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PubMed1994

Tensile bond strength of dental adhesives bonded to simulated caries-exposed dentin.

This study investigated the possibility of resin bonding to carious dentin. The study was divided into two parts, to determine first whether an in vitro model for caries could be developed for testing bond strength and second whether chemical modification of the caries model dentin surface, instead of mechanical removal of the carious layer, would enhance resin bond strengths. Dentin samples were exposed to an artificial caries decalcification solution (lactic acid+nitrocellulose) for 7 days. The depth of the decalcified surface was determined by microhardness and the nature of the surfaces analyzed by use of the scanning electron microscope. After bur removal of the decalcified dentin, samples were bonded with three different dentin bonding systems and the tensile bond strengths were determined. Control specimens were prepared and bonded with no decalcification or bur preparation. These values were compared with specimens prepared by decalcification but with no mechanical removal of the decalcified surface layer before bonding. Additional decalcified samples were treated with phosphoric acid to modify the decalcified surface before dentin bond testing. Bond strengths were significantly higher (p < 0.05) for the decalcified and mechanically prepared dentin as compared with either the unmodified or the phosphoric acid modified decalcified dentin. The highest bond strengths for all systems were found for the undecalcified control group. These results suggest that it may be possible to bond to the collagenous structures remaining in carious dentin. This could lead to conservation of tooth structure and rethinking of cavity preparation design.

Collagen↗
PubMed1994

Detection of mineral loss in approximal enamel by subtraction radiography.

The purpose of the present study was to determine whether digital subtraction radiography will improve detectability of small, mechanically prepared defects within dental enamel. Lesions with an extent of 1 mm in vertical direction and representing 5% to 10% mineral loss in the direction of the x-ray beam were prepared in eight extracted molars. Radiographs of teeth with defects were subtracted from radiographs taken before the lesions were prepared. Seven observers evaluated the images using a five-point confidence rating scale (receiver operating characteristic technique). Examination of the original radiographs showed increasing accuracy of radiographic interpretation with increasing mineral loss as judged from the areas beneath the receiver operating characteristic curves. The same observation was made using subtraction images with and without contrast enhancement. There was no indication that subtracted images provided better diagnostic validity than the original radiographs. In conclusion, subtraction images do not seem to improve the diagnosis of well-defined lesions within dental enamel.

Dental Enamel↗
PubMedDate not supplied

Caries inhibition by a resin-modified and a conventional glass ionomer cement, in vitro.

OBJECTIVES: The aim of this study was to compare inhibition, in vitro, of a resin-modified and a conventional glass ionomer cement. METHODS: Standardized Class V cavities were prepared in extracted human molar teeth and restored with Fuji II LC (n = 14) or Chemfil II (n = 14) according to manufacturers' guidelines. The teeth were submerged in an acid gel (lactic acid, gelatin, thymol, pH 4.5) for 14 days and resin embedded. Photomicrographs of ground sections were examined for enamel surface lesions, dentine surface lesions, wall lesions and evidence of caries inhibition. RESULTS: There was no significant difference between the depths of enamel or dentine surface lesions between the two materials. No wall lesions were found. CONCLUSIONS: Fuji II LC proved more acid resistant than Chemfil II and both materials inhibited caries in vitro.

Cariostatic Agents↗
PubMed1995

Effects of several tea components on acid resistance of human tooth enamel.

OBJECTIVES: The effects of tea components on the acid resistance of human tooth enamel were investigated by an in vitro experiment. A further study focused on the action of tannin, the main component of tea, in combination with fluoride. RESULTS: Some components such as tannin, catechin, caffeine and tocopherol were demonstrated to be effective for increasing acid resistance, and their effects increased dramatically when they were used in combination with fluoride. A mixed solution of tannic acid and fluoride showed the highest inhibitory effect (98%) on calcium release to an acid solution. Tannin in combination with fluoride showed obvious inhibition of the formation of artificial enamel lesions in comparison with APF as determined by electron probe microanalysis, polarized-light microscopy and Vickers microhardness measurement. CONCLUSIONS: These results demonstrate that besides the fluoride, the organic components of tea also possess the property of increasing the acid resistance of tooth enamel. They also suggest that the organic components appear to play a primary role in their actions rather than fluoride.

Acidulated Phosphate Fluoride↗
PubMed2004

Assessing patient-specific decalcification risk in fixed orthodontic treatment and its impact on prophylactic procedures.

