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Biomedical subjects

R M Carvalho

Publications and source records attributed to R M Carvalho.

At least 19 recordsLinked to original sources

Chlorhexidine preserves dentin bond in vitro.

Loss of hybrid layer integrity compromises resin-dentin bond stability. Matrix metalloproteinases (MMPs) may be partially responsible for hybrid layer degradation. Since chlorhexidine inhibits MMPs, we hypothesized that chlorhexidine would decelerate the loss of resin-dentin bonds. Class I preparations in extracted third molars were sectioned into two halves. One half was customarily restored (etch-and-rinse adhesive/resin composite), and the other was treated with 2% chlorhexidine after being acid-etched before restoration. Specimens were stored in artificial saliva with/without protease inhibitors. Microtensile bond strengths and failure mode distribution under SEM were analyzed immediately after specimens' preparation and 6 months later. With chlorhexidine, significantly better preservation of bond strength was observed after 6 months; protease inhibitors in the storage medium had no effect. Failure analysis showed significantly less failure in the hybrid layer with chlorhexidine, compared with controls after 6 months. In conclusion, this in vitro study suggests that chlorhexidine might be useful for the preservation of dentin bond strength.

Acid Etching, Dental↗

Evaluation of a self-limiting concept in dentinal caries removal.

The mechanical removal of dentinal caries traditionally involves the use of tactile sensation and/or caries-indicating dyes. This study tested the hypothesis that self-limiting polymer burs are as effective as conventional carbide burs in creating substrates for dentin bonding. Carious dentin from extracted human molars was removed with carbide or polymer burs, with dental explorer hardness as the end-point for caries removal. Dentin substrates were bonded with etch-and-rinse or self-etch adhesives and prepared for microtensile bond testing and transmission electron microscopy. For each bur type, there was no difference in bond strength between adhesives. However, the polymer bur surface exhibited significantly lower bond strengths than the carbide bur, and both were lower than flat, non-carious dentin controls. TEM revealed areas of incompletely removed, denatured caries-infected dentin in the polymer bur specimens. These first-generation polymer burs might best be utilized for deep caries removal where pulpal exposure is a concern.

Analysis of Variance↗

Incompatibility of oxalate desensitizers with acidic, fluoride-containing total-etch adhesives.

The use of oxalate desensitizers on acid-etched dentin prior to adhesive application can result in subsurface tubular occlusion by calcium oxalate crystals. However, the solubility of calcium oxalate increases in acidic solution. We hypothesized that total-etch adhesives can, depending upon their pH, interact with oxalate-desensitizer-treated dentin in an adverse manner. Acid-etched human dentin treated with 2 oxalate desensitizers (BisBlock and Super Seal) was bonded with 4 simplified total-etch adhesives: One-Step (OS), Single Bond (SB), OptiBond Solo Plus (OB), and Prime&Bond NT (PB). Composite-dentin beams were examined by SEM and TEM, both of which revealed numerous spherical globules on OB- and PB-bonded, desensitizer-treated dentin, but not in OS or SB samples. Bond strengths produced by OB and PB were significantly lower in oxalate-treated specimens than those produced by OS or SB. These surface globules may have interfered with hybridization of demineralized dentin with OB and PB resins and caused compromised bond strengths.

Analysis of Variance↗

Effect of resin hydrophilicity and water storage on resin strength.

This study evaluated the change in the ultimate tensile strength (UTS) of five polymerised resin blends of increasing hydrophilicity, after ageing in distilled water or silicon oil. Resin blocks were prepared from each resin blend by dispensing the uncured resin into a flexible, embedding mould, containing multiple cavities. The resins were polymerised in the moulds under nitrogen at 551.6 kPa and light-activated at 125 degrees C for 10 min. After dry ageing for 24 h at 37 degrees C, the middle third of each resin specimen was trimmed into an 'I' shape. Fifteen control specimens were randomly selected from each resin blend for baseline UTS evaluation. The UTS of the experimental specimens were determined after 1, 3, 6 and 12 months of ageing in water or oil. The UTS of each group of resins at different storage periods in water or oil were analysed using the Friedman multiple ANOVA on ranks and Dunn's multiple comparison tests at 95% confidence level. Significant reduction (p < 0.01) in UTS was observed in Groups II-V resins after 12-month storage in water, while the most hydrophobic Group I resin showed no significant change (p > 0.05) in the same period. The percentage reduction in UTS increased with the hydrophilicity of the resin blends. Long-term water storage of hydrophilic resin blends such as those employed in dentine adhesives, resulted in a marked reduction in their mechanical strength that may compromise the durability of resin-dentine bonds.

