Effect of borate, fluoride and strontium ions on biomimetic nucleation of calcium phosphate studied using solid-state nuclear magnetic resonance and X-ray diffraction

OBJECTIVES

Apatite minerals can have various anions and cations in their crystal structure in addition to phosphate ion (PO₄³⁻) and calcium ion (Ca2+). The aim of this study is to investigate effects of the borate, fluoride and strontium ions on biomimetic nucleation of calcium phosphate.

METHODS

Nano-crystalline hydroxyapatite (H-Ap) was obtained from a supersaturated buffered solution containing 4.12 mM HPO42- and 5.88 mM Ca2+ (H-Ap). Four additives were used in solid solution methods: (i) 0.588 mM F- (F-Ap), (ii) 5.88 mM Sr2+ (Sr-Ap), (iii) 4.12 mM BO33- (BO3-Ap), and (iv) a surface pre-reacted glass ionomer (S-PRG) filler eluate that contained 0.17 mM Sr2+, 0.588 mM F-, 11.1 mM BO33-- (SPRG-Ap). Apatite crystallization was investigated using a solid-state magic-angle spinning NMR spectroscopy and X-ray diffraction (XRD) with the Rietveld analysis.

RESULTS

A 2D 1H-31P heteronuclear-correlation NMR showed F- ion incorporation in the apatite structure of the F-Ap and SPRG-Ap. The peaks on the 31P axis of the F-Ap, Sr-Ap, and BO3-Ap were different from that of the H-Ap, and the full width at half maximum increased in the following order: H-Ap∼F-Ap∼BO3-Ap< SPRG-Ap< Sr-Ap, suggesting the incorporation of the F-, Sr2+ and BO33-. The incorporation of F and BO3 was further confirmed by 19F and 11B NMR. The XRD revealed that Sr2+ was preferentially incorporated into the CaII site.

SIGNIFICANCE

The F-, Sr2+ and BO33-ions might be involved in modifying the crystallization of apatite precipitation, producing a variety of apatite. S-PRG filler that release these ions may have an effect on remineralization, i.e., the reformation of apatite lost due to caries.

Influence of surface pre-reacted glass-ionomer (S-PRG) filler eluate on collagen morphology, remineralization, and ultimate tensile strength of demineralized dentin

OBJECTIVE

To evaluate the effect of ions released from surface pre-reacted glass-ionomer (S-PRG) filler on collagen morphology, remineralization, and ultimate tensile strength (UTS) of demineralized dentin.

MATERIALS AND METHODS

Bovine incisor root dentins were demineralized with EDTA and divided into three treatment groups: 1) water (control); 2) S-PRG filler eluate; 3) 125 ppm sodium fluoride (NaF). After a 3-min treatment, the specimens were stored in simulated body fluid (SBF) for 3 months. Collagen morphology and remineralization were assessed using transmission electron microscopy (TEM), scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR). Additionally, ultimate tensile strength (UTS) was measured.

RESULTS

TEM and SEM demonstrated that S-PRG induced more effective remineralization compared to NaF, while the control group exhibited faint mineral deposition with collagen degradation. S-PRG displayed the most homogenous mineral deposition in collagen fibrils, along with closure of interfibrillar spaces. Extensive mineral precipitation was observed within dentinal tubules in the S-PRG group. In addition, S-PRG filler eluate demonstrated significantly higher phosphate-to-amide ratio and UTS compared to NaF and control groups (p < 0.05).

CONCLUSIONS

Ion released from S-PRG filler positively influenced collagen morphology, remineralization, and ultimate tensile strength of demineralized dentin.

CLINICAL SIGNIFICANCE

S-PRG filler enhances remineralization and improve the biomechanics of demineralized dentin.

In vitro remineralization assessment of enamel subsurface lesions using different percentages of surface reaction-type pre-reacted glass-ionomer containing gum-based material

OBJECTIVE

To identify the remineralization activity of enamel subsurface lesions using different percentages of surface pre-reacted glass-ionomer (S-PRG) filler containing gum-base material.

METHODS

Gum extracts from gum-base materials containing 0wt%, 5wt%, and 10wt% S-PRG filler were prepared as GE0, GE5, and GE10, respectively. A total of 50 bovine enamel specimens were used, and the polished enamel surface of a 3 × 3 mm2 window area was exposed. The specimens were then subjected to a demineralization solution for seven days to create a subsurface enamel lesion. Remineralization was then conducted for seven days using a protocol whereby the specimens were immersed three times a day in prepared gum extracts (0wt%, 5wt%, and 10wt%) and artificial saliva of pH 7 (Control) for 20 min at 37 °C. Thereafter, remineralization assessment was performed by using Swept Source Optical Coherence Tomography (SS-OCT) and micro-computed tomography (μCT). Surface morphology and elemental analysis were conducted by scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS).

RESULTS

The depths of the demineralized lesions in the GE5 and GE10 groups were significantly lower than those of the Control and the GE0 groups. SEM observations of the enamel surface morphology of the GE5 and GE10 groups indicated remineralization with S-PRG filler-related elements present.

CONCLUSION

The GE5 and GE10 S-PRG filler containing gum-base materials showed significantly improved surface remineralization and reduced demineralization of the enamel lesions. EDS analysis suggested that the released ions from the S-PRG filler might be responsible for surface remineralization.

CLINICAL SIGNIFICANCE

The S-PRG filler containing gum-base material may have a significant remineralization effect and improve the surface morphology of enamel subsurface lesions.

Effect of an In-Office Bleaching Agent with Surface Pre-Reacted Glass-Ionomer Filler on the Enamel Surface: A In-Vitro Study

In-office bleaching with high concentrations of hydrogen peroxide (H₂O₂) agents causes undesirable alterations in the enamel. Surface pre-reacted glass-ionomer (S-PRG) filler is a functional material known for its acid-neutralizing and demineralization-inhibition properties. This study evaluates the effect of S-PRG filler incorporation in H₂O₂-based bleaching on the enamel surface. Bovine enamel surfaces were bleached using a bleaching paste formulated with a liquid (35% H₂O₂) and a powder containing 5% or 10% S-PRG filler. The surface roughness and the Vickers microhardness of the treated enamel surfaces were evaluated. The enamel surfaces were observed under a scanning electron microscope (SEM) and analyzed using energy dispersive X-ray (EDX) technology. The surfaces were challenged by citric acid and observed by SEM. The specimens bleached with the paste containing the S-PRG filler showed lower enamel surface roughness and higher microhardness values than did those bleached with the plain paste (0% S-PRG filler); meanwhile, there were no significant differences between the 5% or 10% S-PRG filler groups. The S-PRG filler groups showed enamel surface morphologies similar to those of the non-bleached enamel, according to SEM observation, and EDX analysis detected the presence of fluoride and strontium ions. The S-PRG filler groups showed a higher resistance to erosion. The S-PRG filler mitigated the detrimental effects of bleaching agents on the enamel surface and provided resistance to erosion.

Noninvasive diagnostic method using optical coherence tomography detected a vulnerable dentin enamel junction created by phosphoric acid etching

To investigate the influence of phosphoric acid etching on the dentin enamel junction (DEJ) using optical coherence tomography (OCT). Human teeth were assigned to four groups: 1. control, no additional treatment (CT); 2. The primer of "SE Bond2" was applied (SE), 3. "Enamel Conditioner" was applied (EC), 4. "K-etchant syringe" was applied (KE). After treatment, the DEJ was observed using a laser microscope (CLSM), OCT, and scanning electron microscopy (SEM). Additionally, an ultimate tensile strength (UTS) test at the DEJ was performed. No cracks were observed by CLSM. In contrast, cracks were observed all samples by SEM. Additionally, OCT revealed a white line along the DEJ in all KE specimens and some EC specimens. The UTS test showed a significant difference between CT and KE. This study found that phosphoric acid etching may cause excessive demineralization and weaken the DEJ. This fragility was observed using a non-invasive diagnostic method using OCT.

