Using Proanthocyanidin as a Root Dentin Conditioner for GIC Restorations

2021 ◽  
pp. 002203452110181
Author(s):  
J. Cai ◽  
M.F. Burrow ◽  
D.J. Manton ◽  
J.E.A. Palamara
Keyword(s):  
Failure Modes ◽  
High Viscosity ◽  
Raman Microspectroscopy ◽  
Bonding Interface ◽  
Restorative Treatment ◽  
Complementary Approach ◽  
Carious Lesions ◽  
Root Dentin ◽  
Casein Phosphopeptide ◽  
Acidic Nature

Glass ionomer cements (GICs) are considered the material of choice for restoration of root carious lesions (RCLs). When bonding to demineralized dentin, the collapse of dentinal collagen during restorative treatment may pose challenges. Considering its acidic nature and collagen biomodification effects, proanthocyanidin (PAC) could be potentially used as a dentin conditioner to remove the smear layer while simultaneously acting to biomodify the dentinal collagen involved in the bonding interface. In this study, 6.5% w/v PAC was used as a conditioner for sound (SD) and laboratory demineralized (DD) root dentin before bonding to resin-modified GIC (FII), casein phosphopeptide–amorphous calcium phosphate (CPP-ACP)–modified GIC (FVII), or a high-viscosity GIC (FIX). Root dentin conditioned with deionized distilled water (DDW) or polyacrylic acid (PAA) served as controls. Results indicated FII showed higher shear bond strength (SBS) on SD than the other 2 GICs, especially in PAA-conditioned samples; FIX showed significantly higher SBS than FII and FVII on PAA- or PAC-conditioned DD. In each category of GIC, PAA and PAC did not have a significant influence on SBS in most cases compared to DDW except for a significant decrease in PAC-conditioned SD bonded to FII and a significant increase in PAA-conditioned DD bonded to FIX. The bonding interface between GIC and SD was generally more resistant to the acid-base challenge than DD. Although the alterations in failure modes indicated a compromised interfacial interaction between GICs and PAC-treated root dentin, biomodification effects of PAC on dentin were observed from Raman microspectroscopy analysis in terms of the changes in mineral-to-matrix ratio and hydroxyproline-to-proline ratio of dentin adjacent to the bonding interface, especially of DD. Results from this study also indicated the possibility of using in situ characterization such as Raman microspectroscopy as a complementary approach to SBS test to investigate the integrity of the bonding interface.

Microshear Bond Strength of High-viscosity Glass-ionomer to Normal and Caries-affected Dentin Under Simulated Intrapulpal Pressure

2018 ◽  
Vol 43 (6) ◽  
pp. 665-673 ◽  
Author(s):  
HA El-Deeb ◽  
EH Mobarak
Keyword(s):  
Bond Strength ◽  
Repeated Measures ◽  
Failure Modes ◽  
Testing Machine ◽  
High Viscosity ◽  
Atraumatic Restorative Treatment ◽  
Glass Ionomer ◽  
Restorative Treatment ◽  
Dye Permeability ◽  
Microshear Bond Strength

