RESUMO
Red-fluorescing dentine indicates bacterial contamination [Caries Res 2002; 36: 315-319]. We investigated effect of removal of red fluorescent dentine caries on shear bond strength and fracture mode of 4 adhesive approaches. Sixty-five carious teeth and 50 noncarious controls were distributed into 4 groups: Clearfil™ self-etch (CSE), OptiBond™ FL total etch (OTE), Scotchbond™ Universal total etch (STE) and self-etch (SSE). Samples were excited at 405 nm and viewed through 530 nm filter. Carious samples were ground flat exposing strongly red-fluorescing (StrongRF) dentine, on which a composite cylinder was placed, using one of 4 adhesives. After 22 h in water, shear bond strength and fracture mode were analysed. StrongRF was removed; composite cylinders were placed on weakly red-fluorescing (WeakRF) dentine and tested as described above. Finally, red-fluorescing dentine was removed, and composite cylinders were placed on non-fluorescing (NonRF) dentine and tested. Composites were placed at 3 corresponding heights in controls. After 22 h in water, shear bond strength testing and fracture mode analysis were performed. Differences were tested using Mann-Whitney or Wilcoxon tests (p ≤0.05). Median (Q1, Q3) shear bond strength on StrongRF was SSE 14.4 (9.2, 18.2) MPa >CSE 10.2 (6.4, 17.3) MPa >STE 9.1 (6.9, 11.2) MPa >OTE 6.8 (4.0, 10.8) MPa. Shear bond strength increased statistically significantly for all adhesives on WeakRF: SSE 19.8 (13.6, 24.3) MPa >STE 19.5 (12.7, 23.1) MPa >CSE 17.5 (12.0, 22.5) MPa >OTE 15.8 (11.9, 20.9) MPa. Only STE 25.6 (22.4, 29.1) MPa and CSE 22.1 (17.6, 24.6) MPa were significantly different on NonRF compared to WeakRF. For controls tested at corresponding depths, superficial shear bond strength was OTE 18.7 (16.0, 22.1) MPa >STE 18.4 (12.0, 25.9) MPa >CSE 18.1 (12.7, 20.7) MPa >SSE 13.0 (9.6, 17.8) MPa. This was significantly higher compared to StrongRF except for SSE. Central shear bond strength was not significantly different to WeakRF, deep shear bond strength was significantly lower for SSE and CSE but higher for OTE compared to carious. Conclusion: StrongRF dentine should be removed for higher shear bond strength, but WeakRF dentine can often be preserved without compromising adhesive bond strength.
Assuntos
Resinas Compostas , Colagem Dentária , Humanos , Resinas Compostas/química , Cimentos Dentários , Adesivos Dentinários/química , Cimentos de Resina/química , Condicionamento Ácido do Dente , Dentina , Água , Teste de MateriaisRESUMO
PURPOSE: The purpose of this paper was to compare the ability of fluorescence-aided caries excavation (FACE) to remove infected dentin in primary teeth with that of conventional methods. METHODS: Sixty-six extracted carious primary teeth were divided according to lesion size into 3 groups of 22 teeth. Caries excavation was carried out with a slow-speed handpiece and round burs for all groups. In the first group, caries was excavated conventionally using visual tactile criteria. In the second group, a caries detector dye was used to detect carious dentin. In the FACE group, cavities were excited with violet light (370-420 nm) and observed through a 530 nm highpass filter. Orange-red fluorescing areas were removed. Undecalcified thin slices were prepared, stained with Giemsa, and examined for presence of infected dentin using light microscopy. Four samples were lost during processing. RESULTS: Histology showed infected dentin in significantly less FACE samples (3 of 22) compared to conventional excavation (9 of 20; P=.03), but not significantly less compared to caries detector (5 of 20; P=.35). CONCLUSIONS: Within the limitations of this in vitro study, it can be concluded that fluorescence-aided caries excavation is more effective than conventional excavation in removal of infected primary dentin.
