Adhesion of glass-ionomer cement sealers to bovine dentin conditioned with intracanal medications.

This in vitro study assessed the adherence of glass-ionomer cement (GIC) root canal sealers to dentin conditioned by three endodontic intracanal medications. Three GIC sealers were used: (i) Ketac-Endo; (ii) KT-308, an experimental GIC sealer; and (iii) ZUT, a combination of KT-308 and a silver-containing zeolite (0.2% by weight). Superficial dentin of 120 bovine incisor crowns was used as a substrate. The dentin was irrigated with 2.6% NaOCI for 30 s and then blotted dry. One of the following conditioning media (n = 30) was maintained in contact with the dentin for 7 days: (i) Ca(OH)2 paste; (ii) chlorhexidine gluconate (CHX) liquid 0.12%; (iii) formocresol (FML) liquid; (iv) distilled water (dH2O) used as control. The GIC sealers were applied to the conditioned dentin, bench set for 90 min, stored in 100% humidity at 37 degrees C for 48 h, then tested to failure for shear bond strength (MPa) in an Instron machine. In the ZUT specimens, the shear bond strength did not differ significantly among those conditioned with Ca(OH)2, CHX, FML, and dH2O. For KT-308, the mean scores were significantly lower (p < 0.05) after conditioning with CHX than with dH2O. For Ketac-Endo, the mean scores were significantly lower after conditioning with Ca(OH)2 and FML than with dH2O (p < 0.05). Furthermore Ketac-Endo demonstrated significantly lower (p < 0.05) shear bond strength than KT-308 or ZUT to the dentin conditioned with Ca(OH)2 or FML. The results suggest that intracanal medications differentially influence the adhesion of various GIC sealers to root canal dentin.

In vivo resistance of coronally induced bacterial ingress by an experimental glass ionomer cement root canal sealer.

The resistance of an experimental sealer (KT-308) to bacterial ingress was assessed in six beagle dogs. In four mandibular premolars per dog, canals were prepared, filled with condensed gutta-percha and either KT-308 or Roth 801 cement (n = 24 roots), and the pulp chambers inoculated with plaque. Two additional premolars per dog were similarly root-filled, but not inoculated (n = 12 and 11, respectively). One incisor per dog was inoculated, but not root-filled (n = 6). Dogs were terminated after 6 months, and jaw blocks were retrieved and processed for light microscopic examination of the periapical tissues. Inflammation about the inoculated roots was significantly lower (p < 0.03) for KT-308 (17%) than Roth 801 cement (46%). Inflammation about the noninoculated roots did not differ significantly between KT-308 (8%) and Roth 801 cement (36%). This study demonstrated a better functional efficacy of KT-308 than of Roth 801 cement, and validated this in vivo model for assessment of root filling materials.

Scanning electron microscopic study of the interface of glass ionomer cement sealers and conditioned bovine dentin.

This in vitro study characterized the interface of glass ionomer cement root canal sealers and dentin conditioned by common endodontic irrigants. The interface of Ketac-Endo and two experimental glass ionomer cement sealers (KT-308 and ZUT) with bovine dentin--conditioned with either distilled water, 2.6% NaOCl, or 17% EDTA, followed by 2.6% NaOCl--was investigated. Cylinders of each of the sealers were formed on the conditioned dentin surface and allowed to set for 90 min. They were first shear tested to failure to determine their adhesive bond strength. Then three dentin specimens from each group were processed for scanning electron microscopic study. The test-failed surface of the strongest and weakest bonded specimens was examined. A third specimen, of intermediate bond strength, was cross-sectioned and the interface was also examined. Failures in all of the specimens were found to be mainly cohesive in nature. Specimens conditioned with 2.6% NaOCl only revealed the presence of a hybrid layer at the interface composed of dentin and whichever of the sealers were tested.

The shear bond strength of glass ionomer cement sealers to bovine dentine conditioned with common endodontic irrigants.

