Effect of simulated pulpal pressure on dentin permeability and adhesion of self-etch adhesives

Simulated Hydrostatic Pulpal Pressure Effect on Microleakage-An Initial Study

PURPOSE

This study's purpose was to evaluate the effect of simulated in vitro hydrostatic pulpal pressure (HPP) on microleakage.

METHODS AND MATERIALS

Extracted third molars (n=12) were sectioned 5 mm below the cementoenamel junction, pulp tissue removed, and the sectioned crowns mounted on a Plexiglas plate penetrated by an 18-gauge stainless steel tube. The mounted specimen mesial surface received a 2×4×6 mm Class V preparation followed by restoration with a strongly acidic, one-step dental adhesive and a flowable microfilled resin, following all manufacturers' instructions. Restorations were finished to contour, and tubing was attached to a 20-cm elevated, 0.2% rhodamine G reservoir to the specimen steel tube for 48 hours. Specimens then received a nail polish coating to within 1 mm of the restoration margins and were placed in 2% methylene blue (MB) dye for 24 hours, followed by rinsing, embedding in epoxy resin, and sectioning into 1 mm slices using a diamond saw. Controls were intact molars (n=12) processed as above but without HPP. Specimen slices were evaluated using laser confocal microscopy with images exported to ImageJ software with microleakage assessed as the MB linear penetration as a percentage of the total interfacial wall length. Mean values were evaluated with the Kruskal Wallis/Dunn test at a 95% confidence level.

RESULTS

The control specimens demonstrated significantly greater (p<0.0001) MB penetration than experimental specimens with simulated HPP. Under this study's conditions, simulated HPP significantly decreased MB dye penetration.

CONCLUSION

Studies accomplished without simulated HPP may overestimate microleakage results.

Bonding performance and interfacial adaptation of modern bulk-fill restorative composites after aging in artificial saliva: an in vitro study

OBJECTIVES

This study aimed at comparing the microtensile bond strength (MTBS) and interfacial adaptation of a modern self-curing and a light-curing restorative bulk-fill composite to a conventional composite applied with the layering technique.

METHODS

Forty-eight occlusal cavities were divided in three main groups (16/group) based on tested materials: (i) STELA, bulk-fill self-curing restorative (STELA, SDI Ltd.); (ii) 3 M-BULK, bulk-fill composite (Filtek One Bulk-Fill, 3 M Oral Care); and (iii) 3 M-CTR, a conventional composite (Filtek Supreme XTE, 3 M Oral Care). These were used in combination with their adhesives in self-etch (SE) or etch-and-rinse (ER) mode. Specimens stored in artificial saliva (24 h or 12 months) were evaluated for MTBS and fractography. The interfacial analysis was performed through confocal microscopy. ANOVA and Fisher's LSD post hoc tests were performed with a level of significance of 5%.

RESULTS

All the tested materials applied in ER mode presented (24 h) greater bond strength than in SE mode. Although all materials showed a significant drop in the bond strength after prolonged storage, STELA showed the highest bonding performance and interfaces with few gaps. 3 M-BULK had the lowest bond strength and an interface with several voids and gaps.

CONCLUSIONS

All materials were affected by interface degradation and bonding reduction over prolonged aging. However, their use in combination with adhesives applied in ER mode may offer greater immediate bonding performance.

CLINICAL RELEVANCE

The use of restorative light-curing bulk-fill composites may generate gaps at the bonding interface and voids. STELA may represent a suitable alternative to avoid such issues.

Novel resin-based material containing β-tricalcium phosphate nanoparticles for the reduction of dentin permeability

OBJECTIVES

To synthesize and characterize a novel dentin adhesive containing Beta-Tricalcium Phosphate (β-TCP) nanoparticles and test its ability to reduce dentin permeability (dP).

METHODS

Experimental adhesives were prepared by mixing Bis-GMA, TEGDMA, HEMA (50/25/25 wt.%), photo-initiators, and inhibitors. The following groups were tested: Experimental adhesives without β-TCP (Exp.); with 10 wt.% β-TCP (Exp.10 wt.% β-TCP); with 15 wt.% β-TCP (Exp.15 wt.% β-TCP), Scotchbond Multi-Purpose (SBMP) and Clearfil SE Protect Bond (CFPB). Degree of conversion (DC%, 10 and 20 s); Flexural Strength (FS), Knoop Hardness (KHN), and Cell Viability (OD%) tests were performed. dP was evaluated by hydraulic conductance, using human dentin disks (n=12), at three-time intervals: post-EDTA (T0); post-treatment (T1); and post-erosion/abrasion cycling (T2). Data were statistically analyzed (α=0.05).

RESULTS

For all groups, exposure time for 20 s presented a higher DC% than for 10 s. For FS, filled adhesives did not differ from unfilled and from CFPB. Experimental adhesives did not differ among them and showed lower KHN than the commercial products. Cell viability did not differ among adhesives, except Exp. 15 wt.%, which showed lower OD% than Exp., Exp. 10% and, CFPB. For dP, only Exp.10 and 15 wt.% β-TCP did not present difference between the times T1 and T2. After cycling, Exp.10 wt.% β-TCP presented lower permeability than Exp. and CFPB.

CONCLUSIONS

The incorporation of 10 wt.% β-TCP nanoparticles into the resin-based dental material did not affect its mechanical properties and biocompatibility, and promoted the greatest reduction in dentin permeability, sustaining this effect under erosive/abrasive challenges.

CLINICAL SIGNIFICANCE

A novel resin-based dental material containing β-TCP nanoparticles was able to reduce dentin permeability, maintaining its efficacy after erosive/abrasive challenges. The synthesized material did not affect dental pulp cell viability and might be promising for other conditions that require dental remineralization, such as tooth wear and dental caries.

Influence of Phosphoric, Glycolic, and Ferulic Acids on Dentin Enzymatic Degradation, Ultimate Tensile Strength, and Permeability

This study evaluated dentin enzymatic degradation based on the total matrix metalloproteinase (MMP) activity of demineralized dentin matrices before and after exposure to phosphoric acid (PA), glycolic acid (GA), and ferulic acid (FA). The release of hydroxyproline (HP), ultimate tensile strength (UTS), and dentin permeability (DP) were also evaluated. Dentin collagen matrices were assessed according to total MMP activity before and after treatment with the tested acids (n=10) for 15 seconds and compared with the control (GM6001 inhibitor). Dentin beams were analyzed for HP release and UTS after the treatments. Dentin discs were tested for DP at a pressure of 5 psi before and after treatment with the acids (n=10). The FA group had a lower percentage of enzymatic inhibition than the PA and GA groups (p<0.0001). No significant difference in UTS was found among the acids (p=0.6824), but HP release was significantly higher in the FA group than in the PA and GA groups (p<0.0001). No significant difference in DP was found for the acids (p=0.0535). GA led to less activation of MMPs and less release of HP, whereas the UTS and DP for GA were like those found for PA. In contrast, FA promoted greater enzymatic activity and greater release of HP, while having similar results to GA and PA regarding mechanical properties.

Hydrogen Peroxide Diffusion through Dental Tissues-In Vitro Study

Whitening products commonly utilize hydrogen peroxide (HP) as an active principle, which can penetrate dental tissues with potential side effects due to its low molecular weight. This study aimed to evaluate the HP diffusion of two in-office whitening products, namely 6% VivaStyle Paint On Plus (VS) and Opalescence Boost 40% (OP), in different tooth types. Additionally, the influence of the area of exposure, dental tissue thickness and pulp chamber volume was assessed. Each group consisted of eighteen intact anterior (A), premolar (PM) and molar (M) human teeth, and a positive pulpal pressure model was employed. The samples were analyzed using spectrophotometry, and results were expressed as the mean and 95% confidence interval. Statistical tests and linear regression models were appropriately applied at α = 5%. The total HP (µg) retrieved was as follows: VS-A, 1.333 [1.214, 1.452]; OP-A, 1.538 [1.457, 1.620]; VS-PM, 1.208 [1.123, 1.291]; OP-PM, 3.628 [3.401, 3.855]; VS-M, 2.560 [2.297, 2.823]; and OP-M, 4.197 [3.997, 4.396], with statistically significant differences in diffusion kinetics between whitening products for PM and M. Several HP concentrations attained a minimum cytotoxicity value of 2.22 µg/mL. The regression model shows that OP exposed the pulp chamber to 1.421 µg of HP more than that of VS. Different whitening products can cause cytotoxic HP concentrations in the pulp chamber, with a higher risk observed in molars.

