Natural enamel caries, dentine reactions, dentinal fluid and biofilm.

It is believed that penetration of dentinal fluid into natural enamel caries (NEC) is negligible because of the barrier created by underlying sclerotic dentine, but there are conflicting evidences on whether dentine subjacent to NEC is sclerotic or demineralized. This study aimed at investigating the relationship between NEC, subjacent dentine reactions, modification of dentinal fluid, and composition of cariogenic biofilm formed on the NEC surface. Proximal NEC (PNEC) lesions of human permanent posterior teeth were included in five experiments. Histologically, microradiographic analysis with contrast solution (MRC) in dentine revealed a decreased proportion of sclerotic dentine and an increased proportion of deep dentine demineralization compared to the classical stereomicroscopic histological analysis based on dentin color and translucency. Real-time MRC and 3D optical profilometry, and 3D microtomographic analysis evidenced a facilitated transport of modified dentinal fluid towards PNEC lesions. Cariogenic biofilm formed in vitro on the PNEC surface presented lower amounts of insoluble and soluble matrix polysaccharides when 2% chlorexidine was inserted in the pulp chamber. In conclusion, this study evidenced that dentine subjacent to PNEC is mostly demineralized, providing facilitated pathway for dentinal fluid to penetrate into PNEC and alter the composition of the biofilm formed on the PNEC surface.

Effect of dentinal fluid on enamel permeability under simulated pulpal pressure.

OBJECTIVE: To determine the effect of pulpal perfusion on the fluid flow through human tooth after different treatments at the enamel surface. Changes in mineral density along with fluid flow rate were also analyzed before and after etching. DESIGN: The experiments were carried out on 97 human premolars. Ringer's solution and distilled water (DW) were applied under pressure of 20 mm Hg to the pulpal cavity of tooth crowns in the Ringer's-perfused and water-perfused groups respectively. Fluid flow through each specimen was recorded before and 0, 30, 60, 180 min after treatments at the enamel surface. The treatments included DW, 0.2% sodium fluoride solution, 1.23% acidulated phosphate fluoride gel (APF), 2.26% fluoride varnish (FV), 37% phosphoric acid gel (Etch) and artificial saliva (AS). Mineral density of the enamel was evaluated using micro-computed tomography. RESULTS: In water-perfused group, fluid flow rates recorded after etching were significantly increased (p = 0.005) with the significant reduction of mineral density (p = 0.018) from baseline. A significant negative correlation was found (r = -0.78, p = 0.015). After FV, the percentage reduction from baseline was significant at 180 min (p = 0.003). In Ringer's-perfused group, etching immediately produced the greatest mean flow rate and subsequently returned to the baseline within 60 min after treatment (p < 0.001). There were approximately 40, 55, and 63% reductions of flow rates within 60 min after AS, APF and FV respectively. CONCLUSION: Under simulated pulpal pressure, enamel fluid involves the process of enamel remineralization, particularly after etching.

Observations on fluid flow from exposed dentine in primary teeth: An in vitro study.

OBJECTIVE: To investigate fluid flow through dentine in primary teeth in vitro using the replica technique, and to compare the results with those obtained from permanent dentine. DESIGN: The experiments were carried out on 22 extracted, mandibular, primary, incisor teeth. The incisal edge was removed to 1mm below the dentino-enamel junction and half the exposed surface etched with phosphoric acid. The exposed dentine was blotted dry and the pressure in the pulp cavity held at 0, 15, 30 or 45cm H2O above atmospheric for 30s. Fluid that accumulated on the dentine surface was recorded with impression material and a replica made with epoxy resin which was examined in a scanning electron microscope. RESULTS: Structures resembling fluid droplets were present in the replicas of unetched dentine in all 22 teeth, and at all the pulpal pressures tested. The droplets formed at 45cm H2O were significantly larger (median diam., 5.14mm; interquartile range, 3.26mm; Friedman repeated measures analysis of variance on ranks (RMAVR) and Tukey test) than those formed at other pressures. There was no evidence of droplets in the replicas of etched dentine with any of the pulpal pressures. CONCLUSIONS: These results demonstrate that fluid will tend to flow from dentine in deciduous teeth when it is exposed. They are similar to those obtained in a previous study in this laboratory on permanent teeth. The fact that fluid droplets were absent from etched dentine suggests that, after being blotted, the etched dentine matrix absorbed fluid that tended to flow out through the dentinal tubules.

