Bond strengths and SEM evaluation of Clearfil Liner Bond 2

PURPOSE: To evaluate a dental adhesive system that uses a single conditioning/primer agent. MATERIALS AND METHODS: Twenty-five flat enamel and dentin bonding sites were prepared to 600 grit on human molar teeth. The Clearfil Liner Bond 2 adhesive system was used to bond Clearfil AP-X composite to both enamel and dentin. After 24 hours of water storage, shear bond strengths were determined using an Instron testing machine. Fifty V-shaped cavity preparations were prepared in human molar teeth with an enamel and cementum margin. Composite restorations were placed using the new adhesive system. The teeth were stored for 24 hours, thermocycled, stained with AgNO3 , sectioned and examined for microleakage. SEM examinations were also completed to evaluate the effects of the treatment steps on enamel and dentin surfaces. RESULTS: Mean shear bond strengths for the experimental adhesive to enamel and dentin were 28.2 +/- 4.9 and 19.4 +/- 3.1 MPa. A t-test revealed that the enamel bond strength was significantly greater (P<0.05) than the dentin strength. No marginal leakage was observed from the enamel margins of the restorations. Three restorations showed minimal leakage from the cementum margins. SEM examinations showed resin penetration into both the conditioned enamel and dentin surfaces. The adhesive system produced high bond strengths to both enamel and dentin, exhibited very minimal microleakage and was easy to use.     

Adhesion of a compomer to dental structures

The objective of this study was to evaluate the bond strength of a compomer to dental enamel, dentin, and cementum. Flat surfaces of these tissues were obtained from recently extracted human teeth. The different substrates were either treated with PSA (a primer and adhesive) or acid etched (35% phosphoric acid gel) and treated with PSA. Cylindrical specimens of compomer were then bonded to the substrates. Shear bond strength was determined after a 24-hour immersion in 37 degrees C water. Significant differences were found between both treatments on enamel, while none were found on dentin or cementum. The use of acid etchant on enamel as a surface-conditioning step previous to priming with PSA allowed a better bond between Dyract compomer and that substrate; acid etching was not particularly needed on dentin and cementum.     

Comparison of marginal fit and microleakage of ceramic and composite inlays: an in vitro study

The purpose of this in vitro study was to evaluate the marginal fit and microleakage of four types of ceramic or resin composite inlays. Sixty extracted human third molar teeth were randomly assigned into four groups. MOD cavities without bevels were prepared. The mesiogingival margin was cut in enamel, whereas the distogingival margin was placed below the amelocemental junction. The preparations and inlays were made according to the manufacturers' instructions. After acid-etching and treatment with a dentine bonding agent the inlays were cemented with dual curing CEREC resin composite luting material. After placement and polishing 10 teeth of each group were thermocycled 2500 times between 14 degrees C and 62 degrees C. Each tooth was bisectioned and from each part, one occlusal and three proximal sections of 75-100 microns thickness were cut and ground (EXAKT Cutting and Grinding system). The marginal discrepancy and the thickness of the luting cement were measured microscopically at each section and an average for each tooth was calculated. Considerable variation of marginal fit was seen, within inlays, and among different types of inlays. In general, the Vita Dur N inlays showed the best fit, e.g. the thickness of the luting cement for Vita Dur N was 114 microns occlusally and 119 microns mesiogingivally compared to 199 microns occlusally for CEREC and 219 microns mesiogingivally for Estilux. At enamel margins, a tendency of less microleakage was seen for ceramic inlays compared to composite inlays.     

