Characterising the micro-mechanical behaviour of the carious dentine of primary teeth using nano-indentation

Endodontic irrigants from a comprehensive perspective

This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping. It reviews commonly used endodontic irrigant, namely sodium hypochlorite (NaOCl), herbal extracts, chlorhexidine (CHX), and chelating agents, highlighting their properties, applications, and potential drawbacks. NaOCl, a key antimicrobial agent, demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity. Herbal extracts, gaining recognition in endodontics, present an alternative with potential advantages in preserving dentin integrity. CHX, known for its broad-spectrum antimicrobial activity, is discussed in both liquid and gel formulations, emphasizing its role in reducing smear layer formation and preserving hybrid layer durability. Chelating agents, specifically ethylenediaminetetraacetic acid and citric acid, play a vital role in removing the smear layer, enhancing dentin permeability, and facilitating the penetration of antimicrobial agents. The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures. It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.

Ultrastructure and properties of primary carious molars treated using the Hall Technique

BACKGROUND

The Hall Technique (HT) is a method of restoring decayed primary teeth using stainless steel crowns (SSCs) without tooth preparation, caries removal, or local anaesthetic.

AIM

To investigate the ultrastructural, biomechanical, and chemical characteristics of teeth managed with the Hall Technique in comparison with conventional SSC (controls).

DESIGN

Twelve HT-treated primary molars and four controls were analysed. Teeth were dehydrated in ethanol, embedded in methylmethacrylate, mesio-distally sectioned, X-rayed, mounted, and polished. Biomechanical, ultrastructural, and chemical characterisation was performed for carious lesion and sound areas of each specimen.

RESULTS

Pre-treatment and post-treatment X-rays showed evidence of little to no caries progression over time. In carious lesions, mean hardness and elastic modulus values were lower in HT-treated teeth than in controls. In both controls and HT-treated teeth, carious lesions had the lowest %wt of Ca and P of all tissues sampled.

CONCLUSIONS

Although the retained carious tissue was biomechanically more compromised in HT-treated teeth, the Ca and P values were higher than reported elsewhere for carious lesions in primary molars, suggesting remineralisation may have occurred in caries in HT-treated teeth. Future investigations will help elucidate the processes involved with carious lesion arrest under SSC.

Characterization of Enamel and Dentine about a White Spot Lesion: Mechanical Properties, Mineral Density, Microstructure and Molecular Composition

The study focuses on in vitro tracing of some fundamental changes that emerge in teeth at the initial stage of caries development using multiple approaches. The research was conducted on a mostly sound maxillary molar tooth but with a clearly visible natural proximal white spot lesion (WSL). Values of mineral density, reduced Young's modulus, indentation hardness and creep as well as the molecular composition and surface microstructure of the WSL and bordering dentine area were studied. The results obtained were compared to those of sound enamel and dentine on the same tooth. A decrease of mechanical properties and mineral density both for the WSL and bordering dentine was detected in comparison to the sound counterparts, as well as increase of creep for the enamel WSL. Differences in molecular composition and surface microstructure (including the indenter impressions) were found and described. WSL induces a serious change in the state of not only the visually affected enamel but also surrounding visually intact enamel and dentine in its vicinity. The results provide the basis for future studies of efficacy of minimal invasive treatments of caries.

Enhancing the Mechanical Properties of Glass-Ionomer Dental Cements: A Review

This paper reviews the strategies that have been reported in the literature to attempt to reinforce glass-ionomer dental cements, both conventional and resin-modified. These cements are widely used in current clinical practice, but their use is limited to regions where loading is not high. Reinforcement might extend these applications, particularly to the posterior dentition. A variety of strategies have been identified, including the use of fibres, nanoparticles, and larger particle additives. One problem revealed by the literature survey is the limited extent to which researchers have used International Standard test methods. This makes comparison of results very difficult. However, it does seem possible to draw conclusions from this substantial body of work and these are (1) that powders with conventional particle sizes do not reinforce glass-ionomer cements, (2) certain fibres and certain nanoparticles give distinct improvements in strength, and (3) in the case of the nanoparticles these improvements are associated with differences in the morphology of the cement matrix, in particular, a reduction in the porosity. Despite these improvements, none of the developments has yet been translated into clinical use.

