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Park H, Hong S, Chrzan B, Al-Talib T, Abubakr NH. Resin infiltration for white spot lesions: An in vitro experimental trial. J Orthod 2024:14653125241244806. [PMID: 38587302 DOI: 10.1177/14653125241244806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To evaluate the aesthetic outcome by varying the duration allowed for infiltrant penetration when treating white spot lesions with resin infiltration. DESIGN An in vitro, experimental randomised study. METHODS Artificially created white spot lesions (WSLs) were induced on 100 extracted anterior teeth (T1). Teeth were divided into enamel and dentine groups depending on the extent of the lesion and then randomly assigned into different treatment protocol groups: penetration times of 3, 6 and 9 min. Resin infiltration treatment was applied according to the treatment protocol assigned (T2). Samples were thermocycled for 10,000 cycles (1 clinical year) (T3). The samples from the 3-min enamel and dentine groups were then randomly assigned into either a repeat treatment or no additional treatment group (T4). Samples were then thermocycled for an additional 10,000 cycles (T5). Spectrophotometric analysis was measured colour change (ΔE) for all groups. RESULTS Mean ΔE values equal to or greater than the critical value (3.7) indicate a detectable clinical difference in colour of the treated WSL when compared to before WSL formation. Mean ΔE values, for the enamel groups, were slightly above or significantly below the critical value, and for the dentine groups, were significantly above the critical value. Mean ΔE values within the enamel and dentine groups both demonstrated a downward trend with increasing time allowed for resin infiltrant penetration (P < 0.05). No significant mean ΔE difference (P = 0.53) was found between groups that received a single or repeat treatment. After the first thermocycling event, no significant difference in colour change was observed in all groups except for the deep dentine lesion treated for 3 min. There was a significant difference in colour change for all groups except the enamel group that received a single treatment following thermocycling after a single or repeat treatment. CONCLUSION Increasing the resin infiltrant penetration time to at least 9 min is advised as the most optimised treatment protocol. Resin infiltration treatment should be done only once to treat a particular white spot lesion as subsequent treatment for the same lesion results in marginal colour improvement. The colour improvement of WSLs resulting from the resin infiltration treatment can be expected to last for at least 1 year. Resin infiltration treatment of shallow lesions with a single and optimised infiltration technique can be expected to last an additional year.
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Affiliation(s)
- Hahnnah Park
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Sandy Hong
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Brian Chrzan
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Tanya Al-Talib
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
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Srikumar GPV, Ghosh M, Kumar AA, Bardia S, Wasule A, Beautlin JS. An in vitro evaluation of Icon resin infiltrant penetration into demineralized enamel lesions using an indirect staining technique with confocal laser scanning microscope analysis in dual fluorescence mode. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:366-372. [PMID: 38779214 PMCID: PMC11108420 DOI: 10.4103/jcde.jcde_3_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 05/25/2024]
Abstract
Context White spot lesion is the first clinical sign of a caries lesion and represents mineral loss from the enamel subsurface. Aim The aim of this study was to evaluate the penetration depth (PD) of Icon resin infiltrant into artificially demineralized enamel lesions using confocal laser scanning microscope (CLSM) analysis in dual fluorescence mode. Settings and Designs The design of the study was an in vitro study. Materials and Methods 22 extracted human permanent maxillary central incisor teeth were collected, and enamel sections were obtained from the coronal middle third. All enamel specimens were exposed to demineralization and remineralization solutions for 14 days. On positive confirmation of enamel demineralization by scanning electron microscope analysis, 20 specimens were then subjected to Icon resin infiltration following manufacturer instructions. Specimens were processed with indirect staining technique using rhodamine B and sodium fluorescein dyes and examined under CLSM at ×10 magnification in dual fluorescence mode using ImageJ software to evaluate PD of resin infiltrant into demineralized enamel lesions. Statistical Analysis Used Obtained data were analyzed using an independent t-test. P ≤0.05 was considered statistically significant. Results The maximum depth of demineralized enamel lesion was 590 μm, and the mean depth was 290.78 ± 14.80 μm. The maximum depth of resin infiltrant penetration was 580 μm, and the mean depth was 279.08 ± 13.88 μm; P = 0.006. The percentage penetration of resin infiltrant was 95.99%. Conclusion Icon resin infiltrant was highly effective in its depth of penetration into demineralized enamel lesions. The use of indirect staining and CLSM analysis in dual fluorescence mode is more reliable and accurate technique to evaluate the PD of resin infiltrant.
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Affiliation(s)
- G. P. V. Srikumar
- Department of Conservartive Dentistry and Endodontics, Triveni Institute of Dental Sciences, Hospital and Research Centre, Bilaspur, Chhattisgarh, India
| | - Megha Ghosh
- Department of Conservartive Dentistry and Endodontics, Triveni Institute of Dental Sciences, Hospital and Research Centre, Bilaspur, Chhattisgarh, India
| | - A. Arvind Kumar
- Department of Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, Tamil Nadu, India
| | - Siddharth Bardia
- Department of Conservative Dentistry and Endodontics, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Akansha Wasule
- Department of Conservartive Dentistry and Endodontics, Triveni Institute of Dental Sciences, Hospital and Research Centre, Bilaspur, Chhattisgarh, India
| | - J. S. Beautlin
- Department of Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, Tamil Nadu, India
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Aref NS, Alsdrani RM. Surface topography and spectrophotometric assessment of white spot lesions restored with nano-hydroxyapatite-containing universal adhesive resin: an in-vitro study. BMC Oral Health 2023; 23:911. [PMID: 37993884 PMCID: PMC10666413 DOI: 10.1186/s12903-023-03642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND White spot lesion (WSL) is a main shortcoming accompanied by orthodontic treatment. It impairs the esthetic, surface hardness, and surface texture of enamel. So, this study was conducted to analyze the surface characteristics and color change of white spot lesions treated with nano-hydroxyapatite (nHA)-enriched universal adhesive resin. MATERIALS AND METHODS Eighty sound human permanent molars crowns were sectioned into two halves, producing 160 specimens. 16 specimens were left untreated, and 144 specimens were artificially-demineralized to generate WSLs. The specimens were classified according to the treatment approach applied as follows: I; Sound enamel, Group II; artificially-created WSLs, Group III; ICON resin-restored WSLs, Group IV; Universal adhesive resin-restored WSLs, Group V; 0.5 wt% nHA-containing universal adhesive resin-restored WSLs, Group VI; 1 wt% nHA-containing universal adhesive resin- restored WSLs, and Group VII; 3 wt% nHA-containing universal adhesive resin-restored WSLs, Group VIII; 5 wt% nHA-containing universal adhesive resin-restored WSLs, Group IX; 7 wt% nHA-containing universal adhesive resin-restored WSLs, and Group X; 10 wt% nHA-containing universal adhesive resin-restored WSLs. Some surface characteristics and color changes were assessed. Data was collected and analyzed statistically using ANOVA and the Tukey test at p < 0.05. RESULTS Surface microhardness of WSLs was significantly improved with all investigated ratios of nHA-containing universal adhesive (p < 0.0001), with the highest mean belonging to 10 wt% nHA-containing universal adhesive resin treated WSLs. All ratios of nHA-containing universal adhesive resin significantly reduced the surface roughness of WSLs (p < 0.0001). The investigated ratios of 1, 3, 5, 7, and 10 wt% nHA-containing universal adhesive resin treatment approach could mask the WSLs significantly (p < 0.0001). CONCLUSIONS Nano-hydroxyapatite-containing universal adhesive is a promising contemporary approach for the management of WSLs, coupled both the remineralizing concept and the minimally invasive resin infiltration.
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Affiliation(s)
- Neven S Aref
- Dental Biomaterials Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
- Basic Oral and Medical Sciences Department, College of Dentistry, Qassim University, Buraydah, Saudi Arabia.
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Altan H, Yilmaz RE. Clinical evaluation of resin infiltration treatment masking effect on hypomineralised enamel surfaces. BMC Oral Health 2023; 23:444. [PMID: 37400849 DOI: 10.1186/s12903-023-03140-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 06/15/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Resin infiltration is a micro-invasive treatment for molar incisor hypomineralisation (MIH). In this study it was aimed to evaluate the masking effect of resin infiltration treatment (ICON) on hypomineralised enamel surface of permanent anterior teeth by using laser fluorescence, spectrophotometer, and cross-polarisation photography. METHODS A total of 116 permanent central incisors in 37 patients were included in the study. The resin infiltration treatment (Icon®) was applied to the teeth with MIH; the healthy teeth received no treatment (control). Hypomineralised enamel lesions were evaluated by ICDAS II criteria. DIAGNOdent Pen was used to assess the lesions and healthy enamel surface quantitatively. Colour changes in enamel lesions were evaluated by using a spectrophotometer (VITA EasyShare). Each enamel lesion was imaged using a cross-polarization technique before and after treatment. All photos were assessed using Image J to evaluate the changes in lesion size. Enamel lesions were evaluated before; immediately after; 1; 3; and 6 months after treatment. Statistical significance was set as p < 0.05. RESULTS After the resin infiltration, significant decreases were found in the mean DIAGNOdent values for the treatment group (p < 0.05). The colour differences before and after treatment significantly differed in all follow-ups (p < 0.05). In the treatment group, lesion areas decreased significantly after treatment (p < 0.05). CONCLUSIONS The resin infiltration treatment has a masking effect on MIH lesions without cavities, with stable outcomes after six months. The cross-polarization photography technique may be use to evaluate the lesion size instead of photography with flash. TRIAL REGISTRATION NCT04685889 (registered 28 December 2020).
