Adherence controlling elements in ceramic-metal systems. I. Precious alloys.

Elemental analysis of two precious alloyceramic systems revealed the accumulation of Sn atoms within the interaction zone of couples subjected to a range of metal oxidation time; and varying total firing times. The source of Sn atoms which accumulated within the interaction zone was the opaque porcelain layer which contained an initially higher Sn concentration than the alloy. It is hypothesized that SnO2 provides continuity of electronic structure between alloy and ceramic structures and is a primary factor in controlling ceramic-metal adherence.

The effects of burnishing NaF/kaolin/glycerin paste on dentin permeability.

The effects on dentin permeability of burnishing NaF, kaolin, or glycerin, alone and in various combinations, were determined using an in vitro system. The results indicate that the important variable was not any of the constituents of the paste but the burnishing process itself. Burnishing dentin creates a partial smear layer on the dentin surface, thereby occluding the orifices of dentinal tubules sufficiently to reduce fluid movement across dentin 50 to 80%.

The effect of titanium implant abutment surface irregularities on plaque accumulation in vivo.

The purpose of this study was 2-fold to: 1) evaluate in vitro the surface texture of titanium implant abutments after exposure to plastic scalers, an air-powder abrasive system, rubber cup polishing with flour of pumice, and untreated control abutments; and 2) compare plaque accumulation in humans on abutments treated with the above methods. In part I, 5.5 mm abutments were instrumented for 30 seconds per 90 degrees segment with the respective methods. The surface character was compared to untreated controls using SEM at 260X magnification. The control abutments revealed prominent milling marks and small pits; plastic scalers slightly smoothed the milling marks and created microscratches; the air-powder abrasive largely obliterated the milling marks and caused some surface pitting; the rubber cup with flour of pumice removed the milling marks and created a smooth swirl pattern. None of the instrumentation appeared to roughen the surface. In the clinical experiment (part II), four abutments, one of each type, were placed in 12 patients for a period of 7 days, during which the patients performed no oral hygiene. At the end of 7 days, the abutments were retrieved and processed for SEM. A digitizer and software program were used to determine the percent of total abutment surface area covered by plaque. The demarcation of supragingival and subgingival plaque was well delineated. The total mean percent surface area of plaque ranged from 52.06% for the air-powder abrasive to 55.29% for the plastic scalers.(ABSTRACT TRUNCATED AT 250 WORDS)

Surgical treatment of induced peri-implantitis in the micro pig: clinical and histological analysis.

The purpose of this pilot study was to determine if lost osseous support adjacent to root form implants could be regenerated using a guided tissue regeneration technique. Three fixtures were placed in each edentulous mandibular bicuspid region of two micro pigs. A total of 6 fixtures were placed in each pig. Due to the presence of a pathologic condition, which was in no way related to the research, the results of one pig were not evaluated. Following osseointegration, peri-implantitis were induced by the use of ligatures and a soft diet. Three modalities of treatment were performed. Utilizing a surgical flap approach, one third of the fixtures (one per quadrant) were covered with expanded polytetrafluoroethylene (ePTFE) membrane and submerged under the soft tissue complex. The second group of fixtures were submerged under the soft tissue complex with no ePTFE membrane. The control fixtures along with their abutments were debrided and remained non-submerged. All fixtures were debrided using an air-abrasive polishing system. The osseous defects around the fixtures were measured from a fixed reference point at the time of surgery and after obtaining block sections.(ABSTRACT TRUNCATED AT 250 WORDS)

Dentinal tubule occlusion and root hypersensitivity.

Previous studies have established that root sensitivity is due in part to open dentinal tubules at the root surface. The purpose of this study was to longitudinally evaluate the occlusion of dentinal tubules by various clinical procedures including scaling and root planing and the application of potassium oxalate. A model was developed to evaluate dentinal surfaces in vivo. Six 2 mm x 3 mm sections were taken from the roots of extracted teeth immediately below the CEJ. One half of the treated dentin samples from each donor was incorporated into the removable denture worn by the donor and the other half served as baseline. The dentin samples were evaluated at 1 week by scanning electron microscopy. At day zero no open tubules were observed in any of the samples due to the presence of a smear layer or oxalate crystals. Evaluation of root planed samples revealed that by 7 days the tubules had re-opened. The samples which had been treated with potassium oxalate showed few oxalate crystals by 7 days revealing open tubules. Control samples were etched with EDTA and evaluated in the same manner. Although the number of tubules did not significantly change in the EDTA etched control samples, the diameter of the tubules dramatically decreased by 4 weeks. It can be concluded that the creation of a smear layer or application of oxalates to occlude dentinal tubules to reduce sensitivity are relatively short-lived. These procedures may provide patient comfort prior to natural occlusion of the tubules.

