RESUMO
(1) Background: Dental caries, if diagnosed at the initial stage, can be arrested and remineralized by a non-operative therapeutic approach preserving tooth structure. Accurate and reproducible diagnostic procedure is required for the successful management of incipient caries. The aim of this study was to evaluate the diagnostic accuracy of 3D swept-source optical coherence tomography (3D SS-OCT) for enamel caries at smooth tooth surface if the lesion was with remineralization. (2) Methods: Forty-seven tooth surfaces of 24 extracted human teeth visibly with/without enamel caries (ICDAS code 0−3) were selected and used in this study. The tooth surfaces of investigation site were cleaned and visually examined by four dentists. After the visual inspection, SS-OCT scanning was performed onto the enamel surfaces to construct a 3D image. The 2D tomographic images of the investigation site were chosen from the 3D dataset and dynamically displayed in video and evaluated by the examiners. A five-rank scale was used to score the level of enamel caries according to the following; 1: Intact enamel. 2: Noncavitated lesion with remineralization. 3: Superficial noncavitated lesion without remineralization. 4: Deep nonvacitated lesion without remineralization. 5: Enamel lesion with cavitation. Sensitivity and specificity for 3D OCT image and visual inspection were calculated. Diagnostic accuracy of each diagnostic method was calculated using weighted kappa. Statistical significance was defined at p = 0.05. (3) Results: 3D SS-OCT could clearly depict enamel caries at smooth tooth surface as a bright zone, based on the increased backscattering signal. It was noted that 3D SS-OCT showed higher sensitivity for the diagnosis of remineralized lesions and deep enamel lesions without cavitation, as well as cavitated enamel lesions (p < 0.05). No significant difference of specificity was observed between the two diagnostic methods (p > 0.05). Furthermore, 3D SS-OCT showed higher diagnostic accuracy than visual inspection (p < 0.05). (4) Conclusions: Within the limitations of this in vitro study, 3D SS-OCT showed higher diagnostic capacity for smooth surface enamel caries than visual inspection and could also discriminate lesion remineralization of enamel caries.
RESUMO
Resin bonding to zirconia ceramic cannot be established by standard methods that are utilized for conventional silica-based dental ceramics. This study was aimed to examine the tensile bond strength of resin cement to zirconia ceramic using a new laboratory technique. Sixty-four zirconia ceramic specimens were air-abraded using Al2O3 particles and divided into two groups; the control group with no pretreatment (Control), and the group pretreated using the internal coating technique (INT), in which the surface of the zirconia specimens were thinly coated by fusing silica-based ceramic and air-abraded in the same manner. The specimens in each group were further divided into two subgroups according to the silane coupling agents applied; a mixture of dentin primer/silane coupling agent (Clearfil SE Bond Primer/Porcelain Bond Activator) or a newly developed single-component silane coupling agent (Clearfil Ceramic Primer). After bonding with dual-cured resin cement (Panavia F 2.0), they were stored in water for 24 h and half of them were additionally subjected to thermal cycling. The tensile bond strengths were tested using a universal testing machine. ANOVAs revealed significant influence of ceramic surface pretreatment (p<0.001), silane coupling agent (p<0.001) and thermal cycling (p<0.001); the INT coating technique significantly increased the bond strengths of resin cement to zirconia ceramic, whereas thermal cycling significantly decreased the bond strengths. The use of a single-component silane coupling agent demonstrated significantly higher bond strengths than that of a mixture of dentin primer/silane coupling agent. The internal coating of zirconia dental restorations with silica-based ceramic followed by silanization may be indicated in order to achieve better bonding for the clinical success.