Bond strengths of fluoride-releasing restorative materials

PURPOSE: To compare the shear bond strengths to dentin of four tooth-colored fluoride-releasing restorative materials that utilize different mechanisms of dentin-bonding. MATERIALS AND METHODS: Four materials were tested: a chemically-cured glass ionomer (Ketac-Fil); a light-cured resin-modified glass ionomer (Photac-Fil); a light-cured resin-modified glass ionomer in conjunction with a resin dentin-bonding agent (Vitremer); and a light-cured resin composite in conjunction with a resin dentin-bonding agent (Tetric). The enamel was removed from four sides of the twenty human noncarious extracted molars which had their roots embedded in acrylic blocks. Cylindrical samples of the materials were prepared in plastic molds and bonded to the dentin surface according to the manufacturers' instructions. After 24 hours of storage in a humidor, the samples were sheared with an Instron testing machine at a crosshead speed of 0.5 mm/minute. RESULTS: Statistical evaluation (ANOVA and Duncan's test) suggests that the fluoride-releasing resin composite material utilizing a resin dentin-bonding agent provided a significantly greater mean shear bond strength (16.5 MPa) after 24 hours storage than any of the selected glass ionomer materials. Of the three glass ionomer materials compared, the light-cured resin-modified material with a resin dentin-bonding agent provided a significantly greater mean shear bond strength (6.7 MPa) than the light-cured resin-modified material without a resin dentin-bonding agent (3.0 MPa) or the chemically-cured material (3.8 MPa).     

Effect of peroxide bleaches on fluoride release of dental materials

PURPOSE: To investigate the effect of two bleaching agents, 35% hydrogen peroxide (Superoxal) and 10% carbamide peroxide (Opalescence), on the release of fluoride from Ketac-Fil, a glass ionomer cement, Photac-Fil, a glass ionomer/resin hybrid; and Tetric, a resin composite with fluoride. MATERIALS AND METHODS: Seven disks (9 x 3 mm) of each material were immersed in Superoxal for 1 hour to simulate an in-office application; seven other disks of each material were immersed in Opalescence 1 hour daily for 7 days to simulate a week of home bleaching regimen; and seven additional disks of each material without bleach served as a control. The disks were kept in deionized water and the water was tested for fluoride released every 24 hours for 14, 21, 28, and 35 days, respectively. RESULTS: Repeated measures ANOVA showed that the mean daily release of fluoride did not differ significantly (P > 0.05) between the bleaching agents or the control: Superoxal 6.17 ppm, Opalescence 6.45 ppm, and control 6.50 ppm. Statistically significant differences (P < 0.05) occurred for mean daily fluoride (+/- standard error) released from the three materials over the 35-day period: Photac-Fil 12.31 +/- 0.48 ppm > Ketac-Fil 7.07 +/- 0.66 ppm > Tetric 0.12 +/- 0.01 ppm, respectively.     

Initial tensile bond strength of resin-modified glass ionomers and polyacid-modified resins on perfused primary dentin

The objective of this study was to evaluate the initial tensile bond strength of a resin-modified glass ionomer (Photac-Fil) and two polyacid-modified composite resins (Compoglass, Dyract) to primary dentin. A hybrid composite resin (Tetric) and two chemical cured glass ionomers (BaseLine, Hi-Dense) served as controls. Ninety caries-free dentinal discs were ground flat and perfused with Ringer's solution. Dentinal surfaces were conditioned (except for Base Line). From each material, fifteen standardized specimens were attached to the dentin. Light-curing of the respective materials followed (1 min), and adhesion was tested with a universal testing machine 15 min after application. The highest initial bond strength was observed with Tetric (5.17 MPa). Closed test procedure (Kruskal-Wallis) showed significant differences between all materials (P < 0.05), except for Compoglass (1.82 MPa) vs. Dyract (2.35 MPa), and BaseLine (0.37 MPa) vs. Photac-Fil (0.42 MPa). The condensable glass ionomer Hi-Dense revealed a mean tensile bond strength of 0.79 MPa. Adhesion of (polyacid-modified) composite resins is superior to the other tested glass ionomer materials, when applied to perfused primary dentin.     