MMP-9 in Dentinal Fluid Correlates with Caries Lesion Depth.

The analysis of molecular cues in dentinal fluid from an excavated cavity could improve diagnostics in the context of minimally invasive caries treatment. In the current clinical trial we assessed whether the dentinal fluid levels of MMP-9 (matrix metalloproteinase-9; neutrophil gelatinase) would increase with the progression of carious lesions. MMP-9 is associated with neutrophil-related tissue breakdown in the pulp. Absolute MMP-9 levels were contrasted against the levels of MMP-2, an enzyme related to normal tissue turnover. Dentinal fluid was collected below deep and shallow caries from molars and premolars within the same patients aged 18 years and older (n = 30, 1 tooth per group/patient). Experimental teeth were isolated under a rubber dam prior to excavation. Dentinal fluid was collected from the bottom of the cavity using a size 25 paper point. MMP levels were assessed using an enzyme-linked immunosorbent assay. Nonparametric methods were applied to test for differences between groups. Significantly more (p < 0.05, Wilcoxon test) MMP-9 was collected from the deep carious lesions than from the shallow counterparts. Pairwise comparison of MMP-9 values within patients revealed that there was more MMP-9 collected from deep lesions than from shallow counterparts in 27 of the 30 individuals under investigation (pairwise Wilcoxon test, p < 0.001). In contrast, no such difference existed for MMP-2. There was a high correlation between MMP-9 from deep and shallow lesions (Spearman's ρ = 0.72, p < 0.001), indicating that patients with more MMP-9 in the deep carious lesion also tended to have more MMP-9 in the shallow lesion.

A rapid, efficient, and facile solution for dental hypersensitivity: The tannin-iron complex.

Dental hypersensitivity due to exposure of dentinal tubules under the enamel layer to saliva is a very popular and highly elusive technology priority in dentistry. Blocking water flow within exposed dentinal tubules is a key principle for curing dental hypersensitivity. Some salts used in "at home" solutions remineralize the tubules inside by concentrating saliva ingredients. An "in-office" option of applying dense resin sealants on the tubule entrance has only localized effects on well-defined sore spots. We report a self-assembled film that was formed by facile, rapid (4 min), and efficient (approximately 0.5 g/L concentration) dip-coating of teeth in an aqueous solution containing a tannic acid-iron(III) complex. It quickly and effectively occluded the dentinal tubules of human teeth. It withstood intense tooth brushing and induced hydroxyapatite remineralisation within the dentinal tubules. This strategy holds great promise for future applications as an effective and user-friendly desensitizer for managing dental hypersensitivity.

Adhesive sealing of dentin surfaces in vitro: A review.

PURPOSE: This review describes the evolution of the use of dental adhesives to form a tight seal of freshly prepared dentin to protect the pulp from bacterial products, during the time between crown preparation and final cementation of full crowns. The evolution of these "immediate dentin sealants" follows the evolution of dental adhesives, in general. That is, they began with multiple-step, etch-and-rinse adhesives, and then switched to the use of simplified adhesives. METHODS: Literature was reviewed for evidence that bacteria or bacterial products diffusing across dentin can irritate pulpal tissues before and after smear layer removal. Smear layers can be solubilized by plaque organisms within 7-10 days if they are directly exposed to oral fluids. It is likely that smear layers covered by temporary restorations may last more than 1 month. As long as smear layers remain in place, they can partially seal dentin. Thus, many in vitro studies evaluating the sealing ability of adhesive resins use smear layer-covered dentin as a reference condition. Surprisingly, many adhesives do not seal dentin as well as do smear layers. RESULTS: Both in vitro and in vivo studies show that resin- covered dentin allows dentin fluid to cross polymerized resins. The use of simplified single bottle adhesives to seal dentin was a step backwards. Currently, most authorities use either 3-step adhesives such as Scotchbond Multi-Purpose or OptiBond FL or two-step self-etching primer adhesives, such as Clearfil SE, Unifil Bond or AdheSE.