AIM: The aim of this in vitro study was to evaluate the shear bond strength of commercially available and experimental glass ionomer cement (GIC) sealers to dentine exposed to common endodontic irrigants. METHODOLOGY: The enamel of 90 bovine incisor crowns, randomly divided into nine equal groups, was ground to expose the superficial dentine layer. The exposed surface was conditioned with either: (i) distilled H2O; (ii) 2.6% NaOCl; or (iii) 17% EDTA followed by 2.6% NaOCl. Five cc of each irrigant was applied over a 30-second period. The following GIC sealers were tested: (i) Ketac-Endo; (ii) KT-308, an experimental sealer; and (iii) ZUT, a combination of KT-308 and an antibacterial agent (0.2% by weight). The test sealers were applied to form cylinders with a standardized contact surface area (17.8 mm2) on the conditioned dentine surfaces. Specimens were bench set for 90 min and stored in distilled water at 37 degrees C for 48 h, then tested to failure for shear bond strength (MPa) in an Instron machine. RESULTS: KT-308 and ZUT had significantly higher MPa values than Ketac-Endo (two-factor ANOVA, P < 0.0001), regardless of the dentine conditioning. All specimens conditioned with 17% EDTA and 2.6% NaOCl combined had significantly lower MPa values than those conditioned with water or 2.6% NaOCl alone (P < 0.02). CONCLUSIONS: It was concluded that the experimental sealers KT-308 and ZUT bonded better to bovine dentine than Ketac-Endo, and that the bond of all three GIC sealers was better with the smear layer present.

Susceptibility of Nd:YAG laser-irradiated root surfaces in replanted teeth to external inflammatory resorption.

Nd:YAG laser-induced modification of the root surface may inhibit development of external inflammatory resorption in replanted teeth. This study tested this hypothesis in vivo. The pulp chambers of six mandibular premolars in each of two dogs were accessed, inoculated with plaque, and sealed (Groups 1, 2). Two additional premolars in each dog were endodontically treated without inoculation (Groups 3, 4). After 2 weeks, teeth were hemisected and extracted. Each root had a 2 x 3 mm surface area denuded of cementum on the buccal and lingual surface. In Groups 1 (n = 12 roots) and 3 (n = 4), the denuded surfaces were wiped with 15% EDTA, coated with black ink, and irradiated with Nd:YAG laser (0.75 W, 15 pps, 300 microns tip, 20 s). In Groups 2 (n = 12) and 4 (n = 4), the surfaces were wiped with 15% EDTA, and rinsed with sterile saline for 20 s. Roots were replanted within 5 min. The dogs were perfusion-euthanised 10 weeks after replantation. Block specimens were removed, decalcified, embedded and horizontally sectioned (6 microns) at 180-microns intervals, resulting in 10 to 14 cross-sections of each root. From these, the middle five consecutive sections were stained with hematoxylin and eosin, and observed by light microscopy for occurrence of surface, inflammatory and replacement resorption on the denuded surfaces. No obvious differences were noted between the laser-irradiated and non-irradiated surfaces. Inflammatory resorption was frequent in Groups 1 and 2, and absent in Groups 3 and 4. Replacement resorption was minimal in Groups 1 and 2, and frequent in Groups 3 and 4. Differences between Groups 1 and 2, and between Groups 3 and 4 were not significant, whereas the differences between the two pairs of groups were statistically significant (chi-square and two-way ANOVA, P < 0.006). These results did not support the hypothesis, and questioned the clinical validity of the surface modification in Nd:YAG laser-irradiated dentin. Therefore, the clinical application of Nd:YAG laser to the root surfaces of replanted teeth is not warranted.

In vivo model for assessing the functional efficacy of endodontic filling materials and techniques.

Endodontic fillings were challenged with bacterial ingress in mandibular premolars of 4 beagle dogs. Groups 1, 2, and 3 (n = 9), had canals filled with gutta-percha and sealer, gutta-percha alone, and sealer alone, respectively. After 2 wk, pulp chambers were inoculated with plaque. Group 4 (n = 9) and group 5 (n = 5) had canals either filled as in groups 1 to 3 or unfilled, respectively, but not inoculated. Group 6 (n = 5) had canals unfilled and inoculated. Teeth were radiographed periodically for 14 wk, dogs terminated, and jaw blocks retrieved and processed for light microscopic examination. Rarefying osteitis appeared in group 6 at 3 wk and in groups 2, 3, and 5 at 11 wk. Periradicular inflammation was none, mild, or severe. Occurrence of severe inflammation in groups 1 to 6 was 0, 11%, 33%, 0, 60%, and 100%, respectively. Groups 1 to 3 combined differed significantly from group 4 (repeated-measures ANOVA, p < 0.05). This model could be used to assess the functional efficacy of endodontic fillings in vivo.

3H proline uptake in the tubular compartment of dentin in the rat molar.

With the use of conventional autoradiographic techniques, it was demonstrated that dentin captures 3H proline in significantly greater amounts (p < 0.0002) than sclerotic dentin or alveolar bone. Histological observation and the absence of capture by sclerosed dentin indicated that this capture occurs within the tubular compartment of dentin. It is suggested that this capture reflects the deposition of collagen in this compartment. An increase in 3H proline capture occurs in dentin affected by cavity preparation (p < 0.0001). This increase in capture, on the basis of electron microscopic observation, could not be linked to an increase of collagen deposition in affected tubules.