Insights into the reinforcement role of peritubular dentine subjected to acid dissolution

Human dentine is a mineralised dental tissue that consists of dentinal tubules surrounded by two distinct dentinal phases: peritubular dentine (PTD) and intertubular dentine (ITD). Dental caries, which manifests itself as a consequence of demineralisation, is one of the most common chronic diseases that affect the function of human teeth. Due to the difference in the packing density of crystallites, PTD and ITD exhibit different reaction rates to acid dissolution. The present study evaluates how the effective Young's modulus degrades and how the effective stress redistributes in demineralised human dentine as a result of incremental acid dissolution process. An analytical two-layer composite model is proposed and used for the effective Young's modulus calculation. 3D numerical representative volume elements (RVEs) with different variations in PTD fraction and dentinal tubule density are established to evaluate effective stress redistribution and examine the critical factors that can affect the mechanical performance. The models are then applied on an actual dentine bulk sample. The results reveal how PTD serves as a protection to ITD thus highlight the important role that PTD plays for the structural integrity of dentine. The obtained insights are crucial for advancing the understanding of a variety of natural and therapeutic effects from the mechanical perspective, e.g. the mechanical performance assessment of human dentine subject to complex dynamic processes of de- and re-mineralisation that can occur in human dental caries and dental treatments. It will ultimately inspire the biomimetic design towards strengthening the dentine and dentine-like materials.

Functional disuse initiates medullary endosteal micro-architectural impairment in cortical bone characterized by nanoindentation

In this study, we evaluated the effect of functional disuse-induced bone remodeling on its mechanical properties, individually at periosteum and medullary endosteum regions of the cortical bone. Left middle tibiae were obtained from 5-month-old female Sprague-Dawley rats for the baseline control as well as hindlimb suspended (disuse) groups. Micro-nano-mechanical elastic moduli (at lateral region) was evaluated along axial (Z), circumferential (C) and radial (R) orientations using nanoindentation. Results indicated an anisotropic microstructure with axial orientation having the highest and radial orientation with the lowest moduli at periosteum and medullary endosteum for both baseline control as well as disuse groups. Between the groups: at periosteum, an insignificant difference was evaluated for each of the orientations (p > 0.05) and at endosteum, a significant decrease of elastic moduli in the radial (p < 0.0001), circumferential (p < 0.001) and statistically insignificant difference in axial (p > 0.05) orientation. For the moduli ratios between groups: at periosteum, only significant difference in the Z/R (p < 0.05) anisotropy ratio, whereas at endosteum, a statistically significant difference in Z/C (p < 0.001), and Z/R (p < 0.001), as well as C/R (p < 0.05) anisotropy ratios, was evaluated. The results suggested initial bone remodeling impaired bone micro-architecture predominantly at the medullary endosteum with possible alterations in the geometric orientations of collagen and mineral phases inside the bone. The findings could be significant for studying the mechanotransduction pathways involved in maintaining the bone micro-architecture and possibly have high clinical significance for drug use against impairment from functional disuse.

Effect of Silver Diamine Fluoride and Proanthocyanidin on Mechanical Properties of Caries-Affected Dentin

OBJECTIVES

Inner carious dentin is specified with decreased minerals and collagen cross-links but without protein denaturation. Current minimally invasive dentistry concepts recommend removal of only the outer layer of carious dentin and biomodification of repairable inner carious dentin. The present study aims to investigate the possibility of functional repair of this layer using silver diamine fluoride (SDF) and grape seed extract (GSE).

MATERIALS AND METHODS

Molar teeth with occlusal caries were used to prepare caries-affected dentin specimens for hardness and elastic modulus measurements. The specimens of each test were divided randomly into four equal groups. In the GSE group, the specimens were immersed in 6.5% GSE solution for 10 minutes. In the SDF group, the specimens underwent a topical application of a 30% SDF. In the GSE+SDF group, first the specimens were immersed in GSE and then exposed to SDF. In the SDF+GSE group, first SDF was applied and then the specimens were immersed in GSE. Microhardness measurements were taken at baseline and after treatment. A control group with distilled water treatment was also prepared for elastic modulus measurements.

STATISTICAL ANALYSIS

One-way analysis of variance and post-hoc tests were used for statistical analysis.

