Effect of water glass treatment for zirconia and silane coupling on bond strength of resin cement.

OBJECTIVE: To evaluate the ability of the water glass treatment to penetrate zirconia and improve the bond strength of resin cement. MATERIAL AND METHODS: Water glass was applied to zirconia specimens, which were then sintered. The specimens were divided into water-glass-treated and untreated zirconia (control) groups. The surface properties of the water-glass-treated specimens were evaluated using surface roughness and electron probe micro-analyser (EPMA) analysis. A resin cement was used to evaluate the tensile bond strength, with2 and without a silane-containing primer. After 24 h in water storage at 37 °C and thermal cycling, the bond strengths were statistically evaluated with t-test, and the fracture surfaces were observed using SEM. RESULTS: The water glass treatment slightly increased the surface roughness of the zirconia specimens, and the EPMA analysis detected the water glass penetration to be 50 µm below the zirconia surface. The application of primer improved the tensile bond strength in all groups. After 24 h, the water-glass-treated zirconia exhibited a tensile strength of 24.8 ± 5.5 MPa, which was significantly higher than that of the control zirconia (17.6 ± 3.5 MPa) (p < 0.05). After thermal cycling, the water-glass-treated zirconia showed significantly higher tensile strength than the control zirconia. The fracture surface morphology was mainly an adhesive pattern, whereas resin cement residue was occasionally detected on the water-glass-treated zirconia surfaces. CONCLUSION: The water glass treatment resulted in the formation of a stable silica phase on the zirconia surface. This process enabled silane coupling to the zirconia and improved the adhesion of the resin cement.

Comparative analysis of microbiome in coronal and root caries.

BACKGROUND: The global rise in the elderly population has increased the prevalence of root caries. Streptococcus mutans, Lactobacilli and Actinomyces are considered the primary pathogens of dental caries in culture-based studies. This study aimed to investigate bacterial profiles in coronal and root caries lesions and determine the association of specific bacterial genera at each site. METHODS: Dentine samples from carious lesions were collected from 22 extracted teeth using an excavator. Microbial DNA was extracted from the samples using a protocol developed for this study. 16S rRNA gene amplicon sequencing was employed for microbial analysis. PCR amplification targeted the V3-V4 region of the bacterial 16S rRNA, and the amplicon sequencing used an Illumina MiSeq system (2 × 300 bp paired-end reads). Statistical analysis was performed by the Phyloseq and DESeq2 packages in R. RESULTS: In coronal caries, Olsenella, Lactobacillus and Prevotella were the most prevalent genera, comprising approximately 70% of the microbiome community. In the root caries, however, although Olsenella, Prevotella and Lactobacillus remained the dominant genera, they accounted for only half of the microbiome community. This study identified significant differences in alpha diversity indices between the coronal and root caries. LEfSE analysis revealed several unique genera in each caries lesion. CONCLUSION: The microbiome of root caries lesions was richer and more complex than the coronal caries microbiota. The results suggest that lesion-related variations in the oral microflora may be detected in carious dentine.

The bleaching effect of office bleaching agents containing S-PRG filler evaluated by pH value and electron spin resonance.

OBJECTIVES: Surface reaction-type pre-reacted glass-ionomer (S-PRG) filler releases six types of ions with a neutralizing ability. This study evaluated the effect of S-PRG filler incorporation in an H2O2-based bleaching material on the bleaching efficacy, pH, and reaction state. MATERIALS AND METHODS: The experimental bleaching material was formulated by the addition of 5% or 10% S-PRG fillers to the powder part. The stained bovine teeth were treated with the prepared bleaching paste. Commission internationale de l'éclairage (CIE) L*a*b* color space values were recorded before and after bleaching, and the color difference (ΔE) and whiteness index (WID) were calculated. Moreover, the used bleaching formulations were assessed for their pH values and reaction state by evaluating the oxidation state of manganese (Mn+2) using electron spin resonance (ESR). RESULTS: The results of ΔE and WID showed that the addition of S-PRG filler increased the bleaching effect, but there was no significant difference between the groups with 5% and 10% S-PRG filler. A significant increase in pH in S-PRG filler groups (5% pH 6.7, 10% pH 6.8) was found compared to the 0% group (pH 4.8). ESR measurements showed that the signal emitted from Mn+2 decreased over time. The S-PRG filler groups showed a significantly higher reduction in Mn+2 compared to the 0% group, with no significant difference between the 5% and 10% S-PRG groups. CONCLUSIONS: S-PRG filler addition resulted in improved bleaching efficacy, higher reaction rate, and pH values that are close to neutral. CLINICAL RELEVANCE: S-PRG filler addition may be effective on the bleaching outcome of H2O2-based materials.

