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PubMed1994

Radicular penetration of hydrogen peroxide during intra-coronal bleaching with various forms of sodium perborate.

The development of external cervical root resorption following internal bleaching of discoloured pulpless teeth is associated with the use of hydrogen peroxide. The aim of the study was to determine radicular penetration of hydrogen peroxide following intracoronal bleaching with various forms of sodium perborate. 63 extracted human incisors were root filled and stained artificially. Standardized cementum defects were created on the mesial and distal aspects of the root directly below the cemento-enamel junction (CEJ). Using the walking bleach technique all teeth were bleached for a 6-day period, with replacement of the bleaching paste after days 1 and 3. Sodium perborate monohydrate (MH), trihydrate (TRH) or tetrahydrate (TH) was mixed with H2O2 or H2O and subsequently placed intracoronally 1 mm below the labial CEJ. The teeth were divided into six groups: I. MH + H2O2(30%) (n = 12); II. TRH + H2O2(30%) (n = 12); III. TH + H2O2(30%) (n = 12); IV. TH + H2O (n = 12); V. TH + H2O, gel (n = 12); VI. no bleaching paste (n = 3). At baseline and at days 1, 3 and 6 the amount of H2O2 taken up from the surrounding medium of each root was indirectly recorded and calculated as p.p.m. Almost all teeth of the experimental groups showed leakage of hydrogen peroxide compared to those of the control group. The radicular penetration of hydrogen peroxide was significantly higher in teeth of groups I and III than in those of groups IV and V (P < or = 0.001). In conclusion, the amount of hydrogen peroxide leakage depends, among other factors, on the form of sodium perborate used.(ABSTRACT TRUNCATED AT 250 WORDS)

Borates↗
PubMed1996

Penetration of smeared or nonsmeared dentine by Streptococcus gordonii.

The purpose of this study was to investigate the penetration of smeared and nonsmeared dentine by Streptococcus gordonii. Prepared human roots, grouped as either nonsmeared or smeared, were immersed in a suspension of S. gordonii cells for 3 weeks. The roots were then prepared for scanning electron microscopy and histological analysis. Dentine discs prepared from coronal dentine were grouped similarly. Using a fluid filtration apparatus, the hydraulic conductance (Lp) of each disc was determined before and after incubation with bacterial suspension. Scanning electron microscopy evaluation of the roots following infection with bacteria showed no change in the smear layer (P < 0.0001). Histological sections revealed that bacterial penetration of all the nonsmeared samples had occurred, while nine out of 10 smeared samples showed no bacterial penetration (P < 0.0001). The Lp of the nonsmeared discs was significantly reduced by 42% (P < 0.0001) after bacterial penetration. However, the smeared samples revealed a 1% reduction in Lp which was not significant (P > 0.05). The results suggest that dentinal smear layers are an effective barrier to dentinal tubule invasion by S. gordonii.

Dental Pulp Cavity↗
PubMed1999

Protective effects of resin impregnation on demineralization of enamel.

PURPOSE: To determine if resin penetrated into the enamel etch pattern, in the absence of a polymerized outer surface film, could reduce the degree of demineralization of enamel subjected to a simulated caries challenge, and to evaluate whether the addition of fluoride to the resin would enhance reductions in demineralization. MATERIALS AND METHODS: Enamel surfaces of extracted human incisors were acid-etched. One-half of the etched area was treated with an unfilled bonding resin, while the other one-half was left untreated as a control. In another group, this same procedure was followed except the unfilled bonding resin contained fluoride. The applied resin was aggressively air thinned to ensure oxygen inhibition throughout the external surface film thickness. The thinned film was visible light-cured and the area was wiped with an ethanol swab to remove the inhibited layer. The specimens were exposed to a buffer solution of pH = 4.7 for 4 days, and were sectioned and examined by polarized light microscopy and microradiography. RESULTS: In each of the two test groups, the demineralization of the resin-treated side was significantly lower than the control side (P < 0.015). Under the conditions of this study, the experimental fluoride resin did not produce statistically significant reductions in demineralization compared with the non-fluoride resin.

