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PubMed1996

Diffusion of calcium through dentin.

The purpose of this research was to investigate whether calcium ions from a paste of calcium hydroxide [Ca(OH)2] and saline introduced into root canals diffuse through the dentin to reach the surface of the root. Six teeth were opened and submitted to a biomechanical process, after which all the smear layer was removed. The experiment was divided into three phases: dissolution, dissolution and diffusion I, and dissolution and diffusion II. Dissolution-each tooth, with no Ca(OH)2 paste in place, was sealed both cervically and apically and stored in 700 ml of deonized water until calcium losses from the tooth into the water were stabilized. Dissolution and diffusion I-each root canal was filled with a paste of Ca(OH)2 and saline, sealed again apically and cervically, and returned to its solution. Dissolution and diffusion II-samples were divided into three parts: the control group or group 1, containing the original paste; group 2, in which the existing paste was diluted and the teeth were resealed and replaced in their solutions; and group 3, in which the existing paste was removed and a fresh paste was introduced. The diffusion was greater in group 3, followed by group 2. In the control group, we found a diffusion of calcium, which is statistically null. The results showed that calcium diffusion was observed, in the first 16 days, in all situations in which there was Ca(OH)2 paste inside the root canals.

Calcium↗
PubMed1996

Disinfection by calcium hydroxide pastes of dentinal tubules infected with two obligate and one facultative anaerobic bacteria.

Bovine dentine cylinders were experimentally infected with Actinomyces israelii, Fusobacterium nucleatum, or Enterococcus faecalis. The latter is a facultative anaerobic bacteria and the others are obligate anaerobes commonly found in endodontic infections. The infected specimens were exposed to pastes of calcium hydroxide mixed with saline solution or camphorated paramonochlorophenol for periods of 1 h, 1 day, and 1 week. The viability of bacteria after these exposure times was evaluated by specimen incubation in culture medium to compare the effectiveness of the pastes in disinfecting dentinal tubules. The calcium hydroxide/camphorated paramonochlorophenol paste effectively killed bacteria in the tubules after a 1-h period of exposure, except for E. faecalis that required one day of exposure. In contrast, the calcium hydroxide/saline paste was ineffective against E. faecalis and F. nucleatum even after 1 week of exposure. The results showed that camphorated paramonochlorophenol increased the antibacterial effects of calcium hydroxide.

Actinomyces↗
PubMed1996

pH changes at the surface of root dentin when using root canal sealers containing calcium hydroxide.

The purpose of this study was to investigate long-term pH changes in cavities prepared in root surface dentin of extracted teeth after obturation of the root canal with gutta-percha and a variety of sealers containing calcium hydroxide. After cleaning and shaping, root canals in 50 recently extracted, human single-rooted teeth were divided into five groups. Each of four groups was obturated with gutta-percha and either Sealapex, Sealer 26, Apexit, or CRCS, all of which contain calcium hydroxide. The remaining group served as the control and was not obturated with gutta-percha or sealer. Cavities were prepared in the facial surface of the roots in the cervical and middle regions. The pH was measured in these dentinal cavities at the initiation of the experiment, and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days after obturation. Results indicate that the pH at the surface of the root does not become alkaline when calcium hydroxide cements are used as root canal sealers. Regardless of the sealer used, the observed pattern of pH change was not different from that seen in the control group of roots that were not treated with sealer. It is concluded that calcium hydroxide-containing cements, although suitable for use as root canal sealants, do not produce an alkaline pH at the root surface. If such a pH change is related to treatment of root resorption, these sealants do not contribute to this treatment.

Bismuth↗
PubMed1996

Changes in pH at the dentin surface in roots obturated with calcium hydroxide pastes.