Assuntos
Cárie Dentária/terapia , Preparo da Cavidade Dentária/métodos , Dentina/patologia , Dente Decíduo/patologia , Corantes , Cárie Dentária/diagnóstico , Cárie Dentária/microbiologia , Cárie Dentária/patologia , Preparo da Cavidade Dentária/instrumentação , Esmalte Dentário/patologia , Dentina/microbiologia , Fluorescência , Humanos , Luz , Dente Decíduo/microbiologiaRESUMO
In this in vitro study, quantitative confocal microscopy was used to show differences in the quantity of bacteria remaining in dentin after excavation with different methods. A further parameter was the cavity volume after excavation relative to the original lesion size. Teeth with dentin caries were divided into three groups of 20 each. The caries was removed by a single operator using a slow handpiece and a round bur. In the first group, Fluorescence Aided Caries Excavation (FACE) was carried out: violet light was used to illuminate the operating field and the operator observed the cavity through a high-pass filter and removed the orange-red fluorescing areas. The second group was excavated using Caries Detector, while the third group used conventional excavation. After excavation, cavity volume was measured; samples were stained for bacteria with ethidium bromide, and they were examined using confocal microscopy under standardized conditions. The bound stain was quantified in terms of fluorescence intensity on the confocal images. Total pixel intensity was significantly lower in the FACE Group than in the Caries Detector group (p = 0.046) and in the conventional excavation group (p = 0.021). Differences in cavity volume relative to original lesion size were not statistically significant (p = 0.86, 0.35 and 0.51). Within the limitations of this in vitro study, it can be concluded that FACE is more effective in removing infected dentin without significantly increasing cavity size when compared to conventional excavation and excavation with the aid of caries detector dye.
Assuntos
Testes de Atividade de Cárie Dentária , Cárie Dentária/diagnóstico , Preparo da Cavidade Dentária/métodos , Dentina/microbiologia , Corantes , Cárie Dentária/microbiologia , Cárie Dentária/patologia , Cárie Dentária/terapia , Dentina/patologia , Fluorescência , Humanos , Luz , Microscopia Confocal , Dente Molar , Propilenoglicóis , Rodaminas , Estatísticas não ParamétricasRESUMO
This clinical report describes the prosthodontic treatment of a 60-year-old woman to close an edentulous space in the region of the maxillary canine. Single-retainer resin-bonded fixed partial dentures (FPD) have shown satisfactory results in different studies. Recent in vivo studies have shown excellent results for all-ceramic anterior FPDs after 5 years. In the present situation, a cantilevered all-ceramic FPD chosen to replace a missing maxillary canine showed success at the 2.5-year follow-up. Special attention was given to functional and minimal restorative considerations. The use of single-retainer all-ceramic FPDs is discussed. The present case does not represent a routine and well-documented approach for the replacement of a missing maxillary canine. Rather, it is a rarity that was successful because of space availability, present occlusal scheme, and patient cooperation. Implant-supported restorations always should be considered as the first treatment option in such a clinical situation.
Assuntos
Porcelana Dentária , Planejamento de Dentadura , Retenção de Dentadura/instrumentação , Prótese Adesiva , Dente Canino , Feminino , Humanos , Arcada Parcialmente Edêntula/reabilitação , Maxila , Pessoa de Meia-IdadeRESUMO
This study is on fluoride uptake into enamel following fluoride precipitation with calcium hydroxide. Five specimens each from 12 bovine incisors were polished, covered with a salivary pellicle, and distributed into five groups (n=12). A fluoride solution (43,500 ppm F from magnesiumfluorosilicate, copper-(II)-fluorosilicate and sodium-fluoride, pH 2; Tiefenfluorid Touchierlösung, Humanchemie) and Ca(OH)2-solution (Tiefenfluorid Nachtouchierlösung) were applied subsequently in group TN. "Touchierlosung" only was used in group T, sodium-fluoride (43,500 ppm F, pH 2) in group NaF, and aminefluoride (Elmex fluid, 10,000 ppm F, pH 4) in group EF. No fluoride was used in group NK (negative control). Following rinsing and 24 h storage in artificial saliva surface KOH-soluble fluoride content (KOHF), and structurally bound fluoride content (SBF) from three layers (0-33, 33-66 and 66-99 pm) was determined by fluoride electrode procedures. KOHF (median in microg/cm2) of NK was below the lower limit of quantification of the fluoride electrode. The other group values were significantly higher (Mann-Whitney test, p < or = 0.05). TN (1.6), T (1.4) and NaF (1.1) did not differ significantly. EF (0.6) was significantly smaller than TN and T but not smaller than NaF. SBF (0-33, 33-66, 66-99 pm; median in microg/cm3) of TN (445, 341, 275), T (644, 481, 360), NaF (804, 480, 307) and EF (449, 346, 280) did not differ significantly but, with the exception of TN, were significantly higher as compared to NK. A precipitation reaction with Ca(OH)2 following fluoridation did not increase enamel fluoride uptake.
