Unbound monomers do diffuse through the dentin barrier.

OBJECTIVES: Assessing the role of dentinal fluid proteins in trans-dentinal diffusion of free monomers in vitro. METHODS: An artificial pulp chamber (APC) topped human dentin disks was used. A simplified two-step etch-and-rinse adhesive was formulated with 2-hydroethyl-methacrylate (HEMA), Bisphenol-A-diglycidyl-methacrylate (BisGMA), using Camphorquinone/tertiary amine as initiators. Two extraction media were used: buffered saline (Control), buffered saline with 1% bovine serum albumin (BSA). Samples were acid-etched, rinsed, air dried. Simplified primer was used, adhesive applied then light cured with a LED curing. Monomer diffusion was assessed by reverse phase HPLC. RESULTS: Quantifiable amounts of HEMA were detected in both extraction media while BisGMA was present in quantifiable amounts in BSA medium only. Diffused monomers concentrations were significantly higher for both monomers in BSA extraction medium. SIGNIFICANCE: Albumin is sometimes referred to as taxi protein for its ability to bind and transport hydrophobic ligands. From our results, we hypothesized that albumin can also transport unbound monomers released from dental adhesive through the dentin barrier. However, dentinal fluid proteins like albumin could have significant effect on monomer diffusion through dentin to the dental pulp transporting highly hydrophobic molecules like BisGMA and enhancing diffusion of more hydrophilic ones like HEMA. These results demonstrate a new possible mechanism for cytotoxicity of resin monomers.

Photopolymerization study and adhesive properties of self-etch adhesives containing bis(acyl)phosphine oxide initiator.

OBJECTIVE: This paper investigates the photo-co-polymerization behavior of a blend of a diacrylamide (DEBAAP) with a phosphonylated acidic monomer using either bis(acyl)phosphine oxide or camphorquinone/amine as photo-initiator and studies the effect of variation of the structure of the phosphonylated acidic monomer on the shear bond strength to human dentin. METHODS: Photopolymerization kinetics has been assessed through the use of photo-DSC with either initiating system and with and without a phosphonic acid monomer, while the shear bond strengths (SBS) of dentin bonding agents formulated with several phosphonylated acidic monomers have been evaluated by macro SBS testing on human dentin. RESULTS: Photo-DSC results show that bis(acyl)phosphine oxide initiates a faster polymerization than camphorquinone/amine and that both photopolymerizations are accelerated by the phosphonic acid monomer. Similar results were obtained between adhesives based on camphorquinone/amine and a commercial adhesive (AdheSE, Ivoclar-Vivadent, Schaan, Liechtenstein). The best performances were obtained when BAPO was used as the initiator, in many cases far better than the commercial adhesive. Adhesive SEA6 based on difluoromethylphosphonic acid C demonstrated the best adhesion results of this study. Significance The bis(acyl)phosphine oxide photo-initiator causes faster photopolymerization of two-step self-etching dental adhesive, and its use could yield better bonding performance.

Aging of monolithic zirconia dental prostheses: Protocol for a 5-year prospective clinical study using ex vivo analyses.

BACKGROUND: Recent introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic zirconia dental prostheses raises the issue of material low thermal degradation (LTD), a well-known problem with zirconia hip prostheses. This phenomenon could be accentuated by masticatory mechanical stress. Until now zirconia LTD process has only been studied in vitro. This work introduces an original protocol to evaluate LTD process of monolithic zirconia prostheses in the oral environment and to study their general clinical behavior, notably in terms of wear. METHODS/DESIGN: 101 posterior monolithic zirconia tooth elements (molars and premolars) are included in a 5-year prospective clinical trial. On each element, several areas between 1 and 2 mm2 (6 on molars, 4 on premolars) are determined on restoration surface: areas submitted or non-submitted to mastication mechanical stress, glazed or non-glazed. Before prosthesis placement, ex vivo analyses regarding LTD and wear are performed using Raman spectroscopy, SEM imagery and 3D laser profilometry. After placement, restorations are clinically evaluated following criteria of the World Dental Federation (FDI), complemented by the analysis of fracture clinical risk factors. Two independent examiners perform the evaluations. Clinical evaluation and ex vivo analyses are carried out after 6 months and then each year for up to 5 years. DISCUSSION: For clinicians and patients, the results of this trial will justify the use of monolithic zirconia restorations in dental practice. For researchers, the originality of a clinical study including ex vivo analyses of material aging will provide important data regarding zirconia properties.Trial registration: ClinicalTrials.gov Identifier: NCT02150226.