Effects of Arginine-calcium carbonate pretreatment on the remineralizing and bonding performance of phosphorylated dentin

OBJECTIVES

To evaluate the effects of Arginine-calcium carbonate (Arg-CaCO₃) paste treatment of phosphorylated dentin on remineralizing and bonding performance during direct and indirect restorations under pulpal pressure.

METHODS

Under simulated pulpal pressure, dentin of healthy third molars were abraded and acid etched for 15s, then randomly divided into 4 groups: negative control group; Arg-CaCO₃ group (1min); 2.5% Sodium trimetaphosphate (STMP) group (3min); S-A group, 2.5% STMP + Arg-CaCO₃. After 24h, remineralization and dentin tubular occlusion were assessed by Attenuated total reflection fourier transform infrared spectroscopy (ATR-FTIR), Micro-Raman spectroscopy, Vickers hardness, Field-emission scanning electron microscope (FESEM) and Energy X-ray dispersive spectrometer (EDS). The liquid environment was the simulated body fluid (SBF) permeated from dentin tubules due to pulpal pressure. Stick specimens prepared with self-etch dentin adhesive were tested for microtensile bond strength (μTBS) and interfacial silver nanoleakage on both immediate direct restoration and indirect restoration with a 7-day temporary period. Data were analyzed by the Kruskal-Wallis test, Mann-Whitney test, Welch ANOVA or one-way ANOVA and Tukey post hoc test (p < 0.05).

RESULTS

The pretreatment of 2.5% STMP with Arg-CaCO₃ significantly increased relative mineral content by ATR-FTIR, Raman and FESEM-EDS, simultaneously enhancing dentin tubular occlusion (%) and mechanical property to the most considerable extent. Furthermore, the pretreatment significantly promoted the μTBS of indirect restoration and reduced nanoleakage after 7 days.

CONCLUSIONS

The application of Arg-CaCO₃ paste on phosphorylated dentin could improve intra- and extra-tubular mineralization and the stability of adhesion interface.

CLINICAL RELEVANCE

Without exceeding the amount of conventional tooth preparation, combining 2.5% STMP with Arg-CaCO₃ paste before the self-etch bonding system might be a promising clinical strategy to relieve dentin hypersensitivity and strengthen bonding performance efficiently and conveniently.

Iontophoresis effects of two-step self-etch and total-etch systems on dentin permeability and sealing of composite restoration under simulated pulpal pressure

BACKGROUND

Studies demonstrated the bond strength enhancement and the decrease in degradation of the adhesive interface after applying either self-etch adhesives or two-step, etch-and-rinse adhesives under an electric field. However, the presence of dentinal fluid driven by the pulpal pressure in vivo is a profounding factor affecting both the sealing ability and bond strength of adhesives. This study aimed to evaluate the effect of three-step etch-and-rinse and two-step self-etch adhesives when applied with iontophoresis under simulated pulpal pressure on the permeability of dentin, resin infiltration, and the sealing ability of resin composite.

METHODS

The experiments were done on 32 recently extracted premolars, randomly assigned into four groups (n = 8) according to two adhesive systems (SBMP and SE), applied following the manufacturer's instructions (control) for two groups or with iontophoresis for the others (SBMPi and SEi). For the iontophoresis, the anodal current was applied at 75 μA for 20 s through the cavity electrode during the bond. The fluid flow rate of dentin was recorded after cavity preparation (smear-layer-covered dentin; T1), bonding (T2), and composite restoration (T3) during the maintained pulpal pressure of 20 mm Hg. The flow rates were expressed as a percentage relative to the initial smear-layer-covered value for each specimen. Results were analyzed using repeated measures ANOVA. Scanning electron microscopy (SEM) was performed to observe the resin/dentin interface.

RESULTS

There were no significant increases in the mean flow rates from T1 to T3 in the SBMP (P = 0.355), while these changes in the SE were significant between T1 (100%) and T2 (166.77%) and T1 and T3 (221.16%) (P = 0.002; one-way RM ANOVA; Holm-Sidak test). For the iontophoresis groups, the mean flow rates decreased significantly from T1 to T2 and T1 to T3 of both SBMPi (T2 = 86.43, and T3 = 79.53; P < 0.001) and SEi groups (T2 = 87.96, and T3 = 81.48; P = 0.004). The iontophoresis of both adhesives produced the optimal resin infiltration with improved quality of the hybrid layer and resin tags.

CONCLUSIONS

SBMP bonded with or without iontophoresis performed better sealing ability than SE under the same condition. Both adhesives applied with anodal iontophoresis significantly decreased the dentin permeability, contributing to the improved resin infiltration.

The durability of resin-dentine bonds are enhanced by epigallocatechin-3-gallate-encapsulated nanohydroxyapatite/mesoporous silica

Biomimetic nanohydroxyapatite (nHAp) has long been used as a biocompatible material for bone repair, bone regeneration, and bone reconstruction due to its low toxicity to local or systemic tissues. Various cross-linkers have been employed to maintain the structure of collagen; these include epigallocatechin-3-gallate (EGCG), which can fortify the mechanical properties of collagen and withstand the degradation of collagenase. We hypothesized that EGCG combined with nHAp may promote resin-dentin bonding durability. Here, we examined the effect of epigallocatechin-3-gallate-encapsulated nanohydroxyapatite/mesoporous silica (EGCG@nHAp@MSN) on thermal stability and remineralization capability of dentin collagen. Dentin slices (2 × 2 × 1 mm³ ) were obtained and completely demineralized in a 10% phosphoric acid water solution. The resulting dentin collagen matrix was incubated with deionized water, EGCG, nHAp@MSN, and EGCG@nHAp@MSN. The collagen thermal degradation temperature was assessed utilizing differential scanning calorimetry analysis, which indicated that EGCG, nHAp@MSN, and EGCG@nHAp@MSN reinforced collagen's capability to resist thermal degradation. EGCG@nHAp@MSN resulted in the highest increase in denaturation temperature. Thermogravimetric analysis showed that both nHAp@MSN and EGCG@nHAp@MSN achieved a higher residual mass than the EGCG and control groups. Fourier transform infrared spectroscopy was performed to examine the interaction between EGCG@nHAp@MSN and dentin collagen. The EGCG@nHAp@MSN sample exhibited stronger dentin microhardness and uppermost bond strength after thermocycling. EGCG significantly enhanced collagen's capability to resist thermal degradation. In summary, EGCG and nHAp@MSN may work together to assist the exposed collagen to improve resistance to thermal cycling and promote remineralization while also strengthening the durability of resin-dentin bonds.

Resin-based materials to control human dentin permeability under erosive conditions in vitro: A hydraulic conductance, confocal microscopy and FTIR study

OBJECTIVES

To characterize the behavior of three different polymeric agents before and after an erosive challenge on dentin permeability, to analyze their degradation in both conditions, and to analyze their degree of conversion (DC).

METHODS

The permeability of human dentin disks (1.0 ± 0.2 mm) was measured with smear layer, after its removal, after treatment (LpTreat) with Gluma Desensitizer, PRG Barrier Coat (PBC) or Icon infiltrant (n = 11/group) and after exposure to citric acid (LpEro) (6%, pH 2.1, 1 min). The specimens were analyzed under a Laser Scanning Confocal Microscope (n = 2/group) and the products' DC were calculated. Data were subjected to 2-way repeated measures ANOVA and post-hoc Bonferroni (permeability analysis), to paired t-test (for specimens treated with Icon) and to t-test (DC analysis) (α < 0.05).

RESULTS

Icon showed the lowest LpTreat and LpEro values, while PBC and Gluma did not differ from each other under these conditions. Icon and PBC showed LpEro similar to a dentin with smear layer. Under the Laser Scanning Confocal Microscope, more deposits were noticeable on dentin after treating with PBC. Gluma presented the deepest penetration in dentin. The DC of PBC was the highest.

SIGNIFICANCE

Icon caused the highest reduction on permeability values, followed by PBC and Gluma. PBC generated more deposits covering dentin and seemed to be more efficient after an erosive challenge. The association of a polymeric resin with inorganic ion-releasing fillers seem to be a great strategy to manage dentin hypersensitivity under erosive conditions.

