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Mechanical disruption of dentin collagen fibrils during resin-dentin bond testing.

PURPOSE: To determine if collagen fibrils on the dentin side of failed resin-dentin interfaces undergo mechanical disruption during microtensile bond testing. MATERIALS AND METHODS: Extracted, caries-free human third molars were divided into four groups. The occlusal enamel was removed, leaving a flat dentin surface for bonding. Resin composite buildups were made after the acid-conditioned dentin was bonded with either Single Bond (S) or One-Step (O), and using either moist bonding (M) or air drying for 5 s (D). After storage in water for 24 h, the teeth were vertically sectioned into an array of 0.9 x 0.9 mm resin composite-dentin beams. They were stressed to failure using the nontrimming version of the microtensile bond test. Fractured dentin and resin composite sides of representative beams from each group that exhibited adhesive failures under light microscopy examination were prepared for scanning (SEM) and transmission electron microscopy (TEM). RESULTS: A two-way ANOVA showed that moist bond strengths were significantly higher than those made to dry dentin (M > D; p < 0.001), but that there was no difference between the adhesives (S vs O; p = 0.547). SEM analysis showed the presence of loose collagen fibrils within fractured hybrid layers in the dry groups, but not in the moist groups. TEM examination of the dry-bonded groups revealed collagen fibrils that were thinner and exhibited abnormally wide interfibrillar spaces when hybrid layers were intact. Within dry-bonded fractured hybrid layers, broad mechanical disruption zones could be seen, consisting of fibrils that were devoid of cross banding, defibrillation of the subfibrillar architecture, and gross disaggregation into microfibrils. In the moist-bonded groups, only short mechanical disruption zones were found along the torn edges of the collagen fibrils. The rest of the fibrils beyond the fracture site were intact and retained their periodicity. Mechanical testing of demineralized matrices yielded a maximum modulus of elasticity of 43.9 +/- 6.1 MPa. CONCLUSION: We speculate that adhesive resin has a protective function for demineralized collagen in well-infiltrated hybrid layers. We propose that both the collagen and resin contribute to load sharing during stress application until the final moment of rupture. On the other hand, collagen fibrils in poorly infiltrated hybrid layers, being unsupported by resin, undergo various degrees of irreversible mechanical disruption depending on how the stress is dissipated. The collagen fibril network has a much lower modulus of elasticity compared to those of resin-infiltrated fibrils or the demineralized dentin.

Acid Etching, Dental↗

Bond strengths of dentinal bonding systems to enamel and dentin.

Contemporary, third-generation dentinal bonding products have become highly specialized in producing high bond strengths to dentin. This investigation compared in vitro bond strengths of six dentinal bonding systems and their matched composite resins to human enamel and dentin. The effects of treatment by dentinal primers on enamel bond strengths as well as the effects of phosphoric acid on the strengths of dentinal bonds were measured. The use of dentinal primer on enamel improved the bond strengths of Prisma Universal Bond 3/Prisma APH and XR Bond/Herculite systems and had no effect on Denthesive/Charisma, Scotchbond 2/Silux, and Tenure/Perfection, while the enamel bond strengths of Gluma/Pekalux declined. Pretreatment of dentin with phosphoric acid improved the bond strengths of Denthesive/Charisma, Prisma Universal Bond 3/Prisma APH and XR Bond/Herculite, but had no effect on Gluma/Pekalux, Scotchbond 2/Silux and Tenure/Perfection.

Acid Etching, Dental↗

Ultrastructure of dentin matrix in heritable dentin defects.

Heritable dentin defects form a group of diseases which exclusively affect dentin among the various dental tissues. While one type is associated with the generalized connective tissue disorder, osteogenesis imperfecta, other types occur as single traits. The clinical manifestations of the dentin defects vary from insignificant to severe enough to cause aesthetical and functional failure of the teeth. Scanning and transmission electron microscopic studies, reviewed in this paper, have markedly clarified the ultrastructure of the aberrant dentin matrix. Both similar and different changes seem to occur in the various forms of heritable dentin defects. Abnormalities in the appearance and organization pattern of collagen fibers in the defective dentin partly resemble those observed in skin in generalized connective tissue diseases. The similarity of ultrastructural findings in dentin defects, which are currently classified as distinct entities, and even in diseases affecting other tissues, could be related to the complicated interactions between the extracellular matrix macromolecules. Thus, many of the changes observed may be secondary in nature. Ultrastructural studies can help us to understand the pathogenesis of the different types of heritable dentin defects as well as aid in diagnostics and classification of these diseases.

