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PubMed1992

The role of selected cations in the desensitization of intradental nerves.

Dentinal sensitivity is a common complaint of patients. Removal of cementum or enamel leaves the dentin exposed allowing various stimuli to produce fluid movement through the dentinal tubules. These fluid movements are believed to activate pulpal sensory nerves leading to pain. Various therapeutic approaches have been investigated to treat this problem. Resins, fluoride compounds and oxalate solutions have been used to block the dentinal tubules. KNO3 and SrCl2 are active ingredients in desensitizing tooth pastes but neither compound reduces the permeability of dentine. The ability of various solutions to decrease hypertonic (3M NaCl) evoked nerve activity was tested in the canine teeth of anesthetized cats. Excitatory and desensitizing solutions were placed into a deep dentinal cavity prepared over the incisal pulp horn. An electrode used to record nerve activity was also placed into this deep cavity. KNO3 and other K+ ion containing solutions elicit a biphasic effect on nerve activity. Immediately following application of these solutions into the deep dentinal cavity there is a brief burst of high frequency spike activity. Following this brief period of excitation, the intradental nerves are silent and respond weakly to hypertonic NaCl. CaCl2 and other divalent cation solutions also inhibit hypertonic NaCl induced nerve activity, but have a weaker effect than that exerted by K+. These observations can be explained based on the effects of various ions on nerve excitability. Increasing the K+ ion concentration in the vicinity of the dentinal nerve terminal depolarize and activates the nerve fibers. Following a prolonged period of depolarization the action potential mechanism is inactivated. Divalent cation solutions stabilize the nerve membrane without changing the membrane potential. Desensitizing solutions do not decrease nerve activity by an effect on pulpal blood flow. This experimental model does not entirely explain the clinical action of these desensitizing agents. The role of inflammation in hypersensitivity and dental pain is currently being investigated.

Animals↗
PubMed2000

Penetration of the pulp chamber by carbamide peroxide bleaching agents on teeth restored with a composite resin.

This in vitro study was performed to evaluate the effect of various concentrations of carbamide peroxide bleaching agents on the pulp chambers of teeth restored by a composite resin. Forty-nine human extracted anterior teeth were used. All the teeth were sectioned 3 mm apical of the cemento-enamel junction and the intracoronal tissue removed. The teeth were separated into the seven groups each containing seven teeth. Twenty-eight teeth were used as controls (groups I-IV), standardized cavities were prepared with the remaining 21 teeth (groups V, VI, VII), and restored with a hybrid composite resin (XR Herculite). Acetate buffer was placed in the pulp chamber to absorb and stabilize any peroxide that might penetrate. Group I was exposed only to distilled water. Groups II and V were applied with 10% CP (Contrast PM), groups III and VI were applied with 15% CP (Contrast PM), groups IV and VII were applied with 35% CP (Quik Start) and left for 30 min at 37 degrees C. Then, the acetate buffer solution in the pulp chamber of each tooth was removed and the chamber was then rinsed twice with 100 ml of distilled water. The contents then had leucocryctal violet and enzyme horseradish peroxidase added. The optical density of the resulting blue solution was determined spectrophotometrically, and was converted into microgram equivalents of hydrogen peroxide. A higher level of bleaching agent penetrated into the pulp chamber in the restored teeth than in the sound teeth.

Analysis of Variance↗
PubMed1989

Tubular permeability to calcium hydroxide and to bleaching agents.

Recent reports of clinical cases suggest that cervical root resorption may follow bleaching of endodontically treated teeth. Inflammatory root resorption may be arrested by placement of calcium hydroxide into the root canal. The dentinal tubules are assumed to be a possible route of action for both agents. pH Values of the medium surrounding the tooth after placement of bleaching agents and calcium hydroxide within the root canals were determined in this study. Thirty extracted single-rooted human teeth were divided into three equal groups. The pulp cavity of the experimental teeth was filled with either bleaching agents or calcium hydroxide. In the control group it was left empty. Dipping in paraffin sealed the access cavity and the apical foramina and isolated the teeth except at the cervical root surface. The teeth were placed in vials containing distilled water and the pH of the medium was measured after 1 h, 3 days, and 7 days following renewal of the medium. The level of the pH in the first group increased, indicating that the bleaching agents leaked from the root canal to the medium surrounding the teeth. The pH in other two groups did not change noticeably. The results suggest that bleaching agents may leak from the root canal toward the periodontal tissues but calcium hydroxide does not alkalinize the medium surrounding the teeth. Leakage of the bleaching agents through dentin may, therefore, be considered as a possible etiological factor that initiates an inflammatory process around the teeth that may be followed by cervical root resorption.

