In vitro dentin demineralization inhibition effects of an experimental fluoridated HEMA and water wetting agent

In Vitro Secondary Caries Inhibition by Adhesive Systems in Enamel Around Composite Restorations

The ability of the adhesive system to inhibit secondary caries was similar among the materials tested, according to the enamel mineral content around restorations.

Microhardness evaluation around composite restorations using fluoride-containing adhesive systems

The purpose of this study was to evaluate the microhardness of dental enamel around composite restorations bonded with fluoride-containing adhesive systems (FCAS), after thermo- and pH-cycling protocols. Standardized cylindrical cavities were prepared on enamel surfaces of 175 dental fragments, which were randomly assigned into seven experimental groups (n=25). Four groups used FCAS: Optibond Solo (OS); Prime&Bond 2.1 (PB); Syntac Sprint (SS) and Tenure Quick (TC). Other groups consisted of "Sandwich" technique restoration (STR) (glass ionomer liner + hydrophobic adhesive resin /restorative composite) or used Single Bond with (SB) or without (SBWC) cycling protocols. Adhesive systems were applied according to manufacturers' instructions and cavities were restored with a microfilled composite (Durafill VS). After finishing and polishing, all groups were submitted to 1,000 thermal cycles (5 ºC and 55 ºC) and to demineralization (pH 4.3) and remineralization (pH 7.0) cycling protocols, except for SBWC group. The Knoop microhardness of enamel surfaces were measured around restorations. Indentations were recorded at 150, 300 and 450-mm from the cavity wall. Data were analyzed by two-way ANOVA and Duncan's Test (a=0.05%). Means ± SD of enamel microhardness for the groups were (Kg/mm²): SBWC: 314.50 ± 55.93ª ; SB: 256.78 ± 62.66b; STR: 253.90 ± 83.6b; TQ: 243.93 ± 68.3b; OS: 227.97 ± 67.1c; PB: 213.30 ± 91.3d; SS: 208.73 ± 86.6d. Means ± SD of microhardness for the distances 150, 300, 450mm from the cavity wall were, respectively: 234.46 ± 77.81ª; 240.24 ± 85.12ª; 262.06 ± 79.46b. SBWC group, which was not submitted to thermo- and pH-cycling protocols, showed the highest enamel microhardness mean value and the FCAS resulted in lower microhardness values. At 450 mm from the cavity wall, the enamel microhardness increased significantly.

Fluoride-releasing restorative materials and secondary caries

Secondary caries are responsible for 60% of all replacement restorations in the typical dental practice. Risk factors for secondary caries are similar to those for primary caries development. Unfortunately, it is not possible to predict accurately which patients are at risk for restoration failure. Fluoride-releasing dental materials provide for improved resistance against primary and secondary caries in coronal and root surfaces and have become a part of the dentist's armamentarium. This article discusses the improvement in the properties of dental materials with the ability to release fluoride. It is anticipated that in the near future, the vast majority of restorative procedures will employ fluoride-releasing dental materials as bonding agents, cavity liners, luting agents, adhesives for orthodontic brackets, and as definitive restoratives.

The effect of fluoridated and non-fluoridated rewetting agents on in vitro recurrent caries

OBJECTIVE

This study examined the in vitro caries inhibiting potential of fluoridated and non-fluoridated rewetting agents that are applied to acid-etched enamel and dentine before the use of a water-free, dentine adhesive.

MATERIALS AND METHODS

Twelve caries-free premolars were divided into three groups of four teeth each. 2 x 3 x 1.5 mm cavities were prepared on the mesial and distal surfaces of each tooth, with half of the cavosurface margin in enamel and half in root dentine. In Group I (control), One-Step (Bisco, Schaumburg, USA) was applied without etching or rewetting agents. In Group II, cavities were acid-etched, rinsed, dried, and rewetted with Aqua-Prep (Bisco), a non-fluoridated rewetting agent, and then bonded with One-Step. Treatment for Group III was similar to Group II, except that Aqua-Prep F (Bisco), a fluoridated rewetting agent was used. Bonded cavities were restored with a non-fluoride-containing flowable composite (AEliteFlo, Bisco). Artificial carious lesions were induced in these specimens, from which multiple 100+/-20 microm thick longitudinal sections were prepared, yielding 16 specimens per group for evaluation with polarised light microscopy (PLM) and microradiography (MRG). Representative sections were processed for transmission electron microscopy (TEM) examination and scanning transmission electron microscopy/energy dispersive X-ray (STEM/EDX) analyses.

RESULTS

The differences in demineralisation of dentine among the groups were not statistically significant for 'relative' lesion depth (p > 0.05, ANOVA, Student-Neuman-Keuls test), but highly significant for 'relative' lesion area (p < 0.001). Wall lesions were consistently present in Group I, while inhibition zones were invariably observed in Group III. 87.5% of Group II specimens exhibited neither wall lesion nor inhibition zone. TEM showed that remnant dentine apatite crystallites within the inhibition zones in Group III were larger and denser than those present within the corresponding wall lesions. STEM/EDX analyses confirmed the presence of calcium, phosphorus and fluorine in these plate-like crystallites.

CONCLUSION

When used with a water-free, single-bottle dentine adhesive, a non-fluoridated rewetting agent is able to reduce, but cannot completely prevent recurrent caries. The use of a fluoridated rewetting agent is useful under the situation when microleakage occurs, by providing the additional benefit of fluoride-induced demineralisation inhibition.