Biological response of pulps submitted to different capping materials

Pulp capping is a procedure that comprises adequate protection of the pulp tissue exposed to the oral environment, aiming at the preservation of its vitality and functions. This study evaluated the response of the dental pulps of dog teeth to capping with mineral trioxide aggregate (MTA) or calcium hydroxide P.A. For that purpose, 37 teeth were divided into two groups, according to the capping material employed. Two dogs were anesthetized and, after placement of a rubber dam, their pulps were exposed in a standardized manner and protected with the experimental capping materials. The cavities were then sealed with resin-modified glass ionomer cement and restored with composite resin. After sixty days, the animals were killed and the specimens were processed in order to be analyzed with optic microscopy. It was observed that MTA presented a higher success rate compared to calcium hydroxide, presenting a lower occurrence of infection and pulp necrosis.

Bond strength of a resin cement to high-alumina and zirconia-reinforced ceramics: The effect of surface conditioning

Purpose: The aim of this study was to evaluate the effect of two surface conditioning methods on the microtensile bond strength of a resin cement to three high-strength core ceramics: high alumina-based (In-Ceram Alumina, Procera AllCeram) and zirconia-reinforced alumina-based (In-Ceram Zirconia) ceramics. Materials and Methods: Ten blocks (5 ×6 × 8 mm) of In-Ceram Alumina (AL), In-Ceram Zirconia (ZR), and Procera (PR) ceramics were fabricated according to each manufacturer's instructions and duplicated in composite. The specimens were assigned to one of the two following treatment conditions: (1) airborne particle abrasion with 110-μm Al2O3 particles + silanization, (2) silica coating with 30 μm SiOx particles (CoJet, 3M ESPE) + silanization. Each ceramic block was duplicated in composite resin (W3D-Master, Wilcos, Petrópolis, RJ, Brazil) using a mold made out of silicon impression material. Composite resin layers were incrementally condensed into the mold to fill up the mold and each layer was light polymerized for 40 s. The composite blocks were bonded to the surface-conditioned ceramic blocks using a resin cement system (Panavia F, Kuraray, Okayama, Japan). One composite resin block was fabricated for each ceramic block. The ceramic-composite was stored at 37°C in distilled water for 7 days prior to bond tests. The blocks were cut under water cooling to produce bar specimens (n = 30) with a bonding area of approximately 0.6 mm2. The bond strength tests were performed in a universal testing machine (crosshead speed: 1 mm/min). Bond strength values were statistically analyzed using two-way ANOVA and Tukey's test (≤ 0.05). Results: Silica coating with silanization increased the bond strength significantly for all three high-strength ceramics (18.5 to 31.2 MPa) compared to that of airborne particle abrasion with 110-μm Al2O3 (12.7-17.3 MPa) (ANOVA, p < 0.05). PR exhibited the lowest bond strengths after both Al2O3 and silica coating (12.7 and 18.5 MPa, respectively). Conclusion: Conditioning the high-strength ceramic surfaces with silica coating and silanization provided higher bond strengths of the resin cement than with airborne particle abrasion with 110-μm Al2O3 and silanization.

Densitometric analysis of the autogenous demineralized dentin matrix on the dental socket wound healing process in humans

The aim of this study was to evaluate the effects of the autogenous demineralized dentin matrix (ADDM) on the third molar socket wound healing process in humans, using the guided bone regeneration technique and a polytetrafluoroethylene barrier (PTFE). Twenty-seven dental sockets were divided into three groups: dental socket (Control), dental socket with PTFE barrier (PTFE), and dental socket with ADDM slices associated to PTFE banier (ADDM + PTFE). The dental sockets were submitted to radiographic bone densitometry analysis and statistical analysis on the 15th, 30th, 60th and 90th days using analysis of variance (ANOVA) and Tukey's test (p ≤ 0.05). The radiographic analysis of the ADDM + PTFE group showed greater homogeneity of bone radiopacity than the Control group and the PTFE group, during all the observation times. The dentin matrix gradually disappeared from the dental socket during the course of the repair process, suggesting its resorption during the bone remodeling process. It was concluded that the radiographic bone density of the dental sockets treated with ADDM was similar to that of the surrounding normal bone on the 90th day. The ADDM was biocompatible with the bone tissue of the surgical wounds of human dental sockets. The radiographic analysis revealed that the repair process was discreetly faster in the ADDM + PTFE group than in the Control and PTFE groups, although the difference was not statistically significant. In addition, the radiographic image of the ADDM + PTFE group suggested that its bone architecture was better than that of the Control and PFTE groups.

