Clinical evaluation of the Carisolv chemomechanical caries removal technique according to the site/stage concept,a revised caries classification system

The objective of the present study was to assess the efficiency and benefit of a chemomechanical system for carious dentin removal, Carisolv, in general practice. A revised caries classification, the site/stage concept, was used to describe the clinical situations of all carious lesions treated. The study was performed by 12 investigators, and 120 carious lesions were treated with Carisolv. Sixty percent of the cases were treated without anaesthesia, and we found a significant correlation between chemomechanical treatment without anaesthesia and absence of pain ( P=0.01). In 78.3% of the cases, carious dentin was totally removed with Carisolv, and in 21.7%, the dentin treatment was completed by drilling. In cases performed with Carisolv alone, the time required to remove carious dentin was 11.1+/-9.51 min (mean+/-SD). Treatment time was equivalent for all sites and increased significantly with each successive stage of lesion progression ( P<0.001). In 82.5% of cases, the clinicians were satisfied with Carisolv, and in 99.2%, so were the patients. We conclude that, using clinical examination methods, Carisolv seems to remove carious dentin at all sites and stages of carious lesions but must be made more efficient for use in general practice.     

Immunolocalization of a human cementoblastoma-conditioned medium-derived protein

Little is known about the molecular mechanisms that regulate the cementogenesis process, because specific cementum markers are not yet available. To investigate whether a cementoblastoma-conditioned medium-derived protein (CP) could be useful as a cementum biological marker, we studied its expression and distribution in human periodontal tissues, human periodontal ligament, alveolar bone, and cementoblastoma-derived cells. In human periodontal tissues, immunoreactivity to anti-CP was observed throughout the cementoid phase of acellular and cellular cementum, cementoblasts, cementocytes, cells located in the endosteal spaces of human alveolar bone, and in cells in the periodontal ligament located near the blood vessels. Immunopurified CP promoted cell attachment on human periodontal ligament, alveolar bone-derived cells, and gingival fibroblasts. A monoclonal antibody against bovine cementum attachment protein (CAP) cross-reacted with CP. These findings indicate that CP identifies potential cementoblast progenitor cells, is immunologically related to CAP species, and serves as a biological marker for cementum.     

Dentine bonding agents--a review of adhesion to dentine.

Although constant innovation has improved the performance of dentine adhesives, the true mechanism of resin adhesion to dentine is still not clear and the optimal dentinal surface pretreatment has yet to be determined for adhesive integrity of resin to dentine. The integrity of the collagen fibrils left exposed upon acid etching seem to play a major role in the mechanism of adhesion and intermingling of the adhesive monomers with the filigree of collagen fibers or hybrid layer should be considered the paramount dentine bonding mechanism. Definite trends are emerging but more research is necessary before general conclusions can be made about the functions of different bonding agents. The all-in-one self-etching/self-primer bottle systems are relatively new to the market and need more research before they can be advocated as the agent of choice.     

Caries occurrence in a fluoridated and a nonfluoridated town in Finland: a retrospective study using longitudinal data from public dental records

The tap water of Kuopio, Finland, was fluoridated from 1959 to 1992. In the first decade of fluoridation, children in Kuopio had lower DMF values than children in Jyv?skyl?, a nearby low-fluoride town, but later differences between the towns have been small and inconsistent. The present study aimed to gain further insight into caries occurrence in Kuopio and Jyv?skyl? using longitudinal tooth-specific data from public health records on cohorts born in 1970/71 and 1980/81 (total n = 1,503). Survival analyses were used to summarize the tooth-specific times elapsed between eruption and the first filling (used as a proxy for dental caries). Generally, the first filling was placed sooner after eruption in the 1970/71 cohort than in the 1980/81 cohort. The curves for the two towns were virtually identical except for the first molars of the 1970/71 cohort, for which the percentage of filled first molars was consistently lower in Jyv?skyl? than in Kuopio. This study indicates that, among children and adolescents whose permanent teeth erupted in the mid-1970s or thereafter, even a longitudinal approach did not reveal a lower caries occurrence in the fluoridated than in the low-fluoride reference community. The main reason for the modest effect of water fluoridation in Finnish circumstances is probably the widespread use of other measures for caries prevention. The children have been exposed to such intense efforts to increase tooth resistance that the effect of water fluoridation does not show up any more. The results must not be extrapolated to countries with less intensive preventive dental care.     

