Etched Dentin Surfaces Research Articles

Increased Fluorohydroxyapatite across Dentin after Fluoride Iontophoresis

Due to the multiple factors contributing to dentin demineralization and hypersensitivity among individuals, the effectiveness of the available treatments in the long term remains unclear. A recent study reported a simple strategy to potentially mimic natural remineralization with increased crystallization on the enamel caries using fluoride iontophoresis. Such an effect is also ideal for accomplishing dentin biomineralization and structural strength. This study aimed to investigate structural and compositional characteristics and permeability changes after fluoride iontophoresis with different polarities, cathodal iontophoresis (CIP), anodal iontophoresis (AIP), and the control without iontophoresis for the treatment of etched dentin under simulated pulpal pressure. The 24 premolars were divided into 3 groups: CIP, AIP, and topical application of 5% sodium fluoride (NaF) for 40 s. Relative to before treatment, iontophoresis with both polarities significantly decreased the permeability with a visible increase in occluding tubules containing crystal formation and growth throughout the dentin structure and depth. The CIP not only restored the etched dentin surface into a sound condition but also reinforced the dentin across the structure and depth by the synergistic effects of remineralization, increasing crystal formation and transformation toward the more crystalline structure of fluorohydroxyapatite. Following topical treatment, X-ray diffraction analysis and Raman spectra revealed a significant reduction in the crystal size and crystallinity associated with the raised B-type carbonate substitution into the hydroxyapatite compared with that in the sound dentin. The result was the first to reveal the ideal strategy to rapidly restore the etched dentin surface into a sound condition, including reinforcing the dentin across the structure and depth by the synergistic effects of decreasing permeability, increasing crystal formation, and transformation toward the more crystalline structure of fluorohydroxyapatite using the 5% NaF applied with the DC cathode iontophoresis. The technique is noninvasive and simple and deserves further development for clinical application.

Does dimethyl sulfoxide promote the bonding performance of different universal adhesives to dentin in etch-and-rinse approach?

This study examined the influence of dimethyl sulfoxide (DMSO) on the microtensile bond strength (μTBS) of universal adhesives to dry or wet dentin in the etch-and-rinse approach. Human third molars were cut to reveal the flat mid-coronal dentin surface. The specimens were randomly divided into 16 groups (n = 8) based on dentin condition (dry or wet), dentin pretreatment (with or without DMSO), and adhesive agents (Scotchbond Universal (SBU), Ambar Universal Bond (AUB), G-Premio Bond (GPB), and Clearfil Universal Bond (CUB). The etched-dentin surfaces were pretreated with a 50% DMSO solution before adhesive application. After 24 h or thermocycling, the resin-dentin beams were tested using the microtensile device. μTBS data were analyzed using a four-way ANOVA (α = 0.05). Scanning electron microscopy (SEM) was used to detect nanoleakage at adhesive interfaces. DMSO increased μTBS to wet and dry dentin of CUB, SBU, and AUB but not GPB. CUB, SBU, and AUB bonded better to wet dentin than dry dentin, but GPB bonded equally well to both. DMSO's nanoleakage effect dependent on dentin moisture and the adhesive agent used.

Development of a zinc chloride-based chemo-mechanical system for potential minimally invasive dental caries removal system

Background/purposeThe chemo-mechanical caries-removal technique is known to offer advantages of selective dentin caries treatment while leaving healthy dental tissues intact. However, current sodium hypochlorite based reagents usually excessively damage dentin collagen. Therefore, the purpose of this study was to develop a novel chemo-mechanical caries-removal system to preserve the collagen network for subsequent prosthetic restorations. Materials and methodsThe calfskin-derived collagen was chosen as a model system to investigate the dissolution behavior of collagen under different operating conditions of chemical-ultrasonic treatment systems. The molecular weight, triple-helix structure, the morphology, and functional group of collagen after treatment were investigated. ResultsVarious concentrations of sodium hypochlorite or zinc chloride together with ultrasonic machinery were chosen to investigate. The outcomes of circular dichroism (CD) spectra demonstrated stability of the triple-helix structure after treatment of a zinc chloride solution. In addition, two apparent bands at molecular weights (MWs) of 130 and 121 kDa evidenced the stability of collagen network. The positive 222 nm and 195 nm negative CD absorption band indicated the existence of a triple-helix structure for type I collagen. The preservation of the morphology and functional group of the collagen network on the etched dentin surface were investigated by in vitro dentin decalcification model. ConclusionUnlike NaOCl, the 5 wt% zinc chloride solution combined with ultra-sonication showed dissolution rather than denature as well as degradation of the dentin collagen network. Additional in vivo evaluations are needed to verify its usefulness in clinical applications.