The purpose of this study was to determine the pH, after defined periods of time, in cavities prepared in the facial surface of the cervical, middle, and apical regions of roots obturated with calcium hydroxide pastes. Root canal instrumentation was performed on 40 recently extracted, single-rooted human teeth. Cavities 1.5 mm in diameter and 0.75 mm in depth were prepared in the cervical, middle, and apical regions of the facial surface of each root. Teeth were randomly divided into four groups. One group was left unobturated and served as a control. The three remaining groups were obturated with either aqueous calcium hydroxide, calcium hydroxide mixed with camphorated monochlorophenol. or Pulpdent pastes. Access cavities and apical foramina were closed with Cavit. Each tooth was stored individually in a vial containing unbuffered isotonic saline. pH at the surface was measured in the cervical, middle, and apical cavities at 0 and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days. Results indicate that hydroxyl ions derived from calcium hydroxide pastes diffused through root dentin at all regions over the experimental period of 120 days. The pattern of pH change at the tooth surface was similar in all regions of the root, regardless of the type of calcium hydroxide paste used. This was a rapid rise in pH from a control value of pH 7.6, to greater than pH 9.5 by 3 days, followed by a small decline to pH 9.0 over the next 18 days, before finally rising and remaining at, or above pH 10.0 for the remainder of the experimental period. Pulpdent paste in the apical region was the only exception in this pattern, producing a pH rise nearly one full unit below the other pastes, pH 9.3. These results indicate that, for all pastes tested, a high pH is maintained at the root surface for at least 120 days.

Analysis of Variance↗
PubMed1996

Evaluation of a dentin barrier test by cyctotoxicity testing of various dental cements.

In this study, cell reaction after exposure to several dental cements was determined using a dentin barrier test device. The reaction of mouse fibroblasts grown on the "pulpal" side of a bovine dentin disk was determined after exposure to dental cements applied on the "cavity" side of the disk. For pretreatment, dentin disks (500-micrometer-thick) were etched on one side and either sterilized by autoclaving or disinfected with ethanol. It was found for both pretreatment groups that zinc phosphate cement was less toxic than the conventional glass ionomer cements. A light-cured glass ionomer cement and zinc oxide-eugenol were the most toxic materials tested. Disinfecting the dentin slices instead of autoclaving reduced the toxicity of the phosphate cement and the glass ionomer cements tendentiously. Because the strong cytotoxic reaction evoked by zinc oxide-eugenol and by the glass ionomer cements is in contrast to in vivo findings, further improvements of the dentin barrier test device will be necessary.

Animals↗
PubMed1997

In vitro study of intradentinal calcium diffusion induced by two endodontic biomaterials.

The aim of this in vitro study was to assess intratubular calcium penetration induced by two root canal restoration materials, one calcium oxide based, and the other calcium hydroxide based. Pig teeth were restored with no preliminary root canal preparation. The filing materials were left in place for 8, 15, or 21 days. The samples were then examined using various microanalytical techniques and, in parallel, by backscattered electron image (BEI) scanning electron microscopy. The Ca/P ratios obtained by microanalysis were higher for samples restored with calcium oxide. In addition, the distances over which the ratios increased were also greater than those obtained using calcium hydroxide. BEI photographs confirm these results and show corresponding retrodiffusion fringes.

Animals↗
PubMed1998

Effects of a 532 nm Q-switched nanosecond pulsed laser on dentin.

The purpose of this study was to determine whether a nanosecond-pulsed, frequency-doubled Nd:YAG laser emitting at 532 nm can be used as an alternative to mechanical methods of root canal treatment or as an adjunct to conventional endodontic preparation. Laser parameters whose thermal effects did not exceed safety thresholds for adjacent periodontal tissues were selected in a preliminary study. In 27 extracted human teeth, root canals were irradiated for 30 to 60 s at fluences of 2 to 2.2 J/cm2, and 10 Hz. Samples were observed using SEM. Laser irradiation could achieve smear layer removal after minimal manual preparation. However, results were inhomogeneous, and at higher energy densities thermal damage was observed, especially in the fully manually prepared samples. Nanosecond-pulsed irradiation at 532 nm can achieve complete smear layer removal. However, mechanisms must be developed to monitor laser effects and avoid potential damage to collateral structures.