SUMMARY Objectives: The use of high-viscosity glass-ionomer cements (HVGICs) for atraumatic restorative treatment (ART) restorations is widely practiced with the advent of various HVGICs. However, the bonding of the latter to caries-affected dentin (CAD) should be validated, especially because it is the common substrate left after conservative caries removal following the ART approach. Hence, this study was carried out to evaluate the microshear bond strength (μSBS) of three HVGICs to normal dentin (ND) and CAD under intrapulpal pressure (IPP) simulation. Methods and Materials: The occlusal enamel of 90 molars with mid-coronal caries was cut to expose flat dentin surfaces containing both ND and CAD. Dentin substrates (ND and CAD) were differentiated using visual, tactile, caries-detecting dye, and dye-permeability methods. Prepared crown segments were equally divided (n=30) according to the tested HVGICs into GC Fuji IX GP Fast, Fuji IX GP containing chlorhexidine, and zinc-reinforced ChemFil Rock HVGIC. Microcylinders of tested HVGICs were built up on both dentin substrates (n=30 for each tested HVGIC per each substrate) using starch tubes while the specimens were subjected to simulated IPP of 15 mm Hg. The μSBS test was conducted using a universal testing machine, and failure modes were determined using a scanning electron microscope. Data were statistically analyzed using two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA, and Bonferroni post hoc tests (α=0.05). Results: For both dentin substrates (ND and CAD), the μSBS values of ChemFil Rock were significantly higher than those recorded for the other HVGICs. The μSBS values of each tested HVGIC to ND and CAD were not statistically different. Failure modes were mainly mixed. Conclusions: Zinc-reinforced HVGIC ChemFil Rock showed superior bonding to ND and CAD compared to the GC Fuji IX GP Fast and Fuji IX with chlorhexidine. However, each of the tested HVGICs showed comparable bonding to both dentin substrates (ND and CAD).

scholarly journals Reversal of Root Caries with Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Varnish in Xerostomia

2021 ◽  
pp. 1-10
Author(s):  
Ahmed Sleibi ◽  
Anwar R. Tappuni ◽  
Aylin Baysan
Keyword(s):  
Calcium Phosphate ◽  
Amorphous Calcium Phosphate ◽  
Primary Root ◽  
Severity Index ◽  
Salivary Flow ◽  
Root Caries ◽  
Carious Lesions ◽  
Group 2 ◽  
Casein Phosphopeptide ◽  
Group 1

Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45–92 years) with primary root caries (<i>n</i> = 184 root carious lesions) and unstimulated salivary flow rate of &#x3c;0.2 mL/min were randomly allocated to receive either dental varnish containing CPP-ACP and 5% fluoride (group 1: MI varnish; GC, Japan) (<i>n</i> = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (<i>n</i> = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (<i>n</i> = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (<i>n</i> = 35) in group 2 (<i>p</i> &#x3c; 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, <i>n</i> = 60, 83.3%) (group 2, <i>n</i> = 66, 74.2%) (<i>p</i> = 0.36), and (group 1, <i>n</i> = 60, 89.6%) (group 2, <i>n</i> = 67, 81.7%, <i>n</i> = 1 soft, 1.2%) (<i>p</i> = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (<i>p</i> &#x3c; 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.

scholarly journals Atraumatic Restorative Treatment and Interim Therapeutic Restoration: A Review of the Literature

2019 ◽  
Vol 7 (1) ◽  
pp. 28 ◽  
Author(s):  
Afnan Saber ◽  
Azza El-Housseiny ◽  
Najlaa Alamoudi
Keyword(s):  
Dental Treatment ◽  
High Viscosity ◽  
Atraumatic Restorative Treatment ◽  
Glass Ionomer ◽  
Success Rates ◽  
Traditional Treatment ◽  
Restorative Treatment ◽  
Mechanical Approach ◽  
Better Than ◽  
The Ideal

This review discusses the techniques and uses of atraumatic restorative treatment (ART) and interim therapeutic restoration (ITR) and states the differences between these two approaches. ART and ITR are similar approaches and are performed using the same material, but they differ in the purpose of their use. ART is used in cases when there are obstacles to reaching dental care units and has been proven to have high success rates in primary and permanent dentitions. ITR is used as a temporary restoration that will be replaced with a more definitive one. ITR is used in cases when the ideal dental treatment cannot be performed. Conventional glass polyalkenoate (ionomer) restorative cement (GIC) is the material of choice that has been used for ART and ITR. This is because of its fluoride release properties, including its ability to bond to enamel and dentine, its pulpal biocompatibility, and its ease of manipulation. High-viscosity glass ionomer performed better than low and medium-viscosity glass ionomer in ART. Combining GIC with conditioner, as well as the use of a chemo-mechanical approach, improved the success rate of ART. Both ATR and ITR are acceptable strategies, with success rates comparable to the traditional treatment methods.