Oxidized Dopamine Acrylamide Primer to Achieve Durable Resin-Dentin Bonding.

The durability of the resin-dentin bonding interface is a key issue in clinical esthetic dentistry. Inspired by the extraordinary bioadhesive properties of marine mussels in a wet environment, we designed and synthetized N-2-(3,4-dihydroxylphenyl) acrylamide (DAA) according to the functional domain of mussel adhesive proteins. DAA's properties of collagen cross-linking, collagenase inhibition, inducing collagen mineralization in vitro, and as a novel prime monomer for clinical dentin adhesion use, its optimal parameters, and effect on the adhesive longevity and the bonding interface's integrity and mineralization, were evaluated in vitro and in vivo. The results showed that oxide DAA can inhibit the activity of collagenase and cross collagen fibers to improve the anti-enzymatic hydrolysis of collagen fibers and induce intrafibrillar and interfibrillar collagen mineralization. As a primer used in the etch-rinse tooth adhesive system, oxide DAA can improve the durability and integrity of the bonding interface by anti-degradation and mineralization of the exposed collagen matrix. Oxidized DAA (OX-DAA) is a promising primer for improving dentin durability; using 5% OX-DAA ethanol solution and treating the etched dentin surface for 30 s is the optimal choice when used as a primer in the etch-rinse tooth adhesive system.

To etch or not to etch, Part II: On the hydrophobic-rich content and fatigue strength of universal adhesives

ObjectiveTo determine whether smear layer management, via conservative etching protocols, and the hydrophobic-rich content of hybrid layers would affect the fatigue strength of resin-dentin interfaces. MethodsBar-shaped dentin beams obtained from sound third molars were wet-polished for 30 s. Dentin was etched with 32 % ortho-phosphoric acid for 3 or 15 s, 10 % meta-phosphoric acid for 15 s or by a prime-and-rinse application using a mild universal adhesive (Scotchbond Universal, 3M ESPE). Self-etch application served as control. Coating was performed with a solvent-free bisGMA-based resin. Composite buildups were made with a nanofilled composite. Resin-dentin beams with twin-bonded interfaces were sectioned and stored in deionized water for 24 h at 37 ℃ before 4-point flexural quasi-static monotonic testing (n = 16). Stress-life fatigue behavior was evaluated under cyclic loading (n = 35) by the staircase method at 4 Hz. The tension side of cyclic-loaded unfractured beams were evaluated under SEM, along with the micro-morphology of etched dentin surfaces. Monotonic data was analyzed by two-way ANOVA followed by the Tukey Test and cyclic-loaded data by Kruskal-Wallis on Ranks (α = 0.05). ResultsEtching protocols and higher hydrophobic-rich content produced significantly higher fatigue life distributions (p < 0.05). Dentin demineralization was ranked as OPA 15 s > MPA 15 s > OPA 3 s > P + R > SE. Less aggressive etching and coating reduced crack formation at hybrid layers. SignificanceCurrent oversimplification trends in resin-dentin bonding constitute a trade-off between hybridization quality and easier adhesive handling. Controlled dentin etching and increasing the hydrophobic-rich content of hybrid layers may be necessary to extend the longevity of mild universal adhesives.