Microleakage of new dentin bonding systems using human and bovine teeth

The objective of this study was twofold: to evaluate the microleakage behavior of three dentin bonding systems and to determine if bovine teeth are comparable substrates to human teeth when studying the microleakage of various materials. The materials evaluated were Scotchbond Multi-Purpose Adhesive, Prisma Universal Bond 3, and All-Bond 2. All three bonding systems were used in combination with Prisma APH hybrid composite for comparison of microleakage behavior. Sixty class 5 preparations were cut at the cementoenamel junction for groups containing 30 human and 30 bovine teeth. A 1 mm 45 degree bevel was placed at the enamel margin. Teeth were grouped according to the dentin bonding system used and then restored according to the manufacturer's directions. After restoration, the teeth from each group were stored in distilled water at 37 degrees C for 3 days. The teeth were then thermocycled between 4 degrees C and 58 degrees C for 100 cycles and returned to distilled water at 37 degrees C for an additional 4 days. The teeth were then sealed with nail polish up to 1 mm from the margins of the restoration and placed in 45Ca isotope for 2 hours. The teeth were then sectioned and placed on x-ray film to produce autoradiographs. Microleakage was evaluated for the enamel and dentin margins separately using the following scale: 0 = no leakage, 1 = penetration of isotope to less than 1/2 the distance to the axial wall, 2 = penetration of isotope greater than 1/2 of the distance to the axial wall but short of the axial wall, and 3 = penetration of isotope to the axial wall or beyond. The materials were compared to each other using the Mann-Whitney U and Kruskal-Wallis tests. The gingival margins were compared to the incisal margins for all materials. No statistically significant differences in microleakage were revealed between the incisal and gingival location for human substrates, but there was statistically significant greater gingival microleakage for bovine substrates. All-Bond 2 leaked significantly more than Scotchbond Multi-Purpose for human substrates at the incisal margin. All-Bond 2 had significantly more microleakage than Prisma Universal Bond 3 at both dentin and enamel margins for the bovine substrate. There were no statistically significant differences in microleakage among the bonding systems for the human substrate. No statistically significant differences between the microleakage behavior of human and bovine substrates were found. These results support the use of bovine teeth for in vitro microleakage studies.     

Marginal adaptation of resin in relation to application technique and use of a dental adhesive system

Class V abrasion, erosion and caries lesions restored with composite resin seem to be more susceptible to microleakage, because the gingival margin is usually placed in cementum and/or dentine. The purpose of this study was to evaluate the microleakage, in vitro, of a dentinal bonding system using a technique of restoration with a positive and a negative control. This study was accomplished using extracted human teeth and dye penetration technique. The teeth were examined for microleakage after one month. It was concluded that in the gingival wall of the cavity microleakage was significantly reduced when the dentinal bonding agent and composite resin was placed and polymerized incrementally from enamel, to cementum.     

"Carious" and "noncarious" lesions of the hard dental tissues. Ultrastructural (SEM) and microanalytical (EDS) analyses of teeth from the 3rd century B.C

The study was carried out on 80 teeth (70 of permanent dentition and 10 of primary one) of mandibular and maxillary bones. The teeth owned to subjects lived in the III c.b.C. in Sicily, and they were found in Naxos necropolis. The teeth were examined as far as carious and non carious lesions, then they were prepared for instrumental analyses by Scanning Electron Microscopy (SEM) and Energy dispersed X ray spectrometry (EDS). To an objective examination of the sample no caries were detected in the teeth sample apart one tooth, on the other hand there was an extensive occlusal abrasion, from a macroscopic point of view there were no difference as far teeth morphology. SEM examination pointed out all around dentinal tubules a circle of sclerotic dentin as reaction to occlusal wear. The amelocemental junction showed from a ultramicroscopic point of view an overlap of cementum onto enamel. EDS analysis pointed out a higher P concentration on the crown versus the root in all the teeth of the sample.     

Value of the search for anticardiolipin antibodies during the course of systemic lupus erythematosus

This study investigates the shear bond strengths (SBS) of different products used for bonding amalgam to dentine and the marginal seal provided by these materials. The SBS test was carried out by bonding cylinders of Dispersalloy amalgam to human dentine with an intermediate layer of Amalgambond Plus, All-Bond 2, Imperva Bond/Dual or Scotch Bond Multi-Purpose was first placed. Thereafter the samples were tested to failure in the shear mode. For the microleakage test, standardized class V cavities were prepared in human molars with one cavo margin abutting enamel and another dentine/cementum. Amalgam was condensed into the cavities, pretreated with one of the products mentioned above. In addition two further groups were prepared. One receiving treatment with Polyvar varnish and the other remained untreated as the control. Microleakage was assessed with a reflecting light microscope using I.S.O. criteria and the fracture sites and marginal gaps were examined in a scanning electron microscope. Results indicate that All-Bond 2 and Amalgambond Plus induced similar SBS and Scotchbond Multi-Purpose the weakest. At both enamel and dentine/cementum junctions resin bonding agents reduced microleakage. However, this reduction was greater at the enamel interface than at the other. Varnish allowed the greatest amount of marginal leakage and leakage was similar to the untreated control. Amalgam bonding agents are more effective at preventing marginal leakage at the enamel margin than at the dentine/cementum margin. Cavity varnish is not effective in preventing microleakage around amalgam restorations. There is a correlation between shear bond strength and marginal leakage. Materials giving the highest shear bond strength also exhibited the least marginal leakage. All-Bond 2, Amalgambond Plus and Imperva Bond/Dual are recommended to improve the seal around amalgam restorations.     

