Optical comparison between micro-CT and OCT in imaging of marginal composite adaptation: Observational study.

Dental composite is the most used aesthetic restorative biomaterial worldwide. However, it undergoes polymerisation shrinkage that could lead to loss of the interfacial seal between tooth and resin in some circumstances. This demands high-resolution imaging technologies to detect these defects. This study carried out a comparison between microcomputed tomography (micro-CT; Shimadzu, Japan) and swept-source optical coherence tomography (SS-OCT; Santec, Japan) in the detection of marginal adaptation defects at the tooth-resin interface. Unlike in micro-CT, it was possible to outline interfacial gaps along with tooth-resin interfaces with SS-OCT, which was attributed to the Fresnel diffraction of light. This in vitro comparison demonstrates SS-OCT has great potential in dental imaging to effectively assess dental composite adaptation and marginal defects when high resolution is desired in real time. LAY DESCRIPTION: Detection of tooth-colored restoration defects had been assessed by different radiographic methods. However, most of these methods are either invasive or suffer from low-resolution. In this study, a comparison has been carried out between two different high-resolution imaging systems; microcomputed tomography and optical coherence tomography, to explore their potentials in detecting restorations defects. The results showed optical coherence tomography has a great accuracy in locating the underlying defects when the obtained images were validated against confocal laser scanning microscopy images.

Effect of self-etch adhesives on the internal adaptation of composite restoration: a CP-OCT Study.

Despite improvements in dental adhesive materials, internal adaptation remains a challenge in bonded restorations. The aim of this study was to compare microgaps and internal floor adaptation between two different self-etch adhesives in class-V cavities using cross-polarization optical coherence tomography (CP-OCT). In this in vitro study, standardized round class-V cavities were prepared in 20 non-carious human upper central incisor teeth. They were randomly divided into two groups, TN and SE, with each group receiving a different dental adhesive. In TN group, the adhesive used was all-in-one Tetric N-Bond Self-Etch (TN; Ivoclar/Vivadent, Liechtenstein), while SE group was bonded with two-step self-etch Clearfil SE Bond 2 adhesive (SE; Kuraray Noritake Dental Inc, Japan). The prepared cavities were restored with flowable composite and then stored in distilled water for 24 h. Next, they were immersed in silver nitrate, followed by immersion in a photo-developing solution. Optical comparison was carried out by CP-OCT to assess microgaps and composite adaptation at the cavity floor. A Mann-Whitney test was applied to the data, which showed a statistically significant difference in composite adaptation among the two groups (p < 0.001) with the SE group showing superior adaptation. CP-OCT is a reliable tool for non-invasive imaging that gives an insight into composite performance. Better adaptation was found with the two-step self-adhesive for the composite used in this study.

Ultrastructural features of dentinoenamel junction revealed by focused gallium ion beam milling.

To take full advantage of focused ion beam (FIB) in preparation of ultrathin sections of biological tissues, we have used a cryo-milling process. In this study, extracted human teeth were scanned by optical coherence tomography to inspect the samples for intactness and to determine the area of interest. Then, the selected area of interest was cross-sectioned for examination under a confocal laser scanning microscope to determine the target location of the dentinoenamel junction (DEJ) that was later milled by cryo-FIB at preset parameters, followed by transmission electron microscope examination of the final sliced specimens for ultrastructural characterization. The proposed technique was able to outline the DEJ and to identify the different tooth layers in a single section, without artefacts or tissue damage. The DEJ was outlined as fine longitudinal projections intermingling between the solid electron-dense enamel and intricate electron-lucent hollow dentin. In conclusion, this study has shown the great potential of cryo-FIB in handling different biological tissues having different physical properties, with great precision and accuracy and minimum artefacts.

Characterization of transparent dentin in attrited teeth using optical coherence tomography.