The bleaching effect of office bleaching agents containing S-PRG filler evaluated by pH value and electron spin resonance

OBJECTIVES

Surface reaction-type pre-reacted glass-ionomer (S-PRG) filler releases six types of ions with a neutralizing ability. This study evaluated the effect of S-PRG filler incorporation in an H₂O₂-based bleaching material on the bleaching efficacy, pH, and reaction state.

MATERIALS AND METHODS

The experimental bleaching material was formulated by the addition of 5% or 10% S-PRG fillers to the powder part. The stained bovine teeth were treated with the prepared bleaching paste. Commission internationale de l'éclairage (CIE) L*a*b* color space values were recorded before and after bleaching, and the color difference (ΔE) and whiteness index (WI_D) were calculated. Moreover, the used bleaching formulations were assessed for their pH values and reaction state by evaluating the oxidation state of manganese (Mn⁺²) using electron spin resonance (ESR).

RESULTS

The results of ΔE and WI_D showed that the addition of S-PRG filler increased the bleaching effect, but there was no significant difference between the groups with 5% and 10% S-PRG filler. A significant increase in pH in S-PRG filler groups (5% pH 6.7, 10% pH 6.8) was found compared to the 0% group (pH 4.8). ESR measurements showed that the signal emitted from Mn⁺² decreased over time. The S-PRG filler groups showed a significantly higher reduction in Mn⁺² compared to the 0% group, with no significant difference between the 5% and 10% S-PRG groups.

CONCLUSIONS

S-PRG filler addition resulted in improved bleaching efficacy, higher reaction rate, and pH values that are close to neutral.

CLINICAL RELEVANCE

S-PRG filler addition may be effective on the bleaching outcome of H₂O₂-based materials.

Polymerization shrinkage of light-cured conventional and bulk-fill composites -The effect of cavity depth and post-curing

Volumetric shrinkage (VS) of conventional, bulk-fill, and core build-up resin-based composites (RBCs) of various thickness (1-5 mm) was measured using the modified bonded-disk method with confocal laser scanning microscopy. Additionally, the bottom-to-top ratio of Vickers hardness (%VH) was measured. Conventional RBCs exhibited significantly higher VS than bulk-fill and core build-up RBCs (p<0.05). As specimen thickness increased, VS relative to volume (%VS) and difference in VS at each depth (VS_depth) decreased. For conventional RBCs, there was a significant drop in VS_depth between 1 mm and 2 mm (p<0.05), and another drop was observed between 3 mm and 4 mm (p<0.05) where %VH decreased below 90%. For bulk-fill and core build-up RBCs, VS_depth decreased significantly between 2 mm and 3 mm (p<0.05), but %VH exceeded 90% even in 5 mm deep cavities. These results indicated that post-curing contributed to lower shrinkage in deeper layers, and that conventional RBCs were not adequately polymerized at the depth of over 3 mm.

Effect of Er: YAG laser irradiation with additional low energy on resin-dentin bonding and morphology of bonded interface

OBJECTIVES

To examine the micro tensile bond strength (μTBS) and the resin-dentin interface on a laser-irradiated dentin surface using two different irradiation methods, with or without additional low-energy irradiation.

METHODS

The flat bovine dentin surface was divided into three groups: i). control group (C group, no irradiation), ii) 80 mJ/pulse Er: YAG laser group (80 group), iii) 80 + 30 mJ/pulse Er: YAG laser group (80 + 30 group, with an additional 30 mJ/pulse). After the roughness of the dentin surface was recorded, Clearfil SE Bond 2 or Clearfil Universal Bond Quick (Kuraray Noritake Dental Inc., Tokyo, Japan) was applied. After the μTBS testing, the failure mode was observed. The bonded interface was assessed using Rhodamine-dye incorporated adhesives and observed by optical coherence tomography.

RESULTS

The dentin surface showed opened dentinal tubules without a smear layer after irradiation. For both adhesives, the μTBS was significantly higher in 80 + 30 group than in the 80 group (p < 0.05). In the 80 group, the thickness of the adhesive layer was not uniform, and the dentin surface was occasionally in direct contact with the composite resin. The failure mode images showed that most of the fractures in the 80 group were at the sub-surface of irradiated dentin. The adhesive layers of the 80 + 30 groups were homogeneous.

CONCLUSIONS

The dentin surface was rough and irregular by 80 mJ irradiation, which might result in an inadequate resin-dentin interface and the weak μTBS. The bonded integrity was mitigated by additional irradiation.

Crystallographic and Physicochemical Analysis of Bovine and Human Teeth Using X-ray Diffraction and Solid-State Nuclear Magnetic Resonance

Dental research often uses bovine teeth as a substitute for human teeth. The aim of this study was to evaluate differences in the crystalline nanostructures of enamel and dentin between bovine and human teeth, using X-ray diffraction (XRD) and solid-state nuclear magnetic resonance (NMR). The crystallite size (crystallinity) and microstrains were analyzed using XRD with the Rietveld refinement technique and the Halder-Wagner method. The ³¹P and ¹H NMR chemical environments were analyzed by two-dimensional (2D) ¹H-³¹P heteronuclear-correlation (HETCOR) magic-angle spinning (MAS) NMR spectroscopy. Enamel had a greater crystallite size and fewer microstrains than dentin for both bovine and human teeth. When compared between the species, the bovine apatite had a smaller crystallite size with more microstrains than the human apatite for both dentin and enamel. The 2D HETCOR spectra demonstrated that a water-rich layer and inorganic HPO₄^- ions were abundant in dentin; meanwhile, the hydroxyl group in the lattice site was more dominant in enamel. A greater intensity of the hydroxyl group was detected in human than in bovine for both dentin and enamel. For ³¹P projections, bovine dentin and bovine enamel have wider linewidths than human dentin and human enamel, respectively. There are differences in the crystallite profile between human and bovine. The results of dental research should be interpreted with caution when bovine teeth are substituted for human teeth.

Clinical and primary evidence of silver diamine fluoride on root caries management

Root caries is a growing problem for the worldwide aging population. Silver diamine fluoride (SDF) contains high concentrations of silver and fluoride ions, which prevents and arrests root caries, as well as dentin caries in the primary teeth of young children. Unlike other fluoride products that mainly reduce the formation of new carious lesions, 38% SDF is an effective agent that can efficiently arrest the carious process, remineralize the decayed dental tissues, and protect the tooth structure against the formation of new caries lesions. The use of SDF can result in more caries-resistant tooth structures. Despite these merits, its clinical disadvantages are the deep penetration of silver ions and sequential formation of silver compounds, which cause esthetic concern due to the discoloration and impaired efficacy of dentin bonding after using SDF. Thus, this narrative review, by addressing the primary experimental results and clinical applications of SDF on root caries, proposes management methods for root caries in conjunction with the application of SDF. We propose a two-visit treatment protocol to take advantage of the SDF application for root surface caries and utilize the discoloration caused by SDF.

