Models of Caries Formation around Dental Composite Restorations.

The main reason cited for the replacement of dental composite restorations is the recurrence of caries. Numerous models-both in vitro, with acid gels or bacterial biofilms, and in situ, with dental appliances-have been used to study caries formation around dental composites. The literature shows that many factors may affect caries formation, including marginal gap formation, gap size, the local chemical environment, the durability of the bonded interface, the extent of bacterial penetration, and the presence of mechanical loading. Studies have also shown that what have been called wall lesions may form independent of surface lesions, though not likely due to microleakage through very small gap spaces in the clinical situation. Gap size and mechanical loading have been shown to be related to lesion severity within in vitro models, but these results do not correspond exactly with those obtained from in situ studies using restorations in dental appliances. Though not conclusive, some in vitro models have shown that certain materials possessing antimicrobial characteristics may reduce the severity of lesion formation, suggesting possible pathways for developing new composite and adhesive materials for restorations with potentially enhanced longevity.

Oral Function Improves Interfacial Integrity and Sealing Ability Between Conventional Glass Ionomer Cements and Dentin.

The aim of this study was to investigate if load cycling affects interfacial integrity of glass ionomer cements bonded to sound- or caries-affected dentin. A conventional glass ionomer, Ketac Bond, and a resin-modified glass ionomer (Vitrebond Plus), were applied to dentin. Half of the specimens were load cycled. The interfaces were submitted to dye-assisted confocal microscopy evaluation. The unloaded specimens of sound and carious dentin were deficiently hybridized when Ketac Bond was used. Ketac Bond samples showed an absorption layer and an adhesive layer that were scarcely affected by fluorescein penetration (nanoleakage), in sound dentin. Nevertheless, a higher degree of micropermeability was found in carious dentin. In Ketac Bond specimens, load cycling improves the sealing capability and remineralization at the cement-dentin interface as porosity and nanoleakage was reduced. In contrast, samples treated with Vitrebond Plus exhibited a Rhodamine B-labeled absorption layer with scarce nanoleakage in both sound and carious unloaded dentin. The adhesive layer was affected by dye sorption throughout the porous cement-dentin interface. Samples treated with Vitrebond Plus had significant increases in nanoleakage and cement-dye sorption after load cycling. Within the limitations of an in vitro study, it is expected that conventional glass ionomers will provide major clinical efficacy when applied to carious-affected or sound dentin.

Enamel Surface with Pit and Fissure Sealant Containing 45S5 Bioactive Glass.

Enamel demineralization adjacent to pit and fissure sealants leads to the formation of marginal caries, which can necessitate the replacement of existing sealants. Dental materials with bioactive glass, which releases ions that inhibit dental caries, have been studied. The purpose of this study was to evaluate the enamel surface adjacent to sealants containing 45S5 bioactive glass (BAG) under simulated microleakage between the material and the tooth in a cariogenic environment. Sealants containing 45S5BAG filler were prepared as follows: 0% 45S5BAG + 50.0% glass (BAG0 group), 12.5% 45S5BAG + 37.5% glass (BAG12.5 group), 25.0% 45S5BAG + 25.0% glass (BAG25.0 group), 37.5% 45S5BAG + 12.5% glass (BAG37.5 group), and 50.0% 45S5BAG + 0% glass (BAG50.0 group). A cured sealant disk was placed over a flat bovine enamel disk, separated by a 60-µm gap, and immersed in lactic acid solution (pH 4.0) at 37 °C for 15, 30, and 45 d. After the storage period, each enamel disk was separated from the cured sealant disk, and the enamel surface was examined with optical 3-dimensional surface profilometer, microhardness tester, and scanning electron microscopy. The results showed a significant increase in roughness and a decrease in microhardness of the enamel surface as the proportion of 45S5BAG decreased (P< 0.05). In the scanning electron microscopy images, enamel surfaces with BAG50.0 showed a smooth surface, similar to those in the control group with distilled water, even after prolonged acid storage. Additionally, an etched pattern was observed on the surface of the demineralized enamel with a decreasing proportion of 45S5BAG. Increasing the 45S5BAG filler contents of the sealants had a significant impact in preventing the demineralization of the enamel surface within microgaps between the material and the tooth when exposed to a cariogenic environment. Therefore, despite some marginal leakage, these novel sealants may be effective preventive dental materials for inhibiting secondary caries at the margins.

