Color and translucency stability of CAD/CAM restorative materials

Aim: This study assessed the color and translucency stability of a polymer infiltrated ceramic network (PICN) and compared it with a resin composite (RC) and a feldspathic ceramic (FEL). Methods: Disc-shaped samples of a PICN (Vita Enamic), a feldspathic ceramic (Vitablocks Mark II), and a resin composite (Brava block) were prepared from CAD/CAM blocks. PICN and RC surfaces were finished with a sequence of polishing discs and diamond paste. FEL samples received a glaze layer. The samples were subjected to 30-min immersions in red wine twice a day for 30 days. CIEL*a*b* coordinates were assessed with a spectrophotometer at baseline and after 15 and 30 days of immersion. Color alteration (ΔE00) and translucency parameter (TP00) were calculated with CIEDE2000. Average roughness was measured before the staining procedures. Color difference and translucency data were analyzed with repeated-measures ANOVA and Tukey’s tests. Roughness was analyzed with the Kruskal-Wallis test. Results: Roughness was similar among the experimental groups. All materials had their color alteration significantly increased from 15 to 30 days of staining. PICN reached an intermediate ΔE00 between FEL and RC at 15 days. PICN revealed a color alteration as high as the composite after 30 days. No statistical difference was observed regarding translucency. Conclusion: PICN was not as color stable as the feldspathic ceramic at the end of the study. Its color alteration was comparable to the resin composite when exposed to red wine. However, the translucency of the tested materials was stable throughout the 30-day staining.

Comparative Transcriptome Analysis Revealed Two Alternative Splicing bHLHs Account for Flower Color Alteration in Chrysanthemum

‘Jimba’ is a white chrysanthemum cultivar, which occasionally and spontaneously produces red flower petals under natural cultivation due to cyanidin-based anthocyanin accumulation. To investigate the underlying mechanism of this process, a comparative transcriptome was analyzed between white and turning red ‘Jimba’. The structural and regulatory genes of anthocyanin pathway were significantly up-regulated in turning red ‘Jimba’. Among them, two alternative splicings, CmbHLH2 and CmbHLH2.1, showed the most significantly up-regulated in turning red tissue. Transiently over-expressed 35S::CmMYB6-CmbHLH2 strongly induced anthocyanin accumulation in ‘Jimba’ flower petals, while moderate amount of anthocyanin was detected when over-expressed 35S::CmMYB6-CmbHLH2.1. Both CmbHLH2 and CmbHLH2.1 could interact with CmMYB6 to activate CmDFR promoter according to Yeast two-hybrid and dual-luciferase assay. Moreover, CmMYB6-CmbHLH2 but not CmMYB6-CmbHLH2.1 could activate the CmbHLH2 promoter to provide positive feedback loop regulation. Taken together, it suggested that both CmbHLH2 and CmbHLH2.1 involved in regulation flower color alteration in turning red ‘Jimba’, and CmbHLH2 played a predominant role in this process.

The Correlations between Clinical Features, Dermoscopic and Histopathological Findings, and Treatment Outcomes of Patients with Pitted Keratolysis

Background. Pitted keratolysis (PK) is a superficial bacterial infection diagnosed mainly by clinical manifestations. Current data on its dermoscopic and histopathological findings, and the correlation of those findings, are limited. Objectives. To evaluate the clinical manifestations, dermoscopic, and histopathological findings of PK and to determine the correlations. Methods. Forty naval cadets with PK and five cadets with normal feet were enrolled this cohort study and provided informed consent. Dermoscopy was independently applied and evaluated by 2 dermatologists. Shave biopsies were performed on 37 patients with PK. Results. Pits were the most common dermoscopic finding (88.1%). The dermoscope had more sensitivity for the detection of PK than the naked eye examinations. Apart from the pits and the presence of bacteria, the most common histopathological finding for PK was color alteration of keratin. The presence of bacteria correlated with interrupted dermatoglyphic lines and the color alteration of keratin. Moreover, the presence of bacteria at the base of pits was related to worse treatment outcomes. Conclusions. Dermoscopy is a useful tool for PK diagnosis. Color alteration of keratin is another histopathological finding for PK. The presence of bacteria is associated with worse treatment outcomes.

