Comparison of pulp responses following restoration of exposed and non-exposed cavities

OBJECTIVES: The purpose of this study is to compare and contrast differences of pulp responses between non-exposed and exposed cavity preparations in terms of inflammation, frequency of bacterial microleakage, odontoblast and odontoblastoid cell numbers, and tertiary dentine formation. METHODS: Class V non-exposed cavities (n=161) and exposed cavities (n=161 teeth) were prepared in non-human primate teeth. Cavities were restored with calcium hydroxide [Ca(OH)(2)], resin modified glass ionomer, or resin composite. Following extraction (7-730 days), bacteria were detected with McKays stain and pulp reactions were categorized according to ISO guidelines. Teeth were analyzed histomorphometrically and statistically using analysis of variance tests. RESULTS: Exposed cavities in comparison with non-exposed cavities were found to have more severe inflammation (p=0.0001), greater quantities of tertiary dentine (p=0.0001), and an increased frequency of bacterial microleakage (p=0.0034). The density of odontoblastoid cells beneath pulp exposed tertiary dentine was found to be 47.8% of odontoblast cell density beneath non-exposed dentine (p=0.0001). CONCLUSIONS: The restoration of exposed cavity preparations is associated with more traumatic pulp injury and repair responses. Consequently, efforts should be made to minimize iatrogenic dentine removal during cavity preparation and the creation of pulp exposures whenever possible.     

Effect of saliva contamination on microleakage of a bonding system.

Saliva contamination is a major clinical problem during restorative dental treatment. Restorative systems must possess sufficient marginal sealing ability to avoid microleakage. PURPOSE: The purpose of this study was to investigate the effect of saliva contamination on the microleakage of cavities restored with Prime & Bond NT and Dyract-AP. METHOD: Cavities were prepared with occlusal margins in enamel and gingival margins in dentine on the buccal surfaces of extracted human permanent premolar teeth. The cavities were etched with phosphoric acid or a non rinse conditioner (NRC). Preparations were distributed randomly into 4 treatment groups (N = 18) consisting of two respective etching methods (phosphoric acid/NRC), each with and without saliva contamination. After the restorative process the samples were thermocycled in dye, sectioned, and scored for microleakage. RESULTS: Contamination with saliva had no significant effect on microleakage on the enamel or dentine sides where phosphoric acid was used as conditioner. Where NRC was used, significantly more microleakage was observed at the enamel sides, but significantly less at the dentine sides.     

Effect of previous treatments on bond strength of two self-etching adhesive systems to dental substrate

PURPOSE: The aim of this study was to evaluate the effectiveness of previous dental substrate treatments on the bond strength of two self-etching adhesives. MATERIALS AND METHODS: One hundred bovine incisors were sectioned at the cementoenamel junction. The labial tooth surface was ground to obtain flat superficial dentin. Teeth were randomly divided into two groups (n = 50): Clearfil Protect Bond and One Up Bond F. The specimens of each group were subdivided into five groups, according the dental substrate treatment, and then the adhesive system was applied as follows (n = 10): C: control, without previous treatment; TA: 37% phosphoric acid etching on enamel and dentin for 15 s; PA: 37% phosphoric acid etching only on enamel for 15 s; SB: Al2O3 sandblasting on dental surface; EDTA: enamel and dentin conditioning with 24% EDTA gel, pH 7.0. Resin composite blocks were fixed to the dental surfaces with dual-polymerized resin cement. Samples were sectioned in the mesiodistal direction and were trimmed to reduce the cross-sectional area to approximately 1.2 mm2. They were tested at a crosshead speed of 0.5 mm/min on a testing machine. Microtensile bond strength values from enamel, superficial dentin, and deep dentin were compared. Mean microtensile bond strength values were expressed in MPa and were analyzed by two-way ANOVA (2 x 3 x 5) and Tukey's tests. RESULTS: A significant difference was observed for interaction (p = 0.00001) among the factors. The highest mean bond strength to enamel was found with previous phosphoric acid etching, and to dentin when EDTA was previously applied. CONCLUSION: The most indicated previous treatment for increasing the bond strength to enamel and dentin simultaneously is EDTA for both self-etching adhesive systems used.     