Variability in cytotoxicity and fluoride release of resin-modified glass-ionomer cements

New-generation glass-ionomer cements contain resin to improve their restorative properties. These resin-modified glass-ionomer cements vary considerably in their chemistry, which could result in corresponding variability in their physical and biological properties. This study investigated the cytotoxicity and the fluoride release of two resin-modified glass ionomers, a conventional glass-ionomer cement, and a resin composite. Samples were prepared and extracted in distilled water for 1, 4, and 7 days; eluates were filtered and tested by means of 3T3 mouse fibroblasts. Cytotoxicity (MTT assay) values were low for all materials and extraction times, indicating minimal cytotoxicity of all materials (less than 30% inhibition). Cytotoxicity of one resin-modified glass ionomer was significantly higher than for the other materials (p < 0.001). One resin-modified glass ionomer and the conventional glass-ionomer cement released significantly more fluoride at each time interval (p < 0.001) than the other resin-modified glass-ionomer cement and the resin composite. Fluoride release and cytotoxicity were correlated (r2 = 0.60; p < 0.001), although the fluoride release does not account for the cytotoxicity observed. Cytotoxicity and fluoride release suggest that one hybrid behaved more like a conventional glass ionomer, and the other like a resin composite. These differences may have implications for material selection in specific clinical situations.     

Effectiveness of chlorine dioxide in disinfection on two soft denture liners

OBJECTIVE: The purpose of this study was to evaluate a hydroxylapatite-based material and calcium sulfate when each was used under a resin-modified glass ionomer cement to repair furcation perforations. STUDY DESIGN: Perforations of pulp chamber floors were made in 72 teeth of 9 dogs. Perforations were divided into 3 equal-sized groups and repaired with resin-modified glass ionomer either alone or over an artificial floor. The artificial floor was either a hydroxylapatite-based material or calcium sulfate. Three dogs were killed at each of 3 intervals (1, 3, and 6 months). The tissue response to the tested materials was evaluated clinically, radiographically, and histologically. RESULTS: The hydroxylapatite-based material showed the highest radiographic success; this was followed by calcium sulfate and glass ionomer. From histologic evaluation, the average success rate was found to be 67% for calcium sulfate, 62% for the hydroxylapatite-based material, and 59% for glass ionomer. However, there was no statistical significant difference with the resin-modified glass ionomer when it was used alone and when it was used over a barrier. There was also no significant difference between the hydroxylapatite-based material and the calcium sulfate when they were used as artificial floors. CONCLUSION: The use of an artificial floor may not be necessary when flowable resin-modified glass ionomer cements are used.     

Resin-modified glass ionomers for luting posterior ceramic restorations

OBJECTIVES: Until recently, esthetic inlay restorations in posterior teeth have been limited to cavities surrounded by enamel. Dentin adhesive systems in combination with luting composites and light-cured resin-modified glass ionomer cements offer a possibility for bonding ceramic inlays to cavities when the cervical margin is in dentin. This study was designed to compare in vitro marginal integrity of ceramic inlays bonded to dentin to restorations placed in cavities with margins located entirely in the enamel. METHODS: In the present in vitro study, the sealing abilities of a dentin bonding agent/luting composite combination (Syntac/Dual Cement, Vivadent) and resin-modified glass ionomers (Photac Fil, Photac Bond, ESPE; Dyract, De Trey Dentsply; Fuji II LC, GC Dental Industrial Corp.; and Vitremer, 3M Dental Products) used as luting agents in cavities extending beyond the cemento-enamel junction, were compared to the sealing abilities of a conventional luting composite (Vita Cerec Duo Cement, Vita) in cavities within sound enamel. SEM analysis and dye penetration were performed to evaluate marginal integrity at the cervical cavity margins. RESULTS: The dentin bonding agent/luting composite combination (Syntac/Dual Cement) rendered a marginal seal within the dentin similar to the quality obtained with the conventional luting procedures within sound enamel. When three out of the five resin-modified glass ionomers were used as luting agents (Dyract, Fuji II LC and Vitremer), the results were comparable to those reported for the dentin bonding agents and the conventional method. SIGNIFICANCE: Light-cured resin-modified glass ionomer cements may be considered as an alternative to dentin bonding agents when the cavity margins of ceramic inlay restorations are within the dentin. However, further studies, e.g., wear resistance, must be performed.     