Comparative study of two filling techniques using glass-ionomer (Ketac-endo) root canal cement on fracture resistance of endodontically treated roots (in vitro)

Forty freshly single rooted teeth were selected for this study. The coronal part of teeth were decapitated and the root canals were prepared by modified step-back technique with K-flex files to size 35# at the apex, five ml of 5.25% NaOCl was used as irrigating solution. According to the dentin thickness at the mesio-distal direction of the prepared roots, roots were divided into two groups: Group (I), dentin and cementum thickness from 1.5-2 mm, and Group (II), dentin and cementum thickness 1 mm. According to the filling technique used the teeth were subdivided into four subgroups each of five teeth; Subgroup (A) single gutta-percha cone and Ketac-endo root canal sealer, Subgroup (B) lateral condensation technique with gutta-percha and Ketac-endo sealer, Subgroup (C) laterally condensed gutta-percha with Roth 801 cement and Subgroup (D) teeth left unfilled as negative controls. The prepared roots were placed into acrylic resin so that 10 mm of the root was exposed. A slowly increasing force was applied vertically using a blunt punch with 1 mm tip thickness attached to Instron testing machine. The results showed that group (I) with 1.5-2mm dentin thickness required greater force to fracture in all experimental groups, than that of group (II) with 1 mm dentin thickness. So the amount of remaining dentin thickness significantly affected the resistance to fracture of the prepared roots.     

Dynamic three-dimensional display of common congenital cardiac defects from reconstruction of two-dimensional echocardiographic images

PURPOSE: To investigate the effects of acetone or water based Gluma primers on bonding efficacy when applied to acid-etched wet, dry or rewetted dentin. MATERIALS AND METHODS: Shear bond strength (SBS, 24 hours) was measured on human dentin etched with 20% phosphoric acid gel and rinsed with water in the wet (blot dried), the conventional (2 seconds air blast), the dry (10 seconds air drying), and the rewetted stage (10 seconds air drying, remoistening and blot drying). The priming solution was either the original water based or an acetone based experimental Gluma primer. Cavity sealing performance and depth of resin impregnation were determined by solvent and by technique along the margins of 4.5 mm wide cylindrical dentin cavities with 90 degree cavosurface angle. RESULTS: The SBSs of the wet technique groups were approximately 18 MPa, irrespective of the primer solvent. Conventional drying gave an SBS almost as high (16.5 MPa). Rewetting was highly effective with acetone as the primer solvent. The dry techniques resulted in moderate (water) and poor (acetone) bond strengths. The cavity margins of acetone based primer treated specimens were consistently gap free with the wet technique. The other seven groups showed between two and six gaps in each group of six specimens. The resin impregnated layer (RIL) thicknesses were 12.5 microns approximately in the wet groups, and thus identical with the total depth of demineralization resulting from the 30-second etching. The alternative techniques showed significantly thinner RILs particularly in the dry groups (7.5 microns).     

The cervical third of deciduous teeth. An ultrastructural study of the heard tissues by SEM

As information on amelocemental junction of deciduous teeth is limited, this topographical area was investigated by scanning electron microscopy (SEM) to verify differences from that of permanent teeth. Twenty-six carious and non-carious human maxillary and mandibular primary teeth were placed in a fixative immediately after extraction. Pulpal tissue was removed from the pulpal chambers and root. The primary teeth blocked onto stubs and all specimens were platinum coated and examined by SEM. In these specimens an overlapping of cementum onto to enamel and an edge to edge relationship was dominant. No gaps between enamel and cementum were observed. The amelocemental junction of deciduous teeth seem to differ to that described for permanent teeth.     

Recanalization of aged venous thrombotic occlusions with the aid of a rheolytic system: an experimental study

The purpose of this study is to determine the effects of fluorides and trace elements applied alone or in combination at different concentrations on the solubilities of enamel and cementum surfaces of the same teeth. The study has been performed on enamel and cementum surfaces of the impacted third molars extracted by surgical operation. Aqueous solutions of sodium fluoride, aluminum potassium phosphate, strontium chloride and titanium tetrachloride at different concentrations were applied to the surfaces. The solubilities of enamel and cementum and the depth of etchings have been calculated by means of the inorganic phosphorus in these etching solutions. According to the results, higher concentrations of fluoride and lower concentrations of strontium and titanium led to a significant reduction into solubilities of enamel and cementum. As certain combined applications of fluorides and trace elements decreased both of the enamel and cementum solubilities, it may be assumed that if such a treatment is beneficial during the adolescence of an individual, it may also be used when he is older.     

