Pulp response to a composite resin inserted in deep cavities with and without a surface seal

Heat generated during dental treatments affecting intrapulpal temperature: a review

INTRODUCTION

Heat is generated and transferred to the dentine-pulp complex during various dental procedures, such as from friction during cavity preparations, exothermic reactions during the polymerisation of restorative materials and when polishing restorations. For in vitro studies, detrimental effects are possible when intra-pulpal temperature increases by more than 5.5°C (that is, the intra-pulpal temperature exceeds 42.4°C). This excessive heat transfer results in inflammation and necrosis of the pulp. Despite numerous studies stating the importance of heat transfer and control during dental procedures, there are limited studies that have quantified the significance. Past studies incorporated an experimental setup where a thermocouple is placed inside the pulp of an extracted human tooth and connected to an electronic digital thermometer.

METHODS

This review identified the opportunity for future research and develop both the understanding of various influencing factors on heat generation and the different sensor systems to measure the intrapulpal temperature.

CONCLUSION

Various steps of dental restorative procedures have the potential to generate considerable amounts of heat which can permanently damage the pulp, leading to pulp necrosis, discoloration of the tooth and eventually tooth loss. Thus, measures should be undertaken to limit pulp irritation and injury during procedures. This review highlighted the gap for future research and a need for an experimental setup which can simulate pulp blood flow, temperature, intraoral temperature and intraoral humidity to accurately simulate the intraoral conditions and record temperature changes during various dental procedures.

Phosphorus Effects of Mesoporous Bioactive Glass on Occlude Exposed Dentin

In recent studies, sealing of exposed dentinal tubules is generally considered as one of the most effective strategies to treat dentin hypersensitivity. Mesoporous bioactive glass (MBG) is a potential material for treating dentin hypersensitivity due to its highly specific areas for dissolution and re-precipitated reaction for reduction in dentin permeability. The groups of commercial products of PerioGlas®, synthetic MBG and MBG without phosphorus (MBGNP) were compared. The MBG and MBGNP powders were prepared by the sol-gel method and mixed with different calculated ratios of phosphoric acid (PA) and then was brushed onto dentin surfaces. We used X-ray diffractometer (XRD), scanning electronic microscope (SEM), and Fourier transform infrared spectroscopy (FTIR) to investigate the physiochemistry and the occlusion ability of dentinal tubules. The results showed that MBG paste mixed with PA solution has a better ability for occluding dentinal tubules than MBGNP; it has a short reaction time and good operability. The major crystallite phase of MBG agents was monocalcium phosphate monohydrate [Ca(H₂PO₄)₂·H₂O] in the early stages of the reactions. MBG pastes that were mixed with 30% and 40% PA had the ability to create excellent penetration depth greater than 80 μm. These agents have the potential to treat dentin hypersensitivity.

Molecular toxicology of substances released from resin-based dental restorative materials

Resin-based dental restorative materials are extensively used today in dentistry. However, significant concerns still remain regarding their biocompatibility. For this reason, significant scientific effort has been focused on the determination of the molecular toxicology of substances released by these biomaterials, using several tools for risk assessment, including exposure assessment, hazard identification and dose-response analysis. These studies have shown that substances released by these materials can cause significant cytotoxic and genotoxic effects, leading to irreversible disturbance of basic cellular functions. The aim of this article is to review current knowledge related to dental composites' molecular toxicology and to give implications for possible improvements concerning their biocompatibility.

Biocompatibility of Resin-based Dental Materials

Oral and mucosal adverse reactions to resin-based dental materials have been reported. Numerous studies have examined the biocompatibility of restorative dental materials and their components, and a wide range of test systems for the evaluation of the biological effects of these materials have been developed. This article reviews the biological aspects of resin-based dental materials and discusses the conventional as well as the new techniques used for biocompatibility assessment of dental materials.

