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Objective: To investigate the effect of novel polymeric nanoparticles (NPs) doped with dexamethasone (Dex) on viscoelasticity, crystallinity and ultra-nanostructure of the formed hydroxyapatite after NPs dentin infiltration. Methods: Undoped-NPs, Dex-doped NPs (Dex-NPs) and zinc-doped-Dex-NPs (Zn-Dex-NPs) were tested at dentin, after 24 h and 21 d. A control group without NPs was included. Coronal dentin surfaces were studied by nano-dynamic mechanical analysis measurements, atomic force microscopy, X-ray diffraction and transmission electron microscopy. Mean and standard deviation were analyzed by ANOVA and Student-Newman-Keuls multiple comparisons (p < 0.05). Results: At 21 d of storage time, both groups doped with Dex exhibited the highest complex, storage and loss moduli among groups. Zn-Dex-NPs and Dex-NPs promoted the highest and lowest tan delta values, respectively. Dex-NPs contributed to increase the fibril diameters of dentin collagen over time. Dentin surfaces treated with Zn-Dex-NPs attained the lowest nano-roughness values, provoked the highest crystallinity, and produced the longest and shortest crystallite and grain size. These new crystals organized with randomly oriented lattices. Dex-NPs induced the highest microstrain. Crystalline and amorphous matter was present in the mineral precipitates of all groups, but Zn and Dex loaded NPs helped to increase crystallinity. Significance: Dentin treated with Zn-Dex-NPs improved crystallographic and atomic order, providing structural stability, high mechanical performance and tissue maturation. Amorphous content was also present, so high hydroxyapatite solubility, bioactivity and remineralizing activity due to the high ion-rich environment took place in the infiltrated dentin., This work was funded by Grant PID2020-114694RB-I00 funded by MCIN/AEI 10.13039/501100011033.

To investigate the effects of salivary esterases on biostability of collagen treated by galloylated polyphenols.Human dentin was microtomed into 6-μm-thick films, which were demineralized and treated for 60 s using solutions containing 0.6% and 2% of one of the crosslinkers: tannic acid (TAC), epigallocatechin gallate (EGCG), epigallocatechin (EGC), and N-[3-dimethylaminopropyl]-N'-ethylcarbodiimide hydrochloride (EDC)/N-hydroxysuccinimide (NHS), and for 1 h using EDC/NHS. Half of the treated and untreated (control) films were subjected to human saliva incubation. Collagen biostability was assessed via exogenous protease biodegradation by weight loss and hydroxyproline release, and endogenous MMPs by in situ zymography. The degradation products of galloylated polyphenols (TAC and EGCG) by saliva were monitored using proton nuclear magnetic resonance (Collagen films treated with TAC and EGCG exhibited significantly improved biostability (p 0.05); however, the enhanced biostability was severely reduced after saliva incubation (p 0.001). For EDC/NHS treated collagen, saliva incubation showed negligible effect on the biostability.The galloyl group plays important role in collagen crosslinking, inducing higher biostability. However, galloylated polyphenols crosslinked on collagen are highly susceptible to metabolism of human saliva by salivary esterase, dramatically compromising the enhanced biostability.

ObjectivesThe aim was to investigate shear bond strengths and failure modes of four self-etch bonding agents to bovine dentin and enamel and to compare evaluation of data sets with or without exclusion of cohesive failure specimens.MethodsComposite-cylinders were bonded perpendicularly to bovine dentin and enamel surfaces. Shear-strengths were measured 24 h post-bonding of: Scotchbond Universal® (SBU, 3 M), OptiBond™ XTR (OBXTR, Kerr), OptiBond™ universal (OBU, KaVo-Kerr) and Prime & Bond active® (PBA, Dentsply-Sirona). Analysis of overall data was made via a linear mixed-model. This was repeated after exclusion of specimens associated with cohesive failures.ResultsWhen both adhesive and cohesive failures were considered, OBU and OBXTR showed comparable dentin and enamel bond strengths, whereas lower strengths were found on enamel for SBU (p < 0.001) and PBA (p = 0.015). For OBXTR higher shear strengths were measured for specimens associated with cohesive failures. When cohesive failures were excluded, the majority of shear bond strengths of adhesive failure specimens were only slightly different from overall results. However, uniquely with OBXTR dramatically lower shear bond strengths were found for dentin substrate.SignificanceAfter exclusion of cases with cohesive failures OBXTR adhesive fell behind other materials in the sequence of average shear strengths. This did not reflect the actual performance of the material. Therefore, in statistical analysis we do not recommend exclusion of data based on a specific fracture mode.

Bioactive glasses have been recommended for the occlusion of dentinal tubules in treating cervical dentin hypersensitivity. This study evaluates an in vivo model of dentin exposure, and tests the efficacy of bioglass treatments. Thirty male Wistar rats received gingival recession surgery on the upper left first molar. The treatments were applied over the surface of the exposed dentin every 4 days for 28 days. The groups were as follows: Naive; Gingival recession; Cavity varnish; Biosilicate

SUMMARY Purpose To evaluate the effect of application time and viscosity of meta-phosphoric acid (MPA) and ortho-phosphoric acid (OPA) on the push-out resin-dentin bond strength (PBS) and nanoleakage (NL) at the adhesive-root dentin interface. Methods and Materials Ninety-six roots of premolars were endodontically prepared and randomly assigned into groups according to the (i) acid (OPA and MPA), (ii) viscosity (gel and liquid), and (iii) application time (7 and 15 seconds). Fiber posts were cemented to the roots, which were then transversally sectioned into serial slices. The slices (cervical, medium, and apical) were subjected to PBS or NL. Analysis of the dentin etching pattern was performed using scanning electron microscopy (SEM). The PBS (MPa) and NL (%) data were subjected to three-way repeated-measures analysis of variance (ANOVA) and Tukey’s test (α=0.05). Results The cross-product interaction was significant for both PBS and NL (p0.05). Higher PBS values were observed in the groups etched for 15 seconds compared to 7 seconds, regardless of the acid, viscosity, or root third (p0.05). A more pronounced etching pattern was observed with OPA than MPA regardless of the acid viscosity. Conclusion The use of 40% meta-phosphoric acid promoted adequate bond strength without increasing dentin demineralization or void spaces in the hybrid layer.

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

The aim of this study was to evaluate and compare the effects of chlorhexidine, quercetin, and α-tocopherol on the shear bond strength of universal adhesives in the short (24h) and long term (6 months).Ninety-six extracted sound molars were collected and divided randomly into four groups: control (no treatment), 2% chlorhexidine, 10% α-tocopherol, and 1% quercetin. The solutions were prepared and applied to the teeth for 60 s, followed by application of All-Bond universal adhesive and composite build-up. Half of the specimens in each group (n = 12) were tested for shear bond strength (SBS) after 24 h of storage and the other half were kept in distilled water for 6 months and then tested for shear bond strength. The shear bond strength test was performed and the failure modes were determined using a stereomicroscope. The data were analyzed using two-way analysis of variance and Tukey's post hoc tests with p ˂ .05 as the significance level.The results of the two-way analysis of variance test showed that there was no significant difference in immediate SBS, and after 6 months, α-tocopherol had the lowest SBS in comparison to the control and CHX subgroups (p .05). The t-test showed that the shear bond strength in the α-tocopherol and quercetin groups was significantly decreased after 6 months.It can be concluded that the solutions used in this study had no adverse effect on immediate SBS. After 6 months, the CHX could preserve SBS in comparison to other groups.

The latest advancements in dentin bonding have focused on strategies to impair degradation mechanisms in order to extend the longevity of bonded interfaces. Protease inhibitors can reduce collagen degradation within the hybrid layer (HL). Collagen cross-linkers allow better adhesive infiltration and also inhibit proteases activity. Particles added to adhesive can promote mineral precipitation within the HL, reducing nanoleakage and micropermeability, besides possible antimicrobial and enzymatic inhibition effects. Most of these approaches are still experimental, and aspects of the adhesive under the clinician's control are still determinant for the long-term stability of adhesive restorations.

To characterize the behavior of three different polymeric agents before and after an erosive challenge on dentin permeability, to analyze their degradation in both conditions, and to analyze their degree of conversion (DC).The permeability of human dentin disks (1.0 ± 0.2 mm) was measured with smear layer, after its removal, after treatment (LpTreat) with Gluma Desensitizer, PRG Barrier Coat (PBC) or Icon infiltrant (n = 11/group) and after exposure to citric acid (LpEro) (6%, pH 2.1, 1 min). The specimens were analyzed under a Laser Scanning Confocal Microscope (n = 2/group) and the products' DC were calculated. Data were subjected to 2-way repeated measures ANOVA and post-hoc Bonferroni (permeability analysis), to paired t-test (for specimens treated with Icon) and to t-test (DC analysis) (α 0.05).Icon showed the lowest LpTreat and LpEro values, while PBC and Gluma did not differ from each other under these conditions. Icon and PBC showed LpEro similar to a dentin with smear layer. Under the Laser Scanning Confocal Microscope, more deposits were noticeable on dentin after treating with PBC. Gluma presented the deepest penetration in dentin. The DC of PBC was the highest.Icon caused the highest reduction on permeability values, followed by PBC and Gluma. PBC generated more deposits covering dentin and seemed to be more efficient after an erosive challenge. The association of a polymeric resin with inorganic ion-releasing fillers seem to be a great strategy to manage dentin hypersensitivity under erosive conditions.