Bond strength, interfacial characterization, and fracture surface analysis for a new stress-breaking bonding agent

Three commercial dentin bonding systems were analyzed by tensile bond testing, area analysis of fractured surfaces, and SEM analysis of the tooth-resin interfaces. Tensile bond strengths in megapascals(SD) were Tenure-Marathon V ([T-M]; 8.86[3.02]), new system with low-viscosity resin ([K-LVR-P]; 6.50[2.01]), and new system without low-viscosity resin ([K-P] = 7.28[1.75]), which were significantly greater than Scotch-bond 2-P50 ([SB-P50]; 3.96[1.02]). Gaps that ranged up to 5.6 microns (mean for the group) were observed around most of the restorations at dentin surfaces and less so at enamel surfaces, where some of the restorations remained free of gaps. The gaps near the dentin margin were significantly smaller for K-LVR-P than for SB-P50. The tensile test revealed mixed failure modes in all systems, and in the cross sections of class V restorations, the gaps were confined to the dentin-resin junction.     

Microleakage of multi-step and simplified-step bonding systems

PURPOSE: To measure and compare the microleakage of Class V resin composite restorations using the following three pairs of multi- and simplified-step dentin bonding systems (DBS): OptiBond vs. OptiBond FL, All-Bond 2 vs. One-Step, and Tenure vs. Tenure Quik. MATERIALS AND METHODS: V-shaped cavities were prepared in the mesial and distal surfaces of 30 extracted human mandibular molars with margins in both enamel and cementum, and randomly assigned into three equal groups of 10 each. All DBSs were applied strictly following manufacturers' specifications before three incremental layers of resin composite (Pertac-Hybrid) were applied in all cavities. Specimens were stored for 7 days in 37 degrees C water, thermocycled for 300 cycles between 5 degrees C and 55 degrees C, immersed in 0.5% basic fuchsin solution for 24 hours, and embedded in resin before being sectioned longitudinally in multiple sections. Dye solution penetration at the tooth/composite interface was scored from 0 to 4 under a microscope at x100 at both enamel (E) and cementum (C) margins. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests with alpha = 0.05. RESULTS: OptiBond FL and One-Step showed less microleakage at the cementum margins compared to their multi-step versions. At the enamel margins Tenure Quik showed less microleakage compared to Tenure, and none of the other DBSs tested showed significant dye penetration at that interface. All DBSs showed significantly less microleakage at the enamel margins compared to the cementum margins except for OptiBond FL and One-Step that did not show any significant dye penetration at the cementum margins as well.     

Effects of ArF:excimer laser irradiation on human enamel and dentin

Round enamel and dentin surfaces of sound and carious extracted human teeth were irradiated by an ArF:excimer laser for up to 180 sec. Thermographic measurements indicated that the temperature rise due to heat accumulation caused by laser irradiation on these enamel and dentin surfaces was up to 19 degrees C (10 HZ with 540 J/cm2), and the temperature returned to the preirradiation value within 10 sec after the irradiation was stopped. Under light microscopy, no carbonization was evident on these surfaces, and a simple recess was formed by abrasion or vaporization in the irradiated regions. In the secondary SEM, uniformly distributed fine pores and prism structures appeared slightly on the enamel surfaces. Between the peritubular and the intertubular dentin, there appeared a distinct difference in the dissolved area. The laser almost completely removed carious regions of the enamel and the dentin, and penetration extended beyond the carious regions. In the backscattered electron SEM, highly mineralized layers were observed on the enamel and dentin surfaces dissolved by the laser.     