This longitudinal and prospective clinical study determined the decalcification rate during multibracket treatment (mean duration, 22 months) in 80 randomized, selected adolescents divided into 4 groups of 20 patients each. The study had 2 objectives. The first was to establish whether patient selection based on predefined caries risk indicators, ie, plaque index, approximal plaque index, D(3-4)MFT/d(3-4)mft index, initial lesions, and gingiva index, carried out before the start of treatment allows for valid predictions of the decalcification risk associated with multibracket treatment. The second objective was to determine whether an extended prophylaxis regimen, including regular mechanical tooth cleaning by a hygienist, scaling, and chlorhexidine treatment, as an adjunct to an initial prophylaxis introductory program consisting of patient motivation, oral hygiene checkups, and fluoridation, reduces or prevents decalcification more effectively than initial prophylaxis alone. The results showed that patient selection based on caries risk factors provides a simple and effective method for predicting the decalcification risk in multibracket treatment (P <or=.001). The tests showed a sensitivity of 75% and a specificity of 88%, thereby proving the clinical validity of the results. Although extended prophylaxis significantly reduced the decalcification frequency in the risk group (P <or=.05) compared with the control group, decalcification frequency did not reach the low rate found in the low-risk group (P <or=.05).

Adolescent↗
PubMed2005

The effect of topical fluorides on decalcification in patients with fixed orthodontic appliances: a systematic review.

INTRODUCTION: Decalcification is a significant problem during fixed orthodontic treatment. Topical Fluorides can reduce or eliminate the problem, but the relative effectiveness of different treatments or combinations of topical fluoride preparations is unknown. This systematic review was undertaken to determine the effectiveness of topical fluoride preparations in preventing decalcification during fixed orthodontic treatment. METHODS: A wide search of published and unpublished material in any language was undertaken by using general and specialist databases; key dental journals were searched by hand. Predefined inclusion criteria based on objective outcome measures of decalcification, duration of treatment, presence of a comparison group, and study design were applied to determine study selection. Included studies were double extracted onto pre-designed data extraction sheets. RESULTS AND CONCLUSIONS: By screening titles and abstracts, we identified 143 articles; after the inclusion criteria were applied, 7 reports (of 6 studies) remained. Differences in the methodologies and reporting made statistical analysis impossible. However, the use of topical fluorides in addition to fluoride toothpaste reduced the incidence of decalcification in populations with both fluoridated and non-fluoridated water supplies. Different preparations and formats appear to decrease decalcification, but there was no evidence that any 1 method was superior. There was some evidence that the potency of fluoride preparations might be important.

Cariostatic Agents↗
PubMed2006

Antimicrobial properties of an orthodontic adhesive combined with cetylpyridinium chloride.

INTRODUCTION: Patients undergoing fixed appliance treatment are at greater risk for increases in salivary and plaque levels of Streptococcus mutans and an elevated risk of dental caries. Cetylpyridinium chloride (CPC) is known to be an effective antiplaque agent. The purpose of this study was to investigate whether incorporating CPC into a commercially available orthodontic adhesive would impart antimicrobial properties without altering the diametral tensile strength of the material. METHODS: CPC was added to a commercially available, filled, photo-activated bracket adhesive (Transbond XT, Unitek 3M, Monrovia, Calif) in varying amounts, to obtain specimens with CPC concentrations of 0% (control), 2.5%, 5.0%, and 10.0% by weight. Adhesive discs 2 mm thick and 4 mm in diameter were incubated with Streptococcus mutans for 48 hours. The diameters of the zones of bacterial inhibition were measured in an agar disc diffusion assay; specimens of each concentration were tested every other week for 196 days. Other discs were soaked in distilled water for 180 days. The amount of CPC released into the water from the modified discs was measured and recorded on days 7, 15, 30, 60, and 180 by using a spectrophotometer at 254 nm. Diametral tensile strength of the modified adhesive discs was measured with a universal testing machine, and the effect of water aging was also evaluated. RESULTS: The measured zone of bacterial inhibition increased as CPC content increased. All CPC-adhesive specimens maintained antimicrobial activity up to 196 days. No zone of bacterial inhibition was measured around the control specimens. CPC release was observed through the end of 180-day period, but the greatest release was recorded in the first week. There was no significant difference (P < .05) in diametral tensile strength between the 2.5% CPC-adhesive group and the control; there were significant differences among the 5.0% and 10.0% CPC-adhesive groups and the control. Water aging had no significant effect on diametral tensile strength other than decreasing it for the test group containing 10.0% CPC. CONCLUSIONS: The incorporation of 2.5% CPC in adhesive material imparted antimicrobial activity without altering diametral tensile strength.

Adhesives↗
PubMed2006

Effect of iron on inhibition of acid demineralisation of bovine dental enamel in vitro.