Delayed light activation of resin composite affects the bond strength of adhesives under dynamic simulated pulpal pressure

OBJECTIVE

To evaluate the effect of a time delay before the light activation of resin composite on the microtensile bond strength (µTBS) of self-etch adhesives under dynamic simulated pulpal pressure.

MATERIALS AND METHODS

One hundred twenty crown segments were prepared from human third molars. Dentin surfaces were prepared with coarse diamond burs and connected to a dynamic pulpal pressure device. The self-etch adhesives used were Clearfil SE Bond (CSE), G2-Bond Universal (G2B), Clearfil Universal Bond Quick (CBQ), and G-Premio Bond (GPB). Each adhesive was divided into 3 subgroups: immediate light activation of resin composite (T₀), delayed light activation for 150 s (T₁), and 300 s (T₂). The µTBS data were obtained after 24-h water storage. Scanning electron microscopy was used to evaluate the nanoleakage at the resin-dentin surface. The µTBS data were analyzed using two-way ANOVA and Duncan's multiple comparisons.

RESULTS

All adhesives demonstrated a significant reduction in µTBS at T₂, except for CBQ where the bond strength was not affected by the delayed light activation times. The two-step self-etch adhesives (CSE and G2B) demonstrated higher bond strength than the one-step adhesives at all conditions. Nanoleakage was observed in all adhesives at T₂; however, nanoleakage was detected only in CBQ and GPB at T₁.

CONCLUSIONS

Delayed light activation of resin composite adversely affected the dentin bond strength of self-etch adhesives. Two-step self-etch adhesives had better bonding performance than one-step self-etch adhesives.

CLINICAL RELEVANCE

After adhesive application, resin composite should be adapted and cured as soon as possible.

Influence of chlorhexidine, propolis, pulpal pressure simulation, and aging on dentin bond strength

The present study evaluated the bond strength (μTBS) of dentin treated with chlorhexidine and propolis subjected to simulated pulpal pressure (SPP) and thermocycle aging. One hundred and twenty healthy human molars were sectioned to obtain 2 mm of dentin thickness and were divided into two groups (n = 60): SPP (15 cm H₂ O) and no SPP (Control group). Dentin surfaces were conditioned with 37% phosphoric acid for 15 s and were divided according to the dentin treatment (n = 20): Control; Chlorhexidine gluconate (0.2% for 30 s) and Propolis (aqueous propolis extract for 30 s). Half of the specimens were submitted to 15,000 thermocycle aging (5 ± 2°C and 55 ± 2°C). The samples were sectioned into beams and submitted to μTBS. Data were analyzed by three-way ANOVA (SPP × Dentin treatment × Thermocycle aging) and the Tukey's tests (p < .001). With regard to the SPP, ANOVA revealed that the Control group (32.98 MPa) had significantly higher values of μTBS when compared to the SPP (29.19 MPa). With regard to Thermocycle aging, no aging (34.05 MPa) had significantly higher values of μTBS when compared to the aging (28.12 MPa). With regard to the dentin treatment, Propolis and Chlorhexidine did not statistically influence the results (p > .05). The SPP and thermocycle aging negatively influenced the bond strength between the dentin and resin; the 0.2% chlorhexidine digluconate and aqueous propolis extract solutions did not interfere in the bond strength between the resin and dentin. The use of chlorhexidine and propolis as a dental treatment may not influence the dentin bond strength, but SPP and thermocycle aging may damage the longitudinal dentin bond strength.

Effects of dentin surface preparations on bonding of self-etching adhesives under simulated pulpal pressure

Objectives

This study evaluated the effects of different smear layer preparations on the dentin permeability and microtensile bond strength (µTBS) of 2 self-etching adhesives (Clearfil SE Bond [CSE] and Clearfil Tri-S Bond Universal [CTS]) under dynamic pulpal pressure.

Materials and Methods

Human third molars were cut into crown segments. The dentin surfaces were prepared using 4 armamentaria: 600-grit SiC paper, coarse diamond burs, superfine diamond burs, and carbide burs. The pulp chamber of each crown segment was connected to a dynamic intra-pulpal pressure simulation apparatus, and the permeability test was done under a pressure of 15 cmH₂O. The relative permeability (%P) was evaluated on the smear layer-covered and bonded dentin surfaces. The teeth were bonded to either of the adhesives under pulpal pressure simulation, and cut into sticks after 24 hours water storage for the µTBS test. The resin-dentin interface and nanoleakage observations were performed using a scanning electron microscope. Statistical comparisons were done using analysis of variance and post hoc tests.

Results

Only the method of surface preparation had a significant effect on permeability (p < 0.05). The smear layers created by the carbide and superfine diamond burs yielded the lowest permeability. CSE demonstrated a higher µTBS, with these values in the superfine diamond and carbide bur groups being the highest. Microscopic evaluation of the resin-dentin interface revealed nanoleakage in the coarse diamond bur and SiC paper groups for both adhesives.

Conclusions

Superfine diamond and carbide burs can be recommended for dentin preparation with the use of 2-step CSE.

Evaluation of shear bond strength of various adhesives under Simulated intrapulpal pressure: An in vitro study

Introduction:

The presence of pulpal fluid can influence dentin bonding. This study aimed to evaluate the shear bond strength of universal dental adhesives under simulated intrapulpal pressure.

Materials and Methods:

Forty intact maxillary premolars were distributed into four groups (Group 1 – 3M ESPE Adper Single Bond 2 total etch adhesive, Group 2 – 3M ESPE Single Bond Universal, Group 3 – Prime and Bond universal adhesive, and Group 4 – Ivoclar Tetric N Bond Universal). Adhesive restorative procedures were carried under intrapulpal pressure simulation following which it was subjected to a shear load of 0.5 mm/min. Fracture mode analysis was performed using a stereomicroscope. The data obtained were subjected to ANOVA and Tukey post hoc test with a P < 0.05.

Results:

Highest bond strength was exhibited by Group 3 (7.01 ± 2.02 MPa) and least by Group 1 (5.36 ± 3.03 MPa). However, there were no statistical differences among the groups. Group 1 and 2 showed mostly cohesive failure, whereas Group 3 and 4 showed mixed failure.

Conclusion:

The results demonstrated that the experimental universal adhesive agents exhibited comparative shear bond strength when subjected to pulpal pressure. Pulpal pressure has a significant effect on bond strength.

The Effect of Different Condition of Pulpal Pressure on Microtensile Bond Strength of Several Dentin Bonding Agents on Deep and Superficial Dentin

The objective of this study was to examine the effect of different conditions of simulated hydrostatic pulpal pressure on the μTBS of HEMA-based and HEMA-free dentin bonding agents (DBAs). The influence of dentin location (deep and superficial) on μTBS was also evaluated. Flat coronal dentin surfaces of extracted human molars were prepared. Three groups of resin-bonded specimens were exposed to different pulpal pressures. Pulpal pressure was maintained for 20 min for each group. A flowable resin composite was used for coronal build-up. The bonded teeth were sectioned and, after 24 h of water storage, stressed to failure using the microtensile tester (μTBS). Failed samples were analyzed by SEM inspection. HEMA-based DBAs were much more sensitive to pulpal pressure conditions than non-HEMA-containing DBAs. Pulpal pressure had a greater influence in deep dentin. The HEMA-free DBA was insensitive to the presence or absence of pulpal pressure condition. SEM inspection confirmed a relationship between the presence of voids inside the HEMA-based DBAs layer and the lower μTBS results. HEMA-based DBAs are more sensitive to pulpal pressure conditions than HEMA-free DBAs. Interestingly, HEMA-free DBA showed a greater number of water droplets at resin–dentin interface in all tested conditions.

