Carisolv去龋及酸蚀后牙本质表面形态扫描电镜观察

目的 通过扫描电镜观察比较车针和Carisolv去龋及酸蚀后牙本质表面形态的差异。方法 24颗拔除的中度龋坏的第三磨牙,随机分成A、B、C、D 4组,每个牙先分别用涡轮车针和Carisolv去龋制备两个窝洞后,做如下处理:A组不处理,B组35%磷酸酸蚀,C组32%磷酸酸蚀,D组Tyrian SPE自酸蚀剂处理。扫描电镜观察牙本质表面形态。结果 Carisolv去龋后牙本质表面玷污层少,大部分牙本质小管口开放,表面粗糙不平;涡轮车针去龋后整个表面覆盖较厚玷污层,牙本质小管口堵塞。35%或32%磷酸酸蚀处理后Carisolv组和车针组均去除了玷污层,但Carisolv组牙本质小管无管塞,而车针组牙本质小管残留少量管塞。Tyrian SPE自酸蚀处理后,Carisolv组与车针组玷污层都被溶解,牙本质小管口部分开放。结论 Carisolv去龋后的牙本质表面利于树脂的粘结,不影响酸蚀剂处理玷污层的能力。     

Dentinal composition and Knoop hardness measurements of cavity floor following carious dentin removal with Carisolv

This study evaluated the dentinal composition and Knoop hardness measurements of the cavity floor following the removal of carious dentin by the Carisolv chemo-mechanical caries removal system, in vitro. The carious dentin of 25 extracted human teeth was removed by using Carisolv for one minute with instruments and excavation that was performed until the gel was clear. Caries removal with a sharp explorer was verified according to the color and hardness of the lesion, then, by means of DIAGNOdent. Atomic analysis of treated cavities was performed by energy dispersive x-ray spectroscopy (SEM-EDX) and the Knoop hardness number (KHN) of the cavity floor was determined. Surface characteristics were observed by the scanning electron microscope (SEM). Adjacent sound dentin was used as a control reference. No significant differences were found between the quantities of calcium content (Ca weight %), phosphorus content (P weight %) and the Ca/P weight ratio of Carisolv cavities with that of the adjacent, sound dentin (p<0.01). KHN of the Carisolv cavity floor was almost similar to that of the adjacent sound dentin. SEM analysis revealed an extremely rough or irregular surface, and there remained a minimal debris-like smear layer; most of the dentinal tubules were opened. The results indicated that Carisolv does not produce any adverse side effects on dentinal compositions of the treated cavities. The possibility of remaining residual softened dentin was also minimal in this study.     

Carisolv去龋对牙本质黏结强度影响的实验研究

目的：研究Carisolv去龋对牙本质黏结强度的影响：方法：选择30颗新鲜拔除的[牙合]面中度龋损的第三磨牙，每个牙的龋洞分成两半，一半用Carisolv去龋，另一半用慢速球钻去龋，而后随机分成3组，分别使用Prime＆Bond NT＋Dyract AP复合体黏结；Uni—Etch（320ml／L磷酸）＋One—Step Plus＋Renew树脂黏结：Prompt—L—Pop＋Z100树脂黏结。测试微抗拉强度（MTBS）：结果：Cafisolv组3种黏结系统MTBS分别为：（17．22±7．95）MPa、（25．40±8．44）MPa、（17．66±8．33）MPa，车针组分别为：（16．01±7．43）MPa、（23.45±7．55）MPa、（16.26±7.97）MPa：2种去龋方法间差异无显著性。结论：Carisolv去龋法对以上3种黏结系统与牙本质的黏结强度无不利影响：     

Influence of Carisolv for resin adhesion to sound human primary dentin and young permanent dentin