Attrition and wear of tooth surface occur with aging and result in loss of enamel, with exposure and histological changes in dentin. Dealing with attrited teeth and restoration of the lost tissue are clinically challenging. The main objective of this study is to characterize the exposed transparent dentin in the occlusal surface of attrited teeth by optical coherence tomography (OCT). Naturally attrited, extracted human teeth with occlusal-transparent dentin were investigated in comparison to sound and carious teeth. The teeth were subjected to OCT imaging and then cross-sectioned and polished. OCT B-scans were compared to light microscopy images of the same cross section. In OCT images, some changes were evident at the transparent dentin in attrited teeth. An OCT attenuation coefficient parameter (µ t) was derived based on the Beer-Lambert law as a function of backscatter signal slope. The mean values of µ t were 1.05 ± 0.3, 2.23 ± 0.4, and 0.61 ± 0.27 mm(-1) for sound, carious, and transparent dentins, respectively. One-way ANOVA with Tukey's post-hoc showed a significant difference between groups (p < 0.05). Physiological changes in transparent dentin that involve deposition of mineral casts in the dentinal tubules lead to lower attenuation of OCT signal. OCT has a potential role to detect transparent dentin on the surface of attrited teeth and can be used in the future as a clinical adjunct tool.

Effect of cigarettes smoke on bonded polymeric restorations: OCT study.

Background: Up to date, the effect of cigarette smoke (CS) on the adhesive properties of the restorative materials bonded to tooth structure is still unclear. It is still questionable if it interferes with the durability and clinical success of these restorations. Few numbers of studies reported the assessment of microgaps of dental composite using cross-polarization optical coherence tomography (CP-OCT). The aim of this study was to evaluate the presence of interfacial microgaps between composite resin restoration and the tooth structure with or without exposure to CS under the CP-OCT. Materials and methods: In this in-vitro study, a standardized round class-V cavities were prepared in twenty extracted, caries-free human molar teeth, and they were divided randomly into two groups (n = 10). Adhesive system (Gluma universal, Kulzer GmbH) was applied followed by filing the prepared cavities with flowable composite restoration (Charisma, Kulzer GmbH). Then, exposure to CS (40 cigarettes/day) was carried out for 14 days and the samples were stored in normal saline solution after each smoke exposure cycle. Next, all samples were immersed in ammoniac silver nitrate for 24 h, followed by immersion in a photo-developing solution for 8 h. Optical comparison was carried out by CP-OCT to assess microgaps percentage between smoke (SG) and non-smoke groups (NSG) at the axial walls (AW) and cavity floor (CF). Results: Independent T-test showed that there was a significant difference between the two groups (SG, NSG) in AW microgaps percentage (p = 0.008), while there was no difference in CF (p = 0.15). Conclusion: It can be inferred from the current finding that OCT can be used to predict the adaptability of the bonded restoration under the thermochemical influence. CS has a negative effect on the marginal integrity of the bonded polymeric restorations.

Thermal Sensing of Photo-Activated Dental Resin Composites Using Infrared Thermography.

OBJECTIVE: The goal of this study was to compare the pulp temperature increase during light curing of different composite thicknesses in deep class I cavities using two thermal sensing tools. METHODOLOGY: Round occlusal class I cavities with a remaining dentin thickness (RDT) of 1 mm from the cavity floor were performed on 15 extracted sound molars. Samples were divided into three groups (n = 5). In group A, cavities were restored using the Filtek Z350 XT conventional composite through the incremental filling technique, whereas group B cavities were restored using the Filtek Bulk-Fill flowable composite through the bulk-fill technique. Specimens of the Filtek Bulk-Fill flowable composite using the incremental filling technique were used to restore cavities in group C. An infrared thermal camera (IRT; Flir, Wilsonville, OR, USA) and K-type thermocouple (Perfect Prime TC0520, New York, NY, USA) were used to measure the heat generated during composite photo-polymerization. RESULTS: There were no significant differences within the same group using either the thermocouple or IRT (p > 0.05). One-way ANOVA showed no significant differences between groups A and C (p > 0.05), whereas group B was significantly different from groups A and C with each sensing tool (p < 0.05). CONCLUSION: IRT and thermocouple heat readings were comparable. Based on the current findings, the bulk-fill technique resulted in the lowest heat generation among the groups. Therefore, increasing the light-curing time and the number of composite increments was directly correlated with increases in intra-pulpal temperature.