Evaluation of different types of enamel conditioning before application of a fissure sealant.

The aim of the study was to compare fissure sealant quality after mechanical conditioning of erbium-doped yttrium aluminium garnet (Er:YAG) laser or air abrasion prior to chemical conditioning of phosphoric acid etching or of a self-etch adhesive. Twenty-five permanent molars were initially divided into three groups: control group (n = 5), phosphoric acid etching; test group 1 (n = 10), air abrasion; and test group 2, (n = 10) Er:YAG laser. After mechanical conditioning, the test group teeth were sectioned buccolingually and the occlusal surface of one half tooth (equal to one sample) was acid etched, while a self-etch adhesive was applied on the other half. The fissure system of each sample was sealed, thermo-cycled and immersed in 5% methylene dye for 24 h. Each sample was sectioned buccolingually, and one slice was analysed microscopically. Using specialized software microleakage, unfilled margin, sealant failure and unfilled area proportions were calculated. A nonparametric ANOVA model was applied to compare the Er:YAG treatment with that of air abrasion and the self-etch adhesive with phosphoric acid (α = 0.05). Test groups were compared to the control group using Wilcoxon rank sum tests (α = 0.05). The control group displayed significantly lower microleakage but higher unfilled area proportions than the Er:YAG laser + self-etch adhesive group and displayed significantly higher unfilled margin and unfilled area proportions than the air-abrasion + self-etch adhesive group. There was no statistically significant difference in the quality of sealants applied in fissures treated with either Er:YAG laser or air abrasion prior to phosphoric acid etching, nor in the quality of sealants applied in fissures treated with either self-etch adhesive or phosphoric acid following Er:YAG or air-abrasion treatment.

Use of calcium-containing endodontic sealers as apical barrier in fluid-contaminated wide-open apices.

PURPOSE: The sealing of wide-open apex roots is still a challenge and requires the use of apical barrier techniques. The aim was to evaluate ex vivo the sealing and the apical morphology of 3 commercial calcium oxide (CaO)-containing sealers - namely, 2 zinc oxide-based (CRCS and Sealapex) and a calcium silicate MTA-based (TechBiosealer Endo) - placed in wet root canals with artificial wide-open apices.
 METHODS: Thirty human single-rooted teeth were shaped with Protaper and an artificial open apex (diameter size 110) was created. Each root was inserted in a custom-designed support containing simulated body fluid (Hank's balanced salt solution, HBSS) at the bottom simulating the presence of periapical fluid in the canal. Each sealer (TechBiosealer Endo, CRCS, Sealapex) was compacted to the apical 5 mm and the filled roots stored in HBSS at 37°C. The sealing was evaluated as microinfiltrated fluid since 24 hours up to 6 months using a high-precision digital fluid flow meter. The sealers were also studied for setting time in HBSS, calcium releasing (statistical analysis by 2-way ANOVA followed by Student-Newman-Keuls test, P<0.05) and surface morpho-chemistry by ESEM-EDX and OM analysis.
 RESULTS: All sealers showed a stable seal. TechBiosealer Endo maintained a better seal than the other materials (P<0.05) and ESEM-EDX and OM analyses showed the presence of apatite deposits.
 CONCLUSIONS: The clinical use of hydraulic hydrophilic MTA-based sealers can be recommended to stop/reduce the fluid flow rate through the apex. The artificial apical barrier in wet wide apices is a suitable technique able to seal wet root canals.

[Detection of marginal leakage of Class V restorations in vitro by micro-CT].

