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Biomedical subjects

David H Pashley

Publications and source records attributed to David H Pashley.

At least 91 records · Page 5Linked to original sources

Effect of the hydration status of the smear layer on the wettability and bond strength of a self-etching primer to dentin.

PURPOSE: To evaluate the microtensile bond strength (MTBS) of a resin-based composite to smear layer-covered dentin using a self-etching primer, Clearfil SE Bond (CSEB), under two different hydration states. Surface roughness and wettability (contact angle measurements) of water and the CSEB primer were also evaluated on this substrate. METHODS: Contact angle (CA) measurements were performed on four caries-free extracted human third molars. The specimens were sectioned parallel to the occlusal surface to expose the moderately deep dentin and ground flat (180-grit SiC) under water to provide uniform flat surfaces. In two samples, the smear layer was completely air-dried; in the other two specimens, the smear layer was briefly air-dried. Contact angle measurements were performed to assess wettability of water and CSEB primer using the Axisymmetric Drop Shape Analysis technique. Surface roughness (SR) was determined with a contact profilometer. In another four molars, CSEB was applied to the smear layer-covered dentin with both hydration states. Resin build-ups were performed incrementally with Tetric Ceram. After storage for 24 hours in water at 37 degrees C, the teeth were sectioned to obtain bonded beams with an average cross-sectional area of 1.0 mm2. Each beam was tested in tension in an Instron machine at 0.5 mm/minute. Kolmogorov-Smirnov and Student t-tests were performed at a 95% significance level. RESULTS: Observed water contact angles were lower on the hydrated smear layer but no differences were found between contact angles on completely and briefly air-dried smear layer when the primer was used for CA measurements. SR was similar for both substrates and MTBS was greater when the adhesive was applied on the completely air-dried smear layer.

Acid Etching, Dental↗

Single-step, self-etch adhesives behave as permeable membranes after polymerization. Part II. Silver tracer penetration evidence.

PURPOSE: To investigate the existence of potential water-filled channels in resin-dentin interfaces of some single-step, self-etch adhesives. METHODS: In Experiment I, Prompt L-Pop (3M ESPE) or an experimental adhesive RZ II (Sun Medical) were bonded to hydrated dentin and then coupled with a light-cured composite that was light-activated immediately upon application. In Experiment II, RZ II and FuturaBond (Voco) were similarly bonded to hydrated dentin. Unfilled resins were coupled in the dark to the bonded dentin using the chemical-cured mode, or light-cured mode with a 20-minute delay before light-activation. Bonded assemblies were challenged with ammoniacal silver nitrate as a tracer and examined with transmission electron microscopy. RESULTS: In Experiment I, two types of silver patterns were observed within adhesive layers and hybrid layers: interconnecting reticular, finger-like and tree-like patterns that were collectively named "water trees", and discrete silver grains. In Experiment II, apart from the patterns described above, silver-filled water blisters were also observed between the adhesive and the unfilled coupling resin in RZ II. They were linked to the pre-existing "water trees" in the adhesive layers via multiple, short water bridges. In FuturaBond, similar blisters were located between the first adhesive layer and the second adhesive layer that was light-activated after placement of the coupling resin.

Acid Etching, Dental↗

Single-step, self-etch adhesives behave as permeable membranes after polymerization. Part III. Evidence from fluid conductance and artificial caries inhibition.

PURPOSE: To test the hypothesis that formation of inhibition zones by bonded restorations in artificially-induced carious dentin lesions is related to the permeability of the self-etch adhesives. METHODS: Fluid conductance of four single-step self-etch adhesives (Prompt L-Pop, Etch&Prime 3.0, One-Up Bond F and Reactmer Bond), and a control two-step self-etch adhesive (UniFil Bond) were measured after sound dentin surfaces were:(1) acid-etched; (2) polished to produce smear layers; (3) bonded with the adhesive; each at 20 cm hydrostatic pressure (hp). Osmotic fluid conductance was also determined for the bonded dentin after immersion in 4.8 M CaCl2 at 0 cm hp. For artificial caries inhibition, a non-fluoride releasing (NFR) two-step self-etch adhesive (UniFil Bond) and a fluoride-releasing (FR) single-step adhesive (Reactmer Bond) were used in combination with a NFR composite (Metafil CX) or a FR restorative material (Reactmer Paste). Artificial caries were induced in these restorations, from which 120 +/- 10 microm thick sections and the effect of caries inhibition were quantitatively assessed with polarizing light microscopy and image analysis. RESULTS: Fluid conductance after bonding with the single-step adhesives Prompt L-Pop and Etch&Prime 3.0 were not significantly different from those recorded from smear layer-covered dentin. Although better seals were achieved with One-Up Bond F and Reactmer Bond, fluid conductance at 20 cm hp was significantly higher than the two-step self-etch adhesive UniFil Bond. Osmotic conductance at 0 cm hp were not significantly different from normal fluid conductance at 20 cm hp. The sizes of artificial carious lesions in UniFil Bond were significantly higher irrespective of whether a FR or NFR composite was used. Significant reduction in lesion size occurred in Reactmer Bond with the use of a NFR composite, and even more so with the use of a FR composite.

