Maria Teresa Atta

Cytotoxicity and biocompatibility of direct and indirect pulp capping materials

There are several studies about the cytotoxic effects of dental materials in contact with the pulp tissue, such as calcium hydroxide (CH), adhesive systems, resin composite and glass ionomer cements. The aim of this review article was to summarize and discuss the cytotoxicity and biocompatibility of materials used for protection of the dentin-pulp complex, some components of resin composites and adhesive systems when placed in direct or indirect contact with the pulp tissue. A large number of dental materials present cytotoxic effects when applied close or directly to the pulp, and the only material that seems to stimulate early pulp repair and dentin hard tissue barrier formation is CH.

Effect of the number of thermocycles on microleakage of resin composite restorations

Thermocycling simulates, in vitro, thermal changes that occur in the oral cavity. The aim of this study was to evaluate the influence of the number of cycles on microleakage. Class V cavities (1.5 mm deep, 3 mm in height and 3 mm in width) were prepared in bovine teeth, restored with a Single Bond/Z250 restorative system (3M/ESPE) and then divided into five groups of ten teeth each: group 1 was not thermocycled (control group), and groups 2, 3, 4 and 5 were thermocycled 500, 1,000, 2,500 and 5,000 times, respectively (5 degrees -55 degrees +/- 2 degrees C, 15 s dwell time). The teeth were immersed in 0.5% basic fuchsin aqueous solution for 24 h, sectioned and the sections with the highest degree of microleakage were selected, scanned and the extent of dye penetration was measured by the ImageTool program. The results submitted to one-way ANOVA showed no significant differences between the groups (p > 0.05). The averages of microleakage values in millimeters were: group 1 (3.92); group 2 (3.13); group 3 (4.48); group 4 (4.33) and group 5 (3.42). Thus, it was concluded that there is no relation between the increase of the number of cycles and the increase in microleakage.

Microhardness and chemical analysis of high-viscous glass-ionomer cement after 10 years of clinical service as ART restorations

OBJECTIVES The aim of this study was to evaluate the Knoop microhardness (KHN) and chemical composition of high-viscous glass-ionomer cement (HVGIC) after 10 years of clinical service. METHODS Six HVGIC samples were cut from 10-year ART restorations. The sections were embedded in acrylic moulds with their longitudinal profile exposed. KHN was determined by performing three sequences of five indentations at 10, 30, 50, 70 and 90 μm of HVGIC outer surface. For the control group (n=6), HVGIC specimens were stored in distilled water for 24 months. Hardness measurements were taken at days 7, 30, 60, 120, 180, 360, and 720. For chemical analysis using SEM-EDX, 10-year and control specimens were dehydrated and coated with carbon. Data were analysed using T-test and ANOVA/Tukeys test (p<0.05). RESULTS A significant KHN increase was observed in the control group up to the 180-day period. From this point the values stabilized and no more significant differences were found between the 10-year and the control KHN values. No statistical differences were observed amongst the KHN from inner distances compared to the outer surface of the 10-year HVGIC specimens. In one 10-year specimen, SEM-images identified the transformation of HVGIC in an altered layer with no glass filler particles detectable, and raised Ca, K and P contents. CONCLUSIONS KHN values of ten-year HVGIC specimens were similar to the control group values at 180-day storage period. Except for one 10-year specimen in that an altered layer could be seen, chemical composition was similar amongst the depths evaluated.

Influence of Temperature on the Spreading Velocity of Simplified-Step Adhesive Systems