Connective tissue response to root surfaces resected with Nd:YAG laser or burs.

PROBLEM: The Nd:YAG laser beam may be used for root resection, but the tissue compatibility of the resulting root surface has not been confirmed. OBJECTIVE: This study assessed the connective tissue response over time to implanted root segments with Nd:YAG laser-cut or bur-cut surfaces. STUDY DESIGN: Endodontically treated roots of 25 extracted human teeth were cross sectioned to form 3.5 mm thick disks by alternating a water-cooled Nd:YAG laser with a high-speed water-cooled tungsten fissure bur. A total of 63 disks were implanted into the dorsal subcutaneous tissue of 16 rats, then recovered with the surrounding tissue after periods of 3, 7, 14, 28, 60, and 90 days, and processed for light microscopic examination. Tissue against the cut surfaces was assessed for intensity and extent of inflammation and fibrous capsule thickness. RESULTS: A two-factor analysis of variation showed statistically significant (p < 0.05) differences between the laser-cut and bur-cut surfaces. CONCLUSION: Tissue repair about the root surfaces resected with Nd:YAG laser was delayed when compared with those resected with a bur.

Neurogenic inflammation and tooth pulp innervation pattern in sympathectomized rats.

This study investigated possible collateral C-fiber innervation between the pulps of rat molars by assessing neurogenic inflammation (NI) induced by the C-fiber excitant mustard oil (MO). MO was applied to the pulp of the left mandibular first molar in two groups of rats: group 1, guanethidine sympathectomized rats (to dismiss sympathetic activation by MO); and group 2, unsympathectomized rats. A third group of unsympathectomized rats (group 3) had saline applied to the pulp of the left mandibular molar and served as a MO control. The NI-related plasma extravasation was examined in these teeth and in the remaining left mandibular teeth by a spectrophotometric analysis of extravasated plasma protein bound to Evans' Blue (EB) dye. The collateral innervation pattern was inferred from the NI pattern. EB concentrations were measured in the left mandibular teeth and the corresponding contralateral teeth, and expressed as a ratio. Statistical analysis of the data revealed significant differences in EB ratios in the first, second, and third molars between groups 1 and 3. This result suggests collateral C-fiber innervation exists within the pulps of molar teeth in the same dental quadrant. No difference in EB ratios was noted in the first and second molars between groups 1 and 2. Therefore, sympathetic efferents have no apparent effect on the degree of MO-induced NI.

Inflammatory lesions of the tooth pulp induce changes in brainstem neurons of the rat trigeminal subnucleus oralis.

Neuroplastic changes are known to occur in the CNS in response to injury of peripheral nerves. Previous investigation has demonstrated neuroplasticity in second-order neurons of the subnucleus oralis (SO) of the trigeminal (V) nuclear complex in association with aseptic injury to the tooth pulp. A question arises, therefore, as to whether similar changes occur in response to injury associated with inflammation induced by tooth pulp infection. The effects of tooth pulp infection on the mechanoreceptive fields (RFs) of SO neurons were examined in rats. Infection was established by exposure and removal of the coronal pulp of the mandibular first molar, which was left open to the oral environment for 7 (n = 5) or 28 (n = 6) days. Neurons in SO were then electrophysiologically characterized in chloralose/urethane-anesthetized rats. The RF and the response properties of 118 low-threshold mechanoreceptive (LTM) neurons from seven-day-old rats and 149 LTM neurons from 28-day-old rats were compared with those of 204 LTM neurons tested in 11 untreated (control) rats. Significant differences were noted in RF size and location when control, seven-day-old, and 28-day-old groups were compared. Radiographic examination revealed inconsistencies among examiners in the interpretation of periapical lesions < 2 mm in diameter and general agreement in the identification of periapical lesions > 2 mm in diameter. Histological examination of teeth with pulp exposure revealed superficial necrosis and inflammation without periapical extension in the seven-day-old animals and total pulp necrosis with periapical inflammation, abscess formation, and alveolar bone resorption in the 28-day-old animals. The results indicate that neuroplastic changes in LTM oralis neurons can develop subsequent to tooth pulp infection and that there may be a correlation between the incidence of these changes and the extension of the attending inflammation from the pulp to the dental supporting tissues.

Adhesion of a resin composite to bleached and unbleached human enamel.

