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Influence of bleaching agents and desensitizing varnishes on the water content of dentin.

This in vitro study investigated the possible dehydration of dentin caused by bleaching agents. Furthermore, it tested whether protective dentin varnishes can maintain the physiological moisture of dentin during bleaching treatment. Fifty-five standardized dentin cylinders were prepared from freshly extracted bovine incisors under constant water irrigation. Prior to bleaching, the treatment specimens were conditioned at room temperature in a hygrophor for 14 days. The samples were divided into 11 groups. The Group A specimens, which were completely dehydrated, and Group B, which was stored for 2 weeks in a hygrophor, served as controls (A, B n=5). The other samples (n=10 each group) were coated with Vivasens [VS] (C), Bilfuorid [BF] (D) and Seal&Protect [SP] (E). Five specimens from each group (C-E) were subsequently treated with an experimental bleaching gel (Exp BG) (20% carbamide peroxide [CP], glycerine-based gel): Cb, Db, Eb. The remaining specimens were bleached with Exp BG (F) only, Vivastyle (G: 16% CP, glycerine-based gel) or Vivastyle Paint On (H: 6% CP-varnish) for 7 days (n=5 each group) with bleaching time for gels: 2 hours/day, paint on: 20 minutes/day. After the respective treatments, the overall water content of each specimen was determined using the analytical method of Karl-Fischer-titration. The water content of bovine dentin (Group B, mean%+/-SD) obtained in this study amounted to 15.24+/-0.4. All bleaching products significantly reduced the water content compared to the controls (exp BG: 13.32+/-0.47, Vivastyle 13.2+/-0.27, paint on 13.72+/-0.54; p<0.05). Also, application of SP before bleaching resulted in reduced water content (14.06+/-0.12; p=0.0005). However, bleaching with exp BG following use of VS (14.99+/-0.42) or SP (13.85+/-0.26) did not result in a reduction of water content in dentin. Pretreatment with BF did not protect dentin from water loss during bleaching (12.44+/-0.38; bi p=0.0009). All glycerine-based bleaching products used in this study had a significant dehydrating effect on dentin. The application of protective varnishes prior to bleaching treatment may reduce or even prevent dentin dehydration.

Animals↗

Dental applications of amorphous calcium phosphates.

Certain commercial materials and equipment are identified in this paper to specify the experimental procedure. In no instance does such identification imply recognition or endorsement by the National Institute of Standards and Technology or the ADA Health Foundation, or that the material or equipment identified is necessarily the best available for the purpose.

Calcium Phosphates↗

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↗

Adhesive luting of indirect restorations.

PURPOSE: To describe the potential of adhesive luting procedures with respect to (1) material characteristics and classifications, (2) film thickness, (3) overhang control, (4) bonding to different inlay materials, (5) adhesion to tooth substrates and the problem of hypersensitivities, (6) wear of luting composites, and (7) clinical performance. MATERIALS AND METHODS: A literature review of relevant studies of various in vitro and in vivo studies enables an overview of possibilities and limitations of adhesively luted indirect restorations. RESULTS: (1) Resin-based composites are the material of choice for adhesive luting. Both material properties and wear behavior of fine particle hybrid-type resin-based composites are superior to other materials. The use of compomers is questionable due to hygroscopic expansion and possible crack formation as proven for IPS Empress caps in vitro and in vivo. (2) Recent luting cements exhibit excellent flow characteristics with mean film thicknesses ranging between 8 microm and 21 microm. The ultrasonic insertion technique is recommended for viscous luting composites or conventional restorative composites utilizing their thixotropic properties. (3) For successful overhang control, good fit of the restoration (during luting) and high radiopacity of the cement (after luting) are indispensable. Overhang control is estimated easier when the ultrasonic insertion technique is applied. (4) The pre-treatments of ceramic inlays using hydrofluoric acid or silica coating result in effective bonding; for pre-treatment of resin-based composite inlays, silica coating is promising as well. (5) Bonding to enamel and dentin is proven clinically acceptable, but it should be performed with multi-step systems providing separate primers and bonding agents producing a perfect internal seal with almost no hypersensitivities. Dual-cured multi-step bonding agents provide the most promising potential. (6) The viscosity and filler content of the resin composite used for luting does not influence the wear characteristics within the marginal luting area in vivo. However, the ultrasonic insertion technique involving high viscosity materials provides enhanced handling characteristics for luting of tooth-colored inlays. (7) Clinical results with tooth-colored inlays and veneers are promising over periods of up to 10 yrs, including use in severely destroyed teeth.

Acid Etching, Dental↗

[Cervical dentine hypersensitivity].

Cervical dentine hypersensitivity is a common problem. When gingiva recession has appeared the root cement can become abraded by several causes and this situation can give pain problems when the tubules do not close. The most important part of the treatment is a good diagnosis and to find and eliminate the predisposing factors. After this has been done it is possible to try to close the dentinal tubulus for which there are several treatments. It is difficult to give a good advice for the treatment of cervical dentine hypersensitivity because research in this field is difficult due to the large amount of variables, the placebo effect and because the lack of a good experimental model.