The evaluation of dentinal tubule occlusion by desensitizing agents: a real-time measurement of dentinal fluid flow rate and scanning electron microscopy.

The aims of this study were to examine changes in dentinal fluid flow (DFF) during the application of a desensitizing agent and to compare the permeability reduction levels among different types of desensitizing agents. A cervical cavity was prepared for the exposure of cervical dentin on an extracted human premolar connected to a subnanoliter fluid flow measuring device under 20 cm of water pressure. The cavity was acid-etched with 32% phosphoric acid to make dentin highly permeable. The different types of desensitizing agents that were applied on the cavity were Seal&Protect as the light-curing adhesive type, SuperSeal and BisBlock as oxalate types, Gluma Desensitizer as the protein-precipitation type, and Bi-Fluoride 12 as the fluoride type. DFF was measured from the time before the application of the desensitizing agent throughout the application procedure to five minutes after the application. The characteristics of dentinal tubule occlusion of each desensitizing agent were examined by scanning electron microscopy. The DFF rate after each desensitizing agent application was significantly reduced when compared to the initial DFF rate before application for all of the desensitizing agents (p<0.05). Seal&Protect showed a greater reduction in the DFF rate when compared to Gluma Desensitizer and Bi-Fluoride 12 (p<0.05). SuperSeal and BisBlock exhibited a greater reduction in DFF rate when compared to Bi-Fluoride 12 (p<0.05). The dentin hypersensitivity treatment effects of the employed desensitizing agents in this study were confirmed through real-time measurements of DFF changes. The light-curing adhesive and oxalate types showed greater reduction in the DFF rate than did the protein-precipitation and fluoride types.

Water permeability, hybrid layer long-term integrity and reaction mechanism of a two-step adhesive system.

OBJECTIVES: Our aim was to investigate the reaction mechanism of formation of the hybrid layer by a HEMA-containing self-etch adhesive and to study fluid filtration, contact angle and interfacial ultrastructure by SEM following a 1 year ageing period. METHODS: Acidic behaviour and chemical interactions between Silorane System Adhesive and dentine were studied by potentiometric titrations, atomic absorption spectroscopy and infrared spectroscopy. The hydrophilicity of the adhesive was evaluated using the sessile drop method and dentine permeability by hydraulic conductance. The morphological study of the dentine/adhesive system interface was conducted using SEM. RESULTS: The Silorane System Adhesive behaved as a multi-acid with several different pK(a) values. When the adhesive was in contact with dentine, the acid was progressively consumed and calcium ions were released. The acrylate substituted phosphonate bound strongly to apatite crystals. The polyacrylic acid copolymer reacted with calcium ions and formed an interpenetrating polymer network (IPN). Water contact angle measurements showed rapid spreading on primer (angles reached 15 degrees at 30s) and larger contact angles when the Silorane bonding layer was added (from over 60 degrees to 44 degrees ). A thick, homogeneous hybrid layer was observed both initially and after 1 year of ageing, with a corresponding hydraulic conductance of -48.50% initially and -52.07% at 12 months. CONCLUSION: The Silorane System Adhesive is capable of both dissolving calcium ions and binding to apatite surfaces. The results showed the hydrophilicity of the adhesive, which formed an IPN-like hybrid layer that conserved adequate impermeability over a 1-year period.

Real-time measurement of dentinal fluid flow during amalgam and composite restoration.