Acid Etching, Dental↗

Submicron hiati in acid-etched dentin are artifacts of desiccation.

OBJECTIVES: The submicron hiatus represents a potential space between the base of the collagen network and the mineralized dentin when dentin is acid-etched for bonding. These spaces were observed in SEM studies after acid-etched dentin specimens were critical point dried or dehydrated in hexamethyldisilasane. However, they have never been identified in TEM studies of dentin hybrid layers. This study critically examined the cause of submicron hiati formation using a silver staining technique to measure nanoleakage. METHODS: Two multi-step, total-etch adhesives (One-Step, Bisco; Single Bond, 3M) and two single-step, self-etching adhesives (Prompt L-Pop, ESPE; One-Up Bond F, Tokuyama) were examined. Flat dentin surfaces were bonded with these adhesives and a lining composite. In each adhesive group, 0.8mm thick slabs from the same bonded tooth were coated with nail varnish applied 1mm from the bonded interfaces. The varnish was either left to dry completely for 10min before immersing in 50wt% silver nitrate (AgNO(3)) for 24h (group D), or painted on blotted tooth slabs that were immediately dropped into the AgNO(3) solution (group M). After developing, undemineralized, unstained, epoxy resin-embedded sections were prepared for transmission electron microscopy (TEM) to identify the amount and distribution of silver uptake. RESULTS: Nanoleakage patterns were observed in all adhesive-bonded teeth, regardless of brand. Fine reticular silver deposits were also found in the underlying undemineralized dentin. In group D, submicron hiati were seen as tunnels of heavy silver deposits beneath hybrid layers. Specifically, a hiatus occurred between the undemineralized intertubular dentin and a cohesively fractured layer of the same matrix that was attached to the base of the hybrid layer. Hiati were completely absent in group M, regardless of the brand of adhesive. SIGNIFICANCE: Submicron hiati are artifacts created by desiccation during specimen processing, and should be referred to as such in future studies of bonded dentin interfaces.

Acid Etching, Dental↗

Mapping of tooth deformation caused by moisture change using moiré interferometry.

UNLABELLED: Bonding of composite restorative materials to teeth usually involves surface etching and drying of both dentin and enamel. These two hard tissues have very different water contents. OBJECTIVES: The purpose of this study was to evaluate the effects of changes in humidity on the dimensional changes in dentin disks constrained by enamel and in unconstrained dentin. METHODS: Changes in humidity were used to induce changes in the moisture level of the hard tissues, which created a mechanical load across the dentin-enamel junction (DEJ). High-sensitivity moiré interferometry was used to measure the magnitudes of the strains. Diffraction gratings (with a sensitivity of 2400 lines/mm) were transferred to moist polished sections of human teeth, which were subsequently dehydrated and then hydrated again. The fringe patterns from moiré interferometry recorded the change in deformation between the moisture states. RESULTS: The results indicated that there were wide variations in strain between the two specimen geometries. The strains were fairly constant through the bulk of the dentin in both specimen types. However, the strain gradients were very high across the dentin-enamel interface into the dentin in the unconstrained geometry, and nearly zero in the constrained geometry. SIGNIFICANCE: Moiré interferometry is a powerful tool to study the deformation of materials that are not isotropic and are not linearly elastic. It provides full-field, high-resolution deformation fields in tooth specimens. Deformations observed in this study indicate that the DEJ zone is a unique material interface that needs to be better understood in terms of normal tooth function, and that its material properties be taken into account when natural hard tissues are restored.

Algorithms↗

Microtensile bond strength between adhesive cements and root canal dentin.

