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1.
Characterization of Lactobacilli isolated from carious dentin after selective caries removal and cavity sealing.
Damé-Teixeira, N, Ev, LD, Bitello-Firmino, L, Soares, VK, Dalalba, RS, Rup, AG, Maltz, M, Parolo, CCF
Archives of oral biology. 2021;:104988
Abstract
OBJECTIVE To characterize lactobacilli isolated from residual carious dentin after selective caries removal (SCR), by observing the changes detected in their prevalence, diversity, and cariogenic potential after starvation stress caused by cavity sealing (CS). DESIGN Lactobacilli were cultured from carious dentin lesions (n = 16 patients) treated in a clinical trial, three months before and after CS. Presumptive lactobacilli were selected, isolated, and analyzed by Gram staining. Housekeeping gene sequences were used to identify the species (groEL, rpoA, pheS, and 16S rRNA). RESULTS N = 86 Lactobacillus spp. (n = 41 before and n = 45 after sealing) were genotyped by AP-PCR and analyzed for their cariogenic potential (acid production and acid tolerance). The proportion of lactobacilli to the total anaerobic counts was high, and a significant decrease was observed after sealing (median before sealing = 78.9; 25th-75th = 60.25-97.35; median after sealing = 0.00; 25th-75th = 0.00-77.08; p = 0.001). L. paracasei was the most prevalent species of lactobacilli in carious dentin (p = 0.02). L. rhamnosus prevalence increased to a proportion similar to L. paracasei after CS (p = 0.001). A total of 28 and 14 different genotypes were found before and after CS, respectively. There was no difference between the L. paracasei and the L. rhamnosus isolated from carious dentin, neither regarding acid production nor acid tolerance. CONCLUSIONS Although there was a significant reduction in lactobacilli in the residual carious dentin after SCR, some strains were capable of surviving after three months of CS. However, the sealed available nutrients are low and not sufficient for caries progression. Also, we believe that a longer follow up period may eliminate all the residual lactobacilli. L. paracasei prevailed in carious dentin in a proportion similar to L. rhamnosus in the sealed dentin. Characterization of lactobacilli after SCR and sealing may help the understanding the importance of genotyping of lactobacilli in carious microbiota.
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2.
Effect of silver diamine fluoride solution application on the bond strength of dentine to adhesives and to glass ionomer cements: a systematic review.
Jiang, M, Mei, ML, Wong, MCM, Chu, CH, Lo, ECM
BMC oral health. 2020;(1):40
Abstract
BACKGROUND Silver diamine fluoride (SDF) solution gains increasing popularity in arresting dentine caries in clinical practice. The aim of this systematic review was to summarize the findings from laboratory studies on the influence of SDF application on the bond strength of dentine to various adhesives and to glass ionomer cements (GICs). METHODS Two independent reviewers conducted a literature search in the databases Medline, Ovid, PubMed and Web of Science until 15th August 2019 using the search keywords ['bond strength'] AND ['silver diamine fluoride' OR 'silver diammine fluoride' OR 'SDF' OR 'silver fluoride' OR 'diamine silver fluoride']. Articles investigating the effect of SDF application on the bond strength of dentine to various adhesives and to GICs were included in this review. Information on how SDF application influenced the bond strength was extracted from the included articles. Besides, related information, e.g. test method of bond strength, concentration and brand of SDF, type of adhesive system and GIC, testing dental substrate, protocol of specimen preparation, and failure mode was also reviewed. RESULTS A total of 13 articles were included in this review, with 8 and 6 studies investigating the effect of SDF application on the bond strength of dentine to various adhesives and to GICs, respectively. Sound dentine as well as demineralized dentine created by chemical methods, e.g. immersing in a demineralizing solution, was commonly adopted as the testing dental substrate. The microtensile bond strength (mTBS) test was the predominant method employed. However, the bond strength values had large variations among studies, ranging from <10 to 162 Mpa. Regarding the bond strength to different adhesives, 4 studies indicated that SDF application followed by rinsing with water had no significant influence. However, another 4 studies reported reduced bond strength after SDF application. Regarding the bond strength to GICs, 4 studies concluded that SDF application had no adverse impact on the bond strength. CONCLUSIONS No solid conclusion can be drawn on the effect of SDF application on the bond strength of dentine to adhesives and to GICs due to the high degree of variation of the included studies.
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3.
Effect of Cavity Disinfectants on Dentin Bond Strength and Clinical Success of Composite Restorations-A Systematic Review of In Vitro, In Situ and Clinical Studies.
