Exposed Dentin Tubules Research Articles

Effects of Citric Acid and EDTA on Periodontally Involved Root Surfaces: A SEM Study

Root debridement by scaling and root planing may not completely remove contaminated cementum particularly in more apical areas. The smear layer formed during root planing inhibits cell migration and attachment leading to impaired marginal periodontal healing. The present study was done to compare the morphological effects of root surface demineralization using citric acid and EDTA as root-conditioning agents. Thirty fragments of human dental roots previously exposed to periodontal disease were scaled and randomly divided into the following groups of treatment: Group I: Hand instrumentation and conditioning with normal saline for 5 minutes as control; group II: Hand instrumentation and conditioning with citric acid (pH 1) for 5 minutes and group III: Hand instrumentation and conditioning with EDTA (pH-7.4) for 5 minutes. Scanning electron microscopy was used to check for the presence of residual smear layer and for measuring the number and area of exposed dentin tubules. The mean efficacy of smear layer removal was compared between groups I and II, groups I and III and groups II and III, it was found to be statistically significant at 5%. When the mean diameter of the dentinal tubules and mean total surface area occupied by the dentinal tubule orifices was compared between groups II and III it was found to be statistically significant at 1% level of significance. Citric acid causes greater degree of morphological alterations than EDTA and is considered to be a better root-conditioning agent. However, the use of EDTA cannot be ruled out. This study supports the hypothesis that demineralizing agents can be used as an adjunct to the periodontal treatment aiming at restoring the biocompatibility of roots and helps in choosing an appropriate agent for root conditioning.

Comparison among four commonly used demineralizing agents for root conditioning: a scanning electron microscopy

Dental roots that have been exposed to the oral cavity and periodontal pocket environment present superficial changes, which can prevent connective tissue reattachment. Demineralizing agents have been used as an adjunct to the periodontal treatment aiming at restoring the biocompatibility of roots.ObjectiveThis study compared four commonly used demineralizing agents for their capacity of removing smear layer and opening dentin tubules. MethodsFifty fragments of human dental roots previously exposed to periodontal disease were scaled and randomly divided into the following groups of treatment: 1) CA: demineralization with citric acid for 3 min; 2) TC-HCl: demineralization with tetracycline-HCl for 3 min; 3) EDTA: demineralization with EDTA for 3 min; 4) PA: demineralization with 37% phosphoric acid for 3 min; 5)Control: rubbing of saline solution for 3 min. Scanning electron microscopy was used to check for the presence of residual smear layer and for measuring the number and area of exposed dentin tubules. ResultsSmear layer was present in 100% of the specimens from the groups PA and control; in 80% from EDTA group; in 33.3% from TC-HCl group and 0% from CA group. The mean numbers of exposed dentin tubules in a standardized area were: TC-HCl=43.8±25.2; CA=39.3±37; PA=12.1±16.3; EDTA=4.4±7.5 and Control=2.3±5.7. The comparison showed significant differences between the following pairs of groups: TC-HCl and Control; TC-HCl and EDTA; CA and Control; and CA and EDTA. The mean percentages of area occupied by exposed dentin tubules were: CA=0.12±0.17%; TC-HCl=0.08±0.06%; PA=0.03±0.05%; EDTA=0.01±0.01% and Control=0±0%. The CA group differed significantly from the others except for the TC-HCl group. ConclusionThere was a decreasing ability for smear layer removal and dentin tubule widening as follows: AC>TC-HCl>PA>EDTA. This information can be of value as an extra parameter for choosing one of them for root conditioning.

