sodium-hypochlorite and Dental-Caries

Chemomechanical caries removal is an excellent method for minimally invasive caries excavation, and the removal agents are either sodium hypochlorite (NaOCl)- or enzyme-based. The NaOCl-based agents include GK-101, GK-101E (Caridex) and Carisolv, and the enzyme-based agents include Papacarie and the experimental material, Biosolv. This review outlines the changes in chemomechanical caries removal methods and focuses on recently published laboratory and clinical studies. The historical development, mechanism of action, excavation time and biological effects on pulp and dental hard tissues are described. Based on existing evidence, the currently available chemomechanical caries removal methods are viable alternatives to conventional rotary instrument methods. Chemomechanical methods could be extremely useful in very anxious, disabled and paediatric patients. It does seem some of these agents would still benefit from quicker excavation times in order to achieve more universal acceptance. However, as a means of conserving the caries-affected dentine, chemomechanical caries removal is possibly much more successful than conventional rotary instrumentation.

Topics: Aminobutyrates; Chloramines; Dental Caries; Dental Cavity Preparation; Disinfectants; Equipment Design; Glutamic Acid; Glycine; Hardness; Humans; Leucine; Lysine; Papain; Sodium Hypochlorite

Vital pulp therapy aims to treat reversible pulpal injury and includes 2 therapeutic approaches: (1) indirect pulp treatment for deep dentinal cavities and (2) direct pulp capping or pulpotomy in cases of pulp exposure. Indirect pulp treatment is recommended as the most appropriate procedure for treating primary teeth with deep caries and reversible pulp inflammation, provided that this diagnosis is based on a good history, a proper clinical and radiographic examination, and that the tooth has been sealed with a leakage-free restoration. Formocresol has been a popular pulpotomy medicament in the primary dentition and is still the most universally taught pulp treatment for primary teeth. Concerns have been raised over the use of formocresol in humans, and several alternatives have been proposed. Controlled clinical studies have been critically reviewed, and mineral trioxide aggregate and ferric sulfate have been considered appropriate alternatives to formocresol for pulpotomies in primary teeth with exposed pulps. In most of the studies reviewed, the caries removal method has not been described. The use of a high-speed handpiece or laser might result in an exposure of a "normal" pulp that would otherwise not be exposed.

Topics: Aluminum Compounds; Calcium Compounds; Calcium Hydroxide; Dental Caries; Dental Pulp Capping; Drug Combinations; Ferric Compounds; Formocresols; Humans; Laser Therapy; Oxides; Pulpitis; Pulpotomy; Randomized Controlled Trials as Topic; Root Canal Filling Materials; Silicates; Sodium Hypochlorite; Tooth, Deciduous

This paper reviews current concepts of root canal infection and the consequences for endodontic treatment strategies and practices. In particular, root canal disinfection by chemical and mechanical means is discussed, as are the possibilities and limitations of proposed methods to reduce the time necessary to obtain a disinfected canal.

Topics: Bacterial Infections; Calcium Hydroxide; Dental Caries; Dental Pulp Diseases; Disinfection; Focal Infection, Dental; Humans; Periapical Periodontitis; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Time Factors

Exodontia of extremely carious teeth leads to a significant risk of osteoradionecrosis in patients who have undergone radiotherapy. In these patients, endodontic treatment could be an alternative. Successful root canal therapy in a girl who had been irradiated for head and neck neoplasms is reported. The results indicated that use of calcium hydroxide to obturate the root canals is a viable method of postirradiation endodontics in primary teeth.

Topics: Animals; Calcium Hydroxide; Child; Cranial Irradiation; Dental Care for Chronically Ill; Dental Caries; Dental Pulp Necrosis; Female; Head and Neck Neoplasms; Humans; Hydrogen Peroxide; Osteoradionecrosis; Patient Care Planning; Periapical Abscess; Rhabdomyosarcoma; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Therapy; Sodium Hypochlorite; Tooth, Deciduous