OBJECTIVE: This study evaluated the influence of Carisolv (Medi Team) for resin adhesion to sound human primary and young permanent dentin. METHOD: The buccal surfaces of 64 primary molars and 74 premolars were used. Two adhesive systems and resin composites were used; SD: Super-Bond D Liner DUAL (Sun Medical) and Clearfil Photo Anterior(Kuraray), and FB: Imperva Fluorobond and Lite-Fil IIA (Shofu). Ten groups were prepared. Groups 1-5 were primary dentin and Groups 6-10 were permanent dentin. Groups 1 and 6: Carisolv applied and agitated for 3min, SD was used. Groups 2 and 7: etched with 10-3 solution (Sun Medical) for 10s, SD was used. Groups 3 and 8: treated with Carisolv and then etched, SD was used. Groups 4 and 9: treated with Carisolv, FB was used. Groups 5 and 10: FB was used. The microstructural effects of Carisolv, 10-3 solution and Carisolv plus 10-3 solution applied to dentin were evaluated by SEM. In addition, the microstructure of the resin-dentin interfaces of each group were studied using SEM. Shear bond strengths (SBS) were tested, and the failed surfaces were observed using SEM. Data was statistically analyzed using ANOVA with subsequent application of post hoc Duncan's new multiple range test at p<0.05. RESULTS: The effect of Carisolv on primary dentin was stronger than that to permanent dentin. The mean SBS (unit:MPa) of Groups 1-10 were: 5.6, 15.8, 7.6, 17.5, 13.5, 8.1, 16.2, 18.2, 31.4 and 15.5. The SBS of Group 9 (Carisolv treated permanent dentin) was significantly higher than those of other groups. There was no significant difference of SBS among Groups 2, 4, 5, 7, 8 and 10, Groups 3, 5 and 6, and Groups 1, 3 and 6. SIGNIFICANCE: Carisolv treatment before etching significantly decreased the SBS to primary dentin in SD groups, but significantly increased the SBS to permanent dentin in FB groups.     

Clinical evaluation of Carisolv in the chemico-mechanical removal of carious dentin.

The Chemo-mechanical caries removal technique involves the application of chemical agents, to cause a selective softening of the carious dentine and facilitate removal by gentle excavation. Carisolv is one such new chemical agent used in this minimal invasive technique of carious dentine removal. The present study was, therefore, undertaken to evaluate the efficacy of Carisolv in the chemo-mechanical removal of carious dentine, the time taken for caries removal, the perception of the treatment by the patient, and to evaluate the restorations, radiographically. Accordingly, fifty primary and permanent molars with dentinal carious lesions were excavated using this technique of caries removal. The chemo-mechanical caries removal technique using Carisolv proved to be an effective atraumatic treatment modality with potential interest for use in clinical pediatric dentistry.     

An analysis of surface roughness, surface morphology and composite/dentin bond strength of human dentin following the application of the Nd:YAG laser.

OBJECTIVES: This study was conducted to investigate the surface effects to dentin following laser "etching" with an Nd:YAG laser, and to determine the shear bond strengths of composite to untreated and laser-treated dentin. METHODS: Dentin surfaces from freshly extracted permanent molar teeth were subjected to laser treatment with an Nd:YAG laser using different laser pulse rates and power settings. The effect of application of a laser enhancing gel was also investigated. Surface profile analysis of the dentin surfaces was undertaken with a perthometer. The results were analysed by SPSS/PC multiple range test. Specimens were examined using a scanning electron microscope (SEM). The shear bond strengths of laser-treated dentin/composite and untreated dentin/composite by conventional dentin bonding (Gold Standard, Chameleon Dental Products) were also determined. These results were also compared by SPSS/PC multiple range test. RESULTS: The laser-treated dentin specimens exhibited a qualitatively different surface morphology when compared with untreated dentin. Laser treatment at higher exposures resulted in the formation of microcracks and fissures. Bonding of resin composite to the laser-treated dentin was not significantly different from untreated dentin despite the fact that the surface roughness of laser-treated dentin was significantly higher than untreated dentin (p < 0.05). SIGNIFICANCE: It was concluded from this study that the etched dentin surfaces produced by the Nd:YAG laser operated under the conditions described were not superior to those obtained with conventional dentin bonding.     

Er,Cr:YSGG激光照射后硬化牙本质表面超微结构观察

目的 通过比较Er,Cr:YSGG激光照射、磷酸酸蚀等方法处理后硬化牙本质表面的超微结构特点,寻找适合硬化牙本质粘接的表面处理方法.方法 选择16颗有硬化牙本质的离体牙,使用随机数字表随机分为4组,每组4颗,分别进行磷酸酸蚀(A组)、激光照射(B组)、磷酸酸蚀+激光照射(C组)、激光照射+磷酸酸蚀(D组)处理,扫描电镜观察硬化牙本质表而的超微结构.结果 A组硬化牙本质表而可见大部分牙本质小管被硬化柱堵塞;B组硬化牙本质表面为均匀一致的蜂窝状改变;C组硬化牙本质表面形态特点与B组类似;D组硬化牙本质表面形态类似于A组,无激光照射后形成的蜂窝状改变.结论 Er,Cr:YSGG激光照射硬化牙本质后增加了表面粗糙度,形成的粗糙面可能有利于粘接.     

