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Biomedical subjects

M Toledano

Publications and source records attributed to M Toledano.

At least 19 recordsLinked to original sources

Polymerization efficacy of simplified adhesive systems studied by NMR and MRI techniques.

OBJECTIVE: To ascertain the efficacy of polymerization of self-etching dental adhesives in different solvent evaporation conditions. MATERIAL AND METHODS: Four self-etching adhesive systems were studied. Two of them are classified as mild two-step self-etching adhesives (Clearfil SE Bond, Protect Bond) and the other two are strong one-step systems (Xeno III, ADP-Prompt-L-Pop). The influence of temperature and duration of the air-drying period on photo-polymerization was followed by: gravimetry, (1)H solid-state NMR spectroscopy and stray-field MRI. The evolution of proton magnetization with irradiation time was recorded and correlated with volumetric polymerization shrinkage and extent of reaction; evaporation and hardening effects were identified. RESULTS: Main variables determining water-solvent evaporation of the tested adhesives are: (1) water/HEMA relative concentration, (2) presence of photoinitiator compounds in the primer (SEB) and (3) presence of ethanol (XENO). SEB shows the highest extent of photo-polymerization of the tested adhesives. The lowest volumetric contraction was obtained for APLP and XENO and the attempt to remove the solvents did not increase the extent of polymerization significantly. CONCLUSIONS: Temperature increase following photo-polymerization reaction is dominant towards the effect of the drying step for solvent evaporation in self-etching systems. Attempts to remove the solvents did not increase the extent of polymerization, so other problems are impairing the polymerization of one-step adhesives. CLINICAL SIGNIFICANCE: The use of tested one-step adhesives is discouraged as the attained low extent of polymerization may lead to low bond strength, high susceptibility to degradation and also will favor a continuing etching effect on the underlying dentin.

Dental Bonding↗

Effect of load cycling and in vitro degradation on resin-dentin bonds using a self-etching primer.

The objective of this study was to evaluate the effect of in vitro degradation and mechanical loading on microtensile bond strength (MTBS) and microleakage (ML) of a resin composite to dentin using a self-etching primer adhesive [Clearfil SE Bond (SEB)] under two hydration statuses. Twenty-four flat dentin surfaces were divided in groups: 1) blot-dried, 2) air-dried. SEB was applied and resin buildups were performed with Tetric Ceram. Specimens were divided in four subgroups: a) sectioned into beams, b) load cycled, c) beams were immersed in NaOCl for 5 h, d) load cycled and immersed in NaOCl. Beams were tested in tension. For ML testing, 80 Class V cavities were prepared and molars divided in subgroups as described above (in group c and d, specimens were kept in distilled water for 1 year, instead of the 5-h NaOCl immersion). ML was assessed by dye penetration. Analysis of variance and multiple comparisons tests were used for MTBS. For ML, Mann-Whitney U and Wilcoxon matched pairs signed ranked were used (p<0.05). SEB applied to completely dehydrated dentin produced the highest MTBS, at 24-h evaluation. In vitro degradation always decreased MTBS, and fatigue loading only diminished MTBS on dehydrated dentin. Load cycling increased dye penetration on dentin margins. Degradation always increased ML in both enamel and dentin margins.

Dental Caries↗

Spatially resolved photopolymerization kinetics and oxygen inhibition in dental adhesives.

A comparative study of three commercial dental adhesives was performed by (1)H nuclear magnetic resonance spectroscopy and Stray-Field magnetic resonance imaging. Spectroscopic evidence was found for the presence of solvent and unreacted methacrylate groups in photopolymerized adhesives. Spatially resolved photopolymerization kinetics and volumetric contraction (solvent evaporation and polymerization shrinkage) were obtained without solvent removal and in the presence of oxygen from the atmosphere. The oxygen and solvent inhibitor effects in the photopolymerization were found to be higher for water/ethanol based adhesives. However, was one of these adhesives that exhibited less spatially dependent irradiation time to start vitrification, higher concentration and a more uniform spatial distribution of rigid domains at the end of the photopolymerization.

Biocompatible Materials↗

EDTA treatment improves resin-dentin bonds' resistance to degradation.

The existence of unprotected collagen fibrils within the hybrid layer compromises the longevity of restorations. This phenomenon may be avoided if solutions other than strong acids are used for dentin demineralization. The hypothesis to be tested is that bond durability may be improved by EDTA demineralization. Dentin surfaces (human and bovine) were bonded: (1) after phosphoric-acid-etching, and after EDTA demineralization with (2) a total-etch adhesive and (3) a self-etching adhesive. After the teeth were sectioned into beams, half of the specimens were immersed in NaOCl, while the other half was immersed in water. Beams were tested to failure in tension. ANOVA and multiple-comparisons tests were used (P < 0.05). No differences in bond strength were found among the 3 bonding procedures, although bonds made to human molars were 43-61% higher than those to bovine incisors. After NaOCl immersion, only specimens subjected to EDTA demineralization maintained the initial bond strength. We conclude that the collagen network is better-preserved after EDTA demineralization.