Collagen↗

The effect of dentin surface moisture on bond strength to dentin bonding agents.

This in vitro study compares the mean shear bond strengths of two dentin bonding agents to dry and to moist human dentin. The occlusal surfaces of 60 extracted human molars were ground to produce flat dentin surfaces. The teeth were divided into four groups of 15 specimens each. For Scotchbond Multi-Purpose dentin bonding agent, the teeth were etched, rinsed, and then either blotted with gauze, which left the dentin moist, or dried with compressed air. The primer and adhesive were then applied, and composite cylinders were bonded to the teeth. For Optibond, the teeth were again either blotted with gauze or dried with air. The primer and dual-activated adhesive were applied, and composite cylinders were bonded to the teeth. After storage in room-temperature distilled water for 48 hours, the specimens were thermocycled. Shear bond strength testing was performed at 1 week. Analysis using two-sample t-tests found no significant difference for either product in bond strengths to moist and to dry dentin (P > 0.05). This study indicated that for some current-generation dentin bonding agents, the presence of moisture on dentin surfaces does not compromise short-term bond strength.

Bisphenol A-Glycidyl Methacrylate↗

Effect of desensitizing agents on dentin permeability and dentin tubule occlusion.

PURPOSE: The aim of this study was to evaluate: 1) the effect of five dentin desensitizing agents (DDAs) on permeability using hydraulic conductance, and 2) morphological tubule changes with scanning electron microscopy (SEM). MATERIALS AND METHODS: The agents tested were Seal & Protect, Gluma Desensitizer, HurriSeal, D/Sense 2, and Super Seal. Thirty extracted human molars were sectioned into 1-mm mid-coronal dentin disks. Dentin permeability was measured at baseline and after treatment using bovine serum and phosphate-buffered saline at 10 psi. Treatments were applied to the occlusal surfaces of dentin according to the manufacturer's instructions. Representatives from each group were selected for SEM observation. Kruskal-Wallis ANOVA and Tukey's post-hoc comparisons were used to evaluate differences between groups. RESULTS: Mean percent reduction in dentin permeability for each group: SuperSeal = 97.5 +/- 4.0, HurriSeal = 54.2 +/- 35.3, D/Sense 2 = 46.6 +/- 20.4, Gluma Desensitizer = 39.6 +/- 26.7, and Seal & Protect = 33.8 +/- 19.4. The data provided strong evidence of differences in permeability reduction among the agents (p < 0.01). Pairwise comparisons of means demonstrated that the effects of SuperSeal differed significantly from the reductions achieved using Seal & Protect, Gluma Desensitizer, and D/Sense 2. Differences in the degree and content of dentinal tubule occlusion were seen among all DDAs under SEM. CONCLUSION: Of the materials included in this in vitro study, SuperSeal may be the most beneficial when treating dentin sensitivity. The wide range of results may reflect the various approaches and chemistries used to occlude tubules.

Analysis of Variance↗

An unusual presentation of opalescent dentin and Brandywine isolate hereditary opalescent dentin in an Ashkenazic Jewish family.

Two children of Austrian Ashkenazic Jewish background, related as second cousins, have a variant of opalescent dentin in their deciduous teeth. This has been classified by Witkop as Brandywine isolate hereditary opalescent dentin and by Shields as dentinogenesis imperfecta type III. One of the children also has dysmorphic facial features, seizures, and severe mental retardation. Her mother has dysmorphic facial features and mild mental retardation. The mothers of both children and several other family members have classic opalescent dentin (dentinogenesis imperfecta type II). Radiographs of the deciduous and permanent dentitions of one mother showed obliterated pulp chambers. Confirmation of obliterated pulp chambers in the deciduous teeth of the mother of a child with Brandywine isolate hereditary opalescent dentin makes it unlikely that classic opalescent dentin and Brandywine isolate hereditary opalescent dentin are separate genetic disorders. Evidence from this family supports the hypothesis that Brandywine isolate hereditary opalescent dentin is a variant of opalescent dentin.

Adult↗

The fibrillar structure of cementum and dentin at the cemento-dentinal junction in rat molars.

The cemento-dentinal junction was examined in demineralized rat molars with complete roots by scanning electron microscopy combined with NaOH maceration. It is established that the NaOH maceration removes interfibrillar substances and cells from connective tissues selectively without structural damage to collagen fibrils. The cementum was detached from the dentin by the maceration. The inner cementum surface facing the dentin and the outer dentin surface facing the cementum were observed. In acellular cementum, both the outer dentin surface and the inner cementum surface had a smooth appearance. There was little indication of fibrils intermingling between dentin and cementum. In contrast, both the inner cementum surface and outer dentin surface in cellular cementum had an uneven appearance due to the irregular arrangement of collagen fibrils. Point-like protrusions of fibril bundles were observed on both surfaces. Some (not all) of these point-like protrusions appeared to correspond to places of fibrillar intermingling between dentin and cementum.

