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Dentin adhesion of "modified" 4-META/MMA-TBB resin: function of HEMA.

This study investigated adhesion to dentin of a modified 4-META/MMA-TBB resin (4-methacryloxyethyl trimellitate anhydride in methyl methacrylate initiated by tri-n-butyl borane) which does not require PMMA powder to polymerize. Ground bovine dentin specimens were pre-treated with an aqueous solution of 10% citric acid and 3% ferric chloride (10-3). This solution removes the smear layer and demineralizes the dentin, exposing collagen. Improved bond strengths were obtained when a HEMA-primer was applied to 10-3 pre-treated dentin. SEM examination revealed the formation of a transitional zone of resin-reinforced-dentin (hybrid layer) in 10-3 pre-treated, HEMA-primed samples. The adhesive monomer impregnated exposed collagen fibrils and, upon polymerization, became entangled with them to create the hybrid layer, essential in achieving significantly high tensile bonding strengths. HEMA enhanced the penetration capability of dentinal substrates. After polymerization and formation of the hybrid layer, auto-cured acrylic resin, photo-cured composite and amalgam were all capable of adhering to the dentin. The modified 4-META/MMA-TBB resin created significant adhesive bonds to 10-3 pre-treated ground bovine dentin.

Adhesiveness↗

Outward fluid flow reduces inward diffusion of bacterial lipopolysaccharide across intact and demineralised dentine.

OBJECTIVE: To examine the ability of outward fluid flow (OF) on resisting the inward diffusion of bacterial lipopolysaccharide (LPS) across the demineralised dentine (DD) in comparison with that across the intact dentine (ID). DESIGN: Twenty ID discs were prepared from freshly extracted human third molars. After etching both dentine surfaces, hydraulic conductance (L(p)) of the dentine was measured. Ten dentine discs were then completely demineralised using 10% EDTA, and L(p) was re-measured. The diffusion of LPS through ID and DD was measured against the OF and compared to the non-outward flow (NF) (n = 5 for each group) at 0, 1, 4 and 8h. Longitudinal sections of ID and DD surfaces were observed under a scanning electron microscope (SEM). RESULTS: The L(p) of DD was significantly higher than that of ID (independent t-test, p < 0.001). The application of OF and demineralisation significantly affected LPS diffusion (two-way ANOVA, p < 0.05). In addition, the effect of OF depended on dentine demineralisation. SEM images of ID showed intact dentinal tubules, whereas those of DD showed expanded collagen fibres and enlarged dentinal tubules. CONCLUSIONS: The inward diffusion of LPS across DD differed from that of ID and the OF affected the inward diffusion of LPS. In the presence of the OF, the inward diffusion of LPS was reduced to near zero in both ID and DD. Nevertheless, when compared to that in the ID group, the OF produced the slightly greater effect to resist the inward LPS diffusion in the DD group.

Adolescent↗

Tensile strength and microhardness of treated human dentin.

OBJECTIVES: To determine the ultimate tensile strength and Knoop hardness of mineralized, EDTA-treated, sodium hypochlorite (NaOCl)-treated, EDTA-treated resin-infiltrated, and NaOCl-treated resin-infiltrated dentin. METHODS: Dumbell-shaped specimens with a cross-sectional area of 0.5 mm2 were prepared from the crowns of extracted human third molars. Specimens were randomly assigned to the following experimental groups: (1) mineralized dentin; (2) 0.5 M EDTA-demineralized dentin, pH 7/5 days; (3) 5% NaOCl-deproteinized dentin/2 days; (4) EDTA-treated, Single Bond resin-infiltrated dentin; (5) NaOCl-treated, Single Bond resin-infiltrated dentin. All specimens were tested in tension in a Vitrodyne testing machine at 0.6 mm/min. Knoop microhardness was measured on the fractured edges of specimens in groups 1, 3, 4, and 5. Results were analyzed by ANOVA and SNK tests (p < 0.05). RESULTS: Both EDTA and NaOCl treatments caused significant reductions in the tensile strength and microhardness of mineralized dentin (p < 0.05) with the largest reductions observed after NaOCl treatment (p < 0.05) Resin infiltration of treated dentin resulted in moderate increase of its tensile strength and microhardness, however, the original mineralized values were not recovered (p < 0.05). SIGNIFICANCE: Whenever dentin surfaces are treated with EDTA or NaOCl prior to a clinical bonding procedure, clinicians must be aware that a weak layer may be present at the interface, which may lead to premature failures of resin/dentin bonds.

