Showing papers in "Journal of Dental Research in 1995"

Shear vs. Tensile Bond Strength of Resin Composite Bonded to Ceramic

Abstract: Since the mode of failure of resin composites bonded to ceramics has frequently been reported to be cohesive fracture of either ceramic or resin composite rather than separation at the adhesive interface, this study was designed to question the validity of shear bond strength tests. The reasons for such a failure mode are identified and an alternative tensile bond strength test evaluated. Three configurations (A, conventional; B, reversed; and C, all composite) of the cylinder-on-disc design were produced for shear bond strength testing. Two-dimensional finite element stress analysis (FEA) was carried out to determine qualitatively the stress distribution for the three configurations. A tensile bond strength test was designed and used to evaluate two ceramic repair systems, one using hydrofluoric acid (HF) and the other acidulated phosphate fluoride (APF). Results from the shear bond strength tests and FEA showed that this particular test has as its inherent feature the measurement of the strength of the ...

The Fidelity of Initial Acquisition of Mutans Streptococci by Infants from Their Mothers

Abstract: Previous cross-sectional studies using bacteriocin profiles, serotyping, or genotyping suggest that mothers are the principle source of mutans streptococci (MS) to their infants. This study determined the commonality of MS genotypes between mothers and their infants at the time of initial acquisition. Oral bacteria of mothers and their infants were monitored from birth for approximately 3 years at three-month intervals. Genotypes of MS in infants appeared identical to those present in mothers in approximately 71% of 34 mother-infant pairs studied. Interestingly, female infants acquired MS genotypes identical to their mothers' with significantly greater fidelity than male infants (88% vs. 53%). Homology of genotypes between mothers and their infants at initial acquisition strongly suggests that MS strains were transmitted from mother to infant and that this transfer exhibited gender specificity. In no instance did we observe homology of genotypes between fathers and infants or fathers and mothers, further supporting the notion that acquisition of MS in humans follows maternal lines. Although the prevalence of dental caries was low in this young child population (11/34; 32%), we observed that male children who harbored the same genotype as their mothers had a 13 times greater likelihood of having caries than female children who acquired their mothers' strain; this difference was statistically significant (p < 0.01). Although we do not know the biological mechanisms governing fidelity of acquisition between a mother and her infant, our data suggest that caries outcome may be, in part, determined by both the source of MS and the presence of a specific genotype of MS.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral Candida: Clearance, Colonization, or Candidiasis?

Abstract: Candida albicans is frequently isolated from the human mouth, yet few carriers develop clinical signs of candidiasis. Oral candidiasis presents clinically in many forms. This reflects the ability of the yeast to colonize different oral surfaces and the variety of factors which predispose the host to Candida colonization and subsequent infection. Colonization of the oral cavity appears to be facilitated by several specific adherence interactions between C. albicans and oral surfaces which enable the yeast to resist host clearance mechanisms. Thus, Candida has been shown to adhere to complement receptors, various extracellular matrix proteins, and specific sugar residues displayed on host or bacterial surfaces in the oral cavity. Oral candidiasis results from yeast overgrowth and penetration of the oral tissues when the host's physical and immunological defenses have been undermined. Tissue invasion may be assisted by secreted hydrolytic enzymes, hyphal formation, and contact sensing. While these and other phenotypic characteristics may endow certain Candida species or strains with a competitive advantage in the oral cavity, it is the host's immune competence that ultimately determines whether clearance, colonization, or candidiasis occurs.

Failure of All-ceramic Fixed Partial Dentures in vitro and in vivo: Analysis and Modeling

Abstract: Hertzian cone cracks visible at the loading site of 20 all-ceramic fixed partial dentures (FPDs), tested in vitro, led to the hypotheses that failure was due to the propagation of localized contact damage crack systems (Hertzian stress state) and that such damage was an unlikely clinical failure mode. Fractographic analysis of the 20 laboratory-failed and nine clinically-failed all-ceramic FPDs allowed for definitive testing of these hypotheses and a comparison between in vitro and in vivo failure behavior. In all cases, failure occurred in the FPD connectors (none from contact damage), with approximately 70 to 78% originating from the interface between the core and veneer ceramics. The coincidence between failure origins provides strong evidence that the in vitro test modeled aspects of structural behavior having clinical importance. The fractographic observations, coupled with the in vitro failure load data, furnished very specific boundary conditions which were applied to constrain mathematical models ...

