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[Experimental study of the pulpal response of dogs capping with nHA-PA66].

OBJECTIVE: To investigate the responses of dog pulp tissue to the new nano-hydroxyapatite/polyamide 66 biological composites (nHA-PA66) used as direct pulp capping agent. METHODS: Dogs were used in establishing the experimental model. The reparative dentin bridge formation and the histopathological changes at the pulp-exposed site were observed at 7, 30 and 60 days postoperatively. Calcium hydroxide (Dycal) was used as positive control. RESULTS: After capping with nHA-PA66, some dog teeth were found to have formation of reparative dentin bridge and slight inflammatory response during the pulp healing procedure when compared with the effect of using calcium hydroxide. CONCLUSION: The results indicate that nHA-PA66 has good tissue biocompatibility, but its function of inducing reparative dentin bridge formation is not good enough as compared with that of calcium hydroxide. It has the potential to be used as a direct pulp capping agent, but further researches are needed.

Animals↗

Treatment of severe pre-eruptive intracoronal resorption of a permanent second molar.

Pre-eruptive intracoronal resorption is a lesion often located within the dentin, adjacent to the dentin-enamel junction, in the occlusal aspect of the crown. As the lesions resemble caries, they are often referred as "pre-eruptive caries." The purpose of this case report was to describe the diagnosis and treatment of a permanent molar with pre-eruptive intracoronal resorption and to elaborate on possible associated clinical problems. After surgical exposure of the unerupted tooth, the tooth structure in the resorbed area was removed and the tooth was restored with glass-ionomer material. Three months after the treatment, partial pulpotomy had been performed and the restoration was replaced by amalgam. Elaboration on possible associated clinical problems is provided.

Child↗

Effects of adhesive liner and provisional cement on the bond strength of nickel/chrome/beryllium alloy cemented to dentin.

OBJECTIVE: Treating teeth with adhesive agents before placing a provisional restoration can prevent tooth sensitivity. This study evaluated the bond strength of resin cements to dentin treated with 2 adhesive agents and 2 provisional cements. METHODS AND MATERIALS: Extracted human molars were prepared by exposing dentin and were treated with either Prime & Bond NT or Clearfil SE Bond. After a simulated impression technique, the teeth were provisionalized with either a eugenol or noneugenol temporary cement. Teeth were cleaned for bonding by either mechanical removal of the cement or use of an acid conditioner. Panavia F and Calibra resin cements were used to cement nickel/chrome/beryllium alloy to the tooth surfaces, and the specimens were debonded. Mean shear bond strengths for each group were calculated. RESULTS: Mean shear bond strengths ranged from 26.6 +/- 5.8 MPa for Calibra bonded to dentin treated with Prime & Bond NT, a noneugenol cement, and mechanically cleaned, to 10.6 +/- 4.4 MPa for Panavia F bonded to unlined (no adhesive) dentin treated with a eugenol cement and mechanically cleaned. Of the 14 groups tested, significant differences were observed related to the adhesives and resin cements. Both temporary cements reduced the bond to dentin not treated with a resin adhesive. Use of an acid conditioner for cleaning the temporary cement also reduced bond strengths in all groups. CONCLUSIONS: Placement of a dentin adhesive before provisionalization may prevent the temporary cement from affecting the bond of the final resin cement to the tooth. For the products used in this study, use of phosphoric acid to clean the tooth surface is not recommended.

Cementation↗

Using cavity liners with direct posterior composite restorations.

Cavity liners have traditionally been used in direct and indirect restorations for purposes such as promoting reparative dentin and neutralizing acids. Today, liners are used when resin composites are used as the restorative materials on the posterior teeth, but for a different reason. Clinically, liners are considered to decrease sensitivity and wet the cavity better than restorative composites because of their flowability, adaptation to the dentinal surface, and adhesion. As bonding systems and composite materials continue to improve and become better understood, so do the techniques for placing composites. This has led to the reassessment of the clinical relevance and function of liners. Some clinicians don't use cavity liners, assuming they are a thing of the past; some use composite liners, and others use resin-modified glass ionomer liners. Additionally, there is not a clear agreement over the function of liners, such as when and why they should be used or what type of liner material would provide the best performance for a particular clinical situation. This article attempts to clarify some of the confusion surrounding the use of liners by reviewing the available literature on the subject and attempting to give evidence-based rationale for the use and protocol for the clinician.

Composite Resins↗

Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth.

