Yuichi Kitasako

The influence of storage solution on dentin bond durability of resin cement

OBJECTIVES This study was conducted to determine the influence of storage solution on the bond durability of three resin cements to bovine dentin over the period of 1 year. METHODS Ten bovine dentin specimens were tested for shear bond strength with each material (Panavia 21, Kuraray Co.; BISTITE, Tokuyama Co; MASA Bond, Sun Medical Co.) and storage mode, listed below. Four storage environments were studied as follows: water changed every day for 1 year; water unchanged for 1 year; Phosphate Buffered Saline (PBS) changed every week over 1 year; PBS unchanged for 1 year. Ten teeth were also tested for each material at 1 day as a control. The mode of failure was classified after fracture of the bonds by SEM observation. The means of the bond strengths were compared statistically by two-way ANOVA and Fishers PLSD test (p < 0.05). Results for the mode of fracture were analyzed using the Mann-Whitney U test. RESULTS Although there was no statistical difference in the mean bond strengths between the water and PBS storage solutions (p > 0.05) in all cements, the results for the shear bond strengths in the changed storage solution groups were significantly lower than those where the storage solution remained unchanged (p < 0.05). There were statistical differences between the 1 day results and the changed water groups among all cements (p < 0.05). SIGNIFICANCE The storage condition influenced the long-term durability of dentin bonding with resin cements.

EFFECTS OF DIRECT RESIN PULP CAPPING TECHNIQUES ON SHORT-TERM RESPONSE OF MECHANICALLY EXPOSED PULPS

The aim of this in vivo study was to evaluate the effects of direct pulp capping techniques on the short-term response of mechanically exposed pulps using three commercially available adhesive resin systems. Class V cavities were prepared on the facial surface of 200 intact monkey teeth. Pulps were exposed with a carbide bur on the cavity floor. Each exposed pulp was capped with one of three commercially available adhesive resins or a hard-setting calcium hydroxide liner. All cavities were sealed with an adhesive resin, and were restored with hybrid resin composites. Inflammatory cell infiltration and dentine bridging of the exposed pulp and protrusion of the exposed pulp tissue into the cavities were evaluated histologically at 3, 7, 14, 30 and 60 days. A slight inflammatory cell infiltration was the principal reaction of the exposed pulp. The exposed area was occluded over time with dentine bridging in all groups. However, a protrusion of pulp tissue into the prepared cavity was observed at the periphery of the exposed area in all groups. These tissues communicated with the underlying pulp. The incidence of pulp tissue protrusion was ranked in order of increasing severity: Liner Bond II < Dycal < Bondwell LC = Super Bond C&B. Following pulp capping of the mechanical exposures, slight inflammation was the main reaction. Exposures became occluded with a dentine bridge over time. However, the protrusion of pulp tissue into cavities varied, depending on the materials used.

Shear and tensile bond testing for resin cement evaluation

OBJECTIVES The aim of this study was to compare the tensile and shear bond strengths of one experimental and four commercially available resin cements following the ISO document TR 110405 for bond measurement. METHODS Tensile and shear bond tests were performed using bovine enamel and dentin as the tooth substrate with each of the resin cements. Resin composite rods were cemented to the prepared tooth surfaces. The bond strengths were obtained 24 h after cementation, and mode of failure was classified after fracture of the bonds, both visually and by SEM observation. RESULTS Significant differences existed between the two bond test methods for all materials with enamel and three of the five cements when bonded to dentin. The shear test results were always the higher of the two test methods. Mode of fracture varied little for the visual classification, but the morphology from SEM observations showed considerable differences. SIGNIFICANCE Although there are deficiencies in the current test methods these may be outweighed by substrate variables. A test model should be designed to determine which stresses, tensile or shear, are the greatest for different types of restorations. With this information, the type of test selected could provide appropriate information before clinical trials are commenced.

Shear bond strengths of three resin cements to dentine over 3 years in vitro

OBJECTIVES This study was conducted to evaluate the bond durability of three resin cements bonded to bovine dentine over a period of 3 years. METHODS Ten bovine dentine specimens were tested for shear bond strengths with each of the following materials: Panavia 21, BISTITE resin cement, and MASA Bond (experimental resin cement) at 1 day, 6 months, 1 and 3 years after cementation of a composite rod. All specimens were stressed in shear at a crosshead speed of 1mm min(-1) until failure. The means of the bond strengths were compared statistically by two-way ANOVA and Fishers PLSD test (P<0.05). The mode of failure was classified after fracture of the bonds by SEM observation. Results for the mode of fracture were analyzed using the Mann-Whitney U-test. RESULTS The shear bond strengths (MPa+/-SD) for different times (1 day, 6 months, 1 and 3 years) were: Panavia 21 (15.2+/-3.6, 9.3+/-3.2, 8.5+/-2.1, 6.8+/-2.4), BISTITE (15.6+/-2.8, 11.0+/-1.4, 10.4+/-2.2, 9.0+/-2.7) and MASA Bond (29.6+/-9.5, 17.5+/-4.6, 19.6+/-4.5, 16.1+/-5.4). Panavia 21 and BISTITE strengths were significantly lower (P<0.05) at all times compared with MASA Bond, and 1 day strengths for all three materials were significantly higher (P<0.05) than 3 year strengths. Regarding the fracture modes after bond testing, there were statistical differences between the 1 day and the 1 year results for all cements (P<0.05). Although no Panavia 21 specimen showed complete cohesive failure in the demineralized dentine during the experiment, several BISTITE and MASA Bond specimens showed cohesive fracture in the demineralized dentine. For BISTITE, partially or complete demineralized dentine cohesive failures increased over time. CONCLUSIONS The type of resin cement seemed to have an influence on the long-term durability of bonding to dentine.

