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Biomedical subjects

L Breschi

Publications and source records attributed to L Breschi.

At least 19 recordsLinked to original sources

Technique sensitivity associated with air-drying of HEMA-free, single-bottle, one-step self-etch adhesives.

OBJECTIVES: This study examined the effect of air-drying on bond strength to dentin and nanoleakage in resin-dentin interfaces using HEMA-free one-step self-etch adhesives. METHODS: Twelve teeth had their occlusal dentin exposed and split in half. In the group of G-BOND (GB), the adhesive was dried gently or vigorously on each slit half tooth, and then light-cured. In the group of the experimental adhesive (EX), three coats of adhesive were dried using a single air-drying process prior to light-curing or dried after each of three coats of adhesive before light-curing. The split specimens were built-up with resin composite and then subjected to microtensile bond strength testing and TEM examination. RESULTS: GB showed significantly higher bond strength after vigorous drying than after gentle drying. Three teeth of from EX group showed higher bond strength after triple drying than after single drying, while two teeth showed no significant difference. Droplets were revealed in the adhesive layer after gentle drying with GB, and silver deposits existed along the interfaces in all groups. SIGNIFICANCE: The bonding quality to dentin may be improved by using an accelerated air-drying technique; although it is impossible to remove intrinsic dentin moisture that is drawn upwards from dentin tubules.

Acid Etching, Dental↗

An ex vivo comparison of three different gutta-percha cones when compacted at different temperatures: rheological considerations in relation to the filling of lateral canals.

AIM: To compare ex vivo the penetration of three brands of gutta-percha cones, compacted under a constant force and heated to different temperatures, into artificial lateral canals. METHODOLOGY: Resin blocks with simulated main canals, each having two lateral canals (C at 6.5 and A at 13 mm from the surface of the resin block), were selected. A gutta-percha cone, either Mynol MF, Hygenic MF or GT Tulsa 0.04 was compacted into each main canal for 5 s using a wire rod with a diameter of 0.7 mm soldered to the bottom of a metal cylinder, with a force of 2.7 kg at controlled temperatures of 37, 42, 47, 52, 60 degrees C. The penetration of each brand of gutta-percha into 60 lateral canals (10 at each temperature) was measured using a stereomicroscope. Statistical analysis was performed using the ANOVA, the Scheffè test and the t-test. RESULTS: None of the three brands of cones entered up to 0.1 mm within either lateral canal until a temperature of 47 degrees C was reached; at that temperature only Mynol cones (P < or = 0.05) penetrated in four of 10 A-level canals (mean 0.13 +/- 0.19 mm) and in all 10 C-level canals (mean 0.43 +/- 0.12 mm). The A-level lateral canals were penetrated at 52 degrees C by Mynol cones (mean 0.76 +/- 0.34 mm) to a significantly greater distance (P < or = 0.05) than Tulsa cones (mean 0.31 +/- 0.12 mm) and Hygenic cones (mean 0.11 +/- 0.08 mm). At 60 degrees C the Mynol cones (mean 1.93 +/- 0.34 mm) penetrated significantly more (P < or = 0.05) than the Tulsa cones (mean 0.86 +/- 0.22 mm) and Hygenic cones (mean 0.67 +/- 0.19 mm). The C-level lateral canals were penetrated at 52 degrees C by Mynol cones (mean 0.91 +/- 0.29 mm) to a significantly greater distance (P < or = 0.05) than Tulsa cones (mean 0.47 +/- 0.16 mm) and Hygenic cones (mean 0.46 +/- 0.15 mm), whilst no significant difference was found at 60 degrees C. CONCLUSIONS: When heated and compacted, the three gutta-percha cones penetrated the lateral canals to different degrees. They penetrated more than 0.43 mm into the lateral canals only at temperatures higher than 47 degrees C.

Dental Pulp Cavity↗

Reduced antigenicity of type I collagen and proteoglycans in sclerotic dentin.