Dentin anti-demineralization potential of surface reaction-type pre-reacted glass-ionomer filler containing self-adhesive resin cement.

OBJECTIVE: To investigate the anti-demineralization potential of a newly developed surface reaction-type pre-reacted glass-ionomer (S-PRG) filler containing self-adhesive resin cement against acidic attacks on the dentin surface. MATERIALS AND METHODS: A total of 32 bovine teeth were used. Cavities were prepared on crown dentin slaps and filled with three self-adhesive resin cement: (1) S-PRG-based cement, (2) Si-based cement, and (3) RelyX cement. Specimens were then subjected to pH cycling for 28 days, and the depth of demineralization was assessed using swept-source optical coherence tomography (SS-OCT) after 7, 14, 21, and 28 days. Sixty-four root dentin blocks were divided into four groups and then subjected to a pH cycling procedure with the aforementioned three material blocks and one negative control. The mineral loss was observed using transverse microradiography (TMR), and the surface microhardness (SMH) test was conducted to investigate the mechanical properties of treated dentin surfaces. RESULTS: The depth of demineralization for the S-PRG-based cement was significantly lower than that of the Si-based cement after 7, 21, and 28 days. Conversely, the RelyX cement was not significantly different from the Si-based cement after 7, 14, and 21 days (p < 0.05). Regarding the TMR and SMH test, the S-PRG-based cement showed the least mineral loss with the highest resistance to acidic challenge. CONCLUSION: The S-PRG filler containing resin cement can reduce mineral loss and promote remineralization of dentin substrate and has the potential to preserve dentin integrity and resist acidic attack. Clinical significance Self-adhesive resin cement containing S-PRG fillers maintained the surface integrity of dentin after exposure to 28 days of acidic challenge with a significant anti-demineralization effect.

The effect of surface pre-reacted glass-ionomer filler eluate on dental pulp cells and mineral deposition on dentin: In vitro study.

The effects of surface pre-reacted glass-ionomer (S-PRG) filler on pulpal cells and on the composition of dentinal deposits were investigated. Proliferation (CCK-8), cytotoxicity (LDH), and differentiation activity (ALP) tests, along with cell morphology observations, were conducted at 6 and 24 h after treatment of pulpal cells with different S-PRG filler eluate concentrations. Dentinal surfaces were immersed in deionized water or S-PRG filler eluate followed by immersion in deionized water or simulated body fluid and observed under scanning electron microscope and elemental analysis using energy dispersive x-ray spectrometer. At 24 h, there were significant differences in CCK-8 and ALP activity values between the groups in a concentration-dependent manner. LDH test data were not significantly different among the groups. Cell morphology was not altered at either exposure time. However, decreased cellular density was observed with the highest eluate concentration. Crystalline deposits and occluded dentinal tubules were observed in samples immersed in S-PRG filler with a later immersion in simulated body fluid, which also showed higher concentrations of certain ions compared to surfaces that were not initially treated with S-PRG filler. The lowest two eluate concentrations did not show significant toxicity. S-PRG enhanced the effect of simulated body fluid in the formation of mineral deposits.

Effects of a surface prereacted glass-ionomer filler coating material on biofilm formation and inhibition of dentin demineralization.

OBJECTIVES: This study investigated the ability of a surface prereacted glass-ionomer (S-PRG) coating material to inhibit the biofilm formation and demineralization of dentin. METHODS AND MATERIALS: Dentin specimens were randomly divided into three groups: (1) no coating (control), (2) S-PRG filler-containing coat, and (3) a nonS-PRG filler-containing coat. Streptococcus mutans biofilms were grown on the dentin surfaces in a microcosm for 20 h. Then, the quantity of bacteria and water-insoluble glucan in the retained biofilm on the dentin surface were measured. Regarding demineralization inhibition test, specimens were demineralized for 5 days then sectioned into halves and observed under confocal laser scanning microscope (CLSM). One-way ANOVA and Tukey's HSD were used for statistical analysis. RESULTS: The estimated mean surface roughness for specimens in the S-PRG group was statistically significantly higher than the estimates for both the nonS-PRG and the control group specimens. The quantity of bacteria and water-insoluble glucan/mm2 revealed that the S-PRG group prevented biofilm formation and bacterial adhesion to the dentin surface compared with the control and nonS-PRG groups. The S-PRG group recorded the highest acid-resistance ability with no surface loss. CONCLUSION: Application of S-PRG barrier coat on dentin surfaces can inhibit biofilm formation as well as protecting the dentin surface against demineralization. CLINICAL SIGNIFICANCE: Coating material containing S-PRG fillers might be used for caries prevention, through inhibiting biofilm formation, enhancing mineralization, and reducing acidic attack by cariogenic bacteria.