Absorption↗

Adhesive permeability affects coupling of resin cements that utilise self-etching primers to dentine.

OBJECTIVES: To examine the effects of an experimental bonding technique that reduces the permeability of the adhesive layer on the coupling of resin cements to dentine. METHODS: Extracted human third molars had their mid to deep dentin surface exposed flat by transversally sectioning the crowns. Resin composite overlays were constructed and cemented to the surfaces using either Panavia F (Kuraray) or Bistite II DC (Tokuyama) resin cements mediated by their respective one-step or two-step self-etch adhesives. Experimental groups were prepared in the same way, except that the additional layer of a low-viscosity bonding resin (LVBR, Scotchbond Multi-Purpose Plus, 3M ESPE) was placed on the bonded dentine surface before luting the overlays with the respective resin cements. The bonded assemblies were stored for 24 h in water at 37 degrees C and subsequently prepared for microtensile bond strength testing. Beams of approximately 0.8 mm(2) were tested in tension at 0.5 mm/min in a universal tester. Fractured surfaces were examined under scanning electron microscopy (SEM). Additional specimens were prepared and examined with TEM using a silver nitrate-staining technique. RESULTS: Two-way ANOVA showed significant interactions between materials and bonding protocols (p<0.05). When bonded according to manufacturer's directions, Panavia F produced bond strengths that were significantly lower than Bistite II DC (p<0.05). The placement of an additional layer of a LVBR improved significantly the bond strengths of Panavia F (p<0.05), but not of Bistite II DC (p>0.05). SEM observation of the fractured surfaces in Panavia F showed rosette-like features that were exclusive for specimens bonded according to manufacturer's directions. Such features corresponded well with the ultrastructure of the interfaces that showed more nanoleakage associated with the more permeable adhesive interface. The application of the additional layer of the LVBR reduced the amount of silver impregnation for both adhesives suggesting that reduced permeability of the adhesives resulted in improved coupling of the resin cements to dentin. CONCLUSIONS: Placement of an intermediate layer of a LVBR between the bonded dentine surface and the resin cements resulted in improved coupling of Panavia F to dentine.

Acid Etching, Dental↗

Interaction of resin-modified glass-ionomer cements with moist dentine.

OBJECTIVES: The objective of this study was to report on a novel phenomenon that occurs when resin-modified glass-ionomer cements (RMGICs) are bonded to moist human dentine. METHODS: Dentine surfaces from extracted third molars were abraded with 180-grit SiC paper. Ten teeth were prepared for each of the two RMGICs tested (Fuji II LC, GC Corp. and Photac-Fil Quick, 3M ESPE). RMGIC buildups were made according to the manufacturers' instructions. After storage at 37 degrees C, 100% humidity for 24 h, the bonded specimens were cut occlusogingivally into 0.9 x 0.9 mm beams. Dentine surfaces bonded with the two RMGICs were examined along the fractured RMGIC/dentine interfaces. Additional beams fractured within the RMGICS and at 3 mm away from the interfaces were used as controls. The fractured beams were examined using scanning electron microscopy (SEM), field emission-environmental SEM (FE-ESEM) and transmission electron microscopy (TEM). RESULTS: SEM and FE-ESEM revealed numerous solid spherical bodies along the RMGIC/dentine interfaces. By contrast, no spherical bodies could be identified within the RMGIC fractured 3 mm distant from the bonded interface. TEM and energy dispersive X-ray analyses performed on carbon-coated ultrathin sections showed that these solid spherical bodies consisted of a thin aluminum and silicon-rich periphery and an amorphous hydrocarbon core within the air voids of the original resin matrix. CONCLUSION: The spherical bodies probably represent a continuation of GI reaction and poly(HEMA) hydrogel formation that results from water diffusion from the underlying moist dentine. Their existence provides evidence for the permeation of water through RMGIC/dentine interfaces.

Aluminum↗

Single-bottle adhesives behave as permeable membranes after polymerization. I. In vivo evidence.

