Effect of dentine site on resin and cement adaptation tested using X-ray and electron microscopy to evaluate bond durability and adhesive interfaces.

Glass ionomer (GI) cements and self-etch (SE) or universal adhesives after etching (ER) adapt variably with dentine. Dentine characteristics vary with depth (deep/shallow), location (central/peripheral), and microscopic site (intertubular/peritubular). To directly compare adhesion to dentine, non-destructive imaging and testing are required. Here, GI, ER, and SE adapted at different dentine depths, locations, and sites were investigated using micro-CT, xenon plasma focused ion beam scanning electron microscopy (Xe PFIB-SEM), and energy dispersive X-ray spectroscopy (EDS). Extracted molars were prepared to deep or shallow slices and treated with the three adhesives. Micro-CT was used to compare changes to air volume gaps, following thermocycling, and statistically analysed using a quantile regression model and Fisher's exact test. The three adhesives performed similarly across dentine depths and locations, yet no change or overall increases and decreases in gaps at all dentine depths and locations were measured. The Xe PFIB-SEM-milled dentine-adhesive interfaces facilitated high-resolution characterization, and element profiling revealed variations across the tooth-material interfaces. Dentine depth and location had no impact on adhesive durability, although microscopic differences were observed. Here we demonstrate how micro-CT and Xe PFIB-SEM can be used to compare variable dental materials without complex multi-stage specimen preparation to minimize artefacts.

The Medicare Chronic Disease Dental Scheme: Historical, Scientific, Socio-political Origins.

While evidence and expert opinion are the foundations of effective policy, the politics, economics, and timing of a proposal can affect outcome. Australian government involvement in the planning, funding and delivery of dental services has been minimal and inconsistent. Many believe that the hybrid dispersal model of shared constitutional power has intermittently led to poor administration of national health policy. Throughout the decade-long prelude to the introduction of the Chronic Disease Dental Scheme, a landmark health policy in Australia, Parliamentarians moved responsibility for public dental services of disadvantaged Australians into an impasse between the Federal, State, and Territorial Governments. Developments throughout the era confirm the influence of administrative intrigue, centralized authority, competing priorities, funding pressures, political strategy, public opinion, scientific evidence and the timing of a proposal on the formulation and implementation of oral health policy. Synchronized inter-governmental collaboration was also absent. Moreover, the impasse and its resolution immediately before a national election demonstrate the bipolar roles of centralized political authority and political resolve in either obstructing or implementing policy. The historical, scientific, and socio-political contexts undermining the preamble to the Chronic Disease Dental Scheme lend weight to concerns about the hybrid dispersal model of constitutional power.