Search

To investigate the potential mineralising effects of calcium silicate-based dentine replacement material (Biodentine™) in comparison with glass-ionomer cement (GIC) (Fuji IX™) on different human dentine substrates using a multimodal non-invasive optical assessment.Cements were applied on artificially demineralised or naturally carious dentine and stored for 4 weeks in phosphate-rich media +/- tetracycline used for mineralisation labelling. Interfacial dentine was examined from the same sample and location before and after aging using two-photon fluorescence microscopy, fluorescence lifetime imaging (FLIM) and second harmonic generation (SHG) imaging. Additionally, Raman spectroscopy was used to detect changes in the mineral content of dentine.Significant changes in the fluorescence intensity and lifetime were detected in partially demineralised dentine and caries-affected dentine underneath both tested cements, after storage (p 0.001). This was associated with a significant increase in the mineral content as indicated by the increased intensity of the phosphate Raman peak located at 959 cm

A rotational sliceform (RS) forms a stiff, ringlike array of intersecting planar slices. Removing a few slices and disconnecting the ends of an RS enables the incomplete array to be collapsed scissorlike into a compact stack; it can be expanded smoothly as far as the original incomplete configuration, but not beyond. Its structured architecture, coupled to apparent mechanistic motion and a natural self-locking ability, expresses equivalently a novel deployable metamaterial, and we set out to determine its natural limits of motion for symmetrical and asymmetrical RS architectures. We first reconceptualize the RS as an array of plane-faced pyramidal cells bounded by rigid slices of zero thickness. The minimum articulation range from all cells is shown to set an upper bound on the range of motion of an incomplete RS, specifically, that symmetrical architectures can collapse fully while asymmetrical cannot and that expansion always stops at the design configuration. We also find that planar rotation of slices is not possible without distorting the original intersections. Each slice is then permitted to kink out-of-plane while preserving the initial geometry of each cell, in order to marshal compatible rotations of now compliant slices. Our analysis then reliably captures the deployment features: the minimum collapsed state, the degree of slice deformation as they rotate, and the limit of expansion.

ObjectivesTo test the in vitro subsurface remineralisation efficacy of chitosan-bioglass complex on artificial white spot lesions.Methods: 64 artificial enamel white spot lesions were created by acidic gel and equally separated for static and 7d pH-cycling models. In each model, samples were assigned to 4 groups: (1) bioglass application on chitosan pre-treated lesions (CB); (2) chitosan-bioglass slurry (CBS); (3) "standard" remineralisation solution (RS - positive control); (4) deionised water (NC - negative control). Before each treatment using remineralising agents, 3-minute pellicle was formed on lesions' surfaces. Mineral content changes, surface and subsurface microhardness and ultrastructure were evaluated by Raman intensity mapping, Knoop microhardness and scanning electron microscopy, respectively. Data were statistically analysed using one-way ANOVA with Tukey's test (p < 0.05 is considered as significant).ResultsChitosan-bioglass complexing was found to exhibit greater mineral regain and recovery of surface and subsurface microhardness compared to "standard" remineralisation solution and control groups, after static and dynamic pH-cycling remineralisation for 7 days (p

INTRODUCTION Real-Time Optical Vascular Imaging (RTOVI) is a technology developed in the Centre for Oral Clinical & Translational Sciences, within the Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, that allows rapid and preparation free, in vivo imaging of the microvascular anatomy of the human oral cavity. Microvascular changes are known to be related to disease subtypes, in particular cancer. This makes in vivo microvascular examination clinically valuable. However, at present there is lack of any analytical method able to objectively assess microvascular morphology images. DISCUSSION The assessment of microvascular morphology based on a subjective evaluation was proven to be unreliable. There was a need to develop a software-based analysis for in vivo microvascular images to support the validation of RTOVI. This paper reviews the authors work to develop and test an automated microvascular analysis method for RTOVI based on ImageJ, an open-source software. This allowed to determined which parameters offered a more robust mathematical representation of the microvascular anatomy of the gingival margin, such as the mean area per capillary and mean aspect ratio. However, in vivo microvascular images from elsewhere within the oral cavity posed a bigger challenge to the analysis procedure due to the microvascular architectural complexity and poorer contrast. Angiogenesis Analyzer, a well-known ImageJ plugin used for the quantification of in vitro microvascular images, is under development in collaboration with the University of Paris Est Creteil. The aim of this work is to obtain an automated analysis method for in vivo microvascular images able to offer a solid foundation for the diagnostic potential of RTOVI and subsequent clinical integration of this technology. CONCLUSION An automated analysis method for in vivo microvascular images is paramount before any attempt to clinically validate RTOVI. Our initial work of testing a software-based analysis demonstrated the effectiveness of some parameters, which is valuable for future work, and led us to move into a more sophisticated method involving customising the Angiogenesis Analyzer plugin. This is an essential step, aiming to extend the potential of in vivo microscopy with the clinical integration of RTOVI. LAY DESCRIPTION This article summarises the initial research work done in the field on in vivo microvascular imaging aiming to develop a technique for the diagnosis of oral diseases based on the shape of small blood vessels found just below the surface of the "skin" inside the mouth. This offers the potential to examine lesions without the need to take a sample (biopsy/cutting tissue) to observe it microscopically. This ultimately offers a potential to accelerate diagnostic decision making, avoid unpleasant and often deterrent surgical procedures and reducing diagnostic laboratory time and cost burdens. However, in order to assess images of small blood vessels obtained in clinic, we needed to develop and test a software-based analysis to avoid the subjective human interpretation, known not to work. This article describes the authors journey to achieve an automated and sophisticated analysis method unique in the world for in vivo microvascular images derived from real-time optical vascular imaging.

Background. The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT). Methods. Sixty-five teeth underwent primary RCT and were followed up clinically and radiographically. The outcome was determined radiographically with periapical radiographs (PR) and cone beam computed tomography (CBCT) scans. Results. Success at 12 months was predictable based on the fluorescence score. When the fluorescence score (defined as the percentage of signal over total signal including background) was lower than 67, there was a 4.5 times (Odds ratio (OR) = 0.028, 95% confidence interval (CI): 0.003, 0.291, p = 0.001) greater chance of success (90% overall). When the readings were above this threshold, the success rate was 20%. Conclusion. A chairside sampling method is able to predict the outcome of RCT, through the use of paper point sampling and fluorescence staining. This has reduced the prevalence of persistent infections by guiding the optimum time for obturation. ClinicalTrials.gov trial NCT03660163.

Assess calcium silicate cement (Biodentine™) vs. glass ionomer cement (Fuji IX™, control) as indirect pulp capping (IPC) materials in patients with reversible pulpitis after a 2-year follow-up. Evaluate the integrity of the overlying resin composite restorations using modified USPHS criteria and FDI criteria. Investigate the sensitivity of the modified USPHS criteria compared to the FDI criteria in the assessment of the restorations. Seventy-two restorations (36 Biodentine™, 36 Fuji IX™) were placed randomly in 53 patients. Periapical radiographs were taken at pre-treatment (T0), 12-month (T12), and 24-month (T24) review. Restorations were assessed using the modified USPHS and FDI criteria at T12 and T24. At 24 months, 15 teeth had failed to maintain vitality (6 Biodentine™, 9 Fuji IX™). Clinical success rate of IPC for both materials was 72% and is related to the intensity of reversible pulpitis symptoms. No difference was found between T12 and T24 in the periapical (PA) radiographs and in the integrity of the resin composite restorations overlying Biodentine™ compared to Fuji IX™. There was no difference in the efficacy of the USPHS criteria compared to the FDI criteria in the assessment of the resin composite restorations. Biodentine™ and Fuji IX™ were clinically effective when used as IPC materials in teeth with reversible pulpitis at T24. Resin composite restorations overlying both materials performed well at T24. Using the USPHS or FDI criteria is equally efficient at T24; however, longer term follow-up is needed to establish whether there are sensitivity differences between these assessment criteria. Teeth with deep carious lesions approaching the pulp and with signs of reversible pulpitis can be treated successfully by indirect pulp capping using either Biodentine™ or Fuji IX™. Using the USPHS or FDI criteria to assess restorations is equally effective at 2 years. NCT02201641