Full- vs. Partial-mouth Disinfection in the Treatment of Periodontal Infections: Short-term Clinical and Microbiological Observations

Abstract: In a standard periodontal treatment strategy with consecutive root planings (per quadrant at a one- to two-week interval), re-infection of a disinfected area might occur before completion of the treatment. This study examines, both clinically and microbiologically, whether a full-mouth disinfection within 24 hours significantly improves the outcome of periodontal treatment. Ten patients with advanced chronic periodontitis were randomly allocated to a test and a control group. The patients from the control group received scalings and root planings as well as oral hygiene instructions per quadrant at two-week intervals. Full-mouth disinfection in the test group was sought by the removal of all plaque and calculus (in two visits within 24 hours). In addition, at each of these visits, the tongue was brushed with a 1 % chlorhexidine gel for one min and the mouth rinsed with a 0.2% chlorhexidine solution for two min. Furthermore, subgingival chlorhexidine (1%) irrigation was performed in all pockets. The recolo...

Tooth Color and Reflectance as Related to Light Scattering and Enamel Hardness

Abstract: Tooth color is determined by the paths of light inside the tooth and absorption along these paths. This paper tests the hypothesis that, since the paths are determined by scattering, a relation between color and scattering coefficients exists. One hundred and two extracted incisors were fixed in formalin, mounted in a standardized position in brass holders, and pumiced. A facet was prepared near the incisal edge on the labial plane to allow for Knoop hardness measurements with a 500-gram load. Light scattering by the enamel was measured in a 45°/0° geometry; light scattering by both enamel and dentin was measured in a 0°/0° geometry. The reflection spectrum of the tooth was measured from the labial plane with a spectroradiometer in a 45°/0° geometry, with standard illuminant A and standard illuminant D65. To include all volume-reflected light, we used entire-tooth illumination and small-area measurement. CIELAB color coordinates were calculated from the spectra. Neither spectra nor coordinates showed evid...

Tensile Bond Strength and SEM Evaluation of Caries-affected Dentin Using Dentin Adhesives

Abstract: Tensile bond strength measurements are commonly used for the evaluation of dentin adhesive systems. Most tests are performed using extracted non-carious human or bovine dentin. However, the adhesion of resins to caries-affected dentin is still unclear. The objectives of this study were to test the hypothesis that bonding to caries-affected dentin is inferior to bonding to normal dentin, and that the quality of the hybrid layer plays a major role in creating good adhesion. We used a micro-tensile bond strength test to compare test bond strengths made to either caries-affected dentin or normal dentin, using three commercial adhesive systems (All Bond 2, Scotchbond Multi-Purpose, and Clearfil Liner Bond II). For scanning electron microscopy, the polished interfaces between the adhesive bond and dentin were subjected to brief exposure to 10% phosphoric acid solution and 5% sodium hypochlorite, so that the quality of the hybrid layers could be observed. Bonding to normal dentin with either All Bond 2 (26.9 ± 8...

Cytotoxic Interactive Effects of Dentin Bonding Components on Mouse Fibroblasts

Abstract: Previous studies have shown a wide range of pulpal reactions to dentin bonding systems and a poor correlation between in vitro and in vivo toxicity of dentin bonding agents. Because dentin bonding agents are composed of multiple components which may diffuse through dentin, we hypothesized that these components may cause cytotoxicity through interactive (synergistic) effects. We investigated the cytotoxicities of four dentin bonding components--HEMA, Bis-GMA, TEGDMA, and UDMA--and interactive effects for three binary combinations of the dentin bonding components--HEMA and Bis-GMA, Bis-GMA and TEGDMA, and TEGDMA and UDMA. Cytotoxicities to Balb/c 3T3 mouse fibroblasts were measured by the MTT assay. Concentrations which caused 50% toxicity compared with controls (TC50 values) were compared, and the interactive effects were determined by evaluation of the differences between observed and expected MTT activities of the cells. The ranks of toxicity of the dentin bonding components in terms of TC50 values were as follows: Bis-GMA > UDMA > TEGDMA >>> HEMA (least toxic) after 24- and 72-hour exposures. As binary combinations, the three combinations of dentin bonding components interacted in three ways--synergism, additivism, and antagonism--which were influenced by the concentrations of both components. The longer period of exposure resulted in a significant increase in the cytotoxicity of the dentin bonding components and combinations. The findings indicate that both exposure time and the interactions between the dentin bonding components may be important parameters in determining the cytotoxicity of dentin bonding agents in vivo.