Effect of photo-thermal acceleration on in-office bleaching.

The purpose is to evaluate the effect of photo-thermal acceleration on in-office bleaching efficiency using a bleaching agent without photocatalysts in vitro. Artificially discolored bovine lower incisors were prepared, and the mixed in-office bleaching material contained hydrogen peroxide 23% was applied by following treatment for 10 min: high-(HI group) and low-intensity LED lights (LI group), oven at 38 °C (OV group), and room temperature at 23 °C (RT group). Color was measured before and after bleaching and color difference (∆E*) was calculated. The data were statistically analyzed using a two-way ANOVA and Tukey's post hoc test. The temperature change (∆T) of applied bleaching agent in HI and LI groups was measured using a thermography and was analyzed using a T test. The bleaching procedures were repeated 6 times. Irradiation in the HI group resulted in the highest ΔE, followed by the LI group whose ΔE was significantly lower. Both irradiated modes exhibited higher ΔE compared to non-irradiated OV and RT groups which were not significantly different from each other. The average temperature rise of bleaching agents in HI and LI groups after 10 min irradiation was 15.00 °C and 11.80 °C, respectively. The effect of photo-thermal acceleration was proved for an in-office bleaching agent without photocatalysts in vitro.

Swept-source optical coherence tomographic observation on prevalence and variations of cemento-enamel junction morphology.

To investigate the prevalence of different patterns of cemento-enamel junction (CEJ) morphology under swept-source optical coherence tomography (SS-OCT). One hundred extracted human teeth were used consisting of incisors, premolars, and molars. Each sample was observed for every 500 µm circumferentially along CEJ and OCT images of the pattern were noted. Microscopic observations were done for the representative sample using confocal laser scanning microscope (CLSM) and transmission electron microscope (TEM). The OCT images exhibited four CEJ patterns: edge-to-edge (type I), exposed dentin (type II), cementum overlapping enamel (type III), and enamel overlapping cementum (type IV). The prevalence of CEJ patterns was further statistically considered for mesial, distal, buccal, and lingual surfaces. The real-time imaging by SS-OCT instantly determined CEJ morphology. CLSM and TEM observation revealed morphological features along CEJ, which corresponded to OCT images of CEJ anatomy. OCT results showed 56.8% of type I pattern predominantly found on proximal surfaces, followed by 36.5% of type II pattern on buccal and lingual surface, 6.4% of type III pattern, and 0.3% of type IV pattern. There was a significant difference in prevalence of CEJ patterns among different types of teeth, but there was no statistically significant difference among the four surfaces in each type of teeth. OCT is a non-invasive diagnostic tool to examine the CEJ patterns along the entire circumference. OCT observation revealed even minor dentin exposure that would need clinical and home procedures to prevent any symptoms.

Effect of Silver Diamine Fluoride on Reducing Candida albicans Adhesion on Dentine.

BACKGROUND: Candida albicans is the most frequent pathogenic fungus in oral cavities. It adheres to dental tissues as part of dental plaques and contributes to caries formation. OBJECTIVES: To evaluate the effect of silver diamine fluoride (SDF) on reducing C. albicans adhesion on dentine surfaces. METHODS: Flat dentine surfaces were prepared from bovine dental disks, and samples were divided into three groups. The first and second groups were pretreated for 3 min with 299 mM or 2.99 M SDF, respectively, and the third group (control) did not undergo any SDF pretreatment. All samples were washed, inoculated with C. albicans suspension onto their dentine surface, incubated at 30 °C for 6 h, and washed again to remove any nonadherent cells. The abundance of adherent cells was investigated using colorimetric and real-time polymerase chain reaction approaches. Subsequently, the morphological changes in C. albicans by pretreatment with SDF were observed under a scanning electron microscope (SEM). RESULTS: SDF inhibited candidal growth at concentrations as low as 2.99 µM. Dentine disks pretreated with 299 mM or 2.99 M SDF displayed significantly fewer adhered cells as compared with the control group. Upon pretreatment with SDF, SEM images showed severe morphological changes in the cellular walls, in a dose-dependent manner, suggesting a fungicidal effect of SDF against the yeast. CONCLUSION: SDF should be considered for clinical applications aimed at inhibiting dental plaque caused by C. albicans, particularly in children and elderly individuals.