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Affiliation(s)
- Halenur Altan
- Department of Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey.
| | - Rabia Erağca Yilmaz
- Department of Pediatric Dentistry, Dental Oral and Dental Health Polyclinic, Tokat, Turkey
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Hoyt ALM, Staiger M, Schweinbeck M, Cölfen H. Penetration Coefficients of Commercial Nanolimes and a Liquid Mineral Precursor for Pore-Imitating Test Systems-Predictability of Infiltration Behavior. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2506. [PMID: 36984386 PMCID: PMC10058312 DOI: 10.3390/ma16062506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Nanolimes have been commercially available for over a decade as a remineralization agent for natural stone to combat deterioration. While they have been applied successfully and studied extensively, their penetration abilities in different materials have not yet been readily quantifiable in situ and in real time. Using two transparent pore-imitating test systems (acrylic glass (PMMA) and polydimethylsiloxane (PDMS)) and light microscopy, the penetration coefficients (PCs) of two nanolimes (CaLoSiL (CLS) and Nanorestore Plus (NRP)), as well as their solvents, were determined experimentally in square channels of about 100 µm diameter. Their PCs and those for a previously published glass-resin-based test system were also predicted based on measurable material parameters or literature values using the Lucas-Washburn equation. Additionally, a liquid mineral precursor (LMP) of calcium carbonate based on complex coacervation (CC) was investigated as an alternative to the solid particle dispersions of nanolime. In general, the dispersions behaved like their pure solvents. Overall, trends could be reasonably well predicted with both literature and experimentally determined properties using the Lucas-Washburn equation. In absolute terms, the prediction of observed infiltration behavior was satisfactory for alcohols and nanolimes but deviated substantially for water and the aqueous LMP. The commercially available PMMA chips and newly designed PDMS devices were mostly superior to the previously published glass-resin-based test system, except for the long-term monitoring of material deposition. Lastly, the transfer of results from these investigated systems to a different, nontransparent mineral, calcite, yielded similar PC values independently of the original data when used as the basis for the conversion (all PC types and all material/liquid combinations except aqueous solutions in PDMS devices). This knowledge can be used to improve the targeted design of tailor-made remineralization treatments for different application cases by guiding solvent choice, and to reduce destructive sampling by providing a micromodel for pretesting, if transferability to real stone samples proves demonstrable in the future.
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Evaluation of Resin Infiltration, Fluoride and the Biomimetic Mineralization of CPP-ACP in Protecting Enamel after Orthodontic Inter-Proximal Enamel Reduction. Biomimetics (Basel) 2023; 8:biomimetics8010082. [PMID: 36810413 PMCID: PMC9944074 DOI: 10.3390/biomimetics8010082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND This study investigated the effect of using different agents for protecting enamel proximal surfaces against acidic attack after interproximal reduction (IPR) using the trans micro radiography technique. METHODS Seventy-five sound-proximal surfaces were obtained from extracted premolars for orthodontic reasons. All teeth were measured miso-distally and mounted before being stripped. The proximal surfaces of all teeth were hand stripped with single-sided diamond strips (OrthoTechnology, West Columbia, SC, USA) followed by polishing via Sof-Lex polishing strips (3M, Maplewood, MN, USA). Three-hundred micrometers of enamel thickness was reduced from each proximal surface. The teeth were randomly divided into 5 groups: group 1 (control un-demineralized) received no treatment, group 2 (control demineralized) had their surfaces demineralized after the IPR procedure, group 3 (fluoride) specimens were treated with fluoride gel (NUPRO, DENTSPLY, Charlotte, NC, USA) after the IPR, group 4 (Icon) resin infiltration material (Icon Proximal Mini Kit, DMG, Bielefeld, Germany) was applied after IPR, group 5 (MI varnish) specimens were treated with Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing varnish (MI Varnish, G.C, USA, St. Alsip, IL, USA) after the IPR. The specimens in (groups 2-5) were stored in a 4.5 pH demineralization solution for 4 days. The trans-micro-radiography (TMR) technique was conducted to evaluate the mineral loss (∆Z) and lesion depth of all specimens after the acid challenge. The obtained results were analyzed statistically using a one-way ANOVA at a significance level of α = 0.05. RESULTS The MI varnish recorded significant ∆Z and lesion depth values compared to the other groups p > 0.05. There was no significant difference in ∆Z and lesion depth between the control demineralized, Icon, and fluoride groups p < 0.05. CONCLUSION The MI varnish increased the enamel resistance to acidic attack, and thus can be considered an agent capable of protecting the proximal enamel surface after IPR.
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Resin Infiltration of Non-Cavitated Enamel Lesions in Paediatric Dentistry: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121893. [PMID: 36553336 PMCID: PMC9776437 DOI: 10.3390/children9121893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
The resin infiltration (RI) technique was introduced as one of the minimal intervention dentistry strategies in addressing dental caries among the paediatric population. This technique used the low-viscosity resin monomer to infiltrate the non-cavitated carious lesion and other developmental enamel porosities, thus allowing the conservation of the tooth structure. This narrative review aims to explore the value of RI in Paediatric Dentistry. Through our search of the literature, the development of the material, their clinical applications and shortcomings, as well as the innovation that has been carried out to improve the current RI, were discussed. There are number of high-level evidence supporting the use of RI in arresting non-cavitated proximal caries lesions in primary and permanent teeth, but its efficacy in managing anterior white spot lesions is still unclear. Limited penetration depth, not radiopaque and questionable long-term colour and material stability were among the limitation of the material. Various laboratory-based studies have been conducted to improve the current properties of RI. Nevertheless, RI has emerged as one of the important micro-invasive techniques in addressing non-cavitated and anterior white-spot enamel lesions in children and adolescents with great success.
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Sun Z, You X, Xu J, Chen L, Li S, Zhang Z, Guo L. Effectiveness of sodium hypochlorite treatment on the bonding of four adhesive systems to fluorotic enamel. Dent Mater J 2022; 41:660-667. [PMID: 35584935 DOI: 10.4012/dmj.2021-305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The study evaluated the effect of sodium hypochlorite (NaOCl) treatment on fluorotic enamel bonding of four adhesive systems. They were Single Bond 2 (SB2), Prime&Bond NT (PBN), Clearfil SE Bond (CSB), and Single Bond Universal (SBU). One hundred eighteen extracted moderate fluorotic molars were divided into eight groups according to NaOCl pretreatment and four adhesive systems. The microshear bond strength (μSBS), etching pattern, and penetration depth (PD) were observed. The statistical method was two-way ANOVA and least significant difference (LSD) test (α=0.05). The application of NaOCl significantly increased the μSBS of PBN and SBU (p<0.05). The enamel-etching pattern of CSB and SBU was deeper under SEM. A noticeable increase of PD was in SB2 and SBU after the application of NaOCl (p<0.05). Pretreatment of 5.25% NaOCl for the 60 s can increase μSBS of PBN and SBU, PD of SB2 and SBU, and improve enamel-etching pattern of CSB and SBU to fluorotic enamel.
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Affiliation(s)
- Zhengfan Sun
- Department of Prosthodontics, Graduate School of Stomatology Southwest Medical University
| | - Xiaoxiao You
- Department of Prosthodontics, Graduate School of Stomatology Southwest Medical University
| | - Jie Xu
- Department of Prosthodontics, Graduate School of Stomatology Southwest Medical University
| | - Long Chen
- Department of Prosthodontics, Graduate School of Stomatology Southwest Medical University
| | - Sihui Li
- Department of Prosthodontics, Graduate School of Stomatology Southwest Medical University
| | - Zhenghao Zhang
- Department of Prosthodontics, Graduate School of Stomatology Southwest Medical University
| | - Ling Guo
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University
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Ozan G, Sancakli HS, Erdemir U, Yaman BC, Yildiz SO, Yildiz E. COMPARATIVE EVALUATION OF A FISSURE SEALANT AND A FLOWABLE COMPOSITE: A 36-MONTH SPLIT-MOUTH, RANDOMIZED CLINICAL STUDY. J Dent 2022; 123:104205. [PMID: 35724939 DOI: 10.1016/j.jdent.2022.104205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The purpose of the present clinical evaluation was to investigate the effect of a fissure sealant and a flowable composite at fissures of permanent molars in terms of retention and caries-incidence rates over a 36-month period. METHODS Thirty-four patients, ages varied from 16 to 22 years, diagnosed with at least 2 non-cavitated pit-and-fissure caries in the first and second molars were involved in the study. A total of 220 sealants, were placed in 117 upper molars and 103 lower molars. Teeth were sealed with either a flowable resin composite (Tetric Evo Flow) or a sealant material (Helioseal F)(n=110). Each restoration was evaluated in terms of retention and caries incidence at 6, 12, 24 and 36 months according to their location as well. Data were analyzed using Mann-Whitney U, Friedman and 1-way ANOVA tests at p < 0.05. RESULTS Tetric Evo Flow showed total retention with 95.5%, 93.8%, 88.5% and 80.2% at 6, 12, 24 and 36-month follow-ups respectively, while Helioseal F had retention rates of 95.5%, 94.8%, 85.4% and 80.2% respectively. After 36-months, there were 6 subjects totally lost in Helioseal F group, whereas 7 of the Tetric Evo Flow sunjects were totally lost. Caries development was firstly detected at 12-month evaluation for both of the materials however, no significant differences were observed among materials in retention rates or caries incidence after 36-month follow-ups (p>0.05). SIGNIFICANCE Using the flowable composite found as effective as the fissure sealant after 36-months regarding retention and caries incidence rates.