This study investigated how the double application of adhesives and dentin moisture level influence the microtensile bond strength (µTBS) of universal adhesives containing different hydrophilic monomers to bur-cut dentin. Four universal adhesives (Scotchbond Universal, Clearfil Universal Bond Quick, PrimeBond Universal, BeautiBond Universal) were applied to wet and dry bur-cut dentin either in one or two layers. The µTBS test was performed after 25,000 thermal cycles, and scanning electron microscopy was used for the analysis of failure mode and interfacial ultrastructure. Double application significantly improved µTBS on wet dentin (p0.001), but the effect was not significant on dry dentin (p0.050). Double application also enhanced the formation of resin tags and limited voids within the adhesive layer of BeautiBond Universal. Dentin moisture had a significant effect on µTBS only if the adhesives were applied in a single layer (p=0.007). Except for PrimeBond Universal, the tested universal adhesives performed better on dry dentin.

The relative dentin abrasivity-profilometry equivalent values were compared using non-contact profilometry with three subtypes of regular toothpaste and two subtypes of whitening toothpaste containing sodium bicarbonate and 35% hydrogen peroxide. Bovine dentin specimens were assigned to six groups: regular toothpaste (R): R1 (BAMBOO SALT GUM OINTMENT); R2 (MEDIAN TARTAR ORIGINAL); R3 (PERIOE Alpha), Reference slurry: RS (calcium pyrophosphate), whitening toothpaste (W): W1 (NET. WT); W2 (Vussen 28 WHITENING). Relative dentin abrasion-profilometry equivalent (RDA-PE) was determined by brushing 10,000 times (n=8). The pH of the toothpaste was measured (n=5) and the abrasive constituents of the toothpaste was analyzed by FE-SEM and EDS. The RDA-PE values ranged from 26 to 166, and the pH level ranges were 4.928-9.153. The RDA-PE value of the whitening toothpaste containing hydrogen peroxide was not high compared with that of the regular toothpaste. The RDA-PE values of whitening toothpaste could vary depending on the mechanism and ingredients of the whitening agents.

Pulp-dentine complex regeneration via tissue engineering is a developing treatment modality that aims to replace necrotic pulps with newly formed healthy tissue inside the root canal. Designing and fabricating an appropriate scaffold is a crucial step in such a treatment.The present study aimed to review recent advances in the design and fabrication of scaffolds for de novo regeneration of pulp-dentine complexes via tissue engineering approaches.A literature search was conducted using PubMed, Europe PMC, Scopus and Google Scholar databases. To highlight bioengineering techniques for de novo regeneration of pulp-dentine complexes, both in vitro and in vivo studies were included, and clinical studies were excluded.In the present review, four main classes of scaffolds used to engineer pulp-dentine complexes, including bioceramic-based scaffolds, synthetic polymer-based scaffolds, natural polymer-based scaffolds and composite scaffolds, are covered. Additionally, recent advances in the design, fabrication and application of such scaffolds are analysed along with their advantages and limitations. Finally, the importance of vascular network establishment in the success of pulp-dentine complex regeneration and strategies used to create scaffolds to address this challenge are discussed.In the tissue engineering platform, scaffolds provide structural support for cells to adhere and proliferate and also regulate cell differentiation and metabolism. Up to now, considerable progress has been achieved in the field of pulp-dentine complex tissue engineering, and a spectrum of scaffolds ranging from bioceramic-based to naturally derived scaffolds has been fabricated. However, in designing a suitable scaffold for engineering pulp-dentine complexes, a variety of characteristic parameters related to biological, structural, physical and chemical features should be considered.The variety of biomaterials and fabrication techniques provides a great opportunity to address some of the requirements for scaffolds in regenerative endodontics. However, more studies are required to develop an ideal scaffold for use in a clinical setting.

The aim of this study was to evaluate the effect of previous root canal treatment on dentinal tubule penetration of calcium silicate-based sealers during endodontic retreatment and to compare 2 different (commonly used and modified) tubule penetration depth measurement techniques.The crowns of mandibular premolar teeth were removed, and root canals were prepared (ProTaper Universal; Dentsply Sirona, York, PA) and obturated using AH Plus (AH; Dentsply DeTrey, Konstanz, Germany), MTA Fillapex (MTAF; Angelus, Londrina, Brazil), and WellRoot ST (WRST; Vericom, Gyeonggi-do, South Korea); 0.1% red Rhod-2 dye (Chemodex, St Gallen, Switzerland) was added to the sealers. After storage for 3 weeks (37°C, 100% humid), the following sealer combination subgroups were created (the sealer used during the primary root canal treatment/the sealer used during the retreatment, n = 8): AH/AH, AH/MTAF, and AH/WRST; MTAF/AH, MTAF/MTAF, and MTAF/WRST; and WRST/AH, WRST/MTAF, and WRST/WRST. Green Fluo-3 dye (0.1%) was added to the sealers during retreatment. Sealer penetration depths were measured at 8 points and averaged, and the ratio of the retreatment sealer to the initial sealer was recorded as the mean tubule penetration depth ratio in the first technique, whereas the percentage of the circumferential penetration area ratios of the retreatment and initial sealers was calculated in the second technique. Statistical analyses were performed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests.The mean penetration depth of AH and MTFA was found to be higher at the coronal third region in the control groups (P .05). Both methods showed a significant difference among the groups at the coronal and median regions (P .05). The AH/WRST, MTAH/AH, MTAF/MTAF, MTAF/WRSTS, and WRST/WRST groups showed deeper tubule penetration (first technique, P = .01). Both techniques showed that the penetration depth of the sealers was the same at the apical region (P .05), whereas a difference was found among the techniques at the coronal and median regions. The sealers used in the previous root canal treatment limited the penetration depth of the sealers used during the retreatment process (P .05). When MTAF was used as the initial sealer, the penetration depth of the second sealer did not change, whereas if WRST was the initial sealer, the penetration depth of the sealers at the median and apical regions is negatively affected during the retreatment process (P .05).Previous root canal treatment affects the penetration depth of calcium silicate-based sealers. The use of AH Plus and MTA Fillapex during the retreatment process showed an advantage. Both measurement techniques showed similar performances at the apical region, whereas the results varied at the coronal and midcoronal regions; therefore, a more stable sealer penetration measurement technique is still necessary.

To evaluate the effects of progressive root canal enlargements on the unprepared surface area and remaining dentine thickness of three-rooted maxillary first premolars with different root configurations.Thirty three-rooted maxillary first premolars with three root configurations (n = 10) were selected and scanned in a micro-CT device. The root canals were sequentially enlarged with rotary instruments sizes 30.02 (step 1), 30.04 (step 2) and 30.06 (step 3). After each step, a new scan was taken. Analysed parameters included morphometric measurements (length, volume and surface area), number of static voxels and minimal dentine thickness. Statistical analyses were performed with one-way anova post hoc Tukey tests and paired sample t-test at a significance level of 5%.No statistical differences were observed amongst groups regarding the morphometric parameters and static voxels (p .05). The minimal dentine thickness of the distobuccal root significantly changed depending on the root configuration (p .05), whilst no differences were observed in the other roots (p .05). A great variation in the position of the minimal dentine thickness was observed after preparation. Overall, mean percentage reduction in dentine thickness was higher in the buccal roots than in the palatal root (p .05). In the mesiobuccal and distobuccal root, the number of slices with minimal dentine thickness lower than 0.05 mm increases 2 to 3 times and 3 to 4 times, respectively, from steps 1 to 3.Instruments sizes 30.02 and 30.04 can be safely and effectively used to enlarge the buccal and palatal canals of three-rooted maxillary first premolars.