Analysis of Variance↗

Interaction of glass-ionomer cements with moist dentin.

Glass-ionomer cements (GICs) are regarded as aqueous gels made up of polyalkenoic acid salts containing ion-leachable glass fillers. The consequence of water permeation across the GIC-dentin interface is unknown. This study used SEM, field-emission/environmental SEM (FE-ESEM), and TEM to examine the ultrastructure of GIC-bonded moist dentin. Dentin surfaces bonded with 6 auto-cured GICs were examined along the fractured GIC-dentin interfaces. Additional specimens fractured 3 mm away from the interfaces were used as controls. SEM revealed spherical bodies along GIC-dentin interfaces that resembled hollow eggshells. FE-SEM depicted similar bodies with additional solid cores. Energy-dispersive x-ray analysis and TEM showed that the spherical bodies consisted of a silicon-rich GIC phase that was absent from the air-voids in the controls. The GIC inclusions near dentin surfaces result from a continuation of the GI reaction, within air-voids of the original polyalkenoate matrix, that occurred upon water diffusion from moist dentin.

Adhesiveness↗

Hydrolytic stability of experimental hydroxyapatite-filled dental composite materials.

OBJECTIVES: The purpose of this study was to analyze the behavior in water, related to mechanical properties, of experimental composites for dental restoration. METHODS: The studied materials were composed of a visible-light-curing monomer mixture (Bis-GMA and TEGDMA or HEMA) and micrometric, nanometric or a mixture of both sizes hydroxyapatite particles as a reinforcing filler. Filler particles were modified with a coupling agent (citric, hydrosuccinic, acrylic or methacrylic acid or silane). The hydrolytic stability of the evaluated materials was studied through total elution and water-uptake tests. Percent net-mass variation was daily monitored and analyzed as a function of time. Mechanical performance was examined through flexural properties and Vickers hardness. Morphological surface changes were observed with scanning electron microscopy. ANOVA statistical analysis was performed (P<0.05). RESULTS: In general, the use of HEMA instead of TEGDMA did not substantially worsen the composite quality. Dental composites containing only nanometric particles of hydroxyapatite as a filler are unsuitable for clinical performance. Midway-filled composite resins loaded with micro-HAP particles, coated with citric, acrylic or methacrylic acid displayed low percent elution and water-uptake values. Mechanical properties were similar or even superior to those measured for silane treated particles. SIGNIFICANCE: More research is needed to further improve the interaction of nano-HAP particles with the polymeric matrix, either as a single filler or, preferentially, mixed with micro-HAP, that will allow to increase the total loading of reinforcing filler and, hence, to improve the mechanical properties.

Analysis of Variance↗

Laparoscopic approach to incisional hernia.

BACKGROUND: After more than 8 years of working in the field, we thought it would be interesting to evaluate our experience in the laparoscopic repair of abdominal wall hernias, focusing attention on the lessons learned with time. METHODS: From January 1994 to November of 2000, a total of 270 patients with abdominal wall hernias were treated in our center using the laparoscopic approach. The data collected and analyzed were preoperative evaluation, operative findings, early and long-term complications, and recurrences. RESULTS: The mean follow-up time was 44 months, mean surgical time was 85 min, and mean hospital stay was 1.5 days. The average number of abdominal wall defects was 4.8 per patient. There were 9 (3.3%) small bowel perforations. Conversion to open surgery was required in 1 case (0.3%). Minor early postoperative complications occurred in 38 patients (14.07%). Twenty patients (7.4%) developed persistent postoperative abdominal pain. There was 1 case (0.3%) of small bowel incarceration through the mesh border and another case (0.3%) of small bowel leakage due to ischemia and subsequent peritonitis. The relapse rate was 4.4% (12 cases). CONCLUSION: The laparoscopic approach is a valuable option in the management of abdominal wall hernias, but it requires experience in laparoscopic surgery and there is a specific learning curve for the technique.

Abdominal Pain↗

Reversal of compromised bonding in bleached enamel.