Assuntos
Aminas/farmacocinética , Cariostáticos/farmacocinética , Esmalte Dentário/metabolismo , Fluoretos/análise , Fluoreto de Sódio/farmacocinética , Animais , Hidróxido de Cálcio/química , Bovinos , Precipitação Química , Dentifrícios/farmacocinética , Diaminas , Fluoretos/farmacocinética , Concentração de Íons de Hidrogênio , Hidróxidos/química , Técnicas In Vitro , Eletrodos Seletivos de Íons , Compostos de Potássio/química , Ácido Silícico/farmacocinética , Estatísticas não ParamétricasRESUMO
UNLABELLED: The aim was to evaluate subjectivity (using inter- and intraexaminer repeatability), the effect of examiner experience, and residual caries diagnostic accuracy with visual tactile (VT) criteria and using a caries disclosing agent (CD). Thirty teeth with occlusal caries were excavated by a single operator not involved in the diagnostic part of the study. A test area was marked in each cavity. Four dentists with more than five and five dentists with less than five years' experience rated the marked area twice (a week apart) using VT criteria. A week later, the samples were stained using Caries Detector. The same examiners rated the presence or absence of stain in the marked area twice (a week apart). Undecalcified thin slices were examined for bacteria using light microscopy. Overall kappa for inter-examiner repeatability was higher for CD (0.45) than VT (0.31). In the less experienced group the kappa value was higher for CD (0.41) than for VT (0.23). In the experienced group kappa was lower for CD (0.43) than for VT (0.46). Median kappa for intra-examiner repeatability was higher for caries detector (0.77, 0.53) compared to visual tactile (0.52, 0.34) for the more and less experienced examiners respectively. There was no significant difference between the experienced and the inexperienced group in combined sensitivity and specificity (mean) for VT (0.52, 0.53) or CD (0.60, 0.58). IN CONCLUSION: VT was more subjective than CD, except for experienced examiners who had a higher inter-examiner repeatability for VT than CD. Diagnostic accuracy for residual caries does not increase with experience.
Assuntos
Competência Clínica , Cárie Dentária/diagnóstico , Propilenoglicóis , Rodaminas , Análise de Variância , Dentina/microbiologia , Dentina/patologia , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estatísticas não ParamétricasRESUMO
UNLABELLED: This in vitro study compared the efficiency (time taken to excavate and successfully remove bacterially infected dentin) of Fluorescence Aided Caries Excavation (FACE), caries detector dye (CD), chemomechanical excavation (CS) and conventional excavation (CE). Teeth with dentin caries were assigned to 4 groups (n= 25). Caries excavation was carried out by one operator. In the FACE group, the operating field was illuminated with violet light. The operator observed the teeth through a high-pass filter and removed orange-red fluorescing areas with a slow speed bur. In the CS group, Carisolv was applied to the cavity using CS hand instruments and allowed to act for 30 seconds before caries was removed. In the CD group, caries was removed using the Caries Detector and, in the CE group, conventional excavation was carried out using visual-tactile criteria. The excavation time was recorded. Undecalcified thin slices (8 microm) were prepared, stained with giemsa and examined using light microscopy. The excavation time (median) was significantly shorter for FACE (3 minutes, 3 seconds) compared to CS (5 minutes, 8 seconds, p=0.015), CD (5 minutes, 26 seconds, p=0.003) and CE (4 minutes, 2 seconds, p=0.025). Histology showed remaining bacteria in significantly fewer (5/25) FACE samples compared to CS (15/25 p=0.004) CD (12/25 p=0.037) but not significantly fewer than CE (11/25 p=0.069). IN CONCLUSION: the excavation result with FACE is equal to CE and superior to CD and CS but requires a significantly shorter excavation time.
