Remineralization potential of fully demineralized dentin infiltrated with silica and hydroxyapatite nanoparticles

Objective

This study investigates the potential of a novel guided tissue regeneration strategy, using fully demineralized dentin infiltrated with silica and hydroxyapatite (HA) nanoparticles (NPs), to remineralize dentin collagen that is completely devoid of native hydroxyapatite.

Methods

Dentin blocks were fully demineralized with 4 N formic acid and subsequently infiltrated with silica and HA NPs. The remineralizing potential of infiltrated dentin was assessed following a twelve week exposure to an artificial saliva solution by means of TEM, EDS and micro-CT. Measurements were taken at baseline and repeated at regular intervals for the duration of the study to quantify the P and Ca levels, the mineral volume percentage and mineral separation of the infiltrated dentin specimens compared to sound dentin and non-infiltrated controls.

Results

Infiltration of demineralized dentin with nano-HA restored up to 55% of the P and Ca levels at baseline. A local increase in the concentration of calcium phosphate compounds over a period of twelve weeks resulted in a higher concentration in P and Ca levels within the infiltrated specimens when compared to the non-infiltrated controls. Remineralization of demineralized dentin with silica NPs by immersion in artificial saliva was the most effective strategy, restoring 20% of the P levels of sound dentin. Micro-CT data showed a 16% recovery of the mineral volume in dentin infiltrated with silica NPs and a significant decrease in the mineral separation to levels comparable to sound dentin.

Significance

Demineralized dentin infiltrated with silica NPs appears to encourage heterogeneous mineralization of the dentin collagen matrix following exposure to an artificial saliva solution.     

AFM study of the effects of collagenase and its inhibitors on dentine collagen fibrils

Objective

This study evaluated the effects of exogenous collagenase and two collagenase inhibitors on the variation in microstructure of human collagen fibrils.

Methods

Dentine specimens which were sectioned from 6 freshly extracted human caries-free third molars were wet polished. Each specimen was divided into 4 parts which were treated as experimental groups (group 1, group 2, group 3) and the control group, respectively. All the specimens were etched and further treated with NaClOaq. Subsequently, the topography of each specimen was observed using atomic force microscopy (AFM) in tapping mode in air. Group 1 was then treated with a solution of collagenase II. Group 2 was treated with a solution of collagenase II and chlorhexidine (saturated solution). Group 3 was treated with a solution of collagenase II and captopril (0.3%). The control group was treated with a buffer solution. After 3 h and 6 h of treatment, the topography of the collagen fibrils was measured with AFM in air, respectively.

Results

AFM images of the dentine collagen fibrils were obtained after treatment with NaOClaq. Following further treatment with collagenase II, the topography of the collagen fibrils changed. Most reticular collagen fibrils disappeared after 6 h. After treatment with collagenase II in the presence of chlorhexidine or captopril for 3 h and 6 h, the morphology of the collagen fibres was not changed obviously.

Conclusions

Exogenous collagenase II effectively degraded human dentine collagen fibrils, and its collagenolytic activity was inhibited by the exogenous collagenase inhibitors, chlorhexidine and captopril.     

The effect of dimethyl sulfoxide (DMSO) on dentin bonding and nanoleakage of etch-and-rinse adhesives

Objective

The objective was to examine the effect of a solvent dimethyl sulfoxide (DMSO) on resin–dentin bond durability, as well as potential functional mechanisms behind the effect.

Methods

Microtensile bond strength (μTBS) was evaluated in extracted human teeth in two separate experiments. Dentin specimens were acid-etched and assigned to pre-treatment with 0.5 mM (0.004%) DMSO as additional primer for 30 s and to controls with water pre-treatment. Two-step etch-and-rinse adhesive (Scotchbond 1XT, 3M ESPE) was applied and resin composite build-ups were created. Specimens were immediately tested for μTBS or stored in artificial saliva for 6 and 12 months prior to testing. Additional immediate and 6-month specimens were examined for interfacial nanoleakage analysis under SEM. Matrix metalloproteinase (MMP) inhibition by DMSO was examined with gelatin zymography. Demineralized dentin disks were incubated in 100% DMSO to observe the optical clearing effect.

