Effect of Blood Decontamination Procedures on the Microshear Bond Strength of Resin-modified Glass Ionomer Cement to Resin Composite.

OBJECTIVE: To investigate the effect of decontamination procedures on the microshear bond strength (µSBS) of blood-contaminated resin-modified glass ionomer cement (RMGIC) bonded to resin composite (RC). METHODS: Eighty RMGIC disc specimens were allocated into 5 groups (n=16). All groups except Group 2 were contaminated with blood. Group 1 had no decontamination procedure, Group 3 was decontaminated by rinsing, Group 4 was decontaminated by 34% phosphoric acid etching, and Group 5 was decontaminated by 5% sodium hypochlorite application. RMGIC specimens were subsequently bonded with RC using a universal adhesive in self-etch mode. µSBS tests were conducted using a universal testing machine at a crosshead speed of 1 mm/min. Failure mode analysis was conducted on RMGIC fracture surfaces under a scanning electron microscope. RESULTS: µSBS results indicated that Group 4 had the highest mean µSBS value of 6.22 ± 2.14 MPa, while Group 1 had the lowest mean µSBS value of 3.53 ±1.67 MPa. Significant differences were observed in the µSBS of Group 2 with no contamination (p=0.023) and Group 4 with decontamination by phosphoric acid-etching (p=0.003) when compared to Group 1 with blood contamination. No statistically significant differences (p>0.05) were observed between all other groups' µSBS. For all groups, the predominant mode of failure was adhesive failure between the RMGIC-RC interface, with a few mixed failures in RMGIC for Groups 2-5. CONCLUSIONS: Blood contamination before adhesive application significantly reduced the µSBS between RMGIC and RC. Phosphoric acid etching was the most effective blood decontamination procedure to improve the µSBS.

The Influence of Saliva and Blood Contamination on Bonding Between Resin-modified Glass Ionomer Cements and Resin Composite.

OBJECTIVE: To investigate the influence of blood and saliva contamination on the microshear bond strength (µSBS) between resin-modified glass ionomer cement (RMGIC) and resin composite (RC). METHODS AND MATERIALS: Eighty RMGIC discs were allocated into four groups (n=20). Group 1 received universal dental adhesive application in a self-etch mode followed by a build-up with RC. Group 2 received saliva as a contaminant, Group 3 received blood as a contaminant, Group 4 received a 1:1 blood-saliva mixture as a contaminant. Specimens from Groups 2, 3, and 4 were submerged into their respective contaminants for 15 seconds and dried prior to the adhesive application, followed by the protocol for Group 1. All specimens were stored in distilled water for 24 hours. Subsequently, the bonded specimens were subjected to µSBS testing using a universal testing machine. Failure mode of the debonded RMGIC surfaces was examined using scanning electron microscopy. RESULTS: The µSBS from groups 1-4 were 10.76 ± 3.03 MPa, 9.36 ± 2.54 MPa, 6.55 ± 1.67 MPa and 8.42 ± 2.79 MPa, respectively. Contamination by blood and blood-saliva significantly decreased the µSBS (p<0.001, p=0.029). Saliva contamination alone had no statistically significant effect on the µSBS (p=0.524). A statistically significant difference in the mode of failure was detected between the experimental groups (p=0.012). CONCLUSION: Saliva contamination has no influence on µSBS between RMGIC and RC when it is dried thoroughly, while blood and blood-saliva contamination reduced µSBS between RMGIC and RC even when dried thoroughly.

Influence of Silver Diamine Fluoride Treatment on the Microtensile Bond Strength of Glass Ionomer Cement to Sound and Carious Dentin.

CLINICAL RELEVANCE: This study provides valuable information about the influence of silver diamine fluoride (SDF) treatment on the microtensile bond strength of glass ionomer cement (GIC) to dentin. SUMMARY: Objectives: To investigate the influence of silver diamine fluoride (SDF) treatment on the microtensile bond strength (mTBS) of glass ionomer cement (GIC) to sound and artificial carious dentin.Methods: Thirty dentin blocks prepared from 30 noncarious human molars were randomly allocated into either the sound (Gp1) or artificial carious dentin (Gp2) groups. A microbiological method was adopted to create artificial dentin caries lesions in Gp2 specimens. Each dentin block was sectioned into two halves perpendicularly, and each pair of block halves was randomly assigned to two subgroups to receive topical application of SDF (Gp1-SDF, Gp2-SDF) or water as control (Gp1-water, Gp2-water). An encapsulated GIC was bonded to the exposed dentin surfaces 14 days after the SDF/water application. After immersion for 7 days in artificial saliva, the GIC-dentin specimens were sectioned into beams for mTBS testing. Failure mode was examined after the mTBS test.Results: There was no significant difference in the mean mTBS values between the SDF and control subgroups (Gp1-SDF vs Gp1-water, 10.57±1.6 MPa vs 10.20±1.8 MPa; Gp2-SDF vs Gp2-water, 6.14±2.2 MPa vs 5.97±2.3 MPa; paired t-test, p>0.05). However, the mean mTBS value of the sound dentin group was significantly higher than that of the carious dentin group, irrespective of whether SDF was applied prior to GIC bonding (independent t-test, p<0.001). Proportionally more cohesive failures occurred in the sound dentin groups (Gp1-SDF, 48.4%; Gp1-water, 42.9%) compared with the carious dentin groups (Gp2-SDF, 15.6%; Gp2-water, 9.8%; p<0.05).Conclusions: SDF treatment had no significant influence on the mTBS of GIC to dentin. Compared with sound dentin, dentin with caries had lower mTBS to GIC.

