In vitro study on the dimensional changes of human dentine after demineralization

Shear bond strength of a composite resin restoration in primary teeth following cavity preparation using laser- an in-vitro study

To evaluate and compare the shear bond strength of composite resin restorations in primary teeth, following cavity preparation with both traditional dental burs and laser irradiation. One hundred primary molars extracted from the children visiting our department were collected and randomly divided into five groups (A-E) with 20 teeth in each group. In groups A, B, C, D, and E the teeth samples were etched with phosphoric acid, Er; YAG laser followed by acid etching, Er, Cr: YSGG laser followed by acid etching, Er; YAG laser etching only and Er, Cr: YSGG laser etching only, respectively. Following, all the samples were restored with composite resin and subjected to 500 cycles of thermocycling. The shear bond strength of the resin composite was analyzed. The type of fractures was also noted. Data obtained were subjected to statistical analysis. The mean value of shear bond strength of Group A, B, C, D, and E was 17.562 ± 0.810, 15.928 ± 0.415, 14.964 ± 0.566, 11.833 ± 0.533 and 11.187 ± 0.517, respectively. Adhesive failure was most commonly seen in all the groups. The phosphoric acid etching remains a highly effective technique for pre-treating dentin in composite resin restorations. The shear strength of composite resin to the dentin of laser-prepared cavity in primary teeth can be improved by the addition of acid etching.

Ultrasonic Monitoring of Dentin Demineralization

Demineralization is a process of loss of minerals in the dental hard tissue that affects seriously the health of the patients, as it diminishes the tooth resistance, generating chewing problems by altering the occlusal structure, hypersensitivity, and pulpal problems. Demineralization can be produced by pathological processes as erosion or caries, or by surgical processes as etching. Due to the complexity of natural demineralization processes, it is mandatory to provide quantitative and standardized tests to allow their study in controlled laboratory conditions. Ultrasonic techniques are suitable for this purpose as they are nondestructive, quick, and provide localized mechanical information about the tissue, which is related with its degree of demineralization. In the present work, we evaluate the complete process of demineralization of the human dentin under controlled laboratory conditions using a pulse-echo ultrasonic technique. Up to 15 human dentin teeth have been demineralized with phosphoric acid at 10%. The time-of-flight measurements using the pulse-echo system allows to obtain the speed of sound in healthy (3415 m/s) and demineralized dentin tissue (1710 m/s), as well as to characterize the dynamical process of the acid penetration, which generates well-defined boundaries between two media (demineralized and mineralized dentin), showing very different mechanical properties. These boundaries advance in depth at an initial rate of [Formula: see text]/min, decelerating at -9.3 nm/min² until the whole demineralization of the sample is achieved. In addition, the technique allows to measure the relevance of the demineralization produced by the acid residues inside the tooth once it has been removed from the acidic solution. Beyond the assessment of artificial demineralization lesions under laboratory conditions, as demonstrated in this article, the proposed technique opens new approaches to the assessment of demineralization caused by natural caries in vivo.

The effect of chlorhexidine primer application on the clinical performance of composite restorations: a literature review

To discuss the effectiveness of chlorhexidine (CHX) used as therapeutic dentin primer in adhesively bonded composite restorations. OVERVIEW: An electronic search in MEDLINE database, accessed through PubMed was conducted. No restrictions of languages and date of publication were made. The following key words were used: "chlorhexidine", "composite" and "composite resins." Clinical studies in which CHX was used during bonding procedures were included in this review. Six studies met the inclusion criteria. Of these, five studies were carried out on noncarious cervical lesions (NCCL). Only one study was carried out on class II preparation of permanent molars. In all studies, either etch-and-rinse and self-etch adhesive systems were used during bonding procedures. On the basis of the reviewed clinical trials, it can be concluded that CHX primer application does not seem to influence clinical outcome of composite restorations. CLINICAL SIGNIFICANCE: Current scientific evidence cannot neither strongly recommend nor discourage the application of CHX as therapeutic primer in composite restorations. Studies with longer follow-up periods with adhesive restorations placed on dentin after caries removal, rather than only on NCCL, are desirable to further investigate the therapeutic effect of CHX during bonding procedures.

Peptide-assisted pre-bonding remineralization of dentin to improve bonding

Bonding with dentin is a complex process involving physical and chemical adhesion where the adhesive must be able to penetrate and envelop collagen fibers. Acid etching clears the dentin of debris, which prevents adhesives to interact with dentin. However, it also demineralizes the outermost surface of dentin and exposes collagen fibers. The mineral-free collagen is susceptible to collapse after drying and to proteolytic or microbial attack, ultimately impairing the bonding with dentin. To address this, we have attempted a pre-bonding rapid remineralization approach to recover the mineral content of etched dentin. We have used a mineralization-promoting peptide and high calcium/phosphate concentration to achieve this in a clinically applicable timeframe. Partial remineralization was confirmed via SEM and XRD analyses. The mechanical properties and the stability of the partially remineralized dentin were investigated via microhardness, collagen hydrolysis and shrinkage tests. The bonding properties were investigated via shear bond strength (SBS) and microleakage tests. Pre-bonding remineralization of dentin with peptide for 10 min significantly increased the stiffness, resistance to hydrolysis and reduced shrinkage due to drying. SBS was increased with both an etch&rinse and a self-etch adhesive. However, pre-bonding remineralization resulted in reduced microleakage only with the etch&rinse adhesive. The described method is readily applicable to clinic since it is expected to add only 10 min to the procedure. Future in situ and/or in vivo studies will help to confirm the benefits observed in this in vitro study and allow optimize the parameters of the method.

Assessment of root caries under wet and dry conditions using swept-source optical coherence tomography (SS-OCT)

The purpose of this study was to compare optical properties of root caries under two observing conditions using swept-source optical coherence tomography (SS-OCT). In vitro and natural root caries were observed by SS-OCT under wet and dry conditions, followed by confocal laser scanning microscope (CLSM) and transverse microradiography (TMR). Signal intensity (SI), distance between SI peaks (SI-distance) and optical lesion depth were obtained from OCT. Lesion depth was measured from CLSM; lesion depth (LD_TMR) and mineral loss (ML) were obtained from TMR. In vitro root caries under wet and dry conditions showed different OCT images and SI patterns. Lesion depth of OCT and that of CLSM, SI-distance and LD_TMR, LD_TMR and ML significantly correlated. Under dry conditions, half natural root caries showed similar OCT images and SI patterns as in vitro root caries. The base of demineralized dentin could be detected more clearly under dry conditions than under wet conditions.

Validation of Growth Layer Group (GLG) depositional rate using daily incremental growth lines in the dentin of beluga (Delphinapterus leucas (Pallas, 1776)) teeth

Counts of Growth Layer Groups (GLGs) in the dentin of marine mammal teeth are widely used as indicators of age. In most marine mammals, observations document that GLGs are deposited yearly, but in beluga whales, some studies have supported the view that two GLGs are deposited each year. Our understanding of beluga life-history differs substantially depending on assumptions regarding the timing of GLG deposition; therefore, resolving this issue has important considerations for population assessments. In this study, we used incremental lines that represent daily pulses of dentin mineralization to test the hypothesis that GLGs in beluga dentin are deposited on a yearly basis. Our estimate of the number of daily growth lines within one GLG is remarkably close to 365 days within error, supporting the hypothesis that GLGs are deposited annually in beluga. We show that measurement of daily growth increments can be used to validate the time represented by GLGs in beluga. Furthermore, we believe this methodology may have broader applications to age estimation in other taxa.

