Abstract
The aim of this study was to evaluate different conditioning protocols and sonic/ultrasonic application of an infiltrant resin (IR) in artificial white spot lesions (AWSL). the V/L surfaces of 48 molars were induced to an AWSL and divided in 6 groups, according to the conditioning protocols and application technique: 15% hydrochloric acid (HA) + manual application of the IR; HA + 37% phosphoric acid (PA) + manual application of the IR; HA + ultrasonic application (U) of the IR; HA + sonic application (S) of the IR; PA+HA+S; and PA+HA+U. For the Penetration Depth (PD), the crowns were etched with HA for 120s. The IR Icon® (DMG) was applied according to the manufacturer`s instructions. The crowns were dye penetrated (0.1% red fluorophore rhodamine B isothiocyanate for 12h) and bleached with 30% hydrogen peroxide for 12 h. The discs were immersed in a 50% ethanol solution, containing 100 µM of sodium fluorescein. The PD (in µm) was measured using confocal laser scanning microscopy (20x). The bond strength (BS) was performed by michoshear test (0.5 mm/min). Data were submitted to 2-way ANOVA and Tukey (α=0.05). For BS, the interaction was not significant (p>0.05). For PD, the main factors were significant (application - p<0.001; conditioning technique - p=0.003). The ultrasonic application showed the highest PD values. PA+HA presented higher results than HA. The sonic/ultrasonic applications and the use of phosphoric acid prior to hydrochloric acid improved PD of the infiltrant resin. Conditioning protocols or application techniques did not influence BS values.
Highlights
One of the challenges of the esthetic restorative dentistry is to provide non-invasive treatment alternatives for the surface enamel lesions and the White Stain lesions, diagnosed according to the ICDAS classification system (International System for the Detection and Diagnosis of Cavities) as 2 N [1]
Two-way analysis of variance detected that the cross-product interaction, as the main factors, were not significant (p >0.05)
The recent investigations are focused on new protocols to facilitate the infiltrant resin impregnation into the demineralized enamel, in faster periods, to facilitate the inhibition of the lesion progression rapidly
Summary
One of the challenges of the esthetic restorative dentistry is to provide non-invasive treatment alternatives for the surface enamel lesions and the White Stain lesions, diagnosed according to the ICDAS classification system (International System for the Detection and Diagnosis of Cavities) as 2 N [1]. The white stains are signs of a demineralization process that could evolve into a dentin cavity lesion. These stains occur when the pathogenic bacteria penetrate the base of the enamel and produce organic acids, eliminating calcium and phosphate ions from the enamel, which may be remineralized or not [2]. A less invasive alternative, with promising in vivo results [4], is the infiltration of low-molecular weight resin that penetrates the demineralized tissue, without the necessity to create a cavity, with previous use of 15% hydrochloric acid gel (HCl), which creates smooth porosity allowing the resin infiltration. With a low-viscosity photoactivated resin (Icon®, DMG) was studied. Subramaniam et al [6] evaluated the fabricants protocol with excellent clinical results; Shivanna, Shivakumar [7] concluded that a modification in the treatment time may be necessary to achieve acceptable results
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