ObjectiveMaterials for pulp protection should have therapeutic properties in order to stimulate remineralization and pulp reparative processes. The aim of this study was to evaluate the mechanical properties, biocompatibility, cell differentiation and bioactivity of experimental light-curable resin-based materials containing bioactive micro-fillers.MethodsFour calcium-phosphosilicate micro-fillers were prepared and incorporated into a resin blend: 1) Bioglass 45S5 (BAG); 2) zinc-doped bioglass (BAG-Zn); 3) βTCP-modified calcium silicate (β-CS); 4) zinc-doped β-CS (β-CS-Zn). These experimental resins were tested for flexural strength (FS) and fracture toughness (FT) after 24 h and 30-day storage in simulated body fluid (SBF). Cytotoxicity was evaluated using MTT assay, while bioactivity was evaluated using mineralization and gene expression assays (Runx-2 & ALP).ResultsThe lowest FS and FT at 24 h was attained with β-CS resin, while all the other tested materials exhibited a decrease in FS after prolonged storage in SBF. β-CS-Zn maintained a stable FT after 30-day SBF aging. Incorporation of bioactive micro-fillers had no negative effect on the biocompatibility of the experimental materials tested in this study. The inclusion of zinc-doped fillers significantly increased the cellular remineralization potential and expression of the osteogenic genes Runx2 and ALP (p SignificanceThe innovative materials tested in this study, in particular those containing β-CS-Zn and BAG-Zn may promote cell differentiation and mineralization. Thus, these materials might represent suitable therapeutic pulp protection materials for minimally invasive and atraumatic restorative treatments.

Objective To investigate the remineralisation of chitosan pre-treated enamel white spot lesions (WSLs) by bioglass in the presence of the pellicle layer.Methods50 artificial enamel white spot lesions were created by acidic gel. Two lesions were used to investigate the formation of the pellicle layer by treating with human whole saliva for 3 min. 48 lesions were assigned to 6 experimental groups (n = 8): (1) bioactive glass slurry, (2) bioactive glass containing polyacrylic acid (BG + PAA) slurry, (3) chitosan pre-treated WSLs with BG slurry (CS-BG), (4) chitosan pre-treated WSLs with BG + PAA slurry (CS-BG + PAA), (5) “standard” remineralisation solution (RS) and (6) de-ionised water (negative control, NC). Remineralisation was carried out using a pH-cycling model for 7 days. Before each treatment using remineralising agents, 3-min pellicle was formed on lesions’ surfaces. Mineral content changes, surface and subsurface microhardness and ultrastructure were evaluated by Raman intensity mapping, Knoop microhardness and scanning electron microscopy, respectively. Data were statistically analysed using one-way ANOVA with Tukey’s test (p

Bacteria present in the root canal (RC) space following an RC treatment (RCT) can lead to persistent infections, resulting in treatment failure and the need for reintervention or extraction. Currently, there are no standardized methods in use to clinically detect bacterial presence within RC spaces. The use of paper point sampling and fluorescence staining was shown to be a rapid method, able to detect residual bacteria following treatment. The study demonstrated that Calcein acetoxymethyl (AM) proved to be a suitable dye for detecting vital bacteria within mature endodontic biofilms, with an improved sensitivity over colony-forming unit counting in a stressed biofilm model. Furthermore, in a clinical trial with primary RCTs, 53 infected teeth were sampled in vivo, and increased detection of vital cells was found when compared with colony-forming unit counting, highlighting the sensitivity of the technique in detecting low cell numbers. By combining fluorescent staining and microspectroscopy with software-based spectral analysis, successful detection of vital cells from RCs was possible after 5 min of Calcein AM incubation. Application of this technology during RCT has the potential to reduce persistent infections through vital cell detection and additional treatment. Furthermore, this technique could be applied to antimicrobial research and disinfection control in clinical settings ( ClinicalTrials.gov NCT03055975).

Objective The aim of this study was to examine the behavior of posterior teeth restored with single-tooth restorations with intentionally high occlusal contacts. Methods Consent was obtained from 17 patients who were seen a total of 5 times over 3.5 years. The restorations placed were all full occlusal coverage gold restorations. Tooth mobility was recorded using the Periotest device and tooth movement was determined from impressions and 3D imaging. Patients were randomly assigned into two groups, the control group which received restorations with no intentional increase of the occlusal vertical dimension; or the treatment group where they received intentionally high restorations in 0.5 mm supraocclusion. Results Statistical analysis showed no significant difference in mobility between visits for both the control and the treatment groups while a significant dependency and difference in tooth movement was observed between the subjects of the two groups. Most patients from the treatment group reported discomfort but no pain for the first 7–10 days after the restoration was fitted, which subsided over a period of couple of weeks. At review, 3 years later, no mobility or additional movement was observed. Conclusions Cementation of an intentionally high single-tooth restoration causes no increase in tooth mobility while occlusal adaptation re-establishes and restores the occlusal plane.

To evaluate the effect of pre-conditioning enamel white spot lesion (WSL) surfaces using bioactive glass (BAG) air-abrasion prior to remineralization therapy.Ninety human enamel samples with artificial WSLs were assigned to three WSL surface pre-conditioning groups (n=30): (a) air-abrasion with BAG-polyacrylic acid (PAA-BAG) powder, (b) acid-etching using 37% phosphoric acid gel (positive control) and (c) unconditioned (negative control). Each group was further divided into three subgroups according to the following remineralization therapy (n=10): (I) BAG paste (36 wt.% BAG), (II) BAG slurry (100 wt.% BAG) and (III) de-ionized water (negative control). The average surface roughness and the lesion step height compared to intra-specimen sound enamel reference points were analyzed using non-contact profilometry. Optical changes within the lesion subsurface compared to baseline scans were assessed using optical coherence tomography (OCT). Knoop microhardness evaluated the WSLs' mechanical properties. Raman micro-spectroscopy measured the v-(CO3)(2-)/v1-(PO4)(3-) ratio. Structural changes in the lesion were observed using confocal laser scanning microscopy (CLSM) and scanning electron microscopy-energy dispersive X-ray spectrometry (SEM-EDX). All comparisons were considered statistically significant if p0.05.PAA-BAG air-abrasion removed 5.1 ± 0.6 μm from the lesion surface, increasing the WSL surface roughness. Pre-conditioning WSL surfaces with PAA-BAG air-abrasion reduced subsurface light scattering, increased the Knoop microhardness and the mineral content of the remineralized lesions (p0.05). SEM-EDX revealed mineral depositions covering the lesion surface. BAG slurry resulted in a superior remineralization outcome, when compared to BAG paste.Pre-conditioning WSL surfaces with PAA-BAG air-abrasion modified the lesion surface physically and enhanced remineralization using BAG 45S5 therapy.

Objective To evaluate the effect of load-cycle aging and/or 6 months artificial saliva (AS) storage on bond durability and interfacial ultramorphology of resin-modified glass ionomer cement (RMGIC) applied to dentine air-abraded using Bioglass 45S5 (BAG) with/without polyacrylic acid (PAA) conditioning.Methods RMGIC (Ionolux, VOCO) was applied onto human dentine specimens prepared with silicon-carbide abrasive paper or air-abraded with BAG with or without the use of PAA conditioning. Half of bonded-teeth were submitted to load cycling (150,000 cycles) and half immersed in deionised water for 24 h. They were cut into matchsticks and submitted immediately to microtensile bond strength (μTBS) testing or 6 months in AS immersion and subsequently μTBS tested.Results were analysed statistically by two-way ANOVA and Student–Newman–Keuls test (α = 0.05). Fractographic analysis was performed using FE-SEM, while further RMGIC-bonded specimens were surveyed for interfacial ultramorphology characterisation (dye-assisted nanoleakage) using confocal microscopy. Results RMGIC applied onto dentine air-abraded with BAG regardless PAA showed no significant μTBS reduction after 6 months of AS storage and/or load cycling (p > 0.05). RMGIC–dentine interface showed no sign of degradation/nanoleakage after both aging regimens. Conversely, interfaces created in PAA-conditioned SiC-abraded specimens showed significant reduction in μTBS (p ConclusionsDentine pre-treatment using BAG air-abrasion might be a suitable strategy to enhance the bonding performance and durability of RMGIC applied to dentine. The use of PAA conditioner in smear layer-covered dentine may increase the risk of degradation at the bonding interface.Clinical significanceA combined dentine pre-treatment using bioglass followed by PAA may increase the bond strength and maintain it stable over time. Conversely, the use of PAA conditioning alone may offer no significant contribute to the immediate and prolonged bonding performance of modern RMGICs.

