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[Treatment of dentin sensitivity with stannous fluoride gel. Electron microscopic study and evaluation of dentin permeability].

Dentine hypersensitivity still represent a major clinical problem only partially solved. The presence of exposed opened dentinal tubules has been demonstrated increase the dentine permeability and it is the responsible for pain and sensitivity. Stannous fluoride solution has been recently proposed to reduce dentine hypersensitivity. The aim of the present study was to evaluate the dentinal permeability of a new stannous fluoride gel proposed for the therapy of dentine hypersensitivity. Human extracted teeth have been used and mounted and connected with a hydraulic pressure apparatus working at 1 psi (70 cm of water pressure). It was calculated the permeability of untreated smear layer, treated smear layer (after gel application) and after acidic treatment. It was observed that gel treatment was able to reduce dentine permeability. Scanning electron microscopy demonstrated the presence of a homogeneous smear layer after treatment with gel. This in vitro study confirms that stannous fluoride treatment has the capacity to modify dentine permeability of sensitive dentine.

Dentin↗

Dentine permeability and dentine adhesion.

OBJECTIVES: The objectives of this paper are to review the structure of dentine as it pertains to adhesive bonding and to describe the importance of resin permeation into dentinal tubules and into spaces created between collagen fibrils by acid-etching during resin bonding. The advantages and disadvantages of separate acid-etching, priming and adhesive applications are discussed. DATA SOURCES: Although not an exhaustive review, the concepts included in the review were obtained from the dentine bonding literature. STUDY SELECTION: Attempts were made to critically evaluate what is known about dentine permeability and adhesion and what remains to be discovered. Speculations were made on a number of controversial issues that are not yet resolved. CONCLUSIONS: Acid-etching of dentine produces profound changes in the chemical composition and physical properties of the matrix which can influence the quality of resin-dentine bonds, their strength and perhaps their durability.

Acid Etching, Dental↗

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↗

Dentin permeability and dentin sensitivity.

The hydrodynamic theory of dentin sensitivity is based on the premise that sensitive dentin is permeable throughout the length of the tubules. Such a condition may permit the diffusion of bacterial products across dentin to the pulp where they may cause irritation of pulpal soft tissues. However, the slow outward movement of dentinal fluid tends to flush the tubules free of exogenous substances. This balance between the inward diffusion of exogenous substances, whether bacterial or the active ingredients in desensitizing medicaments, and the cleansing action of dentinal fluid flow needs to be examined experimentally.

Dentin↗

Dentin permeability: sealing the dentin in crown preparations.

Provisional restorations of full crown preparations may permit more microleakage of bacteria and their products than the final castings do. However, most investigations of the sealing qualities of cemented castings have reported that they too permit dye leakage. One approach to the problem is to seal the dentin with dentin bonding agents at the completion of the crown preparation. This study evaluated the ability of six different dentin bonding agents to seal the dentin of crown preparations of human teeth in vitro using two independent techniques. The first technique quantitated fluid filtration across dentin before and after treatment with dentin bonding agents at one hour, one day, one week, and one month and after thermocycling. The second method measured silver nitrate penetration of the thin veneers of dentin bonding agents into the dentin. Both methods correlated well with each other. The best seals were obtained with Prisma Universal Bond 2 or Superbond powder plus liquid. The worst seals were found using Gluma and Superbond liquid only. Clearfil PhotoBond, Amalgambond, and Scotchbond 2 gave intermediate results. Although the dentin bonding agents tend to accumulate on chamfers, thereby increasing their thickness to 200-300 microns, the method looks promising as a simple way to protect the pulp from the consequences of microleakage.

Analysis of Variance↗

Influence of concentration and application time of maleic acid on dentin permeability.

OBJECTIVES: Since dentin permeability ultimately affects bond strength, the purpose of this study was to compare the effects of different concentrations of maleic acid, and different exposure times on dentin permeability. METHODS: One hundred and thirty freshly extracted human non-carious third molars were used. Hydraulic conductance was determined after various treatments. The teeth were divided into five groups. In the first group, the smear layer was untreated. In three other groups, 0.10, 0.25, or 0.5 M aqueous solution of maleic acid was applied on dentin slices for 15, 30, or 60 s. In the last group, the Scotchbond Multi-Purpose dental adhesive system (3M Dental Products) conditioner was applied for 15, 30, or 60 s. RESULTS: After a 60 s exposure time, the Scotchbond Multi-Purpose dentin conditioner or the 0.1 M solution of maleic acid was as effective at increasing dentin permeability as the 0.25 M and 0.5 M maleic acid solutions. The maximum dentin permeability was reached after 15 s with 0.25 M and 0.5 M solutions of maleic acid, after 30 s with Scotchbond Multi-Purpose and after 60 s with the 0.1 M solution of maleic acid. During the first 30 s, the 0.1 M solution of malic acid did not increase dentin permeability and did not completely remove the smear layer; a SEM examination of the dentin slices corroborated the functional results. SIGNIFICANCE: The manufacturer's recommendation of 15 s of etching using Scotchbond Multi-Purpose conditioning gel produced a moderate amount of etching which increases dentin permeability to about one-half its maximum value.