Raman Analyses of Laser Irradiation-Induced Microstructural Variations in Synthetic Hydroxyapatite and Human Teeth

The microstructural and molecular-scale variations induced by laser irradiation treatment on human teeth enamel in comparison with synthetic hydroxyapatite (HAp) were examined through Raman microprobe spectroscopy as a function of irradiation power. The results demonstrated that laser irradiation could modify stoichiometry, microstructure, and the population of crystallographic defects, as well as the hardness of the materials. These modifications showed strong dependences on both laser power and initial nonstoichiometric structure (defective content of HPO₄), because of the occurrence of distinct reactions and structural reconstruction. The reported observations can redirect future trends in tooth whitening by laser treatment and the production of HAp coatings because of the important role of stoichiometric defects.

Effect of Surface Pre-Reacted Glass Ionomer Containing Dental Sealant on the Inhibition of Enamel Demineralization

The effect of a surface pre-reacted glass ionomer (S-PRG)-containing sealant on the demineralization inhibition and remineralization of intact enamel adjacent to the sealant material was investigated. BeautiSealant (BTS, S-PRG sealant, Shofu), Teeth Mate F-12.0 (TMF, fluoride-releasing sealant, Kuraray Noritake Dental), and an experimental silica-filler sealant were investigated. After pH cycling for 10 days, the enamel surface adjacent to the sealant material was observed using confocal laser microscopy and scanning electron microscopy. The polymerized sealant disks were immersed in a demineralized solution (pH: 4.3) to measure pH change. The enamel specimens with polymerized sealant disks were additionally immersed in demineralized solution, followed by energy-dispersive X-ray spectroscopy. The demineralized area of BTS was significantly smaller than that of TMF and SS (p < 0.05). The surfaces adjacent to the sealant of TMF and SS were demineralized, while the surface of BTS was comparatively intact. An increase in pH values were observed in the BTS and TMF groups. Enamel surfaces presented an inhibition of demineralization for BTS and TMF, but not for SS. Fluoride uptake from the polymerized sealant was greater for BTS than for TMF. The S-PRG-containing sealant showed a buffering ability, demineralization inhibition, promotion of remineralization, and it can be advised for clinical applications.

Evaluation of Incipient Enamel Caries at Smooth Tooth Surfaces Using SS-OCT

(1) Background: Dental caries, if diagnosed at the initial stage, can be arrested and remineralized by a non-operative therapeutic approach preserving tooth structure. Accurate and reproducible diagnostic procedure is required for the successful management of incipient caries. The aim of this study was to evaluate the diagnostic accuracy of 3D swept-source optical coherence tomography (3D SS-OCT) for enamel caries at smooth tooth surface if the lesion was with remineralization. (2) Methods: Forty-seven tooth surfaces of 24 extracted human teeth visibly with/without enamel caries (ICDAS code 0−3) were selected and used in this study. The tooth surfaces of investigation site were cleaned and visually examined by four dentists. After the visual inspection, SS-OCT scanning was performed onto the enamel surfaces to construct a 3D image. The 2D tomographic images of the investigation site were chosen from the 3D dataset and dynamically displayed in video and evaluated by the examiners. A five-rank scale was used to score the level of enamel caries according to the following; 1: Intact enamel. 2: Noncavitated lesion with remineralization. 3: Superficial noncavitated lesion without remineralization. 4: Deep nonvacitated lesion without remineralization. 5: Enamel lesion with cavitation. Sensitivity and specificity for 3D OCT image and visual inspection were calculated. Diagnostic accuracy of each diagnostic method was calculated using weighted kappa. Statistical significance was defined at p = 0.05. (3) Results: 3D SS-OCT could clearly depict enamel caries at smooth tooth surface as a bright zone, based on the increased backscattering signal. It was noted that 3D SS-OCT showed higher sensitivity for the diagnosis of remineralized lesions and deep enamel lesions without cavitation, as well as cavitated enamel lesions (p < 0.05). No significant difference of specificity was observed between the two diagnostic methods (p > 0.05). Furthermore, 3D SS-OCT showed higher diagnostic accuracy than visual inspection (p < 0.05). (4) Conclusions: Within the limitations of this in vitro study, 3D SS-OCT showed higher diagnostic capacity for smooth surface enamel caries than visual inspection and could also discriminate lesion remineralization of enamel caries.

Japanese sound-symbolic words in global contexts: from translation to hybridization

This paper explores the global reception and development of the artistic expression of onomatopoeia and mimetic words in modern and contemporary Japanese literary texts adopting the method of comparative literature. By analyzing sound-symbolic words and their translations in modern Japanese poetry and contemporary comics, the intercultural dialogues of these texts are examined and the emergence of hybrid onomatopoeia in global comic works is illuminated. The Japanese language is often noted for its richness of sound-symbolic words. In the literary world, modern poetry adopted and elaborated the use of these words from the late 19th century in its quest for a new style of poetry. In the early 20th century, poets developed the artistic expression of sound-symbolic words and succeeded in giving musicality to the “new-style poem”. However, the translation of Japanese sound-symbolic words has always been problematic. Experimental uses of these words in modern poems were often untranslatable, making the translations incomprehensible or dull. Nevertheless, graphic narratives and their worldwide distribution changed that situation. Japanese comics (manga) has particularly developed the artistic expression of sound-symbolic words. Usually placed outside speech balloons, these words are elaborately depicted and are important elements of the panel/page layout. Notably, the global popularity of the genre developed a new phase of intercultural dialogue. As not every word has an equivalent or is translatable in the target language, translators have left sound-symbolic words untouched in the translated versions, putting translation aside. Thus, the combination of Japanese and the target language seems to influence the visual comprehension of sound effects among the readers. Through the examinations of some cases, this paper brings to light the emergence of some hybrid onomatopoeia and reveals that the “Third Space” formed by the translation and hybridization of manga is a dynamic field that creates a new culture.

Effect of smear layer removal agents on the microhardness and roughness of radicular dentin

Purpose

To evaluate the effect of phytic acid (IP6) on the surface roughness and microhardness of human root canal dentin and compare it to other smear layer removal agents.

Materials and methods

Fifty extracted human maxillary incisors were sectioned longitudinally into a total of 100 specimens followed by embedding in auto-polymerizing acrylic resin. The specimens were polished and then randomly divided into five groups (n = 20) according to the test solution used to condition root canal dentin: 17% ethylenediaminetetraacetic acid (EDTA); 10% citric acid (CA); 1% IP6; 37% phosphoric acid (PA); or distilled water (control group). Each specimen was treated with a total volume of 1 ml of each solution for 1 min with agitation. Each group was then divided into two subgroups of 10 specimens each. The specimens of the first subgroup were used to determine microhardness, using Vickers hardness tester, and the specimens of the second subgroup were used to measure surface roughness, using a confocal laser scanning microscope. The results were analyzed statistically using one-way ANOVA and Tukey tests, α = 0.05.

Results

All the tested groups exhibited microhardness and surface roughness values that were statistically significantly different when compared with the control group (P < 0.05). The microhardness value obtained with IP6 was significantly lower when compared to EDTA, CA, and the control group, whereas its roughness value was significantly higher compared to the aforementioned groups. However, there was no significant difference between IP6 and PA (P > 0.05).

Conclusions

IP6 and PA showed the lowest microhardness and the highest surface roughness values.

Dentin anti-demineralization potential of surface reaction-type pre-reacted glass-ionomer filler containing self-adhesive resin cement

OBJECTIVE

To investigate the anti-demineralization potential of a newly developed surface reaction-type pre-reacted glass-ionomer (S-PRG) filler containing self-adhesive resin cement against acidic attacks on the dentin surface.