Magnetic motion of superparamagnetic iron oxide nanoparticles- loaded dental adhesives: physicochemical/biological properties, and dentin bonding performance studied through the tooth pulpal pressure model

The limited durability of dentin bonding harshly shortens the lifespan of resin composites restorations. The controlled, dynamic movement of materials through non-contacting forces provides exciting opportunities in adhesive dentistry. We, herein, describe comprehensive investigations of a new dental adhesive with superparamagnetic iron oxide nanoparticles (SPIONs) sensitive to magnetic fields for bonding optimization. This contribution outlines a roadmap of (1) designing and tuning of an adhesive formulation containing SPIONs to enhance penetrability into etched dentin guided by magnetic-field; (2) employing a clinically relevant model of simulated hydrostatic pulpal pressure on the microtensile bond to dentin; and (3) investigating a potential antibacterial effect of the formulated adhesives, and their biocompatibility. SPION-concentration-dependency chemical and mechanical behavior was shown via the degree of conversion, ultimate tensile strength, and micro shear bond strength to dentin. The effects of SPIONs carried on a dental adhesive on the bonding strength to dentin are studied in depth by combining experiments with in vitro simulated model. The results show that under the guided magnetic field, 0.07 wt.% of SPIONs-doped adhesive increased the bond strength that surpasses the reduction caused by hydrostatic pulpal pressure. Using a magnetic guide workflow during the bonding procedures, SPIONs-doped adhesives improved dentin's adhesion without changing adhesives' physicochemical properties. This outcome addresses the key challenge of poor resin infiltration of dentin's conventional total etching during the bonding procedure. The real-time magnetic motion of dental adhesives may open new paths to enhance resin-based restorations' longevity. STATEMENT OF SIGNIFICANCE: In this study, dental adhesives containing superparamagnetic iron oxide nanoparticles (SPIONs) were developed to enhance penetrability into dentin guided by a magnetic field. The adhesives were screened for physical, chemical, antibacterial properties, and cytotoxicity. For the first time, simulated pulpal pressure was used concurrently with the magnetic field to simulate a clinical setting. This approach showed that it is feasible to overcome pulpal pressure jeopardization on bond strength when SPIONs and a magnetic field are applied. The magnetic-responsive adhesives had great potential to improve bond strength, opening new paths to enhance resin-based restorations' longevity without affecting adhesives' biological properties. The use of magnetic-responsive particles and magnetically assisted motion is a promising strategy to improve the sealing ability of dental adhesives.

Effect of Novel Bioactive Glass-Containing Dentin Adhesive on the Permeability of Demineralized Dentin

This study aimed to evaluate the effect of a novel bioactive glass (BAG)-containing dentin adhesive on the permeability of demineralized dentin. Bioactive glass (85% SiO₂, 15% CaO) was fabricated using the sol-gel process, and two experimental dentin adhesives were prepared with 3 wt% silica (silica-containing dentin adhesive; SCA) or BAG (BAG-containing dentin adhesive; BCA). Micro-tensile bond strength (μTBS) test, fracture mode analysis, field-emission scanning electron microscopy (FE-SEM) analysis of adhesive and demineralized dentin, real-time dentinal fluid flow (DFF) rate measurement, and Raman confocal microscopy were performed to compare SCA and BCA. There was no difference in μTBS between the SCA and BCA (p > 0.05). Multiple precipitates were evident on the surface of the BCA, and partial occlusion of dentinal tubules was observed in FE-SEM of BCA-approximated dentin. The DFF rate was reduced by 50.10% after BCA approximation and increased by 6.54% after SCA approximation. Raman confocal spectroscopy revealed an increased intensity of the hydroxyapatite (HA) peak on the dentin surface after BCA application. The novel BAG-containing dentin adhesive showed the potential of both reducing dentin permeability and dentin remineralization.

Universal adhesive: the effect of different simulated pulpal pressure fluids and bonding modes to dentin

The aim of this study was to evaluate the effect of SPP with either fetal bovine serum (FBS) or deionized water (DW) on the bond strength (μTBS) of a Universal adhesive to dentin, in both etch-and-rinse (ER) and self-etch (SE) modes. The kinematic viscosity (cSt) of FBS and DW was measured at 25 °C ± 0.1 ºC. Seventy-two sound human molars were sectioned and randomly divided into three groups according to the SPP conditions: (1) Control (0 cm H₂O), (2) SPP (15 cm H₂O) with FBS, (3) SPP (15 cm H₂O) with DW. Each group was subdivided (n = 10) based on the bonding modes: ER (37% phosphoric acid + ScothBond Universal Adhesive) or SE (ScothBond Universal Adhesive). Samples were then submitted to μTBS. Data were analyzed by Student's t test, two-way ANOVA and Tukey tests (p < 0.05). The cSt results showed that DW (23.59 ± 0.39) had significantly higher values than FBS (22.33 ± 0.06). With regard to SPP, the control group (36.1 MPa) had significantly higher values of μTBS when compared to the SPP using FBS (31.06 MPa) and SPP with DW (26.55 MPa). According to ANOVA, the bonding modes and the interaction of simulated pulpal pressure (SPP) did not statistically influence the results (p < 0.05). The presence of SPP reduced the bond strength of Universal adhesive to dentin. DW during SPP had significantly reduced bonding values when compared to FBS. Bonding strategies were not affected by SPP when evaluated in a short period of time (24 h).

Immediate Dentin Sealing: A Literature Review

Purpose

The immediate application of a dentin-bonding agent after tooth preparation and before impression-taking (immediate dentin sealing [IDS]) has been suggested to provide several advantages concerning bacterial microleakage, hypersensitivity, and bonding quality. We reviewed the literature and clarified certain aspects related to each step of IDS application.

Materials and Methods

The search strategy comprised an electronic research in MEDLINE, Cochrane, Ovid and Scopus for studies published from January 1990 to December 2020 regarding the IDS technique and including both in vitro and clinical studies.

Results

After exclusion of irrelevant or duplicate articles, 88 articles focusing on aspects of the IDS technique were assessed. IDS seems to be advantageous with regard to bond strength, gap formation, bacterial microleakage, and dentin hypersensitivity. However, issues arising from interaction with impression materials, the provisional phase, and conditioning methods before cementation require further investigation.

Conclusion

There are no documented reasons preventing clinicians applying IDS in their everyday practice. On the contrary, the presented technique seems to be beneficial in certain aspects regarding indirect restorations.

The evaluation of the desensitization effect of a desensitizing agent and desensitizing toothpastes in vitro

This study was evaluating how three desensitizing toothpastes used at home influence the effect associated with desensitizing agents after application in the clinic. Fifty dentine disks measure it permeability and 32 dentine disks with similar permeability levels were selected. Following Dental desensitizer treatment, dentine disks were randomly divided into three subgroups (n=10) that received applications of three toothpastes, respectively. The permeability (Lp) of each specimen was measured after each treatment. One specimen was selected from each group for scanning electron microscopy (SEM) observation. After each treatment, the Lp values decreased significantly for each group (p<0.05) and either completely or partially blocked the dentine tubules upon SEM observation. However, no significant differences in Lp values were observed amongst subgroups (p>0.05). After using the Dental desensitizer, Sensodyne, Crest and Colgate desensitizing toothpastes both can continued to reduce the permeability of the dentine disk, and no significant differences were found amongst them.

Hydraulic conductance of dentin after treatment with fluoride toothpaste containing sodium trimetaphosphate microparticles or nanoparticles

OBJECTIVES

To evaluate the hydraulic conductance of dentin after treatment with fluoride toothpastes containing sodium trimetaphosphate microparticles (TMPmicro) or nanoparticles (TMPnano).

MATERIALS AND METHODS

The dentinal tubules of bovine dentin blocks (4 × 4 × 1 mm) were unobstructed for determination of the maximum hydraulic conductance of the dentin. The dentin blocks were randomized into four groups (n = 15/group) of toothpastes (placebo, 1100 ppm F, and 1100 with 3% TMPmicro or 3% TMPnano) which were applied for 7 days (2×/day) using a brushing machine. The dentin surface (5/group) was analyzed by scanning electron microscopy. The hydraulic conductance post-treatment was measured in the other ten blocks. Thereafter, the same blocks were immersed in citric acid (pH 3.2) for 1 min, and the conductance was determined again. The data were submitted to 2-way ANOVA repeated measures, followed by the Student-Newman-Keuls test (p < 0.05).

RESULTS

The percentage conductance reduction post-treatment for the groups were placebo = 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). After acid attack, the percentage reduction was placebo < 1100 ppm F < 1100 TMPnano < 1100 TMPmicro (p < 0.001). The toothpastes containing TMP showed the highest obliteration of dentinal tubules.

CONCLUSIONS

The addition of TMPmicro to fluoride toothpaste produced a greater reduction in hydraulic conductance when compared with 1100 ppm F toothpaste.

CLINICAL RELEVANCE

The increased capacity of toothpastes containing TMP to reduce hydraulic conductance indicates their potential to reduce symptoms of dentinal hypersensitivity.