Cylinders of a visible light-cured microfil resin were formed on and bonded to the flattened enamel surface of 15 human hemisected premolar teeth which had previously been subjected to three different treatments: (a) immersion in 35% hydrogen peroxide (HP) for 60 min, (b) immersion in 35% HP for 60 min followed by storage in distilled water for 1 day prior to resin application, and (c) immersion in saline (S) for 60 min. Specimens were stored in distilled water at 37 degrees C for 7 days prior to shear bond strength testing. A total of 30 specimens were tested. Statistical analysis of the data indicated that there was a highly significant reduction in shear bond strength between HP- and saline-treated specimens. Water storage of HP-treated specimens for 1 day prior to resin application appeared to restore the adhesiveness but not to a point that was statistically significant. Scanning electron microscopic examination of randomly selected, fractured test specimens indicated that the reduction in bond strength may be related to alterations in the ability of the resin to attach itself to the HP-treated surface and to possible effects of the HP on the resin itself.

Leaching of hydrogen peroxide from bleached bovine enamel.

Accurately weighed bovine enamel slabs were individually immersed in 2 ml of 35% hydrogen peroxide for 1, 3, 5, 30, or 60 min. A control group was obtained by individual immersion of bovine enamel slabs in 2 ml of saline for 60 min. All samples were washed, dried, acid-etched with 37% phosphoric acid for 60 s, then washed and dried again. Two milliliters of double-distilled water were used for individual sample leaching. Leaching was done for 1, 5, 10, 20 min, or 7 days for the experimental groups and for 7 days for the control group. The samples of one of the experimental groups were leached for a second time for 1 min. A total of 112 samples was used in this study. Hydrogen peroxide was spectrophotometrically identified and quantified in all leaching solutions based on the oxidation reaction of leuco-crystal violet buffer solution by hydrogen peroxide, a reaction catalyzed by horseradish peroxidase. The results revealed a significant difference in the quantity of leached peroxide between bleached samples (irrespective of the duration of leaching) and control, saline-treated ones. No difference was observed in the quantity of leached peroxide between releached samples and control, saline-treated ones. However, these were small, random, and numerically insignificant. Statistically significant differences were also noted among some of the experimental groups. They were thought to hold no clinical significance. The results suggested that upon immersion, the complete leaching of peroxide from bleached enamel occurs rapidly.

The effect of carbamide-peroxide gel on the shear bond strength of a microfil resin to bovine enamel.

Cylinders of a visible-light-cured microfil resin were formed on, and bonded to, the flattened labial enamel surfaces of young bovine incisor teeth which had previously been subjected to four different treatments: (1) immersion in 10% carbamide-peroxide gel, pH 4.7, for three h; (2) immersion in 10% carbamide-peroxide gel, pH 4.7, for six h; (3) immersion in 10% carbamide-peroxide gel, pH 7.2, for three h; and (4) immersion in 10% carbamide-peroxide gel, pH 7.2, for six h. For each experimental group, a control group of resin-bonded to saline-immersed teeth was prepared. In addition, two groups, prepared according to treatment 4, were leached in distilled water for one and seven d, respectively, prior to resin application. Specimens were stored in distilled water at 37 degrees C for seven d prior to shear-bond-strength testing. A total of 90 teeth was tested. Statistical analysis of the results indicated that there was a highly significant reduction in the shear bond strength to carbamide-peroxide-treated enamel as compared with that to saline-treated enamel. The effects of duration of peroxide treatment and pH, as well as the interaction term, were not statistically significant. Leaching of the peroxide-treated enamel in water for either one or seven d prior to resin application restored the adhesiveness of the enamel. Scanning electron microscopic examination of randomly selected, fractured test specimens indicated that the peroxide-induced reduction in enamel adhesiveness was related to alterations in both attachment-surface area at the resin-enamel interface and resin quality.

Effect of water leaching the adhesion of composite resin to bleached and unbleached bovine enamel.

Standardized cylinders of light-cured composite resin were bonded to the ground labial enamel surface of bovine incisor teeth that had been immersed in double-distilled water for 7 days after having been (a) immersed in hydrogen peroxide for 5, 30, or 60 min, then etched for 60 s with 37% phosphoric acid; (b) immersed in saline for 5, 30, or 60 min, then etched for 60 s with 37% phosphoric acid; (c) etched with 37% phosphoric acid for 60 s, then immersed in hydrogen peroxide for 5, 30, or 60 min; or (d) etched with 37% phosphoric acid for 60 s, then immersed in saline for 5, 30, or 60 min. The enamel surface was washed with water for 1 min and dried with compressed air for 30 s prior to applying the resin. The tooth and applied resin were stored in water at 37 degrees C for 1 day prior to shear and tensile testing. A total of 192 specimens was used, 8 for each enamel preparation mode, for each time period, and for each test. Test values were tabulated and statistically analyzed. Analysis of variance revealed significantly higher bond strength values (p less than 0.005) for hydrogen peroxide-treated as compared with saline-treated specimens. A significant interaction was also noted between test solution and etching order. Scanning electron microscopic examination of failed shear- and tensile-tested specimens revealed no significant solution-related differences in the fracture pattern or the resin quality.(ABSTRACT TRUNCATED AT 250 WORDS)

Scanning electron microscopy observations on the penetration and structure of resin tags in bleached and unbleached bovine enamel.

