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Induction of reparative dentin formation in dogs by bovine bone morphogenetic protein bound to ceramic dentin.

Bone morphogenetic protein (BMP) refers to a group of bone-inducing growth factors used to enhance experimental osseous repair. Previous studies have indicated that BMP promotes the proliferation and differentiation of fibroblasts from human dental pulp both in vitro and in vivo. Furthermore, when BMP is used as a pulp capping agent, it has ability to induce the formation of both osteodentin and tubular dentin. In this study, we sought to explore whether or not BMP, complexed to ceramic dentin (BMP/CD), would constitute a more effective pulp capping agent than BMP alone. Experimental pulp exposures were created in dogs, and BMP/CD was placed on the surface of the exposed dental pulp. The inductive effect of such stimulation on reparative dentin formation was observed morphologically. Results showed that two weeks after exposure, some osteodentinal matrix was formed in the space surrounding the implanted BMP/CD particles while the remainder of the space was occupied by proliferating fibroblasts. At 4 weeks postoperatively, the dential bridge was complete. When ceramic dentin without BMP was used, there was minimal bone-like matrix formed even at 4 weeks postoperatively. These results suggest that the BMP/CD complex is effective as a stimulant of reparative dentin formation and shows potential as a therapeutically useful pulp-capping agent in a clinical setting.

Animals↗

Scanning electron microscopic evaluation of resin-dentin and calcium hydroxide-dentin interface with resin composite restorations.

Calcium hydroxide has been used as a liner in resin composite restorations to protect the pulp. Recent research has demonstrated that pulpal inflammation is caused by microleakage of restorations and by the subsequent passage of bacteria. The present study involved scanning electron microscopic observation of cross-sections of resin composite-dentin interfaces after the interposition of a layer of calcium hydroxide. A new-generation adhesive system that involves etching of the dentin was used. Ultrastructural analysis indicated that polymerization shrinkage of the resin composite caused the separation of the calcium hydroxide from the dentinal surface, forming 8- to 15-micron-wide interfacial gaps in 100% of the areas studied. Where the adhesive was applied directly to dentin, it adhered closely, forming a gap-free attachment with evidence of an acid-resistant hybrid layer (4 to 6 microns in thickness) and resin tags of various lengths that hermetically sealed the dentinal tubules.

Acid Etching, Dental↗

In vitro dentine permeability: the relative effect of a dentine bonding agent on crown preparations.

OBJECTIVE: The aim of this study was to determine whether a dentine bonding agent (DBA) had an effect in reducing fluid filtration under cemented provisional crowns. METHODS: Crown preparations on 34 premolars, randomly allocated to two equal-sized test and control groups, were assessed for dentine permeability by a fluid filtration technique. In the test group, prepared crowns were acid-etched and then treated with a DBA (Prime & Bond NT). In the control group, no such DBA was applied. Provisional crowns were cemented on both groups of teeth using non-eugenol zinc oxide cement. Fluid filtration rates were measured repeatedly after crown preparation, at cementation, 1 h, 1 day, 1 week and 3 weeks following crown cementation for both groups. Filtration rates were also measured after acid-etching and dentine bonding for the test group. RESULTS: There was insufficient evidence to suggest any statistically significant differences either between the two groups or, on average, across the five time points in each group in terms of the relative percentage of fluid filtration. CONCLUSION: The DBA used did not seal dentinal tubules any more than did the smear layer and provisional crowns luted with a non-eugenol ZnO cement.

Acid Etching, Dental↗

A scanning electron microscopic and tensile bond strength evaluation of Gluma dentin bond application, as a function of dentinal pretreatment.

Scanning Electron Micrographs (SEM) and Tensile Bond Strength (TBS) measurements were used to evaluate the influence of three different dentinal pretreatments. A new testing device was developed for the TBS measurements. Human tooth roots were ground with a diamond bur. Tap water, Gluma Cleanser, and Neo-Sabenyl-Tubulicid were used to clean the surfaces before SEM inspection. The adhesion between root dentin and Lumifor Composite restorations was mediated by Gluma Bond. SEM observations revealed that a 30-second application of Gluma Cleanser removes the smear layer totally. Neo-Sabenyl-Tubulicid produced a very smooth surface. Application of Gluma Bond did not alter this appearance. Mean TBS values for surfaces sprayed with tap water, Gluma Cleanser, and Neo-Sabenyl-Tubulicid were 10 MPa, 7.3 MPa, and 10 MPa, respectively. There was a significant difference between group 2 (Gluma Cleanser) and the other groups. From this in vitro study, it is concluded that total removal of the smear layer with opening of the dentinal tubules (e.g., by means of Gluma Cleanser) reduces the TBS of Gluma Dentin Bond-Lumifor restorations to ground root dentin.