The lipopolysaccharides-dentine-infection (LPS-dentine-infection) models and sampling techniques frequently used to evaluate LPS disinfection have limitations. In this study, a LPS-dentine-infection model was devised using fluorescent conjugate LPS. Secondly, a sampling technique using cryogenic grinding for intraradicular LPS analysis was evaluated. Thirdly, the effectiveness of the XP-endo Finisher (XP-EF) was compared with passive ultrasonic irrigation (PUI) in removing LPS from root canal system.Sixty-nine mandibular premolars were submitted to dentine pretreatment and inoculated with fluorescent LPS conjugate (Alexa Fluor® 594). Twenty-three teeth were analysed under confocal laser scanning microscopy (CLSM) to validate this modified LPS-dentine-infection model. Forty-six teeth were randomly divided into two experimental groups: XP-EF (n = 23) and PUI (n = 23). All teeth were instrumented with XP-endo shaper (XPS; FKG Dentaire) and 2.5% NaOCl. The root canals were sampled with paper points before (s1) and after (s2) instrumentation and after supplemental treatment (s3) with XP-EF and PUI. After s3, all roots were cryogenically ground for intraradicular LPS analysis (s4). Limulus amebocyte lysate assay was used for LPS quantification. The Friedman test was used for differences in LPS among four time-points (s1, s2, s3, and s4). Dunn's test was used for pairwise testing of time-points. The significance level was set at 5% (p .05).Fluorescent LPS conjugate was detected in 100% of the samples under CLSM with a penetration depth of approximately 400 μm into dentine. Chemo-mechanical preparation using XPS files significantly reduced LPS levels (p .05). Both the XPS and PUI improved the LPS disinfection (p .05), with no difference between them (p .05). LPS was recovered from all samples after cryogenic grinding. The residual amount of LPS detected using the cryogenically sampling technique at s4 was approximately three times greater than with the paper-point sampling technique at s3.This study established a modified LPS-dentine-infection model using fluorescent conjugate LPS, and validated a LPS sampling technique for using cryopulverization intraradicular LPS analysis. Moreover, both the XP-EF and PUI further improved LPS disinfection from the root canals, and the innovative XP-EF was as effective as PUI.

To determine whether smear layer management, via conservative etching protocols, and the hydrophobic-rich content of hybrid layers would affect the fatigue strength of resin-dentin interfaces.Bar-shaped dentin beams obtained from sound third molars were wet-polished for 30 s. Dentin was etched with 32 % ortho-phosphoric acid for 3 or 15 s, 10 % meta-phosphoric acid for 15 s or by a prime-and-rinse application using a mild universal adhesive (Scotchbond Universal, 3M ESPE). Self-etch application served as control. Coating was performed with a solvent-free bisGMA-based resin. Composite buildups were made with a nanofilled composite. Resin-dentin beams with twin-bonded interfaces were sectioned and stored in deionized water for 24 h at 37 ℃ before 4-point flexural quasi-static monotonic testing (n = 16). Stress-life fatigue behavior was evaluated under cyclic loading (n = 35) by the staircase method at 4 Hz. The tension side of cyclic-loaded unfractured beams were evaluated under SEM, along with the micro-morphology of etched dentin surfaces. Monotonic data was analyzed by two-way ANOVA followed by the Tukey Test and cyclic-loaded data by Kruskal-Wallis on Ranks (α = 0.05).Etching protocols and higher hydrophobic-rich content produced significantly higher fatigue life distributions (p 0.05). Dentin demineralization was ranked as OPA 15 s MPA 15 s OPA 3 s P + R SE. Less aggressive etching and coating reduced crack formation at hybrid layers.Current oversimplification trends in resin-dentin bonding constitute a trade-off between hybridization quality and easier adhesive handling. Controlled dentin etching and increasing the hydrophobic-rich content of hybrid layers may be necessary to extend the longevity of mild universal adhesives.

This study aims to characterize the cytotoxicity potential of silver diamine fluoride (SDF) on dental pulp stem cells (DPSC) and gingival equivalents.DPSC cultured on 96-well plates was exposed directly to SDF (0.0001-0.01%) and cell viability (ICDPSC exposed directly to SDF showed a dose-dependent reduction in cell viability (ICSDF penetrated the dentin (≤1 mm thick) inducing significant death of the pulp cells. SDF also disrupted gingival epithelial integrity resulting in mucosal corrosion.

To evaluate the bond strength of four types of posts (pre-fabricated fiberglass post, fiberglass post anatomized with composite resin, milled fiberglass post, and milled polyetheretherketone (PEEK) post), and two types of resin cements (conventional and self-adhesive) by assessing immediate bond strength and post-mechanical aging at each root third.Bovine endodontically treated roots (16 groups, n = 8) were prepared and the posts were produced and luted; the specimens of aging groups were cycled (300,000 cycles under 50 N load at 1.2 Hz frequency); six slices of each root were obtained; push-out test was performed by using a universal testing machine (500 N load at 1 mm/min cross speed); fracture pattern was classified into five levels. The statistical analyses used were three-way ANOVA, Tukey's test (for bond strength), and Fisher's test (for fracture pattern) (α 0.05).Differences were found between the cements for posts (conventional: p 0.001; self-adhesive: p = 0.002), whereas no difference was found for root region (p = 0.941; p = 0.056, respectively); analysis of each root showed significant differences for cements (p 0.001), posts (p 0.001), and mechanical cycling (p = 0.001); in terms of double interaction, differences were found for posts and mechanical cycling (p = 0.005); no other interactions were observed (double or triple); the fracture pattern showed difference between the groups for both cements.Milled PEEK posts seem to be a good clinical option, but they require improvement of CAD-CAM technology and advances towards their adhesion.Milled posts are promising and can reduce clinical time for rehabilitation of extensively destroyed teeth.

The aim of this study was to assess the utility of an actuator-driven pulsed water jet (ADPJ) as a hardness-dependent carious dentin removal device by using different outputs. Thirty-six plane surface dental caries samples were treated with the ADPJ at 150, 200, and 250 voltage (12 teeth each). The Knoop hardness number (KHN) and Ca/P mass ratio were measured at 70 μm from the deepest point of the removing groove. Furthermore, three other teeth samples were manually treated with the ADPJ at the three above mentioned voltages (one tooth each) for 1 min. The KHN and Ca/P mass ratio were measured at 70 μm from the surface of the residual dentin part. In both the KHN and Ca/P mass ratio, higher residual dentin depended on the applied voltage of ADPJ. The ADPJ enabled the removal of softened carious dentin in an applied voltage-dependent manner.

The use of high-concentration sodium hypochlorite (NaOCl) as an endodontic irrigant remains controversial because of its potential impact on the fracture strength of endodontically treated teeth. This study evaluated the effects of using different NaOCl concentrations, with 2-min-ethylenediaminetetraacetic acid (EDTA) as the final active irrigant, on the biomechanical and structural properties of root dentine.A new test method, which is more clinically relevant, was utilized to calculate the fracture strength of root dentine. Bovine incisors were used to obtain root dentine discs. The root canals were enlarged to mean diameter of 2.90 mm with a taper of 0.06. The resulting discs were divided into five groups (n = 20) and treated with different concentrations of NaOCl (5.25%, 2.5%, and 1.3%) for 30 min plus 17% EDTA for 2 min. The discs were then loaded to fracture by a steel rod with the same taper through the central hole. The fractured specimens were examined by scanning electron microscopy to evaluate changes in the dimensions of the remaining intertubular dentine and the tubular radius. Micro-hardness was also measured with a Knoop diamond indenter along a radius to determine the depth of dentine eroded by the irrigation. Results were analysed by one-way anova and the Tukey test. The level of significance was set at α = 0.05.The damage by NaOCl increased with its concentration. 5.25% NaOCl greatly reduced the fracture strength of root dentine from 172.10 ± 30.13 MPa to 114.58 ± 26.74 MPa. The corresponding reduction in micro-hardness at the root canal wall was 34.1%. The damages reached a depth of up to 400 μm (p .05). Structural changes involved the degradation of the intratubular wall leading to enlarged dentinal tubules and the loss of intertubular dentine. Changes in the microstructural parameters showed positive linear relationships with the fracture strength.With the adjunctive use of EDTA, NaOCl caused destruction to the intratubular surface near the root canal and, consequently, reduced the root dentine's mechanical strength. The higher the concentration of NaOCl, the greater the effect. Therefore, endodontists should avoid using overly high concentration of NaOCl for irrigation to prevent potential root fracture in endodontically treated teeth.

The aim of this study was to evaluate the effect of decontamination agents against saliva contamination on the bonding of computer-aided design/computer-aided manufacturing (CAD/CAM) resin block. Three commercially available decontamination agents were used in this study. The samples were subjected to microtensile bond strength test. A saliva protein staining test was performed by the pigment binding method to investigate the effect of removing saliva protein. All the decontamination agents could significantly restore the bond strength from the saliva contamination, and KATANA Cleaner showed no significant difference with the control. From the results of the saliva protein staining test, KATANA Cleaner showed higher removal effect of saliva protein for CAD/CAM resin block surface than the other materials due to the surface active effect of MDP salt. It was suggested that cleaners containing MDP salt were more effective in removing artificial saliva contamination than cleaners containing other ingredients for CAD/CAM resin blocks.