OBJECTIVES: The hypotheses tested were that the bond strength of adhesive cements to root canal dentin (1) would be reduced as a function of configuration factor, polymerization process and type of luting material and (2) would be lowered near the apex of the tooth. METHODS: Human canines and premolars were prepared for post cementation using Single Bond/Rely X ARC, ED Primer/Panavia F, C and B Metabond, and Fuji Plus. The specimens were divided into two groups. For intact roots, the posts were luted using standard clinical procedures. For flat roots, the posts were applied directly into flat ground canals. All roots were sectioned into 0.6 mm thick slices, trimmed mesio-distally and stressed to failure at 1 mm/min. The muTBS of each slab was calculated as the force at failure divided by the bonded cross-sectional surface area. The results were compared using a one-way ANOVA and Tukey multiple comparison intervals (alpha=0.05). Least squares linear regression analysis was used to assess the effect of dentin location on bond strength. RESULTS: All cements showed significantly (p</=0.05) lower bond strengths in intact vs. flat roots. The muTBS of posts to intact roots were not significantly different for Single Bond/Rely X ARC and Panavia F, but both were significantly lower (p</=0.05) than the bonds produced by C and B Metabond and Fuji Plus cements. For Single Bond/Rely X ARC and Fuji Plus a significant decrease in bond strength was observed in dentin closer to the apex of the root. SIGNIFICANCE: Stresses from polymerization shrinkage and problems with adequate access to the root canal complicate the formation of high-strength bonds when cementing endodontic posts with resin cements.

Analysis of Variance↗

Effects of water and water-free polar solvents on the tensile properties of demineralized dentin.

OBJECTIVES: The aim of this study was to test the null hypothesis that the tensile properties of demineralized dentin are not influenced by the hydrogen bonding ability of anhydrous polar solvents. METHODS: Dentin disks 0.5mm thick were prepared from mid-coronal dentin of extracted, unerupted, human third molars. 'I' beam and hour-glass shaped specimens were prepared from the disks, the ends protected with nail varnish and the central regions completely demineralized in 0.5M EDTA for 5 days. Ultimate tensile stress (UTS) and low-strain apparent modulus of elasticity (E) were determined with the specimens immersed for 60 min in water, methanol, HEMA, acetone or air prior to testing in those same media. Apparent moduli of elasticity were measured on the same specimens in a repeated measures experimental design. The results were analyzed with a one-way ANOVA on ranks, followed by Dunn's test at alpha=0.05. Regression analysis examined the relationship between UTS or E and Hansen's solubility parameter for hydrogen bonding (delta(h)) of each solvent. RESULTS: The UTS of demineralized dentin in water, methanol, HEMA, acetone and air was 18(7), 29(7), 31(6), 41(13) and 146(27)MPa, x(SD), n=10. Low-strain E for the same media were 11(7), 43(12), 79(21), 132(31) and 253(115)MPa. Regression analysis of UTS vs delta(h) revealed a significant (p<0.0005, r=-0.69, R(2)=0.48) inverse, exponential relationship. A similar inverse relationship was obtained between low-strain E vs delta(h) (p<0.0001, r=-0.93, R(2)=0.86). SIGNIFICANCE: The tensile properties of demineralized dentin are dependent on the hydrogen bonding ability of polar solvents (delta(h)). Solvents with low delta(h) values may permit new interpeptide H-bonding in collagen that increases its tensile properties. Solvents with high delta(h) values prevent the development of these new interpeptide H-bonds.

Acetone↗

Viscoelastic properties of demineralized dentin matrix.

OBJECTIVES: To evaluate the viscoelastic properties of demineralized dentin matrix. Stress-relaxation studies were done on matrices in tension and strain elongation or creep studies were done in both tension and compression. METHODS: Mid-coronal dentin disks were prepared from extracted unerupted human third molars. Disks were 0.5 mm thick for stress-relaxation or tensile creep experiments and 0.2-0.3 mm thick for compressive creep studies. 'I' beam specimens were prepared from dentin disks and the middle region was demineralized in 0.5 M EDTA (pH 7) for 4 days. The specimens were held in miniature friction grips in water and pulled at 100 micro m s(-1) to strains of 5, 10, 15 or 20% and then held for 10 min to follow the decay of stress over time. Creep was determined on demineralized dentin immersed in water in tension and in compression. Compressive creep was measured using an LVDT contact probe with loads of 0.02-0.5 N. Strain data were converted to compliance-time curves (strain/stress) and expressed as total compliance (J(t)), instantaneous elastic compliance (J(o)), retarded elastic compliance (J(R)) and viscous response (t/eta) or creep. RESULTS: The dentin matrix exhibits both stress-relaxation and creep behavior. Stress-relaxation and tensile creep were independent of strain but compressive creep rates were inversely related to compressive strain. Creep values were about 10% at low compressive strains, but fell progressively to 1% at high strains. Compliance-time curves fell with stress and came closer together. However, tensile creep was about 3% regardless of the strain. SIGNIFICANCE: The dentin matrix exhibits viscoelastic properties, but is not linearly viscoelastic. The relatively high creep rates of the matrix under low compressive loads may cause viscous deformations in poorly infiltrated hybrid layers in resin-bonded teeth under function.

