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Kongyodsueb P, Poolthong S, Chumprasert S, Sae-Ear P, Tantilertanant Y. The effect of silver nanoparticles in addition to sodium fluoride on remineralization of artificial root dentin caries. Aust Dent J 2024; 69:56-66. [PMID: 37813824 DOI: 10.1111/adj.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Silver nanoparticle was developed to overcome the drawback of silver diamine fluoride. However, evidence is limited, especially in root caries. The aim of this study was to evaluate the remineralization effect of silver nanoparticles on root caries. MATERIALS AND METHODS Fifty-five root human dentin slices size 5 × 5 mm2 from patients aged over 60 years old were immersed in demineralized solution to create artificial caries. Specimens were allocated into five groups according to the remineralizing agents: silver diamine fluoride (SDF), silver nanoparticles solution (AgNPs), silver nanoparticle solution followed by sodium fluoride varnish (AgNPs+NaF), sodium fluoride varnish (NaF), and tap water. After 8 days of pH-cycling challenge, the microhardness test, lesion depth evaluation, dentin surface morphology, and elemental analysis were performed. Data was analysed using F-test One-way ANOVA followed by Tukey's post hoc test and paired T-test. RESULTS All test groups demonstrated a significantly higher microhardness value and lower lesion depth compared with the control group. AgNPs+NaF and NaF-treated groups showed lower efficacy than SDF. Crystal precipitation was presented in all groups composed of silver. CONCLUSION Addition of fluoride varnish did not benefit for silver nanoparticles in preventing further demineralization. SDF provides the highest effectiveness in elderly root carious dentin.
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Affiliation(s)
- P Kongyodsueb
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Poolthong
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Chumprasert
- Oral Biology Research Center, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - P Sae-Ear
- Oral Biology Research Center, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Y Tantilertanant
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Zaeneldin A, Chu CH, Yu OY. Dental Pulp Response to Silver-Containing Solutions: A Scoping Review. Dent J (Basel) 2023; 11:dj11050114. [PMID: 37232765 DOI: 10.3390/dj11050114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Dentists used silver-containing solutions for deep cavity disinfection before restoration. This review aims to identify the silver-containing solutions reported in the literature for deep cavity disinfection and summarize their effects on dental pulp. An extensive search was performed using the search words "(silver) AND (dental pulp OR pulp)" in ProQuest, PubMed, SCOPUS, and Web of Science to identify English publications on silver-containing solutions for cavity conditioning. The pulpal response to the included silver-containing solutions was summarized. The initial search identified 4112 publications and 14 publications met the inclusion criteria. Silver fluoride, silver nitrate, silver diamine nitrate, silver diamine fluoride, and nano-silver fluoride were used in deep cavities for antimicrobial purposes. Indirect silver fluoride application induced pulp inflammation and reparative dentine in most cases, and pulp necrosis in some cases. Direct silver nitrate application caused blood clots and a wide inflammatory band in the pulp, whilst indirect silver nitrate application caused hypoplasia in shallow cavities and partial pulp necrosis in deep cavities. Direct silver diamine fluoride application induced pulp necrosis, while indirect silver diamine fluoride application induced a mild inflammatory response and reparative dentine formation. No evidence of the dental pulpal response to silver diamine nitrate or nano-silver fluoride was available in the literature.
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Affiliation(s)
- Ahmed Zaeneldin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Babaie E, Bacino M, White J, Nurrohman H, Marshall GW, Saeki K, Habelitz S. Polymer-Induced Liquid Precursor (PILP) remineralization of artificial and natural dentin carious lesions evaluated by nanoindentation and microcomputed tomography. J Dent 2021; 109:103659. [PMID: 33836248 DOI: 10.1016/j.jdent.2021.103659] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The study evaluates the efficacy to remineralize artificial and natural dentin lesions through restorative dental procedures that include the Polymer-Induced Liquid Precursor (PILP) method comprising polyaspartic acid (pAsp). METHODS Novel ionomeric cement compositions based on bioglass 45S5 and pAsp mixtures, as well as conditioning solutions (conditioner) containing 5 mg/mL pAsp, were developed and tested on demineralized dentin blocks (3-4 mm thick) on shallow and deep lesions with the thickness of 140 μm ± 50 and 700 μm ± 50, respectively. In the first treatment group, 20 μL of conditioner was applied to demineralized shallow (n = 3) and deep (n = 3) lesion specimens for 20 s before restoration with glass ionomer cement (RMGIC). For the PILP cement treatment group, cement was applied onto the wet surface of the demineralized specimen for both shallow (n = 3) and deep (n = 3) artificial lesions after the application of the conditioner and before the final restoration. Sample groups were compared to RMGIC restoration, for both shallow and deep lesions (n = 3 each) and treatments in PILP-solution (n = 3 for deep lesions) without restoration for 4 weeks. All of the restored specimens were immersed in simulated body fluid (SBF) solution for 2 weeks and 4 weeks for shallow and deep lesions respectively to allow for remineralization. The artificial lesion specimens were evaluated for changes in the nanomechanical profile (E-modulus and hardness) using nanoindentation. Shallow lesions were analyzed by SEM under vacuum for changes in morphology caused by PILP treatments. Also, a pilot study on human third molars with moderate lesions in dentin (n = 3) was initiated to test the efficacy of treatments in natural lesions based on mineral densities using microcomputed tomography (μCT) at 0, 1, and 3 months. RESULTS This study showed that functional remineralization of artificial lesions using PILP-releasing restoratives occurred, indicated by an increase of the elastic modulus in shallow lesions and in the middle zone of deep artificial lesions. The mechanical improvement was significant when compared to RMGIC restoration without pAsp (P < 0.05). Nonetheless, recovery across artificial lesions was most significant when specimens were immersed into PILP-solution with restorative (P < 0.01). Furthermore, natural lesions increased in mineral volume content to a higher degree when the restorative treatment included the PILP-method (P < 0.05). However, none of the natural lesions recovered to full mineral degree regardless of the treatments. CLINICAL SIGNIFICANCE/CONCLUSION These findings indicate the benefit of PILP applications in the functional repair of dentin caries and illustrate the challenge to integrate the PILP-method into a restorative approach in minimally invasive dental procedures.