OBJECTIVES: This study examined changes in the dentinal fluid flow (DFF) during restorative procedures and compared permeability after restoration among restorative materials and adhesives. METHODS: A class 1 cavity was prepared and restored with either amalgam (Bestaloy), or composite (Z-250) with one of two etch-and-rinse adhesives (Scotchbond MultiPurpose: MP and Single Bond 2: SB) or one of two self-etch adhesives (Clearfil SE Bond: CE and Easy Bond: EB) on an extracted human third molar which was connected to a sub-nanoliter fluid flow measuring device (NFMD) under 20 cm water pressure. DFF was measured from the intact tooth state through the restoration procedures to 30 min after restoration, and re-measured at 3 and 7 days post-restoration. RESULTS: Inward flow during cavity preparation was followed by outward flow after preparation. In amalgam restoration, the outward flow changed into an inward flow during amalgam filling, which was followed by a slight outward flow after finishing. In composite restoration, MP and SB showed an inward flow and outward flow for the rinsing and drying steps, respectively. Application of a hydrophobic bonding resin in the MP and CE systems caused a decrease in the flow rate. Air-drying of solvent for the CE and EB systems caused a sudden outward flow, whereas light-curing of the adhesive and composite caused an abrupt inward flow. CONCLUSIONS: Each restorative step clearly changed the direction and the rate of the DFF during restoration, which could be well identified with NFMD.

Fluid flow after resin-composite restoration in extracted carious teeth.

The aim of this study was to investigate fluid flow in dentin after restoration of carious teeth with resin composite bonded with a total-etching adhesive, with or without glass-ionomer cement lining. The roots of extracted third molars were removed and the crowns were connected to a fluid flow-measuring device. Each carious lesion was stained with caries detector dye and caries was removed using slow-speed burs and spoon excavators. Caries-excavated teeth were divided into two groups for restoration with resin composite bonded with a total-etch adhesive: (i) without lining; and (ii) lined with glass-ionomer cement before bonding. In non-carious teeth, cavities of similar dimensions were prepared, divided into two groups, and restored in the same manner. Fluid flow was recorded, after restoration, for up to 1 month. Caries-affected dentin was examined by scanning electron microscopy (SEM), and the bonded interfaces were observed using a confocal laser scanning microscope. No significant difference in fluid flow was observed between the two restorative procedures or between the carious and non-carious groups. The SEM images showed that the dentinal tubules of acid-etched, caries-affected dentin were usually still occluded, while some were patent. Limited penetration of fluorescent dye into dentin and into the bonded interfaces of restored carious teeth was observed.

Fluoropolymers as low-surface-energy tooth coatings for oral care.

A range of low-surface-energy fluoropolymers has been synthesised and their effectiveness as dental-care coatings for plaque, stain and erosion prevention has been evaluated using a series of oral care models employing pressed discs of calcium hydroxyapatite or sections of human teeth. Since the blocking of dentinal tubules is a key mechanistic strategy in the treatment of dentine hypersensitivity, the capability of these non-permanent fluoropolymer coatings to occlude the pore structure of human dentine and to reduce the outward flow of simulated dentinal fluid has also been investigated. Several of the fluoropolymer coatings have been found to inhibit bacterial adhesion but no correlation has been established between anti-adhesion efficacy and fluorine content or surface energy. All the fluoropolymers have been seen to reduce stain uptake by pellicle-coated HA discs, with homopolymers being considerably more effective than copolymers. Some fluoropolymer coatings have also been shown to inhibit the acid demineralisation of hydroxyapatite discs and to reduce dentine permeability. Coatings of the 2:1 copolymer of 1H,1H,2H,2H-perfluorodecyl acrylate and 2-hydroxyethyl acrylate are most promising, exhibiting significant anti-adhesion and anti-erosion efficacy and reducing dentine permeability to a level that is comparable with that achieved with the standard treatment employed in commercial anti-sensitivity formulations.

The relationship between the discharge of intradental nerves and the rate of fluid flow through dentine in the cat.