Aldehydes↗

Dentin surface roughness vs. bond strength of dentin adhesives.

The effects of differently prepared dentin surfaces on the bond strength mediated by five dentin adhesive/composite resin systems were investigated: Clearfil new bond/Clearfil Ray, Gluma/Lumifor, Scotchbond/Silux, Scotchbond 2/Valux, and Tenure/Silux. Bonding surfaces were produced either by wet-grinding of human teeth on SiC paper, grits 180, 240, 320, 400, 600, and 4000, respectively, or by cutting them with dental preparation instruments. The surfaces of the dentin were analyzed by a profilometer. Tensile bond strengths (TBS) were determined two min after light activation of the restorative systems. In spite of greatly different effective areas for bonding, ANOVA showed no significant differences on the 5% level between the TBS means of one material system recorded for the different dentin preparations. It was concluded that the dentin roughness produced by preparation has no significant influence on early bond strengths of bonding composite resin systems.

Dental Bonding↗

Colocalization of dentin matrix protein 1 and dentin sialoprotein at late stages of rat molar development.

Dentin matrix protein 1 (DMP1) and dentin sialophosphoprotein (DSPP) are acidic proteins found in the extracellular matrices of bones and teeth. Recent data from gene knockouts, along with those of gene mutations, indicate that these two phosphoproteins are critical for bone and tooth development and/or maintenance. However, the precise functions of the two proteins have not been elucidated. In order to gain insights into their functions in tooth formation, we performed systematic, comparative investigations on the immunolocalization of DMP1 and dentin sialoprotein (DSP, a cleaved fragment of DSPP), using the rat first molar at different developmental stages as a model. Immunohistochemistry (IHC) was performed with specific, monoclonal antibodies against the COOH-terminal fragments of DMP1 and against DSP. In 1-day- and 1-week-old rats, weak immunoreactions for DMP1 were observed in dentinal tubules while stronger reactions for DSP were seen in the tubules and predentin. In rats older than 2 weeks, immunoreactions for DMP1 were found in dentinal tubules, predentin and odontoblasts. In 5-week- and 8-week-old rats, strong immunoreactions for DMP1 were widely distributed in odontoblasts and predentin. The distribution pattern of DSP was strikingly similar to that of DMP1 after 2 weeks and the localization of each was distinctly different from that of bone sialoprotein (BSP). The unique colocalization of DMP1 and DSPP in tooth development suggests that the two proteins play complementary and/or synergistic roles in formation and maintenance of healthy teeth.

Animals↗

Bond strengths of dentine bonding agents to dentine.

This study assessed comparatively the tensile bond strengths to dentine of four resin dentine bonding agents. Flat surfaces were produced in the occlusal dentine of human third molars, finished with 600-grit paper and prepared for bonding to Silux Plus composite with Gluma, Prisma Universal Bond 2, Scotchbond 2 and Tenure. After 24 hours in water and 250 thermal cycles, the specimens were loaded in tension to failure on an Instron machine. There were 20 specimens in each test group. An analysis of variance and Duncan's test showed that the bond strengths of Scotchbond 2 (22.8 +/- 7.2 MPa) and Prisma Universal Bond 2 (20.1 +/- 7.8 MPa) were similar but significantly higher than those of Tenure (14.3 +/- 5.3 MPa) or Gluma (12.3 +/- 6.4 MPa). A Weibull analysis confirmed the superiority of Scotchbond 2 and Prisma Universal Bond 2. Scotchbond 2 and Prisma Universal Bond 2 specimens failed either in an adhesive-cohesive mode, or cohesively through the composite or the dentine. It was concluded that Scotchbond 2 and Prisma Universal Bond 2 are effective and are the dentine bonding agents of choice.

Composite Resins↗

Effects of chlorhexidine on the bacterial colonization and degradation of dentin and completely demineralized dentin in situ.

The effects of 0.2% chlorhexidine on selected plaque microorganisms were studied in an intraoral dentin caries model. In 8 individuals wearing partial dentures, sound and completely demineralized dentin specimens were placed consecutively in 2 periods of 4 weeks, respectively. Throughout the experimental period, the specimens were treated 2 x daily with 0.2% chlorhexidine; control specimens were treated with water. Plaque accumulation on the specimens was left undisturbed. No protection against demineralization of the dentin or degradation of the dentin collagen by the chlorhexidine treatment was observed. The chlorhexidine treatment did not result in a reduction of the total cultivable flora when compared with the control specimens. A significant reduction of mutans streptococci and total streptococci recovered from completely demineralized dentin treated with chlorhexidine was observed, but the proportions of Actinomyces and lactobacilli were not affected significantly. It is speculated that areas of exposed roots, which are difficult to reach by oral hygiene measurements, such as approximal surfaces, will not be protected by a 0.2% chlorhexidine mouthrinse against the caries process.