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Affiliation(s)
- Elham Babaie
- Department of Preventative and Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA, USA
| | - Margôt Bacino
- Department of Preventative and Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA, USA
| | - Joel White
- Department of Preventative and Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA, USA
| | - Hamid Nurrohman
- Department of Preventative and Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA, USA; Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, MO, USA
| | - Grayson W Marshall
- Department of Preventative and Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA, USA
| | - Kuniko Saeki
- Department of Preventative and Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA, USA
| | - Stefan Habelitz
- Department of Preventative and Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA, USA.
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Subjective versus objective, polymer bur-based selective carious tissue removal: 1-year interim analysis of a randomized clinical trial. Sci Rep 2020; 10:9130. [PMID: 32499552 PMCID: PMC7272648 DOI: 10.1038/s41598-020-66074-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/08/2020] [Indexed: 11/08/2022] Open
Abstract
We aimed to compare subjective (S) vs. objective (O) selective carious tissue removal using hand-excavation versus a self-limiting polymer bur, respectively. A community-based single-blind cluster-randomized controlled superiority trial was performed. This is a 1-year-interim analysis. 115 children (age 7-8 years) with ≥1 vital primary molar with a deep dentin lesion (>1/2 dentin depth) were included (60 S/55 O). The cluster was the child, with eligible molars being treated identically (91 S/86 O). Cavities were prepared and carious tissue on pulpo-proximal walls selectively removed using hand instruments (S), or a self-limiting polymer bur (Polybur P1, Komet). Cavities were restored using glass-hybrid material (Equia Forte, GC). Treatment times and children's satisfaction were recorded. Generalized-linear models (GLM) and multi-level Cox-regression analysis were applied. Initial treatment times were not significantly different between protocols (mean; 95%CI S: 433; 404-462 sec; O: 412; 382-441 sec; p = 0.378/GLM). There was no significant difference in patients' satisfaction (p = 0.164). No pulpal exposures occurred. 113 children were re-examined. Failures occurred in 22/84 O-molars (26.2%) and 26/90 S-molars (28.9%). Pulpal complications occurred in 5(6%) O and 2(2.2%) S molars, respectively. Risk of failure was not significantly associated with the removal protocol, age, sex, dental arch or tooth type (p > 0.05/Cox), but was nearly 5-times higher in multi-surface than single-surface restorations (HR: 4.60; 95% CI: 1.70-12.4). Within the limitations of this interim analysis, there was no significant difference in treatment time, satisfaction and risk of failure between O and S.
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Lohmann J, Schäfer E, Dammaschke T. Histological determination of cariously altered collagen after dentin caries excavation with the polymer bur PolyBur P1 in comparison to a conventional bud bur. Head Face Med 2019; 15:19. [PMID: 31307514 PMCID: PMC6628479 DOI: 10.1186/s13005-019-0205-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the polymer bur PolyBur P1 (P1) with tungsten carbide bud bur H1 SE (H1) in removing cariously altered collagen during dentin caries excavation. METHODS Fifty extracted teeth were split in the center of a carious lesion. The 100 specimens were randomly divided into 5 groups. Five dentists were asked to excavate 10 teeth each: one half with P1 and the corresponding half with H1. The time needed for caries excavation was measured. Subsequently, histological specimens were produced and analyzed by light-microscope after Mallory-Azan-staining. The thickness of remaining cariously altered collagen was measured (< 1 mm or > 1 mm). The results were statistically evaluated. RESULTS The average time to excavate a cavity with P1 was 254 (± 148) sec and 202 (± 129) sec with H1. The difference in times was not statistically significant (p > 0.05). In the group P1 in 66.1% of the sections cariously altered collagen remained, whereas 33.9% showed sound collagen. In the group H1 45.7% sections had remaining cariously altered collagen and 54.3% showed sound collagen. The difference between P1 and H1 was statistically significant (p = 0.004). In the group P1 the layer of cariously altered collagen was significantly more often thicker than 1 mm than in the group H1 (p < 0.05). The variable "type of bur" had a statistically significant influence for the presence of cariously altered collagen (p = 0.003). CONCLUSIONS Conventional H1 bud burs were significantly more effective in removing cariously altered collagen during dentin caries excavation than the polymer bur P1.
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Affiliation(s)
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, Albert-Schweitzer-Campus 1, building W 30, 48149, Münster, Germany
| | - Till Dammaschke
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, building W 30, 48149, Münster, Germany.