Calcium Hydroxide↗
PubMedDate not supplied

The effect of 10% carbamide peroxide bleaching material on microhardness of sound and demineralized enamel and dentin in situ.

This in situ study evaluated the microhardness of sound and demineralized enamel and dentin submitted to treatment with 10% carbamide peroxide for three weeks. A 10% carbamide peroxide bleaching agent--Opalescence/Ultradent (OPA)--was evaluated against a placebo agent (PLA). Two hundred and forty dental fragments--60 sound enamel fragments (SE), 60 demineralized enamel fragments (DE), 60 sound dentin fragments (SD) and 60 demineralized dentin fragments (DD)--were randomly fixed on the vestibular surface of the first superior molars and second superior premolars of 30 volunteers. The volunteers were divided into two groups that received bleaching or the placebo agent at different sequences and periods at a double blind 2 x 2 crossover study with a wash-out period of two weeks. Microhardness tests were performed on the enamel and dentin surface. The SE and DE submitted to treatment with OPA showed lower microhardness values than the SE and DE submitted to treatment with PLA. There were no statistical differences in microhardness values for SD and DD submitted to the treatment with OPA and PLA. The results suggest that treatment with 10% carbamide peroxide bleaching material for three weeks alters the enamel microhardness, although it does not seem to alter the dentin microhardness.

Adult↗
PubMed1994

Effect of smear layer removal on the diffusion permeability of human roots.

Ten human maxillary incisors, extracted because of periodontal disease or nonrestorable caries, were obtained and instrumented to a size #70 K-Flex file at the working length using a standard stepback technique. Tritiated water (3H2O) was placed in the root canals and allowed to diffuse to the external surface of the roots until it reached a constant rate. The smear layer in each of the experimental roots was then removed using 0.5 M EDTA followed by 5.25% sodium hypochlorite (NaOCI). The constant rate diffusion of 3H2O was remeasured. The roots were then stored in deionized H2O for 2 months and the constant rate diffusion of 3H2O was remeasured. A statistically significant difference was noted between all three groups. A decrease in the diffusion permeability of the root to 3H2O was noted immediately after smear layer removal and the highest permeability was recorded after storage in the deionized water for 2 months.

Dentin↗
PubMed1992

Biocompatibility of an enamel-dentin adhesive.

To assess the biocompatibility of a third-generation dentinal adhesive that uses a smear layer conditioner (Scotchbond 2), Class V cavities were prepared and restored in vivo, following a standardized protocol, in 32 human premolars to be extracted for orthodontic reasons. Histologic observation showed seven slight, five moderate, and one severe reaction short term, while 11 slight and three moderate reactions were observed long term. It appeared that the intensity of the reactions decreased with time. Bacteria were observed on only five teeth, and no correlation could be established between the presence of bacteria and the intensity of the reactions. It seemed that the conditioning of the smear layer, although it might have rendered the residual dentin more permeable, limited percolation phenomena by increasing adhesion. Although only one severe reaction was observed, it is mandatory in a clinical setting to place a protective lining near the pulp.

Biocompatible Materials↗
PubMed1989

Demonstration of physiological barrier between pulpal odontoblasts and its perturbation following routine restorative procedures: a horseradish peroxidase tracing study in the rat.

Vascular injection of the macromolecular tracer, horseradish peroxidase (HRP), was used to study the permeability of the odontoblast cell layer in developing and mature rat molar teeth, and to investigate the effect of cavity preparations on the permeability of this epithelioid cell layer in adult animals. HRP injected into the vascular system of normal animals 28 days of age and older was localized histochemically (from 5 to 90 min after injection) throughout the extracellular spaces of the maxillary dental pulps; however, the tracer did not penetrate beyond the tight junctions at the apical region of the odontoblast cell layer, and was absent from the predentin and dentin. In contrast, HRP injected into very young neonatal animals (e.g., day 3) resulted in free passage of HRP between odontoblasts and into the overlying predentin and dentin. When Class V cavities had been prepared in adult maxillary molars after HRP was injected into the blood stream, HRP reaction product penetrated the predentin and dentin immediately beneath the cavity preparation; however, adjacent, untraumatized areas of predentin and dentin in the operated teeth were devoid of reaction product. These results provide evidence that: (1) a physiological barrier develops between the distal segments of odontoblast cell bodies in normal rat molar teeth between days 15 and 28 of postnatal life, and this barrier prevents the passage of macromolecules from the pulp into the predentin and dentin; and (2) this barrier is perturbed following routine restorative procedures in adult animals.