This study compared and evaluated the effectiveness of Brix 3000 and 2.25 % sodium hypochlorite (NaOCl) gel with conventional rotary instrumentation method in caries excavation of primary molars. The null hypothesis: no difference between the two tested chemo-mechanical caries removal (CMCR) agents used in this trial.. a randomized controlled clinical trial conducted with 32 children suffering from proximal caries of primary maxillary molars, age ranging between 6 and 9 years old. Subjects were randomly assigned into three groups: Brix 3000, NaOCl gel, and conventional with 10, 12, and 10 teeth in each group, respectively. After isolation of selected teeth, either CMCR agent were applied for two minutes. The application was repeated as needed until a caries-free surface was obtained. The conventional group used low-speed burs to excavate all carious lesions. The time required to obtain a caries-free result for each testing method was recorded. Wong-Baker FACES pain rating scale was used to assess the acceptance of the technique used by the child.. Conventional treatment required significantly less time for caries removal compared to Brix 3000 (P = .002) and NaOCl gel (P = .000). No significant difference observed between Brix 3000 and NaOCl gel (P = .679). Statistically higher pain scores were observed with conventional treatment compared to both Brix 3000 (P = .000) and NaOCl gel (P = .005). Pain scores were lower with Brix 3000, and NaOCl gel with no significant difference observed between the CMCR agents (p = .690).. CMCR agents that are effective in removing the carious dentine of primary teeth without negatively affecting the cooperation of children.. The use of a 2.25 % sodium hypochlorite gel can be an effective and well-tolerated method of removing decay from primary teeth and reduce the trauma associated with conventional rotary caries removal.

Topics: Child; Dental Caries; Dental Cavity Preparation; Dentin; Humans; Patient Compliance; Sodium Hypochlorite

To evaluate the clinical and radiographical success of primary molar pulpotomies which used 15.5% ferric sulfate (FS) or 1.25% sodium hypochlorite (NaOCl) for hemostasis and zinc oxide-eugenol (ZOE) and calcium hydroxide (CH) pastes as base materials.. In 29 healthy children, 80 primary molars were randomly allocated to one of the study groups: Group 1: FS-ZOE, Group 2: FS-CH, Group 3: NaOCl-ZOE, and Group 4: NaOCl-CH. After hemostasis with the respective solutions, pulp stumps and floor of the pulp chambers were covered with either ZOE or CH pastes. All teeth were restored with stainless steel crowns. Follow-up examinations were carried out at 1, 3, 6, and 12 months.. One tooth in Group 1 and two teeth in Group 4 were extracted because of pain and periapial pathosis at sixth month. After 12 months, clinical success rates of pulpotomies in Groups 1-4 were 95%, 100%, 100%, and 89.5%, respectively. The differences were not significant (P = 0.548). Radiographic success rates for Groups 1-4 were 80%, 88.9%, 78.9%, and 84.2%, respectively. No statistically significant difference was found (P = 0.968). Pain on percussion was the most observed clinical finding. However, internal root resorption was the most common radiological finding and it was observed significantly more in mandibular primary molars (P < 0.05).. Both ZOE and CH can be preferred as base materials after hemostasis achieved by the use of 15.5% FS or 1.25% NaOCl in primary tooth pulpotomy.

Topics: Bone Cements; Calcium Hydroxide; Child; Child, Preschool; Dental Caries; Dental Pulp; Female; Ferric Compounds; Follow-Up Studies; Hemostatics; Humans; Male; Pulpotomy; Radiography, Dental; Root Canal Irrigants; Root Resorption; Sodium Hypochlorite; Tooth Resorption; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

To evaluate, via clinical and radiographic assessment; the success of calcium hydroxide pulpotomies with the application of 5% sodium hypochlorite as a haemostatic agent compared with physiologic saline in primary molars and to evaluate if there is improved efficacy of increased concentration of sodium hypochlorite application in calcium hydroxide pulpotomies.. Thirty children aged between 3 and 8 years, having at least two vital primary molars (split mouth design) with deep carious lesions with probable exposure of the pulp, were selected. The 60 teeth were randomly allocated to two groups and conventional calcium hydroxide pulpotomies were performed on all selected primary molars in both the groups. A cotton pellet saturated with 5% sodium hypochlorite was applied to teeth as a haemostatic agent in group A (experimental) for 30 s while physiologic saline was used to manage haemorrhage in group B (control). Teeth were restored with preformed metal crowns (PMC) in both the groups after the procedure. Evaluation for clinical and radiological success of calcium hydroxide pulpotomies was performed at baseline, 1, 3, 6 and 12 months follow-up.. Statistical analysis did not show (p > 0.05) significant differences in the clinical and radiological success rates of calcium hydroxide pulpotomies in both the groups at 12 months follow-up.. The increased concentration of sodium hypochlorite showed lower success rate in calcium hydroxide pulpotomies when compared to physiologic saline, although this difference was not statistically significant.