Effect of residual solvent on performance of acrylamide-containing dental materials

OBJECTIVE

Methacrylamide-based monomers are being pursued as novel, hydrolytically stable materials for use in dental adhesives. The impact of residual solvents, due to the chemical synthesis procedures or the need for solvated adhesives systems, on the kinetics of polymerization and mechanical properties was the aim of the present investigation.

METHODS

Two base monomers (70wt% BisGMA or HEMAM-BDI - newly synthesized secondary methacrylamide) were combined with 30wt% N,N-dimethylacrylamide. Eethyl acetate (EtOAc), or 75vol% ethanol/25vol% water (EtOH/H2O) were added as solvents in concentrations of 2, 5, 15 and 20wt%. The resins were made polymerizable by the addition of 0.2wt% 2,2-dimethoxy-2-phenyl acetophenone (DMPA) and 0.4wt% diphenyliodonium hexafluorophosphate (DPI-PF6). Specimens (n=3) were photoactivated with a mercury arc lamp (Acticure 4000, 320-500nm, 250mW/cm2) for 5min. Degree of conversion (DC, %) was tracked in near-IR spectroscopy in real time and yield strength and modulus of elasticity were measured in three-point bending after dry and wet storage (n=6). The data was subject to one-way ANOVA/Tukey's Test (p≤0.05), or Student's t-test (p≤0.001).

RESULTS

In all groups for both BisGMA and HEMAM-BDI-based materials, DC and DC at Rpmax increased and maximum rate of polymerization decreased as solvent concentration increased. Despite the increased DC, BisGMA mixtures showed a decrease in FS starting at 5wt% EtOAc or 15wt% EtOH/H2O. Yield strength for the HEMAM-BDI groups was overall lower than that of the BisGMA groups, but the modulus of elasticity was significantly higher.

SIGNIFICANCE

The presence of residual solvent, from manufacturing or from practitioner's handling, affects polymerization kinetics and mechanical properties of resins. Methacrylates appear to be more strongly influenced than methacrylamides.

The effect of vitality and dentin depth on resin tags length of resin-dentin interface in dogs' teeth

The aim of this study was to evaluate the effect of pulpal pressure and dentin depth on the quality of hybrid layer of bonded composite. Four healthy dogs, aged between 12 and 18 months, with intact dentitions were used for the experimental work. A total of 24 teeth were available for the study by using the six upper anterior teeth of each of the four dogs used in the study. The 24 teeth included in the study were divided according to presence or absence of pulpal pressure (P) into two groups with 12 teeth in each group. P₁ teeth with positive pulpal pressure and P₂ teeth with no pulpal pressure. Each of these two groups was further divided into two subgroups, according to the cavity depth (D) they received, where in D₁ a class V cavity with depth of 1 mm was performed, while in D₂ a class V cavity with depth of 2 mm was performed. The cavities were restored with micro hybrid composite restorative material and the samples were then left in the dogs’ mouth for 30 days. At the end of the experimental period, the dogs were euthanized by injecting an overdose of thiopental sodium. The anterior part of the upper jaw was sawed out of each dog’s mouth and the teeth were sectioned to evaluate the resin–dentin interface using Environmental Scanning Electronic Microscope. Results of the study showed that the mean resin tag length value was significantly affected by vitality and dentin depth. The presence of pulpal pressure together with depth of dentin could adversely affect the quality of hybridization.

Effects of different resin adhesives on the microleakage in a new model with simulated subgingival condition and pulpal pressure

Resin adhesive restorations are susceptible to oral fluid contamination and greatly influenced by dentinal tubule fluid because of pulpal pressure, especially when the restorative cavities are near gingival tissues. This study designed a novel model to evaluate the microleakage of self-adhesive flowable composite and traditional resin adhesives under simulated subgingival cavity preparations and pulpal pressure. We applied three different adhesive systems, include Vertise Flow, Optibond all-in-one, and Optibond S, on premolars with V-shaped cavity. All samples exhibited good marginal sealing at resin-enamel interfaces. At resin-dentin interfaces, microleakage in control group was similar among different adhesive systems. Microleakage in group pulpal pressure was greater than that in control group for all adhesive systems except Vertise Flow. All adhesive systems in pulpal pressure and simulated subgingival group exhibited significantly greater microleakage. In total, Vertise Flow exhibited better marginal sealing under pulpal pressure than other traditional adhesives.

Impact of Dentinal Tubule Orientation on Dentin Bond Strength

This study aimed to determine the impact of dentinal tubule orientation on dentin bond strength to provide a reference for clinical cavity preparation in resin-bonded restoration. Patients aged 13-16 years were selected, including 18 males and 21 females. Forty-eight human maxillary first premolars from orthodontic extractions were chosen to prepare the test models with the dentinal tubule orientations perpendicular and parallel to the bonding substrate. The test models in the vertical and parallel groups were divided into three groups: total-etching with 20% phosphoric acid, total-etching with 35% phosphoric acid and self-etching, with the dentinal tubule surfaces bonded with composite resin blocks in each group. After the standard test models of dentinal tubule-composite resin blocks were placed in distilled water and stored at 37°C for 24 h, shearing tests were performed using a universal material testing machine at a crosshead speed of 0.5 mm/min. The bond strength values in the vertical group were 19.33±1.59 MPa for the 20% phosphoric acid group, 21.39±2.34 MPa for the 35% phosphoric acid group, and 16.88±1.54 MPa for the self-etching group. The bond strength values in the parallel group were 24.53±1.99 MPa for the 20% phosphoric acid group, 25.16±2.88 MPa for the 35% phosphoric acid group, and 20.83±1.99 for the self-etching group. After using same total-etching adhesive, the shear bond strength of the parallel group was higher than that of the vertical group, and the difference was statistically significant (P<0.05). Regardless of vertical group or parallel group, the difference in the bond strength value between the total-etching groups and the self-etching group was statistically significant (P<0.05). It was concluded that the dentin bonding substrate which was parallel to the direction of the dentin tubule achieved an improved bond strength; the total-etching adhesives achieved higher bond strengths in dentin bond than the self-etching adhesives.

Application of Calcium Silicate Materials After Acid Etching May Preserve Resin-Dentin Bonds

INTRODUCTION

The aim of the present study was to evaluate the effect of the application of calcium silicate materials (CSMs), after acid etching, on the longevity of the hybrid layer and marginal adaptation of composite restorations.

METHODS AND MATERIALS

Eighty human permanent molars received an intrapulpal pressure of 15 cm H₂O. Sixty teeth received a mesial proximal slot preparation with the gingival margin extending 1 mm below the cemento-enamel junction. The samples were divided into two groups. Group 1 received restorations using two types of etch-and-rinse adhesives: ethanol based (Single Bond, 3M ESPE, St Paul, MN, USA) and acetone based (Prime & Bond NT, Dentsply, DeTrey GmbH, Germany). In group 2 samples, a commercially available CSM (ProRoot MTA) was allowed to set before grinding and placing into a distilled water solution. This solution was applied on the cavity floor after acid etching. The surface was washed after 30 seconds followed by application of adhesives and restorations as in group 1. The samples were stored in phosphate-buffered saline for six months, maintaining the intrapulpal pressure. An epoxy replica was made, and the marginal adaptation was evaluated using scanning electron microscopy. The percentage of continuous margin (CM) was recorded for each group. Another 20 samples were used for hybrid layer evaluation. The crowns were ground to expose dentin. Intrapulpal pressure was applied. The samples were divided into two groups and restored similar to samples restored for marginal adaptation evaluation. The samples were longitudinally cut in 1-mm slices. The slices were stored under 15 cm of phosphate-buffered saline to simulate the pulpal pressure. After six months, the adhesive interface was evaluated using a scanning electron microscope. Statistical analysis was done with two-way analysis of variance with Holm-Sidak's correction for multiple comparisons.

RESULTS

Application of CSMs improved the marginal adaptation values in both adhesive groups. In group 1, there were areas of incomplete penetration of resins along with evidence of partial degradation of resin tags. Samples receiving CSM application after acid etching demonstrated long and regular resin tags with very few signs of degradation.

CONCLUSIONS

Application of CSMs after acid etching can be a potential avenue in preserving the resin-dentin bonds.