An in vitro study of dentinal tubule occlusion by ferric oxalate.

This study examined ferric oxalate's ability to occlude dentinal tubules both in the presence of a smear layer and after its removal. Radicular dentinal chips were prepared with a smear layer created from a high speed carbide bur. The dentinal chips were then grouped as follows: 1) those with the smear layer remaining intact; 2) those sonicated for 7 minutes; 3) those treated with 10% tetracycline HCl; 4) those treated with 0.5M EDTA; 5) those treated with 20% citric acid; or 6) those treated with saturated citric acid. Six percent ferric oxalate was applied for 1 minute to the dentinal chips under blinded conditions. The chips were examined under SEM and the number of small and large crystals formed were counted. The results indicate that a decrease in the number of small crystals occurs following pretreatment of the smear layer by chemical means. An increased variability in size and shape of the crystals is also observed when no chemical pretreatment is used. Thus, relative to the number of crystals that form, no chemical pretreatment of radicular dentin is indicated prior to application of ferric oxalate in the treatment of root sensitivity.

An in vivo study of dentin sensitivity: the relation of dentin sensitivity and the patency of dentin tubules.

Dentin hypersensitivity can be a major problem for periodontal patients. The relationship between dentin hypersensitivity and the patency of dentin tubules in vivo has been established. Thirteen adult patients with teeth scheduled for extraction were selected and a stent fabricated to confirm location of the root surface being examined. Response to a constant air blast was recorded on a numeric pain rating scale (from 0 to 4) during the course of treatment. The tooth surface was initially treated with 0.5 molar EDTA (pH = 7.4), to remove the smear layer and expose tubules. The region was then treated with either a 3% monopotassium-monohydrogen oxalate solution or a 3% sodium chloride solution, both at pH = 2.4. Solutions were prepared to be indistinguishable to the examiner. Response to air was evaluated before and after EDTA treatment and after treatment with a desensitizing agent. The patient was anesthetized and the treated tooth extracted. Specimens were sectioned, critical point dried, sputter coated with gold, and examined under the scanning electron microscope. Photomicrographs were analyzed by computer assisted digital analysis to evaluate the degree of tubule occlusion. Statistical analysis by repeated measures ANOVA for univariate tests of hypothesis for within subject effects showed the sodium chloride solution was more effective in reducing dentin sensitivity than the potassium oxalate solution. Scanning electron micrographic analysis revealed a mean dentin tubule aperture size of 1.720 square microns following EDTA treatment alone, 0.564 square micron following potassium oxalate treatment, and 0.386 square micron following sodium chloride treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Structural and functional changes in root dentin following exposure to KTP/532 laser.

The use of a new, modified Nd:YAG laser called the KTP/532 laser was evaluated within root canals to determine whether it would modify dentin permeability or alter the scanning electron microscopic appearance of canal dentin. Energies and exposure times were chosen which did not permit periodontal temperatures to increase above 5 degrees C (1 W x 1 s-5 W x 0.5 s). Half of the root canals were covered with smear layer and half were treated with EDTA/NaOCI to remove the smear layer. The results showed that this laser did not change the permeability of the smear layer-covered dentin, although scanning electron microscopic examination revealed modifications to the surface of smear layer. Lasing of etched dentin produced modest increases in root permeability which were associated with enlargement and cracking of tubule orifices.

Effects of CO2 laser energy on dentin permeability.

The effect of a CO2 laser on the structure and permeability of smear layer-covered human dentin was evaluated in vitro. Three different energy levels were used (11, 113, and 566 J/cm2). The lowest exposure to the laser energy increased dentin permeability, measured as a hydraulic conductance, due to partial measured as a hydraulic conductance, due to partial loss of the superficial smear layer and smear plugs. The intermediate energy level also increased dentin permeability by crater formation, making the dentin thinner. The lack of uniform glazing of the surface of the crater, leaving its surface porous and in communication with the underlying dentinal tubules also contributed to the increase in dentin permeability seen with the intermediate laser energy. The highest laser energy produced complete glazing of the crater surfaces and sealed the dentinal tubules beneath the crater. However, it also completely removed the smear layer in a halo zone about 100-microns wide around each crater which increased the permeability of the pericrater dentin at the same time it decreased the permeability of the dentin within the crater. The combined use of scanning electron microscopy and permeability measurements provides important complementary information that is essential in evaluating the effects of lasers on dentin.