Analysis of Variance↗

Bonding of an auto-adhesive luting material to enamel and dentin.

OBJECTIVES: The objectives of this study were (1) to assess the bonding performance of a new auto-adhesive cement (RelyX Unicem, 3M ESPE) to enamel and dentin, using a standard micro-tensile bond strength (microTBS) test set-up, and (2) to evaluate the interaction of this material with dentin by means of high-resolution electron microscopy. METHODS: The microTBS of RelyX Unicem with and without prior acid etching was determined to enamel and dentin after 24 h of water storage and compared to the bonding effectiveness of the control cement (Panavia-F, Kuraray). In addition, diamond-knife cut interfaces of RelyX Unicem and Panavia-F bonded to dentin were examined using field-emission scanning (Fe-SEM) and transmission electron microscopy (TEM). RESULTS: The microTBS of RelyX Unicem to enamel was significantly lower than that of the control cement, whereas no significant difference was found when both cements were bonded to dentin. Acid etching prior to the application of RelyX Unicem raised the enamel microTBS to the same level as that of the control, but was detrimental for the dentin bonding effectiveness. The latter must be attributed to inadequate infiltration of the collagen mesh as revealed by Fe-SEM and TEM. Morphological evaluation additionally revealed that RelyX Unicem only superficially interacted with enamel and dentin, and that application using some pressure is required to ensure close adaptation of the cement to the cavity wall. SIGNIFICANCE: (1) RelyX Unicem should always be applied with some pressure, to ensure that the relatively high viscous cement intimately adapts to the cavity wall; (2) The cement only interacted superficially with dentin and enamel; (3) The best bonding effectiveness with this new auto-adhesive cement was obtained by selectively acid-etching enamel prior to luting.

Acid Etching, Dental↗

Importance of mini-dumbbell specimen to access tensile strength of restored dentine: historical background and the future perspective in dentistry.

OBJECTIVES: The development of adhesive resins to dentine enables resin restorations to be more durable. Several bond strength measurement techniques for measuring adhesion have been proposed. A standardised method is needed which produced higher and more consistent bond strength values which allow bond stability and the bonding mechanism to be studied. Our aim was to investigate mainly the adhesives and not the substrate. DATA SOURCES: This review is based on the literature on an adhesive, 4-META/MMA-TBB resin and conditioners to modify dentine substrates. The latter is a very important topic for developing our understanding of the bonding to dentine. The objective of the review is to explain the efficacy of the mini-dumbbell specimen in measuring the tensile strength of resin to dentine and to analyze the resin to dentine interface. Both the adhesive and the substrate control the quality of hybridized dentine. CONCLUSIONS: By creating an impermeable acid resistant barrier to both biological and chemical stimuli between the exposed dentine and the restored tooth surface we are able to protect exposed dentine from caries (infection) at the same time as protecting the pulp and preventing toothache. This barrier also helps maintain tooth vitality and for the purposes of this article is termed 'artificial enamel'. Microleakage free restorations are possible through the introduction of this 'impermeable artificial enamel' barrier.

Animals↗

Microhardness of acid-treated and resin infiltrated human dentine.

OBJECTIVE: The aim is to determine if superficial or deep dentine microhardness (MH) is affected by different chemical dentine pre-treatments performed for resin bonding. METHODS: Dentine discs of superficial (SD) and deep dentine (DD) were obtained by transversally sectioning the crowns of human third molars. Knoop MH was measured after different treatments: (1) polished up to 4000 grit, (2) polished and etched (37% ortophosphoric acid for 15 s), (3) resin (Single Bond -SB-) infiltrated dentine after acid etching, (4) polished, etched and treated with 5% NaOCl for 2 min, (5) resin infiltrated (SB) after etching and NaOCl treatment. For resin infiltrated surfaces care was taken in order to remove the excess adhesive layer, and obtain infiltrated dentine, by measuring thickness of the sample before resin infiltration and polishing after resin infiltration until obtaining the initial thickness of the sample. Indentations (n=20) were performed on moist surfaces with a standard Knoop MH tester (20 g, 5 s). Data were expressed in Knoop Hardness Numbers (KHN) and analysed by ANOVA and multiple comparisons (P<0.05). RESULTS: Dentine KHN decreased on both SD and DD after acid etching. NaOCl treatment after acid etching did not affect MH on SD, but KHN of DD was lowered. Resin infiltration increased KHN but did not recover the initial MH values in both SD and DD. CONCLUSIONS: Treating dentine with either H3PO4 or NaOCl caused marked reduction of its surface hardness and subsequent resin infiltration was not capable to restore it.