OBJECTIVE: To evaluate the reliability and superiority of micro-CT in marginal leakage assessment of Class V restorations. METHODS: Class V preparations with gingival margins in dentin and occlusal in enamel were made in sixteen extracted non-carious human molars and restored with dental bonding agents and composite resin. All teeth were then immersed in 50% ammonia-silver nitrate solution for 12 hours, followed by developing solution for 8 hours. Each restoration was scanned by a micro-CT and silver leakage was measured and three-dimensional image of the silver leakage alone cavity wall were reconstructed. Afterward, all restorations were sectioned and examined for leakage depth using a microscope. The silver leakage depth of each restoration obtained by micro-CT and microscope were compared for equivalency. RESULTS: The silver leakage depths in gingival wall obtained with micro-CT (0.78 mm) and microscope (0.74 mm) showed no significant difference (P > 0.05), while the judgment of leakage depths in occlusal wall in micro-CT image (0.40 mm) was affected by adjacent enamel structure, giving less leakage depths compared to microscope (0.72 mm)(P < 0.01). The three-dimensional shapes of the microleakages displayed clearly by micro-CT alone wall of Class V restorations were multiform and some leakages showed channels on their way to spreading. CONCLUSIONS: Micro-CT can detect precisely the silver leakage in the dentin wall of a restoration and display its three-dimensional shape fully. Enamel structure affects the detection of the silver leakage next to it.

Back-scattered electron imaging for leakage analysis of four retrofilling materials.

This study aimed to evaluate, ex vivo, the nanoleakage in dentinal tubules, the linear infiltration of silver nitrate in the dentin wall/root-end filling material interface, and the presence of gaps in this interface in root-end cavities filled with 4 filling materials. Forty-eight disto-buccal root canals of maxillary molars were instrumented and filled. Retrograde cavities were prepared with ultrasonic points (apical 2 mm). The samples were divided into 2 control groups (n = 4) and 4 experimental groups (n = 10): Group I--white mineral trioxide aggregate (MTA); Group II--Super EBA; Group III--Portland cement; and Group IV--Sealer 26. After 1 week, the specimens were subjected to silver nitrate and prepared for SEM (backscattered electrons). In the apical-apical segment, an area with significantly higher leakage was observed for Super EBA, followed by Portland cement, MTA, and Sealer 26 (P = 0.0054). In the medium and cervical segments, all materials showed the same leakage behavior (P = 0.1815 and P = 0.1723, respectively). The linear infiltration at the dentin wall/root-end filling material interface was higher with Super EBA than the other groups. No differences in the percentage of gaps along the 3 mm of dentin wall/root-end filling material interface between the 4 materials were evident (P > 0.05). Nanoleakage occurred mainly in the apical segment of the samples, and Super EBA showed the highest values. The area and linear leakage were lower in the middle and coronal segments, regardless of the root-end filling material. No material perfectly sealed the root-end cavities, which allowed for the leakage occurrence.

[Nanoleakage at the resin-dental interface of four self-etching adhesives].

OBJECTIVE: To evaluate the nanoleakage and ultramorphology of four self-etching adhesives. METHODS: Sixteen freshly extracted, caries-free human third molars were selected. A flat dentin surface was exposed by removing occlusal enamel. All teeth were randomly divided into four groups acorrding to four different self-etch adhesive: Adper Prompt (A), iBond (B), Xeno III (C) and SE Bond (D). The dentin were bonded with dentin adhesive system according to manufacturer's directions. Composite layers were built up incrementally. The specimens were sectioned longitudinally across the resin-dentin interface into 4.0 mm×0.9 mm sticks and then traced with ammoniacal silver solution. Epoxy resin-embedded sections were prepared for transmission electron microscope (TEM) to observe nanoleakage. The images were qualitatively compared by NIH software, and data was analyzed by SPSS. RESULTS: Different thickness of hybrid layer and adhesives layer were observed for each adhesive. The hybrid layer of A, C was thicker than that of B, D, and adhesive layer of D was thicker than the others. The extent of nanoleakage varied among different adhesives: A (45.02 ± 9.49), B (43.97 ± 8.55), C (27.02 ± 10.86), D (12.94 ± 2.07). D presented significantly less silver deposition than any of the others did (P < 0.05). CONCLUSIONS: The thickness of hybrid layer and adhesive layer vary among the four adhesives. The shape and extent of nanoleakage of each adhesive are also different. Two-step system shows less nanoleakage than one-step systems do.