Xylitol Chewing Gums and Caries Rates: A 40-month Cohort Study

Abstract: Dental caries is a pandemic infectious disease which can affect the quality of life and consumes considerable health care resources. The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates. No clinical study has simultaneously investigated the effectiveness of these gums when compared with a group receiving no chewing gum. A 40-month double-blind cohort study on the relationship between the use of chewing gum and dental caries was performed in 1989-1993 in Belize, Central America. One thousand two hundred and seventy-seven subjects (mean age, 10.2 years) were assigned to nine treatment groups: one control group (no supervised gum use), four xylitol groups (range of supervised xylitol consumption: 4.3 to 9.0 g/day), two xylitol-sorbitol groups (range of supervised consumption of total polyols: 8.0 to 9.7 g/day), one sorbitol group (supervised consumption: 9.0 g/day). The gum use during school hours was supervised. Four calibrated dentists performed the caries registrations by means of a modified WHO procedure. The primary endpoint was the development of an unequivocal caries lesion on a non-cavitated tooth surface. Compared with the no-gum group, sucrose gum usage resulted in a marginal increase in the caries rate (relative risk, 1.20; 95% confidence interval,0.96 to 1.49; p = 0.1128). Sorbitol gum significantly reduced caries rates (relative risk 0.74; 95% confidence interval, 0.6 to 0.92 ; p = 0.0074). The four xylitol gums were most effective in reducing caries rates, the most effective agent being a 100% xylitol pellet gum (relative risk, 0.27; 95% confidence interval, 0.20 to 0.36; p = 0.0001). This gum was superior to any other gum (p < 0.01). The xylitol-sorbitol mixtures were less effective than xylitol, but they reduced caries rates significantly compared with the no-gum group. DMFS analyses were consistent with these conclusions. The results suggest that systematic usage of polyol-based chewing gums reduces caries rates in young subjects, with xylitol gums being more effective than sorbitol gums.

Anticariogenicity of Calcium Phosphate Complexes of Tryptic Casein Phosphopeptides in the Rat

Abstract: Casein phosphopeptides (CPP) stabilize calcium phosphate through the formation of casein-phosphopeptide amorphous calcium-phosphate complexes (CPP-CP). The ability of CPP-CP to reduce caries activity was investigated by use of specific-pathogen-free rats inoculated with Streptococcus sobrinus. The animals consumed a defined cariogenic diet free of dairy products. Solutions (100 microL) of the CPP-CP (0.1, 0.2, 0.5, 1.0% w/v) were applied to the animals' molar teeth twice daily. Other groups of animals received solutions containing 500 ppm F, the non-phosphorylated peptides of a casein tryptic digest (0.5% w/v), or the calcium-phosphate complex of a synthetic octapeptide, Ac-Glu-Ser(P)-Ile-Ser(P)-Ser(P)-Ser(P)-Glu-Glu-NHMe, corresponding to the common sequence in the CPP. The CPP-CP significantly reduced caries activity in a dose-response fashion, with 1.0% CPP-CP producing 55% and 46% reductions in smooth surface and fissure caries activity, respectively, being similar to that of 500 ppm F. The anticariogenic effects of CPP-CP and fluoride were additive, since animals receiving 0.5% CPP-CP plus 500 ppm F had significantly lower caries activity than those animals receiving either CPP-CP or fluoride alone. The tryptic digest of casein with the phosphopeptides selectively removed showed no anticariogenic activity. The synthetic octapeptide-calcium phosphate complex significantly reduced caries activity, confirming that this calcium-phosphate-stabilizing portion of the casein phospho-peptides is associated with anticariogenicity. The CPP-CP did not significantly affect the level of S. sobrinus in fissure plaque.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of Treatment and Storage Conditions on Ceramic/Composite Bond Strength

Abstract: During the past few years, the interest in using ceramic inlays and veneers has increased. New materials and methods have been introduced to bond these restorations to resinous materials. Since our knowledge of how to optimize such bonding is limited, the objective of this study was to test the hypothesis that various surface treatment variables and combinations of these variables affect the strength of the ceramic/composite interphase of ceramic inlays differently. The influences of material composition, surface-roughening method, silane treatment, silane heat treatment, and storage condition on bond strength were investigated. Three ceramics (Dicor, Mirage, Vitabloc), three surface-roughening methods (etching, sandblasting, grinding), three silane treatments (gamma-methacryloxypropyltrimethoxysilane [MPS], MPS+paratoluidine, vinyltrichlorosilane), two heat treatments (20 degrees C for 60 s, 100 degrees C for 60 s), and two storage conditions (24-hour dry, one yr in water at 37 degrees C) were studied. For each of the 108 combinations, five specimens were tested. Ceramic cylinders were treated according to group assignment and bonded to blocks of the same ceramic material with a dual-cured resin. The shear bond strength was determined, and the experimental factors were evaluated by analysis of variance. The results showed that surface-roughening method had the strongest effect on bond strength, while ceramic selection had the least significant effect. Of the surface-roughening methods, etching was associated with higher bond strength values than either sandblasting or grinding.(ABSTRACT TRUNCATED AT 250 WORDS)

Relation between Clinical Dental Status and Subjective Impacts on Daily Living

Abstract: Although clinical dental status has weak correlations with subjective impacts, some of them are significant. Those variables which had significant correlations could be used as a starting point to understand clinical and social characteristics of people who experience dental problems. This is indeed the basis for the current research. The study compares psychosocial impacts on the quality of people's life with their respective oral status. To that end, a socio-dental indicator, the 'Dental Impact of Daily Living' (DIDL), involving five dimensions, together with a scale which assesses dimension impacts, was developed. The resulting instrument was validated and the reliability tested. The instrument generates a total final score, in addition to scores for each dimension. The method was tested in Brazil on a sample of 662 people, aged from 35 to 44 years, of two social classes, both sexes, and with three different levels of dental caries status or with a full upper denture. To test whether DIDL discriminated...