Dentin Sensitivity↗

Short-term clinical evaluation of inlay and onlay restorations made with a ceromer.

PURPOSE: This prospective clinical trial evaluated the clinical acceptability of a new material, ceromer, used for inlay and onlay restorations in single- or multisurface cavities of posterior teeth. MATERIALS AND METHODS: Forty-three Targis inlay and onlay restorations were placed in 25 patients and evaluated using the United States Public Health Service criteria. The laboratory work was conducted by three dental technicians according to the manufacturer's recommendations. Twenty-five restorations were luted with Syntac bonding system and Variolink II, and 18 were luted with Scotchbond Multi Purpose and Opal Luting Composite. The recalls were done at 6, 12, and 18 months. Restorations were evaluated for six parameters and scored as ideal (A), clinically acceptable (B), or clinically unacceptable (C). RESULTS: Indirect restorations received, after 18 months, scores of A at the following rates: color match 77%; marginal discoloration 93%; secondary caries 100%; anatomic form 93%; and marginal integrity 95%. For these parameters, statistical analysis indicated no significant differences at baseline and after 18 months. Postoperative hypersensitivity was reported by seven patients at baseline, but it decreased and there was no hypersensitivity at 12- and 18-month follow-ups. CONCLUSION: Over an 18-month period the Targis restorative system yielded good clinical service.

Adult↗

The influence of a dentin desensitizer on the microtensile bond strength of two bonding systems.

A laboratory study evaluated the influence of a dentin desensitizer (D/Sense 2) on the microtensile bond strength of two adhesive systems: a self-etching primer (Bistite II SC) and a one-bottle adhesive (Prime & Bond 2.1). Sixteen crown dentin discs were obtained from extracted sound human third molars. Dentin surfaces were ground with 600 grit silicon carbide (SiC) abrasive papers to produce a standardized smear layer. Teeth were randomly divided into four groups (n=4). G1-D/Sense 2 + Prime & Bond 2.1; G2-D/Sense 2 + Bistite II SC; G3- and G4-dentin surfaces were bonded with Prime & Bond 2.1 and Bistite II SC, respectively, with no previous treatment with D/Sense 2. Eight mm high resin composite crowns (TPH Spectrum) were incrementally built-up on the treated surfaces. One sample from each group was prepared for evaluation of the hybrid layer on SEM. The specimens for the microtensile test were serially sectioned perpendicular to the adhesive layer to obtain 1 mm2 bounded sticks. Then, each stick was submitted to the microtensile test performed at a 0.5 mm/min crosshead speed. One-way ANOVA and Tukey test showed statistically significant differences among the groups (p<0.05). Values in MPa were: G1-17.85; G2-9.88; G3-35.16; G4-15.57. Based on the results of this study, it can be concluded that the D/Sense 2 desensitizer decreased the bond strength of Prime & Bond 2.1 and Bistite II SC bonding systems.

Acetone↗

Treatment of cervical dentin hypersensitivity with resin adhesives: 4-week evaluation.

PURPOSE: To evaluate the effectiveness of a dentin bonding agent containing HEMA compared to a resin emulsion in the reduction of cervical dentin hypersensitivity (CDH). MATERIALS AND METHODS: The study was a randomized-within-subject, double blind design. Twenty patients who were suffering from CDH from at least two teeth (canines and/or premolars) were enrolled. The subjective perceptions of pain in response to tactile, air blasts and cold ethyl chloride stimuli were evaluated using a visual analog scale (VAS) at baseline and 10 minutes, 1 week and 4 weeks after the treatments. Scotchbond 1 (a dentin bonding agent similar to Single Bond in the USA) and MS Coat (a resin emulsion), both applied according to the manufacturers' directions, were selected for the study. RESULTS: Multiple regression ANOVA for repeated measures showed that both treatments significantly reduced the CDS with respect the baseline values after just 10 minutes. There were no significant differences between the ability of the two treatments to reduce CDH for each of the three evaluation stimuli or for subjective evaluation.

Adult↗

[Controlled clinical study of the anterior composite-adhesive system Point 4/OptiBond Solo Plus].

A wide variety of presently sold composites exhibit a large diverse range of colors and yield the desired esthetic result by the "Chameleon Effect" and by the application of a thin layer technique. The present clinical trial of the ultra-small-particle-hybrid composite Point 4 with its dentin adhesive OptiBond Solo Plus just reached the one-year evaluation. Of the originally applied 73 restorations of anterior teeth in the classes III to V, 62 could be re-examined after half a year and 60 after one year according to an examination scheme by Lutz et al. (1977) and Ryge (1980), modified by Böhm et al. (1991). While the color of restorations and the amazingly smooth surface only changed slightly, significant differences could be established in the criteria bond zone morphology and volume behaviour after half a year and one year compared with baseline. Results showed retention rates of 98% (2% total loss) and 97% (3% inclusive partial loss) as well as initial marginal discolorations of 20%. Thus, the moist-bonding technique, applied here, appeared less suitable than the wet-bonding technique.

Color↗