Topics: Calcium Hydroxide; Child; Child, Preschool; Crowns; Dental Caries; Female; Hemostatics; Humans; Male; Molar; Pulp Capping and Pulpectomy Agents; Pulpotomy; Radiography, Dental; Sodium Hypochlorite; Tooth, Deciduous

The aim of the present study was to evaluate the reduction in bacterial loading uing MTAD as an irrigating solution in pulpectomized primary teeth.. A randomized, controlled clinical trial was performed that included primary teeth with pulp necrosis. Sixty necrotic canals were included, 30 irrigated with MTAD (experimental group) and 30 with 1% Na0Cl solution (control group); in all cases, 2 microbiological samples from within the canals were taken with sterile paper points, the first after the canal opening and before the first irrigation, and the second after instrumentation and final irrigation, before obturation. All samples were evaluated by Agar plate method.. The results were statistically analyzed by student 't' test. After analyzing samples before and after irrigation in the control group (NaOCl), we found a significant decrease of bacterial load ( p = < 0.001). The same occurred in the MTAD group samples ( p = < 0.001). When both groups were compared post irrigation, a statistically significant difference was observed in favor of MTAD.. MTAD can be suggested as an alternative irrigant for pulpectomy of necrotic teeth.

Topics: Bacterial Load; Bacteriological Techniques; Calcium Hydroxide; Child; Child, Preschool; Citric Acid; Dental Caries; Dental Pulp Necrosis; Doxycycline; Female; Humans; Male; Polysorbates; Pulpectomy; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Silicones; Sodium Hypochlorite; Tooth, Deciduous

The aim of this study was to evaluate the 5-year clinical performance of composite restorations of non-carious cervical lesions (NCCL) using a total-etch adhesive system with or without collagen removal with 10% sodium hypochlorite (NaOCl).. In this study randomized controlled split-mouth clinical trial, one-hundred and thirty-eight NCCL were restored into 30 patients. Each patient received at least one pair of composite restorations (Filtek A110/3M ESPE), bonded either with 2 techniques: Conventional Technique--acid etching with 37% phosphoric acid+Prime & Bond NT (Denstply DeTrey); Deproteinization Technique--acid etching with 37% phosphoric acid+10% NaOCl for 1min+Prime & Bond NT. The two techniques were evaluated using the United States Public Health Service (USPHS) criteria at baseline, 18 months, 3 and 5 years. After five years, one-hundred and six restorations were evaluated in 24 patients. Data were analyzed using the Chi-Square test (p<0.05).. There were no statistically significant differences between the two techniques regarding the evaluated parameters (p>0.05).. After 5 years, the application of 10% NaOCl deproteinization on etched dentine did not affect the clinical performance of composite restorations placed in NCCL when compared to the conventional total-etch technique.. Clinical studies evaluating the performance of the Deproteinization Technique are scarce. In this study, this technique showed similar clinical performance at the end of 5 years when compared to a conventional total-etch technique.