Antigenic alterations to the dentin organic matrix may be detected by an immunohistochemical approach. We hypothesized that alterations in the antigenicity of type I collagen and proteoglycans occur in sclerotic dentin under caries lesions. Transverse sections were prepared from carious teeth in the sclerotic zone and normal hard dentin. A double-immunolabeling technique was performed on these sections, with anti-type I collagen and anti-chondroitin 4/6 sulfate monoclonal primary antibodies. We used gold-conjugated secondary antibodies to visualize the distribution of intact collagen fibrils and proteoglycans by high-resolution SEM. For sclerotic dentin, labeling densities were 19.57 +/- 3.01/microm2 for collagen and 9.84 +/- 2.62/microm2 for proteoglycans. For normal hard dentin, values were 35.20 +/- 2.73/microm2 and 17.03 +/- 1.98/microm2, respectively. Distribution of intact collagen fibrils and proteoglycans in sclerotic dentin was significantly lower than in normal hard dentin. Reductions in antigenicity from the organic matrix of sclerotic dentin under caries lesions raise concern about the potential of intrafibrillar remineralization.

Collagen Type I↗

Electric-current-assisted application of self-etch adhesives to dentin.

The use of electric current during the application of etch-and-rinse adhesive systems has been recently claimed to increase bonding of etch-and-rinse adhesives by enhancing substrate impregnation. The null hypothesis tested in this study was that electrically assisted application has no effect on bond strength of self-etching bonding systems. Three self-etch adhesives (Protect-Bond, Xeno III, and Prompt L-Pop) were applied with the aid of an electric signal-generating device (ElectroBond) and tested vs. controls prepared with the same disposable sponges but without electric current. Specimens bonded under the influence of electric current exhibited increased microtensile bond strength compared with the controls (p<0.05). High-resolution SEM analysis showed that bonding under the influence of electricity reduced interfacial nanoleakage. It is speculated that resin infiltration may be improved by the attraction of polar monomers by an electric current or by modification of the dentin surface charges, resulting in better water substitution or evaporation.

Ammonia↗

A comparison between two electronic apex locators: an in vivo investigation.

AIM: To compare in vivo the Apex Finder and Root ZX electronic apex locators (EALs) at five different stages during root canal instrumentation. METHODOLOGY: The Apex Finder and Root ZX were used in 64 teeth with either vital or necrotic pulps. Informed consent was obtained by each patient under a study protocol approved by an ethical committee from the University of Trieste. Measurements were made: (stage 1) before instrumentation and irrigation; (stage 2) after brief filing, irrigation with 70% isopropyl alcohol and partial drying; (stage 3) after canal lubrication with EDTA gel (RC-Prep); (stage 4) after complete instrumentation and irrigation with NaOCl 5%; (stage 5) after drying of the final instrumented canal. Stages 2, 3 and 5 were considered low canal conductivity conditions and stage 4 as high. Teeth were then extracted and a size 15 K-file was inserted until its tip was observed under stereomicroscope to reach the foramen and the corresponding length was recorded to an accuracy of 0.25 mm and compared with values derived from the EALs. RESULTS: The data revealed 133 unstable measurements (out of 640): some (68) related to low canal conductivity conditions (more frequently for Root ZX, 67; P < 0.05), and others (63) related to NaOCl presence in the canal (more frequently for Apex Finder, 58; P < 0.05). Accuracy was calculated only on stable measurements. The Root ZX showed significantly (P < 0.05) more precise measurements overall (-0.03 +/- 0.39 mm) compared with the Apex Finder (-0.31 +/- 0.46 mm). Under dry canal conditions the Apex Finder provided the greatest accuracy (-0.0 +/- 0.21) compared with the Root ZX (-0.05 +/- 0.32) (significance P < 0.05). CONCLUSIONS: Under the five different clinical situations both EALs revealed accurate measurements. Apex Finder was negatively influenced by NaOCl in the root canal. The Root ZX was more frequently unable to reveal stable measurements in low conductivity canals.

Analysis of Variance↗

No genotoxicity of a new nickel-free stainless steel.