Acid Etching, Dental↗

A comparative profilometric in vitro study of the susceptibility of polished and natural human enamel and dentine surfaces to erosive demineralization.

This study sought to compare the depths of erosive lesions in samples from different tooth sides as well as from enamel, dentine and root surfaces, and to examine the effect of preparation and polishing of specimens on erosive demineralization. From 30 impacted human third molars, two enamel samples from the mesial, distal, buccal and oral aspects, and similar samples from the radicular dentine, were prepared. One of each pair of samples was polished whereas the other was left untreated. Four samples were also prepared from the coronal dentine. For erosive demineralization, all samples were immersed in 0.05 M citric acid for 3 h and the erosion depth was calculated profilometrically. In general, natural surfaces showed significantly smaller erosion depths than polished surfaces (p< or =0.001) and enamel samples showed greater depths than coronal dentine (not significant) and root dentine (p< or =0.001). The erosion depths of the four tooth sides correlated significantly for polished enamel and coronal dentine samples but not for natural enamel specimens. There was no correlation between erosion depths for enamel and coronal dentine, and only a weak correlation between enamel and root dentine.

Citric Acid↗

Bonding to dentin with a self-etching primer: the effect of smear layers.

OBJECTIVE: The purpose of this study was to investigate the effect of smear layers on the tensile bond strength to human dentin. Bond strength was determined on dumbbell-shaped specimens to determine the feasibility for clinical use of a self-etching primer. METHODS: The dentin of extracted human teeth was exposed by grinding with either #180 or #600 abrasive paper. A self-etching primer was then applied to the prepared dentinal surfaces and left undisturbed for 30s. It was then air-dried and a photocured bonding agent applied and irradiated for 20s. A composite resin was then added to the primed dentin and light-cured for 60s to complete the bonded assemblies. Mini-dumbbell specimens (3.0 x 2.0 mm2) were prepared from the bonded samples. These specimens were stored in 37 degrees C water for 24h before tensile loading to failure at a crosshead speed of 1.0 mm/min. Surfaces of fractured specimens, both resin and dentin, were examined under a scanning electron microscope (SEM). RESULTS: Significantly different tensile bond strengths (TBS) of 10.0+/-7.2 and 28.5+/-5.2MPa were found for #180- and #600-prepared dentin, respectively (p<0.01). The former specimens fractured within the hybridized, relatively coarse smear layer, while the latter demonstrated adhesive failure between the composite resin and an attached PMMA rod, not between the dentin and applied adhesive agent. SIGNIFICANCE: The presence and quality of a smear layer yields significantly different bond strengths to prepared human dentin, in vitro. However, a TBS of 10+/-7MPa is evidently adequate, since self-etching primers have been well accepted in dental clinics.

Acid Etching, Dental↗

Submicron hiati in acid-etched dentin are artifacts of desiccation.