RESULTS

There were significant differences in H₁-H₀ (final hardness-baseline hardness) among the groups. Baseline and final hardness of each group was also significantly different (SDF>SDF+GSE>GSE>GSE+SDF). Elastic modulus of SDF and SDF+GSE increased compared to the control group.

CONCLUSIONS

SDF and SDF+GSE treatment can be recommended to increase hardness and elastic modulus of caries-affected dentin.

Spatial distribution and remodeling of elastic modulus of bone in micro-regime as prediction of early stage osteoporosis

We assessed the local distribution of bone mechanical properties on a micro-nano-scale and its correlation to strain distribution. Left tibia samples were obtained from 5-month old female Sprague Dawley rats, including baseline control (n=9) and hindlimb suspended (n=9) groups. Elastic modulus was measured by nanoindentation at the dedicated locations. Three additional tibias from control rats were loaded axially to measure bone strain, with 6-10N at 1Hz on a Bose machine for strain measurements. In the control group, the difference of the elastic modulus between periosteum and endosteum was much higher at the anterior and posterior regions (2.6GPa), where higher strain differences were observed (45μɛ). Minimal elastic modulus difference between periosteum and endosteum was observed at the medial region (0.2GPa), where neutral axis of the strain distribution was oriented with lower strain difference (5μɛ). In the disuse group, however, the elastic modulus differences in the anterior posterior regions reduced to 1.2GPa from 2.6GPa in the control group, and increased in the medial region to 2.7GPa from 0.2GPa. It is suggested that the remodeling rate in a region of bone is possibly influenced by the strain gradient from periosteum to endosteum. Such pattern of moduli gradients was compromised in disuse osteopenia, suggesting that the remodeling in distribution of micro-nano-elastic moduli among different regions may serve as a predictor for early stage of osteoporosis.

Characterization of the elastic and viscoelastic properties of dentin by a nanoindentation creep test

Dentin is the main supporting structure of teeth, but its mechanical properties may be adversely affected by pathological demineralization. The purposes of this study were to develop a quantitative approach to characterize the viscoelastic properties of dentin after de- and re-mineralization, and to examine the elastic properties using a nanoindentation creep test. Dentin specimens were prepared to receive both micro- and nano-indentation tests at wet and dry states. These tests were repeatedly performed after demineralization (1% citric acid for 3 days) and remineralization (artificial saliva immersion for 28 days). The nanoindentation test was executed in a creep mode, and the resulting displacement-time responses were disintegrated into primary (transient) and secondary (viscous) creep. The structural changes and mineral densities of dentin were also examined under SEM and microCT, respectively. The results showed that demineralization removed superficial minerals of dentin to the depth of 400 μm, and affected its micro- and nano-hardness, especially in the hydrate state. Remineralization only repaired the minerals at the surface layer, and partially recovered the nanohardness. Both the primary the secondary creep increased in the demineralized dentin, while the hydration further enhanced creep deformation of untreated and remineralized dentin. Remineralization reduced the primary creep of dentin, but did not effectively increase the viscosity. In conclusion, water plasticization increases the transient and viscous creep strains of demineralized dentin and reduces load sustainability. The nanoindentation creep test is capable of analyzing the elastic and viscoelastic properties of dentin, and reveals crucial information about creep responses.

Review of research on the mechanical properties of the human tooth

‘Bronze teeth' reflect the mechanical properties of natural teeth to a certain extent. Their mechanical properties resemble those of a tough metal, and the gradient of these properties lies in the direction from outside to inside. These attributes confer human teeth with effective mastication ability. Understanding the various mechanical properties of human teeth and dental materials is the basis for the development of restorative materials. In this study, the elastic properties, dynamic mechanical properties (visco-elasticity) and fracture mechanical properties of enamel and dentin were reviewed to provide a more thorough understanding of the mechanical properties of human teeth.

Finite-element modeling and analysis in nanomedicine and dentistry

This article aims to provide a brief background to the current applications of finite-element analysis (FEA) in nanomedicine and dentistry. FEA was introduced in orthopedic biomechanics in the 1970s in order to assess the stresses and deformation in human bones during functional loadings and in the design and analysis of implants. Since then, it has been applied with great frequency in orthopedics and dentistry in order to analyze issues such as implant design, bone remodeling and fracture healing, the mechanical properties of biomedical coatings on implants and the interactions at the bone–implant interface. More recently, FEA has been used in nanomedicine to study the mechanics of a single cell and to gain fundamental insights into how the particulate nature of blood influences nanoparticle delivery.