Animals↗

The effect of thermocycling and dentine pre-treatment on the durability of the bond between composite resin and dentine.

The high bond strength between restorative resin and dentine plays an important role in long-term performance of restorations in the oral environment. A variety of treatment techniques have been described to enhance the bond strength of composite resin to dentine. Unfortunately, few studies have reported available bond durability of adhesive resins to dentine. The purpose of this research was to study the shear bond strength of composite resin to dentine pre-treated with phosphoric acid, self-etching agent or Nd:YAP laser irradiation. The durability of bond strength between resin and dentine stored in the artificial saliva thermocycling between 5 and 55 degrees C was also evaluated. The scanning electron microscope was used to assess the treated-dentine surfaces. The mean value of the shear bond strength in the acid-etching group (18.2 +/- 4.9 MPa) was the highest among the three dentine treatments (self-etching system: 12.6 +/-3.0 MPa, Nd:YAP laser: 13.4 +/- 3.3 MPa) prior to thermocycling. After thermocycling, shear strength values of all treated dentines decreased with increasing number of the cycles. When subjected to 3000 thermocycles, the mean bond strengths of these pre-treated samples to composite resin became 9.1 +/- 1.4, 7.8 +/- 1.8, and 8.1 +/- 1.7 MPa for acid-etching, self-etching and laser-irradiation, respectively, with a significant reduction of 38-50%.

Acid Etching, Dental↗

In vitro shear bond strength of two resin composites to dentin with five different dentin adhesives.

OBJECTIVE: The aim of this in vitro study was to evaluate the shear bond strength to dentin of five different dentin bonding agents in combination with two resin composites (Tetric and Z-100). METHOD AND MATERIALS: Human third molars were selected for the study, and cylindrical posts of either Tetric or Z-100 were bonded vertically to a standard flat dentinal area, prepared on the buccal surface of the teeth. A chisel-shaped shearing blade, attached to the crosshead of a universal testing machine, was positioned so that its edge was immediately adjacent to the adhesive joint. The shear bond strengths to dentin of 10 resin composite-dentin adhesive combinations were measured. RESULTS: The results showed that the bond strength of dentin bonding agents may depend on the choice of restorative material. The in vitro bond strength of dentin bonding agents also differed significantly. In several cases, the bond strength exceeded the cohesive strength of dentin. CONCLUSION: It seems important for clinicians to be acquainted with the variation in bond strength values that is experienced with any bonding system.

Bisphenol A-Glycidyl Methacrylate↗

Fluoride uptake in dentin with and without simulating dentinal fluid flow.

The aim of the present study was to compare fluoride uptake of dentin with and without simulating dentinal fluid flow. Eighty-five dentinal discs were prepared from retained human molars. Seventeen discs were used to assess baseline fluoride content (controls). Sixty-eight discs were evenly distributed among two experimental groups and were fixed for 24 h in a two-chamber device allowing for simulating dentinal fluid flow. Thirty-four samples were treated with dentifrice slurry containing a low fluoride concentration (Elmex, dilution 1:5); the remaining discs were treated with a solution of a high fluoride concentration (Elmex Fluid). For the perfused group, each of the 17 discs of the high and low concentration fluoride groups were constantly perfused during the experiment. The remaining fluoridated specimens were not perfused. All specimens were assayed for KOH-soluble fluoride and structurally bound fluoride. Structurally bound fluoride was determined in three successive layers of 20 microns each. Uptake of KOH-soluble fluoride was significantly higher in the specimens fluoridated with Elmex Fluid compared to the samples treated with the dentifrice slurry. The uptake of KOH-soluble fluoride was not influenced by perfusion of the dentinal discs. However, perfusion resulted in lower acquisition of structurally bound fluoride in the samples treated with the dentifrice slurry. After application of Elmex Fluid, no significant difference was found in the amount of structurally bound fluoride between the perfused specimens and non-perfused samples. It is suggested that further studies on fluoride uptake in dentin should use a model simulating outward dentinal fluid flow.

Analysis of Variance↗

Selective influence of dentin thickness upon cytotoxicity of dentin contacting materials.