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Affiliation(s)
- Gunce Ozan
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry
| | - Hande Sar Sancakli
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry.
| | - Ugur Erdemir
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry
| | - Batu Can Yaman
- Osmangazi University Faculty of Dentistry Dept. of Restorative Dentistry
| | | | - Esra Yildiz
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry
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Desai H, Stewart CA, Finer Y. Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review. Dent J (Basel) 2021; 9:dj9120147. [PMID: 34940044 PMCID: PMC8700643 DOI: 10.3390/dj9120147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
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Affiliation(s)
- Hetal Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Correspondence:
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Almahdy A, Al-Otaibi A, Binhamdan A, AlNatheer Y, Alqahtani N, Alrahlah A, Albarakati S. Using bonding agent prior to pits and fissure sealant application enhances the microtensile bond strength and the interface morphology. Saudi Dent J 2021; 33:487-494. [PMID: 34803291 PMCID: PMC8589607 DOI: 10.1016/j.sdentj.2020.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/23/2020] [Accepted: 09/30/2020] [Indexed: 01/14/2023] Open
Abstract
Background A pits and fissures sealant is an effective method for preventing dental caries. Using a bonding agent before applying the sealant may increase its retention. This study aimed to compare the microtensile strength (µTBS) of a fissure sealant with and without a bonding agent and to characterize the enamel-sealant interface using confocal laser scanning microscopy (CLSM). The null hypothesis was that the use of a bonding agent before fissure sealant application would not change the microtensile strength or the enamel-sealant interface. Materials and methods Twenty caries-free premolars were used. Each tooth was divided into four parts. The first two parts were assigned to the bonded group, where a bonding system was used before sealant application. The remaining two parts were treated only with a fissure sealant (i.e., the nonbonded group). In each group, the µTBS was examined after 24 h (n = 20) and after a 3-month aging period (n = 20). Five other caries-free extracted premolars were used to assess the enamel-sealant interface using CLSM. Two-way analysis of variance (ANOVA) and Pearson chi-square statistical analysis tests were used to analyze the µTBS and the enamel-sealant interface, respectively. Results The mean µTBS for the bonded group was significantly higher (p = 0.001) in the immediate group (36.87 ± 14.95 MPa) and the aged group (31.08 ± 15.88 MPa) than in the respective nonbonded groups (19.77 ± 9.67 MPa and 19.52 ± 14.14 MPa). The µTBS was not significantly different in either group after aging (p = 0.46 [bonded group] and p = 0.98 [nonbonded group]). In addition, using a dental adhesive, before applying a fissure sealant resulted in a significantly higher (53%) resin penetration into the enamel with the continuous integrity of the resin. Conclusion The use of a bonding agent before the application of fissure sealant resulted in superior microtensile bond strength immediately and after aging. In addition, the enamel-sealant interface characteristics were improved.
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Affiliation(s)
- Ahmed Almahdy
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Yaser AlNatheer
- Oral and Maxillofacial Surgery Resident, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nasser Alqahtani
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alrahlah
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, King Saud University, Riyadh 11545, Saudi Arabia
| | - Sahar Albarakati
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Diniz M, Campos P, Souza M, Guaré R, Cardoso C, Lussi A, Bresciani E. The Evaluation of Different Treatments of Incipient Caries Lesions: An in Situ Study of Progression Using Fluorescence-based Methods. Oper Dent 2021; 46:87-99. [PMID: 33882139 DOI: 10.2341/19-268-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2020] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE Effective methods to control incipient caries lesions are needed. In this investigation, several methods provide encouraging results. SUMMARY This study aimed to evaluate in situ the inhibition of incipient caries lesion progression using different treatment protocols and to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, DIAGNOdent pen, and VistaProof fluorescence camera [FC]) in monitoring this process. The research was conducted in four phases: (1) at baseline, (2) after a first cariogenic challenge, (3) after treatment modalities, and (4) after a second cariogenic challenge. Sixteen volunteers used intraoral acrylic palatal appliances, each containing six enamel blocks (n=96). The cariogenic challenge was performed using a 20% sucrose solution over a 14-day period. The appliances were removed eight times a day and, upon removal, two drops of the solution were placed onto each enamel block. The enamel blocks were randomly assigned to three treatment groups: fluoride varnish ([FV] Duraphat; n=32), resin infiltrant ([RI] Icon; n=32), and adhesive system ([AS] Scotchbond; n=32). At the end of each phase, the surface microhardness (SMH) was measured, and two trained examiners evaluated the specimens using fluorescence-based methods. In addition, integrated mineral loss (ΔΔZ; vol%.min x μm) and lesion depth (ΔLD; μm) were evaluated using transverse microradiography. A two-way analysis of variance and a Tukey post hoc test were calculated (α=5%). Significant differences in SMH were observed according to the treatment, phases, and interaction of factors (p<0.001). Treatment with FV resulted in significantly higher SMH values in phases 3 and 4 compared to RI and AS, with the last two treatments resulting in similar values (p>0.05). The ΔΔZ value was similar for FV and AS but significantly higher for RI (p=0.016). ΔLD was not significantly different among the groups (p=0.126). Significant differences in the measurement of fluorescence for each fluorescence-based method were observed between each phase of the study (p<0.05). It can be concluded that all treatments were effective in inhibiting the in situ progression of incipient lesions, although to different degrees, with minor mineral loss changes observed for the AS and FV. Besides, all fluorescence-based methods tested, except for that using the FC device, were effective in monitoring caries lesion progression.
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Wang L, Freitas MCCDA, Prakki A, Mosquim V, González AHM, Rios D, Honório HM. Experimental self-etching resin infiltrants on the treatment of simulated carious white spot lesions. J Mech Behav Biomed Mater 2020; 113:104146. [PMID: 33125956 DOI: 10.1016/j.jmbbm.2020.104146] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate the penetration depth (μm) of experimental resin infiltrants containing different percentages of triethylene glycol dimethacrylate (TEGDMA) and phosphoric acid 2-hydroxyethyl methacrylate ester (PAM) in artificial carious white spot lesions (WSL). METHODS WSL were produced in 65 bovine flat enamel specimens by pH cycling protocol, which were treated with either Icon (control) or experimental acidic infiltrants based on different percentages of TEGDMA and PAM monomers (acidic), and their association or not with previous acid-etching with phosphoric acid. Ten readings using Confocal Laser Scanning Microscopy were conducted on each specimen and the penetration depth was calculated from the surface until the deepest point with the fluorescent dye Rhodamine B (0.02 mg/mL). The pH and the viscosity of the experimental infiltrants were also tested. Data were statistically analyzed with two-way ANOVA and Tukey tests (α < 0.05). RESULTS The material factor and the interaction material*acid-etching were statistically significant. The lowest penetration depth was observed for the samples treated with the commercial infiltrant after etching with 15% hydrochloric acid. When specimens were pre-treated with PA, highest penetration was seen for specimens treated with 100% TEGDMA, which differed from all other groups. The lowest penetration was seen for those treated with 50:50 TEGDMA:PAM infiltrants. When specimens were not previously etched, highest penetration was seen for Icon, which differed only from those treated with 25% TEGDMA 75% PAM, where the lowest values were seen. The values of viscosity increased and the pH decreased with the addition of PAM in the infiltrant formulations. CONCLUSION the association between TEGDMA and PAM seems to allow similar infiltration depth reached by Icon infiltrant without acid etching the enamel surface.
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Affiliation(s)
- Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil.
| | - Maria Cristina Carvalho de Almendra Freitas
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil; DeVry FACID, DeVry Education Group, Teresina-PI, Brazil
| | - Anuradha Prakki
- Faculty of Dentistry, University of Toronto, Restorative Department, Toronto-ON, Canada
| | - Victor Mosquim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | | | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
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NÓBREGA MTC, DANTAS ELDA, ALONSO RCB, ALMEIDA LDFDD, PUPPIN-RONTANI RM, SOUSA FBDE. Hydrolytic degradation of different infiltrant compositions within different histological zones of enamel caries like-lesions. Dent Mater J 2020; 39:449-455. [DOI: 10.4012/dmj.2019-108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Zakizade M, Davoudi A, Akhavan A, Shirban F. Effect of Resin Infiltration Technique on Improving Surface Hardness of Enamel Lesions: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101405. [PMID: 32473796 DOI: 10.1016/j.jebdp.2020.101405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 07/31/2019] [Accepted: 11/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE White spot lesion (WSL) is recognized as the first clinical sign of enamel caries; it is a very critical phase because it can be prevented from progression to frank caries by changing the surrounding destructive environment. The present study was undertaken to systematically review the effect of resin infiltration (RI) technique on surface hardness (SH) of WSL. METHODS Five electronic databases were searched with proper key words. Related titles and abstracts, up to October 2018, were screened, selected, and subjected to quality assessments. After collecting data, meta-analyses were carried out to compare the effect of RI with untreated WSL and sound enamel by using the STATA software. RESULTS A total of 4567 articles were included in the study after initial search. Finally, 10 studies were reliable enough in methodology to be included in the study. Metadata analyses, carried out on 7 studies that compared SH of RI group with untreated samples, showed a significant increase in SH with 3.66 mean difference (95% confidence interval = 2.56‒4.77, Q value = 36.07, I2 = 83.4%). However, meta-analysis on 4 studies that compared SH of RI with sound enamel showed a significant decrease in SH with -2.35 overall mean difference (95% confidence interval = -3.91-0.98, P = .00, Q value = 31.75, I2 = 90.6%). CONCLUSION The RI technique can enhance SH of WSL; however, regaining the SH of RI-treated WSLs similar to sound enamel is doubtful. Application of RI is more effective than other methods, including application of fluoride, enamel pro-varnish, adhesive, and colloidal silica infiltration for enhancing SH of WSLs.
