A new electrical method for detecting marginal leakage of in vitro resin restorations

Enamel Surface with Pit and Fissure Sealant Containing 45S5 Bioactive Glass

Enamel demineralization adjacent to pit and fissure sealants leads to the formation of marginal caries, which can necessitate the replacement of existing sealants. Dental materials with bioactive glass, which releases ions that inhibit dental caries, have been studied. The purpose of this study was to evaluate the enamel surface adjacent to sealants containing 45S5 bioactive glass (BAG) under simulated microleakage between the material and the tooth in a cariogenic environment. Sealants containing 45S5BAG filler were prepared as follows: 0% 45S5BAG + 50.0% glass (BAG0 group), 12.5% 45S5BAG + 37.5% glass (BAG12.5 group), 25.0% 45S5BAG + 25.0% glass (BAG25.0 group), 37.5% 45S5BAG + 12.5% glass (BAG37.5 group), and 50.0% 45S5BAG + 0% glass (BAG50.0 group). A cured sealant disk was placed over a flat bovine enamel disk, separated by a 60-µm gap, and immersed in lactic acid solution (pH 4.0) at 37 °C for 15, 30, and 45 d. After the storage period, each enamel disk was separated from the cured sealant disk, and the enamel surface was examined with optical 3-dimensional surface profilometer, microhardness tester, and scanning electron microscopy. The results showed a significant increase in roughness and a decrease in microhardness of the enamel surface as the proportion of 45S5BAG decreased (P< 0.05). In the scanning electron microscopy images, enamel surfaces with BAG50.0 showed a smooth surface, similar to those in the control group with distilled water, even after prolonged acid storage. Additionally, an etched pattern was observed on the surface of the demineralized enamel with a decreasing proportion of 45S5BAG. Increasing the 45S5BAG filler contents of the sealants had a significant impact in preventing the demineralization of the enamel surface within microgaps between the material and the tooth when exposed to a cariogenic environment. Therefore, despite some marginal leakage, these novel sealants may be effective preventive dental materials for inhibiting secondary caries at the margins.

Relationship between laser fluorescence and bacterial invasion in arrested dentinal carious lesions

This study investigated the relationship between caries assessment using a laser fluorescence device (DIAGNOdent), and bacterial invasion in arrested carious dentin detected by polymerase chain reaction (PCR). The ten extracted human molars used in this study had black or dark brown, hard occlusal carious lesions, and were found to be only weakly stained or unstained with a caries detector dye of 1% acid red in propylene glycol. In those extracted human molars, dentin was removed in the direction of the pulp chamber at 150-μm intervals. During each removal (104 sections in total), the dentin surface was assessed with DIAGNOdent, and a dentinal tissue sample was taken with a round bur. Bacterial DNA of each tissue sample was examined using PCR and primers based on the nucleotide sequence of a conserved region of bacterial 16S rDNA. Rates of bacterial detection increased as the DIAGNOdent values increased. When the DIAGNOdent values were <10, the rate of bacterial detection was 0%. The area under the receiver operating characteristic curve of the DIAGNOdent values was 0.87. These results indicate that the DIAGNOdent values of arrested dentinal carious lesion were closely related to the rates of bacterial detection.

The accuracy of electrical method for microleakage evaluation by a three-dimensional analysis

OBJECTIVES

This in vitro study aimed to investigate the accuracy of an electrical method for the evaluation of microleakage by a three-dimensional analysis of dye penetration.

METHODS

Coronal cavities were prepared on buccal, palatal or lingual surfaces in extracted human molars. The cavities were then filled with resin composites and were subjected to 10,000 load cycles (425g). Before cavity preparation and after load cycling, physiological saline was applied and wiped off, and the change in conductance was measured across the margin of the restoration in each specimen. After dye penetration, the specimens were reduced by 100 microm in a direction parallel to the cavity floor, from the surface of the restoration to the cavity floor. The sequence of reducing the sections by 100 microm and image taking was repeated. Three-dimensional images of dye penetration were made and the proportions of the interface showing penetration were calculated.

RESULTS

Pearson's correlation coefficients between changes in conductance and the surface area of dye penetration, between these and the rate of dye penetration, and between these and the depth of dye penetration were 0.932, 0.920 and 0.732, respectively. The correlations were significant (p<0.05).

CONCLUSIONS

The results of this electrical method for microleakage evaluation showed stronger correlations with the three-dimensional amount of marginal leakage (surface area of dye penetration and rate of dye penetration) than the two-dimensional amount (depth of dye penetration).

