Mohannad Nassar

Adhesion of Epiphany Self-etch Sealer to Dentin Treated with Intracanal Irrigating Solutions

INTRODUCTION This in vitro study assessed the adhesion of Epiphany self-etch (SE) root canal sealer to dentin treated with different irrigation regimens. METHODS Flat dentin surfaces were obtained from human third molar teeth; smear layer was created on each sample. Five groups of 10 samples each were conditioned with one of the following regimens: (1) deionized water for 10 minutes; (2) 5% sodium hypochlorite (NaOCl) for 10 minutes; (3) 5% NaOCl for 10 minutes and then 10% sodium ascorbate (Na-Ascr) for 10 minutes; (4) 5% NaOCl for 10 minutes and then 2% chlorhexidine (CHX) for 5 minutes; or (5) 5% NaOCl for 10 minutes and then 10% Na-Ascr for 10 minutes, followed by 2% CHX for 5 minutes. The conditioned dentin surfaces were dried with absorbent paper points. The Epiphany SE sealer was placed on each dentin surface with the use of hollow stainless steel tubes with specific diameter and height. The samples were stored in 100% humidity at 37°C for 7 days and then tested for shear bond strength in a universal testing machine. RESULTS Shear bond strength data were analyzed by one-way analysis of variance and Tukey post hoc tests (P < .05). There were statistically significant differences among the groups. CONCLUSIONS NaOCl decreased the bond strength of Epiphany SE sealer to dentin, whereas the use of Na-Ascr reversed this negative effect of NaOCl. CHX had neither negative nor positive influence on the bond strength.

Effect of natural cross-linkers incorporation in a self-etching primer on dentine bond strength.

OBJECTIVES The aim of this in vitro study was to investigate the effect of incorporation of natural cross-linkers into the primer of a self-etching adhesive on resin-dentine bond strength. METHODS Flat dentine surfaces were prepared from extracted human molar teeth and were applied with the following self-etching primers. The 0.5% hesperidin (HPN), 0.5% chlorhexidine (CHX) or 0.5% grape seed extract (GSE) was incorporated into Clearfil SE primer (Kuraray Medical, Inc.) to formulate three experimental primers. The original SE primer served as control. Following primer application, the teeth were bonded with Clearfil SE bond, restored with resin composite and stored in water for 24 h at 37 °C. The bonded specimens were sectioned into beams and subjected to micro tensile bond testing (μTBS). Failure analysis and morphological evaluation of the dentine surfaces were performed using a scanning electron microscope (SEM). Hardness (H) and elastic modulus (EM) were measured using nano-indentation technique to examine the mechanical properties of the bonded interfaces. RESULTS One-way ANOVA showed significant differences in μTBS, H and EM among the tested and control groups (p < 0.001). Tukey post hoc test revealed that incorporation of HPN significantly increased μTBS, H and EM, when compared with the other groups (p < 0.006). The GSE-incorporated group significantly decreased μTBS, H and EM, when compared with the other groups (p < 0.006); while CHX-incorporated group did not show any statistical significant difference when compared with the control group. CONCLUSION Incorporation of HPN into Clearfil SE primer had a positive influence on the immediate μTBS and mechanical properties of the bonded interface.

The inhibition effect of non-protein thiols on dentinal matrix metalloproteinase activity and HEMA cytotoxicity

OBJECTIVES Phosphoric acid (PA) etching used in etch-and-rinse adhesives is known to activate host-derived dentinal matrix-metalloproteinases (MMPs) and increase dentinal permeability. These two phenomena will result, respectively; in degradation of dentine-adhesive bond and leaching of some monomers especially 2-hydroxyethyl methacrylate (HEMA) into the pulp that would negatively affect the viability of pulpal cells. This study is the first to investigate the inhibitory effect of non-protein thiols (NPSH); namely reduced glutathione (GSH) and N-acetylcysteine (NAC) on dentinal MMPs and compare their effects on HEMA cytotoxicity. METHODS Dentine powder was prepared from human teeth, demineralized with 1% PA and then treated with 2% GSH, 2% NAC or 2% chlorhexidine (CHX). Zymographic analysis of extracted proteins was performed. To evaluate the effect of GSH, NAC and CHX on HEMA cytotoxicity, solutions of these compounds were prepared with or without HEMA and rat pulpal cells were treated with the tested solutions for (6 and 24h). Cells viability was measured by means of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Cytotoxicity data were analysed by one-way ANOVA and Tukey post hoc tests (p<0.05). RESULTS The inhibitory effect of GSH and NAC on dentinal MMPs was confirmed. GSH showed similar effectiveness to NAC regarding HEMA cytotoxicity inhibition. CONCLUSION NPSH were effective to inhibit dentinal MMPs and HEMA cytotoxicity. CLINICAL SIGNIFICANCE The tested properties of NPSH provide promising clinical use of these agents which would enhance dentine-bond durability and decrease post-operative sensitivity.