Noninvasive Adaptation Appraisal of Antimicrobial Nano-Filled Composite.

OBJECTIVE: The aim of this research was to assess the effect of incorporating zein-coated magnesium oxide (zMgO) nanofillers to resin-based composite on the internal adaptation of the restorations using cross-polarisation optical coherence tomography (CP-OCT). METHODS: Thirty noncarious human molar teeth were used. Class V cavities (3 × 5 mm) were prepared on the buccal and lingual surfaces of each tooth. Clearfil SE Bond 2 was applied to all the cavities and then the teeth were divided into 3 groups (n = 10) as follows: group 1-restored with N-Flow composite; group 2 and group 3-restored with N-Flow composite mixed with different zMgO nanoparticle concentrations (0.3% and 0.5% by weight, respectively) and then light cured using an LED curing device. Specimens were examined for interfacial adaptation examination under CP-OCT. Characterisation of the dental composite incorporating zMgO was done by Fourier-transform infrared spectroscopy (FTIR), x-ray diffraction (XRD), and field emission scanning electron microscopy (FESEM). Results were analysed with Kruskall-Wallis test followed by Mann-Whitney U test, at a significance level of P < .05. RESULTS: XRD spectra exhibited the sharp peaks of zMgO in the composite enhanced with zMgO nanoparticles. FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. The gap percentage along the cavity floor was significantly lower in groups 2 and 3 in comparison to group 1 (P < .05). Also there was a significant difference in gap percentages between groups 2 and 3 (P < .05), with group 3 showing the lowest gap percentage. CONCLUSIONS: The incorporation of 0.3% and 0.5% zMgO nanoparticles in flowable composite assists in improving the internal adaptation of the composite to the tooth surface.

Non-Destructive In Vitro Evaluation of an Internal Adaptation of Recent Pulp-Capping Materials in Permanent Teeth Using OCT and Micro-CT.

The objective of this study was to assess and compare the internal adaptation of various pulp-capping materials, namely TheraCal, Biodentine, and mineral trioxide aggregate (MTA), on the dentin of permanent teeth through the utilization of micro-computed tomography (MCT) and optical coherence tomography (OCT). Thirty permanent molars were divided into three groups using a random process: group A (TheraCal), group B (Biodentine), and group C (MTA, which served as the control group). On the buccal surface of each tooth, a class V cavity of a standardized cylindrical shape was prepared. Subsequently, the respective pulp-capping material was applied to the cavity based on the assigned group, followed by restoration with composite resin. Based on the MCT results, it was observed that group A had a considerably larger gap volume in comparison to groups B and C (p < 0.001). There was no significant difference in gap volume between groups B and C. Regarding the OCT findings, group A displayed a substantially higher level of light reflection than groups B and C (p < 0.001). Group C exhibited a significantly lower level of light reflection in comparison to group B (p < 0.001). Biodentine and MTA revealed similar outcomes in terms of how well they adhered to the dentinal surface in permanent teeth. Both materials exhibited superior performance in comparison to TheraCal. The utilization of OCT in clinical practice could be advantageous as it enables dentists to monitor and evaluate restorations during post-treatment follow-up. It is imperative to intensify efforts aimed at making OCT equipment more accessible and applicable, overcoming its current limitations, and allowing for its widespread utilization in clinical practice.

Progression of Enamel Demineralisation Around Fissure Sealants: Optical Coherence Tomography Study.