Results

The use of 0.5 mM DMSO had no effect on immediate bond strength or nanoleakage. In controls, μTBS decreased significantly after storage, but increased significantly in DMSO-treated group. The control group had significantly lower μTBS than DMSO-group after 6 and 12 months. DMSO also eliminated the increase in nanoleakage seen in controls. 5% and higher DMSO concentrations significantly inhibited the gelatinases. DMSO induced optical clearing effect demonstrating collagen dissociation.

Significance

DMSO as a solvent may be useful in improving the preservation of long-term dentin–adhesive bond strength. The effect may relate to dentinal enzyme inhibition or improved wetting of collagen by adhesives. The collagen dissociation required much higher DMSO concentrations than the 0.5 mM DMSO used for bonding.     

Grape seed proanthocyanidins increase collagen biodegradation resistance in the dentin/adhesive interface when included in an adhesive

Objectives

Contemporary methods of dentin bonding could create hybrid layers (HLs) containing voids and exposed, demineralised collagen fibres. Proanthocyanidins (PA) have been shown to cross-link and strengthen demineralised dentin collagen, but their effects on collagen degradation within the HL have not been widely studied. The purpose of this study was to compare the morphological differences of HLs created by BisGMA/HEMA model adhesives with and without the addition of grape seed extract PA under conditions of enzymatic collagen degradation.

Methods

Model adhesives formulated with and without 5% PA were bonded to the acid etched dentin. 5-μm-thick sections cut from the bonded specimens were stained with Goldner's trichrome. The specimens were then exposed to 0.1% collagenase solution for 0, 1, or 6 days. Following collagenase treatment, the specimens were analysed with SEM/TEM.

Results

Staining did not reveal a difference in the HLs created with the two adhesives. SEM showed the presence of intact collagen fibrils in all collagenase treatment conditions for specimens bonded with adhesive containing PA. These integral collagen fibrils were not observed in the specimens bonded with adhesive without PA after the same collagenase treatment. TEM confirmed that the specimens containing PA still showed normal collagen fibril organisation and dimensions after treatment with collagenase solution. In contrast, disorganised collagen fibrils in the interfacial zone lacked the typical cross-banding of normal collagen after collagenase treatment for specimens without PA.

Conclusions

The presence of grape seed extract PA in dental adhesives may inhibit the biodegradation of unprotected collagen fibrils within the HL.     

Effect of dentin pretreatment with mild acidic HOCl solution on microtensile bond strength and surface pH

Objectives

To evaluate the pretreatment effect of mild acidic HOCl solution on the microtensile bond strength (μTBS) of a two-step self-etch adhesive to dentin and the alteration of dentin surface pH.

Methods

Thirty-nine flat ground coronal dentin specimens were divided into one control group and 12 experimental groups, which were treated with 6% NaOCl or 50, 100 and 200 ppm HOCl (Comfosy^®) solutions for 5, 15 and 30 s. After rinsing with running water for 30 s, all the dentin surfaces were bonded with Clearfil SE Bond according to the manufacturer's instructions. After 24 h water storage, the bonded specimens were sectioned and trimmed to an hourglass shape with a cross-sectional area of approximately 1.0 mm² and then subjected to the μTBS test. Thirty-six mid-coronal dentin discs were used for surface pH measurement. Dentin surface pH with or without pretreatment was examined using a pH-imaging microscope (SCHEM-100). The μTBS data were analyzed by one-way ANOVA (Dunnett's T3) and the surface pH data were analyzed by non-parametric statistics (Mann–Whitney U-test).

Results

Pretreatment with Comfosy^® at concentrations of 50, 100 and 200 ppm did not significantly affect μTBS regardless of the application time compared with the control group, however the 100 and 200 ppm Comfosy^® groups showed significantly lower surface pH values. For the NaOCl pretreatment groups, a longer application time significantly decreased the μTBS and increased the surface pH values compared to the control group.

Conclusions

The 50 ppm Comfosy^® pretreatments for 5, 15 and 30 s did not affect the μTBS of the two-step self-etch adhesive to dentin and dentin surface pH.     

Effect of saliva contamination on bond strength of resin luting cements to dentin

Objectives

This study examined the effect of saliva contamination on the microtensile bond strength (μTBS) of resin luting cements to dentin.