Effects of Different Tooth Conditioners on the Bonding of Universal Self-etching Adhesive to Dentin.

PURPOSE: To investigate the effect of different etching products used prior to the application of universal self-etching adhesive on dentin bonding. MATERIALS AND METHODS: The etching products Multi Etchant (ME), Enamel Conditioner (EC), and K-etchant GEL (KE) were used as pre-treatments prior to the application of the one-bottle self-etching adhesive Adhese Universal (AU). Ground human dentin surfaces were randomly divided into four treatment groups: 1. control (CT; AU without con-ditioner); 2. ME; 3. EC; 4. KE. Microtensile bond strength (µTBS) tests with a thermocycling challenge (0-TC or 10,000-TC) were carried out and the morphological attributes of the adhesive-dentin interface were observed after an acid-base challenge using SEM to observe the acid-base resistant zone (ABRZ). RESULTS: The KE group had a statistically significantly lower µTBS than did the ME and EC groups at 0-TC, and than the CT, ME, and EC groups at 10,000-TC (p < 0.05). An ABRZ was observed in all groups but had partially disappeared in KE. A funnel-shaped area of erosion was also observed at the junction of the dentin and bonding layer in the CT, ME, and EC groups, while the hybrid layer was thicker in the KE group with no evidence of erosion. CONCLUSION: The application of ME or EC did not reduce the microtensile bond strength and resulted in ABRZ formation, while the ABRZ was partially reduced in the KE group.

Effect of Glutathione Bio-Molecule on Tooth Discoloration Associated with Silver Diammine Fluoride.

This study evaluated the effect of Glutathione (GSH) bio-molecule on the reduction of enamel and dentin discoloration after application of 38% silver diammine fluoride solution (SDF). One hundred and twenty bovine teeth specimens were used. The enamel and dentin specimens were divided into three groups: (1) SDF only (control); (2) SDF followed by application of a potassium iodide solution (KI); and (3) SDF mixed with 20% GSH. Half the specimens were exposed to light and the remainder kept in dark conditions (n = 10) Color changes were measured using a spectrophotometer at the following time intervals: before solution application (baseline) and immediately after application, then 3, 6, 24, 48, 72 h, and 7, 10 and 14 days. SEM/EDS analysis was performed on treated enamel and dentin. Statistical analysis was done using a repeated measures ANOVA test. The spectrophotometer results showed that the SDF group exhibited the greatest color changes under both light exposed and dark conditions, while SDF + GSH group was effective in decreasing the color changes in both light and dark conditions. The SDF + KI group showed an insignificant color changes over time. SEM/EDS analysis showed different patterns for the silver crystal formation in each group (SDF, SDF + GSH, and SDF + KI group). It was concluded GSH can effectively minimize color changes after application of SDF, especially on enamel and to a lesser extent on dentin.

Effect of borate, fluoride and strontium ions on biomimetic nucleation of calcium phosphate studied using solid-state nuclear magnetic resonance and X-ray diffraction.