MATERIALS AND METHODS

A total of 32 bovine teeth were used. Cavities were prepared on crown dentin slaps and filled with three self-adhesive resin cement: (1) S-PRG-based cement, (2) Si-based cement, and (3) RelyX cement. Specimens were then subjected to pH cycling for 28 days, and the depth of demineralization was assessed using swept-source optical coherence tomography (SS-OCT) after 7, 14, 21, and 28 days. Sixty-four root dentin blocks were divided into four groups and then subjected to a pH cycling procedure with the aforementioned three material blocks and one negative control. The mineral loss was observed using transverse microradiography (TMR), and the surface microhardness (SMH) test was conducted to investigate the mechanical properties of treated dentin surfaces.

RESULTS

The depth of demineralization for the S-PRG-based cement was significantly lower than that of the Si-based cement after 7, 21, and 28 days. Conversely, the RelyX cement was not significantly different from the Si-based cement after 7, 14, and 21 days (p < 0.05). Regarding the TMR and SMH test, the S-PRG-based cement showed the least mineral loss with the highest resistance to acidic challenge.

CONCLUSION

The S-PRG filler containing resin cement can reduce mineral loss and promote remineralization of dentin substrate and has the potential to preserve dentin integrity and resist acidic attack. Clinical significance Self-adhesive resin cement containing S-PRG fillers maintained the surface integrity of dentin after exposure to 28 days of acidic challenge with a significant anti-demineralization effect.

Effect of photo-thermal acceleration on in-office bleaching

The purpose is to evaluate the effect of photo-thermal acceleration on in-office bleaching efficiency using a bleaching agent without photocatalysts in vitro. Artificially discolored bovine lower incisors were prepared, and the mixed in-office bleaching material contained hydrogen peroxide 23% was applied by following treatment for 10 min: high-(HI group) and low-intensity LED lights (LI group), oven at 38 °C (OV group), and room temperature at 23 °C (RT group). Color was measured before and after bleaching and color difference (∆E*) was calculated. The data were statistically analyzed using a two-way ANOVA and Tukey’s post hoc test. The temperature change (∆T) of applied bleaching agent in HI and LI groups was measured using a thermography and was analyzed using a T test. The bleaching procedures were repeated 6 times. Irradiation in the HI group resulted in the highest ΔE, followed by the LI group whose ΔE was significantly lower. Both irradiated modes exhibited higher ΔE compared to non-irradiated OV and RT groups which were not significantly different from each other. The average temperature rise of bleaching agents in HI and LI groups after 10 min irradiation was 15.00 °C and 11.80 °C, respectively. The effect of photo-thermal acceleration was proved for an in-office bleaching agent without photocatalysts in vitro.

The effect of reduced glutathione on the toxicity of silver diamine fluoride in rat pulpal cells

Introduction

Due to its ability to arrest untreated dental caries, silver diamine fluoride (SDF) has been advocated for indirect pulp capping procedures. However, the high concentrations of silver and fluoride in SDF raise concerns about its biocompatibility to pulpal tissues.

Objectives

This study aimed to investigate the effect of SDF on the viability, alkaline phosphatase (ALP) activity, and morphology of pulpal-like cells (RPC-C2A) and to evaluate the influence of reduced glutathione (GSH) on SDF-induced cytotoxicity and deposit formation on dentin.

Methodology

The cytotoxicity of diluted 38% SDF solutions (10-4 and 10-5), with or without the addition of 5 mM or 50 mM GSH, was evaluated at 6 and 24 hours. Cell viability was detected using WST-8 and the effect on ALP activity was performed using an ALP assay kit. Cell morphology was observed using a phase-contrast microscope. Scanning electron microscopy analysis was conducted to evaluate the effect of GSH incorporation or conditioning on SDF-induced deposit formation on dentin discs. Cytotoxicity data were analyzed by two-way analysis of variance (ANOVA) and Tukey post hoc tests (p<0.05).

Results

There were significant differences between the groups. The results demonstrated that all tested SDF dilutions caused a remarkable cytotoxic effect, while the addition of GSH prevented SDF-induced damage at 6-hour exposure time in the higher dilution of SDF. Dentin treated with plain SDF or GSH-incorporated SDF solution showed deposit formation with occluded dentinal tubules, unlike the other groups.

Conclusion

SDF severely disturbed the viability, mineralization-ability, and morphology of pulpal-like cells, while controlled concentrations of GSH had a short-term protective effect against SDF-induced damage. GSH showed an inhibitory effect on SDF-induced dentinal deposit formation. Further research is warranted to evaluate the effect of GSH on caries-arresting, anti-hypersensitivity, and antibacterial functions of SDF.

Effects of silver diamine fluoride preparations on biofilm formation of Streptococcus mutans

Effects of silver diamine fluoride preparations (SDFs) on cariogenic biofilm formation on root dentin (RD) were investigated. Streptococcus mutans (S. mutans) biofilms were formed on bovine RD blocks coated with one of three the SDFs (38%-SDF, 3.8%-SDF and 35%-SDF+potassium-iodide; SDF+KI) and a non-coated Control which were quantified (spectrometric-measurement) and thickness measured (optical coherence tomography) after 20 h. Bacterial viability test (BacLight) and biofilm-morphometry (SEM) of 2 h biofilms were also performed. The amounts of biofilms (bacteria and water insoluble glucan) and the thickness of biofilm were minimum on 38%-SDF specimen; 3.8%-SDF and SDF+KI had significantly more than that, but had significantly less than Control (p<0.05). Most S. mutans cells found dead and morphology damaged by 38%-SDF. Some dead bacteria and remarkably damaged biofilms were observed in case of 3.8%-SDF and SDF+KI. Inhibition potential of 3.8%-SDF and SDF+KI on S. mutans biofilm formation is almost similar, although not equivalent to 38%-SDF.

The effect of surface pre-reacted glass-ionomer filler eluate on dental pulp cells and mineral deposition on dentin: In vitro study

The effects of surface pre-reacted glass-ionomer (S-PRG) filler on pulpal cells and on the composition of dentinal deposits were investigated. Proliferation (CCK-8), cytotoxicity (LDH), and differentiation activity (ALP) tests, along with cell morphology observations, were conducted at 6 and 24 h after treatment of pulpal cells with different S-PRG filler eluate concentrations. Dentinal surfaces were immersed in deionized water or S-PRG filler eluate followed by immersion in deionized water or simulated body fluid and observed under scanning electron microscope and elemental analysis using energy dispersive x-ray spectrometer. At 24 h, there were significant differences in CCK-8 and ALP activity values between the groups in a concentration-dependent manner. LDH test data were not significantly different among the groups. Cell morphology was not altered at either exposure time. However, decreased cellular density was observed with the highest eluate concentration. Crystalline deposits and occluded dentinal tubules were observed in samples immersed in S-PRG filler with a later immersion in simulated body fluid, which also showed higher concentrations of certain ions compared to surfaces that were not initially treated with S-PRG filler. The lowest two eluate concentrations did not show significant toxicity. S-PRG enhanced the effect of simulated body fluid in the formation of mineral deposits.

Effect of pH of bleaching agent on tooth bleaching action in vitro

This study investigated the effect of pH of bleaching agent, photo-irradiation time or application times on bleaching action using hematoporphyrin-stained papers (HSPs) and artificially stained bovine-teeth (BT). 23% H2O2 with pH 5.5, 6.0, 7.0, 8.0 and 9.0 were applied on the specimens. HSP was photo-irradiated for 1, 3 and 5 min. BT were photo-irradiated for 10 min and the bleaching was repeated ten times (n=10). CIE L*a*b* of the specimens were measured before and after the procedure. Data were analyzed by repeated-measures ANOVA followed by multiple comparisons with Bonferroni correction. For the HSP, longer irradiation time and higher pH yielded significantly higher color difference (ΔE). As for BT, increasing application times and higher pH resulted in higher ΔE. It was concluded that the pH of the bleaching agent significantly improved the bleaching effect with increased photo-irradiation time for HSP and with an increase of repeated application times for BT.