Structure-mechanical function relations at nano-scale in heat-affected human dental tissue

The knowledge of the mechanical properties of dental materials related to their hierarchical structure is essential for understanding and predicting the effect of microstructural alterations on the performance of dental tissues in the context of forensic and archaeological investigation as well as laser irradiation treatment of caries. So far, few studies have focused on the nano-scale structure-mechanical function relations of human teeth altered by chemical or thermal treatment. The response of dental tissues to thermal treatment is thought to be strongly affected by the mineral crystallite size, their spatial arrangement and preferred orientation. In this study, synchrotron-based small and wide angle X-ray scattering (SAXS/WAXS) techniques were used to investigate the micro-structural alterations (mean crystalline thickness, crystal perfection and degree of alignment) of heat-affected dentine and enamel in human dental teeth. Additionally, nanoindentation mapping was applied to detect the spatial and temperature-dependent nano-mechanical properties variation. The SAXS/WAXS results revealed that the mean crystalline thickness distribution in dentine was more uniform compared with that in enamel. Although in general the mean crystalline thickness increased both in dentine and enamel as the temperature increased, the local structural variations gradually reduced. Meanwhile, the hardness and reduced modulus in enamel decreased as the temperature increased, while for dentine, the tendency reversed at high temperature. The analysis of the correlation between the ultrastructure and mechanical properties coupled with the effect of temperature demonstrates the effect of mean thickness and orientation on the local variation of mechanical property. This structural-mechanical property alteration is likely to be due to changes of HAp crystallites, thus dentine and enamel exhibit different responses at different temperatures. Our results enable an improved understanding of the mechanical properties correlation in hierarchical biological materials, and human dental tissue in particular.

A novel method for single sample multi-axial nanoindentation of hydrated heterogeneous tissues based on testing great white shark jaws

Nanomechanical testing methods that are suitable for a range of hydrated tissues are crucial for understanding biological systems. Nanoindentation of tissues can provide valuable insights into biology, tissue engineering and biomimetic design. However, testing hydrated biological samples still remains a significant challenge. Shark jaw cartilage is an ideal substrate for developing a method to test hydrated tissues because it is a unique heterogeneous composite of both mineralized (hard) and non-mineralized (soft) layers and possesses a jaw geometry that is challenging to test mechanically. The aim of this study is to develop a novel method for obtaining multidirectional nanomechanical properties for both layers of jaw cartilage from a single sample, taken from the great white shark (Carcharodon carcharias). A method for obtaining multidirectional data from a single sample is necessary for examining tissue mechanics in this shark because it is a protected species and hence samples may be difficult to obtain. Results show that this method maintains hydration of samples that would otherwise rapidly dehydrate. Our study is the first analysis of nanomechanical properties of great white shark jaw cartilage. Variation in nanomechanical properties were detected in different orthogonal directions for both layers of jaw cartilage in this species. The data further suggest that the mineralized layer of shark jaw cartilage is less stiff than previously posited. Our method allows multidirectional nanomechanical properties to be obtained from a single, small, hydrated heterogeneous sample. Our technique is therefore suitable for use when specimens are rare, valuable or limited in quantity, such as samples obtained from endangered species or pathological tissues. We also outline a method for tip-to-optic calibration that facilitates nanoindentation of soft biological tissues. Our technique may help address the critical need for a nanomechanical testing method that is applicable to a variety of hydrated biological materials whether soft or hard.

A characterization of the mechanical behavior of resin-infiltrated dentin using nanoscopic Dynamic Mechanical Analysis

This study explored the spatial variations in mechanical behavior of resin-infiltrated dentin using nanoscopic Dynamic Mechanical Analysis (DMA).

OBJECTIVE

The objectives were to: (1) evaluate the mechanical behavior of resin-infiltrated dentin using a scanning-based approach to nanoindentation, (2) identify contributions of the collagen matrix to time-dependent deformation of the hybrid layer, and (3) assess the importance of specimen hydration on the nanoDMA response.