Jaw Pain Prevalence Among French-speaking Canadians in Quebec and Related Symptoms of Temporomandibular Disorders

Abstract: The purpose of this study was to assess the prevalence and pattern of self-reported TMD jaw pain in a randomized stratified sample from the general population living in the Province of Quebec, Canada. Through a telephone survey, standardized questions were asked to 897 French-speaking respondents, aged 18 years old and over, regarding frequency, severity, daily pattern of jaw pain, presence of difficulty in opening, joint clicking, and sleeping problems. All prevalence estimates were adjusted to the sociodemographic distribution of the non-institutionalized population. The results indicate that TMD jaw pain is self-reported by 30% of the general population; however, the prevalence of cases reporting frequent episodes (quite often or very often) is estimated at 7%, with more than two-thirds (69%) of the respondents in this subgroup experiencing moderate to severe pain. The prevalence rates of frequent difficulty in opening and joint clicking were estimated at 9% and 4%, respectively. Approximately one in f...

Inhibition of prostaglandin E2 and interleukin 1-beta production by low-power laser irradiation in stretched human periodontal ligament cells.

Abstract: It is well-known that orthodontic treatment usually causes some discomfort and pain to the patients Recently, it has been reported that low-power laser irradiation is effective in reducing the pain accompanying tooth movement However, the mechanism of such pain relief cannot be elucidated Since high levels of prostaglandin (PG) E2 and interleukin (IL)-1 beta are found in the periodontal ligament (PDL) during tooth movement, and both factors are involved in the induction of pain, the effects of low-power laser irradiation on PGE2 and IL-1 beta production in stretched human PDL cells were studied in vitro The PDL cells, derived from healthy premolars extracted for orthodontic treatment, were utilized for experiments Cells were seeded in flexible-bottomed culture plates, and the bottom of each plate was elongated (18% increase) under vacuum at 6 cycles per min for 1, 3, or 5 days The stretched cells were irradiated with a Ga-Al-As low-power diode laser (60 mW) once a day for 3, 6, or 10 min (from 108 to 360 J) for 1, 3, or 5 days PGE2 and IL-1 beta levels in the medium were measured by radioimmunoassay In response to mechanical stretching, human PDL cells showed a marked elevation in PGE2 production in a time-dependent manner IL-1 beta production was also elevated, but this remained constant The increase in PGE2 production was significantly inhibited by laser irradiation in a dose-dependent manner The increase in IL-1 beta production was also significantly inhibited by laser irradiation, although the inhibition was only partial(ABSTRACT TRUNCATED AT 250 WORDS)

Hypermineralization of Dentinal Lesions Adjacent to Glass-ionomer Cement Restorations

Abstract: Previous reports have shown a release of fluoride from glass-ionomer cement (GIC) restorations into the oral fluids. Fluoride in the ambient fluids has a caries-preventive effect by enhancing remineralization and inhibiting demineralization of the dental hard tissues. Therefore, the current investigation was undertaken to determine whether GIC fillings could contribute to the remineralization of caries lesions in dentin. Small circular preparations were made in disks of dentin which had incipient caries-like lesions in the remaining tissue. The preparations were filled with amalgam or composite materials (as controls) or with GIC. The specimens thus contained a restoration close to a dentinal caries-like lesion. The specimens were placed contralaterally in the buccal surfaces of removable partial dentures and were worn intra-orally by volunteers for a 12-week experimental period, after which the specimens were sectioned and analyzed by microradiography. All specimens with GIC restorations exhibited hypermineralization in the tissue bordering the filling and in the wall of the preparation which had been in contact with the restoration. The (caries-like) lesions were remineralized, even under conditions of heavy plaque formation. In contrast, specimens with amalgam or composite restorations showed further extensive demineralization. This study demonstrates a significant remineralization potential exerted by the fluoride-releasing GIC restorative material. Consequently, the choice of the restorative material might be crucial for the occurrence or prevention of recurrent caries around restorations.