PURPOSE: To evaluate the progression of enamel demineralisation around fissure sealants using cross-polarisation optical coherence tomography (CP-OCT). MATERIALS AND METHODS: Three fissure sealants; Fuji Triage (FJ, GC), Beautisealant (BT, Shofu) and Helioseal resin sealant (HL, Ivoclar Vivadent) were placed in cavities (3 × 0.5 × 1 mm) prepared in bovine enamel blocks (n = 5). After 7-day artificial saliva incubation, specimens were subjected to demineralisation for 4 weeks (pH 4.5). CP-OCT scans (Santec) were acquired for each specimen after 1, 2 and 4 weeks of demineralisation and lesions were quantitatively measured to analyse lesion progression. RESULTS: Repeated-measures ANOVA demonstrated that lesion size was statistically significantly affected by demineralisation period, fissure sealant type, and their interaction (P < 0.001). At 4 weeks, the highest mean value of lesion size was observed in HL group while FJ group showed the lowest. The rate of lesion progression was slower in FJ and statistically significantly different from BT (P < 0.05), which in turn was statistically significantly different than HL (P < 0.001). CONCLUSION: Fissure sealants that actively release ions are capable of improving the acid resistance of adjacent enamel. Beautisealant showed increased demineralisation inhibition compared to conventional resin sealant, but less than that provided by glass-ionomer sealant.

An Eggshell-Based Toothpaste as a Cost-Effective Treatment of Dentin Hypersensitivity.

OBJECTIVES: This study aimed to test the efficacy of two experimentally produced eggshell-based toothpastes on dentinal tubules occlusion. MATERIALS AND METHODS: Two experimental eggshell toothpastes, based on natural ingredients, with or without titanium dioxide nanoparticles (TNPs) were produced and coded "TNPs eggshell toothpaste [TNPsESTP]" or "eggshell toothpaste [ESTP]," respectively. Mid-coronal dentin discs, from 28 human extracted molar teeth, etched with 37% phosphoric acid for 60 seconds to simulate the hypersensitive dentin, were randomly divided into four groups-G1: no treatment (negative control), G2: ESTP treated, G3: TNPsESTP treated, and G4: Biorepair treated (positive control). All treated discs were brushed for 2 weeks and 1 month using a toothbrush simulator at 40 mm/s. Dentinal tubules occlusion was studied using a cross-polarization optical coherence tomography (CP-OCT) and scanning electron microscopy (SEM). STATISTICAL ANALYSIS: Unpaired t-test was conducted using GraphPad software (San Diego, California, United States). Continuous variables were expressed as means ± standard deviation and p < 0.05 was considered statistically significant. RESULTS: From CP-OCT, a marked increase in surface reflectivity of dentin was observed after brushing with tested toothpastes. ESTP and NPsESTP showed higher or comparable grayscale values than Biorepair indicating increase in surface density of dentin. From SEM, at 2 weeks, ESTP showed comparable number of completely occluded dentinal tubules to Biorepair. TNPsESTP showed significantly lower numbers of CODT than Biorepair. At 1 month, the number of CODT was difficult to count for all treated groups. Both ESTP and TNPsESTP showed significantly higher numbers of partially occluded dentinal tubules than Biorepair. CONCLUSION: ESTP or TNPsESTP could offer a cost-effective substitute for the treatment of dentin hypersensitivity.

A Novel Evaluation Method for Detecting Defects of the Bonded Orthodontic Bracket-Tooth Interface.