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Schwendicke F, Al-Abdi A, Pascual Moscardó A, Ferrando Cascales A, Sauro S. Remineralization effects of conventional and experimental ion-releasing materials in chemically or bacterially-induced dentin caries lesions. Dent Mater 2019; 35:772-779. [DOI: 10.1016/j.dental.2019.02.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 02/13/2019] [Indexed: 01/16/2023]
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Schwendicke F, Leal S, Schlattmann P, Paris S, Dias Ribeiro AP, Gomes Marques M, Hilgert LA. Selective carious tissue removal using subjective criteria or polymer bur: study protocol for a randomised controlled trial (SelecCT). BMJ Open 2018; 8:e022952. [PMID: 30552261 PMCID: PMC6303626 DOI: 10.1136/bmjopen-2018-022952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Selective (incomplete/partial) carious tissue removal is suitable for treating deep carious lesions in teeth with vital, asymptomatic pulps. In the periphery of a cavity, removal to hard dentin is performed, while in pulpo-proximal areas, leathery or soft dentin is left to avoid pulp exposure. As the decision of what contains 'soft' or 'leathery' dentin is subjective, using self-limiting burs which help to standardise the hardness of the remaining dentin, has been suggested to increase the reliability of carious tissue removal. The trial compares subjectively measured selective carious tissue removal in deep lesions in primary teeth with objectively measured selective removal with a self-limiting bur (Polybur, Komet). METHODS AND ANALYSIS A community-based single-blind clustered randomised controlled superiority trial nested into a larger evaluation is performed. Recruitment for this trial has been concluded. We have recruited 115 children aged 6-8 years with ≥1 vital primary molar with a deep dentin lesion. The unit of randomisation was the child, with all eligible molars per child treated identically. Treatment was performed in a mobile dental unit. Subjective and objective carious tissue removal was performed at random. Teeth were restored using glass ionomer cement (Equia Forte, GC). Our primary outcome will be the time until complications occur, evaluated via multilevel survival analysis. Secondary outcomes will be the time until extraction is needed, subjective satisfaction of the child with the treatment (measured using a Likert scale) and cost-effectiveness. Re-examination will be performed after 12, 24 and 36 months (the final examination is expected in 2020). ETHICS AND DISSEMINATION This trial has been approved by the Ethics Committee of the Health Sciences of the University of Brasília (CAAE 51310415.0.0000.0030). Trial results will be published in peer-reviewed journals and presented on conferences. TRIAL REGISTRATION NUMBER NCT02754466.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - Soraya Leal
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Peter Schlattmann
- Department of Medical Statistics, Informatics and Documentation, Jena University Hospital, Jena, Germany
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - Ana Paula Dias Ribeiro
- Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Marta Gomes Marques
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Leandro Augusto Hilgert
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasilia, Brazil
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Zhou Y, Shimada Y, Matin K, Sadr A, Yoshiyama M, Sumi Y, Tagami J. Assessment of root caries under wet and dry conditions using swept-source optical coherence tomography (SS-OCT). Dent Mater J 2018; 37:880-888. [PMID: 29962412 DOI: 10.4012/dmj.2017-273] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to compare optical properties of root caries under two observing conditions using swept-source optical coherence tomography (SS-OCT). In vitro and natural root caries were observed by SS-OCT under wet and dry conditions, followed by confocal laser scanning microscope (CLSM) and transverse microradiography (TMR). Signal intensity (SI), distance between SI peaks (SI-distance) and optical lesion depth were obtained from OCT. Lesion depth was measured from CLSM; lesion depth (LDTMR) and mineral loss (ML) were obtained from TMR. In vitro root caries under wet and dry conditions showed different OCT images and SI patterns. Lesion depth of OCT and that of CLSM, SI-distance and LDTMR, LDTMR and ML significantly correlated. Under dry conditions, half natural root caries showed similar OCT images and SI patterns as in vitro root caries. The base of demineralized dentin could be detected more clearly under dry conditions than under wet conditions.
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Affiliation(s)
- Yuan Zhou
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yasushi Shimada
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Operative Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Khairul Matin
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Endowed Department of International Oral Health Science (affiliated with Department of Translational Research), School of Dental Medicine, Tsurumi University
| | - Alireza Sadr
- Biomimetics Biomaterials Biophotonics Biomechanics & Technology Laboratory, Department of Restorative Dentistry, University of Washington
| | - Masahiro Yoshiyama
- Department of Operative Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Yasunori Sumi
- Division of Oral and Dental Surgery, Department of Advanced Medicine, National Hospital for Geriatric Medicine, National Center for Geriatrics and Gerontology
| | - Junji Tagami
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Zhang C, Campbell SD, Dickens SH, Yang B. Remineralization of Natural Human Carious Dentin Lesions with an Experimental Whisker-Reinforced Atraumatic Restorative Treatment Composite. J Prosthodont 2018; 28:920-926. [PMID: 29323776 DOI: 10.1111/jopr.12754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the remineralization of natural human dentin caries with an experimental whisker-reinforced Atraumatic Restorative Treatment (ART) composite. MATERIALS AND METHODS Teeth with moderate active dentin caries were prepared with caries-disclosing dye and hand instruments, restored with ART or resin-modified glass ionomer cement (RM-GIC), and then wet sliced into 120-µm sections with 15 sections in each group. After taking transverse microradiographs and implementing digital image analysis to determine the "mineral-loss-before," each section was incubated in artificial saliva solution (pH = 7.0) for 4 weeks and 8 weeks with 1 hour each workday in demineralization solution (pH = 4.3). Transverse microradiographs of each section were retaken, and the "mineral-loss-after" was determined. The remineralization was calculated from [1-("mineral-loss-after"/"mineral-loss-before")] × 100%. Results were statistically analyzed with a repeated-measures ANOVA with one within-subject factor (time: 4 and 8 weeks) and one between-subject factor (material: ART and RM-GIC) (α = 0.05). RESULTS The statistical analysis indicated that ART composite resulted in significantly higher remineralization than the RM-GIC (p ≤ 0.05). For the remineralization of each material, there was a statistical difference between 4 weeks and 8 weeks (p ≤ 0.05). CONCLUSIONS This experimental ART composite remineralized natural human dentin caries better than the RM-GIC.