The permeability of dentine from bovine incisors in vitro.

The permeability of coronal dentine was investigated by measuring the hydraulic conductance of dentine discs. Reductions in dentine thickness from the enamel side of disc resulted in a greater increase in permeability than reductions from the pulpal side. Scanning electron microscopy revealed fewer dentinal tubules with smaller diameters in superficial dentine than in deep dentine. The permeability of coronal incisor bovine dentine is six to eight times less than that of unerupted coronal human third molar dentine but similar to that of human root dentine.

Scanning electron microscopy of the substructure of smear layers in human dentine.

Smear-layer debris was sonicated from dentine surfaces and trapped on microfilters for microscopy, which showed that the layers are composed, in part, of aggregates of globular subunits approx. 0.05-0.1 micron in diameter. Such globules were also seen in smear layers in situ and on fractured dentine surfaces. The composition of smear layers may reflect the substructure of dentine matrix.

Regional bond strengths of resins to human root dentine.

OBJECTIVES: The demand for restoration of root dentine defects such as cervical erosion and root caries has significantly increased recently, but there is limited information on the performance of the adhesive resins to radicular dentine. The purpose of this study was to measure the regional tensile bond strength (TBS) of composite bonded to human root and coronal dentine, and to observe the interface between resin and root dentine by SEM. METHODS: Human extracted cuspid teeth were used to measure TBS with a new microtensile bond test. Enamel and cementum were removed from the labial tooth surfaces to form a long cavity preparation into dentine from the mid-crown to the apex of the root within the same tooth. All Bond 2 (all etch technique) or Imperva Bond (no etch) was bonded to dentine surfaces and covered with Protect Liner resin composite. The resin-bonded teeth were serially sliced into 16 sections at right angles to the long axis of the tooth, and the bonded surfaces were trimmed to give a bonded surface area of 1 mm2 for TBS testing. RESULTS: All Bond 2 bond strengths to coronal and apical dentine showed high values (23.5 MPa) but the bond strength was significantly lower on cervical root dentine. Imperva Bond produced a relatively high tensile bond strength to all regional areas. SEM showed that the thickness of the resin-infiltrated layer formed by All Bond 2 in root dentine was less than coronal areas. Resin infiltration with Imperva Bond was always less than 0.5 micron. The results suggest that high TBS values can be obtained with minimal resin infiltration in root dentine.

Interactions of conditioners on the dentin surface.

The distinction between dentin conditioners and primers has become blurred as agents have been combined to simplify the steps required in dentin bonding. Most bonding systems use acidic conditioners designed to remove the smear layer and demineralize the dentin surface. It would seem desirable to reduce the acid concentration and/or application time to the minimum required to obtain maximum bond strengths and minimum microleakage. The pulpal effects of acidic conditioners seem to be minimal if the subsequently placed bonding agents and resin composites truly seal dentin. Several systems have been designed to be bonded to smear layers, including the new light-cured glass-ionomer cements. More research is needed to develop methods of strengthening smear layers and the bonds between them and adhesive resins.

Nanoleakage: leakage within the hybrid layer.

Most microleakage studies involve quantitating the magnitude of movement of a tracer molecule through a gap between restorative materials and the wall of cavity preparations. The present microscopic study examined the migration of silver nitrate into the interface between dentin and five different dentin bonding agents used to restore class 5 cavities, in the absence of gap formation. Several different leakage patterns were seen, but they all indicated leakage within the hybrid layer when viewed by SEM. The ranking of microleakage from most to least was: All-Bond 2 > Suberbond C&B > Scotchbond Multi-Purpose > Clearfil Liner Bond System > Kuraray Experimental System, KB-200. To distinguish this special type of microleakage within the basal, porous region of the hybrid layer in the absence of gap formation, we propose the term nanoleakage.

Dentin permeability: sealing the dentin in crown preparations.

Provisional restorations of full crown preparations may permit more microleakage of bacteria and their products than the final castings do. However, most investigations of the sealing qualities of cemented castings have reported that they too permit dye leakage. One approach to the problem is to seal the dentin with dentin bonding agents at the completion of the crown preparation. This study evaluated the ability of six different dentin bonding agents to seal the dentin of crown preparations of human teeth in vitro using two independent techniques. The first technique quantitated fluid filtration across dentin before and after treatment with dentin bonding agents at one hour, one day, one week, and one month and after thermocycling. The second method measured silver nitrate penetration of the thin veneers of dentin bonding agents into the dentin. Both methods correlated well with each other. The best seals were obtained with Prisma Universal Bond 2 or Superbond powder plus liquid. The worst seals were found using Gluma and Superbond liquid only. Clearfil PhotoBond, Amalgambond, and Scotchbond 2 gave intermediate results. Although the dentin bonding agents tend to accumulate on chamfers, thereby increasing their thickness to 200-300 microns, the method looks promising as a simple way to protect the pulp from the consequences of microleakage.