Effect of phytic acid as an endodontic chelator on resin adhesion to sodium hypochlorite-treated dentin

Objectives

Phytic acid (IP6), a naturally occurring agent, has been previously reported as a potential alternative to ethylenediaminetetraacetic acid (EDTA). However, its effect on adhesion to sodium hypochlorite (NaOCl)-treated dentin and its interactions with NaOCl have not been previously reported. Thus, in this study, the effects of IP6 on resin adhesion to NaOCl-treated dentin and the failure mode were investigated and the interactions between the used agents were analyzed.

Materials and Methods

Micro-tensile bond strength (µTBS) testing was performed until failure on dentin treated with either distilled water (control), 5% NaOCl, or 5% NaOCl followed with chelators: 17% EDTA for 1 minute or 1% IP6 for 30 seconds or 1 minute. The failed specimens were assessed under a scanning electron microscope. The reaction of NaOCl with EDTA or IP6 was analyzed in terms of temperature, pH, effervescence, and chlorine odor, and the effects of the resulting mixtures on the color of a stained paper were recorded.

Results

The µTBS values of the control and NaOCl with chelator groups were not significantly different, but were all significantly higher than that of the group treated with NaOCl only. In the failure analysis, a distinctive feature was the presence of resin tags in samples conditioned with IP6 after treatment with NaOCl. The reaction of 1% IP6 with 5% NaOCl was less aggressive than the reaction of the latter with 17% EDTA.

Conclusions

IP6 reversed the adverse effects of NaOCl on resin-dentin adhesion without the chlorine-depleting effect of EDTA.

Raman spectroscopy for early detection and monitoring of dentin demineralization

Early detection of dental caries and variations in composition/structure of both enamel and dentin represents an important issue in modern dentistry. Demineralization has been associated to teeth discoloration, development of caries, and formation of cavities.

OBJECTIVE

In this study, we systematically monitored the processes of demineralization/remineralization in dentin samples by means of three different spectroscopic techniques, namely, Raman spectroscopy, X-Ray Photo-electron spectroscopy (XPS), and X-Ray Diffractometry (XRD).

METHODS

Bovine dentin samples were first exposed to acidic solutions and their structure systematically monitored as a function of time and pH. Then, the samples were rinsed in artificial saliva to simulate remineralization.

RESULTS

The above three spectroscopic techniques provided quantitative structural information spanning from the nanometer to the millimeter scale of sample penetration depth. An irreversible level of demineralization was reached when dentin was exposed to pH 2 beyond a time threshold of 6h, successive treatments with artificial saliva being unable to restore the mineral fraction. On the other hand, short-term treatments at pH 5 and long-term treatments at pH 6 could partially or completely recover the dentin structure within one week of remineralization treatment.

SIGNIFICANCE

Two specific Raman parameters, namely, the bandwidth of the symmetric phosphate-stretching signal and the mineral-to-matrix intensity ratio, showed strong correlations with XPS and XRD data, and matched laser microscopy observations. Such correlations open the path to apply Raman spectroscopy in monitoring dentin demineralization in vivo and provide quantitative working algorithms for the prevention of oral caries.

The Hormetic Effect of Arsenic Trioxide on Rat Pulpal Cells: An In Vitro Preliminary Study

Objectives  Despite the agreement that there is no longer any indication for arsenic use in modern endodontics, some concerns are surfacing about the minute amount of arsenic trioxide (As ₂ O ₃ ) released from Portland cement-based materials. The present study investigated the effect of different concentrations of As ₂ O ₃ on rat pulpal cells and the efficacy of N -acetylcysteine (NAC) in preventing As ₂ O ₃ -mediated toxicity.

Materials and Methods  Cytotoxicities of 50, 10, or 5 µm As ₂ O ₃ and the effect of cells co-treatment with 50 µm As ₂ O ₃ and 5,000 µm NAC or 500 µm NAC were tested at 24 hours or 3 days. Cell viability was assessed by means of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and cellular morphological changes were observed under phase contrast microscope.

Statistical Analysis  Two-way analysis of variance with Tukey’s post-hoc test was used to evaluate differences between the groups (α = 0.05).

Results  At both exposure times, 50 µm As ₂ O ₃ resulted in lower optical density (OD) values when compared with 10 or 5 µm As ₂ O ₃ . At 24 hours, 10 µm As ₂ O ₃ resulted in a higher OD value compared with the control; however, at 3 days the difference was statistically insignificant. At each exposure time, the OD value of 5 µm As ₂ O ₃ group was comparable to the control and 10 µm As ₂ O ₃ group. There were no significant differences between 50 µm As ₂ O ₃ group and 500 μm NAC+50 μm As ₂ O ₃ group; however, these two groups had lower OD values when compared with 5,000 μm NAC+50 μm As ₂ O ₃ group at 24 hours and 3 days. The latter group showed significantly lower OD value in comparison with the control at 24 hours and 3 days. Control cells were polygonal-shaped while 50 µm As ₂ O ₃ -treated cells exhibited contracted and spherical morphology with increased intercellular spaces. At 24 hours, 10 μm and 5 µm As ₂ O ₃ -treated cells were slightly hypertrophic. Cells co-treated with NAC and As ₂ O ₃ showed increased intercellular spaces and lower cellular density compared with the control.

Conclusions  As ₂ O ₃ displayed a hormetic effect on pulpal cells; however, the proliferative effect induced by low As ₂ O ₃ concentrations should be interpreted with caution. NAC did not prevent As ₂ O ₃ -mediated toxicity; however, it demonstrated potential for ameliorating this toxicity.

Effects of a surface prereacted glass-ionomer filler coating material on biofilm formation and inhibition of dentin demineralization

OBJECTIVES

This study investigated the ability of a surface prereacted glass-ionomer (S-PRG) coating material to inhibit the biofilm formation and demineralization of dentin.

METHODS AND MATERIALS

Dentin specimens were randomly divided into three groups: (1) no coating (control), (2) S-PRG filler-containing coat, and (3) a nonS-PRG filler-containing coat. Streptococcus mutans biofilms were grown on the dentin surfaces in a microcosm for 20 h. Then, the quantity of bacteria and water-insoluble glucan in the retained biofilm on the dentin surface were measured. Regarding demineralization inhibition test, specimens were demineralized for 5 days then sectioned into halves and observed under confocal laser scanning microscope (CLSM). One-way ANOVA and Tukey's HSD were used for statistical analysis.

RESULTS

The estimated mean surface roughness for specimens in the S-PRG group was statistically significantly higher than the estimates for both the nonS-PRG and the control group specimens. The quantity of bacteria and water-insoluble glucan/mm² revealed that the S-PRG group prevented biofilm formation and bacterial adhesion to the dentin surface compared with the control and nonS-PRG groups. The S-PRG group recorded the highest acid-resistance ability with no surface loss.

CONCLUSION

Application of S-PRG barrier coat on dentin surfaces can inhibit biofilm formation as well as protecting the dentin surface against demineralization.

CLINICAL SIGNIFICANCE

Coating material containing S-PRG fillers might be used for caries prevention, through inhibiting biofilm formation, enhancing mineralization, and reducing acidic attack by cariogenic bacteria.