Analysis of Variance↗

Bonding mechanism and ultrastructural interfacial analysis of a single-step adhesive to dentin.

OBJECTIVES: to characterize the interaction of 4-acryloxyethyltrimellitic acid (4-AET), a key ingredient in a commercial all-in-one adhesive (Reactmer Bond) with dentin apatite, to measure the solubility of 4-AET calcium (4-AETCa), and to examine the ultrastructure of the resin-dentin interface bonded by this adhesive. METHODS: solubility of synthesized 4-AETCa in several solutions was measured. Flattened bovine dentin blocks were treated with 0.1wt% NaOCl for 10 min, or 5.0wt% NaOCl for 10 min, or 30 min. Fourier transform infrared analysis using attenuated total reflection (FT-IR/ATR) was performed on these four substrates before and after treatment with a 4-AET mixture (4-AET/HEMA: 40/60wt%). Undemineralized, unstained sections of human sound dentin that were bonded with the same comonomers were examined by transmission electron microscopy (TEM). RESULTS: the respective solubilities of the 4-AETCa in water, 2-hydroxyethyl methacrylate (HEMA; 100wt%) and HEMA/water (70/30wt%) were 0.023, 0.003 and 0.014 mol/l after 2 min. The IR analysis indicated that Ca-carboxylate (new bands: nuCz.dbnd6;O:1580 and 1413 cm(-1)) was formed on all dentin specimens following application of 4-AET, with or without NaOCl pretreatment. TEM showed a 1 micro m thick hybrid layer with some remnant apatite crystallites that were encapsulated by a layer of less electron-dense material. SIGNIFICANCE: the results suggest that ionized carboxyl groups in 4-AET may interact with Ca(2+) from apatite crystallites within the partially demineralized hybrid layer to form an insoluble calcium salt (4-AETCa) that may aid in bonding this resin system to dentin.

Animals↗

Microtensile bond strength of total-etch and self-etching adhesives to caries-affected dentine.

OBJECTIVES: To evaluate the microtensile bond strength of total-etch or self-etch adhesives to caries-affected versus normal dentine, and to correlate these bond strengths with DIAGNOdent laser fluorescence and Knoop microhardness (KH) measurements of the substrates. METHODS: Extracted carious human molars were ground to expose flat surfaces where the caries lesion was surrounded by normal dentine. Surfaces were bonded with either Prime & Bond NT, Scotchbond 1, Clearfil SE Bond or Prompt L-Pop, according to manufacturers' recommendations. A crown was built up using resin composite (Tetric Ceram). After storage in water (37 degrees C, 24 h), teeth were vertically serially sectioned into 0.7 mm thick slabs and trimmed to yield 1 mm(2) test area that contained either caries-affected or normal dentine. Samples were tested in tension in an Instron machine at 1 mm/min. The quality of the dentine just beneath each fractured specimen was measured by laser fluorescence and KH. RESULTS: Total-etch adhesives yielded higher bond strengths than self-etching systems. Significantly lower results were obtained with Prompt L-Pop. All the adhesives attained higher strengths in normal than in caries-affected dentine, but the differences were only significant for Prime & Bond NT and Clearfil SE Bond. Higher laser fluorescence values and lower KH (p<0.001) were recorded in caries-affected dentine compared to normal dentine. CONCLUSIONS: The total-etch adhesives evaluated produced higher bond strengths to normal and caries-affected dentine than self-etching systems. Laser fluorescence measurements discriminated caries-affected dentine from normal dentine, and were strongly correlated with KH. However, laser fluorescence and KH did not permit high correlations with resin-dentine bond strengths in caries-affected dentine.

Acid Etching, Dental↗

Effect of root resection on the apical sealing ability of mineral trioxide aggregate.