BACKGROUND Flowability and viscosity vary for different adhesive systems owing to differences in their composition. These characteristics can be modified by environmental temperature. PURPOSE The purpose of this study was to determine the influence of temperature on the spreading (flow capacity) of simplified-step adhesive systems. MATERIALS AND METHODS Spreading velocities of adhesive systems (Adper Single Bond and Single Bond Plus [3M ESPE, St. Paul, MN, USA]; Prime & Bond 2.1 and Prime & Bond NT [Dentsply Indústria e Comércio Ltda, Petrópolis, RJ, Brazil]; Adper Prompt [3M ESPE]; and One Up Bond F [Tokuyama Corp, Tokyo, Japan]) were analyzed at intervals of 10, 15, 20, and 30 seconds at both 25 degrees C and 37 degrees C by placing 10 microL drops on a glass slide surface with an inclination of 45 degrees. The spreading of each adhesive system was measured in millimeters per second. RESULTS Data were analyzed by two-way analysis of variance and Student-Newman-Keuls tests. Regression analysis was used to determine a correlation between spreading velocity and time. Statistical significance was considered at a confidence level of 95%. Temperature influenced the spreading velocity, increasing it for Single Bond and Prime & Bond 2.1 and decreasing it for Adper Prompt (p < .05). No differences on spreading were observed for the other adhesives studied (p >.05). Regression analysis of each adhesive system demonstrated an inverse correlation between mean spreading velocity and time (R2 = .999) on both temperatures. CONCLUSIONS Temperature increases yielded an increase of spreading for Single Bond and Prime & Bond 2.1. The influence of temperature on the spreading velocity was material dependent. CLINICAL SIGNIFICANCE Environmental temperature can influence the rate of spreading of the adhesive system in clinically relevant times and may influence adhesive thickness on cavity walls.

Prevalence of enamel defects in permanent teeth of patients with complete cleft lip and palate

Objective To evaluate the prevalence, types, location, and characteristics of enamel defects in anterior permanent teeth of patients with complete unilateral and bilateral cleft lip and palate, as well as the relation with the cleft. Setting Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil. Participants Eighty patients of both genders, 12 years and older, with unilateral or bilateral cleft lip and palate. Methods A single examiner carried out clinical examination under artificial light with a dental probe and mirror after drying teeth according to the modified DDE index. Results Seventy-four of 80 patients presented with at least one tooth affected by enamel defects: 165 of 325 evaluated teeth (50.8%) presented enamel defects, with hypoplasia being the most prevalent (50.7%), followed by diffuse opacity (23.1%) and demarcated opacity (18.4%). The most affected tooth was 21 (36.5%), followed by 11 (34%), located at the middle (40%) and incisal (33%) thirds. Most defects occur at the buccal surface (47.7%), followed by the distal (22.7%), the mesial (19%), and the palatal (10.6%) surfaces. A significant relationship was found between the cleft side and enamel defects. Conclusion Upper anterior teeth of patients with complete cleft lip and palate present a high prevalence of enamel defects; the highest percentage on the cleft side suggests that the cleft does influence the occurrence of enamel defects in permanent teeth.

Push-out bond strength and SEM evaluation of a new bonding approach into the root canal

Objective This study evaluated the performance of different adhesive systems in fiber post placement aiming to clarify the influence of different hydrophobic experimental blend adhesives, and of one commercially available adhesive on the frictional retention during a luting procedure. Material and Methods One luting agent (70 Wt% BisGMA, 28.5% TEGDMA; 1.5% p-tolyldiethanolamine) to cement fiber posts into root canals was applied with 4 different adhesive combinations: Group 1: The etched roots were rinsed with water for 30 s to remove the phosphoric acid, then rinsed with 99.6% ethanol for 30 s, and blotdried. A trial adhesive (base to catalyst on a 1:1 ratio) was used with an experimental luting agent (35% Bis-GMA, 14.37% TeGDMA, 0.5% eDMAB, 0.13% CQ); Group 2: A trial adhesive (base to catalyst on a 1:2 ratio) was luted as in Group 1; Group 3: One-Step Plus (OSP, Bisco Inc.) following the ethanol bonding technique in combination with the luting agent as in Group 1; Group 4: OSP strictly following the manufacturers instructions using the luting agent as in Group 1. The groups were challenged with push-out tests. Posted root slices were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under scanning electron microscopy. Results Push-out strength was not significantly influenced by the luting agent (p>0.05). No statistically significant differences among the tested groups were found as Group 1 (exp 1 - ethanol-wet bonding technique)=Group 2 (exp 2 - ethanol-wet bonding technique)=Group 3 (OSP - ethanol-wet bonding technique)=Group 4 (control, OSP - water-wet bonding technique) (p>0.05). The dominating failure modes in all the groups were cohesive/adhesive failures, which were predominantly observed on the post/luting agent interface. Conclusions The results of this study support the hypothesis that the proposal to replace water with ethanol to bond fiber posts to the root canal using highly hydrophobic resin is plausible, but this seems to be more the proof of a concept than a clinically applicable procedure.

