The effects of a multi-step dentin bonding system on dentin permeability.
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A technique is described which permits measurements of the ease with which fluid permeates dentin. This value, the hydraulic conductance of dentin, increased as surface area increases and/or as dentin thickness decreases. It increased 32-fold when dentin was acid etched due to removal of surface debris occluding the tubules.
The results indicate that Ip measurements are fairly closely related to the pore volume of the enamel to a depth of about 13 micrometer. A previous finding - that intraoral exposure produced substantial mineralization of abraded enamel after one h, and a slower rate of mineralization during the next two h - was confirmed, and it was shown that the rate of mineralization decreased with a decrease in the pore volume of the enamel. The rapid rate of intraoral mineralization represents a powerful mechanism for maintaining a fully mineralized enamel surface. The sensitivity of the Ip method demonstrated in this study, and the finding that Ip measurements relate to the pore volume of the enamel, coupled with previous findings that the increase in Ip produced by mild acid etching of intact enamel is proportional with the amount of dissolved Ca, indicate that the method provides valid measurement of intraoral de- and remineralization.
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Diffusion processes proceeding in the dentin are of fundamental scientific interest and of major importance to numerous therapeutical measures, with the permeability of dentin playing an essential role. Their exact quantitative determination is possibly in vitro only and depends upon various factors. Relevant investigative results obtained using standardized parameters and the methods employed are subjected to a critical analysis and interpreted with regard to the possibility of using them for specific comparative studies. The results reported in this paper are only indirectly applicable to clinical studies. However, they can considered a useful starting point for further studies.
The measurement of dentinal permeability has been useful in confirming the mechanism of the hydrodynamic hypothesis for pain transmission in hypersensitive patients, has advanced our understanding of how neural agents can reach the pulpal nerves, and has provided useful data to compare and evaluate therapeutic agents. Methods to assess permeability have varied from direct dye penetration techniques to measurement of fluid flow through dentin sections to SEM photography of impression replicas in vivo. A number of clinical therapeutic strategies have emerged from this work as well as ways to mitigate the progressive nature of the condition.
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This investigation demonstrates the reliability of fluorescein for detecting the permeability of incipient dental caries (white spots). Artificial white spots were created on the buccal surface of 12 human bicuspids by viscous lactic acid (pH 4). Permeability of these lesions was assessed and reassessed before and after 24 and 48 hr of acid challenge using two disclosants: sodium iodide and sodium fluorescein. Estimates obtained from both disclosants showed that the microvoid volume approximately doubled as the decalcification time doubled. The two disclosants exhibited good intraclass reliability and their scores were correlated (r = 0.69 to r = 0.91). However, only fluorescein disclosed the extent of porous white spot lesions. Thus, fluorescein should be considered when the objective is to detect the location and permeability of incipient lesions.
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Numerous reports suggest that removal of the smear layer increases the bond strengths of some dentin adhesives while lowering the bond strengths of others. Smear layer removal also increases dentin permeability and wetness. The purpose of this study was to compare the permeability and shear bond strengths of occlusal vs. buccal dentin before and after removal of the smear layer with 6% citric acid and before and after substitution of the smear layer by topical oxalate treatment. Shear bond strengths of Scotchbond/Silux to smear layers were higher than those to acid-etched dentin. Oxalate treatment of acid-etched dentin increased bond strengths to levels that were higher than smear layer controls. Removal of the smear layer increased dentin permeability. This result was completely reversed by oxalate treatment.
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