OBJECTIVE: The purpose of this in vitro study was to determine the minimum depth of mineral trioxide aggregate (MTA; ProRoot; DENTSPLY/Tulsa Dental, Tulsa, Okla) required to maintain an apical seal following root resection. Study design. In 10 instrumented teeth, MTA was used to obturate the apical 6 mm of the root canal and was allowed to set for 48 hours. Leakage was determined by means of a fluid filtration method at a pressure of 20 cm H(2)O. Leakage was measured before root resection, and after 3, 4, 5, and 6 mm apical resections. Data were analyzed by means of a Kruskal-Wallis one-way analysis of variance with P <.05. RESULTS: Fluid leakage was shown to increase after each resection, but did not reach statistical significance (P <.05) until 4 mm of the apex had been removed. CONCLUSION: The results indicate that root resection did not significantly affect the sealing ability of MTA when at least 3 mm of the MTA remained. Although there was a statistically significant difference in leakage following the 4 mm resection, it is unknown what the biological difference would be between the 3 mm and 4 mm resections.

Aluminum Compounds↗

Identification of resected root-end dentinal cracks: a comparative study of visual magnification.

The purpose of this in vitro study was to evaluate and compare the effectiveness of visual enhancements as aids in identifying artificially created dentinal cracks in resected root ends. Fifty human maxillary central incisors were decoronated, and the root canals were instrumented to ISO size 50 at the working length. The apical 3 mm of the roots were resected, and cracks were artificially created in the apical dentin with an average load of 5.6 kg using a cylindrical wedge in a miniature drill press. A video microscope at x65 magnification was used to observe the cracks as they developed. Four independent examiners evaluated the root specimens using unaided/corrected vision (group 1), loupes at x3.3 magnification (group 2), a surgical operating microscope at x10 magnification (group 3), and the Orascope at x35 magnification (group 4). The examiners' proficiency at correctly identifying root ends with and without cracks was evaluated. The data were compared to the predetermined standard (27 cracked, 23 not cracked) with a one-tailed Fisher's exact test (alpha = 0.05). Statistically, the Orascope (p = 0.02) was significantly superior, whereas using unaided/corrected vision (p = 0.99), loupes (p = 0.88), or the microscope (p = 0.14) was not significantly better than guessing. The accuracy of correct identification for unaided/ corrected vision, loupes, the microscope, and the Orascope was 39%, 45%, 53%, and 58%, respectively. A two-way analysis of variance of the accuracy of crack identification showed a significant difference among the four visualization techniques (p = 0.0007) and also among the four evaluators (p = 0.006).

Analysis of Variance↗

Effect of depth and tubule direction on ultimate tensile strength of human coronal dentin.

The purpose of this study was to evaluate the effect of dentin depth and tubule direction on the ultimate tensile strength (UTS) of human dentin. Dentin slabs of 0.5-mm thickness were trimmed either from the mesial and distal (for specimens with the tubules parallel to the tensile force; parallel group) or from the occlusal and pulpal surfaces (perpendicular group) to reduce the cross-sectional area of the superficial, middle, and deep regions to 0.25 mm2, and subjected to microtensile testing. From SEM photomicrographs of the fractured specimens of the parallel group, the tubule density was investigated. For both parallel and perpendicular groups, superficial dentin showed a significantly higher UTS than deep dentin. The tubule density of superficial dentin was significantly lower than that of middle and deep dentin. When performing the microtensile bond test to deep dentin, it is possible that cohesive failure of dentin can occur at relatively low tensile stresses.

Dental Restoration Failure↗

Factors contributing to the incompatibility between simplified-step adhesives and chemically-cured or dual-cured composites. Part I. Single-step self-etching adhesive.