Bacterial reduction in sealed caries lesions is strain- and material-specific

Sealing can arrest caries lesions. We aimed to evaluate if sealing effects and kinetics are bacterial-strain and sealing-material specific. Human dentin discs were mounted in a dual-chamber device. Caries lesions were induced chemically and contaminated with either Lactobacillus rhamnosus (LR) or Streptococcus sobrinus (SS). For (1) kinetics assessment, the initial bacterial load and the sealing period were varied, and lesions sealed using a self-etch adhesive and composite. For (2) comparing materials, six sealing protocols (#1-#6) were evaluated: 1# Self-etch adhesive plus composite placed without a liner, or #2 calcium hydroxide, or #3 mineral trioxide aggregate, or #4 Biodentine liners; #5 antibacterial adhesive plus composite; #6 glass ionomer cement. Pulpal fluid flow was simulated during sealing. The outcome was the number of surviving bacteria (CFU) per g dentin. For LR, bacterial survival increased significantly with increasing initial bacterial load and decreased with longer sealing periods. The relative reduction followed a first-order kinetics. More LR survived under calcium hydroxide or MTA than other materials (p < 0.001). For SS, nearly no bacteria survived sealing regardless of sealing period, initial bacterial load or sealing material. In conclusion, sealing effects and kinetics were strain- and material-specific.

Effect of Dentin Wetness on the Bond Strength of Universal Adhesives

The effects of dentin wetness on the bond strength and adhesive interface morphology of universal adhesives have been investigated using micro-tensile bond strength (μTBS) testing and confocal laser scanning microscopy (CLSM). Seventy-two human third molars were wet ground to expose flat dentin surfaces. They were divided into three groups according to the air-drying time of the dentin surfaces: 0 (without air drying), 5, and 10 s. The dentin surfaces were then treated with three universal adhesives: G-Premio Bond, Single Bond Universal, and All-Bond Universal in self-etch or etch-and-rinse mode. After composite build up, a μTBS test was performed. One additional tooth was prepared for each group by staining the adhesives with 0.01 wt % of Rhodamine B fluorescent dye for CLSM analysis. The data were analyzed statistically using ANOVA and Tukey's post hoc tests (α = 0.05). Two-way ANOVA showed significant differences among the adhesive systems and dentin moisture conditions. An interaction effect was also observed (p < 0.05). One-way ANOVA showed that All-Bond Universal was the only material influenced by the wetness of the dentin surfaces. Wetness of the dentin surface is a factor influencing the micro-tensile bond strength of universal adhesives.

Effect and Stability of Poly(Amido Amine)-Induced Biomineralization on Dentinal Tubule Occlusion

In recent years, scientists have developed various biomaterials to remineralize human teeth to treat dentine hypersensitivity. Poly(amido amine) (PAMAM) dendrimers have become a research focus in this field. It has been demonstrated that PAMAM is able to create precipitates both on the surface of and within the dentinal tubules, however, there is little information about its effect on reducing dentine permeability in vitro. This study aimed to evaluate the in vitro effectiveness and stability of the fourth generation amine-terminated PAMAM on dentinal tubule occlusion, especially on dentine permeability. Sodium fluoride (NaF), which has been widely used as a desensitizing agent, is regarded as positive control. Demineralized sensitive dentine samples were coated with PAMAM or sodium fluoride solutions and soaked in artificial saliva (AS) at 37 °C for different periods. Four weeks later, samples in each group were then equally split into two subgroups for testing using a brushing challenge and an acid challenge. Dentine permeability of each specimen was measured before and after each challenge using a fluid filtration system. Dentine morphology and surface deposits were characterized by scanning electron microscope (SEM) and analyzed with Image-Pro Plus software. Data were evaluated through multifactorial ANOVA with repeated measures and pair-wise comparisons at a level of 5%. The results showed that PAMAM and NaF significantly reduced dentine permeability to 25.1% and 20.7%. Both of them created precipitates on dentine surfaces after AS immersion for 28 days. PAMAM-induced biomineralization not only on dentine surfaces, but also deeper in dentinal tubules, significantly reduced dentine permeability. Moreover, PAMAM-induced biomineralization elicited excellent stable occlusion effects after acid challenge. In conclusion, PAMAM demonstrated a strong ability to resist acid and showed great potential to be used in the treatment of dentine hypersensitivity in future.

Evaluation of Five Different Desensitizers: A Comparative Dentin Permeability and SEM Investigation In Vitro

BACKGROUND/OBJECTIVE

The purpose of this study was to evaluate the efficacy and durability of five different dentin desensitizers (Gluma Desensitizer Powergel, Bifluorid 12, Gluma Self Etch Bond, D/Sense Crystal, Nupro Sensodyne Prophylaxis Paste with Novamin) on tubule occlusion and dentin permeability reduction in vitro.

METHOD

The quantitative changes in permeability of 100 dentin discs were measured after desensitizer treatments and following post-treatments of 6% citric acid challenge for 1 min or immersion in artificial saliva for 24 hours under hydrostatic pressure generated by a computerised fluid filtration meter. Qualitative SEM analyses were also carried out.

RESULTS

Dentin permeability decreased after desensitizer application in all groups. Nevertheless, only the difference between 'Gluma Self Etch Bond' and 'Nupro Sensodyne Prophylaxis Paste with Novamin' groups was significantly different (p<0.05). Dentin permeability increased significantly after post-treatments (p<0.05). There was no statistically difference among the citric acid-subgroups (p>0.05). Of all the artificial saliva-subgroups, only the difference between 'D/Sense Crystal' and 'Bifluorid 12' was significantly different (p<0.05). In SEM analysis, morphological changes were detected on the dentin surface and within the tubules following desensitizer treatments and post-treatments.

CONCLUSION

All the desensitizers significantly reduced dentin permeability by changing the morphology of the dentin surface and/or dentinal tubules. Following post-treatments, there was some reduction in the efficacy of the desensitizers which was represented by the reduction in permeability values. SEM analysis revealed some physical changes in the dentin structure which can partly give an explanation to the reduced efficacy of tested desensitizers.

Tubular Occlusion Optimizes Bonding of Hydrophobic Resins to Dentin

Although hydrophobic resins may be bonded to acid-etched dentin with an ethanol wet-bonding technique, the protocol is sensitive to moisture contamination when bonding is performed in deep dentin. This study tested the hypothesis that the use of oxalate or poly(glutamic) acid-modified, diluted ceramicrete (PADC) for dentinal tubule occlusion prevents fluid contamination and improves the bonding of an experimental hydrophobic adhesive to acid-etched, ethanol-dehydrated dentin. Mid-coronal and deep acid-etched moist dentin pre-treated with oxalate or PADC was dehydrated by ethanol wet-bonding and infiltrated with the experimental three-step etch-and-rinse hydrophobic adhesive under simulated pulpal pressure. Tensile bond strengths to deep dentin without pre-treatment were severely compromised. Conversely, oxalate and PADC pre-treatments reduced dentin permeability, prevented water contamination, and improved bond strengths. Minimal nanoleakage was identified within hybrid layers created in the oxalate- and PADC-pre-treated deep dentin. The use of tubular occluding agents optimized bonding of hydrophobic resins to dentin.

Influence of dentin thickness on intrapulpal temperature under simulated pulpal pressure during Nd:YAG laser irradiation

The aim of this study was to evaluate the effects of dentin thickness and pulpal pressure simulation (PPS) on the variation of intrapulpal temperature (∆T) when submitted to an adhesive technique using laser irradiation. Sixty sound human molars were sectioned and randomly divided into two groups (n = 30): group 1-1 mm of dentin thickness; group 2-2 mm of dentin thickness. Each group was divided into two subgroups (n = 15): subgroup A-absence of PPS; subgroup P-presence of PPS (15 cm H₂O), sequentially treated with the following: 37 % phosphoric acid, adhesive system (Adper Single Bond), irradiation with Nd:YAG laser (1064 nm, 10 Hz, 60 s) using 60, 80, and 100 mJ/pulse energy parameters and light-curing (10 s). The ∆T was evaluated during the laser irradiation with a digital thermometer. Data were analyzed by three-way ANOVA and Tukey tests (p < 0.05). Three-way ANOVA revealed no significant differences for dentin thickness (p = 0.6512) on ∆T. PPS significantly reduced ∆T (p = 0.0001). The laser energy parameters (p = 0.0027) indicated that 100 mJ presented with significantly greater ∆T when compared to the groups irradiated with 80 and 60 mJ. Dentin thickness did not affect ∆T. The presence of PPS reduced the mean temperature values. The Nd:YAG laser energy parameters had a negative influence on the variation of temperature in the absence of PPS. In the presence of PPS, there was no risk to the pulp, since this study obtained temperature increases below 5.5 °C for all energy parameters, showing the technical viability for in vivo conditions.