A Numerical Method to Improve the Representativeness of Real Microstructure Cut-Outs Applied in Finite Element Simulations

To improve the representativeness of a real microstructural cut-out for modeling purposes, a numerical method named as “boundary pixel color alteration (BPCA)” is presented to modify measured 2D microstructure cut-outs. Its physical background is related to the phase growth. For the application, the precondition is that the representativeness of the microstructure is already satisfied to a certain extent. This method resolves the problem that the phase composition of a small cut-out can have a large discrepancy to the real one. The main idea is to change the pixel color among neighboring pixels belonging to different phases. Our process simultaneously maintains most of the characteristics of the original morphology and is applicable for nearly all kinds of multi-phase or polycrystalline metallic alloys, as well. From our axisymmetric finite element (FE) simulations (ABAQUS ) applied with 2D real microstructures, it shows that the volume ratios of microstructural phases, as a function of the structure position to the symmetric axis, converge to phase area ratios in the 2D cut-out, even though the axisymmetric element volume is position dependent. A mathematical proof provides the reason for the aforementioned convergence. As examples to achieve real compositions and to numerically prove the aforementioned convergence, four different materials including multiphase polycrystals are implemented. An improvement of the predicted FE result is presented for the application of a modified microstructure (with a higher representativeness) compared to the original one.

Tooth Discoloration Using Calcium Silicate-Based Cements For Simulated Revascularization in Vitro

The endodontic revascularization may be an alternative treatment for necrotic immature teeth, however, several treatment steps may cause tooth discoloration. This study evaluated the use of three calcium silicate-based cements with different radiopacifying agents on the color alteration (∆E) of extracted premolars after simulation of revascularization. Forty single rooted extracted premolars were shaped with #1-6 gates Glidden drills, rinsed with sodium hypochlorite, and filled with fresh human blood. Three calcium silicate-based cements with different radiopacifying agents (bismuth oxide - CSBi, calcium tungstate - CSW, and zirconium oxide - CSZr) were applied over the blood clot (n=10). The control group received the application of a temporary zinc oxide-based cement (TFZn) (n=10). ∆E was measured with a spectrophotometer, using the L*a*b* color system of the International Commission on Illumination (CIELab), in different times: prior to the preparation of the access cavity (t0); right after treatment (t1); and after one (t2), two (t3), three (t4) and four (t5) months. The tooth site for color evaluation was standardized by silicon matrix, the color reading was performed 3 times per tooth, and the teeth were stored in 37º water between evaluations. ∆E, whiteness (WID index) and yellowness (b*) were evaluated. Data were subjected to one-way ANOVA and repeated measures ANOVA, followed by Tukey’s post hoc test (α=0.05). All groups were similar in ∆E1 (t0-t1). The ∆E was the lowest and constant in the control group. In all evaluation times, CSBi presented the highest ∆E (p<0.01). CSW and CSZr were similar in all evaluated times and presented intermediate ∆E values. WID index from CSBi and CSW presented more distancing from ‘white’ reference. CSBi presented the greatest decrease in yellowness (b* value). The cement containing bismuth oxide presented the highest color alteration values. All tested calcium silicate-based cements presented clinically perceptible discoloration. Calcium tungstate and zirconium oxide may be used as alternative radiopacifiers to decrease tooth discoloration after endodontic tooth revascularization.

Effectiveness of Whitening Strips Use Compared With Supervised Dental Bleaching: A Systematic Review and Meta-analysis