Objective To test the null hypothesis that chitosan application has no impact on the remineralisation of artificial incipient enamel white spot lesions (WSLs). Methods 66 artificial enamel WSLs were assigned to 6 experimental groups (n = 11): (1) bioactive glass slurry, (2) bioactive glass containing polyacrylic acid (BG + PAA) slurry, (3) chitosan pre-treated WSLs with BG slurry (CS-BG), (4) chitosan pre-treated WSLs with BG + PAA slurry (CS-BG + PAA), (5) remineralisation solution (RS) and (6) de-ionised water (negative control, NC). Surface and cross-sectional Raman intensity mapping (960 cm−1) were performed on 5 samples/group to assess mineral content. Raman spectroscopy and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) were used to identify the type of newly formed minerals. Surface and cross-sectional Knoop microhardness were implemented to evaluate the mechanical properties after remineralisation. Surface morphologies and Ca/P ratio were observed using scanning electron microscopy (SEM) coupled with energy dispersive X-ray spectroscopy (EDX). Data were statistically analysed using one-way ANOVA with Tukey’s test. Results BG + PAA, CS-BG, RS presented significantly higher mineral regain compared to NC on lesion surfaces, while CS-BG + PAA had higher subsurface mineral content. Newly mineralised crystals consist of type-B hydroxycarbonate apatite. CS-BG + PAA showed the greatest hardness recovery, followed by CS-BG, both significantly higher than other groups. SEM observations showed altered surface morphologies in all experimental groups except NC post-treatment. EDX suggested a higher content of carbon, oxygen and silicon in the precipitations in CS-BG + PAA group. There was no significant difference between each group in terms of Ca/P ratio. Significance The null hypothesis was rejected. Chitosan pre-treatment enhanced WSL remineralisation with either BG only or with BG-PAA complexes. A further investigation using dynamic remineralisation/demineralisation system is required with regards to clinical application.

Two-photon fluorescence microscopy, in combination with tetracycline labelling, was used to observe the remineralising potentials of a calcium silicate-based restorative material (Biodentine(TM) ) and a glass ionomer cement (GIC:​Fuji​IX) on totally demineralised dentine. Forty demineralised dentine discs were stored with either cement in three different solutions: phosphate buffered saline (PBS) with tetracycline, phosphate-free tetracycline, and tetracycline-free PBS. Additional samples of demineralised dentine were stored alone in the first solution. After 8-week storage at 37 °C, dentine samples were imaged using two-photon fluorescence microscopy and Raman spectroscopy. Samples were later embedded in PMMA and polished block surfaces studied by 20 kV BSE imaging in an SEM to study variations in mineral concentration. The highest fluorescence intensity was exhibited by the dentine stored with Biodentine(TM) in the PBS/tetracycline solution. These samples also showed microscopic features of matrix remineralisation including a mineralisation front and intra- and intertubular mineralisation. In the other solutions, dentine exhibited much weaker fluorescence with none of these features detectable. Raman spectra confirmed the formation of calcium phosphate mineral with Raman peaks similar to apatite, while no mineral formation was detected in the dentine stored in cement-free or PBS-free media, or with GIC. It could therefore be concluded that Biodentine(TM) induced calcium phosphate mineral formation within the dentine matrix when stored in phosphate-rich media, which was selectively detectable using the tetracycline labelling.

This study analyzed the amounts of solubilized telopeptides cross-linked carboxyterminal telopeptide of type I collagen (ICTP) and C-terminal crosslinked telopeptide of type I collagen (CTX) derived from matrix-metalloproteinases (MMPs) and cysteine cathepsins (CTPs) subsequent to application of a filler-free (Res.A) or an ion-releasing resin (Res.B) to ethylenediaminetetraacetic acid (EDTA)-demineralized dentin with or without zoledronate-containing primer (Zol-primer) pre-treatment. The chemical modification induced following treatments and artificial saliva (AS) storage was also analyzed through attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). Totally EDTA-demineralized specimens were infiltrated with Res.A or Res.B with or without Zol-primer pre-treatment, light-cured, and immersed in AS for up to 4 wk. ICTP release was reduced following infiltration with Res.B and further reduced when Res.B was used with Zol-primer; remarkable phosphate mineral uptake was attained after AS storage. CTX release was increased in Res.A- and Res.B-treated dentin. However, when Zol-primer was used with Res.A, the CTX release fell significantly compared to the other tested resin-infiltration methods. In conclusion, zoledronate offers an additional inhibitory effect to the ion-releasing resins in MMP-mediated collagen degradation. However, Zol-primer induces a modest reduction in CTX release only when used with resin-based systems containing no ion-releasing fillers.

Objective To evaluate the potential of bio-active glass (BAG) powder and BAG containing polyacrylic acid (PAA-BAG) to remineralise enamel white spot lesions (WSL). Methods 32 human enamel samples with artificial WSLs were assigned to 4 experimental groups ( n = 8); (a) BAG slurry, (b) PAA-BAG slurry, (c) “standardised” remineralisation solution (positive control) and (d) de-ionised water (negative control). Mechanical properties of enamel were assessed using surface and cross-section Knoop microhardness. Micro-Raman spectroscopy in StreamLine™ scan mode was used to scan lesion cross-sections. The intensity of the Raman phosphate peak at 959 cm −1 was fitted and measured producing depth profiles analysed using a double-step fitting function. A further 20 samples ( n = 5) were used to obtain 3D images of surfaces using non-contact white light profilometry permitting measurement of lesion step height in relation to the sound enamel reference level, and to scan the lesion surface using scanning electron microscopy (SEM). Data were analysed statistically using one-way ANOVA with Tukey's HSD post-hoc tests. Results BAG, PAA-BAG and the remineralisation solution exhibited statistically significantly higher surface and cross-section Knoop microhardness compared to the negative control. Micro-Raman spectroscopy detected significantly higher phosphate content within the treated groups compared to the negative control group. Lesions’ depth was not significantly reduced. SEM images revealed mineral depositions, with different sizes and shapes, within BAG, PAA-BAG and the positive control groups. Conclusion BAG and PAA-BAG surface treatments enhance enamel WSL remineralisation, assessed by the resultant improved mechanical properties, higher phosphate content and morphological changes within the artificial lesions.

Objective The objective of the study was to determine if zinc-doped etch-and-rinse dentin adhesive may induce therapeutic effects within the resin–dentin interface. Methods Human acid-etched dentin was infiltrated with Adper™ Single Bond Plus (SB, 3M ESPE, St. Paul, MN, USA), SB doped with 10 wt.% ZnO nanoparticles (ZnO-SB) or SB doped with 2 wt.% ZnCl 2 (ZnCl 2 -SB). AFM/nanoindentation analysis was performed on fully hydrated specimens to evaluate the nanomechanical properties ( H i : hardness; E i : modulus of elasticity) across the resin–dentin interface after different SBF storage periods (24 h, 1 m, 3 m). Confocal laser microscopy (CLSM) was used to evaluate the ultramorphology and micropermeability at 24 h and 3 m of SBF storage. Results SB control specimens exhibited a decrease in H i in the hybrid layer (HL) and bottom of the hybrid layer (BHL) and a decrease in E i in the HL after 3 m of SBF storage, indicating that severe degradation occurred in the control interface. ZnO-SB bonded specimens preserved the initial H i and E i at the HL and BHL subsequent SBF storage; ZnCl 2 -SB bonded specimens showed a decrease in E i , in the HL over time. CLSM analysis confirmed that both Zn-doped adhesives were able to preserve the integrity of the HL. Significance Specific formulation of Zn-doped etch-and-rinse adhesives may offer the possibility to maintain the nano-mechanical properties along the dentin-bonded interface by inhibiting dentin MMPs and by protective mineral crystals formation within the resin–dentin interface. Clinical advantages may be expected by preserving and improving the integrity of the hybrid layer when Zn-doped adhesives are employed.

