Effect of a new liner/base on human dentin permeability

Comparison of indirect pulp treatment and iRoot BP Plus pulpotomy in primary teeth with extremely deep caries: a prospective randomized trial

OBJECTIVES

The purpose of this randomized controlled trial was to compare the 24-month success rates of indirect pulp treatment (IPT) and iRoot BP Plus pulpotomy of primary molars with extremely deep caries.

MATERIALS AND METHODS

Generally healthy children aged 3-7 years requiring general anesthesia for treating primary molars with extremely deep caries or reversible pulpitis were recruited. Patients with systemic disease, mental health problems, or manifestations of irreversible pulpitis were excluded. In total, 175 molars were randomized and blinded for either IPT (n = 87) or iRoot BP Plus pulpotomy (n = 88). All teeth were restored with stainless steel crowns and evaluated after 6, 12, 18, and 24 months by two blinded calibrated investigators. Kaplan-Meier survival curves were used to compare the survival rates between the groups. The correlations between success rate and patient characteristics were explored with the Cox proportional hazards model.

RESULTS

A total of 168 primary molars in 67 patients (average age: 3.83 years) were evaluated. The cumulative survival probability at 24 months was not significantly different between the IPT (93.8%) and pulpotomy (97.7%) groups (P = 0.238). IPT treatment success was significantly associated with age (odds ratio = 2.347; 95% CI: 1.068-5.156; P = 0.034) and preoperative sensitivity (odds ratio = 9.742; 95% CI: 1.079-87.970; P = 0.043).

CONCLUSIONS

The 24-month success rates of IPT and iRoot BP Plus pulpotomy performed in primary molars with extremely deep caries were not significantly different. Increasing age and preoperative sensitivity were found to be associated with the cumulative survival probability in IPT-treated primary molars with extremely deep caries. Primary teeth with extremely deep carious lesions without signs of irreversible pulpitis can be treated successfully by either indirect pulp capping or iRoot BP Plus pulpotomy.

TRIAL REGISTRATION

ChiCTR2000032462.

Effects of two disinfection/sterilization methods for dentin specimens on dentin permeability

OBJECTIVES

To investigate the effects of two disinfection/sterilization methods on the permeability of dentin specimens.

MATERIALS AND METHODS

Forty intact human third molars were freshly extracted and cut, close to the pulp chamber, into dentin disks with a 500-μm thickness. The disks were randomized (n = 20 each) into a 70% ethanol group (acid-etched dentin disks soaked in 70% ethanol for 15 min) and a steam autoclaving group (acid-etched dentin disks autoclaved for 25 min). The permeability (Lp) of each dentin disk was measured before and after either treatment using a hydraulic device, and intra- and inter-group differences in values before and after treatment were analyzed using t tests. Field emission scanning electron microscopy (FE-SEM) micrographs of the dentin surface were acquired and examined. FE-SEM samples were prepared using the critical point drying (CPD) method.

RESULTS

Immersion in 70% ethanol increased the Lp values of dentin specimens by 17%, which was not statistically significant. Steam autoclaving significantly reduced dentin permeability by 66% because the dentin collagen mesh became compact and collapsed, as detected by FE-SEM.

CONCLUSIONS

The disinfection of acid-etched dentin disks using 70% ethanol for 15 min does not significantly affect dentin permeability, whereas sterilization of acid-etched dentin disks via autoclaving significantly reduces dentin permeability.

CLINICAL RELEVANCE

Considering the influences of dentin permeability by disinfection/sterilization methods, the disinfection of the acid-etched dentin disks using 70% ethanol for 15 min could be used for the study related to dentin permeability, while the sterilization of autoclaving could not.

Short-term response of three resin-based materials as desensitizing agents under oral environmental exposure

OBJECTIVE

This paper focuses on clinical responses after 7 days of oral exposure to two resin-based materials as desensitizing agents compared to a fluoride varnish and on morphological and analytical study as a means to elucidate the mechanism of action.

MATERIALS AND METHODS

The elemental composition of Vertise™ Flow (VF), Universal Dentine Sealant (UDS) and Flor-Opal® Varnish (FOV) were investigated by using an X-ray energy dispersive spectrometer (EDX) in conjunction with a scanning electron microscope (SEM). SEM morphology of the material-treated dentine surfaces and pain reduction ability according to the Visual Analogue Scale (VAS) were evaluated in selected hypersensitive teeth. Post treatments and 7 day controls were recorded with SEM and VAS measurements. Clinical data was analysed with the Student's t-test for paired data, with a 5% significance level.

RESULTS

Silicon, ytterbium and alumina were the most present elements in VF, whilst calcium, chloride, silicon and alumina were highest in UDS. Within a 7 day oral environment all the tested materials modified the treated-dentine surfaces showing tubular occlusion of different morphology. Clinically, the efficacy of all materials was similar after a 7-day examination. However, VAS scores were significantly reduced if compared with the baseline (p < 0.05).

CONCLUSIONS

Within the limits of this study, data indicate that both resins are effective in sealing tubules and reducing VAS. A resin-related effect on the dentine's morphology was observed, which may influence the long-term response of the resins in the treatment of dental hypersensitivity, which requires further investigation.

Influence of thicknesses of smear layer on the transdentinal cytotoxicity and bond strength of a resin-modified glass-ionomer cement

This study evaluated the transdentinal cytotoxicity (TC) and the bond strength (BS) of a resin-modified glass-ionomer cement (RMGIC) applied to dentin covered with smear layer (SL) of different thicknesses. Forty dentin discs had thick (TSL) or thin (THSL) smear layer created on their occlusal side. In artificial pulp chambers, MDPC-23 cells were seeded on the pulpal side of the dentin discs and divided into five groups: G1TC: no treatment (control); G2TC: TSL + RMGIC; G3TC: THSL + RMGIC; G4TC: TSL removal + RMGIC; G5TC: THSL removal + RMGIC. After 24 h, cell metabolism and morphology were evaluated by the methyltetrazolium (MTT) assay and by scanning electron microscopy (SEM), respectively. For BS, the following groups were determined: G1BS: TSL removal + RMGIC; G2BS: THSL removal + RMGIC; G3BS: TSL + RMGIC; G4BS: THSL + RMGIC. Shear bond strength was tested to failure in a mechanical testing machine MTS (0.5 mm/min). Statistically significant difference was observed only between the control and experimental groups (Kruskal-Wallis, p<0.05). The metabolic activity of the viable MDPC-23 cells in G2TC, G3TC, G4TC and G5TC decreased by 54.85%, 60.79%, 64.12% and 62.51%, respectively. Mean shear bond strength values for G1BS, G2BS, G3BS and G4BS were 7.5, 7.4, 6.4 and 6.7 MPa, respectively, without significant difference among them (ANOVA, p>0.05). RMGIC presented moderate transdentinal cytotoxic effects. Maintenance or removal of smear layer did not affect the bond strength of RMGIC to dentin substrate.