Methods

For RelyX ARC (ARC, 3M ESPE), dentin surfaces were etched with 32% phosphoric acid. The subgroups were: ARC-control (uncontaminated), ARC-I (saliva contamination, blot-dried), ARC-II (saliva contamination, rinse, blot-dried) and ARC-III (saliva contamination, rinse, re-etch, rinse, blot-dried). For Panavia F 2.0 (PF, Kuraray), the subgroups were: PF-control (uncontaminated), PF-I (saliva contamination, dried), PF-II (saliva contamination, rinse, dried), PF-III (primer, saliva contamination, dried), PF-IV (primer, saliva contamination, dried, primer re-applied) and PF-V (primer, saliva contamination, rinse, dried, primer re-applied). Composite blocks were luted onto dentin using the two cements. Bonded specimens were sectioned into 0.9 mm × 0.9 mm beams for μTBS testing. Representative fractured beams were prepared for fractographic analysis.

Results

For ARC, salivary contamination of etched dentin (ARC-I) significantly lowered bond strength (p = 0.001). Rinsing saliva off with water (ARC-II) restored bond strength to control level. Re-etching dentin surface after rinsing (ARC-III) resulted in the lowest bond strength (p < 0.001). For PF, salivary contamination of dentin before (PF-I) and after application of primer (PF-III and PF-IV) significantly lowered bond strength (p < 0.001). Rinsing saliva off with water and re-application of primer (PF-II and PF-V) improved bond strength.

Conclusion

Saliva contamination during luting deteriorated the bond quality of resin cements. Decontamination by rinsing with water was most effective in restoring the bond strength of RelyX ARC. Decontamination by water-rinsing and primer re-application after rinsing improved the bond strength of Panavia F 2.0.     

HEMA reactivity with demineralized dentin

Objectives

2-Hydroxyethylmethacrylate (HEMA) was compared to its epoxy analogue, glycidoxypropylmethacrylate (GMA), for reactivity with 2,6-diaminohexanoic acid (Lysine), an amino acid present in collagen possessing a reactive amino side chain. The aim was to verify whether HEMA could chemically react with collagen fibers.

Methods

Capillary electrophoresis was used to analyse reaction products together with computer aided chemistry. Retention of HEMA in demineralized dentine particles was investigated by infrared spectroscopy.

Results

It was found by that HEMA does not form any new molecular species when contacted with lysine whereas GMA completely reacts to form the expected addition product. Computer aided chemistry confirmed this finding. Infrared spectroscopy showed that demineralized dentin has strong affinity for HEMA and retains this monomer despite extensive water washing.

Conclusions

We interpret this behavior as demonstrating solvation of HEMA in the collagen polymer network.     

Biomimetic remineralization of dentin

Objectives

Remineralization of demineralized dentin is important for improving dentin bonding stability and controlling primary and secondary caries. Nevertheless, conventional dentin remineralization strategy is not suitable for remineralizing completely demineralized dentin within hybrid layers created by etch-and-rinse and moderately aggressive self-etch adhesive systems, or the superficial part of a caries-affected dentin lesion left behind after minimally invasive caries removal. Biomimetic remineralization represents a different approach to this problem by attempting to backfill the demineralized dentin collagen with liquid-like amorphous calcium phosphate nanoprecursor particles that are stabilized by biomimetic analogs of noncollagenous proteins.

Methods

This paper reviewed the changing concepts in calcium phosphate mineralization of fibrillar collagen, including the recently discovered, non-classical particle-based crystallization concept, formation of polymer-induced liquid-precursors (PILP), experimental collagen models for mineralization, and the need for using phosphate-containing biomimetic analogs for biomimetic mineralization of collagen. Published work on the remineralization of resin–dentin bonds and artificial caries-like lesions by various research groups was then reviewed. Finally, the problems and progress associated with the translation of a scientifically sound concept into a clinically applicable approach are discussed.

Results and significance

The particle-based biomimetic remineralization strategy based on the PILP process demonstrates great potential in remineralizing faulty hybrid layers or caries-like dentin. Based on this concept, research in the development of more clinically feasible dentin remineralization strategy, such as incorporating poly(anionic) acid-stabilized amorphous calcium phosphate nanoprecursor-containing mesoporous silica nanofillers in dentin adhesives, may provide a promising strategy for increasing of the durability of resin–dentin bonding and remineralizing caries-affected dentin.     

