L.G. Watanabe

The influence of the dentin smear layer on adhesion: a self-etching primer vs. a total-etch system

OBJECTIVE To determine the effect of dentin smear layers created by various abrasives on the adhesion of a self-etching primer (SE) and total-etch (SB) bonding systems. METHODS Polished human dentin disks were further abraded with 0.05 micro m alumina slurry, 240-, 320- or 600-grit abrasive papers, # 245 carbide, # 250.9 F diamond or # 250.9 C diamond burs. Shear bond strength (SBS) was evaluated by single-plane lap shear, after bonding with SE or SB and with a restorative composite. Smear layers were characterized by thickness, using SEM; surface roughness using AFM; and reaction to the conditioners, based on the percentage of open tubules, using SEM. RESULTS Overall, SBS was lower when SB was used than when SE was used. SBS decreased with increasing coarseness of the abrasive in the SE group. Among burs, the carbide group had the highest SBS, and 320- and 240-grit papers had SBS close to the carbide group. Surface roughness and smear layer thickness varied strongly with coarseness. After conditioning with SE primer, the tubule openness of specimens abraded by carbide bur did not differ from 240- or 320-grit paper, but did differ from the 600-grit. SIGNIFICANCE Even though affected by different surface preparation methods, SE yielded higher SBS than SB. The higher SBS and thin smear layer of the carbide bur group, suggests its use when self-etching materials are used in vivo. Overall, the 320-grit abrasive paper surface finish yielded results closer to that of the carbide bur and its use is recommended in vitro as a clinical simulator when using the SE material.

Dentin shear strength: Effects of tubule orientation and intratooth location

OBJECTIVES Dentin has a highly oriented tubule structure, and the tubule number density and area fraction of intertubular dentin vary with distance from the pulp. This investigation sought to determine the influence of tubule orientation on shear strength of dentin from samples derived at various intratooth locations. METHODS Third molars were sectioned and prepared to provide samples from two locations (center and cusp) and with one of three specific tubule orientations. In series 1, matched pairs of midcoronal samples were tested using two tubule orientations. A paired t-test was used for statistical analysis. In series 2, three samples from central and cuspal areas were tested using three different tubule orientations. A two-day ANOVA was used for statistical analysis. Each sample had dimensions of approximately 1 x 1 x 5 mm and was tested in a hydrated state by a single plane lap shear method. RESULTS The paired dentin samples of the midcoronal dentin in the two orientations had shear strengths of 72.4 +/- 15.6 MPa and 78.4 +/- 13.2 MPa, and were not significantly different (p > 0.05; paired t-test). In the second series, samples from the center location with tubules parallel to the shear plane with applied force in directions rotated by 90 degrees did not exhibit a significant difference (p > 0.05), with an average value of 53.5 +/- 9.5 MPa. Samples oriented with tubules along the long axis of the specimen and tested with shear force applied perpendicular to the tubule direction had significantly higher (p < 0.05; two-way ANOVA) shear strength (78.0 +/- 8.5 MPa). The specimens from the cusp area did not exhibit a statistically significant difference (p > 0.05; two-way ANOVA) with respect to the three orientations (83.6 +/- 8.4; +/- 13.8; 91.8 +/- 12.7 MPa). Cuspal areas were stronger than central areas in two of the three orientations tested. SIGNIFICANCE Results indicated that the shear strength differs in central and cusp areas and is dependent on dentin tubule orientation in the central area. Shear strengths were much larger than values reported in shear bond strength tests. This suggests that dentin shear strength is far in excess of dentin bond strengths using shear tests, and that fractures through dentin in such result from flaws or stress concentration in the dentin.