Acid Etching, Dental↗
PubMed2001

Pulp-dentin biology in restorative dentistry. Part 1: normal structure and physiology.

Considerable knowledge has accumulated over the years on the structure and function of the dental pulp and dentin. Some of this knowledge has important clinical implications. This review, which is the first of seven articles, will be limited to those parts of the normal structure and physiology of the pulp and dentin that have been shown to result in, or are likely lead to, tissue reactions associated with the clinical treatment of these tissues. Although certain normal structures will be highlighted in some detail, a basic knowledge of pulpal and dentinal development and structure is a prerequisite for an understanding of this text.

Biology↗
PubMed1992

Extracellular fluid movement in the pulp; the pulp/dentin permeability barrier.

Fluid movement in the pulp depends largely upon the physiology of the blood vessels; normally there is a net efflux of fluid and proteins from the capillaries into the extracellular environment. Most pulp capillaries lie close to the odontoblast layer and in order to see whether fluid can pass between the odontoblasts into the predentin we have perfused the vessels of molar tooth germs in anesthetized piglets with the electron dense tracer lanthanum. The results show that the tracer permeates the capillaries but encounters a barrier to permeability at the apical (predentinal) ends of the odontoblasts. The completeness of the barrier to the tracer lanthanum is discussed together with structural evidence of tight junctions between odontoblasts in both pigs and humans and the presence of collagen fibers through the tight junctional zone. It is concluded that there is little or no evidence that pulp fluid is normally confluent with predentin. An advantage of this arrangement may be that by maintaining an enclosed microenvironment it permits regulation of the orderly process of matrix deposition and mineralization of predentin to dentin. In order to maintain constant vascular and extracellular fluid pressures the capillary efflux has to be balanced by fluid removal; recent work in cats has shown that lymphatic vessels are available to transport fluid out of the pulp. In this paper the differences in the intrapulpal distribution of these vessels have been extrapolated to human teeth in an attempt to explain certain variations in the symptoms and progress of pulpal inflammatory conditions.

Animals↗
PubMedDate not supplied

The clinical significance and management of microleakage. Part one.

This research reviews relevant articles related to microleakage from 1966 to the present. The review discusses what the sensation of microleakage is clinically; how dentin permeability is related to microleakage; how the quality of dentin affects permeability and microleakage; what the effects of bacterial infiltration from microleakage can be, as well as the body's defenses against bacterial infiltration within the tooth complex; how caries and microleakage are related; and how various materials and procedures can be used to limit microleakage.

Bacteria, Anaerobic↗
PubMed1997

Enhanced permeability of acid-etched or ground dental enamel.

STATEMENT OF PROBLEM: Acid etching creates retentive microcraters on enamel surfaces. Designing of a partial denture often involves reshaping the supporting and retentive teeth by grinding the enamel. Unfortunately, both these procedures damage the enamel surface. In vivo such surface damage takes several months to recover. PURPOSE: This study evaluated the effect of 1-minute etching, prolonged etching, and grinding on the permeability of dental enamel for water-soluble molecules. MATERIAL AND METHODS: With the electron paramagnetic resonance and a two-chamber diffusion cell, the influence of etching and grinding on the diffusion of spin label molecules through the enamel was studied quantitatively. The enamel permeability was measured in 30 sound enamel samples, of which 10 samples were exposed to 1-minute etching with 37% phosphoric acid, 10 samples were etched for 5 minutes, and 10 samples were ground with a diamond bur. RESULTS AND CONCLUSIONS: All procedures significantly increased the permeability of dental enamel. These results demonstrate that in vivo the acid-etched and ground dental enamel surfaces are less protected and consequently, unless the tooth is properly protected, are more susceptible to carious lesions. Therefore ground or accidentally etched enamel should be protected.

Acid Etching, Dental↗
PubMed2004

Biological factors in dental caries enamel structure and the caries process in the dynamic process of demineralization and remineralization (part 2).

Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The physicochemical properties of the mineral comprising the tooth surface and subsurface modulate the development, arrestment and remineralization of dental caries. Post-eruption maturation of enamel surfaces and exposed root surfaces is important in order for more susceptible mineral phases to be modified by incorporation of soluble fluoride from the plaque into dental hydroxyapatite. The chemical reactions that occur during acidic conditions when tooth mineral dissolves (critical pH) are determined by the supersaturation of calcium and phosphate within plaque and saliva, as well as if fluoride is present.