Oxygen inhibits polymerization of resin-based materials. We hypothesized that compromised bonding to bleached enamel can be reversed with sodium ascorbate, an anti-oxidant. Sandblasted human enamel specimens were treated with distilled water (control) and 10% carbamide peroxide gel with or without further treatment with 10% sodium ascorbate. They were bonded with Single Bond (3M-ESPE) or Prime&Bond NT (Dentsply DeTrey) and restored with a composite. Specimens were prepared for microtensile bond testing and transmission electron microscopy after immersion in ammoniacal silver nitrate for nanoleakage evaluation. Bond strengths of both adhesives were reduced after bleaching but were reversed following sodium ascorbate treatment (P < 0.001). Resin-enamel interfaces in bleached enamel exhibited more extensive nanoleakage in the form of isolated silver grains and bubble-like silver deposits. Reduction of resin-enamel bond strength in bleached etched enamel is likely to be caused by a delayed release of oxygen that affects the polymerization of resin components.

Acid Etching, Dental↗

Bonding to Er-YAG-laser-treated dentin.

Er-YAG laser irradiation has been claimed to improve the adhesive properties of dentin. We tested the hypothesis that dentin adhesion is affected by Er-YAG laser conditioning. Superficial or deep dentin from human molars was: (a) acid-etched with 35% H3PO4; (b) irradiated with an Er-YAG laser (KaVo) at 2 Hz and 180 mJ, with water-cooling; and (c) laser- and acid-etched. Single Bond (3M ESPE) and Z100 composite (3M ESPE) were bonded to the prepared surfaces. After storage, specimens were tested in shear to failure. Bonded interfaces were demineralized in EDTA and processed for transmission electron microscopy. Two-way ANOVA revealed that conditioning treatment and interaction between treatment and dentin depth significantly influenced shear bond strength results. Acid-etching alone yielded shear bond strength values that were significantly higher than those achieved with laser ablation alone, or in combination with acid-etching. The Er-YAG laser created a laser-modified layer that adversely affects adhesion to dentin, so it does not constitute an alternative bonding strategy to conventional acid etching.

Acid Etching, Dental↗

Dental composites reinforced with hydroxyapatite: mechanical behavior and absorption/elution characteristics.

The purpose of this study was to analyze the behavior in water as well as the mechanical and surface properties of experimental composites designed for dental restoration. Studied materials were composed of a visible-light-cured monomer mixture as a matrix (bisphenol-alpha-glycidyl methacrylate with triethyleneglycol dimethacrylate or hydroxyethyl methacrylate) and either micrometric or nanometric hydroxyapatite (HA) particles as a reinforcing filler. The surface of the filler particles was modified by using different coupling agents (citric, hydroxysuccinic, acrylic, or methacrylic acid). The hydrolytic stability of the evaluated materials was studied through elution-in-water and water-uptake tests. Mechanical and surface properties were examined through the results of flexural, hardness, and surface roughness tests. Means and standard deviations were calculated for each variable. Analysis of variance and multiple comparison tests were performed. Materials containing bisphenol-alpha-glycidyl methacrylate:triethyleneglycol dimethacrylate and micrometric-HA coated with citrate, acrylate, or methacrylate displayed the most favorable results. Improvements should be obtained by increasing the total filler amount, and by the introduction of nanometric-HA filler into a micrometric-HA reinforced composite resin system.

Absorption↗

Microleakage of composite restorations after acid or Er-YAG laser cavity treatments.

OBJECTIVES: The purpose of this study was to compare microleakage of Class V restorations following acid, laser or laser and acid treatment of cavity walls. METHODS: Standardized lingual and buccal Class V preparations were made in 18 human extracted third molars. The preparations were randomly assigned to three equal groups (n=12). Group 1: cavities were treated with 35% phosphoric acid. Group 2: cavities were irradiated with an Er-YAG laser at 2Hz and 250mJ on dentin and 300mJ on enamel, with water cooling. Group 3: cavities were irradiated with the laser before acid etching. Scotchbond 1 Adhesive System and Z100 resin composite were used for restorations. The specimens were stored in water for 24h at 37 degrees C and thermally cycled (500x) between 6-60 degrees C. After 24h immersion in 0.5% basic fuchsin, dye penetration was recorded according to an ordinal scale. Data were analysed using non-parametric statistical tests (Kruskal-Wallis and Mann-Whitney). RESULTS: On the occlusal walls, microleakage in acid etched cavities was significantly lower than that achieved after laser treatment (P<0.001) or after both treatments (P<0.05). On the gingival walls, no statistical differences were found. SIGNIFICANCE: Laser irradiation of enamel is not a valid alternative to acid-etching pretreatment for resin composite materials adhesion. Acid etching alone gave the lowest microleakage at the occlusal margin. No differences were found for microleakage on gingival wall, although lased dentin surfaces presented several characteristics that appear to be advantageous for bonding.