BACKGROUND: Orthodontic patients are at high risk to develop caries. This study is introducing a clinical method detecting interfacial defects between ceramic brackets and enamel utilizing optical coherent tomography in addition to using the nanoleakage expression in vitro test. METHODS: Transbond XT primer and moisture insensitive primer (MIP) were bonded to 75 human premolar enamel surfaces and divided into (XTD), (MIPD), and (MIPW) groups. The (XTD) and (MIPD) groups had ceramic brackets bonded to dry enamel surfaces using TransBond and moisture insensitive primers, respectively, while the (MIPW) samples were bonded to moist enamel using moisture insensitive primer. All specimens were examined under crosspolarization optical coherence tomography. Debonding forces of the brackets to 45 teeth (15 teeth/group). 30 bonded specimens (15 specimens/group) were cross-sectioned to detect the nanoleakage expression using scanning electron microscope equipped with energy-dispersive spectroscopy (SEM/EDS). The degree of conversion of the specimens in the experimental groups was tested using attenuated total reflectance Fourier transform infrared spectroscopy (FTIR/ATR). RESULTS: Optical coherence tomography detected the interfacial defects between the ceramic brackets and tooth structure. One way ANOVA showed that (XTD) and (MIPD) groups recorded significantly higher bond strength values and less nanoleakage expression when compared to MIPW (p > 0.05). CONCLUSIONS: Optical coherence tomography can be utilized to detect interfacial adhesive-tooth defects. Dry enamel surfaces improve the quality of the enamel/primer interface (200 words).

Evaluation of Newly Introduced Bioactive Materials in Terms of Cavity Floor Adaptation: OCT Study.

OBJECTIVE: The aim of the present study was to evaluate the adaptation of newly introduced bioactive restorative materials to the cavity floor using cross-polarization optical coherence tomography (CP-OCT). MATERIALS AND METHODS: Round class V cavities were prepared on the proximal surfaces of sixty non-carious human anterior teeth (0.5 mm depth × 4 mm diameter), which were divided into groups according to the restorative material (n = 15). In the VF group, Vertise flow composite (Kerr, Orange, CA, USA) was used, in the BF group, Beautifil II composite (Shofu, Koyoto, Japan) was used, and in the AB group, ACTIVA BioACTIVE composite (Pulpdent, Watertown, NY, USA) was used. Cavities were restored using the bulk filling technique and cured according to the manufacturers' instructions. Then, the specimens were immersed in a contrasting agent, and image acquisitions were taken by CP-OCT to calculate the adaptation percentage by using an image analysis software. RESULTS: B-scans showed a diffuse bright band of white pixels at the tooth-resin interface that was interpreted as a micro-gap present between the cavity floor and restorative material. The Kruskal-Wallis test showed a statistically significant difference between all tested groups with the AB group representing the least gap formation, followed by the BF group, and then the VF group, which demonstrated the highest gap formation. CONCLUSIONS: In class V cavities, better adaptation to the cavity floor can be obtained when using ACTIVA BioACTIVE more than Vertise flow and Beautifil II composites. In addition, CP-OCT is considered a non-destructive imaging tool that helps in evaluating the quality of the tooth-restoration interface when bioactive composites are used.

Inhibitory effect of Salvadora persica extract (Miswak) on collagen degradation in demineralized dentin: In vitro study.

BACKGROUND/PURPOSE: Root dentin is vulnerable to acid attack, suggesting a higher risk of demineralization than coronal enamel. This study aimed to evaluate the inhibitory effect of Miswak extract on collagen degradation of demineralized dentin lesion. MATERIALS AND METHODS: Demineralized bovine root dentin specimens were treated for 1 h by 20% Miswak extract and 0.12% Chlorehexidine (CHX) as a positive control group, and then subjected to collagenolytic attack (clostridium histolyticum 0.5 CDU/mL, 16 h). These cyclic treatments were repeated for 3 days. After the cyclic treatment, the images of the specimens were captured with a light microscope and the lesion depth of degraded collagen layer of all specimens was measured. The mean lesion depth was calculated and compared between the groups using descriptive and One-way ANOVA followed by Post hoc Tukey's tests. Significant level was set at p < 0.05. RESULTS: The mean lesion depth of CHX (28.6 ±â€¯3.37 µm) had the least value, followed by Miswak (37.5 ±â€¯4.01 µm) then the control (78.4 ±â€¯18.43 µm) group. There was a significant difference in the mean lesion depth among the three groups (p = 0.000). CONCLUSION: Miswak aqueous extract from S. persica was found to preserve the dentin collagen matrix from collagenase enzyme. This could be due to the organic compounds like flavonoids, saponins, alkaloids, tannins, and others which have been reported in literature. Present finding suggests that Miswak might play a positive effect in dentin caries prevention.