Effect of acid etching on the dental pulp in adhesive composite restorations.

Pulpal response to marginal enamel etching or both enamel and dentine etching with 37% phosphoric acid for adhesive composite restorations was studied in the teeth of the Japanese monkey (Macaca fuscata). Dentine etching irritated the pulp and caused moderate to severe initial changes along the odontoblastic layer at 3 days. When no bacteria were present along the cavity walls, the subsequent pulpal reactions at 30 and 90 days decreased with time and large amounts of irritation dentine were formed. These inflammatory reactions were less than those caused by enamel etching only, or zinc oxide/eugenol cement. Significant correlation (P less than 0.01) was found between the intensity of the inflammatory reactions and the degree of bacterial infection. The pulpal irritation caused by acid etching of dentine for composite restorations is transitory only when the fillings have a good marginal seal and wall adaptation.     

Evaluation of pumice,fissure enameloplasty and air abrasion on sealant microleakage

PURPOSE: The purpose of this in vitro study was to evaluate microleakage of pit and fissure sealants after using three different pit and fissure preparation techniques: (1) traditional pumice prophylaxis and acid etching, (2) fissure enameloplasty and acid etching and (3) air abrasion and acid etching. METHODS: Sixty extracted third molars with no clinical evidence of caries were randomly divided into 3 groups of 20 each. Teeth were prepared using 1 of 3 occlusal surface treatments prior to placement of Delton opaque light-cured sealant. The teeth were thermocycled between 5 +/- 2 degrees C and 55 +/- 2 degrees C for 500 cycles with a dwell time of 30 seconds and then stored in 0.9% normal saline. All teeth were sealed apically and coated within 1.5 mm of the sealant margin with two layers of nail varnish. The teeth were immersed in a 1% solution of methylene blue for 24 hours to allow dye penetration into possible gaps between enamel and sealant. Three buccolingual cuts parallel to the long axis of the tooth were made yielding 4 sections and 6 surfaces per tooth for analysis. The surfaces were scored 0 to 3 for extent of microleakage using a binocular microscope at 25X magnification. RESULTS: Kruskal-Wallis and t tests revealed no significant difference in microleakage between the 3 fissure preparation methods prior to sealant placement. CONCLUSIONS: Neither air abrasion nor enameloplasty followed by acid etching produced significantly less microleakage than the traditional pumice prophylaxis with acid etching technique.     

Influence of phosphoric acid etching on microleakage of a self-etch adhesive and a self-adhering composite

Background: The aim of this study was to evaluate the influence of preliminary phosphoric acid etching on the microleakage of a self‐adhering flowable composite and a self‐etch adhesive used in combination with the proprietary flowable composite. Methods: Standard Class V cavities were prepared on the buccal side of 20 extracted sound human molars. Specimens were randomly divided into five groups: (1) Gel Etchant/Optibond FL/Premise Flowable; (2) Vertise Flow; (3) Optibond XTR/Premise Flowable; (4) Gel Etchant/Vertise Flow; and (5) Gel Etchant/Optibond XTR/Premise Flowable (Kerr). The interfacial sealing ability of the materials was evaluated by scoring the depth of silver nitrate penetration and through scanning electron microscopy observations. Differences in leakage at either the enamel or the dentine interface were evaluated for statistical significance (Kruskal–Wallis ANOVA, Mann–Whitney U test, p < 0.05). Results: At the enamel interface, no significant differences were found among the materials. On dentine, Gel Etchant/Vertise Flow had the highest leakage scores and the difference was statistically significant (p < 0.05). Conclusions: The early sealing ability of the self‐adhering flowable composite and the self‐etch adhesive in Class V restorations did not significantly benefit from selective enamel etching. Preliminary phosphoric acid etching of dentine negatively affected the quality of the seal when using the adhesive‐free flowable composite.     