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Affiliation(s)
- Mehrnaz Zakizade
- Department of Orthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Davoudi
- Dental Implants Research Center, Department of Prosthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ali Akhavan
- Dental Materials Research Center, Department of Endodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farinaz Shirban
- Dental Research Center, Department of Orthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
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Aswani R, Chandrappa V, Uloopi KS, Chandrasekhar R, RojaRamya KS. Resin Infiltration of Artificial Enamel Lesions: Evaluation of Penetration Depth, Surface Roughness and Color Stability. Int J Clin Pediatr Dent 2019; 12:520-523. [PMID: 32440067 PMCID: PMC7229383 DOI: 10.5005/jp-journals-10005-1692] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim To evaluate the penetration depth, surface roughness, and color stability of resin infiltration restoration of artificial enamel lesions induced in primary and permanent teeth. Materials and methods Primary (group I, n = 30) and permanent (group II, n = 30) extracted non-carious human anterior teeth were subjected to demineralization for four days after creating a window of 5 mm × 5 mm on the labial surfaces. Demineralized area was infiltrated with the low viscosity resin. Ten samples from each group were evaluated for penetration depth, surface roughness, and color stability, respectively. Penetration depth was determined using a stereomicroscope at 80× magnification. Surface roughness of sound and infiltrated enamel was recorded using a profilometer. The color stability was assessed at 2, 4, and 8 weeks along with baseline values using vita easy shade spectrophotometer. Results Data were analyzed using the student “t” test and Friedman test. The degree of resin penetration was observed to be higher in primary teeth (32.6 ± 15.72 μm) compared to permanent teeth (24.23 ± 6.85 μm), but no significant difference was found (p = 0.138). Surface roughness values of resin infiltrated enamel is similar to that of sound enamel in both primary (p = 0.617) and permanent teeth (p = 0.234). The mean color stability scores immediately after resin infiltration at 2, 4, and 8 weeks intervals showed no statistically significant difference in primary (p = 0.998) and permanent teeth (p = 0.213). Conclusion Resin penetration into enamel lesions was more in primary teeth enamel compared to permanent. The early enamel lesions, when treated with resin infiltration, showed surface characteristics similar to sound enamel and also exhibited acceptable color up to 8 weeks duration. Clinical significance Resin infiltration can be considered as an effective and predictable treatment option for the restoration of early enamel lesions owing to its deeper penetration, provision of better surface characteristics, and reliable masking of white spot lesions in both primary and permanent dentitions. How to cite this article Aswani R, Chandrappa V, Uloopi KS, et al. Resin Infiltration of Artificial Enamel Lesions: Evaluation of Penetration Depth, Surface Roughness and Color Stability. Int J Clin Pediatr Dent 2019;12(6):520–523.
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Affiliation(s)
- RajaSagi Aswani
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Vinay Chandrappa
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - K S Uloopi
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Rayala Chandrasekhar
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Kakarla Sri RojaRamya
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Yazkan B, Ermis RB. Effect of resin infiltration and microabrasion on the microhardness, surface roughness and morphology of incipient carious lesions. Acta Odontol Scand 2018; 76:473-481. [PMID: 29447057 DOI: 10.1080/00016357.2018.1437217] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The effects of resin infiltration and microabrasion on incipient carious lesions by surface microhardness, roughness and morphological assessments, and resistance to further acid attack of treated lesions were evaluated. MATERIAL AND METHODS Eighty artificially-induced incipient lesions were randomly divided into five groups (n = 16): resin infiltration with an adhesive resin (Excite F, Ivoclar Vivadent, Schaan, Liechtenstein), resin infiltration with a resin infiltrant (Icon, DMG, Hamburg, Germany), microabrasion without polishing (Opalustre, Ultradent, South Jordan, UT, USA), microabrasion with polishing (Opalustre, Ultradent, Diamond Excel, FGM, Joinville, SC, Brazil), and distilled water (control group). All specimens were exposed to demineralization for another 10 d. Microhardness, roughness and morphological assessments were done at baseline, following initial demineralization, treatment and further demineralization. Data were analysed by the Kruskal-Wallis, Friedman's and Bonferroni tests (p < .05). RESULTS Enamel lesions treated with resin infiltrant and microabrasion demonstrated similar hardness values, with a nonsignificant difference compared with sound enamel. Resin infiltration demonstrated lower roughness values than those of microabrasion, and the values did not reach the values of sound enamel. Further demineralization for 10 d did not affect the hardness but increased the roughness of infiltrated and microabraded enamel surfaces. Polishing did not influence the roughness of microabraded enamel surfaces. After resin infiltration, porosities on enamel were sealed completely. The surface structure was similar to that of the enamel conditioning pattern for microabraded enamel lesions. CONCLUSIONS Within the limitations of this study, the icon infiltration and microabrasion technique appeared to be effective for improving microhardness. Icon appeared to provide reduced roughness, although not equal to sound enamel. Further research is needed to elucidate their clinical relevance.
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Affiliation(s)
- Basak Yazkan
- Department of Restorative Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - R. Banu Ermis
- Department of Restorative Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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18
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Chatzimarkou S, Koletsi D, Kavvadia K. The effect of resin infiltration on proximal caries lesions in primary and permanent teeth. A systematic review and meta-analysis of clinical trials. J Dent 2018; 77:8-17. [DOI: 10.1016/j.jdent.2018.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022] Open
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Freitas MCCDA, Nunes LV, Comar LP, Rios D, Magalhães AC, Honório HM, Wang L. In vitro effect of a resin infiltrant on different artificial caries-like enamel lesions. Arch Oral Biol 2018; 95:118-124. [PMID: 30099240 DOI: 10.1016/j.archoralbio.2018.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES A resin infiltrant was employed for the treatment of active white spot lesions due to its ability to penetrate into the enamel pores and prevent the progression of the lesion. However, limited information is available about its mechanical effect on different artificial enamel lesions as well as on its resistance to further demineralization. Therefore, this study aimed to evaluate the effects of the Icon® infiltrant on different artificial caries-like enamel lesions and its resistance to new acid challenges. DESIGN Artificial lesions were produced in bovine enamel using three different protocols (demineralization/remineralization cycling, DE-RE; 8% methylcellulose gel, MC; and methyl ethyl diphosphonate solution, MHDP; n = 13). The specimens were treated with Icon® and subjected to a new acid challenge using DE-RE cycling. The surface and cross-sectional hardness were evaluated in sound, demineralized, treated and further demineralized enamel areas. Data were statistically analyzed using ANOVA and Tukey's test (p < 0.05). RESULTS All of the demineralizing protocols produced subsurface artificial caries lesions. The infiltrant was able to partially recover the surface hardness and prevent further surface hardness loss in enamel previously demineralized using the DE-RE and MHDP protocols. In regard to cross-sectional hardness, no positive effect was found. CONCLUSIONS The effect of the infiltrant depends on the type of lesion created in vitro, and its action is limited to the lesion surface.
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Affiliation(s)
- Maria Cristina Carvalho de Almendra Freitas
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil; DeVry FACID, DeVry Education Group, Avenida Rio Poti, 2381, ZIP code: 64999-999, Teresina, PI, Brazil
| | - Larissa Vasconcellos Nunes
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Lívia Picchi Comar
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil.
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Prajapati D, Nayak R, Pai D, Upadhya N, K Bhaskar V, Kamath P. Effect of Resin Infiltration on Artificial Caries: An in vitro Evaluation of Resin Penetration and Microhardness. Int J Clin Pediatr Dent 2017; 10:250-256. [PMID: 29104384 PMCID: PMC5661038 DOI: 10.5005/jp-journals-10005-1445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 02/02/2017] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate the effectiveness of resin infiltration on artificial caries lesion by assessing the depth of resin penetration and the change in microhardness of lesion postinfiltration. Materials and methods Totally 45 human extracted premolars were used to create an artificial demineralized lesion in enamel using demineralizing solution. A total of 15 samples (group I) were infiltrated with resin. The depth of resin penetration was studied using scanning electron microscope (SEM). Other half (n = 30) of samples was equally divided into three subgroups and Vickers hardness number (VHN) values were obtained to measure the surface microhardness as group 11 a—before demineralization, 11 b—after demineralization, IIc—postresin infiltration. Results Mean depth of penetration in group I was 516.8 urn. There was statistically significant increase in VHN values of demineralized lesion postresin infiltration (independent Student’s t-test, p < 0.001). Conclusion Penetration depth of the resin infiltrant was deep enough to render beneficial effects, while significant increase in microhardness was observed postresin infiltration. Clinical significance Infiltrant used can be considered as a valid treatment option for noncavitated lesions. How to cite this article Prajapati D, Nayak R, Pai D, Upadhya N, Bhaskar VK, Kamath P. Effect of Resin Infiltration on Artificial Caries: An in vitro Evaluation of Resin Penetration and Microhardness. Int J Clin Pediatr Dent 2017;10(3):250-256.