Evaluation of microleakage in class-II bulk-fill composite restorations.

BACKGROUND/PURPOSE: Despite the clinical appeal of restoring deep class II cavities in single increment using bulk-fill resin composite, sealing of bulk-filled composite restorations is a concern. This study evaluated interfacial adaptation of bulk-fill composite restoration to axial wall and gingival floor of class II cavities using cross-polarization optical coherence tomography (CP-OCT). MATERIALS AND METHODS: Box-shaped class II cavities were prepared in extracted molars and divided into three groups (n = 7) according to adhesive used; Clearfil SE Bond 2 (SE2), Tetric-N Bond Self-Etch (TSE) or Tetric-N Bond Universal (TNU). All adhesives were applied in self-etch mode and according to manufacturers' recommendation. Then, preparations were bulk-filled with Filtek Bulk Fill Posterior Restorative resin composite and immersed in a contrast agent. Tomographic images of axial wall and gingival floor of each restoration were obtained by CP-OCT (IVS-300, Santec) with a central wavelength of 1330 nm and were imported to an image analysis software to quantify microleakage. RESULTS: Mann-Whitney U test showed statistically significant difference in microleakage percentage between the groups at both axial wall and gingival floor (p < 0.05). SE2 group had the lowest percentage of microleakage (p < 0.05), as only few cross-sections showed areas of reflections from contrast agent penetrating into axial wall (8.23 ±â€¯6.8) and gingival floor (7.07 ±â€¯4.1), followed by TNU group (18.13 ±â€¯12.9 axially and 30.61 ±â€¯11.9 gingivally). Microleakage was frequently observed at the axial wall and gingival floor of TSE group, showing the highest percentages of 25.50 ±â€¯12.5 and 36.97 ±â€¯10.2, respectively (p < 0.05). CONCLUSION: All tested groups exhibited different extent of interfacial microleakage, however, two-step self-etch adhesive yielded superior adaptation in comparison to one-step self-etch adhesive and universal adhesive.

Effect of light irradiation condition on gap formation under polymeric dental restoration; OCT study.

OBJECTIVE: To investigate the effect of two light-curing systems; quartz tungsten-halogen (QTH) and light-emitting diode (LED), and irradiation time on interfacial gap formation of dental composite resin restorations bonded with an adhesive resin using optical coherence tomography (OCT). MATERIALS AND METHODS: Forty cavities were prepared in extracted human molar teeth and divided into four groups (n=10) based on the type of light curing system QTH (LITEX 680A) and LED (Demi Plus) and curing duration (10 s or 40 s). A single-step self-etching dental adhesive (Tetric® N-Bond; Ivoclar Vivadent AG, Schaan, FL, Liechtenstein) was applied and polymerized with QTH for 10 s (QTH-10), or for 40 s (QTH-40). Similarly, the adhesive in LED-10 and LED-40 groups was polymerized with an LED for 10 s or 40 s, respectively. Then, all specimens were restored with Filtek™ Z350 XT flowable composite (3M ESPE AG, St. Paul, MN, USA) and immersed in ammoniacal silver-nitrate contrasting solution. Cross-sectional images were recorded at every 250µm using cross-polarization OCT system (CP-OCT; IVS-300, Santec, Komaki, Aichi, Japan). Image analysis to quantify the percentage of gap at resin-dentin interface was performed using a custom plugin for ImageJ software. RESULTS: Data analysis using one-way ANOVA showed a significant difference in mean gap percentage between the four test groups (p<0.0001). Mean gap percentage values were 75.8%, 53.2%, 9.9% and 5.6%. The highest for LED-10 followed by LED-40 (p <0.05). QTH-40 revealed a slightly better adaptation compared with QTH-10, but the difference between them was not significant (p <0.05). CONCLUSION: CP-OCT with a contrast agent is a useful non-invasive imaging tool for dental composite resin materials. QTH showed better results than LED under the experimental conditions. When using an LED light-curing unit, prolonged irradiation improved interfacial adaptation of dental composite bonded with a self-etching adhesive.