In vitro evaluation of plant-derived agents to preserve dentin collagen

Objective

Biomodification of dentin by a natural crosslinker has been recommended to improve a mechanical property of demineralized dentin. This study investigated the effect of various plant-derived agents (hesperidin, proanthocyanidin, epigallocatechin gallate and genipin) on the stability of dentin collagen matrix to resist collagenase degradation.

Methods

The dentin specimens were treated with glutaraldehyde (0.5% and 5.0%) and each plant-derived test solution (0.5%). They were subjected to ultimate tensile strength (UTS) and swelling ratio measurements. Demineralized human dentin powder was incubated with 0.02%, 0.1% and 0.5% of each test agent and followed by bacterial collagenase digestion. The extent of collagen degradation was investigated using hydroxyproline assay.

Results

The UTS and swelling ratio measurements revealed that the mechanical property of dentin was improved by the use of these natural agents. The greatest reduction in collagen degradation was shown following the use of hesperidin, proanthocyanidin, and epigallocatechin gallate at 0.5%.

Significance

The use of hesperidin, proanthocyanidin, and epigallocatechin gallate could improve the mechanical properties of collagen and resist enzymatic degradation, leading to functional repair of pathological dentin lesion.     

Stabilization of dentin matrix after cross-linking treatments,in vitro

Objectives

To evaluate the effect of EDC on elastic modulus (E), MMPs activity, hydroxyproline (HYP) release and thermal denaturation temperature of demineralized dentin collagen.

Methods

Dentin beams were obtained from human molars and completely demineralized in 10 wt% H₃PO₄ for 18 h. The initial E and MMP activity were determined with three-point bending and microcolorimetric assay, respectively. Extra demineralized beams were dehydrated and the initial dry mass (DM) was determined. All the beams were distributed into groups (n = 10) and treated for 30 s or 60 s with: water, 0.5 M, 1 M or 2 M EDC or 10% glutaraldehyde (GA). After treatment, the new E and MMP activity were redetermined. The beams submitted to DM measurements were storage for 1 week in artificial saliva, after that the mass loss and HYP release were evaluated. The collagen thermal denaturation temperature (TDT) was determined by DSC analysis. Data for E, MMP activity and HYP release were submitted to Wilcoxon and Kruskal–Wallis or Mann–Whitney tests. Mass loss and TDT data were submitted to ANOVA and Tukey tests at the 5% of significance.

Results

EDC was able to significantly increase collagen stiffness in 60 s. 10% GA groups obtained the highest E values after both 30 and 60 s. All cross-linking agents decreased MMP activity and HYP release and increased TDT temperature. Significant differences were identified among EDC groups after 30 or 60 s of cross-linking, 1 M or 2 M EDC showed the lowest MMP activity.

Significance

Cross-linking agents are capable of preventing dentin collagen degradation. EDC treatment may be clinically useful to increase resin-dentin stability.     

Zinc reduces collagen degradation in demineralized human dentin explants

Objectives

Dentin matrix metalloproteinases are implicated in the pathogenesis of caries and contribute to collagen degradation in resin-dentin interfaces. The objective was to determine if collagen degradation may be modulated by an excess of zinc or zinc chelators.

Methods

Mineralized and phosphoric acid demineralized human dentin specimens were tested. Chlorhexidine digluconate, doxycycline or ZnCl₂ were added to the media. In half of the groups, active exogenous metalloproteinase-2 was incorporated into the solution. C-terminal telopeptide determinations (radioimmunoassay) were performed after 24 h, 1 and 3 weeks.

Results

Collagen degradation was prominent in demineralized dentin. Doxycycline fully blocked dentin proteolysis. Chlorhexidine digluconate reduced the degradation at the 24-h period. Zinc in excess strongly inhibits hydrolysis of collagen and its effect was maintained for 3 weeks.

Conclusions

Zinc in excess reduces MMP-mediated collagen degradation. The hypothesis that binding of zinc to collagen results in protection of sensitive cleavage sites of metalloproteinases requires further validation.     

Improving the effect of NaOCl pretreatment on bonding to caries-affected dentin using self-etch adhesives

Objective

To evaluate the effect of sodium hypochlorite pretreatment on adhesion to normal and caries-affected dentin using self-etch adhesives.

