental pulp interface indirectly with biomaterials via a calcified permeable membrane, formed by the dentin matrix and several thousands of dentinal tubules (∼2 μm in diameter). Although the cytotoxic response of the dental pulp to biomaterials has been extensively studied, there is a shortage of in vitro model systems that mimic the dentin-pulp interface and enable an improved understanding of the morphologic, metabolic and functional influence of biomaterials on live dental pulp cells. To address this shortage, here we developed an organ-on-a-chip model system which integrates cells cultured directly on a dentin wall within a microfluidic device that replicates some of the architecture and dynamics of the dentin-pulp interface. The tooth-on-a-chip is made out of molded polydimethylsiloxane (PDMS) with a design consisting of two chambers separated by a dentin fragment. To characterize pulp cell responses to dental materials on-chip, stem cells from the apical papilla (SCAPs) were cultured in odontogenic medium and seeded onto the dentin surface, and observed using live-cell microscopy. Next, to evaluate the tooth-on-a-chip as a platform for materials testing, standard dental materials used clinically (2-hydroxyethylmethacrylate - HEMA, phosphoric acid - PA, and Adper-Scotchbond - SB) were tested for cytotoxicity, cell morphology, and metabolic activity on-chip, and compared against standardized off-chip controls. All dental materials had cytotoxic effects in both on-chip and off-chip systems in the following order: HEMA > SB > PA (p < 0.05), and cells presented consistently higher metabolic activity on-chip than off-chip (p < 0.05). Furthermore, the tooth-on-a-chip enabled real-time tracking of gelatinolytic activity in a model hybrid layer (HL) formed in the microdevice, which suggests that dental pulp cells may contribute to the proteolytic activity in the HL more than endogenous proteases. In conclusion, the tooth-on-a-chip is a novel platform that replicates near-physiologic conditions of the pulp-dentin interface and enables live-cell imaging to study dental pulp cell response to biomaterials.