Etching of dentin surface with ammonium citrate aqueous solution

New dentin etchants AC (ammonium citrate) were examined. The pH of the AC solution was 7.3-7.4, and the concentration of the solutions varied from 5% to 30%. The etching of a 10% AC solution was the most effective in improving the adhesion between the composite resin and dentin among the AC solutions employed when MTYA.G.H was used as a dentin primer. The smear layer was removed and the tubules were not generally opened with AC etching. The bond strengths to dentin etched with 10% AC were comparable with those to dentin etched with neutralized 0.5 M EDTA or EDTA 3.2. The bond strengths increased with primers MTYA.H and MTYA.G.H, in that order.     

Primer application technique and remaining dentin thickness affected microtensile bond strength of contemporary dentin adhesives under simulated pulp pressure

Clinical Oral Investigations - To evaluate the effect of application techniques, type of adhesives and remaining dentin thicknesses on microtensile bond strength (µTBS) of 3 adhesive systems....     

Effect of a chemo-mechanical caries removal system (Carisolv) on dentin topography of non-carious dentin.

The purpose of the present study was to examine the morphology of healthy dentin surfaces after treatment with Carisolv followed by conditioning with phosphoric acid and EDTA, since surface morphology may be of interest for dentin bonding. Another purpose was to evaluate the effect of treatment with Carisolv on healthy non-carious dentin surfaces with exposed collagen fibers. Scanning electron microscopy was utilized to carry out a detailed morphological examination of the dentin surfaces with regard to presence or absence of both smear layer and collagen fibers. Twelve premolars extracted for orthodontic reasons from young adults were used. The two etchants appeared to have produced two distinctly different surfaces. Etching with phosphoric acid following Carisolv treatment resulted in a porous dentin surface, while EDTA etching without prior Carisolv treatment appeared to have uncovered an intact collagen network. In contrast, the surfaces treated with Carisolv prior to EDTA etching displayed smooth intertubular surfaces with only occasional fibers. Apparently, the ability of EDTA to expose collagen in the dentin surface is counteracted or inhibited by the Carisolv treatment. Furthermore, it cannot be excluded that the Carisolv treatment in itself may have dissolved collagen fibers. Since most bonding systems claim bonding to the collagenous component of dentin, the question arises which of the etched surfaces is preferable and to what degree the collagenous component contributes to bonding strength. Further studies are thus needed to evaluate the micromechanical retention of a restoration to the different surfaces described in the present study.     

Analysis of surface roughness and microleakage of fissure sealants following organic debris removal with Carisolv

OBJECTIVE: The objective of the present study was to improve fissure sealing by pre-treatment with Carisolv in order to remove organic debris. The surface morphology and roughness of fissure cavities and the degree of microleakage after Carisolv application were compared with those after bristle brush treatment in vitro. METHODS: Fifty extracted human teeth were used in this study. The teeth were randomly divided into two groups of 25 each. Artificial fissures were prepared in all teeth into which artificial organic debris was placed. The debris in 25 teeth of one group was removed using Carisolv applied for 30s and excavation was performed with a dental explorer until the gel was clear. The remaining 25 teeth were then cleaned using bristle brush with prophylaxis paste. Surface roughness was analyzed in five samples from each group by color laser three-dimensional (3D) microscopy and by scanning electron microscopic examination. The remaining samples were filled with sealant and subjected to a microleakage test under thermocycling. Statistical analysis was performed using the Mann-Whitney U-test; a value of p<0.05 was considered significant. RESULTS: Morphologically, most of the debris in the fissures was removed by Carisolv treatment, whereas some fissures were not cleaned by bristle brush. Carisolv-treatment with acid-etching resulted in removal of debris-like smear layer leaving enamel prisms open, and 3D laser microscopy demonstrated that the roughness values increased after acid-etching. However, microleakage test of both Carisolv and brush methods showed similar results. CONCLUSIONS: Carisolv-treated surfaces especially when subjected to acid-etching might facilitate good adaptation of sealant to enamel, because of an increase in surface roughness and favorable surface characteristics.     