Bonding mechanism of VariGlass to dentin.

PURPOSE: This study investigated the hypothesis that the new resin-reinforced, light-cured ionomer cement (GIC) can develop mechanical retention by forming a hybrid layer in acid-etched dentin. MATERIALS AND METHODS: Dentin discs were obtained from extracted human third molars and sanded with 320 SiC abrasive paper. One third of the surface was acid etched with 10% maleic acid for 15 seconds, washed and gently air-dried for 5 seconds. ProBond primer from the VariGlass (VG) GIC kit was applied onto the acid-etched surface (A) and another third of the unetched surface (B) for 30 seconds. One third of the surface was not treated (C). VG GIC was then applied onto the ++entire surface of the disc. After 24 hours the discs were fractured along their diameters. One half of the fractured disc was highly polished at the interface and treated with 6N HCl for 30 seconds while the other half of the fractured specimen was left untreated. Both halves were viewed by SEM. In another part of the study, a micro-tensile bond strength (MTBS) test was carried out to compare the acid-etched group vs. the nonetched group. RESULTS: SEM pictures revealed a well defined demineralized, resin-infiltrated zone approximately 3 micrometers in thickness for group (A) for both fractured and polished surface. Dentin surfaces that only received primer (B) showed an irregular zone 0.5 micrometers thick. Such a resin-infiltrated layer was resistant to HCl treatment. A gap was observed between the GIC and dentin in group (C). Polished interfaces appeared to be highly infiltrated. However, fractured interfaces revealed considerable porosity within the demineralized-infiltrated zone. MTBS results were (X +/- SD, MPa): 28.9 +/- 5.8 for the etched group and 24.5 +/- 4.9 for the nonetched group. This difference was statistically significant.

Effects of aluminum oxalate/glycine pretreatment solutions on dentin permeability.

Aluminum oxalate buffered with glycine to pH 0.5-2.5 has been proposed as a dentin pretreatment for the Gluma bonding system. In this experiment, the effects of 1-minute treatments of smear layers with these aluminum oxalates on the permeability of human dentin were determined in vitro. The aluminum oxalate solutions at pH 0.5-1.5 removed most of the original smear layer but occluded the tubules with crystalline deposits which decreased dentin permeability. Those solutions used at pH 2.0 and 2.5 increased dentin permeability. All dentin pretreatments increased dentin permeability when measured after a 24-hour storage period, especially the solutions at pH 2.0 and 2.5. The SEM correlates of these permeability changes indicated that these solutions remove the smear layer but reocclude the tubules with precipitates which are probably different forms of calcium oxalate, aluminum phosphate and calcium phosphates.

Permeability of dentin to adhesive agents.

The permeability of dentin to adhesive agents is of crucial importance in obtaining good dentinal bonding. In those systems that remove the smear layer, the opportunity exists for resin to infiltrate both tubules and intertubular dentin. Resin penetration into tubules can effectively seal the tubules and can contribute to bond strength if the resin bonds to the tubule wall. Resin infiltration into intertubular dentin can only occur if the mineral phase of dentin is removed by acidic conditioners or chelators. This is more easily accomplished in fractured dentin than in smear layer-covered dentin because of the residual collagen debris that remains on the surface following acid etching of smear layers. The channels for resin infiltration are the perifibrillar spaces created around the collagen fibers of dentin following removal of apatite mineral by acids. The diffusion of adhesive resins through these narrow, tortuous, long channels in 1 to 2 minutes offers a number of challenges that require further research.

The effect of dentin depth on the permeability and ultrastructure of primary molars.

The purpose of this study was to measure the permeability of primary molar and permanent premolar dentin at various thicknesses from the pulp and to correlate permeability with the tubule density and diameter of dentin using SEM. The data were examined for statistically significant differences using two-way analysis of variance, multiple comparison Scheffe, and regression analysis. The permeability of all teeth increased with decreasing dentin thickness. The removal of the smear layer resulted in a significant increase in the permeability. However, the permeability of the dentin in premolars was significantly higher than that in the primary molars. The density and diameter of the dentinal tubular in primary molars were lower than the values reported for permanent teeth and may account for the lower permeability of the primary molars.