Dental properties, ultrastructure, and pulp cells associated with a novel DSPP mutation.

OBJECTIVE: To investigate physical characteristics and behaviours of dental pulp cells of teeth isolated from a dentinogenesis imperfecta (DGI) patient with a novel dentin sialophosphoprotein (DSPP) mutation. SUBJECTS AND METHODS: Whole exome and Sanger sequencing were employed to identify mutations. Physical characteristics of the teeth were examined. Pulp cells' behaviours including cell proliferation, colony-forming unit, osteogenic differentiation, pluripotent markers, and mesenchymal stem cell markers were investigated. RESULTS: The proband had opalescent brown primary teeth with extensive loss of enamel. Mutation analysis revealed a novel heterozygous 4-bp deletion, c.1915_1918delAAGT (p.K639QfsX674), in exon 5 of the DSPP associated with DGI. Analysis of the extracted primary incisor demonstrated a decrease in brightness but an increase in yellow and red chroma. The dentin showed reduced mineral density. The dentinal tubules were present in the predentin, but progressively collapsed in the dentin. The pulp cells exhibited markedly reduced CD105 expression, decreased cell proliferation, and smaller colony-forming units. CONCLUSIONS: We identified a novel mutation in the DSPP gene which disturbed dentin characteristics and pulp cells' behaviours. Our study expands the mutation spectrum and understanding of pathologic dentin phenotypes related to the frameshift deletion in the dentin phosphoprotein (DPP) region of the DSPP gene.

Starch Combined with Sucrose Provokes Greater Root Dentine Demineralization than Sucrose Alone.

Since there is no consensus about whether starch increases the cariogenic potential of sucrose, we used a validated 3-species biofilm model to evaluate if starch combined with sucrose provokes higher root dentine demineralization than sucrose alone. Biofilms (n = 18) composed by Streptococcus mutans (the most cariogenic bacteria), Actinomces naeslundii (which has amylolytic activity), and Streptococcus gordonii (which binds salivary amylase) were formed on root dentine slabs under exposure 8 ×/day to one of the following treatments: 0.9% NaCl, 1% starch, 10% sucrose, or a combination of 1% starch and 10% sucrose. Before each treatment, biofilms were pretreated with human whole saliva for 1 min. The pH of the culture medium was measured daily as an indicator of biofilm acidogenicity. After 96 h of growth, the biofilms were collected, and the biomass, bacteria viability, and polysaccharides were analyzed. Dentine demineralization was assessed by surface hardness loss (% SHL). Biofilm bioarchitecture was analyzed using confocal laser scanning microscopy. Treatment with a starch and sucrose combination provoked higher (p = 0.01) dentine demineralization than sucrose alone (% SHL = 53.2 ± 7.0 vs. 43.2 ± 8.7). This was supported by lower pH values (p = 0.007) of the culture medium after daily exposure to the starch and sucrose combination compared with sucrose (4.89 ± 0.29 vs. 5.19 ± 0.32). Microbiological and biochemical findings did not differ between biofilms treated with the combination of starch and sucrose and sucrose alone (p > 0.05). Our findings give support to the hypothesis that a starch and sucrose combination is more cariogenic for root dentine than sucrose alone.

Tooth displacement in shortened dental arches: a three-dimensional finite element study.

STATEMENT OF PROBLEM: Some patients may opt for a prosthetic rehabilitation without replacing all missing teeth, finishing treatment with a reduced dental arch. This choice may be due to biologic reasons or financial restrictions. It is unclear if a reduced dental arch functions as well as a complete dental arch. PURPOSE: The purpose of this study was to analyze whether shortened dental arches could result in tooth displacement. MATERIAL AND METHODS: Four different 3-dimensional maxillary and mandibular arches with different levels of arch length reduction were created. In all models, anatomic structures that represent the temporomandibular joint, cortical and cancellous bone, enamel, dentin, and periodontal ligament were modeled. Mechanical properties were attributed to each anatomic component, and a total occlusal load of 100 N on masseter, temporal, and medial pterygoid muscles was simulated for each model. The MSC. Patran software was used for the preprocessing and postprocessing of the biomechanical analysis of the models. One complete dental arch was used as the control. RESULTS: The simulations showed that shortened dental arches presented greater tooth displacements than those found in a complete dental arch. The changes in mandibular tooth position were greater than those observed in the maxillary arches. In finite element models 1 and 2, the largest maxillary displacements were found for posterior teeth. CONCLUSIONS: Decreasing numbers of occlusal units resulted in increasing amounts of displacements of the remaining teeth, which may compromise dental stability in patients with shortened dental arches.