Clinical Relevance Bleaching performed at home while under the supervision of a dentist provides greater color alteration compared with whitening strips when evaluated with a spectrophotometer, although the color alteration was undetectable by unaided human eyes. SUMMARY Objective: A systematic review and meta-analysis were performed to answer the following research question: Does the use of whitening strips (WS) lead to an equivalent color change compared with supervised dental bleaching in patients with permanent dentition? Methods: A search was performed on August 10, 2017 (updated on March 22, 2019), in PubMed, the Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature database, Cochrane Library, Scopus, Web of Science, and SIGLE, without restrictions regarding date or language. Abstracts from the International Association for Dental Research, unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (parallel or split mouth) in patients with permanent dentition that compared WS with dentist-supervised dental bleaching performed at home (AH) or in office (IO) were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A meta-analysis with subgroup analysis (low and high peroxide concentration) was conducted for color change ΔE* (spectrophotometer) and ΔSGU (shade guide units), risk and intensity of tooth sensitivity (TS), gingival irritation (GI), and patient satisfaction using a random effects model. Heterogeneity was assessed with the Cochrane Q test and I2 statistics. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) was used to assess the quality of the evidence. Results: After the removal of duplicates, followed by title and abstract screening, 20 studies remained. Only two studies were considered to have a low RoB; 11 had a high RoB, and seven had an unclear RoB. For WS versus IO, data were not available for the meta-analysis. For WS versus AH bleaching, a significant difference in ΔE* favoring the AH group was observed (standardized mean difference [SMD] = −0.50, 95% confidence interval [CI] −0.79 to 0.21), but the risk (risk ratio = 0.78, 95% CI 0.65 to 0.93) and intensity of TS (SMD = −0.30, 95% CI −0.56 to −0.04) were lower in the WS group. Color change in ΔSGU, risk and intensity of GI, and patient satisfaction were not significantly different between groups (p&gt;0.20). The quality of evidence for ΔE*, risk and intensity of TS, and intensity of GI were graded as moderate. Conclusion: Although the risk and intensity of TS were lower in the WS group, dentist-supervised at-home bleaching led to a better color change when measured with a spectrophotometer, although the color alteration was undetectable by unaided human eyes.

Effects of Orthodontic Adhesives on Dental Enamel Color Alteration Using Chemically Cured and Light-Cured Composites

Objectives: The purpose of this investigation was to evaluate the color alteration of dental enamel following the use of light-cured and chemically cured composites for bonding of metal brackets. Materials and Methods: Sixty extracted human premolars divided into five groups (n=12) were included in this study. Metal brackets were bonded using chemically cured (System 1+ and Unite) and light-cured (Transbond XT and Grengloo) composites. The control group remained untreated. After 72 hours of immersion in a staining solution and 24 hours of photoaging, the brackets were debonded, and adhesive remnants were cleaned using a 12-blade tungsten carbide bur and polished with Sof-Lex discs. The color was assessed at the baseline and after cleaning procedures in accordance with the CIE L*a*b (lightness, red/green, blue/yellow) color system. Statistical analyses were performed using paired sample t-test and one-way analysis of variance (ANOVA). Results: The L*, a*, and b* parameters showed a significant increase in all adhesive groups (P<0.001). The experimental groups showed significant color changes (P<0.05), and the mean ΔE ranged from 2.46 to 3.15 units. No significant difference was found between the ΔE of the adhesive groups (P>0.05). Conclusion: The enamel color change is influenced by bonding and debonding procedures. Chemically cured and light-cured composites have similar effects on dental enamel color alterations.

Analysis of Color and Hardness of a Medical Silicone with Extrinsic Pigmentation after Accelerated Aging

Objective The aim of this study is to evaluate the color alteration and shore A hardness of a medical silicone with extrinsic pigmentation, before and after accelerated aging. Materials and Methods Twenty samples (Silastic Q7–4735) were made with an intrinsic pigmentation. This intrinsic pigmentation was composed of a pink pigment (H-109-P, Factor II) and an opacifier (ZnO). All samples had standardized dimensions (45-mm diameter and 2-mm thickness). Half of the 20 samples manufactured subsequently received an extrinsic pigment (Tan FE–215, Factor II). Therefore, two groups were created (n = 10): Group 1, group with intrinsic pigmentation and without extrinsic pigmentation (control) and Group 2, group with intrinsic and extrinsic pigmentation. Samples were submitted to color and Shore A hardness tests, before and after 1,008 hours of aging. Statistical Analysis Color alteration data were submitted to Student’s t-test (α = 0.05). Shore A hardness data were submitted to two-way analysis of variance and Tukey test (α = 0.05). Results The incorporation of the extrinsic pigment on the silicone did not affect its color (ΔE) when the two groups were compared (p = 0.232). Regarding the hardness test, the interaction between group and period did not interfere with the hardness results(p=0.599). However, the period factor showed that there was a reduction in the hardness of the silicone after aging (p < 0.05). Conclusion In this study, all the hardness and color results of the silicone used were clinically acceptable, regardless of the presence of extrinsic pigmentation.