OBJECTIVES: The submicron hiatus represents a potential space between the base of the collagen network and the mineralized dentin when dentin is acid-etched for bonding. These spaces were observed in SEM studies after acid-etched dentin specimens were critical point dried or dehydrated in hexamethyldisilasane. However, they have never been identified in TEM studies of dentin hybrid layers. This study critically examined the cause of submicron hiati formation using a silver staining technique to measure nanoleakage. METHODS: Two multi-step, total-etch adhesives (One-Step, Bisco; Single Bond, 3M) and two single-step, self-etching adhesives (Prompt L-Pop, ESPE; One-Up Bond F, Tokuyama) were examined. Flat dentin surfaces were bonded with these adhesives and a lining composite. In each adhesive group, 0.8mm thick slabs from the same bonded tooth were coated with nail varnish applied 1mm from the bonded interfaces. The varnish was either left to dry completely for 10min before immersing in 50wt% silver nitrate (AgNO(3)) for 24h (group D), or painted on blotted tooth slabs that were immediately dropped into the AgNO(3) solution (group M). After developing, undemineralized, unstained, epoxy resin-embedded sections were prepared for transmission electron microscopy (TEM) to identify the amount and distribution of silver uptake. RESULTS: Nanoleakage patterns were observed in all adhesive-bonded teeth, regardless of brand. Fine reticular silver deposits were also found in the underlying undemineralized dentin. In group D, submicron hiati were seen as tunnels of heavy silver deposits beneath hybrid layers. Specifically, a hiatus occurred between the undemineralized intertubular dentin and a cohesively fractured layer of the same matrix that was attached to the base of the hybrid layer. Hiati were completely absent in group M, regardless of the brand of adhesive. SIGNIFICANCE: Submicron hiati are artifacts created by desiccation during specimen processing, and should be referred to as such in future studies of bonded dentin interfaces.

Acid Etching, Dental↗

Micromorphological spectrum of acid-conditioned dentin following the application of a water-based adhesive.

OBJECTIVES: The goal of this study was to illustrate the micromorphological spectrum along the resin-dentin interface when a water-based, dentin adhesive (Scotchbond Multi-purpose) was applied to acid-conditioned dentin under different dry and wet bonding conditions. METHODS: Twenty-eight 1 mm dentin discs were each conditioned with 10% maleic acid for 15 s. Twenty-four of these discs were randomly divided into four groups, based upon the status of the remaining surface moisture: Group I (30 s dry); Group II (3 s dry); Group III (visibly moist) and Group IV (overwet). They were bonded using Scotchbond Multi-purpose. The remaining four discs were bonded using an experimental water-based primer containing 35 vol.% HEMA (Group V). Laminated dentin disc pairs were prepared for transmission electron microscopic examination. RESULTS: In all groups, diffusion of the polyalkenoic acid copolymer component of the primer into acid-conditioned dentin was localized to the surface region of the hybrid layer. The remaining part of the hybrid layer (the subsurface region) appeared variable. In Group I (30 s dry), collagen fibrils were collapsed. In Group II (3 s dry) and Group III (visibly moist), stained collagen fibrils were surrounded by wide electron-lucent interfibrillar spaces. In Group IV (overwet), a marked diffusion gradient was observed representing dilution of part of the primer components. In addition, an electron-dense primer phase, containing electron-lucent globular domains was invariably observed, irrespective of the hydration status of the demineralized collagen matrix. This electron dense phase was absent when HEMA alone was used as the primer (Group V). SIGNIFICANCE: With the use of a water-based adhesive, one could briefly air-dry the acid-conditioned dentin and allow the water in the primer to rehydrate the collapsed collagen matrix, without the risk of incomplete hybridization or tubular seal along the resin-dentin interface. However, care should be exercised to minimize dilution of the water-soluble primer component.

Acid Etching, Dental↗

The durability of adhesion to phosphoric acid etched, wet dentin substrates.

OBJECTIVE: The purpose of this study was to investigate the influence of remaining non-resin-impregnated, phosphoric acid demineralized dentin upon the long-term durability of specimens that were wet-bonded to bovine dentin substrates. METHODS: Prepared bovine dentin samples were etched with 65% phosphoric acid then rinsed with water and kept wet during application of 5 wt% 4-methacryloyloxyethyl trimellitate anhydride (4-META) in acetone primer. This was followed by application of a photocured dentin-bonding agent consisting of 4-methacryloyloxyethyl trimellitate anhydride/triethyleneglycol dimethacrylate-camphorquinone/N-phenylglycine (4-META/TEGDMA-CQ/NPG). The tensile bond strength (TBS) of bonded specimens was determined after immersion in 37 degrees C water for various time intervals. Generated data were analyzed for statistical significance by one-way ANOVA and Duncan's New Multiple Range Test (p < 0.05). The dentin side of the tensile-load-fractured specimens was examined under optical and scanning electron microscopes (SEM). RESULTS: TBS decreased from 6.6 +/- 1.0 MPa after 1-day water immersion to 3.4 +/- 1.7 MPa after 1 month of water immersion. After 6 months of water immersion, TBS was found to be 3.9 +/- 0.9 MPa and this decreased to 2.0 +/- 1.0 MPa for specimens immersed in water for 1 year, a statistically significant difference (p < 0.05). Optical microscopic and SEM observations disclosed failure patterns within demineralized, non-resin-impregnated dentin that increased with the period of water immersion. SIGNIFICANCE: The bond durability to wet dentin was poor when demineralized dentin was not resin-impregnated, resulting in exposure of collagen fibrils which hydrolyzed during long periods of water immersion.