Effect of Er,Cr:YSGG laser on human dentin fluid flow.

The aim of the current investigation was to assess the rate and magnitude of dentin fluid flow of dentinal surfaces irradiated with Er,Cr:YSGG laser. Twenty extracted third molars were sectioned, mounted, and irradiated with Er,Cr:YSGG laser at 3.5 and 4.5 W power settings. Specimens were connected to an automated fluid flow measurement apparatus (Flodec). The rate, magnitude, and direction of dentin fluid flow were recorded at baseline and after irradiation. Nonparametric Wilcoxon signed ranks repeated measure t test revealed a statistically significant reduction in fluid flow for all the power settings. The 4.5-W power output reduced the flow significantly more than the 3.5 W. The samples showed a baseline outward flow followed by inward flow due to irradiation then followed by decreased outward flow. It was concluded that Er,Cr:YSGG laser irradiation at 3.5 and 4.5 W significantly reduced dentinal fluid flow rate. The reduction was directly proportional to power output.

The effect of type of restoration on the stress field developed in terminal abutments with severely reduced periodontal support and coronal structure.

STATEMENT OF PROBLEM: Periodontally compromised teeth (PCT) that serve as terminal abutments (TAs) are often challenging depending on the post-and-core treatment, the type of partial fixed dental prosthesis (PFDP), and the periodontal support. PURPOSE: The purpose of this study was to investigate the biomechanical impact of 3 types of PFDP supported by cast post-and-cores on PCT serving as terminal abutments. MATERIAL AND METHODS: A 3-dimensional (3D) model of a human mandible was fabricated by using computed tomography (CT) images and parameterized in a computer-aided design (CAD) environment as follows: Right premolar preparation geometries were designed. The second premolar was assembled with 7-mm or 10-mm cast post-and-core models. Both premolar-models were designed to support single, splinted, or 1-unit cantilever splinted crowns. In each situation, their periodontium geometries were designed to be reduced by 10%, 50%, and 70%. All models were imported into a 3D finite element analysis (FEA) environment and loaded; von Mises stress values and distribution patterns were evaluated. RESULTS: Insertion of the post primarily affected the apical areas of both the root and post; the type of PFDP and periodontal support mainly affected stress distribution. In patients with a normal periodontium, splinting the teeth did not contribute to their stress relief. By extending the post length, a stressful area close to the apex of the post was developed. Splinting mitigated the stress field of the coronal part of the 50% PCT (up to 98.9%); the 30% PCT experienced a substantial decrease (up to 215.9%) in stress in the radical part as well. The increase in the length of the post produced negligible stress-related differences in the apical part of the 50% PCT (0.2% to 2.6%). The use of the 7-mm post effectively relieved the radical part of the splinted 30% PCT. The magnitude of the stress on the radical part of post-restored PCT was considerably increased in the presence of a cantilever. CONCLUSIONS: Splinted crowns supported by a 7-mm cast post-and-core are a favorable biomechanical approach for the restoration of PCT with severe loss of coronal structure. The use of a cantilever greatly aggravates the biomechanical response, especially of post-restored PCT.

TEM morphological characterization of a one-step self-etching system applied clinically to human caries-affected dentin and deep sound dentin.