Component release from light-activated glass ionomer and compomer cements

The purpose of this study was to identify and quantify any component released from seven commercially available light-cured or resin-modified glass ionomer and compomer cements. Twenty-one separate cylindrical stainless steel moulds 6 mm in diameter and 1.0 mm deep were filled with one of seven glass ionomer or compomer cements, light activated and then immediately immersed in separate containers of distilled water. Water samples were retrieved over a time period of up to 30 days and retained for analysis. An occlusal cavity 6 mm in diameter was prepared in extracted human third molar teeth with a remaining dentin thickness of 1.6-2.0 mm. A polypropylene chamber was attached to the cemento-enamel junction of each tooth to contain 1 mL of distilled water. Ten teeth were each filled with one of three cements and light activated. Water samples (eluates) were retrieved over a period of time. All samples were analysed by high performance liquid chromatography. Only one component, hydroxyethyl methacrylate (HEMA), was detected in the eluates from both tooth and mould samples. Analysis of diffusion of the HEMA through dentin showed a relatively sustained movement into the pulp space during the first day, with exponential decline thereafter. Our data show that HEMA was released from all of the light activated glass ionomer cements studied and from the compomer, both directly into water and through dentin. This release may be relevant both to the risk of adverse pulpal responses in patients and to the risk of allergy in patients and dental personnel.

Enhanced permeability of acid-etched or ground dental enamel

STATEMENT OF PROBLEM

Acid etching creates retentive microcraters on enamel surfaces. Designing of a partial denture often involves reshaping the supporting and retentive teeth by grinding the enamel. Unfortunately, both these procedures damage the enamel surface. In vivo such surface damage takes several months to recover.

PURPOSE

This study evaluated the effect of 1-minute etching, prolonged etching, and grinding on the permeability of dental enamel for water-soluble molecules.

MATERIAL AND METHODS

With the electron paramagnetic resonance and a two-chamber diffusion cell, the influence of etching and grinding on the diffusion of spin label molecules through the enamel was studied quantitatively. The enamel permeability was measured in 30 sound enamel samples, of which 10 samples were exposed to 1-minute etching with 37% phosphoric acid, 10 samples were etched for 5 minutes, and 10 samples were ground with a diamond bur.

RESULTS AND CONCLUSIONS

All procedures significantly increased the permeability of dental enamel. These results demonstrate that in vivo the acid-etched and ground dental enamel surfaces are less protected and consequently, unless the tooth is properly protected, are more susceptible to carious lesions. Therefore ground or accidentally etched enamel should be protected.

Bioavailability of components of resin-based materials which are applied to teeth

Chemical components of many materials used in dental practice can move into the local biophase, where they can have beneficial or adverse effects. The strongest indirect evidence that components of resin-based materials used in dentistry can move into the biophase are the many reports of allergic dermatitis in dental personnel. Direct measurement of component release has shown that triethylene glycol dimethacrylate (TEGDMA), hydroxyethyl methacrylate (HEMA), and, in the case of some orthodontic cements, bis-glycidyl methacrylate and benzoyl peroxide can move into an aqueous medium from a range of resin-based materials which are applied to teeth as part of oral care. In the case of resin composite restorations, HEMA and TEGDMA are available in microgram quantities via the salivary surface in the minutes and hours after clinical placement and via dentin and pulp in the hours and days after placement. Fortunately, moderate thickness of dentin protects pulp tissue against local toxicity. There are no data which suggest that systemic toxicity is a risk with any of these materials. There are some case reports of allergic responses to the monomers in patients, but the incidence of such responses appears at present to be much lower than that in dental personnel.

Effect of glass ionomer liners on bonding strength of laminate veneers

This study compared shear bond strengths of porcelain laminate veneers, fabricated on refractory dies, which were lengthened incisally by 0.5 mm. Specimens were divided into four separate groups. In group A, the teeth were reduced 0.5 mm and the bonding was to enamel. The teeth of the remaining groups were reduced 1.0 mm and the bonding was to dentin. For two of the groups glass ionomer liners were applied before etching. Bonding to enamel was best, with cohesive fractures in porcelain. In the other groups, failure was adhesive in nature, occurring at the resin-tooth interface.

Clinical evaluation of four anterior composite resins over five years

Four hundred and thirty nine chemical-cured composite resin restorations were placed in the anterior teeth of 86 patients treated in a private dental practice. Four anterior resins were used, and placement was performed with acid etching and appropriate enamel bonding resins. Assessments were made of the handling characteristics, condition of the gingiva, surface staining, marginal staining, color deterioration, and of the longevity of the four materials. Clinical deterioration rates and failures of the different types of composites were evaluated over periods of up to five years. Although all the assessed clinical factors deteriorated with time, there were very few unsatisfactory rating scores. Most of the composite restorations performed well over the study. Eight per cent of the restorations failed during the study. Class IV preparations showed the highest restoration failure rates.