Introduction This study aimed to investigate in an ex vivo model the reduction in patient radiation dose while maintaining accurate linear measurements by comparing cone-beam computed tomography (CBCT) scans taken at 360° versus 180° rotation, with porcine jaw specimens as a reference standard. Methods CBCT scans of 12 sectioned porcine hemimandibles at 360° and 180° rotations were taken with standardized clinical exposure parameters. To assess interobserver variability, 6 assessors who were blinded to the degree of rotation took linear measurements of anatomic structures on each scan. The measurements were repeated after 2 weeks to assess intraobserver variability. Accuracy of measurement was judged against the corresponding measurements taken from the porcine jaw specimens. Results Intraclass correlations signaled good-to-excellent intraobserver and interobserver agreement (0.65–0.98 and 0.79–0.98), respectively. Mixed regression analysis found no significant difference between the measurements from 180° or 360° rotations and no difference between the 2 rotations and porcine jaw specimens. Conclusions A CBCT image sufficient to make accurate clinical measurements with a reduced radiation exposure may be obtained by using 180° rotation of the CBCT tube head.

Background Fissure sealants prevent occlusal caries in permanent molars. Enamel preparation methods are used before fissure sealing. Aims To investigate effects of bioglass air-abrasion pre-treatment with and without an adhesive, on fissure enamel of permanent teeth, with respect to etchability, microleakage and microtensile bond strength. Design Half of the occlusal surfaces of 50 extracted premolars underwent bioglass air-abrasion. Dye was applied to the entire occlusal surface. Photographs were taken to score etched surface by dye uptake. Adhesive was applied to 25 of the bioglass-treated areas and all teeth were fissure sealed, sectioned, and evaluated using confocal microscopy. Buccal and lingual surfaces of a further eight premolars were acid-etched and randomly received: air-abrasion, adhesive, both, or none before sealant application for microtensile bond strength measurement in half of the samples immediately and half following 6 months of water immersion. Results Linear mixed models and multinomial logistic regression were used (P = 0.05). Bioglass air-abrasion significantly improved enamel etchability and reduced microleakage. The addition of an adhesive made no difference to either microleakage or microtensile bond strength. The combination of bioglass abrasion and adhesive led to more cohesive, rather than adhesive, failure. Conclusions Bioglass air-abrasion improved enamel etchability and reduced microleakage irrespective of the adhesive use but neither pre-treatment affected the microtensile bond strength.

This study aimed at evaluating the chemophysical properties of experimental resin infiltrants (ERIs) doped with different bioactive particles. A control resin infiltrant (CR) was formulated using triethylene glycol dimethacrylate (TEGDMA) and ethoxylated bisphenol A dimethacrylate (BisEMA). Moreover, five experimental ERIs were also created by incorporating the following bioactive fillers (10 wt%) into the CR: hydroxyapatite (Hap), amorphous calcium phosphate (ACP), zinc-polycarboxylated bioactive glass (BAG-Zn), bioactive glass 45S5 (BAG 45S5), and calcium silicate modified with beta tricalcium phosphate (β-TCP). ICON® resin infiltrant was also used as control. All the ERIs used in this study were assessed for degree of conversion (DC), Knoop microhardness (KHN), softening ratio (SR), tensile cohesive strength (TCS), modulus of elasticity (E-modulus), water sorption (WS), and solubility (SL). Data were subjected to ANOVA and Tukey’s test (α = 5%). ICON® presented the lowest DC, KHN, TCS, E-modulus, and SR. Incorporation of bioactive fillers into CR caused significant increase in the KHN. Conversely, no significant effect was observed on DC, TCS, and E-modulus. The resin infiltrant containing Hap showed a significant increase in softening ratio, while, ICON® presented the highest WS and SL. The WS of ACP-doped resin infiltrant was significantly higher than that of the Hap-doped infiltrant. The SL of the ACP-doped infiltrant was higher than CR BAG-Zn or BAG 45S5. The incorporation of bioactive particles into experimental resin infiltrants can improve the chemomechanical properties and reduce water sorption and solubility. Resin infiltrants doped with bioactive particles may improve the long-term performance of the treatment of white-spot lesions.

ObjectivesThe aim of this study was to compare the hydrolytic effects induced by simulated pulpal pressure, direct or indirect water exposure within the resin–dentine interfaces created with three “simplified” resin bonding systems (RBSs).MethodsA two-step/self-etching (CSE: Clearfil SE Bond), one-step/self-etching (S3: Clearfil S3) and etch-and-rinse/self-priming (SB: Single-bond 2) adhesives were applied onto dentine and submitted to three different prolonged (6 or 12 months) ageing strategies: (i) Simulated Pulpal Pressure (SPP); (ii) Indirect Water Exposure (IWE: intact bonded-teeth); (iii) Direct Water Exposure (DWE: resin–dentine sticks). Control and aged specimens were submitted to microtensile bond strength (μTBS) and nanoleakage evaluation. Water sorption (WS) survey was also performed on resin disks. Results were analysed with two-way ANOVA and Tukey's test (p0.05) and no evident change in nanoleakage. Conversely, SPP induced a clear formation of “water-trees” in CS3 and SB. WS outcomes were CS3>SB=CSE.ConclusionThe hydrolytic degradation of resin–dentine interfaces depend upon the type of the in vitro ageing strategy employed in the experimental design. Direct water exposure remains the quickest method to age the resin–dentine bonds. However, the use of SPP may better simulate the in vivo scenario. However, the application of a separate hydrophobic solvent-free adhesive layer may reduce the hydrolytic degradation and increase the longevity of resin–dentine interfaces created with simplified adhesives.

The aim of this study was to evaluate the microtensile bond strength (μTBS) and confocal micropermeability of resin bonded-dentin specimens created using two representative two-step/self-etch adhesives submitted to short-term period degradation strategies such as simulated pulpal pressure, thermo- or mechanical-cycling challenges. Clearfil SE Bond (CSE) and Silorane adhesive (SIL) were bonded to flat deep dentin from seventy extracted human molars and light-cured for 10 s. Composite build-ups were constructed using with Filtek Z350 XT and Filtek P90 respectively. The specimens of each adhesive group were subjected to three different accelerated aging methods: (1) thermo-cycling challenge (5000 cycles); (2) mechanical-cycling load (200,000 cycles); (3) experiment and (4) conventional method for simulated pulpal pressure (20 cm H₂O). Control resin-bonded specimens were stored in distilled water for 24 h. μTBS and confocal microscopy (CLSM) micropermeability evaluation were performed and the results were analyzed using Two-way ANOVA and Tukey's tests (α=0.05). The CLSM evaluation revealed micro-cracks within the Silorane-bonded dentin subsequent to mechanical-cycling load, whereas, the simulated pulpal pressure induced evident micropermeability in both bonding agents. Mechanical loading provides discernible bonding degradation in a short-term period in resin-bonded dentin created using two-step/self-etch adhesives. However, simulated pulpal pressure may reduce the sealing ability of self-etch adhesives causing greater water uptake within the resin-dentin interface.