Coelho, A, Amaro, I, Rascão, B, Marcelino, I, Paula, A, Saraiva, J, Spagnuolo, G, Marques Ferreira, M, Miguel Marto, C, Carrilho, E
International journal of molecular sciences. 2020;(1)
Abstract
Cavity disinfection becomes an important step before a dental restorative procedure. The disinfection can be obtained cleaning the dental cavity with antimicrobial agents before the use of adhesive systems. The aim of this study was to conduct a systematic review on the effect of different cavity disinfectants on restorations' adhesion and clinical success. A search was carried out through the Cochrane Library, PubMed, and Web of Science. In vitro and in situ studies reporting results on dentin bond strength tests, and clinical studies published until August 2020, in English, Spanish and Portuguese were included. The methodological quality assessment of the clinical studies was carried out using the Revised Cochrane risk-of-bias tool. Chlorhexidine could preserve adhesion to dentin. EDTA and ethanol had positive results that should be further confirmed. Given the significant lack of scientific evidence, the use of lasers, fluoridated agents, sodium hypochlorite, or other products as cavity disinfectants should be avoided. Chlorhexidine is a safe option for cavity disinfection with adequate preservation of adhesion to dentin. Moreover, future researches should be focused on the efficacy of these disinfectants against cariogenic bacteria and their best application methods.
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4.
Push-out bond strength of calcium-silicate cements following Er:YAG and diode laser irradiation of root dentin.
Mohammadian, F, Soufi, S, Dibaji, F, Sarraf, P, Chiniforush, N, Kharrazifard, MJ
Lasers in medical science. 2019;(1):201-207
Abstract
This study aimed to compare the effects of diode and Er:YAG laser irradiation of root dentin on push-out bond strength of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cements. An in vitro experimental study was conducted on 90 dentin discs, cut out of freshly extracted human teeth. The discs were instrumented to obtain 1.3-mm lumen diameter. Then, they were randomly divided into six groups (n = 15). Groups 1 and 4 subjected to diode laser (Wiser, Doctor Smile, Italy) (980 nm, 1 W, continuous mode) for 10 s and filled with MTA and CEM cements. Groups 2 and 5 subjected to Er:YAG laser (Deka, Italy) (2940 nm, 1 W, 10 Hz, 230 μs) for 10 s and filled with MTA and CEM cements. Groups 3 and 6 (control groups) were filled with MTA and CEM cements without laser irradiation. After 7 days, push-out bond strength test was performed using a universal testing machine in order to evaluate the adhesion of the biomaterials to dentin. The samples were evaluated under a light microscope at × 40 magnification to determine the mode of fracture. Data were analyzed using two-way ANOVA. The highest push-out bond strength (8.76 ± 3.62 MPa) was noted in group 1 (diode/MTA), which was significantly higher than the other groups (P < 0.001). The lowest bond strength (2.61 ± 0.81) was noted in group 6 (control/CEM). Diode laser significantly increased the bond strength of both cements (P < 0.05), but Er:YAG laser irradiation only increased the bond strength of CEM and had no significant effect on MTA (P = 0.603). The bond strength of MTA control group was higher than that of CEM control group (P = 0.001). Push-out bond strength of endodontic cements can be affected by dentin conditioning with diode 980 nm and Er:YAG laser. Nine hundred eighty-nanometer diode laser irradiation is recommended to increase the bond strength of endodontic cements particularly the CEM cement to dentin.
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Quantitative/qualitative analysis of adhesive-dentin interface in the presence of 10-methacryloyloxydecyl dihydrogen phosphate.
Zhou, J, Wurihan, , Shibata, Y, Tanaka, R, Zhang, Z, Zheng, K, Li, Q, Ikeda, S, Gao, P, Miyazaki, T
Journal of the mechanical behavior of biomedical materials. 2019;:71-78
Abstract
Dental adhesive provides effective retention of filling materials via adhesive-dentin hybridization. The use of co-monomers, such as 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP), is thought to be crucial for hybridization owing to their ionic-binding to calcium and co-polymerization in the polymerizable adhesives. Optimal hybridization partly depends on the mechanical properties of polymerized adhesives, which are likely to be proportional to the degree of conversion ratio. This study assessed the correlation between polymerization quality and mechanical properties at the adhesive-dentin interfaces in the presence or absence of 10-MDP. In situ Raman microspectroscopy and nanoindentation tests were used concurrently to quantify the degree of conversion ratio and dynamic mechanical properties across the adhesive-dentin interfaces. Despite the excellent diffusion and apparent higher degree of co-polymerization, 10-MDP reduced the elastic modulus of the interface. The higher viscoelastic properties of the adhesive are suggestive of poor polymerization, namely polymerization linearity related to the long carboxyl chain of 10-MDP. Such reduced mechanical integrity of hybridization could also be associated with the inhibition of nano-layering between 10-MDP and mineralized tissue in the presence of hydroxyethyl methacrylate (HEMA). This potential drawback of HEMA necessitates further qualitative/quantitative characterization of adhesive-dentin hybridization using a HEMA-free/low concentration experimental 10-MDP monomer, which theoretically possesses superior chemical bonding potential to the current HEMA-rich protocol.