METHODS

Specimens of completely demineralized dentin infiltrated with commercial resin adhesive and control samples of resin adhesive were evaluated using a nanoindenter in scanning mode. The load and displacement responses were used to perform DMA and to estimate the complex (E*), storage (E') and loss (E″) moduli over selected regions of evaluation. The importance of hydration on the mechanical behavior was also examined from a comparison of responses in the hydrated and dehydrated conditions.

RESULTS

In the hydrated state the apparent complex, storage and loss moduli for the resin-infiltrated dentin samples were 3.5±0.3GPa, 3.4±0.2GPa and 0.9±0.3GPa, respectively. Those values for the resin adhesive control were 2.7±0.3GPa, 2.7±0.3GPa and 0.2±0.02GPa, respectively. Viscoelastic deformation of the resin-infiltrated collagen exceeded that occurring in regions of uniform resin adhesive. Though dehydration resulted in a significant increase in both the complex and storage moduli of the macro hybrid layer, the largest changes occurred to the resin adhesive.

SIGNIFICANCE

The microstructure and hydration play critical roles on the mechanical behavior of the hybrid layer and nanoDMA provides a potent measurement tool for identifying the spatial variations.

The effect of Nd:YAG and Er,Cr:YSGG lasers on the microhardness of human dentin

The current investigation determined the microhardness of dentin tissue irradiated with erbium, chromium-doped yttrium scandium gallium garnet (Er,Cr:YSGG) and neodymium-doped yttrium-aluminum garnet (Nd:YAG) lasers. Thirty non-carious human molars were used in this study. Dentin disks were prepared by horizontal sectioning of one third of the occlusal surface. Halves of dentin specimens were irradiated with 3.5- and 4.5-W Er,Cr:YSGG lasers and with a 2-W Nd:YAG laser. The remaining halves served as controls. The microhardness measurements were recorded with a Vickers surface microhardness tester. The results were statistically evaluated by paired t test and one-way ANOVA (p = 0.05). Laser irradiation has significantly reduced the microhardness of dentin within each group compared to its control. Moreover, statistically significant differences were observed among the different groups (p < 0.05). The 3.5-W Er,Cr:YSGG laser produced the greatest reduction in microhardness of dentin followed by 4.5 W and Nd:YAG laser. The differences between all the groups were statistically significant. It was concluded that both laser devices used in this study have resulted in significant thermal damage and subsequent reduction in dentin microhardness values.

Stress-strain analysis for evaluating the effect of the orientation of dentin tubules on their mechanical properties and deformation behavior

A model whose porosity does not vary with compression depth is developed for evaluating the mechanical properties of dentin tubules with various orientation angles from micro-pillar nanocompression tests. Experimental results for a range of loading rates indicate that the yielding parameters and the elastic modulus are little affected by the creep behavior. For a given compression depth, the hardness, elastic modulus, and yielding strength decrease with increasing orientation angle of dentin. The mechanical properties obtained using the proposed model are consistent with the reported data, and are actually more precise since they consider the orientation angle. The proposed testing method can be applied to materials that yield a negative value of the elastic modulus due to creep behavior.

Antioxidant and osteogenic properties of anodically oxidized titanium

Cells adhering onto implant surfaces are subjected to oxidative stress during wound healing processes. Although titanium and its alloys are among the most frequently used biomaterials in orthopedic and dental implants, titanium surfaces do not have antioxidant properties, and cells grown on these surfaces can show permanent oxidative stress. The present study assessed the antioxidant property and osteogenic properties of titanium samples with or without oxidation treatments. A thick rutile TiO₂ film was observed on thermally oxidized titanium surfaces, while amorphous anatase TiO₂ formed on anodically oxidized titanium surfaces prepared by discharging in 1 M Na₂HPO₄. A resistance to the depletion of reduced glutathione in adherent osteoblasts, which correlates with antioxidant behavior, occurred on anodically oxidized titanium. Enhanced osteogenic gene expressions and nano-biomechanical properties of mineralized tissue were achieved on anodically oxidized titanium, in comparison with thermally oxidized or untreated titanium. Thus, anodic oxidation by discharging in electrolyte is expected to be a useful surface modification for titanium implants.