Effect of chlorhexidine-loaded poly(amido amine) dendrimer on matrix metalloproteinase activities and remineralization in etched human dentin in vitro

To investigate the effect of chlorhexidine (CHX)-loaded carboxyl-terminated poly (amido amine) dendrimer (CHX-PAMAM-COOH) on matrix metalloproteinase (MMP) activities and remineralization in human dentin, CHX-PAMAM-COOH was prepared and characterized by Fourier-transform infrared spectroscopy. The inhibitory effects of CHX, PAMAM-COOH, and CHX-PAMAM-COOH on soluble recombinant human matrix metalloproteinase (rhMMP-2) and dentin-bound endogenous MMP activity were measured using an MMP Activity Assay Kit. In situ zymography was performed to evaluate the gelatinase activity in dentin pretreated with CHX, PAMAM-COOH, and CHX-PAMAM-COOH. The remineralization of etched dentin pretreated with CHX, PAMAM-COOH, and CHX-PAMAM-COOH was evaluated by field emission-scanning electron microscopy (SEM) and energy disperse spectroscopy (EDS) after incubation in artificial saliva for 14 days. The results of the rhMMP-2 activity assay showed that the MMP-2 activity in the CHX-PAMAM-COOH group and the CHX group decreased significantly to 5.58 ± 0.85% (P < 0.05) and 4.86 ± 1.12% (P < 0.05), respectively, but that in the PAMAM-COOH group increased significantly to 213.38 ± 0.11% (P < 0.05). The results of total MMP activity and in situ zymography showed a significant reduction in endogenous gelatinase activity in dentin in the CHX-PAMAM-COOH group and the CHX group. The SEM and EDS results showed that rod-like crystals were formed on the etched dentin surface in the PAMAM-COOH group and the CHX-PAMAM-COOH group, and their Ca/P ratios were 1.73 and 1.71, respectively. In conclusion, CHX-PAMAM-COOH can inhibit dentin-bound endogenous MMPs and induce remineralization in etched dentin simultaneously. However, it is important to note that the catalytic role of PAMAM dendrimers may have an undesired excitatory effect on MMP activity, which cannot be ignored if PAMAM dendrimers were used alone in the oral environment.

To etch or not to etch, Part I: On the fatigue strength and dentin bonding performance of universal adhesives

ObjectiveTo characterize whether the bonding performance and fatigue strength of resin-dentin interfaces created by a universal adhesive would be affected by different H3PO4-application times to more accurately assess long-term durability. MethodsMid-coronal flat dentin surfaces with standardized smear-layers were produced on sound third molars, etched with 32% H3PO4 for 0, 3 and 15 s, bonded with a mild universal adhesive (3M-ESPE) and restored with a nanofilled composite. Bonded specimens (0.9 × 0.9 mm) were stored in deionized water for 24 h and sectioned into beams for microtensile testing (n = 10). Resin-dentin beams were tested under tension until failure (0.5 mm/min) after 24 h or 6 month storage in artificial saliva at 37 ̊C. Bar-shaped resin-dentin beams (0.9 × 0.9 × 12 mm) were tested under 4-point-flexure initially at quasi-static loads (n = 22) and then under cyclic loads (n > 50). The stress-life fatigue behavior was evaluated using the twin-bonded interface approach by the staircase method at 4 Hz. Fractured interfaces and the tension side of unfractured beams were evaluated under SEM, along with the micro-morphology of the etched dentin surfaces and hybrid layers. Data were analyzed by ANOVA and Tukey test and Wilcoxon Rank Sum Test (α = 0.05). ResultsQuasi-static loads were limited to discriminate the bonding performance of resin-dentin interfaces. Application modes significantly affected etching patterns, fatigue strength, endurance limits and hybrid layer morphology (p < 0.001). SignificanceReductions in fatigue strength of self-etched bonded interfaces raise concerns about the true ability of universal adhesives to properly bond to dentin.

