Nondestructive evaluation of microleakage in restored primary teeth using CP-OCT.

BACKGROUND: Although the demand for esthetic filling of primary teeth with resin composite is increasing, there is no enough data on the adhesive performance of composite restorations in primary teeth. Despite the improvements in resin composites, interfacial gap is still a disadvantage as it may cause marginal staining, secondary caries, and restoration failure. Previous studies have validated the efficiency of optical coherence tomography (OCT) in the evaluation of adhesive interface in permanent teeth, but not in primary teeth. AIMS: The aim of this study was to assess microleakage upon composite restorations in primary teeth using cross-polarization OCT (CP-OCT). METHODOLOGY: Cylindrical class-V cavities were prepared in extracted human primary second molars and divided into four groups randomly. In groups 1 and 2, cavities were restored using Tetric N-Universal adhesive in the self-etch mode followed by IPS Impress Direct Composite and Ceram.x One Universal composite, respectively. In groups 3 and 4, one-step self-etch Prime and Bond Elect adhesive was used followed by ID composite and CX composite in groups 3 and 4, respectively. The specimens were then immersed in a contrasting solution followed by interfacial microleakage examination under CP-OCT. The recorded images were analyzed to quantify the mean gap percentages. RESULTS: All tested groups showed variable degree of interfacial microleakage under composite restorations. Two-way ANOVA showed the composite factor was significantly influencing the results, unlike the adhesive. Group 1 and 2 had the lowest and highest mean gap percentage, respectively, which were significantly different from the other groups. Groups 3 and 4 were not significantly different. CONCLUSION: Based on the current finding, a polymeric restorative system from the same manufacturer reduces the risk of interfacial microleakage in primary teeth.

Novel evaluation and treatment techniques for white spot lesions. An in vitro study.

OBJECTIVE: White spot lesions (WSLs) are commonly seen during and after orthodontic treatment. Therefore, the objective of this in vitro study was to assess the effect of 45S5-bioglass in remineralizing WSLs using cross-polarization optical coherence tomography (CP-OCT) and confirm the findings by micro-hardness test. METHODS: Ceramic orthodontic brackets were bonded to the buccal surface of 45 human premolars with Transbond XT primer followed by Transbond PLUS according to the manufacturer's instructions. Then, all specimens were varnished excluding the area of interest (AOI) around the bonded brackets, immersed in demineralizing solution and divided into three groups: BG, REM and CONT. In BG group, 15 specimens were treated with bioglass paste for 24 hours. REM group had 15 specimens stored in remineralization solution for 24 hours. CONT group had the remaining 15 specimens with no treatment. All specimens were examined under CP-OCT and tested using cross-sectional micro-hardness techniques. RESULTS: CP-OCT analysis showed that the maximum pixel value after bioglass application was significantly increased at AOI when compared to CONT and REM groups (P>.05), which was confirmed by the cross-sectional micro-hardness results (P>.05). CONCLUSION: Early enamel demineralization and remineralization can be easily and non-invasively monitored with CP-OCT. Bioglass is a potent remineralizing agent.

The Effect of Thermocycling on Interfacial Bonding Stability of Self-Etch Adhesives: OCT Study.

OBJECTIVE: The aim of this study was to monitor the behavior of interfacial gaps formed under different bonded polymeric restorations before and after thermocycling (TC), using swept-source optical coherence tomography (SS-OCT) and confirming the obtained findings with confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS: Cylindrical class I cavities were prepared in twenty noncarious human premolar teeth (1.5 mm depth × 3.5 mm diameter) and divided randomly into two groups: TS and SN, according to the adhesive system (n = 10). In the TS group, one-step self-etch adhesive Clearfil Tri-S Bond Plus (Kuraray Noritake Dental, Japan) was used, followed by composite restoration using Estelite Sigma Quick (Tokuyama Dental, Japan). In the SN group, the cavities were restored with the two-step self-etch/composite silorane-based resin restoration system (3M ESPE, USA). All specimens were restored in bulk filling technique and cured in accordance with the manufacturers' instructions. Both groups were imaged under SS-OCT after 24 h and recorded as controls. Then, each group was subjected to thermal challenge using the TC machine (5-55°C) and B-scans were recorded at different TC intervals (2600, 5200, and 10000). In order to confirm the SS-OCT findings, additional specimens were prepared, scanned, and sectioned for CLSM observation. RESULTS: B-scans demonstrated white clusters at the tooth-resin interface that corresponded to the gap location on CLSM images. The TS group showed significantly less gap formation than the SN group before and after TC (p < 0.001). CONCLUSIONS: An optimal composite adaptation can be achieved when the bonded restoration comprises a combination of an adhesive containing 10-MDP monomer and a considerable highly filled composite.