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Affiliation(s)
- Chao Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology, Hubei Province and Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBME), School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Stephen D Campbell
- Restorative Department, College of Dentistry, University of Illinois at Chicago, Chicago, IL
| | - Sabine H Dickens
- American Dental Association Foundation, Paffenbarger Research Center, National Institute of Standards and Technology, Gaithersburg, MD
| | - Bin Yang
- Restorative Department, College of Dentistry, University of Illinois at Chicago, Chicago, IL
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Ntovas P, Loubrinis N, Maniatakos P, Rahiotis C. Evaluation of dental explorer and visual inspection for the detection of residual caries among Greek dentists. J Conserv Dent 2018; 21:311-318. [PMID: 29899636 PMCID: PMC5977782 DOI: 10.4103/jcd.jcd_67_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives The objective of this study was to assess the effect of the operator's degree of clinical experience on the residual caries diagnosis through visual inspection and tactile sensation. Materials and Methods The participants were asked about the years of their clinical practice, any further training concerning cariology, their familiarity with the minimal invasive philosophy, and the techniques that they use to remove dental caries and detect when to stop the removal of carious tissues. In addition, an in vitro diagnostic test was conducted. Carious teeth were excavated to a level selected in random. Teeth were examined by each participant individually. Initial examination was performed by visual inspection. Subsequently, a dental explorer was used concerning the potential need for further removal of dental tissues. A sample of 380 dentists and dental school students were selected for the purposes of this study. Results Dental students presented statistically significant better sensitivity, than dentists from both age groups, during both visual inspection and tactile sensation of residual caries. Participants' ability to diagnose residual caries during cavity preparation was independent of their years of experience. Conclusions During the removal of carious lesions, with the goal of limiting the sacrifice of healthy structures and the leftover of residual caries, clinicians should combine a selective removal technique and the attentive visual inspection, with at least one further diagnostic method, aside from the dental explorer. Tactile examination of residual caries solely with the dental explorer must be used with attention.
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Affiliation(s)
- Panagiotis Ntovas
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | - Nikolaos Loubrinis
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | - Panagiotis Maniatakos
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | - Christos Rahiotis
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
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11
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Medioni E, Rocca JP, Fornaini C, Merigo E. Histological evaluation of three techniques for caries removal. J Oral Sci 2017; 58:583-589. [PMID: 28025444 DOI: 10.2334/josnusd.16-0225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
A number of concepts and devices have been proposed for caries removal. Among these, the Er:YAG laser is a potential alternative to conventional mechanical treatment. This study compared the effectiveness of the Er:YAG laser with that of low-speed rotary instruments for removal of carious tissue in 26 extracted human molars and premolars with severe decay (i.e., large occlusal or proximal decay but no pulpal contact). The teeth were divided into three groups of eight teeth, and two teeth were used as controls. After sectioning all the teeth through the center of the carious lesion before excavation, each group was randomly assigned to three groups-Er:YAG laser versus tungsten bur, Er:YAG laser versus polymer bur, and polymer bur versus tungsten bur-to evaluate the efficacy of the three techniques. The time required for carious treatment of each half was recorded, and samples were then histologically examined. Mean duration of caries removal did not significantly differ in relation to the technique used. Histological analysis of tooth halves treated with the Er:YAG laser revealed a regular 5-µm-thick stained layer that appeared to be denatured collagen. A smear layer was often detectable in halves treated with carbide burs. A superficial disorganized layer, which was found to be affected dentin, was observed in halves treated with polymer burs. The present findings indicate that the three techniques were clinically and histologically effective in removing the infected dentin layer.(J Oral Sci 58, 583-589, 2016).
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Affiliation(s)
- Etienne Medioni
- Micoralis Laboratory EA 7354, Faculty of Dentistry, University of Nice Sophia Antipolis
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Giacomini MC, Scaffa PMC, Chaves LP, Vidal CMP, Machado TN, Honório HM, Tjäderhane L, Wang L. Role of Proteolytic Enzyme Inhibitors on Carious and Eroded Dentin Associated With a Universal Bonding System. Oper Dent 2017; 42:E188-E196. [DOI: 10.2341/16-178-l] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives: The aim of this study was to evaluate the effect of proteolytic inhibitors on the bond strength of a universal adhesive system (etch-and-rinse mode) applied to artificial carious and eroded dentin. Methods: Ninety molars were prepared and randomly divided into three groups according to the substrate: N, no challenges; ACD, artificial carious dentin simulation and ERO, artificial erosion simulation with orange juice. All groups were redivided into three subgroups according to the dentin pretreatment: W, water; CHX, 2% digluconate chlorhexidine; and E-64 (trans-epoxysuccinyl-L-leucylamido-[4-guanidino] butane), 5 μM E-64 inhibitor. They constituted a total of nine groups (n=10): N-W, N-CHX, N-E64, ACD-W, ACD-CHX, ACD-E64, ERO-W, ERO-CHX, and ERO-E64. All specimens were restored with Adper Single Bond Universal/Filtek Z250. Beams (0.64 mm2) were obtained and subjected to the microtensile test (μTBS) in a universal testing machine at 0.5 mm/min. The failure mode of the interfaces was determined by optical microscopy (40× magnification). Data were statistically analyzed by three-way analysis of variance and Tukey tests (p<0.05). Results: All individual factors (p<0.0001) and the interaction between substrate and treatment (p=0.0011) and between substrate and time (p=0.0003) were statistically significant. The caries substrate contributed negatively to bond strength. Chlorhexidine reduced bond strength for normal and eroded conditions. Only the normal substrate was negatively affected by time despite the pretreatment. Conclusions: The universal bonding system appears to be a promising bonding strategy for the maintenance of bond strength to affected dentin. E-64 did not affect bonding to the dentin in contrast to the use of chlorhexidine, which, when associated with the universal system, did affect the microtensile bond strength for artificial carious dentin.