OBJECTIVES: This study tested the hypothesis that single-bottle total-etch adhesives are effective in reducing dentine permeability under in vivo conditions. METHODS: Crown preparations on vital human teeth were performed under local analgesia as part of the treatment plan for prosthetic rehabilitation. Four single-bottle adhesives (Single Bond, 3M ESPE; Excite DSC, Ivoclar Vivadent; Prime and Bond NT Dual-Cure, Dentsply DeTrey and One-Step, Bisco Inc.) were applied to the cut dentine after acid-etching. Polyvinyl siloxane impressions were taken, using an ultra-low viscosity impression material, of the smear layer-covered dentine before applying the adhesives to deep vital dentine, and after adhesive placement. Additional impressions were taken of the adhesive-sealed dentine following the removal of the provisional prostheses after a 7-10 day period. Epoxy resin replicas of the crown preparations were examined with scanning electron microscopy to evaluate the extent of dentinal fluid transudation during pre-bonded, immediately bonded and post-bonded periods. RESULTS: Dentinal fluid transudation from localised areas that were close to the dental pulp was universally observed from all epoxy resin replicas, irrespective of the adhesive employed. The transudation of dentinal fluid from the control smear layer-covered dentine of each crown preparation was comparatively mild when compared to the extent that was observed after total-etching and application of the single-bottle adhesive. Dentinal fluid droplets were specifically located over the surface of the adhesive layer. Continuous transudation of dentinal fluid occurred even after the removal of the provisional prostheses, and was considerably more profuse in subjects who opted for the fitting of the permanent prostheses without the use of a local anaesthetic solution. CONCLUSION: Single-bottle adhesives, because of their lack of a comparatively more hydrophobic bonding resin layer, behave as permeable membranes after polymerisation. They permit the continuous transudation of dentinal fluid and do not provide a hermetic seal in vital deep dentine. Although the relatively slow rate of diffusion of dentinal fluid is unlikely to result in post-operative cold sensitivity, it may interfere with the optimal polymerisation of dual-cured or auto-cured composites or resin cements in both direct and indirect restorations.

Adhesives↗

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↗

Dimensional changes in acid-demineralized dentin matrices following the use of HEMA-water versus HEMA-alcohol primers.

Although dried acid-etched dentin can be reexpanded by hydroxyethyl methacrylate (HEMA)/water primers, the primed dentin collapses when the water is evaporated. Experimental HEMA/alcohol primers should stiffen the matrix and permit less shrinkage when the solvent is evaporated. The purpose of this study was to test the hypotheses that matrix shrinkage induced by solvent evaporation from HEMA primers is inversely related to solvent-induced matrix stiffness. Dentine discs were prepared from midcoronal dentine of unerupted human third molars. After demineralization in 37% phosphoric acid, the specimens were placed in the well of a linear variable differential transformer instrument, which measures changes in the matrix height and stiffness by load displacement after the application of weights. This was done in their hydrated state after water had been applied, after drying with dry nitrogen gas, and after the application of 35 vol % HEMA-water, HEMA-methanol, HEMA-ethanol, or HEMA-propanol primers. The degree of reexpansion after the application of the primers to the dentine in the dried state was found to be highest using the HEMA-water primer, followed by HEMA-methanol and HEMA-ethanol, with the HEMA-propanol primer producing no expansion. However, when the solvents were evaporated the HEMA-water-treated specimens shrank the most, the HEMA-ethanol-treated specimens shrank an intermediate amount, and the HEMA-methanol-treated specimens shrank the least. The net result of expansion minus shrinkage produced by evaporation determines how much HEMA remains in the hybrid layer just prior to polymerization.

Acids↗

Effect of storage time on microtensile strength of polyacid-modified resin composites.

OBJECTIVE: The purpose of this study was to determine the cohesive microtensile strength of four polyacid-modified resin composites (PAMRC: Dyract, Dyract AP, Freedom and F2000) after 24h and 6 months of storage in water using the microtensile technique. METHODS: Blocks measuring 1.5 cm x 1.5 cm x 1.0 cm were constructed incrementally for each material using a silicone matrix. The blocks were stored in distilled water at 37 degrees C for 24 h and were then serially sectioned in both x and y directions to obtain several beams measuring 1.0 cm x 1.0 mm x 1.0 mm. Each beam was gently trimmed from two sides with ultra-fine diamond burs to reduce the cross-sectional area to a 'neck' of approximately 0.4mm(2) located in the middle of their length. The beams (18-22 per material) were randomly divided and tested in tension either after 24 h or after 6 months of storage in water at 37 degrees C in a Vitrodyne testing machine at 0.6 mm/min. RESULTS: Mean microtensile strengths (MPa) at 24 h were: 48.7+/-13.8 for Dyract AP; 36.5+/-14.1 for Dyract; 38.2+/-14.5 for Freedom and 48.6+/-7.2 for F2000. There was no statistically significant difference among the materials (p>0.05). At 6 months, only Dyract AP showed significant increase in microtensile strength (p<0.05) while the other materials showed no differences in microtensile strength with time (p>0.05). SIGNIFICANCE: The results indicate that storage in water for 6 months caused no reduction of the microtensile strength of PAMRC materials.

