Prognosis test by visualization of demineralized dentin under restorations to prevent initial wall-lesions initiated by lactic acid.

PURPOSE: To visualize the complete protection of restored dentin in the acidic environment by the complete impregnation of resin into demineralized dentin. METHODS: Class V cavities prepared in extracted human molars composed of enamel, cementum and dentin surfaces were sealed using either 4-META/MMA-TBB resin with conditioning periods of 10, 30, 60 seconds with 10% citric acid and 3% ferric chloride mixed aqueous solution (10-3) or Single-Bond 2 adhesives prior to restoration with light-cured resin-composite. Specimens were either immersed in artificial saliva or 0.1 mol/L buffered lactic acid solutions at 37°C for 14 days. After immersion in 0.5% basic fuchsin dye for 24 hours, the extent of dye penetration at the margin was measured. SEM micrography was used to investigate the quality of hybridized dentin when immersed in HCl followed by NaOCl solutions. RESULTS: After lactic acid exposure, dye penetration into the adjacent demineralized cementum/dentin was found to be significantly lower than the leakage distance under 30 and 60 seconds and Single-Bond 2 specimens. Leakage-free margins were found in 10-second conditioning period specimens for both control and after soaking in buffered lactic solution with the stable hybridized dentin after chemical challenge. CLINICAL SIGNIFICANCE: A leakage-free interfacial layer, provided by complete hybrid layer formation, can block lactic acid penetration. Using this novel prognosis test for visualization of demineralized dentin, clinical restorations are likely to be more reliably predictable in the prevention of initial wall-lesions, post-operative hypersensitivity and/or pulpal infection.

A 10-Year Clinical Evaluation of Resin-Bonded Fixed Dental Prostheses on Non-Prepared Teeth.

This study evaluated the conditions of the non-invasive resin-bonded fixed dental prostheses (FDP) and patient satisfaction up to 10 years of clinical function. A total of 23 patients who required fixed prostheses in the areas of mandibular anterior and premolar, and maxillary anterior region received resin-bonded restorations between 1999-2003. In 13 patients with 14 edentulous areas were restored with an adhesive pontic (natural tooth, acrylic and porcelain). Two indirect proximal veneers using resin composite were placed in each space in 10 patients having 13 edentulous spaces. All prostheses were bonded to the proximal surface of adjacent teeth using resin cement based on 4-META/MMA-TBB. No debonding of proximal veneers but 4 pontic debonding was observed which were rebonded and remained functional until final follow up. The abutments in pontic and proximal veneer groups were free of caries and hypersensitivity. Periodontal health was improved after treatment and was maintained for 10 years except for 4 abutments that still showed some bleeding on probing. Non-invasive resin-bonded FDPs are simple, pain-free, less costly treatment procedures that could provide acceptable clinical longevity with high patient satisfaction.

Dentin protection by a primer-less adhesive technique.

PURPOSE: To identify the remaining demineralized dentin (the permeable layer that allows leakage) when using primer-less wet bonding with a total etching period of 10 to 60 seconds compared with contemporary resin adhesives. METHODS: Extracted human molars were selected and Class V cavities were prepared on the axial surfaces at the CEJ, providing margins in enamel and dentin for leakage testing using a basic dye (n = 10). Seven groups of conditioned teeth [1-1 etched for 10, 30, and 60 seconds (primer-less wet), All-Bond 2 and Single-Bond 2 (wet), AQ-Bond (self-etched), Super-Bond C&B (dry)] were used as bonding systems for resin composite restoration. All specimens were stored in water at 37 degrees C for 24 hours before soaking in a 0.5% basic fuchsin solution for 24 hours. The distance of dye penetration was measured using stereomicroscopy. RESULTS: No leakage at the enamel- and dentin-resin interfaces was found for all etching periods of 1-1 primer-less, Super-Bond C&B, and AQ-Bond specimens. However, leakage was observed at dentin margins in two wet with primer systems, All-Bond 2 (1.31 +/- 1.39 mm) and Single-Bond 2 (0.37 +/- 0.28 mm), which required phosphoric etching to remove a weak smear layer on prepared dentin.