Comparison of microtensile bond strength on non-carious cervical lesions according to biofilm removal method

Dentin surface of non-carious lesion is usually attached with oral biofilm. The biofilm should be removed before application of restorative material, because it may reduce the bond strength of adhesive system. The aim of this study was to evaluate the microtensile bond strength, when the biofilm was removed with brush or bur. Twenty extracted human third molars were sectioned horizontally to obtain dentin surface. Specimen were divided randomly into four group. Biofilm formation was performed in three group, except for Group 1 (negative control). Biofilm was removed as follows: Group 3, using ICB brush; Group 4, using lowspeed round bur #2. Group 2 (positive control) was not removed Biofilm. And in all four groups, the adhesive system (Optibond FL, Kerr) was applied to etched dentin surface, and resin composite was built up in three 1mm increments. After 24 hour storage in distilled water, the teeth were perpendicularly sectioned to obtain beams (1 &amp;#x00D7; 1 mm2). Microtensile bond strength was measured and the data were statistically analyzed using one-way ANOVA and Tukey's post hoc test (p&lt;0.05). Group 4 showed the highest microtensile bond strength (p&lt;0.05), Group 3 showed no significant improvements when compared to Group 1. Group 2 showed lowest microtensile bond strength (p&lt;0.05). When restoring a non-carious cervical lesion, it is essential to remove the biofilm present on the dentin surface. In addition, in the method of removing the biofilm, both the brush removal method and the bur removal method were effective.

Mechanical and Chemical Changes in the Adhesive-Dentin Interface after Remineralization.

To evaluate the remineralization effects of Bioglass 45S5 (BAG) on dentin composition, adhesive-dentin bond strength, as well as interface and diffusion zone thickness. Dentin specimens were assigned to a control group (CG), in which the adhesive was applied following the manufacturer's instructions, and a remineralized group (RG), in which remineralization treatment was carried out by rubbing a remineralization solution (0.015 g of BAG with 1.35 ml of distilled water) on the etched dentin surface for 30 s before applying the adhesive. For bioactive analysis (n = 10), control and remineralized dentin were investigated using micro-Raman spectroscopy (mRS) and scanning electron microscopy (SEM). Stick specimens prepared with a three-step etch-and-rinse adhesive were submitted to a microtensile bond strength (µTBS) test (n = 10) after 24 h (24 h) and eight months (8 m). Micro-RS 3D-maps (n = 10) characterized the adhesive-dentin interface composition and diffusion zone thickness, and SEM images (n = 10) evaluated interface thickness. Data were analyzed using Student's t-test or two-way ANOVA and Tukey-Kramer's post-hoc test (α = 0.05). Remineralization treatment increased the mineral content of dentin. Mean µTBSs were statistically different at 24 h, with RG higher than CG; however, this difference was not significant at 8 m. When the adhesive was applied on remineralized dentin, its penetration was reduced, its physical interaction with phosphate was improved, and its degree of conversion increased. The diffusion zone in the CG did not differ from that of the RG, and interface thickness values of the CG did not differ from that of the RG. Remineralization treatment promoted mineral growth on the dentin surface, improved the interaction of dentin with adhesive monomers, and consequently resulted in higher immediate bond strengths.

Effects of Bioactive Agents on Dentin Mineralization Kinetics After Dentin Bleaching.

This study evaluated effects of Bioglass 45S5 (BG) and Biosilicate (BS) remineralization on the chemical composition and bond strength of control dentin (CD) and bleached dentin (BD) surfaces. Dentin bleaching treatment was performed using the walking bleaching technique with 0.01 g of sodium perborate and 0.5 mL of 3% hydrogen peroxide for 14 days. Remineralization treatment was carried out by rubbing a remineralization solution (0.015 g of BG or BS diluted in 1.35 mL of distilled water) on the etched dentin surface for 30 seconds. Micro-Raman spectroscopy (MRS) was used to quantitatively analyze the mineral matrix ratios of CD and BD (n=5) after remineralization treatment with BG and BS over 15 days of incubation in artificial saliva. The CD and BD discs (n=10) with and without remineralization treatment with BG and BS were restored using a two-step etch-and-rinse adhesive system (Optibond S, Kerr) and five layers of 1-mm-thick composite resin (Filtek Z250, 3M ESPE). The restored dentin discs were sectioned into nine bonded beams with cross-sectional areas of approximately 0.9 mm2 and tested for microtensile bond strength (μTBS). The dentin surface of one fractured beam per tooth was submitted to MRS to characterize the physicochemical composition (n=10) at the interface. The data were analyzed using one-way analysis of variance and the Tukey-Kramer post hoc test (p<0.005). MRS bioactive analyses revealed that both BG and BS promoted increased mineral matrix ratios in the CD and BD. Significantly higher μTBS values were found after CD treatment with BG (CD: 57 MPa±11; CD-BG: 78 MPa±15) and when BG and BS were applied to the BD (BD: 42 MPa±5; BD-BG: 71 MPa±14; BD-BS: 64 MPa±11) (p<0.005). The MRS analysis of the fractured dentin beam showed that the remineralization treatment significantly increased the dentin relative mineral concentration and promoted the appearance of new interface peaks, indicating a chemical interaction (p<0.005). Remineralization of BD is an effective therapy to restore damage caused by dentin bleaching and acid conditioning. This approach not only increases dentin mineral compounds but also improves dentin's ability to interact chemically with the adhesive system.