PURPOSE: To examine morphologically the hybrid layer of one-step self-etching adhesive, Clearfil S3 Bond (S3bond), in caries-affected dentin (CAD) and deep sound dentin (DSD) cavities performed clinically. For a comparative group, the two-step self etching adhesive Clearfil Protect Bond (Pbond) was used in a similar clinical situation. METHODS: This study was carried out on carious and sound teeth clinically selected for extraction. In carious teeth, CAD was obtained by way of subjective criteria by removing infected tissue to form a cavity bottom. DSD was obtained at a depth of 4 mm in the dentin cavity of sound teeth. S3bond and Pbond were applied in the CAD and DSD cavities as indicated by the manufacturer, followed by a composite restoration. Teeth were extracted about 20 minutes after the bonding procedure, and processed for TEM analysis. RESULTS: Expression of S3bond in CAD was morphologically highly variable. When affected tubules were occluded by intratubular mineralized deposits, the interface displayed a dense poly-HEMA hydrogel as water sorption by the hydrophilic S3bond toward the porous affected collagen. Conversely, when tubules appeared empty, voids of various sizes were formed by tubular fluid shift. In DSD, S3bond clearly exhibited voids and water channels as signs of the high permeability of the sub-surface. Although porosities were somewhat retained, Pbond expression showed a hermetic character which was independent of the dentin substrate.

Is dental erosion really a problem?

Dental erosion is the non-carious dental substance loss induced by direct impact of exogenous or endogenous acids. It results in a loss of dental hard tissue, which can be serious in some groups, such as those with eating disorders, in patients with gastroesophageal reflux disease, and also in persons consuming high amounts of acidic drinks and foodstuffs. For these persons, erosion can impair their well-being, due to changes in appearance and/or loss of function of the teeth, e.g., the occurrence of hypersensitivity of teeth if the dentin is exposed. If erosion reaches an advanced stage, time- and money-consuming therapies may be necessary. The therapy, in turn, poses a challenge for the dentist, particularly if the defects are diagnosed at an advanced stage. While initial and moderate defects can mostly be treated non- or minimally invasively, severe defects often require complex therapeutic strategies, which often entail extensive loss of dental hard tissue due to preparatory measures. A major goal should therefore be to diagnose dental erosion at an early stage, to avoid functional and esthetic impairments as well as pain sensations and to ensure longevity of the dentition.

Dentin hypersensitivity.

CONTEXT: In dental practice, dentin hypersensitivity is a commonly presenting condition, which consists of sharp pain arising from exposed dentin in response to a varied assortment of stimuli; for example, dietary factors, such as an ice-cold beverage, to even environmental considerations, such as the exposure to atmospheric air on a cold winter's day. The heterogeneity of this presentation, ranging from minor inconvenience to the patient, to a near incapacitating quality-of-life disturbance, as well as the wide range of treatment strategies, as is discussed in this article, certainly pose a challenge to the clinician. EVIDENCE ACQUISITION: A search was performed on the MEDLINE database (2002 to present) by way of OVID. Search terms, such as dentin hypersensitivity and variants (eg, dentinal hypersensitivity, cervical dentin hypersensitivity) were used. Select references of review-type articles from the original search were sought. EVIDENCE SYNTHESIS: Efforts were made to identify multiple comparative clinical treatment studies that were of highest quality study design-specifically, randomized control trials. Efforts also were made to identify rigorous meta-analysis in the literature on the subject of dentin hypersensitivity treatment. CONCLUSION: Although multiple treatment approaches appear to provide clinical success in managing dentin hypersensitivity, the entire body of clinical research literature is far from being unequivocal in pronouncing one superior strategy. Equally as important is the clinician's consideration of the predisposing factors that initially localized the lesion on the tooth surface. Together, personalized preventive measures and therapies focusing on disrupting pathophysiology form the core of effective dentin hypersensitivity management.

Influence of irrigant, dowel type, and root-reinforcing material on fracture resistance of thin-walled endodontically treated teeth.