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.

Detection of dentinal cracks after root-end resection: an ex vivo study comparing microscopy and endoscopy with scanning electron microscopy.

INTRODUCTION: Dentinal cracks are occasionally observed at the cut root face after root-end resection in apical surgery. The objective of this ex vivo study was to evaluate and compare the efficiency of visual aids to identify root-end dentinal cracks. METHODS: Twenty-six extracted human molars were decoronated, and the root canals were instrumented and filled. The apical 3 mm of the roots were resected, and the cut root faces were assessed with microscopy at x16 and x24 magnification and with endoscopy at x8 and x64 magnification (four visual aids). Roots were then duplicated for inspection with scanning electron microscopy. The presence, type, and location of cracks were registered by a blinded observer, with the scanning electron microcopy serving as the reference. The percentages of correct identification of dentinal cracks were then statistically compared among the four test configurations. RESULTS: Endoscopy x64 showed the highest sensitivity for crack identification, irrespective of the applied methodology (ie, per root and per crack). However, higher scores of false-positive cracks (lower specificity) were found with endoscopy x64 than with the other tested visual aids. The correct detection and location of complete canal cracks (55.3%, 52.6%, 68.4%, and 78.9%) were higher than the detection of incomplete canal cracks (42.2%, 42.2%, 52.0%, and 64.7%) using the four tested visual aids (microscopy at x16 and x24 magnification and endoscopy at x8 and x64 magnification, respectively). Only one of five intradentin cracks was identified with endoscopy x64. CONCLUSIONS: Overall, endoscopy x64 proved the most accurate visual aid for the identification of dentinal cracks after root-end resection in extracted human teeth; however, it also provided the most false identifications.

Qualitative analysis of adhesive interface nanoleakage using FE-SEM/EDS.

OBJECTIVES: The purpose of this study was to evaluate the quality of short term sealing of current adhesives. METHODS: Five adhesive systems were used and evaluated in this study; two kinds of two-step adhesives (Single Bond and Clearfil SE Bond) and three one-step adhesives (Clearfil S3 Bond, G Bond and One-Up Bond F-plus). Flat occlusal superficial dentin surfaces from extracted human third molars were finished with wet 600-grit silicon-carbide paper and bonded with one of the adhesives. After 24h storage at 37 degrees C in water, the bonded assemblies were sectioned into approximately 1mm thick slabs. Two central slabs from each tooth were chosen and immersed into 50% (w/v) solution of silver ammoniacal nitrate for 18 h and exposed to photodeveloping solution for 6h. The specimens were then slightly polished, argon ion-etched. In order to examine the nanoleakage within the resin/dentin interface, penetration of silver was observed in a field emission (FE)-SEM using yttrium-aluminium-garnet (YAG) backscattered electron mode. EDS analysis was also carried out in parallel to identify the existence of metallic silver particles. RESULTS: The penetration pattern of silver depended on the adhesive used, indicating different nanoleakage in different adhesive systems. Single Bond, One-Up Bond F-plus and G Bond showed clear silver uptake in both the adhesive and hybrid layer. Clearfil SE Bond showed less silver penetration and slight silver peak on the elemental energy spectroscopy of EDS. Clearfil S3 Bond did not display clear silver penetration under 2000x magnification by FE-SEM, and no existence of metallic silver of the Clearfil S3 Bond group by EDS, could be detected. SIGNIFICANCE: The nanoleakage, as well as its location depends on the adhesives. Different nanoleakage expressions were revealed between two-step and one-step adhesives and also among one-step adhesives themselves.

Apical leakage of resin based root canal sealers with a new computerized fluid filtration meter.

