Elettra De Stefano Dorigo

Chlorhexidine stabilizes the adhesive interface: a 2 year in vitro study

OBJECTIVES This study evaluated the role of endogenous dentin MMPs in auto-degradation of collagen fibrils within adhesive-bonded interfaces. The null hypotheses tested were that adhesive blends or chlorhexidine digluconate (CHX) application does not modify dentin MMPs activity and that CHX used as therapeutic primer does not improve the stability of adhesive interfaces over time. METHODS Zymograms of protein extracts from human dentin powder incubated with Adper Scotchbond 1XT (SB1XT) on untreated or 0.2-2% CHX-treated dentin were obtained to assay dentin MMPs activity. Microtensile bond strength and interfacial nanoleakage expression of SB1XT bonded interfaces (with or without CHX pre-treatment for 30s on the etched surface) were analyzed immediately and after 2 years of storage in artificial saliva at 37 degrees C. RESULTS Zymograms showed that application of SB1XT to human dentin powder increases MMP-2 activity, while CHX pre-treatment inhibited all dentin gelatinolytic activity, irrespective from the tested concentration. CHX significantly lowered the loss of bond strength and nanoleakage seen in acid-etched resin-bonded dentin artificially aged for 2 years. SIGNIFICANCE The study demonstrates the active role of SB1XT in dentin MMP-2 activation and the efficacy of CHX inhibition of MMPs even if used at low concentration (0.2%).

Use of a specific MMP-inhibitor (galardin) for preservation of hybrid layer.

OBJECTIVE Dentinal MMPs have been claimed to contribute to the auto-degradation of collagen fibrils within incompletely resin-infiltrated hybrid layers and their inhibition may, therefore, slow the degradation of hybrid layer. This study aimed to determine the contribution of a synthetic MMPs inhibitor (galardin) to the proteolytic activity of dentinal MMPs and to the morphological and mechanical features of hybrid layers after aging. METHODS Dentin powder obtained from human molars was treated with galardin or chlorhexidine digluconate and zymographically analyzed. Microtensile bond strength was also evaluated in extracted human teeth. Exposed dentin was etched with 35% phosphoric acid and specimens were assigned to (1) pre-treatment with galardin as additional primer for 30s and (2) no pre-treatment. A two-step etch-and-rinse adhesive (Adper Scotchbond 1XT, 3M ESPE) was then applied in accordance with manufacturers instructions and resin composite build-ups were created. Specimens were immediately tested for their microtensile bond strength or stored in artificial saliva for 12 months prior to being tested. Data were evaluated by two-way ANOVA and Tukeys tests (alpha=0.05). Additional specimens were prepared for interfacial nanoleakage analysis under light microscopy and TEM, quantified by two independent observers and statistically analyzed (chi(2) test, alpha=0.05). RESULTS The inhibitory effect of galardin on dentinal MMPs was confirmed by zymographic analysis, as complete inhibition of both MMP-2 and -9 was observed. The use of galardin had no effect on immediate bond strength, while it significantly decreased bond degradation after 1 year (p<0.05). Interfacial nanoleakage expression after aging revealed reduced silver deposits in galardin-treated specimens compared to controls (p<0.05). CONCLUSIONS This study confirmed that the proteolytic activity of dentinal MMPs was inhibited by the use of galardin in a therapeutic primer. Galardin also partially preserved the mechanical integrity of the hybrid layer created by a two-step etch-and-rinse adhesive after artificial aging.

Influence of different initiators on the degree of conversion of experimental adhesive blends in relation to their hydrophilicity and solvent content

OBJECTIVES The aim of this study was to compare the curing reaction of five experimental adhesive blends containing different photo-initiating systems. The hypothesis tested was that degree of conversion (DC) of resin blends is affected by resin type, solvent content and photo-initiating system. METHODS The experimental methacrylate resin blends were ranked from hydrophobic (R2) to hydrophilic (R3 and R4) and tested as neat, or solvated with 10% or 20% ethanol, or 10% ethanol and 10% water. Three different photo-initiators were used: IS-1=0.25% CQ (camphorquinone)+1% EDMAB (ethyl 4-dimethylaminobenzoate); IS-2=1.25% TPO (diphenyl(2,4,6-trimethylbenzoyl)-phosphine oxide); IS-3=0.25% CQ+0.50% EDMAB+0.50% TPO. DC of resin blends was measured with a differential scanning calorimeter. Data were analyzed with a three-way ANOVA. RESULTS Neat resin type influenced DC, as R4 showed the highest values compared to R2 and R3 (p<0.05). Solvent had a significant effect on DC (p<0.05): dilution of resin blends with 10% or 20% ethanol or 10% ethanol+10% water increased the DC of all resins, except for R4. Initiators influenced the polymerization since neat resins and mixtures solvated with 10% or 20% ethanol showed their highest DC values when polymerized with IS-1 or IS-3 (p>0.05), while IS-2 or IS-3 increased the DC values of resins diluted with 10% ethanol and 10% water (p<0.05). CONCLUSIONS Water-compatible photo-initiators such as TPO should be included in the hydrophilic solvated adhesive formulation to ensure an appropriate DC of the adhesive layer.