Solvent type influences bond strength to air or blot-dried dentin

Background

Air-drying of etched and rinsed dentin surface may force the exposed collagen fibrils to collapse. Blot-drying is an alternative method to wipe the excess water from the dentin surface without compromising the monomer penetration. Contemporary total etch adhesives contain ethanol/water or acetone as solvent in which resin monomers are dissolved. Solvent type of the adhesive system has an important role in bonding to dentin. An adhesive containing tertiary butanol as an alternative solvent has been in the market. Purpose of this study is to determine the shear bond strengths of three total-etch adhesives with different solvents (acetone, ethanol or tertiary butanol) applied to air or blot dried moist dentin.

Methods

Sixty extracted non-carious human third molars were divided into three main groups according to solvent content of the adhesives [acetone based - One Step (OS, Bisco, IL, USA); ethanol/water based - Optibond Solo Plus (OB, Kerr, CA, USA); and tertiary butanol based - XP Bond (XP, Caulk/Dentsply, DE, USA)]. Each main group was divided into two groups according to drying methods (blot or air) (n = 10). Shear bond strengths (SBS) were measured. Data were analyzed by Student’s t test and Tukey HSD test (p < 0,05).

Results

XP showed highest SBS values in both drying methods applied (p < 0.05). Drying method did not influence the SBS in OS and OB (p > 0.05). XP-blot produced significantly higher SBS than XP-air (p < 0.05).

Conclusions

Tertiary butanol based adhesive showed higher bond strength values than ethanol or acetone based adhesives. Blot drying of dentin improved the bond strength values of tertiary butanol based adhesive. Further research is necessary to determine in vivo and in vitro performance of tertiary butanol based adhesives.

Chlorhexidine Nanocapsule Drug Delivery Approach to the Resin-Dentin Interface

In this study, we are introducing a new drug-delivery approach to demineralized dentin substrates through microsized dentinal tubules in the form of drug-loaded nanocapsules. Chlorhexidine (CHX) is widely used in adhesive dentistry due to its nonspecific matrix metalloproteinase inhibitory effect and antibacterial activities. Poly(ε-caprolactone) nanocapsules (nano-PCL) loaded with CHX were fabricated by interfacial polymer deposition at PCL/CHX ratios of 125:10, 125:25, and 125:50. Unloaded nanocapsules (blank) were fabricated as control. The fabricated nanocapsules were characterized in vitro in terms of particle size, surface charges, particle recovery, encapsulation efficiency, and drug loading. Nanocapsule morphology, drug inclusion, structural properties, and crystallinity were investigated by scanning and transmission electron microscopes (SEM/TEM), energy-dispersive x-ray analysis, Fourier transform infrared spectroscopy, and x-ray diffraction. Initial screening of the antibacterial activities and the cytotoxicity of the nanocapsules were also conducted. Nanocapsules, as carried on ethanol/water solution, were delivered to demineralized dentin specimens connected to an ex vivo model setup simulating the pulpal pressure to study their infiltration, penetration depth, and retention inside the dentinal tubules by SEM/TEM. Nanocapsules were Ag labeled and delivered to demineralized dentin, followed by the application of a 2-step etch-and-rinse dentin adhesive. CHX-release profiles were characterized in vitro and ex vivo up to 25 d. Spherical nanocapsules were fabricated with a CHX core coated with a thin PCL shell. The blank nanocapsules exhibited the largest z-average diameter with negatively charged ζ-potential. With CHX incorporation, the nanocapsule size was decreased with a positive shift in ζ-potential. Nano-PCL/CHX at 125:50 showed the highest drug loading, antibacterial effect, and CHX release both in vitro and ex vivo. SEM and TEM revealed the deep penetration and retention of the CHX-loaded nanocapsules inside dentinal tubules and their ability to be gradually degraded to release CHX in vitro and ex vivo. Ag-labeled nanocapsules revealed the close association and even distribution of nanocapsules throughout the resin tag structure. This study demonstrated the potential of introducing this novel drug-delivery approach to demineralized dentin substrates and the resin-dentin interface with nanosized CHX-loaded nanocapsules through the microsized dentinal tubules.

Evaluation of HEMA released from four different adhesive systems by HPLC

PURPOSE

This study evaluated the elution of 2-hydroxyethyl methacrylate (HEMA) from 4 different adhesives, using high-performance liquid chromatography (HPLC).

MATERIALS AND METHODS

The adhesives were applied on a bovine dentin surface and polymerized using an LED curing unit (n=5). After polymerization, specimens were stored in 75% ethanol solution (6 mL). Residual HEMA that was eluted from adhesives (after 10 minutes, 1 hour, 24 hours, 7 days and 30 days) was analyzed using HPLC. Statistical analyses were performed using 1-way ANOVA, Tukey HSD test and paired 2-sample t-test.

RESULTS

There were statistically significant differences among adhesive systems for the cumulative released HEMA and among the time periods (p&lt;0.05). Clearfil SE Bond showed the highest amount of HEMA released, while Easy Bond showed the lowest. Among the time periods, the highest eluted HEMA value was detected in 10 minutes for all adhesives, and elution continued for up to 30 days.

CONCLUSIONS

The HEMA eluted from adhesives was in different amounts, and the elution continued for a long time. The amount of eluted HEMA from adhesives used in this study was not viewed as critical for toxic reactions in biological tissues.

Assessing microleakage of composite restorations in class V cavities prepared by Er:YAG laser irradiation or diamond bur

Introduction:

The aim of this study was to make a comparison between microleakage of conventionally restored class V cavities using bur and acid etchant and, the ones prepared and conditioned by Er:YAG laser.

Materials and Methods:

30 recently extracted intact caries and filling free human permanent molars were used for this study. Then, Cold cure acrylic resin was used to seal the apices. The samples were randomly assigned to 5 groups of six each. Class V cavities were prepared one on buccal and one on lingual surface of each sample. Group 1: cavity preparation by diamond bur and turbine + acid etch, Group 2: cavity preparation by Er:YAG laser + acid etch, Group 3: cavity preparation by Er:YAG laser + Laser etching, Group 4: cavity preparation by diamond bur and turbine + laser etching, Group 5: cavity preparation by Er:YAG laser with no conditioning procedure. The cavities restored with restorative composite resin. Samples were then immersed in 2% methylene blue solution for 24 hours. The data were then analyzed using Wilcoxon signed ranks test and Kruskal-Wallis statistical tests.

Results:

The Kruskal Wallis test showed a significant difference (P < 0.05) between enamel and cementum margin microleakage, while the higher microleakage was related to the cementum margin of restorations.

Conclusion:

There was no significant difference in evaluating microleakeage degree of cavities prepared by Er:YAG laser and diamond bur.