The effect of a resin-modified glass ionomer restorative material on artificially demineralised dentine caries in vitro

OBJECTIVES: Recurrent caries is one of the most common reasons for the replacement of restorations. One method of reducing the frequency of this problem may be by using fluoride-releasing restorative materials. The aim of this in vitro study was to evaluate the progression of artificial lesions around resin-modified glass ionomer (Vitremer) restorations placed in root surfaces. Class V cavities were prepared on the mesial and distal surfaces of 28 human premolar teeth. Artificial carious wall lesions were created in all cavities. The root of each tooth was then hemisected through the middle of the two cavities, before being restored with either the glass ionomer or amalgam, while the opposing cavities on the same root portion were varnished as negative controls. Forty-eight specimens were pH-cycled in remineralising and demineralising solutions for 20 h and 4 h, respectively, each day for 4 weeks, whilst in a smaller control group of eight specimens, the demineralising solution was replaced with deionised water. Mineral changes in the carious lesions were evaluated using contact microradiography. RESULTS: Results showed that varying degrees of subsurface demineralisation and remineralisation were evident, with a laminated appearance in lesions adjacent to the glass ionomer. There was higher remineralisation in the glass ionomer-filled cavities compared with the amalgam-filled cavities. In the water-cycled group, glass ionomer showed an increase in mineral content (p < 0.05), while no changes were observed in the amalgam-filled cavities. CONCLUSIONS: This model has shown that glass ionomer has a greater potential than amalgam for remineralisation of artificially created wall lesions within an acidic environment.     

Interfacial characteristics of resin-modified glass-ionomer materials: a study on fluid permeability using confocal fluorescence microscopy

The tooth interface with resin-modified glass-ionomer cements (RM GICs) is poorly understood. This study examined the interface, especially with dentin. Cervical cavities in extracted teeth were restored with Fuji II LC, Vitremer, Photac-Fil, or a conventional GIC, Fuji Cap II. Fluorescent dye was placed in the pulp chambers for 3 hrs before the specimens were sectioned. Examination of the tooth/material interface with a confocal microscope showed that dye uptake by the restoration varied among materials. A "structureless", non-particulate, highly-stained layer of GIC was observed next to dentin in Fuji II LC. This layer varied in width, was prominent where the dentin tubules were cut "end-on" and in areas closer to the pulp, and was not seen adjacent to enamel. Vitremer showed minimal dye uptake, and the "structureless" layer was barely discernible. Photac-Fil showed more uniform uptake and absence of this layer. Cracking of enamel was also noted with these materials. The conventional GIC did not show any dye uptake, presence of a "structureless" layer, or enamel cracking. We elucidated the potential mechanisms involved in the formation of a "structureless" interfacial layer in Fuji II LC by studying the variables of cavity design, surface pre-treatment, water content of the tooth, time for it to develop, early finishing, and coating of the restoration. This layer, the "absorption layer", is probably related to water flux within the maturing cement, depending on environmental moisture changes and communication with the pulp in a wet tooth. The "micropermeability model" was useful in this study of the interfacial characteristics of RM GICs.     