Ameloblasts↗
PubMedDate not supplied

[Quantitative evaluation of permeability of root canalicular system].

The purpose of this study was to evaluate the rate of permeability of the canalicular system of the root (apical and central portion) using albumin labelled with 131J-radioisotope. Freshly extracted central maxillar incisors were divided in three groups: I 10 specimens were used to quantity the rate of the tracer penetration through the apical foramen and apical ramification; II 10 specimens were used for the measurement of central root portion permeability for the same tracer; III. This group was the control group; it consisted of 5 samples which were tested to the sealing ability of the used sticky-wax. The results showed: 1). Through an apical foramen and ramification 56% of radiolabelled albumin penetrated into an external saline eluent; 2). When albumin was used as an eluent another amount of 6.5% of 131J-albumin was released; 3) About 38% of total albumin tracer was irreversibly bound to the components of root dentine and cement; 4). Through the central portion of the root canalicular system 50% of radiolabelled albumin penetrated from the root canal; 5). Penetration of large molecules (m.w. 67000), like bacterial endotoxins and protein metabolic products, is absolutely possible and penetration occurs primarily through a system of apical ramification and pulpo-periodontal communication as well as through a canalicular pattern of root dentine and cement.

Dental Pulp Cavity↗
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↗
PubMed1998

Effects of pulsed Nd:YAG laser irradiation on root canal wall dentin with different laser initiators.

The effects of pulsed Nd:YAG laser irradiation with different laser initiators on the permeability and ultrastructure of the root canal wall dentin were investigated in vitro. Forty extracted human single-rooted teeth were randomly assigned to four groups. Group 1 teeth were not lased as a control. Group 2 specimens received four 10-s duration laser exposures for a total exposure of 40 s/canal. In group 3 specimens, the root canals were painted with black ink and then lased by the same method as group 2 teeth. In group 4 specimens, root canals were treated with 38% Ag(NH3)2F and then lased by the same method as group 2 teeth. Laser parameters were set at 2 W, 20 pps. After being placed in 0.6% rhodamine B solution for 48 h, the teeth were sectioned for study by stereoscope and scanning electron microscopy. Statistical analysis showed there were significant differences (p < 0.05) in dentin permeability in the apical areas between groups 3 and 1, 4 and 1, and 4 and 2. Scanning electron microscopic examination showed that laser treatment alone had no obvious effects on the root canal wall. The root canal surfaces prepared for by laser irradiation with black ink or 38% Ag(NH3)2F revealed melting, smear layer evaporation, and open dentinal tubules. Black ink was more effective than 38% Ag(NH3)2F as a Nd:YAG laser initiator.

Dental Pulp Cavity↗
PubMed1995

Tooth color and reflectance as related to light scattering and enamel hardness.

Tooth color is determined by the paths of light inside the tooth and absorption along these paths. This paper tests the hypothesis that, since the paths are determined by scattering, a relation between color and scattering coefficients exists. One hundred and two extracted incisors were fixed in formalin, mounted in a standardized position in brass holders, and pumiced. A facet was prepared near the incisal edge on the labial plane to allow for Knoop hardness measurements with a 500-gram load. Light scattering by the enamel was measured in a 45 degrees/0 degrees geometry; light scattering by both enamel and dentin was measured in a 0 degrees/0 degrees geometry. The reflection spectrum of the tooth was measured from the labial plane with a spectroradiometer in a 45 degrees/0 degrees geometry, with standard illuminant A and standard illuminant D65. To include all volume-reflected light, we used entire-tooth illumination and small-area measurement. CIELAB color coordinates were calculated from the spectra. Neither spectra nor coordinates showed evidence of a contribution of fluorescence to tooth color. Averaged values and standard deviations for L*,a*,b* were 69.9 (4.1), 1.22 (1.4), and 17.9 (2.9), respectively. Both scattering coefficients averaged to 0.6 (0.4) mm-1; Knoop hardness number was, on average, 271 (39) kg/mm2. L* correlated with a* (r = -0.51), with the enamel scattering coefficient (r = 0.60), and slightly with hardness (r = 0.17, p = 0.03). The colors of 28 teeth from which the enamel was removed correlated strongly with the colors of the complete tooth.(ABSTRACT TRUNCATED AT 250 WORDS)