Adaptation Assessment of Three Bonded Resin Restorations at the Cavity Floor Using Cross-Polarization Optical Coherence Tomography.

Objective: The aim of the study was to compare the composite adaptation of three systems by using cross-polarization optical coherence tomography (CP-OCT). Background data: Most polymer-based restorations suffer from polymerization shrinkage that affects the interfacial seal. This shrinkage cannot be detected by conventional X-ray methods. Optical coherence tomography was proved to be a reliable non-invasive imaging tool to examine biological structures and biomaterials at micron scale. Methods: Twenty-four cylindrical class-V cavities were prepared on the buccal surfaces of the extracted human molars. After cavity preparation, samples were randomly divided into three groups (n = 8) according to the restoration system: one-step self-etch Clearfil Tri-S Bond Plus with Clearfil Majesty ES-2 composite (TS; Kuraray Noritake Dental), Single Bond Universal in self-etch mode with Filtek Z350 XT composite (SB; 3M ESPE), and one-step self-etch Plafique Bond with Plafique LX 5 composite (PB; Tokuyama Dental). The restoration placement was carried out according to the manufacturers' recommendations. Later, the specimens were immersed in a contrasting agent; then, image acquisitions were taken by CP-OCT to calculate the adaptation percentage by using an image analysis software. Results: Mann-Whitney U test showed no statistical significant difference in the adaptation percentage between TS (91.72 ± 11.6) and SB (93.43 ± 6.9) groups (p > 0.05). However, the adaptation percentage in PB (41.83 ± 28.5) was significantly lower than in the other tested groups (p < 0.05). Conclusions: Within the limitation of the study, TS and SB groups showed better adaptation than PB. Moreover, CP-OCT is a useful imaging tool that can display composite adaptation at micron scale.

Effects of coating materials on nanoindentation hardness of enamel and adjacent areas.

OBJECTIVES: Materials that can be applied as thin coatings and actively release fluoride or other bioavailable ions for reinforcing dental hard tissue deserve further investigation. In this study we assessed the potential of resin coating materials in protection of underlying and adjacent enamel against demineralization challenge using nanoindentation. METHODS: Enamel was coated using Giomer (PRG Barrier Coat, PBC), resin-modified glass-ionomer (Clinpro XT Varnish, CXT), two-step self-etch adhesive (Clearfil SE Protect, SEP) or no coating (control). After 5000 thermal cycles and one-week demineralization challenge, Martens hardness of enamel beneath the coating, uncoated area and intermediate areas was measured using a Berkovich tip under 2mN load up to 200µm depth. Integrated hardness and 10-µm surface zone hardness were compared among groups. RESULTS: Nanoindentation and scanning electron microscopy suggested that all materials effectively prevented demineralization in coated area. Uncoated areas presented different hardness trends; PBC showed a remarkable peak at the surface zone before reaching as low as the control, while CXT showed relatively high hardness values at all depths. SIGNIFICANCE: Ion-release from coating materials affects different layers of enamel. Coatings with fluoride-releasing glass fillers contributed to reinforcement of adjacent enamel. Surface prereacted glass filler-containing PBC superficially protected neighboring enamel against demineralization, while resin-modified glass-ionomer with calcium (CXT) improved in-depth protection. Cross-sectional hardness mapping of enamel on a wide range of locations revealed minute differences in its structure.

In situ characterization of resin-dentin interfaces using conventional vs. cryofocused ion-beam milling.