Impact of oxalate desensitizer combined with ethylene-diamine tetra acetic acid-conditioning on dentin bond strength of one-bottle adhesives during dry bonding

Background:

Elimination of water entrapment in hybrid layer during bonding procedure would increase bonding durability.

Aims:

This study evaluated the effect of oxalate desensitizer (OX) pretreatment on bond strength of three one-bottle adhesives to ethylene-diamine tetra acetic acid (EDTA)-conditioned dentin under dry bonding.

Materials and Methods:

Three adhesive systems, One-Step Plus (OS), Optibond Solo Plus (OP) and Adper Single Bond (SB) were bonded on dentin surfaces under four bonding conditions: (1) Wet-bonding on acid-etched dentin, (2) wet bonding on EDTA-conditioned dentin, (3) dry bonding on EDTA-conditioned dentin, (4) dry bonding associated with OX on the EDTA-conditioned dentin. After storage and thermo cycling, shear bond strength test was performed. Data were analyzed using two-way analysis of variance and Tukey tests.

Results:

Wet bonding with EDTA or acid etching showed similar bond strength for test adhesives. Dry bonding with EDTA significantly decreased the bond strength of OS, but it had no effect on the bonding of OP and SB. OX application in the forth bonding condition, in comparison with the third condition, had a negative effect on the bond strength of OP, but not influence on OS and SB.

Conclusions:

The use of an OX on EDTA-conditioned dentin compromised the bonding efficacy of OS and OP under dry bonding but compatible for SB.

Effect of saliva contamination on bond strength with a hydrophilic composite resin

OBJECTIVE

To evaluate the influence of saliva contamination on the bond strength of metallic brackets bonded to enamel with hydrophilic resin composite.

METHODS

Eighty premolars were randomly divided into 4 groups (n = 20) according to bonding material and contamination: G1) bonded with Transbond XT with no saliva contamination, G2) bonded with Transbond XT with saliva contamination, G3) bonded with Transbond Plus Color Change with no saliva contamination and G4) bonded with Transbond Plus Color Change with saliva contamination. The results were statistically analyzed (ANOVA/Tukey).

RESULTS

The means and standard deviations (MPa) were: G1) 10.15 ± 3.75; G2) 6.8 ± 2.54; G3) 9.3 ± 3.36; G4) 8.3 ± 2.95. The adhesive remnant index (ARI) ranged between 0 and 1 in G1 and G4. In G2 there was a prevalence of score 0 and similar ARI distribution in G3.

CONCLUSIONS

Saliva contamination reduced bond strength when Transbond XT hydrophobic resin composite was used. However, the hydrophilic resin Transbond Plus Color Change was not affected by the contamination.

Biomechanics of a bone-periodontal ligament-tooth fibrous joint

This study investigates bone-tooth association under compression to identify strain amplified sites within the bone-periodontal ligament (PDL)-tooth fibrous joint. Our results indicate that the biomechanical response of the joint is due to a combinatorial response of the constitutive properties of organic, inorganic, and fluid components. Second maxillary molars within intact maxillae (N=8) of 5-month-old rats were loaded with a μ-XCT-compatible in situ loading device at various permutations of displacement rates (0.2, 0.5, 1.0, 1.5, 2.0 mm/min) and peak reactionary load responses (5, 10, 15, 20 N). Results indicated a nonlinear biomechanical response of the joint, in which the observed reactionary load rates were directly proportional to displacement rates (velocities). No significant differences in peak reactionary load rates at a displacement rate of 0.2mm/min were observed. However, for displacement rates greater than 0.2mm/min, an increasing trend in reactionary rate was observed for every peak reactionary load with significant increases at 2.0mm/min. Regardless of displacement rates, two distinct behaviors were identified with stiffness (S) and reactionary load rate (LR) values at a peak load of 5 N (S(5 N)=290-523 N/mm) being significantly lower than those at 10 N (LR(5 N)=1-10 N/s) and higher (S(10 N-20 N)=380-684 N/mm; LR(10 N-20 N)=1-19 N/s). Digital image correlation revealed the possibility of a screw-like motion of the tooth into the PDL-space, i.e., predominant vertical displacement of 35 μm at 5 N, followed by a slight increase to 40 μm at 10 N and 50 μm at 20 N of the tooth and potential tooth rotation at loads above 10 N. Narrowed and widened PDL spaces as a result of tooth displacement indicated areas of increased apparent strains within the complex. We propose that such highly strained regions are "hot spots" that can potentiate local tissue adaptation under physiological loading and adverse tissue adaptation under pathological loading conditions.

Effect of dentin etching and chlorhexidine application on metalloproteinase-mediated collagen degradation

Dentin matrix metalloproteinases (MMPs) are involved in the degradation of collagen in resin-dentin interfaces. This study evaluated whether collagen degradation can be prevented by chlorhexidine digluconate (CHX) after different dentin demineralization procedures. The demineralization of human dentin was performed with phosphoric acid (PA), EDTA or acidic monomers (Clearfil SE Bond and Xeno V). Specimens were stored (for 24 h, or for 1 or 3 wk) in the presence or absence of CHX. In half of the groups, active MMP-2 was incorporated into the storage solution. At the end of each storage period, the C-terminal telopeptide (ICTP) concentration (which indicates the amount of collagen degradation) was measured in the storage solution. Collagen degradation was higher in PA- and EDTA-demineralized dentin. Chlorhexidine digluconate reduced collagen degradation in these groups only for 24 h. When dentin was demineralized with Clearfil SE Bond or Xeno V, collagen degradation was reduced by up to 30%, but the addition of exogenous MMP-2 significantly increased collagen degradation. In self-etchant-treated dentin, the inhibitory effect of CHX on MMPs lasted for up to 3 wk. Treating dentin with EDTA, PA or self-etching agents produces enough demineralization to permit cleavage of the exposed collagen. Monomer infiltration may exert protection on demineralized collagen, probably through immobilization of MMPs. The partial inhibitory action of CHX on MMP activity produced by self-etching adhesives was prolonged compared with the short-acting PA- or EDTA-treated dentin.

Zinc reduces collagen degradation in demineralized human dentin explants

OBJECTIVES

Dentin matrix metalloproteinases are implicated in the pathogenesis of caries and contribute to collagen degradation in resin-dentin interfaces. The objective was to determine if collagen degradation may be modulated by an excess of zinc or zinc chelators.

METHODS

Mineralized and phosphoric acid demineralized human dentin specimens were tested. Chlorhexidine digluconate, doxycycline or ZnCl₂ were added to the media. In half of the groups, active exogenous metalloproteinase-2 was incorporated into the solution. C-terminal telopeptide determinations (radioimmunoassay) were performed after 24 h, 1 and 3 weeks.

RESULTS

Collagen degradation was prominent in demineralized dentin. Doxycycline fully blocked dentin proteolysis. Chlorhexidine digluconate reduced the degradation at the 24-h period. Zinc in excess strongly inhibits hydrolysis of collagen and its effect was maintained for 3 weeks.