Assuntos
Cárie Dentária/terapia , Preparo da Cavidade Dentária/métodos , Corantes Azur , Cárie Dentária/microbiologia , Cárie Dentária/patologia , Dentina/microbiologia , Dentina/patologia , Eficiência , Filtração/instrumentação , Fluorescência , Corantes Fluorescentes , Ácido Glutâmico/uso terapêutico , Humanos , Leucina/uso terapêutico , Iluminação/instrumentação , Lisina/uso terapêutico , Propilenoglicóis , Rodaminas , Fatores de TempoRESUMO
A recent study showed that orange-red fluorescence in carious dentin could be used to detect residual caries (Lennon & others, 2002). This study compared the ability of a new fluorescence-aided caries excavation technique (FACE) with the conventional method. Forty extracted teeth with occlusal dentin caries were selected. The teeth were bisected longitudinally through the center of the lesion. Lesion depth and width were measured and the teeth were divided into two groups of 20, each with the same average lesion size. The tooth halves were reassembled and fixed by embedding the roots in acrylic resin. Access cavities were prepared using a high-speed handpiece and diamond fissure bur. In the FACE group, violet light (370-420 nm) was fed into the fiber optics of a slow-speed hand-piece, so that it illuminated the operating field. The cavity was observed through a 530-nm high-pass filter and orange-red fluorescing areas were removed. In the conventional group, a sharp probe was used to detect soft dentin, which was removed. One-half of each tooth was stained for bacteria using Ethidium Bromide and examined using Confocal Laser Scanning Microscopy (CLSM). Bacteria were present in significantly (p=0.037) fewer FACE samples (3) compared to conventional samples (9). It can be concluded that the new method is more effective than conventional caries excavation.
Assuntos
Testes de Atividade de Cárie Dentária , Cárie Dentária/diagnóstico , Preparo da Cavidade Dentária/métodos , Cárie Dentária/microbiologia , Preparo da Cavidade Dentária/instrumentação , Dentina/patologia , Fluorescência , Humanos , Microscopia ConfocalRESUMO
This study investigated the effect of compomer on initial interproximal caries development. One-hundred and sixty cylindrical, and 40 semispherical, bovine enamel samples (control) were prepared, polished, and sterilized. Sixty semicircular samples were prepared from each of the compomer Dyract eXtra and the fluoride-free composite Spectrum TPH. Samples were stored in water and fluoridated twice daily for 28 d. A baseline quantitative light fluorescence (QLF) image was made of each cylindrical sample. Twenty volunteers received intra-oral appliances with eight sample chambers. Each wing contained 1 control sample and either 3 Dyract eXtra or 3 Spectrum TPH samples in contact with the enamel surface of a cylindrical enamel sample. Appliances were worn for 24 h a day for 28 d except during toothbrushing (twice daily) and placement in 10% sucrose solution (five times daily). A final QLF image was made after 28 d. Caries development was analyzed as the lesion area x mean fluorescence loss (DeltaQ % mm(2)) between these and the baseline images using QLF subtract software. The median DeltaQ was significantly lower in the Dyract eXtra group (-6.1% mm(2)) than in the Spectrum TPH (-13.9% mm(2), P Assuntos
Cariostáticos/uso terapêutico
, Compômeros/uso terapêutico
, Cárie Dentária/tratamento farmacológico
, Materiais Dentários/uso terapêutico
, Fluoretos/uso terapêutico
, Adolescente
, Adulto
, Animais
, Bovinos
, Compômeros/química
, Materiais Dentários/química
, Humanos
, Pessoa de Meia-Idade
, Estatísticas não Paramétricas
RESUMO
In this study, the light-emission properties of carious and sound root surfaces were investigated under a wide range of excitation wavelengths. Human molar teeth with exposed root surfaces containing light- and dark-discolored root caries (n = 3 of each) were selected. Emission spectra were recorded from carious and corresponding sound root surface areas from each tooth by using a fluorescence spectrophotometer at excitation wavelengths from 360 nm up to 580 nm, in steps of 20 nm. The spectra were corrected for fluctuations in detector sensitivity and excitation light intensity, and normalized to peak intensity. Excitation spectra were recorded for selected emission wavelengths that showed maximum intensity. Light- and dark-discolored root surface caries showed distinct fluorescence emission bands between 600 and 700 nm that were not present in sound root surface areas. These bands were strongest for excitation wavelengths between 390 and 420 nm. The excitation spectra of root caries revealed maximum excitation at around 405 nm, which is equivalent to the Soret band of porphyrin compounds. The emission spectra of both types of root caries lesions were shifted towards longer wavelengths (red shift at half maximum) when compared to the spectra of corresponding sound root surfaces. The red shift for dark-discolored root caries was higher than for light-discolored lesions at all excitation wavelengths.