Farklı beyazlatma ajanlarının ve beyazlatma sonrası uygulanılan remineralize edici ajanın mine yüzeyine etkilerinin in vitro olarak incelenmesi
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Tarih
2021
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Araştırmamızda kliniklerde ve ev beyazlatma tedavilerinde rutin olarak kullanılan faklı beyazlatma ajanları, eşdeğer etki gösterdikleri prosedürlerde uygulanarak diş yüzeyi üzerinde oluşturdukları fiziksel ve kimyasal etkiler incelendi. Beyazlatma tedavisi sonrası önerilen remineralize edici ajan uygulamanın etkinliği ve etkileri değerlendirildi. Gereç ve Yöntem: Çalışmada kullanmak amacıyla yeni çekilmiş gömülü yirmi yaş dişleri %0,2 timol solüsyonunda oda sıcaklığında biriktirildi. Dişler bukko-lingual yönde kesildi. Kesilen dişler her grupta 5 örnek olacak şekilde toplam 10 gruba ayrılıp, Nanoindenter ve Vita Easyshade cihazıyla yapılacak ölçümler için teflon halkalara yerleştirildi. Her beyazlatma ajanı için birer örnek EDS ve SEM değerlendirmesi amacıyla teflon halkaya yerleştirilmeden taban kısmı paralel olacak şekilde hazırlandı ve aynı prosedürler bu dişlere de uygulandı. Nanoindenter ölçümü için HYSITRON TI 950 TriboIndenter cihazı kullanıldı. Kimyasal içeriklerdeki değişiklikleri incelemek için UltraDry EDS Dedektör ve Quasor II EBSD ile donatılmış Thermo Fisher Scientific (FEI) Apreo S Taramalı Elektron mikroskobu kullanıldı. Teflon bloğa yerleştirilen dişlerin ilk ölçümleri yapıldıktan sonra Opalescence Boost %40 PF (Ultradent, South Jordan, UT, ABD), Philips Zoom DayWhite %9.5 (Discus, Dental, LLC, Ontario, CA, ABD), Whiteness Perfect %16 PF (FGM, Joinville, Brazilya), Opalescence PF %10 (Ultradent, South Jordan, UT, ABD) beyazlatma ajanları uygulandı ve ikinci ölçümler gerçekleştirildi. Remineralize edici ajan uygulanacak olan gruplara (Grup2, 4, 6, 8, 10), bir remineralize edici ajan olan Remin Pro uygulandıktan sonra tüm gruplar bir hafta yapay tükürükte bekletildi, sonrasında Nanoindenter ve SEM/EDS ölçümleri tekrarlandı. Ölçümlerde diş yüzeyinin renk, elastik modül, sertlik, pürüzlülük ve kimyasal içeriğine bakıldı. Beyazlatma öncesi ve sonrası diş renkleri Vıta Easyshade Compact (Vita Zahnfabrik, BadSäckingen, Almanya) spektrofotometre cihazıyla tespit edildi ve renk ölçümleri için CIE L*a*b* renk sisteminden faydalanıldı. Veriler IBM SPSS V23 ile analiz edildi. Normal dağılıma uygunluk Shapiro-Wilk testi ile incelendi. Beyazlatma ajanları ve remineralize edici ajanın esneklik, sertlik ve pürüzlülük değerleri üzerine etkilerini incelemek için Genelleştirilmiş Lineer Modeller yöntemi kullanıldı ve çoklu karşılaştırmalar Bonferroni testi ile gerçekleştirildi. Gruplara göre normal dağılan ΔE değerlerinin karşılaştırılmasında Tek yönlü varyans analizi kullanıldı ve çoklu karşılaştırmalar Tamhane's T2 testiyle gerçekleştirildi. Analiz sonuçları ortalama ± standart sapma olarak hesaplandı. Önem düzeyi p<0,050 olarak alındı. Bulgular: Uygulanan dört farklı beyazlatma ajanı da kontrol grubuna göre istatistiksel olarak anlamlı şekilde diş beyazlatması sağlamıştır (p<0,001). En fazla renk değişimi Opalescence PF %10 beyazlatma ajanını uyguladığımız grupta görülürken en az renk değişikliği Opalescence Boost %40 PF beyazlatma ajanı uygulanan grupta görüldü. Beyazlatma ajanları, diş minesinin nanosertlik ve elastik modül değerlerinde istatistiksel olarak anlamlı şekilde azalma meydana getirirken; yüzey pürüzlülüğünde istatistiksel olarak anlamlı bir artış gözlemlenmiştir (p<0,001). Remin Pro uygulanan grupların nanosertliğinde ve elastik modülünde bir miktar artma tespit edildi. Beyazlatma ajanı uygulanan örneklerin SEM incelemelerinde mine yüzey morfolojisinin bozulduğu izlendi. EDS elementel analiz bulgularında Ca, C ve Na elementlerinin molekül ağırlık yüzdelerinin azaldığı, Remin Pro uygulaması sonrası ise bu elementlerin molekül ağırlık yüzdelerinin arttığı gözlendi. Sonuç: Uygulanan dört farklı beyazlatma ajanı da etkili bir beyazlatma sağlamıştır. Beyazlatma ajanları, diş minelerinin nanosertlik ve elastik modüllerinde azalma meydana getirirken, yüzey pürüzlülüğünde artışa neden olmuştur. SEM görüntüleri incelendiğinde, beyazlatma ajanlarının diş minesi morfolojisinde bozulmaya neden olduğu, EDS analiz sonuçlarında ise elementel değişikliklere yol açtığı tespit edildi. Beyazlatma sonrası kullanılan remineralize edici ajanın diş minesi yüzeyinde meydana gelen bu morfolojik bozulma ve elementel değişiklikleri bir miktar düzelttiği gözlenmiştir.