Dentin↗
PubMed1998

Scanning electron microscopic study of dentin lased with argon, CO2, and Nd:YAG laser.

The purpose of this study was to compare morphological changes on the dentin surface induced by laser light delivered perpendicular or parallel to the dentin surface. The surface of the dentin slices and the root canal walls were lased with argon, CO2, and Nd:YAG lasers. When the laser beam was parallel to the dentin, the effects of the laser energy ranged from no effect to eroding and melting of the smear layer and dentin in the samples. When the laser beam was perpendicular to the surface, all three lasers produced well-shaped craters. From this, it was concluded that the angle of the laser beam in relation to the target surface can be a deciding factor of how much energy will be absorbed by the dentin and consequently of the morphological changes induced by the laser.

Argon↗
PubMed1999

A comparison of the effects of three chelating agents on the root canals of extracted human teeth.

The effects of EDTA were compared in vitro with the effects of two other chelating agents: succimer and trientine HCl. Thirty extracted human teeth with single canals were used. Groups of 10 were treated by the three agents and then examined under the scanning electron microscope. The results showed that EDTA widened the dentinal tubules. Trientine HCl also produced widening of the dentinal tubules very similar to EDTA, whereas succimer produced more extensive widening.

Chelating Agents↗
PubMed1999

Dentinal tubule penetration of root canal sealers after root canal dressing with calcium hydroxide.

The purpose of this study was to evaluate the dentinal tubule penetration of root canal sealers after root canal dressing with calcium hydroxide (Ca(OH)2). Forty-two single-rooted teeth were instrumented to size 60. Six teeth served as the control group, and the remaining teeth were assigned to two groups. Root canals of the first group were filled with the Ca(OH)2 paste; the second group was filled with TempCanal, and all were incubated for 7 days. The samples were either irrigated with only NaOCl or with EDTA, followed by NaOCl to remove Ca(OH)2. All of the teeth were obturated with CRCS, AH26, and Ketac Endo by a lateral condensation technique. The specimens were then kept at the same conditions for another 7 days, and then all of the roots were prepared for scanning electron microscopic evaluation. Scanning electron microscopic examination revealed that Ca(OH)2 was not completely removed from the root canal surfaces, and root canal sealers did not penetrate into the dentinal tubules when only NaOCl was used. EDTA followed by NaOCl irrigation resulted in complete removal of Ca(OH)2 and root canal sealers penetrated into the dentinal tubules.

Bismuth↗
PubMed2002

Influence of drying and HEMA treatment on dentin wettability.

OBJECTIVES: The aim of this study was to evaluate the effect of drying time and primer pre-application (35% HEMA in water) on water spreading/infiltration on dentin. METHODS: Freshly extracted molars were embedded in resin and sectioned on their coronal side. Flat occlusal dentin surfaces were prepared using wet SiC paper from nos. 80-4000. A computerized contact angle device complementing a special software (Wingoutt) was used to measure the contact angle (theta) kinetics of a reference liquid (pure H(2)O) in the ten groups each of ten dentin surfaces during 120 s: Gp1: etched (37% phosphoric acid for 15 s) and blot-dried; Gp2: 3 s dried; Gp3: 5 s air-dried; Gp4: 10 s air-dried; Gp5: 20 s air-dried; Gp6: 30 s air-dried; Gp7: 1 min dried with hair dryer; Gp8: 5 s air-dried and HEMA treated; Gp9: 30 s air-dried followed by HEMA treatment; Gp10: HEMA treated prior to 30 s air-drying. three drops were applied on each sample. 40 contact angles were recorded for each drop with a frequency of one measure every 3 s. A one-way ANOVA test was used for data analysis. A PLSD test was conducted to identify statistical differences between pairs of groups at a reliability level of 95%. RESULTS: At each measurement time, air-drying, whatever its duration, significantly decreased the wetting ability of the pure water on the etched dentin in comparison with the blot-dried group. The contact angle increases with drying time. No significant differences in water contact angle were obtained between 3, 5 and 10 s in spite of a slight decrease in the spreading/infiltration ability of water the longer the drying time. HEMA increases the spreading/infiltration ability of water on 5 or 30 s air-dried etched dentin surfaces; 30 s air-drying did not alter the spreading/infiltration ability of the water on etched and HEMA treated dentin. SIGNIFICANCE: Dentin hydrophobicity increases depending on air-drying time. HEMA-based primer allows to prevent collagen collapse, which may be created by air-drying and partly rewet the collapsed collagen network.