Effectiveness of Etching by Three Acids on the Morphological and Chemical Features of Dentin Tissue

The purpose of this study was to evaluate the microscopic and chemical effects of phosphoric acid gel, phosphoric acid liquid, and polyacrylic acid application for 15 seconds (s) on coronal dentin. Twelve extracted teeth were selected. Three etching acids were used to prepare the dentin surfaces. Scanning electron microscopy (SEM) and X-ray energy dispersive spectroscopy (EDX) were used to analyze the chemical and morphological changes of the dentinal surfaces, including the depth of demineralization. Collected data were statistically analyzed by the one-way analysis of variance test. Dentin etched with phosphoric acid gel or liquid showed greater peritubular dentin dissolution, including complete removal of the smear layer. In addition, there were many silica particles on the dentin etched by phosphoric acid gel 37%. The dentin that was etched with 25% polyacrylic acid for 15 seconds showed no smear layer removal. Chemical analysis (EDX) showed that dental surfaces etched with phosphoric acid liquid 37% for 15 seconds showed the strongest mineral dissolution at the calcium surface, with a calcium content of 5.25%. On the other hand, EDX analysis of the dental surface etched with 25% polyacrylic acid showed more surface enrichment in calcium (17.19%). Although phosphoric acid (gel or liquid) 37% cleans the dental surface, phosphoric acid gel precipitates silica particles on the etched dentin surface. These particles cannot be removed by rinsing off this acid. The application of polyacrylic acid for 15 seconds does not noticeably demineralized dentin, nor remove the smear layer. The clinician should use phosphoric acid (gel or liquid) to clean dental surfaces to prepare them for the bonding process. The low demineralizing effects of the polyacrylic acid permits its use near the pulp.

Improved resin-to-dentin bond strength and durability via non-thermal atmospheric pressure plasma drying of etched dentin.

This study aimed to evaluate the improvement in strength and durability of the bond between dentin and composite resins following plasma drying of the etched dentin surface using non-thermal atmospheric pressure plasma. Plasma drying was applied to the etched dentin before applying adhesive. Conventional wet-bonding and helium (He) gas-dried bonding schemes were used as control groups. The bond strength of the composite resin to dentin was measured as the microtensile bond strength at 24 h after bonding and after 10,000 cycles of thermocycling. Hybrid layer formation was observed using micro-Raman spectroscopy and scanning electron microscopy. Although the bond-strength values were not statistically different either at 24 h after bonding or after thermocycling, the bond strength of the plasma-dried bonding group was significantly higher than the conventional wet-bonding group and He gas-dried bonding group. Micro-Raman spectral analysis revealed effective penetration of the adhesive and an improved polymerization rate of the adhesive after plasma drying. Plasma drying increased the penetration of hydrophobic resin into the collagen mesh structure, which improved mechanical bonding and long-term durability between dentin and composite resin.