Stainless steel is a metallic alloy largely employed in orthopedics, maxillofacial surgery and orthodontic therapy. However, the presence in its composition of a high quantity of nickel, an agent known to trigger toxic, allergic and cancerogenous responses in humans, is cause of some concern. In this study, we have investigated the in vitro mutagenicity and genotoxicity of a new nickel-free stainless steel, namely P558, in comparison to the conventional stainless steel AISI 316L. The cytogenetic effects were evaluated by studying the frequency of Sister Chromatid Exchanges (SCE) and chromosomal aberrations. Ames test was performed to detect the mutagenic activity. Both P558 and AISI 316L did not cause any significant increase in the average number of SCE and in chromosomal aberrations, either with or without metabolic activation. Furthermore, the Ames test showed that the extracts of both P558 and of AISI 316L are not mutagenic. Overall, these findings prove that P558 is devoid of genotoxicity and mutagenicity. The present results, together with other previous interesting observations that P558 promotes osseointegration, suggest that this new nickel-free stainless steel can represent a better alternative to other conventional steel alloys.

Animals↗

Cyclosporin A specifically affects nuclear PLCbeta1 in immunodepressed heart transplant patients with gingival overgrowth.

One of the most commonly observed adverse effects of cyclosporin A (CsA) is the development of gingival overgrowth (GO). Fibroblasts are involved in GO, but the question why only a percentage of patients undergoing CsA treatment shows this side-effect remains unanswered. In a previous study, CsA has been demonstrated to induce over-expression of phospholipase C (PLC) beta(1) in fibroblasts of patients with clinical GO, in cells from both enlarged and clinically healthy gingival sites. In this work, we assessed the expression of PLCbeta isoforms to investigate whether the exaggerated fibroblast response to CsA related to increased PLCbeta(1) expression could also be detected in CsA-treated patients without clinical signs of GO. Our results support the hypothesis of a multi-factorial origin of gingival overgrowth, including specific changes within the gingival tissues orchestrating fibroblastic hyper-responsiveness as a consequence of a long-term in vivo exposure to cyclosporin A.

Adult↗

Ability of restorative and fluoride releasing materials to prevent marginal dentine demineralization.

The study aimed to define the in vitro secondary caries inhibiting potential of restorative materials currently used in dental practice. Class V restorations were prepared in extracted human third molars and immersed in a demineralizing solution (lactic acid, pH 4.5) at 37 degrees C for 2 days to simulate secondary caries formation. The bonding and the restorative systems tested in the study were: Scotchbond 1+Z 250 (Group A), Scotchbond 1+F 2000 (Group B), ABF+APX (Group C), ABF+F2000 (Group D). Perimarginal dentine, immediately close to the margin of the restoration, and exposed dentine, at approximately 0.5 mm from the margins of the restoration, after exposure to the acid solution, were investigated; protected dentine, at approximately 4 mm from the margin in a varnish-covered area, was analysed as control. Polarized light microscopy and contact transverse microradiography (TMR) were employed. The output parameters were lesion shape and size (depth in microm) of the exposed dentine, dentine mineral volume%, and integrated mineral loss (Delta Z, in %volmicrom) of the lesions. Compomers (Groups B and D) showed a thinner demineralization of the outer lesions, a less demineralization along the perimarginal dentine (inner lesion) and more caries inhibition zones or CIZs (Delta Z positive values) compared to composites (Groups A and C). In conclusion, Groups B and D materials seemed to partially counteract the marginal demineralization induced by an acid solution and favourably influence the formation of CIZs along the restorations. On the contrary, composites did not show a protective effect, probably due to an insufficient marginal seal and the lack of fluoride release.

Absorptiometry, Photon↗

SEM evaluation of canal wall dentine following use of Mtwo and ProTaper NiTi rotary instruments.

AIM: To compare using scanning electron microscopy (SEM) root canal walls following instrumentation in vitro with two different rotary NiTi instruments. The hypothesis was that no difference should be observable between the experimental groups in terms of debris on canal walls and surface morphology. METHODOLOGY: Twenty-four single-rooted human teeth were selected. Two types of NiTi instruments were used, Mtwo (Sweden & Martina, Padova, Italy) and ProTaper (Dentsply Maillefer, Ballaigues, Switzerland). Irrigation for both groups was performed after each instrument change with 5% NaOCl, 3% H2O2 and 17% EDTA solutions. Three different areas (coronal, middle and apical thirds) of the root canal were evaluated using SEM. The canal wall of each sample was assessed and compared using a predefined scale of four parameters, namely, smear layer, pulpal debris, inorganic dentine debris, surface profile. Data were analysed statistically using the Kruskal-Wallis test (anova). RESULTS: A statistically significant difference (P < 0.01) was found between the apical third and the middle and coronal thirds for both groups. No difference was observable between instrumentation groups. In the apical third canal walls were often contaminated by inorganic debris and by smear layer. In the apical third, the surface profile was affected by uninstrumented regions, comprising dentine depressions and grooves in which predentine was still visible. CONCLUSION: Both instruments produced a clean and debris-free dentine surfaces in the coronal and middle thirds, but were unable to produce a dentine surfaces free from smear layer and debris in the apical third. The presence of deep grooves and depression on dentine walls in the apical third may well explain the presence of less-instrumented areas.