Topics: Acid Etching, Dental; Adult; Collagen; Color; Composite Resins; Dental Bonding; Dental Caries; Dental Marginal Adaptation; Dental Materials; Dental Restoration Failure; Dental Restoration, Permanent; Dentin; Dentin Sensitivity; Female; Follow-Up Studies; Humans; Male; Middle Aged; Oxidants; Phosphoric Acids; Polymethacrylic Acids; Protein Denaturation; Sodium Hypochlorite; Tooth Cervix; Tooth Wear; Young Adult

The aim of this randomised clinical trial was to compare the clinical and radiographic success rate of 5% sodium hypochlorite (NaOCl) and 20% Formocresol (FC) as a pulpotomy medicament in carious primary molars.. Twenty-four children aged 4-8 years with at least 2 primary molars indicated for pulpotomy were included in this study. Eighty-two teeth received either 5% NaOCl or 20% FC using split mouth design, followed by restoration with IRM base/stainless steel crown (SSC). Clinical and radiographic evaluations were performed at 3, 6 and 12 months.. NaOCl and FC groups demonstrated 100% clinical success at 3 months. At 6 months, NaOCl showed 95% and 87.5% clinical and radiographic success rate respectively, while FC showed 95% clinical and radiographic success rate. After 12 months, the clinical and radiographic success rates were 94.6% and 86.5% respectively for NaOCl, and 92.1% and 86.8% for FC.. The results of this study showed the success rate for NaOCl pulpotomy to be comparable to those for FC pulpotomy.

Topics: Child; Child, Preschool; Crowns; Dental Alloys; Dental Caries; Dental Pulp; Female; Follow-Up Studies; Formocresols; Humans; Male; Methylmethacrylates; Molar; Periapical Diseases; Prospective Studies; Pulpotomy; Radiography; Root Canal Filling Materials; Root Canal Irrigants; Sodium Hypochlorite; Stainless Steel; Tooth Root; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

This was to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) therapy in primary molar teeth following haemostasis with various antiseptics for 12 months.. A total of 70 vital primary molar teeth with deep dentin caries were randomly allocated to different antiseptic groups. After observing the pinpoint exposure, 0.9% saline solution (SS, control), 0.5% sodium hypochlorite (SH), 2% chlorhexidine digluconate (CHX), or 0.1% octenidine dihydrochloride (OCT) was applied with sterile cotton pellets for 3 min before calcium hydroxide (CH) DPC therapy. Statistical evaluation: The intergroup radiographic success criteria were analysed using a Kruskal-Wallis test in each follow-up period at a confidence interval of 95%.. After 12 months, all groups showed a clinical success rate of 100% (no clinical failures were observed at the time of pulpectomy or extraction), and the overall radiographic success rates were OCT (100%) > SH (94.74%) > CHX (93.3%) > SS (84.21%), respectively (p > 0.05). OCT did not exhibit any failures. The undesirable radiographic failure types (pulpectomy or extraction) were mostly observed in the SS group.. Compared with SS, the success of conventional CH usage in DPC therapy of primary molar teeth could be enhanced by providing acceptable disinfection features with antiseptic solutions. OCT seems to have relative beneficial effects compared to SH and CHX.

Topics: Anti-Infective Agents, Local; Calcium Hydroxide; Child; Chlorhexidine; Crowns; Dental Amalgam; Dental Caries; Dental Cavity Lining; Dental Pulp Capping; Dental Restoration, Permanent; Female; Follow-Up Studies; Hemostatic Techniques; Humans; Imines; Male; Methylmethacrylates; Molar; Periapical Diseases; Pulp Capping and Pulpectomy Agents; Pyridines; Radiography; Root Resorption; Single-Blind Method; Sodium Hypochlorite; Stainless Steel; Time Factors; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

This study evaluated the microbiological conditions of root canals, using smears and culture from anterior teeth and premolars with necrotic pulps associated with chronic periapical pathologies, before and after biomechanical preparation (BMP). During double-flared instrumentation, 1, 2.5 and 5% sodium hypochlorite (NaOCl)-based irrigants were used in 3 groups: GI (n=39), GII (n=36) and GIII (n=36), respectively. Before BMP, all cultures were positive and the smears showed microbiologically diverse morphotypes, including fusiforms, pleomorphic, rods, cocci and filaments. Quantitatively, 20, 20 and 23 morphotypes were identified in GI, GII and GIII, respectively). After BMP, the percentages of negative cultures in GI, GII and GIII were 74.2%, 86.3% and 93.4% (p>0.05) and the number of morphotypes decreased to 14, 15 and 5, respectively. All teeth with 2 root canals and/or associated fistulas were microbiologically negative after BMP, regardless of irrigant concentration. Gram-negative morphotypes were more susceptible to the action of irrigants. After irrigation with 5% NaOCl, only structural arrangements consisting of Gram-positive cocci and bacilli persisted. Thus, BMP plus 5% NaOCl offered the best antiseptic potential because in the few positive cultures a significant reduction in the number of microbiological morphotypes was also shown (p<0.05).