CONCLUSIONS

Zinc in excess reduces MMP-mediated collagen degradation. The hypothesis that binding of zinc to collagen results in protection of sensitive cleavage sites of metalloproteinases requires further validation.

Class II restorations with margins below the CEJ

INTRODUCTION

Historically, Class II restorations using resin composite with margins below the dentino-enamel junction (dej) have fared poorly in investigations, exhibiting significant dye penetration along the marginal interfaces. In all reports located by the authors the gingival margins of sub-CEJ restorations have been finished, even though in actual practice this is not feasible in the vast majority of cases.

PURPOSE

The purpose of this study was to examine the effect of finishing on gingival margins located below the cemento-enamel junction of Class II resin composite restorations.

MATERIALS AND METHODS

Class II resin composite restorations with margins below the dej were placed in 40 extracted human molars using a dentin-enamel adhesive, a flowable resin composite, and a universal microhybrid resin composite restorative material. In all groups the adhesive was light activated for ten seconds and the restorative resin composite was light activated for ten seconds. The flowable increments were 1 mm in thickness and the restorative resin composite increments were 2 mm in thickness. In groups 1, 3, and 4 the flowable was light activated for ten seconds while in group 2 the flowable was light activated for 40 seconds. In groups 1, 2, and 4 the sub-CEJ margins were finished with finishing discs while in group 3 the sub-CEJ margins were unfinished. In group 4 the dentin adhesive was reapplied following finishing procedures. All groups were immersed in dye for 24 hours.

RESULTS

The two groups in which the margins were finished exhibited varying degrees of dye penetration. There was no dye penetration in the unfinished and the resealed groups.

CONCLUSIONS

It was concluded that the finishing procedure itself causes damage to the resin-dentin interface, which allows dye penetration to occur. This could potentially explain why resin adhesive materials have fared so poorly in Class II in vitro investigations, which is not the common clinical experience.

A rapid nondestructive method for root dentin moisture measurements: in vitro pilot study

Dentin moisture content is important in adhesive bonding and structural strength research; however, there is no rapid method available to assess dentin moisture without sample destruction. This study examined the use of a digital grain moisture meter to measure root dentin moisture in vitro. Extracted mandibular single-rooted teeth were sectioned at the CEJ. The moisture of the root dentin was measured at 6 measuring modes for different grains and repeated 5 times. Dentin weight changes before and after drying were measured to obtain control values. The control values were compared with machine readings. In conclusion, (1) each nondestructive measurement took less than 30 seconds, (2) 24 hours of storage at 37 degrees C and 100% humidity did not restore dentin moisture, and (3) 5 grain modes had a high validity and could be used for dentin moisture measurements.

Influence of glutaraldehyde priming on bond strength of an experimental adhesive system applied to wet and dry dentine

OBJECTIVES

This study tested the following null hypotheses: (1) there is no difference in resin-dentine bond strength when an experimental glutaraldehyde primer solution is added prior to bonding procedures and (2) there is no difference in resin-dentine bond strength when experimental glutaraldehyde/adhesive system is applied under dry or wet demineralized dentine conditions.

METHODS

Extracted human maxillary third molars were selected. Flat, mid-coronal dentine was exposed for bonding and four groups were formed. Two groups were designated for the dry and two for the wet dentine technique: DRY: (1) Group GD: acid etching+glutaraldehyde primer (primer A)+HEMA/ethanol primer (primer B)-under dried dentine+unfilled resin; (2) Group D: the same as GD, except for primer A application; WET: (3) Group GW: the same as GD, but primer B was applied under wet dentine condition; (4) Group W: the same as GW, except for primer A application. The bonding resin was light-cured and a resin core was built up on the adhesive layer. Teeth were then prepared for microtensile bond testing to evaluate bond strength. The data obtained were submitted to ANOVA and Tukey's test (alpha=0.05).

RESULTS

Glutaraldehyde primer application significantly improved resin-dentine bond strength. No significant difference was observed when the same experimental adhesive system was applied under either dry or wet dentine conditions. These results allow the first null hypothesis to be rejected and the second to be accepted.

CONCLUSION

Glutaraldehyde may affect demineralized dentine properties leading to improved resin bonding to wet and dry substrates.

Dentine sealing provided by smear layer/smear plugs vs. adhesive resins/resin tags

The aim of this study was to evaluate the ability of five experimental resins, which ranged from hydrophobic to hydrophilic blends, to seal acid-etched dentine saturated with water or ethanol. The experimental resins (R1, R2, R3, R4, and R5) were evaluated as neat bonding agents (100% resin) or as solutions solvated with absolute ethanol (70% resin/30% ethanol). Fluid conductance was measured at 20 cm H(2)O hydrostatic pressure after sound dentine surfaces were: (i) covered with a smear layer; (ii) acid-etched; or (iii) bonded with neat or solvated resins, which were applied to acid-etched dentine saturated with water or ethanol. In general, the fluid conductance of resin-bonded dentine was significantly higher than that of smear layer-covered dentine. However, when the most hydrophobic neat resins (R1 and R2) were applied to acid-etched dentine saturated with ethanol, the fluid conductance was as low as that produced by smear layers. The fluid conductance of resin-bonded dentine saturated with ethanol was significantly lower than for resin bonded to water-saturated dentine, except for resin R4. Application of more hydrophobic resins may provide better sealing of acid-etched dentine if the substrate is saturated with ethanol instead of with water.

Effect of loading and pH on the subsurface demineralization of dentin beams

It is important to understand subsurface dentin demineralization and caries from the clinical perspective as dentin properties are modified under acidic conditions and mechanical loading. This study was conducted to observe the subsurface demineralization of dentin beams at three different pH levels under tension and compression. Bovine dentin beams (10 x 3.75 x 1.45 mm) were fixed at one end and immersed in 0.1 M lactic acid solution at pH levels 4.5, 7, and 10 for 5 days under a load of 6.5 N (663 g), and the subsurface demineralization depth was measured using a polarized light microscope. The mean subsurface demineralization depth was more subjacent to the surface under compression than that under tension at pH 4.5 and decreased as the distance from the fixed end increased. No subsurface demineralization was observed at pH 7 or 10. It was concluded that both stress and low pH are associated with increased subsurface demineralization at the fixed end of the beam.

Effect of Dentin Conditioning Time on Nanoleakage

Increasing dentin conditioning time did not affect nanoleakage for any of the dentin adhesives used in this study.

HEMA diffusion from dentin bonding agents in young and old primary molars in vitro

OBJECTIVE

The objective of this study was to evaluate and compare amounts of HEMA diffusion from three dentin bonding systems in young and old primary molars at a remaining dentin thickness (RDT) of 1 mm.

METHODS

Occlusal cavities were prepared with RDT of 1 mm in young and old primary molars. Chambers that contain 1 ml of distilled water were attached to each tooth. The groups were treated with Total Etch+Syntac Single Component, Syntac Single Component and Clearfil SE Bond. Water eluates were analyzed by HPLC at 4 min, 24 h and 72 h.

RESULTS

The cumulative HEMA release amounts were significantly different among all groups (p<0.05). Acid-etching significantly increased pulpward diffusion of HEMA and young primary teeth presented higher dentin permeability.