Marginal integrity between a prefabricated composite block and enamel, DEJ, and dentin.

PURPOSE: To evaluate the stability of the interfacial layer and leakage patterns between enamel, DEJ, dentin and three adhesive systems as demonstrated by either a dye or a silver nitrate technique to understand the marginal integrity of restored tooth substrates. METHODS: Extracted human molars were cross-sectioned to prepare enamel, DEJ and dentin surfaces. Areas with the DEJ aligned in the middle were restored with prefabricated flat composite blocks using either Superbond C&B (SB), Panavia Fluorocement (PN) or Variolink II (VL) cements. 7 restored specimens for each cement were prepared to investigate the interfacial layer after chemical challenge using SEM. Restored and control specimens for each cement were prepared for leakage tests by soaking either in 0.5% basic fuchsin or 50% silver nitrate solutions for 24 hours (n = 8). The penetration depth of tracer was measured using stereoscopy and a digital micrometer. SEM backscattered electron image and energy dispersive x-ray spectrometry were used to detect the location of the silver. RESULTS: Prepared SB hybridized enamel, dentin and DEJ were stable against soaking in HCl followed by NaOCl solutions whereas prepared DEJ- and dentin-resin interfacial layers were degraded, detached and thinner than that of enamel in VL and PN specimens. No leakage was found at the enamel-resin interface for all cements and at the DEJ- and dentin-resin interfaces for SB specimens. VL specimens showed significantly greater leakage at the interface of dentin and DEJ than did PN specimens.

Evaluation of Caries-Free Restorations Bonded with Various Adhesive Systems: In Vitro Study.

PURPOSE: Secondary caries originate from a leakage pathway where oral acids can penetrate faster and demineralize the tooth substrate deeper which can be visualized by dye penetration. The ability to prevent secondary caries by contemporary adhesive systems was evaluated in this study. Dye penetration distance through leakage and into the tooth substrate adjacent to Class V restorations after artificial caries exposure was compared. MATERIALS AND METHODS: Previously frozen extracted human molars were used to prepare the Class V cavities at the CEJ on axial surfaces. All cavities were restored with either the resin-composite or amalgam with or without resin adhesives: dry bonding: Super-Bond D-Liner II Plus; moist bonding: All-Bond 2; and self-etch bonding: AQ Bond and Clearfil Protect Bond. Two subgroups of Super-Bond D-Liner II Plus were immersed for 14 days at 37°C either in artificial saliva (negative control) or the artificial caries solution. The other groups were soaked in the artificial caries solution. The distance of dye penetration into the adjacent enamel, cementum/dentin, and tooth-resin interfaces was measured after immersion in 0.5% basic fuchsin dye for 24 h. The tooth-resin interfacial layer was investigated using SEM. RESULTS: No dye penetration into the tooth-resin interface was found in Super-Bond D-Liner II Plus and AQ Bond groups which demonstrated a constant hybrid layer after a chemical challenge. The leakage distance at the cementum/dentin-resin interface of All-Bond 2, Clearfil Protect Bond, and non-adhesive amalgam (positive control) groups was significantly higher than the distance of dye penetration into the adjacent demineralized root surface (p < 0.05). CONCLUSION: Caries associated with either amalgam or resin-composite restorations can be prevented using resin adhesives which can penetrate into the intact tooth substrate to form a stable hybrid layer. With caries-free restorations, tooth vitality may be conserved lifelong.

Stress response of adherent cells on a polymer blend surface composed of a segmented polyurethane and MPC copolymers.