Apatites↗
PubMed2005

The bleaching depth of a 35% hydrogen peroxide based in-office product: a study in vitro.

OBJECTIVES: The aim of the present study was to quantify the penetration of 35% hydrogen peroxide into enamel and dentine and to relate this to the resultant shade change of the tooth. METHOD: The crowns of 24 caries and developmental defect free human maxillary incisors were stained internally with a standardised tea solution. Twelve specimens were power bleached with light activated 35% hydrogen peroxide and 12 placed in water; both exposure times were 30min. Three different shade assessment methods (Vita shade guide [SG], shade vision system [SVS] and a chromometer) were employed prior to, after tea staining and after power bleaching/water treatments. Twelve specimens each from the bleach group and the water control water group were sectioned mesio-distally. An additional 12 specimens from the bleach and the control group were sectioned labio-palatally. The stain area for each specimen was measured using image analysis software. RESULTS: With tea staining, the mean changes in Vita shade guide units (SGU) ranged from 3.66 to 8.33. With the SVS system changes of 3.66-9 units were seen. Chromometer readings showed that following bleaching the L* values moved in the direction of black (3.8-6.7) and a* and b* values were in the red (0.3) and yellow (1.5) direction, respectively. Samples bleached and sectioned mesio-distally showed stain coverage of 28.6-39.4%, while palatal sections showed stain coverage of 58-72%. Control samples, whether sectioned mesio-distally or labio-palatally, showed staining throughout the dentine (97-100% coverage). CONCLUSION: A 35% hydrogen peroxide in-office bleaching gel demonstrated bleaching into dentine of uniform depth.

Analysis of Variance↗
PubMed1997

Effects of a high-bicarbonate dentifrice on intraoral demineralization.

Dentifrices available on the market today contain sodium bicarbonate in a wide range of concentrations. Anticaries efficacy has been demonstrated for these dentifrices in a variety of tests. New insights were gained in the present study in which the effect of a high-bicarbonate dentifrice on the sucrose-induced demineralization of tooth enamel in situ was examined. With the intraoral Delta Ip system it is possible to follow the minute changes in tooth enamel that essentially model the daily episodes of demineralization accompanying the ingestion of various foods. The results revealed a pronounced effect on the pH of the test plaque and a considerable reduction in mineral loss from the enamel. The effect persisted for more than 1 hour and, during that time, appeared to predominate over the effect of fluoride. These findings suggest that bicarbonate may provide additional protection against the loss of tooth enamel. Such effects may be significant for the design of new high-bicarbonate products.

Animals↗
PubMed2003

Scanning electron microscopy study of dental enamel surface exposed to 35% hydrogen peroxide: alone, with saliva, and with 10% carbamide peroxide.

Several vital bleaching systems have been introduced in response to the demand in esthetic dentistry. The active agents are commonly hydrogen peroxide or carbamide peroxide used in at-home or in-office techniques. Although generally positive results have been reported concerning the whitening ability of these agents, concerns still remain as to their effects on dental tissues. The purpose of this investigation was to evaluate the effect of these bleaching agents on the enamel surface morphology. Twelve extracted teeth were used according to three experimental protocols. In experimental protocol 1, specimens were treated with 35% hydrogen peroxide. In experimental protocol 2, after treatment with 35% hydrogen peroxide the specimens were immersed in natural saliva for 1 week. In experimental protocol 3, 35% hydrogen peroxide was applied once and 10% carbamide peroxide was applied for 1 week (12 h of 10% carbamide peroxide alternating with 12 h saliva). Scanning electron microscopy evaluation revealed that regional variation in tooth morphology surface sometimes exceeded the effects of the peroxide used according to experimental protocols. Thirty-five percent hydrogen peroxide had a tendency to promote an increase in density of pits. Precipitates were observed on specimen surfaces immersed in natural saliva according to protocol 2. A smooth and shiny surface was observed in specimens treated according to protocol 3. The potential relationship between surface alterations and differences in enamel permeability is currently under investigation. CLINICAL SIGNIFICANCE The differences in various articles written on the subject cannot be reconciled because of the lac of standardization of baseline data regarding factors such as location on the tooth, type of tooth eruption or noneruption, and age in the oral cavity. This article demonstrates that, despite changes observed in the enamel surface after bleaching, normal variation in tooth morphology may exceed the effects of 35% hydrogen peroxide and 10% carbamide peroxide on the teeth. Hence, considering the morphologic features of the tooth surface, bleaching, as described in thi study, can be considered safe for enamel.