OBJECTIVE: The introduction of focused ion beam (FIB) milling has facilitated preparation of hard tissue samples for transmission electron microscope (TEM). However, this technique generates high temperature that may alter or damage morphological features in biological tissue. Therefore, the aim of this study was to determine the effects of cryogenic cooling on the morphological features of dentin interfaces with dental restorative materials in samples prepared by FIB for TEM examination. METHODS: After preparation of a cylindrical-shaped cavities in extracted, non-carious premolar teeth, the specimens were restored with dental adhesive/composite and categorized into two restorative materials groups; (PB) a combination of Clearfil Protect Bond (Kuraray Noritake Dental, Japan)/Estelite Sigma Quick composite (Tokuyama Dental, Japan), and (SB) Filtek Silorane restorative system (3M ESPE, USA). The specimens were subjected to interfacial cross-sectioning, followed by observation and area selection using confocal laser microscopy. Later, ultrathin sections were prepared using FIB with cryogenic cooling (PB-C) and (SB-C), or without cooling (PB-NC) and (SB-NC) that all were examined under TEM. RESULTS: Resulting TEM images of the ultra-morphological features at the resin-dentin nano-interaction zone were improved when FIB preparation was conducted in the cryogenic condition and no sign of artifacts were detected. SIGNIFICANCE: Conducting ion beam milling with cryogenic cooling was advantageous in minimizing the elevation in specimen temperature. This led to preservation of dentin microstructures that revealed additional information about substrates that are necessary for advanced characterization of tooth-biomaterial interactions.

Optical coherence tomography for evaluation of enamel and protective coatings.

Optical coherence tomography (OCT) is an interferometric imaging technique. This study aimed to employ OCT to evaluate four different resin-based materials including a coating containing glass-ionomer filler and calcium, a giomer, and two fluoride-releasing self-etch resins. The coating and its underlying and adjacent enamel were monitored using swept-source OCT (center wavelength: 1330 nm) at baseline, after 5,000 thermal cycles, and after 1, 4 and 7 days of demineralization (pH 4.5). The coatings showed different thicknesses (60-250 micrometers) and various levels of structural and interfacial integrity. OCT could detect a demineralization inhibition zone adjacent to the edge of the fluoride- and calcium-releasing material. Localized demineralization was occasionally observed under thinner coatings. Protection of susceptible enamel surfaces by thin resin-based bioactive coatings provides protection from demineralization. OCT can be used to non-destructively monitor the integrity of such coatings, as well as enamel changes beneath and adjacent to them.

Concurrent evaluation of composite internal adaptation and bond strength in a class-I cavity.

OBJECTIVES: This study investigated class-I cavity floor adaptation by swept-source optical coherence tomography (OCT) in combination with microtensile bond strength (MTBS) using different filling methods. METHODS: Two adhesive systems; Tokuyama Bond Force and Tri-S Bond Plus were used in conjunction with a universal composite (Estelite Sigma Quick) placed either incrementally (oblique) or in bulk with or without a flowable composite lining (Palfique Estelite LV). Ten serial B-scan images were obtained throughout each cavity by OCT (center wavelength: 1319nm). In order to evaluate adaptation defined as the cavity floor percentage showing no gap, a significant increase in the signal intensity was considered as gap at the bonded interface of the cavity floor. The same specimens were then cut into beams to measure MTBS at the cavity floor. RESULTS: Two-way ANOVA demonstrated that the interaction of adhesive systems and filling techniques was significantly affecting both adaptation and MTBS (p<0.05). There was a significant correlation between MTBS and adaptation at cavity floor (p<0.05). Cavity floor adaptation and MTBS were improved when incremental filling technique was applied, while the outcome of lining technique was variable. CONCLUSIONS: Quantitative assessment by OCT can non-destructively provide information on the performance and effectiveness of dental composites and restoration techniques. There was a moderate correlation between floor adaptation and bond strength in class-I cavities. Incremental application of composite restoration showed the best performance in terms of bond strength and internal adaptation. CLINICAL SIGNIFICANCE: Incremental application of composite restoration was the most advantageous placement technique in terms of bond strength and internal adaptation. The lack of placement pressure with flowable composites may affect their adaptation to all-in-one adhesives; therefore, the outcome of cavity lining by flowable composite was variable.