Chelating Agents↗

Collagen degradation by host-derived enzymes during aging.

Incompletely infiltrated collagen fibrils in acid-etched dentin are susceptible to degradation. We hypothesize that degradation can occur in the absence of bacteria. Partially demineralized collagen matrices (DCMs) prepared from human dentin were stored in artificial saliva. Control specimens were stored in artificial saliva containing proteolytic enzyme inhibitors, or pure mineral oil. We retrieved them at 24 hrs, 90 and 250 days to examine the extent of degradation of DCM. In the 24-hour experimental and 90- and 250-day control specimens, we observed 5- to 6-microm-thick layers of DCM containing banded collagen fibrils. DCMs were almost completely destroyed in the 250-day experimental specimens, but not when incubated with enzyme inhibitors or mineral oil. Functional enzyme analysis of dentin powder revealed low levels of collagenolytic activity that was inhibited by protease inhibitors or 0.2% chlorhexidine. We hypothesize that collagen degradation occurred over time, via host-derived matrix metalloproteinases that are released slowly over time.

Acid Etching, Dental↗

In vivo and in vitro permeability of one-step self-etch adhesives.

Adhesive dentistry should effectively restore the peripheral seal of dentin after enamel removal. We hypothesize that non-rinsing, simplified, one-step self-etch adhesives are effective for minimizing dentin permeability after tooth preparation procedures. Crown preparations in vital human teeth were sealed with Adper Prompt, Xeno III, iBond, or One-Up Bond F. Epoxy resin replicas were produced from polyvinyl siloxane impressions for SEM examination. Dentin surfaces from extracted human teeth were bonded with these adhesives and connected to a fluid-transport model for permeability measurements and TEM examination. Dentinal fluid droplets were observed from adhesive surfaces in resin replicas of in vivo specimens. In vitro fluid conductance of dentin bonded with one-step self-etch adhesives was either similar to or greater than that of smear-layer-covered dentin. TEM revealed water trees within the adhesives that facilitate water movement across the polymerized, highly permeable adhesives. Both in vitro and in vivo results did not support the proposed hypothesis.

Acid Etching, Dental↗

Immunocytochemical analysis of dentin: a double-labeling technique.

Immunocytochemical analysis is a fundamental and selective technique for identifying different molecular components of human dental structure. The hypothesis tested here is that the application of different etching solutions on dentin does not hinder collagen fibrils and proteoglycans from maintaining their immunochemical antigenicity. Human dentin disks were treated with 0.5M of EDTA, citric acid, maleic acid, or phosphoric acid (for 15 or 30 s). A double-immunolabeling technique was performed to identify, simultaneously, collagen fibrils and chondroitin sulfate. The use of different acids resulted in different degrees of labeling. Maleic and citric acids revealed a diffuse and intense labeling for both collagen fibrils and proteoglycans. The use of phosphoric acid on dentin showed a massive coagulation of the proteoglycans (15 s) or very low labeling (30 s). These data clarify that the use of acids on dentin components is able to modify their antigenicity. Moreover, the double-labeling immunocytochemical technique allows understanding of the spatial relationships between the collagen fibrils and proteoglycans of the dentin matrix.

Animals↗

Resistance of marginal enamel to acid solubility is influenced by restorative systems: an in vitro scanning electron microscopic study.

