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Dentinal permeability in assessing therapeutic agents.

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.

Dentin↗

In vitro evaluation of fluorescein for testing the permeability of white spots on tooth enamel.

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.

Bicuspid↗

Dentin permeability and bond strengths after various surface treatments.

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.

Acid Etching, Dental↗