Reaction of dogs' teeth to root canal filling with mineral trioxide aggregate or a glass ionomer sealer

This study was conducted to observe the reaction of apical tissues of dogs' teeth after root canal filling with gutta-percha and mineral trioxide aggregate (MTA) or a glass ionomer (Ketac-Endo) as a sealer. The root canals were instrumented and filled by the lateral condensation technique with the sealers studied. Animals were killed 6 months later, and the specimens were removed and prepared for histological analysis. Results showed no inflammatory reaction of apical tissue and total closure of the apical foramen of all the teeth sealed with MTA. The teeth sealed with Ketac-Endo showed two cases of partial closure and different degrees of chronic inflammatory reaction. In conclusion, MTA exhibited better biological properties than Ketac-Endo. Copyright © 1999 by The American Association of Endodontists.

Cytotoxic effects of current dental adhesive systems on immortalized odontoblast cell line MDPC-23

Objectives: Evaluate the cytotoxic effect of the three dental adhesive systems. Methods: The immortalized mouse odontoblast cell line (MDPC-23) was plated (30,000 cell/cm 2) in 24 well dishes, allowed to grow for 72 h, and counted under inverted light microscopy. Uncured fresh adhesives were added to culture medium to simulate effects of unset adhesive. Three adhesives systems were applied for 120 min to cells in six wells for each group: Group 1) Single Bond (3M), Group 2) Prime & Bond 2.1 (Dentsply), and Group 3) Syntac Sprint (Vivadent). In the control group, PBS was added to fresh medium. The cell number was counted again and the cell morphology was assessed under SEM. In addition, the adhesive systems were applied to circles of filter paper, light-cured for 20 s, and placed in the bottom of 24 wells (six wells for each experimental materials and control group). MDPC-23 cells were plated (30,000 cell/cm 2) in the wells and allowed to incubate for 72 h. The zone of inhibition around the filter papers was measured under inverted light microscopy; cell morphology was evaluated under SEM; and the MTT assay was performed for mitochondrial respiration. Results: The fresh adhesives exhibited more toxic (cytopathic effects) to MDPC-23 cells than polymerized adhesives on filter papers, and as compared to the control group. The cytopathic effect of the adhesive systems occurred in the inhibition zone around the filter papers, which was confirmed by the MTT assay and statistical analysis (ANOVA) combined with Fisher's PLSD test. In the control group, MDPC-23 cells were dense on the plastic substrate and were in contact with the filter paper. In the experimental groups, when acid in the adhesive systems was removed by changing the culture medium, or when the adhesives were light-cured, some cells grew in the wells in spite of the persistent cytotoxic effect. Significance: All dentin adhesive systems were cytotoxic odontoblast-like cells. Both acidity and non-acidic components of these systems were responsible for the high cytopathic effect of those dental materials. © 1999 Academy of Dental Materials. Published by Elsevier Science Ltd. All rights reserved.

Immediate replantation of maxillary incisors in rats: effects of tooth immersion in sodium fluoride and subsequent removal of the periodontal ligament.

The advantages and disadvantages of maintaining the periodontal ligament (PDL) in immediate replantation as well as chemical treatment of the root surface have been a matter of discussion because the vitality of such tissue in surgery is always questioned. This study evaluated the effects of conserving the tooth in sodium fluoride and the removal of the PDL before replantation of incisors in rats. There was more cementum-dentin resorption in the group with the PDL. The group without the PDL showed more discreet resorption, repair occurred through the newly formed bone tissue in the PDL space and ankylosis was more extensive than in the group with the PDL.

Use of one-bottle adhesive as an intermediate bonding layer to reduce sealant microleakage on saliva-contaminated enamel

Purpose: To evaluate the influence of three different adhesives, each used as an intermediary layer, on microleakage of sealants applied under condition of salivary contamination. Materials and Methods: Six different experimental conditions were compared, 3 with adhesives and 3 without. After prophylaxis and acid etching of enamel, salivary contamination was placed for 10 s. In Group SC the sealant was applied after saliva without bonding agent and then light-cured. In Group SCA, after saliva, the surface was air dried, and then the sealant was applied and cured. In Groups ScB, SB and PB, a bonding agent (Scotchbond Dual Cure/3M, Single Bond/3M and Prime & Bond 2.1/Dentsply, respectively) was applied after the saliva and prior to the sealant application and curing. After storage in distilled water at 37°C for 24 hrs, the teeth were submitted to 500 thermal cycles (5°C and 55°C), and silver nitrate was used as a leakage tracer. Leakage data were collected on cross sections as percentage of total enamel-sealant interface length. Representative samples were evaluated under SEM. Results: Sealants placed on contaminated enamel with no bonding agent showed extensive microleakage (94.27% in SC; 42.65% in SCA). The SEM revealed gaps as wide as 20 μm in areas where silver nitrate leakage could be visualized. In contrast, all bonding agent groups showed leakage less than 6.9%. Placement of sealant with a dentin-bonding agent on contaminated enamel significantly reduced microleakage (P< 0.0001). The use of a bonding agent as an intermediary layer between enamel and sealant significantly reduced saliva's effect on sealant microleakage.