PURPOSE: To determine if adverse chemical interaction and adhesive permeability are both responsible for the incompatibility between a single-step, self-etching adhesive and chemically-cured or dual-cured composites. MATERIALS AND METHODS: Bonding was performed with Xeno CF Bond (Dentsply-Sankin), on either hydrated (H) or dehydrated (DH) human dentin. For microtensile bond strength evaluation, a dual-cured hybrid composite (Bis-Core) was activated using: (1) the light-cured (L) mode (base syringe only), (2) delayed light activation (DL) (base syringe left on top of cured adhesive in the dark for 20 min before activation), and (3) the chemically-cured (C) mode (base and catalyst syringes in the dark). A chemical co-initiator (B; BondLink) was also applied to the cured adhesive before coupling with the composite in chemically-cured mode. This resulted in seven experimental groups: (1) L-H (control); (2) DL-H; (3) DL-DH; (4) C-H; (5) C-DH; (6) C-B-H; and (7) C-B-DH. For transmission electron microscopy, the dual-cured composite in the seven groups was replaced with a light-cured microfilled composite (Metafil CX) and an experimental chemically-cured microfilled composite of the same composition. Specimens were immersed in ammoniacal silver nitrate for 24 h. After reduction of the diamine silver ions to silver, undemineralized and unstained sections were examined for nanoleakage within the resin-dentin interfaces of the seven groups. RESULTS: For the light-cured modes, bond strengths fell substantially in DL-H but not in DL-DH. For the chemically-cured modes, bond strengths were lowest in C-H and only increased slightly in C-DH. The use of a chemical co-initiator with the adhesive further improved the bond strength in C-B-H. Only C-B-DH was not significantly different from the control light-cured mode L-H. Two abnormal modes of silver deposition were observed in resin-dentin interfaces. A continuous layer of silver was observed when the chemically-cured composite was applied to the cured adhesive in the absence of the chemical co-initiator (C-H; C-DH). Silver-impregnated water blisters were identified when the chemically-cured composite was coupled to bonded hydrated dentin (C-H; C-B-H). Similar water blisters were seen in DL-H in which adverse chemical interaction should not occur. CONCLUSION: Adverse chemical interaction between catalytic components of chemically-cured composite and the tested single-step, self-etching adhesive was the major cause of reductions in bond strength, while adhesive permeability was a minor cause of bond strength reduction. The combination of these two factors accounts for the substantial reduction in bond strength when chemically-cured or dual-cured composites were coupled to bonded hydrated dentin.

Acid Etching, Dental↗

Water treeing--a potential mechanism for degradation of dentin adhesives.

PURPOSE: To test the hypothesis that water channels are present along the adhesive-dentin interface that can be detected using transmission electron microscopy examination of tracer penetration. MATERIALS AND METHODS: Different total-etch adhesives (Single Bond, Excite, and PQ1) and self-etch adhesives (Prompt L-Pop, Reactmer Bond, and an experimental self-etch adhesive) were bonded to dentin and enamel. Bonded resin-tooth slabs were immersed in 50 wt% conventional silver nitrate or 50 wt% basic, ammoniacal silver nitrate for 24 hours, exposed to a photodeveloping solution, and prepared for transmission electron microscopy. RESULTS: With both types of silver nitrate, all adhesives exhibited nanoleakage within hybrid layers. In addition, water trees in the form of interconnecting, dendritic silver deposits were seen along the surface of the hybrid layers that extended perpendicularly into the adhesive layers. With ammoniacal silver nitrate, additional isolated, unconnected silver grains were observed within the adhesives.

Acid Etching, Dental↗

Resin adhesion to carious dentin.

PURPOSE: To investigate the microtensile bond strength (microTBS) of a self-etching priming adhesive system to normal, caries-affected and caries-infected dentin, and to observe the ultrastructure of the resin-dentin interface by transmission electron microscopy (TEM). MATERIALS AND METHODS: Twelve extracted human molar teeth with deep occlusal caries were stained with caries detector solution and ground flat occlusally. The red-stained soft dentin was classified as caries-infected. The surrounding discolored dentin was classified as caries-affected dentin. The surrounding normal dentin served as a control. The entire flat surface was bonded with Clearfil Liner Bond 2V (CV) and covered with resin composite to form a composite crown 5 mm high. One day later the specimens were serially sectioned vertically into multiple slabs 0.8 mm thick. Under microscopic observation, the specimens were divided into normal or caries-infected or caries-affected dentin. These regions were isolated by cutting away the remaining dentin to form hour-glass shapes with the smallest surface area at the test site. After measuring the areas, the specimens were fixed to a microtensile tester and pulled under tension to failure. Additional slabs that were not used for bond strength tests were processed for TEM. Bond strength data were analyzed by Kruskal-Wallis one-way ANOVA and Student-Newman-Keuls multiple comparisons. RESULTS: The microTBS of CV to normal, caries-affected and caries-infected dentin were 45 +/- 10 MPa, 30 +/- 10 MPa, 10 +/- 5 MPa, respectively. TEM images showed that CV formed thin hybrid layers that were less than 1 microm thick in normal dentin, but that were between 6-8 microm thick in caries-affected dentin. Bacteria were only sparsely observed in the dentin tubules of bonded caries-affected dentin. However, in caries-infected dentin, an unusual interface was seen in which carious bacteria within disorganized non-banded collagen fibrils could be seen embedded by the adhesive. The hybrid layer in caries-infected dentin was found to be 30-60 microm thick.

Acid Etching, Dental↗