Ability of different restorative materials to prevent in situ secondary caries: analysis by polarized light-microscopy and energy-dispersive X-ray

Secondary caries is the main cause of direct restoration replacement. The purpose of this study was to analyze enamel adjacent to different restorative materials after in situ cariogenic challenge using polarized-light microscopy (PLM), scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDS). Twelve volunteers, with a low level of dental plaque, a low level of mutans streptococci, and normal salivary flow, wore removable palatal acrylic appliances containing enamel specimens restored with Z250 composite, Freedom composite, Fuji IX glass-ionomer cement, or Vitremer resin-modified glass-ionomer for 14 days. Volunteers dripped one drop of 20% sucrose solution (n = 10) or distilled water (control group) onto each specimen 8 times per day. Specimens were removed from the appliances and submitted to PLM for examination of the lesion area (in mm(2)), followed by dehydration, gold-sputtering, and submission to SEM and EDS. The calcium (Ca) and phosphorus (P) contents were evaluated in weight per cent (%wt). Differences were found between Z250 and Vitremer, and between Z250 and FujiIX, when analyzed using PLM. Energy-dispersive X-ray analysis results showed differences between the studied materials regarding Ca %wt. In conclusion, enamel adjacent to glass-ionomer cement presented a higher Ca %wt, but this material did not completely prevent enamel secondary caries under in situ cariogenic challenge.

Reactionary dentinogenesis after applying restorative materials and bioactive dentin matrix molecules as liners in deep cavities prepared in nonhuman primate teeth

Objective: the aim of this in vivo study was to evaluate the response of the pulp-dentin complex following application of resin-modified glass-ionomer cement, calcium hydroxide hard-setting cement and EDTA-soluble preparation of dentine matrix proteins (ESDP) in deep cavities prepared in non-human primate teeth. Methods: Eighteen deep Class V buccal cavities were prepared in premolars of four capuccin monkeys. In Groups 1 and 2, the cavity floor was lined with ESDP or a resin-modified glass-ionomer cement (Vitrebond - 3M ESPE), respectively. In Group 3 (control), the cavity was lined with a hard setting calcium hydroxide cement (Dycal - Dentsply). The cavities were subsequently filled with amalgam. After 6 months, the animals were sacrificed and the teeth were prepared for microscopic assessment. Six-micron thick serial sections were stained with H/E, Masson's trichrome and Brown & Brenn techniques. Results: No inflammatory pulpal response was observed for all experimental and control Groups. However, the amount of reactionary dentin deposition differed between groups in the rank order ESDP (Group 1) > calcium hydroxide (Group 3) > resin-modified glass-ionomer (Group 2). These differences were statistically significant. Conclusions: All materials were biocompatible when applied in deep cavities. ESDP stimulated higher deposition of reactionary dentin matrix than Vitrebond and Dycal.

Radiopacity of esthetic restorative materials compared with human tooth structure

Purpose : To compare the radiopacity of 13 restorative materials, (a conventional glass-ionomer cement, three resin-modified glass-ionomer cements, six polyacid-modified resin-based composites, and three resin-based composites) to sound tooth structure. Materials and Methods: 315 specimens were made of the restorative materials (n= 21), of 2 min height and 4.1 mm diameter. Radiographs were taken of the specimens, together with the tooth structure sample and an aluminum step wedge. The radiopacity values of each specimen were taken using a transmission densitometer. Results: ANOVA and Tukey's test (95% level of confidence) revealed that, except for a resin-based composite, a polyacid-modified resin-based composite, a resin-modified glass-ionomer cement and the conventional glass-ionomer cement, all the evaluated restorative materials were more radiopaque than the tooth structure.

Fluoride release by restorative materials before and after a topical application of fluoride gel

The release of fluoride from restorative materials (Vitremer, Ketac-Fil, Fuji II LC and Freedom) was evaluated during two 15-day periods, before and after a topical application of acidulated phosphate fluoride gel (APF). For each material, 6 specimens were made, which were immersed in 2 ml of deionized water. The fluoride concentration dosages in the solutions were read at intervals of 24 hours for 15 days. After this period, the specimens of each material received treatment with APF gel for 4 minutes and the fluoride released was analyzed at 24-hour intervals during the following 15 days. The analysis of variance and the Tukey test (p < 0.05) showed that the total mean fluoride released during the initial 15 days was greater for Vitremer and Ketac-Fil and lower for Fuji II LC and Freedom; and in the final 15 days there was a difference in release readings, with the greatest value for Vitremer, followed by Fuji II LC, Ketac-Fil and Freedom. The comparison of the results between the 1st day and the 16th day (after gel application) showed a greater fluoride release on the 16th day for Vitremer, Fuji II LC and Freedom and was equal for Ketac-Fil. Although all the materials evaluated gained fluoride with the application of APF, the data suggest that the resin-modified ionomers are more efficient in releasing fluoride to the medium than the other materials.

Radiopacity of restorative materials using digital images

The radiopacity of esthetic restorative materials has been established as an important requirement, improving the radiographic diagnosis. The aim of this study was to evaluate the radiopacity of six restorative materials using a direct digital image system, comparing them to the dental tissues (enamel-dentin), expressed as equivalent thickness of aluminum (millimeters of aluminum). Five specimens of each material were made. Three 2-mm thick longitudinal sections were cut from an intact extracted permanent molar tooth (including enamel and dentin). An aluminum step wedge with 9 steps was used. The samples of different materials were placed on a phosphor plate together with a tooth section, aluminum step wedge and metal code letter, and were exposed using a dental x-ray unit. Five measurements of radiographic density were obtained from each image of each item assessed (restorative material, enamel, dentin, each step of the aluminum step wedge) and the mean of these values was calculated. Radiopacity values were subsequently calculated as equivalents of aluminum thickness. Analysis of variance (ANOVA) indicated significant differences in radiopacity values among the materials (P<0.0001). The radiopacity values of the restorative materials evaluated were, in decreasing order: TPH, F2000, Synergy, Prisma Flow, Degufill, Luxat. Only Luxat had significantly lower radiopacity values than dentin. One material (Degufill) had similar radiopacity values to enamel and four (TPH, F2000, Synergy and Prisma Flow) had significantly higher radiopacity values than enamel. In conclusion, to assess the adequacy of posterior composite restorations it is important that the restorative material to be used has enough radiopacity, in order to be easily distinguished from the tooth structure in the radiographic image. Knowledge on the radiopacity of different materials helps professionals to select the most suitable material, along with other properties such as biocompatibility, adhesion and esthetic.