Glass hybrid, but not calcium hydroxide, remineralized artificial residual caries lesions in vitro

OBJECTIVES

For deep carious lesions, less invasive carious tissue removal is recommended. The resulting residual carious lesions might benefit from remineralization by lining or restoration materials. We aimed to compare mineral gains in artificial residual lesions provided by calcium hydroxide and glass hybrid materials in combination with pulpal fluid simulation.

METHODS

On the coronal aspect of human dentin discs (n = 20), artificial carious lesions were induced using acetic acid. Median mineral loss ΔZ [25th/75th percentiles] of resulting lesions was 1643 [1301/1858] vol% μm. One third of each disc served as baseline sample. The remaining disc was divided into four groups, each being covered with one experimental material (n = 20/group): flowable composite (control (CO)), setting or non-setting calcium hydroxide liner plus flowable composite (CH-S, CH-NS), and glass hybrid (GH). Samples were mounted in a dual-chamber device. Pulpal surfaces were exposed to simulated pulpal fluid at 2.94 kPa. Coronal surfaces were exposed to artificial saliva and rinsed with 200 ppm NaF every 2 weeks. After 12 weeks, mineral loss differences (ΔΔZ) were assessed using transverse microradiography. Electron probe microscopic analysis was used to measure fluoride and strontium concentrations.

RESULTS

Mineral gains were not significantly different between CO (ΔΔZ = 372 [115/501] vol% μm), CH-S (ΔΔZ = 317 [229/919] vol% μm), or CH-NS (ΔΔZ = 292 [130/579] vol% μm; p > 0.05/Wilcoxon test) but significantly increased in GH (ΔΔZ = 1044 [751/1264] vol% μm, p < 0.001). Samples in GH showed fluoride and strontium enrichment deep into the dentin. Such enrichment was not found in CO.

CONCLUSIONS

Within the limitations of this study, GH, but not calcium hydroxide, provided coronal remineralization of residual carious lesions.

CLINICAL RELEVANCE

Glass hybrids might provide additional remineralization of residual carious lesions. The functional implications of this mineral gain need to be evaluated.

Effect of Different Light Sources and Enamel Preconditioning on Color Change, H2O2 Penetration, and Cytotoxicity in Bleached Teeth

This study evaluated the effects of acid etching of the enamel and the combination of different light sources (halogen light, light-emitting diodes [LEDs], and LED/Laser) and the bleaching product on color change, penetration of hydrogen peroxide (H2O2), and cytotoxicity over time. The color change (ΔE) and the amount of H2O2 that permeated the tooth tissue were analyzed using a spectrophotometer. Cell metabolism and morphology were evaluated using the methylthiazol tetrazolium assay and scanning electron microscopy, respectively. The ΔE values and H2O2 permeation were not significantly different under any of the experimental conditions. Tooth whitening significantly reduced cell metabolism, regardless of whether a light source was used. Preconditioning the enamel did not influence the cellular metabolism in any group. In conclusion, combining the bleaching product with different light sources and/or preconditioning the enamel resulted in few significant changes in color, transenamel and transdentinal penetration of H2O2, or cytotoxicity and cell morphology.

Durability of solvent-free one-step self-etch adhesive under simulated intrapulpal pressure

Background

There are different solvents presented in simplified adhesives. Bond-1 SF has been developed, which contains neither water nor organic solvents, in order to eliminate technical issues in terms of evaporation of solvents and concerns for the durability of resin-dentin bond. Thus this study was conducted to evaluate the microtensile bond strength (?TBS) of solvent-free and ethanol-based one-step self-etch adhesives to dentin under simulated intrapulpal pressure (IPP).

Material and Methods

Occlusal surfaces of human molars were prepared to expose mid-dentin depth. Bond-1SF Solvent-Free SE [SF] and AdperTM easy one adhesives [AE] were applied on dentin specimens. Resin composite build up was done in increments. Then specimens were stored under simulated IPP 20 mmHg, immersed in artificial saliva at 37 ºC for 24 hours (24h) and 6 months (6m). Specimens were sectioned into sticks of (1 mm²) to be tested for (?TBS) using a universal testing machine. Both fractured sections of each stick were inspected using a stereomicroscope at 40× magnification to determine the mode of failure. Data were statistically analyzed by Two-way ANOVA of Variance.

Results

There was no statistically significant difference between the mean ?TBS of both [SF] and [AE] adhesives at both aging periods, 24h and 6m (p< 0.1103) and (p< 0.7148) respectively. Only for [AE] there was statistical significance for aging periods (p< 0.0057*). The most represented modes of failure were adhesive failure at tooth side.

Conclusions

Under simulated IPP solvent-free adhesive [SF] had comparable performance as ethanol-based adhesive [AE] when bonded to dentin substrate.

Key words:Bond strength, dentin, simulated intrapulpal pressure, self-etch adhesives, solvents.

Cytotoxicity of universal, self-etching and etch-and-rinse adhesive systems according to the polymerization time

This in vitro study evaluated in fibroblast cultures the direct cytotoxicity of universal, self-etching and etch-and-rinse adhesive systems according to the polymerization time. Paper discs were impregnated with adhesives and light-cured (10, 20 or 40 s). The discs were then immersed in culture medium to obtain the eluates for the experimental groups (A1-Single Bond 2; A2-Scotchbond Multi-purpose; A3-Clearfil SE Bond; A4 Scotchbond Universal). As a negative control, paper discs were immersed in culture medium only. After 24 h or 7 days, the eluate obtained was applied on fibroblast culture. Cell viability, cell morphology, membrane damage and the presence of residual monomers were evaluated by MTT assay, SEM, flow cytometry and high-performance liquid chromatography (HPLC), respectively. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests (=0.05). All adhesive systems significantly reduced 33-51% cell metabolism when compared to the negative control, regardless of polymerization time, storage period and adhesive system. Moreover, the adhesives caused intense morphological alterations and cell membrane damage. Toxicity was directly related to the presence of residual monomers in the eluates. Residual monomers and additional components are capable of reducing mitochondrial activity, causing morphological alterations and disruption of the cell membrane in fibroblasts, regardless of the polymerization time. This study highlights that despite the more complex composition of the universal adhesive system, its biological response was not more toxic when compared with other systems, even when the shortest polymerization time was tested in cell culture.

Immediate human pulp response to ethanol-wet bonding technique

OBJECTIVES

To evaluate the short-term response of human pulps to ethanol-wet bonding technique.

METHODS

Deep class V cavities were prepared on 17 sound premolars and divided into three groups. After acid-etching, the cavities from groups 1 (G1) and 2 (G2) were filled with 100% ethanol or distilled water, respectively, for 60 s before the application of Single Bond 2. In group 3 (G3, control), the cavity floor was lined with calcium hydroxide before etching and bonding. All cavities were restored with resin composite. Two teeth were used as intact control. The teeth were extracted 48h after the clinical procedures. From each tooth serial sections were obtained and stained with haematoxylin and eosin (H/E) and Masson's trichrome. Bacteria microleakage was assessed using Brown & Brenn. All sections were blindly evaluated for five histological features.

RESULTS

Mean remaining dentine thickness was 463±65μm (G1); 425±184μm (G2); and 348±194μm (G3). Similar pulp reactions followed ethanol- or water-wet bonding techniques. Slight inflammatory responses and disruption of the odontoblast layer related to the cavity floor were seen in all groups. Stained bacteria were not detected in any cavities. Normal pulp tissue was observed in G3 except for one case.

CONCLUSIONS

After 48h, ethanol-wet bonding does not increase pulpal damage compared to water-wet bonding technique.

CLINICAL SIGNIFICANCE

Ethanol-wet bonding may increase resin-dentine bond durability. This study reported the in vivo response of human pulp tissue when 100% ethanol was applied previously to an etch-and-rinse simplified adhesive system.

Indirect cytocompatibility of a low-concentration hydrogen peroxide bleaching gel to odontoblast-like cells

AIM

To assess the initial cytotoxicity and the late phenotype marker expression of odontoblast-like cells (MDPC-23) subjected to less aggressive in-office bleaching therapies.