Bond strength of hard chairside reline resins to a rapid polymerizing denture base resin before and after thermal cycling

Purpose: This study assessed the shear bond strength of 4 hard chairside reline resins (Kooliner, Tokuso Rebase Fast, Duraliner II, Ufi Gel Hard) to a rapid polymerizing denture base resin (QC-20) processed using 2 polymerization cycles (A or B), before and after thermal cycling. Materials and Methods: Cylinders (3.5 mm x 5.0 mm) of the reline resins were bonded to cylinders of QC-20 polymerized using cycle A (boiling water-20 minutes) or B (boiling water; remove heat-20 minutes; boiling water-20 minutes). For each reline resin/polymerization cycle combination, 10 specimens (groups CAt e CBt) were thermally cycled (5 and 55°C; dwell time 30 seconds; 2,000 cycles); the other 10 were tested without thermal cycling (groups CAwt ad CBwt). Shear bond tests (0.5 mm/min) were performed on the specimens and the failure mode was assessed. Data were analyzed by 3-way ANOVA and Newman-Keuls post-hoc test (α=.05). Results: QC-20 resin demonstrated the lowest bond strengths among the reline materials (P<.05) and mainly failed cohesively. Overall, the bond strength of the hard chairside reline resins were similar (10.09±1.40 to 15.17±1.73 MPa) and most of the failures were adhesive/cohesive (mixed mode). However, Ufi Gel Hard bonded to QC-20 polymerized using cycle A and not thermally cycled showed the highest bond strength (P<.001). When Tokuso Rebase Fast and Duraliner II were bonded to QC-20 resin polymerized using cycle A, the bond strength was increased (P=.043) after thermal cycling. Conclusions: QC-20 displayed the lowest bond strength values in all groups. In general, the bond strengths of the hard chairside reline resins were comparable and not affected by polymerization cycle of QC-20 resin and thermal cycling.

Bond strength of adhesive systems to human tooth enamel

The purpose of this study was to evaluate in vitro three adhesive systems: a total etching single-component system (G1 Prime & Bond 2.1), a self-etching primer (G2 Clearfil SE Bond), and a self-etching adhesive (G3 One Up Bond F), through shear bond strength to enamel of human teeth, evaluating the type of fracture through stereomicroscopy, following the ISO guidance on adhesive testing. Thirty sound premolars were bisected mesiodistally and the buccal and lingual surfaces were embedded in acrylic resin, polished up to 600-grit sandpapers, and randomly assigned to three experimental groups (n = 20). Composite resin cylinders were added to the tested surfaces. The specimens were kept in distilled water (37°C/24 h), thermocycled for 500 cycles (5°C-55°C) and submitted to shear testing at a crosshead speed of 0.5 mm/min. The type of fracture was analyzed under stereomicroscopy and the data were submitted to Anova, Tukey and Chi-squared (5%) statistical analyses. The mean adhesive strengths were G1: 18.13 ± 6.49 MPa, (55% of resin cohesive fractures); G2: 17.12 ± 5.80 MPa (90% of adhesive fractures); and G3: 10.47 ± 3.14 MPa (85% of adhesive fractures). In terms of bond strength, there were no significant differences between G1 and G2, and G3 was significantly different from the other groups. G1 presented a different type of fracture from that of G2 and G3. In conclusion, although the total etching and self-etching systems presented similar shear bond strength values, the types of fracture presented by them were different, which can have clinical implications.

Tensile bond strength of self-etching versus total-etching adhesive systems under different dentinal substrate conditions

The use of acid etchants to produce surface demineralization and collagen network exposure, allowing adhesive monomers interdiffusion and consequently the formation of a hybrid layer, has been considered the most efficient mechanism of dentin bonding. The aim of this study was to compare the tensile bond strength to dentin of three adhesive systems, two self-etching ones (Clearfil SE Bond - CSEB and One Up Bond F - OUBF) and one total-etching one (Single Bond - SB), under three dentinal substrate conditions (wet, dry and re-wet). Ninety human, freshly extracted third molars were sectioned at the occlusal surface to remove enamel and to form a flat dentin wall. The specimens were restored with composite resin (Filtek Z250) and submitted to tensile bond strength testing (TBS) in an MTS 810. The data were submitted to two-way ANOVA and Tukey's test (p = 0.05). Wet dentin presented the highest TBS values for SB and CSEB. Dry dentin and re-wet produced significantly lower TBS values when using SB. OUBF was not affected by the different conditions of the dentin substrate, producing similar TBS values regardless of the surface pretreatments.