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Affiliation(s)
- Deepesh Prajapati
- Senior Lecturer, Department of Pedodontics, NIMS Dental College and Hospital Jaipur, Rajasthan, India
| | - Rashmi Nayak
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Deepika Pai
- Reader, Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Nagraj Upadhya
- Associate Professor, Department of Dental Materials, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Vipin K Bhaskar
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Mahe Institute of Dental Sciences & Hospital, Marie, Puducherry, India
| | - Pujan Kamath
- Private Practitioner, Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal, Karnataka, India
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Vennat E, Wang W, Genthial R, David B, Dursun E, Gourrier A. Mesoscale porosity at the dentin-enamel junction could affect the biomechanical properties of teeth. Acta Biomater 2017; 51:418-432. [PMID: 28110070 DOI: 10.1016/j.actbio.2017.01.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 01/16/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Abstract
In this paper, the 3D-morphology of the porosity in dentin is investigated within the first 350μm from the dentin-enamel junction (DEJ) by fluorescence confocal laser scanning microscopy (CLSM). We found that the porous microstructure exhibits a much more complex geometry than classically described, which may impact our fundamental understanding of the mechanical behavior of teeth and could have practical consequences for dental surgery. Our 3D observations reveal numerous fine branches stemming from the tubules which may play a role in cellular communication or mechanosensing during the early stages of dentinogenesis. The effect of this highly branched microstructure on the local mechanical properties is investigated by means of numerical simulations. Under simplified assumptions on the surrounding tissue characteristics, we find that the presence of fine branches negatively affects the mechanical properties by creating local stress concentrations. However, this effect is reduced by the presence of peritubular dentin surrounding the tubules. The porosity was also quantified using the CSLM data and compared to this derived from SEM imaging. A bimodal distribution of channel diameters was found near the DEJ with a mean value of 1.5-2μm for the tubules and 0.3-0.5μm for the fine branches which contribute to 30% of the total porosity (∼1.2%). A gradient in the branching density was observed from the DEJ towards the pulp, independently of the anatomical location. Our work constitutes an incentive towards more elaborate multiscale studies of dentin microstructure to better assess the effect of aging and for the design of biomaterials used in dentistry, e.g. to ensure more efficient bonding to dentin. Finally, our analysis of the tubular network structure provides valuable data to improve current numerical models.
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ZHOU Y, MATIN K, SHIMADA Y, SUMI Y, TAGAMI J. Evaluation of resin infiltration on demineralized root surface: An in vitro study. Dent Mater J 2017; 36:195-204. [PMID: 28111390 DOI: 10.4012/dmj.2016-229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yuan ZHOU
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Khairul MATIN
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
- Endowed Department of International Oral Health Science (affiliated with Department of Translational Research), School of Dental Medicine, Tsurumi University
| | - Yasushi SHIMADA
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yasunori SUMI
- Division of Oral and Dental Surgery, Department of Advanced Medicine, National Hospital for Geriatric Medicine, National Center for Geriatrics and Gerontology
| | - Junji TAGAMI
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Caglar E, Kuscu OO, Hysi D. Four year Evaluation of Proximal Resin Infiltration in Adolescents. Acta Stomatol Croat 2016; 49:304-8. [PMID: 27688414 DOI: 10.15644/asc49/4/5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
AIM Resin infiltration of proximal lesions is a new approach to stopping caries progression. Therefore, the aim of the present study was to evaluate four-year efficacy of proximal infiltrates in adolescents. MATERIALS AND METHODS In ten adolescents, a total of 21 proximal infiltrates (ICON® (DMG, Germany) were applied to initial proximal lesions of permanent incisors and premolars according to the manufacturer's instruction. The clinical quality of resin infiltration was assessed at 1 week, 1, 2, 3 and 4 years after the treatment and the evaluation of the therapeutic effect was analyzed by radiographs. RESULTS Ten patients were followed up clinically for four years. The majority of the infiltrated lesions were located on permanent incisors. Teeth which were proximally infiltrated did not exhibit dental plaque and gingival bleeding in most cases. At annual recalls, plaque scores remained constant. The gingival status remained steady and no differences in tooth shape and contour were detected. Discoloration was detected in four teeth (19%) in 1st year recall and was constant at annual intervals. The radiographic evaluation of the bitewing radiographs showed no progression in 21 lesions (100%) from baseline to the 4-year recall. Overall oral hygiene of the patients was satisfactory. CONCLUSION In conclusion, proximal infiltration is an effective prophylactic measure in adolescents.
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Affiliation(s)
- Esber Caglar
- Associate Prof PhD, Dept. of Paediatric Dentistry, Private practice, Istanbul, Turkey/Tirana, Albania
| | - Ozgur Onder Kuscu
- Private practice, Department of Paediatric Dentistry, Istanbul, Turkey
| | - Dorian Hysi
- University of Tirana, School of Dentistry, Tirana, Albania
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Arnold WH, Meyer AK, Naumova EA. Surface Roughness of Initial Enamel Caries Lesions in Human Teeth After Resin Infiltration. Open Dent J 2016; 10:505-515. [PMID: 27733877 PMCID: PMC5040761 DOI: 10.2174/1874210601610010505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 07/21/2016] [Accepted: 08/07/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Low viscosity resin infiltration of initial caries lesions is a modern microinvasive method to treat initial cries lesions. However, only scarce information is available about the long-term surface alterations of infiltrated lesions. METHODS Twenty-eight premolar teeth exhibiting non-cavitated initial caries lesions (International Caries Detection and Assessment System (ICDAS code 1&2)) were divided into two groups, one of which was infiltrated with resin, and the other remained untreated. The teeth underwent two thermocycling procedures. The surface roughness was determined quantitatively, and the results were evaluated statistically. In addition, the surfaces of the lesions were investigated by scanning electron microscopy (SEM), and the surface was analyzed visually with respect to surface irregularities. RESULTS The results showed a reduction in the surface roughness that was significant after 2500 thermocycles compared to the untreated surface. In the control specimens, no change in the surface roughness was found. The qualitative SEM data also showed a smooth surface after thermocycling, which supported the statistical findings. CONCLUSION After thermocycling, resin-infiltrated enamel surfaces become smoother and had no additional risk for plaque accumulation.
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Affiliation(s)
- Wolfgang H Arnold
- Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University (UW/H), Witten, Germany
| | - Ann-Kathrin Meyer
- Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University (UW/H), Witten, Germany
| | - Ella A Naumova
- Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University (UW/H), Witten, Germany
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Cocco AR, Lund RG, Torre E, Martos J. Treatment of Fluorosis Spots Using a Resin Infiltration Technique: 14-month Follow-up. Oper Dent 2016; 41:357-62. [PMID: 27455116 DOI: 10.2341/14-335-s] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to report a clinical case of moderate fluorosis spots treated with infiltration of low-viscosity resin. A commercial resin was applied to the facial surfaces on the anterior teeth in both the maxillary and mandibular arches. The white spots of fluorosis lost their whitish appearance and appeared similar to sound enamel. This technique, which might constitute an alternative to white-masking of fluorosis spots, showed optimal esthetic results.
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Oral biofilm and caries-infiltrant interactions on enamel. J Dent 2016; 48:40-5. [DOI: 10.1016/j.jdent.2016.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 03/04/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023] Open
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SILTHAMPITAG P, CHAIJAREENONT P, TATTAKORN K, BANJONGPRASERT C, TAKAHASHI H, ARKSORNNUKIT M. Effect of surface pretreatments on resin composite bonding to PEEK. Dent Mater J 2016; 35:668-74. [DOI: 10.4012/dmj.2015-349] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Pisaisit CHAIJAREENONT
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University
| | | | | | - Hidekazu TAKAHASHI
- Oral Biomaterials Engineering, Department of Oral Materials Sciences and Technology, Course of Oral Health Engineering, School of Oral Health Care Sciences, Faculty of Dentistry, Tokyo Medical and Dental University
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Baka ZM, Akin M, Ileri Z, Basciftci FA. Effects of remineralization procedures on shear bond strengths of brackets bonded to demineralized enamel surfaces with self-etch systems. Angle Orthod 2015; 86:661-7. [PMID: 26524389 DOI: 10.2319/041515-247.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the effects of different remineralization procedures on the surface roughness of teeth, shear bond strengths (SBSs), and Adhesive Remnant Index scores of self-etching primer (SEP) used to bond orthodontic brackets to previously treated demineralized enamel surfaces. MATERIALS AND METHODS A total of 140 extracted human premolar teeth were randomly divided into seven equal groups. Group I was the control group. A demineralization procedure was performed in the other six groups. A remineralization procedure was performed before bonding by using casein phosphopeptide-amorphous calcium phosphate, fluoride, a microabrasion mixture (18% hydrochloric acid-fine pumice), a microabrasion agent, and resin infiltration in groups III to VII. Brackets were bonded using a self-etching primer/adhesive system. The specimens were tested for SBS. The roughness and morphology of the enamel surfaces were analyzed using profilometer and scanning electron microscopy. Data were analyzed with analysis of variance, Tukey, and G-tests at the α = .05 level. RESULTS Significant differences were found in the SBS values among the seven groups (F = 32.69, P = .003). The lowest SBS value was found in group II (2.62 ± 1.46 MPa). No significant differences were found between groups I, III, and VII, between groups III and IV, or between groups V and VI. The differences in the roughness values were statistically significant among the groups (P = .002). CONCLUSIONS Remineralization procedures restore the decreased SBS of orthodontic brackets and decrease surface roughness caused by enamel demineralization. SEPs provide clinically acceptable SBS values for bonding orthodontic brackets to previously treated demineralized enamel surfaces.