Monitoring remineralization of enamel subsurface lesions by optical coherence tomography.

Abstract. Optical coherence tomography (OCT) is a potential clinical tool for enamel lesion monitoring. Swept-source OCT findings were compared with cross-sectional nanohardness findings of enamel. Subsurface bovine enamel lesions in three groups were subjected to (1) deionized water (control), (2) phosphoryl oligosaccharide of calcium (POs-Ca) or (3) POs-Ca with 1 ppm fluoride for 14 days. B-scans images were obtained at 1310-nm center wavelength on sound, demineralized and remineralized areas after 4, 7, and 14 days. The specimens were processed for cross-sectional nanoindentation. Reflectivity from enamel that had increased with demineralization decreased with remineralization. An OCT attenuation coefficient parameter (μt), derived based on the Beer-Lambert law as a function of backscatter signal slope, showed a strong linear regression with integrated nanohardness of all regions (p<0.001, r=−0.97). Sound enamel showed the smallest, while demineralized enamel showed the highest μt. In group three, μt was significantly lower at four days than baseline, but remained constant afterwards. In group two, the changes were rather gradual. There was no significant difference between groups two and three at 14 days in nanohardness or μt POs-Ca with fluoride-enhanced nanohardness of the superficial zone. OCT signal attenuation demonstrated a capability for monitoring changes of enamel lesions during remineralization.

Comparison of Enamel and Dentin Microshear Bond Strengths of a Two-step Self-etching Priming System with Five All-in-One Systems

Data on the adhesive strength of new all-in-one adhesives are still relatively limited. This study compared the microshear bond strengths of five recent all-in-one self-etching priming systems (G-Bond, One-Up Bond-F Plus, Clearfil S3 Bond, Adper Prompt L-Pop and Go!) with a widely used two-step self-etching priming system (Clearfil SE Bond). Human molars were sectioned and finished with 600-grit SiC paper. Both enamel and dentin were bonded using adhesives with a 0.7 mm bonding diameter. Bond strengths were tested using a microshear bond test method at a crosshead speed of 1 mm/minute. The mean bond strengths and standard deviations were calculated and analyzed using ANOVA and the Tukeys HSD test. Results showed the two-step self-etching system had significantly higher bond strengths to dentin. However, for enamel bond strength, Clearfil SE Bond showed no statistical difference to G-Bond and Go!; however, all of the other materials were statistically lower. It is necessary to examine these new materials clinically to determine their efficacy.

Effect of artificial saliva contamination on pH value change and dentin bond strength

OBJECTIVE This study was to examine the effect of artificial saliva contamination on pH change of the dentin surface and the micro-shear bond strength (MSBS) of the two bonding systems to contaminated dentin. METHODS Fifty-six human dentin disks were tested with two resin bonding systems: a self-etching primer system, Clearfil SE Bond (Kuraray Medical Inc., Tokyo, Japan), and a one-bottle adhesive system, Single Bond (3M-ESPE, St. Paul, MN). Dentin surfaces were conditioned with the self-etching primer (primer) or phosphoric acid (etchant) and divided into four groups: conditioning without contamination (conditioning), contamination with artificial saliva (contamination), re-conditioning the contaminated dentin (re-conditioning), water-rinsing the contaminated dentin and re-conditioning (rinsing and re-conditioning). The pH change on the dentin surface was measured using a pH-imaging microscope (SCHEM-100, Horiba Ltd, Kyoto, Japan) to estimate the acid-base characteristics of the conditioned and contaminated dentin surface. The MSBS to the dentin was examined after storage in distilled water at 37 degrees C for 1 week. RESULTS The pH of intact dentin surfaces was 6.9. Conditioning with the primer and etchant decreased the pH to 5.4 and 5.9, respectively. Saliva contamination increased the pH slightly, and re-conditioning decreased the pH again. The MSBS of the two bonding systems decreased after contamination. Re-priming restored the MSBS to control values, while re-etching did not. Rinsing and re-priming produced a reduction in MSBS, and rinsing and re-etching did not increase the MSBS. SIGNIFICANCE The conditioning and saliva contamination changed the pH value of dentin surface. The MSBS decreased after contamination; however, re-priming with SE Bond primer was an adequate treatment to restore the bond strength.

Pulpal responses to bacterial contamination following dentin bridging beneath hard-setting calcium hydroxide and self-etching adhesive resin system.