Actinomyces↗

In vitro study of remineralization of dentin: effects of ions on mineral induction by decalcified dentin matrix.

We examined the effects of various ions on the mineralization of dentin matrix in vitro. Demineralized dentin matrix was incubated in a metastable calcium phosphate solution with or without silicate, fluoride, calcium, phosphate, magnesium or silver. Insoluble dentin matrix induced mineral formation after incubation for 10.2 h in the metastable solution without added ions. Silicate at 5 microM and fluoride at 40 microM significantly reduced the mineral induction time. At least 200 microM calcium or 100 microM phosphate was required to promote mineral induction. Conversely, magnesium and silver concentrations as low as 10 and 2 microM inhibited mineral induction. The mineral induced by each sample after incubation for 24 h was identified by its X-ray diffraction pattern as apatite. We concluded that silicate is a stronger inducer of remineralization of dentin matrix than fluoride, calcium or phosphate, and that magnesium and silver inhibit the induction of remineralization of dentin matrix.

Animals↗

Rapid-freezing and malachite green-acrolein-osmium tetroxide freeze-substitution fixation improve visualization of extracellular lipids in rat incisor pre-dentin and dentin.

Rat incisor tissue sections were fixed by a modified version of the malachite green-aldehyde method (MGA) composed of rapid-freezing, malachite green-acrolein staining, and osmium tetroxide freeze-substitution (Fr.MGAO). In the pre-dentin, a thick, dense network of branched fibrous structures was observed. Cryotechniques allowed visualization of complexes about twice as thick and dense as the aggregates visualized on MGA-treated sections. Pretreatment of rapid-frozen samples with methanol before freeze-substitution fixation and staining prevented staining of the complexes otherwise revealed by the Fr.MGAO method. Electron-dense material stained by this procedure resisted de-mineralization with EDTA, while intramitochondrial granules and dentin crystallites were dissolved. EDTA treatment demonstrated unequal distribution of Fr.MGAO staining in dentin in the form of tiny dots underlining the collagen fibers. These results support the concept that rapid-freezing, followed by staining and freeze-substitution fixation, improves preservation of the phospholipids visualized as extracellular matrix components in pre-dentin and dentin of rat incisors.

Acrolein↗

Efficacy of dentin bonding agents combined with self-etching dentin primers containing Phenyl-P.

The bonding efficacies of three commercial dentin bonding agents and an intermediate resin combined with two self-etching dentin primers (aqueous solutions of methacryloxyethyl hydrogen phenyl phosphate (Phenyl -P, 20 wt%) and either hydroxyethyl methacrylate (HEMA, 35 wt%) or glyceryl methacrylate (GM, 35 wt%)) were examined by measuring the wall-to-wall contraction gap of a light-activated resin composite in a cylindrical dentin cavity prepared in extracted human teeth. Among the tested bonding agents, only one material showed complete adaptation between the resin composite and the dentin cavity margin i. e. a dual -cured agent that contained 10-methacryloxydecyl dihydrogen phosphate (MDP). The contraction gap of the intermediate resin was significantly reduced by pretreatment with the experimental self-etching dentin primers containing Phenyl-P.

Acid Etching, Dental↗

Effect of tubule orientation and dentin location on the microtensile strength of bovine root dentin.

To investigate the mechanical properties of root dentin and to further clarify the cause of vertical root fracture (VRF), this study evaluated the effect of tubule orientation (parallel, perpendicular and oblique to the cross-section of dumbbell specimens in microtensile tests) and dentin location (cervical, middle, and apical location of the root) on the microtensile strength of bovine root dentin. Each specimen was stressed in tension at a crosshead speed of 1.0 mm/min. The results of the microtensile strength measurements were statistically analyzed with one-way ANOVA and the Fisher PLSD. The oblique group (95.18+/-23.80 MPa) was significantly (p<0.01) higher than the parallel group (38.93+/-5.28 MPa) or the perpendicular group (32.64+/-4.69 MPa). There were no significant differences among the different dentin locations within the parallel group (p>0.05). It was clarified that the VRF occurs frequently in practical situations due to the tubule orientation of root dentin.

Analysis of Variance↗

[Attempt at a comparison of healthy coronal dentin and carious coronal dentin].

The amino acid composition of normal human coronal dentine has been studied. The amino acid composition of carious coronal dentine was compared to that of the normal coronal dentine. The study was conducted on non demineralized samples. The results lead to a reconsideration of the so-called "normal dentine" in relation to different parameters: tooth age, sample location. A precise comparison between normal and carious dentine appears difficult to make.

Amino Acids↗

Effect of dentinal tubule orientation on the microtensile bond strength to primary dentin.