Phytic acid: an alternative root canal chelating agent.

INTRODUCTION The objectives of this study were to investigate the effect of phytic acid, inositol hexakisphosphate (IP6), as a final rinse on the surface of instrumented root canals and smear-layered flat dentin surfaces treated with sodium hypochlorite (NaOCl) and to evaluate its effect on the viability and alkaline phosphatase activity of osteoblast-like cells (MC3T3-E1). METHODS The universally accepted chelating agent EDTA was used as the control in all conducted experiments. Root canals of human canines were instrumented with rotary files and irrigated with 5% NaOCl, followed by a final rinse of 17% EDTA (1 minute), 1% IP6 (1 minute or 30 seconds), or distilled water. NaOCl-treated flat coronal dentin surfaces were also treated with 17% EDTA (1 minute), 1% IP6 (1 minute or 30 seconds), or distilled water. The presence or absence of smear layer was evaluated with scanning electron microscopy. Cell viability and alkaline phosphatase assays were performed to evaluate the effect of IP6 and EDTA on cultured MC3T3-E1 cells. RESULTS The results demonstrated the ability of IP6 to remove the smear layer from instrumented root canals and flat coronal dentin surfaces. When compared with EDTA, IP6 was less cytotoxic and did not affect the differentiation of MC3T3-E1 cells. CONCLUSIONS IP6 shows the potential to be an effective and biocompatible chelating agent.

Effect of hesperidin incorporation into a self-etching primer on durability of dentin bond

OBJECTIVE Collagen degradation at the resin-dentin interface deteriorates dentin bond durability. The use of natural cross-linkers might offer a positive approach to stabilize the resin-dentin interface. This study evaluated the effects of incorporation of natural cross-linkers into a self-etch adhesive primer on the immediate and long-term micro-tensile bond strengths (μTBS) to dentin. METHODS Experimental primers were prepared by incorporating either 0.5%, 1%, 2%, 5% of hesperidin (HPN) or 0.5% of proanthocyanidins (PA) into Clearfil SE primer. Extracted human molar teeth were restored using the experimental primers or the pure SE primer (control). The mechanical properties of the bonded interfaces were measured using the nano-indentation tests. Beam-shaped bonded specimens were sub-divided for one-day and one-year μTBS test. Interfacial collagen morphology was observed using transmission electron microscopy. RESULT The immediate μTBS significantly increased in 0.5%, 1% and 2% HPN-incorporated groups when compared with the control. The mechanical properties of bonded interface were improved with 1% and 2% HPN-incorporated primers. For the long-term μTBS, the 2% and 5% HPN-incorporated group were significantly higher than the control. The morphology of the collagen fibrils were preserved by 5% HPN-incorporation after one-year storage. The PA group, however, failed to improve the μTBS and the mechanical properties of the bonded interfaces. SIGNIFICANCE The incorporation of 2% HPN into the self-etching primer had a positive effect on the immediate μTBS and mechanical properties of the resin-dentin interfaces. The 5% HPN group preserved the morphology of the collagen in the hybrid layer after one-year storage in artificial saliva.

Effect of phytic acid etchant on the structural stability of demineralized dentine and dentine bonding