The interfacial properties of a new calcium-silicate-based coronal restorative material (Biodentine™) and a glass-ionomer cement (GIC) with dentin have been studied by confocal laser scanning microscopy (CLSM), scanning electron microscopy (SEM), micro-Raman spectroscopy, and two-photon auto-fluorescence and second-harmonic-generation (SHG) imaging. Results indicate the formation of tag-like structures alongside an interfacial layer called the “mineral infiltration zone”, where the alkaline caustic effect of the calcium silicate cement’s hydration products degrades the collagenous component of the interfacial dentin. This degradation leads to the formation of a porous structure which facilitates the permeation of high concentrations of Ca2+, OH-, and CO32- ions, leading to increased mineralization in this region. Comparison of the dentin-restorative interfaces shows that there is a dentin-mineral infiltration with the Biodentine, whereas polyacrylic and tartaric acids and their salts characterize the penetration of the GIC. A new type of interfacial interaction, “the mineral infiltration zone”, is suggested for these calcium-silicate-based cements.

Sauro S, Watson TF, Thompson I, Toledano M, Nucci C, Banerjee A. Influence of air-abrasion executed with polyacrylic acid-Bioglass 45S5 on the bonding performance of a resin-modified glass ionomer cement. Eur J Oral Sci 2012; 120: 168–177. © 2012 Eur J Oral Sci The aim of this study was to test the microtensile bond strength (μTBS), after 6 months of storage in PBS, of a resin-modified glass ionomer cement (RMGIC) bonded to dentine pretreated with Bioglass 45S5 (BAG) using various etching and air-abrasion techniques. The RMGIC (GC Fuji II LC) was applied onto differently treated dentine surfaces followed by light curing for 30s. The specimens were cut into matchsticks with cross-sectional areas of 0.9 mm2. The μTBS of the specimens was measured after 24 h or 6 months of storage in PBS and the results were statistically analysed using two-way anova and the Student–Newman–Keuls test (α = 0.05). Further RMCGIC-bonded dentine specimens were used for interfacial characterization, micropermeability, and nanoleakage analyses by confocal microscopy. The RMGIC–dentine interface layer showed no water absorption after 6 months of storage in PBS except for the interdiffusion layer of the silicon carbide (SiC)-abraded/polyacrylic acid (PAA)-etched bonded dentine. The RMGIC applied onto dentine air-abraded with BAG/H2O only or with BAG/PAA-fluid followed by etching procedures (10% PAA gel) showed no statistically significant reduction in μTBS after 6 months of storage in PBS. The abrasion procedures performed using BAG in combination with PAA might be a suitable strategy to enhance the bonding durability and the healing ability of RMGIC bonded to dentine.

The effect of loading on microleakage and microtensile bond strength of MOD composite restorations bonded with either self-etching or etch-and-rinse adhesive was investigated. MOD cavities were prepared in 28 extracted molar teeth. 14 teeth were bonded with a one-step self-etching adhesive (G-Bond) and 14 with an etch-and-rinse adhesive (Optibond Solo Plus) then restored with resin composite. For each adhesive, 7 teeth were loaded and 7 unloaded (controls). Loading was achieved with an axial force of 80 N at 2.5 cycles/s for 250,000 cycles. All the teeth were stored in 0.25% rhodamine solution for 24 h and sectioned in a bucco-lingual direction at the proximal boxes to examine microleakage then further sliced mesiodistally into beams for the μTBS test. Failure modes were determined using confocal and scanning electron microscopy. ANOVA assessed the effect of loading on microleakage and bond strength. After loading, restorations bonded with G-Bond exhibited significantly greater dye penetration compared to Optibond Solo Plus at both the axial walls and cavity floor. On the other hand, loading significantly reduced the μTBS of Optibond Solo Plus, whereas it had no significant effect on the μTBS of G-Bond.

The aim of this study was to evaluate and correlate objectively the microspectroscopically derived biochemical components of sound, infected and affected carious dentine with their microhardness and autofluorescence (AF) characteristics. Over 3 million high-resolution Raman spectra from 8 extracted human carious teeth were recorded using Raman spectrometer with parallel spectrum acquisition. Green AF signals across each carious lesion from all samples were acquired with a similar spatial resolution using confocal fluorescence microscopy. The Knoop microhardness (KHN) from a total of 233 co-localized areas was recorded from the same samples and allocated subjectively into the three zones. Cluster analysis of the Raman data, performed using in-house software, produced five independent spectral components representing mineral content, protein content, porphyrin fluorescence (PF), putative infected dentine signal (IDS) and affected dentine signal (ADS). The distributions of the 5 Raman components and the AF signal were matched across all samples and their average values were calculated for each corresponding KHN area. The infected dentine was defined significantly by the KHN, AF and by the relative contribution of the mineral, PF and IDS clusters. Protein cluster was not statistically related to the KHN or AF. A delineation between affected and sound dentine was observed using the KHN, AF, PF and ADS parameters. This study concludes that micro-Raman spectroscopy can provide a non-invasive and objective evaluation of different carious dentine zones. Being able to detect and assess clinically the caries-affected dentine during minimally invasive operative caries management is important to control the risk of unnecessary tissue removal.

Objectives The present study aimed to evaluate dentine remineralization through a 7-day period of artificial saliva (AS) storage induced by bioactive glass 45S5 (BAG) and by bioactive glass modified with soda-lime spherical glass. Methods Partially demineralized dentine disks were treated by BAG or the spherical-glass modified bioactive glass (M-BAG) and subsequently immersed in AS for 7 days. Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) was used to quantitatively analyse the mineral variation of the dentine surface by calculating the spectra parameters. X-ray diffraction (XRD) and energy-dispersive X-ray analysis (EDX) were performed on completely demineralized dentine to confirm the apatite formation. The roughness of the dentine surface was evaluated by atomic force microscopy (AFM) and the morphology was also examined by scanning electron microscopy (SEM). Results ATR-FTIR showed a significant increase of the mineral matrix area ratio in dentine specimens treated with the two bioactive glasses subsequent to 7 days of AS storage. The XRD spectrum exhibited apatite growth and mineral elements could be found on completely demineralized samples analysed by EDX after remineralization treatments. The dentine specimens treated with bioactive glass showed lower roughness, and most of the dentinal tubules appeared completely occluded during the AFM and SEM examination. Conclusions Although the concentration of bioactive glass in the M-BAG is 60% of that contained in the original version, both formulations have similar potential in dentine remineralization. These bioactive powders developed for air-abrasive use may be considered as innovative bioactive materials for therapeutic remineralization of dental hard tissues.

Purpose: The erbium laser has been introduced for cutting enamel and dentin and may have an application in the surface modification of high-strength aluminum oxide and zirconia ceramics. The aim of this study was to evaluate the durability of the bond of conventional dual-cured resin cements to Procera Al2O3 and zirconium oxide ceramics after surface treatment with air abrasion and erbium laser. Materials and Methods: One hundred twenty Al2O3 and 120 zirconia specimens measuring 3 × 3 × 0.7 mm3 were divided equally into three groups, and their surfaces treated as follows: either untreated (controls), air abraded with Al2O3 particles, or erbium-laser-treated at a power setting of 200 mJ. The surface of each specimen was then primed and bonded with one of two dual-cured resin cements (either SCP-100 Ceramic Primer and NAC-100 or Monobond S and Variolink II) using a 1-mm thick Tygon tube mold with a 0.75-mm internal bore diameter. After 24 hours and 6 months of water storage at 37°C, a microshear bond strength test was performed at a crosshead speed of 1 mm/min. Surface morphology was examined using a confocal microscope, and failure modes were observed using an optical microscope. The data were analyzed using the Kaplan-Meier nonparametric survival analysis. Results: In the case of zirconia, air abrasion and Erbium:yttrium-aluminum-garnet (Er:YAG) laser treatment of the ceramic surface resulted in a significant reduction in the bond strengths of both resin cements after 6 months water storage; however, when the zirconia surface was left untreated, the SCP-100/NAC-100 group did not significantly reduce in bond strength. In the case of alumina, no treatment, air abrasion and Er:YAG laser treatment of the surface led to no significant reduction in the bond strengths of the three SCP-100/NAC-100 groups after 6 months water storage, whereas all three Monobond S/Variolink II groups showed a significant reduction. Conclusion: Er:YAG laser treatment of the zirconia surface did not result in a durable resin cement/ceramic bond; however, a durable bond between a conventional dual-cured resin cement and Procera All Ceram and Procera All Zirkon was formed using a ceramic primer containing the phosphate monomer, MDP, without any additional surface treatment.