Resistance pattern of middle ear fluid isolates in acute otitis media recently treated with antibiotics

The incorporation of fluoride into restorations is desirable because of its cariostatic action. The purpose of this study was to determine fluoride release and fluoride uptake by enamel and cementum from three visible light-cured fluoride-containing composites. Seven circular discs of each composite were prepared and the amount of fluoride released into distilled water was determined at daily intervals for 14 days and then after 30, 60 and 90 days. The fluoride concentration in enamel and cementum was determined in three successive depths by an acid etch biopsy procedure. The composite slabs were made and ligated to the enamel and cementum surfaces and the teeth were immersed in synthetic saliva for 7 days. After removal of the composite slabs, three successive biopsies were again performed. Then the teeth were immersed in 1 M KOH for 24 h and similar biopsies done. The fluoride concentrations were adjusted to standardized depths of 10microm, and the total and bound fluoride uptake calculated. The amounts of fluoride released were significantly different among the three composites. The fluoride released decreased sharply after 1 day and then gradually reached a plateau. As for the enamel and cementum fluoride uptake, FluorEver showed the largest uptake followed by FluoroCore and then Pertac-Hybrid.     

The biologic concept for the use of enamel matrix protein: true periodontal regeneration

Guided tissue regeneration procedures have been used successfully to reestablish periodontal attachment. However, this new attachment reportedly differs from the original attachment in strength and continuity. Enamel matrix proteins secreted by Hertwig's epithelial sheath play an important role in cementogenesis on roots and in the development of the periodontal attachment apparatus. Enamel matrix protein harvested from developing porcine teeth, or enamel matrix derivative (Emdogain), is reported to induce true periodontal regeneration (the attachment of new, acellular cementum to the underlying dentin surface). The results of experimental and clinical trials of Emdogain are reviewed, and the procedure for application of the material is described.     

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.     

Nature and attachment of cementum formed under guided conditions in human teeth. An electron microscopic study

In an attempt at characterizing the nature and attachment of cementum formed under conditions of guided tissue regeneration (GTR) in humans, front teeth from 4 patients aged 42 to 72 years were examined at the electron microscopic level. All teeth were affected by complex periodontitis associated with advanced loss of periodontal support. Roots were surgically planed and notched, but not chemically conditioned. Either the mesial or distal surface of each tooth represented the experimental site and was covered with a biodegradable polyglactin 910 barrier, while the opposite approximal surface served as control. Following 3 months of healing, teeth were removed together with surrounding periodontal tissues including some alveolar bone. These blocks were fixed histologically, decalcified, embedded in epoxy, and sectioned for examination in the scanning (backscatter mode) and transmission electron microscope. Both experimental and control sites disclosed 2 types of regenerative cementum that seemed to be formed by cells resembling cementoblasts. The first type was characterized by a thin fringe of collagen fibrils which were arranged perpendicular to the root surface and appeared mineralized in a zone extending about 1 to 3 microm from the dentin. The second type occurred as thick patches which revealed scattered cementocytes and sheets of collagen fibrils oriented mainly parallel to the root surface, running both circularly and axially. In both situations, a continuous, thin, electrondense layer was interposed between newly formed cementum and preexisting radicular hard tissues. Interdigitation of collagen fibrils from cementum and dentin, such as observed along the natural cemento-dentinal junction, did not occur. Thus, regenerative cementum laid down in humans under guided conditions on previously diseased and planed, but not otherwise treated root surfaces shares some morphologic features with cementum formed during spontaneous repair of root resorptions. However, unlike in the course of such repair, a fibrous attachment of new cementum resembling the natural cemento-dentinal junction does not seem to be regenerated under guided conditions.     

A standardized classification of ocular trauma

This study evaluated the effects of pulsed Nd:YAG laser treatment on root surface in vitro with or without fluoride. Fifty specimens of human teeth were randomly assigned to five different treatment groups: (1) untreated group; (2) laser-treated only; (3) laser-treated after applying black ink; (4) laser-treated after applying 38% Ag(NH3)2F for 1 min; (5) laser-treated followed by applying 2% NaF for 4 min. Following their respective treatments, all specimens were prepared for evaluation by light microscopy, scanning electron microscopy, and EDX (Energy dispersive x-ray spectroscopy). Specimens from group 2 to 4 exhibited gross alterations of root surface not observed in controls such as pitting, crater formation, cracking, and porous globules. The specimens of group 5 had rough surfaces with some particles of approximately 1-micron diameter on the root surface. The fluoride uptake into the root measured by EDX was higher in groups 4 and 5. The depth of penetration of fluoride and silver was approximately 20 microns. Under light microscopy, the specimens of group 2, 3, 4, and 5 revealed some melted cementum, with no changes of underlying dentin. The results of this in vitro study suggested that the laser irradiation with or without fluoride, altered the morphology of the root surface and improved the fluoride uptake into the root surface. Whether the laser-induced surface changes with or without fluoride are beneficial to prevention of root surface caries needs to be studied further.