In this in vitro study, the apical leakage of three root-canal sealers: AH Plus, Diaket, and EndoREZ was evaluated using a new computerized fluid filtration meter. Forty-five extracted human premolar teeth with single root and canal were used. The coronal part of each tooth was removed and the root canals were prepared using GT Rotary files and crown-down technique. The roots were randomly divided into three groups of 15 samples, filled with one of the test materials and gutta-percha cones by the cold lateral condensation technique and were stored at 37 degrees C and 100% humidity for 7 days. One-week later, apical parts of roots of 10 +/- 0.05 mm were attached to computerized fluid filtration meter. Apical leakage quantity was determined as microl/cmH(2)O/min(-1). Statistical analysis indicated that root fillings with Diaket in combination with cold lateral condensation technique showed lower apical leakage than the others (p < 0.05). In addition, this new computerized fluid filtration meter allowed quantitative measurement of leakage easily. As it is a newly developed device to measure apical leakage of endodontic sealers, the reliability of it needed to be tested.

Effects of dentin collagen removal on microleakage of bonded restorations.

PURPOSE: To evaluate the effects of removing dentin collagen exposed by acid etching on the microleakage of bonded restorations with and without flowable composite application and submitted to thermocycling and long-term water storage. MATERIALS AND METHODS: Standardized Class V cavities were prepared in 180 bovine incisors. They were randomly assigned to three groups according to the adhesive technique used. Conventional group (C): Single Bond was applied according to the manufacturer's instructions and Z250 composite was placed. Hypochlorite group (H): After acid etching a 10% NaOCl aqueous solution was applied for 1 min, then Single Bond and Z250 were applied. Hypochlorite and Flowable group (HF): Similar to group H, but following adhesive application, a thin layer of Natural Flow flowable composite was applied before the Z250. Each group was divided into three subgroups (0, 6, 12), which remained immersed in distilled water for 24 h or 6 or 12 months and underwent 500, 1500 or 2500 thermal cycles, respectively. At the end of each storage time, the specimes were stained with silver nitrate, decalcified, immersed in methyl salicylate for clearing and observed under a stereomicroscope to determine microleakage (scores 0 to 4). The data were analyzed using the Kruskal-Wallis and the Multiple Comparison Tests (alpha = 0.05). RESULTS: After 12 months, every group showed significant increases in microleakage. There was no significant difference between Groups H and HF for the three different periods of time, but they showed statistically less microleakage than Group C. CONCLUSION: The removal of dentinal collagen reduced the marginal microleakage when compared to the conventional technique. The use of the flowable composite did not produce significant effects. No technique was completely effective in preventing microleakage.

Effects of calcium hydroxide paste medication on coronal leakage.

The purpose of this in vitro study was to examine the coronal leakage of canals medicated with Ca(OH)(2) compared with the canals which did not receive Ca(OH)(2) medication before obturation with laterally condensed gutta-percha points and sealer. Sixty-one single rooted permanent canines and premolars were used. The crowns were removed from the cemento-enamel junction. After the canals were chemomechanically prepared, the roots were divided into three experimental groups as group 1, 2 and 3. The canals in group 1 and 2 were treated with ethylenediaminetetraacetic acid (EDTA) and NaOCl in order to remove the smear layer and then the canals were filled with Ca(OH)(2) paste. The coronal 3 mm of the cavities were sealed with Cavit and the samples were kept in an incubator at 37 degrees C for 7 days. No intra-canal medication was applied in group 3. The root canals were irrigated with NaOCl in group 1 and with EDTA and NaOCl in group 2, in order to remove Ca(OH)(2) before obturation. Two samples from group 1 and two from group 2 were examined under SEM in order to reveal the removal of Ca(OH)(2) paste. Following this, the canals in the experimental groups were obturated with gutta-percha and sealer. The roots were placed in India ink for 7 days and the linear dye penetration was evaluated. No significant statistical difference was found in the amount of coronal dye leakage between experimental groups (P > 0.05). The results of the present study indicated that the application of Ca(OH)(2) as a temporary dressing material had no effect on coronal leakage.

The effect of thermocycling on microleakage of several commercially available composite Class V restorations in vitro.