Effect of application of desensitizers before bleaching on change of tooth shade

The aim of this in vitro study was to evaluate the effects of desensitizer pre-treatment on in-office bleaching using an artificial discoloration tooth model. The stained specimens were divided into four groups (n=10); without application (Control group), Shield Force plus (SF group), UltraEz (UE group) and Teeth Mate AP paste (TM group) applied before bleaching. Each group was bleached by an in-office bleaching agent. The CIE L*a*b* values were measured by a colorimeter before and after ten consecutive bleaching treatments and the color difference (∆E) was calculated. There was no statistical difference among ∆E values of Control, UE, and TM groups (p>0.05). There was a significant difference between SF and Control groups (p<0.001). It was concluded that application of TM and UE did not affect the change of tooth shade while SF application impeded the bleaching effect.

Effects of Different Tooth Conditioners on the Bonding of Universal Self-etching Adhesive to Dentin

PURPOSE

To investigate the effect of different etching products used prior to the application of universal self-etching adhesive on dentin bonding.

MATERIALS AND METHODS

The etching products Multi Etchant (ME), Enamel Conditioner (EC), and K-etchant GEL (KE) were used as pre-treatments prior to the application of the one-bottle self-etching adhesive Adhese Universal (AU). Ground human dentin surfaces were randomly divided into four treatment groups: 1. control (CT; AU without con-ditioner); 2. ME; 3. EC; 4. KE. Microtensile bond strength (µTBS) tests with a thermocycling challenge (0-TC or 10,000-TC) were carried out and the morphological attributes of the adhesive-dentin interface were observed after an acid-base challenge using SEM to observe the acid-base resistant zone (ABRZ).

RESULTS

The KE group had a statistically significantly lower µTBS than did the ME and EC groups at 0-TC, and than the CT, ME, and EC groups at 10,000-TC (p < 0.05). An ABRZ was observed in all groups but had partially disappeared in KE. A funnel-shaped area of erosion was also observed at the junction of the dentin and bonding layer in the CT, ME, and EC groups, while the hybrid layer was thicker in the KE group with no evidence of erosion.

CONCLUSION

The application of ME or EC did not reduce the microtensile bond strength and resulted in ABRZ formation, while the ABRZ was partially reduced in the KE group.

Effect of the Dentin Chelating Agents Phytic Acid and EDTA on Degree of Conversion, Microhardness, and Bond Strength of Chemical-curing Self-adhesive Cements

PURPOSE

To evaluate the effect of the chelating agents phytic acid and EDTA on the degree of conversion (DC), microhardness, and tensile bond strength (TBS) of two chemical-curing self-adhesive cements.

MATERIALS AND METHODS

A total of 110 samples were prepared, with n = 6 in the control group to measure microhardness, n = 6 for DC measurement, and n = 10 for TBS measurement. The bovine dentin specimens were divided into five groups according to treatment: group A (control group): no treatment; group B, 1% phytic acid with ultrasonic rinsing (UR); group C: 1% phytic acid without UR; group D: 18% EDTA with UR; group E: 18% EDTA without UR. A 1-mm-thick coat of self-adhesive cement, G-CEM LinkAce (GC) or RelyX Unicem 2 (3M) was placed on control and treated dentin surfaces and stored in a dark box at 37°C, 93% ± 1% ambient humidity. DC and microhardness of cement surfaces were measured after 1 hour, 1 day, 3 days, and 1 week using Fourier transform infrared spectroscopy and a Vickers microhardness tester, respectively. TBS on treated and control dentin was evaluated after 1 week of storage in the dark box. Data were analyzed using two-way ANOVA, followed by Tukey's post-hoc test, at the 0.05 level of significance.

RESULTS

DC and microhardness of both types of cement without UR were significantly lower than that of groups in which UR was performed. Neither chelating agent had a significant effect on the TBS of G-CEM. For Rely X, the phytic acid treatment with UR showed a significantly higher TBS than the control and the EDTA groups.

CONCLUSION

The chelating agents had a negative effect on DC and microhardness of the resin cements when UR was not used. Phytic acid increased the TBS of RelyX, while EDTA groups did not with either cement.

Evaluation of discoloration of sound/demineralized root dentin with silver diamine fluoride: In-vitro study

The objective was to evaluate the effect of application of silver diamine fluoride (SDF) on discoloration of demineralized dentin over time. Dentin specimens were divided into four groups according to time of dentin demineralization. A 38% SDF solution was then applied to the dentin surfaces. Half of the specimens were placed in light-proof boxes while the remainder were exposed to light. Both groups were maintained at 37˚C. Color change was determined using a spectrophotometer at different time intervals. SEM/EDS analysis were also undertaken. The 13 h EDTA demineralized group showed the highest values for color change among different time intervals, with the control being the lowest. The light exposed groups showed more color change compared to the unexposed groups. We concluded that the degree of dentin demineralization leads to a significant increase of the rate of dentin color change after application of SDF.

Effect of Calcium-phosphate Desensitizers on Staining Susceptibility of Acid-eroded Enamel

OBJECTIVE

To investigate the effect of calcium-phosphate-based desensitizers, Teethmate AP paste (TMAP) and Teethmate Desensitizer (TMD) (Kuraray Noritake Dental, Tokyo, Japan), on the prevention of staining on acid-eroded enamel.

METHODS AND MATERIALS

Forty polished enamel samples (4×4×1 mm) from bovine incisors were randomly divided into five groups (n=8). After immersion in 50 mL of 0.5% citric acid (pH 2.5) for 15 minutes to form acid-eroded surfaces, the surfaces were subjected to different treatments with TMAP, TMD, and NaF (0.21% means 950 ppm) for five minutes. Another eroded group was not treated with desensitizer. For the control group, the samples were not eroded or treated. All the samples were stored in artificial saliva (AS) at pH 7.2 for 24 hours at 37°C. The TMAP, TMD, or NaF was reapplied at eight and 16 hours during the 24 hours of storage time. The surface roughness (Sa) was evaluated following ISO 25178 for surface texture using confocal laser scanning microscopy (VK-X 150 series, Keyence, Osaka, Japan) before acid erosion, after acid erosion, and after 24 hours of incubation in AS. Afterward, the color difference was measured with a dental colorimeter (Shade Eye NCC, Shofu, Kyoto, Japan) before and after staining with tea solution.

RESULTS

One-way repeated measures analysis of variance showed that acid erosion significantly increased Sa (p<0.001). TMAP- and TMD-treated groups exhibited lower Sa values than the NaF group and the no-desensitizer treatment group. The greatest staining was observed in the NaF group and the no-desensitizer group, while the TMAP and TMD groups significantly decreased the formation of stains.

CONCLUSIONS

Acid-eroded enamel increased surface roughness and tended to absorb more stains. However, the application of TMAP and TMD moderated the roughness and thus prevented the formation of extrinsic stains.

Effect of fluoride mouthrinse on adhesion to bovine root dentin

The purpose of this study was to evaluate the effect of fluoride mouthrinses on dentin bonding performance of a two-step selfetch adhesive; Clearfil SE Bond. Bovine root dentin surface was treated with either 450, 900, or 9,000 ppm F solutions for 30 s (immediate), and continually treated for one month (one month) before the bonding procedures. Microtensile bond strength (µTBS) test and scanning electron microscopic (SEM) observation of the acid-base resistance zone (ABRZ) were performed. Chemical state of fluorine on dentin surface was analyzed by X-ray absorption fine structure (XAFS). The 450 and 900 ppm F fluoride mouthrinses did not influence the µTBS to dentin, while the 9,000 ppm F fluoride solution adversely affected the µTBSs. The fluoride application to dentin significantly enhanced acid resistance at the adhesive/dentin interface including the ABRZ. The XAFS analysis indicated different concentrations of fluoride might create different chemical compounds on the dentin surface, influencing the µTBS results.