Acid Etching, Dental↗

Dentin wetting by four adhesive systems.

OBJECTIVES: To evaluate the dentin wetting by four adhesive systems and to relate the wetting properties with the adhesive efficiency. METHODS: Scotch Bond Multipurpose Plus (3M), Syntac Single-Component (Vivadent), One-Step (Bisco) and Heliobond (Vivadent) were used. The substrate was superficial and deep human dentin. Roughness and water contact angle were measured before and after acid etching. Dentin wetting by resins was studied by contact angle measurements as a function of time to evaluate the spreading time. The shear bond strength was evaluated following a single plane method, and the microleakage was evaluated in Class V cavities. RESULTS: Acid etching increased dentin roughness and wettability and no differences were found between acids tested. Dentin wetting and roughness was higher on deep dentin. Dentin wetting and shear bond strength of resins was similar except for Heliobond that displayed the lowest value. Microleakage was higher on the gingival wall, and the leaking was lowest for Scotch Bond Multipurpose Plus, and maximum for Heliobond. The spreading time exceeded 30s with water-based and hydrophobic adhesives, and was lower with an acetone-based adhesive. Dentin depth had some influence on contact angle and shear bond strength: contact angles obtained with SBMP and One-Step were higher on superficial dentin, and shear bond strength for One-Step was higher on superficial dentin. Dentin wetting by resins could be correlated to shear bond strength and microleakage. SIGNIFICANCE: Dentin acid etching with different conditioners promotes similar roughness and wetting changes. On a similar substrate, the adhesion depends on the chemical and wetting characteristics of resins.

Acid Etching, Dental↗

Reversal of compromised bonding to oxidized etched dentin.

The mechanism responsible for hydrogen-peroxide- or sodium-hypochlorite-induced reductions in dentin bond strength is unknown. This in vitro study tested the hypothesis that these oxidizing agents were responsible by attempting to reverse the effect with sodium ascorbate, a reducing agent. Human dentin was treated with these oxidants before or after being acid-etched and with or without post-treatment with sodium ascorbate. They were bonded with either Single Bond or Excite. Hydrogen peroxide reduced the bond strengths of both adhesives, while sodium hypochlorite produced reduction in adhesion of only Single Bond (p < 0.05). Following treatment with sodium ascorbate, reductions in bond strength were reversed. Transmission and scanning electron microscopy showed partial removal of the demineralized collagen matrix only by sodium hypochlorite. The observed compromised bond strengths cannot be attributed to incomplete deproteinization and may be related to changes in the redox potential of the bonding substrates.

Acid Etching, Dental↗

[Evaluation methods of the degree of regeneration after experimental nerve repair. Evaluation model for the facial nerve in rats].

The AA. after sever the facial nerve trunk of Wistar mice (so interrupting its path owing to the loss of about 4 mm of its anatomical continuity) repair the faulty portion with several grafts, and 4 months later consider the gained results achieved in each of the following parameters: functional, morphological, biochemical and electrophysiological and, finally, compare the own outcomes with bibliographic references of literature regarding this subject.

Animals↗

Influence of self-etching primer on the resin adhesion to enamel and dentin.

PURPOSE: To evaluate the shear bond strength of resin-based composite to dentin and enamel using three adhesive systems, two of them containing self-etchant primers. Wettability (contact angle measurements) of the primers of these three adhesive systems was also evaluated on superficial and deep dentin. MATERIAL AND METHODS: Contact angle measurements were performed on 30 caries-free extracted human third molars; specimens were sectioned parallel to the occlusal surface to expose superficial and deep dentin. Dentin was ground flat (600-grit SiC) under water to provide uniform surfaces. Contact angle measurements were performed to assess wettability using the Axisymmetric Drop Shape Analysis technique. In order to test the enamel bond strength, 30 extracted bovine incisors were embedded in acrylic resin and ground flat to 800-grit. The adhesives and composite resins were applied following the manufacturers' instructions. All the specimens were stored in water for 24 hrs at 37 degrees C and thermocycled (500x). Shear bond strengths were determined using a universal testing machine and the Watanabe device. For dentin bond strength testing, superficial and deep dentin was exposed in 60 third molars, by sectioning the occlusal surface immediately under the enamel-dentin junction or close to the pulp chamber. After grinding (500 grit SiC), the dentin surfaces were assigned to three groups: (1) Clearfil SE Bond (CSEB)/Clearfil AP-X resin composite. (2) Etch & Prime (E&P)/Degufill mineral resin composite. (3) Scotchbond Multi-Purpose Plus (SBMP)/Z100 resin composite. RESULTS: One-way ANOVA and Student-Newman-Keuls multiple comparisons tests showed that no differences were found between contact angles on superficial and deep dentin. CSEB and E&P, without significant differences between them, had greater mean contact angle than SBMP. On enamel, Etch & Prime resulted in the lowest bond strength, but no significant differences existed with Scotchbond Multi-Purpose were found. On dentin, Clearfil SE Bond resulted in the significantly highest bond strength; no significant differences exist between Etch & Prime and Scotchbond Multi-Purpose.