The aim of the present study was to compare and evaluate the efficacy of two minimally invasive methods in the removal of infected carious dentin in primary molars.Eighty primary molars with class I occlusal caries involving dentin were selected and allocated to either of the two groups using convenient sampling. Group A (The results indicated that BRIX 3000 was effective in the removal of caries from primary molars with a significant difference. While there was no statistically significant difference seen in pain perception on caries excavation using both the methods. Although, a mild discomfort was noted in Group B.Comparing the two minimally invasive techniques, the new chemomechanical solution (BRIX 3000) was an effective method for the removal of caries from primary molars. So, it can be considered an alternative to the conventional caries removal method in treating pediatric dental patients.BRIX 3000 gel is effective in the removal of caries in children who are anxious and apprehensive as it is a noninvasive method of treatment in the pediatric age group.

SUMMARY Objectives This study evaluated the influence of irradiance/exposure time on the Knoop hardness (KHN) and polymer cross-linking density (PCLD), as well as microtensile bond strength (μTBS), nanoleakage (NL), and in situ degree of conversion (DC) of universal adhesives. Methods and Materials Two universal adhesive systems, Clearfil Universal Bond Quick (CUQ) and Scotchbond Universal Adhesive (SBU), were light-cured using various irradiance/exposure times: 1400 mW/cm2 for 5 s (1400*5); 1400 mW/cm2 for 10 s (1400*10); 3200 mW/cm2 for 5 s (3200*5); and 3200 mW/cm2 for 10 s (3200*10). Adhesive disks from each group were used to measure PCLD by KHN. One hundred and twenty-eight human molars were randomly assigned to 16 groups according to the following variables: adhesive system vs adhesive strategies vs radiance/exposure times. After restoration, specimens were sectioned into resin-dentin sticks and tested for μTBS, NL, and DC. The data from PCLD (%), KHN, μTBS (MPa), NL (%), and DC (%) data were subjected to ANOVA and Tukey’s test (α=0.05). Results Significant reductions in KHN, μTBS, and DC (p=0.00001) values and an increase in NL and PCLD (p=0.00001) values were observed for 3200*10 when compared with other groups. Higher KHN, μTBS, and DC (p=0.000001) values were observed for 3200*5 in comparison with the other groups. The 1400*5 (7 J/cm2) and 1400*10 (14 J/cm2) groups showed intermediate values (p=0.000001). Conclusion Although similar results in terms of hardness, polymer cross-linking density and nanoleakage were observed when 5 seconds at 3200 mW/cm2 and 10 seconds at 1400 mW/cm2 groups were compared, the use of higher irradiance (3200 mW/cm2) for only 5 seconds showed better results in terms of bond strength and degree of conversion for both universal adhesives to dentin. The prolonged exposure time (10 seconds) at the higher irradiance (3200 mW/cm2) showed the worst results.

This study investigated the significance of pericervical dentin after coronal canal flaring on the biomechanical behavior and life span of a maxillary molar using finite element analysis (FEA).In addition to the intact tooth (IT) model, 4 experimental FE models were designed: conservative access cavity model (CON), and 3 models with different radicular preparations for the coronal 4 mL considering 3 instruments: ProTaper SX model (SX), OneFlare model (OF), and Gates-Glidden model (GG). Cyclic loading of 50 N was applied on the occlusal surface and number of cycles until failure (NCF) was compared with the IT model. Mathematical analysis was done to evaluate the stress distribution patterns and calculated maximum von Mises (VM) and maximum principal stresses.Access cavity preparation (CON) decreased NCF significantly when compared with the IT model (93.99%). The coronal preparation of the root canal did not have a significant effect even when the preparation was taken to the extreme (GG: 92.02%). VM analysis confirmed apical dispersion of stresses, with maximum value registered on the occlusal surface in the GG model (7.88 MPa), and minimum on the IT model (7.01 MPa). The furcation area showed higher maximum principal stresses, yet stress values remained minimal and distributed over larger surfaces with the progressive enlargement among models.Within the limitations of this study, coronal canal flaring affects tooth integrity minimally, and when loading conditions lie within normal functional ranges, tooth structure has the capacity to disperse increasing stresses over a wider surface area.

SUMMARY Objective To evaluate the shear bond strength and interfacial morphology of sound and caries-affected dentin (CAD) bonded to two resin-modified glass ionomer cements (RMGICs) after 24 hours and two months of storage in simulated body fluid at 37°C. Methods and Materials Sixty-four permanent human mandibular first molars (32 sound and 32 with occlusal caries, following the International Caries Detection and Assessment System) were selected. Each prepared substrate (sound and CAD) was conditioned (10% polyacrylic acid) and bonded to Activa BioACTIVE Restorative (Activa) and Fuji II LC (F2LC) as per the manufacturers’ instructions. Shear bond strength (SBS) was performed after 24 hours and two months of storage. The interfacial surfaces were examined using a digital microscope and scanning electron microscope (SEM). Three-way ANOVA, Bonferroni post-hoc tests (α=0.05), and independent T-tests were used for multifactorial analysis. Results Activa exhibited reduced bond strength values to sound and CAD in comparison to F2LC after two time periods (p=0.01). There is a pronounced enhancement in SBS of F2LC when bonded to CAD (p=0.01) after storage, with no statistically significant effect on sound dentin (p=0.309). Activa showed stable SBS to sound and CAD immediately and post-aging (p>0.05). However, the evidence of mineral-like deposits under an SEM attached to the aged, debonded dentin surfaces, thereby obliterating the exposed dentinal tubules, might support the tissue repair potential of Activa. Conclusions The SBS of Activa was lower than F2LC when bonded to sound and CAD, but the bonding stability and sealing ability is advantageous in minimally invasive therapy, suggesting use with a resin composite coverage when used in stress-bearing areas.

The conventional radiotherapy protocol to treat head-and-neck cancer is usually followed by tooth-decay onset. Radiation impact on mineralized tooth structures is not well-understood. This systematic review aimed to collect the recorded effects of therapeutic radiation on tooth chemical, structural and mechanical properties, in relation with their means of investigation.Systematic search (January 01 2012 - September 30 2021) terms were "Radiotherapy", "Radiation effects", "Dental enamel", "Dentin", "Human" and "Radiotherapy" NOT "Laser".PubMed, DOSS and Embase databases were searched.Selected studies compared dental enamel, coronal and root dentin properties before and after in vitro or in vivo irradiation up to 80 Gy.The systematic search identified 353 different articles, with 28 satisfying inclusion criteria. Their reference lists provided two more. Twenty-two studies evaluated dental enamel evolution, nine assessed coronal dentin and eight concerned root dentin. Coronal and root dentin results indicate a major impact of the radiation on their organic matrix. Dental enamel's chemical properties are less modified. Enamel and root dentin's hardness are decreased by therapeutic radiation, but no consensus arises for coronal dentin.Our findings revealed some interesting information about enzymatic degradation mechanisms of dentin organic matrix and highlighted that dental hard-tissue characterization requires highly specific expertise in materials science. That scientific knowledge is necessary to design suitable protocols, adequately analyze the obtained data, and, thus, provide relevant conclusions.Better knowledge and understanding of the mechanisms involved in the degradation of enamel and dentin would enable development of new preventive and therapeutic methods for improved medical care of patients undergoing radiotherapy.

The purpose of this study was to evaluate the effect of dentin moisture (moist and dry) on the bonding of fiber posts to root dentin with different adhesive strategies (etch-and-rinse, self-etch, and self-adhesive). Seventy-two extracted single-rooted human teeth were endodontically treated and divided into six groups (n = 12) according to the moisture of dentin surface and adhesive systems as follows: a) etch-and-rinse/moist, b) etch-and-rinse/dry, c) self-etch/moist, d) self-etch/dry, e) self-adhesive/moist, and 6) self-adhesive/dry. The specimens were sectioned into six slices for push-out bond strength (BS), nanoleakage (NL) by SEM, and Vickers microhardness (VHN) of the resin cement. A universal testing machine (AG-I, Shimadzu Autograph) was used at a crosshead speed of 0.5 mm/min until post extrusion, with a load cell of 50 kg for evaluation of the push-out strength. Data on BS, NL, and VHN were evaluated by two-way ANOVA and Tukey’s test (α = 0.05). Dentin moisture as the main factor was not significantly different for the push-out test. However, higher BS values can be observed for the etch-and-rinse group. A lower percentage of NL was found in the dry dentin groups. The moisture pattern was not significant in the hardness values for the pre-etching groups. Additional moisture did not increase the evaluated properties.