Influence of cavity preparation and curing method on the marginal seal of resin composite restorations: an in vitro evaluation.

OBJECTIVE: To evaluate the influence of cavity design and photocuring method on the marginal seal of resin composite restorations. METHOD AND MATERIALS: Seventy-two bovine teeth were divided into 2 groups: group 1 received box-type cavity preparations, and group 2 received plate-type preparations. Each group was divided into 3 subgroups. After etching and bonding, Z250 resin composite (3M Espe) was applied in 2 equal increments and cured with 1 of 3 techniques: (1) conventional curing for 30 seconds at 650 mW/cm2; (2) 2-step photocuring, in which the first step was performed 14 mm from the restoration for 10 seconds at 180 mW/cm2 and the second step was performed in direct contact for 20 seconds at 650 mW/cm2; or (3) progressive curing using Jetlite 4000 (J. Morita) for 8 seconds at 125 mW/cm2 and then 22 seconds at 125 mW/cm2 up to 500 mW/cm2. The specimens were thermocycled for 500 cycles and then submitted to dye penetration with a 50% silver nitrate solution. Microleakage was assessed using a stereomicroscope. Data were analyzed using analysis of variance and Tukey test (5% level of significance). RESULTS: A statistically significant difference was found between groups when a double interaction between photocuring and cavity preparation was considered (P = .029). CONCLUSIONS: No one type of cavity preparation or photocuring method prevented micro-leakage. The plate-type preparation showed the worst dye penetration when conventional and progressive photocuring methods were used. The best results were found using the 2-step photocuring with the plate-type preparation.

Bond strength of acrylic teeth to denture base resin after various surface conditioning methods before and after thermocycling

This study aimed to evaluate the durability of adhesion between acrylic teeth and denture base acrylic resin. The base surfaces of 24 acrylic teeth were flatted and submitted to 4 surface treatment methods: SM1 (control): No SM; SM2: application of a methyl methacrylate-based bonding agent (Vitacol); SM3: air abrasion with 30-μm silicone oxide plus silane; SM4: SM3 plus SM2. A heat-polymerized acrylic resin was applied to the teeth. Thereafter, bar specimens were produced for the microtensile test at dry and thermocyled conditions (60 days water storage followed by 12,000 cycles). The results showed that bond strength was significantly affected by the SM (P < .0001) (SM4 = SM2 > SM3 > SM1) and storage regimens (P < .0001) (dry > thermocycled). The methyl methacrylate-based adhesive showed the highest bond strength.

In vitro evaluation of surface roughness of 4 resin composites after the toothbrushing process and methods to recover superficial smoothness.

OBJECTIVE: This study evaluated the efficiency of repolishing, sealing with surface sealant, and the joining of both in decreasing the surface roughness of resin-based composites after a toothbrushing process. METHOD AND MATERIALS: Ten specimens of each composite (Alert, Z100, Definite, and Prodigy Condensable), measuring 2 mm in thickness and 4 mm in diameter, were made and submitted to finishing and polishing processes on both sides of the specimens using the Sof-Lex system. The specimens were then subjected to toothbrushing (30,000 cycles), and surface roughness (Ra) was analyzed with a Surfcorder SE 1700 profilometer. The upper surface of each composite was etched with 37% phosphoric acid, and the surface-penetrating sealant Protect-it was applied on 1 surface. The roughness of these surfaces was again measured. On the other side, the surface of the specimen was repolished, and the efficiency of this procedure was measured using the profilometer. The surface roughness resulting from the joining of the 2 methods was verified by applying, in the final stage, the surface-penetrating sealant on the repolished surface. Data were analyzed with analysis of variance and Tukey test (P <.05). RESULTS: Results showed that the lowest surface roughness values were obtained for Definite, Z100, and Prodigy Condensable after the repolishing process and after the repolishing plus sealing. For Alert, the joining of repolishing plus sealing promoted the lowest values of surface roughness. CONCLUSION: Of the resin-based composites, Alert demonstrated the highest values of surface roughness in all the techniques tested.