Response of human pulps capped with a self-etching adhesive system

Objective: The aim of this study was to evaluate the human pulp response following direct pulp capping with a current self-etching bonding agent and calcium hydroxide (CH). Methods: Thirty-three sound human premolars had their pulp tissue mechanically exposed. Sterile distilled water was used to control the hemorrhage and exudation from the pulp exposure site. The pulps were capped with Clearfil Liner Bond 2 (CLB-2) or CH and the cavities were filled with a resin composite (Z-100) according to the manufacturer's instructions. After 5, 30 and 120-300 days, the teeth were extracted and processed for microscopic examination. Results: At short-term, CLB-2 elicited a mild to moderate inflammatory pulp response with dilated and congested blood vessels adjacent to pulp exposure site. With time, macrophages and giant cells engulfing globules and particulates of resinous material displaced into the pulp space were observed. This chronic inflammatory pulp response triggered by fragments of bonding agent displaced into the pulp space did not allow pulp repair interfering with the dentin bridging. On the other hand, pulps capped with CH exhibited an initial organization of elongated pulp cells underneath the coagulation necrosis. Pulp repair and complete dentin bridge formation was observed at long-term evaluation. Significance: The present study demonstrated that CH remains the pulp capping agent of choice for mechanically exposed human pulps. CLB-2 did not allow complete connective tissue repair adjacent to the pulp exposure site. Consequently, this bonding agent cannot be recommended for pulp therapy of sound human teeth. © 2001 Academy of Dental Materials. Published by Elsevier Science Ltd. All rights reserved.

Healing process of dog dental pulp after pulpotomy and pulp covering with mineral trioxide aggregate or Portland cement.

Considering several reports about the similarity between the chemical compositions of the mineral trioxide aggregate (MTA) and Portland cement (PC), the subject of this investigation was to analyze the behavior of dog dental pulp after pulpotomy and direct pulp protection with these materials. After pulpotomy, the pulp stumps of 26 roots of dog teeth were protected with MTA or PC. Sixty days after treatment, the animal was sacrificed and the specimens removed and prepared for histomorphological analysis. There was a complete tubular hard tissue bridge in almost all specimens. In conclusion, MTA and PC show similar comparative results when used in direct pulp protection after pulpotomy.

Microleakage in primary teeth restored by conventional or bonded amalgam technique.

The aim of this in vitro study was to evaluate marginal leakage in class V restorations in primary teeth restored with amalgam, using three different techniques. Thirty maxillary anterior primary teeth, clinically sound and naturally exfoliated, were used. In group 1 (n = 10), two thin layers of a copal varnish (Cavitine) were applied. In group 2 (n = 10), Scotchbond Multi-Purpose Plus, a dual adhesive system, was used according to manufacturer instructions. In group 3 (n = 10), One-Step adhesive system in combination with a low-viscosity resin (Resinomer) were used according to manufacturer instructions. All samples were restored with a high-copper dental amalgam alloy (GS 80, SDI). After restoration, the samples were stored in normal saline at 37 degrees C for 72 h. The specimens were polished, thermocycled (500 cycles, 5 degrees and 55 degrees C, 30-s dwell time) and impermeabilized with fingernail polish to within 1.0 mm of the restoration margins. The teeth were then placed in 0.5% methylene blue for 4 h. Finally, the samples were sectioned and evaluated for marginal leakage. The Kruskal-Wallis test showed that the filled adhesive resin (group 3) had the least microleakage. There was no significant difference between groups 1 and 2.

Calcium salts deposition in rat connective tissue after the implantation of calcium hydroxide-containing sealers

This study was conducted to observe the rat subcutaneous connective tissue reaction to implanted dentin tubes that were filled with mineral trioxide aggregate, Sealapex, Calciobiotic Root Canal Sealer (CRCS), Sealer 26, and the experimental material, Sealer Plus. The animals were sacrificed after 7 and 30 days, and the specimens were prepared for histological analysis after serial sections with a hard-tissue microtome. The undecalcified sections were examined with polarized light after staining according to the Von Kossa technique for calcium. At the tube openings, there were Von Kossa-positive granules that were birefringent to polarized light. Next to these granulations, there was irregular tissue, like a bridge, that was Von Kossa-positive. The dentin walls of the tubes exhibited a structure highly birefringent to polarized light, usually like a layer, in the tubules. These results were observed with all the studied materials, except the CRCS, which didn't exhibit any kind of mineralized structure. The results suggest that among the materials studied, the CRCS could have the least possibility of encouraging hard tissue deposition.