OBJECTIVES: Iron ions (Fe(2+)) have been shown to be cariostatic in many studies particularly by their ability to reduce bacterial metabolism. Nevertheless, the role of iron ions on dissolution of enamel is unexplored. The aim of the present study was therefore to investigate the protective effect of increasing concentrations (0-120mmol/L) of Fe(2+) on the dissolution of enamel. DESIGN: Enamel powder was subjected to acetic acid made with increasing concentrations with respect to FeSO(4)x7H(2)O. In order to determine the amount of enamel dissolved, the phosphate released in the medium was analysed spectrophotometrically using the Fiske-Subarrow method. Data were tested using Kruskall-Wall and Dunn's tests (p<0.05). The degree of protection was found to approach maximum at about 15mmol/L Fe(2+). Higher concentrations of Fe(2+) did not have an extra effect on inhibition of dissolution of enamel powder. In the next step, the protective effect of 15mmol/L Fe(2+) against mineral dissolution of the bovine enamel was evaluated using a simple abiotic model system. Enamel blocks were exposed to a sequence of seven plastic vials, each containing 1mL of 10mmol/L acetic acid. The acid in vial 4 was made 15mmol/L with respect to FeSO(4)x7H(2)O. The mineral dissolved during each challenge was thus determined by phosphate released as described above. Data were tested using two-way ANOVA (p<0.05). RESULTS: Lower demineralisation (around 45%) was found in vial 4 (with Fe) that continued stable until vial 7. CONCLUSIONS: Thus, our data suggest that Fe(2+) can be effective on inhibition of dissolution of enamel and that this effect may be durable.

Acetic Acid↗
PubMed2005

[Clinical consequences of dioxins exposure during tooth development].

Commonly designed by the term "dioxins", polychlorinated aromatic hydrocarbons are environmental pollutants leading to several toxic effects during development and growth in embryo and child. The general consequences of dioxin exposure are particularly well-documented whereas only few data are mentioned by the experts concerning tooth development. However, studies performed in rodents have shown many disruptions during odontogenesis and enamel mineralisation. Moreover, recent epidemiological studies have demonstrated in human the incidence of dioxin exposure on enamel hypomineralisation and hypodontia. The aim of this review is to report recent data about consequences of dioxin exposure on tooth development, tooth being considered as a biological marker of potential dioxin poisoning.

Anodontia↗
PubMed2005

A transmission electron microscopy study of mineralization in age-induced transparent dentin.

It is known that fractures are more likely to occur in altered teeth, particularly following restoration or endodontic repair; consequently, it is important to understand the structure of altered forms of dentin, the most abundant tissue in the human tooth, in order to better define the increased propensity for such fractures. Transparent (or sclerotic) dentin, wherein the dentinal tubules become occluded with mineral as a natural progressive consequence of aging, is one such altered form. In the present study, high-resolution transmission electron microscopy is used to investigate the effect of aging on the mineral phase of dentin. Such studies revealed that the intertubular mineral crystallites were smaller in transparent dentin, and that the intratubular mineral (larger crystals deposited within the tubules) was chemically similar to the surrounding intertubular mineral. Exit-wave reconstructed lattice-plane images suggested that the intratubular mineral had nanometer-size grains. These observations support a "dissolution and reprecipitation" mechanism for the formation of transparent dentin.

Adult↗
PubMed2005

Sealing smooth enamel surfaces with a newly devised adhesive patch: a radiochemical in vitro analysis.

OBJECTIVES: To assess the enamel-protective potential of a newly devised adhesive patch when used as a smooth surface sealant. METHODS: Eighty enamel discs were prepared from bovine lower central incisors and then irradiated. Twenty specimens were treated with one of three sealing options: enamel bond in a two-step application, the prototype of an adhesive patch, or a flowable resin. Unsealed enamel served as positive controls. Loss of apatite was determined using a radiochemical liquid scintillation method after immersion of the samples in saliva or lactic acid (n=10 per treatment group) each for up to 21 days, during which this experimental and control enamel surfaces were exposed to ten toothbrush strokes per day. Quantitative liquid scintillation data were verified by polarized light microscopy. RESULTS: With lactic acid exposure, a double layer of enamel bonding showed better enamel protection than untreated controls, but was significantly less effective than the adhesive patch or filled composite (P<0.05). No significant differences were noted between the latter two treatments. SIGNIFICANCE: It was concluded that the adhesive patch under investigation merits further studies to assess its potential as an inter-proximal sealant.

Acrylates↗
PubMed2005

Microhardness evaluation of in situ vital bleaching on human dental enamel using a novel study design.