Interaction between total-etch and self-etch adhesives and conventional and self-adhesive resin cements

The aim of this study was to compare the bond strength to enamel between resin cements combined with total-etch and self-etch adhesive systems and a self-adhesive cement. Eighty bovine incisors had their buccal surface ground flat exposing a plane area in the enamel. Eighty Artglass resin cylinders measuring 3 mm in diameter and 4 mm in height were fabricated. The teeth were divided into eight groups of 10 teeth each and the resin cylinders were cemented with different adhesive systems and resin cements; G1: RelyX Unicem (self-adhesive cement); G2: H 3PO 4 + Single Bond + RelyX ARC; G3: AdheSE + Variolink II; G4: H 3PO 4 + Excite + Variolink II; G5: Xeno III + Enforce; G6: H 3PO 4 + Prime&Bond NT + Enforce; G7: Biatite Primers 1 and 2 + Bistite II DC; G8: H 3PO 4 + Bistite Primers 1 and 2 + Bistite II DC. After application of the adhesives, the cylinders were cemented according to manufacturer instructions. The specimens were submitted to 2000 thermal cycles at a temperature ranging from 5±5°C to 55±5°C, and shear bond strength was then tested at a variety of 1 mm/min. The data were analyzed by ANOVA and the Tukey's test (á=5%), obtaining a p value of 0.00. The following mean (±standard deviation) bond strength values were observed for each group: G1: 5.14(±0.99)a; G3: 16.23(±4.69)b; G7: 17.82(±3.66)b; G5: 18.48(±2.88)bc; G8: 20.15(±4.12)bc; G4: 22.85(±3.08)cd; G2: 24.96(±2.89)d; G6: 26.07(±1.69)d. Groups followed by the same letters did not differ significantly. For most of the resin cements tested, the application of adhesive systems using acid etching resulted in a higher bond strength when compared to the self-etch adhesive systems and to the self-adhesive cement.

Resin microtensile bond strength to feldspathic ceramic: Hydrofluoric acid etching vs tribochemical silica coating

This study aimed to compare the microtensile bond strength of resin cement to alumina-reinforced feldspathic ceramic submitted to acid etching or chairside tribochemical silica coating. Ten blocks of Vitadur-α were randomly divided into 2 groups according to conditioning method: (1) etching with 9.6% hydrofluoric acid or (2) chairside tribochemical silica coating. Each ceramic block was luted to the corresponding resin composite block with the resin cement (Panavia F). Next, bar specimens were produced for microtensile testing. No significant difference was observed between the 2 experimental groups (Student t test, P> .05). Both surface treatments showed similar microtensile bond strength values.

Diametral tensile strength of dual-curing resin cements submitted exclusively to autopolymerization.

OBJECTIVES: To evaluate, at different times, the diametral tensile strength (DTS) of dual-curing resin cements that were not photopolymerized. METHOD AND MATERIALS: Equal amounts of base and catalyst pastes of Panavia F (Kuraray), Variolink II (Vivadent), Rely X (3M ESPE), and Enforce (Dentsply) were mixed and inserted into cylindrical molds (4 x 2 mm) (n = 10). Cements were not photopolymerized. DTS test was performed in a testing machine at 30 minutes, 1 hour, 24 hours, and 7 days. The specimens were stored in light-proof containers with distilled water at 37 degrees C until the time of assay. An autopolymerizing resin cement (Cement-It, Jeneric Pentron) and a zinc phosphate cement served as controls. One-way analysis of variance (ANOVA) and Tukey test were performed separately for each cement and for each time (P <.05). RESULTS: All cements showed an increase in DTS when tested at 1 and 24 hours. Tests at 24 hours and 7 days revealed no statistically significant differences. In all groups, the zinc phosphate cement had the lowest DTS mean values (2.1 MPa, 3.6 MPa, 6.5 MPa, and 6.9 MPa), while Cement-It (35.1 MPa, 33.6 MPa, 46.9 MPa, and 46.3 MPa) and Enforce (31.9 MPa, 31.7 MPa, 43.4 MPa, and 47.6 MPa) presented the highest DTS mean values. CONCLUSION: All cements presented maximal strength at 24 hours. The dual-curing resin cements, even when nonphotopolymerized, demonstrated higher DTS than the zinc phosphate cement and similar or lower values than the autopolymerizing resin cement.