Synthesis of nanobioglass and formation of apatite rods to occlude exposed dentine tubules and eliminate hypersensitivity

The occlusion of patent dentine tubules may reduce or eliminate hypersensitivity by restricting dentinal fluid movement. The efficacy of a novel sol-gel nanobioglass and a melt-derived bioglass to occlude tubules and promote apatite formation was tested by mechanically brushing a slurry of bioglass powder and human saliva onto dentine possessing exposed tubules. Scanning electron microscopy, focused ion beam and energy-dispersive X-ray spectroscopy were used to characterize the powders and assess tubule occlusion. Melt-derived bioglass possessed an irregular particle morphology and had a mean size of 3.30 +/- 0.42 microm. The sol-gel bioglass particles were spherical, with a mean size of 0.65 +/- 0.19 microm. Dentine treated with melt-derived bioglass exhibited a tightly adherent continuous apatite layer. Treatment with nanobioglass resulted in particle deposition within tubules and formation of apatite rods which were tightly adherent to tubule walls and continuous to a measured depth of 270 microm.

Scanning electron microscopic observations of human dentine after mechanical caries excavation

Objectives: the structural integrity and surface characteristics of dentine remaining after caries excavation may be relevant to the subsequent bonding of adhesive restorative materials to the prepared cavity. This in vitro investigation aimed to analyse the different surface characteristics of the dentine cavity floor created after preparation using five different mechanical and chemo-mechanical methods of excavation: hand excavation, slow-speed bur, sono-abrasion, air-abrasion and Carisolv™ gel. Methods: ten cavities were prepared using each excavation method in extracted teeth with occlusal carious lesions. Epoxy resin replicas of the 50 cavities were manufactured from silicone impressions and then analysed using secondary electron scanning electron microscopy (SEM) to ascertain the surface characteristics of the dentine at the cavity floor. Results and conclusions: results from the 50 cavities examined suggested that each alternative excavation technique produced a different and characteristic dentine surface. Carisolv™ gel was the only method examined that consistently removed the smear layer during excavation to leave exposed dentine tubules at the end of cavity preparation.

Interstitial Fluid Pressure in Normal and Inflamed Pulp

Tissue pressure is the hydrostatic pressure in the interstitial fluid which surrounds the pulpal cells. This pressure outside the vessels is normally considerably lower than the blood pressure inside the vessels. The dental pulp has a relatively low interstitial compliance due to its enclosure between rigid dentin walls. Accordingly, even a modest increase in pulpal fluid volume will raise the tissue pressure, which may compress blood vessels, leading to ischemia and necrosis. Inflammation may lead to an increase in both interstitial fluid volume and blood volume in the low-compliant pulp and thereby increase the tissue pressure. However, the increased tissue pressure may, in turn, initiate increased lymph flow and absorption of fluid into capillaries in nearby non-inflamed tissue. Both of these latter factors will transport fluid out of the affected area and subsequently out of the tooth and consequently lower the tissue pressure. Increased tissue pressure, whether caused by increased blood volume or increased capillary filtration, will promote outward flow of fluid through exposed dentin tubules and thereby help to protect the pulp against entry of harmful substances. It seems physiologically beneficial, therefore, for the pulp to have a high tissue pressure, which promptly increases when blood flow increases due to its low compliance.

Scanning electron microscopy and thermal characteristics of dentin ablated by a short-pulse XeCl excimer laser.

The interaction of a short pulse XeCl excimer laser radiation with human dentin was investigated. The dependence of surface temperatures and temperature gradients into the treated teeth on laser parameters such as fluence (0.5J/cm2-7J/cm2), pulse repetition rate (1Hz-35Hz), and spot size (0.004cm2-0.12cm2) was studied. Additionally, the effect of fluence and pulse repetition rate on dentin microstructure was studied using scanning electron microscopy (SEM). It is demonstrated that this "cold ablation" excimer laser can result in significant thermal modification in the dentin surfaces. Changes include the formation of melted dentin grains, which uniformly cover the surface and the exposed dentin tubules. Maximum temperatures of the ablated surfaces, however, remained relatively low at most laser parameters used. Also, the immediate neighborhood of the root canal was essentially undisturbed at most laser parameters. These observations suggest that with the appropriate choice of parameters XeCl lasers can be effective in producing surface structures that may prove useful in enhancing bond strength or other applications in dentistry, without exposing tooth pulp to significant temperature elevation.