Effect of molecular size on permeability coefficients in human dentine.
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The rates of fluid movement across dentin discs, in vitro, were measured at 10, 20, 30, 40, and 50 degrees C in unetched and acid-etched dentin. Increasing the temperature 40 degrees (i.e., from 10 to 50 degrees C) resulted in a 1.8-fold increase in fluid flow in unetched dentin, which was of a magnitude similar to the decrease in viscosity that occurred over the same temperature range. In acid-etched dentin, the 40 degrees C temperature change produced more than a four-fold increase in fluid conductance, more than double that which could be accounted for by changes in viscosity. Analysis of the data suggests that this additional increment in hydraulic conductance is due to thermal expansion-induced increases in tubular diameter.
Calcium hydroxide paste was applied to human dentin in vitro to determine its effects on dentin permeability. Discs of dentin were acid-etched on both sides to permit determination of their maximum permeability. Smear layers were then applied to the enamel sides of the discs, thereby reducing dentin permeability 99%. Topical application of Ca(OH)2 paste to the smear layer reduced dentin permeability further, to levels 48% below that of untreated smear layers. When the Ca(OH)2-treated smear layers were exposed to 6% citric acid for two min, dentin permeability returned to the initial acid-etched value, demonstrating that Ca(OH)2 offers little protection to acid challenge. Treatment of acid-etched dentin with Ca(OH)2 produced a similar reduction in dentin permeability, which was restored to normal following acid challenge. Thus, Ca(OH)2 is effective at reducing the permeability of both the smear layer and of acid-etched dentin, in vitro.
Patients using placebo dentifrices in clinical trials usually show a significant decrease in dentin sensitivity over a 2- to 4-week period. If their sensitivity were due to hydrodynamic fluid movement, then the results suggest that there was a decrease in their dentin permeability. This hypothesis was tested in vitro by measuring the ease with which fluid could flow (i.e., hydraulic conductance) across dentin discs before and after brushing the discs with a variety of dentifrices, including most of the marketed densensitizing dentifrices. All dentifrices decreased the hydraulic conductance of dentin. An experimental dentifrice containing oxalate as the active ingredient was far more effective than any of the marketed dentifrices. The results tend to support the hypothesis that, at least part of the reduction in clinical sensitivity in patients with hypersensitive dentin is due to the abrasive action of the dentifrice.
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Cavities were prepared into the dentine of mandibular first molars of anaesthetized dogs. Conical plastic chambers were cemented into the cavities to permit quantitation of dentine permeability using a fluid-filtration technique. There was a progressive fall in dentine permeability every hour for the 6 h of study, to about 20 per cent of zero time values. The fall in dentine permeability could be delayed but not prevented, by filtering fluid across the dentine into the pulp. Similar experiments on teeth from which the pulps had been removed showed no change or a slight increase in permeability with time. No change in dentine permeability was seen in dogs killed after the zero time measurement and followed for an extra 6 h. This decrease of dentine permeability in response to cavity preparations only occurs in teeth with intact pulps.
The effects of evaporation produced by air blasts of 0, 0.5, 2 or 5 min to dentine in vitro were evaluated by measuring dentine hydraulic conductance before and after each trial. When the tubules were filled with water, even prolonged evaporation had no effect on dentine permeability. Tubules filled with physiological salt solution produced a time-dependent decrease in dentine permeability. Tubules filled with 1.5 per cent albumin in water gave the largest reductions in dentine permeability. These effects were more marked in unetched as opposed to acid-etched dentine. The results suggest that part of the reduction in dentine sensitivity produced clinically by prolonged air blasts may be due to precipitation of organic and inorganic constituents of dentinal fluid at the surface.
The results of this study permit the following conclusions: 1. The use of dilute (6%) citric acid for very short time intervals permits sequential removal of the smear layer on human dentin. 2. Acid-etching for as little as 5 seconds removes much of the smear layer and exposes the orifices of dentinal tubules. 3. Dentin permeability increased rapidly during acid-etching with 6% citric acid, reaching a maximum value after only 15 seconds of etching. 4. The production of a smear layer on dentin during restorative procedures establishes a protective diffusion barrier. Removal of the smear layer by acid-etching increases the permeability of dentin which, under some conditions, must be regarded as a liability.
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The effectiveness of three resin-compatible cavity varnishes in reducing the dentin permeability to free monomer liquid was evaluated by means of a dentin disk mounted within a pressurized split-chamber diffusion device filled with low-viscosity aliphatic dimethacrylate. Substantial reduction in dentin permeability was obtained with all of the products tested (Microjoin, Cavi-Line, and Universal). This study suggests their likely effectiveness as a protective barrier against permeation of free monomer into the dental pulp.
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