Acid Etching, Dental↗

ER-YAG laser pretreatment effect on in vitro secondary caries formation around composite restorations.

PURPOSE: This in vitro study determined if Er-YAG laser used in instead of acid-etching influenced artificial secondary caries formation in enamel and root surfaces. MATERIALS AND METHODS: Class V cavities were prepared in buccal and lingual surfaces of 10 extracted caries-free molars, with cervical margins in the root surface and occlusal margins in enamel. The specimens were randomly assigned to 2 groups: Group 1: Enamel and dentin etched with 35% phosphoric acid gel (Scotchbond 15s, rinse 10s; n=5 teeth with 2 cavities per specimen, 10 occlusal and 10 root surface margins at caries risk). Group 2: Enamel and dentin surfaces conditioned using a pulsed Er-YAG laser (KAVO) with 2.94 microm wavelength, 250 micros pulse duration, 300 mJ for enamel and 250 mJ for root surface pulse energy, 2 Hz repetition rate, and water cooling (n=5 teeth with 2 cavities per specimen, 10 occlusal and 10 root surface margins at caries risk). The cavity preparations were restored with a wet-bonding technique (Scotchbond 1 adhesive system) and a hybrid resin, light-cured composite (Z100, A3 shade), according to the manufacturer's instructions. Acid-resistant varnish was applied leaving the restoration and a 1 mm rim of adjacent surface enamel and root surface exposed. The specimens were thermocycled (5-50 degrees C, 500 cycles, dwell time 30s). Following artificial caries formation (2.2 mM calcium, 2.2 mM phosphate, 50 mM acetic acid, 5.0 mg/L fluoride, pH 4.25, 10 days), longitudinal sections (3/tooth, 30 occlusal and cervical caries risk sites per group) were taken for polarized light microscopic examination (water imbibition). Primary surface lesion depth and wall lesion frequency was determined and compared between groups (Student's t-test). RESULTS: Er-YAG laser irradiation resulted in a 56% reduction in primary enamel surface lesion depth (116 microm mean depth) when compared with the acid-etched group (263 microm mean depth), and a 39% decrease in root surface lesion depth (194 microm mean depth) compared with that (316 microm mean depth) for acid-etching pretreatment (P< 0.05). Wall lesion frequency was similar (P>0.05) between treatment groups.

Acetates↗

[Cryopreservation of neural allografts for the nerve reconstruction in experimental surgery].

The possibility of clinical employment of nervous allografts depends on the likehood of its storage and also of the need of decreasing its antigenecity. We report our methodology for cryo-preservation and storage of nervous grafts, in view of animal experimentation as well as a re-examination of other methods in order to remember grafts storages done in previous epochs.

Animals↗

Microleakage and SEM interfacial micromorphology of amalgam restorations using three adhesive systems.

OBJECTIVE: This study evaluated the microleakage and interfacial micromorphology of Class V cervical amalgam restorations lined with OptiBond, AElitebond, or Panavia 21. METHODS: Unlined amalgams served as control. Cavities were treated with each dentin bonding system according to the manufacturers' instructions and restored with Tytin non-gamma 2 spherical amalgam. After one week of storage in tap water at 37 degrees C, the specimens were thermocycled (1000 cycles, 6-60 degrees C, 30s dwell time). Microleakage was assessed by means of basic fuchsin dye penetration and recorded according to an ordinal scale. RESULTS: None of the systems tested in this study completely eliminated microleakage. Kruskal-Wallis one-way ANOVA and Mann-Whitney U test found that on the occlusal wall, Panavia 21 and the control group had the least leakage (P<0.05). No statistically significant differences were found at dentin margins (P>0.05). Wilcoxon matched pairs signed rank test found that Panavia 21 and the control group had less leakage at the occlusal than at the dentin margins (P<0.05); when AElitebond and OptiBond groups were evaluated, microleakage at the enamel and at the dentin margins was similar for each group. With the adhesive systems, perhaps the hydrophilic bonding agents incorporated the dye during specimen immersion and/or sectioning. CONCLUSIONS: The use of adhesives may not be as worthy as resin cements for sealing and bonding amalgam restorations to enamel and dentin.

Adhesives↗