Degree of conversion and interfacial nanoleakage expression of three one-step self-etch adhesives.

Suboptimally polymerized monomers may be responsible for the reduced material properties of simplified adhesives and their inherent bonded interface instability. This study was performed to determine the degree of cure within the hybrid layers produced by three one-step self-etch adhesives in situ using Raman microspectroscopy and to investigate nanoleakage expression. Dentin disks were bonded with AdheSE One, Adper Prompt L-Pop, or iBond. Composite layers of 2-mm thickness were built up in bulk on the polymerized adhesive surfaces and then the adhesive-dentin interfaces were exposed to a micro-Raman beam. Adhesive penetration was calculated using the relative intensities of bands associated with mineral and adhesive, and the degree of conversion (DC) was evaluated. Interfacial nanoleakage expression was evaluated on the same specimens. The DC values for the tested adhesives were found to increase in the following order: AdheSE One (48 +/- 16%) < Adper Prompt L-Pop (83 +/- 2%) = iBond (90 +/- 6%; P < 0.05). AdheSE One showed greater nanoleakage expression than iBond or Adper Prompt L-Pop. Increased nanoleakage expression was associated with AdheSE One that showed the lowest DC. This suggests that a low DC may affect the quality and the long-term stability of the adhesive interface owing to the elution of unreacted monomers forming a porous and highly permeable hybrid layer.

Flowability of composites is no guarantee for contraction stress reduction

OBJECTIVES The purpose of this study was to measure the contraction stress development of three flowable resin-composite materials (Grandio Flow, VOCO GmbH, Cuxhaven, Germany; Tetric Flow, Ivoclar Vivadent, Schaan, Liechtenstein; Filtek Supreme XT Flowable Restorative, 3M ESPE, ST. Paul, MN, USA) and an universal micro-hybrid composite resin (Filtek Z250, 3M ESPE, St. Paul, MN, USA) during photopolymerization with a halogen curing light, using a novel stress-measuring gauge. METHODS Curing shrinkage stress was measured using a stress-analyzer. Composites were polymerized with a halogen curing unit (VIP, Bisco Inc., Schaumburg, IL, USA) for 40s. The contraction force (N) generated during polymerization was continuously recorded for 180s after photo-initiation. Contraction stress (MPa) was calculated at 20s, 40s, 60s, 120s and 180s. Data were statistically analyzed. RESULTS Filtek Supreme XT Flowable Restorative exhibited the highest stress values compared to other materials (p<0.05), while the lowest values were recorded with Tetric Flow (p<0.05). Tetric Flow was also the only flowable composite showing stress values lower than the conventional composite Filtek Z250 (p<0.05). SIGNIFICANCE Flowable composites investigated with this experimental setup showed shrinkage stress comparable to conventional resin restorative materials, thus supporting the hypothesis that the use of flowable materials do not lead to marked stress reduction and the risk of debonding at the adhesive interface as a result of polymerization contraction is similar for both type of materials.

The influence of dental metal alloys on cell proliferation and fibronectin arrangement in human fibroblast cultures.

The biocompatibility of six single-phase dental metal alloys was studied by determining cell proliferation rates correlated to the arrangement of fibronectin (FN) in fibroblast cultures. Immunocytochemical methods were used to detect cell proliferation by 5-bromodeoxyuridine (BrdU) incorporation, and FN organization [i.e. diffuse in the extracellular matrix and organized in fibrils or in focal adhesions (FA)] in human fibroblast cultures. Cell proliferation rates were related to FN arrangement and in particular a higher percentage of cells in the S-phase was related to a predominance of FA. The greatest difference in behaviour compared to that of the controls was detected after 120 and 168 hr: at these times, as well as at previous ones, the alloy with the highest Au content seemed the most biocompatible among those tested, as it behaved in a very similar way to the controls. In contrast, fibroblasts exposed to the other five alloys showed different behaviours from the controls. It is assumed that a correlation exists between FN organization and the percentage of BrdU-positive cells, and that these features vary in the presence of different alloys. The observation of FN arrangement together with cell proliferation rates could be another useful tool in determining the biocompatibility of dental metal alloys.