A novel dry-bonding approach to reduce collagen degradation and optimize resin-dentin interfaces

In dentistry, the wet-bonding approach relies on water to maintain demineralized collagen expanded for proper resin infiltration; nevertheless, hydrolytic instability of the resin-dentin interface is inevitable with current bonding techniques. Considering dimethyl sulfoxide’s (DMSO) ability to “biomodify” collagen and precipitate enzymes, the aim was to test whether the use of DMSO would permit adequate resin bonding to H3PO4-etched dehydrated dentin and assess its impact on collagen degradation by host-derived enzymes. Etched dentin surfaces from extracted sound human molars were randomly bonded in wet or dry conditions using aqueous or ethanolic DMSO solutions as pretreatments and bonding resins with or without DMSO. Bonded teeth were sectioned into resin-dentin slabs for confocal in situ zymography and beams for microtensile bond strength test. Demineralized powdered dentin was incubated in the tested DMSO -media and a hydroxyproline assay evaluated dissolution of collagen peptides. Zymography was performed on protein extracts obtained from dry and wet H3PO4-ecthed dentin powder treated with the DMSO- media. The correlative biochemical analysis demonstrated that reduction of water content during dentin hybridization by the innovative dry-bonding approaches with DMSO is effective to inactivate host-derived MMP-2 and MMP-9 and thus reduce collagen degradation while simultaneously optimizing resin-dentin bonding.

Selective dentin etching: A potential method to improve bonding effectiveness of universal adhesives.

To evaluate whether selective dentin etching protocols using reduced phosphoric acid (H3PO4) etching-times would affect the resin-dentin interaction of a universal adhesive to improve long-term bonding effectiveness. Mid-coronal flat dentin surfaces were produced on sound third molars, selectively etched with 32% H3PO4 for 3, 5, 10 or 15 s and bonded with a universal adhesive (Scotchbond Universal, 3 M ESPE: SU). SU in self-etch mode and a three-step etch-and-rinse adhesive were used as control groups. Bonded specimens were stored in deionized water for 24 h and sectioned into beams (cross sectional area of 0.7 mm2). Micro-tensile bond strength test (n = 6) and nanoleakage evaluation were performed immediately, after thermocycling or 6-month storage in artificial saliva. Energy dispersive X-ray analysis (n = 6) was performed to determine the residual Ca-content ratio at the hybrid layers and scanning electron microscopy (SEM) was used to observe the micromorphology of the etched dentin surfaces before and after SU application. Data were analyzed by ANOVA and Tukey test (α = 0.05). Selective dentin etching for 3 s improved the interaction depth of the tested universal adhesive without overexposing demineralized collagen or reducing Ca-content availability at the bonded interface. The improved immediate bond strengths of the selective etching protocol remained significantly higher (p < 0.05) after long-term aging producing hybrid layers without significant differences (p > 0.05) in silver uptake levels compared to those produced on non-etched dentin. Despite the adjunctive conclusion that universal adhesives used in self-etch mode produce superior long-term dentin bonding compared to the etch-and-rinse mode, selective etching for 3 s with conventionally used H3PO4 improves dentin bonding effectiveness; nonetheless, longer etching times should be strictly avoided.

Calcium Phosphate Cementを応用した象牙質知覚過敏症の治療に関する研究

Calcium phosphate remineralizing slurry (CPRS), consisting of an equimolar mixture of tetracalcium phosphate (TTCP) and dicalcium phosphate dihydrate (DCPD), has previously been shown to form hydroxyapatite (HAp) spontaneously at physiological pH. Since considerable amounts of HAp may be formed in situ by CPRS, it may be effective for desensitizing hypersensitive dentin by obturating exposed dentinal tubule openings. In the present study, the effects of topically applied CPRS to etched dentin surfaces were investigated. The samples were randomly divided into 3 groups: (1) the control specimens were soaked in a saliva-like (SL) solution (2) the specimens received either 10-minute or 1-hour treatment with CPRS and (3) the specimens were treated with viscous CPRS, containing carboxymethyl cellulose (CMC) gel, for 8 hours. The SEM observations revealed that the control specimens were covered with a thin layer of plate-like crystals indicative of octacalcium phosphate (OCP). No significant penetration of the crystals into the dentinal tubules was detected. In CPRS group, the 10-minute treatment produced a 10 to 15 microns thick dense layer of precipitation consisting of needle-, rod-, and plate-like crystals. The 1-hour treatment produced a similar precipitation except that the crystals were mostly needle-like. A cross section view of the samples indicated remarkable penetration of the crystals into the tubules, thus providing significant obturation of tubule openings. Samples in the CMC-gel group were covered with an even more impervious layer of precipitation consisting of crystals of a variety of morphologies.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of Proteolytic Agents on Microleakage of Etch and Rinse Adhesive Systems