Methods

Forty extracted human molars with coronal carious lesions were used in this experiment. The occlusal dentin surfaces including the caries-affected dentin in each group were treated as follows: group 1, rinsed with water; group 2, treated with 6% NaOCl for 15 s; group 3, treated with 6% NaOCl for 30 s; group 4, application with Accel for 30 s after NaOCl-30 s pretreatment. After rinsing with water and air-drying, the treated dentin surfaces were applied with self-etch systems (Bond Force and Clearfil Protect Bond) according to the manufacturers’ instructions, and built-up with resin composite. After 37 °C water storage for 24 h, the bonded normal or caries-affected dentin areas were isolated to create an hourglass configuration with a cross-sectional area of approximately 1 mm². The specimens were subjected to tensile stress at a cross-head speed of 1.0 mm/min.

Results

NaOCl-15 s pretreatment significantly improved the μTBS of both self-etch adhesives to caries-affected dentin, while the 30 s pretreatment did not affect them. For normal dentin, NaOCl-30 s pretreatment significantly reduced the μTBS of both self-etch adhesives although the 15 s pretreatment did not alter them. Furthermore, the application of Accel with a reducing effect increased the μTBS to normal and caries-affected dentin treated with NaOCl for 30 s.

Conclusions

The effects of NaOCl pretreatment on bonding of both self-etch adhesives were dependent upon type of dentin (normal and caries-affected dentin) and the treatment time.     

Primary dentin etching time,bond strength and ultra-structure characterization of dentin surfaces

Objectives

To evaluate the effect of shortening the etching time on roughness, microhardness and bond strength of three adhesive systems to primary tooth dentin.

Methods

Flat dentin surfaces from primary molars were randomly assigned to six experimental groups. Three different adhesive systems were used: an etch-and-rinse adhesive (Single Bond), a two-step self-etching (Clearfil SE Bond), and a one-step self-etching (One-Up Bond F) adhesive. In half of the specimens, the recommended etching time was used, in the other half the etching time was 50% reduced. After applying the adhesive, resin composite build-ups were constructed and stored in a humid environment for 24 h at 37 °C. Specimens were sectioned into 1 mm² beams and tested for microtensile bond strength (MTBS). Debonded surfaces were analyzed by scanning electron microscopy (SEM). Additional surfaces were conditioned for microhardness measurements (KHN) and for atomic force microscopy (AFM) analysis. Intertubular and total surface roughness (Ra) were recorded. Results were analyzed with ANOVA and Student–Newman–Keuls tests (P < 0.05).

Results

Single Bond and Clearfil SE Bond showed higher MTBS than One-Up Bond F. Bond strength and intertubular roughness increased when Single Bond and One-Up Bond F were used with a reduced etching time. For Clearfil SE Bond no differences in MTBS were detected when reducing the etching time. The application of phosphoric acid, Clearfil SE Bond primer and One-Up Bond F decreases dentin microhardness.

Conclusions

Shortening One-Up Bond F application time and reducing the etching time of phosphoric acid to one-half of the manufacturer's recommended etching time when using Single Bond are recommended when bonding to primary dentin.     

Chlorhexidine and green tea extract reduce dentin erosion and abrasion in situ

Objectives

This in situ/ex vivo study aimed to analyse the impact of possible MMP-inhibitors (chlorhexidine and green tea extract) on dentin wear induced by erosion or erosion plus abrasion.

Methods

Twelve volunteers took part in this cross-over and double-blind study performed in 4 phases of each 5 days. Bovine dentin samples were worn in palatal appliances and subjected to extraoral erosion (4 times/day, Coca-Cola, 5 min) or erosion plus abrasion (2 times/day, fluoride-free toothpaste and electrical toothbrush, 15 s/sample). Immediately after each erosion, the appliances were reinserted in the mouth and the oral cavity was rinsed for 60 s with: 250 ppm F solution (SnF₂/AmF, pH 4.5, Meridol-Gaba, Switzerland), 0.12% chlorhexidine digluconate (0.06% chlorhexidine, pH 6.0, Periogard-Colgate, Brazil), 0.61% green tea extract solution (OM24^®, 100% Camellia Sinensis leaf extract, catechin concentration: 30 ± 3%, pH 7.0, Omnimedica, Switzerland) or deionized water (pH 6.0, control). Dentin loss was assessed by profilometry (μm). The data were analysed by two-way repeated measures ANOVA and Bonferroni post hoc test.