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The recovery effect of proanthocyanidin on microtensile bond strength to sodium hypochlorite-treated dentine.
Wang, Y, Chen, C, Zang, HL, Liang, YH
International endodontic journal. 2019;(3):371-376
Abstract
AIM: To evaluate the recovery effect of proanthocyanidin (PA) on microtensile bond strength (μTBS) to sodium hypochlorite (NaOCl)-treated dentine. METHODOLOGY Fifty-five freshly extracted third molars with intact dental crowns, no caries or restorations were sectioned to expose a sound middle layer of dentine and were randomly divided into 11 groups. In the blank control group, dentine surfaces were immersed in deionized water for 20 min. In the negative control group, dental surfaces were immersed in 5.25% NaOCl for 20 min. In the other nine experimental groups, after immersion for 20 min in 5.25% NaOCl, followed by PA (5%, 10%, or 15%) treatment for 1, 5 min or 10 min. The NaOCl solution was renewed every 5 min. Then dentine surfaces were bonded using SE bond. Bonded samples were sectioned into dentine-resin sticks (n = 45) for microtensile bond strength testing (MPa). Failure modes were observed and classified into three types with a stereomicroscope. Microtensile bond strength data were analysed using one-way anova. The confidence interval test was performed to analyse the recovery effect of PA on bond strength to NaOCl-treated dentine. The chi-squared test was used to analyse failure mode distribution. RESULTS After use of 5.25% NaOCl for 20 min, microtensile bond strength in the negative control group decreased significantly compared with that of the untreated group (P < 0.05). After a recovery treatment of 10% PA for 10 min or 15% PA for more than 5 min, the bond strength was restored to at least 90% of baseline (P < 0.05). No recovery effect on bond strength was detected after the application of 5% PA for 1 min (P > 0.05). Adhesive fracture was found to be the most common failure mode in the NaOCl-treated group. After the recovery application of PA, the proportion of mixed failures increased significantly (P < 0.05). CONCLUSIONS Microtensile bond strength to NaOCl-treated dentine recovered after the application of either 5% PA for more than 5 min or 10% or 15% PA for more than 1 min. The application of PA before an adhesive procedure may immediately restore the compromised bond strength of NaOCl-treated dentine.
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7.
Do ozonated water and boric acid affect the bond strength to dentin in different adhesive systems?
Akturk, E, Bektas, OO, Ozkanoglu, S, G Akin, EG
Nigerian journal of clinical practice. 2019;(12):1758-1764
Abstract
AIM: The aim of this in vitro study was to compare the effects of the application of three different cavity disinfecting agents to dentin on the micro-shear bond strength (μ-SBS) of one self-etch and two universal adhesive systems. MATERIALS AND METHODS In total, 120 caries-free human permanent molar teeth were used in this study. Mid-coronal dentin surfaces were revealed by cutting occlusal enamel and a standard smear layer was obtained by using 600-800-1200 grid silicon carbide abrasive papers. Specimens were randomly assigned to four groups according to the disinfectant used: Group 1: Control (no disinfectant); Group 2: 2% chlorhexidine based (Consepsis); Group 3: 10 ppm ozonated water (TeknO3zone); Group 4: 5% boric acid (Handmade). Each group was divided into three subgroups according to the type of adhesive (Clearfil SE Bond, OptiBond XTR, and Tokuyama Universal). Specimens were bonded using either Clearfil SE Bond, OptiBond XTR or Tokuyama Universal, which were employed according to the manufacturer's instructions. Resin composite microcylinders were bonded using Tygon® tubes for μ-SBS testing. After specimens were stored for 24 h, at 37°C in distilled water, μ-SBS test was measured with a universal test machine (LF Plus, Lloyd, Instrument). μ-SBS results were analyzed by one-way analysis of variance (ANOVA) and Tukey's tests. RESULTS When the mean microshear bond strength values of the control group were compared, the difference between the subgroups was not significant (P < 0.05). When the mean microshear bond strength values of the chx, ozonated water, and boric acid were compared, the difference between Clearfil SE Bond and Tokuyama Universal was significant (P < 0.05) and the difference between the other groups was not significant (P > 0.05). CONCLUSION Ozonated water and boric acid may be as an alternative to other materials used as cavity disinfectants.
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Microcomputed Tomography Evaluation of Dentine Mineral Concentration in Primary Molars Managed by Three Treatment Protocols.