Acid Etching, Dental↗

Effect of hydrostatic pressure on regional bond strengths of compomers to dentine.

OBJECTIVES: The aim of this study was to evaluate the effect of hydrostatic pressure on the regional bond strengths of compomers to dentine. METHODS: Thirty freshly extracted molars were ground flat to expose the dentine and randomly divided into two groups for bonding: no hydrostatic pressure and hydrostatic pressure of 15cm H(2)O. Xeno CF, Dyract AP and F 2000 were applied to dentine surfaces pretreated by the respective bonding systems following the manufactures' instructions, and then restored with Clearfil AP-X. After 24h storage in water, the teeth were sectioned into 0.7-mm thick slabs and visually divided into three regional subgroups: the region communicating with the pulp through dentinal tubules (pulp horn); the region between the pulp horns (center); and the region between the pulp horn and DEJ (periphery). The specimens were trimmed to a cross-sectional area of 1mm(2) and subjected to the micro-tensile bond test. The data were analyzed by one- and three-way ANOVA, and Fisher's PLSD (p<0.05). RESULTS: There were no significant regional differences of bond strengths for all the compomers tested (p>0.05). However, hydrostatic pressure significantly decreased the bond strength of F 2000 to all regions (p<0.05), while the bond strength of Dyract AP significantly decreased only at the pulp horn region (p<0.05). On the other hand, the bond strengths of Xeno CF seemed not to be affected by hydrostatic pressure (p>0.05). For Dyract AP and F 2000, the fracture modes were affected by hydrostatic pressure, while, for Xeno CF, there were no significant differences between the fracture modes with non- or positive hydrostatic pressure. SIGNIFICANCE: Simulated pulpal pressure of 15cm H(2)O had a greater influence on the bond strengths of compomers to dentine than did dentine regions. Therefore, when measuring the bond strengths of compomers to dentine under the simulated in vivo conditions, the wetness of the dentine surface, as well as the intrinsic properties of each material should be seriously considered.

Analysis of Variance↗

Permeability changes of dentine treated with titanium tetrafluoride.

OBJECTIVES: The aim of this research was to evaluate the effect of titanium tetrafluoride on dentine permeability in comparison with sodium fluoride and acidulated phosphate fluoride to determine their contribution to acid resistance of dentine. METHODS: Thirty-two dentine discs were prepared from extracted mandibular molars. The hydraulic conductance of all discs was measured before and after the formation of smear layer. The discs were then randomly divided into five experimental and one-control groups. Coronal surfaces of dentine discs were treated with either fluoride solutions of NaF, APF, 1% TiF4, 0.5% TiF4 and 0.1% TiF4 or de-ionised water. Following the measurement of hydraulic conductance, treated surfaces were subjected to 25% citric acid application. Then, final permeability measurements were made. The data were statistically analysed using ANOVA and Tukey's HSD multiple comparisons. RESULTS: While smear layer formation considerably reduced dentinal permeability of dentine discs, fluoride or de-ionised water application to smeared surfaces did not cause any significant change in hydraulic conductance (p > 0.05). After citric acid application, control and NaF groups showed higher permeability values than 1%, 0.5% and 0.1% TiF4 and APF groups (p < 0.01). CONCLUSION: Clinical use of acidic solutions of titanium tetrafluoride in dentine cavities may be considered since smeared dentine surfaces are modified to a stabile and acid-resistant state.

Acidulated Phosphate Fluoride↗

Molecular cloning of a human dentin sialophosphoprotein gene.