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Affiliation(s)
- MC Giacomini
- Marina Ciccone Giacomini, DDS, MS, PhD student, Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - PMC Scaffa
- Polliana Mendes Candia Scaffa, DDS, MS, PhD, postdoctoral student, Department of Biological Science, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - LP Chaves
- Larissa Pinceli Chaves, DDS, MS, PhD, Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - CMP Vidal
- Cristina de Mattos Pimenta Vidal, DDS, MS, PhD, assistant professor, Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - TN Machado
- Thaís Nayara Machado, DDS, Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - HM Honório
- Heitor Marques Honório, DDS, MS, PhD, associate professor, Department of Pediatric Dentistry, Orthodontics, and Collective Health, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - L Wang
- Linda Wang, DDS, MS, PhD, associate professor, Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
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Hassan AF, Yadav G, Tripathi AM, Mehrotra M, Saha S, Garg N. A Comparative Evaluation of the Efficacy of Different Caries Excavation Techniques in reducing the Cariogenic Flora: An in vivo Study. Int J Clin Pediatr Dent 2016; 9:214-217. [PMID: 27843252 PMCID: PMC5086008 DOI: 10.5005/jp-journals-10005-1366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/02/2016] [Indexed: 11/23/2022] Open
Abstract
Background Caries excavation is a noninvasive technique of caries removal with maximum preservation of healthy tooth structure. Aim To compare the efficacy of three different caries excavation techniques in reducing the count of cariogenic flora. Materials and methods Sixty healthy primary molars were selected from 26 healthy children with occlusal carious lesions without pulpal involvement and divided into three groups in which caries excavation was done with the help of (1) carbide bur; (2) polymer bur using slow-speed handpiece; and (3) ultrasonic tip with ultrasonic machine. Samples were collected before and after caries excavation for microbiological analysis with the help of sterile sharp spoon excavator. Samples were inoculated on blood agar plate and incubated at 37°C for 48 hours. After bacterial cultivation, the bacterial count of Streptococcus mutans was obtained. Statistical analysis All statistical analysis was performed using SPSS 13 statistical software version. Kruskal-Wallis analysis of variance, Wilcoxon matched pairs test, and Z test were performed to reveal the statistical significance. Results The decrease in bacterial count of S. mutans before and after caries excavation was significant (p < 0.001) in all the three groups. Conclusion Carbide bur showed most efficient reduction in cariogenic flora, while ultrasonic tip showed almost comparable results, while polymer bur showed least reduction in cariogenic flora after caries excavation. How to cite this article Hassan AF, Yadav G, Tripathi AM, Mehrotra M, Saha S, Garg N. A Comparative Evaluation of the Efficacy of Different Caries Excavation Techniques in reducing the Cariogenic Flora: An in vivo Study. Int J Clin Pediatr Dent 2016;9(3):214-217.
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Affiliation(s)
- Afrah Fatima Hassan
- Student, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gunjan Yadav
- Reader, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhay Mani Tripathi
- Professor, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Mridul Mehrotra
- Professor, Department of Microbiology, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sonali Saha
- Reader, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nishita Garg
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Ferraz C, Freire AR, Mendonça JS, Fernandes CAO, Cardona JC, Yamauti M. Effectiveness of Different Mechanical Methods on Dentin Caries Removal: Micro-CT and Digital Image Evaluation. Oper Dent 2015; 40:263-70. [PMID: 25575196 DOI: 10.2341/13-278-l] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To determine the caries removal effectiveness (CRE) and minimal invasive potential (MIP) of caries excavation methods using digital imaging and microtomography analyses. METHODS Twelve human molars with occlusal caries lesions in dentin were randomly divided into three groups (carbide bur, exacavator, and polymer bur). They were sectioned mesiodistally, and standardized digital and computed microtomography x-ray (micro-CT) images were taken from each section before and after caries excavation. On each image, initial carious dentin (IC), prepared cavity (PC), and residual caries (RC) were defined according to visual criteria using ImageJ software. CRE was determined based on the RC/IC ratio, whereas MIP was determined by the PC/IC ratio. Data were analyzed using one-way analysis of variance and Student t-test or with Kruskal-Wallis and Student-Newman-Keuls test. The level of significance was set at 0.05. RESULTS For both digital image and micro-CT analysis, the carbide bur showed higher CRE values than the excavator (p=0.0063 and p=0.0263, respectively) and the polymer bur (p=0.0028 and p=0.0005, respectively). The latter two presented similar results (p>0.05). Regarding MIP, for the digital image analysis, the polymer bur was different from the carbide bur (p=0.0030) but was not different from that of the excavator (p=0.1240). For micro-CT analysis, the MIP values of all the groups were significantly different, and the polymer bur was the most conservative method (p<0.05). CONCLUSIONS The carbide bur was the most effective method for caries removal but was not completely conservative. The polymer bur and excavator presented low invasive potential but were not able to remove all of the carious dentin.