SIGNIFICANCE

Acid-etching significantly increases pulpward release of HEMA from dentin bonding systems in primary molar teeth. Young primary molars have higher dentin permeability; so the pulp should be protected with cavity liners in deep cavities. However, the dentin bonding systems can be considered safe for clinical use in primary teeth, even in deep cavities, since the released HEMA amounts are below the level of cytotoxicity.

Microleakage of class V resin composite restorations after conventional and Er:YAG laser preparation

This in vitro study compared the microleakage of Class V resin composite restorations at bevelled enamel/composite and dentin/composite interfaces following Er:YAG laser (pre-treatment modalities: laser-etching and/or acid-etching) or conventional preparation and acid-etch, in association with two resin composite formulations and their three-step adhesive system. Class V cavities with conventional bevel produced on the lingual and buccal surfaces of eighty extracted caries- and restoration-free human teeth, were assigned to eight groups: cavities were or Er:YAG-lased and acid-etched (groups 1 and 5); or Er:YAG-lased, laser-etched and acid-etched (groups 2 and 6); or Er:YAG-lased and only laser-etched (groups 3 and 7); or cut by dental drill at high-speed and acid-etched (groups 4 and 8). The specimens were restored with Optibond FL+Herculite XRV (groups 1, 2, 3 and 4) or with Scotchbond MP+Z 100 (groups 5, 6, 7 and 8), stored in distilled water at 37 degrees C for 24 h, thermocycled 1500 times between 5 and 55 degrees C, placed in a 2% aqueous solution of methylene blue for 24 h at 37 degrees C, embedded in resin and sectioned. Microleakage was assessed according to the depth of dye penetration along the restoration. There were statistically significant differences between occlusal and cervical regions for all groups (P<0.01) except for groups 3 and 7. Pair-wise comparison of groups showed that acid-etch is advocated when using resin composite in Er:YAG-lased Class V cavities; the seal at enamel margins in Er:YAG-lased and laser-etched cavities depended on the resin composite formulation and corresponding adhesive (P<0.05).

Direct restoration of worn maxillary anterior teeth with a combination of composite resin materials: a case report

Tooth loss, alterations on tooth structure, and reduced vertical dimension are known to severely compromise the stomatognathic system. This case report describes the treatment of a patient who presented with an extremely worn maxillary anterior dentition with a loss of posterior support owing to the loss of almost all the posterior teeth, except the mandibular premolars. Provisional removable partial dentures were used to create an optimum maxillomandibular relationship and to provide restorative space prior to the restoration of the remaining teeth. This restoration was accomplished with a combination of layered hybrid and microfilled composite materials, which restored the maxillary anterior teeth to optimum esthetics and function.

Water content and apparent stiffness of non-caries versus caries-affected human dentin

Caries-affected dentin contains less mineral and more water than surrounding normal dentin. Such dentin should be less stiff and should shrink more than normal dentin when dried. The purpose of this study was to test the relationships between the stiffness, shrinkage, and water content of caries-affected versus normal dentin. Extracted human carious third molars were stained with caries-detector dye and the occlusal surfaces ground down until only caries-affected dentin remained, surrounded by normal dentin. Dentin disks were prepared from these crowns placed in a aluminum well positioned under a modified thermal mechanical analyzer. Changes in specimen height and stiffness were measured following drying or static loading in both caries-affected and surrounding normal dentin. Core samples of these two types of dentin were used to gravimetrically measure water content. Two-way ANOVA and regression analysis was used to test the relationship between shrinkage versus water content, stiffness versus water content, and stiffness versus shrinkage. Caries-affected dentin was found to be less stiff and contained more water than normal dentin (p < 0.05). Regression analysis revealed highly significant inverse relationships between stiffness and water content, and stiffness and shrinkage (p < 0.0005).

Effects of solvents on the early stage stiffening rate of demineralized dentin matrix

OBJECTIVES

To monitor the stiffening rate of demineralized dentin matrix at the early stages after exposure to different neat solvents.

METHODS

Dentin beams approximately 0.8x0.7x8.0 mm were obtained from human third molars. After covering their ends with resin composite, the middle exposed length of 4.0mm (gauge-length) was demineralized in 0.5 M EDTA (pH 7.0) for 7 days. The specimens were gripped by a testing machine, pre-loaded to 10 g and cyclically stressed in tension to 5% strain, for 30 repeated cycles (total 20 min) at 0.6 mm/min while immersed in water (control). Then, water was replaced by either 100% acetone, methanol, ethanol, propanol, HEMA or air and the specimens subjected to the same cyclic protocol. The maximum apparent modulus of elasticity (E(Max)) was calculated for every cycle, plotted as a function of time and subjected to regression analysis. Stiffening rate was calculated as changes in E (min). Regression analysis examined the relationship between E and time for each solvent. Data were analyzed by one-way ANOVA and Student-Newman-Keuls test at alpha=0.05.

RESULTS

Regression analysis showed that E increased significantly with time in all water-free solvents (R2=0.8-0.99). Stiffening rate was higher for acetone (0.9 MPa/min) and ethanol (0.8 MPa/min), intermediate for air (0.7 MPa/min), methanol (0.6 MPa/min) and propanol (0.5 MPa/min), lower for HEMA (0.2 MPa/min) and practically none for water (0.07 MPa/min) with p<0.05.

CONCLUSIONS

The solvent-induced stiffening rate of demineralized dentin matrix is both time and solvent-dependent. The ability of solvents to promptly stiffen the demineralized dentin matrix may be important in maintaining the resin-infiltrated matrix expanded during the solvent evaporation stage of resin bonding.

Mechanical stability of resin-dentin bond components

OBJECTIVES

To evaluate the effects of long-term storage on the mechanical properties of the components of resin-dentin bonds, that is, resin composite, adhesive system, demineralized and mineralized dentin.

METHODS

Specimens of resin composite (Z250) and adhesive systems (Single Bond-SB; One-Step-OS and Clearfil Liner Bond 2V-CL) were cast in molds. Dentin specimens were prepared from dentin discs obtained from the crowns of extracted human molars. Specimens of demineralized dentin were obtained by immersion of dentin discs for 6 days in 0.5 mol/l EDTA (pH 7.0). Both dentin and resin-based substrates were shaped to hourglass or I-beam specimens that were used to determine the true stress (TS) or apparent modulus of elasticity (E), respectively. Control specimens were subjected to tensile testing at 0.6 mm/min after 24 h of immersion in distilled water. Experimental specimens were stored at 37 degrees C in either distilled water or mineral oil and tested after 12 months. The data of each group were individually analyzed by ANOVA and Tukey's test.

RESULTS

Both TS and E of the resin-based materials decreased significantly after 12 months of storage in water (p < 0.05) except the TS of SB (p > 0.05). No changes were observed for specimens of mineralized dentin, regardless of storage condition (p > 0.05). Storage of demineralized dentin in water did not cause any significant effect in either TS or E (p > 0.05), however, significant reductions of TS and E of demineralized dentin occurred after storage in oil for 1 year (p < 0.05).