Sealing capacity of a photochromatic flowable composite as protective base in nonvital dental bleaching

AIM: To evaluate microleakage of a flowable composite used as a protective isolating base, applied with different adhesive systems. METHODOLOGY: Seventy root-filled teeth were divided into seven groups. A flowable composite base (Tetric Flow Chroma) was used with three adhesive techniques (Syntac, Excite, Excite DCS; in the three cases with and without acid etching) and in a control group without dentine conditioning or adhesive placement. A 30% hydrogen peroxide solution was applied for 24 h in the pulp chambers, followed by the placement of a dye (silver nitrate) for 4 h. Each tooth was sectioned longitudinally, and examined under 4x magnification to assess the tooth/restoration dye leakage following a four-degree scale. Percentage of dye penetration was registered. Statistical analysis was made through the Tukey and Mann-Whitney U-tests. RESULTS: Maximum leakage (100% of specimens) was recorded in the control group without an adhesive system. In the groups subjected to acid etching, the percentage of leakage corresponded to Excite DSC (10%), followed by Syntac (20%) and Excite (30%). In the groups in which only an adhesive system was used, 50% of the teeth demonstrated dye leakage. Statistically significant differences in terms of leakage were observed between the control group and the experimental groups (P < 0.05). There were no significant differences among the experimental groups, but comparing the leakage percentages obtained between the groups in which the teeth were subjected to prior acid etching, and those in which no etching was carried out, observed differences were significant (P = 0.04). CONCLUSIONS: There were no significant differences between the adhesive systems in terms of leakage. Acid etching significantly reduced leakage.     

The effect of acid primer or conventional acid etching on microleakage in a photoactivated sealant

PURPOSE: The purpose of this study was to examine differences in microleakage in extracted human teeth when placing sealants using conventional acid etching or an acidic primer resin. METHODS: Three experimental groupings were used: group 1--conventional acid etching with placement of light-cured sealant; group 2--application of acidic primer resin (Prompt-L-Pop) and light curing, followed by sealant placement; group 3--similar to group 2, but acidic primer and sealant were photocured after placement of sealant. Teeth were thermocycled, stained, sectioned and examined for marginal microleakage. RESULTS: In group 1, 94% of the enamel-sealant interfaces were free of microleakage. For groups 2 and 3, only 28% showed no leakage, with most leakage occurring at both margin and base areas. Nonparametric data analysis indicated acid etching demonstrated significantly lower microleakage than either treatment using the acidic primer resin (P<.001) and that leakage scores in the acidic primer groups were identical (P=.4011). CONCLUSIONS: Use of this specific acidic resin primer in lieu of conventional acid etching (whether cured prior to or subsequent to sealant placement) demonstrated greater incidence of microleakage and would not be advocated over traditional etching procedures.     

Effects of additional and extended acid etching on bonding to caries-affected dentine

This study evaluated the effects of additional and extended acid etching on microtensile bond strength ( micro TBS) of two adhesive systems to sound (SD) and caries-affected dentine (CAD). Flat surfaces of CAD surrounded by SD of 36 extracted carious third molars were assigned to four treatments (i): self-etching adhesive system (Clearfil SE Bond) applied to dentine surfaces following manufacturer's instructions (MI); (ii) after additional etching for 15 s (35% phosphoric acid, PA); (iii) total-etch one-bottle adhesive (Single Bond) applied to dentine surfaces following MI; or (iv), after etching for 45 s with PA. Composite 'blocks' were built on bonded surfaces and restored teeth were vertically sectioned to obtain bonded slices of 0.7 mm thick. Slices were trimmed to create hourglass-shaped specimens (cross-sectional area of 1 mm(2)), which were tested under tension in a universal testing machine. Additional CAD and SD samples were prepared for scanning electron microscopy observations. Additional and extended etching significantly increased micro TBS to CAD; however, micro TBS of both adhesives to CAD were significantly lower than to SD. Additional and extended etching can improve bonding to CAD; however, adhesives applied on SD showed the best results for bonding.     