PURPOSE: Unresolved controversy exists concerning the optimum restorative material to reinforce the thin-walled roots of endodontically treated teeth to improve their fracture resistance under occlusal load. This study evaluated the effectiveness of irrigant, dowel type, and root-reinforcing material on the fracture resistance of thin-walled endodontically treated teeth. MATERIALS AND METHODS: The root canals of 140 maxillary central incisors were enlarged and equally divided into seven groups according to the canal irrigant: no irrigant (control), 5% hydrogen peroxide, 5% sodium hypochlorite, a combination of 5% hydrogen peroxide and sodium hypochlorite, 15% ethylenediaminotetraacetic acid (EDTA), 10% lactic acid, or 20% lactic acid. Within each group, root canals were lined with composite resin (PermaFlo) or glass ionomer cement (Fuji II LC). A light-transmitting plastic dowel (Luminex) was used to create space for a quartz fiber-reinforced dowel (Aestheti Post) or a titanium alloy dowel (ParaPost XH) and to cure the restorative materials. Following dowel cementation and restoration of the roots with composite core, the teeth were submitted to fracture resistance testing, and data were analyzed with 3-way ANOVA followed by Ryan-Einot-Gabriel-Welsch Multiple Range Test (α= 0.05). RESULTS: Fracture resistance values were significantly different among irrigants, restorative materials, and their interaction (p < 0.001); however, the dowel type was not significantly different (p= 0.51). CONCLUSIONS: Thin-walled roots that had the smear layer removed with lactic acid and that were then lined with composite resin had a higher fracture resistance.

The three-dimension finite element analysis of stress in posterior tooth residual root restored with postcore crown.

OBJECTIVE: Teeth that have been endodontically treated and restored with postcore crown may experience fracture sometimes. Some researchers have analyzed the stress of the anterior teeth after postcore crown restoration, but the stress of the posterior teeth after such restoration has not been reported. We used three-dimension finite element methods to analyze the stress magnitude and distribution of remaining dentin in posterior tooth residual root restored with postcore crown. The binding material, loading direction, number, length and material of posts were studied. METHODS: The models of residual root of maxillary first molar restored with postcore crown were created by CT scanning, mimics software and abaqus software. Different number, length and material of posts were used in the modeling. The posts were cemented with zinc-phosphate cement or composited resin. A load of 240 N was applied to the occlusal surface in four directions and tensile, shear, and von Mises stresses were calculated. RESULT: (i) The maximum stress on remaining dentin changed irregularly as the number and length of posts changed. (ii) The maximum stress on remaining dentin decreased slightly as elastic modulus of the material of posts increased. (iii) The maximum stress on bonding layer and remaining dentin was lower when bonded with resin luting agent than with zinc-phosphate cement. (iv) The maximum stress on remaining dentin increased markedly as loading angle increased. CONCLUSION: The number, length, material of posts, bonding material and loading angle all have influence on the magnitude and distribution of stress. The influence of loading angle is most apparent.

Repair of root resorption 4 and 8 weeks after application of continuous light and heavy forces on premolars for 4 weeks: a histology study.

INTRODUCTION: Repair of root resorption cavities has been studied under light microscopy, scanning electron microscopy, and transmission electron microscopy. The aim of this investigation was to demonstrate the use of microcomputed tomography (micro-CT) to assist in the identification of the region of interest for light microscopy preparation. This study also qualitatively illustrated the root resorption craters with 4 or 8 weeks of retention after 4 weeks of continuous light or heavy orthodontic force application. METHODS: Four patients who required bilateral extractions of maxillary first premolars as part of their orthodontic treatment were divided into 2 groups (groups I and II) of 2. The maxillary left and right first premolars were loaded with light (25 g) or heavy (225 g) orthodontic force for 4 weeks. After 4 or 8 weeks of retention, the maxillary first premolars were extracted. The extracted teeth were investigated with micro-CT. By using 3-dimensional images created by the micro-CT, the largest resorption craters on the buccal and lingual sides were identified. Parasagittal sections of these resorption craters were studied histologically under hematoxylin and eosin staining. RESULTS: The use of micro-CT improved the efficiency and accuracy of histologic techniques. Comparatively, less root resorption was repaired by new cementum after heavy orthodontic force application and short retention time. The reparative processes seemed to depend on time, with longer retention time yielding the most amount of repair. Reparative cementum was a mixture of acellular and cellular cementum. Reparative processes seemed to commence at the central part of the resorption cavity and expand to the periphery. CONCLUSIONS: Root resorption cavities have the potential to repair regardless of the orthodontic force magnitude. Correlative microscopy with micro-CT and conventional light microscopy adds a new dimension to current root resorption investigation techniques.

