Efeito de agentes remineralizantes sobre a microdureza, cor e desgaste do esmalte dental clareado
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Data
2017-02-06
Autores
Crastechini, Érica [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo deste estudo foi avaliar o efeito da aplicação de agentes remineralizantes contendo silicato de cálcio / fosfato e flúor ou fluoreto de sódio somente, sobre a redução da microdureza do esmalte causada pelo clareamento dental, cor dos dentes e perda de estrutura resultante da abrasão. Duzentos e quarenta amostras circulares de esmalte bovino foram preparadas, embutidas e polidas. Em seguida foram realizados testes iniciais de cor, microdureza e perfilometria. As amostras foram distribuídas aleatoriamente em 6 grupos (n=40): Grupo C –(controle negativo) – nenhum tratamento; Grupo CL (controle positivo)- Aplicação do agente clareador a base de peróxido de hidrogênio a 40% (Opalescence boost, Ultradent); Grupo CL/Rs – Aplicação do agente clareador seguido da aplicação do gel remineralizante a base de silicato de cálcio/fosfato (Regenerate Boosting serum- Unilever); Grupo Rs/CL - Aplicação do gel de silicato de cálcio/fosfato seguido da aplicação do agente clareador; Grupo Rs/CL/Rs - Aplicação do gel de silicato de cálcio/fosfato seguida da aplicação do agente clareador e aplicação novamente do gel de silicato de cálcio/fosfato; Grupo CL/F – Aplicação do agente clareador seguida da aplicação do gel de fluoreto de sódio a 2%. Após a etapa de clareamento (3 aplicações de 20 min) foram novamente realizadas as leituras de cor e microdureza. Em seguida os espécimes foram submetidos a 100.000 ciclos abrasivos em máquina de escovação. Cada grupo foi dividido em dois subgrupos de acordo com o dentifrício utilizado (n=20): Subgrupo Cp –creme dental Close Up proteção bioativa (Unilever); Subgrupo Rp- creme dental Regenerate (Unilever). Os perfis finais das superfícies do esmalte foram avaliados e o desgaste calculado. Os dados foram analisados utilizando o teste de análise de variância ANOVA e Tukey. Diferenças significativas foram observadas para a variação de cor (∆E) (p = 0,000). Os resultados do teste Tukey foram: C (1,31±0,58)a , Rs/CL/Rs (3,72±1,28)b, CL (3,75±1,04)b , CL/Rs (3,87±0,91)b, Rs/CL (3,88±0,94)b, CL/F (4,03±1,22)b. Diferenças estatisticamente significantes foram observadas para a microdureza (Knoop) após os tratamentos (p= 0,00001). Os resultados do teste Tukey foram: CL (246,28±30.46)a, Rs/CL/Rs (263,55±18,66)b, CL/Rs (264,06±28,54)b, Rs/CL (265,22±23,58)b, CL/F (269,10±25,66)b C (323,28±10,96)c. Para o desgaste dental (µm) o teste ANOVA a dois fatores mostrou diferenças significativas entre os grupos e os dentifrícios. Os resultados do teste de Tukey para os grupos foram: CL/F (2,12±0,70)a, Rs/CL (2,13±0,85)a, Rs/CL/Rs (2,19±0,70)a, CL/Rs (2,23±0,91)a, C (2,85±0,98)b , CL (3,36±0,84)c. Os resultados do teste de Tukey para os dentifrícios foram: Rp (2,04±0,80)a, Cp (2,92±0.88)b. Concluiu-se que todos os tratamentos com géis remineralizantes testados minimizaram a redução da microdureza promovida pelo clareamento, embora não evitaram que ela acontecesse. Além disso, a aplicação desses não interferiu na mudança da cor promovida pelo clareamento dental. O clareamento sozinho aumentou o desgaste abrasivo dos dentes, porém todos os tratamentos da superfície com géis remineralizantes testados reduziram a perda de estrutura por abrasão. O dentifrício Regenerate resultou em menor desgaste abrasivo do esmalte em relação ao Close UP. Não existiram diferenças significativas entre os diferentes tratamentos remineralizantes com relação aos efeitos sobre a microdureza, cor e desgaste.