Marginal adaptation of resin-bonded light-cured glass ionomers in dentin cavities

PURPOSE: To investigate the marginal adaptation of resin-modified glass ionomer cements in dentin cavities placed with or without additional application of resin bonding systems. MATERIALS AND METHODS: Three resin-modified materials (Fuji II LC, Photac-Fil, Vitremer), one compomer (Dyract) and as reference an adhesively bonded resin composite system (Gluma CPS-Pekafill) were used. Flat peripheral dentin surfaces on human molar teeth were produced by wet grinding on SiC paper. Cylindrical cavities, 3.5 mm wide, were prepared in these dentin areas and restored with the individual materials. Sixty cavities were pretreated and restored as requested by the respective manufacturers. Following water storage of the specimens for 15 minutes or 24 hours, excess was gently removed by wet grinding for microscopic inspection of the marginal area. Additionally, in 30 cavities an experimental one-component adhesive resin system, a proprietary dimethacrylate and HEMA mixture dissolved in acetone, was combined with each of the restoratives for evaluation after 15-minutes water storage. Finally, in six cavities each, Dyract was combined with Prime and Bond 2.0, and Vitremer with Scotchbond Multi-Purpose Plus for assessment after 15 minutes. Maximum marginal gap widths (MGW) were measured. One-way ANOVA by ranks (Kruskal-Wallis-Test) followed by Wilcoxon's Two-Sample test were used to study the statistical difference of MGW among the treatment groups at a rejection level P = 0.05. RESULTS: Neither the conventionally placed material systems nor the restorations in combination with adhesives showed consistently gap-free margins after 15-minute water storage. After 24-hour storage with Vitremer 4 of the 6 restorations were gap-free, whereas with all other materials only perfect margins were registered. There was, however, no significant difference between the groups. Application of the experimental and/or the specific resin bonding agents had no effect on early MGW except for the Photac-Fil group, which was significantly reduced.     

The effect of different reinforced glass ionomer restorative cement on vital tooth structure

The study was carried out on twenty-one contralateral pairs of caries free, premolars, that were indicated for extraction in conjunction with orthodontic treatment. The study was carried out on a Human male ranging in age from 12-22 y. Three different restorative reinforced glass ionomer cements were investigated two of them were commercial (chelon silver and legend silver) and experimental stainless-steel reinforced one. Three groups each formed of seven persons, the right side premolars used as control and the left side premolar received the investigated material. The experimental and its control tooth were extracted after four weeks of placement the filling materials. The enamel samples in the control and experimental teeth was obtained and prepared for x-ray diffraction analysis, then the teeth were prepared for histologic study. The x-ray diffraction analysis of the enamel samples revealed that, the intensity of fluorapatite was highest in the legend silver group, and the stainless-steel group was less than legend silver but higher than control and chelon silver specimens. Subsequently, the order of fluoride release was L > E > Ch & C. The histologic finding of this study showed that all the reinforced glass ionomer materials under investigation were non irritant to pulp tissue.     

Prevalence and depth of artificial caries-like lesions adjacent to cavities prepared in roots and restored with a glass ionomer or a dentin-bonded composite material

One potential advantage of glass-ionomer materials for the treatment of root caries is their ability to release fluoride and so resist cariogenic attack. A commercially available composite material has also been reported to release fluoride which reduced caries lesions in the tooth tissue adjacent to it. The aim of this study was to assess the effectiveness of a conventional glass-ionomer restoration compared with a dentin-bonded, fluoride-releasing, composite restoration when exposed to a microbial artificial caries system. Artificial caries-like lesions produced in relation to the restorations were examined and classified either as outer (surface) lesions or as wall lesions. A split-unit experimental design allowed for within-tooth comparisons of the 2 experimental restorations at different sites on the root surface. These were either totally within the root surface or positioned at the amelo-cemental junction. Outer lesion depths were significantly (p < 0.001) shallower at all sites adjacent to the glass ionomer when compared with the composite restorations. Wall lesions were significantly (p < 0.01) more prevalent adjacent to the composite material. In addition, the cavity margin position significantly (p < 0.05) affected the incidence of wall lesions, particularly in the composite group. In conclusion, glass ionomer was successful in reducing the caries-like lesion production in the adjacent root surface. This resulted from improved marginal integrity and fluoride release from this material when compared with the composite bonding system used.     