Levels of matrix metalloproteinase-8 and cold test in reversible and irreversible pulpitis.

ABSTRACT: Researchers have reported false positive/negative results of the cold test in the diagnosis of pulpitis. Knowledge of the correlation between results of the cold test and proteins could aid in decreasing the frequency of incorrect diagnosis. To associate the levels of matrix metalloproteinase-8 (MMP-8) with the responses (in seconds) to the cold test in teeth diagnosed with reversible and irreversible pulpitis.A cross-sectional study was performed. A total of 150 subjects were evaluated, of which 60 subjects met the selection criteria. The participants were divided into 3 groups: Group 1, healthy pulps, 20 subjects with 20 posterior teeth (premolars) with clinically normal pulp tissue; Group 2, reversible pulpitis, 20 patients with 20 teeth diagnosed with reversible pulpitis; and Group 3, irreversible pulpitis, 20 subjects with 20 teeth diagnosed with irreversible pulpitis. All participants were evaluated based on the following variables: medical and dental history, cold test, and expression of MMP-8 by enzyme-linked immunosorbent assay in dentin samples.Responses to the cold test between 4 to 5 seconds (second evaluation; P < .0001) were associated with high levels of MMP-8 (mean, 0.36 ng/mL) in the reversible pulpitis group. In the irreversible pulpitis group, the responses from 6 to ≥10 seconds (second evaluation; P < .0001) were associated with a higher average of MMP-8 levels (mean, 1.97 ng/mL).We determined that an increase in the duration of response to the cold test was associated with an increase in MMP-8 levels (Rho = 0.81, P < .0001) in teeth with pulpitis. The above correlations can be considered an adjunct to the clinical diagnosis of pulpitis.

The effect of resin-based sealers on fracture properties of dentine.

AIM: To determine whether resin-based sealer cements are able to strengthen root dentine, as measured by work of fracture (Wf), micro-punch shear strength (MPSS) and resistance to vertical root fracture (VRF). METHODOLOGY: One hundred and twenty extracted premolar teeth were randomly assigned amongst four treatments before testing: intact, root canals prepared but unfilled, or root filled using epoxy- or urethane dimethacrylate (UDMA)-based sealer (plus core material). Samples were then prepared for measuring Wf, MPSS or VRF using standard test procedures. Data were analyzed using one-way anova with significance set at P < 0.05. RESULTS: For all three tests, root canals filled using epoxy resin-based sealer were not statistically significantly different compared with UDMA resin (P = 1 for Wf, P = 0.7 for MPSS and P = 0.12 for VRF), or different from both sound and prepared dentine (P > 0.05). There was also no significant difference between sound dentine and prepared dentine for both Wf (P = 0.92) and resistance to VRF (P = 1). CONCLUSIONS: Neither epoxy nor UDMA resins used as sealer cements enhanced fracture resistance of root dentine when placed within root canals of extracted teeth.

Influence of post and resin cement on stress distribution of maxillary central incisors restored with direct resin composite.

The current study evaluated the influence of two endodontic post systems and the elastic modulus and film thickness of resin cement on stress distribution in a maxillary central incisor (MCI) restored with direct resin composite using finite element analysis (FEA). A three-dimensional model of an MCI with a coronary fracture and supporting structures was performed. A static chewing pressure of 2.16 N/mm2 was applied to two areas on the palatal surface of the composite restoration. Zirconia ceramic (ZC) and glass fiber (GF) posts were considered. The stress distribution was analyzed in the post, dentin and cement layer when ZC and GF posts were fixed to the root canals using resin cements of different elastic moduli (7.0 and 18.6 GPa) and different layer thicknesses (70 and 200 microm). The different post materials presented a significant influence on stress distribution with lesser stress concentration when using the GF post. The higher elastic modulus cement created higher stress levels within itself. The cement thicknesses did not present significant changes.

