Indiana University-Purdue University Indianapolis (IUPUI) / While most sealants available are resin-based, glass ionomer-based cements can be used as sealants, with the advantage of being more tolerant to moisture during placement and of releasing fluoride. The objective of this study was to evaluate the influence of different fissure conditioning techniques on penetration and microleakage of glass ionomer (GI) and resin-modified glass ionomer cements (RMGI) used as sealants. Clinically sound extracted human molars were distributed into nine experimental groups (n = 15 each). Group 1 (control) was sealed with resin-based sealant (Delton) following clinically accepted techniques. Groups 2 through 6 were sealed with RMGI (Vitremer) after having the fissure conditioned with either polyacrylic acid (RMGI-control), 35-percent H3PO4, low viscosity 35-percent H3PO4 with a surfactant, self-etch conditioner, or 35-percent H3PO4 followed by self-etch conditioner. Groups 7 through 9 were sealed with GI sealant (Fuji Triage) after having the fissures conditioned with either polyacrylic acid (GI-control), 35- percent H3PO4 or low viscosity 35-percent H3PO4 with a surfactant. After aging through thermocycling (2500 cycles), specimens were incubated in methylene blue for four hours and sectioned at multiple locations. Digital images were obtained using a digital stereomicroscope, and microleakage was determined by scoring the dye penetration along the enamel-sealant interface. The penetration of the material was determined by calculating the percentage of the total length of the fissure penetrated by the material. Results: The use of self etch-conditioner significantly increased RMGI penetration, while surface conditioning with 35-percent phosphoric acid with surfactant significantly decreased microleakage of GI. The resin-based sealant placed after 35-percent phosphoric acid surface conditioning showed the best penetration and the least level of microleakage. In conclusion, results from this study suggest that the placement of glass ionomer-based sealants can be enhanced by modifying current conditioning methods.

Indiana University-Purdue University Indianapolis (IUPUI) / Etching of enamel caries lesions has been demonstrated to enhance remineralization. However, this effect reaches a plateau after a period of time. This study aimed at investigating the effectiveness of additional acid etching on remineralization. Forty 1 mm × 2 mm human enamel blocks with chemically induced artificial incipient lesions were used. Ten specimens were randomly selected at the end of demineralization for transverse microradiography (TMR) analysis. The remaining specimens were then divided into three groups (n = 10). Group A was remineralized by a pH cycling system with 1100 ppm sodium fluoride for 20 days. In group B, the specimens were etched with 35-percent phosphoric acid for 30 s and then remineralized. Group C was remineralized by same procedure as group B plus and given an additional acid etch after 10 days of remineralization. Mineral density was measured by x-ray microtomography (µ-CT). The volumetric mineral content [VM (µm3×105)] was determined between 91 and 0-wt%. The µ-CT % mineral recovery (%) was calculated using the formula 100×(remineralize VM - demineralization VM) / (sound VM - demineralization VM). One-hundred-μm sections of demineralized and remineralized specimens were used to assess the mineral loss (IML: vol%×µm) and lesion depth (µm) using TMR. The three groups showed no significant difference in mineral change or mineral content for µ-CT or TMR lesion depth. The TMR IML showed a significant difference between the demineralized specimens and the three remineralized groups. The correlation between TMR IML and TMR lesion depth was 0.66 (p < 0.0001). The µ-CT percent mineral recovery from demineralization was correlated with neither TMR IML nor TMR lesion depth. When evaluated with µ-CT, the twice-acid-etched group presented lower mineral gain values than the group etched only once with acid. Also, the twice-etched group presented lower mineral gain and greater TMR IML compared with the non-acid etch group. TMR images revealed reduction of surface layer in the acid-etched groups, especially in the twice-etched group, in which significant reduction or loss of surface layer occurred. Based on these results, we conclude that additional acid etching with 35-percent phosphoric acid does not enhance remineralization compared with a single application of acid etching. We believe that the viable existence of the surface layer is essential for remineralization of the lesion. Further investigations into the accuracy of µ-CT to detect minute mineral changes in incipient caries lesions are probably needed.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Numerous studies have reported the use of hydrofluoric (HF) acid as one of the most effective methods for the achievement of a durable bond between glass-based ceramics and resin cements. Nevertheless, there is little information available regarding the potential deleterious effect on the ceramic mechanical strength. Objectives: (1) to investigate the effect of HF acid etching regimens on the biaxial flexural strength of a low-fusing nanofluorapatite glass-ceramic (IPS e.max ZirPress, Ivoclar Vivadent), (2) to study the ability of an unfilled resin (UR) to restore the initial (i.e., before etching) mechanical strength, and (3) to evaluate the effect of HF acid etching on the ceramic surface morphology before and after UR treatment via scanning electron microscopy (SEM). Methods: One hundred and forty-four disc-shaped (15 ± 1 mm in diameter and 0.8 ± 0.1 mm in thickness) IPS e.max ZirPress specimens were allocated into 12 groups, as follows: G1-control (no etching), G2-30 s, G3-60 s, G4-90 s, G5-120 s, G6- 60 + 60 s. Meanwhile, groups (G7- G12) were treated in the same fashion as G1-G6, but followed by silane and UR applications. Surface morphology evaluation of non-etched and etched IPS e.max ZirPress (G1-G12) was carried out by scanning electron microscopy (SEM). The flexural strength was determined by biaxial testing as described in ISO 6872. Statistics were performed using two-way ANOVA and the Sidak multiple comparisons (α = 0.05). In addition, the Weibull statistics were estimated. Results: A significant effect of etching time (p=0.0290) on biaxial flexural strength was observed. Indeed, G4 led to a significantly (p=0.0392) higher flexural strength than G1. Correspondingly, G10 revealed a considerably higher flexural strength than G7 (p=0.0392). Furthermore, biaxial flexural strength was significantly higher for G7 – G12 than for G1 – G6 (p<0.0001). For G1 – G6, G4 showed the highest Weibull characteristic strength while the lowest Weibull characteristic strength was seen in G6. In G7 – G12, the highest Weibull characteristic strength was presented in G10 whereas G7 had the lowest. Finally, the SEM data revealed that the HF acid etching affected the surface of IPS e.max ZirPress by generating pores and irregularities and more importantly that the UR was able to penetrate into the ceramic microstructure. Conclusion: Within the limitations of this study, HF acid etching time did not show a damaging effect on the biaxial flexural strength of the IPS e.max ZirPress ceramic. Moreover, the ceramic biaxial flexural strength could be enhanced after UR treatment.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / PURPOSE: To assess the long-term effect of a 2% aqueous chlorhexidine (CHX) solution on bond strength to artificially eroded dentin compared to sound dentin. MATERIALS AND METHODS: Flat mid-coronal dentin surfaces of extracted third molars (n = 28) were subjected only to grinding with a 600-grit SiC paper for 1 min (sound dentin S, n = 14) or additionally to erosive pH cycling with a cola-based soft-drink (eroded dentin E, n = 14). After acid etching, rinsing, and air drying, S and E were rehydrated with 1.5 μl of 2% CHX (S2%, n = 7; E2%, n = 7) or of distilled water (control SC, n = 7; EC, n = 7). Composite buildups were incrementally constructed with Filtek Z350 following Adper Single Bond 2 application. Specimens were sectioned into beams, which were subjected to microtensile testing immediately or after 6 or 12 months of aging. Fractured surfaces were observed under a digital microscope (50X magnification). Microtensile bond strength (μTBS) (MPa) was analyzed by three-way ANOVA and Tukey's tests (α = 0.05) and failure mode by the Kruskal-Wallis test (α = 0.05). RESULTS: Compared to sound dentin, eroded dentin was consistently related to lower μTBS. Immediately and after 12-month aging, the effect of CHX was insignificant, but it was significant after 6-month aging, when it conserved the bond strength to both eroded and sound dentin. The percentage of adhesive and mixed failures were equivalent, and significantly more frequent than cohesive failures, whether in dentin or in composite. CONCLUSION: The 2% CHX effect on bond strength conservation to both eroded and sound dentin was not found to be persistent. / Revisión por pares