The effect of three dentin contacting materials on three-dimensional cultures of pulp-derived cells was evaluated in a dentin barrier test device. The test materials (Syntac Classic, Prompt L-Pop, Vitrebond) were applied on dentin disks of different thicknesses ranging from 100 to 500 microm. After 24 h of exposure with and without perfusion of the test chamber, cell survival was evaluated using the MTT assay and related to a nontoxic control material. Syntac Classic decreased cell activity significantly (p </= 0.0003), independently of the dentin thickness. For Prompt L-Pop and Vitrebond a significant influence of dentin thickness was found on the cell reaction. After exposure of the control material, photometric readings showed no dependency of the cellular reaction on dentin thickness (p > 0.05). It could be demonstrated that dentin acts as a barrier, decreasing the elicited cytotoxicity with increasing thickness. This effect is material related, showing little influence for the nontoxic or the glutaraldehyde containing material.

Animals↗

Dentine hypersensitivity: uptake of toothpastes onto dentine and effects of brushing, washing and dietary acid--SEM in vitro study.

Toothpastes are commonly used in the treatment of dentine hypersensitivity. One mode of action could be to block patent dentinal tubules with toothpaste ingredients or by abrasion to form a smear layer. Studies in vitro have shown that toothpaste abrasives have variable affinity for the dentine surface but retention may be limited. This SEM study extended previous work and determined the uptake in vitro of toothpaste ingredients onto the dentine surface and their retention when challenged by washing with water or orange juice. All products were seen to leave variable residues on the surface of etched or unetched dentine specimens, furthermore brush application produced some smearing with closure of previously open tubules. Washing with water and more particularly orange juice removed most residues and orange juice etched the dentine to open previously closed tubules. One product with an artificial silica abrasive was relatively resistant to both water and orange juice washings and in a pilot experiment showed some penetration into tubules not seen with another desensitizing product. These findings suggest that some abrasives may be usefully employed in desensitizing products, but without consideration of erosive factors in the aetiology of dentine hypersensitivity recurrences of the condition will be common.

Acid Etching, Dental↗

Dentinal adhesion and histomorphology of two dentinal bonding agents under the influence of eugenol.

This study examined the influence of eugenol on the dentinal adhesion of an enamel-dentin bonding agent that removes the smear layer (total-etch technique) and a system that partially dissolves the smear layer (self-conditioning adhesive system). The tensile bond strength was measured on flat, dentinal surfaces after application and removal of pure eugenol for 15 minutes and a eugenol-containing temporary luting agent for 24 hours. In addition, the resin-dentin interface was evaluated with confocal laser scanning microscopy. Dentinal adhesion was found to be significantly reduced after the application of eugenol when a dentin bonding agent that dissolves the smear layer was used. Under confocal laser scanning microscopy, the resin-dentin interdiffusion zone of both adhesive was found to be changed, not only after application of eugenol but also after application of a eugenol-containing temporary luting agent.

Adhesiveness↗

The influence of human plasma used for in vitro dentin perfusion on microtensile bond strength of 5 self-conditioning dentin adhesives.

OBJECTIVE: The aim of this in vitro study was to evaluate the effect of human plasma, compared to physiologic saline, on microtensile bond strengths of 5 self-conditioning dentin adhesives when used as a dentin perfusion medium. METHOD AND MATERIALS: One hundred and fifty extracted human third molars were prepared in a special manner allowing the simulation of intrapulpal pressure and dentin perfusion. The specimens were randomly divided into 10 experimental groups. Five groups were perfused with physiologic saline, while the others were perfused with diluted human plasma, each under constant hydrostatic pressure of 30 cm H2O. One saline group and 1 human plasma group was then assigned to each of the following dentin adhesives: Clearfil SE Bond (Kuraray), Clearfil Protect Bond (Kuraray), Xeno 3 (Dentsply), Futurabond NR (Voco), and iBond (Heraeus Kulzer). The microtensile bond strength for each group was evaluated using a Zwick universal testing machine 10 minutes after light curing. RESULTS: Pairwise comparison showed a significant increase of bond strength in all human plasma-perfused subgroups (P < .05, Tukey's test). The influence of the different dentin adhesives was significant (P < .001, analysis of variance). The highest significant values were observed for Futurabond NR and iBond with human plasma (P < .05, closed test procedure). CONCLUSION: The use of human plasma might be a suitable alternative to imitate perfused dentin conditions in testing devices and might eliminate the discrepancy between different in vitro investigations focusing on bond strength of dentin adhesives.

Dental Stress Analysis↗

Effect of anti-sensitive toothpastes on opened dentinal tubules and on two dentin-bonded resins.