Analysis of Variance↗

Degradation of resin-dentin bonds using NaOCl storage.

OBJECTIVE: Several recent studies have reported collagen hydrolysis within bonds over the long-term. This may be one reason for the degradation of the bonds. This study therefore aimed to determine the effects of NaOCl on adhesive system bonds (total-etch bonding system vs. self-etching primer system) to dentin in order to accelerate the durability testing. METHODS: Resin-dentin bonded specimens were produced using Liner Bond 2V (Kuraray), a self-etching primer system, and OptiBond SOLO (Kerr), a total-etch bonding system, according to the manufacturers' instructions. The bonded specimens were serially sectioned in both x and y directions across the adhesive interface to obtain beams (adhesive area: 0.9 mm(2)). The specimens were immersed in 10% NaOCl solution for 1-5h after being stored in water at 37 degrees C for 24h. Control specimens were tested without exposure to NaOCl. After storage, micro-tensile bond tests were performed. Results were analyzed by two-way ANOVA and Fisher's PLSD tests (p<0.05). All fractured surfaces were observed by SEM, and examined using an image analyzer. RESULTS: The bond strengths decreased with increasing storage time in NaOCl. Fractography showed that NaOCl had a greater effect on the bond structure of OptiBond SOLO than on that of Liner Bond 2V, although both adhesives were susceptible. SIGNIFICANCE: Deterioration of the bonds was responsible for the effect of NaOCl on the hybrid layer. This deterioration may occur in humans in cases of deproteinization within the bonds.

Acid Etching, Dental↗

Effects of HEMA/solvent combinations on bond strength to dentin.

Re-expansion of dried demineralized dentin is required to optimize resin adhesion. This study tested the hypothesis that bond strengths to dentin depend upon the ability of experimental HEMA(2-hydroxy-ethyl-methacrylate)/solvent primers to re-expand the matrix. Dentin surfaces were acid-etched with 37% phosphoric acid for 20 sec, air-dried for 30 sec, primed with either 35/65% (v/v) HEMA/water, HEMA/methanol, HEMA/ethanol, or HEMA/propanol for 60 sec, and bonded with 4-META-TBBO(4-methacryloyloxyethyl trimellitate anhydride-tri-n-butyl borane) adhesive. After storage in water for 1 day at 37 degrees C, the samples were prepared for microtensile bond strength testing. We used transmission electron microscopy to measure the width of interfibrillar spaces in the hybrid layers. The HEMA/ethanol primer and the HEMA/propanol primer produced the highest and the lowest bond strengths, respectively (p < 0.05). Bond strengths were directly correlated with the width of the interfibrillar spaces (p < 0.05). Bond strengths are related to the ability of the primer to maintain the re-expansion of collapsed demineralized dentin matrix.

1-Propanol↗

Integrating oxalate desensitizers with total-etch two-step adhesive.

Compromised bonding of total-etch adhesives to dentin treated with oxalate desensitizers results from the interference of a surface layer of acid-resistant crystals of calcium oxalate. We hypothesize that effective tubular occlusion and dentin bonding may be simultaneously achieved by depleting dentin surfaces of calcium with acids before desensitizer application. Dentin specimens treated with 4 oxalate desensitizers before or after being acid-etched were bonded with a two-step adhesive. Microtensile bond strengths ( micro TBS) were significantly lower, compared with the control, when oxalates were used before the specimens were acid-etched; in contrast, when oxalates were used after acid-etching. micro TBS were similar to nonoxalate-treated controls. Dentin surfaces and tubular orifices were covered with a surface layer of crystals when desensitizers were applied to fractured dentin and smear-layer-covered dentin before specimens were acid-etched. However, when the dentin was acid-etched prior to the application of oxalate desensitizers, the crystals were largely limited to the subsurface of dentinal tubules, where they did not interfere with subsequent resin bonding.

Acid Etching, Dental↗

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 of self-etch and total-etch adhesives to carious dentin.