Objectives Alumina air-abrasion has been used to clean teeth and shown to over-prepare access cavity preparation to caries. This study investigated the working hypothesis that bio-active glass air-abrasion is more self-limiting than alumina for minimally invasive caries removal. Methods Human extracted molars were scored visually using ICDAS II criteria, divided into sound and carious groups and air-abraded with alumina ( n = 10) and bio-active glass ( n = 10) in each group, using identical operating parameters. The amount of enamel removed was semi-quantitatively assessed using scanning electron microscopy. Operating time was recorded. Results Bio-active glass abrasion removed extrinsic stain and substantial quantities of enamel from all carious fissures but not from sound, where only minimal microscopic surface modifications were observed. Alumina air-abrasion resulted in faster extrinsic stain and clinically substantial enamel removal in both sound and carious groups equally. Conclusions Bio-active glass air-abrasion appeared to show a significant self-limiting tendency towards demineralised enamel and extrinsic stain removal but was slower in comparison to alumina air-abrasion. Self-limiting bio-active glass air-abrasion could be used clinically to clean teeth, detect caries and minimally prepare carious enamel as part of MI caries access or placing a sealant restoration.

Unnecessary over-preparation of carious enamel often occurs clinically during operative caries management. The working hypothesis to be investigated in this study is the potential for bio-active glass air abrasion to remove selectively only demineralised enamel in artificial enamel lesions when compared to equivalent alumina air abrasion, so potentially minimising cavity over-preparation. Bisected artificial, paired smooth surface enamel lesions on ethics-approved, extracted sound human molars were created and subsequently air abraded with 27 μm alumina (n = 19) and bio-active glass (n = 19). The difference between pre-operative lesion boundary and post-operative cavity margin was calculated following optical confocal fluorescent assessment of the lesion boundary. Data indicated mean% over-preparation (sound enamel removal) of 176% with alumina and 15.2% for bio-active glass (p = 0.005). Bio-active glass abrasion removed completely the demineralised enamel from artificial lesions with clinically insignificant over-preparation of sound tissue, indicating technique selectivity towards grossly demineralised enamel. Alumina air abrasion resulted in substantial enamel removal in both sound and demineralised tissues indicating the operator selectivity required to use the techniques effectively in clinical practice.

Objective To compare resin–dentin bond strengths and the micropermeability of hydrophobic vs. hydrophilic resins bonded to acid-etched or EDTA-treated dentin, using the ethanol wet-bonding technique. Methods Flat dentin surfaces from extracted human third molars were conditioned before bonding with: 37% H 3 PO 4 (15 s) or 0.1 M EDTA (60 s). Five experimental resin blends of different hydrophilicities and one commercial adhesive (SBMP: Scotchbond Multi-Purpose) were applied to ethanol wet-dentin (1 min) and light-cured (20 s). The solvated resins were used as primers (50% ethanol/50% comonomers) and their respective neat resins were used as the adhesive. The resin-bonded teeth were stored in distilled water (24 h) and sectioned in beams for microtensile bond strength testing. Modes of failure were examined by stereoscopic light microscopy and SEM. Confocal tandem scanning microscopy (TSM) interfacial characterization and micropermeability were also performed after filling the pulp chamber with 1 wt% aqueous rhodamine-B. Results The most hydrophobic resin 1 gave the lowest bond strength values to acid-etched dentin and all beams failed prematurely when the resin was applied to EDTA-treated dentin. Resins 2 and 3 gave intermediate bond strengths to both conditioned substrates. Resin 4, an acidic hydrophilic resin, gave the highest bond strengths to both EDTA-treated and acid-etched dentin. Resin 5 was the only hydrophilic resin showing poor resin infiltration when applied on acid-etched dentin. Significance The ethanol wet-bonding technique may improve the infiltration of most of the adhesives used in this study into dentin, especially when applied to EDTA-treated dentin. The chemical composition of the resin blends was a determining factor influencing the ability of adhesives to bond to EDTA-treated or 37% H 3 PO 4 acid-etched dentin, when using the ethanol wet-bonding technique in a clinically relevant time period.

This study aimed to investigate the null hypothesis that there is no relationship between the microhardness of carious dentine and its native autofluorescence (AF). Six extracted, carious molars were sectioned through natural lesions in the mesio-distal longitudinal plane. The Knoop microhardness (Knoop hardness number, KHN) of the cut surfaces of each sample was recorded at regular intervals through sound and carious dentine. Confocal fibre-optic micro-endoscopic (CFOME) examination of the carious dentine and the sound dentine was carried out at the same intervals using the Cellvizio system (600 microm wide, flat-end probe) with an excitation wavelength of 488 nm. The blindly collected numerical data were analysed using the original microhardness KHN. The data analysis indicated that the autofluorescence signals increased significantly when the microhardness of dentine dropped below 25 KHN. Therefore, the null hypothesis was disproved, and it was concluded from this investigation that the autofluorescent signal intensity recorded using CFOME could produce an objective and reproducible correlation to the microhardness of carious dentine. Confocal fibre-optic micro-endoscopic examination could have clinical potential as a technology to help delineate the carious dentine that might be excavated in a clinical procedure in vivo.

Objectives The aim of this study was to investigate the droplet formation using a real-time/confocal microscopy technique, when different self-etching and etch-and-rinse adhesives were applied in the presence or absence of pulpal pressure. Resin–dentin permeability (% P ) was also evaluated. Methods Optibond FL, Silorane adhesive, Scotchbond 1XT, G-Bond and DC-Bond were bonded in the presence or in absence of simulated pulpal pressure. A fluid-transport model was used to measure the water permeability through resin-bonded dentin. Half of the specimens bonded in the presence of the hydrostatic pulpal pressure (20 cm H 2 O) were light cured, whereas the remnant half received no light curing. The same was done with the half of the specimens bonded under no pulpal pressure. The specimens were investigated under a confocal TSM. Results Optibond FL and G-Bond had the lowest dentin permeability. Optibond FL adhesive showed few water droplets on the polymerized external surface and within the resin–dentin interface. G-Bond showed static interfacial globular-like droplet formation. DC-Bond and Scotchbond 1XT were the most water permeable adhesives both in the presence and in absence of pulpal pressure. A dynamic interfacial non-globular-like droplet formation was observed. Severe droplet formation was observed on the polymerized external surface. Significance The presence of the pulpal pressure may cause increasing in fluid filtration and droplet formation in simplified adhesives containing HEMA. The adhesives containing 4-META (G-Bond) may be affected by static phase separation but by very low osmotic droplets formation and water permeability. The three-step adhesives are less affected by these problems.

Objectives Helium is currently used as a propellant gas for air-abrasion with manufacturer claims that this affords greater cutting efficiency compared to the use of air as a propellant. Higher cutting rates, when desired, can reduce operative times. This study set out to investigate these claims by comparing the rate at which helium propelled air-abrasion cut a standard enamel analogue, Macor ® , versus that of standard air propelled air-abrasion at different propellant pressures. Methods An enamel substitute, Macor ® , was used as the substrate in order to enable a greater control of physical variables. Powder flow rate, air abrasion nozzle distance and angle to the enamel substitute were constant throughout the experiments. The cutting efficiency of air and helium with propellant pressures of 20, 40, 60, 80 and 100 PSI were dynamically investigated, attempting to replicate clinical use. Results Helium air-abrasion was significantly more efficient in cutting the enamel analogue at all pressures, with a 40% increase for 100 PSI propellant pressure. Significance This finding suggests that air-abrasion units using helium as a propellant will be able to cut enamel more quickly in the clinical setting.