Histomorphometric analysis of odontoblast-like cell numbers and dentine bridge secretory activity following pulp exposure

AIM: The purpose of this study was to collect quantitative information about the numbers and dentine bridge secretory activity of odontoblast-like cells following dental pulp exposure. METHODOLOGY: The numbers and secretory activity of odontoblast-like cells were measured histomorphometrically between 7 days and 2 years in 161 pulp-exposed nonhuman primate teeth. The area of dentine bridges and the dimensions of cavity preparations were measured. The density of odontoblast-like cells and subjacent reorganizing tissue cells were measured beneath dentine bridge formation. The presence of operative dentine debris and tunnel defects in bridges was noted. Pulp inflammation was categorized according to ISO standards. Bacteria were detected using McKay's stain. RESULTS: The area of dentine bridges was mediated by the density and secretory activity of odontoblast-like cells over time. The cell density of subjacent reorganizing tissue was found to be strongly associated with that of odontoblast-like cells. Bacterial microleakage was found to impede dentine bridge secretion by odontoblast-like cells. CONCLUSIONS: Pulp reparative activity occurs naturally beneath capping materials in the absence of bacterial microleakage. The outcome of pulp-capping treatments could be beneficially influenced by concentrating attention on limiting the width of pulp exposure, minimizing pulp injury by limiting the creation of operative debris and placing materials which prevent bacterial microleakage.     

Microleakage of composite resin restorations in cervical cavities prepared by Er,Cr:YSGG laser radiation

BACKGROUND: Evaluation of microleakage is important for assessing the success of new methods for surface preparation and new adhesive restorative materials. The aim of this laboratory study was to assess microleakage at the margins of composite restorations in Er,Cr:YSGG laser prepared cavities on the cervical aspects of teeth by means of dye penetration, and compare this with conventionally prepared and conditioned cavities. METHODS: Class V cavities were produced on sound extracted human teeth, which had been assigned randomly to one of three groups (N = 10 each), as follows: Group 1 - prepared using a diamond cylindrical bur and then treated with 37% phosphoric acid; Group 2 - irradiated with an Er,Cr:YSGG laser (Biolase Waterlase) and then treated with 37% phosphoric acid; Group 3 - irradiated only with the laser. After application of bonding agent (Excite, Ivoclar Vivadent), all cavities were restored with composite resin (Heliomolar). After polishing the restorations, the teeth were thermocycled from 5-50 degrees C for 500 cycles. Dye leakage was assessed after immersion in methylene blue, by examining longitudinal sections in a stereomicroscope at x 30 magnification. RESULTS: The extent of dye penetration was lowest in the laser only group (Group 3). Penetration of dye to dentine and axial walls occurred in 80 per cent of conventionally prepared (bur + acid) specimens, but in the laser group, dye penetration to the axial wall occurred in only 30 per cent of cases. There was a strong statistical association between treatment group and the distribution of microleakage scores (Chi-square, P = 0.0023). CONCLUSIONS: For Class V cavities, with the adhesive materials employed, higher microleakage occurs with phosphoric acid etching of bur- or laser-cut surfaces, than with the surface created by use of the laser alone without additional conditioning.     

SEM-EDX study of prepared human dentine surfaces exposed to gingival retraction fluids

OBJECTIVES: To evaluate the effects of gingival retraction fluids (GRF) on prepared dentine surfaces, and to test the null-hypothesis that prior exposure of dentine surfaces for prolonged period to any of the fluids evaluated does not influence acid-etching of the exposed surfaces. METHODS: The investigation was carried out using SEM and energy-dispersive X-ray analysis (EDX). The GRF studied were Hemodent (HMDT), Astringedent (AST) and Ultradent buffered 25% Aluminium Chloride (ULTB). Longitudinal sections of 220-grit ground dentine surfaces were exposed to GRF for 0.5-, 1-, 2- and 5-min (n=4 each). Another group of samples was produced by 20s application of 35% phosphoric acid (PA) on GRF-pretreated dentine. Control samples were not exposed to GRF. Differences in etching effect-a function of the Ca-contents detected by EDX, were analysed using Friedman's and Wilcoxon's rank test (P<0.05). RESULTS: The SEM demonstrated the presence of a relatively non-porous amorphous dentine matrix, but many of the dentine tubule orifices remained occluded. Granular precipitates, which remained even after acid-etching, were noted on surfaces exposed to Hemodent for 5 min. Characteristic crystal growth was observed on surfaces exposed to Astringedent for 1- or 2-min prior to acid-etching. The EDX data demonstrated that there were differences in resulting Ca-content; ULTB >AST>HMDT>ULTB+PA>HMDT+PA>AST+PA>PA, but AST and HMDT were not significantly different. CONCLUSIONS: The exposure of dentine prepared surfaces to these three GRF altered its morphology and reduced the dentine's susceptibility to acid-etching, thus the null-hypothesis is rejected.     