The effect of air abrasion on shear bond strength to dentin with dental adhesives

This study compared the effects of different dentin surface treatments on the shear bond strengths of three adhesive systems. The adhesive systems included a resin-modified glass ionomer, Fuji II LC, and two dentin bonding systems, One Step and Scotchbond Multi-Purpose Plus. The surface treatments compared for each adhesive system were as follows: 1) the controls, which were conditioned, 2) air abrasion at 120 psi without conditioning, 3) air abrasion at 160 psi without conditioning, 4) air abrasion at 120 psi with conditioning, and 5) air abrasion at 160 psi with conditioning. The KCP 1000 Whisperjet was used for all air-abrasive specimens. Controls for each adhesive material (Fuji II LC, One Step, Scotchbond Multi-Purpose Plus) were bonded using manufacturers' recommendations. Results showed that air abrasion significantly lowered bond strength of the resin-modified glass ionomer, conditioned or nonconditioned (P < 0.01). Air abrasion alone significantly lowered bond strengths of the dentin bonding agent systems (P < 0.01). However, air abrasion plus conditioning of the dentin surface resulted in bond strengths that were similar to the conditioned-only specimens (P < 0.01).     

RNA-binding proteins tamed

OBJECTIVES: Enhancement of the remineralisation of artificial enamel lesions has been observed in an intraoral model whether subjects chewed gum sweetened with a non-cariogenic sweetener such as sorbitol [1-3] or sucrose [4] after meals or snacks, and with use of a conventional (1500 ppm F) fluoride dentifrice. Since most of the clinical surveys which have shown the potential cariogenicity of sucrose chewing gum [5] were conducted before use of fluoridated dentifrices became widespread, the effect of fluoride dentifrice on de- and remineralisation of artificial lesions in enamel in response to chewing sucrose-sweetened gum has been examined with the aim of attempting to resolve this apparent discrepancy. METHODS: Subjects wore an intraoral device bearing an enamel lesion and chewed one piece of sucrose gum for 20 min after each of three meals and two snacks daily for two 3-week periods, during which they used a dentifrice containing either 0 or 1500 ppm F in a double-blind, cross-over design. Measurement of the mineral content of the lesions was determined by microradiography or polarised light microscopy. RESULTS: It was found that remineralisation tended to occur with 1500 ppm F dentifrice, but demineralisation with non-F dentifrice; the difference in enamel mineral content between the two periods was significant (P < 0.05). CONCLUSIONS: The results indicate that the potential cariogenicity of sucrose-containing chewing gum may indeed be negated by the use of a conventional fluoride dentifrice.     

Effectiveness of caries removal by the partial tunnel preparation method

The tunnel preparation method is designed to remove approximal caries through a channel from the occlusal surface while preserving the marginal ridge. This method entails reduced access to the caries lesion and thereby uncertainty as to the complete removal of caries. The purpose of the present investigation was to study the effectiveness of caries removal in 60 extracted premolars and molars by the partial tunnel preparation method. The glass polyalkenoat (ionomer) filling and the distance to the pulp were also examined. Examination of the sectioned teeth showed residual caries in the axial wall of two teeth and in dentin close to the enamel lesion in 10 teeth. Very few porosities were found within the glass polyalkenoat material and at the interface between the filling and the cavity walls.     