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Bacteria; Biomechanical Phenomena; Chelating Agents; Dental Caries; Dental Pulp Cavity; Dental Pulp Necrosis; Edetic Acid; Gram-Negative Bacteria; Gram-Positive Bacteria; Gram-Positive Cocci; Humans; Middle Aged; Oral Fistula; Periapical Diseases; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite

The aim of the study was the morphological analysis of coronal dentin caries and the modifications induced by different pretreatments with phosphoric acid or sodium hypochlorite. Carious dentin specimens were obtained from human molars affected by carious lesions. Specimens were divided in four groups and submitted to: (1) untreated; (2) 35% phosphoric acid for 15 s; (3) 35% phosphoric acid for 15 s and 5% sodium hypochlorite for 2 min; (4) sodium hypochlorite for 5 min. Specimens were observed under high-resolution SEM. Different areas were identified within the carious lesion: a deeper, inner region revealing closed highly mineralized tubules, and a more superficial outer layer showing an increasing demineralization rate toward the surface of the lesion. Phosphoric acid followed by NaOCl treatment removed all collagen fibrils from greatly altered carious outer-dentin layer. The 5-min treatment with sodium hypochlorite affected both inner and outer dentin, removing all collagen fibrils and increasing the porosities of deeper intertubular hypermineralized dentin. FEISEM analysis confirmed that only inner carious dentin after phosphoric acid treatment may be considered a suitable substrate for dentinal bonding system. On the contrary, the outer dentin is an unstable substrate for any type of bonding systems and must be avoided/removed from any surface before conditioner application.

Topics: Acid Etching, Dental; Adult; Collagen; Dental Caries; Dentin; Dentin-Bonding Agents; Humans; Microscopy, Electron, Scanning; Phosphoric Acids; Porosity; Sodium Hypochlorite; Time Factors; Tooth Demineralization

To investigate the morphology of the resin-dentin interface of three dentin adhesive systems (One Coat Bond, Clearfil SE Bond and One-Up Bond F) bonded to caries-affected dentin, exposed using either rotary instrumentation in conjunction with a caries detector dye or a chemo-mechanical caries removal system (Carisolv).. 60 extracted human molars with occlusal caries were used. 30 teeth had carious dentin removed using slow-speed round steel burs after staining with the caries detector dye, and carious dentin from the remaining teeth was removed using Carisolv. The teeth from each caries removal technique were randomly divided into three groups, bonded with one of the three adhesive systems above according to the manufacturers' instructions, and a thin layer of resin-based composite applied. The teeth were sectioned parallel to the bonded surface to obtain a 3 mm thick bonded dentin disc. The specimens were assigned to one of two observation techniques: a fracture technique or an acid-base technique. Fracture technique: a shallow groove was prepared across the dentin surface of the specimen, fixed in 10% buffered formalin, dehydrated in an ascending ethanol series up to 100%, critical-point dried, and fractured along the prepared groove. Acid-base technique: the specimens were sectioned vertically across the bonded interface, fixed in 10% phosphate buffered formalin, polished with diamond paste down to 0.25-microm particle size, immersed in 10% orthophosphoric acid for 3-5 s and 5% sodium hypochlorite for 10 min. All specimens were gold sputter-coated and observed using FE-SEM.. All groups showed hybrid layer formation. However, the thickness varied depending on the adhesive system and the carious dentin removal technique used. One Coat Bond (a "one-bottle" system) showed the thickest hybrid layer (approximately 2 microm) in acid/base treated specimens when bonded to caries-affected dentin, whereas One-Up Bond F (an "all-in-one" system) bonded to normal dentin exhibited the thinnest hybrid layer (approximately 0.3 microm).