OBJECTIVES: Apatite minerals can have various anions and cations in their crystal structure in addition to phosphate ion (PO4³â») and calcium ion (Ca2+). The aim of this study is to investigate effects of the borate, fluoride and strontium ions on biomimetic nucleation of calcium phosphate. METHODS: Nano-crystalline hydroxyapatite (H-Ap) was obtained from a supersaturated buffered solution containing 4.12 mM HPO42- and 5.88 mM Ca2+ (H-Ap). Four additives were used in solid solution methods: (i) 0.588 mM F- (F-Ap), (ii) 5.88 mM Sr2+ (Sr-Ap), (iii) 4.12 mM BO33- (BO3-Ap), and (iv) a surface pre-reacted glass ionomer (S-PRG) filler eluate that contained 0.17 mM Sr2+, 0.588 mM F-, 11.1 mM BO33-- (SPRG-Ap). Apatite crystallization was investigated using a solid-state magic-angle spinning NMR spectroscopy and X-ray diffraction (XRD) with the Rietveld analysis. RESULTS: A 2D 1H-31P heteronuclear-correlation NMR showed F- ion incorporation in the apatite structure of the F-Ap and SPRG-Ap. The peaks on the 31P axis of the F-Ap, Sr-Ap, and BO3-Ap were different from that of the H-Ap, and the full width at half maximum increased in the following order: H-Ap∼F-Ap∼BO3-Ap< SPRG-Ap< Sr-Ap, suggesting the incorporation of the F-, Sr2+ and BO33-. The incorporation of F and BO3 was further confirmed by 19F and 11B NMR. The XRD revealed that Sr2+ was preferentially incorporated into the CaII site. SIGNIFICANCE: The F-, Sr2+ and BO33-ions might be involved in modifying the crystallization of apatite precipitation, producing a variety of apatite. S-PRG filler that release these ions may have an effect on remineralization, i.e., the reformation of apatite lost due to caries.

Influence of surface pre-reacted glass-ionomer (S-PRG) filler eluate on collagen morphology, remineralization, and ultimate tensile strength of demineralized dentin.

OBJECTIVE: To evaluate the effect of ions released from surface pre-reacted glass-ionomer (S-PRG) filler on collagen morphology, remineralization, and ultimate tensile strength (UTS) of demineralized dentin. MATERIALS AND METHODS: Bovine incisor root dentins were demineralized with EDTA and divided into three treatment groups: 1) water (control); 2) S-PRG filler eluate; 3) 125 ppm sodium fluoride (NaF). After a 3-min treatment, the specimens were stored in simulated body fluid (SBF) for 3 months. Collagen morphology and remineralization were assessed using transmission electron microscopy (TEM), scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR). Additionally, ultimate tensile strength (UTS) was measured. RESULTS: TEM and SEM demonstrated that S-PRG induced more effective remineralization compared to NaF, while the control group exhibited faint mineral deposition with collagen degradation. S-PRG displayed the most homogenous mineral deposition in collagen fibrils, along with closure of interfibrillar spaces. Extensive mineral precipitation was observed within dentinal tubules in the S-PRG group. In addition, S-PRG filler eluate demonstrated significantly higher phosphate-to-amide ratio and UTS compared to NaF and control groups (p < 0.05). CONCLUSIONS: Ion released from S-PRG filler positively influenced collagen morphology, remineralization, and ultimate tensile strength of demineralized dentin. CLINICAL SIGNIFICANCE: S-PRG filler enhances remineralization and improve the biomechanics of demineralized dentin.

Effect of phytic acid used as etchant on bond strength, smear layer, and pulpal cells.

This study aimed to evaluate the effect of phytic acid (IP6), used as etchant, on resin-dentin bond strength, smear layer removal, and the viability of pulpal cells. Flat dentin surfaces with smear layer were etched with 1% IP6 for 60, 30, or 15 s; in the control group 37% phosphoric acid (PA) was used. Dentin surfaces were rinsed, blot-dried, and bonded with an etch-and-rinse adhesive, followed by composite build-ups. The specimens were subjected to tensile testing after 24 h of water storage at 37°C, and failure modes were determined using scanning electron microscopy. The effectiveness of IP6 to remove the smear layer was observed using scanning electron microscopy. To evaluate the effect on pulpal cells, solutions of 0.1 and 0.01% IP6 and of 3.7 and 0.37% PA were prepared and rat pulpal cells were treated with these solutions for 6 and 24 h. Cell viability was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The results demonstrated that all application times of IP6 produced bond-strength values that were significantly higher than that of the control. Phytic acid effectively removed the smear layer and plugs, thus exposing the collagen network. Phytic acid had a minimal effect on pulpal cells, whereas PA resulted in a marked decrease in their viability.

Effect of an In-Office Bleaching Agent with Surface Pre-Reacted Glass-Ionomer Filler on the Enamel Surface: A In-Vitro Study.