Mijan, MC, Frencken, JE, Schwass, DR, Chaves, SB, Leal, SC
Caries research. 2018;(4):303-311
Abstract
The objectives of the study were to quantify the dentine mineral concentration (DMC) in teeth restored conventionally, according to the atraumatic restorative treatment (ART) and ultraconservative (UCT) protocols (open cavities and small ART restorations), and the DMC underneath the open cavities of teeth managed by UCT versus nontreated, open cavities. We studied 50 teeth with restorations/open cavities, 39 restored teeth (9 by conventional restorative treatment [CRT], 17 by ART, and 13 by UCT) and 16 teeth with open cavities. Each restoration/open cavity was scanned using microcomputed tomography, with 3 hydroxyapatite disks with respective densities of 1.24, 1.33, and 1.57 g/cm3 as a reference. Images were reconstructed and the greyscale images were converted into DMC values. For each restoration/open cavity, 15 measurements of dentine immediately underneath and from the corresponding area in sound dentine were taken. DMC was expressed as a percentage of the DMC of sound dentine. ANOVA and the Student t test were used for statistical analysis. The mean DMC underneath restorations of the ART protocol group (98.93%) was statistically significantly higher than that of the UCT protocol group (91.98%), but not of the CRT protocol group (91.33%). On multiple surfaces, mean DMC in the axial area (94.32%) was statistically significantly higher than in the gingival area (92.80%). The mean DMC of open cavities managed by UCT protocol (89.05%) was statistically significantly higher than in nontreated open cavities (83.90%). In conclusion, a dentine-hypermineralized area underneath ART restorations was observed. Managing open cavities with a toothbrush and fluoride toothpaste (the UCT protocol) resulted in higher mineralized dentine underneath the cavity than in nontreated open cavities.
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A zinc-doped endodontic cement facilitates functional mineralization and stress dissipation at the dentin surface.
Toledano, M, Osorio, R, Pérez-Álvarez, MC, Osorio, E, Lynch, CD, Toledano-Osorio, M
Medicina oral, patologia oral y cirugia bucal. 2018;(6):e646-e655
Abstract
BACKGROUND The purpose of this study was to evaluate nanohardness and viscoelastic behavior of dentin surfaces treated with two canal sealer cements for dentin remineralization. MATERIAL AND METHODS Dentin surfaces were subjected to: i) 37% phosphoric acid (PA) or ii) 0.5 M ethylenediaminetetraacetic acid (EDTA) conditioning prior to the application of two experimental hydroxyapatite-based cements, containing sodium hydroxide (calcypatite) or zinc oxide (oxipatite), respectively. Samples were stored in simulated body fluid during 24 h or 21 d. The intertubular and peritubular dentin were evaluated using a nanoindenter to assess nanohardness (Hi). The load/displacement responses were used for the nano-dynamic mechanical analysis to estimate complex modulus (E*) and tan delta (δ). The modulus mapping was obtained by imposing a quasistatic force setpoint to which a sinusoidal force was superimposed. AFM imaging and FESEM analysis were performed. RESULTS After 21 d of storage, dentin surfaces treated with EDTA+calcypatite, PA+calcypatite and EDTA+oxipatite showed viscoelastic discrepancies between peritubular and intertubular dentin, meaning a risk for cracking and breakdown of the surface. At both 24 h and 21 d, tan δ values at intertubular dentin treated with the four treatments performed similar. At 21 d time point, intertubular dentin treated with PA+oxipatite achieved the highest complex modulus and nanohardness, i.e., highest resistance to deformation and functional mineralization, among groups. CONCLUSIONS Intertubular and peritubular dentin treated with PA+oxipatite showed similar values of tan δ after 21 d of storage. This produced a favorable dissipation of energy with minimal energy concentration, preserving the structural integrity at the dentin surface.
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10.
Response of periodontium to mineral trioxide aggregate and Biodentine: a pilot histological study on humans.
Tirone, F, Salzano, S, Piattelli, A, Perrotti, V, Iezzi, G
Australian dental journal. 2018;(2):231-241
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Abstract
BACKGROUND The aim of this study was to investigate for the first time the histological response of human periodontium to mineral trioxide aggregate (MTA) and Biodentine. METHODS Six patients scheduled for implant full-arch rehabilitation were randomly assigned to one of the two test groups: MTA or Biodentine treatment. For each patient, two teeth scheduled for strategic extraction were randomly assigned either to the test or to the control treatment. A lateral perforation was drilled on the root and either repaired with MTA/Biodentine or filled with gutta-percha(control). Three months later, the teeth were extracted along with the coronal third of the alveolar bone and a portion of gingival tissue, while performing implant placement, and processed for histological analysis. RESULTS Biodentine resulted in less extrusion into the periodontal environment. All the materials showed good biocompatibility. A new mineralized cementum-like tissue incorporating periodontal fibres was visible in all cases treated with MTA. A small amount of new mineralized tissue was found in two Biodentine cases but not in control cases. Biodentine resulted in less damage to the periodontal ligament. CONCLUSIONS Bioactivity and biocompatibility of MTA were confirmed in human models. Biodentine proved to be biocompatible, but it seems not to induce cementum regeneration.