Response of L-929 Fibroblasts, Human Gingival Fibroblasts, and Human Tissue Mast Cells to Various Metal Cations

Abstract: Recent data suggest that under certain conditions, various metal cations are released from dental alloys. These ions may produce adverse effects in various cell types in vivo. In this study, the cytopathogenic effects of 13 metal cations on murine L-929 fibroblasts, human gingival fibroblasts, and human tissue mast cells were analyzed in vitro. Several metal cations (dose range, from 0.0033 to 1.0 mmol/L) were found to induce dose-dependent inhibition of 3H-thymidine incorporation into cultured fibroblasts. The rank order of potency (lowest observed effect level, LOEL) for L-929 fibroblasts was: Ag+ > Pt4+ > Co2+ > In3+ > Ga3+ > Au3+ > Cu2+ > Ni2+ > Zn2+ > Pd2+ > Mo5+ > Sn2+ > Cr2+. A similar rank order of potency was obtained for primary human gingival fibroblasts: Pt4+ > Ag+ > Au3+ > In3+ > Ga3+ > Ni2+ > Co2+ > Zn2+ > Cu2+ > Cr2+ > Pd2+ > Mo5+ > Sn2+. In primary human mast cells, Ag+ and Au3+ caused dose-dependent toxic histamine release, whereas the other metal cations were ineffective over the dose range tested. To investigate the mechanism of metal cation-induced effects, we performed DNA as well as electron microscopic analyses on cultured fibroblasts. Both the DNA pattern and the ultrastructure of L-929 cells and gingival fibroblasts after exposure to cytopathogenic metal cations revealed signs of necrosis but no signs of apoptosis. Together, our data provide evidence that various metal cations produce dose-dependent cytopathogenic effects in distinct cell types, including human gingival fibroblasts and human tissue mast cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Electromyographic Heterogeneity in the Human Temporalis and Masseter Muscles during Static Biting, Open\ Close Excursions, and Chewing

Abstract: The human temporalis and masseter muscles are not activated homogeneously during static bite force tasks. In this study, we studied the possible existence of regional differences in these muscles under dynamic conditions. Electromyographic (EMG) activity was recorded by means of bipolar fine-wire electrodes. Six electrodes were inserted into the temporalis muscle and three into the masseter muscle. Recordings were made during maximal effort intercuspal and incisal static clenches, open/close excursions from both the intercuspal and incisal positions, and unilateral gum and licorice chewing on right and left sides. The EMG peak amplitudes and the peak occurrences were compared. During the static clenches and the open/close excursions, no differences could be demonstrated between the regions of the temporalis muscle. However, during the chewing tasks, the anterior and posterior regions behaved differently. Throughout almost all tasks, both superficial and deep parts could be distinguished in the masseter muscle. A further division of the deep masseter was task-dependent. In both the temporalis and masseter muscles, maximal activity (100%) was reached during intercuspal clenches. The average activity declined to 35% of the maximal activity in the temporalis muscle, to 47% in the deep, and to 86% in the superficial masseter during incisal clenches. During all chewing tasks, the EMG peak activity of the anterior temporalis and the superficial masseter muscles was higher in the working than in the balancing condition. The general finding was that different regions were preferentially activated, according to task. The detailed regional specialization previously observed during static bite force tasks could not be demonstrated in the present study.

Mineral Distribution and Dimensional Changes in Human Dentin during Demineralization

Abstract: Many bonding agents require the dentin surface to be acid-etched prior to being bonded. Understanding the stability and morphology of the etched dentin surface is important for improving bond strength and reliability in these systems. In this study, the atomic force microscope was used to quantify dimensional changes that occur to fully hydrated dentin during demineralization with a pH 4.0 lactic acid gel. A high-resolution microtomography instrument, the x-ray tomographic microscope, was also used to quantify the mineral density distribution in the dentin as a function of etching time. The intertubular dentin surface shrank by less than 0.5 microns during etching, while the peritubular dentin receded at an initially rapid linear rate. The dentin surface retained its initial morphology, although it was more porous with the removal of the peritubular dentin. Beneath the etched surface, there were three major zones characterized by mineral density differences. The first zone was a fully demineralized collagen layer, subjacent to which was a partially demineralized zone of roughly constant mineral density. Immediately following the partially mineralized layer was normal dentin. The presence of the partially mineralized layer could be explained in terms of different transport rates in the peritubular and intertubular dentin.

Differential expression of IL-1 beta, TNF-alpha, IL-6, and IL-8 in human monocytes in response to lipopolysaccharides from different microbes.