Objective: this study aimed to assess the effect of treatment of phosphoric acid etched dentin surface with 5% bromelain enzyme and Nd:YAG laser prior to the use of etch and rinse adhesive systems on microleakage margins of class V composite restorations. Materials and Methods: sixty sound premolar teeth were selected. Standard class V cavities were prepared in the buccal and lingual surfaces of each teeth. Preparation in that way 1 mm of the cavity was above and 1 mm of it was below the cementoenamel junction. The teeth were then randomly divided into three groups including 20 teeth(40cavities in each gorup). Two ethanol base etch and rinse system (Adper Single Bond and OptiBond Solo) was applied in each group. In the control group, cavities were etched with 37% phosphoric acid. Adper Single Bond was applied to 20 and OptiBond Solo was applied to the remaining 20 cavities and they were restored with Z250 composite (n=40). The same procedures were performed in bromelain and Nd:YAG laser groups with the difference that prior to the application of adhesive, aqueous 5% bromelain was applied in bromelain group while Nd:YAG laser was irradiated in laser group. All teeth were thermocycled and their apices were sealed with sticky wax. The tooth surfaces were coated with nail varnish except for 1 mm around the restoration margins, and the teeth were then immersed in fuchsine and sectioned by a diamond disc into mesial and distal halves. Marginal microleakage at both sides was determined and scored under a stereomicroscope at x40 magnification. Then data were analyzed using the Kruskal Wallis and Mann Whitney tests (α=0.05). Results: according the result of Mann Whitney test, Cervical margins showed significantly higher microleakage than the occlusal margins (P=0.000) but no significant difference was noted in microleakage of occlusal (P=0.362) or gingival (P=0.147) margins among the three groups by Kruskal Wallis test. Conclusion: in conclusion, application of proteolytic agents(5% bromelain solution and Nd:YAG laser) on acid-etched dentin surface prior to the application of adhesive has no significant effect on marginal microleakage of class V composite restorations.

Dimethyl Sulfoxide Wet-bonding Technique May Improve the Quality of Dentin Bonding.

To investigate the effect of the dimethyl-sulfoxide wet-bonding technique on composite-dentin bonds and to explore its potential mechanism. Thirty human third molars were segmented, ground, etched, and randomly divided into three groups according to the following pretreatments: 1. water; 2. ethanol; 3. 50% (v/v) dimethyl sulfoxide (DMSO). Then, Single Bond 2 was applied and composite buildups were constructed. After 24 h of water storage or 10,000 cycles of thermocycling, the microtensile bond strength (MTBS) and nanoleakage were measured. Contact angle measurement, Masson's trichrome staining, and in situ zymography were used to explore the possible action mechanism of DMSO on adhesive-dentin interfaces. DMSO pretreatment prevented the decline of thermocycled MTBS (p < 0.05) without affecting the immediate MTBS (p > 0.05) compared to the water wet-bonded group. Nanoleakage expression in the thermocycled DMSO wet-bonded group was also less than that in the thermocycled water-wet group (p < 0.05). Moreover, DMSO decreased the contact angle of the dentin surfaces (p < 0.05), reduced the amount of collagen exposure (p < 0.05), and decreased the collagenolytic activity in the hybrid layer (p < 0.05). The 50% DMSO pretreatment was effective in increasing the wettability of the etched dentin surface, promoting the penetration of the adhesive monomer, and enhancing the stability of the dentin collagen at the adhesive- dentin interface. All these changes may lead to higher quality dentin bonds, suggesting that DMSO wet bonding is a viable alternative to improve the durability of dentin bonding.