Nanoscopic dynamic mechanical properties of intertubular and peritubular dentin

An experimental evaluation of intertubular and peritubular dentin was performed using nanoindentation and Dynamic Mechanical Analysis (DMA). The objective of the investigation was to evaluate the differences in dynamic mechanical behavior of these two constituents and to assess whether their response is frequency dependent. Specimens of hydrated coronal dentin were evaluated by DMA using single indents over a range of parametric conditions and using scanning probe microscopy. The complex (E∗), storage (E') and loss moduli (E″) of the intertubular and peritubular dentin were evaluated as a function of the dynamic loading frequency and static load in the fully hydrated condition. The mean complex E∗ (19.6 GPa) and storage E' (19.2 GPa) moduli of the intertubular dentin were significantly lower than those for peritubular dentin (E∗ = 31.1 GPa, p < 0.05; E' = 30.3 GPa, p < 0.05). There was no significant influence of dynamic loading frequency on these measures. Although there was no significant difference in the loss modulus (E″) between the two materials (p > 0.05), both constituents exhibited a significant increase in E″ with dynamic load frequency and reduction in the quasi-static component of indentation load. The largest difference in dynamic behavior of the two tissues was noted at small quasi-static indentation loads and the highest frequency.

Evaluation of surface structural and mechanical changes following remineralization of dentin

This study sought to gain insights into the surface structural and mechanical changes leading to remineralization of dentin. Remineralization was compared between a continuous remineralization approach and a nonbuffered static approach using solutions of the same initial composition. Artificial carious lesions were treated for 5 days and analyzed every 24 h using nanoindentation in water, SEM, and AFM. The continuous approach yielded a recovery of mechanical properties of up to 60% of normal dentin, whereas the static approach led to recovery of only 10%. Image analysis revealed that the static approach yielded the formation of areas suggestive of an apatite precipitate on the surface of the dentin matrix. In contrast, surface precipitate was absent using the continuous approach, suggesting that mineral formed within the lesion and re-associated with the collagenous matrix. This study provided evidence that mechanical recovery of dentin in near physiological conditions is attainable through the continuous delivery of calcium and phosphate ions.

Chemical, mechanical and morphological properties of hypomineralized enamel of permanent first molars

OBJECTIVE

The microstructure of hypomineralized enamel in permanent teeth has been described in several studies as less distinct prism sheaths and disorganized enamel with lack of organization of the enamel crystals. The mechanical properties, hardness and modulus of elasticity of the hypomineralized enamel have lower values compared with normal. The aim of this study was to examine normal and hypomineralized enamel using scanning electron microscopy (SEM), hardness measurements and X-ray microanalysis (XRMA).

MATERIAL AND METHODS

Four extracted hypomineralized permanent first molars, sectioned and cut in half, were analyzed with SEM, XRMA and hardness measurements.

RESULTS

An inverse relation was found between the micro hardness and the Ca:C ratio in hypomineralized and normal enamel. The acid-etched hypomineralized enamel appeared on SEM to be covered with a structureless layer and the prisms appeared disorganized, with thick prism sheaths and loosely packed crystallites. Furthermore, bacteria were found deep in porous hypomineralized enamel close to the enamel-dentin junction.

CONCLUSIONS

Teeth diagnosed with molar incisor hypomineralization have significantly lower hardness values in the hypomineralized enamel compared with normal enamel. The hardness values vary according to the morphological and chemical properties.

The use of nanoindentation for characterizing the properties of mineralized hard tissues: state-of-the art review

The use of nanoindentation to determine nanomechanical properties of mineralized tissues has been investigated extensively. A detailed, critical, and comprehensive review of this literature is the subject of the present work. After stating the motivation for the review, a succinct presentation of the challenges, advantages, and disadvantages of the various quasi-static nanoindentation test methods (to obtain elastic modulus, E, and hardness, H) and dynamic test methods (to obtain storage and loss moduli and/or loss/damping factor) is given in the form of a primer. Explicative summaries of literature reports on various intrinsic and extrinsic factors that significantly influence E and H, followed by 15 suggested topics for future research, are included additionally. This review is designed to present a compact guide to the principles of the nanoindentation technique and to emphasize considerations when determining material properties of mineralized tissues.