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15
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Schwendicke F, Paris S, Tu YK. Effects of using different criteria for caries removal: A systematic review and network meta-analysis. J Dent 2015; 43:1-15. [DOI: 10.1016/j.jdent.2014.10.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 10/10/2014] [Accepted: 10/13/2014] [Indexed: 11/15/2022] Open
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Toledano M, Ghinea R, Cardona JC, Cabello I, Yamauti M, Pérez MM, Osorio R. Digital image analysis method to assess the performance of conventional and self-limiting concepts in dentine caries removal. J Dent 2013; 41 Suppl 3:e31-8. [PMID: 23507398 DOI: 10.1016/j.jdent.2013.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 02/27/2013] [Accepted: 03/01/2013] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To assess dentine caries removal effectiveness (CRE) and minimal invasiveness potential (MIP) of carbide and polymer burs. METHODS Sectioned carious molars were photographed. Digital images were taken, before and after caries removal, using a Digital Single Lens Reflex camera. The following regions of interest were measured using visual criteria: Residual Infected Dentine (RI), Residual Affected Dentine (RA), Removal Sound Dentine (RA), Prepared Cavity (PC) and Removed Sound Dentine (RS). CRE was determined on basis of: relative residual infected dentine (RI/II), relative residual carious-affected dentine (RA/IA) and total relative residual dentine (RI+RA/II-IA). MIP was determined on basis of: infected dentine cavity size (PC/II), total relative cavity size (PC/II+IA), and corrected relative cavity size (PC-RS/II+IA). RESULTS The polymer bur showed the highest preservation of carious-affected dentine after excavation, when the RA/IA ratio was studied. Both kind of burs showed similar values after assessing the RI/II and RI+RA/II-IA ratios. The infected dentine relative cavity size (PC/II) was higher when the carbide bur was used. Both burs attained similar PC/II+IA and PC-RS/II+IA ratios. CONCLUSIONS Polymer burs accomplished the concept of minimal-invasive dentistry, showing its self-limiting ability. The minimal-invasiveness potential showed that carbide burs resulted in the worst compromise between effective and selective infected-caries removal.
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Affiliation(s)
- Manuel Toledano
- University of Granada, School of Dentistry, Dental Materials, Campus de Cartuja, s/n, 18071 Granada, Spain.
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Toledano M, Cabello I, Yamauti M, Osorio R. Differential resin-dentin bonds created after caries removal with polymer burs. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2012; 18:497-508. [PMID: 22640962 DOI: 10.1017/s1431927612000074] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The objective of this article was to investigate the effect of carbide and polymer burs caries removal methods on the bond strength of different adhesives to dentin. Resin restorations were performed in sound and caries-affected dentin, after using polymer or carbide burs and bonding with four different adhesive (Single bond, SB; Clearfil SE bond, SEB; FL-Bond II, FLB; and Fuji II-LC, FUJI). Microtensile bond strength (MTBS) was measured. Data were analyzed with ANOVA and Student-Newman-Keuls tests. Debonded surfaces were observed by scanning electron microscopy. Bonded interfaces were examined using light microscopy (Masson's trichrome staining). In sound dentin, MTBS was similar for SEB and SB, and higher than that of FLB and FUJI. Bond strength to carbide bur prepared dentin was similar for SB, SEB, and FLB; FUJI presented the lowest. SB applied on polymer bur excavated dentin presented similar values to those of the carbide bur group; MTBS attained by SEB, FLB, and FUJI decreased when bonding to dentin treated with polymer burs; FUJI yielded pretesting failures in all specimens. Polymer burs created a thick smear layer that was not infiltrated by tested self-etching agents. The bonding effectiveness of self-etching and glass-ionomer-like adhesives to dentin decreased when polymer burs were used.
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Affiliation(s)
- Manuel Toledano
- Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja, University of Granada, 18071 Granada, Spain
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Qi YP, Li N, Niu LN, Primus CM, Ling JQ, Pashley DH, Tay FR. Remineralization of artificial dentinal caries lesions by biomimetically modified mineral trioxide aggregate. Acta Biomater 2012; 8:836-42. [PMID: 22085925 DOI: 10.1016/j.actbio.2011.10.033] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 09/23/2011] [Accepted: 10/26/2011] [Indexed: 01/20/2023]
Abstract
Fluoride-releasing restorative materials are available for remineralization of enamel and root caries. However, remineralization of dentin is more difficult than remineralization of enamel due to the paucity of apatite seed crystallites along the lesion surface for heterogeneous crystal growth. Extracellular matrix proteins play critical roles in controlling apatite nucleation/growth in collagenous tissues. This study examined the remineralization efficacy of mineral trioxide aggregate (MTA) in phosphate-containing simulated body fluid (SBF) by incorporating polyacrylic acid and sodium tripolyphosphate as biomimetic analogs of matrix proteins for remineralizing caries-like dentin. Artificial caries-like dentin lesions incubated in SBF were remineralized over a 6 week period using MTA alone or MTA containing biomimetic analogs in the absence or presence of dentin adhesive application. Lesion depths and integrated mineral loss were monitored with microcomputed tomography. The ultrastructure of baseline and remineralized lesions was examined by transmission electron microscopy. Dentin remineralization was best achieved using MTA containing biomimetic analogs regardless of whether an adhesive was applied; dentinal tubules within the remineralized dentin were occluded by apatite. It is concluded that the version of MTA employed in this study may be doped with biomimetic analogs for remineralization of unbonded and bonded artificial caries-like lesions in the presence of SBF.
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Mobarak EH. Effect of Chlorhexidine Pretreatment on Bond Strength Durability of Caries–affected Dentin Over 2-Year Aging in Artificial Saliva and Under Simulated Intrapulpal Pressure. Oper Dent 2011; 36:649-60. [DOI: 10.2341/11-018-l] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective
To evaluate the influence of 2% and 5% chlorhexidine (CHX) pretreatment on bond durability of a self-etching adhesive to normal (ND) and caries-affected (AD) dentin after 2-years of aging in artificial saliva and under simulated intrapulpal pressure (IPP).