The purpose of this study was to determine the effect of hydrogen peroxide on the ability of composite resin to penetrate bovine enamel etched with phosphoric acid. In a previous investigation, the flattened enamel surfaces of extracted bovine incisors were immersed in either saline (control) or 35% hydrogen peroxide (experimental) for 5 or 30 min before or after acid etching with 37% phosphoric acid gel for 60 s. A standard-sized light-cured resin cylinder was then bonded to the enamel surface. The specimens were stored in a water bath at 37 degrees C for 1 day or 7 days, after which the enamel-resin bond was tensile tested to failure. Sixteen of the failed specimens (eight control and eight experimental) were randomly selected for the present scanning electron microscopic study to evaluate the appearance of the resin tags at the resin-enamel interface. In the control specimens, the tags were well defined and contiguous with resin which was uniformly adherent to the enamel surface. In the experimental specimens, large areas of the enamel surface were free of resin. When tags were present, they were fragmented, poorly defined, and penetrated to a lesser depth than in the saline controls. The changes observed suggest that there may be interaction between resin and residual peroxide at or near the enamel surface.

Preliminary surface analysis of etched, bleached, and normal bovine enamel.

X-ray photoelectron spectroscopic (XPS) and secondary ion-mass spectroscopic (SIMS) analyses were performed on unground un-pumiced, unground pumiced, and ground labial enamel surfaces of young bovine incisors exposed to four different treatments: (1) immersion in 35% H2O2 for 60 min; (2) immersion in 37% H3PO4 for 60 s; (3) immersion in 35% H2O2 for 60 min, in distilled water for two min, and in 37% H3PO4 for 60 s; (4) immersion in 37% H3PO4 for 60 s, in distilled water for two min, and in 35% H2O2 for 60 min. Untreated unground un-pumiced, unground pumiced, and ground enamel surfaces, as well as synthetic hydroxyapatite surfaces, served as controls for intra-tooth evaluations of the effects of different treatments. The analyses indicated that exposure to 35% H2O2 alone, besides increasing the nitrogen content, produced no other significant change in the elemental composition of any of the enamel surfaces investigated. Exposure to 37% H3PO4, however, produced a marked decrease in calcium (Ca) and phosphorus (P) concentrations and an increase in carbon (C) and nitrogen (N) concentrations in unground un-pumiced specimens only, and a decrease in C concentration in ground specimens. These results suggest that the reported decrease in the adhesive bond strength of resin to 35% H2O2-treated enamel is not caused by a change in the elemental composition of treated enamel surfaces. They also suggest that an organic-rich layer, unaffected by acid-etching, may be present on the unground un-pumiced surface of young bovine incisors. This layer can be removed by thorough pumicing or by grinding. An awareness of its presence is important when young bovine teeth are used in a model system for evaluation of resin adhesiveness.

The influence of time of hydrogen peroxide exposure on the adhesion of composite resin to bleached bovine enamel.

Standard sized cylinders of a small particle light-cured resin were bonded to the flattened labial surface of young bovine incisor teeth which had been previously subjected to four different treatments: (a) immersion in 35% hydrogen peroxide and etched with 37% phosphoric acid gel for 60 s, (b) immersion in saline and etched for 60 s, (c) etched for 60 s and immersion in hydrogen peroxide, and (d) etched for 60 s and immersion in saline. Two hydrogen peroxide and saline immersion periods were used, 5 and 30 min. Specimens were stored in water at 37 degrees C for 1 and 7 days before tensile and shear testing. A total of 256 teeth were used, 8 for each treatment group, each immersion period, and each water storage period for each test. Statistical analysis of the results indicated that there was a highly significant reduction in the adhesive bond strength of the resin when the enamel was exposed to hydrogen peroxide and that the reduction was, within the limits of this study, time dependent. The bond strength was unaffected by the etching order and the period of water storage. Scanning electron microscopic examination of randomly selected fractured peroxide-treated specimens indicated that the failure occurred primarily at the bonding resin-enamel interface and that it was associated with areas of resin nonattachment and an alteration in resin quality. It is suspected that these changes were caused by the presence of residual peroxide or peroxide-related substances at or near the enamel surface.