This study aimed to evaluate the effect of the application of remineralizing agents containing calcium/phosphate silicate and fluoride or only sodium fluoride on the reduction of enamel microhardness caused by tooth bleaching, tooth color and loss of structure resulting from abrasion. Two hundred and forty circular bovine enamel samples were prepared, embedded and polished. After that, initial tests of color, microhardness and profile were performed. Samples were randomized into six groups (n=40): Group C - (negative control) - no treatment; Group CL (positive control) – application of 40% hydrogen peroxide bleaching agent (Opalescence boost, Ultradent); Group CL/Rs - Application of bleaching agent followed by remineralizing gel based on calcium/phosphate silicate (Regenerate Boosting serum- Unilever); Group Rs/CL – Application of calcium/phosphate silicate gel followed by bleaching agent; Group Rs/CL/Rs – Application of calcium/phosphate silicate gel followed by bleaching agent and new application of calcium/phosphate silicate gel; Group CL/F – Application of bleaching agent followed by 2% sodium fluoride gel. After bleaching stage (3 applications/20 min), color and microhardness readings were performed. Then, the specimens were subjected to 100.000 abrasive cycles in a brushing machine. Each group was divided into two subgroups according to the dentifrice used (n=20): Subgroup Cp –Close Up bioactive protection toothpaste (Unilever); Subgroup Rp- Regenerate toothpaste (Unilever). Final profiles of enamel surface were evaluated and the wear was calculated. Data were analyzed using ANOVA and Tukey variance analysis. Significant differences were observed for color variation (∆E) (p=0.000). Tukey test results were: C (1.31±0.58)a, Rs/CL/Rs (3.72±1.28)b, CL (3.75±1.04)b, CL/Rs (3.87±0.91)b, Rs/CL (3.88±0.94)b, CL/F (4.03±1.22)b. Statistically significant differences were observed for microhardness (Knoop) after treatments (p=0.00001). Tukey test results were: CL (246.28±30.46)a, Rs/CL/Rs (263.55±18.66)b, CL/Rs (264.06±28.54)b, Rs/CL (265.22±23.58)b, CL/F (269.10±25.66)b, C (323.28±10.96)c. For dental wear (µm), two-factor ANOVA test showed significant differences among groups and dentifrices. Tukey test results were were: CL/F (2.12±0.70)a, Rs/CL (2.13±0.85)a, Rs/CL/Rs (2.19±0.70)a, CL/Rs (2.23±0.91)a, C (2.85±0.98)b, CL (3.36±0.84)c. Tukey test results for the dentifrices were: Rp (2.04±0.80)a, Cp (2.92±0.88)b. It was concluded that all treatments with the remineralizing gels minimized the reduction of microhardness promoted by bleaching, although they did not prevent it from happening; In addiction, their application did not interfere in the color change promoted by dental bleaching. Bleaching alone increased the abrasive wear of the teeth. However, all surface treatments, with the remineralizing gels, reduced abrasion structure. Regenerate toothpaste resulted in less abrasive enamel wear regarding Close up toothpaste. There were no significant differences among the different remineralizing treatments with regarding their effects on microhardness, color and wear.
This study aimed to evaluate the effect of the application of remineralizing agents containing calcium/phosphate silicate and fluoride or only sodium fluoride on the reduction of enamel microhardness caused by tooth bleaching, tooth color and loss of structure resulting from abrasion. Two hundred and forty circular bovine enamel samples were prepared, embedded and polished. After that, initial tests of color, microhardness and profile were performed. Samples were randomized into six groups (n=40): Group C - (negative control) - no treatment; Group CL (positive control) – application of 40% hydrogen peroxide bleaching agent (Opalescence boost, Ultradent); Group CL/Rs - Application of bleaching agent followed by remineralizing gel based on calcium/phosphate silicate (Regenerate Boosting serum- Unilever); Group Rs/CL – Application of calcium/phosphate silicate gel followed by bleaching agent; Group Rs/CL/Rs – Application of calcium/phosphate silicate gel followed by bleaching agent and new application of calcium/phosphate silicate gel; Group CL/F – Application of bleaching agent followed by 2% sodium fluoride gel. After bleaching stage (3 applications/20 min), color and microhardness readings were performed. Then, the specimens were subjected to 100.000 abrasive cycles in a brushing machine. Each group was divided into two subgroups according to the dentifrice used (n=20): Subgroup Cp –Close Up bioactive protection toothpaste (Unilever); Subgroup Rp- Regenerate toothpaste (Unilever). Final profiles of enamel surface were evaluated and the wear was calculated. Data were analyzed using ANOVA and Tukey variance analysis. Significant differences were observed for color variation (∆E) (p=0.000). Tukey test results were: C (1.31±0.58)a, Rs/CL/Rs (3.72±1.28)b, CL (3.75±1.04)b, CL/Rs (3.87±0.91)b, Rs/CL (3.88±0.94)b, CL/F (4.03±1.22)b. Statistically significant differences were observed for microhardness (Knoop) after treatments (p=0.00001). Tukey test results were: CL (246.28±30.46)a, Rs/CL/Rs (263.55±18.66)b, CL/Rs (264.06±28.54)b, Rs/CL (265.22±23.58)b, CL/F (269.10±25.66)b, C (323.28±10.96)c. For dental wear (µm), two-factor ANOVA test showed significant differences among groups and dentifrices. Tukey test results were were: CL/F (2.12±0.70)a, Rs/CL (2.13±0.85)a, Rs/CL/Rs (2.19±0.70)a, CL/Rs (2.23±0.91)a, C (2.85±0.98)b, CL (3.36±0.84)c. Tukey test results for the dentifrices were: Rp (2.04±0.80)a, Cp (2.92±0.88)b. It was concluded that all treatments with the remineralizing gels minimized the reduction of microhardness promoted by bleaching, although they did not prevent it from happening; In addiction, their application did not interfere in the color change promoted by dental bleaching. Bleaching alone increased the abrasive wear of the teeth. However, all surface treatments, with the remineralizing gels, reduced abrasion structure. Regenerate toothpaste resulted in less abrasive enamel wear regarding Close up toothpaste. There were no significant differences among the different remineralizing treatments with regarding their effects on microhardness, color and wear.
Descrição
Palavras-chave
Clareamento dental, Cor, Remineralização dentária, Dureza, Flúor, Dentifrício, Abrasão dentária, Dental bleaching, Color, Tooth remineralization, Hardness, Fluoride, Dentifrice, Dental abrasion