Acid Etching, Dental↗

The relationship between dentin bond strengths and dentin permeability.

The relationship between dentin permeability and the shear bond strength of Scotchbond/Silux was investigated. In the presence of a smear layer, there was no correlation between dentin permeability and dentin bond strengths. After removal of the smear layer with acids, there was an inverse relationship between dentin permeability and dentin bond strength. The bond strengths were high when dentin permeability was low and decreased as dentin permeability increased. Creation of smear layers with abrasive paper or dental burs reduced permeability by 80-85%. When Scotchbond/Silux bonds were made to such smear layers and then broken, the permeability of the dentin remained low. If the smear layer was removed by acid-etching prior to bonding, the permeability increased. When these bonds were broken, the permeability of the dentin remained elevated.

Adolescent↗

Scanning electron microscopy and dentinal permeability analysis of smear layer.

The aim of the present study was to evaluate the surface morphology and the permeability of dentine after different acid treatments: polyacrylic acid, maleic acid, phosphoric acid and saline solution as control. Dentine permeability was expressed as hydraulic conductance. All the acid treatments removed the smear layer and increased the dentine permeability.

Acid Etching, Dental↗

[Effect of various pretreatments for dentin bonding on dentin permeability].

Pretreatment of the dentinal surface with acidic solution is now considered to be necessary to obtain strong bonding between dentin and resin materials. Effects of various surface treatments for dentin bonding on dentinal smear removal have been reported by SEM observation. In this study, changes of dentin permeability after the surface treatments were measured using Pashley's technique. Forty-second treatments with either phosphoric acid gel, aqueous phosphoric acid, 10-3 solution or aqueous 10-20 Ca solution (10% citric acid containing 20% CaCl2) produced greater increases in dentin permeability compared with the treatments using either 10-20 Ca gel, Tenure Conditioner, Scotchprep or Gluma 2 for 40 seconds. Treatments with primers including adhesive monomers such as Scotchprep and Mirage Conditioner also increased the dentin permeability by removal of the smear layers and smear plugs. Application of a bonding agent (Clearfil Photobond) for 1 minute did not remove the smear plugs and the dentin permeability remained the same as before the treatment. The changes in dentin permeability were not predictable by SEM observation in some cases.

Acid Etching, Dental↗

A study of the dentinal permeability of the pulp chamber floor of human lower molars with separate roots.

The permeability of the dentin of the pulp chamber floor of lower molars with separate roots was studied, after instrumentation of the root canals by manual or ultrasonic techniques. The dentinal permeability was evaluated by the degree of penetration of copper ions in the tissue and quantified by methods used in morphometry. None of the combinations of irrigating solution/instrumentation technique caused an increase in the permeability of dentinal tissue in the pulp chamber region, probably because the dentin is reparative dentin, which is more amorphous and less tubular than primary dentin.

Analysis of Variance↗

Effects of fibrinogen in vivo on dentine permeability in the dog.

Dentine permeability measurements were made each hour for 6 h in tooth cavities prepared in control dogs or dogs which had been pretreated with a purified fraction of snake venom to deplete their plasma of fibrinogen. The control dogs exhibited a progressive fall in dentine permeability (approximately 50 per cent reduction in 6 h); the permeability in the fibrinogen-depleted dogs only fell 15 per cent in 6 h. The results implicate plasma proteins, particularly high molecular-weight proteins such as fibrinogen, as agents which reduce dentine permeability in vivo.

Animals↗

[The effect of Kaviner and the smear layer on dentin permeability of permanent teeth in children].

The dentin permeability is defined as a moving of fluid, of chemical substances and microbial products as well through the dentin. The clinical protection of children permanent teeth in other words the protection of pulp-dentin complex after their preparation makes a big problem into the restorative stomatology. Caviner is one of the newer means which is used in the protection of pulp-dentin complex which represents the components of powder dispersing within the ethyl-acetate mixture of polystirol. The important variable in this study is the presence or absence of smearing layer which has the important influence onto the dentin permeability. In order to confirm the Caviner and smearing layer working onto the dentin permeability of the children permanent teeth in vitro experiment was designed. We used for it the dentin disks made of the intact first premolar, extracted because of orthodontic reasons at the ten years old children. They were put into the split chamber which represents a part of apparatus made at our Faculty, which is, in fact, a modified apparatus which was formed by prof. D.H. Pashley (Georgia, USA), and it is used for measuring of dentin permeability with the help of hydraulic conductance (Lp) of dentin. The dentin permeability is expressed by the hydraulic conductance term, but the measures are still expressed as the Lp percentage maximum because of better survey of results. Comparing the obtained results with the other authors results we have come to the similar conclusions, and that is in fact, that the smearing layer significantly reduces the dentin permeability, and that the Caviner, as the other layners, reduces the dentin permeability. If we compare the reduction of dentin permeability at the dentin covered with the smearing layer and with the Caviner, it has been noticed that the smearing layer reduces more significantly. It should be accented that the Caviner reduces the dentin permeability less than the most earlier researched means for the protection of pulp-dentin complex.