Effect of Glutathione Bio-Molecule on Tooth Discoloration Associated with Silver Diammine Fluoride

This study evaluated the effect of Glutathione (GSH) bio-molecule on the reduction of enamel and dentin discoloration after application of 38% silver diammine fluoride solution (SDF). One hundred and twenty bovine teeth specimens were used. The enamel and dentin specimens were divided into three groups: (1) SDF only (control); (2) SDF followed by application of a potassium iodide solution (KI); and (3) SDF mixed with 20% GSH. Half the specimens were exposed to light and the remainder kept in dark conditions (n = 10) Color changes were measured using a spectrophotometer at the following time intervals: before solution application (baseline) and immediately after application, then 3, 6, 24, 48, 72 h, and 7, 10 and 14 days. SEM/EDS analysis was performed on treated enamel and dentin. Statistical analysis was done using a repeated measures ANOVA test. The spectrophotometer results showed that the SDF group exhibited the greatest color changes under both light exposed and dark conditions, while SDF + GSH group was effective in decreasing the color changes in both light and dark conditions. The SDF + KI group showed an insignificant color changes over time. SEM/EDS analysis showed different patterns for the silver crystal formation in each group (SDF, SDF + GSH, and SDF + KI group). It was concluded GSH can effectively minimize color changes after application of SDF, especially on enamel and to a lesser extent on dentin.

Mechanisms of silver diamine fluoride on arresting caries: a literature review

OBJECTIVE

To review the evidence regarding the mechanisms of silver diamine fluoride (SDF) for arresting caries.

METHODS

A literature search was conducted using the keywords silver diamine fluoride, and its alternative names, in seven databases: PubMed, Embase and Scopus (English); China National Knowledge Infrastructure (Chinese); Bilioteca Virtual em Saude (Portuguese); Biblioteca Virtual en Salud Espana (Spanish); and Ichushi-Web (Japanese). The titles and abstracts were screened. Full texts were retrieved for publications that studied mechanisms of actions of SDF, including its effects on remineralisation of carious lesions and on cariogenic bacteria.

RESULTS

A total of 1,123 publications were identified. Twenty-nine articles were included and they investigated the effect of SDF on cariogenic bacteria and dental hard tissues. Eleven studies investigated the antibacterial properties of SDF. They found that SDF was bactericidal to cariogenic bacteria, mainly Streptococcus mutans. It inhibited the growth of cariogenic biofilms on teeth. Twenty studies reported the remineralisation of demineralised enamel or dentine by SDF. They found that mineral loss of demineralised enamel and dentine was reduced after SDF treatment. A highly mineralised surface rich in calcium and phosphate was formed on arrested carious lesions. Four studies examined the effect of SDF on dentine collagen. They found that SDF inhibited collagenases (matrix metalloproteinases and cysteine cathepsins) and protected dentine collagen from destruction.

CONCLUSION

SDF is a bactericidal agent and reduces the growth of cariogenic bacteria. It inhibits demineralisation and promotes the remineralisation of demineralised enamel and dentine. It also hampers degradation of the dentine collagen.

Tubular Occlusion Prevents Water-treeing and Through-and-Through Fluid Movement in a Single-bottle, One-step Self-etch Adhesive Model

Water entrapment occurs at resin-dentin interfaces of one-step self-etch adhesives. We hypothesized that by preventing water fluxes from dentin, any water entrapment would be attributed to incomplete removal of adhesive solvents. We tested this hypothesis by bonding to transparent carious dentin containing occluded dentinal tubules. An experimental single-bottle, one-step self-etch adhesive was applied to flat surfaces of caries-affected dentin surrounded by sound dentin, with or without pulpal pressure. Resin-dentin interfaces were examined with TEM after silver-impregnation. Although caries-affected dentin was highly porous, adhesive layers were devoid of silver deposits when tubules were occluded. Conversely, variable extents of water-treeing and water-droplets were identified from adhesive layers in bonded sound dentin. Water-treeing and water-droplet formation, being manifestations of evaporative and convective water fluxes, can be eliminated during bonding to occluded transparent carious dentin. However, the highly porous nature of this clinically relevant substrate after bonding may lead to potentially undesirable consequences.

Hesperidin interaction to collagen detected by physico-chemical techniques

OBJECTIVE

Dentin collagen can be modified by some plant-derived flavonoids to improve properties of dentin organic matrix. Hesperidin (HPN), a hesperetin-7-O-rutinoside flavonoid, has a potential of dentin modification for being based on evidence that a treatment with HPN may resist collagenase degradation and arrest demineralization of human dentin. In this study, biophysical and molecular-level information on the interaction of HPN and collagen was investigated.

METHODS

HPN is extracted from citrus fruits. Sample collagenous solution was prepared using atelocollagen (ATCL) as a triple-helical peptide model. We have performed circular dichroism spectroscopic analysis, sedimentation velocity measurement by ultracentrifuge and saturation transfer difference measurement (STD) by NMR on HPN-collagen in solution state.

RESULTS

The circular dichroism and sedimentation velocity measurement showed the evidence for the molecular interaction between ATCL and HPN, while HPN did not induce any conformational change of ATCL. The STD-NMR study further confirmed this interaction and suggested that HPN interacted with ATCL through its aromatic part, not through its disaccharide moiety.

SIGNIFICANCE

These findings indicated that HPN is weakly bound to ATCL not causing structural modification of collagen. This interaction may contribute to the preservation of collagen by protecting from collagenase degradation.

Clinical Trials of Silver Diamine Fluoride in Arresting Caries among Children: A Systematic Review

This review aims to investigate the clinical effectiveness of silver diamine fluoride (SDF) in arresting dental caries among children. A systematic search of publications was conducted with the key words "silver diamine fluoride," "silver diammine fluoride," "silver fluoride," "diamine silver fluoride," or "diammine silver fluoride" as well as their translation in Chinese, Japanese, Portuguese, and Spanish in 7 databases: PubMed (English), Embase (English), Scopus (English), China National Knowledge Infrastructure (Chinese), Ichushi-web (Japanese), Biblioteca Virtual em Saude (Portuguese), and Biblioteca Virtual en Salud Espana (Spanish). Duplicated publications were deleted. The title and abstract were screened and irrelevant publications were excluded. The full text of the remaining publications was retrieved. Prospective clinical studies of SDF that reported a caries-arresting effect among children were included. Meta-analysis was performed for quantitative analysis. A total of 1,123 publications were found, including 19 publications of clinical trials. Sixteen clinical trials studied the caries-arresting effect on primary teeth, and 3 clinical trials were on permanent teeth. Fourteen studies used 38% SDF, 3 used 30% SDF, and 2 used 10% SDF. Meta-analysis was performed on extracted data from 8 studies using 38% SDF to arrest caries in primary teeth. The overall percentage of active caries that became arrested was 81% (95% confidence interval, 68% to 89%; P < 0.001). Apart from staining the arrested lesion black, no significant complication of SDF use among children was reported. SDF was commonly used at 38%. It was effective in arresting dentine caries in primary teeth among children. Knowledge Transfer Statement: This systematic review found that 38% silver diamine fluoride (SDF) can effectively arrest caries among children. SDF treatment is noninvasive and easily operated. It can be a promising strategy to manage dental caries in young children or those who have special needs.