SIGNIFICANCE

Storage time and medium may be deleterious to the mechanical properties of the resin-dentin bond components, which ultimately could compromise the durability of resin-dentin bonds.

Tensile strength and microhardness of treated human dentin

OBJECTIVES

To determine the ultimate tensile strength and Knoop hardness of mineralized, EDTA-treated, sodium hypochlorite (NaOCl)-treated, EDTA-treated resin-infiltrated, and NaOCl-treated resin-infiltrated dentin.

METHODS

Dumbell-shaped specimens with a cross-sectional area of 0.5 mm2 were prepared from the crowns of extracted human third molars. Specimens were randomly assigned to the following experimental groups: (1) mineralized dentin; (2) 0.5 M EDTA-demineralized dentin, pH 7/5 days; (3) 5% NaOCl-deproteinized dentin/2 days; (4) EDTA-treated, Single Bond resin-infiltrated dentin; (5) NaOCl-treated, Single Bond resin-infiltrated dentin. All specimens were tested in tension in a Vitrodyne testing machine at 0.6 mm/min. Knoop microhardness was measured on the fractured edges of specimens in groups 1, 3, 4, and 5. Results were analyzed by ANOVA and SNK tests (p < 0.05).

RESULTS

Both EDTA and NaOCl treatments caused significant reductions in the tensile strength and microhardness of mineralized dentin (p < 0.05) with the largest reductions observed after NaOCl treatment (p < 0.05) Resin infiltration of treated dentin resulted in moderate increase of its tensile strength and microhardness, however, the original mineralized values were not recovered (p < 0.05).

SIGNIFICANCE

Whenever dentin surfaces are treated with EDTA or NaOCl prior to a clinical bonding procedure, clinicians must be aware that a weak layer may be present at the interface, which may lead to premature failures of resin/dentin bonds.

AFM observation of collapse and expansion of phosphoric acid-demineralized dentin

The objective of this study is to provide additional data regarding morphological changes that occur to dentin matrices following demineralization with etchants. Our understanding of the mechanism of diffusion of comonomers into the demineralized substrate is very limited. It has been hypothesized that certain water-soluble polyelectrolytes (acidic proteins) and neutral proteins in dentin can influence the collapse of demineralized dentin when it is air dried. Some of these solubilized substances are thought to aggregate by the action of Ca cations, which become dissolved during H(3)PO(4) etching, ultimately resulting in some degree of collapse. In the current study, dentin surfaces were examined by atomic force microscopy (AFM) before and after treatment by 10% H(3)PO(4)containing increasing concentrations of CaHPO(4). Reversal of matrix collapse by aqueous 30% 2-hydroxyethyl methacrylate (HEMA) was evaluated by AMF for 60 min. The results demonstrate two forms of matrix collapse; we speculate that one form is induced by acidic noncollagenous polyelectrolytes and the other by neutral peptides. Our data indicate that further evaluation of the influence of endogenous noncollagenous proteins must be studied to understand the mechanism of the collapse and reexpansion dynamics of demineralized dentin networks.

Effect of sodium hypochlorite on the bond strength of an adhesive system to superficial and deep dentin

The objective of this study was to evaluate the bond strength to superficial (SU) and deep (D) dentin, accessed via apical (DA) or occlusal (DO), using One-Step adhesive system applied according to the manufacturer's instructions (C) or following deproteinization with 10% sodium hypochlorite (H) for 60s, after acid etching. Three sound extracted human molars were prepared for each experimental condition. Restorations were performed using Z100 in 2mm increments, each one being light-cured for 40s. Teeth were longitudinally sectioned to obtain stick-shaped specimens with a cross-sectional area of 0.8mm², which were submitted to bond strength test (0.6mm/min). Results obtained after statistical analysis using a two-way ANOVA (substrate vs. surface treatment) and Tukey's test were: SU (35.4 ± 12.3), DO (26.5 ± 8.5), DA (26.1 ± 10.2) following conventional surface treatment, and SU (28.82 ± 12.7), DO (24.3 ± 8.3) and DA (23.5 ± 8.5), after surface treatment using sodium hypochlorite. The interaction of the factors was not significant (p>0.05). However, the main factors were significant (p<0.05). Mean bond strength values in superficial dentin were statistically superior to deep dentin (p<0.05), although no statistically significant difference was observed between the two via of access to deep dentin (SU>DO=DA). The conventional surface treatment resulted in higher bond strength values than the sodium hypochlorite treatment (p<0.05). It was concluded: 1) bond strength values were higher in superficial dentin, 2) no difference was found between the two deep substrate preparations, and 3) the application of sodium hypochlorite following dentin acid etching may reduce bond strengths.

Effects of HEMA/solvent combinations on bond strength to dentin

Re-expansion of dried demineralized dentin is required to optimize resin adhesion. This study tested the hypothesis that bond strengths to dentin depend upon the ability of experimental HEMA(2-hydroxy-ethyl-methacrylate)/solvent primers to re-expand the matrix. Dentin surfaces were acid-etched with 37% phosphoric acid for 20 sec, air-dried for 30 sec, primed with either 35/65% (v/v) HEMA/water, HEMA/methanol, HEMA/ethanol, or HEMA/propanol for 60 sec, and bonded with 4-META-TBBO(4-methacryloyloxyethyl trimellitate anhydride-tri-n-butyl borane) adhesive. After storage in water for 1 day at 37 degrees C, the samples were prepared for microtensile bond strength testing. We used transmission electron microscopy to measure the width of interfibrillar spaces in the hybrid layers. The HEMA/ethanol primer and the HEMA/propanol primer produced the highest and the lowest bond strengths, respectively (p < 0.05). Bond strengths were directly correlated with the width of the interfibrillar spaces (p < 0.05). Bond strengths are related to the ability of the primer to maintain the re-expansion of collapsed demineralized dentin matrix.

Effect of artificial saliva contamination on pH value change and dentin bond strength

OBJECTIVE

This study was to examine the effect of artificial saliva contamination on pH change of the dentin surface and the micro-shear bond strength (MSBS) of the two bonding systems to contaminated dentin.

METHODS

Fifty-six human dentin disks were tested with two resin bonding systems: a self-etching primer system, Clearfil SE Bond (Kuraray Medical Inc., Tokyo, Japan), and a one-bottle adhesive system, Single Bond (3M-ESPE, St. Paul, MN). Dentin surfaces were conditioned with the self-etching primer (primer) or phosphoric acid (etchant) and divided into four groups: conditioning without contamination (conditioning), contamination with artificial saliva (contamination), re-conditioning the contaminated dentin (re-conditioning), water-rinsing the contaminated dentin and re-conditioning (rinsing and re-conditioning). The pH change on the dentin surface was measured using a pH-imaging microscope (SCHEM-100, Horiba Ltd, Kyoto, Japan) to estimate the acid-base characteristics of the conditioned and contaminated dentin surface. The MSBS to the dentin was examined after storage in distilled water at 37 degrees C for 1 week.

RESULTS

The pH of intact dentin surfaces was 6.9. Conditioning with the primer and etchant decreased the pH to 5.4 and 5.9, respectively. Saliva contamination increased the pH slightly, and re-conditioning decreased the pH again. The MSBS of the two bonding systems decreased after contamination. Re-priming restored the MSBS to control values, while re-etching did not. Rinsing and re-priming produced a reduction in MSBS, and rinsing and re-etching did not increase the MSBS.