Resistance to maxillary premolar fractures after restoration of class II preparations with resin composite or ceromer.

OBJECTIVE: The aim of this study was to evaluate the resistance to fracture of intact and restored human maxillary premolars. METHOD AND MATERIALS: Thirty noncarious human maxillary premolars, divided into three groups of 10, were submitted to mechanical tests to evaluate their resistance to fracture. Group 1 consisted of intact teeth. Teeth in group 2 received mesio-occlusodistal cavity preparations and were restored with direct resin composite restorations. Teeth in group 3 received mesio-occlusodistal cavity preparations and were restored with ceromer inlays placed with the indirect technique. After restoration, teeth were stored at 37 degrees C for 24 hours and then thermocycled for 500 cycles at temperatures of 5 degrees C and 55 degrees C. RESULTS: Statistical analysis revealed that group 3 (178.765 kgf) had a significantly greater maximum rupture load than did group 1 (120.040 kgf). There was no statistically significant difference between groups 1 and 2 or between groups 2 and 3. CONCLUSION: Class II cavity preparations restored with indirect ceromer inlays offered greater resistance to fracture than did intact teeth. The fracture resistance of teeth restored with resin composite was not significantly different from that of either the ceromer or intact teeth.

Neuroendocrine alterations impair enamel mineralization, tooth eruption and saliva in rats.

Neonatal administration of monosodium glutamate (MSG) in rats causes definite neuroendocrine disturbances which lead to alterations in many organ systems. The possibility that MSG could affect tooth and salivary gland physiology was examined in this paper. Male and female pups were injected subcutaneously with MSG (4 mg/g BW) once a day at the 2nd, 4th, 6th, 8th and 10th day after birth. Control animals were injected with saline, following the same schedule. Lower incisor eruption was determined between the 4th and the 10th postnatal days, and the eruption rate was measured between the 43rd and the 67th days of age. Pilocarpine-stimulated salivary flow was measured at 3 months of age; protein and amylase contents were thereby determined. The animals treated with MSG showed significant reductions in the salivary flow (males, -27%; females, -40%) and in the weight of submandibular glands (about -12%). Body weight reduction was only about 7% for males, and did not vary in females. Saliva of MSG-treated rats had increased concentrations of total proteins and amylase activity. The eruption of lower incisors occurred earlier in MSG-treated rats than in the control group, but on the other hand the eruption rate was significantly slowed down. The incisor microhardness was found to be lower than that of control rats. Our results show that neonatal MSG treatment causes well-defined oral disturbances in adulthood in rats, including salivary flow reduction, which coexisted with unaltered protein synthesis, and disturbances of dental mineralization and eruption. These data support the view that some MSG-sensitive hypothalamic nuclei have an important modulatory effect on the factors which determine caries susceptibility.

Evaluation of marginal microleakage in Class II cavities: Effect of microhybrid, flowable, and compactable resins

Objective: The goal of the present study was to evaluate the microleakage on the cementum/dentin and enamel surfaces in Class II restorations, using different kinds of resin composite (microhybrid, flowable, and compactable). Method and materials: Forty human caries-free molars were extracted and selected. Eighty Class II standardized cavities were made in the cervical wall at the cementoenamel junction (CEJ) and at the mesial and distal surfaces. The teeth were divided into four groups: G1 - adhesive system + microhybrid resin composite Z100; G2 - adhesive system + compactable resin composite Prodigy Condensable; G3 - adhesive system + flowable resin composite Revolution + Z100 resin composite; G4 - adhesive system + Revolution fluid resin + compactable resin composite Prodigy Condensable. The adhesive system used in this study was Scotchbond Multi-Purpose Plus. The specimens were thermocycled in baths of 5°C and 55°C for 1,000 cycles and immersed in 50% silver nitrate solution. The specimens then were sectioned and evaluated on degree of dye penetration. Results: The results were evaluated using the nonparametric Kruskall-Wallis test, which showed a statistically significant difference between groups G1 and G4, G2 and G4, and G3 and G4. Conclusions: None of the materials was able to eliminate the marginal microleakage at the cervical wall; the application of a low-viscosity resin composite combined with a compactable resin composite significantly decreased the microleakage.