To better understand the effect of 2-methacryloyloxyethyl phosphorylcholine (MPC) copolymer in improving the biocompatibility of segmented polyurethane (SPU), the expression of heat shock protein (HSP) mRNA in HeLa S3 cells adhered on SPU blended with MPC copolymers was measured. Conventionally, MPC copolymers (PMEH) were synthesized by changing the feed ratios of MPC and 2-ethylhexyl methacrylate. X-ray photoelectron spectroscopic analysis of the SPU/PMEH film indicated that the surface concentration of MPC units on the SPU/PMEH film increased with an increase in PMEH composition. HeLa S3 cells were cultured on SPU/PMEH films. The number of adherent cells on the SPU/PMEH films decreased with an increase in the concentration of PMEH. When the PMEH composition was greater than 0.5 wt %, cell adhesion and proliferation decreased markedly. Expressions of HSP27 and HSP47 mRNA were detected using the reverse transcription-polymerase chain reaction (RT-PCR). After incubation for 24 h, both the HSP mRNA expressions in the HeLa S3 cells showed no significant differences among all samples. In HeLa S3 cells that adhered to the SPU film for 48 h, the expressions of HSP27 and HSP47 mRNA increased significantly when compared with those incubated for 24 h. In contrast, the two kinds of mRNA expressions decreased in the HeLa S3 cells that adhered to the SPU/PMEH films for 48 h. From these results, we concluded that PMEH was quite important in suppressing the stress response of adherent HeLa S3 cells. Therefore, SPU/PMEH blend polymers are useful as implantable biomedical materials.

Direct Tensile Strength and Characteristics of Dentin Restored with All-Ceramic, Resin-Composite, and Cast Metal Prostheses Cemented with Resin Adhesives.

A dentin-cement-prosthesis complex restored with either all-porcelain, cured resin-composite, or cast base metal alloy and cemented with either of the different resin cements was trimmed into a mini-dumbbell shape for tensile testing. The fractured surfaces and characterization of the dentin-cement interface of bonded specimens were investigated using a Scanning Electron Microscope. A significantly higher tensile strength of all-porcelain (12.5 ± 2.2 MPa) than that of cast metal (9.2 ± 3.5 MPa) restorations was revealed with cohesive failure in the cement and failure at the prosthesis-cement interface in Super-Bond C&B group. No significant difference in tensile strength was found among the types of restorations using the other three cements with adhesive failure on the dentin side and cohesive failure in the cured resin. SEM micrographs demonstrated the consistent hybridized dentin in Super-Bond C&B specimens that could resist degradation when immersed in hydrochloric acid followed by NaOCl solutions whereas a detached and degraded interfacial layer was found for the other cements. The results suggest that when complete hybridization of resin into dentin occurs tensile strength at the dentin-cement is higher than at the cement-prosthesis interfaces. The impermeable hybridized dentin can protect the underlying dentin and pulp from acid demineralization, even if detachment of the prosthesis has occurred.

Dental biomaterials and the healing of dental tissue.

This paper addresses the application of new adhesive technologies to dentistry. The bonding of synthetic polymers to dentin is difficult and it has taken a long time to produce reliable methods. Success has been achieved suing a 4-methacryloyloxyethyltrimellitate anhydride/methyl methacrylate-tri-n-butyl borane system which allows the generation of a layer of hybridised dentin. This provides a pseudo-wound-healing layer that resists demineralisation and degradation, is impermeable and inhibits secondary caries and hypersensitivity.

Physical properties and blood compatibility of surface-modified segmented polyurethane by semi-interpenetrating polymer networks with a phospholipid polymer.

Segmented polyurethanes, (SPU)s, are widely used in the biomedical fields because of their excellent mechanical property. However, when blood is in contact with the SPU, non-specific biofouling on the SPU occurs which reduces its mechanical property. To obtain novel blood compatible elastomers, the surface of the SPU was modified with 2-methacryloyloxyethyl phosphorylcholine (MPC) by forming a semi-interpenetrating polymer network (semi-IPN). The SPU film modified by MPC polymer with the semi-IPN (MS-IPN film) was prepared by visible light irradiation of the SPU film in which the monomers were diffused. X-ray photoelectron spectroscopy confirmed that the MPC units were exposed on the MS-IPN film surface. The mechanical properties of the MS-IPN film characterized by tensile testing were similar to those of the SPU film. Platelet adhesion on MS-IPN films was also investigated before and after stress loading to determine the effects of the surface modification on the blood compatibility. Many platelets did adhere on the SPU film before and after stress loading. On the other hand, the MS-IPN film prevented platelet adhesion even after repeated stress loading.

Frictional properties of poly(MPC-co-BMA) phospholipid polymer for catheter applications.

A fundamental understanding of surface properties of the biomaterials at a nanometer scale should be generated in order to understand cellular responses of the tissue to biomaterials thereby minimizing or eliminating tissue trauma at a macrometer scale. In this study poly(2-methacryloyloxyethyl phosphorylcholine-co-n-butyl methacrylate) ([poly(MPC-co-BMA]) was evaluated as a potential coating material for vascular applications to provide smooth catheterization using atomic force microscopy (AFM) techniques.A uniform coating of [poly(MPC-co-BMA] equivalent to a thickness of 2.5 microm on a polyurethane (PU) catheter material was provided using dip casting technique. Using a contact mode AFM, no significant difference in surface roughness (R(a)) and frictional force (f) between uncoated (R(a)=10.2+/-1.9 nm, f=0.907+/-0.02) and coated (R(a)=11.7+/-1.8 nm, f=0.930+/-0.06) surfaces was observed under dry conditions. However, under wet conditions the R(a) of the coated surface (3.4+/-1.0 nm) was significantly lower than uncoated PU surface (9.0+/-1.8 nm). The coating on PU substrate offered the least frictional resistance (f=0.004+/-0.001) illustrating enhanced boundary lubrication capability due to hydration of phosphorylcholine polymer as compared to a significantly higher f for uncoated PU (0.017+/-0.007) surfaces. These tribological and chemical characteristics of the [poly(MPC-co-BMA)] coating could increase the overall efficacy of PU for clinical applications.

A nonthrombogenic gas-permeable membrane composed of a phospholipid polymer skin film adhered to a polyethylene porous membrane.

Polymer membranes are widely used in biomedical applications such as hemodialysis, membrane oxygenator, etc. When the membranes come in contact with blood or body fluids, protein adsorption and cell adhesion occur rapidly. Nonspecific protein adsorption and cell adhesion on the membranes induce not only various bio-rejections but also a decrease in their performance. We hypothesized that a blood compatible gas-permeable membrane could be prepared from polyethylene (PE) porous membranes modified with phospholipid polymers. In this study, poly[(2-methacryloyloxyethyl phosphorylcholine) (MPC)-co-dodecyl methacrylate] (PMD) skin film adhered to a PE porous membrane (PMD/PE porous membrane) was prepared. Elution of PMD was not detected meaning that the PMD film did not detach from the PE porous membrane even after soaking in water for more than 6 months. The permeation coefficient of oxygen gas through the PE membrane with the adhered PMD containing more than 0.20 mole fraction of the MPC unit, was the same as that of the original PE porous membrane. The PMD surface effectively reduced biofouling. We concluded that the PMD/PE porous membrane is useful as a novel membrane oxygenator due to its excellent gas-permeability and blood compatibility.

The vascular prosthesis without pseudointima prepared by antithrombogenic phospholipid polymer.

On the luminal surface of the common synthetic vascular prostheses, blood coagulation can occur and a thrombus membrane is formed when blood flow passes through it. The thrombus membrane should be organized according to the wound healing process and it becomes a pseudointima which could serve as a blood conduit. However, the small-diameter vascular prosthesis may be quickly occluded by the initial thrombus. Therefore, no clinically applicable small-diameter prostheses have been developed to date. 2-Methacrylovloxyethyl phosphoryleholine (MPC) polymers resemble the structure of an outer cell membrane similar to the fluid mosaic model and demonstrate excellent antithrombogenicity. The purpose of this study is to develop a clinically applicable small-diameter prosthesis based on the new concept of the MPC polymer. We prepared vascular prostheses (2mm ID) from polymer blend composed of segmented polyurethane and the MPC polymer. The prostheses were placed in rabbit carotid arteries. The luminal surface retrieved at eight weeks after implantation was clear without thrombus and pseudointima. We now realize that the vascular prosthesis having the MPC polymer can be applied as a small-diameter prosthesis because it functions without thrombus and pseudointima formation.

AFM observation of collapse and expansion of phosphoric acid-demineralized dentin.

The objective of this study is to provide additional data regarding morphological changes that occur to dentin matrices following demineralization with etchants. Our understanding of the mechanism of diffusion of comonomers into the demineralized substrate is very limited. It has been hypothesized that certain water-soluble polyelectrolytes (acidic proteins) and neutral proteins in dentin can influence the collapse of demineralized dentin when it is air dried. Some of these solubilized substances are thought to aggregate by the action of Ca cations, which become dissolved during H(3)PO(4) etching, ultimately resulting in some degree of collapse. In the current study, dentin surfaces were examined by atomic force microscopy (AFM) before and after treatment by 10% H(3)PO(4)containing increasing concentrations of CaHPO(4). Reversal of matrix collapse by aqueous 30% 2-hydroxyethyl methacrylate (HEMA) was evaluated by AMF for 60 min. The results demonstrate two forms of matrix collapse; we speculate that one form is induced by acidic noncollagenous polyelectrolytes and the other by neutral peptides. Our data indicate that further evaluation of the influence of endogenous noncollagenous proteins must be studied to understand the mechanism of the collapse and reexpansion dynamics of demineralized dentin networks.

Improved wet bonding of methyl methacrylate-tri-n-butylborane resin to dentin etched with ten percent phosphoric acid in the presence of ferric ions.

The objective of this study was to determine the influence of dissolved dentinal substances in demineralized dentin on the hybridization of resin for bonding to dentin. It was hypothesized that these substances, including polyelectrolytes, significantly change the substrates, which could then be assessed by the addition of Na(+), Ca(2+), or Fe(3+) in 10% phosphoric acid. Bovine dentin specimens were etched for 10 s with a solution of 10% phosphoric acid (control) or of 22.0 mM dissolved sodium chloride (10P-Na), calcium chloride (10P-Ca), or ferric chloride (10P-Fe). The specimens were then rinsed, blot-dried, and primed three times with 5% 4-methacryloyloxyethyl trimellitate anhydride in acetone for 60 s. Methyl methacrylate-tri-n-butylborane resin was then applied. The tensile bond strength of each of the dumbbell-shaped specimens was then measured. The fractured surfaces and modified cross-sections were examined by scanning electron microscopy. The cross-sections were soaked in 6N HCl for 10 s and then in 1% sodium hypochlorite for 30 min to determine the resin content in the hybridized specimens. Shrinkage of the demineralized dentins upon drying was assessed by atomic force microscopy. The tensile bond strengths were 10.8 +/- 4.5 (control), 15.0 +/- 7.0 (10P-Na), 19.3 +/- 5.5 (10P-Ca), and 27.8 +/- 8.1 (10P-Fe) MPa. The atomic force microscopy studies showed that Fe(3+) minimized the shrinkage by drying for 10 s but Ca(2+) and Na(+) did not decrease the shrinkage the same as the control. The results support the hypothesis that the monomer permeability of wet demineralized dentin is effectively improved by dissolving ferric ions in the phosphoric acid, resulting in a greater bond strength and higher resin content in the hybridized dentin. The dissolved dentinal substances, including the polyelectrolytes, had a significant influence on the characteristics of the demineralized dentin, changing the degree of hybridization and bonding.

Reduced adhesion of blood cells to biodegradable polymers by introducing phosphorylcholine moieties.

Aliphatic polyesters are believed to be good biocompatible polymers for tissue engineering because of their biodegradability and nontoxicity of the degradated products. However, it is necessary to reduce the nonspecific protein adsorption for the application of biodegradable polymers to drug delivery systems or antiadhesive membranes. We hypothesized that novel biodegradable polymers could be synthesized by introducing phosphorylcholine moieties into aliphatic polyesters. The L-lactide was polymerized in the presence of L-alpha-glycelophosphorylcholine (LGPC) using stannous octate as the catalyst. The molecular weight and crystallinity of poly(L-lactide) (PLLA)-based phospholipid polymers (PLLA-PC) decreased with an increase in the composition of the LGPC unit in the PLLA-PC. The hydrolysis of the PLLA-PC was evaluated by soaking the polymer membranes in a phosphate buffer solution. The rate of weight loss was increased with increasing the LGPC units in PLLA-PC. The surface analysis of the membranes using an X-ray photoelectron microscope showed the composition of phosphorylcoline groups on the surface. The amount of adsorbed protein and adherent blood cell on the polymer surface was decreased with introducing LGPC unit. PLLA-PC is a promising biodegradable polymer having blood compatibility and antiadhesive property.

Suppression of the inflammatory response from adherent cells on phospholipid polymers.

The expression of interleukin-1beta (IL-1beta) messenger RNA (mRNA) in macrophage-like cells cultured on phospholipid polymers was evaluated to determine the extent of the inflammatory response. As phospholipid polymers, poly(2-methacryloyloxyethyl phosphorylcholine(MPC)-co-n-butyl methacrylate(BMA)s (PMBs) were synthesized. Poly(ethylene terephthalate) (PET), poly(2-hydroxyethyl methacrylate) (PHEMA), and segmented poly(ether urethane) (Tecoflex 60) were used as reference biomedical polymers. The protein adsorption onto the polymer surfaces from a cell culture medium was determined. The amount of the total protein adsorbed onto the PMBs was lower than that adsorbed onto the reference polymers, and the amount of adsorbed protein decreased with an increase in the MPC units in the PMBs. Human premyelocytic leukemia cell line (HL-60) was used, and the expression of IL-1beta mRNA was investigated with the reverse transcription polymerase chain reaction (RT-PCR) method. When HL-60 cells were cultured on PMBs, the expression of IL-1beta mRNA in the cells was much less than that on the reference polymers. In particular, the expression of IL-1beta mRNA in HL-60 cells cultured on the PMBs containing more than 10 mol % MPC units was not detected. This corresponded to the reduced amount of adsorbed proteins on the PMB surfaces. These results suggest that the PMBs effectively suppressed the activation and inflammatory response of adherent macrophagelike cells.

Importance of mini-dumbbell specimen to access tensile strength of restored dentine: historical background and the future perspective in dentistry.

OBJECTIVES: The development of adhesive resins to dentine enables resin restorations to be more durable. Several bond strength measurement techniques for measuring adhesion have been proposed. A standardised method is needed which produced higher and more consistent bond strength values which allow bond stability and the bonding mechanism to be studied. Our aim was to investigate mainly the adhesives and not the substrate. DATA SOURCES: This review is based on the literature on an adhesive, 4-META/MMA-TBB resin and conditioners to modify dentine substrates. The latter is a very important topic for developing our understanding of the bonding to dentine. The objective of the review is to explain the efficacy of the mini-dumbbell specimen in measuring the tensile strength of resin to dentine and to analyze the resin to dentine interface. Both the adhesive and the substrate control the quality of hybridized dentine. CONCLUSIONS: By creating an impermeable acid resistant barrier to both biological and chemical stimuli between the exposed dentine and the restored tooth surface we are able to protect exposed dentine from caries (infection) at the same time as protecting the pulp and preventing toothache. This barrier also helps maintain tooth vitality and for the purposes of this article is termed 'artificial enamel'. Microleakage free restorations are possible through the introduction of this 'impermeable artificial enamel' barrier.

Effect of remaining demineralised dentine on dental microleakage accessed by a dye penetration: how to inhibit microleakage?

OBJECTIVES: To demonstrate that microleakage has taken place at the defect, which was analysed previously by a tensile test using dumbbell shaped specimens trimmed from bonded resin/dentine restorations, and to suggest how microleakage can be inhibited reliably in dental treatment. METHODS: A total of 60 Class V box cavities were prepared at the cemento-enamel junction on fresh bovine incisors and randomly divided into four groups of 15 specimens each. Exposure times of etching for 10:3 conditioner were set at 10, 30 or 60 s, and for 10% phosphoric acid (positive control) at 10 s. The cavity walls were rinsed with water for 10 s, air-dried for 10 s and hybridised with 4-META/MMA-TBB resin. All the cavities were filled with a light cured resin composite and stored in 37 degrees C water for 24 h and then immersed in 15% methylene blue for 2 h. The length of dye penetration along the interface was graded by defined criteria and analysed using Kruskal-Wallis and Mann-Whitney tests. The dye penetration patterns were examined by light microscopy and the remaining demineralised dentine was analysed by Transmission Electron Microscopy (TEM). RESULTS: The least leakage score was obtained in 10s-10:3 etched group with 12 out of 15 specimens demonstrating no leakage. Leakage was significantly lower at the cementum margin than for the other three groups. No significant difference in the extent of greatest dye penetration was found between the 60s-10:3 and 10s-phosphoric etched groups. Dye penetration along the cementum margins was significantly higher than that of the enamel margins in all groups, except the 10s-10:3 etched group. TEM examination confirmed that there were exposed collagen fibrils in the remaining demineralised dentine, where microleakage had taken place. SIGNIFICANCE: It could be concluded from this study that microleakage has taken place at the defect in the bonded specimens which has correlations with zones of incompletely infiltrated demineralised dentine that was observed using TEM. A reliable method of inhibiting microleakage is the presence of well prepared hybridised dentine.

Improving a self-curing dental resin by eliminating oxygen, hydroquinone and water from its curing process.

Self-curing dental resins are always manipulated in the presence of curing inhibitory factors such as oxygen, hydroquinone, water and another contaminants such as saliva and blood. The purpose of this study was to elucidate the effects of eliminating these curing inhibitory factors on resin properties. Several clinically relevant characteristics of an experimental resin cured in the absence of inhibitory factors (purified group) were determined and compared with the resin cured conventionally (control group). The purified group showed a significantly shorter induction period and higher reaction exotherm. It also showed significantly higher tensile strength and lower strain to failure. With regard to the amount of residual monomer, fracture toughness and fatigue strength the improvements were not significant. These findings suggest that the polymerization outcomes and mechanical properties of the purified group resin can be improved in general. Dental clinicians should pay attention to the storage and curing environments while manipulating the self-curing resin.

Influence of dentin substrates to simplify wet-bonding: a leakage-free and reliable tensile strength interface for long-lasting restorations.

The wet-bonding procedure can be simplified by eliminating the primer. An aqueous mixture of 1% citric acid and 1% ferric chloride (1-1) was hypothesized as providing an easier dehydratable thinner substrate to which 4-META/MMA-TBB resin can adhere reliably. The 1-1 was applied for 10 s and rinsed off with water for 10 s. Demineralized dentin under four conditions was prepared before bonding to PMMA rod using 4-META/MMA-TBB resin: air-dried 10 s (D-NP); air-dried 10 s, primed 60 s with 5% 4-META in acetone (D-P); blotted dry 10 s (W-NP); blotted dry 10 s, primed 60 s (W-P). The tensile strengths (MPa) using mini-dumbbell specimens were 4.0 ± 2.4 for D-NP, 10.6 ± 5.4 for D-P, 38.3 ± 4.4 for W-NP, and 42.9 ± 3.3 for W-P. There was no significant difference between W-NP and W-P with cohesive failure in the dentin and the cured resin. In the wet groups, the hybridized dentin was stable against both HCl and NaOCl challenges. TEM examination and a leakage tests confirmed a perfect seal with a leakage-free interface of W-NP. These results suggest that this primer-less wet-bonding is promising method to protect the underlying intact dentin and pulp, thus providing long-lasting dental treatment.