Relationship between Colors of Carious Dentin and Laser Fluorescence Evaluations in Caries Diagnosis

This in vitro study investigated the relationship between assessments of dentin caries using a laser fluorescence device (DIAGNOdent) and a caries detector dye during caries removal. The dentin of eight extracted carious molars was removed at 300-microm interval points from the dentin surface toward the pulp chamber. Before and after each removal, images of the carious surfaces were taken in association with color-matching stickers (for color correction) and the surfaces were evaluated by DIAGNOdent based on fluorescence emission from the tooth surface. For the L* values (CIE 1976 L*a*b* color system), there was a strong negative correlation between DIAGNOdent results and the corrected L* values of the carious surfaces (Pearson's correlation coefficient: -0.853); additionally, there was a significant correlation between them (p<0.05). However, there were no significant correlations between the DIAGNOdent results and the corrected a* and b* values of the carious surfaces (Pearson's correlation coefficients: 0.108 and 0.018 respectively). In conclusion, DIAGNOdent was shown to be applicable for caries diagnosis during caries removal.

Three-dimensional evaluation of gap formation of cervical restorations

OBJECTIVES

In some studies gap formation has been evaluated in just one section of the restorative. This in vitro study aimed to design a quantitative three-dimensional method for evaluation of the contraction gap in restoratives.

METHODS

Cervical cavities were prepared on buccal, palatal or lingual surfaces in human extracted molars and were then filled with resin composites. Specimens were reduced every 100 microm in a direction parallel to the tooth axis, and perpendicular to the cavity floor from one proximal side to the other. The sequence of reducing the sections by 100 microm, image taking (250x) and observation of these images (maximal 2500x) were repeated. Three-dimensional images of the contraction gap were made using analytical software and the proportions of the interface with gap formation calculated.

RESULTS

The mean proportions of the interface with gap formation of the self-etching system (Clearfil Liner Bond II Sigma) was 41.7+/-6.3% and that of the self-priming system (Single Bond) was 38.2+/-3.9%; there was no significant difference.

CONCLUSIONS

Approximate three-dimensional images of the in vitro contraction gap could be drawn and the mean proportions of the interface with gap formation could be more precisely calculated than by previous methods.

Relationship between bacterial infection and evaluation using a laser fluorescence device, DIAGNOdent

The aim of this in vitro study was to investigate the relationship between bacterial infections in carious dentin when detected by two different methods -- polymerase chain reaction (PCR), and a laser fluorescence device, DIAGNOdent. Dentin was removed every 300 micro m in the direction of the pulp chamber in 10 extracted molars with occlusal dentin caries and 3 extracted sound molars. Dentin surfaces were evaluated using DIAGNOdent, and dentinal tissue samples were removed by using a round bur before and after each removal. Bacterial DNA in the dentinal tissues was detected by PCR, using primers based on the nucleotide sequence of a conserved region of the 16S rDNA, and yielded a PCR product of 466 bp. The rates of bacterial detection increased as the DIAGNOdent values increased. In the 10 specimens, the lowest DIAGNOdent value at which bacteria were detected was 15.6; at DIAGNOdent values below 15.6, no bacteria were detected. The results of a receiver operating characteristic (ROC) curve for the DIAGNOdent values showed that the area under the ROC curve was 0.91. This study clarified the relationship between the DIAGNOdent values of dentin caries and the rates of bacterial detection.

In vitro analysis of ‘smear layer’ on human dentine using ac-impedance spectroscopy

OBJECTIVE

To analyse smear layers on human dentine using ac-impedance spectroscopy.

METHODS

Dentine samples were prepared from extracted, sound, third molars. Impedance measurements were carried out on dentine samples before and after etching. After measuring, samples were examined under scanning electron microscope (SEM) to correlate electrical measurements with structure.

RESULTS

Marked differences in impedance before and after etching were demonstrated. SEM investigation showed that a smear layer overlies dentine surfaces before etching, but completely disappeared after etching, leaving open dentinal tubules.

CONCLUSIONS

The clinical removal of smear layers is still subjective. This objective method, based on combined ac-impedance and admittance measurement in vitro, has the potential to allow development of standardised techniques and if developed further may be of use in vivo.

Evaluation of microleakage of composite resin restorations by an electrochemical technique: the impedance methodology

OBJECTIVES

The aim of our in vitro study was to quantitatively evaluate dentin microleakage by means of the impedance technique.