Introduction and Aim: In our study different whitening agents used routinely both at home and in clinics will be applied in equivalent procedures, and their physical and chemical effects they form on teeth surface were examined. The evaluation of effects and efficiency of remineralizing agent application proposed after whitening treatment is aimed in this study. Materials and Methods: Newly extracted impacted wisdom teeth have been deposited in 0.2% thymol solution at room temperature in order to use them in the study. The teeth were cut in the buccolingual direction. The teeth cut have been divided into 10 groups, each group having 5 samples, and placed on teflon rings for measurement with Nanoindenter and Vita Easyshade device. A sample for each whitening agent has been prepared, the base parallel to the Teflon ring, for EDX and SEM evaluation, and the same procedures have been applied to these teeth. The HYSITRON TI 950 TriboIndenter device has been used for nanoindenter measurement. Thermo Fisher Scientific (FEI) Apreo S Scanning Electron microscope equipped with UltraDry EDX Detector and Quasor II EBSD has been used to examine changes in chemical contents. After the first measurements of the teeth placed in the Teflon block, Opalescence Boost 40% PF (Ultradent, South Jordan, UT, USA), Philips Zoom DayWhite 9.5% (Discus, Dental, LLC, Ontario, CA, USA), Whiteness Perfect 16% PF (FGM) , Joinville, Brazil), Opalescence PF 10% (Ultradent, South Jordan, UT, USA) whitening agents have been applied and second measurements performed. After the application of Remin Pro, a remineralizing agent, to the groups (Groups 2, 4, 6, 8, 10), all groups have been kept in artificial saliva for one week, and then Nanoindenter and SEM/EDX measurements have been repeated. Color, young's modulus, hardness, roughness and chemical content of the tooth surface have been examined in the measurements. Teeth colors before and after whitening have been determined through Vita Easyshade Compact (Vita Zahnfabrik, BadSackingen, Germany) spectrophotometer device and CIE L*a*b* color system has been used for color measurements. Data has been analyzed with IBM SPSS V23. Suitability to normal distribution has been examined with the Shapiro-Wilk test. Generalized Linear Models method has been used in order to examine the effects of whitening agents and remineralizing agents on young's modulus, hardness and roughness values, and multiple comparisons have been made with Bonferroni test. One-way variance analysis has been used in comparision of normally distributed ΔE values according to the groups, and multiple comparisons have been performed with Tamhane's T2 test. The analysis results have been calculated as mean ± standard deviation. Significance level has been taken as p<0.050. Results: The applied four different whitening agents provided statistically significant teeth whitening compared to the control group (p<0,001). While the most color change has been seen in the group in which we applied Opalescence PF 10% whitening agent, the least color change has been seen in the group in which Opalescence Boost 40% PF whitening agent was applied. While whitening agents cause a statistically significant decrease in the nanohardness and Young's modulus values of tooth enamel a statistically significant increase in surface roughness has been observed (p<0,001). A slight increase has been detected in the nanohardness and Young's modulus of the Remin Pro applied groups. In the SEM examination of the samples to which whitening agent has been applied, enamel surface morphology has been observed to deteriorate. In the EDS elemental analysis findings, the molecular weight percentages of Ca, C and Na elements have been observed to decrease while the molecular weight percentages of these elements to increase after Remin Pro application. Conclusions: The application of four different whitening agents have provided an effective whitening. The whitening agents have caused a decrease in the nanohardness and elastic modulus of the tooth enamel, and an increase in the surface roughness. In the examination of SEM images we have observed that whitening agents caused deterioration in tooth enamel morphology, and elemental changes in EDX analysis results. It has been observed that the remineralizing agent used after whitening has slightly improved the morphological deterioration and elemental changes on the tooth enamel surface. Key words: Tooth whitening, Nanoindenter, SEM/EDX.