SIGNIFICANCE

The conditioning and saliva contamination changed the pH value of dentin surface. The MSBS decreased after contamination; however, re-priming with SE Bond primer was an adequate treatment to restore the bond strength.

Esthetic rehabilitation of anterior teeth affected by enamel hypoplasia: a case report

Alterations during tooth structure formation, mainly on anterior teeth, are known to severely compromise esthetics. This article presents a case report in which the etiology and clinical characteristics of anterior teeth affected by enamel hypoplasia are analyzed. The restoration treatment sequence is also discussed, demonstrating that the use of a hybrid and a microfilled composite associated with tooth hybridization (interdiffusing zone) can be used to conservatively rehabilitate a smile.

CLINICAL SIGNIFICANCE

This article presents a simple and conservative technique for restoring disfiguring areas of enamel hypoplasia to achieve an optimally esthetic result.

Influence of drying and HEMA treatment on dentin wettability

OBJECTIVES

The aim of this study was to evaluate the effect of drying time and primer pre-application (35% HEMA in water) on water spreading/infiltration on dentin.

METHODS

Freshly extracted molars were embedded in resin and sectioned on their coronal side. Flat occlusal dentin surfaces were prepared using wet SiC paper from nos. 80-4000. A computerized contact angle device complementing a special software (Wingoutt) was used to measure the contact angle (theta) kinetics of a reference liquid (pure H(2)O) in the ten groups each of ten dentin surfaces during 120 s: Gp1: etched (37% phosphoric acid for 15 s) and blot-dried; Gp2: 3 s dried; Gp3: 5 s air-dried; Gp4: 10 s air-dried; Gp5: 20 s air-dried; Gp6: 30 s air-dried; Gp7: 1 min dried with hair dryer; Gp8: 5 s air-dried and HEMA treated; Gp9: 30 s air-dried followed by HEMA treatment; Gp10: HEMA treated prior to 30 s air-drying. three drops were applied on each sample. 40 contact angles were recorded for each drop with a frequency of one measure every 3 s. A one-way ANOVA test was used for data analysis. A PLSD test was conducted to identify statistical differences between pairs of groups at a reliability level of 95%.

RESULTS

At each measurement time, air-drying, whatever its duration, significantly decreased the wetting ability of the pure water on the etched dentin in comparison with the blot-dried group. The contact angle increases with drying time. No significant differences in water contact angle were obtained between 3, 5 and 10 s in spite of a slight decrease in the spreading/infiltration ability of water the longer the drying time. HEMA increases the spreading/infiltration ability of water on 5 or 30 s air-dried etched dentin surfaces; 30 s air-drying did not alter the spreading/infiltration ability of the water on etched and HEMA treated dentin.

SIGNIFICANCE

Dentin hydrophobicity increases depending on air-drying time. HEMA-based primer allows to prevent collagen collapse, which may be created by air-drying and partly rewet the collapsed collagen network.

In vivo influence of residual moisture on microtensile bond strengths of one-bottle adhesives

PURPOSE

This study evaluated the microtensile bond strengths of three dentin adhesives applied on clinically moist dentin or on dentin that was dried with air for 5 seconds. The null hypothesis to test was that the level of residual moisture does not influence bond strengths when restorations are placed in vivo.

MATERIALS AND METHODS

Twenty-four premolars scheduled to be extracted for orthodontic reasons from patients between the ages of 15 and 23 years were restored with one of the following adhesive systems followed by a mini hybrid composite resin: Excite (Ivoclar/Vivadent), an ethanol-based dentin adhesive; Prime & Bond NT (Dentsply/Caulk), an acetone-based dentin adhesive; and Single Bond (3M ESPE), an ethanol and water-based dentin adhesive. After extraction, the specimens were sectioned with a slow-speed diamond saw in two perpendicular directions to obtain sticks with a cross-section of 0.7 +/- 0.2 mm2. The specimens were attached to a Geraldeli device and fractured using a universal testing machine at a crosshead speed of 1 mm per minute.

RESULTS

For each dentin adhesive, there were no statistical differences between means for dry dentin versus moist dentin. Single Bond and Prime & Bond NT ranked in the same statistical subset regardless of the moisture condition of the substrate. Both Excite, dry, and Excite, moist, resulted in statistically lower bond strengths than Single Bond, moist, but similar to those of Single Bond, dry, Prime & Bond NT, moist, and Prime & Bond NT, dry.

CLINICAL SIGNIFICANCE

In this study, the level of residual moisture did not influence microtensile bond strengths. Clinically, the degree of moisture left on the dentin surface upon rinsing off the etching gel may not be as relevant as previously reported in laboratory studies.

The effect of thermocycling regimens on the nanoleakage of dentin bonding systems

OBJECTIVES

The purpose of this study was to compare nanoleakage associated with polished and fractured specimens, and evaluate the effects of thermocycling on nanoleakage.

METHODS

The dentin bonding systems used in this study were PermaQuik and Prime and Bond NT (PBNT). Flat occlusal dentin surfaces and class V cavities from extracted human molars were bonded with one of the dentin bonding systems. With or without thermocycling, samples were immersed in a 50% w/v solution of silver nitrate for 24h, and exposed to photodeveloping solution for 8h. The specimens were cut or fractured, and mounted on stubs, carbon coated and observed in a Field Emission-SEM using backscattered electron mode.

RESULTS

Polished and fractured specimens showed similar nanoleakage patterns for both dentin-bonding systems. Thermocycling with regimens of different temperatures and number of cycles did not result in different nanoleakage patterns and leakage lengths in controls and thermocycled groups. PBNT combined with non-rinse conditioner (NRC) produced no significant difference in nanoleakage length, but a somewhat different nanoleakage pattern, compared with PBNT and 34% phosphoric acid.

SIGNIFICANCE

Thermocycling does not have an effect on nanoleakage of dentin bonding systems. The smearing effect from sectioning and polishing procedures does not affect the nanoleakage result.

Morphology and thickness of the diffusion of resin through demineralized or unconditioned dentinal matrix

The formation of a hybrid layer is the main bonding mechanism of current dentin-bonding systems. This study evaluated the morphology and thickness of the resin-infiltrated dentinal layer after the application of adhesive systems. The dentin-bonding agents were evaluated on flat dentinal preparations confected on the occlusal surfaces of human teeth. The test specimens were prepared and inspected under scanning electron microscopy at a magnification of X 2,000. The adhesive systems were responsible for different hybrid layer thicknesses (p < 0.05), and the mean values were: for Scotchbond MP Plus (SM), 7.41 +/- 1.24 micrometer for Single Bond (SB), 5.55 +/- 0.82 micrometer for Etch & Prime 3.0 (EP), 3.86 +/- 1.17 micrometer and for Clearfil SE Bond (CB), 1.22 +/- 0.45 micrometer. The results suggest that the conventional three-step adhesive system (SM) was responsible for the thickest hybrid layer, followed by the one-bottle adhesive (SB). The self-etching adhesives, EP and CB, produced the formation of the thinnest hybrid layers.