In vitro study of the effect of a pulsed 10.6μm CO 2 laser and fluoride on the reduction of carious lesions progression in bovine root dentin

2010 ◽  
Author(s):  
Thaís M. Parisotto ◽  
Patrícia A. Sacramento ◽  
Marcelo C. Alves ◽  
Regina M. Puppin-Rontani ◽  
Maria Beatriz D. Gavião ◽  
...  
Keyword(s):  
In Vitro Study ◽  
Vitro Study ◽  
Carious Lesions ◽  
Root Dentin

scholarly journals Restorative treatment for initial, cavitated and gross coronal carious lesions

2016 ◽  
Vol 61 (3) ◽  
pp. 350-356
Author(s):  
DS Brennan ◽  
M Balasubramanian ◽  
AJ Spencer
Keyword(s):  
Restorative Treatment ◽  
Carious Lesions

scholarly journals Adhesion of real seal to human root dentin treated with different solutions

2012 ◽  
Vol 23 (5) ◽  
pp. 521-526 ◽  
Author(s):  
Renata Baldissera ◽  
Ricardo Abreu da Rosa ◽  
Márcia Helena Wagner ◽  
Milton Carlos Kuga ◽  
Fabiana Soares Grecca ◽  
...  
Keyword(s):  
Bond Strength ◽  
Root Canal ◽  
Failure Modes ◽  
Chlorhexidine Gluconate ◽  
The Other ◽  
Significant Difference ◽  
Root Dentin ◽  
Bond Strengths ◽  
Group 2 ◽  
Push Out

The aim of this study was to evaluate the effects of different irrigants on sealer-dentin bond strength when using Real Seal. Thirty single-rooted teeth were divided into 3 groups. In one group, the teeth were irrigated with 3 mL of 2.5% NaOCl after each file change, flushed with 17% EDTA for 3 min and finally rinsed with 3 mL of 2.5% NaOCl. In the other two groups, rinse with NaOCl was replaced with 2% chlorhexidine gluconate (CHX) and 0.9% saline, respectively. Each root was sectioned transversally into apical, middle and coronal thirds to obtain 2-mm-thick slices. Each slice was filled with Real Seal and Resilon. Push-out test was used to analyze bond strength and failure modes were classified as adhesive, cohesive or mixed, according to SEM observations. The push-out test did not reveal any statistically significant difference (p>0.05) between the irrigants. However, the groups exhibited significantly different (p<0.05) bond strengths in terms of the root canal third. Higher bond strength was observed at the apical third when compared with coronal third, while middle third presented intermediary values. Fifteen specimens were analyzed by SEM (5 per group). Eleven specimens exhibited adhesive failures (5 in saline, 4 in NaOCl and 2 in CHX group); 2 cohesive failures were observed in the CHX group, and 1 mixed failure each was observed in the CHX and NaOCl groups. The tested irrigants did not influence the bond strength of Resilon and Real Seal to dentin. The apical third exhibited higher mean bond strengths and adhesive failures were predominant.

scholarly journals Influence of Etching Mode and Composite Type on Bond Strength to Biodentine Using a “No-Wait” Universal Adhesive

2021 ◽  
pp. 354-365
Author(s):  
Ayça Sarialioğlu Güngör ◽  
Betül Aycan Uysal
Keyword(s):  
Bond Strength ◽  
Failure Modes ◽  
High Viscosity ◽  
Resin Composites ◽  
Universal Adhesive ◽  
Low Viscosity ◽  
Composite Type ◽  
Etch And Rinse ◽  
No Wait ◽  
Post Hoc