Acid-etching and Hydration Influence on Dentin Roughness and Wettability

Adhesion of restorative and protective materials to dentin is an important requirement for operative and preventive dentistry. Wettability and roughness are dentin substrate conditions that are critical to establishing good adhesion. This study examined superficial and deep dentin for variations in water contact angle measurements and roughness for polished, etched, dehydrated, and rehydrated states. Superficial and deep dentin disks from 6 non-carious third molars were prepared for AFM (Atomic Force Microscope) observation, roughness measurement, and contact angle measurements following specific treatments: hydrated and polished, etched (10% H3P04), dehydrated (desiccator for 24 hrs); and rehydrated (in water for 24 hrs). Contact angles were measured by means of the ADSA (Axisymmetric Drop Shape Analysis) technique with filtered and purified water of surface tension 72.79 ergs/cm2. The AFM was used to quantify the intertubular roughness. Mean and SD of roughness and contact angle were calculated for each dentin state, and two-way Repeated Measures ANOVA with Tukeys HSD multiple comparisons were performed at p < 0.05. Wetting and roughness both increased after etching, with roughness tending to increase further while wettability dramatically decreased after desiccation. After rehydration, water contact angle values were equivalent to those of the etched condition. Although intertubular roughness did not depend on depth, lower water contact angles were found for deep dentin. Depth and dehydration resulted in altered dentin substrates with exposed hydrophobic moieties that could interfere with bonding to hydrophilic primer coats.

Measurement of temperature generated by visible-light-cure lamps in an in vitro model.

The dental pulp is vulnerable to cavity preparation and restoration procedures. This vulnerability may be a result of the temperature rise generated by those procedures. When visible-light-cure lamps are used to place composite restorations, they cause the temperature in the pulp to rise. This study measured the temperature rise recorded when six visible-light-cure lamps were tested for 20- and 60-second exposure times. They were also tested in conjunction with an air current passed along the face of the lens in order to lower the temperature. Analysis of the data indicates that the lamps do cause a temperature rise within the pulp chamber--a higher rise the longer the lamp is used. Dentin thickness is important, and air lowers the temperature generated.

Removal of intracanal smear by doxycycline in vitro

UNLABELLED Cleansing and shaping result in a smear layer on the instrumented canal wall surfaces. The smear layer may inhibit close contact between sealers and dentin, and inhibits diffusion of medicaments. OBJECTIVE This study assessed the effect of doxycycline hydrochloride (DH) on smear layer on intracanal walls. STUDY DESIGN Scanning electron microscopy was used to evaluate the remaining smear layer using different concentrations of DH. Single-canal palatal roots of extracted maxillary molars were irrigated with saline-15% EDTA; saline-25 mg/ml DH; saline-50 mg/ml DH; saline-100 mg/ml DH; NaOCl-15% EDTA; NaOCl-25 mg/ml DH; NaOCl-50 mg/ml DH; and NaOCl-100 mg/ml DH. The roots were fractured into halves and the amount of smear layer assessed in the middle and apical third. RESULTS Doxycycline-HCl of 100 mg/ml was the most effective in removing smear layer. In the saline group, 100 mg/ml of DH was more effective than EDTA. In the hypochlorite group, 50 mg/ml and 100 mg/ml of DH were more effective than EDTA (p < 0.05). CONCLUSION Doxycycline solution may be an effective irrigant.

Effect of citric acid concentration on dentin demineralization, dehydration, and rehydration: Atomic force microscopy study

Most current dentin bonding procedures use acid etchants to partially demineralize the dentin structure and provide pathways for resin infiltration. This study determined the recession rates of peritubular dentin and intertubular dentin as a function of pH during demineralization in citric acid solutions (0.0005-2.5M) and the effects of dehydration and rehydration on the partially demineralized dentin. Polished dentin disks were prepared with an internal reference layer and were studied at specific intervals for citric acid etching between pH 1 and 3.4 in an atomic force microscope. Peritubular dentin etched rapidly and linearly with time until it could no longer be measured. The intertubular surface began etching at nearly the same rate, but then recession slowed for all concentrations and stabilized after recession of less than 1 microm for all but the pH 1 solution. The decrease in recession was attributed to the limitation of contraction of the demineralized collagen scaffold as long as it remained hydrated. Dehydration following etching resulted in significant collapse of the surface, changes in roughness, and a slight decrease in tubule diameter for samples etched for 30 min. Measurements could not be made of the collapse for low pH samples, because shrinkage stresses disrupted the integrity of the reference layer. On rehydration, the dehydrated surfaces underwent an expansion up to the level seen after etching and tubule diameters returned to the etched values. These results indicate that the collapse of demineralized matrix is almost totally recoverable on rehydration.