Dentin sialoprotein (DSP) and dentin phosphoprotein (DPP; phosphophoryn) are two principal dentin-specific non-collagenous proteins. DPP is extremely acidic and is rich in aspartic acid and serine. By virtue of this structure, DPP may bind large amounts of calcium and may facilitate initial mineralization of dentin matrix collagen as well as regulate the size and shape of the crystals. The function of DSP is not known. DSP and DPP are encoded by a single gene in both rat and mouse, and are uniquely expressed in odontoblasts and transiently in pre-ameloblasts. Because DSP and DPP are isolated from dentin as distinct proteins and appear to be present in different amounts, the nascent dentin sialophosphoprotein (DSPP) is likely cleaved to yield DSP and DPP. However, when, where and how the DSPP is cleaved into DSP and DPP is not clear. To further elucidate the structure and function of human DSP and DPP, we have cloned DPP and DSP cDNA by reverse transcriptase-polymerase chain reaction (RT-PCR) strategies, and then cloned and initiated characterization of a human dentin sialophosphoprotein gene. The genomic organization of human DSPP is very similar to that of mouse, containing five exons and four introns, suggesting it is a homologue of mouse dentin sialophosphoprotein (DSPP). Exons 1-4 encode for DSP, while exon 5 encodes for the C-terminus of DSP and the whole DPP. A 4.6-kb RNA transcript was detected on Northern blot analyses of total RNA extracted from immature (open root apices) human teeth using either a human DPP or DSP probe.

Amino Acid Sequence↗

Resin-modified glass-ionomers: effect of dentin primer application on the development of bond strength.

The purpose of this study was to investigate the rate of development of dentin bond strengths of resin-modified glass-ionomer cements (RMGIC) with use of dentin primers. The prepared dentin surface was treated according to each manufacturer's instruction or the dentin primer. Cements were condensed into a vinyl mold and light activated. The shear bond strengths were measured at a crosshead speed of 1.0 mm/min after 1, 5, 10, 30, 60 min, 2, 5, and 24 h storage in water at 37 degrees C. Presence of a significant difference between the mean bond strength at 1 min and each of the other test times was analyzed. The first time at which there was a significant increase in bond strength was defined as the "initial increasing time". As compared with the manufacturer's suggested dentin treatments, the bond strengths increased significantly when the dentin primers were used. The initial increasing times when the specimens were made following each manufacturer's instructions were 10 approximately 60 min. When dentin primer was used, the initial increasing time shortened to 5 approximately 10 min. It was concluded that the use of dentin primers for RMGIC restorations resulted in reduction of the initial increasing time.

Acrylic Resins↗

Shear bond strength of resin cements to both ceramic and dentin.

STATEMENT OF PROBLEM: All ceramic restorations benefit from resin cement bonding to the tooth. However, the literature is unclear on which cement, ceramic conditioning treatment, and dentin bonding agent produce the highest and longest-lasting bond strength. PURPOSE: This in vitro study evaluated immediate and 6-month shear bond strengths between a feldspathic ceramic and 4 different resin cements with the use of 6 different surface-conditioning treatments. Shear bond strengths between the 4 resin cements and dentin also were measured. MATERIAL AND METHODS: Four hundred eighty discs (10 mm in diameter and 4 mm thick) of Ceramco II porcelain were randomly divided into 6 main groups (n = 80). The ceramic specimens received 6 different surface conditioning treatments before the application of resin cement. These surface treatments were sanding with 600-grit silicon carbide paper, microetching with aluminum oxide, sanding followed by silane application, microetching followed by silane application, hydrofluoric acid-etching, and hydrofluoric acid-etching followed by silane application. Each group then was subdivided into 4 subgroups (n = 20) for the application of 1 of 4 cements: Nexus, Panavia 21, RelyX ARC, and Calibra. All cemented specimens were tested under shear loading until fracture on a universal testing machine; the load at fracture was reported in MPa as the bond strength. Bond strengths were determined at 24 hours and after 6 months of specimen storage in a saline solution. For dentin-resin cement shear bond strength testing, dentin specimens were treated with dentin bonding agents, and a thin layer of resin cement was applied according to the manufacturer's directions. Prodigy composite was bonded to the cement. Shear bond strengths were determined as above and reported in MPa at fracture. Data were analyzed with 3-way analysis of variance (P<.01). RESULTS: Hydrofluoric acid-etching followed by silane application produced bond strengths (15.0 +/- 7.4 to 21.8 +/- 5.8 MPa) in the highest statistical group with all 4 cements at both 24 hours and 6 months (P<.01). Sanding with 600-grit silicon carbide paper and microetching with aluminum oxide produced the lowest bond strengths (0.0 to 4.0 +/- 3.5 MPa). At 24 hours and 6 months, there were no significant differences among the 4 cements when hydrofluoric acid-etching was followed by silane application. Both auto- and light-polymerized dentin bonding agents bonded better to dentin than dual-polymerized bonding agents. CONCLUSION: Within the limitations of this study, hydrofluoric acid-etching followed by silane application produced the best bonds at 24 hours and 6 months with all 4 cements. Auto- and light-polymerized adhesives were associated with higher bond strengths to dentin than dual-polymerized adhesives.

