[Dentin sensitivity and fluorine during dental cavity preparation. 2. Ahistologic study].
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Air abrasion cutting, using particulates accelerated in a controlled compressed gas stream, is currently being re-evaluated as a precision tissue removal technique for dental cavity preparation. The minimal vibrations and heat generated during cutting commend the technique for use in the shaping of fragile or brittle materials that are vulnerable to vibrations and thermal stresses. Traditional air abrasion studies have relied solely upon post-procedure imaging, and cutting process details have been inferred from the nature of the residual surface. In this paper, however, a real-time confocal microscopic imaging method is described, which for the first time has allowed prior target structure characterization with subsequent imaging of cutting interactions and substrate failure patterns. Using internally focusing long working distance Hill objective lenses, focusing deep to a protective microscope slide and adhesive interfaces, unhindered remote image sampling within the bulk of specimens such as tooth tissue, acrylic and brittle ceramics was possible. Moreover, areas of active cutting and inactive regions were identified within air abraded cavities during their creation. The characteristics of the finished cut surfaces were demonstrated and confirmed the findings of previous SEM studies. The method allowed direct control over all the known variables influencing cutting with particulate streams.
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There are major differences in morphological detail after cutting the dentin surface among the methods commonly used to prepare dental cavities. The purpose of this study was to compare dentin permeability and the morphology of the dentin surfaces prepared with diamond and carbide steel burs after etching with 6% citric acid. Twenty-four freshly extracted human third molars were sectioned, mounted on plexiglass, and connected to the dentin-permeability measuring apparatus. The permeability of dentin was measured by fluid filtration and expressed as hydraulic conductance. There were two study groups of 12 teeth. Each tooth had one occlusal cavity preparation prepared but utilized three depths: the original was prepared just into the dentin, the second 0.5 mm deeper than the first, and the third 0.5 mm deeper than the second. One group had the first cavity prepared with a diamond, the second deepened using a steel bur, then the third depth was made by use of the diamond. The other group had the first cavity preparation prepared with a steel bur, deepened 0.5 mm again using a diamond, then deepened again using a steel bur. Dentin permeability was measured after cavity preparation, then after 2 minutes of acid etching. Analysis of variance and Duncan's multiple range test were used to establish whether differences were significant at the 0.05 confidence level. Prepared and acid-etched surfaces were characterized using a scanning electron microscope to identify any differences between the two groups. After acid etching with 6% citric acid, the permeability of dentin cavities prepared with diamond burs was significantly less than the permeability of cavities prepared with carbide steel burs. After etching, there were differences in the appearance of the dentin surfaces prepared with diamonds and steel burs. Dentin bonding agents may have their effectiveness reduced when placed following cavity preparation by use of a diamond.
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