Abstract: Macrophages respond to bacterial lipopolysaccharides (LPS) and activate several host defense functions through production of mediators. However, it is not clear whether the degree of macrophage responsiveness to different sources of LPS is equivalent to or varies with the source of LPS. Therefore, in this report, we examined the extent of the human monocyte response to LPS derived from two oral pathogens, Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg). Additionally, due to its well-established ability to activate monocytes, we used LPS from Escherichia coli (Ec). Human monocytes, when activated with a specific source of LPS, exhibited rapid expression of mRNA for IL-1 beta, TNF-alpha, and IL-8, which was followed by IL-6, as measured by RNA-PCR. Moreover, the expression of mRNA for these cytokines was followed by cytokine synthesis. Monocytes from the same subject, when activated with LPS from Pg, Aa, or Ec expressed quantitatively different levels of mRNA and proteins for all four cytokines. A given LPS induced either high or low expression of the battery of cytokines tested, indicating that the expression of these pro-inflammatory cytokines may be regulated by a single or a cluster of gene(s). However, no apparent differences in the time course of mRNA expression for these cytokines were observed in response to any of the LPS tested. Furthermore, the relative ability of the different sources of LPS to induce mRNA for cytokines varied throughout a wide range of LPS concentrations. This suggests that differences exist in the sensitivity of monocytes to a specific LPS, rather than in the kinetics of the secretory process itself.(ABSTRACT TRUNCATED AT 250 WORDS)

Saliva and Growth Factors : The Fountain of Youth Resides in Us All

Abstract: The predominant focus of research dealing with saliva revolves around the role in the maintenance of oral health through a number of physiological and biological properties of constituent proteins. An ever-expanding literature exists indicating that the salivary glands additionally synthesize, and secrete into saliva, a wide range of growth factors. Animal studies with epidermal growth factor have provided evidence for a role in both oral and systemic health, through the promotion of wound healing rates. Thus, the ability to manipulate their rates of synthesis and absorption from saliva holds the potential to enhance tissue regeneration and homeostasis.

Marginal Ditching and Staining as a Predictor of Secondary Caries Around Amalgam Restorations: A Clinical and Microbiological Study

Abstract: Caries at the margins of restorations is difficult to diagnose. In particular, the relevance of both marginal ditching and staining around amalgam restorations is unclear. This clinical study questions the relevance of marginal ditching and color change to the level of infection of the dentin beneath the margins of amalgam restorations. Clinically visible sites (330) on the tooth/restoration margin were selected on 175 teeth. The enamel adjacent to each site was noted as stained (a grey discoloration) or stain-free. One hundred and seventy-eight sites were clinically intact, 83 sites had narrow ditches ( 0.4 mm). Twenty sites with frankly carious lesions were also included. Plaque was sampled at the tooth-restoration margin, and the dentin was sampled at the enamel-dentin junction below each site. Samples were vortexed, diluted, and cultured for total anaerobic counts, mutans streptococci, lactobacilli, and yeasts. Plaque samples showed that margins with wide ditches (> 0.4 mm) harbored significantly more bacteria, mutans streptococci, and lactobacilli than did clinically intact margins and margins with narrow ditches. There were no significant differences in the degree of infection of the dentin beneath clinically intact restorations and those with narrow ditches, but samples associated with wide ditches and carious lesions yielded significantly more bacteria, mutans streptococci, and lactobacilli. The color of the enamel adjacent to the sample site was irrelevant to the level of infection of the dentin beneath the filling margin, provided a frankly carious lesion was not present.(ABSTRACT TRUNCATED AT 250 WORDS)

Volatile Fatty Acids, Metabolic By-products of Periodontopathic Bacteria, Inhibit Lymphocyte Proliferation and Cytokine Production

Abstract: Short-chain fatty acids are a major by-product of anaerobic metabolism and can be detected in gingival fluid from periodontal pockets. Since most T cells are present subjacent to the pocket epithelium in conjunction with the plasma cells, it is important to know how these T cells are affected by short-chain fatty acids produced by subgingival plaque. The purpose of this study is to examine the effects of extracellular metabolites from periodontopathic bacteria on the proliferation and cytokine production of mouse splenic cells as a potential mechanism of imbalance among host-microbial interactions. A low-molecular-weight, heat-stable agent present in the two-day culture filtrate of Porphyromonas gingival is, Prevotella loescheii, and Fusobacterium nucleatum significantly depressed Con A- and LPS- induced cell proliferation. To determine whether short-chain fatty acids present in the filtrate could account for the depression, we tested extracted volatile and nonvolatile fatty acids for their effects on mit...