This study tested the ability of bioactive pastes containing niobophosphate and 45S5 glasses to reduce dentin permeability and to obliterate dentinal tubules, as a mean of reducing human dentin hypersensitivity.Experimental pastes with concentrations of 10, 20, and 30 wt% of two bioactive glasses (45S5 or niobophosphate [NbG]) were formulated. A paste without bioactive glass (placebo) and a commercial paste (Nano P, FGM) were used as controls. Forty dentin disc specimens were obtained from caries-free extracted third human molars and divided in 8 groups (n = 5). Percentage of permeability (%Lp) was assessed in a dental permeability machine considering hydraulic conductance, immediately after pastes application and at day 7, day 14, and day 21. The precipitates formed on the surface of the dentin discs (and dentinal tubules) were analyzed by SEM/EDS and micro-Raman spectra. Data of dentin permeability (%) 2-way repeated-measures (ANOVA) and Holm-Sidak post-tests (α = 0.05). Dentinal tubule obliteration was visually (and elemental) evaluated and descriptively reported.The experimental bioactive glass pastes containing NbG and 45S5, regardless of the concentration, reduced dentin permeability in comparison with pastes without bioactive glasses (P0.05). The formulated placebo and commercial paste did not reduce permeability over time (P0.05). SEM/EDS and micro-Raman analyses showed that both type of bioactive pastes (NbG or 45S5-based) presented mineral precipitates obliterating the dentinal tubules at day 21. NbG seems to offer a better initial effect than 45S5, while at 21 days there is no difference between both glasses.Experimental bioactive pastes containing NbG and 45S5 (at concentrations of 10%, 20%, or 30%) have potential to reduce dentin permeability (over time) in comparison with pastes without bioactive glasses; and this occurs on behalf of obliteration of dentinal tubules by microparticle and precipitate formation.Bioactive pastes containing NbG and 45S5 may benefit patients presenting dentin hypersensitivity, because these pastes can start acting fast after application and maintain their action up to 21 days.

Introduction: Rice husk nanosilica has a porous, amorphous structure with a surface containing silica (SiO2). Silica interacts with calcium ions to form hydroxyapatite and can induce the formation of reactive oxygen species (ROS), which harm microorganisms. Aims: To determine the effect of rice husk nanosilica on the increase in dentin hydroxyapatite and its antimicrobial effects against S. Mutans. Methods: Nine dental cavity samples were divided into 3 groups: group 1, normal dentin; group 2, demineralised dentin and group 3, demineralised dentin treated with rice husk nanosilica. The samples were analysed using XRD to evaluate the formation of dentin hydroxyapatite, and the results were statistically evaluated using the Kruskal-Wallis test. An antimicrobial test was conducted using an MTT assay to analyse the viability of S. mutans after exposure to 2% nanosilica rice husk, and the results were statistically evaluated using a t-test. Results: There was an increase in the amount of dentin hydroxyapatite after the application of rice husk nanosilica compared with the control group (normal dentin), and 2% rice husk nanosilica had an antimicrobial effect (p

Made available in DSpace on 2022-05-01T15:46:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objectives: Targeting a tissue engineering-based vital pulp therapy (VPT), this study investigated the incorporation of nano-hydroxyapatite (nHA) into polycaprolactone (PCL) nanofibers, and the metabolism of human dental pulp cells (HDPCs) seeded on the scaffolds. Methods: PCL-based solutions (10% w/v) containing nHA (0 – control; 0.5; 1.0; or 2.0% w/v) were electrospun into nanofibrous scaffolds. The scaffolds were characterized for morphology and composition (MEV/EDS), solubility, the release of calcium/phosphate (C/P), and modulation of medium pH. Then, HDPCs were seeded on the scaffolds and evaluated for cell viability (alamarBlue and live/dead), adhesion and spreading (F-actin), total protein (TP; Lowry), alkaline phosphatase activity (ALP; thymolphthalein assay), expression of odontogenic genes (RT-qPCR), and formation of a mineralized matrix (Alizarin Red). Data were analyzed with ANOVA and post-hocs (α = 5%). Results: Higher nHA concentrations roughened fiber surfaces, whereas PCL+ 2%nHA increased the interfibrillar spaces. PCL+ 1%nHA or PCL+ 2%nHA significantly released more C/P but the medium pH was maintained below 8.0. HDPCs viability was not affected by nHA, while cell adhesion/spreading was favored, especially for PCL+ 2%nHA. Higher protein content and ALP activity were seen for scaffolds incorporated with nHA, after 21 days. PCL+ 1%nHA and PCL+ 2%nHA upregulated the expression of DSPP and DMP1 in 14 days, and COL1A1, ALPL, and DMP1 in 21 days. The formation of a mineralized matrix was nHA concentration-dependent, and it was about 9 × higher for PCL+ 2%nHA. Significance: nHA-incorporated PCL nanofibrous scaffolds are cytocompatible and can stimulate the adhesion and odontogenic potential of HDPCs. PCL+ 2%nHA formulation is a bioactive tissue engineering-based cell-homing strategy for VPT. Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) School of Dentistry Department of Genetics Morphology Orthodontics and Pediatric Dentistry São Paulo State University (UNESP) School of Dentistry Department of Oral Health Sciences The University of British Columbia Faculty of Dentistry Department of Physiology and Pathology São Paulo State University (UNESP) School of Dentistry Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) School of Dentistry Department of Genetics Morphology Orthodontics and Pediatric Dentistry São Paulo State University (UNESP) School of Dentistry Department of Physiology and Pathology São Paulo State University (UNESP) School of Dentistry FAPESP: 2019/07400–0 FAPESP: 2019/16473–1

The tooth-resin composite interface is frequently associated with failure because of microbial contamination, hydrolytic and collagenolytic degradation. Thus, designing a dentine bonding system (DBS) with an intrinsically antimicrobial polymerisable monomer is of significance especially if it can be used with self-etching primers enabling resistance to degradation of the interface.Experimental adhesives were developed incorporating eugenyl methacrylate (EgMA) at concentrations of 0,10 or 20 wt%, designated as EgMA0, EgMA10 and EgMA20, respectively, for use as a two-step self-etch DBS with the functional monomer bis[2-(methacryloyloxy) ethyl] phosphate (BMEP) in the primer. The curing, thermal and wettability properties of the adhesives were determined, and hybrid layer formation was characterised by confocal laser scanning microscopy, microtensile bond strengths (µTBS) and nanoleakage by back-scattered SEM. In situ zymography was used to assess MMP inhibitory activity of the BMEP-EgMA DBS.EgMA in the adhesives lowered the polymerisation exotherm and resulted in higher Tg, without negatively affecting degree of conversion. Water sorption and solubility were significantly lower with higher concentrations of EgMA in the adhesive. The formation of a distinct hybrid layer was evident from confocal images with the different adhesives, whilst EgMA20 yielded the highest µTBS post water storage challenges and lowest nanoleakage after 6 months. The experimental DBS exhibited minimal to no MMP activity at 3 months.The hydrophobic nature of EgMA and high cross-link density exerts considerable benefits in lowering water uptake and polymerisation exotherm. The application of EgMA, adhesives in conjunction with BMEP in a multi-functional self-etching DBS can resist MMP activity, hence, enhance longevity of the dentine-resin composite interface.

Due to its low tolerance to external factors such as enzymes, dentin collagen often requires stabilization, which can be achieved through cross-linking. In this study, qualitative and quantitative Fourier transform infrared (FTIR) analyses were used to assess dentin collagen stabilization effects of three structurally-different flavonoids -A-type linkage proanthocyanidins (A-PA), B-type linkage proanthocyanidins (B-PA), and epigallocatechin gallate (EGCG), all from natural extracts. Particularly, transmission FTIR spectroscopy was used for the first time to quantitatively assess the biodegradation of fresh ultra-thin (10 µm) dentin collagen films caused by collagenase digestion. Two traditional analytical methods, namely the hydroxyproline assay and weight loss analysis, were also used for comparison purposes. The results from all three methods showed consistently that A-PA and B-PA provide better collagen stabilization than EGCG at concentrations of 0.65% and 1.3% (p0.01). FTIR is demonstrated to be a valuable and reliable analytical tool for qualitative and quantitative evaluation of ultra-thin collagen films.

We sought to compare the bond strength of resin cement on moist dentin to that on dry dentin, and determine the relationship between the bond strength and flexural strength of resin cement. The water content of the moist and dry dentins was estimated using infrared spectroscopy. Four adhesive and three self-adhesive resin cements were used. At three times of immediately, after one-day storage, and after 20,000 thermocycles (TC 20k), the shear bond strengths were measured. For all resin cements, both the shear bond strength and the flexural strength were the lowest immediately after setting; however, after one day of water storage or TC 20k, these resin cements had the highest values. Regardless of the condition of the dentin surface upon shear bond strength, the flexural strength of each resin cement was correlated with the shear bond strength of the dentin surface.