To evaluate the pulp healing to bacterial contamination beneath a hard-setting calcium hydroxide (DY: Dycal, L.D. Caulk Co.) and a self-etching adhesive resin (2V: Clearfil Liner Bond 2V, Kuraray Medical Inc.) following dentin bridge formation. Class V cavities were prepared on 30 monkey teeth, and the pulps were exposed with a carbide bur through the cavity floor. Each exposed pulp was capped with either DY or 2V. The cavities were restored with a hybrid resin composite. The resin composite was removed at 180 days after capping, and then cavities were left open to the oral environment for 2 weeks to obtain bacteria contamination DY (BDY) and 2V (B2V; n = 10). A non-bacterial-contaminated group capped with DY was used as control. After bacterial challenges, inflammatory cell infiltration, incidence and differentiation of dentin bridges were evaluated histologically. There were significant differences in the presence of inflammatory cell infiltration among all groups (P < 0.05). No moderate or severe inflammatory reaction was found in Group DY. Group BDY showed moderate or severe inflammatory cell infiltration in 50%, and showed four necrotic specimens. Although no statistically significant difference was found in the formation and differentiation of dentin bridges among all groups, tunnel defects in dentin bridges were detected in 70% (DY), 80% (BDY), and 50% (B2V). Group B2V showed a significantly lower presence of inflammatory cell infiltration than Group BDY (P < 0.05). Bonding agent is supposed to seal the exposure site, and the remaining bonding agent on the cavities was effective as the barrier in the dentin bridges after bacterial challenges.

Hierarchy of variables correlated to odontoblast-like cell numbers following pulp capping

OBJECTIVES Following tooth pulp exposure, pulpal repair is accomplished by dentine bridge secretion by odontoblast-like cells. However, little information is available about the hierarchy of variables, which influence odontoblast-like cell numbers. The purpose of this study was to examine correlations between pulp capping events and odontoblast-like cell numbers. METHODS Two hundred and fifty standardised pulp exposed cavities were prepared in non-human primate teeth according to ISO usage guidelines. Exposed pulps were capped with Calcium hydroxide [Ca(OH)(2)], and multi-step and self-etching primer composite resins. Teeth were collected from 3 to 60-days to observe pulp reactions. Statistical analysis was evaluated using analysis of variance. RESULTS The hierarchy of variables correlated to odontoblast-like cells were the dentine bridge area (P = 0.0001), time since pulp exposure (P = 0.0001), odontoblast numbers opposite the exposure site (P = 0.0002), and pulp capping materials (P = 0.0313). Other pulp capping variables were found to be less likely to be correlated with odontoblast-like cell numbers. CONCLUSIONS The area of dentine bridge formation is directly related to the numbers of odontoblast-like cells, cell activity is time dependent, and the cell numbers are much lower than original odontoblast cells. The time-lag between the appearance of odontoblast-like cells at the site of pulp exposure, and the limited numbers of these cells, explain why pulpal repair is difficult to achieve successfully following pulp exposure.

Relationship between ceramic primer and ceramic surface pH on the bonding of dual-cure resin cement to ceramic

OBJECTIVES This study examined the relationship between a ceramic primer and ceramic surface pH on the microtensile bond strength of dual-cure resin cement to ceramic. METHODS Ceramic blocks (Vita Celay Blanks) were cut into multiple 3mm-thick slices and polished using 600-grit SiC paper. Two pairs were left untreated (controls), six pairs were treated with 40% phosphoric acid (PA), six pairs were treated with 20% hydrofluoric acid (HFA), and rinsed with water for either 15, 30 or 60 s. Half the specimens were silanated with Tokuso ceramics primer (TCP) (Tokuyama) and the other half with TCP formulated without phosphate monomer (TCP-NoPM). All the pairs were bonded with Bistite II dual-cure resin cement (Tokuyama) and light-cured. After 24 h water storage at 37 degrees C, the bonded specimens were cut into 6x0.7x0.7 mm(3) beams and their microtensile bond strengths (micro TBS) determined. Failure modes were determined using a confocal laser-scanning microscope. For scanning chemical analysis, the polished slices were cut into quarters, divided into seven groups of six, and treated in a similar manner as described for the micro TBS test. Surface pH was then determined using a scanning chemical microscope. For SEM examination, one ceramic quarter from each of the seven groups was used. RESULTS Three-way ANOVA revealed that the micro TBS of TCP was significantly higher than TCP-NoPM with no acidic treatment (p<0.05). However, after treatment of the ceramic surface with either PA or HFA, and 15 s rinsing, there was a significant reduction in surface pH (p<0.05), and no significant difference in micro TBS between TCP and TCP-NoPM (p>0.05). For TCP, there were no significant differences in micro TBS and failure mode between the control, PA, and HFA treated groups when the water rinsing time was increased. Whereas, for TCP-NoPM and surface treatment with PA, an increase in rinsing time resulted in a significant reduction in micro TBS and a significant increase in surface pH (p<0.05). SIGNIFICANCE Acidic treatment of the ceramic surface did not significantly increase dual-cure resin/ceramic bond strengths when the ceramic primer, TCP, was used. It is suggested that when no phosphate monomer is present in a ceramic primer, dual-cure resin cement/ceramic bond strength is dependent upon the concentration of H(+) ions on the ceramic surface.