The effect of glutathione on 2-hydroxyethylmethacrylate cytotoxicity and on resin-dentine bond strength

AIM

To evaluate the influence of reduced glutathione (GSH) application on 2-hydroxyethylmethacrylate (HEMA) cytotoxicity on rat pulpal cells and evaluate the effect of etched-dentine treatment with GSH on the immediate microtensile bond strength (μTBS) of etch-and-rinse adhesive.

METHODOLOGY

The cytotoxicity of 10 mmol L(-1) HEMA, 10 mmol L(-1) HEMA + 1 mmol L(-1) GSH, 10 mmol L(-1) HEMA + 5 mmol L(-1) GSH and 10 mmol L(-1) HEMA + 10 mmol L(-1) GSH was compared (6 h and 24 h). Cells viability was measured by means of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, followed by morphological observation of cells. Etched-dentine surfaces were rinsed and treated with one of the following solutions: 2% GSH, 5% GSH or 10% GSH, bonded with Adper Single Bond Plus (3M, ESPE, St. Paul, MN, USA) and restored with resin composite. The control group received no GSH treatment. After 1 day of water-storage at 37 °C, the specimens were subjected to μTBS testing. Cytotoxicity and μTBS data were analysed by one-way anova and Tukey post hoc tests (P < 0.05).

RESULTS

There were significant differences between the groups. HEMA elicited a remarkable toxic effect. 10 mmol L(-1) GSH prevented HEMA-induced damage at both exposure times. Whilst 5 mmol L(-1) GSH lost its protective effect at 24-h exposure time and 1 mmol L(-1) GSH showed no protective effect at both exposure times, GSH had no significant effect on the immediate μTBS; however, 5% GSH had higher bond strength value when compared to 10% GSH (P = 0.003).

CONCLUSION

Controlled concentrations of GSH had a protective effect against HEMA cytotoxicity. GSH had neither positive nor negative influence on μTBS.

Mussel-mimetic, bioadhesive polymers from plant-derived materials

AIM

Mussel-mimetic, bioadhesive polymers are synthesized from plant-derived sources. The strong adhesive action is caused by interactions between the catechol groups at the end of the polymer terminal chains and the substrate surface. Here, we present a preliminary study of the adhesion properties and a discussion of the adhesion mechanism.

METHODS

Two bioadhesive polymers were synthesized from natural plant-derived monomers by the transesterification of: (a) caffeic acid (3,4-dihydroxycinnamic acid; DHCA) and p-coumaric acid (4-hydroxycinnamic acid; 4HCA) to produce poly(DHCA-co-4HCA); and (b) 4-dihydroxyhydrocinnamic acid (DHHCA) and 3-(3-hydroxyphenyl) propionic acid (3HPPA) to produce poly(DHHCA-co-3HPPA). Thermoplastic poly(DHCA-co-4HCA) or poly(DHHCA-co-3HPPA) was placed between glass, carbon, steel, or bovine dentin substrates, and a lap shear adhesion test was conducted to compare them using conventional cyanoacrylate glue and epoxy resin.

RESULTS

The greatest adhesion for all tested substrates was exhibited by poly(DHHCA-co-3HPPA), followed by epoxy resin adhesive, poly(DHCA-co-4HCA), and cyanoacrylate adhesive. The adhesive strength of poly(DHHCA-co-3HPPA) was greater than 25.6 MPa for glass, 29.6 MPa for carbon, 15.7 MPa for steel, and 16.3 MPA for bovine dentin.

CONCLUSION

The adhesion of poly(DHHCA-co-3HPPA) might be the strongest reported for a mussel-mimic adhesive system, and could be a feasible alternative to petroleum adhesives.

Monomer-Collagen Interactions Studied by Saturation Transfer Difference NMR

Functional monomers in dentin adhesives are involved in wetting dental substrates, demineralization, and the formation of calcium salts. However, the interaction of these monomers with collagen is not understood at a molecular/atomic level. We performed saturation transfer difference (STD) NMR spectroscopy to investigate the binding interaction of 2 functional monomers, 4-methacryloyloxyethyl trimellitate anhydride (4-META) and 10-methacryloyloxydecyl dihydrogenphosphate (MDP), with atelocollagen as a triple-helical peptide model. High STD intensities were detected on the protons in the aliphatic region in MDP, whereas they were not detected for 4-META. The STD results imply that MDP has a relatively stable interaction with the collagen, because of the hydrophobic interactions between the hydrophobic MDP moieties and the hydrophobic collagen surface. This finding indicates that MDP-collagen complexation accounts for stable dentin bonding.

Effect of chlorhexidine incorporation into dental adhesive resin on durability of resin-dentin bond

PURPOSE

This study evaluated the effect of chlorhexidine (CHX) incorporation into experimental dentin adhesives with different hydrophilicities on the microtensile bond strength (µTBS) to dentin.

MATERIALS AND METHODS

Flat, deep dentin surfaces were prepared from 60 extracted human third molars. Three ethanol-solvated (50 wt% ethanol/50 wt% comonomers) experimental adhesives with varying degrees of hydrophilicity were prepared for the CHX-free groups. For the CHX-containing groups, chlorhexidine diacetate was further added to the ethanol-solvated adhesives to form a concentration of 2.0 wt% CHX. Dentin surfaces were etched with 37% phosphoric acid for 15 s, rinsed and blot dried before bonding. The adhesives were generously applied to dentin with a microbrush for 15 s. A second application of fresh adhesive was made and light cured for 20 s (600 mW/cm2) after solvent evaporation. Composite buildups were made using Filtek Z250 (3M ESPE). The bonded teeth were sectioned into 0.9 mm x 0.9 mm beams and stressed to failure at a crosshead speed of 1 mm/min. Testing was performed 24 h after specimen preparation and 12 months after storage in artificial saliva. The µTBS data were analyzed using three-way ANOVA and Tukey's multiple comparison tests. Fractographic analysis was performed by SEM.

RESULTS

Significant differences were observed for the three factors "adhesive hydrophilicity" (p < 0.001), "CHX incorporation" (p = 0.001), and "storage time" (p < 0.001). Interaction among these three factors was also significant (p < 0.001). Incorporation of CHX had no effect on the immediate bond strength of the three experimental adhesives (p > 0.05). After storage in artificial saliva, significant reduction in bond strength was observed in all adhesive groups, except for CHX-containing adhesive I (p < 0.001). The µTBS of the CHX-containing experimental adhesive III was significantly higher than the corresponding CHX-free adhesive (p < 0.001) after aging.

CONCLUSION

When incorporated into hydrophilic dental adhesives, chlorhexidine can partially reduce the degradation of the resin-dentin bonds.

In vitro effect of hesperidin on root dentin collagen and de/re-mineralization

The aims of this study were to investigate the effects of hesperidin, a citrus flavonoid, on human root dentin demineralization and collagen preservation, and compare it with chlorhexidine and grape seed extract. Specimens were assigned to different treatment groups: hesperidin, chlorhexidine and grape seed extract. Specimens were subjected to pH cycling by demineralization for 14 h, incubation in testing solutions for 2 h and remineralization in presence of bacterial-derived collagenase for 8 h, for 8 days. Calcium release was measured by means of an atomic absorption spectrophotometer, and degraded collagen matrix was investigated by hydroxyproline assay. Specimens were assessed longitudinally with transverse micro-radiography to investigate lesion depth and mineral loss. In hesperidin and grape seed extract groups, demineralization was reduced when the collagen matrix was preserved. The hesperidin group showed the lowest value in lesion depth and mineral loss, indicating that hesperidin inhibited demineralization and probably enhanced remineralization even under fluoride-free conditions.