A case of tracheal obstruction during oesophageal removal of a foreign body

PURPOSE: To examine the effect of mixing techniques (hand-mixing vs. trituration) on fluoride release from chemically-cured (Fuji II) and resin-modified (Fuji II LC) glass ionomer products. MATERIALS AND METHODS: Fluoride measurements were determined and comparisons made between hand-mixed-type materials that were both hand-mixed (60 seconds) and triturated (10 seconds). Hand-mixed specimens were made using the manufacturer's recommended powder/liquid ratio. Triturated specimens of the same material were made using the same powder/liquid ratio. Disk specimens (8.5 mm diameter, 2 mm thickness; n = 6) were stored in deionized water for 23 hours to obtain Day 1 solutions. Solutions were also obtained at 2, 3, 4, 5, 6, 7, 14, 21, and 28 days after fabrication and were changed 24 hours before fluoride concentration was determined using a fluoride ion selective electrode. Daily rates of fluoride release and 28-day cumulative fluoride totals were calculated. Cumulative data were analyzed by two-way ANOVA and Scheffé's test (alpha = 0.05). Daily results were analyzed by the Mann-Whitney U-test. RESULTS: A significant difference was observed between materials (P < 0.001). Depending on the kind of material used, the method of manipulation affected the fluoride release. Data analysis revealed that: (1) Fuji II LC released significantly more fluoride than Fuji II for both triturated (P = 0.005) and hand-mixed (P < 0.005); (2) the triturated Fuji II released significantly more fluoride than the hand-mixed (P = 0.02); and (3) the hand-mixed Fuji II LC released more fluoride than the triturated, but was not statistically significant (P = 0.16).     

Adhesive luting cements--classes, criteria, and usage

Clinical studies have shown that recurrent decay and lack of retention are the major causes of traditional crown and bridge failure. Optimal marginal accuracy and preparation retention form are important pre-requisites for longevity, as well as good patient oral hygiene. In an effort to provide improved clinical success, new classes of luting agents with improved physical properties and new therapeutic capabilities have been developed. Conventional glass ionomer cements provide fluoride release and adhesive properties. Recently introduced resin-modified glass ionomer luting materials add the potential for increased resistance to dissolution and improved physical and biological attributes. The resin luting cements are more difficult to use but provide greatly increased bonding capabilities and are necessary for strength requirements of all-ceramic restorations. This article describes the three classes of adhesive luting materials, provides a comparison of biological and physical properties, describes the indications and limitations of each class, and makes recommendations for clinical usage.     

Uptake and release of fluoride by saliva-coated glass ionomer cement

The 'recharging' of aged glass ionomer cement restorations with fluoride by exposing them to a concentrated NaF solution has been suggested to improve their performance as devices with slow fluoride release. We have studied the interference of salivary coatings on glass ionomer cement with the uptake of fluoride in vitro. Freshly prepared glass ionomer discs were leached in distilled water for 14 weeks, then incubated in human saliva for 2 h, 24 h or 1 week before exposure to 0.53 M NaF (1% fluoride) for 5 min. Fluoride uptake by the cement was measured indirectly as the subsequent increase in fluoride release. A 2-hour incubation in saliva reduced the fluoride uptake by half, a 24-hour incubation by 74%. The major part (93-95%) of the fluoride that was taken up was released on the first day. A 1-week salivary coating reduced the uptake by 49%, but also caused some retardation of the fluoride release: 80% of the total release was on the first day. It was concluded that despite the considerable interference by salivary coating, the amount of fluoride that can be taken up by aged glass ionomer cement remains significant. However, the fast release will limit the usefulness of such recharging in vivo.     

Fluoride release from tooth-colored restorative materials: a 12-month report

BACKGROUND: This study measured the amount of fluoride released from three light-activated glass polyalkenoate (ionomer) cements, a conventional glass polyalkenoate, a compomer and a fluoridated composite over a period of 12 months. METHODS: Five discs (7 x 2 mm) of each material were sequentially immersed in 4 mL portions of deionized water at 37 degrees C and before each measurement, the test specimen was rinsed with 1 mL of deionised water. An Orion Model 901 microprocessor digital Ionalyzer was used for the measurements and the data obtained were converted into microgram/cm2. The amount of fluoride released was measured 86 times during the 12-month test period. RESULTS: It was found that the pattern of fluoride release from the light-activated glass polyalkenoates was similar to that of the conventional glass polyalkenoate. The light-activated glass polyalkenoates, however, released significantly more fluoride than the conventional material. The composite and the compomer released significantly less fluoride than any glass polyalkenoate tested and the difference between the composite and the compomer was not significant. CONCLUSION: It was concluded that the light-activated glass polyalkenoates tested released more fluoride than a conventional glass polyalkenoate, a compomer or a composite, and that with regard to fluoride release the compomer behaved more or less like the composite.     