Effects of conditioners on microshear bond strength to enamel after carbamide peroxide bleaching and/or casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) treatment

OBJECTIVES: To evaluate (a) the enamel microshear bond strength (MSBS) of a universal adhesive and (b) the effects of conditioning with a self-etching primer adhesive with/without prior bleaching and/or casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application. METHODS: Thirty-five molars were cut into four sections, assigned randomly to four groups (no treatment; 16% carbamide peroxide bleaching; CPP-ACP-containing paste (Tooth Mousse, TM); bleaching and TM) and treated accordingly. Specimens were divided into two for bonding with either a self-etching primer (Clearfil SE Bond, CSE) or a total-etch adhesive (Single Bond, SB). Specimens for CSE bonding were subdivided for one of four preconditioning treatments (no conditioning; 30-40% phosphoric acid (PA); 15% EDTA; 20% polyacrylic acid conditioner (Cavity conditioner, CC) and treated. The adhesives were applied and resin composite bonded to the enamel using microtubes (internal diameter 0.75mm). Bonds were stressed in shear until failure, mean MSBS calculated and data analysed using ANOVA with Tukey's HSD test (alpha=0.05). The modes of bond failure were assessed and classified. RESULTS: Two-way ANOVA revealed significant differences between treatments (P<0.0001), conditioners (P<0.0001) and a significant interaction between treatments and conditioners (P=0.001). One-way ANOVA revealed no significant differences in MSBS following any of the treatments for SB; following TM application for CSE without preconditioning; and significant differences in MSBS following bleaching with and without TM application for CSE. With preconditioning, applying PA before CSE post-bleaching and either PA or CC before CSE post-TM application, resulted in significant differences in MSBS (P<0.05). CONCLUSIONS: The use of conditioners prior to bonding with the self-etching primer adhesive system on treated enamel may significantly improve bond strengths.     

Bacterial microleakage and pulp inflammation associated with various restorative materials.

OBJECTIVES: Many restorative materials are claimed to be successful in preventing bacterial microleakage and minimizing pulp inflammation. However, information regarding the in vivo performance of materials in comparison with each other is limited. The aim of this study was to evaluate and compare the pulp response of nine restorative materials when placed in non-exposed monkey cavities.METHODS: 279 standardized non-exposed Class V cavities, were prepared into buccal dentin. Cavities were restored with a number of materials in the following categories: Zinc oxide eugenol (ZnOE), Calcium hydroxide [Ca(OH)(2)], zinc phosphate (ZP), Resin-modified glass ionomer (RMGI), Composite resin (CR), Bonded amalgam (BA), Gutta-percha (GP), Compomer and Silicate. Pulp tissues were collected and evaluated at short, intermediate and long-term intervals according to ISO guidelines; employing histomorphometric analysis, Spearman's rho and ANOVA statistics. Pulp responses were categorized according to FDI, ISO and ADA standards. Bacteria were detected using McKay stains.RESULTS: Pulp inflammation was found to be correlated to bacterial microleakage around the restoration (p < or =0.0001). The frequency of bacterial microleakage was found to vary between restorative materials (p < or =0.0001). In rank order of preventing bacterial microleakage from best to the worst; RMGI (100%), BA (88%), ZnOE (86%), CR (80%), GP (64%), Ca(OH)(2) (58%), compomer (42%), silicate (36%) and ZP (0%).SIGNIFICANCE: The most effective restorative materials to prevent bacterial microleakage and pulp injury from inflammatory activity were RMGI, BA, ZnOE and CR restorations.     