Results

There was a significant difference between the conditions (Ero × Ero + Abr, p < 0.001) and among the solutions (p < 0.001). All solutions (F: 1.42 ± 0.34; 1.73 ± 0.50, chlorhexidine: 1.15 ± 0.26; 1.59 ± 0.32, green tea: 1.06 ± 0.30; 1.54 ± 0.55) significantly reduced the dentin wear when compared to control (2.00 ± 0.55; 2.41 ± 0.83) for both conditions. There were not significant differences among green tea extract, chlorhexidine and F solutions.

Conclusions

Thus, the possible MMP-inhibitors tested in this study seem to be a promising preventive measure to reduce dentin erosion-abrasion, but their mechanism of action needs to be investigated in further studies.     

Bonding effectiveness of two contemporary self-etch adhesives to enamel and dentin

Objectives

Among contemporary adhesives, self-etch adhesives have been adopted by general practitioners for routine adhesive restorative purposes, mainly because of their ease of use. However, many versions that differ for their clinical application procedure, pH, number of components, etc., are currently available on the market. The purpose of this study was to determine the bonding effectiveness of two new self-etch adhesives (Adper Easy Bond and Adper ScotchBond SE, 3M ESPE) to enamel and dentin using a micro-tensile bond strength (μTBS) protocol and to characterise the interfacial ultra-structure at enamel and dentin using transmission electron microscopy (TEM).

Methods

The adhesives were applied onto coronal human enamel and dentin surfaces and built up with the micro-hybrid resin composite Z100 (3M ESPE). The ‘gold-standard’ two-step self-etch adhesive Clearfil SE Bond (Kuraray) served as control. Specimens were sectioned to sticks and trimmed at the interface to a cylindrical hour-glass shape (‘trimmed’ micro-specimens). Non-demineralized and demineralized TEM sections through the adhesive-dentin/enamel interface were prepared by ultra-microtomy.

Results

The μTBS of the two self-etch adhesives to enamel was statistically significantly lower than that of the control. To dentin, the μTBS of Adper Easy Bond was significantly lower than that of Adper ScotchBond SE and the control. TEM showed a tight interface to enamel for all three self-etch adhesives. A relatively thick, completely demineralized and acid-resistant hybrid layer was formed at dentin by Adper ScotchBond SE, whereas the interaction of Adper Easy Bond was much shallower, and comparable to that of so-called ‘ultra-mild’ self-etch adhesives. Some degree of spot- and cluster-like nano-leakage was observed for both adhesives, but did not differ in extent and form from that observed for the control.

Conclusions

Although the new two self-etch adhesives revealed a tight interaction at both enamel and dentin, their bond strength to both tooth tissues was generally lower than that of the control adhesive. Nevertheless, their bonding effectiveness appears in line with other simplified self-etch adhesives.     

Micro-tensile bond strength and interfacial characterization of an adhesive bonded to dentin prepared by contemporary caries-excavation techniques

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.     

Clinical evaluation of polypropylene glycol-based caries detecting dyes for primary and permanent carious dentin

Objective

The aim of this study was to compare the clinical efficacy of new caries detecting dye Caries Check Blue (CCB) with Caries Check (CC) and Caries Detector (CD) using a laser fluorescence device (DIAGNOdent).

Method

Primary and permanent teeth with dentin caries were stained with polypropylene glycol (MW = 300) based new caries detecting dyes CCB, CC, or propylene glycol (MW = 76) based CD. In the CCB and CC groups, stained dentin was completely removed. In the CD groups, pink-stained dentin was retained according to the manufacturers’ instructions. Cavities before and after caries removal were measured with the DIAGNOdent. Data were analyzed using ANOVA and Fisher’s PLSD multiple comparison test at α = 0.05. Regression analyses were performed between DIAGNOdent readings and scores obtained from the clinical parameters.

Results

The DIAGNOdent readings after caries removal were: primary-CCB (13.2 ± 10.4), primary-CC (14.3 ± 16.7), primary-CD (9.0 ± 5.2), permanent-CCB (22.7 ± 13.4), permanent-CC (10.6 ± 6.8) and permanent-CD (9.7 ± 9.0). Significant differences were identified between the permanent-CCB and all other groups. Correlation coefficients between DIAGNOdent readings and clinical parameters were low.