OBJECTIVE This study examined the effect of phytic acid (IP6) in stabilizing the morphology of dentine collagen network and resin-dentine bonding. METHODS Dentine beams were fully demineralized with 10% phosphoric acid (PA) or 1% IP6 (pH 1.2). PA-demineralized beams were divided into three groups: (a) no further treatment (control), (b) treatment with 5% glutaraldehyde (GA) for 1 h and (c) treatment with 1% IP6 (pH 7) for 1 h. IP6-demineralized beams received no further treatment. The beams were then subjected to ultimate tensile strength (UTS) testing. Dentine micromorphology evaluation was performed using a field-emission scanning electron microscope (FE-SEM). Dentine disks were etched with 35% PA for 15 s or 1% IP6 for 30s. PA-etched dentine disks were divided into three groups as (a), (b) and (c) as for UTS testing, but the treatment with GA or IP6 was done in 1min. For microtensile bond strength (µTBS) testing, flat dentine surfaces etched with PA or IP6 were blot-dried (wet dentine) or air-dried for 10s (dry dentine) and bonded with an etch-and-rinse adhesive followed by composite build-up. RESULTS IP6-demineralized dentine showed significantly higher UTS, when compared to PA-demineralized dentine. GA and IP6 significantly improved UTS of PA-demineralized dentine. FE-SEM observation revealed that dentine collagen network was preserved by GA and IP6. No significant difference in µTBS was found between the wet and dry IP6-etched dentine groups. CONCLUSION IP6 etching showed a structural stabilizing effect on demineralized dentine matrix and produced good resin-dentine bonding, regardless of dentine moistness or dryness.

Effect of phytic acid etchant on resin–dentin bonding: Monomer penetration and stability of dentin collagen

PURPOSE Phytic acid (IP6) works well as an etchant in dentin bonding to remove the smear layer due to its acidity and chelating effect. This study compared the etching effect of IP6 with phosphoric acid (PA) and ethylenediaminetetraacetic acid (EDTA) on resin-dentin bond strength, micromorphology of the etched dentin surface and nanoleakage formation along resin-dentin interfaces and compared the protecting effect against collagen degradation. METHODS Dentin disks and flat dentin surfaces were obtained from extracted human teeth. Specimens were etched with 35% PA (15s), 0.5M EDTA (30s) or 1% IP6 (30s). The surfaces and longitudinal sections of the etched dentin disks were observed using field emission scanning electron microscope (FE-SEM). An etch-and-rinse adhesive was used to create composite build up-specimens for microtensile bond strength (μTBS) testing and nanoleakage observation. To evaluate the effect on collagen degradation, demineralized bovine root dentin blocks were challenged with bacterial collagenase and then observed under light microscope. RESULTS PA- and EDTA- treated groups showed significantly lower μTBS when compared to IP6-treated group. PA showed distinct nanoleakage and severe collagen degradation. Only slight nanoleakage was detected in IP6 group. IP6 showed better effect than EDTA in preventing collagen degradation induced by bacterial collagenase. CONCLUSIONS IP6 effectively removed the smear layer and etched dentin, providing high bond strength values and causing minimal nanoleakage and slight collagen degradation.

The effect of glutathione on 2‐hydroxyethylmethacrylate cytotoxicity and on resin–dentine bond strength

AIM To evaluate the influence of reduced glutathione (GSH) application on 2-hydroxyethylmethacrylate (HEMA) cytotoxicity on rat pulpal cells and evaluate the effect of etched-dentine treatment with GSH on the immediate microtensile bond strength (μTBS) of etch-and-rinse adhesive. METHODOLOGY The cytotoxicity of 10 mmol L(-1) HEMA, 10 mmol L(-1) HEMA + 1 mmol L(-1) GSH, 10 mmol L(-1) HEMA + 5 mmol L(-1) GSH and 10 mmol L(-1) HEMA + 10 mmol L(-1) GSH was compared (6 h and 24 h). Cells viability was measured by means of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, followed by morphological observation of cells. Etched-dentine surfaces were rinsed and treated with one of the following solutions: 2% GSH, 5% GSH or 10% GSH, bonded with Adper Single Bond Plus (3M, ESPE, St. Paul, MN, USA) and restored with resin composite. The control group received no GSH treatment. After 1 day of water-storage at 37 °C, the specimens were subjected to μTBS testing. Cytotoxicity and μTBS data were analysed by one-way anova and Tukey post hoc tests (P < 0.05). RESULTS There were significant differences between the groups. HEMA elicited a remarkable toxic effect. 10 mmol L(-1) GSH prevented HEMA-induced damage at both exposure times. Whilst 5 mmol L(-1) GSH lost its protective effect at 24-h exposure time and 1 mmol L(-1) GSH showed no protective effect at both exposure times, GSH had no significant effect on the immediate μTBS; however, 5% GSH had higher bond strength value when compared to 10% GSH (P = 0.003). CONCLUSION Controlled concentrations of GSH had a protective effect against HEMA cytotoxicity. GSH had neither positive nor negative influence on μTBS.