Methods
One hundred twenty freshly extracted carious teeth were ground to expose ND and AD. Specimens were distributed into three equal groups (n=40) according to whether the dentin substrates were pretreated with 2% or 5% CHX or with water (control). Clearfil SE Bond (Kuraray) was applied to both substrates and composite cylinders (0.9 mm diameter and 0.7 mm height) were formed. Pretreatment and bonding were done while the specimens were subjected to 15 mm Hg IPP. After curing, specimens were aged in artificial saliva at 37°C and under IPP at 20 mm Hg until being tested after 24 hours or 2 years (n=20/group). Microshear bond strength was evaluated. Failure modes were determined using a scanning electron microscope (SEM) at 400× magnification. Data were statistically analyzed using three-way analysis of variance (ANOVA); one-way ANOVA tests, and t-test (p<0.05). Additional specimens (n=5/group) were prepared to evaluate interfacial silver precipitation.
Results
For the 24-hour groups, there were no significant differences among the ND groups and AD groups. For ND aged specimens, the 5% CHX group had the highest value followed by the 2% CHX and control groups, although the difference was statistically insignificant. For AD aged specimens, the 5% CHX group revealed statistically higher bond values compared to the 2% CHX and control groups. Fracture modes were predominately adhesive and mixed. Different interfacial silver depositions were recorded.
Conclusions
Two percent or 5% CHX pretreatment has no adverse effect on the 24-hour bonding to ND and AD. Five percent CHX was able to diminish the loss in bonding to AD after 2years of aging in artificial saliva and under simulated IPP.
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Cardoso MV, de Almeida Neves A, Mine A, Coutinho E, Van Landuyt K, De Munck J, Van Meerbeek B. Current aspects on bonding effectiveness and stability in adhesive dentistry. Aust Dent J 2011; 56 Suppl 1:31-44. [PMID: 21564114 DOI: 10.1111/j.1834-7819.2011.01294.x] [Citation(s) in RCA: 202] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M V Cardoso
- Catholic University of Leuven, School of Dentistry, Oral Pathology and Maxillo-facial Surgery, Department of Conservative Dentistry, Leuven BIOMAT Research Cluster, Leuven, Belgium
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Yang B, Flaim G, Dickens SH. Remineralization of human natural caries and artificial caries-like lesions with an experimental whisker-reinforced ART composite. Acta Biomater 2011; 7:2303-9. [PMID: 21232637 DOI: 10.1016/j.actbio.2011.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 12/07/2010] [Accepted: 01/05/2011] [Indexed: 11/30/2022]
Abstract
This paper compares the remineralization of human natural caries and artificial caries-like dentin lesions treated with a novel whisker-reinforced experimental composite resin (ART composite) with a resin-modified glass ionomer cement (RM-GIC) as control. Ten molars with moderate natural dentin caries were prepared (N). Artificial caries-like dentin lesions were prepared in occlusal dentin of 10 caries-free molars and demineralized at pH 4.3 for 48 h (A). The cavities were restored with ART composite or RM-GIC. All restored teeth were sliced into 120 μm sections. Transverse microradiography combined with digital image analysis was performed to analyze the change in mineral density at the same position in the specimens before and after 4 and 8 weeks remineralization/demineralization treatment. The mean percent remineralization ± standard deviation after 4 and 8 weeks are: N with ART composite, 27 ± 9 and 46 ± 14, respectively; N with RM-GIC, 18 ± 6 and 36 ± 11, respectively; A with ART composite, 48 ± 9 and 66 ± 11, respectively; A with RM-GIC, 50 ± 13 and 62 ± 11, respectively. There was a significant difference between the ART composite and RM-GIC for the remineralization of natural caries (P<0.05). For both restoratives there were significant differences between the remineralization of natural and artificial caries (P<0.001). The ART composite and RM-GIC remineralized natural and artificial caries differently, most likely due to differences in the microstructure and composition of the caries dentin.
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Affiliation(s)
- Bin Yang
- American Dental Association Foundation, Paffenbarger Research Center, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA.
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Neves ADA, Coutinho E, Cardoso MV, de Munck J, Van Meerbeek B. Micro-tensile bond strength and interfacial characterization of an adhesive bonded to dentin prepared by contemporary caries-excavation techniques. Dent Mater 2011; 27:552-62. [PMID: 21489617 DOI: 10.1016/j.dental.2011.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 10/24/2010] [Accepted: 02/15/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the micro-tensile bond strength (μTBS) and interfacial characteristics of adhesive-dentin bonds produced after caries-removal with contemporary techniques. METHODS Carious molars were cut at the base of the fissure, exposing 'sound' and 'carious' dentin at different spots. After caries-excavation, a composite was bonded using a 2-step self-etch adhesive. The μTBS was measured and the mode of fracture analyzed using a stereomicroscope and imaged by Feg-SEM, while additional non-fractured specimens were histologically analyzed after Masson's trichrome staining in order to identify potentially incompletely resin-enveloped collagen. RESULTS μTBS to residual caries-excavated dentin was lower than to sound dentin. The different caries-removing techniques had a significant effect on the μTBS. Er:YAG laser guided by a LIF-feedback system (Kavo) resulted in the lowest μTBS (26.8% lower than to 'sound' dentin) and a distinct layer of incompletely resin-enveloped collagen at the interface. Although different degrees of collagen exposure were seen for other caries-removing techniques, such as a thick layer for CeraBur (Komet-Brasseler), some unprotected collagen areas for Cariex (Kavo), or completely resin-enveloped collagen for a tungsten-carbide-bur (Komet), the μTBS appeared not directly affected (10%, 16.6%, and 15.3% lower than to 'sound' dentin, respectively). Carisolv (MediTeam) resulted in the highest μTBS (only 1% reduction compared to that to 'sound' dentin), followed by the tungsten-carbide-bur aided by Caries Detector (Kuraray) (4.8% reduction). Enzymatic caries excavation using the experimental SFC-VIII (3M-ESPE) aided by a disposable plastic instrument resulted in a 19.4% reduction in μTBS as compared to that to 'sound' dentin. SIGNIFICANCE The dentin bonding receptiveness depends to a large extent on the caries-excavation method employed.