Topics: Composite Resins; Dental Bonding; Dental Caries; Dental Cavity Preparation; Dental Restoration, Permanent; Dentin; Dentin-Bonding Agents; Glutamic Acid; Humans; Leucine; Lysine; Methacrylates; Microscopy, Electron, Scanning; Phosphoric Acids; Resin Cements; Sodium Hypochlorite; Stress, Mechanical; Surface Properties

An in vitro study has been carried out on the chemomechanical removal of caries in deciduous and permanent teeth. The aims of the study were to compare the efficacy of caries removal by various chemical agents including N-monochloro-DL-2-aminobutyrate (NMAB) and NMAB containing urea (NMAB-urea), to compare the efficacy on permanent and deciduous teeth and to study the dentinal surfaces produced.. The addition of urea to NMAB resulted in an improvement in the efficacy of caries removal. Sodium hypochlorite, saline and urea alone were also studied as caries removal agents, but were not significantly different from NMAB. Chemomechanical caries removal solutions were more effective in removing caries from deciduous teeth than from permanent teeth, especially in terms of the volume of solution used. The improvement on addition of urea was found to be greater in deciduous than in permanent teeth, the number of deciduous teeth with 'complete cares removal' being increased by about 25%. The dentinal surfaces of the cavities prepared using these solutions and in which 'complete caries removal' had been achieved were studied by scanning electron microscopy. Generally after treatment with NMAB or NMAB-urea, the surface appearance was very uneven with many undermined areas. NMAB-urea produced a 'cleaner' surface compared with that produced by NMAB alone.. NMAB appears to be potentially more effective and clinically more useful in removing caries in deciduous teeth than in permanent teeth, and the addition of urea may enhance its efficacy, especially in the treatment of paediatric dental patients.

Topics: Aminobutyrates; Child; Dental Caries; Dental Cavity Preparation; Dental Enamel; Dentin; Drug Combinations; Humans; Microscopy, Electron, Scanning; Single-Blind Method; Sodium Chloride; Sodium Hypochlorite; Tooth; Tooth, Deciduous; Urea

The present study aimed to evaluate the efficiency, effectiveness, and biocompatibility of two agents used for the chemomechanical removal of carious dentin. Sixty extracted carious human teeth were treated with a conventional bur (CBG) or chemomechanical agents - Papacarie Duo (PG) and Brix 3000 (BG). Treatment efficiency and effectiveness were assessed by the working time for carious dentin removal and Knoop microhardness values, respectively. Human pulp fibroblasts (FP6) were used to evaluate cytotoxicity by incorporating MTT dye, and genotoxicity was evaluated with the micronuclei test. The carious tissue was removed in a shorter time with CBG (median = 54.0 seconds) than the time required for chemomechanical agents (p = 0.0001). However, the time was shorter for Brix 3000 (BG) than that for Papacarie Duo (PG), showing mean values of 85.0 and 110.5 seconds, respectively. Regarding microhardness testing, all approaches tested were effective (p < 0.05). The final mean microhardness values were 48.54 ± 16.31 KHN, 43.23 ± 13.26 KHN, and 47.63 ± 22.40 KHN for PG, BG, and CBG, respectively. PG decreased cell viability compared to that of BG, but it presented no genotoxicity. Brix 3000 may be a good option for chemomechanical dentin caries removal due to its reduced removal time and lower cytotoxicity compared to the other treatment options.

Topics: Cell Proliferation; Cells, Cultured; Dental Caries; Dental Cavity Preparation; Dentin; Fibroblasts; Hardness; Humans; In Vitro Techniques; Papain; Sodium Hypochlorite; Stress, Mechanical

This study indented to assess the clinical and radiographic assessment of Allium sativum extract as an intracanal irrigant for pulpectomy of primary molars. Ninety children with 110 teeth submitted were categorized into two groups. Clinical and radiographic success rates were checked at 3, 6, and 12 months. Qui-square test at a level of significance was ˂0.05. There was no statistically significant difference (

Topics: Child; Child, Preschool; Dental Caries; Feasibility Studies; Female; Garlic; Humans; Male; Molar; Plant Extracts; Pulpectomy; Root Canal Irrigants; Sodium Hypochlorite; Tooth, Deciduous; Treatment Outcome