Analysis of Variance↗
PubMed2002

Dentin shear strength: effect of distance from the pulp.

OBJECTIVE: Dentin structure varies with orientation and location. Ultimate shear strength (USS) has also been found in previous studies to vary with location. The present study further explores this relationship between USS and various locations in coronal dentin as well as distance from the pulp. METHODS: Stick specimens were prepared from coronal dentin located in the center or under cusps of human molar teeth. These were tested in the shear mode at various distances from the pulp. RESULTS: Median values ranged from 52.7 (range 29.0-73.1) MPa near the pulp to 76.7 (range 53.9-104.0) MPa near the dentino-enamel junction. No differences were found among the buccal, central or lingual locations, however, the USS near the pulp was found to be significantly lower. SIGNIFICANCE: The properties of coronal dentin vary with distance from the pulp, which may affect adhesion and other aspects of restorative dentistry.

Anisotropy↗
PubMed2003

Marginal integrity of ceramic inlays luted with a self-curing resin system.

OBJECTIVE: Aim of this study was to observe the efficacy of two different composite cements on the prevention of marginal deterioration around adhesive ceramic inlay restorations, under laboratory conditions, and to test the null hypothesis that different luting procedures cannot affect sealing ability of luted inlays. METHODS: Twenty-six standardized mesio-occlusal Class II cavities were prepared in extracted posterior teeth. Class II inlays were fabricated with IPS Empress II system following the manufacturer's instructions. The samples were divided into two groups of 13 teeth each at random. Group 1: The ceramic inlays of Group 1 were luted using Excite DSC and an experimental self-curing resin cement (Multilink, Vivadent); in this group, Excite DSC was self-activated and not light-cured. Group 2: Excite DSC in combination with a dual-curing resin cement (Variolink II, Vivadent) was used (as control). In this group Excite DSC was light-cured for 20s separately, before resin cement application. The 'wet' bonding technique was followed. Three samples of each group were selected at random for SEM observations, while the other 10 samples were processed for marginal leakage. The bonding mechanism to dentin and resin cement thickness was evaluated. RESULTS: Samples of both groups showed resin tag and adhesive lateral branch formation. In Group 1 the hybrid layer was mainly uniform along the interface between dental substrates and adhesive material, and resin cement thickness was between 20 and 85 microm. At the cervical margin no gap was detected. In Group 2 the cement thickness was between 30 and 110 microm and hybrid layer formation was observed along the interface but at the cervical margin it was not always uniform and continuous. Resin tag formation was uniform in both groups. At cervical margins, 80% of Group 1 samples showed a perfect seal at the dentin-cementum margins, and 90% at enamel margins. Group 2 samples showed only 50% of cervical margins free from leakage and 80% at the occlusal enamel margins. Statistically significant differences were found at cervical margins between the two groups, while no significant differences were found at enamel site. CONCLUSIONS: It can be concluded that the self-curing adhesive-resin cement combination can properly seal Class II porcelain inlays.

Dental Bonding↗
PubMed2004

Density of dentinal tubules affects the tensile strength of root dentin.