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Affiliation(s)
- Zeliha Müge Baka
- a Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Mehmet Akin
- a Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Zehra Ileri
- a Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Faruk Ayhan Basciftci
- b Professor and Chair, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
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Penetration of micro-filled infiltrant resins into artificial caries lesions. J Dent 2015; 43:832-8. [DOI: 10.1016/j.jdent.2015.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/02/2015] [Accepted: 03/04/2015] [Indexed: 11/22/2022] Open
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Setting characteristics of a resin infiltration system for incipient caries treatment. J Dent 2015; 43:715-9. [DOI: 10.1016/j.jdent.2015.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 03/21/2015] [Accepted: 03/30/2015] [Indexed: 11/23/2022] Open
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Arslan S, Zorba YO, Atalay MA, Özcan S, Demirbuga S, Pala K, Percin D, Ozer F. Effect of resin infiltration on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Dent Mater J 2015; 34:25-30. [PMID: 25748455 DOI: 10.4012/dmj.2014-078] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate and compare the effects of resin infiltration and sealant type on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Artificial enamel lesions were produced on the surfaces of 120 enamel specimens, which were divided into two groups: Group A and Group B (n=60 per group). Each group was further divided into four subgroups (n=15 per subgroup) according to sealant type: Group I-Demineralized enamel (control); Group II-Enamel Pro Varnish; Group III-ExciTE F; and Group IV-Icon. In Group A, hardness and surface roughness were evaluated; in Group B, bacterial adhesion was evaluated. Icon application resulted in significantly lower surface roughness and higher hardness than the other subgroups in Group A. In Group B, Enamel Pro Varnish resulted in lowest bacterial adhesion, followed by Icon. This study showed that resin infiltration of enamel lesions could arrest lesion progress.
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Affiliation(s)
- Soley Arslan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Erciyes
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Gelani R, Zandona AF, Lippert F, Kamocka MM, Eckert G. In Vitro Progression of Artificial White Spot Lesions Sealed With an Infiltrant Resin. Oper Dent 2014; 39:481-8. [DOI: 10.2341/13-202-l] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This study assessed the ability of an infiltrant resin (Icon, DMG Chemisch-Pharmazeutische Fabrik GmbH, Hamburg, Germany) to prevent artificial lesion progression in vitro when used to impregnate white spot lesions and also assessed the effect of saliva contamination on resin infiltration. Enamel specimens (n=252) were prepared and covered with nail varnish, leaving a window of sound enamel. After demineralization (pH 5.0; four weeks), specimens were divided into six groups (n=42 per group): group 1, 2% fluoride gel (positive control); group 2, resin infiltrant; group 3, resin infiltrant + fluoride gel; group 4, no treatment (negative control); group 5, resin infiltrant application after saliva contamination; and group 6, resin infiltrant + fluoride gel after saliva contamination. Specimens from each group were cut perpendicular to the surface, and one-half of each specimen was exposed to a demineralizing solution for another four weeks. The other half was set aside as a record of initial lesion depth and was used later in the determination of lesion progression. Lesion progression and infiltrant penetration were measured using confocal laser scanning microscopy (CLSM) and transverse microradiography (TMR). For lesion depth, based on CLSM, groups 2 and 3 showed the least changes when submitted to demineralization challenge, followed by group 1, then groups 5 and 6, and finally group 4. There were no significant differences between groups 2 and 3 or groups 5 and 6 in their ability to inhibit further lesion progression (p<0.05). Based on TMR, groups 2 and 3 also showed the fewest changes when submitted to demineralization challenge, followed by group 5, then groups 1 and 6, and finally group 4. In terms of mineral loss as measured by TMR, all groups that contained fluoride (groups 1, 3, and 6) show less percentage change in mineral loss than the groups that did not contain fluoride (groups 2, 4, and 5). It can be concluded that infiltrant penetration into early enamel lesions inhibited further demineralization in vitro, especially in the presence of fluoride. Saliva contamination decreased the ability of the infiltrant to prevent further demineralization, but the presence of fluoride seemed to counteract this effect.
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Affiliation(s)
- R Gelani
- Rakhi Gelani, BDS, MSD Preventive Dentistry student, Indiana University School of Dentistry, Indianapolis IN, USA
| | - AF Zandona
- Andrea Ferreira Zandona, DDS, MSD, PhD, associate professor/director, MSD Preventive Dentistry, Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis IN, USA
| | - F Lippert
- Frank Lippert, MSc, PhD, assistant research professor/director, OHRI Remineralization Research Program, Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis IN, USA
| | - MM Kamocka
- Malgorzata Maria Kamocka, PhD, assistant research professor of medicine, Department of Medicine/Division of Nephrology, Research Institute, Indiana University School of Medicine, Indianapolis IN, USA
| | - G Eckert
- George Eckert, biostatistician supervisor, Department of Biostatistics, Indiana University School of Medicine, Indianapolis IN, USA
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Yim HK, Min JH, Kwon HK, Kim BI. Modification of surface pretreatment of white spot lesions to improve the safety and efficacy of resin infiltration. Korean J Orthod 2014; 44:195-202. [PMID: 25133134 PMCID: PMC4130915 DOI: 10.4041/kjod.2014.44.4.195] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 12/17/2013] [Accepted: 01/09/2014] [Indexed: 11/25/2022] Open
Abstract
Objective A low-viscosity resin (infiltrant) was used to inhibit the progression of white spot lesions (WSLs) and resolve associated esthetic issues. An alternative pretreatment was explored to increase the pore volume of the surface layer of the WSLs. Also, the penetration effects of the infiltrant were evaluated for various pretreatments. Methods Sixty two artificial lesions were fabricated on bovine teeth. As a positive control, 15% HCl gel was applied for 120 seconds. Further, 37% H3PO4 gel was applied for 30 seconds using three methods. The samples were divided as follows: H3PO4 only group, H3PO4 sponge group, and H3PO4 brush group. The acid was gently rubbed with the applicators (i.e., a sponge or brush) throughout the application time. To compare the effects of resin infiltration, twenty paired halves of specimens were treated with an infiltrant (ICON®). Results Thicknesses of the removed surface layers and infiltrated areas were evaluated by confocal laser scanning microscope. The positive control and the 37% H3PO4 brush group failed to show significant differences in the removed thickness (p > 0.05); however, the mean percentage of the infiltrated area was higher in the 37% H3PO4 brush group (84.13 ± 7.58%) than the positive control (63.51 ± 7.62%, p < 0.001). Scanning electron microscope observations indicate higher pore volumes for the 37% H3PO4 brush group than for the positive control. Conclusions Application of 37% H3PO4 with a brush for 30 seconds increased the pore volume of WSL surface layers and the percentage of infiltrated areas in comparison to the use of 15% HCl for 120 seconds.
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Affiliation(s)
- Hyun-Kyung Yim
- Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ji-Hyun Min
- Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ho-Keun Kwon
- Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea
| | - Baek-Il Kim
- Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea
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Ammari MM, Soviero VM, da Silva Fidalgo TK, Lenzi M, Ferreira DMTP, Mattos CT, de Souza IPR, Maia LC. Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis. J Dent 2014; 42:1217-27. [PMID: 25066832 DOI: 10.1016/j.jdent.2014.07.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to perform a systematic review and meta-analysis on the effectiveness of sealing non-cavitated proximal caries lesions in primary and permanent teeth. DATA Only controlled clinical trials and randomized controlled clinical trials that evaluated the effectiveness of sealing on non-cavitated proximal caries with a minimum follow-up of 12 months were included in the study. The primary outcome should be arrestment/progression of proximal caries evaluated by bitewing radiographs. A risk of bias evaluation based on the Cochrane Collaboration common scheme for bias was carried out for each study. The meta-analysis was performed on the studies considered low risk of bias and with pair-wise visual reading results through RevMan software. SOURCES A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs, SIGLE, and on website Clinical trials.gov, through until June 2013. STUDY SELECTION From 967 studies identified, 10 articles and 3 studies with partial results were assessed for eligibility. However three articles were excluded and our final sample included 10 studies. According to the risk of bias evaluation, six studies were considered "high" risk of bias, and four "low" risk of bias. The forest plot of the meta-analysis showed low heterogeneity (I(2)=29%) and a favourable outcome for the Infiltrant. The chance of caries progression when this technique was used was significantly lower (p=0.002) compared with Placebo. CONCLUSION Our results suggest that the technique of sealing non-cavitated proximal caries seems to be effective in controlling proximal caries in the short and medium term. Further long-term randomized clinical trials are still necessary to increase this evidence. CLINICAL SIGNIFICANCE Contemporary dentistry is focused in minimally invasive approaches that prevent the destruction of sound dental tissues next to carious lesions. This paper searches for evidence of the efficacy of sealing/infiltrating non-cavitated proximal caries in arresting caries progression both in permanent and primary teeth.
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Affiliation(s)
- Michelle Mikhael Ammari
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Department of Specific Training, School of Dentistry, Universidade Federal Fluminense, Nova Friburgo, Brazil
| | - Vera Mendes Soviero
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michele Lenzi
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Cláudia Trindade Mattos
- Department of Dental Clinics, School of Dentistry, Universidade Federal Fluminense, Niterói, Brazil
| | - Ivete Pomarico Ribeiro de Souza
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Arnold WH, Bachstaedter L, Benz K, Naumova EA. Resin infiltration into differentially extended experimental carious lesions. Open Dent J 2014; 8:251-6. [PMID: 26019729 PMCID: PMC4442406 DOI: 10.2174/1874210601408010251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 11/24/2014] [Accepted: 12/11/2014] [Indexed: 11/22/2022] Open
Abstract
Resin infiltration of initial caries lesions is a novel method of caries therapy. However, it has some limitations. Therefore, further experimental studies are needed to improve resin infiltration. It was the aim of this investigation to study resin infiltra-tion into different experimental carious lesions. Caries-free extracted human molars and premolars were demineralized for 3, 6, 9 and 12 days and infiltrated with resin. Prior to infiltration, the teeth were incubated with sodium fluorescein. After em-bedding, serial sections were cut through the experimental lesions, and the penetration of the resin was measured with fluo-rescence microscopy. Two infiltrated teeth from each time interval were not embedded and cut. Infiltration of the resin was then studied with EDS element analysis. The results showed that with increasing demineralization time, the lesion expansion was also increasing, and the resin infiltration was always almost complete. From these results it can be concluded that artifi-cial standardized caries-like lesions are suitable for experimental studies of resin infiltration.