Direction of dentin tubules is an important factor that affects bond strength of contemporary adhesive materials. Because conservative proximal cavity preparations in primary teeth contain more dentin tubules running oblique or parallel to the cavity walls, this study was conducted to evaluate the influence of tubule orientation on the bond strength to primary dentin. A polyacid-modified resin composite material was used as the test material. A microtensile test was utilized to enable evaluation of bond strengths in three different tubule orientations (perpendicular, oblique, parallel) following aging of the resindentin bonds by long-term immersion of the test samples in water. Samples bonded parallel to the dentin tubules showed the highest microtensile bond strength, followed by the oblique and perpendicular groups. Statistical analysis of the data showed no significant difference between the bond strength of parallel and oblique groups. Independent of the tubule orientation, all samples revealed cohesive fracture within dentin.

Analysis of Variance↗

The dentinal surface: its influence on dentinal adhesion. Part I.

Three categories of dentinal adhesive are proposed: category I includes adhesives with shear bond strength values between 5 and 7 MPa; category II includes dentinal adhesives with shear bond strengths between 8 and 14 MPa; and category III includes adhesives with shear bond strength values up to 20 MPa. In part I of this article, photomicrographs of the dentinal smear layer and three category I first-generation dentin-adhesive interfaces are presented. The photomicrographs show that the wetting and penetration of the first-generation dentinal adhesives were not adequate to produce high shear bond strengths. When the category I adhesives were tested for shear bond strength, failures occurred at the interface or in the resin adhesive. Future articles will explain wetting and adhesive performance of category II and III adhesives.

Acrylic Resins↗

[Glass ionomer cements and dentinal pretreatments: the evaluation of their adhesion to the dentin].

The aim of the present study was to evaluate the shear bond strength test of two glass-ionomer cements (G C cement and Ketac Bond) after different chemical pretreatments of dentine surface. The following dentine pretreatments were used: sodium hypochlorite, polyacrylic acid, tannic acid, H3PO4, FeCl3, Fe ossalate, Tubulicid, H2O2 and aqueous solution as control. Flat dentine surface of human extracted teeth was treated with the chemical agents, washed and dried. Cylindrical specimens of glass-ionomer cement were applied on dentine surface. After 24 hours in humidifier the specimens were tested in a universal testing machine. A significant higher bond was obtained only from polyacrylic acid and sodium hypochlorite treatments. The present results suggest that dentine pretreatment represent an essential step in composite resin/glass-ionomer cement restorations.

Adhesiveness↗

Influence of dentin primer application methods on dentin bond strength.

This study was carried out to determine the influence of dentin primer application methods on bond strength to human dentin. Two dentin bonding restorative systems, Imperva Bond/Lite-Fil II A (Shofu) and Scotchbond Multi-Purpose/Z-100 (3M) were employed. Human molars were mounted in self-cured resin and the buccal surfaces were prepared with #600-grit SiC paper. These surfaces were then conditioned according to each manufacturer's instructions. Two experiments were designed: (1) effect of the primer application procedures (inactive and active application), and (2) effect of the air drying time (0, 1, 5, 10, 20, and 30 seconds). The adhesives were applied and resin composites were bonded to the teeth. Ten samples per test group were stored in 37 degrees C deionized water for 24 hours, and shear tested with a circular knife edge at a crosshead speed of 1.0 mm/minute. A one-way ANOVA followed by the Newman-Keuls multiple comparison at P < 0.05 was done. For both restorative systems, the bond strengths for active application were higher than those for inactive application, but there was no significant difference between the two mean values. According to the air drying time, there appeared to be an optimal range of drying times, longer for Imperva Bond (10-30 seconds) than for Scotchbond MP (1-5 seconds). The data suggest that the bond strengths of employed dentin bonding systems were greatly influenced by the methods of the dentin primer application.

Air↗

Dental pain evoked by hydrostatic pressures applied to exposed dentin in man: a test of the hydrodynamic theory of dentin sensitivity.

The hydrodynamic theory of dentin sensitivity holds that pain is evoked by stimuli producing minute shifts in tubule fluid. In human volunteers hydrostatic pressures were applied to prepared dentinal cavities. The subjects reported the magnitude and quality of their sensations of pain by means of an intermodal matching technique in combination with verbal descriptors. No pain could be elicited when the smear layer was present. After removal of this layer, pressure stimuli of either direction evoked sharp pain. Rapid changes in pressure induced higher pain intensities than slow changes, indicating that the dental A-delta system is dynamic and gradient dependent. These results provide support for the hydrodynamic theory of dentin sensitivity and also lend credence to the notion that the movement of fluid across dentin induces a selective activation of the A-delta nerves in healthy pulps which is highly correlated with a sensation of sharp and/or shooting pain.

Acid Etching, Dental↗