The aim of this study was to evaluate the morphology of the enamel surface along margins of class V restorations following exposure to cariogenic solution. Restorations were placed in vitro in human third molars. The specimens were divided into groups according to resin composition: (1) Scotchbond 1 + Filtek Flow, (2) Scotchbond 1 + F2000, and (3) Prompt L-Pop + experimental flowable composite. Samples were stored in a demineralizing solution (lactic acid, pH 4.5, 0.1 M) at 37 degrees for 1-4 weeks or in deionized water (control group). The solution was changed every day. Replicas of the specimens were obtained in order to exclude drying artifacts. Scanning electron microscopy (SEM) of original and replica specimens identified a distinct enamel zone, defined as perimarginal enamel showing numerous fractures, porosities, voids, and pits. After the 4-week treatment, perimarginal prismatic enamel was greatly removed, while interprismatic enamel was still in place and only partially dissolved. Enamel not in relation with composite/compomer margins (0.5-1 mm away) showed minor alterations. Perimarginal enamel fractures probably due to composite/compomer shrinkage or the bur preparation may greatly contribute to this marginal enamel demineralization by increasing the number and size of porosities, that enhance the penetration and diffusion of cariogenic solution and create a sort of demineralized enamel subsurface. Only compomer restorations revealed a thin caries inhibition zone (1-2 micro m) probably related to fluoride release. Below this protected area, we observed the typical alterations of the other samples. These morphological alterations are probably related to secondary demineralization lesions and may affect the clinical life of restorations.

Adult↗

A preliminary analysis of the morphology of lateral canals after root canal filling using a tooth-clearing technique.

AIM: This study used a modified tooth-clearing technique to allow observation of accessory canals following filling with a warm gutta-percha technique and one of two endodontic cements. METHODOLOGY: Ten extracted human maxillary molars with three roots were selected and divided into two equal groups of five teeth. Each group had 15 canals. Root canal preparation was performed with a modified double flared technique; irrigation with 5% NaOCl and lubrication with RC-Prep were used. The canals were then filled with gutta-percha and cement utilizing a warm vertical condensation technique in the apical third followed by thermo-mechanical compaction in the middle and coronal thirds. Pulp Canal Sealer or AH-Plus were used in the experimental groups. The teeth were demineralized with a modified buffered acid solution, cleared in methylsalicylate and examined under a stereomicroscope. Accessory canals were evaluated in the apical, middle and coronal thirds of each root canal and categorized as narrow or wide, following observation on four surfaces. The depth of penetration of gutta-percha and cement into lateral canals was scored using a 5-point system. RESULTS: Complete transparency of the roots was achieved. Accessory canals were detected in all specimens. In coronal ramifications, gutta-percha filled the empty spaces (coronal thirds, grades 3 and 4: 70.9% in AH-Plus group and 68.8% in Pulp Canal Sealer group). In the apical accessory canals, gutta-percha entered less frequently (apical thirds, grades 3 and 4: 17.9% in the AH-Plus group and 3.2% in the Pulp Canal Sealer group); cement without gutta-percha (grades 1 and 2) was present in 55.5% in the AH-Plus group and 38.7% of the Pulp Canal Sealer group. Analysis showed that AH-Plus cement resulted in significantly greater filling of the apical accessory canals compared to Pulp Canal Sealer. CONCLUSIONS: The modified tooth-clearing technique allowed observation of fine morphological details in all specimens. Effective gutta-percha filling was evident in most of the wide coronal lateral canals whilst the apical narrow ramifications were often incompletely filled by cement. Overall AH-Plus demonstrated better diffusion into lateral accessory canals compared to Pulp Canal Sealer.

Citrates↗

Dentin proteoglycans: an immunocytochemical FEISEM study.

Dentin proteoglycans are fundamental constituents of the dentin matrix and are distributed ubiquitously both in dentin and cement. They have several important functional properties; in particular, they have a fundamental role in the maintenance and the correct stabilization of collagen fibers. The use of phosphoric acid on dentin, as proposed in most common dental adhesive systems to establish a reliable bond, may affect the molecular structure of proteoglycans. The aim of this study was to evaluate, after the application of EDTA or phosphoric acid on dentin, the dentin proteoglycans with an immunocytochemical approach with high resolution SEM. For this purpose, dentin disks obtained from recently extracted human molars were etched with a 35% water solution of phosphoric acid for 15 s, 30 s, and 60 s. Control specimens were conditioned with EDTA. Specimens were immunolabeled with a monoclonal antibody antichondroitin sulfate and visualized with a gold-conjugated secondary antibody. Conditioning dentin with EDTA resulted in a distinct labeling of the proteoglycans, as visualized on branching fibrillar structures in the order of 10-20 nm. The use of 35% phosphoric acid on dentin revealed a coagulation of proteoglycans after etching for 15 s while a very low labeling signal was detectable after 30 s. No labeling was obtained after etching dentin with phosphoric acid for 60 s. These results suggest that the use of 35% phosphoric acid on dentin is able to produce significant structural modifications of the dentin proteoglycans even after short application times. Additionally, when applied on the dentin surface for more than 30 s, phosphoric acid produces a dramatic decrease in proteoglycans' antigenicity, probably due to structural modifications of the three-dimensional conformation of these molecules.