Effect of phytic acid etchant on resin–dentin bonding: Monomer penetration and stability of dentin collagen

PurposePhytic acid (IP6) works well as an etchant in dentin bonding to remove the smear layer due to its acidity and chelating effect. This study compared the etching effect of IP6 with phosphoric acid (PA) and ethylenediaminetetraacetic acid (EDTA) on resin–dentin bond strength, micromorphology of the etched dentin surface and nanoleakage formation along resin–dentin interfaces and compared the protecting effect against collagen degradation. MethodsDentin disks and flat dentin surfaces were obtained from extracted human teeth. Specimens were etched with 35% PA (15s), 0.5M EDTA (30s) or 1% IP6 (30s). The surfaces and longitudinal sections of the etched dentin disks were observed using field emission scanning electron microscope (FE-SEM). An etch-and-rinse adhesive was used to create composite build up-specimens for microtensile bond strength (μTBS) testing and nanoleakage observation. To evaluate the effect on collagen degradation, demineralized bovine root dentin blocks were challenged with bacterial collagenase and then observed under light microscope. ResultsPA- and EDTA- treated groups showed significantly lower μTBS when compared to IP6-treated group. PA showed distinct nanoleakage and severe collagen degradation. Only slight nanoleakage was detected in IP6 group. IP6 showed better effect than EDTA in preventing collagen degradation induced by bacterial collagenase. ConclusionsIP6 effectively removed the smear layer and etched dentin, providing high bond strength values and causing minimal nanoleakage and slight collagen degradation.

CO&lt;sub&gt;2&lt;/sub&gt;レーザー照射とグラスアイオノマーセメントによる象牙質の再石灰化

We investigated the effects of CO2 laser irradiation combined with immersion in a solution containing fluoride ions on the remineralization of etched dentin surface. Human premolars were divided randomly into four groups (1, control: NL; 2, immersion in fluoride-ion-containing solution: NLF; 3, laser irradiation: L; 4, laser irradiation plus immersion in fluoride-ion-containing solution: LF). Embedded human dentin blocks were etched with phosphoric acid, fixed on a specimen stage, and then a CO2 laser (10.6-µm wavelength) was applied (15 W/cm2), followed by immersion in fluoride-ion-containing solution. Nanoindentation testing was carried out before and after CO2 laser irradiation and during the immersion period, and then the dentin surfaces were observed by scanning electron microscopy. Phosphoric acid etching markedly decreased the mechanical properties (hardness and elastic modulus) of dentin surfaces. The mechanical properties of the etched dentin specimens subjected to laser irradiation plus immersion in fluoride-ion-containing solution recovered significantly during the immersion period compared to those of the other specimens. After immersion for 1 month in the fluoride-ion-containing solutions (NLF, LF), the wide-open dentinal tubules caused by acid etching were partly filled by a remineralized layer. In conclusion, CO2 laser irradiation with low output plus immersion in fluoride-ion-containing solution may enhance the remineralizing ability of etched dentin surface.

Effect of Chlorhexidine Application on Bond Durability of a Filled-Adhesive System

The aim of this study was to evaluate the effect of chlorhexidine (CHX) application on immediate and two-month bond strength of a filled adhesive system. Methods: Forty eight non-carious human third molars without enamel of occlusal surface were randomly divided into two main groups according to CHX application: control and CHX. Each main group was further subdivided into 2 subgroups depending on storage time: immediate or two-month collagenase storage. In CHX groups, 2% CHX was applied for 30 s. Filled adhesive resin (PQ1) was applied on the etched dentin surfaces and cured in all experimental groups. Composite resin (Amelogen) was placed on the dentin surfaces and shear bond strength (SBS) was evaluated immediately and after two-month storage in collagenase solution. Failure modes were determined by stereomicroscope. Results: There was no significant difference in immediate SBS between groups (P>0.05). After two-month collagenase storage, although SBS was significantly reduced in control group (P 0.05). SBS in CHX group was significantly higher than the control group (P<0.05). Conclusion: The use of CHX had no adverse effect on immediate bond strength of filled adhesive and could preserve the bond strength.