Tensile Properties of Resin-infiltrated Demineralized Human Dentin

Abstract: The ability of adhesive resins to restore the physical properties of demineralized dentin has not been well-documented. The unfilled resins that are used for adhesion have relatively low moduli of elasticity and limited ability to increase dentin stiffness, although they may increase the ultimate tensile strength of dentin. This study tested the hypothesis that resin infiltration of demineralized dentin can restore its tensile properties to those of mineralized dentin. Small (ca. 0.5 mm thick x 0.5 mm wide) specimens of demineralized human dentin were infiltrated with one of five different dentin bonding resins over many hours, to determine how these resins altered the tensile properties of dentin. Tensile stress and strain were measured in these and control (mineralized and demineralized) specimens until their ultimate failure. The results indicate that some adhesive resins, after infiltrating demineralized dentin, can restore and even exceed the ultimate tensile strength of mineralized dentin. These resins increased the modulus of elasticity of resin-infiltrated dentin to values equal to or greater than those of the resins but far below those of mineralized dentin. Although the conditions in this experiment were far removed from the manufacturer's recommendations or clinical practice, the results support the potential of resin infiltration for reinforcing dentin.

Scanning Electron Microscope Observations of CO2 Laser Effects on Dental Enamel

Abstract: Studies of the effects of carbon dioxide (CO2) lasers on dental enamel have demonstrated that surface changes can be produced at low fluences (< 10 J/cm2) if wavelengths are used which are efficiently absorbed by the hard tissues. In this study, scanning electron microscopy (SEM) was used to characterize the wavelength dependence of surface changes in dental enamel after exposure to an extensive range of CO2 laser conditions. Bovine and human enamel were irradiated by a tunable, pulsed CO2 laser (9.3, 9.6, 10.3, 10.6 microns), with 5, 25, or 100 pulses, at absorbed fluences of 2, 5, 10, or 20 J/cm2, and pulse widths of 50, 100, 200, 500 microseconds. SEM micrographs revealed evidence of melting, crystal fusion, and exfoliation in a wavelength-dependent manner. Crystal fusion occurred at absorbed fluences as low as 5 J/cm2 per pulse at 9.3, 9.6, and 10.3 microns, in contrast to no crystal fusion at 10.6 microns (< or = 20 J/cm2). Longer pulses at constant fluence conditions decreased the extent of surface melting and crystal fusion. The total number of laser pulses delivered to the tissue did not significantly affect surface changes as long as a minimum of 5 to 10 pulses was used. Within the four easily accessible wavelengths of the CO2 laser, there are dramatic differences in the observed surface changes of dental hard tissue.

Fracture Toughness of Experimental Dental Composites Aged in Ethanol

Abstract: Fracture toughness (KIc) is an intrinsic property which may be related to the ability of a restorative material to resist fracture and abrasion. This property may change for a dental composite restorative due to the effects of various oral solvents. The hypothesis to be tested was that aging in ethanol would cause a reduction in the fracture toughness of dental composites, and that the extent of this reduction might be dependent upon certain compositional variables. The fracture toughnesses of three series of experimental composites with various degrees of conversion, filler volume, and percent of silane-treated fillers were compared after the composites were aged for periods of one month and six months in 75% ethanol/water, a solvent which serves as a food-simulating liquid. An unfilled Bis-GMA/TEGDMA resin served as the control. All composites, with the exception of one subjected to a post-light-curing heat treatment, experienced a significant reduction (from 30 to 56%) in KIc after being aged in 75% ethanol for six months. A similar reduction in KIc of 58% for the unfilled resin suggested that the reduction for the composites was due to a weakening of the resin matrix, which facilitated crack propagation. A simultaneous reduction in microhardness was also demonstrated. One month of aging in ethanol also produced large reductions in KIc for specimens with insufficient cure and minimal filler volume, suggesting that the properties of the resin matrix predominated for these composites.(ABSTRACT TRUNCATED AT 250 WORDS)

Variability in Microleakage Observed in a Total-etch Wet-bonding Technique under Different Handling Conditions

Abstract: Using a stereoscopic clearing protocol and scanning electron microscopy, we investigated the extent and nature of microleakage in a total-etch, current-generation dentin adhesive by a wet-bonding technique under different handling conditions. The hypotheses were that inadequate light curing of the primer or incomplete drying of the primer solvent might adversely affect the sealing ability of an acetone-containing adhesive system. The study consisted of three experimental groups: (I) a control group with an adequate light source and with the primer solvent completely dried; (II) an "inadequate-light" group; and (III) an "incomplete evaporation of primer solvent" group. The extent of microleakage after silver staining and clearing of the specimens was scored based on a modified five-point scale. Nonparametric statistical analysis (Kruskal-Wallis ANOVA) followed by a multiple comparison test (Dunn test) indicated significant differences among the three groups (p < 0.05). SEM examination of the restorative interface revealed that microleakage appeared to be initiated from the bonding resin-hybrid layer interface in all three groups, representing the weak link in the adhesive system. In addition, microleakage was characterized by 5 zones, each delineating a stage in a continuous array of progressively deleterious microleakage patterns variously distributed among the three groups. It was suggested that, while the bonding resin-hybrid layer interface represented the intrinsic weakness in an already much improved dentin adhesive, extrinsic factors such as the adequacy of the curing light and, more importantly, complete removal of the primer solvents can and should be avoided to preserve the structural integrity of the marginal seal.