In-office bleaching with high concentrations of hydrogen peroxide (H2O2) agents causes undesirable alterations in the enamel. Surface pre-reacted glass-ionomer (S-PRG) filler is a functional material known for its acid-neutralizing and demineralization-inhibition properties. This study evaluates the effect of S-PRG filler incorporation in H2O2-based bleaching on the enamel surface. Bovine enamel surfaces were bleached using a bleaching paste formulated with a liquid (35% H2O2) and a powder containing 5% or 10% S-PRG filler. The surface roughness and the Vickers microhardness of the treated enamel surfaces were evaluated. The enamel surfaces were observed under a scanning electron microscope (SEM) and analyzed using energy dispersive X-ray (EDX) technology. The surfaces were challenged by citric acid and observed by SEM. The specimens bleached with the paste containing the S-PRG filler showed lower enamel surface roughness and higher microhardness values than did those bleached with the plain paste (0% S-PRG filler); meanwhile, there were no significant differences between the 5% or 10% S-PRG filler groups. The S-PRG filler groups showed enamel surface morphologies similar to those of the non-bleached enamel, according to SEM observation, and EDX analysis detected the presence of fluoride and strontium ions. The S-PRG filler groups showed a higher resistance to erosion. The S-PRG filler mitigated the detrimental effects of bleaching agents on the enamel surface and provided resistance to erosion.

In vitro remineralization assessment of enamel subsurface lesions using different percentages of surface reaction-type pre-reacted glass-ionomer containing gum-based material.

OBJECTIVE: To identify the remineralization activity of enamel subsurface lesions using different percentages of surface pre-reacted glass-ionomer (S-PRG) filler containing gum-base material. METHODS: Gum extracts from gum-base materials containing 0wt%, 5wt%, and 10wt% S-PRG filler were prepared as GE0, GE5, and GE10, respectively. A total of 50 bovine enamel specimens were used, and the polished enamel surface of a 3 × 3 mm2 window area was exposed. The specimens were then subjected to a demineralization solution for seven days to create a subsurface enamel lesion. Remineralization was then conducted for seven days using a protocol whereby the specimens were immersed three times a day in prepared gum extracts (0wt%, 5wt%, and 10wt%) and artificial saliva of pH 7 (Control) for 20 min at 37 °C. Thereafter, remineralization assessment was performed by using Swept Source Optical Coherence Tomography (SS-OCT) and micro-computed tomography (µCT). Surface morphology and elemental analysis were conducted by scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS). RESULTS: The depths of the demineralized lesions in the GE5 and GE10 groups were significantly lower than those of the Control and the GE0 groups. SEM observations of the enamel surface morphology of the GE5 and GE10 groups indicated remineralization with S-PRG filler-related elements present. CONCLUSION: The GE5 and GE10 S-PRG filler containing gum-base materials showed significantly improved surface remineralization and reduced demineralization of the enamel lesions. EDS analysis suggested that the released ions from the S-PRG filler might be responsible for surface remineralization. CLINICAL SIGNIFICANCE: The S-PRG filler containing gum-base material may have a significant remineralization effect and improve the surface morphology of enamel subsurface lesions.

Effect of Er: YAG laser irradiation with additional low energy on resin-dentin bonding and morphology of bonded interface.

OBJECTIVES: To examine the micro tensile bond strength (µTBS) and the resin-dentin interface on a laser-irradiated dentin surface using two different irradiation methods, with or without additional low-energy irradiation. METHODS: The flat bovine dentin surface was divided into three groups: i). control group (C group, no irradiation), ii) 80 mJ/pulse Er: YAG laser group (80 group), iii) 80 + 30 mJ/pulse Er: YAG laser group (80 + 30 group, with an additional 30 mJ/pulse). After the roughness of the dentin surface was recorded, Clearfil SE Bond 2 or Clearfil Universal Bond Quick (Kuraray Noritake Dental Inc., Tokyo, Japan) was applied. After the µTBS testing, the failure mode was observed. The bonded interface was assessed using Rhodamine-dye incorporated adhesives and observed by optical coherence tomography. RESULTS: The dentin surface showed opened dentinal tubules without a smear layer after irradiation. For both adhesives, the µTBS was significantly higher in 80 + 30 group than in the 80 group (p < 0.05). In the 80 group, the thickness of the adhesive layer was not uniform, and the dentin surface was occasionally in direct contact with the composite resin. The failure mode images showed that most of the fractures in the 80 group were at the sub-surface of irradiated dentin. The adhesive layers of the 80 + 30 groups were homogeneous. CONCLUSIONS: The dentin surface was rough and irregular by 80 mJ irradiation, which might result in an inadequate resin-dentin interface and the weak µTBS. The bonded integrity was mitigated by additional irradiation.