Modern restorative dentistry would not be possible without the ability to bond to tooth structure. The development of dental adhesives has a lengthy gestation, from the beginnings around 1950, to the latest generation: modern universal adhesives, which were introduced during the 2010s. The foundation for these developments was a deeper understanding of the mechanisms of adhesion to the tooth structure, and to restoration materials. Typically, the performance of an adhesive does not depend on the use of a single ingredient, but on an overall balanced and optimised formulation that contains various components with different roles, such as functional adhesive monomers.While a wealth of literature exists on adhesives that have a long and successful clinical history ('gold standards'), some universal adhesives have also accumulated a lot of scientific evidence while offering benefits like ease of use, low technique sensitivity and versatility.To achieve reliable results with a modern adhesive, several tips should be kept in mind regardless of the product, which result in a homogeneous adhesive layer, proper cure and ultimately high bond strength. Although high performance is already achieved with the adhesives currently available, this is still an exciting area of ongoing research.

To investigate the antibacterial activity of calcium silicate-based sealers (CSBSs) against Enterococcus faecalis biofilm in a neutral or acidic condition.Dentin cylinders (4 mm length) were prepared and infected with 3-week-old E. faecalis. The samples were filled with BioRoot RCS (BR), EndoSequence BC (ES), and NeoMTA Plus (NMTA) and incubated in either neutral or acidic conditions for 7 days (n=10/group). Sterile or infected samples alone were used as the positive and negative control. The root canal sealers were removed after 7 days, and the remaining bacteria on dentinal walls were determined by colony-forming units (CFUs/ml), and three samples from each group were visualized under a confocal laser scanning microscope (CLSM). The pH was also measured (n=3/group) after 4 h and 7 days of incubation at 37°C in both conditions.In the neutral condition, all sealers significantly decreased the log-CFU values (p0.05), while in the acidic condition, the log-CFU reduction was less for ES and NMTA, but a higher reduction was observed in BR (p0.05). The antibacterial activity of CSBSs was similar in neutral conditions (p0.05), and BR showed a greater antibacterial effect than ES and NMTA in the acidic condition (p0.05). The pH of BR, ES, and NMTA ranged from 8.2 to 8.8 in the neutral condition in the presence of dentin after 7 days. However, acidic conditions reduced the pH values to 7.8 for BR, 6.0 for ES, and 5.8 for NMTA.All CSBSs showed similar antibacterial activity in neutral conditions, while acidic pH had a reducing antibacterial effect on CSBSs.Inflammatory pH decreased the antibacterial properties of CSBSs depending on the sealer type.

Chemically released growth factors play a vital role in regenerative endodontics. Transforming growth factor beta 1 (TGF-β1) is 1 of the most extensively studied bioactive molecules that promotes cell proliferation, differentiation, and chemotaxis. The goal of the current research was to analyze the effect of 7% maleic acid (MA) root conditioning of an infected root canal on the release of TGF-β1.Single-rooted human teeth were decoronated, and the canals were enlarged with a Peeso reamer. The samples were divided into biofilm and nonbiofilm groups. Subsequently, all the samples of both groups were flushed with 10 mL of each irrigant, namely, 1.5% sodium hypochlorite (NaOCl), 7% MA, 17% EDTA, and a combination of 1.5% NaOCl with 17% EDTA or 7% MA, for 10 minutes each. TGF-β1 was estimated quantitatively using an enzyme-linked immunosorbent assay kit.TGF-β1 release was lowest among the biofilm samples compared with nonbiofilm among all the groups. MA 7% with 1.5% NaOCl rendered higher amounts of growth factor release in contrast to the combination of 17% EDTA and 1.5% NaOCl in both the biofilm and nonbiofilm groups (P.048). The nonbiofilm samples treated with 7% MA alone illustrated higher growth factor release compared with 17% EDTA only (P.006), but there was no significant difference in growth factor release among the biofilm samples treated with 7% MA and 17% EDTA.Bacterial biofilms modified the release of TGF-β1. MA 7% was observed to be significantly more efficacious than 17% EDTA in TGF-β1 growth factor release from radicular dentin.

A novel method of combining chlorhexidine (CHX) loaded poly (amido amine) (PAMAM) dendrimers with a dental adhesive containing amorphous calcium phosphate (ACP) nanofillers are proposed for etch-and-rinse bonding system to enhance resin-dentin bonding durability.The CHX-loaded PAMAM and ACP nanofillers were synthesized and characterized. Their effects on the cytotoxicity were tested by MTT assay. Micro-tensile bond strength (μTBS) before and after thermomechanical challenges were used to evaluate the bonding durability. Anti-matrix metalloproteinase (MMPs) property was examined using in-situ zymography. A double-fluorescence technique was used to examine interfacial permeability after bonding. Dentin remineralization in Ca/P lacking solution was observed under scanning electron microscopy.Compared with a 0.2 wt% CHX solution, the PAMAM loaded CHX had less cytotoxicity, while the in situ zymography showed it could still inhibit MMPs activity within the hybrid layer after released from PAMAM. The application of the novel method maintained the μTBS better than the control group after thermomechanical challenges, and it did not negatively affect water permeability of the bonding interfaces. CHX-loaded PAMAM regulated the calcium (Ca) and phosphate (P) ions provided by the ACP-containing adhesives to remineralize the demineralized dentin surfaces without initial Ca/P in the environment.The novel method can reduce the cytotoxicity of CHX, inhibit MMPs activities, maintain μTBS, and induce dentin remineralization, which are crucial factors for enhancing bonding durability.

The purpose of this study was to evaluate the influence of a contracted endodontic cavity (CEC) on dentin preservation, biomechanical property, and instrumentation efficacy of first permanent molars in comparison with a traditional endodontic cavity (TEC).Forty-eight extracted intact maxillary and mandibular first molars were selected and scanned by micro-computed tomographic (micro-CT) imaging. Each tooth type was anatomically matched and assigned to the CEC group or the TEC group (n = 12). After root canal instrumentation with the ProGlider (Dentsply Maillefer, Ballaigues, Switzerland) and WaveOne Gold (Dentsply Maillefer), the specimens were scanned by micro-CT again. Pre- and postpreparation micro-CT imaging was used to evaluate the dentin preservation and instrumentation efficacy. The results on volume and thickness reduction in the coronal dentin and pericervical dentin (PCD), root canal volume and surface area, percentage of unprepared surface area, canal transportation and centering ratio, and canal wall thickness in the "danger zone" were measured and analyzed with the Shapiro-Wilk and independent sample t tests. Based on micro-CT imaging of maxillary and mandibular first molars, CEC and TEC models were constructed on the intact tooth, and 2 different static loads were applied to the occlusal load points. The stress distribution patterns and von Mises stress on the occlusal surface and cervical region were assessed by 3-dimensional finite element analysis.The CEC had a significantly lower volume and thickness reduction of coronal dentin and PCD above the alveolar crest compared with the TEC group (P .05), whereas no difference was observed in PCD below the alveolar crest between the 2 groups (P.05). There was no difference regarding all instrumentation efficacy outcomes (root canal volume and surface area, percentage of unprepared surface area, canal transportation and centering ratio, and canal wall thickness) in the danger zone between the 2 groups (P.05). The CEC effectively reduced the maximum von Mises stress and stress concentration area on the occlusal surface and cervical region compared with the TEC.The CEC preserved more coronal dentin and PCD above the alveolar crest and thus reduced stress concentration on the occlusal surface and cervical region. The CEC had no significant adverse effects on the instrumentation efficacy compared with the TEC given that the instrumentation procedures were performed with ProGlider and WaveOne Gold files.