Effects of Unpolymerized Resin Components on the Function of Accessory Cells Derived from the Rat Incisor Pulp

Abstract: Monomeric resin components from dental composites are toxic to fibroblasts in culture and thus may interfere with the local immune system of the pulp, reducing its effective defense potential, either by cytotoxicity or by a more specific immune mechanism. Therefore, the present study was undertaken to observe the cytotoxic effects elicited by certain unpolymerized components of resin composites upon the function of accessory pulp cells in mitogen-induced proliferation of T-lymphocytes. Accessory cells from the rat incisor pulp were released following enzymatic digestion with collagenase. The assay included incubation of these cells with purified T-lymphocytes from cervical lymph nodes for 72 h in the presence of different concentrations of the resin components. The proliferative T-lymphocyte response was monitored by 3H-thymidine incorporation. Initially, we conducted experiments on spleen cells to determine the proper concentration intervals for suitable testing of the resin components. To assess the ind...

Salivary Amylase Promotes Adhesion of Oral Streptococci to Hydroxyapatite

Abstract: Recent studies have demonstrated that several species of oral streptococci, such as Streptococcus gordonii, bind soluble salivary alpha-amylase. The goal of the present study was to determine if amylase immobilized onto a surface such as hydroxyapatite can serve as an adhesion receptor for S. gordonii. Initially, human parotid saliva was fractionated on Bio-Gel P60, and fractions were screened for their ability to promote adhesion of S. gordonii to hydroxyapatite. Fractions containing alpha-amylase and proline-rich proteins promoted the adhesion of [3H]-labeled S. gordonii to hydroxyapatite. Similar findings were obtained with purified amylase and acidic proline-rich protein 1 (PRP1). Incubation of S. gordonii G9B in the presence of starch and maltotriose increased the binding of this strain to amylase-coated hydroxyapatite, while the adhesion of S. sanguis 10556 to amylase-coated hydroxyapatite was not affected by these saccharides. These results suggest that amylase may serve as a hydroxyapatite pellicle receptor for amylase-binding streptococci. Furthermore, starch and starch metabolites may enhance the adhesion of amylase-binding streptococci to amylase in dental pellicles to augment the formation of dental plaque.

Cellular Response to Metallic Ions Released from Nickel-Chromium Dental Alloys

Abstract: Concerns exist over the potential release of elevated levels of metal ions such as Ni and Be from Ni-Cr dental casting alloys, due to their susceptibility to accelerated corrosion. In this investigation, we evaluated the release of metal ions from four commercial Ni-Cr alloys, representing a range of compositions, in three-day cell culture tests. Metal ion release, as measured by atomic absorption spectroscopy, was correlated to changes in cellular morphology, viability, and proliferation. The results showed that the test alloys and their corrosion products did not affect cellular morphology or viabilities, but did decrease cellular proliferation. The types and amounts of metal ions released, which corresponded to the alloys' reported surface and corrosion properties, also correlated to observed decreases in cellular proliferation after 72 h. Neptune, which caused the smallest decrease in cellular proliferation as compared with control cells, released the lowest amount of corrosion products, due to its co...

Alkaline Phosphatase Activity in the Periodontal Ligament and Gingiva of the Rat Molar: Its Relation to Cementum Formation

Abstract: Alkaline phosphatase (ALP) is a glycoprotein thought to be involved in processes leading to mineral formation in tissues like bone and cementum. In the rat molar periodontium, several regions are associated with the formation of cementum (periodontal ligament, inner part of the gingiva), whereas other areas are not (e.g., the outer part of the gingiva just beneath the outer oral epithelium). In an attempt to establish how the spatial distribution of ALP activity relates to cementum formation, we assessed the activity of the enzyme quantitatively in the periodontium of the rat maxillary molars, by using the indoxyl-tetrazolium salt method. It appeared that the distribution of enzyme activity in the ligament was heterogeneous, indicating local variations in the phosphate household. Highest activity was found in areas related to mineralization, adjacent to the alveolar bone and cementum. Enzyme activity was higher adjacent to cellular cementum than to acellular cementum. With respect to acellular cementum, a highly significant positive correlation was found between ALP activity and cementum thickness, which indicates a close relationship between local phosphate production and cementum formation rate. An interesting observation in the connective tissue of the gingiva mesial to the first molar was a sharp demarcation between an ALP-positive inner part, adjacent to the tooth, and an ALP-negative outer part, underneath the outer oral epithelium. In the interdental gingiva, the entire connective tissue proved positive for the enzyme, suggesting that this region consists of the combined inner gingival parts of two adjacent teeth.