Mechanical properties of mineralized collagen fibrils as influenced by demineralization

Dentin and bone derive their mechanical properties from a complex arrangement of collagen type-I fibrils reinforced with nanocrystalline apatite mineral in extra- and intrafibrillar compartments. While mechanical properties have been determined for the bulk of the mineralized tissue, information on the mechanics of the individual fibril is limited. Here, atomic force microscopy was used on individual collagen fibrils to study structural and mechanical changes during acid etching. The characteristic 67 nm periodicity of gap zones was not observed on the mineralized fibril, but became apparent and increasingly pronounced with continuous demineralization. AFM-nanoindentation showed a decrease in modulus from 1.5 GPa to 50 MPa during acid etching of individual collagen fibrils and revealed that the modulus profile followed the axial periodicity. The nanomechanical data, Raman spectroscopy and SAXS support the hypothesis that intrafibrillar mineral etches at a substantially slower rate than the extrafibrillar mineral. These findings are relevant for understanding the biomechanics and design principles of calcified tissues derived from collagen matrices.

Comparative assessment of hardening of demineralized dentin under lining materials using an ultramicroindentation system

The aim of the current in vitro study was to evaluate the influence of three lining materials with a reported mineralizing capacity on hardness and elasticity of demineralized dentin. Four standardized microcavities were prepared in exposed dentin surfaces of 16 extracted human molars each. Dentin was demineralized in 0.5M EDTA for 2 h. One microcavity was left empty. The others were filled with a resin-modified glass ionomer cement (RMGIC), a bioactive glass S53P4 suspension, and a prototype Ca-PO(4) cement. Teeth were then immersed in deionized water or simulated oral fluid. After 3 weeks, hardness and composite elastic modulus of the dentin subjacent to the microcavities were assessed under wet conditions using the ultramicroindentation system (UMIS). After immersion in deionized water, there was no significant improvement of the mechanical properties of dentin irrespective of the material applied beforehand, indicating a lack of direct material effects. Exposure to simulated oral fluid resulted in significantly (p < 0.05) higher hardness and composite elastic modulus values of the dentin subjacent to empty microcavities and counterparts lined with bioactive glass compared to corresponding dentin under the RMGIC. UMIS profiles showed little variance.

Nanoindentation derived stress–strain properties of dental materials

OBJECTIVES

The aim of the study is to investigate the stress-strain response of different dental materials, especially dental brittle materials, and compare them with enamel.

METHODS

A nano-based indentation system (Ultra Micro-Indentation System, UMIS-2000, CSIRO, Australia) was used to determine the indentation stress-strain response of two kinds of dental ceramics (Cerec 2 Mark II and Vita VM9), one kind of dental alloy (Wiron 99) and healthy enamel. A spherical indenter was used to test the materials with nanometer and micro-Newton displacement and force resolution. Assuming the elastic modulus remained constant, a plot of contact pressure versus contact strain, H-a/R, of each material was obtained.

RESULTS

By comparing the H-a/R curve of the different materials with enamel, it can be concluded that only the metallic alloy, has similar stress-strain response as enamel. Dental ceramics showed much higher yield stress response than enamel. VM9, a porcelain veneer component of crown/bridge structure, is slightly softer than its core, Mark II. The yield point for Mark II and VM9 are nearly 10 and 7GPa, respectively, and approximately 2GPa for Wiron alloy and enamel.

SIGNIFICANCE

H-a/R curves provide a new method to compare the mechanical properties of different dental materials. From the standpoint of structural reliability, strong and tough materials with primarily elastic response, such as toughened ceramics are required to enable dental crown/bridges to have long term reliability. On the other hand, materials with too high hardness or yield response may damage opposing teeth during occlusal contact. Future studies may establish a relationship between stress and strain property and abrasive wear of dental material.

Effect of different power parameters of Er,Cr:YSGG laser on human dentine

The aim of this work was to determine the optimal power setting of an Er,Cr:YSGG laser for cutting human dentine to produce a surface that remains suitable as a foundation on which to build and bond a dental restoration. The cutting efficiency and resulting microhardness of the dentine were evaluated for various laser power settings, and representative samples were examined by SEM. The microhardness of the dentine was significantly reduced by 30-50% (p < 0.05, paired t test) after laser irradiation, irrespective of the power setting used. The mean ablation efficiency increased in proportion to the power setting of the laser. Although the laser power setting did not affect the extent of reduction in microhardness, it did affect the microstructure of human dentine.