PURPOSE: To evaluate clinically and microbiologically the effect of calcium hydroxide (CH) on carious dentin on primary teeth submitted to indirect pulp capping (IPC). METHODS: Twenty 4-7 year-old subjects with 42 treated teeth participated in the study. The treatment consisted of incomplete excavation of the demineralized dentin, application of a CH or gutta-percha (GP) layer and sealing with a resin-based composite for 4-7 months. After cavity preparation and sealing, the dentin was evaluated clinically (color and consistency) and microbiologically. Dentin samples were cultured on blood agar under aerobic and anaerobic conditions, in Mitis Salivarius agar and Rogosa SL agar. RESULTS: 39 teeth (20 in the CH Group and 19 in the GP Group) were reopened 4-7 months post-treatment for clinical and microbiological evaluation. In all teeth, the initial demineralized dentin was wet and soft or leathery. In the CH Group, 10% of the lesions were yellow, 80% light brown and 10% dark brown and in the GP Group, 94.7% were light brown and 5.3% dark brown. After treatment, the dentin was dry, 90% (Group CH) and 84.2% (Group GP) were dark brown. The final consistency was either leathery or hard. Three samples in the CH Group and five in Group GP changed from soft to leathery; only one sample (GP) remained leathery. 85% in the CH Group and 68.4% in GP Group turned hard after treatment. All bacterial counts decreased significantly by the end of treatment. In the CH Group, the bacterial (Log10 CFU + 1) anaerobic growth decreased from 4.84 +/- 1.31 to 1.35 +/- 1.54, aerobic from 4.09 +/- 1.04 to 0.92 +/- 1.30 and lactobacilli from 3.24 +/- 1.22 to 0.36 +/- 0.89, respectively; the mutans streptococci from 2.05 +/- 1.84 to 0.14 +/- 0.60. In GP Group, anaerobic growth decreased from 5.22 +/- 0.96 to 2.02 +/- 1.65 and aerobic from 4.23 +/- 1.37 to 1.08 +/- 1.29 and lactobacilli from 2.06 +/- 1.81 to 0.00 +/- 0.00, respectively; the mutans streptococci from 3.16 +/- 1.59 to 0.28 +/- 0.84.

Calcium Hydroxide↗

[Structural changes in human dentin with the use of modern filling materials].

Changes in human dentin surface structure, effected by potassium oxalate, potassium nitrate, calcium hydroxide, were studied by scanning electron microscopy. Crystal layers of different structures with complete or partial occlusion of the dentin tubes were detected. Complete occlusion was achieved only if potassium oxalate was used.

Calcium Hydroxide↗

A clinical and histological evaluation of conservative pulpal therapy in human teeth.

Three intermediary base materials, a zinc oxide-eugenol (Cavitec) and two calcium hydroxide liners (Life and Dycal), were selected at random for use as a base beneath amalgam or composite restorations on humans following complete caries removal. Life and Dycal, selected at random, were also used as direct and indirect pulp capping agents as clinically indicated. Clinical evaluations of signs and symptoms were made before treatment and at one-week, six-month, and one-year intervals following treatment. Histological evaluations were performed on three complete caries removal teeth and 18 direct pulp capping teeth six months following treatment. No significant differences in clinical symptomatology resulted between the materials in the complete caries removal group or the indirect and direct pulp capping groups.

Adult↗

Oxalate solution and collagen-oxalate solution as protective liners for dentine.

The aim of the present study was to evaluate under scanning electron microscopy the ability of different chemically reactive solutions to form a protective layer on dentine. The materials selected were an oxalate solution, a collagen-oxalate solution, a collagen-oxalate solution plus glutaraldehyde and a saline control solution. Small dentine fragments, obtained from extracted human teeth, were treated with the various chemical solution for 60 seconds. All samples were then examined in a Jeol scanning electron microscope. The preliminary observations suggest that dentine may be covered by a mixture of oxalate crystals and collagen producing a homogeneous layer of reactive agents.

Collagen↗

Pulp therapy in the primary dentition.

Several treatment options for pulp therapy in primary teeth are reviewed. Conservative treatments are recommended for primary teeth whose pulps have the potential to recover once the irritation has been removed. The role of dentin permeability and microleakage is emphasized when protective basis and indirect pulp treatment are discussed. Alternative dressings for formocresol pulpotomies such as 6.25% glutaraldehyde solution, antigen-extracted allogeneic dentin matrix, and crude bone morphogenetic protein are reported with promising results. Pulpectomy is recommended for teeth with evidence of chronic inflammation involving radicular pulp or pulp necrosis with and without periapical involvement. The main disadvantage of zinc oxide-eugenol paste, widely used for primary root fillings in the United States, is its slow resorption rate, frequently much slower than that of the root. Other root canal pastes containing iodoform, or a modification of this with the addition of calcium hydroxide, are being utilized in South America, Japan, and Europe.

Child, Preschool↗