Introduction and Aim: In our study different whitening agents used routinely both at home and in clinics will be applied in equivalent procedures, and their physical and chemical effects they form on teeth surface were examined. The evaluation of effects and efficiency of remineralizing agent application proposed after whitening treatment is aimed in this study. Materials and Methods: Newly extracted impacted wisdom teeth have been deposited in 0.2% thymol solution at room temperature in order to use them in the study. The teeth were cut in the buccolingual direction. The teeth cut have been divided into 10 groups, each group having 5 samples, and placed on teflon rings for measurement with Nanoindenter and Vita Easyshade device. A sample for each whitening agent has been prepared, the base parallel to the Teflon ring, for EDX and SEM evaluation, and the same procedures have been applied to these teeth. The HYSITRON TI 950 TriboIndenter device has been used for nanoindenter measurement. Thermo Fisher Scientific (FEI) Apreo S Scanning Electron microscope equipped with UltraDry EDX Detector and Quasor II EBSD has been used to examine changes in chemical contents. After the first measurements of the teeth placed in the Teflon block, Opalescence Boost 40% PF (Ultradent, South Jordan, UT, USA), Philips Zoom DayWhite 9.5% (Discus, Dental, LLC, Ontario, CA, USA), Whiteness Perfect 16% PF (FGM) , Joinville, Brazil), Opalescence PF 10% (Ultradent, South Jordan, UT, USA) whitening agents have been applied and second measurements performed. After the application of Remin Pro, a remineralizing agent, to the groups (Groups 2, 4, 6, 8, 10), all groups have been kept in artificial saliva for one week, and then Nanoindenter and SEM/EDX measurements have been repeated. Color, young's modulus, hardness, roughness and chemical content of the tooth surface have been examined in the measurements. Teeth colors before and after whitening have been determined through Vita Easyshade Compact (Vita Zahnfabrik, BadSackingen, Germany) spectrophotometer device and CIE L*a*b* color system has been used for color measurements. Data has been analyzed with IBM SPSS V23. Suitability to normal distribution has been examined with the Shapiro-Wilk test. Generalized Linear Models method has been used in order to examine the effects of whitening agents and remineralizing agents on young's modulus, hardness and roughness values, and multiple comparisons have been made with Bonferroni test. One-way variance analysis has been used in comparision of normally distributed ΔE values according to the groups, and multiple comparisons have been performed with Tamhane's T2 test. The analysis results have been calculated as mean ± standard deviation. Significance level has been taken as p<0.050. Results: The applied four different whitening agents provided statistically significant teeth whitening compared to the control group (p<0,001). While the most color change has been seen in the group in which we applied Opalescence PF 10% whitening agent, the least color change has been seen in the group in which Opalescence Boost 40% PF whitening agent was applied. While whitening agents cause a statistically significant decrease in the nanohardness and Young's modulus values of tooth enamel a statistically significant increase in surface roughness has been observed (p<0,001). A slight increase has been detected in the nanohardness and Young's modulus of the Remin Pro applied groups. In the SEM examination of the samples to which whitening agent has been applied, enamel surface morphology has been observed to deteriorate. In the EDS elemental analysis findings, the molecular weight percentages of Ca, C and Na elements have been observed to decrease while the molecular weight percentages of these elements to increase after Remin Pro application. Conclusions: The application of four different whitening agents have provided an effective whitening. The whitening agents have caused a decrease in the nanohardness and elastic modulus of the tooth enamel, and an increase in the surface roughness. In the examination of SEM images we have observed that whitening agents caused deterioration in tooth enamel morphology, and elemental changes in EDX analysis results. It has been observed that the remineralizing agent used after whitening has slightly improved the morphological deterioration and elemental changes on the tooth enamel surface. Key words: Tooth whitening, Nanoindenter, SEM/EDX.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry, Diş Beyazlatma, Nanoindenter, SEM/EDS.