Chemical Phenomena↗
PubMed2007

Infiltration/evaporation-induced shrinkage of demineralized dentin by solvated model adhesives.

During dentin bonding, solvated adhesive comonomers are applied to water-saturated decalcified dentin matrices. When alcohol-solvated hydrophilic or hydrophobic methacrylate monomers are applied, they chemically remove water and cause matrix shrinkage during comonomer infiltration. Evaporation of solvent induces further shrinkage. The purpose of this work was to compare the shrinkage of water-saturated dentin matrices infiltrated with ethanol- or methanol-solvated 2-hydroxyethyl methacrylate (HEMA), 2,2-bis[4(2-hydroxy-3-methacryloyloxy-propyloxy)-phenyl] propane (BisGMA), or triethyleneglycol dimethacrylate (TEGDMA) at 90/10, 70/30, 50/50, and 30/70 mass fraction % alcohol/monomer before and after evaporation of alcohol. Thin (ca 0.2 mm) disks of human mid-coronal dentin were demineralized and placed in a well beneath the contact probe of a linear variable differential transformer (LVDT). The height of the matrix was measured before and after random application of one of the twelve alcohol/monomer mixtures. Matrix height was measured during infiltration and during solvent evaporation. Between trials, residual monomer was extracted using ethanol. These studies were repeated on specimens in which 100% alcohol was used to substitute for water in the matrix. Both studies revealed that matrices shrink 30-50% but that pretreatment of matrices with alcohol prevents BisGMA phase separations from occurring. Wet bonding with ethanol instead of water permits infiltration of relatively hydrophobic alcohol/monomers.

Adhesives↗
PubMed2003

Pulpal response to Er:YAG laser drilling of dentine in healthy human third molars.

BACKGROUND AND OBJECTIVES: Maintenance of pulpal health is a critical prerequisite for successful application of light amplification by stimulated emission of radiations (lasers) in the hard tissue management of vital teeth. The purpose of this study was to investigate the short- and long-term pulpal effects to cavity-preparations in healthy human teeth using erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser. MATERIALS AND METHODS: A total of seven healthy third molars that were to be removed due to space-problem were used. Following the laser excavation, the cavities in dentine were closed temporarily and the teeth were extracted after 7 days (n = 5) and 3 months (n = 2) post-operation. The specimens were fixed, decalcified, subdivided, and processed for light and transmission electron microscopy. RESULTS: In the short-term group, four of the five laser-drilled teeth did not reveal any pathological changes in the pulp-dentine complex. One tooth showed mild disruption of odontoblasts (OB) and vascular dilatation subjacent to the deepest point of the cavity-preparation with a remaining dentine thickness (RDT) of less than 80 microm. The two teeth under long-term observation revealed distinct apposition of tertiary dentine (TD), lined predominantly with cuboidal cells on its pulpal aspect. CONCLUSIONS: These results would allow a conclusion to be drawn that the Er:YAG laser under investigation is a pulp preserving hard-tissue drilling tool when used with the specific energy settings and emitting radiation at a wavelength of 2.94 microm.

Dental Pulp↗
PubMed2002

All-ceramic crowns: bonding or cementing?

Despite the wide variety of all-ceramic systems available today, the majority of dental practitioners hesitate to recommend and insert all-ceramic crowns. This article regards the nature of the ceramic materials, the principles of bonding and adhesion, and the clinical problems of the acid-etch technique for crowns. Advantages and disadvantages are discussed, and the influences of different factors on the strength of all-ceramic crowns are presented. Finally, the conclusion is drawn that conventional cementing of all-ceramic crowns is possible when the specific properties of the ceramics are taken into consideration.

Cementation↗