The effect of different light-curing units on tensile strength and microhardness of a composite resin

The aim of this study was to evaluate the influence of different light-curing units on the tensile bond strength and microhardness of a composite resin (Filtek Z250 - 3M/ESPE). Conventional halogen (Curing Light 2500 - 3M/ESPE; CL) and two blue light emitting diode curing units (Ultraled - Dabi/Atlante; UL; Ultrablue IS - DMC; UB3 and UB6) were selected for this study. Different light intensities (670, 130, 300, and 600 mW/cm2, respectively) and different curing times (20s, 40s and 60s) were evaluated. Knoop microhardness test was performed in the area corresponding to the fractured region of the specimen. A total of 12 groups (n=10) were established and the specimens were prepared using a stainless steel mold composed by two similar parts that contained a cone-shaped hole with two diameters (8.0 mm and 5.0 mm) and thickness of 1.0 mm. Next, the specimens were loaded in tensile strength until fracture in a universal testing machine at a crosshead speed of 0.5 mm/min and a 50 kg load cell. For the microhardness test, the same matrix was used to fabricate the specimens (12 groups; n=5). Microhardness was determined on the surfaces that were not exposed to the light source, using a Shimadzu HMV-2 Microhardness Tester at a static load of 50 g for 30 seconds. Data were analyzed statistically by two-way ANOVA and Tukey's test (p<0.05). Regarding the individual performance of the light-curing units, there was similarity in tensile strength with 20-s and 40-s exposure times and higher tensile strength when a 60-s light-activation time was used. Regarding microhardness, the halogen lamp had higher results when compared to the LED units. For all light-curing units, the variation of light-exposure time did not affect composite microhardness. However, lower irradiances needed longer light-activation times to produce similar effect as that obtained with high-irradiance light-curing sources.

Homogenous demineralized dentin matrix for application in cranioplasty of rabbits with alloxan-induced diabetes: Histomorphometric analysis

Purpose: The aim of this work was to evaluate the bone-repair process after implantation of homogenous demineralized dentin matrix (HDDM) slices in surgical defects created in the parietal bones of rabbits with alloxan-induced diabetes. Materials and Methods: Forty-eight rabbits were selected and divided into 4 groups of 12 rabbits: the control group, diabetic rabbits (D), diabetic rabbits with a PTFE barrier (D-PTFE), and diabetic rabbits with a PTFE barrier and with slices of homogenous demineralized dentin matrix (D-PTFE+HDDM). The diabetic animals received a single dose of alloxan monohydrate (90 mg/kg) intravenously on the marginal ear vein, and their blood glucose was verified daily. The rabbits were sacrificed after 15, 30, 60, and 90 days. The histologic findings show both better bone structure and significantly greater bone density, as determined by histomorphometric analysis, for the D-PTFE + HDDM group than for the other 3 groups (P < .01). It was also observed that the mean bone density increased gradually from 15 to 90 days (except in the D-PTFE group). Conclusion: It was concluded that the HDDM was biocompatible with the bone repair of diabetic rabbits and that HDDM slices stimulated bone tissue formation. Facilitation of bone repair with HDDM could be useful in diabetic patients.

Effects of hemostatic agents on the histomorphologic response of human dental pulp capped with calcium hydroxide

Objective: To evaluate the response of human pulps capped with a calcium hydroxide [Ca(OH)2] cement after bleeding control with 2 hemostatic agents. Method and Materials: Pulps were exposed on the occlusal floor, and the bleeding was controlled either with saline solution (SS) or 2.5% sodium hypochlorite (NaOCI) (SH). After that, the pulp was capped with Ca(OH) 2 cement and restored with resin composite. After 30 (groups SS30 and SH30) and 60 (groups SS60 and SH60) days, the teeth were extracted and processed with hematoxylin-eosin and categorized in a histologic score system. The data were subjected to Kruskal-Wallis and Mann-Whitney tests (α = .05). Results: Regarding dentin bridge formation, an inferior response of SH60 group was observed when compared to SS60 (P < .05). The response of the SH30 group generally was similar to that of the groups treated with saline solution. However, after 60 days, 2.5% NaOCl showed a trend toward having an inferior response. Conclusion: Using saline solution as a hemostatic agent before pulp capping with Ca(OH)2 resulted in a significantly better histomorphologic response than using 2.5% NaOCl as a hemostatic agent before capping with Ca(OH)2.