OBJECTIVES: The aim of this 'in situ' study was to evaluate the microhardness of dental enamel following treatment with an in-office and an at-home vital bleaching agent through a novel approach using samples temporarily bonded 'in vivo'. METHODS: Human dental enamel slabs (n=88) were subjected to sequential polishing and initial Knoop microhardness tests were performed. The slabs were fixed to the facial surfaces of the maxillary first molars of 44 human volunteers. They were divided into four groups (n=11) according to the treatment group: G1- in-office-CP37+ at-home-CP10; G2- in-office-CP37+ at-home-PLA; G3- in-office-PLA and at-home-CP10; G4- in-office and at-home-PLA. After 3 weeks of treatment, final microhardness measurements were performed. RESULTS AND SIGNIFICANCE: ANOVA and Tukey's HSD hoc analysis (alpha=0.05) revealed no differences among initial or final microhardness values (p>0.05); however, significant differences occurred between initial and final values for each group (p<0.01), The evaluation of microhardness revealed a reduction of 6.8% for G1, 4.1% for G2, 3.4% for G3 and 3.5% for G4. In-office bleaching with 37% carbamide peroxide, an at-home bleaching with 10% carbamide peroxide, and a combination of both resulted in lower enamel microhardness when measured immediately post-treatment. However, long-term effects of these treatments are not known, and are believed to be clinically insignificant due to the relatively small reductions observed in enamel microhardness. Interestingly, the carrier, Cabopol 934P, also resulted in similar reduction in enamel microhardness even when administrated alone as a placebo.

Acrylates↗
PubMed2006

Interfacial characteristics of adhesive luting resins and composites with dentine.

PURPOSE: To evaluate the interfacial characteristics of five adhesive resin luting agents with dentine including tensile bond strength, failure mode, extent of demineralisation, morphological changes and hybrid layer formation. MATERIALS AND METHODS: The products tested were Bistite II DC (BDC), C&B Super-Bond (CBM), M-Bond (MBD), Panavia-F (PAF) and Rely-X Unicem (RXU). For tensile bond strength measurements (TBS), metallic rods were bonded to standardised dentine surface areas (n=10), thermal-cycled (3000x 5-55 degrees C, 4 cycles/min) and debonded at 1mm/min crosshead speed. The failure mode was examined on dentine surfaces by LV-SEM (n=10), whereas the thickness of the hybrid layer by HV-SEM (n=4). FT-IR microscopy (n=4) and ESEM (n=4) were used to assess the extent of demineralisation and the morphological changes induced on dentine by the conditioning and priming treatments. RESULTS: TBS (MPa) values were BDC (13.01), MBD (9.19) and PAF (7.07) significantly different from CBM (4.79) and RXU (4.47). The percentage of debonded dentine area covered with resin showed the highest values in BDC (47.80) and MBD (38.12) significantly different from CBM (17.20), PAF (16.47), and RXU (16.50). The extent of demineralisation for CBM was 100%. No statistical differences were found among BDC (60.86%), MBD (60.22%) and PAF (51.99%). RUX (45.03%) showed the lowest value. CBM induced the most pronounced tubule funneling and intertubular dissolution, followed by PAF, BDC and MDB. RXU partially removed the smear layer without opening tubule orifices. The thickest hybrid layer was found in CBM (4.17microm) followed by MBD (2.39microm). No statistically significant differences were found between PAF (0.95microm) and BDC (1.12microm), whereas RXU showed no detectable hybrid layer. SIGNIFICANCE: Significant differences were found in the interfacial properties among the materials tested, that may lead to differences in their clinical performance.

Analysis of Variance↗
PubMed2004

Effect of remaining demineralised dentine on dental microleakage accessed by a dye penetration: how to inhibit microleakage?

OBJECTIVES: To demonstrate that microleakage has taken place at the defect, which was analysed previously by a tensile test using dumbbell shaped specimens trimmed from bonded resin/dentine restorations, and to suggest how microleakage can be inhibited reliably in dental treatment. METHODS: A total of 60 Class V box cavities were prepared at the cemento-enamel junction on fresh bovine incisors and randomly divided into four groups of 15 specimens each. Exposure times of etching for 10:3 conditioner were set at 10, 30 or 60 s, and for 10% phosphoric acid (positive control) at 10 s. The cavity walls were rinsed with water for 10 s, air-dried for 10 s and hybridised with 4-META/MMA-TBB resin. All the cavities were filled with a light cured resin composite and stored in 37 degrees C water for 24 h and then immersed in 15% methylene blue for 2 h. The length of dye penetration along the interface was graded by defined criteria and analysed using Kruskal-Wallis and Mann-Whitney tests. The dye penetration patterns were examined by light microscopy and the remaining demineralised dentine was analysed by Transmission Electron Microscopy (TEM). RESULTS: The least leakage score was obtained in 10s-10:3 etched group with 12 out of 15 specimens demonstrating no leakage. Leakage was significantly lower at the cementum margin than for the other three groups. No significant difference in the extent of greatest dye penetration was found between the 60s-10:3 and 10s-phosphoric etched groups. Dye penetration along the cementum margins was significantly higher than that of the enamel margins in all groups, except the 10s-10:3 etched group. TEM examination confirmed that there were exposed collagen fibrils in the remaining demineralised dentine, where microleakage had taken place. SIGNIFICANCE: It could be concluded from this study that microleakage has taken place at the defect in the bonded specimens which has correlations with zones of incompletely infiltrated demineralised dentine that was observed using TEM. A reliable method of inhibiting microleakage is the presence of well prepared hybridised dentine.