OBJECTIVE: To investigate further the relationship between dentinal tubular flow and the discharge evoked in intradental nerves. DESIGN: In anaesthetised cats, recordings were made of fluid flow through dentine during the application of hydrostatic pressure stimuli of 5 s duration in the range +500 to -500 mm Hg to exposed dentine and of the nerve impulses evoked by these stimuli. Single unit recordings were obtained from filaments dissected from the inferior alveolar nerve and multi-unit recordings, from the exposed dentine. RESULTS: Of 20 single units tested, 10 (conduction velocities: 2.4-36.2 m s(-1)) responded to negative pressures and four of these, also to positive pressures. None responded to only positive pressures. The pressure thresholds of the units (single and multi-unit preparations) ranged from -100 to -500 and +100 to +500. In terms of flow (measured 1 s after the start of a stimulus) the thresholds ranged from 0.4 to 2.2 nl s(-1) mm(-2) exposed dentine with outward flow, and 0.4-2.1 nl s(-1) mm(-2) with inward flow. The outward flow per tubule at the threshold of the most sensitive units was estimated to be 21 fl s(-1) and the corresponding mean velocity of the contents of the dentinal tubules at their pulpal ends, 27 microm s(-1). Although the thresholds to outward and inward flow were similar, with outward flow the mean discharge rate increased with stimulus intensity; whereas with inward flow few impulses were evoked and the number was little affected by the stimulus intensity. CONCLUSION: The transduction mechanism that generates impulses in hydrodynamic intradental afferents is much more responsive to outward than inward flow through the dentinal tubules, although the thresholds in both directions are similar.

Conversion of one-step to two-step self-etch adhesives for improved efficacy and extended application.

PURPOSE: One-step self-etch adhesives have restricted use due to their acid-base incompatibility with autocured composites and their behavior as permeable membranes after polymerization. This study examined the feasibility of their conversion to two-step self-etch adhesives via the adjunctive use of a non-solvented, relatively hydrophobic resin coating. METHODS: iBond, Xeno III and Adper Prompt were used either in multiple coats, or in a single coat followed by the use of a layer of Scotchbond Multi-Purpose Plus bond resin for coupling to light- and auto-cured composites. Four types of experiments were performed. Bonded specimens were examined with TEM after immersion in an ammoniacal silver nitrate tracer. Fluid flow measurements of iBond were conducted using the two application protocols to compare the permeability of the bonded dentin with the original smear layer. Permeability of vital dentin bonded with both application protocols were compared for the transudation of dentin fluid across the bonded dentin. Microtensile bond strengths of dentin bonded with the two protocols were examined for their compatibility with an auto-cured composite. RESULTS: The results of the four experiments were complementary. iBond and Xeno III exhibited "apparent incompatibility" to auto-cured composites that resulted from their inherent permeability. This was confirmed by the presence of dentin fluid transudate on the adhesive surfaces when they were bonded to vital dentin. Conversely, Adper Prompt exhibited "true incompatibility" to auto-cured composites that was caused by adverse acid-base interaction, masking the inherent permeability of this adhesive. "True" and "apparent" incompatibility issues were eliminated upon their conversion to two-step self-etch adhesives.

In vivo fluid movement through dentin adhesives in endodontically treated teeth.

Fluid transudation through simplified dentin adhesives can occur in bonded vital crown dentin, since these adhesives behave as permeable membranes after polymerization. The effect of adhesive permeability in endodontically treated teeth is unknown. This study examined the hypothesis that in vivo fluid movement through simplified adhesives occurs when they are applied to root canals. Dowel spaces were prepared in endodontically treated teeth with single root canals. Six adhesives were applied to the intra-radicular dentin of canal walls. Impressions were obtained with polyvinyl siloxane, and replicas were fabricated with the use of polyether impression material. Replica hemisections were gold-coated for SEM examination. Fluid transudation was evident on the adhesive surfaces of all simplified total-etch and self-etch adhesives. Conversely, most of the specimens bonded with the control three-step total-etch adhesive were devoid of fluid droplets. Permeability of simplified adhesives results in water movement, even in root-treated dentin. This may adversely affect the coupling of auto-/dual-cured resin cements.

Single-bottle adhesives behave as permeable membranes after polymerization. I. In vivo evidence.