OBJECTIVES: To assess dentin collagen denaturation from phosphoric acid and enzyme treatments using collagen hybridizing peptide (CHP) and to investigate the effect of collagen denaturation on bio-stabilization promoted by proanthocyanidins (PA). METHODS: Human molars were sectioned into 7-μm-thick dentin films, demineralized, and assigned to six groups: control with/without PA modification, H(3)PO(4)-treated collagen with/without PA modification, enzyme-treated collagen with/without PA modification. PA modification involved immersing collagen films in 0.65% PA for 30 seconds. H(3)PO(4) and enzyme treatments were used to experimentally induce collagen denaturation, which was quantitated by fluorescence intensity (FI) from the fluorescently-conjugated-CHP (F-CHP) staining (n=4). FTIR was used to characterize collagen structures. All groups were subject to collagenase digestion to test the bio-stabilization effect of PA on denatured collagen using weight loss analysis and hydroxyproline assay (n=6). Data were analyzed using two-factor ANOVA and Games-Howell post hoc tests (α=0.05). RESULTS: FTIR showed collagen secondary structural changes after denaturation treatments and confirmed the incorporation and cross-linking of PA in control and treated collagen. F-CHP staining indicated high-degree, medium-degree, and low-degree collagen denaturation from H(3)PO(4)-treatment (FI=83.22), enzyme-treatment (FI=36.54), and control (FI=6.01) respectively. PA modification significantly reduced the weight loss and hydroxyproline release of all groups from digestion (p

Methacryloyloxydecyl dihydrogen phosphate (MDP) has been speculated to induce mineralization, but there has been no convincing evidence of its ability to induce intrafibrillar mineralization. Polymers play a critical role in biomimetic mineralization as stabilizers/inducers of amorphous precursors. Hence, MDP-induced biomimetic mineralization without polymer additives has not been fully verified or elucidated. By combining 3-dimensional stochastic optical reconstruction microscopy, surface zeta potentials, contact angle measurements, inductively coupled plasma–optical emission spectroscopy, transmission electron microscopy, atomic force microscopy, and Fourier transform infrared spectroscopy with circular dichroism, we show that amphiphilic MDP can not only demineralize dentin by releasing protons as an acidic functional monomer but also infiltrate collagen fibrils (including dentin collagen), unwind the triple helical structure by breaking hydrogen bonds, and finally immobilize within collagen. MDP-bound collagen functions as a huge collagenous phosphoprotein (HCPP), in contrast to chemical phosphorylation modifications. HCPP can induce biomimetic mineralization itself without polymer additives by alternatively attracting calcium and phosphate through electrostatic attraction. Therefore, we herein propose the dual functions of amphiphilic MDP monomer with de- and remineralizing ability. MDP in the free state can demineralize dentin substrates by releasing protons, whereas MDP in the collagen-bound state as HCPP can induce intrafibrillar mineralization. The dual functions of MDP monomer with de- and remineralization properties might create a new epoch in adhesive dentistry and preventive dentistry.

The aim was to investigate the fatigue performance of endodontically treated (ET) molars restored by various dentin-replacing materials and material configurations. Moreover, the impact of additional adhesive treatment with glass-ionomer cement (GIC) was evaluated.250 intact molars were collected and randomly distributed into ten groups (n = 25). After endodontic procedure standard Class I cavities were prepared and restored with different direct restorative techniques and dentin-replacing materials. Two-group were restored with either packable or flowable short fiber-reinforced composites (SFRCs). Two-group were restored by experimental fiber-reinforced GIC with and without adhesive treatment. Four-group were restored by conventional and resin-modified GICs with or without adhesive treatment. One-group was restored with a dual-cure composite resin and last group was restored with only conventional composite resin (control). Fatigue-survival was measured for all specimens using a cyclic-loading machine until fracture occurred or a number of 40.000 cycles were achieved. Kaplan-Meyer survival analysis was conducted, followed by pairwise log-rank post hoc comparisons. Fracture mode was then examined by means of optical microscopy and SEM.Group restored with flowable SFRC showed significantly higher survival (p 0.05) compared to all of the groups, except for group restored with packable SFRC (p 0.05). Group restored with fiber-reinforced GIC had significantly (p 0.05) higher survival rates compared to other commercial GICs. SEM demonstrated change of the fracture line when fracture reached the SFRC layer.Direct restoration of Class I in ET molars with the use of SFRCs as dentin-replacing materials demonstrated its ability to reinforce the dental structures and to increase the fatigue resistance in this specific clinical situation.

Canal instrumentation with rotary nickel-titanium (NiTi) instruments might weaken the dentinal wall. This study aims to investigate the apical root defects during canal instrumentation with two NiTi rotary systems by using optical coherence tomography (OCT) scans.Twenty mandibular incisors were selected and divided into two groups instrumented using HyFlex CM (HCM) and ProTaper Universal (PTU) systems. OCT scans were taken immediately after canal instrumentation with file #25, #30 and #40. Each cross-sectional reconstructed image of 1, 2 and 3 mm from the apex was examined, root cracks were scored, and dentin thickness was measured at 12 sites. The risk sites with dentin thickness less than 0.30 mm were recorded.In HCM group, no cracks were observed after instrumentation with file #30/.06, while in PTU group, root cracks were found in 6 teeth with a total score of 9 after using F3 (#30/.09) (P 0.05). After file #40, 8 teeth with cracks had a score of 14 in PTU group, while one tooth was observed crack with a score of 1 in HCM group (P 0.05). The number of risk sites in PTU group was 49 (13.16%), which was significantly more than the 28 (7.78%) in HCM group (P 0.05) when canals were instrumented with file #30.Within the limitations of this study, when the canals of mandibular incisors were instrumented with size #30 and #40 files, OCT scans showed less root defects in HCM group.

Regenerative endodontic treatment was introduced with the aim of reinforcing the root and enabling further root development. In the process of dentin mineralization, bioactive molecules are entrapped in the dentin matrix, which can be released later by rinsing the dentin with chelating agents. This study aimed to compare the effects of citric acid and EDTA on radiographic root development in regenerative endodontic treatment in an animal model.Premolars of 3 beagle dogs were used in this study. The teeth at 1 side of the jaw were irrigated with EDTA according to the regeneration protocol of the American Association of Endodontists. The teeth in the other quadrant were irrigated with citric acid in the second treatment session. Follow-up radiographs were obtained at 6 months, and the primary and final data were analyzed in SPSS Version 23 (IBM Corp, Armonk, NY) using the analysis of covariance.There was no significant difference between the 2 irrigating solutions regarding the increase in root length (P = .668); however, EDTA showed significantly superior efficacy in increasing the root dentin thickness compared with citric acid (P = .022).Within the limitations of this study, the use of citric acid versus EDTA was not superior on radiographic root development in regenerative endodontic treatment.

testing if hypothetical transverse centripetal strains due to polymerization contraction of luting materials produce differential alterations in its bonding to luted structures, depending on distances to the center of the luting mass, and if this effect is C-factor related. Two hypotheses were tested: (1) there is a statistically significant decreasing relationship between the bonding strength and the transverse distances to the center of the luting material, and (2) there is a statistically significant difference between bonding strengths among luting spaces with different configuration factors.10 PMMA (15 mm Ø) pairs of cylinders were cemented (Scotchbond Universal adhesiveRelyx Universal, both chemically cured) in a compliant setup under two (20 and 70 N) luting forces forming 2 groups (5 samples each), resulting in different C-factors. Whole samples were sectioned in x and y directions obtaining non-trimmed beams from all along the luting surfaces. Their relative positions in each sample were assessed before separating and categorized (10 categories) according to their distances to the center of the sample. All beams were tested in tension and, because of their uneven bonding areas and to balance its influence, UTS results were transformed into UTSANOVA's p of the regression UTSbonded attachment of cemented materials decreases from centers to outbounds in plane, extensive surfaces, and this decrease is C-factor related.

This study was funded by PID2020-116660GB-I00 by the Ministry of Economy and Competitiveness (MINECO) of the Spanish Government and FEDER A-RNM-408-UGR20. PAL acknowledges the European Regional Development Fund (ERDF) – Next Generation/ EU program., Objective: (1) to determine the effects of the silver diamine fluoride (SDF) and sodium fluoride (NaF) in demineralized dentin exposed to an acid challenge by pH-cycling, (2) to evaluate the remineralizing capacity of SDF/NaF products based on the physicochemical and mechanical properties of the treated dentin surfaces. Methodology: In total, 57 human molars were evaluated in different stages of the experimental period: sound dentin - negative control (Stage 1), demineralized dentin - positive control (Stage 2), and dentin treated with SDF/ NaF products + pH-c (Stage 3). Several commercial products were used for the SDF treatment: Saforide, RivaStar, and Cariestop. The mineral composition and crystalline and morphological characteristics of the dentin samples from each experimental stage were evaluated by infrared spectroscopy (ATR-FTIR), X-ray diffraction, and electron microscopy (SEM-EDX) analytical techniques. Moreover, the mechanical response of the samples was analyzed by means of the three-point bending test. Statistics were estimated for ATR-FTIR variables by Wilcoxon test, while the mechanical data analyses were performed using Kruskal-Wallis and Mann Whitney U tests. Results: Regarding the chemical composition, we observed a higher mineral/organic content in the SDF/NaF treated dentin + pH-c groups (Stage 3) than in the positive control groups (Saforide p=0.03; Cariestop p=0.008; RivaStar p=0.013; NaF p=0.04). The XRD results showed that the crystallite size of hydroxyapatite increased in the SDF/NaF treated dentin + pH-c groups (between +63% in RivaStar to +108% in Saforide), regarding the positive control. SEM images showed that after application of the SDF/NaF products a crystalline precipitate formed on the dentin surface and partially filled the dentin tubules. The flexural strength (MPa) values were higher in the dentin treated with SDF/NaF + pH-c (Stage 3) compared to the positive control groups (Saforide p=0.002; Cariestop p=0.04; RivaStar p=0.04; NaF p=0.02). Conclusions: The application of SDF/ NaF affected the physicochemical and mechanical properties of demineralized dentin. According to the results, the use of SFD/NaF had a remineralizing effect on the dentin surface even under acid challenge., Spanish Government PID2020-116660GB-I00, European Commission A-RNM-408-UGR20, European Regional Development Fund (ERDF) - Next Generation/EU program