Mechanical design optimization of bioabsorbable fixation devices for bone fractures.

Bioabsorbable bone plates can eliminate the necessity for a permanent implant when used to fixate fractures of the human mandible. They are currently not in widespread use because of the low strength of the materials and the requisite large volume of the resulting bone plate. The aim of the current study was to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a standard titanium bone plate. A finite element model of a mandible with a fracture in the body region is subjected to bite loads that are common to patients postsurgery. The model is used first to determine benchmark stress and strain values for a titanium plate. These values are then set as the limits within which the bioabsorbable bone plate must comply. The model is then modified to consider a bone plate made of the polymer poly-L/DL-lactide 70/30. An optimization routine is run to determine the smallest volume of bioabsorbable bone plate that can perform and a titanium bone plate when fixating fractures of this considered type. Two design parameters are varied for the bone plate design during the optimization analysis. The analysis determined that a strut style poly-L-lactide-co-DL-lactide plate of 690 mm2 can provide as much mechanical stability as a similar titanium design structure of 172 mm2. The model has determined a bioabsorbable bone plate design that is as strong as a titanium plate when fixating fractures of the load-bearing mandible. This is an intriguing outcome, considering that the polymer material has only 6% of the stiffness of titanium.

Elastic modulus of posts and the risk of root fracture.

The definition of an optimal elastic modulus for a post is controversial. This work hypothesized that the influence of the posts' elastic modulus on dentin stress concentration is dependent on the load direction. The objective was to evaluate, using finite element analysis, the maximum principal stress (sigma(max)) on the root, using posts with different elastic modulus submitted to different loading directions. Nine 3D models were built, representing the dentin root, gutta-percha, a conical post and the cortical bone. The softwares used were: MSC.PATRAN2005r2 (preprocessing) and MSC.Marc2005r2 (processing). Load of 100 N was applied, varying the directions (0 degrees, 45 degrees and 90 degrees) in relation to the post's long axis. The magnitude and direction of the sigma(max) were recorded. At the 45 degrees and 90 degrees loading, the highest values of sigma(max) were recorded for the lowest modulus posts, on the cervical region, with a direction that suggests debonding of the post. For the 0 degrees loading, the highest values of sigma(max) were recorded for higher modulus posts, on the apical region, and the circumferential direction suggests vertical root fracture. The hypothesis was accepted: the effect of the elastic modulus on the magnitude and direction of the sigma(max) generated on the root was dependent on the loading direction.

Effect of ageing and endodontic treatment on the thermal stability of human dentin.

BACKGROUND: Human dentin is a highly calcified tissue of mesenchymal origin with a heterogeneous structure. Its morphology is constantly remodelled throughout the life span of the tooth, as well as under the influence of external stimuli. OBJECTIVE: The aim of the present study was to obtain information about the thermal changes in the crown and root dentin specimens of vital and devitalized teeth. METHODS: The investigated samples were divided into 6 groups, depending on the patients' age and dentin location (crown, root). An additional group of endodontically treated teeth was created. The methods of choice were were combined thermal analysis (DTA-TG(DTG)-MS and gas chromatography-mass spectrometry. RESULTS: After heating up to 1200 °C, endo- and exothermal effects were observed. The effects' dynamic was the same for all samples. The differences were in the samples' weight after the experiment, with root dentin showing the greatest mass loss percentage. CONCLUSIONS: The observed mass loss differences could be attributed to the presence of impurities in the dentin, as well as alterations in the collagen matrix. Ageing and endodontic treatment could catalyse the accumulation of such changes and affect the microstructure of the mineralized tissue.

Micromechanical property recovery of human carious dentin achieved with colloidal nano-beta-tricalcium phosphate.