OBJECTIVES: This study tested the hypothesis that single-bottle total-etch adhesives are effective in reducing dentine permeability under in vivo conditions. METHODS: Crown preparations on vital human teeth were performed under local analgesia as part of the treatment plan for prosthetic rehabilitation. Four single-bottle adhesives (Single Bond, 3M ESPE; Excite DSC, Ivoclar Vivadent; Prime and Bond NT Dual-Cure, Dentsply DeTrey and One-Step, Bisco Inc.) were applied to the cut dentine after acid-etching. Polyvinyl siloxane impressions were taken, using an ultra-low viscosity impression material, of the smear layer-covered dentine before applying the adhesives to deep vital dentine, and after adhesive placement. Additional impressions were taken of the adhesive-sealed dentine following the removal of the provisional prostheses after a 7-10 day period. Epoxy resin replicas of the crown preparations were examined with scanning electron microscopy to evaluate the extent of dentinal fluid transudation during pre-bonded, immediately bonded and post-bonded periods. RESULTS: Dentinal fluid transudation from localised areas that were close to the dental pulp was universally observed from all epoxy resin replicas, irrespective of the adhesive employed. The transudation of dentinal fluid from the control smear layer-covered dentine of each crown preparation was comparatively mild when compared to the extent that was observed after total-etching and application of the single-bottle adhesive. Dentinal fluid droplets were specifically located over the surface of the adhesive layer. Continuous transudation of dentinal fluid occurred even after the removal of the provisional prostheses, and was considerably more profuse in subjects who opted for the fitting of the permanent prostheses without the use of a local anaesthetic solution. CONCLUSION: Single-bottle adhesives, because of their lack of a comparatively more hydrophobic bonding resin layer, behave as permeable membranes after polymerisation. They permit the continuous transudation of dentinal fluid and do not provide a hermetic seal in vital deep dentine. Although the relatively slow rate of diffusion of dentinal fluid is unlikely to result in post-operative cold sensitivity, it may interfere with the optimal polymerisation of dual-cured or auto-cured composites or resin cements in both direct and indirect restorations.

In vitro evaporative vs. convective water flux across human dentin before and after conditioning and placement of glass-ionomer cements.

PURPOSE: To assess the convective and evaporative fluid movement across glass-ionomer treated dentin. METHODS: Crown segments made from extracted human teeth, were divided into two groups of 14 teeth each. Each segment was cemented onto a plexiglass slab penetrated by a stainless steel tube, permitting filling of the pulp chamber with water. This set-up was attached to a device that measured fluid movement through the dentin in the crown segment. The experimental design involved repeated measurements of convective and evaporative fluid movements in each of the following conditions: smear layer-covered dentin, conditioned dentin, dentin after placement of one of two glass-ionomers (Fuji IX or Ketac-Molar), with and without a protective coating. The same water fluxes were remeasured after storage of the samples for 24 hours in distilled water. RESULTS: Statistical analysis of the results using ANOVA indicated a significant difference between the two measured water fluxes (P < 0.001). There was also a significant difference between the two materials (P < 0.001), with Ketac-Molar allowing higher permeability than Fuji IX. Conditioning the dentin surface with polyacrylic acid increased the convective water flux (P < 0.05) but did not change the evaporative water flux. Placement of the glass-ionomer material did not change the rate of spontaneous evaporation of water from the dentin, but the application of a coating agent reduced the evaporative water loss. These values were not significantly different when the specimens were stored for 24 hours.

The use of the replica technique to record fluid emerging from exposed dentine.

The effect of pulpal cavity pressure on structures present on etched and unetched dentine was determined in 24 human premolars in vitro. The dentine was exposed in vivo. After extraction, the pulp was removed and the crown stored in 2.5 N sodium hydroxide for 3 days to remove the odontoblasts. The pulp cavity was filled with Ringer's solution at atmospheric pressure, +30 or -5 mmHg. After 30s-5 min a silicone-rubber impression was taken of the cavity floor and a resin cast prepared and examined in a SEM. The replicas reproduced the dentine surface accurately when there was no outward flow through dentine. With a pressure of + 30 mmHg in the pulp cavity, but not at the lower pressures, droplets were present on unetched dentine after 30s. Droplets accumulated less rapidly on etched dentine, indicating that it may act as a sponge.