Influence of dental care for infants on caries prevalence: A comparative study

Purpose: The influence of early dental care on the prevalence of dental caries was determined in children ages 35 to 40 months divided into 2 groups of 160 children each, with 1 group participating in a dental care program from the first year of life to the time of the study, while the other group did not receive any dental care. Methods: The clinical conditions considered for the evaluation were: sound teeth, enamel caries without cavitation, enamel caries with cavitation, and dentinal caries. The proportion and chi-square tests were used for statistical analysis with the level of significance set at 5%. Results: A significant difference regarding the presence of dental caries, especially in the number of children presenting enamel caries with cavitation (P<.0001), was observed between the 2 groups. The number of children with enamel caries without cavitation and dentinal caries was similar for the 2 groups. Conclusions: Considering the aspect of dental caries prevention, the authors concluded that children in the age range of 3 to 4 years who received early dental care showed better oral conditions.

Polymerization shrinkage evaluation of three packable composite resins using a gas pycnometer.

Modern restorative dentistry has been playing an outstanding role lately since composite resins, allied to adhesive systems, have been widely applied on anterior and posterior teeth restorations. The evolution of composite resins has mostly been verified due to the improvement of their aesthetic behavior and the increase in their compressive and abrasive strengths. In spite of these developments, the polymerization shrinkage inherent to the material has been a major deficiency that, so far, has been impossible to avoid. Using a gas pycnometry, this research investigated the polymerization shrinkage of three packable composite resins: Filtek P60 (3M), Prodigy Condensable (Kerr), and SureFil (Dentsply/Caulk), varying the distance from the light source to the surface of the resins (2 mm or 10 mm). The pycnometer Accupyc 1330 (Micromeritics, USA) precisely records helium displacement, allowing fast and reliable measurements of the volume of composite resin immediately before and after polymerization, without interference of temperature or humidity. Results were not found to be statistically different for the three tested resins, either for 2 mm or 10 mm-distance from the light source to the composite surface.

Effectiveness of EDTA and EDTA-T brushing on the removal of root surface smear layer.

The purpose of this study was to compare the removal of root surface smear layer following active application of EDTA gel and EDTA-T (texapon) gel in different concentrations (5%, 10%, 15%, 20% and 24%), using scanning electron microscopy. A total of 220 dentin blocks obtained from the root surfaces of extracted teeth were divided into 3 groups: Group I - (control) application of saline solution (n = 20); Group II - EDTA gel (pH 7.0) was applied in the following concentrations: 5%, 10%, 15%, 20% and 24% (n = 100); Group III - EDTA-T gel (pH 7.0) applied in the same concentrations described above (n = 100). The photomicrographs were evaluated by one calibrated examiner using a smear layer removal index and following statistical analysis (Kruskal-Wallis test). The results demonstrated that the specimens treated with EDTA and EDTA-T gel presented a better smear layer removal than the control group (p < 0.01); no statistically significant differences were observed between the EDTA and EDTA-T groups and between the concentrations tested (Mann-Whitney, p > 0.05). Within the limits of this study, it can be concluded that all treatment modalities effectively removed the smear layer from the root surface. The addition of texapon into the EDTA gel formulation did not increase its effectiveness.

Effect of the Clinical Application of the GaA1As Laser in the Treatment of Dentine Hypersensitivity

Objective: The aim of this study was to evaluate the effectiveness of the clinical use of the gallium-aluminum-arsenium (GaAlAs) laser at the maximum and minimum energies recommended by the manufacturer for the treatment of dentine hypersensitivity. Background Data: Dentine hypersensitivity (DH) is a response to a stimulus that would not usually cause pain in a healthy tooth. It is characterized by sharp pain of short duration from the denuded dentin. Its etiology is unknown. The dentin only begins to show sensitivity when exposed to the buccal environment. This exposure can result after removal of the enamel and/or dental cement, or after root denudation. Different treatments are proposed for this disorder. Materials and Methods: In this study, 25 patients, with a total number of 106 cases of DH, were treated with GaAlAs low-level laser therapy (LLLT). 65% of the teeth were premolars; 14% were incisors and molars; 6.6% were canines. The teeth were irradiated with 3 and 5 J/cm 2 for up to six sessions, with an interval of 72 h between each application, and they were evaluated initially, after each application, and at 15 and 60 days follow-up post-treatment. Results: The treatment was effective in 86.53% and 88.88% of the irradiated teeth, respectively, with the minimum and maximum energy recommended by the manufacturer. There was a statistically significant difference between DH and after a follow-up of 60 days for both groups. The difference among the energy maximum and minimum was not significant. Conclusion: The GaAlAs low-level laser was effective in reducing initial DH. A significant difference was found between initial values of hypersensitivity and after 60 days follow-up post-treatment. No significant difference was found between minimum (3 J/cm 2) and maximum (5 J/cm 2) applied energy.