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Affiliation(s)
- Wolfgang H Arnold
- Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred Herrhausenstrasse 44, 58455 Witten, Germany
| | - Lena Bachstaedter
- Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred Herrhausenstrasse 44, 58455 Witten, Germany
| | - Korbinian Benz
- Department of Oral Surgery, School of Dentistry, Faculty of Health, Witten/Herdecke University, Germany
| | - Ella A Naumova
- Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred Herrhausenstrasse 44, 58455 Witten, Germany
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Araújo GSA, Sfalcin RA, Araújo TGF, Alonso RCB, Puppin-Rontani RM. Evaluation of polymerization characteristics and penetration into enamel caries lesions of experimental infiltrants. J Dent 2013; 41:1014-9. [PMID: 24004967 DOI: 10.1016/j.jdent.2013.08.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 08/20/2013] [Accepted: 08/22/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To evaluate the properties of experimental infiltrant blends by comparing them with the commercial infiltrant Icon(®) and penetration homogeneity into enamel caries lesions. METHODS Groups were set up as follows: G1 (TEGDMA 100%); G2 (TEGDMA 80%, Ethanol 20%); G3 (TEGDMA 80%, HEMA 20%); G4 (TEGDMA 75%, BisEMA 25%); G5 (TEGDMA 60%, BisEMA 20%, Ethanol 20%); G6 (TEGDMA 60%, BisEMA 20%, HEMA 20%); G7 (TEGDMA 75%, UDMA 25%); G8 (TEGDMA 60%, UDMA 20%, Ethanol 20%); G9 (TEGDMA 60%, UDMA 20%, HEMA 20%) and Icon(®). Ten specimens were comprised by each group for the following tests (n=10): degree of conversion (DC), elastic modulus (EM), Knoop hardness (KH), and softening ratio (SR). Infiltrant penetration was evaluated using confocal microscopy (CLSM). Data were subjected to two-way ANOVA and a Tukey's test (5%). Data comparing experimental materials and Icon(®) were analysed using ANOVA and Dunnett's test (5%). RESULTS The highest DC values were found in G1, G7, G8, and G9. The lowest DC values were found in G2, G4, G5, and G6. EM and KHN were significantly lower in HEMA and with ethanol addition for all blends, except for G9. There was no significant difference among the groups regarding SR, and it was not possible to take KHN readings of G2, G5, and G8 after storage. There was no significant difference among groups for infiltrant penetration into enamel lesions. CONCLUSIONS The addition of hydrophobic monomers and solvents into TEGDMA blends affected DC, EM, and KHN. UDMA added to TEGDMA resulted in an increase in DC, EM, and KHN. Overall, solvents added to monomer blends resulted in decreased properties. The addition of hydrophobic monomers and solvents into TEGDMA blends does not improve the penetration depth of the infiltrants.
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Pretreatment of natural caries lesions affects penetration depth of infiltrants in vitro. Clin Oral Investig 2012; 17:2085-9. [DOI: 10.1007/s00784-012-0909-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 12/06/2012] [Indexed: 10/27/2022]
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Protection of sound enamel and artificial enamel lesions against demineralisation: caries infiltrant versus adhesive. J Dent 2012; 40:851-6. [PMID: 22800853 DOI: 10.1016/j.jdent.2012.07.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 07/06/2012] [Accepted: 07/09/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the protective potential of a conventional adhesive, a caries infiltrant and a combination of both against acidic challenge in vitro. METHODS One-hundred-and-fifty discs from bovine lower central incisors were fabricated. Seventy-five samples remained untreated, whereas the other half was subjected to a demineralisation process (14 days, acidic buffer, and pH 5) to create artificial enamel lesions. Specimens were then radioactively irradiated, and each 15 sound and demineralised specimens were treated with a caries infiltrant (Icon, DMG), an unfilled adhesive (Heliobond, IvoclarVivadent) or a combination of infiltrant and adhesive. Specimens treated with the adhesive followed by a flowable composite (TetricEvoFlow, IvoclarVivadent) served as positive control, while untreated specimens served as negative control. All samples were then subjected to lactic acid for 3 weeks at pH 4. Loss of apatite was determined using the radiochemical method of liquid scintillation. Data were statistically analysed by Kruskal-Wallis-test, one-way ANOVA and Scheffe's post hoc tests (p ≤.05). RESULTS In both sound enamel and artificial caries lesions, untreated specimens showed the highest rate of apatite loss, whereas enamel treated with the adhesive and the flowable composite showed almost complete protection surface against dissolution. The caries infiltrant, the adhesive and the combination of both were able to decrease enamel dissolution, but the adhesive and the combination of adhesive and infiltrant were more effective than the infiltrant alone. CONCLUSION Within the limitations of this in vitro study, the application of an adhesive (alone or in combination with the caries infiltrant) is more effective to protect enamel dissolution than the infiltrant alone.
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Oguri M, Yoshida Y, Yoshihara K, Miyauchi T, Nakamura Y, Shimoda S, Hanabusa M, Momoi Y, Van Meerbeek B. Effects of functional monomers and photo-initiators on the degree of conversion of a dental adhesive. Acta Biomater 2012; 8:1928-34. [PMID: 22293580 DOI: 10.1016/j.actbio.2012.01.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 12/12/2011] [Accepted: 01/10/2012] [Indexed: 11/25/2022]
Abstract
Besides functional and cross-linking monomers, dental adhesives contain a photo-initiator system for polymerization, thereby providing physico-mechanical strength to the adhesive-tooth interface. Few studies have investigated the effect of the functional monomer and polymerization-initiation system on the polymerization efficiency of the adhesive. Here, we tested the effect of two different functional monomers (MAC-10 vs. SR) and two photo-initiator systems, camphorquinone-amine (CQ) vs. borate (BO), on the degree of conversion (DC) of different adhesive formulations. The DC of the CQ-cured adhesive formulations was significantly affected by the MAC-10 monomer. This should be ascribed to the known inactivation of the amine co-initiator through acid-base reaction. However, the SR monomer did not decrease the DC, which could be attributed to a "gel effect" or the so-called "Trommsdorff-Norrish" phenomenon of enhanced DC with more viscous resins, and to the more favorable availability of CC double bonds. In contrast, the DC of the BO-cured adhesive formulations was not affected by any acidic monomer. It is concluded that the degree of conversion of an adhesive can be affected by the functional monomer, but this depends on the kind of photo-initiator system used. As bond durability depends, among other factors, on the strength and thus degree of conversion of the adhesive, potential interaction between adhesive ingredients and the photo-initiator system definitely needs to be studied further.
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Ekizer A, Zorba YO, Uysal T, Ayrikcila S. Effects of demineralizaton-inhibition procedures on the bond strength of brackets bonded to demineralized enamel surface. Korean J Orthod 2012; 42:17-22. [PMID: 23112927 PMCID: PMC3481961 DOI: 10.4041/kjod.2012.42.1.17] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 10/24/2011] [Accepted: 10/25/2011] [Indexed: 11/25/2022] Open
Abstract
Objective To study and compare the effects of different demineralization-inhibition methods on the shear bond strength (SBS) and fracture mode of an adhesive used to bond orthodontic brackets to demineralized enamel surfaces. Methods Eighty freshly extracted, human maxillary premolars were divided into 4 equal groups and demineralized over the course of 21 days. Brackets were bonded to the demineralized enamel of teeth in Group 1. In Group 2, bonding was performed following resin infiltration (ICON®, DMG, Hamburg, Germany). Before bonding, pre-treatment with acidulated phosphate fluoride (APF) or solutions containing casein phosphopeptide-amorphous calcium phosphate with 2% neutral sodium fluoride (CPP-ACP/wF) was performed in Groups 3 and 4, respectively. The SBS values of the brackets were measured and recorded following mechanical shearing of the bracket from the tooth surface. The adhesive remnant index (ARI) scores were determined after the brackets failed. Statistical comparisons were performed using one-way ANOVA, Tukey's post-tests, and G-tests. Results Significant differences were found in some of the intergroup comparisons of the SBS values (F = 39.287, p < 0.001). No significant differences were found between the values for the APF-gel and control groups, whereas significantly higher SBS values were recorded for the resin-infiltrated and CPP-ACP/wF-treated groups. The ARI scores were also significantly different among the 4 groups (p < 0.001). Conclusions Tooth surfaces exposed to resin infiltration and CPP-ACP/wF application showed higher debonding forces than the untreated, demineralized surfaces.