OBJECTIVES: The aim of this study is to count the dentinal tubules in the coronal and middle-apical third of root dentin of teeth extracted due to the progression of periodontal disease, and to compare the Ultimate Tensile Strength (UTS) of the same areas. The research hypothesis was that root dentin areas with different densities of dentinal tubules would also show different UTS values. METHODS: From 10 caries free maxillary central, lateral incisors and canines, extracted for periodontal reasons from three patients, cylindrical specimens approximately 10 mm long were prepared parallel to the long axis of the root and then divided into two parts using a low speed diamond saw one from the coronal third of the root, (Group 1) and one from the middle-apical third of the root (Group 2). The density of the dentinal tubules of the specimens of the two groups was measured by means of a scanning electron microscope and the UTS of the specimens was measured by a microtensile test. One way ANOVA was used to assess the effect of specimen location (coronal specimens vs. middle-apical specimens) on UTS. The differences in the density of dentinal tubules between coronal and middle-apical specimens were also subjected to statistical analysis using one-way ANOVA. RESULTS: UTS values of middle-apical specimens were found to be significantly (p < 0.05) higher than those of coronal specimens. The results of the one-way analysis of variance showed that the number of dentinal tubules of the samples from the coronal part of the root groups was significantly higher than that of samples from the middle-apical part (p < 0.05). SIGNIFICANCE: These results suggest that high values of tensile strength of the dentin are associated with low densities of dentinal tubules and that apical areas of root dentin are more resistant to tension than coronal ones.

Analysis of Variance↗
PubMed1997

Dentin demineralization: effects of dentin depth, pH and different acids.

OBJECTIVES: This investigation sought to determine: 1) if dentin demineralization rates are proportional to acid concentration for demineralization in phosphoric acid (10% or 1.76 M, 0.025 M, 0.0001 M, with pH = 0.95, 2.0, 4.0 respectively); 2) if the etching characteristics are independent of dentin depth; and 3) if the etching characteristics for phosphoric acid were comparable to those for citric acid over a similar pH range. METHODS: Highly polished dentin disks from freshly extracted, non-carious, third molars were prepared with a reference layer. Samples were prepared from either superficial or deep coronal dentin. The samples were etched for periods of up to 30 min using phosphoric acid solutions (pH = 0.95, 2.0, 4.0) in a wet cell of an atomic force microscope (AFM). Depth changes with respect to the reference layer were determined for the intertubular and peritubular dentin to quantify structural changes. The results were compared with similar studies using citric acid (pH = 1.0, 2.15 or 3.4). Etching characteristics were statistically compared using 2-way repeated measures ANOVA at p < 0.05 and the Tukey's multiple comparison test. RESULTS: The relation between time and recession for peritubular dentin was initially linear. The intertubular dentin recession started rapidly but then reached a plateau within a very short interval for etching solutions at pH = 2.0 and 4.0. At the highest concentration, the recession decreased with time, but a clear plateau was not established. There was no statistical difference between peritubular etching rates of superficial and deep dentin surfaces with phosphoric acid at any concentration. There was also no difference in the intertubular dentin recession at the location of the plateau that depended on dentin depth. Etching rates increased dramatically with decreased pH for both phosphoric and citric acids, but were higher for citric acid than for phosphoric acid. SIGNIFICANCE: The AFM allowed quantification of changes during etching of wet dentin. Peritubular dentin etching rates increased with decreasing pH, as expected, but changes were not linear and were different for the two acids studied over a similar pH range. Intertubular dentin surface recession was small and plateaued for low concentrations. The peritubular etching rate and intertubular dentin recession did not depend on dentin depth.

Acid Etching, Dental↗
PubMed2003

Reduction of viable bacteria in dentinal tubules treated with clindamycin or tetracycline.