The current procedures for treating tooth decay are not always guaranteed to successfully remove all microorganisms which cause disease. For elimination of bacteria and prevention of their effects, different methods are recommended, such as antibacterial materials and cavity disinfectants. The aim of this study was to compare the antibacterial activity of photodynamic therapy (PDT) using diode laser with indocyanin green (ICG) on Streptococcus (S.) mutans biofilm with conventional methods.. All the treatments significantly reduced the number of S. mutans compared with the positive control group (p < 0.05). The antimicrobial effectiveness of CHX, NaOCl, ozone, PDT, Er:YAG laser, and diode laser groups were similar. The lowest bacterial reduction was observed in the ICGgroup.. This work concludes that PDT using diode laser with ICG may be suggested on the cavity disinfection after caries excavation as an alternative to conventional methods.

Topics: Biofilms; Dental Caries; Disinfection; Humans; In Vitro Techniques; Indocyanine Green; Lasers, Semiconductor; Molar; Ozone; Photochemotherapy; Photosensitizing Agents; Sodium Hypochlorite; Streptococcus mutans

The aim of this study was to evaluate the influence of the smear layer on the antimicrobial activity of a 2.5% sodium hypochlorite (NaOCl)/9% etidronic acid (HEBP) irrigating solution against bacteria growing inside dentin tubules.. Dentin tubules were infected with Enterococcus faecalis by centrifugation. After 5 days of incubation, the smear layer had formed in half of the samples, which were then treated with 2.5% NaOCl either alone or combined with 9% HEBP for 3 minutes. The percentage of dead cells in infected dentinal tubules was measured using confocal laser scanning microscopy and the live/dead technique. The smear layer on the surface of the root canal wall was also observed by scanning electron microscopy. Results of the percentage of dead cells were compared using parametric tests after subjecting data to the normalized Anscombe transformation. The level of significance was P < .05.. In the absence of the smear layer, 2.5% NaOCl alone and combined with 9% HEBP showed high antimicrobial activity without significant differences between the 2. The smear layer reduced the antimicrobial activity of 2.5% NaOCl significantly, whereas the solution with HEBP was not affected. No dentin tubules free of the smear layer were obtained in the 2.5% NaOCl group. In the case of 2.5% NaOCl/9% HEBP, 95.40% ± 3.63% of dentin tubules were cleaned.. The presence of the smear layer reduced the antimicrobial activity of 2.5% NaOCl. The combination of 2.5% NaOCl/9% HEBP exerted antimicrobial activity that was not reduced by the smear layer.

Topics: Anti-Infective Agents; Bacteria; Bicuspid; Dental Caries; Dental Pulp Cavity; Dentin; Enterococcus faecalis; Etidronic Acid; Humans; Microscopy, Electron, Scanning; Random Allocation; Root Canal Irrigants; Smear Layer; Sodium Hypochlorite

Some lasers have demonstrated to provide effective disinfection when used as adjunctive device to the conventional treatment. The aim of this in vitro study was to determine the effectiveness of the erbium, chromium:yttrium scandium gallium garnet (Er, Cr:YSGG) laser by measuring its bactericidal effect inside the root canal experimentally colonized with Enterococcus faecalis. The laser was tested at different irradiation times (30 and 60 s) and energy of impulses (75 and 25 mJ). A total of 52 single-rooted extracted human teeth were endodontically prepared with rotary instrumentation. All were sterilized and inoculated with a suspension of E. faecalis (105 bacteria/ml). The teeth were randomized into three treatment (group 1, group 2, and group 3) and one control groups. In all groups, teeth were chemically irrigated with 5.25% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Groups 1 and 2 were also irradiated at 30 and 60 s, respectively, with an Er, Cr:YSGG laser at 75 mJ. Teeth of group 3 were treated with laser for 60 s at 25 mJ. Samples were processed to detect the presence of E. faecalis. For all groups, a bactericidal effect was observed. The use of laser at 75 mJ with an irradiation time of 30 and 60 s eliminated a percentage of 92.3 and 100% of E. faecalis, respectively. In the control group, a reduction of 92.3% was observed. Lower percentage of reduction (46.1%) was obtained in teeth treated with laser at 25 mJ for 60 s. No statistical differences were observed between the groups (P = 0.543, Fisher's exact test). The results indicated a bactericidal effect of Er, Cr:YSGG laser irradiation at the settings used in this study. The highest bactericidal effect of this laser was observed at 60 s of irradiation time, using an energy pulse of 75 mJ.