Solvent-induced dimensional changes in EDTA-demineralized dentin matrix

The purpose of this study was to test the null hypothesis that the re-expansion of dried matrix and the shrinkage of moist, demineralized dentin is not influenced by polar solvents. Dentin disks were prepared from midcoronal dentin of extracted human third molars. After complete demineralization in 0.5M of EDTA (pH 7), the specimens were placed in the well of a device that measures changes in matrix height in real time. Dry, collapsed matrices were created by blowing dry N(2) on the specimens until they shrank to a stable plateau. Polar solvents [water, methanol, ethanol, n-propanol, n-butanol, formamide, ethylene glycol, hydroxyethyl methacrylate (HEMA), or mixtures of water-HEMA] as model primers then were added and the degree of re-expansion measured. These same solvents also were applied to moist, expanded matrices and the solvent-induced shrinkages measured. Regression analysis was used to test the correlations between matrix height and Hansen's dispersive, polar, hydrogen bonding, and total solubility parameters (delta(d), delta(p), delta(h), delta(t)). The results indicate that water-free polar solvents of low hydrogen bonding (H-bond) ability (e.g., neat HEMA) do not re-expand dried matrices and that they shrink moist matrices. When HEMA was mixed with progressively higher water concentrations, the model water-HEMA primers expanded the dried matrix in proportion to their water concentrations and they produced less shrinkage of moist matrices. Solvents with higher H-bonding capacities (methanol, ethanol, ethylene glycol, formamide, and water) re-expanded the dried matrix in proportion to their solubility parameters for H-bonding (delta(h)). They also induced small transient shrinkages of moist matrices, which slowly re-expanded. The results require rejection of the null hypothesis.

The effect of fluoridated and non-fluoridated rewetting agents on in vitro recurrent caries

OBJECTIVE

This study examined the in vitro caries inhibiting potential of fluoridated and non-fluoridated rewetting agents that are applied to acid-etched enamel and dentine before the use of a water-free, dentine adhesive.

MATERIALS AND METHODS

Twelve caries-free premolars were divided into three groups of four teeth each. 2 x 3 x 1.5 mm cavities were prepared on the mesial and distal surfaces of each tooth, with half of the cavosurface margin in enamel and half in root dentine. In Group I (control), One-Step (Bisco, Schaumburg, USA) was applied without etching or rewetting agents. In Group II, cavities were acid-etched, rinsed, dried, and rewetted with Aqua-Prep (Bisco), a non-fluoridated rewetting agent, and then bonded with One-Step. Treatment for Group III was similar to Group II, except that Aqua-Prep F (Bisco), a fluoridated rewetting agent was used. Bonded cavities were restored with a non-fluoride-containing flowable composite (AEliteFlo, Bisco). Artificial carious lesions were induced in these specimens, from which multiple 100+/-20 microm thick longitudinal sections were prepared, yielding 16 specimens per group for evaluation with polarised light microscopy (PLM) and microradiography (MRG). Representative sections were processed for transmission electron microscopy (TEM) examination and scanning transmission electron microscopy/energy dispersive X-ray (STEM/EDX) analyses.

RESULTS

The differences in demineralisation of dentine among the groups were not statistically significant for 'relative' lesion depth (p > 0.05, ANOVA, Student-Neuman-Keuls test), but highly significant for 'relative' lesion area (p < 0.001). Wall lesions were consistently present in Group I, while inhibition zones were invariably observed in Group III. 87.5% of Group II specimens exhibited neither wall lesion nor inhibition zone. TEM showed that remnant dentine apatite crystallites within the inhibition zones in Group III were larger and denser than those present within the corresponding wall lesions. STEM/EDX analyses confirmed the presence of calcium, phosphorus and fluorine in these plate-like crystallites.

CONCLUSION

When used with a water-free, single-bottle dentine adhesive, a non-fluoridated rewetting agent is able to reduce, but cannot completely prevent recurrent caries. The use of a fluoridated rewetting agent is useful under the situation when microleakage occurs, by providing the additional benefit of fluoride-induced demineralisation inhibition.

Study of the maturation of the organic (type I collagen) and mineral (nonstoichiometric apatite) constituents of a calcified tissue (dentin) as a function of location: a Fourier transform infrared microspectroscopic investigation

Fourier transform infrared microspectroscopy (FTIRM) was used to investigate the organic and mineral phases of a calcified tissue (dentin) as a function of its location from predentin toward enamel. Thin dentin slices (decalcified or not) were fixed in formaldehyde and embedded in glycolmethylmethacrylate (GMA). Fixation did not denature collagen, and GMA did not interact with organic or mineral constituents of dentin. The v1v3 PO4 domain was studied in particular in order to estimate mineral maturity and amide I, II, A, and B to obtain data on protein conformation. The results showed that dentin apatite became increasingly mature (stoichiometric) from the mineralization front toward the enamel, especially through loss of HPO4(2-) groups and vacancies. Moreover, collagen fibrils became less and less hydrated, suggesting that intrafibrillar mineralization partially dehydrated the collagen. Combined study of the organic and mineral fractions of calcified tissues may help clarify their relationships in physiological and pathological tissues.

Marginal quality and microleakage of adhesive class V restorations

OBJECTIVES

The aim of this in vitro study was to determine the marginal quality and microleakage of composite resin class V restorations.

METHODS

Standardized mixed class V cavities (diameter: 4mm, depth: 2mm) with half of the finish lines limited within dentin were cut in 90 freshly extracted human molars and randomly assigned to nine groups (n=10). After etching enamel and dentin, the cavities were restored with nine different restorative systems (Syntac Sprint/Tetric Ceram=SS, Syntac Single-Component/Tetric Ceram=SC, Onestep/Aeliteflo=OS, Aquaprep+Onestep/Aeliteflo=OA, Prime & Bond 2.1/TPH=PB, Optibond Solo/Prodigy=OP, Singlebond/Z100=SB, Tenure Quik/Marathon=TQ, Solobond M/Arabesk=SM) using a wet-bonding procedure. After finishing and polishing, the teeth were stored for 24h in distilled water at 37 degrees C before they were subjected to thermocycling (5/55 degrees C, 1000x). Epoxy replicas were made for margin analysis in the SEM. Specimens were stained in methylene blue, sectioned, and evaluated for microleakage. Dye penetration was scored on a 0-3 ordinal scale.

RESULTS

Statistical analysis (Kruskal-Wallis H-test, Mann-Whitney U-test) revealed significant differences (P<0.05) among the groups at dentin and enamel margins for the microleakage scores as well as for the results of the quantitative SEM margin analysis. SC revealed a significantly higher percentage of perfect margins in the SEM than OS and SM in enamel and dentin, respectively. OA exhibited significantly more leakage in enamel than all other groups.

CONCLUSIONS

None of the tested restorative systems achieved a perfect seal in dentin and enamel of mixed class V cavities. Marginal quality and sealing ability of adhesive systems to dentin, using a wet-bonding procedure, is still inferior compared with enamel margins.