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Affiliation(s)
- Abdullah Ekizer
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Attin R, Stawarczyk B, Keçik D, Knösel M, Wiechmann D, Attin T. Shear bond strength of brackets to demineralize enamel after different pretreatment methods. Angle Orthod 2012; 82:56-61. [PMID: 21793714 PMCID: PMC8881030 DOI: 10.2319/012311-48.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Accepted: 05/01/2011] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE To compare the influence of demineralized and variously pretreated demineralized enamel on the shear bond strength of orthodontic brackets. MATERIALS AND METHODS Sixty bovine enamel specimens were allocated to five groups (n = 12). Specimens of group 1 were not demineralized and were not pretreated, but served as controls. The other specimens were demineralized to form artificial carious lesions. Samples from group 2 were only demineralized and were kept untreated in artificial saliva. The other samples were pretreated with highly concentrated fluoride preparations (group 3: Elmex Gelee, 1.23% F; group 4: Clinpro White Varnish, 2.23% F) or with an infiltrating resin (group 5: Icon). After respective pretreatments, brackets were adhesively fixed on all specimens with an adhesive system after etching with 35% phosphoric acid and application of a primer and bracket resin cement (Transbond XT). Bracket shear bond strength was evaluated with a universal testing machine. Statistical analysis was performed by one-way analysis of variance followed by a post-hoc Scheffé test. RESULTS Shear bond strength in control group 1 was statistically significantly greater compared with that in all other groups. Application of the infiltrating resin Icon (group 5) as pretreatment resulted in statistically significantly greater bond strength as compared with pretreatments with fluoride compounds (groups 3 and 4) and treatment provided without pretreatment (group 2). Groups 2, 3, and 4 did not significantly differ from each other. CONCLUSION Pretreatment with the infiltrating resin is a beneficial approach to increasing the shear bond strength of brackets to demineralized enamel.
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Affiliation(s)
- Rengin Attin
- Department of Preventive Dentistry, Periodontology, Cariology, Plattenstr 11,Zurich, 8032, Switzerland.
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Arnold WH, Gaengler P. Light- and electronmicroscopic study of infiltration of resin into initial caries lesions--a new methodological approach. J Microsc 2011; 245:26-33. [PMID: 21919904 DOI: 10.1111/j.1365-2818.2011.03540.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
It was the purpose of this pilot study to investigate resin infiltration into various types of initial subsurface caries lesions using a combined microscopic technique with polarized light microscopy and fluorescence microscopy and subsequent scanning microscopy with EDX-element analysis. Six extracted premolars with initial caries lesions were used. Five were infiltrated with resin after imbibition of the subsurface carious pore volume of enamel with sodium fluorescein solution. After light curing the unbound dye was removed by washing out in water. Serial sections were cut through the lesions and investigated with polarized light microscopy, fluorescence microscopy and simultaneously with both microscopic techniques. The same sections were then studied with scanning electron microscopy and EDX-element analysis to prove the infiltration of the resin into the lesions. The results showed, that the combination technique adds further morphologic information to infiltration behaviour of the resin. The individual volume of early acute lesions versus chronic lesions involving dentin, and the fluorescein bound by resin was well documented in serial sections. The EDX calcium and phosphorus signals correlate negatively with the lesion extension, and the carbon signal correlates positively, thus labelling the resin infiltration. It could be demonstrated that resin infiltration is dependent from the pore volume of the lesion. It can be concluded that the combined polarized light microscopy with fluorescence microscopy is an advantageous tool for studying infiltration of resin into hard tissues.
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Affiliation(s)
- W H Arnold
- Faculty of Health, School of Dentistry, University of Witten/Herdecke, Witten, Gemany.
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Kim S, Kim EY, Jeong TS, Kim JW. The evaluation of resin infiltration for masking labial enamel white spot lesions. Int J Paediatr Dent 2011; 21:241-8. [PMID: 21401750 DOI: 10.1111/j.1365-263x.2011.01126.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to clinically assess the effectiveness of masking white spot enamel lesions using a resin infiltration technique that was recently developed to arrest incipient caries in a micro-invasive concept. METHODS Twenty teeth with a Developmental Defect of Enamel (DDE) and 18 teeth with Post-orthodontic Decalcification (POD) were selected and treated with resin infiltration. Standardized photographs were taken before, immediately after, and 1 week after treatment and were analysed using image analysing software to calculate the ΔE values. The results were classified into three groups: completely masked, partially masked, and unchanged. RESULTS Among the 20 teeth with DDE, five teeth (25%) were classified as completely masked, whereas seven (35%) and eight teeth (40%) were partially masked and unchanged, respectively. Among the 18 teeth with POD, 11 teeth (61%) were completely masked, six teeth (33%) were partially masked, and one tooth (6%) was unchanged. In some teeth, the result was more improved after 1 week than immediately after infiltration. CONCLUSION The masking effect was dramatic in some cases but not in others. The long-term colour stability of the result should be followed up through continuous clinical and scientific studies.
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Affiliation(s)
- Shin Kim
- Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Yangsan, Korea.
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Wiegand A, Stawarczyk B, Kolakovic M, Hämmerle C, Attin T, Schmidlin P. Adhesive performance of a caries infiltrant on sound and demineralised enamel. J Dent 2011; 39:117-21. [DOI: 10.1016/j.jdent.2010.10.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 10/11/2010] [Accepted: 10/11/2010] [Indexed: 11/16/2022] Open
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Surface conditioning of natural enamel caries lesions in deciduous teeth in preparation for resin infiltration. J Dent 2010; 38:65-71. [DOI: 10.1016/j.jdent.2009.09.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 08/21/2009] [Accepted: 09/01/2009] [Indexed: 11/20/2022] Open
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Paris S, Bitter K, Renz H, Hopfenmuller W, Meyer-Lueckel H. Validation of two dual fluorescence techniques for confocal microscopic visualization of resin penetration into enamel caries lesions. Microsc Res Tech 2009; 72:489-94. [DOI: 10.1002/jemt.20701] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
In artificial lesions, improved penetration and the caries-inhibiting properties of infiltrating resins could be observed with increasing penetration coefficients (PCs). The aim of the present study was to compare the penetration abilities of an experimental ‘infiltrant’ into natural lesions with those of an adhesive in vitro. Extracted human molars and premolars showing proximal white spots were cut across the lesions perpendicular to the surface. Corresponding lesion halves were etched for 120 sec with 15% hydrochloric acid gel and were subsequently treated with either an adhesive (PC: 31 cm/sec) or an infiltrant (PC: 273 cm/sec). Specimens were observed by confocal microscopy and transverse microradiography. Penetration depths of the adhesive were significantly lower compared with those of the infiltrant (p < 0.001; Wilcoxon). It can be concluded that resins with higher PCs (infiltrants) show superior ability to penetrate natural lesions compared with resins with lower PCs.
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Affiliation(s)
- H. Meyer-Lueckel
- Department of Operative Dentistry and Periodontology, CharitéCentrum for Dental Medicine, Charité-Universitätsmedizin Berlin and Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Arnold-Heller-Str. 3, house 26, 24105 Kiel, Germany
| | - S. Paris
- Department of Operative Dentistry and Periodontology, CharitéCentrum for Dental Medicine, Charité-Universitätsmedizin Berlin and Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Arnold-Heller-Str. 3, house 26, 24105 Kiel, Germany
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Meyer-Lueckel H, Paris S. Progression of Artificial Enamel Caries Lesions after Infiltration with Experimental Light Curing Resins. Caries Res 2008; 42:117-24. [DOI: 10.1159/000118631] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Accepted: 01/10/2008] [Indexed: 11/19/2022] Open
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Abstract
Infiltration of non-cavitated caries lesions with light-curing resins could lead to an arrest of lesion progression. The aim of this study was to evaluate the penetration of a conventional adhesive into natural enamel caries after pre-treatment with two different etching gels in vitro. Extracted human molars and premolars showing proximal white-spot lesions were cut across the lesions perpendicular to the surface. Corresponding lesion halves were etched for 120 sec with either 37% phosphoric acid gel (H(3)PO(4)) or 15% hydrochloric acid gel (HCl), and subsequently infiltrated with an adhesive. Specimens were observed by confocal microscopy. Mean penetration depths (SD) in the HCl group [58 (37) microm] were significantly increased compared with those of the H(3)PO(4) group [18 (11) microm] (p < 0.001; Wilcoxon). It can be concluded that etching with 15% hydrochloric acid gel is more suitable than 37% phosphoric acid gel as a pre-treatment for caries lesions intended to be infiltrated.
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Affiliation(s)
- S Paris
- Dept. of Operative Dentistry and Periodontology, University School of Dental Medicine, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Meyer-Lueckel H, Paris S, Kielbassa AM. Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration. Caries Res 2007; 41:223-30. [PMID: 17426404 DOI: 10.1159/000099323] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2006] [Accepted: 10/06/2006] [Indexed: 11/19/2022] Open
Abstract
The infiltration of proximal enamel lesions with low-viscosity light curing resins could be a viable approach to stop lesion progression. However, penetration of sealant might be hampered by the comparatively highly mineralized surface layers of natural lesions. Therefore, the aim of this study was to compare the efficacy of three different etching gels in removing the surface layer in various etching times. Extracted human molars and premolars showing proximal white spot lesions were cut across the demineralized areas. Ninety-six lesions expected from visual examination to be confined to the outer enamel (C1) were selected. The cut surface and half of each lesion were varnished, thus serving as control. Subsequently, the lesions were etched with either phosphoric (37%) or hydrochloric (5 or 15%) acid gel for 30-120 s (n = 8/group). Specimens were examined using confocal microscopy and transversal microradiography. Surface layer reduction was significantly increased in lesions etched with 15% HCl gel for 90 and 120 s compared to those etched with H(3)PO(4) gel for 30-120 s (p < 0.05). No significant differences regarding the depths of erosion in the lesions compared to sound enamel could be observed (p > 0.05). An effective reduction in the surface layer of natural enamel caries can be achieved by etching with 15% hydrochloric acid gel for 90-120 s.
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Affiliation(s)
- H Meyer-Lueckel
- Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Campus Benjamin Franklin, Charité--Universitatsmedizin Berlin, Berlin, Germany
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