The purpose of this study was to compare the shear bond strength (SBS) of four resin-based composite materials to a silicate-based cement using a “no-wait” universal bond with self-etch (SE) and etch-and-rinse (ER) modes. Acrylic blocks (n=80, 2mm depth, 5mm diameter central hole) were prepared. The holes were filled with BiodentineTM (BD) and divided into 4 main groups (n=20) according to the composite resin type used: Group FZ250: FiltekTM Z250 Universal Restorative (microhybrid), Group SDR: SDR Plus U Bulk Fill Flowable (low-viscosity bulk-fill), Group FBP: FiltekTM Bulk Fill Posterior (high-viscosity bulk-fill), Group EF: EsFlow™ Universal Flowable Composite (nanohybrid). A ‘no-wait’ universal bond (Clearfil Universal Bond Quick) was used for bonding application. Then each group was divided into 2 subgroups according to the etching mode applied (ER and SE). SBSs were measured and stereomicroscope was used to identify the failure modes. Selected samples of fracture surfaces were imaged by SEM. Tukey’s post-hoc and One-way ANOVA tests were used to analyze data. There were statistically significant differences among the composite groups (p<0.05). When SDR  showed the highest bond strength values in SE (17.13 ± 2.98 MPa) mode, FBP showed the lowest bond strength values in ER (8.89 ± 2.46 MPa) mode. The mean SBS was not different between the SE and ER modes (p> 0.05). The SBS of BD to the resin composites depends on the composite type but  application of the ‘no-wait’ universal bond in different etching modes is regardless of the SBS of BD to resin composites.

scholarly journals Caries burden and suitability for atraumatic restorative treatment among schoolchildren in Indonesia

2020 ◽  
Vol 3 ◽  
pp. 77-81
Author(s):  
Irene Adyatmaka ◽  
Jilen Patel
Keyword(s):  
Dental Caries ◽  
Mixed Dentition ◽  
Caries Experience ◽  
Good Effect ◽  
Atraumatic Restorative Treatment ◽  
Older Children ◽  
Cross Sectional ◽  
Restorative Treatment ◽  
Stage Of Development ◽  
Carious Lesions

Objectives: Dental caries remains among the most prevalent chronic conditions in childhood and remains highly prevalent among schoolchildren in Indonesia. Globally, atraumatic restorative treatment (ART) has been used to good effect in the management of carious lesions among high-risk cohorts, particularly in challenging environments. However, in settings, where labor, time, facilities, and materials are particularly limited, strategic triaging of teeth suitable for ART restorations may be valuable to better direct public health expenditure. Therefore, this study aims to (i) describe the prevalence of dental caries among Indonesian schoolchildren and (ii) evaluate the proportion of lesions indicated for ART. Materials and Methods: A cross-sectional cohort study of elementary schoolchildren from West Java, Indonesia, was examined and categorized according to Hellman’s dental development stages (Groups 1–4 corresponding to the early mixed dentition through to complete permanent dentition). Descriptive statistics and proportional analysis were conducted with the following variables being evaluated: Teeth with early caries (EC), late/advanced caries (LC), recurrent caries (RC), and total caries experience (TC = EC+ART+LC+RC). In evaluating the suitability for ART, additional variables of ART indicated carious lesions (ART) and lower molars with lesions indicated for ART (LM) were assessed. Results: A total of 437 children ranging from 8 to 14 years of age were examined. Out of 8882 teeth examined, 996 had active carious lesions and only 57 had received satisfactory restorative treatment. Children in Hellman’s Group 1 stage of development had the highest prevalence of EC (62%) and ART indicated caries (32%). Meanwhile, older children in Group 4 experienced the highest portion of advanced caries (15%). The proportion of lower molars indicated for ART was 87%, 76%, 70%, and 67% in Groups 1–4, respectively. Conclusion: Indonesian schoolchildren face a high burden of untreated dental caries from a young age. The younger the developmental stage, the higher the prevalence of early and ART-indicated lesions with the majority being found in lower permanent molars. Although ART and preventive strategies show the highest potential in the early mixed dentition, they alone cannot completely meet the dental needs of populations such as this where the severity and disease burden are extremely high.

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