Polymerization shrinkage of light-cured conventional and bulk-fill composites -The effect of cavity depth and post-curing.

Volumetric shrinkage (VS) of conventional, bulk-fill, and core build-up resin-based composites (RBCs) of various thickness (1-5 mm) was measured using the modified bonded-disk method with confocal laser scanning microscopy. Additionally, the bottom-to-top ratio of Vickers hardness (%VH) was measured. Conventional RBCs exhibited significantly higher VS than bulk-fill and core build-up RBCs (p<0.05). As specimen thickness increased, VS relative to volume (%VS) and difference in VS at each depth (VSdepth) decreased. For conventional RBCs, there was a significant drop in VSdepth between 1 mm and 2 mm (p<0.05), and another drop was observed between 3 mm and 4 mm (p<0.05) where %VH decreased below 90%. For bulk-fill and core build-up RBCs, VSdepth decreased significantly between 2 mm and 3 mm (p<0.05), but %VH exceeded 90% even in 5 mm deep cavities. These results indicated that post-curing contributed to lower shrinkage in deeper layers, and that conventional RBCs were not adequately polymerized at the depth of over 3 mm.

Noninvasive diagnostic method using optical coherence tomography detected a vulnerable dentin enamel junction created by phosphoric acid etching.

To investigate the influence of phosphoric acid etching on the dentin enamel junction (DEJ) using optical coherence tomography (OCT). Human teeth were assigned to four groups: 1. control, no additional treatment (CT); 2. The primer of "SE Bond2" was applied (SE), 3. "Enamel Conditioner" was applied (EC), 4. "K-etchant syringe" was applied (KE). After treatment, the DEJ was observed using a laser microscope (CLSM), OCT, and scanning electron microscopy (SEM). Additionally, an ultimate tensile strength (UTS) test at the DEJ was performed. No cracks were observed by CLSM. In contrast, cracks were observed all samples by SEM. Additionally, OCT revealed a white line along the DEJ in all KE specimens and some EC specimens. The UTS test showed a significant difference between CT and KE. This study found that phosphoric acid etching may cause excessive demineralization and weaken the DEJ. This fragility was observed using a non-invasive diagnostic method using OCT.

Effect of chlorhexidine incorporation into dental adhesive resin on durability of resin-dentin bond.

PURPOSE: This study evaluated the effect of chlorhexidine (CHX) incorporation into experimental dentin adhesives with different hydrophilicities on the microtensile bond strength (µTBS) to dentin. MATERIALS AND METHODS: Flat, deep dentin surfaces were prepared from 60 extracted human third molars. Three ethanol-solvated (50 wt% ethanol/50 wt% comonomers) experimental adhesives with varying degrees of hydrophilicity were prepared for the CHX-free groups. For the CHX-containing groups, chlorhexidine diacetate was further added to the ethanol-solvated adhesives to form a concentration of 2.0 wt% CHX. Dentin surfaces were etched with 37% phosphoric acid for 15 s, rinsed and blot dried before bonding. The adhesives were generously applied to dentin with a microbrush for 15 s. A second application of fresh adhesive was made and light cured for 20 s (600 mW/cm2) after solvent evaporation. Composite buildups were made using Filtek Z250 (3M ESPE). The bonded teeth were sectioned into 0.9 mm x 0.9 mm beams and stressed to failure at a crosshead speed of 1 mm/min. Testing was performed 24 h after specimen preparation and 12 months after storage in artificial saliva. The µTBS data were analyzed using three-way ANOVA and Tukey's multiple comparison tests. Fractographic analysis was performed by SEM. RESULTS: Significant differences were observed for the three factors "adhesive hydrophilicity" (p < 0.001), "CHX incorporation" (p = 0.001), and "storage time" (p < 0.001). Interaction among these three factors was also significant (p < 0.001). Incorporation of CHX had no effect on the immediate bond strength of the three experimental adhesives (p > 0.05). After storage in artificial saliva, significant reduction in bond strength was observed in all adhesive groups, except for CHX-containing adhesive I (p < 0.001). The µTBS of the CHX-containing experimental adhesive III was significantly higher than the corresponding CHX-free adhesive (p < 0.001) after aging. CONCLUSION: When incorporated into hydrophilic dental adhesives, chlorhexidine can partially reduce the degradation of the resin-dentin bonds.