Acid Etching, Dental↗
PubMed2005

The short-term in situ model to evaluate the anticariogenic potential of ionomeric materials.

OBJECTIVES: Aiming to contribute to the study of mechanisms involved in the anticariogenic properties of dental materials, this study assessed the suitability of a short-term in situ model to evaluate the anticariogenic potential of ionomeric materials. METHODS: The study used a 3-phase crossover, double blind design, and in each phase eight volunteers wore palatal appliances containing four enamel blocks restored with one of the following materials: composite resin (CR-Z250) (negative control), a conventional glass ionomer cement (GIC-Ketac-Fil) or a resin-modified GIC (RM-GIC-Vitremer). The restored blocks were covered with a "test plaque" of S. mutans, placed in palatal appliances and a cariogenic challenge was made during 1 min with 20% sucrose solution. After 45 min, test plaque was collected for fluoride (F) analysis. Enamel surface microhardness was previously determined at one side of the restoration and the percentage of surface microhardness change (%SMC) in relation to baseline (other side) was calculated. F concentration in enamel was also evaluated. RESULTS: Split-plot ANOVA showed a statistically lower %SMC on enamel around the ionomeric materials than around the CR (p<0.05). This result was supported by a statistically higher F concentration in test plaque (P<0.001) and in enamel (P<0.001) restored with the ionomeric materials when compared to the CR. CONCLUSIONS: The results suggest that the short-term in situ model tested is useful for studying the anticariogenic potential of dental materials that release fluoride.

Animals↗
PubMed2005

13C NMR analysis of the etching efficacy of acidic monomers in self-etching primers.

It is well understood that the application of a self-etching primer enhances the bonding of the resin to the tooth. In this study, the demineralisation aspects by the Mega Bond Primer (MB) or the UniFil Bond Primer (UB) on the tooth were investigated by using liquid-state and solid-state 13C NMR techniques. The addition of hydroxyapatite or dentine to MB and the addition of dentine to UB resulted in the decrease in the peak intensity of the 13C NMR peaks attributed to the methacryloxy decyl phosphoric acid, MDP in the MB or 4-methacryloyloxy ethoxy carbonylphthalic acid, 4-MET in the UB. This decrease was because the MDP or 4-MET demineralised the tooth and the calcium salts produced from the MDP or 4-MET were precipitated from the MB or UB solution. The NMR technique is very powerful in evaluating the demineralisation aspects of the tooth by a self-etching primer. However, the calcium salts produced by the MDP or 4-MET on the tooth surface would not facilitate retention in bonding, since these calcium salts were merely deposited on to the surface of the tooth.

Acid Etching, Dental↗
PubMed2006

The composition and structure of bovine peritubular dentin: mapping by time of flight secondary ion mass spectroscopy.

The dentin layer of the tooth is a complex mineralized tissue traversed by a closely packed system of tubules. Each tubule is surrounded by highly mineralized tissue referred to as peritubular dentin (PTD). The remaining mineralized collagen network between the tubules is the intertubular dentin (ITD). A TOF-SIMS analysis of the PTD constituents has been used to compare the PTD to the ITD. The PTD differs from the ITD not only in the degree of mineralization but also in the amount and nature of the mineral elements and amino acids. The organic matrix of the PTD consists of a unique collagen free assembly of proteins rich in glutamic acid, where the ITD organic matrix is collagen-rich and Asp-rich. The apparent concentration of organic fragment ions observed in the PTD in the TOF-SIMS negative ion mode was much higher than expected. The PTD was found to be rich in Ca2+, Na+, Mg2+, and K+. The amount of Mg2+ and K+ in the PTD was significantly reduced after deproteination, while Ca2+ and Na+ were still accumulated in the PTD. This implies that Mg2+ and K+ are mainly associated with the organic matrix rather than with the mineral of the PTD.

Animals↗