Advanced imaging of dentin microstructure.

This study aimed to demonstrate the feasibility of using optical coherence tomography (OCT) for locating the sectioning site of a specimen before characterizing the ultrastructural features of dentin surfaces as well as the inner wall of the dentinal tubules (DT) using a field emission scanning electron microscope (FESEM). Eight sound human molar teeth were extracted, examined via cross-polarization optical coherence tomography (CP-OCT), embedded, and hemisectioned using a low-speed diamond sawing machine. Next, each sectioned surface was further trimmed, polished, and examined under a confocal laser scanning microscope (CLSM) to locate the target area on the superficial dentin. Subsequently, each section was gold-coated and examined using FESEM. Backscattered reflection from the dentin layer was less than that from the enamel under CP-OCT. Distinct reflections from certain enamel and dentin microstructures were observed before sectioning the specimens. Areas with enamel cracks and dentin defects were identified and avoided during sectioning. At the micron level, the CLSM images exhibited a homogenous distribution of the DT orifices. Low magnification FESEM images showed intertubular dentin as a loosely condensed globular layer with shallow grooves in between, whereas peritubular dentin exhibited more organized condensation of apatite crystals surrounding the DT orifices. High magnification of the DT revealed a cross-linking layer of mineralized collagen network extending in the peri-intratubular lumen, with scattered globules of matrix vesicles. CP-OCT enabled the realization of rapid initial scanning and image acquisition with high contrast at the micron scale before profound insights into dentin ultrastructures at the nano scale were provided by FESEM. The variations in structural densities of the dental tissues significantly affected the image contrast and helped identify underlying structures.

Tomographic Evaluation of the Internal Adaptation for Recent Calcium Silicate-Based Pulp Capping Materials in Primary Teeth.

OBJECTIVES: To evaluate the internal adaptation of recent pulp capping materials (TheraCal and Biodentine) relative to MTA when used as indirect pulp capping for primary teeth. MATERIALS AND METHODS: Thirty primary molars were randomly allocated into three groups, group (A) was TheraCal, group (B) was Biodentine, and MTA was the control group (C). A standardized round class-V cavity (1.5 mm diameter and 2 mm depth) was prepared using a milling machine on the buccal surface of each tooth with the pulpal floor located on the dentin. Then, pulp-capping materials were applied. Finally, all teeth were restored by composite restoration. The internal adaptation of the pulp-capping materials to the dentinal surface was investigated by microcomputed tomography (Micro-CT) to determine the internal gap volume, and by optical coherence tomography (OCT) to determine the high-intensity reflection of light from the floor. RESULTS: Based on Micro-CT findings, TheraCal showed significantly higher internal gap volume than both MTA and Biodentine (p < 0.001), while MTA and Biodentine did not show a significant difference in the gap volume. Based on the OCT findings, TheraCal showed a significantly higher intensity of light reflection than both MTA and Biodentine (p < 0.001); however, there was no significant difference between MTA and Biodentine. Pearson's correlation test showed that there was a strong positive correlation between Micro-CT and OCT (r = 0.686, N = 30, p < 0.001). CONCLUSIONS: Biodentine and MTA showed a comparable result in terms of their internal adaptation on the dentinal surface of the primary teeth, and both were better than TheraCal. There is a moderate to a strong positive correlation between Micro-CT and OCT in the measurement of internal adaptation of the tested pulp capping materials. OCT can be helpful and beneficial for the clinical setting and allow dentists to screen and evaluate restorations during follow-up.