Treatment of dentin hypersensitivity will become of increasing importance in the daily practice of dentistry. The goal of any therapy should be the closure of opened dentinal tubules. The present study made an SEM evaluation of the effect of anti-sensitive toothpastes on root dentin with regard to the superficial changes and possible penetration by toothpaste particles. Further, the study performed an evaluation of the wear-resistance of two dentin-bonded resins during brushing, using the same anti-sensitive toothpastes. Having induced coverage of the dentinal tubules with the toothpastes (Sensodyne, Emoform and Macleans Sensitive), no particles were found within the tubules. The application of dentin-bonded resins seems an alternative solution for treating dentin hypersensitivity.

Acrylic Resins↗

Effects of protein deficiency induced by raw soy with and without sucrose on dentine formation and dentinal caries in young rats.

OBJECTIVES: The effects of protein deficiency and sucrose on formation and mineralization of dentine and dental caries in the molars of young rats were investigated. MATERIALS AND METHODS: Two groups of weaning Wistar rats received raw soy flour to induce protein deficiency with sucrose or starch as the carbohydrate source; the other two groups received skim milk powder as the protein source with sucrose or starch as the carbohydrate source. At the onset, tetracycline was injected to mark the dentine formed at that moment. After 6 weeks, lower molars were sectioned sagittally, and the areas of dentine formation and dentinal caries developed during the experiment were quantified separately in the first and second molars. Dental caries was also classified according to Schiff's reaction. Calcium (Ca), phosphorus (P) and total mineral elements were analyzed using an electron probe microanalyzer. RESULTS: Rats in both protein-deficient groups and normal protein sucrose group had significantly larger areas of dentine formed compared with rats fed with normal protein starch diet. Ca, P and total mineral elements in dentine were significantly reduced by normal protein sucrose diet. P content was significantly reduced in dentine of rats in protein-deficient sucrose group. Rats in normal protein sucrose group had significantly more and larger dentinal caries lesions than in any other group. CONCLUSION: This study suggests that protein deficiency induced by soy prevents the progression of dental caries even in highly cariogenic environment.

Animals↗

Dentin thickness, hardness, and Ca-concentration vs bond strength of dentin adhesives.

The relationship between the tensile bond strength (TBS) and three dentin characteristics: remaining dentin thickness (RDT), Ca-concentration, and hardness, were investigated. Sixty-two extracted bovine incisors, divided into four groups, were prepared using 600-grit SiC paper to create flat dentinal surfaces. The materials tested in this study consisted of three commercially available and one experimental dentin bonding systems. The TBS and modes of failure were determined after storage for 24 h in 37 degrees C water. Then RDT, Ca-concentration, and hardness were measured. Data were statistically compared with TBS of each group. The mean bond strength of the commercial materials ranged from 2.5 +/- 0.9 MPa to 7.7 +/- 2.8 MPa. Correlations with Ca-concentration and RDT varied, depending on the product. The bond strength of the experimental material was 9.2 +/- 4.4 MPa and significantly correlated with RDT and hardness. With two of the dentin bonding agents, specimens showed a high number of cohesive fractures in dentin, 40% to 82%. It was concluded that the variability of TBS was influenced by dentinal characteristics in three of the four materials tested.

Adhesiveness↗

Dentine hypersensitivity--effects of some proprietary mouthwashes on the dentine smear layer: a SEM study.

Exposed dentine may be sensitive to stimuli depending on the patency of the dentinal tubules. Most abrasive elements tend to produce a smear layer which obturates the dentinal tubules. This layer is easily removed by a number of erosive agents, particularly dietary acids. Mouthwashes are increasingly used and largely investigated for possible benefits to dental health. Rarely do studies assess potential detrimental activity. The aim of the present study was to examine effects of mouthwashes on dentine. Smear layers artificially produced on dentine sections were exposed, for time periods ranging from 3 to 300 min, to mouthrinses alone, or with subsequent brushing for 2 min using water or a fluoride toothpaste. Assessments were made by scanning electron microscopy. Of the nine rinses tested, six produced no consistently observable changes compared to water treated controls at any time period with or without brushing. A hexetidine rinse and a fluoride/antiseptic rinse both exposed tubules after exposure times of 2 h and longer, an effect enhanced by post-treatment brushing. A phenolic antiseptic rinse consistently removed the smear layer from specimens, an effect enhanced by brushing such that after 10 min exposure and 2 min brushing many tubules were open at the surface. The results indicate that the use of some mouthrinses could predispose to excessive tooth substance loss and dentine hypersensitivity, particularly if used prior to toothbrushing. There is a need to determine whether the intermittent use of some mouthrinses produces cumulative effects on dentine.

Benzoates↗