METHODS

Forty-five 2 mm thick dentin disks were embedded in a hollow polyurethane resin cylinder. The system used was a 'like' permeation cell. Standard cylindrical cavities (1.5 mm deep, 3.5 mm diameter) were prepared on the occlusal side of the disk. The current passing through the dentin was measured to calculate impedance and to establish resistance of the sample. The doses were then randomly divided into nine groups (n = 5). Each group was bounded with a different adhesive system and filled with microhybrid composite resin (Filtek P60). The initial measurement with the empty cavity and the record measurement (t = 0) were performed to evaluate initial resistance after filling. Samples were then thermocycled.

RESULTS

At t = 0, the highest value was obtained with EP (550%), the lowest with PLP (115%). The values of other adhesives ranged in a group (350-450%) without statistical difference. After thermocycling, all groups exhibited no significant difference (350-230%) except PLP (50%). The lower joint degradation rate (5%) was obtained with OS with a significant difference for all systems, the higher with PLP (35%). The results for other adhesives ranged from 20 to 27% without significant difference.

SIGNIFICANCE

Dentin microleakage may be quantified with the impedance technique and this has shown that, except for PLP, the differences between the two families of adhesives are slight. This methodology is able to prove the influence of thermocycling in terms of joint degradation.

Effect of conditioners on dentin permeability using an impedance method

OBJECTIVES

The aim of our in vitro study was to contribute to an elaboration of a protocol to evaluate the permeability of dentin and the effect of different acid conditioners by means of the electrochemical impedance technique.

MATERIALS AND METHODS

Twenty-four 1.1mm thick dentin disks were embedded in a hollow polyurethane resin cylinder. The system used was a 'like' permeation cell: two electrodes immersed in a 10(-1) KCl solution were attached to a potentiostat. It was connected to a microcomputer controlled frequency response analyzer and a 10 mV sinusoidal voltage signal over a frequency range of 1 Hz to 65 kHz was applied between the electrodes. The current passing through the dentin was measured to enable a calculation of impedance expressed in a complex number. To establish an evaluation of permeability variation, the resistance was noted for all specimens before and after the application of dentin conditioners.

RESULTS

The highest resistance decrease was obtained with 32% phosphoric acid and 10-3 solution which improved the permeability, respectively, 9.0 and 6.9% with no significant difference. The acidic monomer can be considered as intermediate (4.3%) between 10-3 solution and the polyacrylic acid (2.8%) with no significant difference.

CONCLUSIONS

By measuring electrical resistance of dentin disks with the impedance method, we can evaluate the ionic conduction through the sample and achieve quantitative values about permeability. The action of dentin conditioners can be significantly evaluated regarding their action in terms of resistance of the etched zone (REZ) and increasing dentin permeability.

Polymerization Contraction Stress of Resin Composite Restorations in a Model Class I Cavity Configuration Using Photoelastic Analysis

PURPOSE

An important factor that contributes to deterioration of resin composite restorations is contraction stress that occurs during polymerization. The purpose of this article is to familiarize the clinician with the characteristics of contraction stress by visualizing the stresses associated with this invisible and complex phenomenon.

MATERIALS AND METHODS

Internal residual stresses generated during polymerization of resin composite restorations were determined using micro-photoelastic analysis. Butt-joint preparations simulating Class I restorations (2.0 mm x 5.0 mm, 2.0 mm in depth) were prepared in three types of substrates (bovine teeth, posterior composite resin, and transparent composite resin) and were used to examine contraction stress in and around the preparations. Three types of composite materials (a posterior composite, a self-cured transparent composite, and a light-cured transparent composite) were used as the restorative materials. The self-cured composite is an experimental material, and the others are commercial products. After treatment of the preparation walls with a bonding system, the preparations were bulk-filled with composite. Specimens for photoelastic analysis were prepared by cutting sections perpendicular to the long axis of the preparation. Fringe patterns for directions and magnitudes of stresses were obtained using transmitted and reflected polarized light with polarizing microscopes. Then, the photoelastic analysis was performed to examine stresses in and around the preparations.

RESULTS

When cavity preparations in bovine teeth were filled with light-cured composite, a gap was formed between the dentinal wall and the composite restorative material, resulting in very low stress within the restoration. When cavity preparations in the posterior composite models were filled with either self-cured or light-cured composite, the stress distribution in the two composites was similar, but the magnitude of the stress was greater in the light-cured material. When preparations in the transparent composite models were filled with posterior composite and light-cured transparent composite material, significant stress was generated in the preparation models simulating tooth structure, owing to the contraction of both restorative materials.

CLINICAL SIGNIFICANCE

Polymerization contraction stress is an undesirable and inevitable characteristic of adhesive restorations encountered in clinical dentistry that may compromise restoration success. Clinicians must understand the concept of polymerization contraction stress and realize that the quality of composite resin restorations depends on successful management of these stresses.