Carisolv去龋对牙本质粘结界面影响的实验研究

目的:研究Carisolv去龋对牙本质粘结界面的影响。方法:24颗新鲜拔除的中度龋损的第三磨牙,随机分成ABCD4组。每个牙的龋洞分成两半,一半用Carisolv去龋,另一半用涡轮车针去龋后,做如下处理:A组不处理;B组320ml/L磷酸酸蚀,扫描电镜观察牙本质表面形态;C组不酸蚀,DyractAP复合体充填;D组320ml/L磷酸酸蚀后复合树脂充填,扫描电镜观察牙本质-充填体界面。结果:A组:Carisolv去龋后牙本质表面玷污层少,大部分牙本质小管口开放,清晰可见,表面粗糙不平;涡轮车针去龋后牙本质表面覆盖较厚玷污层,牙本质小管口堵塞,很少见到开口。B组:Carisolv去龋组和涡轮车针去龋组均去除了玷污层,牙本质小管口开放,但Carisolv组牙本质小管无管塞,而涡轮车针组牙本质小管残留部分管塞。C组:观察牙本质-复合体界面见Carisolv去龋组有较多树脂突形成,深入牙本质小管及管周;而涡轮车针去龋组未见明显树脂突起形成。D组:观察牙本质-树脂界面见2组树脂突的密度和长度无明显差异,但Carisolv去龋组树脂突之间的侧枝连接较涡轮车针去龋组多见。结论:Carisolv去龋后牙本质表面玷污层少,牙本质小管口开放,表面粗糙不规则,利于粘结,尤其在使用不需酸蚀的复合体充填时优势突出。     

In vitro influence of Carisolv on shear bond strength of dentin bonding agents.

OBJECTIVE: The aim of this study was to evaluate the influence of Carisolv on the shear bond strength (SBS) of hydrophilic adhesive systems in dentin. METHOD AND MATERIALS: Two hundred bovine incisors were polished with 320- to 1,000-grit aluminum oxide paper and randomly divided into 10 groups (n = 20). The adhesive systems were used according to manufacturer's instructions, and a restorative resin composite (Definite) was inserted in a Teflon matrix and cured. The specimens were kept in humid storage for 7 days at 37 degrees C. The SBS tests were performed in an EMIC universal testing machine with a crosshead speed at 0.5 mm/min. The mean values (MPa +/- [SD]) were analyzed with analysis of variance and Dunnett and Tukey tests. RESULTS: The results were expressed in decreasing values (MPa): G6 = 18.55 +/- 6.95; G3 = 17.55 +/- 5.73; G2 = 17.05 +/- 5.33; G8 = 16.95 +/- 7.13; G7 = 16.94 +/- 5.22; G4 = 16.31 +/- 3.38; G1 = 15.85 +/- 4.45; G9 = 14.21 +/- 5.87; G5 = 12.89 +/- 3.79; and G10 = 12.31 +/- 5.18. CONCLUSION: Carisolv did not interfere in the adhesion to dentin, but its cleanser technique did interfere.     

Effect of concentrated hydrogen peroxide solution on the surface morphology of cut human dentin

Abstract The effect of concentrated hydrogen peroxide solution, alone and in combination with acid-etching with 37% phosphoric acid for 60 s, on the surface morphology of cut human dentin was investigated by SEM and compared to controls in which saline solution rather than hydrogen peroxide solution was used. Examination of the specimens revealed that the smear layer on the surface of cut dentin was not removed by hydrogen peroxide alone, and that a dense amorphous precipitate was formed on the surface of the smear layer after extended exposure. The precipitate accumulation was first noted after 20 min of exposure. Examination of the dentin after hydrogen peroxide exposure followed by acid-etching revealed the presence of a fine granular deposit on an otherwise clean dentin surface. A modest amount of amorphous precipitate was seen over the entire dentin surface after 60 min of hydrogen peroxide exposure. Examination of specimens that were acid-etched before being exposed to hydrogen peroxide indicated that the smear layer was effectively removed and the orifices of the dentinal tubules were enlarged to permit more effective penetration of the peroxide solution. It also resulted in less accumulation of precipitate on the dentin surface than the other methods.     

