[Is amalgam stained dentin a proper substrate for bonding resin composite?]. / Hora est 2. Is door amalgaam verkleurd dentine een geschikt substraat voor hechting van composiet?

After the removal of amalgam restorations, black staining of dentin is often observed, which is attributed to the penetration of corrosion products from amalgam. A study was carried out to determine whether this amalgam stained dentin is a proper substrate for bonding resin composites. A literature study and an in vitro study showed that Sn and Zn in particular are found in amalgam stained dentin, and this was the case only in demineralised dentin. In vitro, demineralised dentin acted as porte d'entrÈe for amalgam corrosion products. Bond strength tests with 5 adhesive strategies showed no differences between bond strengths to amalgam stained and to sound dentin, but did show different failure types. A clinical study showed good survival of extensive cusp replacing resin composite restorations. No failures were attributed to inadequate adhesion. It is concluded that staining of dentin by amalgam corrosion products has no negative effect upon bond strength of resin composite. It is suggested that Sn and Zn may have a beneficial effect upon dentin, thus compensating the effects of previous carious attacks, preparation trauma and physico-chemical challenges during clinical lifetime.

Microtensile bond strength of three simplified adhesive systems to caries-affected dentin.

PURPOSE: The purpose of the study was to determine the microtensile bond strength of three different simplified adhesive systems to caries-affected dentin. MATERIALS AND METHODS: Fifteen extracted human molars with primary carious lesions were ground flat until dentin was exposed. Soft caries-infected dentin was excavated with the help of caries detector dye. On the remaining hard dentin, a standardized smear layer was created by polishing with 600-grit SiC paper. Teeth were divided into three groups and treated with one of the three tested adhesives: Adper Scotchbond 1 XT (3M ESPE), a 2-step etch-andrinse adhesive, Clearfil S3 Bond (Kuraray), a 1-step self-etching or all-in-one adhesive, and Clearfil SE Bond (Kuraray), a 2-step self-etching adhesive. Five-mm-thick composite buildups (Z-250, 3M ESPE) were built and light cured. After water storage for 24 h at 37ºC, the bonded specimens were sectioned into bars (1.0 x 1.0 mm; n = 20 to 30). Microtensile bond strength of normal dentin specimens and caries-affected dentin specimens was measured in a universal testing machine (crosshead speed = 1 mm/min). Data were analyzed using two-way ANOVA and Tukey's post-hoc test (p < 0.05). RESULTS: No significant differences in bond strength values to normal dentin between the three adhesives were found. Adper Scotchbond 1 XT and Clearfil S3 Bond showed significantly lower bond strength values to caries-affected dentin. For Clearfil SE Bond, bond strength values to normal and caries-affected dentin were not significantly different. CONCLUSION: All the tested simplified adhesives showed similar bond strength values to normal dentin. For the tested 2-step etch-and-rinse adhesive and the all-in-one adhesive, the bond strength values to caries-affected dentin were lower than to normal dentin.

[Gingiva damaged by ill-fitting scuba-diving mouthpiece]. / Schade aan gingiva door slecht passend mondstuk.

A 46-year old man presented a hyperlasia of the marginal gingiva of a mandibular molar. The reason of the hyperlasia could be found after further anamnestic questions: irritation by pressure of an ill-fitting scuba-diving mouthpiece. The patient was sports-diver and instructor. After instructions to the patient and an expectative approach, the hyperplasia disappeared spontaneously within a few months, without any kind of therapy.