Carious dentin is partially demineralized and contains mineral crystals in the tubules. This may permit the deeper etching of intertubular dentin but prevent resin tag formation during bonding. We hypothesize that resin adhesives will produce lower bond strengths to caries-infected and caries-affected dentin compared with normal dentin. We tested this by measuring the microtensile bond strength of a total-etch adhesive and an experimental self-etching adhesive (ABF) to caries-infected, caries-affected, and sound dentin and by correlating those results with ultrastructural observations. The bond strengths of both adhesives to sound dentin were significantly (p < 0.05) higher than those to caries-affected dentin, which, in turn were significantly (p < 0.05) higher than those to caries-infected dentin. For both adhesives, hybrid layers in caries-affected dentin were thicker but more porous than those in sound dentin. The lower bond strengths may be due to the lower tensile strength of caries-affected dentin. Clinically, this may not be a problem, since such lesions are normally surrounded by normal dentin or enamel.

Acid Etching, Dental↗

Solvent-induced dimensional changes in EDTA-demineralized dentin matrix.

The purpose of this study was to test the null hypothesis that the re-expansion of dried matrix and the shrinkage of moist, demineralized dentin is not influenced by polar solvents. Dentin disks were prepared from midcoronal dentin of extracted human third molars. After complete demineralization in 0.5M of EDTA (pH 7), the specimens were placed in the well of a device that measures changes in matrix height in real time. Dry, collapsed matrices were created by blowing dry N(2) on the specimens until they shrank to a stable plateau. Polar solvents [water, methanol, ethanol, n-propanol, n-butanol, formamide, ethylene glycol, hydroxyethyl methacrylate (HEMA), or mixtures of water-HEMA] as model primers then were added and the degree of re-expansion measured. These same solvents also were applied to moist, expanded matrices and the solvent-induced shrinkages measured. Regression analysis was used to test the correlations between matrix height and Hansen's dispersive, polar, hydrogen bonding, and total solubility parameters (delta(d), delta(p), delta(h), delta(t)). The results indicate that water-free polar solvents of low hydrogen bonding (H-bond) ability (e.g., neat HEMA) do not re-expand dried matrices and that they shrink moist matrices. When HEMA was mixed with progressively higher water concentrations, the model water-HEMA primers expanded the dried matrix in proportion to their water concentrations and they produced less shrinkage of moist matrices. Solvents with higher H-bonding capacities (methanol, ethanol, ethylene glycol, formamide, and water) re-expanded the dried matrix in proportion to their solubility parameters for H-bonding (delta(h)). They also induced small transient shrinkages of moist matrices, which slowly re-expanded. The results require rejection of the null hypothesis.

Biocompatible Materials↗

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↗

The use of oxalate to reduce dentin permeability under adhesive restorations.

PURPOSE: To test a novel approach to reducing dentin permeability that localizes occlusion of dentin tubules by calcium oxalate crystals to the subsurface without lowering resin bond strengths to oxalate-treated dentin surfaces. MATERIALS AND METHODS: Flat dentin surfaces of extracted human third molars were etched with a mass fraction of 32% phosphoric acid (Bisco) for 15 s and rinsed. Half of the surface was treated with a potassium oxalate gel (mass fraction of 3% monopotassium monohydrogen oxalate) for 2 mins. The entire surface was then moist bonded with either One Step (OS) or Scotchbond Multi-Purpose (SB) adhesive systems. A resin-based composite (Z-100) buildup was made over the entire surface. After storage for 24 hrs in distilled water, the teeth were longitudinally sectioned to separate the oxalate-treated half from the untreated (control) half. Each half was serially sectioned into several 0.7 mm thick slabs which were then trimmed to an hour-glass shape to reduce the bonded area to approximately 0.8 mm2 and tested in tension. Pre- and post-treatment hydraulic conductance (Lp) of dentin was determined using dentin discs with a standard protocol. SEM images were obtained to examine the effects of treatment both on the dentin surface and along the tubules beneath the surface. The bonded interface was also examined by SEM. RESULTS: Treating etched dentin discs with the oxalate gel caused significant reduction of the Lp of dentin (80% reduction, P < 0.05). There were no statistically significant differences between bond strengths of oxalate-treated and untreated surfaces for either adhesive system. OS resulted in a bond strength of 25.8 +/- 9.2 MPa to untreated and 27.8 +/- 8.9 MPa to oxalate treated surfaces (P > 0.05). SB showed bond strengths of 22.9 +/- 7.9 MPa and 22.9 +/- 9.6 MPa to untreated and treated surfaces, respectively (P > 0.05). SEM images showed that the application of potassium oxalate gel on etched dentin resulted in the formation of crystals inside the tubules rather than on the surface. Examination of the bonded interfaces demonstrated that the crystal formation inside the tubules did not compromise the formation of a typical hybrid layer on the top of dentin surfaces. Resin monomers penetrated into the tubules filling the spaces around the crystals forming resin tags with a jagged-like feature.

Analysis of Variance↗