AIM: We sought to evaluate and compare the antibacterial effect of clindamycin and tetracycline in bovine dentinal tubules. METHODS: Dentinal tubules of 32 cylindrical bovine root specimens were infected with Streptococcus sanguis N1. Clindamycin 2% or tetracycline 2% (Ledermix) was placed in the root canal for 1 week. Powder dentin samples obtained from within the canal lumina by using International Standards Organization No. 25 to No. 31 burs were examined for the presence of vital bacteria after the brain-heart infusion plates were inoculated and the colony-forming units were counted. The potent effect of the medicaments was also evaluated through the use of the agar diffusion test. RESULTS: Heavy bacterial infection was observed in the control bovine root specimens at the layer close to the lumen. This decreased rapidly from layer to layer up to the deepest layer tested (300-400 microm), which contained several hundred colony-forming units. Clindamycin significantly reduced the amount of viable bacteria in each dentin layer compared with the positive control and tetracycline (P <.01). The agar diffusion test, wherein dilutions in increments of 1/3 and 1/9 were used, revealed that both medicaments had antibacterial activity, but clindamycin was significantly better. In the 1/27 dilution, clindamycin had a minor effect and tetracycline had no effect at all. CONCLUSION: Under the experimental conditions used in this study, the commercial preparations of clindamycin were more effective than those of tetracycline (Ledermix) in the agar diffusion test and clindamycin penetrated into dentinal tubules up to 400 microm. Thus, it has the potential to serve as an effective intracanal medicament in persistent infections when other medicaments fail.

Analysis of Variance↗
PubMed1995

Effect of reduced air pressure on dye penetration in standardized voids.

OBJECTIVE: This study determined the correlation between the degree of dye penetration in standardized voids to various reduced pressures. STUDY DESIGN: Standardized voids of 0.50 and 0.22 mm in diameter were created in 60 human roots; specimens were divided into five groups. Four groups were subjected to a 2% filtered aqueous methylene blue dye solution under different conditions of atmospheric pressure for 7 days and reduced pressures of a 10 torr, a 260 torr, and a 510 torr for 30 minutes. The conditions for the fifth group were similar to the last group except that ethyl alcohol was substituted for water in the dye. RESULTS: All positive control specimens showed complete dye penetration. The least linear dye penetration was observed in passively immersed specimens. The results were significantly different from those when reduced pressure had been used (p < 0.001). There were no significant differences among the groups with reduced pressure. No significant difference was found at any pressure level between the means of dye diffusion in the 0.50 and the 0.22 mm voids. The smallest standard deviations were observed for the most reduced air pressure of 10 torr, followed by the group of the least reduced pressure of 510 torr, with the use of the tincture dye solution. CONCLUSIONS: A 10-torr reduced pressure and an application of the tincture dye solution would provide an improved method for microleakage studies.

Air Pressure↗
PubMed1996

Effect of dentin treatment on in vitro root tubule bacterial invasion.

In light of the in vitro S. sanguis bacterial migration observed deep into root dentin, an in vitro system was developed to determine the viability of these bacteria at the end of migration. Also of interest is whether the smear layer formed during root canal instrumentation modifies migration into root dentinal tubules. Forty-eight bovine root dentin samples were randomly split into two groups. Group 1 dentin blocks were not instrumented and were treated with 17% ethylenediamine tetraacetic acid and 2.5% sodium hypochlorite for 4 minutes in an ultrasonic bath Group 2 root canals were conventionally instrumented. The smear layer formed was not removed. Dentin blocks were inoculated with a S. sanguis National Collection of Type Culture 7863 suspension. Each sample was immersed in a receiver broth, incubated at 37 degrees C, and checked daily for 14 days. After a 14-day incubation period, group 1 S. sanguis cells remained viable and capable of inoculating the receiver medium after migration through the tubules. Group 2 cells, where the smear layer was intact, revealed an absence of S. sanguis migration in 88% of the cases. It is therefore plausible that smear layer on canal walls limits S. sanguis penetration of dentinal tubules in vitro.

Animals↗