Resistance of marginal enamel to acid solubility is influenced by restorative systems: an in vitro scanning electron microscopic study

Determinants of enamel decalcification during simulated orthodontic treatment

OBJECTIVE

To determine the relative effects that phosphoric acid etching, metal brackets, composite resin adhesives, and filled resin sealants have on enamel decalcification.

MATERIALS AND METHODS

One hundred and fifty teeth were randomly divided into six groups to test the effects of acid etching, brackets, and a composite resin adhesive. The right side of each tooth was sealed. The teeth were submitted to a simulated carious challenge by Streptococcus mutans in a nutritive media for 42 days. Scanning electron photomicrographs (SEMs) were used to qualitatively evaluate the tooth surfaces. DIAGNOdent laser fluorescence was used to quantify the decalcification changes that occurred.

RESULTS

SEMs showed normal enamel on the control teeth, etching patterns on the acid-etched teeth, surface degradation on the teeth that had resin, and sealant tags on the sealed side. The untreated control group showed significantly less decalcification (P ≤ .05) than did all groups except the no etch+bracket group. The no etch+bracket group showed significantly less decalcification than did the etch+bracket, no etch+resin, and the etch+resin groups. Acid-etched teeth demonstrated significantly more decalcification (34%) than did those that were not etched. The teeth with resin showed significantly more decalcification (24%) than did those without resin. There was no significant difference between teeth that did and did not have brackets. The unsealed side of the teeth showed small amounts of--but significantly more--decalcification (5%) compared to the sealed side.

CONCLUSIONS

Acid etching and composite resin adhesives increase enamel decalcification in vitro, while brackets do not. Filled resin sealants protect the teeth from decalcification.

In vitro-evaluation of secondary caries formation around restoration

The objective of this in vitro study was to evaluate demineralization around restorations. Class V preparations were made on the buccal and lingual surfaces of each tooth. TPH (Group 1), Fuji II LC (Group 2), Tetric (Group 3), Dyract (Group 4), GS 80 (Group 5) and Chelon Fil (Group 6) were randomly placed in equal numbers of teeth. The teeth were submitted to a pH-cycling model associated with a thermocycling model. Sections were made and the specimens were examined for the presence of demineralization under polarized light microscopy. Demineralization was significantly reduced with Chelon Fil (Group 6). Furthermore, a similar inhibitory effect on the development of demineralization was observed in Groups 2, 4 and 5.

SEM investigation of composite restoration adaptation to enamel after use of total etch and self etch adhesive system

Introduction Quality and durability of enamel/composite interface essentially depend on an adhesive restorative system. Objective The aim of this study was to evaluate the quality of marginal adaptation of composite adhesive systems to enamel by scanning electron microscopy (SEM), and to analyze the morphology of the enamel surface along margins of composite restorations, following exposure to cariogenic solution. Methods The study material included 56 extracted human third molars. Class V cavities were prepared with margins at enamel. Cavities were restored with Single Bond/Z250 and Single Bond/Filtek flow, using the total etch adhesive system, and Prompt-L-Pop/Z250 and Prompt-L-Pop/Filtek flow, using the self etch adhesive system. After the restorative procedure, the restorations were submitted to demineralization during 7 and 28 days. Samples were stored in a cariogenic solution (lactic acid, pH 4.5; 0.1 M) at 37?C or in deionized water (the control group). The margins of restorations and perimarginal enamel were examined by scanning electron microscope (SEM). The gap formations around restoration were measured on cervical, occlusal and approximate margins. Results The usage of the total etch adhesive system showed statistically significant lower marginal gap width around composite restoration, compared with the self etch system (p<0.01). The SEM examination also showed perimarginal enamel zones presenting several signs of demineralization and erosion (alteration of rods, porosities) after acting of a cariogenic solution, in both adhesive methods. Less alteration was found on the enamel surfaces not included in the perimarginal zone. Conclusion Treating the cavity with 35% phosphoric acid in the total etch system significantly improved the adaptation of the composite resins to enamel, compared with the self etch treatment. Stronger demineralization of the perimarginal enamel in a cariogenic solution was observed around all restorations in both adhesive systems.

The resistence of conditioned enamel to the effect of cariogenic solution

INTRODUCTION Enamel surface around restoration is very sensitive to the effect of cariogenic solution. It is the consequence of the manner the cavity is prepared before restoration, the existence of marginal cracks around restoration, that is, irregular polishing of filling. OBJECTIVE The aim of this study is to analyze the morphology of the marginal enamel surface around composite fifth class restoration after the application of cariogenic solution. METHOD In this study 28 extracted molars were used. After the V class preparation of the buccal crown surface, teeth samples were divided into two groups. The first group was restored with the composite system Single Bond +Z250, applying the total etching technique. The second group was restorated with Prompt L-pop +Z250 and by applying self-etching primers. After the cavity restoration, teeth samples were kept in demineralising solution (lactic acid, pH 4.5, 0.1 M) at the temperature of 37?C during 7 and 28 days. Control group samples were kept in distilled water during the experiment. The marginal enamel surface analysis was done by a scanning electron microscope. RESULTS The achieved results showed that there was a denivelation and severe demineralization of the perimarginal enamel zone after 7 and 28 days, while on the remaining enamel there were some minor changes. Along the marginal composite/ enamel joint there was the central type of demineralization of enamel prisms and preserved inter prismatic enamel. The existence of pores of different sizes and scattered enamel fractures was established. The marginal joint was mostly without any gaps in the first group samples, while in the second group samples there were narrow or wider edge gaps. CONCLUSION After the application of cariogenic solution, perimarrginal enamel showed conspicuous morphological damage in comparison to the remaining enamel surface.

Permeability of marginal hybrid layers in composite restorations

The goal of adhesive dentistry is to restore the peripheral seal of dentin lost from removal of enamel. Unfortunately, the hybrid layer (HL) that is used to create that seal is permeable to small ions or molecules, even in the absence of detectable, interfacial gap formation via nanoleakage. This nanoleakage results from several mechanisms including incomplete infiltration of adhesive monomers into demineralized collagen matrix, presence of hydrophilic monomers, and insufficient removal of solvent or water that remains trapped inside the HL. These mechanisms lead to a porous interface with nanometer-sized channels that increase the permeability of the HL. The null hypothesis tested in this study was that water and acidic solution storage are able to alter in vitro the resin-dentin interface, further increasing the marginal hybrid layer (MHL) permeability. Class II cavities were made in vitro. The specimens were stored in water for 1 week and in lactic acid solution for 3 days. Polyvinyl siloxane impressions of restoration margins were taken before and after storage in water and lactic acid solution. Polyether replicas were obtained using the silicon impressions as molds. Replicas and original samples were observed under scanning electron microscopy. Lines of water droplets were detected on MHLs and overlying adhesive only after storage. Replicas obtained after acidic solution storage showed great numbers of irregularities such as gaps, voids, and degradation of the dentin-restoration surface margin, but also a great number of droplets. Dentin-restoration resin interfaces absorb water and are damaged by storage in dilute lactic acid. The presence of water droplets probably indicates water that flows out of the interface during the setting time of the impression and thus represents an index of marginal HL water permeability.