Hardness and Elasticity of Sound and Caries-affected Primary Dentin Bonded with One-step Self-etch Adhesive

Biomechanical properties of bonded dentin are important for resin restorations. We hypothesized that there are no differences in the hardness and elasticity of sound and caries-affected primary dentin bonded with a one-step self-etch adhesive. Resin-dentin interfaces in sound and caries-affected primary dentin were measured with a nano-indentation tester and observed with SEM and TEM. Interfacial dentin hardness was similar for sound and caries-affected dentin, but significantly lower than the underlying intact dentin. As for the Young's modulus of interfacial dentin, both substrates exhibited significantly lower values than the subsurface dentin. Further, the Young's modulus of interfacial dentin was significantly lower in caries-affected dentin. TEM revealed extensive interfacial nanoleakage in bonded sound dentin, while it was minimal in bonded caries-affected dentin. However, in the latter, silver deposits were identified within the porous substrate. Shorter application time and/or improvement of the adhesive components may be required to obtain stable adhesion in primary dentin.

Behaviour of primary incisor caries: a micromechanical study

OBJECTIVES

To date, there has been no attempt to assess the mechanical properties of the entirety of a smooth-surface carious lesion in primary teeth, despite the fact that these lesions are not only common, but clinically challenging. Therefore, the aim of this study was to describe the hardness and modulus of elasticity across smooth surface lesions of primary incisors.

STUDY DESIGN

An in vitro study of the micromechanical properties of primary incisors.

MATERIALS AND METHODS

Carious primary incisor teeth were set in resin, sectioned and polished. A series of indentations using the ultra-micro-indentation system were conducted in fully hydrated carious and sound dentine from the minimally affected pulpal region towards the tooth surface. A single set of indentations were duplicated for sound dentine.

RESULTS

Although the mechanical properties of the carious dentine varied between the test teeth, the median hardness of the surface, middle and inner (pulpal) region of the carious dentine was 0.01, 0.10 and 0.28 GPa, respectively. The modulus of elasticity of the surface, middle and inner (pulpal) carious dentine was 0.12, 2.16 and 5.98 GPa, respectively. The mechanical properties of the sound dentine varied less, and were consistent between the pulpal and surface regions. Examination of the individual series of indentations indicated that, although the majority of the test teeth showed a decrease in the mechanical properties from the 'unaffected dentine' to the surface of the lesion, in the last 300-500 microm, both the hardness and modulus of elasticity showed a dramatic increase.

CONCLUSIONS

This study has confirmed that the carious process has a deleterious effect on the mechanical properties of dentine in primary incisors. This, in turn, increases the likelihood of restorative failure. However, the slight increase in mechanical properties seen at the surface of the carious lesion suggests an increase in mineral content.

Root Canal Irrigants

Local wound debridement in the diseased pulp space is the main step in root canal treatment to prevent the tooth from being a source of infection. In this review article, the specifics of the pulpal microenvironment and the resulting requirements for irrigating solutions are spelled out. Sodium hypochlorite solutions are recommended as the main irrigants. This is because of their broad antimicrobial spectrum as well as their unique capacity to dissolve necrotic tissue remnants. Chemical and toxicological concerns related to their use are discussed, including different approaches to enhance local efficacy without increasing the caustic potential. In addition, chelating solutions are recommended as adjunct irrigants to prevent the formation of a smear layer and/or remove it before filling the root canal system. Based on the actions and interactions of currently available solutions, a clinical irrigating regimen is proposed. Furthermore, some technical aspects of irrigating the root canal system are discussed, and recent trends are critically inspected.

Nanoindentation hardness of mineralized tissues

A series elastic and plastic deformation model [Sakai, M., 1999. The Meyer hardness: a measure for plasticity? Journal of Materials Research 14(9), 3630-3639] is used to deconvolute the resistance to plastic deformation from the plane strain modulus and contact hardness parameters obtained in a nanoindentation test. Different functional dependencies of contact hardness on the plane strain modulus are examined. Plastic deformation resistance values are computed from the modulus and contact hardness for engineering materials and mineralized tissues. Elastic modulus and plastic deformation resistance parameters are used to calculate elastic and plastic deformation components, and to examine the partitioning of indentation deformation between elastic and plastic. Both the numerical values of plastic deformation resistance and the direct computation of deformation partitioning reveal the intermediate mechanical responses of mineralized composites when compared with homogeneous engineering materials.