Reconstitution of carious dentin has been recognized as difficult, because it progresses by loss of collagen polymerization and by demineralization under acidic conditions. Recently, colloidal alkaline nano-calcium phosphate, prepared by electrical discharge in a buffered physiological saline solution, has been shown to be effective in the formulation of a bone-like biocomposite by simply being mixed with acidic collagen solution. It was hypothesized that colloidal calcium phosphate was suitable for the reconstitution of carious dentin. Natural caries lesions in dentin from permanent teeth were exposed to colloidal hydroxyapatite and beta-tricalcium phosphate for 10 days. The micromechanical properties of these tissues were evaluated by nano-indentation. The elastic modulus of human carious dentin improved after samples were immersed in colloidal beta-tricalcium phosphate. The mineral density of carious dentin exposed to beta-tricalcium phosphate increased more than that immersed in hydroxyapatite. However, since it was not directly proportional to micromechanical recovery, mineral density alone was not a sufficient indicator of mechanical behavior.

Histomorphologic characterization and bond strength evaluation of caries-affected dentin/resin interfaces: effects of long-term water exposure.

OBJECTIVES: To evaluate the longevity of sound (SD) and caries-affected dentin (CAD) bonds made with etch-and-rinse and self-etching adhesives after a 6-month water-storage period, using bond strength and morphological evaluations. METHODS: Extracted human molars with coronal carious lesions were selected. Flat surfaces of CAD surrounded by SD were bonded with etch-and-rinse (Adper Scotchbond 1) or with self-etching (Clearfil Protect Bond and AdheSE) adhesives. Trimmed resin-dentin bonded interfaces (1mm2) were stored in distilled water for 24h or 6 months and subjected to microtensile bond strength (microTBS) evaluation. The quality of the dentin beneath fractured specimens was measured by Knoop microhardness (KHN). ANOVA and multiple comparisons tests were used (P<0.05). Fractographic analysis and interfacial nanoleakage evaluation were performed by scanning electron microscopy (SEM). Resin-dentin bonded sections (10microm thick) were stained with Masson's trichrome and examined using light microscopy. Collagen exposure and adhesive penetration were examined qualitatively. RESULTS: microTBS to SD was significantly higher than that to CAD for all bonding agents. Bonds made with AdheSE were weaker than the other adhesives after 6-months storage regardless of the dentin substrate. CAD bonded specimens presented a significant muTBS decrease over time. Lower KHN was recorded in CAD compared to SD. An increase in the exposed collagen zone and a decrease in the quality of the adhesive infiltration were observed in CAD interfaces. SIGNIFICANCE: CAD bonded interfaces are more prone to hydrolytic degradation than SD bonds. Additionally, as compared to SD, there were remarkable differences in depth of demineralization, adhesive infiltration and interfacial bond strength with CAD.

Fracture resistance and microtensile bond strength of maxillary premolars restored with two resin composite inlay systems.

PURPOSE: To compare the in vitro fracture resistance and the microtensile bond strength (muTBS) of premolar teeth restored with two light-cured resin composite inlay systems. METHODS: 50 sound human maxillary premolars were divided randomly into five equal groups. Four groups received mesial-occlusal-distal (MOD) inlay preparations. Restorative treatments comprised: Group 1 (Renew direct resin composite), Group 2 (Renew direct resin composite inlay), Group 3 (Tescera indirect resin composite inlay), Group 4 (non-restored), Group 5 (intact). All teeth were loaded axially until fracture. The same resin-based materials as used in Groups 1-3 were bonded to the superficial coronal dentin of 15 teeth. Beams approximately 1.0 mm x 1.0 mm were prepared and tested in microtensile mode. Results were compared using one-way ANOVA and Tukey's multiple comparison tests. RESULTS: Mean fracture strengths (KN): Group 1, 2.06 (0.76); Group 2, 2.30 (0.49); Group 3, 2.62 (0.68); Group 4, 1.24 (0.44); Group 5, 2.40 (0.71). Group 4 was significantly weaker that the other four groups, P < 0.01. Mean muTBSs (MPa): Group 1, 33.38 (6.24); Group 2, 20.38 (6.24); Group 3, 20.87 (4.62). Group 1 was significantly stronger than the other two groups, P < 0.01.