Influence of Carisolv on resin adhesion for two different adhesive systems to sound human primary dentin and young permanent dentin

OBJECTIVE: This study evaluated the influence of Carisolv (Medi Team) for resin adhesion to sound human primary and young permanent dentin. METHODS: The buccal surfaces of 28 primary molars and 64 premolars were used. Two adhesive systems and resin composites were used; SE: Clearfil SE (Kuraray) and Clearfil APX (Kuraray), and SB: Single Bond (3M) and Z250 (3M). Six groups were prepared. Groups 1-2 were primary dentin and Groups 3-6 were permanent dentin. Groups 1 and 3: SE was used. Groups 2 and 4: treated with Carisolv and then primed, SE was used. Group 5: SB was used. Group 6: treated with Carisolv and then etched, SB was used. The microstructural effects of primer or etchant, and Carisolv plus primer or etchant applied to dentin were evaluated by SEM. In addition, the microstructure of the resin-dentin interfaces of each group was studied using SEM. Shear bond strengths (SBS) were tested, and the failed surfaces were observed using SEM. Data was statistically analyzed using ANOVA with subsequent application of Fisher's PLSD at p<0.05. RESULTS: The mean SBS (unit: MPa) of Groups 1-6 were: 27.8, 19.2, 21.3, 21.7, 6.7 and 7.6. The SBS of Group 2 was significantly lower than that of Group 1. There was no significant difference of the SBS among Groups 1 and 4, 2, 3 and 4, and 5 and 6. In SE groups, the hybrid layer for primary dentin was thicker than that for permanent dentin. CONCLUSIONS: Carisolv treatment before priming significantly decreased the SBS to primary dentin in SE groups, but did not influence the SBS to permanent dentin in both SE and SB groups.     

Dye penetration of the smear layer and fluoride application to the dentin surface

A smear layer is formed after cavity or root canal preparation. The aim of the present study was to reinforce the dental surface in order to prevent the invasion of foreign irritants, by treating the smear layer with fluoride. Dentinal samples whose surfaces had been washed with water after the formation of a smear layer, and corresponding samples without washing, were examined by the dye penetration test, and the results were compared. Although there was no significant difference between the two groups of samples, dye penetration was suppressed by about 30% in washed samples, whereas the suppression was 20% in unwashed samples. When washed samples were treated with 1.0% SnF2, 10.0% SnF2, 7.5% Na2PO2F, 15% Na2PO2F, APF, 10 mM In(NO3)3, 100 mM TiF3, 50 mM TiF3, or 10 mM TiF3, samples washed after treatment with 1.0% SnF2 showed a dye penetration suppression of about 60% as a whole, in comparison with samples having no smear layer. Hardly any suppression of dye penetration was observed after treatment with other fluorides.     

Micromorphological spectrum of acid-conditioned dentin following the application of a water-based adhesive.

OBJECTIVES: The goal of this study was to illustrate the micromorphological spectrum along the resin-dentin interface when a water-based, dentin adhesive (Scotchbond Multi-purpose) was applied to acid-conditioned dentin under different dry and wet bonding conditions. METHODS: Twenty-eight 1 mm dentin discs were each conditioned with 10% maleic acid for 15 s. Twenty-four of these discs were randomly divided into four groups, based upon the status of the remaining surface moisture: Group I (30 s dry); Group II (3 s dry); Group III (visibly moist) and Group IV (overwet). They were bonded using Scotchbond Multi-purpose. The remaining four discs were bonded using an experimental water-based primer containing 35 vol.% HEMA (Group V). Laminated dentin disc pairs were prepared for transmission electron microscopic examination. RESULTS: In all groups, diffusion of the polyalkenoic acid copolymer component of the primer into acid-conditioned dentin was localized to the surface region of the hybrid layer. The remaining part of the hybrid layer (the subsurface region) appeared variable. In Group I (30 s dry), collagen fibrils were collapsed. In Group II (3 s dry) and Group III (visibly moist), stained collagen fibrils were surrounded by wide electron-lucent interfibrillar spaces. In Group IV (overwet), a marked diffusion gradient was observed representing dilution of part of the primer components. In addition, an electron-dense primer phase, containing electron-lucent globular domains was invariably observed, irrespective of the hydration status of the demineralized collagen matrix. This electron dense phase was absent when HEMA alone was used as the primer (Group V). SIGNIFICANCE: With the use of a water-based adhesive, one could briefly air-dry the acid-conditioned dentin and allow the water in the primer to rehydrate the collapsed collagen matrix, without the risk of incomplete hybridization or tubular seal along the resin-dentin interface. However, care should be exercised to minimize dilution of the water-soluble primer component.