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Affiliation(s)
- Aline de A Neves
- Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, Leuven, Belgium
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The use of sodium trimetaphosphate as a biomimetic analog of matrix phosphoproteins for remineralization of artificial caries-like dentin. Dent Mater 2011; 27:465-77. [PMID: 21354608 DOI: 10.1016/j.dental.2011.01.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 01/19/2011] [Accepted: 01/24/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study examined the use of sodium trimetaphosphate (STMP) as a biomimetic analog of matrix phosphoproteins for remineralization of artificial carious-affected dentin. METHODS Artificial carious lesions with lesion depths of 300±30μm were created by pH-cycling. 2.5% hydrolyzed STMP was applied to the artificial carious lesions to phosphorylate the partially-demineralized collagen matrix. Half of the STMP-treated specimens were bonded with One-Step. The adhesive and non-adhesive infiltrated specimens were remineralized in a Portland cement-simulated body fluid system containing polyacrylic acid (PAA) to stabilize amorphous calcium phosphate as nanoprecursors. Micro-computed tomography (micro-CT) and transmission electron microscopy (TEM) were used to evaluate the results of remineralization after a 4-month period. RESULTS In absence of PAA and STMP as biomimetic analogs (control groups), there was no remineralization irrespective of whether the lesions were infiltrated with adhesive. For the STMP-treated experimental groups immersed in PAA-containing simulated body fluid, specimens without adhesive infiltration were more heavily remineralized than those infiltrated with adhesive. Statistical analysis of the 4-month micro-CT data revealed significant differences in the lesion depth, relative mineral content along the lesion surface and changes in ΔZ between the non-adhesive and adhesive experimental groups (p<0.05 for all the three parameters). TEM examination indicated that collagen degradation occurred in both the non-adhesive and adhesive control and experimental groups after 4 months of remineralization. SIGNIFICANCE Biomimetic remineralization using STMP is a promising method to remineralize artificial carious lesions particularly in areas devoid of seed crystallites. Future studies should consider the incorporation of MMP-inhibitors within the partially-demineralized collagen matrix to prevent collagen degradation during remineralization.
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Dental caries: Therapeutic possibilities. SRP ARK CELOK LEK 2008; 136:662-6. [DOI: 10.2298/sarh0812662p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Contemporary tendencies in dentistry are based on the concept of maximal protection of healthy tooth tissues. Caries removal has been done traditionally with mechanical rotary instruments that are fast and precise. However, conventional cavity preparation has potential adverse effects to the pulp due to heat, pressure and vibrations. Moreover, drilling often causes pain and requires local anaesthesia, and these procedures are frequently perceived as unpleasant. Etiology, development and prevention of dental caries are better understood today and new restorative materials that bond micromechanically and/or chemically to dental tissues have been introduced. Thus, development of a new, less destructive caries removal technique is allowed. In the last decades, many alternative methods have been introduced in an attempt to replace rotary instruments. These are claimed to be efficient and selective for diseased tissues and to offer comfortable treatment to the patients. New methods include air abrasion, air polishing, ultrasonic, polymer burs, enzymes, systems for chemo-mechanical caries removal, and lasers. The aim of this paper was to discuss various caries removal techniques and possibilities of their use in clinical practice. Based on the literature review it can be concluded that none of the new caries removal methods can completely replace conventional rotary instruments.
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Hosoya Y, Tay FR. Hardness, elasticity, and ultrastructure of bonded sound and caries-affected primary tooth dentin. J Biomed Mater Res B Appl Biomater 2007; 81:135-41. [PMID: 16941582 DOI: 10.1002/jbm.b.30646] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Biomechanical properties of bonded dentin are important factors for resin restoration. We evaluated the hardness and elastic modulus of bonded sound and caries-affected primary tooth dentin using a one-step adhesive system, and observed the microstructure of the bonded interface. Six sound and six carious primary teeth were used. For sound teeth, flat occlusal dentin surfaces were prepared with a water-cooled high-speed diamond bur. For carious teeth, infected dentin was stained with a caries detector and removed with a water-cooled low-speed round steel bur and hand instruments. The prepared dentin was bonded with One-Up Bond F Plus (Tokuyama Dental Co., Tokyo, Japan). The resin-dentin interface and dentin beneath the interface were measured with a nano-indentation tester and observed with SEM and TEM. For both the carious and sound teeth, there was no significant difference between the hardness of the interfacial dentin and dentin 10-80 microm beneath the interface. However, the Young's modulus of the interfacial dentin was significantly lower than the dentin 40-80 microm (carious teeth) or 50-80 microm (sound teeth) beneath the interface. Both the hardness and Young's modulus of the interfacial dentin were not significantly different between the carious and sound teeth. Compared to the sound dentin, the hybrid layer on the caries-affected dentin was thicker and exhibited more complicated morphologic features. The thickness of the hybrid layers was generally less than 1 microm.
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Affiliation(s)
- Y Hosoya
- Division of Pediatric Dentistry, Department of Developmental and Reconstructive Medicine, Course of Medical and Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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