Accelerated evolution and molecular surface of venom phospholipase A2 enzymes

The objective of this study was to determine the in vitro shear bond strength (in megapascals) and location of bond failure with two light-cured glass ionomer resin systems. One system was a hybrid glass ionomer cement with resin (GC Orthodontics, Aslip, Ill), and the other system a glass-filled resin system (Reliance Orthodontic Products, Inc, Itasca, Ill). These systems, Fuji Ortho LC (GC Orthodontics) and Ultra Band Lok (Reliance), respectively, were compared to a light-cured composite resin. Maxillary premolar brackets (n = 200) were bonded to the facial surface of human premolar teeth. The two glass ionomer resin systems were each evaluated by two protocols, one according to the manufacturers' direction plus a variation of their respective technique. The five distinct groups (n = 40) were stored in 37 degreesC distilled water for 30 days and subjected to thermocycling before shear bond strength testing. The findings indicated that large variations existed between the bond strengths of the materials tested. The laboratory shear bond strength of the glass-filled resin glass ionomer cement (Reliance), whether tested in a dry or moist field, was similar to the composite control with all of the previous materials being significantly (P <.01) higher than both the hybrid glass ionomer cement groups (Fuji Ortho LC). However, the hybrid glass ionomer cement with enamel conditioner demonstrated a clinically acceptable mean megapascal value. The Adhesive Remnant Index values ranged from 0.53 to 1.62. The hybrid glass ionomer cement without enamel conditioning recorded the lowest mean adhesive remnant index score and the lowest mean megapascal score. Although both products are glass ionomer resin systems, their individual chemistries vary; this affects their clinical performance. Clinically, it may be suggested that glass ionomers used in a dry field may be beneficial for orthodontic bonding, and that glass ionomer resin systems used in a moist environment need an enamel conditioner.     

Arrest of root surface caries in situ

This study tests the hypothesis that daily oral hygiene combined with topical fluoride arrests active root-surface caries lesions without changing the mineral content of the lesions. Therefore, changes in mineral content and distribution were studied in root surfaces during caries lesion development and subsequent arrest of lesion progression in situ. In 18 subjects, lesions were developed during 3 months in sound root-surface specimens inserted into lower partial dentures. After 3 months, ground sections were prepared from each lesion prior to re-insertion of the specimens into the dentures. In addition, one sound root specimen was added per subject. During the following 3 months, half of the subjects cleaned both sound and carious specimens once a day with an 1100-ppm fluoride toothpaste, and the specimens were treated twice with 2% NaF for 2 min in situ. The other half of the subjects continued the experiment without cleaning. During the initial three-month period, all specimens developed subsurface lesions extending 187 to 583 microm into the dentin. Lesion depth increased somewhat in both experimental groups during the following 3 months (P > or = 0.1). There was a non-significant increase in mineral loss in the plaque-covered specimens (P = 0.08). However, the total mineral content of specimens subjected to plaque removal and topical fluoride did not change. This treatment resulted in an increased mineral content in the surface layer (P < 0.01) and formation of a zone of higher mineral content within the body of the lesion. The sound root surfaces which had been cleaned for a three-month period showed mineral uptake in the surface layer, occasionally associated with subsurface demineralization extending 20 to 70 microm into the tissue. The mineral loss of these specimens was significantly smaller than that of plaque-covered surfaces (P < 0.001). It is concluded that daily plaque removal and topical fluoride use influence the distribution of mineral in sound and carious root surfaces and may arrest lesion progression without affecting the total mineral content.