Arresting Dentine Caries with Silver Diamine Fluoride: What's Behind It?

Unlike other fluoride-based caries preventive agents, silver diamine fluoride (SDF) can simultaneously prevent and arrest coronal and root dentine caries. The profound clinical success of SDF has drawn many clinicians and researchers to study the mechanism of SDF in arresting dentine caries. This critical review discusses how silver and fluoride contribute to caries arrest, in terms of their effects on bacteria as well as on the mineral and organic content of dentine. Silver interacts with bacterial cell membrane and bacterial enzymes, which can inhibit bacterial growth. Silver can also dope into hydroxyapatite and have an antibacterial effect on silver-doped hydroxyapatite. Furthermore, silver is also a strong inhibitor of cathepsins and inhibits dentine collagen degradation. Early studies proposed that silver hardened caries lesions by forming silver phosphate. However, recent studies found that little silver phosphate remained on the arrested dentine lesion. The principal silver precipitate was silver chloride, which could not contribute to the significant hardening of the arrested lesions. On the other hand, fluoride enhances mineral formation by forming fluorohydroxyapatite with reduced solubility. A significant increase in microhardness occurs with an elevated level of calcium and phosphorus but not silver on the surface layer of the arrested dentine caries lesion following SDF treatment. Fluoride also inhibits matrix metalloproteinases activities and therefore inhibits dentine collagen degradation. The combination of silver and fluoride in an alkaline solution has a synergistic effect in arresting dentine caries. The alkaline property of SDF provides an unfavorable environment for collagen enzyme activation. Understanding the mechanisms of SDF in arresting dentine caries helps clinicians to develop appropriate protocols for the use of SDF in clinical care.

Formation of Fluorohydroxyapatite with Silver Diamine Fluoride.

Silver diamine fluoride (SDF) is found to promote remineralization and harden the carious lesion. Hydroxyapatite crystallization is a crucial process in remineralization; however, the role of SDF in crystal formation is unknown. We designed an in vitro experiment with calcium phosphate with different SDF concentrations (0.38, 1.52, 2.66, 3.80 mg/mL) to investigate the effect of this additive on the nucleation and growth of apatite crystals. Two control groups were also prepared-calcium phosphate (CaCl2·2H2O + K2HPO4 in buffer solution) and SDF (Ag[NH3]2F in buffer solution). After incubation at 37 oC for 24 h, the shape and organization of the crystals were examined by bright-field transmission electron microscopy and electron diffraction. Unit cell parameters of the obtained crystals were determined with powder X-ray diffraction. The vibrational and rotational modes of phosphate groups were analyzed with Raman microscopy. The transmission electron microscopy and selected-area electron diffraction confirmed that all solids precipitated within the SDF groups were crystalline and that there was a positive correlation between the increased percentage of crystal size and the concentration of SDF. The powder X-ray diffraction patterns indicated that fluorohydroxyapatite and silver chloride were formed in all the SDF groups. Compared with calcium phosphate control, a contraction of the unit cell in the a-direction but not the c-direction in SDF groups was revealed, which suggested that small localized fluoride anions substituted the hydroxyl anions in hydroxyapatite crystals. This was further evidenced by the Raman spectra, which displayed up-field shift of the phosphate band in all the SDF groups and confirmed that the chemical environment of the phosphate functionalities indeed changed. The results suggested that SDF reacted with calcium and phosphate ions and produced fluorohydroxyapatite. This preferential precipitation of fluorohydroxyapatite with reduced solubility could be one of the main factors for arrest of caries lesions treated with SDF.

Clinical Trials of Silver Diamine Fluoride in Arresting Caries among Children: A Systematic Review.