Cytotoxicity of a dentine bonding agent on four different cell-lines.

The aim of this study was to compare the cytotoxicity of a recently available dentine bonding agent on four different cell-lines (three human dental pulp fibroblast cell-lines and one mouse 3T3 fibroblast cell-line). METHODOLOGY: Three human dental pulp cell-lines from 3 different donors and one established 3T3 mouse cell-line were grown and sub-cultured. Cell viability following exposure to Scothbond was then compared to a similar number of controls using the MTT assay. RESULTS: Scotchbond 1 was cytotoxic to all four cell-lines. 3T3 cells showed a survival rate of about 60% as compared to two of the human dental pulp cells which showed a significantly lower survival rate (p<0.05, Kruskal-Wallis Multiple-Comparison Test). CONCLUSION: These findings indicated that is cytotoxic to both human pulp and 3T3 cell-lines. In general, the human pulp cell-lines showed higher sensitivity than the 3T3 cell-lines. CLINICAL SIGNIFICANCE: Scotchbond 1 cannot be recommended for direct pulp capping techniques and care should be taken when using this dentine bonding agent in cavities where the remaining dentine layer is minimal.     

Effectiveness of composite cure associated with different light-curing regimes

This study investigated the use of various light-curing regimens with standardized light energy density on the effectiveness of cure of a visible light activated resin composite (Z100, 3M-ESPE). A light-cure unit (Variable Intensity Polymerizer (VIP), BISCO Inc) which permitted individual control over time and intensity, was used. The five light-curing modes investigated include Pulse Delay (PD), Pulse Cure (PC), Soft-start (SS), Turbo (T) and Control (C). Effectiveness of cure was established by measuring the top and bottom Knoop hardness of 2-mm thick composite specimens using a digital microhardness tester (n=5, load=500g; dwell time=15 seconds) immediately and at one-day post-polymerization. Data obtained was analyzed using one-way ANOVA/Scheffe's post hoc test and Independent Samples t-tests (p<0.05). Top KHN observed immediately after polymerization with C was significantly lower than PD. At one day post-polymerization, the top KHN obtained with C was significantly lower than PD, SS and T. No significant difference in bottom KHN was observed among the different curing modes immediately after curing. At one day post-polymerization, the bottom KHN obtained with C was significantly lower than SS and T. Regardless of curing regimens, top and bottom values at one day were significantly higher than those observed immediately after light polymerization. No significant difference in mean hardness ratio was observed among the different curing regimens immediately and one day later. Effectiveness of the cure at the bottom surfaces of composites may be increased by soft-start and turbo polymerization regimens.     

Volumetric polymerization shrinkage of resin composites under simulated intraoral temperature and humidity conditions

This study measured the volumetric shrinkage of resin composites polymerized under temperature and humidity conditions simulating the oral cavity and compared them to those occurring under ambient room conditions. Small, semispherical specimens of a microhybrid (Z100), microfill (Filtek A110) and flowable microhybrid (4 Seasons Flow) resin composite were manually formed and light activated for 40 seconds using a halogen light-curing unit (Spectrum Curing Light). The volumetric polymerization shrinkage of 10 specimens of each brand of resin composite was measured using a drop shape analysis unit (Drop Shape Analysis System, model DSA10 Mk2) under each of two temperature/relative humidity conditions: room conditions (22 +/- 2 degrees C and 60 +/- 5%) and those simulating intraoral conditions (35 degrees C and 92 +/- 5%). Mean volumetric shrinkage values were calculated for each resin composite and the data were analyzed using two-way analysis of variance and t-test (a=0.05) to determine if significant differences existed between the amount of volumetric polymerization shrinkage that occurred under ambient room conditions and that which occurred under simulated intraoral conditions. Mean volumetric shrinkage values measured for the resin composites were: 2.26 +/- 0.04% (ambient) and 2.61 +/- 0.04% (intraoral) for Z100; 1.96 +/- 0.04% (ambient) and 2.28 +/- 0.04% (intraoral) for Filtek A110 and 4.53 +/- 0.06% (ambient) and 5.34 +/- 0.05% (intraoral) for 4 Seasons Flow. For each resin composite, statistical analysis indicated that the amount of volumetric shrinkage measured under simulated intraoral conditions was significantly greater than what was measured under ambient room conditions (p<0.0001).