Dentin↗

Temperature change within gutta-percha induced by the System-B Heat Source.

AIM: This study evaluated the temperature change within gutta-percha during the vertical compaction technique performed with a System-B Heat Source. METHODOLOGY: Extracted human teeth were prepared and divided in two equal groups depending on the apex diameter (group 1: 0.20-0.25 mm and group 2: 0.30-0.35 mm). Teeth were root treated with a combination of step-back and coronal flaring instrumentation using Gates Glidden burs and hand stainless steel K- and H-files. Two thermocouples were connected to the outer surface of the root: the first one was placed 2 mm apically from cement-enamel junction (CEJ) (point C); and the second one 1.5 mm from the apex (point A). The instrumented canals were filled with size F gutta-percha cones. All teeth were then immersed in a thermostatic bath at a constant temperature of 37 degrees C and warm vertical compaction was performed using a System-B Heat Source. delta T values were recorded by means of a digital thermometer connected to the thermocouples. RESULTS: Increments of temperature (delta T) recorded in point A revealed a mean value of 0.5 +/- 0.5 degree C for group 1 and 0.9 +/- 1.1 degrees C for group 2; delta T values recorded at point C gave a mean value of 4.1 +/- 1.7 degrees C for group 1 and 3.9 +/- 1.81 degrees C in group 2. No statistical difference was found between the groups, whilst a difference was present between the measurements at points A and C (P < 0.01). CONCLUSIONS: The use of the System-B Heat Source on root canals maintained at a constant body temperature by a thermostatic bath revealed that the increase of temperature of the gutta-percha at the apical third of the canal was negligible and that the compaction of the mass of the gutta-percha close to the apex was performed at body temperature. Minor changes in temperature of the outer surface of the root canals occurred, suggesting no danger for the periradicular tissues.

Analysis of Variance↗

Enamel microhardness after in vitro demineralization and role of different restorative materials.

This study aimed to evaluate the extension of enamel demineralization around the margin of restorations after immersion in cariogenic solution, in an attempt to define the role of new restorative materials in preventing secondary caries formation. For this purpose, enamel microhardness was measured. Twelve class V restorations in human extracted third molars were prepared in vitro and immersed in a demineralizing solution (lactic acid, pH 4.5) at 37 degrees C for 3 days to simulate the formation of secondary caries and its effect on the marginal integrity of composite restorations. The restorative systems tested in the study were Scotchbond 1 + Z 250 (group A), ABF + APX (group B), Fuji IX (group C), SE Bond + APX (group D), and Scotchbond 1 + F 2000 (group E). The microhardness was measured close to the margin of restoration (marginal exposed enamel), at 2.0 mm from the margin (exposed enamel), and at approximately 4 mm from the margin in a varnish-covered enamel area (protected enamel). Five measurements were made on each site at 20, 40, 60, 80, and 100 microm depth from the external enamel surface. Exposed enamel and marginal exposed enamel were greatly affected by the cariogenic solution, as confirmed by the high rate of demineralization. The marginal exposed enamel showed a higher rate of demineralization than the exposed enamel, as demonstrated by the lowest microhardness values. The materials that claimed fluoride release did not prevent any type of enamel marginal alteration. This study revealed that enamel close to the margin of restoration may be rapidly affected by secondary caries formation when immersed in a demineralizing-cariogenic solution and that fluoride-releasing materials are unable to reduce the marginal demineralization processes. These demineralization processes may be responsible for marginal secondary caries and for restoration failures.

Biomechanical Phenomena↗