Acetates↗

The influence of dentine permeability on cytotoxicity of four dentine bonding systems, in vitro.

Dentine adhesives are often placed directly on dentine from which the smear layer has been removed, the thickness of the dentine is minimal and the potential for diffusion of adhesive components into the pulp is greatest. The permeability of the dentine is one factor that should be critical to whether sufficient diffusion of adhesive components occurs to cause damage to pulpal cells. Dentine discs were prepared and divided into those with low-, medium-, and high-permeability. They were then treated with four different dentine adhesives, after which the pulpal side of the dentine was placed in contact with 1 mL of cell-culture medium. The medium was collected at 24 h intervals for 168 h, and was then placed on monolayers of human pulpal fibroblasts for 24 h. The response of the cells was assessed by succinic dehydrogenase activity (MTT method). The results showed that four dentine adhesive systems released sufficient components to cause suppression of cellular metabolism through dentine. High-permeability dentine generally allowed more diffusion of these components, but the effect of dentine permeability depended on the material. On the other hand, the time interval between the application of the bonding agent and collection of the eluant was consistently important for all materials. Materials were most cytotoxic at early intervals, and were generally less cytotoxic at later intervals, although there were exceptions and there was persistent (> 15%) suppression of cellular metabolism even at late (168 h) intervals. The results suggest that application of these materials to dentine, and particularly dentine with high permeability, poses a potential risk to the health of pulpal tissues.

Analysis of Variance↗

[A morphological analysis and assessment of the dentinal permeability of detergents and liners].

In this study we evaluated the morphological aspect at scanning electron microscopy (SEM) and the degree of permeability of the dentinal surface after treatment with different detergent solutions, liners and cleansers. In particular we tested new potassium oxalate products. The results obtained with in vitro tests showed that many detergents, liners and cleansers are able to maintain almost unaltered the smear layer, causing small modifications for the diameter and the number of dentinal tubules which are partially exposed. The materials we used were able to deterge the dentinal surface, as demonstrated by SEM analysis, but one of them was able to stabilize and to protect the surface. All tested products, except potassium oxalate, caused an increase in dentinal permeability, proving to exercise a potential by damaging action towards the dentine and the pulpal tissue. Only DDS was able to reduce the dentinal permeability, causing the formation of calcium oxalate precipitates which occlude the dentinal tubules.

Dentin↗

Progressive decrease in dentine permeability following cavity preparation.

Dentine permeability determinations were made longitudinally in cavities prepared in dog teeth in vivo, using two different techniques: isotope clearance and fluid filtration. Measurements made with both techniques indicate that there is a large reduction in dentine-permeability within the first week following cavity preparation. The phenomenon requires an intact pulp and is not the result of microleakage of temporary restorations.

Animals↗

In vitro dentine permeability: the relative effect of a dentine bonding agent on crown preparations.

OBJECTIVE: The aim of this study was to determine whether a dentine bonding agent (DBA) had an effect in reducing fluid filtration under cemented provisional crowns. METHODS: Crown preparations on 34 premolars, randomly allocated to two equal-sized test and control groups, were assessed for dentine permeability by a fluid filtration technique. In the test group, prepared crowns were acid-etched and then treated with a DBA (Prime & Bond NT). In the control group, no such DBA was applied. Provisional crowns were cemented on both groups of teeth using non-eugenol zinc oxide cement. Fluid filtration rates were measured repeatedly after crown preparation, at cementation, 1 h, 1 day, 1 week and 3 weeks following crown cementation for both groups. Filtration rates were also measured after acid-etching and dentine bonding for the test group. RESULTS: There was insufficient evidence to suggest any statistically significant differences either between the two groups or, on average, across the five time points in each group in terms of the relative percentage of fluid filtration. CONCLUSION: The DBA used did not seal dentinal tubules any more than did the smear layer and provisional crowns luted with a non-eugenol ZnO cement.

Acid Etching, Dental↗

The effects of dentin permeability on restorative dentistry.

The permeability properties of dentin determine its sensitivity and the degree of pulpal response to restorative procedure materials and microleakage. Most pulpal reactions are due to bacteria or bacterial products that permeate across dentin. These reactions can be prevented if dentin is sealed with resins as soon as it is exposed. In the future, restorative dentists may employ topical application of biologic growth factors to permeate across dentin to modify the formation of reactionary or reparative dentin, thereby lowering dentin permeability and protecting the pulp.

Dental Leakage↗