Acid Etching, Dental↗

SEM analysis of dentin treated with the Er:YAG laser: a pilot study of the consequences resulting from laser use on adhesion mechanisms.

OBJECTIVES: The purpose of this study was to compare the morphological characteristics of lased dentinal surfaces obtained by chemical etching, which was applied either before or after laser treatment. The adhesive interface after the application of an adhesive-composite system on the above mentioned dentinal surfaces was also evaluated. MATERIALS AND METHODS: Eighteen caries-free permanent molars were transversally cut to obtain the dentinal surfaces. Ten of these surfaces were divided into three main groups according to their preparation modality: laser only, laser followed by chemical etching, and chemical etching before laser. The Er:YAG laser was used with two different energy outputs: 200 and 400 mJ at 1 Hz. The eight remaining surfaces were divided into two groups and followed the same preparation as the first three groups. The only difference was a change in frequency: 4 Hz was used for treating these surfaces. An adhesive system (Scotchbond 1, 3M), a thin layer of flowable composite (Tetric Flow, Vivadent), and a regular composite (Z250, 3M) were applied to each dentinal surface and then separately light cured. In order to evaluate the dentine-restoration interface, the samples were cut longitudinally and prepared for SEM observation. RESULTS: The dentinal surfaces that were etched by the laser treatment did not demonstrate the characteristics necessary for guaranteeing a good bond with the adhesive materials. A closer observation of the dentine-restoration interface revealed some micro-fractures located just below the lased dentinal surface. CONCLUSION: The decision to use the Er:YAG laser as an alternative to conventional techniques of acid etching is currently arguable. Given that the available adhesive systems require acid conditioning, it would not be advisable to skip this operative step.

Acid Etching, Dental↗

Effects of Er:YAG and Nd:YAG lasers on dentin permeability in root surfaces: a preliminary in vitro study.

OBJECTIVE: This in vitro study evaluated the effects of Nd:YAG and Er:YAG lasers on reducing dentin permeability by sealing opened tubules. BACKGROUND DATA: According to hydrodynamic theory, dentine hypersensitivity occurs when dentin is exposed with tubules opened. Consequently, a painful sensation occurs due to an intensification of the dentinal permeability. Treatment, therefore, should be based on a decrease of this permeability, achieved by the obliteration of dentinal tubules. The Nd:YAG laser is known for its capacity to seal dentinal tubules; however, few studies concerning treatment with Er:YAG laser are available. METHODS: The Nd:YAG laser was used, based on two parameters: (A) 1.0 W, 10 Hz, and (B) 1.5 W, 15 Hz. The Er:YAG laser was used at 60 mJ, 2 Hz, four applications of 20 sec each, at 6 mm from the surface. After irradiation, all samples were immersed in 1% Rodamine B dye solution, in order to evaluate the penetration of the dye solution and observe the decrease/increase of dentinal permeability after the laser treatment. RESULTS: The laser conditions used in the present study decreased the permeability as follows: (a) when using the Er:YAG laser at 60 mJ, 2 Hz in 26.05%, and (b) when using the Nd:YAG laser at 1.5 W, 15 Hz in 19.03%--with no statistical difference between them. Additionally, the Nd:YAG laser at 1.0 W, 10 Hz, decreased permeability in 4.59%, with a smaller effect. CONCLUSIONS: According to the results of this in vitro study, the Er:YAG laser at 60 mJ, 2 Hz, and the Nd:YAG laser at 1.5 W, 15 Hz are useful for decreasing dentin permeability.

Analysis of Variance↗