Conclusions

When dentin stained with Caries Check Blue or Caries Check was completely removed, the DIAGNOdent readings were higher than those recorded when palely-stained pink dentin was retained with the Caries Detector, with significant difference observed for the permanent-CCB group. Caries Check Blue may be used clinically to avoid excessive removal of caries-affected or sound dentin in permanent teeth but not in primary teeth.     

Peritubular dentin lacks piezoelectricity

Dentin is a mesenchymal tissue, and, as such, is based on a collagenous matrix that is reinforced by apatite mineral. Collagen fibrils show piezoelectricity, a phenomenon that is used by piezoresponse force microscopy (PFM) to obtain high-resolution images. We applied PFM to image human dentin with 10-nm resolution, and to test the hypothesis that zones of piezoactivity, indicating the presence of collagen fibrils, can be distinguished in dentin. Piezoelectricity was observed by PFM in the dentin intertubular matrix, while the peritubular dentin remained without response. High-resolution imaging of chemically treated intertubular dentin attributed the piezoelectric effect to individual collagen fibrils that differed in the signal strength, depending on the fibril orientation. This study supports the hypothesis that peritubular dentin is a non-collagenous tissue and is thus an exception among mineralized tissues that derive from the mesenchyme.     

Effects of different photo-polymerization protocols on resin-dentine μTBS, mechanical properties and cross-link density of a nano-filled resin composite

Objectives

To evaluate the effects of four different light-curing protocols on the microtensile bond strength (μTBS), ultimate tensile strength (UTS), Knoop micro-hardness (KH) and cross-link density (CLD) of a nano-filled resin composite.

Methods

Filtek Supreme XT (3M-ESPE) was used for the entire experiments following four light-curing approaches: ST, standard irradiance; HI, high irradiance; PD, pulse delay; SS, soft start. The specimens were submitted to different storage periods (24 h or 6 months), cut into match-sticks and subsequently submitted to μTBS testing. Hourglass specimens were also prepared for UTS and KH. Cylindrical specimens were prepared for the CLD evaluation after absolute ethanol challenge. The results were statistically analyzed with a two-way ANOVA and Tukey's test (α = 0.05).

Results

For UTS and KH, continuous irradiance (PD and SS) induced statistically higher results (p < 0.05) both after 24 h and 6 months of water storage compared to ST and HI groups. However, a drop in UTS and KH was obtained after 6 months in all groups. The μTBS was not affected by the different light-curing approaches and, no statistical differences (p > 0.05) were observed between 24 h and 6 months storage. The CLD evaluation showed a statistical drop in KH after 24 h of ethanol storage for PD and SS (step-curing protocols) compared to those attained in continuous mode (ST and HI).

Conclusion

The soft-start mode may improve the UTS and KH of nano-filled resin composites without compromising the resin–dentine μTBS. However, both the step-curing protocols may reduce the cross-link density of the composite polymeric network.

Clinical significance

High irradiances photo-polymerization may be adequate for direct aesthetic restorations such as veneers and onlays. Meanwhile, the soft start protocol would seem more appropriate for the photo-polymerization of high c-factors class I and II restorations.     

Effect of a new liner/base on human dentin permeability

Objectives

Resin-modified glass ionomers (RMGI) have demonstrated clinical success in their ability to minimize post-operative sensitivity of restorations. RMGIs have been recently introduced as paste-liquid systems for convenience of clinical usage. The objective of this study was to measure the ability of a new paste-liquid RMGI liner/base to reduce fluid flow through human dentin.

Methods

Dentin permeability was measured on human crown sections on etched dentin, using etched dentin as a model for the exposed tubules typical of root sensitivity, and permitting measurement of the maximum permeability. In the one group, the etched dentin was coated with the RMGI, and pre- and post-treatment permeability was measured on the coated dentin. In the second group, a smear layer was created on the dentin with sandpaper, then the samples were coated with the RMGI; permeability was measured on the smeared and coated dentin. Samples from each group were sectioned and examined via scanning electron microscopy (SEM).

Results

The new paste-liquid RMGI liner/base significantly reduced fluid flow through dentin, and exhibited excellent seal on dentin with either a smear layer or open tubules. SEM images show evidence that the RMGI infiltrated the smear layer with resin during placement, penetrated dentin tubules, and formed resin tags in acid-etched dentin.

Conclusions

Based on these results, combined with previous research on adhesion and microleakage, it is concluded that the new RMGI liner/base should minimize post-operative sensitivity in restorations.