Adhesion To Intraradicular Dentin: A Review

Luting fiber posts to intraradicular dentin remains an unpredictable goal due to various clinical factors influencing the clinical procedure. Primarily differences can be found between bonding to coronal or to intraradicular dentin due to the different histological characteristics of the substrates, the high C-factor of the endodontic space, the presence of smear layer due to the post preparation technique, incompatibility between some adhesive systems and resin-based cements, and finally the limited access of the post space that may lead the clinician to different mistakes. Thus this article critically evaluates all aspects that may jeopardize the adhesion of luted fiber posts within the endodontic space, suggesting the use of standardized techniques that improve immediate adhesion and stabilize the adhesive interface over time. The review of the data currently available in peer-reviewed journals suggests that a strict following of a step-by-step clinical standardized technique allows the clinician to minimize bond failure and obtain a clinically reliable durable bond.

ElectroBond improves immediate dentin microtensile bond strength of two etch-and-rinse adhesives.

PURPOSE The aim of this study was to investigate whether an electrical device for dental adhesive application (ElectroBond) influences bonding of two-step etch-and-rinse adhesives. MATERIALS AND METHODS Human teeth were selected and cut perpendicularly to their long axis to expose middle/ deep dentin. Specimens were then longitudinally sectioned into halves (experimental and control halves) to create two similar bonding substrates. Experimental halves were bonded using an ElectroBond-assisted application, while control halves were bonded with disposable sponges. The adhesives tested were Adper Scotchbond 1XT and XP-BOND. Bonded specimens were submitted to the microtensile bond strength test. Additional adhesive interfaces were prepared and processed for nanoleakage investigation involving TEM examination. RESULTS The microtensile bond test revealed higher values (p < 0.05) for both adhesives if ElectroBond was used during layering (55.5 +/- 7.9 MPa for Adper Scotchbond 1XT and 54.7 +/- 7.1 MPa for XP-BOND) compared to the conventional mechanical adhesive application technique (41.1 +/- 6.1 MPa for Adper Scotchbond 1XT and 38.0 +/- 7.8 MPa for XP-BOND). No difference between the two adhesives was found under the same application conditions. With electricity-assisted application, TEM micrographs revealed a significant decrease in nanoleakage expression compared to the controls. CONCLUSION The use of an electric current produced by ElectroBond during the application of two-step etch-and-rinse adhesives may enhance resin impregnation, thus improving dentin hybridization. Further studies should be done to confirm that this device can similarly improve adhesive application in vivo.

Titanium implants with two different surfaces: Histomorphologic and histomorphometric evaluation in rabbit tibia

This study aimed to compare two different implant surface treatments of the implant system Bi-Implant (Plan 1 Health): one surface sandblasted with hydroxyapatite (HA) (Osseogrip(R)) and one machined surface. Histomorphologic and histomorphometric evaluations of the bone healing at the interface between a titanium implant and bone were performed using a light microscopic technique. Twenty-four commercially pure titanium implants with a smooth surface and 24 implants with a sandblasted surface were inserted in the tibias of 12 rabbits. The 12 rabbits were divided into three groups, each consisting of four animals, were sacrificed at 4 weeks (I group), 8 weeks (II group) and 12 weeks (III group) after the insertion of the bio-material. The results emphasized that in the sections examined with the light microscope, the bone was in intimate contact with the implant surface and the bone surrounding the implants was mostly lamellar. After 4 weeks, mature bone tightly surround-ing some areas of the implant perimeter was observed. The implant with the Osseogrip(R) surface showed an average percentage of bone-implant contact (%BIC) equal to 33%, while the one with the machined surface showed a %BIC equal to 17%. After 8 weeks, a progressive increase in mineralized bone surrounding the implant surface was detected, making the results of the machined surface superposable to the Osseogrip(R) surface results (48 and 44%). After 12 weeks, the implants with the machined surface exhibited close contact with the bone tissue corresponding to 62% of their perimeter, while for the implants with the Os-seogrip(R) surface the surface contact was 67% of the implant surface. The morphometric evaluation of %BIC at the three time points evidenced an increase in bone-titanium contact over time on both machined and Osseogrip(R) surfaces. Moreover, implants with rough surfaces demonstrated better behavior than the implants with the machined surface when taking into account the earlier osteointegration (4 weeks) of the peri-implantar tissues.