This study aimed to investigate the effect of different energy intensities of the Er:YAG laser and of air abrasion with Al(2)O(3) particles on the surface roughness and morphologic characteristics of yttrium-stabilized tetragonal zirconia (Y-TZP) ceramics.Surface roughness enhances the micromechanical interlocking of luting agents to ceramic surfaces. However, the most appropriate surface treatment for Y-TZP ceramics has yet to be determined.Two Y-TZP materials were evaluated: Cercon Smart Ceramics and Procera Zirconia. Thirty plates from each ceramic material were randomly divided into five groups according to the surface treatment received (none [control], air abrasion, or irradiation with the Er:YAG laser at three different energy intensities [200, 400, or 600 mJ]). After the surface treatments, the ceramic plates were gold-coated and their surface roughness (Ra, microm) was measured using confocal microscopy. For each ceramic system, the surface roughness was analyzed through two-way ANOVA/Tukey's test, with a 5% significance level. Changes in the morphological characteristics of the ceramics were examined through light and scanning electron microscopy.For both zirconia-based materials, irradiation with 400 mJ or 600 mJ increased surface roughness and provided significant morphological changes. Air-abraded Cercon surfaces were rougher compared to the ones irradiated with 200 mJ of laser energy, whereas Procera surfaces irradiated with 200 mJ were rougher than the air-abraded ones.Higher laser power settings (400 and 600 mJ) cause excessive material deterioration, making them unsuitable as surface treatments for zirconia surfaces. Irradiation with 200 mJ provides mild surface alterations, with intermediary features between the effects of air abrasion and higher laser intensities.

Statement of problem Little information exists regarding the outcome of crown build-ups on endodontically treated teeth restored with metal-ceramic crowns or with only a direct-placed composite. Purpose The aim of this study was to evaluate the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite restorations and compare that treatment with a similar treatment of full-coverage with metal-ceramic crowns. Material and methods Subjects included in this study had one maxillary or mandibular premolar for which endodontic treatment and crown build up was indicated and met specific inclusion/exclusion criteria. Only premolars with Class II carious lesions and preserved cusp structure were included. Subjects were randomly assigned to 1 of the following 2 experimental groups: (1) teeth endodontically treated and restored with adhesive techniques and composite or (2) teeth endodontically treated, restored with adhesive techniques and composite, and then restored with full-coverage metal-ceramic crowns. Sixty teeth were included in the first group and 57 in the second. All restorations were performed by one operator. Causes of failure were categorized as root fracture, post fracture, post decementation, clinical and/or radiographic evidence of marginal gap between tooth and restoration, and clinical and/or radiographic evidence of secondary caries contiguous with restoration margins. Subjects were examined for the listed clinical and radiographic causes of failure by 2 calibrated examiners at intervals of 1, 2, and 3 years. Exact 95% confidence intervals for the difference between the 2 experimental groups were calculated. Results At the 1-year recall, no failures were reported. The only failure modes observed at 2 and 3 years were decementations of posts and clinical and/or radiographic evidence of marginal gap between tooth and restoration. There was no difference in the failure frequencies of the 2 groups (95% confidence interval, -17.5 to 12.6). There was no difference between the number of failures caused by post decementations and the presence of marginal gaps observed in the 2 groups (95% confidence intervals, -9.7 to 16.2 and -17.8 to 9.27). Conclusion Within the limitations of this study, the results upheld the research hypothesis that the clinical success rates of endodontically treated premolars restored with fiber posts and direct composite restorations after 3 years of service were equivalent to a similar treatment of full coverage with metal-ceramic crowns.

Complete removal of the collagen matrix with sodium hypochlorite (NaOCl) as an adjunctive step of restorative and adhesive dentistry is still a subject for debate. This study evaluated the efficacy of a 12 w/v% NaOCl solution for complete removal of exposed collagen matrices from acid-etched dentin surfaces within a maximum clinically possible period of 120 seconds and a longer period of application (10 minutes) using confocal reflection/immuno-fluorescence microscopy and ESEM. An extended period (45 minutes) of NaOCl application was also performed as a negative control. Unstained and immunohistochemically-stained collagen fibrils were imaged using a confocal laser-scanning microscope for the reflection/fluorescence experiment. Fully-hydrated specimens were also examined with an ESEM. Unetched dentin was devoid of exposed collagen fibrils. Conversely, confocal microscopy showed demineralized collagen after acid-etching, which appeared as a hydrogel-like layer during ESEM examination. The application of NaOCl for two minutes left remnants of dentin collagen on intertubular and intratubular surfaces. The ESEM examination confirmed the presence of remnants of a hydrogel-like layer. After 10 minutes of NaOCl application, residual collagen reflection and immuno-fluorescence signals were detected around dentinal tubules, appearing as spike-like projections during the ESEM investigation. Complete dissolution of the collagen presence was achieved after 45 minutes of NaOCl treatment. Complete deproteinization of acid-etched dentin is unachievable in a maximum clinically possible period of 120 seconds.

Air-abrasion is a tooth preparation technology developed in the 1940s that is currently gaining popularity due to its compatibility with adhesive restorations. Variables, including propellant pressure, powder flow rate, nozzle angle and distance to the tooth surface abrasion time, can affect the cutting rate of the air-abrasion unit. A static setup and a more clinically realistic dynamic experimental setup have been used to assess the effect of these parameters of the cutting rate on an enamel analogue. By keeping each parameter fixed, its effect on the cutting rate was examined. The results showed that increasing the propellant pressure (20-100 PSI) caused an almost linear increase in the cutting rate in both setups. Increasing the powder flow rate (0.5 - 3 g/minute) concurrently increased the powder flow and caused an increase in the cutting rate but with a plateau differing for the different propellant pressures. The nozzle angles producing the highest cutting rates were 60 degrees and 75 degrees for static and dynamic cutting, respectively, with smaller and larger angles producing lower rates. Increasing abrasion time in static cutting and the nozzle advancement rate in dynamic cutting both caused an increase in the cutting rate. These findings are relevant for both clinicians, who might wish to alter the cutting rate of their instrument, and researchers, who should always control the numerous parameters in studies involving air-abrasion in order to control the variables, which can influence the end effect of air-abrasion.

This study evaluated the micropermeability of six etch-and-rinse adhesives bonded to dentin. There were two principal groups: wet bonding with water or wet bonding with absolute ethyl alcohol. After bonding and the creation of composite build-ups, the pulp chambers were filled with 0.1% Lucifer Yellow. The contents of the pulp chamber were kept under 20 cm H2O pressure to simulate pulpal pressure for 3 h. The specimens were vertically sectioned into multiple 0.5 mm thick slabs that were polished and then examined in a two-photon confocal laser scanning microscope (TPCLSM). The results showed that specimens bonded with adhesives using the water wet-bonding condition all showed tracer taken up uniformly by the hybrid layer. This uptake of fluorescent tracer into the hybrid layer was quantified by computer software. The most hydrophobic experimental resins showed the highest fluorescent tracer uptake (ca. 1800 ± 160 arbitrary fluorescent units/std. surface area). The most hydrophilic experimental resins showed the lowest tracer uptake into water-saturated hybrid layers (ca. 1000 ± 100 units). When ethanol wet-bonding was used, significantly less tracer was seen in hybrid layers. The most hydrophilic experimental resins and Single Bond Plus only took up about 100 ± 20 units. Clearly, ethanol wet-bonding seals dentin significantly better than water-wet dentin regardless of the adhesive in etch-and-rinse systems.