METHODOLOGY

A 17.5% hydrogen peroxide (H2O2) gel was applied for 45, 15 or 5 min to enamel/dentine discs adapted to trans-wells positioned over cultured MDPC-23 cells. No treatment was performed on the negative control. Immediately after bleaching, the cell viability, gene expression of inflammatory mediators and quantification of H2O2 diffusion were evaluated. The ALP activity, DSPP and DMP-1 gene expression and mineralized nodule deposition (MND) were assessed at 7, 14 or 21 days post-bleaching and analysed statistically with Mann-Whitney U-tests (α = 5%).

RESULTS

H2O2 diffusion, proportional to treatment time, was observed in all bleached groups. Reductions of approximately 31%, 21% and 13% in cell viability were observed for the 45-, 15- and 5-min groups, respectively. This reduction was significant (P < 0.05) for the 45- and 15-min groups, which also presented significant (P < 0.05) over-expression of inflammatory mediators. The 45-min group was associated with significant (P < 0.05) reductions in DMP-1/DSPP expression at all periods, relative to control. The ALP activity and MND were reduced only in initial periods. The 15-min group had less intense reduction of all markers, with no difference to control at 21 days.

CONCLUSIONS

The 17.5% H2O2 applied to tooth specimens for 5 min caused no alteration in the odontoblast-like cells. When this gel was applied for 45 or 15 min, a slight cytotoxicity, associated with alterations in phenotypic markers, was observed. However, cells were able to recover their functions up to 21 days post-bleaching.

In vitro evaluation of shear bond strength of nanocomposites to dentin

AIMS

To compare the shear bond strength of nanocomposites to dentin using three different types of adhesive systems; and to test few specimens under Scanning Electron Microscope (SEM) for analysing whether the bond failure is adhesive or cohesive.

MATERIALS AND METHODS

Sixty human premolar teeth were selected and were randomly grouped, with 20 specimens in each group: group 1 - fluoride releasing dentin bonding agent; group 2 - antibacterial containing dentin bonding agent; and group 3 - one step conventional self etch adhesive. Each group was treated with its respective bonding agents, composite resin build up was done, and shear bond strengths were tested using Instron Universal testing machine. Few of the specimens were tested under SEM.

RESULTS

The results were statistically analysed using One-way ANOVA and paired t-test. It was observed that group 3 has the highest shear bond strength followed by group 2, and then group 1. Adhesive failures and mixed failures were most frequent types of failures as seen under SEM.

CONCLUSION

Addition of antimicrobial agent decreases the bond strength of dentin bonding agent and addition of fluoride further decreases the bond strength. From SEM results it can be concluded that the zone of failure could not be defined and also that the failure mode was independent of the dentin bonding agent used.

Validity of bond strength tests: A critical review-Part II

Background:

Macro-bond strength tests resulted in cohesive failures and overestimation of bond strengths. To reduce the flaws, micro-bond strength tests were introduced. They are the most commonly used bond-strength tests.

Objective:

Thus the objective of this review is to critically review the reliability of micro-bond strength tests used to evaluate resin-tooth interface.

Data Collection:

Relevant articles published between January 1994 and July 2013 were collected from Pubmed database, Google scholar and hand searched journals of Conservative Dentistry, Endodontics and Dental materials.

Data Synthesis:

Variables that influence the test outcome are categorized into substrate related factors, factors related to specimen properties, specimen preparation and test methodology. Impact of these variables on the test outcome is critically analyzed.

Conclusion:

Micro-bond tests are more reliable than macro-bond tests. However, no standard format exists for reporting the bond strength tests which could lead to misinterpretation of the data and bonding abilities of adhesives.

Immediate and late analysis of dental pulp stem cells viability after indirect exposition to alternative in-office bleaching strategies

OBJECTIVES

To evaluate human dental pulp stem cell viability and capacity to recover from experimental dental bleaching techniques.

MATERIAL AND METHODS

Enamel/dentin disks adapted to trans-wells were positioned on previously cultivated dental pulp stem cells. Bleaching gels containing 35, 17.5, 10, and 8 % hydrogen peroxide (H2O2) were applied one or three times (each application lasting 15 min) on enamel. Cell viability (MTT assay) and morphology (SEM) were evaluated immediately (T1) or 72 h (T2) post-bleaching.

RESULTS

The 35 % H2O2 gel promoted intense reduction in viability (93-97 %) and morphological alterations of the cells at T1, irrespective of frequency of application, with absence or limited capacity for recovery being observed at T2. The other bleaching gels presented significant lower toxicity when compared with the 35 % H2O2 gel, in a time/concentration fashion. In T1, no significant difference was observed between the negative control (without bleaching) and the 8 and 10 % H2O2 gels applied on enamel for 15 min, in which the cells presented elevated viability and morphology similar to the negative control at T2.

CONCLUSIONS

Bleaching gels with 8 and 10 % H2O2 in their composition cause limited immediate toxic effect on pulp stem cells, which recover their viability 3 days after treatment.

CLINICAL RELEVANCE

This study presents proposals for in-office dental bleaching to be performed with limited aggressive effect on dental pulp stem cells. Therefore, we are able to offer interesting clinical alternatives for bleaching vital teeth, under professional supervision, maintaining the integrity and reparative capacity of pulp-dentin complex.

Color alteration, hydrogen peroxide diffusion, and cytotoxicity caused by in-office bleaching protocols

OBJECTIVES

This study evaluated the color alteration, cytotoxicity, and hydrogen peroxide (HP) diffusion associated with different in-office bleaching protocols.

MATERIALS AND METHODS

Bovine enamel/dentin disks were subjected to three bleaching sessions with 35 % HP (three 15-min applications), 35 % HP (one 45-min application), or 20 % HP (one 45-min application). The control group was not bleached. Before bleaching, the disks were adapted to artificial pulp chambers positioned in compartments containing 1 ml of acetate buffer or medium, so that the dentin remained in contact with these substances. Immediately after bleaching, the HP that diffused through the disks was stabilized by acetate buffer and was quantified (two-way repeated measures ANOVA/Fisher's protected least significant difference (PLSD) test; α = 5 %). Cells of mouse dental papilla cell-23 (MDPC-23) were incubated in this culture media for 1 h, followed by analysis of cellular metabolism (methyl tetrazolium assay) (one-way ANOVA/Tukey test; α = 5 %) and morphology (scanning electron microscopy). The specimen color alteration (ΔE) was analyzed by reflection spectrophotometry (two-way repeated measures ANOVA/Fisher's PLSD test; α = 5 %).

RESULTS

All protocols showed equal effectiveness at the end of the treatment. HP diffusion was significantly higher in the groups bleached with 35 % HP. Reapplication of 35 % HP resulted in increased diffusion only in the first session; however, the decrease in cell metabolism was similar for all studied protocols.

CONCLUSION

Despite greater peroxide diffusion in the groups treated with 35 % HP, all protocols showed the same effectiveness and were cytotoxic to MDPC-23 cells.

CLINICAL RELEVANCE

Bleaching protocols using high HP concentrations should be avoided because they exert aggressive actions on odontoblast-like cells.

Effect of fluoride-treated enamel on indirect cytotoxicity of a 16% carbamide peroxide bleaching gel to pulp cells

The aim of this study was to evaluate the possibility of fluoride solutions applied to enamel to protect pulp cells against the trans-enamel and transdentinal cytotoxicity of a 16% carbamide peroxide (CP) bleaching gel. The CP gel was applied to enamel/dentin discs adapted to aicial pulp chambers (8 h/day) during 1, 7 or 14 days, followed by fluoride (0.05% or 0.2%) application for 1 min. The extracts (culture medium in contact with dentin) were applied to MDPC-23 cells for 1 h, and cell metabolism (MTT assay), alkaline phosphatase (ALP) activity and cell membrane damage (flow cytometry) were analyzed. Knoop microhardness of enamel was also evaluated. Data were analyzed statistically by ANOVA and Kruskal-Wallis tests (α=0.05). For the MTT assay and ALP activity, significant reductions between the control and the bleached groups were observed (p<0.05). No statistically significant difference occurred among bleached groups (p>0.05), regardless of fluoride application or treatment days. Flow cytometry analysis demonstrated 30% of cell membrane damage in all bleached groups. After 14 days of treatment, the fluoride-treated enamel presented significantly higher microhardness values than the bleached-only group (p<0.05). It was concluded that, regardless of the increase in enamel hardness due to the application of fluoride solutions, the treated enamel surface did not prevent the toxic effects caused by the 16% CP gel to odontoblast-like cells.