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / PURPOSE: To evaluate the effect of aqueous solutions of chlorhexidine digluconate (CHX) in different concentrations on bond strength to eroded dentin up to 6 months, using normal dentin as a control. METHODS: Exposed flat dentin of extracted third molars was only ground with 600-grit SiC paper/1 minute (normal dentin - N), or subsequently eroded by a regular-cola soft-drink (eroded dentin - E). N and E were acid-etched, washed, dried and rehydrated with 1.5 μL, respectively, of distillated water (control - NC / EC); of 0.004% CHX (N0.004% / E0.004%); or of 2% CHX (N2% / E2%). Adper Single Bond 2 was applied in all specimens and resin composite buildups were constructed with Filtek Z350. Specimens were sectioned in beams, which were tested (μTBS) immediately or after 6 months of aging. RESULTS: Microtensile bond strength to eroded dentin was always significantly lower than that to normal dentin. Application of tested CHX solutions did not exert a significant effect immediately; however, after aging, the 2% CHX prevented abrupt bond strength loss both to eroded and normal dentin. / Revisión por pares

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / PURPOSE: To assess the influence of simulated oral erosive/abrasive challenges on the bond strength of an etch-and-rinse two-step bonding system to enamel using an in situ/ex vivo protocol. METHODS: Bovine enamel blocks were prepared and randomly assigned to four groups: CONT - control (no challenge), ABR - 3x/day-1 minute toothbrushing; ERO - 3x/day - 5 minutes extraoral immersion into regular Coca Cola; and ERO+ABR - erosive protocol followed by a 1-minute toothbrushing. Eight blocks were placed into an acrylic palatal appliance for each volunteer (n = 13), who wore the appliance for 5 days. Two blocks were subjected to each of the four challenges. Subsequently, all the blocks were washed with tap water and Adper Single Bond 2/Filtek Z350 were placed. After 24 hours, 1 mm2 beams were obtained from each block to be tested with the microtensile bond strength test (50 N load at 0.5 mm/minute). The data were statistically analyzed by one-way RM-ANOVA and Tukey's tests (alpha = 0.05). RESULTS: No difference was detected among the ABR, ERO, and CONT groups (P > 0.05). ERO+ABR group yielded lower bond strengths than either the ABR and ERO groups (P < 0.0113). / Revisión por pares