Malignant and dysplastic epithelial lesions have often been reported to excite vascular responses by histopathological characterization. Little is reported concerning in vivo real-time imaging of vascular patterns and flow in health or disease but the development of miniature imaging instrumentation has now allowed such developments. We describe the application of a selective wavelength (540 nm) epi-illumination Hopkins pattern endoscopic imaging system to image vascular tissues and capillary blood flow in vivo. The contrast mechanism in such imaging was characterized, haemoglobin acting as a chromatic transmission filter despite endoscopy being a non-invasive and therefore principally reflection mode imaging system. In vivo adrenergic vascular responses, capillary flow rate variations over time and variations in normal capillary architecture around the oral cavity were recorded; demonstrating that simple imaging systems can be used for non-surgical diagnosis and characterization of vascular lesions, tumours and treatment responses.

To examine the removal rate of sound and carious dentine using bioactive glass air-abrasion and investigate abrasive particle retention of alumina and bioactive glass on abraded dentine.Crushed bioactive glass was investigated as an alternative air-abrasive to alumina at air pressures of 138, 413 and 689 kPa in the presence or absence of water. The correlation coefficient between the amount of dentine removed using bioactive glass air-abrasion and the Knoop Hardness Number of dentine was calculated. The comparative retention of bioactive glass (BG) and alumina (AL) abrasive on human dentine blocks were calculated as atomic ratios acquired by spectral analysis between air-abrasive tracers (Si for bioactive glass, and Al for alumina) and Ca. A total of 60 dentine blocks were abraded using Al or BG in 12 groups of 5 using three different pressures in using wet and dry air-abrasion.The amount of dentine removed using bioactive glass air-abrasion had a Somers'D coefficient of 0.65 for the Knoop hardness. Wet air-abrasion caused a significant (p 0.05) decrease in the amount of abrasive retained on the surface for Al air-abrasion at 138 and 413 kPa and BG air-abrasion at 413 and 689 kPa.There was a negative correlation between propellant pressure and abrasive retained. Bioglass removed healthy dentine at a higher rate than carious dentine - the difference however, being less than with equivalent alumina air-abrasion, thus making it a potentially more selective instrument for clinical caries excavation.

We reviewed studies wherein the cutting of dental tissues, simulating interactions that would occur under clinical circumstances in the mouth, have been observed directly-first by real time, video rate, stereoscopic, three-dimensional scanning electron microscopy; and second and more conveniently, by video rate confocal optical microscopy. We have observed, directly, both the interactions of slow-moving cutting instruments emulating "chisels" and high-speed events, including the effects of rotary burs and air-propelled abrasive particles and soft powder slurries. The observational data contribute to our basic understanding of the functional behavior of dental tissues and formed a useful background for the practitioner of operative dentistry.

This study evaluated the long-term durability of three one-step adhesive-composite systems to ground enamel and dentin. Twenty-seven teeth were randomly divided into three groups of nine. The first group had its crowns sectioned to expose superficial dentin, which was then ground with 600 grit SiC paper. One of three one-step adhesives: a trial bonding agent, OBF-2; i Bond or Adper Prompt L-Pop was applied to the dentin of three teeth and built-up with the corresponding resin composite (Estelite sigma, Venus or Filtek Supreme). The second group of nine teeth had their enamel approximal surfaces ground with wet 600-grit SiC paper, then one of the three one-step adhesives was applied and built-up with resin composite. The bonded specimens were sliced into 0.7 mm-thick slabs. After 24 hours and one year of water storage at 37 degrees C, the slabs were sectioned into beams for the microtensile bond strength test. Failure modes were observed using optical and electron scanning microscopy. The third group of nine teeth had approximal wedge-shaped cavities prepared above the CEJ into dentin. Two-to-three grains of rhodamine B were added to each of the three adhesives prior to restoring the cavities with resin composite. After 24 hours storage, the teeth were sectioned and their interfaces examined with a laser scanning confocal microscope. The bond strengths of the three adhesive-composite systems to both enamel and dentin significantly lessened after one year of water storage, however, there was no significant difference between the materials.

Objectives The role of fluoride in preventing erosion and abrasion on dentine remains unclear. The aim of this study was to investigate the effect of repeated applications of a 0.05% fluoride mouthwash and an adhesive on wear of dentine using stainless steel discs reference points and a laser profilometer. Methods Small stainless steel discs were bonded to 60 caries free extracted molars which had previously been sectioned horizontally. The teeth were equally divided and subjected to four modalities in an erosion and abrasion laboratory model. Step heights were measured from the metal discs using a non-contacting laser profilometer at 100, 500, 1000, 2500 and 5000 cycles. Results The results after 5000 cycles showed that dentine coated with a dentine adhesive (0.015 μm, S.D. 0.090) had statistically less wear than fluoride (0.127 μm, S.D. 0.150), abrasion and erosion (0.182 μm, S.D. 0.150) or abrasion only (0.096 μm, S.D. 0.090) (p Conclusion In conclusion dentine surfaces coated with a resin-based adhesive provided more protection against erosion and abrasion than a fluoride mouthrinse. There were no statistical differences between the modalities for cycles less than 5000.

We report the demonstration of time-correlated single-photon counting (TCSPC) fluorescence lifetime imaging (FLIM) to ex vivo decayed and healthy dentinal tooth structures, using a white-light supercontinuum excitation source. By using a 100 fs-pulsed Ti:Sapphire laser with a low-frequency chirp to pump a 30-cm long section of photonic crystal fibre, a ps-pulsed white-light supercontinuum was created. Optical bandpass interference filters were then applied to this broad-bandwidth source to select the 488-nm excitation wavelength required to perform TCSPC FLIM of dental structures. Decayed dentine showed significantly shorter lifetimes, discriminating it from healthy tissue and hard, stained and thus affected but non-infected material. The white-light generation source provides a flexible method of producing variable-bandwidth visible and ps-pulsed light for TCSPC FLIM. The results from the dental tissue indicate a potential method of discriminating diseased tissue from sound, but stained tissue, which could be of crucial importance in limiting tissue resection during preparation for clinical restorations.

AIM: To develop and evaluate an objective method for assessing lip size and treatment-related morphological changes in orofacial granulomatosis (OFG) patients. MATERIALS AND METHODS: Patients with swollen lips because of OFG (n ¼ 21) were enrolled. A light-body polyvinylsiloxane material was used to take lip impressions before and after treatment (n ¼ 10), or during treatment (n ¼ 11). Plaster models were cast from the impressions and the lips were measured using callipers. The intra-examiner and inter-examiner reproducibility of the technique were assessed. RESULTS: OFG patients had significantly larger lips than controls (P < 0.0001). The coefficient of variation on repeated measurements of the same impression was 1.6% and for duplicate impressions was 2.6%. Significant reduction in lip size was shown in all 10 patients after diet restriction (P < 0.002). Seven of 11 patients whose impressions were taken at least 3 months after the initiation of cinnamon- and benzoate-free diet also showed reduction in lip size during follow up (P < 0.002). CONCLUSIONS: Serial lip impressions appear to be reliable for routine quantification of morphological changes of the lips in OFG patients. We present a new reproducible and sensitive method for assessing changes in lip size in response to treatment in OFG. Oral Diseases (2007) 13, 93–98

MDPB, 12-methacryloyloxydodecylpyridinium bromide, was tested for its ability to inhibit the growth of organisms associated with active root caries lesions and to modify the growth characteristics of these organisms at sub-MICs. MICs and MBCs of MDPB for independent isolates (n=5) of the following taxa: Streptococcus mutans, Streptococcus oralis, Streptococcus salivarius, Actinomyces naeslundii, Actinomyces israelii, Actinomyces gerensceriae, Actinomyces odontolyticus, Lactobacillus spp., and Candida albicans were determined, and the effects at sub-MIC on microbial growth kinetics were assessed. All isolates were sensitive to inhibition by MDPB. The median MICs and MBCs of MDPB for these organisms were in the range of 3.13 to 25.0 microg/ml and 6.25 to 50.0 microg/ml, respectively. As for the influence of pH, inhibition was sensitive to acidic pH. Even at sub-MICs, the growth of all strains, measured as cell yield and doubling time, was significantly reduced. Based on the results of this study, MDPB exhibited the potential to inhibit the growth of microbiota associated with active root caries lesions.