An in vitro investigation of penetration depth of dentine bonding agents into carious dentine

The aim of the present in vitro study was to determine the penetration depth of dentine bonding agents into carious dentine as a possible strategy in caries treatment of deep lesions. Forty-eight extracted carious teeth were used for the experiments and divided in four groups. In a split-tooth design, one half of each tooth was treated without caries excavation, and the second half after caries excavation. In group 1 the teeth were treated with Prime & Bond 2.0 without phosphoric acid etching, and in group 2 with phosphoric acid etching. In group 3, the teeth were treated with All-Bond 2 without phosphoric acid etching, and in group 4 with phosphoric acid etching. Bonding agents were marked with an orange dye prior to application. The composition of the bonding agents had no significant influence on penetration depths. The mean thickness of the outer, necrotic caries zone in unexcavated specimens was 117 microm (+/-126). Bonding agents penetrated significantly deeper into unexcavated carious dentine (mean 124 +/- 76 microm) compared with excavated dentine (11 +/- 14 microm) and sound dentine (3 +/- 4 microm). Acid etching significantly reduced the thickness of the outer caries zone, and the penetration depth of the bonding agents into unexcavated carious specimens by approximately 50%, and increased it into sound dentine. The results indicate that dentine bonding agents could completely penetrate the unexcavated outer carious dentine in 90% of specimens. Further studies are required to determine whether further caries activity is arrested after treatment with dentine bonding procedures.     

Pulp capping with adhesive resin-based composite vs. calcium hydroxide: a review

Abstract – The results of some short-term experiments suggest that direct capping of a vital pulp with the modern resin-based composite systems may be as effective as capping with calcium hydroxide. Total cavity etching with 10% phosphoric acid seems to be safe for the exposed pulp, but unless annulled by calcium hydroxide 35% phosphoric acid may be disastrous. For hemostasis and cleaning of the pulp wound both sodium hypochlorite and saline seem suitable, whereas the effectiveness of a 2% chlorhexidine solution is questionable. Although hard-setting calcium hydroxide cements may induce the formation of dentin bridges, they appear not to provide an effective long-term seal against bacterial factors. Within a few years, the majority of mechanically exposed and capped pulps show infection and necrosis due to microleakage of such capping materials and tunnel defects in the dentin bridges. It is unknown whether newer types of resin containing calcium-hydroxide-products will act as a permanent barrier. The cytotoxicity of the resin-based composites and the temperature rise during polymerisation may not be of concern, but microleakage, sensitisation and allergic reactions may pose problems. Based on available data, pulp capping with resin-based composites may be said to be promising, but more and long-term research is mandatory before the method can be recommended.     

Pulp capping with adhesive resin-based composite vs. calcium hydroxide: a review

The results of some short-term experiments suggest that direct capping of a vital pulp with the modern resin-based composite systems may be as effective as capping with calcium hydroxide. Total cavity etching with 10% phosphoric acid seems to be safe for the exposed pulp, but unless annulled by calcium hydroxide 35% phosphoric acid may be disastrous. For hemostasis and cleaning of the pulp wound both sodium hypochlorite and saline seem suitable, whereas the effectiveness of a 2% chlorhexidine solution is questionable. Although hard-setting calcium hydroxide cements may induce the formation of dentin bridges, they appear not to provide an effective long-term seal against bacterial factors. Within a few years, the majority of mechanically exposed and capped pulps show infection and necrosis due to microleakage of such capping materials and tunnel defects in the dentin bridges. It is unknown whether newer types of resin containing calcium-hydroxide-products will act as a permanent barrier. The cytotoxicity of the resin-based composites and the temperature rise during polymerisation may not be of concern, but microleakage, sensitisation and allergic reactions may pose problems. Based on available data, pulp capping with resin-based composites may be said to be promising, but more and long-term research is mandatory before the method can be recommended.     