The bonding effects of EDTA-chitosan, phosphoric acid, and SE-Bond were compared.Material synthesis, Fourier transform infrared spectroscopy, transmission electron microscopy, scanning electron microscopy, laser confocal microscopy, microtensile bond strength, stereomicroscope observation section, CCK8 cytotoxicity assay, and microfluidic experiments were applied.EDTA-chitosan was synthesized, and it was found by transmission electron microscopy that the application of EDTA-chitosan to dentin can extrafibrillarly demineralize collagen fibers. Scanning electron microscopy provided evidence for the retention of smear plugs in dentin conditioned with 1 wt% EDTA-chitosan. Mixed layer and long resin protrusions can be formed after bonding under a laser confocal microscope. The microtensile strength test found that the bonding strength and the durability obtained by applying the chelating agent EDTA-chitosan to dentin were equivalent to SE-Bond and better than the phosphoric acid wet bonding commonly used clinically (P 0.05). The cytotoxicity of EDTA-chitosan was lower than that of phosphoric acid and SE-Bond in the CCK-8 assay and lower than that of phosphoric acid in the microfluidics experiment.Taken together, the EDTA-chitosan extrafibrillar demineralization strategy retains intrafibrillar minerals and provides better bonding strength and durability with lower cytotoxicity.EDTA-chitosan has the potential to be applied to dentin resin for direct bonding restoration and has good clinical application prospects.

The aim of this study was to evaluate the microhardness of caries-affected dentin and color stability of teeth restored after treatments with silver diamine fluoride (SDF) associated to potassium iodide (KI) and Biosilicate.Different samples from bovine teeth were obtained. For color readings, 80 cavities (6 mm × 6 mm × 2 mm) were prepared, and for microhardness, teeth were flattened into dentine to obtain 40 samples. All samples were submitted to cariogenic challenge and separated in 4 groups, according to the treatment used: 12% SDF + KI; 38% SDF; Biosilicate and control (no treatment). Cavities were restored with resin-modified glass-ionomer cement (RMGIC, Vitremer, 3 M ESPE) or composite resin (CR, Z350, 3 M ESPE). After restoration, the samples were submitted to thermo-mechanical cycling (TMC) for 1,200,000 cycles. Color readings (EasyShade, Vita) were performed after restorations, after TMC, and 30 days after TMC. Knoop microhardness was evaluated on the planned samples before and after cariogenic challenge, after treatments, and after 30 days. Scanning electron microscopy (SEM) evaluated the dentine surface after treatments. Data were analyzed (ANOVA, Bonferroni, p .05).The results showed a higher color alteration for RMGIC than CR. The time of analysis was significant (p .05) for the 12% SDF + KI and control group. There was no difference (p .05) in microhardness between groups. However, there was evidence of dentin remineralization after treatments.It was concluded that the samples treated with Biosilicate resulted in a color alteration similar to control. The treatments presented dentin remineralizing potential for microhardness, below the demineralization level, caused by the cariogenic challenge.Considering the remineralizing potential presented by Biosilicate, this agent is a promising alternative that overcomes the SDF adverse effects such as tooth staining.

The aim was to compare the compressive strength of dentin after irrigation with different concentrations of sodium hypochlorite (NaOCl).A total of 259 extracted human tooth roots with no root caries or previous endodontic treatment were collected. They were sorted by size and length, and assigned to 7 groups (n = 37): negative control (no instrumentation, no irrigant), positive control (saline irrigant), 1%, 2.5%, 4%, 5.25%, and 10% NaOCl. A total of 13 mL NaOCl or saline (in 1-mL increments) was used per canal while being instrumented to #35 files (approximately 13 minutes). EDTAC (15%) was then used to remove the smear layer (2 minutes), followed by NaOCl as a final rinse. The roots were sectioned into 2-mm-thick disks and subjected to compression testing.There was a significant difference between the negative control group and all instrumented groups (P .05). The positive control group was significantly different from the 5.25% group (P .05) and had a low P value when compared with the 2.5% group and the other higher concentrations (P ≅ .1). When the NaOCl groups were compared with each other, there was a significant difference between 1% NaOCl and all higher concentrations (P .05), but no significant difference when 2.5% NaOCl was compared with higher concentrations.A concentration of 1% NaOCl had the least effect on the compressive strength of dentin and this was significantly different from all higher concentrations tested. Therefore, the use of concentrations of NaOCl above 1% should be reconsidered.

OBJECTIVES: Universal adhesives (UAs) can optionally be applied in either an etch-and-rinse (E&R) or self-etch (SE) bonding mode. As the preferred bonding mode differs for enamel versus dentin, a universal conditioner for both enamel and dentin in replacement of the relatively aggressive phosphoric-acid etchant remains desirable. This study aimed to test if a metal salt-based etchant (ZrO(NO3)2) provides as durable bonding to dentin as a classic E&R or SE bonding mode METHODS: Before applying the UA Adhese Universal ('AdU'; Ivoclar Vivadent) to bur-cut dentin of 24 teeth (n = 8), dentin was conditioned with either (1) an experimental metal salt-based conditioner ('ZON'; Ivoclar Vivadent) or (2) 37% phosphoric acid (Total Etch gel, Ivoclar Vivadent), representing a classic 'E&R' mode; (3) a third experimental group involved AdU applied in SE mode. Bonding effectiveness was determined in terms of immediate ('1w') and aged ('50k' TC) micro-tensile bond strength (μTBS) to bur-cut dentin. Adhesive-conditioned dentin interfacial interactions were characterized by S/TEM. RESULTS: Linear mixed-effects modeling revealed significantly higher immediate μTBS to dentin of ZON_AdU than E&R_AdU, while ZON_AdU performed not significantly different from SE_AdU. No significant differences were found between the three experimental groups after 50k TC (aged μTBS). S/TEM disclosed less exposure of dentinal collagen fibrils when AdU was bonded upon ZON etching than when applied in E&R mode. Moreover, ZON resulted in more hydroxyapatite (HAp) crystals remaining at the bottom of the hybrid layer, while dentinal tubule orifices remained nearly fully closed, by which hardly any resin tags were formed. SIGNIFICANCE: The alternative metal salt-based conditioner revealed at dentin a more HAp-protected hybrid layer with less exposure of collagen fibrils, while a comparable bond strength was obtained to that with a phosphoric-acid E&R as well as with an SE (no conditioner) bonding mode. These findings confirm that the metal salt-based conditioner can be considered as a suitable alternative (enamel/)dentin conditioner to classic phosphoric acid employed in an E&R bonding mode. ispartof: DENTAL MATERIALS vol:38 issue:3 pages:554-567 ispartof: location:England status: published

SUMMARYAimTo evaluate and compare the effects of both manual and ultrasonic scaling on surface roughness of four different base materials, used for elevating dentin/cementum gingival margins of proximal cavities.Methods and MaterialsEighty human upper molars with compound Class II mesial cavities, with gingival margins 1 mm below the cemento–enamel junction (CEJ), were divided into four different groups according to the type of the base material used; resin-modified glass ionomer (RMGI), glass hybrid (HV-GIC), flowable bulk-fill resin composite (Bulk Flow) and bioactive ionic resin (Activa). This was followed by completing the restorations with the same resin composite. All materials were used according to the manufacturers’ instructions. All groups were further subdivided into two subgroups according to the scaling technique: manual (hand) or ultrasonic. All restorative and scaling procedures were performed after fixation of specimens with acrylic beside neighboring teeth to simulate natural contact. The mean surface roughness (Ra, μm) of all specimens was measured quantitatively and qualitatively by a three-dimensional (3D) surface analyzer system at two stages; (1) after thermal cycling for 5000 cycles without scaling and (2) after scaling. Data were statistically analyzed using analysis of variance (ANOVA), Tukey post hoc tests, and paired sample t-tests (at α=0.05).ResultsFor baseline readings, the Bulk Flow group had the lowest Ra values, while HV-GIC group had the highest. RMGI and Activa groups had no statistical significant difference between their Ra values (p>0.05). For post scaling readings, hand scaling had significantly lower Ra values than ultrasonic scaling in all the material groups (p0.05)ConclusionBulk Flow had the smoothest surfaces when cured against a matrix band compared with the other tested base materials. When hand and ultrasonic scaling methods were compared, the latter technique had more detrimental effect on the surface texture of the four tested base materials.