STATEMENT OF THE PROBLEM: Microleakage is a major factor contributing to the occurrence of secondary carious lesions around composite restorations. PURPOSE OF STUDY: This in vitro study investigated the effect of thermocycling on microleakage of several composite Class V restorations. MATERIAL AND METHODS: One hundred twenty molars were randomly distributed into 6 groups of 20 teeth. Class V preparations were made in the buccal and lingual surfaces of each tooth and restored in bulk by use of 6 composites (Arabesk, Silux-Plus, Solitaire 2, Durafill VS, Charisma, and Renew) according to the manufacturers' recommendations. The teeth were stored in distilled water at room temperature for 24 hours. The teeth in each group were divided randomly into 2 subgroups: (a) thermocycled for 500 cycles between 5 degrees and 55 degrees C with a dwell time of 30 seconds, (b) no thermocycling treatment. All restored teeth were immersed in 1% methylene blue dye for 4 hours and sectioned buccolingually with a diamond wheel. Dye penetration was scored by use of a stereomicroscope at original magnification x4. The generalized linear models statistical analysis was used (alpha=.05). RESULTS: The preparation margins (enamel/dentin) and thermocycling had a significant effect on microleakage (P=.0351, P<.0001, respectively); the type of material had no significant effect (P=.1689). CONCLUSIONS: Thermocycling significantly increased the microleakage (P<.0001). The overall microleakage at the enamel margins was significantly less than at the dentinal margins (P=.0351).

Water treeing--a potential mechanism for degradation of dentin adhesives.

PURPOSE: To test the hypothesis that water channels are present along the adhesive-dentin interface that can be detected using transmission electron microscopy examination of tracer penetration. MATERIALS AND METHODS: Different total-etch adhesives (Single Bond, Excite, and PQ1) and self-etch adhesives (Prompt L-Pop, Reactmer Bond, and an experimental self-etch adhesive) were bonded to dentin and enamel. Bonded resin-tooth slabs were immersed in 50 wt% conventional silver nitrate or 50 wt% basic, ammoniacal silver nitrate for 24 hours, exposed to a photodeveloping solution, and prepared for transmission electron microscopy. RESULTS: With both types of silver nitrate, all adhesives exhibited nanoleakage within hybrid layers. In addition, water trees in the form of interconnecting, dendritic silver deposits were seen along the surface of the hybrid layers that extended perpendicularly into the adhesive layers. With ammoniacal silver nitrate, additional isolated, unconnected silver grains were observed within the adhesives.

Comparison of the apical seal obtained by a dual-cure resin based cement or an epoxy resin sealer with or without the use of an acidic primer.

This study compared the apical leakage of roots obturated with gutta-percha using either a dual-cure resin based cement (Panavia F) or an epoxy-resin sealer (Thermaseal plus) with or without the application of an acidic primer (ED Primer). Eighty-six single rooted canine teeth were decoronated, cleaned, and shaped by using hand and rotary instruments, randomly divided into four groups, and obturated as follows: group A (n = 20): ED Primer applied followed by thermoplastized obturation with gutta-percha and Thermaseal Plus sealer; group B (n = 20): thermoplastized obturation with gutta-percha and Thermaseal Plus; group C (n = 20): ED primer applied followed by thermoplastized obturation with gutta-percha and Panavia F; group D (n = 20): thermoplastized obturation with gutta-percha and Panavia F. Both a negative control (n = 3; entire root coated with wax) and a positive control (n = 3; obturated with only a fitted master cone) were included in the study. Groups A, B, C, D, and the controls were immersed in molten sticky wax, leaving the apical 2-mm exposed, and quickly chilled. All teeth were immersed in 1% methylene blue dye solution for 10 days, rinsed, and sectioned longitudinally. Apical dye penetration was measured stereomicroscopically at 10-fold magnification. The analysis of variance and Duncan Multiple Range were used for result analysis. The specimens obturated with gutta-percha and an epoxy-resin sealer (with or without an acidic primer) demonstrated significantly less linear dye penetration than specimens obturated with gutta-percha and the dual-cure, resin-based cement (with or without an acidic primer).

Effect of finishing time and techniques on marginal sealing ability of two composite restorative materials.