Permeability of dentine after Nd:YAG laser treatment: an in vitro study

summary The purpose of this investigation was to determine the effects of Nd:YAG laser treatment on the permeability of dentine. Forty dentine discs were prepared by horizontal sectioning through the middle coronal third of freshly extracted non-carious third molars. After the removal of the pulp the discs were finished with 600 grit and divided into three test groups and one control group (n = 10). For the test groups three different laser power settings were chosen: test group A: 3 × 60 sec, 60 mJ; test group B: 3 × 60 sec, 90 mJ; test group C: 3 × 60 sec, 120 mJ. No laser treatment was performed on the control group. In a two-chamber system the filtration rate of dentine tubules from an exactly defined area of the specimens was measured using a radioactive Ringer solution under a pressure of 30 cm H2O. Permeability measurements were carried out three times prior to lasing, three times immediately following laser treatment and six times after the application of phosphoric acid. Analysis of variance showed a significant influence of the Nd:YAG laser treatment on the permeability of dentine (P < 0.001). The mean quotient of non-treated control vs. lased dentine was 2.19 ± 0.86 for the 60 mJ beam, 1.49 ± 0.88 for the 90 mJ beam, and 204 ± 2.17 for the 120 mJ beam. Etching the lased surfaces had a statistically significant influence on the permeability of the dentine only in the 60 mJ group ( P < 0.001). The data show that the Nd:YAG laser treatment often increases the permeability of smear layer covered dentine but moderates the increase of permeability after etching the surface with phosphoric acid.     

NaOCl effects on primary and permanent pulp chamber dentin

OBJECTIVES: The dentin quality of primary and permanent pulp chamber was inspected by Fourier-transformed Raman spectroscopy (FT-Raman) and scanning electron microscopy (SEM). Fragments of pulp chamber dentin were obtained from 20 human molar crowns (primary and permanent). METHODS: The fragments were assigned to 8 groups (n=5)-Primary teeth: G1, pulp chamber dentin; G2, pulp chamber dentin irrigated with NaOCl 1% (30min); G3, pulp chamber dentin irrigated with NaOCl 1% (30min) and etched by 35% phosphoric acid; G4, pulp chamber dentin etched by 35% phosphoric acid. Permanent teeth: G5, pulp chamber dentin; G6, pulp chamber dentin irrigated with NaOCl 1% (30min); G7, pulp chamber dentin irrigated with NaOCl 1% (30min) and etched by 35% phosphoric acid; G8, pulp chamber dentin etched by 35% phosphoric acid. The spectra were subjected to the Cluster analysis. The SEM images were scored. RESULTS: Inorganic content: There was a difference between primary and permanent dentin. The groups treated with NaOCl were statistically similar between them, but differed from the groups not treated. Organic content: There was no difference between primary and permanent dentin. The groups became similar after NaOCl and phosphoric acid treatments. The microscopic images showed the presence of calcospherites on permanent dentin and their absence on primary dentin. CONCLUSIONS: The NaOCl changed the inorganic content in both dentitions; regardless of the following phosphoric acid etching. However, the chemical changes caused by NaOCl were not detected by SEM when it was followed by etching.     

Microleakage of a pit-and-fissure sealant: effect of air-abrasion compared with classical enamel preparations

PURPOSE: The aim of this study was to assess the microleakage of a pit-and-fissure sealant after classical enamel preparations (prophylaxis followed by acid etching alone and mechanical widening with bur) and after air abrasion. MATERIALS AND METHODS: Ninety noncarious freshly extracted third molars were randomly assigned to three groups of 30. In each group, the mesial halves of the fissures were treated with air abrasion and conditioned with acid etching for 15 s. In group 1, the distal halves were treated with acid etching alone. In group 2, the distal halves of the fissures were widened mechanically with a bur and etched for 15 s. In group 3, the distal halves were prepared with air abrasion alone. Then the sealant (Clinpro) was applied on the occlusal fissures of all teeth, according to the manufacturer's recommendations. The teeth were thermocycled and the samples placed in a 1% methylene blue dye solution. The teeth showing microleakage and the means of infiltration were assessed with an image analysis system. RESULTS: The microleakage of sealants prepared with air abrasion alone displayed significantly greater microleakage (80%) (p < 0.0001) than the ones placed after prophylaxis and etching (13.33%), bur and etching (20%), or air abrasion and etching (22.2%). The samples prepared with air abrasion alone also showed the highest mean microleakage (1.14 +/- 1.4 mm) when compared to samples receiving prophylaxis and acid etching (0.12 +/- 0.41), bur and acid etching (0.08 +/- 0.26), or air abrasion and acid etching (0.09 +/- 0.4) (p < 0.05). No significant difference was noted between the three types of enamel preparation when etching was performed. CONCLUSION: Air-abrasion treatment does not eliminate the need for etching the enamel surface before applying the sealant.