Adult↗
PubMedDate not supplied

Effect of cutting instruments on permeability and morphology of the dentin surface.

There are major differences in morphological detail after cutting the dentin surface among the methods commonly used to prepare dental cavities. The purpose of this study was to compare dentin permeability and the morphology of the dentin surfaces prepared with diamond and carbide steel burs after etching with 6% citric acid. Twenty-four freshly extracted human third molars were sectioned, mounted on plexiglass, and connected to the dentin-permeability measuring apparatus. The permeability of dentin was measured by fluid filtration and expressed as hydraulic conductance. There were two study groups of 12 teeth. Each tooth had one occlusal cavity preparation prepared but utilized three depths: the original was prepared just into the dentin, the second 0.5 mm deeper than the first, and the third 0.5 mm deeper than the second. One group had the first cavity prepared with a diamond, the second deepened using a steel bur, then the third depth was made by use of the diamond. The other group had the first cavity preparation prepared with a steel bur, deepened 0.5 mm again using a diamond, then deepened again using a steel bur. Dentin permeability was measured after cavity preparation, then after 2 minutes of acid etching. Analysis of variance and Duncan's multiple range test were used to establish whether differences were significant at the 0.05 confidence level. Prepared and acid-etched surfaces were characterized using a scanning electron microscope to identify any differences between the two groups. After acid etching with 6% citric acid, the permeability of dentin cavities prepared with diamond burs was significantly less than the permeability of cavities prepared with carbide steel burs. After etching, there were differences in the appearance of the dentin surfaces prepared with diamonds and steel burs. Dentin bonding agents may have their effectiveness reduced when placed following cavity preparation by use of a diamond.

Dental Bonding↗
PubMed1986

The diffusion in vitro of fluoride and chlorhexidine in the enamel of human deciduous and permanent teeth.

The permeability of human dental enamel was studied by following the diffusion of [51Cr]-ethylenediaminetetraacetate (EDTA), F and [14C]-chlorhexidine using two-chamber diffusion cells. The [51Cr]-EDTA served as a marker to control the change in enamel permeability during the diffusion process. An average increase in enamel permeability of about 1.6-fold was recorded following the initial diffusion of the test compounds in the deciduous and permanent enamel. The permeability of deciduous enamel was much higher than that of permanent enamel. For [51Cr]-EDTA and [14C]-chlorhexidine, the average diffusion coefficient was about 30-fold more than in permanent enamel; for F it was 150-fold more. The difference was statistically significant (p less than 0.001). Co-administration of F and [14C]-chlorhexidine showed a higher diffusion rate for each compound than when separately diffused. Whether this is due to a synergetic effect or to increased enamel permeability following the initial diffusion of the compound, or both, is still uncertain.

Adolescent↗
PubMed1991

The permeability of cat dentine in vivo and in vitro.

The apparent impermeability of dentinal tubules to chemicals applied to exposed dentine in vivo was investigated. It was shown that whereas Evans' blue diffused readily into dentine in extracted teeth, it did not do so in visible amounts when it was applied in vivo. In the in vitro experiments, decreasing the pressure of the Evans' blue solution to 20 cmH2O below atmospheric apparently prevented the dye entering the tubules, while increasing the pressure of the solution to 15 cmH2O or more above atmospheric in vivo resulted in the dye penetrating the dentine in high concentrations. It is concluded that, in cat dentine in vivo, there is an outward flow of fluid through exposed dentinal tubules, and that this flow is sufficient to substantially reduce diffusion into the tubules of chemicals such as Evans' blue.