2000 Judson C. Hickey Scientific Writing Award. Effect of impression materials on hybridized dentin.

STATEMENT OF PROBLEM: Tooth sensitivity after crown preparation is not an uncommon complication. For dentin bonding agents to be effective in preventing postoperative sensitivity, they must remain intact throughout the fixed prosthodontic procedures. PURPOSE: This study evaluated, by analyzing the change in dentin permeability, whether a dentin bonding agent was removed from the surface of prepared teeth in the process of making an impression. MATERIAL AND METHODS: Eighty extracted human molars were cut horizontally apical to the cemento-enamel junction and horizontally through the middle of the clinical crown. The specimens were prepared to measure dentin permeability (fluid flow rate, Lp). The specimens (n = 40) were randomly assigned to either the primer-only group (PO) or the primer + adhesive group (PA). Five different impression materials were tested: vinyl polysiloxane, polyether, polysulfide, irreversible hydrocolloid, and reversible hydrocolloid. Dentinal permeability was measured after smear layer removal (control, etched Lp = ELp), after coating the dentin with either PO or PA (coated Lp = CLp), and again after making an impression (impression Lp = ILp). A 1-way ANOVA of differences, followed by a Student-Newman-Keuls test (alpha=.05), was performed to compare the ELp, CLp, and ILp values. RESULTS: A statistically significant difference was found between the CLp and ELp for all 5 impression materials in both groups (PO and PA). No difference was found between the CLp and ILp values for any of the impression materials. No significant differences were found between any of the 5 impression materials or either of the dentin surface treatments (PO or PA) when measuring the CLp and ILp. CONCLUSION: The dentin bonding agent had a significant effect in decreasing the Lp of the treated specimens. None of the impression materials significantly affected the measured CLp. There was no significant difference between the PO or PA (CLp) values.

Odontoblast function seen as the response of dentinal tissue to dental caries.

Microbes are responsible for the initiation and maintaining of carious processes. They have an efficient machinery for dissolving crystalline hydroxyapatite. When initiating carious processes, microbial acid formation determines the rate of the process in enamel. When the process reaches dentin, the micro-environment changes. Dential fluid in dentin tubules is the liquid where dissolving products of apatites are destroyed. Inorganic composition of dentinal fluid, however, is not altered much during the carious process, indicating that a functional secretory domain is working to pump the dissolved calcium and phosphate ions out of the fluid. Activation of odontoblast alkaline phosphatase and dentin latent collagenases is the known cellular event during the carious process in dentin. Because the caries lesion is by definition undermining, this suggests that, in this degradation process, the extracellular compartment, crystalline hydroxyapatite is dissolved by microbial acids, and a mixture of proteinases degrades the organic matrix. The degradation products of collagen and other matrix components in dentinal fluid must be transported either through the caries lesion in the enamel to saliva or through the odontoblast to the pulp (active transport). This facilitates further processing of the degradation products intracellularly during the passage through the cell.

Self-contamination of deep dentin by dentin fluid.

PURPOSE: To compare, with the use of a resin replica technique, surface features of deep, acid-conditioned dentin from vital human molars that were anesthetized with an anesthetic: Group 1: without a vasoconstrictor (Mepivacaine 3%), and Group 2: containing a vasoconstrictor (Lidocaine 2% with 1:80,000 epinephrine). MATERIALS AND METHODS: 10 Class I cavities with dentin caries were included in each group. Following complete caries removal, a total-etch technique was performed with 32% phosphoric acid (Uni-Etch) for 15 s. After rinsing, each cavity was air-dried for 1 s, then a slow setting vinyl polysiloxane (President) impression was taken. As a control, impressions were taken from three additional cavities in teeth that were anesthetized with Mepivacaine 3% but not acid etched. A TEM-grade epoxy resin was used to prepare replicas from the impressions. Polymerized replicas were coated with gold and examined with a scanning electron microscope. RESULTS: In Group 1, fluid was visible leaving tubular orifices in all replicas. In addition, three were covered with a smooth, amorphous film that was different from the granular appearance of the smear layer in the control cavities. In Group 2, patent tubular orifices without fluid were observed in all specimens. Odontoblast process-like structures were seen from some dentin tubules.