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.

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.

Monitoring remineralization of enamel subsurface lesions by optical coherence tomography.

Optical coherence tomography (OCT) is a potential clinical tool for enamel lesion monitoring. Swept-source OCT findings were compared with cross-sectional nanohardness findings of enamel. Subsurface bovine enamel lesions in three groups were subjected to (1) deionized water (control), (2) phosphoryl oligosaccharide of calcium (POs-Ca) or (3) POs-Ca with 1 ppm fluoride for 14 days. B-scans images were obtained at 1310-nm center wavelength on sound, demineralized and remineralized areas after 4, 7, and 14 days. The specimens were processed for cross-sectional nanoindentation. Reflectivity from enamel that had increased with demineralization decreased with remineralization. An OCT attenuation coefficient parameter (µt), derived based on the Beer-Lambert law as a function of backscatter signal slope, showed a strong linear regression with integrated nanohardness of all regions (p<0.001, r=-0.97). Sound enamel showed the smallest, while demineralized enamel showed the highest µt. In group three, µt was significantly lower at four days than baseline, but remained constant afterwards. In group two, the changes were rather gradual. There was no significant difference between groups two and three at 14 days in nanohardness or µt POs-Ca with fluoride-enhanced nanohardness of the superficial zone. OCT signal attenuation demonstrated a capability for monitoring changes of enamel lesions during remineralization.

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.