STATEMENT OF PROBLEMS: Finishing of composites may adversely influence the sealing ability of direct adhesive restorations. PURPOSE: This study was conducted to determine whether finishing time and techniques under wet or dry conditions affect the microleakage of 2 types of class V composite restorations. MATERIAL AND METHODS: Eighty class V preparations were made in the buccal surfaces of noncarious molars with the occlusal margins ending in enamel and the gingival margins in dentin. Dental adhesive (Single Bond) was applied according to the manufacturer's instructions. Half of the preparations were restored with a microfilled composite (Silux Plus) and the other half with a hybrid composite (Filtek Z250). Within each major composite group (n = 40), 4 subgroups (n = 10) were established based on finishing technique (diamond finishing burs or aluminum oxide discs) and finishing time (immediate or delayed by 24 hours). The specimens were stored for 24 hours in 37 degrees C water, thermocycled for 250 cycles between 5 degrees C and 55 degrees C, immersed in 2% methylene blue solution for another 24 hours, and sectioned longitudinally. For both enamel and dentin margins, dye solution penetration at the tooth/composite interface was scored from 0 to 4 under stereoscopy at original magnification x 20. Data were analyzed with the Kruskal-Wallis test (P<.05). RESULTS: Significantly lower leakage scores were recorded for teeth restored with microfilled composite and finished under wet conditions after 24 hours (P<.01). No significant differences were found among the hybrid composite groups. CONCLUSION: For microfilled composite restorations on dentin margins, delayed wet finishing with diamond burs resulted in significantly lower microleakage scores than all other finishing protocols. Hybrid composite restorations had equivalent levels of microleakage regardless of the finishing method.

A nanoleakage perspective on bonding to oxidized dentin.

The mechanism responsible for sodium-hypochlorite-induced reduction in dentin bond strength and its reversal with reducing agents is unknown. This study examined the relationship between nanoleakage and reversal of compromised bonding to oxidized dentin. Acid-etched dentin was completely depleted of demineralized collagen matrix when sodium hypochlorite was used. Specimens were bonded with two single-bottle dentin adhesives. They were immersed in ammoniacal silver nitrate for 24 hrs before being processed for transmission electron microscopy. For both adhesives, tensile bond strengths of acid-etched dentin were significantly reduced after sodium hypochlorite treatment, but were reversed when sodium ascorbate was used. After sodium hypochlorite application, reticular nanoleakge patterns in hybrid layers were replaced by vertical, shag-carpet-like patterns along the demineralization front. This type of nanoleakage was completely eliminated after sodium ascorbate treatment with the materials tested. Residual sodium hypochlorite within the porosities of mineralized dentin may result in incomplete resin polymerization, and hence compromised bond strength.

Bacterial microleakage and pulp inflammation associated with various restorative materials.

OBJECTIVES: Many restorative materials are claimed to be successful in preventing bacterial microleakage and minimizing pulp inflammation. However, information regarding the in vivo performance of materials in comparison with each other is limited. The aim of this study was to evaluate and compare the pulp response of nine restorative materials when placed in non-exposed monkey cavities. METHODS: 279 standardized non-exposed Class V cavities, were prepared into buccal dentin. Cavities were restored with a number of materials in the following categories: Zinc oxide eugenol (ZnOE), Calcium hydroxide [Ca(OH)(2)], zinc phosphate (ZP), Resin-modified glass ionomer (RMGI), Composite resin (CR), Bonded amalgam (BA), Gutta-percha (GP), Compomer and Silicate. Pulp tissues were collected and evaluated at short, intermediate and long-term intervals according to ISO guidelines; employing histomorphometric analysis, Spearman's rho and ANOVA statistics. Pulp responses were categorized according to FDI, ISO and ADA standards. Bacteria were detected using McKay stains. RESULTS: Pulp inflammation was found to be correlated to bacterial microleakage around the restoration (p < or =0.0001). The frequency of bacterial microleakage was found to vary between restorative materials (p < or =0.0001). In rank order of preventing bacterial microleakage from best to the worst; RMGI (100%), BA (88%), ZnOE (86%), CR (80%), GP (64%), Ca(OH)(2) (58%), compomer (42%), silicate (36%) and ZP (0%). SIGNIFICANCE: The most effective restorative materials to prevent bacterial microleakage and pulp injury from inflammatory activity were RMGI, BA, ZnOE and CR restorations.