Animals↗
PubMed1991

Temperature dependence of water transport into the mineralized matrix of freeze-dried human dentine.

Ten dentine sections cut perpendicular to the dentinal tubules from human mature non-carious third molars, were freeze-dried and then rehydrated by immersion in water at four temperatures, 10, 25, 40 and 70 degrees C. The uptake of water by the sections was assessed as a function of rehydration time. The data were analysed using a theoretical model in which the uptake is ascribed to two processes. The first is capillary suction of water into the dentinal tubules, the second is the diffusion of water from the two faces of the section into the mineralized matrix. By fitting theory to experiment the diffusion coefficient of water in intertubular dentine at the different temperatures was found. Using the Arrhenius relation the activation energy of diffusion of water in intertubular dentine was calculated as Ea = 29.5 +/- 2.2 kJ/mol, which is of the order of the strength of a hydrogen bond. Transport of water in the mineralized matrix during rehydration is thus most likely a hopping of water molecules along the surfaces of the collagen and/or mineral, each jump involving the breaking of one hydrogen bond.

Dentin↗
PubMed2006

Protective effect of the in situ pellicle on dentin erosion - an ex vivo pilot study.

AIM: The acquired pellicle is well known as an anti-erosive proteinaceous layer on enamel, but its protective properties on dentin have not been investigated in detail until now. The aim of the present ex vivo study was to evaluate the erosive effects on pellicle coated dentin. METHODS: Bovine dentin slabs were exposed to the oral cavity of one subject for 120 min for in situ pellicle formation. Subsequently, the slabs were incubated with HCl (pH 2.3) in vitro for 5 min and erosive calcium-release was measured photometrically. In addition, the acid treated specimens were evaluated by transmission electron microscopy (TEM). Pellicle free samples served as controls. RESULTS: Calcium erosion from the pellicle coated dentin slabs amounted to 23.5+/-2.9 microg Ca/min (pellicle free samples: 32.2+/-4.2 microg Ca/min). The difference was statistically significant (p < or = 0.05). In pellicle coated as well as in uncoated dentin samples, TEM-evaluation showed a demineralised dentinal surface layer which thickness ranged between 3 and 6 microm. The pellicle itself was partially dissolved but not removed by hydrochloric acid treatment. CONCLUSION: The protective properties of the acquired pellicle against an erosive challenge of the dentinal surface are limited. The dentinal pellicle functions like an ion permeable network rather than a barrier.

Adult↗
PubMed2003

Effect of internal bleaching agents on dentinal permeability of non-vital teeth: quantitative assessment.

The aim of this in vitro study was to assess quantitatively dentin permeability of pulpless teeth after intracoronal bleaching therapy with three different agents. Twenty-four maxillary central incisors were randomly assigned to four groups according to the bleaching agent used: I--non-bleached control; II--37% carbamide peroxide; III--sodium perborate/20% hydrogen peroxide paste; IV--27% carbamide peroxide. After standard access and root-canal preparation the access opening, biomechanical preparation and root-canal filling, a cervical glass ionomer plug was prepared and intracoronal bleaching procedures were carried out in a standardized fashion. The access cavities were opened and the teeth were externally sealed and immersed in a 10% copper sulfate aqueous solution for 30 min, in vacuum for the first 5 min. Then, samples were removed, dried with absorbing paper and immersed in a 1% rubianic acid alcohol solution, for the same above-mentioned period in solution and in vacuum. Copper ion penetration was indicated by the rubianic acid staining. Mean values and SD for the experimental groups were: I--7.88% (+/-1.33), II--16.94% (+/-5.72); III--11.45% (+/-3.90) and IV--8.98% (+/-4.19). Data were submitted to one-way anova. The results showed that the 37% carbamide peroxide provided the highest increase in dentin permeability, followed by sodium perborate with 20% hydrogen peroxide. The 27% carbamide peroxide provided the lowest results and showed statistical similarity to the control group. On basis of these findings, it may be concluded that, among the tested intracoronal bleaching agents, 37% carbamide peroxide presented an optimized overall performance in increasing dentinal permeability.

Analysis of Variance↗