In vitro microleakage at the gingival margin of porcelain and resin veneers

This in vitro study investigated the effect of dental surface treatments on the seal of porcelain and resin laminate veneers to tooth structure. Nine groups of 20 teeth were prepared for labial veneers--six groups with the apical margin of the veneer in dentin, two groups with the veneer wholly bordered by enamel, and one group with the apical margin coincident with the apical margin of a previously placed glass ionomer restoration. The teeth were treated with a variety of dentin-bonding agents prior to restoration of eight groups with porcelain veneers and one group with Visio-Gem microfilled resin veneers. After placement, the veneers were stored in water for 4 days, then subjected to thermocycling before silver staining and sectioning. Results showed no leakage around the margins of the veneers wholly bordered by enamel. Complete leakage was found around the glass ionomer restorations, and nearly total leakage was found along the resin-dentin interface of the resin veneers. The porcelain veneers that extended onto dentin showed variable but limited leakage for four of five of the dentin-bonding treatments.

Bond strength of 4-META acrylic resin denture base to cobalt chromium alloy

This study was designed to compare the bond strength of a conventional poly(methyl methacrylate) acrylic resin denture base (Lucitone 199) with a recently developed acrylic resin base containing 4-META (Meta-Dent) to CoCr metal alloy by using various designs representative of clinical situations. The mechanical bond strength of Lucitone 199 resin was compared with the chemical and combination chemical and mechanical bond strength of Meta-Dent resin. The following conclusions may be extrapolated from the results. 1. The highest bond strength was observed between Meta-Dent resin and the plain flat metal plate. 2. The second highest bond strength was observed between Meta-Dent resin and the flat metal plate with two posts. 3. The lowest bond strengths were observed between Meta-Dent resin and the samples containing mesh retentive mechanisms. 4. The mean bond strength of Lucitone 199 resin was highest for the flat metal plate with two posts, followed by the large mesh. Bond strength with the small-mesh samples was lowest. These differences were not statistically significant. 5. The mean bond strengths of Meta-Dent resin to flat metal plates with or without posts was significantly higher than any of the Lucitone 199 resin metal bond strengths, to the 99% confidence level. Additional studies will be necessary to confirm the validity of these conclusions with respect to clinical removable partial dentures. Longitudinal investigations will be required to reveal clinical performance of these resin systems.

Dentin Erosion Simulation by Cantilever Beam Fatigue and pH Change

Exposed root surfaces frequently exhibit non-carious notches representing material loss by abrasion, erosion, and/or abfraction. Although a contribution from mechanical stress is often mentioned, no definitive proof exists of a cause-effect relationship. To address this, we examined dimensional changes in dentin subjected to cyclic fatigue in two different pH environments. Human dentin cantilever-beams were fatigued under load control in pH = 6 (n = 13) or pH = 7 (n = 13) buffer, with a load ratio (R = minimum load/maximum load) of 0.1 and frequency of 2 Hz, and stresses between 5.5 and 55 MPa. Material loss was measured at high- and low-stress locations before and after cycling. Of the 23 beams, 7 withstood 1,000,000 cycles; others cracked earlier. Mean material loss in high-stress areas was greater than in low-stress areas, and losses were greater at pH = 6 than at pH = 7, suggesting that mechanical stress and lower pH both accelerate erosion of dentin surfaces.

Dentin shear strength: effect of distance from the pulp

OBJECTIVE Dentin structure varies with orientation and location. Ultimate shear strength (USS) has also been found in previous studies to vary with location. The present study further explores this relationship between USS and various locations in coronal dentin as well as distance from the pulp. METHODS Stick specimens were prepared from coronal dentin located in the center or under cusps of human molar teeth. These were tested in the shear mode at various distances from the pulp. RESULTS Median values ranged from 52.7 (range 29.0-73.1) MPa near the pulp to 76.7 (range 53.9-104.0) MPa near the dentino-enamel junction. No differences were found among the buccal, central or lingual locations, however, the USS near the pulp was found to be significantly lower. SIGNIFICANCE The properties of coronal dentin vary with distance from the pulp, which may affect adhesion and other aspects of restorative dentistry.