Water interaction and bond strength to dentin of dye-labelled adhesive as a function of the addition of rhodamine B

ABSTRACT Objective This study investigated the effect of the fluorescent dye rhodamine B (RB) for interfacial micromorphology analysis of dental composite restorations on water sorption/solubility (WS/WSL) and microtensile bond strength to dentin (µTBS) of a 3-step total etch and a 2-step self-etch adhesive system. Material and Methods The adhesives Adper Scotchbond Multi-Purpose (MP) and Clearfil SE Bond (SE) were mixed with 0.1 mg/mL of RB. For the WS/WSL tests, cured resin disks (5.0 mm in diameter x 0.8 mm thick) were prepared and assigned into four groups (n=10): MP, MP-RB, SE, and SE-RB. For µTBS assessment, extracted human third molars (n=40) had the flat occlusal dentin prepared and assigned into the same experimental groups (n=10). After the bonding and restoration procedures, specimens were sectioned in rectangular beams, stored in water and tested after seven days or after 12 months. The failure mode of fractured specimens was qualitatively evaluated under optical microscope (x40). Data from WS/WSL and µTBS were assessed by one-way and three-way ANOVA, respectively, and Tukey’s test (α=5%). Results RB increased the WSL of MP and SE. On the other hand, WS of both MP and SE was not affected by the addition of RB. No significance in µTBS between MP and MP-RB for seven days or one year was observed, whereas for SE a decrease in the µTBS means occurred in both storage times. Conclusions RB should be incorporated into non-simplified DBSs with caution, as it can interfere with their physical-mechanical properties, leading to a possible misinterpretation of bonded interface.

Kinetic of water diffusion and color stability of a resin composite as a function of the curing tip distance

, and net water uptake) and color stability of a composite were evaluated. Composite samples were polymerized at different distances (5, 10, and 15 mm) and compared to a control group (0 mm). After desiccation, the specimens were stored in distilled water to evaluate the water diffusion over a 120-day period. Net water uptake was calculated (sum of WSP and WSB). The color stability after immersion in a grape juice was compared to distilled water. Data were submitted to three-way ANOVA/Tukey’s test (α = 5%). The higher distances caused higher net water uptake (p < 0.05). The immersion in the juice caused significantly higher color change as a function of curing tip distance and the time (p < 0.05). The distance of photoactivation and storage time provide the color alteration and increased net water uptake of the resin composite tested.

Determining Optimal Fluorescent Agent Concentrations in Dental Adhesive Resins for Imaging the Tooth/Restoration Interface

Fluorescent dyes like Rhodamine B (RB) have been used to identify the spatial distribution of adhesive restorative materials in the tooth/restoration interface. Potential effects of the addition of RB to dental adhesives were addressed in the past, but no further information is available on how to determine suitable concentrations of RB in these bonding agents for imaging in the confocal laser scanning microscope. This study provides systematical strategies for adding RB to viscous dental adhesive resins, focusing on the determination of the lowest range of dye concentrations necessary to achieve an acceptable image of the dentin/adhesive interface. It was demonstrated that optimized images of the resin distribution in dentin can be produced with 0.1-0.02 mg/mL of RB in the (tested) adhesives. Our approaches took into account aspects related to the dye concentration, photophysical parameters in different host media, specimen composition and morphology to develop a rational use of the fluorescent agent with the resin-based materials. Information gained from this work can help optimize labeling methods using dispersions of low-molecular-weight dyes in different monomer blend systems.

Effect of resin-modified glass-ionomer cement lining and composite layering technique on the adhesive interface of lateral wall

Interface integrity can be maintained by setting the composite in a layering technique and using liners. Objective The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations. Material and Methods Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) – no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher’s test. Results There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups. Conclusions RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations.