A retrospective study of root canal therapy in non-vital primary molars.

AIM: This study was performed to assess the clinical and radiographic success rates of a formocresol and zinc oxide eugenol (ZOE) primary molar root canal therapy (RCT) technique. The effects of this treatment on the permanent successors and on exfoliation times were also investigated. MATERIALS AND METHODS: Study design: the retrospective study included 161 patients with 211 primary molars treated by RCT by a single operator in a private paediatric dental office in the Toronto area. Data were coded and entered into a Microsoft Excel database and analysis undertaken using SPSS software. Predominantly non-parametric tests were used to evaluate statistical differences (p < 0.05). RESULTS: A clinical success rate of 90% (190/211) and a radiographic success rate of 77.3% (136/176) were obtained. Following RCT in a primary molar, enamel defects were found in 6.8% (7/103) of premolars, all of which occurred in first premolars, and in patients treated at a mean age of 54.1 months (p < 0.005). Treated molars exfoliated on average 7.6 months sooner than contralateral teeth (p < 0.005). CONCLUSION: This formocresol and ZOE RCT is a viable treatment for necrotic primary molars and yielded very high clinical and acceptable radiographic success rates.

An in vitro comparison of short and long term bond strengths of polyacid modified composite resins to primary human and bovine enamel and dentine.

AIM: This in vitro study compared the shear bond strengths and fracture patterns over 7 and 180 day periods of two PMCRs bonded to both human and bovine primary tooth enamel and dentine to determine if the bovine tooth model is a suitable substitute for the human tooth model. METHODS: Flattened enamel and dentine surfaces were produced using water irrigated #600 grit SiC paper and the teeth randomly placed in groups of N=10. Cylinders of Dyrat AP (Dentsply/DeTrey) or F2000 (3M/ESPE) were bonded to the surfaces that were either etched with 37% H(3)PO(4) (etch, E groups) or treated with their respective conditioners, primers and adhesives (no etch, NE groups). The teeth were stored in distilled water at 37(o)C and shear bond strength (SBS) tested to failure at either 7 (human and bovine) or 180 days (bovine). The modes of failure were assessed under a dissecting microscope at x30. RESULTS: In general the results showed comparable mean SBS for both human and bovine enamel with Dyract AP, E and NE and also for F2000, E. Lower enamel SBS were recorded for F2000 NE but there was no significant differences in mean SBS for bovine enamel after long term storage. For dentine, significantly larger SBS were recorded for human versus bovine teeth for all of the four bonding protocols. There were also significant species differences, the mean SBS for Dyract AP, E and F2000, E for human dentine were higher than bovine but the mean SBS for the respective NE groups showed no significant differences between species. It was concluded that 37% H(3)PO(4) has a detrimental effect on SBS for bovine dentine. Over long term storage SBS of bovine dentine bonds decreased. The modes of failure were related to SBS with varying degrees of significance. CONCLUSION: Bovine primary incisor enamel and dentine, provided the latter is not conditioned with 37% H(3)PO(4), are suitable alternative test SBS substrates for human enamel and dentine.

Glass ionomer cements as luting agents for orthodontic brackets.

The objectives of the present study were to (1) assess the shear bond strengths of resin-reinforced glass ionomer Fuji Ortho LC and GC Fuji Ortho cements under differing conditions and (2) compare their bonding performance with that of conventional resin composite bonding systems. A sample of 264 bovine incisors was divided into 22 groups of 12 teeth each and bonded with SPEED central incisor brackets. Enamel surfaces of the teeth in the two experimental groups were conditioned according to the manufacturer's instructions; moreover, groups unconditioned before bonding were also included under both wet and dry conditions. A self-cure composite resin (Phase II) and a light-cure composite resin (Transbond XT) served as controls and were etched with 37% phosphoric acid and bonded in a dry field. After incubation at 37 degrees C for 24 hours and for seven days, the specimens were tested to failure with a shear force in an Instron machine. The Adhesive Remnant Index (ARI) was used to assess the amount of resin left on the enamel surfaces after debonding. Selected specimens were examined using scanning electron microscopy. Statistical analyses included analysis of variance tests, t-tests, and correlation coefficient calculations and showed that no significant difference existed between the glass ionomer cements under wet or dry conditions, provided the enamel was conditioned with 10% polyacrylic acid before bonding. Both glass ionomer cements were thus acceptable for bonding. Transbond XT had the highest mean shear bond strength irrespective of the incubation period. A positive correlation was obtained between the ARI scores and bond strength.

Combinations of etchants, composite resins, and bracket systems: an important choice in orthodontic bonding procedures.

The objectives of this investigation were: (1) to compare the shear bond strengths (SBS) of metal, ceramic, and plastic brackets using different concentrations of maleic and phosphoric acid gels and aqueous solutions, and (2) to determine if a relationship exists between the type of acid etchant and the location of resin after debonding. A sample of 210 bovine incisors was divided among three different bracket groups (Victory series metal, Transcend 6000 ceramic, Spirit MB plastic). Prior to bonding, enamel was acid-etched using 37% phosphoric acid (H3PO4) gel and aqueous solution, 10% maleic acid gel and aqueous solution, 10% H3PO4 gel and aqueous solution, or 2% H3PO4 aqueous solution. SBS testing and the adhesive remnant index (ARI) score provided insight into the effects of the bonding process on enamel. Resin tags associated with each etchant type were inspected under scanning electron microscopy (SEM). Statistical analyses (level of significance, p = 0.05) of the data showed significant differences among groups. It was concluded that specific acid-composite-bracket combinations are recommended for use in clinical orthodontic practice in order to achieve efficient bonding.

Scanning electron microscopic study of the interface of glass ionomer cement sealers and conditioned bovine dentin.

This in vitro study characterized the interface of glass ionomer cement root canal sealers and dentin conditioned by common endodontic irrigants. The interface of Ketac-Endo and two experimental glass ionomer cement sealers (KT-308 and ZUT) with bovine dentin--conditioned with either distilled water, 2.6% NaOCl, or 17% EDTA, followed by 2.6% NaOCl--was investigated. Cylinders of each of the sealers were formed on the conditioned dentin surface and allowed to set for 90 min. They were first shear tested to failure to determine their adhesive bond strength. Then three dentin specimens from each group were processed for scanning electron microscopic study. The test-failed surface of the strongest and weakest bonded specimens was examined. A third specimen, of intermediate bond strength, was cross-sectioned and the interface was also examined. Failures in all of the specimens were found to be mainly cohesive in nature. Specimens conditioned with 2.6% NaOCl only revealed the presence of a hybrid layer at the interface composed of dentin and whichever of the sealers were tested.

The effect of various storage methods and media on shear-bond strengths of dental composite resin to bovine dentine.

A variety of media and methods have been used to store teeth used in bond-strength studies of resin restorative materials to dentine. This study examined the effect of 2 months of storage using 11 different methods and media on the shear-bond strength of Z100 resin composite to bovine dentine mediated by Scotchbond Multi Purpose adhesive. Freshly harvested teeth were used as controls. The results showed that 7 of the l1 storage methods or media were similar in shear-bond strengths and bond-failure characteristics. Four of the 11 methods (irradiation, or storage in thymol, methanol, and glutaraldehyde) resulted in significantly lower shear-bond strengths and atypical shear-bond failure, indicating that these are the least desirable methods of tooth storage for studies of this type. This study has further shown that if insufficient numbers of fresh teeth are available for studies of shear-bond strength, then freezing is the preferred method of storage for the registration of high shear-bond strengths. It is also apparent that further investigations are needed to examine what post mortem changes occur in dentine, whether these changes are modified by various storage conditions, and whether they have any significant effect on bonding of resin composites.

The relationship between bond strength and orthodontic bracket base surface area with conventional and microetched foil-mesh bases.

The aim of this study was to test the effects on the shear bond strength by sandblasting bracket base surfaces, reducing base surface area, and etching enamel with various acid types. Four different base sizes, used as either standard (untreated), sandblasted or microetched were bonded with Phase II resin (Reliance Orthodontic Products, Inc.) in four groups of 12 bovine enamel specimens after enamel etching with phosphoric acid gel (37%), 37% phosphoric acid aqueous solution, 10% maleic acid gel, or 10% maleic acid aqueous solution. Storage of samples was for 7 days in distilled water at room temperature before shear bond testing with an Instron universal testing machine with a crosshead speed of 0.5 mm/min. Statistical analyses included the analysis of variance, the Student t test, and the Chi-square test at p < 0.05. An increase in shear bond strength was associated with sandblasting and microetching of foil-mesh bases for all base sizes (p < 0.05). No statistically significant difference in shear bond strength existed between the three larger base sizes, which indicated that shear bond strength is independent of surface area between 6.82 and 12.35 mm2. A reduction in bond strength was associated with the reduction of base surface area from 6.82 to 2.38 mm2 (p < 0.05). There appears to be no need to increase base surface area beyond 6.82 mm2. Aqueous maleic acid (10%) etching of the enamel was associated with the highest shear bond strength, with no statistically significant difference between the other three acids used.

A short- and long-term shear bond strength study using acids of varying dilutions on bovine dentine.

OBJECTIVES: The purpose of this study was to evaluate the short-(24 h) and long-(180 day) term shear bond strengths of resin to bovine dentine etched with varying dilutions of aqueous solutions of phosphoric and maleic acids. METHODS: Bovine dentine surfaces were prepared using water irrigated #600 grit SiC paper. The dentine surfaces were etched in groups of 10 teeth using various dilutions of phosphoric or maleic acid. Using the Scotchbond Multipurpose System (SBMP; 3M Co., MN, USA) and a wet technique the etched surfaces were primed and unfilled bonding resin (UBR) was applied to the dentine surface within the confines of a gelatin cylinder. A cylinder of filled resin (Z 100; 3M Co., MN, USA) was then photocured and the specimens were then stored in water for 24 h or 180 days prior to shear bond testing to failure. RESULTS: The results showed that high bond strengths were recorded using acids which were more dilute than those commercially available. There were also indications that phosphoric acid is not the etching acid of choice for the SBMP system. CONCLUSIONS: The results of this study showed that high bond strengths can be achieved in dentine using etching acids which are more dilute than those commercially available. Maleic acid appears to be the etchant of choice for the SBMP system.

SEM observations of the reactions of the components of a light-activated glass polyalkenoate (ionomer) cement on bovine dentine.

OBJECTIVES: Glass ionomer cements are used in clinical dentistry as lining, luting and restorative materials. The precise nature of their bonding mechanism to dentine is unclear. This study is an SEM examination of the effect of the liquid contained in Vitrebond cement (3M Co., MN) on the surface of bovine dentine, with respect to delays in photocuring and washing off with water under pressure or as a gentle stream. The effects of delaying photocuring of the mixed and applied cement for up to 120 s were also examined. RESULTS: The results of this study demonstrated that the liquid component of Vitrebond reacts chemically with dentine in a manner suggestive of an effervescent chemical reaction. This reaction produces plugs in the dentinal tubules which are resistant to dislodgement by water under pressure or by gentle washing. Similarly, a delay in photocuring the mixed and applied cements results in porosity of the cement at the dentine interface. CONCLUSION: The findings in this study suggest that the adhesion of Vitrebond to dentine is primarily chemical in nature and that its mechanical strength is compromised if there are substantial delays in photocuring.

An SEM examination of etched dentin and the structure of the hybrid layer.

The clinical requirements of dentin bonds are that they should be non-permeable to oral fluids, seal dentinal tubules, protect the pulp, and be long lasting and durable. Dentin bonding systems that use acidic agents to remove the smear layer are currently being used. Acid conditioning not only removes the smear layer, but also demineralizes the surface of the intertubular dentin and produces intratubular demineralization and funnelling. A dentin bond is produced when hydrophillic resin monomers infiltrate the dentinal tubules and collagen of the demineralized intertubular zone, producing a hybrid layer. The use of a critical point drying technique and SEM allows a clear visualization of the structure of the hybrid layer. This study showed that currently used hydrophillic resin monomers are unable to completely infiltrate the demineralized zone, and it is speculated that this failure could contribute to microleakage and influence the long-term durability of the bond. It is also apparent that these bonds depend on the mechanical investment of collagen by the infiltrating monomer. Since none of the unfilled resins tested seem capable of completely infiltrating the demineralized collagenous zone, the degree of demineralization produced by the commercial acid concentrations in current use is questioned. More dilute acids than those available commercially are shown to reduce both the degree and depth of demineralization, and we suggest that the resultant thinner layer may lend itself to more complete resin infiltration of the collagen.

Adhesion of a resin composite to bleached and unbleached human enamel.

Cylinders of a visible light-cured microfil resin were formed on and bonded to the flattened enamel surface of 15 human hemisected premolar teeth which had previously been subjected to three different treatments: (a) immersion in 35% hydrogen peroxide (HP) for 60 min, (b) immersion in 35% HP for 60 min followed by storage in distilled water for 1 day prior to resin application, and (c) immersion in saline (S) for 60 min. Specimens were stored in distilled water at 37 degrees C for 7 days prior to shear bond strength testing. A total of 30 specimens were tested. Statistical analysis of the data indicated that there was a highly significant reduction in shear bond strength between HP- and saline-treated specimens. Water storage of HP-treated specimens for 1 day prior to resin application appeared to restore the adhesiveness but not to a point that was statistically significant. Scanning electron microscopic examination of randomly selected, fractured test specimens indicated that the reduction in bond strength may be related to alterations in the ability of the resin to attach itself to the HP-treated surface and to possible effects of the HP on the resin itself.

Leaching of hydrogen peroxide from bleached bovine enamel.

Accurately weighed bovine enamel slabs were individually immersed in 2 ml of 35% hydrogen peroxide for 1, 3, 5, 30, or 60 min. A control group was obtained by individual immersion of bovine enamel slabs in 2 ml of saline for 60 min. All samples were washed, dried, acid-etched with 37% phosphoric acid for 60 s, then washed and dried again. Two milliliters of double-distilled water were used for individual sample leaching. Leaching was done for 1, 5, 10, 20 min, or 7 days for the experimental groups and for 7 days for the control group. The samples of one of the experimental groups were leached for a second time for 1 min. A total of 112 samples was used in this study. Hydrogen peroxide was spectrophotometrically identified and quantified in all leaching solutions based on the oxidation reaction of leuco-crystal violet buffer solution by hydrogen peroxide, a reaction catalyzed by horseradish peroxidase. The results revealed a significant difference in the quantity of leached peroxide between bleached samples (irrespective of the duration of leaching) and control, saline-treated ones. No difference was observed in the quantity of leached peroxide between releached samples and control, saline-treated ones. However, these were small, random, and numerically insignificant. Statistically significant differences were also noted among some of the experimental groups. They were thought to hold no clinical significance. The results suggested that upon immersion, the complete leaching of peroxide from bleached enamel occurs rapidly.

The effect of carbamide-peroxide gel on the shear bond strength of a microfil resin to bovine enamel.

Cylinders of a visible-light-cured microfil resin were formed on, and bonded to, the flattened labial enamel surfaces of young bovine incisor teeth which had previously been subjected to four different treatments: (1) immersion in 10% carbamide-peroxide gel, pH 4.7, for three h; (2) immersion in 10% carbamide-peroxide gel, pH 4.7, for six h; (3) immersion in 10% carbamide-peroxide gel, pH 7.2, for three h; and (4) immersion in 10% carbamide-peroxide gel, pH 7.2, for six h. For each experimental group, a control group of resin-bonded to saline-immersed teeth was prepared. In addition, two groups, prepared according to treatment 4, were leached in distilled water for one and seven d, respectively, prior to resin application. Specimens were stored in distilled water at 37 degrees C for seven d prior to shear-bond-strength testing. A total of 90 teeth was tested. Statistical analysis of the results indicated that there was a highly significant reduction in the shear bond strength to carbamide-peroxide-treated enamel as compared with that to saline-treated enamel. The effects of duration of peroxide treatment and pH, as well as the interaction term, were not statistically significant. Leaching of the peroxide-treated enamel in water for either one or seven d prior to resin application restored the adhesiveness of the enamel. Scanning electron microscopic examination of randomly selected, fractured test specimens indicated that the peroxide-induced reduction in enamel adhesiveness was related to alterations in both attachment-surface area at the resin-enamel interface and resin quality.

Effect of water leaching the adhesion of composite resin to bleached and unbleached bovine enamel.

Standardized cylinders of light-cured composite resin were bonded to the ground labial enamel surface of bovine incisor teeth that had been immersed in double-distilled water for 7 days after having been (a) immersed in hydrogen peroxide for 5, 30, or 60 min, then etched for 60 s with 37% phosphoric acid; (b) immersed in saline for 5, 30, or 60 min, then etched for 60 s with 37% phosphoric acid; (c) etched with 37% phosphoric acid for 60 s, then immersed in hydrogen peroxide for 5, 30, or 60 min; or (d) etched with 37% phosphoric acid for 60 s, then immersed in saline for 5, 30, or 60 min. The enamel surface was washed with water for 1 min and dried with compressed air for 30 s prior to applying the resin. The tooth and applied resin were stored in water at 37 degrees C for 1 day prior to shear and tensile testing. A total of 192 specimens was used, 8 for each enamel preparation mode, for each time period, and for each test. Test values were tabulated and statistically analyzed. Analysis of variance revealed significantly higher bond strength values (p less than 0.005) for hydrogen peroxide-treated as compared with saline-treated specimens. A significant interaction was also noted between test solution and etching order. Scanning electron microscopic examination of failed shear- and tensile-tested specimens revealed no significant solution-related differences in the fracture pattern or the resin quality.(ABSTRACT TRUNCATED AT 250 WORDS)

Scanning electron microscopy observations on the penetration and structure of resin tags in bleached and unbleached bovine enamel.

The purpose of this study was to determine the effect of hydrogen peroxide on the ability of composite resin to penetrate bovine enamel etched with phosphoric acid. In a previous investigation, the flattened enamel surfaces of extracted bovine incisors were immersed in either saline (control) or 35% hydrogen peroxide (experimental) for 5 or 30 min before or after acid etching with 37% phosphoric acid gel for 60 s. A standard-sized light-cured resin cylinder was then bonded to the enamel surface. The specimens were stored in a water bath at 37 degrees C for 1 day or 7 days, after which the enamel-resin bond was tensile tested to failure. Sixteen of the failed specimens (eight control and eight experimental) were randomly selected for the present scanning electron microscopic study to evaluate the appearance of the resin tags at the resin-enamel interface. In the control specimens, the tags were well defined and contiguous with resin which was uniformly adherent to the enamel surface. In the experimental specimens, large areas of the enamel surface were free of resin. When tags were present, they were fragmented, poorly defined, and penetrated to a lesser depth than in the saline controls. The changes observed suggest that there may be interaction between resin and residual peroxide at or near the enamel surface.

Preliminary surface analysis of etched, bleached, and normal bovine enamel.

X-ray photoelectron spectroscopic (XPS) and secondary ion-mass spectroscopic (SIMS) analyses were performed on unground un-pumiced, unground pumiced, and ground labial enamel surfaces of young bovine incisors exposed to four different treatments: (1) immersion in 35% H2O2 for 60 min; (2) immersion in 37% H3PO4 for 60 s; (3) immersion in 35% H2O2 for 60 min, in distilled water for two min, and in 37% H3PO4 for 60 s; (4) immersion in 37% H3PO4 for 60 s, in distilled water for two min, and in 35% H2O2 for 60 min. Untreated unground un-pumiced, unground pumiced, and ground enamel surfaces, as well as synthetic hydroxyapatite surfaces, served as controls for intra-tooth evaluations of the effects of different treatments. The analyses indicated that exposure to 35% H2O2 alone, besides increasing the nitrogen content, produced no other significant change in the elemental composition of any of the enamel surfaces investigated. Exposure to 37% H3PO4, however, produced a marked decrease in calcium (Ca) and phosphorus (P) concentrations and an increase in carbon (C) and nitrogen (N) concentrations in unground un-pumiced specimens only, and a decrease in C concentration in ground specimens. These results suggest that the reported decrease in the adhesive bond strength of resin to 35% H2O2-treated enamel is not caused by a change in the elemental composition of treated enamel surfaces. They also suggest that an organic-rich layer, unaffected by acid-etching, may be present on the unground un-pumiced surface of young bovine incisors. This layer can be removed by thorough pumicing or by grinding. An awareness of its presence is important when young bovine teeth are used in a model system for evaluation of resin adhesiveness.

The influence of time of hydrogen peroxide exposure on the adhesion of composite resin to bleached bovine enamel.

Standard sized cylinders of a small particle light-cured resin were bonded to the flattened labial surface of young bovine incisor teeth which had been previously subjected to four different treatments: (a) immersion in 35% hydrogen peroxide and etched with 37% phosphoric acid gel for 60 s, (b) immersion in saline and etched for 60 s, (c) etched for 60 s and immersion in hydrogen peroxide, and (d) etched for 60 s and immersion in saline. Two hydrogen peroxide and saline immersion periods were used, 5 and 30 min. Specimens were stored in water at 37 degrees C for 1 and 7 days before tensile and shear testing. A total of 256 teeth were used, 8 for each treatment group, each immersion period, and each water storage period for each test. Statistical analysis of the results indicated that there was a highly significant reduction in the adhesive bond strength of the resin when the enamel was exposed to hydrogen peroxide and that the reduction was, within the limits of this study, time dependent. The bond strength was unaffected by the etching order and the period of water storage. Scanning electron microscopic examination of randomly selected fractured peroxide-treated specimens indicated that the failure occurred primarily at the bonding resin-enamel interface and that it was associated with areas of resin nonattachment and an alteration in resin quality. It is suspected that these changes were caused by the presence of residual peroxide or peroxide-related substances at or near the enamel surface.