This review aims to investigate the clinical effectiveness of silver diamine fluoride (SDF) in arresting dental caries among children. A systematic search of publications was conducted with the key words "silver diamine fluoride," "silver diammine fluoride," "silver fluoride," "diamine silver fluoride," or "diammine silver fluoride" as well as their translation in Chinese, Japanese, Portuguese, and Spanish in 7 databases: PubMed (English), Embase (English), Scopus (English), China National Knowledge Infrastructure (Chinese), Ichushi-web (Japanese), Biblioteca Virtual em Saude (Portuguese), and Biblioteca Virtual en Salud Espana (Spanish). Duplicated publications were deleted. The title and abstract were screened and irrelevant publications were excluded. The full text of the remaining publications was retrieved. Prospective clinical studies of SDF that reported a caries-arresting effect among children were included. Meta-analysis was performed for quantitative analysis. A total of 1,123 publications were found, including 19 publications of clinical trials. Sixteen clinical trials studied the caries-arresting effect on primary teeth, and 3 clinical trials were on permanent teeth. Fourteen studies used 38% SDF, 3 used 30% SDF, and 2 used 10% SDF. Meta-analysis was performed on extracted data from 8 studies using 38% SDF to arrest caries in primary teeth. The overall percentage of active caries that became arrested was 81% (95% confidence interval, 68% to 89%; P < 0.001). Apart from staining the arrested lesion black, no significant complication of SDF use among children was reported. SDF was commonly used at 38%. It was effective in arresting dentine caries in primary teeth among children. Knowledge Transfer Statement: This systematic review found that 38% silver diamine fluoride (SDF) can effectively arrest caries among children. SDF treatment is noninvasive and easily operated. It can be a promising strategy to manage dental caries in young children or those who have special needs.

Viruses and marine pollution.

This short review summarises the present knowledge on pollutant impacts on marine viruses, virus-host systems and their potential ecological implications. Excess nutrients from sewage and river effluents are a primary cause of marine eutrophication and mucilage formation, often related to the development of large viral assemblages. At the same time, hydrocarbons, polychlorinated biphenyl and pesticides alter ecosystem functioning and can determinate changes in the virus-host interactions, thus increasing the potential of viral infection. All these pollutants might have synergistic effects on the virus-host system and are able to induce prophage, thus increasing the impact of viruses on marine ecosystems.

Assessing the trophic state and eutrophication of coastal marine systems: a new approach based on the biochemical composition of sediment organic matter.

We used a biochemical approach based on the analysis of the quality and quantity of sedimentary organic matter for identifying new descriptors of the trophic state and environmental quality of coastal marine systems. A large-scale study, including 99 stations, belonging to 33 transects, was carried out along 250 km of the Apulian coasts (Mediterranean Sea) in March and September 2000. The investigated area covered a wide range of anthropogenic impacts (industrial ports, tourist harbours, areas affected by power plants and industrial wastes, mariculture areas). Other sites, including marine protected areas (i.e., without any apparent impact), were used as "control". Water column and benthic parameters provided different indications and classifications of the trophic state of coastal marine systems. We found that phytopigment content of the sediments changed in response to all different sources of anthropogenic impact and resulted in a useful descriptor of the trophic state and environmental quality. Highest sediment chlorophyll-a concentrations, indicating conditions of increasing eutrophication, were found in areas impacted by the discharge of heated waters from a power plant. In particular, the contribution of the autotrophic biomass to the biopolymeric carbon pool appeared to be a good descriptor of the decreasing environmental quality. Independently from the sampling period or the pollution source such contribution was significantly lower in transects subjected to anthropogenic impact than in control areas. Differences in trophic conditions were evident both in terms of quantity (i.e., total organic matter content) and quality (i.e., biochemical composition) of sediment organic matter. In particular, sediment protein concentration appeared to be a good descriptor of the trophic state of the benthic systems at different spatial scales. Multivariate (MDS) analysis allowed identifying areas characterised by hypertrophic, eutrophic and meso-oligotrophic conditions and to define relative threshold levels. A classification of the trophic state of coastal systems based on protein and carbohydrate concentrations is proposed.

Pelagic-benthic coupling of nucleic acids in an abyssal location of the northeastern Atlantic Ocean.

Spatial and temporal changes in sedimentary nucleic acid concentrations in an abyssal locality of the northeastern Atlantic Ocean were investigated in relation to fluxes of nucleic acids produced in the photic layer. Sediment trap material, collected between 1996 and 1998 at depths of 1,000, 3,000, and 4,700 m, and sediment samples were analyzed for DNA and RNA content. Nucleic acid concentrations in the sediments were very high and displayed significant temporal changes, whereas mesoscale variability was low. DNA and RNA concentrations generally displayed opposite temporal patterns, which are likely to be dependent on the nature and characteristics of DNA and RNA molecules. Nucleic acid fluxes were high and displayed clear seasonal changes apparently coupled with seasonal pulses of primary production. However, while median values of DNA fluxes were relatively similar in all sediment traps, median values of RNA fluxes almost doubled from the 1,000- to the 4,700-m depth, suggesting differences in the metabolic activity of microbes associated with sinking particles. Significant relationships between DNA concentrations in the sediments and DNA fluxes and between RNA concentrations and RNA fluxes, indicating the presence of a clear pelagic-benthic coupling of particulate nucleic acids, were observed. The benthic system investigated was not steady state since we estimated that, from September 1996 to October 1998, nucleic acid concentration in the sediments decreased by about 165 mg of DNA m(-2). Vertical profiles revealed a significant decrease in DNA concentration with depth in the sediments, reaching an asymptotic value of about 5 microg g(-1). This DNA fraction constitutes a pool of potentially refractory DNA (accounting for 16 to 40% of the total DNA pool) that might be buried in the sediments.