Lincoln Dias Lanza

Subclinical Failures of Direct Pulp Capping of Human Teeth by Using a Dentin Bonding System

INTRODUCTION The goal of this study was to examine the adhesive interface of pulp tissue to investigate subclinical failures after direct pulp capping (DPC) of human teeth by using a dentin adhesive system. METHODS The pulps of 12 caries-free first premolars scheduled for extraction for orthodontic reasons were exposed and capped with the Single Bond adhesive system. The adhesive technique was carefully performed to ensure complete coverage of the exposed area and a satisfactory clinical aspect. After 1 (n = 6) and 30 days (n = 6), the teeth were extracted for evaluation of the adhesive interface under light microscopy and scanning electron microscopy. Brown-Brenn staining was used to detect bacteria. RESULTS The clinical aspect of direct pulp capping during the operation was satisfactory, and all patients were asymptomatic in the postoperative phase. Brown-Brenn staining revealed no bacterial microleakage at both time points. A hybrid layer was seen on all walls but decreased gradually toward the area of pulp exposure. In contrast to clinical data, light microscopy and scanning electron microscopy revealed important subclinical bond failures near the area of exposed pulp. Some frequent findings were gaps between the restoration and the dentin substrate; unpolymerized monomers under the adhesive layer; interface breaks with blood extravasation between the layers of the adhesive system; rupture of the odontoblast layer; and multinucleated giant cells close to the bonding agent. CONCLUSIONS The Single Bond adhesive system should not be used for direct pulp capping of human teeth because subclinical adhesive failures invariably occur at its interface with the pulp tissue.

Ultrastructural evaluation of the hybrid layer after cementation of fiber posts using adhesive systems with different curing modes

This in vitro study evaluated the adhesive interface of intraradicular fiber glass posts and root dentin using scanning electron microscopy (SEM). Forty-eight single-rooted premolars were randomly divided into 6 groups consisting of chemical, dual, or light cured adhesive systems combined with either chemical or dual cure resin cements. Scanning electron microscopic analysis showed the best results for continuity, density and morphology of the hybrid layer and resin tags for the combination of a self-cure adhesive with self-cure cement resin, followed by a dual-cure adhesive with self-cure cement resin, and finally a light-cure adhesive with self-cure cement. For the dual-cure resin cement, the same relation may be observed. The apical third was the most critical region for evaluated the criteria for all combinations of materials (Kruskal-Wallis and Friedman tests; p<0.001). Generally, the simplification of steps in the adhesive system and the polymerization reaction of resin adhesives and cements produced a direct effect on the quality of the adhesive post/dentin substrate interface.

Influence of different light sources on the conversion of composite resins.

AIMS The purpose of this paper was to evaluate the influence of different light curing units on the conversion of four composite resins with different compositions (Durafill VS - Heraeus-Kulzer, Tetric Ceram - Ivoclar/Vivadent, Filtek Supreme XT - 3M ESPE e Aelite LS Packable - Bisco), using differential scanning calorimetry. MATERIALS AND METHODS A stainless steel matrix was used to prepare 48 cylindrical composite test samples (n=6), measuring 3 mm in diameter and 1 mm in thickness. The samples were photoactivated using a halogen lamp (Optilux 500 - Demetron/Kerr) and three different generations of light-emitting diodes (LEDs) (LEC-470 I - MMOptics, Radii Plus - SDI and Ultra-Lume LED 5 - Ultradent). After removal of the matrix, each sample was weighed and hermetically sealed in an aluminum pan and analyzed. The amount of heat liberated by thermopolymerisation of residual monomers after photoactivation was measured in Joules/gram (J/g). The data were submitted to Analysis of Variance (ANOVA) test (P ≤ 0.002) and the Tukey test (P < 0.05). RESULTS The Ultra-Lume LED 5 was superior on degree of conversion for all resins. The Radii Plus was equal to the Ultra-Lume LED 5, except for the resin Tetric Ceram , were the Optilux 500 was superior. The LEC-470 I was inferior for the conversion of all resins. CONCLUSION The study proves the importance of the compatibility of the different photoinitiators in resin composites with the different light sources.