Dpto. Odontología

The contemporary approach for operative caries management emphasizes personalized interventions for each patient, dependent upon the individual’s caries susceptibility/risk, the stage of the carious lesion and its activity. The clinician’s challenge is to optimize the extent of cavity preparation and the choice of dental restorative biomaterials, appreciating the benefits offered by ionreleasing restorative materials. There is a growing application of bioactive/bio-interactive materials in minimally invasive operative dentistry, as they may help with tissue recovery by ion release. In case of moderate or extensive occlusal cavitation, the clinical criteria include the individual caries susceptibility and carious lesion activity. In high caries risk cases, ion-releasing biomaterials (IRB) can be used, as well as for active carious lesions. In proximal lesions, the clinical criteria include the individual caries susceptibility, the lesion activity and presence of cavities with little or no enamel at the gingival margin. This article aims to discuss the restorative ion-releasing options, according to different clinical situations, and the caries susceptibility to manage cavitated carious lesions in permanent adult teeth.

Minimally invasive (MI) concepts in restorative dentistry in the year 2020 request from the practitioner, not only a scientifically supported rational for carious tissue removal/excavation and defect-oriented, biological cavity preparation, but also a deep understanding of how to ensure a biomechanically stable and durable restoration in different clinical situations by applying different restorative options. Bio-reactive materials play an increasingly relevant role, as they not only replace diseased or lost tissue but also optimise tissue mineral recovery (among other properties) when used in restorative and preventive dentistry. Indeed, this is of certain interest in MI restorative dentistry, especially in those cases where gap formation jeopardises the integrity of the margins along resin composite restorations, causing penetration of bacteria and eventually promoting the formation of secondary caries. Recently, the interest on whether ion-releasing materials may reduce such biofilm penetration into margin gaps and reduce such a risk for development and propagation of secondary caries is growing significantly among clinicians and scientists. The aim of this article was to explore mechanisms involved in the process that allow mineral deposition at the interface between such materials and dentine and describe how conventional “bioactive” restorative materials currently available on the market may beneficial treatments in MI Dentistry.

The aim of this study was to evaluate the infuence of boron-nitride nanotubes (BNNTs) on the properties of resin-based light-curing dental sealants (RBSs) when incorporated at diferent concentration. RBSs were formulated using methacrylate monomers (90 wt.% TEGDMA, 10 wt.% BisGMA). BNNTs were added to the resin blend at 0.1 wt.% and 0.2 wt.%. A Control group without fller was also designed. Degree of conversion, ultimate tensile strength, contact angle, surface free energy, surface roughness and color of the RBSs were evaluated for the tested materials. Their cytotoxicity and mineral deposition ability (Bioactivity) were also assessed. A suitable degree of conversion, no efect in mechanical properties and no cytotoxic efect was observed for the experimental materials. Moreover, the surface free energy and the surface roughness decreased with the addition of BNNTs. While the color analysis showed no diference between specimens containing BNNTs and the control group. Mineral deposition occurred in all specimens containing BNNTs after 7d. In conclusion, the incorporation of BNNTs may provide bioactivity to resin-based dental sealants and reduce their surface free energy.

INTRODUCTION AND AIMS: This study investigates the effects of the application of antimicrobial phototherapy on black-stained tooth surfaces. Key variables were area, color and time taken to reappearance of black stain following dental prophylaxis with and without antimicrobial phototherapy. Differences in bacterial composition of black stain (specifically Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Porphyromonas gingivalis) were analyzed. MATERIAL AND METHODS: The phototherapy device used was GLO™ Science LLC, New York, America, emitting light at 475 nm and a power of 3W. Light was applied in 2 cycles of 8 min on 31 volunteers. Microbial identification was carried out on DNA extracted from black plaque. This study is registered with ClinicalTrials.gov, number NCT03309748. RESULTS: Following antimicrobial phototherapy, 64.5% of patients displayed reduced pigmentation area. Plaque color was lighter in 48.4% of subjects. Pigmentation area and depth of color returned to normal levels during the course of the study. Colonization by the three bacterial species decreased, although the changes were not statistically significant. We report a key novel finding showing elevated levels of colonization by Tannerella forsythia (83.9%) in adult black stain. CONCLUSIONS: Application of phototherapy results in a reduction in area, color and bacterial colonization of black plaque in adults. The changes were not found to be statistically significant, perhaps owing to the low illumination power of the homewhitening device. For the first time, we document the elevated presence of Tannerella forsythia in adult black stain. We also demonstrate the potential application of a commercially available home-whitening device for black plaque treatment.