Topics: Dental Caries; Dental Pulp Cavity; Disinfectants; Disinfection; Enterococcus faecalis; Erbium; Gram-Positive Bacterial Infections; Humans; Lasers; Lasers, Solid-State; Models, Dental; Periodontal Diseases; Root Canal Therapy; Sodium Hypochlorite; Tooth Root

In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures.

Topics: Acid Etching, Dental; Composite Resins; Dental Caries; Dental Enamel; Dental Enamel Hypoplasia; Dental Materials; Dental Restoration, Permanent; Enamel Microabrasion; Ethanol; Fluorosis, Dental; Humans; Light-Curing of Dental Adhesives; Resins, Synthetic; Sodium Hypochlorite; Tooth Bleaching; Tooth Discoloration; Tooth Injuries

Sodium hypochlorite (bleach) is commonly used as an irrigant during dental procedures as well as a topical antiseptic agent. Although it is generally safe when applied topically, reports of accidental injection of sodium hypochlorite into tissue have been reported. Local necrosis, pain and nerve damage have been described as a result of exposure, but sodium hypo-chlorite has never been implicated as a cause of an acute kidney injury (AKI). In this report, we describe the first case of accidental sodium hypochlorite injection into the infraorbital tissue during a dental procedure that precipitated the AKI. We speculate that oxidative species induced by sodium hypochlorite caused AKI secondary to the renal tubular injury, causing mild acute tubular necrosis.

Topics: Acute Kidney Injury; Dental Caries; Ecchymosis; Edema; Humans; Iatrogenic Disease; Injections; Kidney Tubules; Medication Errors; Oxidants; Sodium Hypochlorite

The aim of this study was to assess the effect on bacterial viability within dentinal tubules after the application of sodium hypochlorite (NaOCl)- or enzyme-based chemomechanical caries removal agents.. Twenty-five caries-free dentin discs prepared from 25 sound maxillary premolars were used. The discs were then infected with Streptococcus mutans suspension and randomly divided into the following 6 groups according to the dentin treatments: the negative control group: noninfected sound dentin discs, the positive control group: infected discs were left untreated; the NaOCl group: treated with 5% NaOCl solution, the chlorhexidine (CHX) group: 2% CHX solution, the Carisolv group: Carisolv gel (Medi Team Dentalutveckling AB, Savedalen, Sweden), and the Papacarie group: Papacarie gel (Formula & Acao, São Paulo, Brazil). All the agents were applied for 5 minutes. The dentin discs were fractured into 2 halves and stained with fluorescent LIVE/DEAD Stain (Molecular Probes, Eugene, OR). Each specimen was observed using confocal laser scanning microscopy at 5 different randomly selected sites.. The results of 1-way analysis of variance revealed that 5% NaOCl solution achieved the highest intratubular antibacterial effect, whereas Carisolv gel had the lowest antibacterial effect (P < .05). No significant difference in antibacterial effect was observed between the Papacarie gel and 2% CHX solution (P > .05).. The enzyme-based chemomechanical caries removal (Papacarie) was effective in the reduction of residual cariogenic bacteria in the dentinal tubules of coronal dentin.

Topics: Chlorhexidine; Dental Caries; Dental Cavity Preparation; Dental Disinfectants; Dentin; Fluorescent Dyes; Gels; Glutamic Acid; Humans; Hydrogen-Ion Concentration; Leucine; Lysine; Materials Testing; Microbial Viability; Microscopy, Confocal; Microscopy, Electron, Scanning; Papain; Random Allocation; Sodium Hypochlorite; Streptococcus mutans; Time Factors

To study the degree of penetration of an adhesive resin in artificial enamel carious lesions after using sodium hypochlorite as deproteinization agent.. Twenty included human third-molars, extracted for surgical indication, were used. Artificial lesions were created in the buccal and lingual sides of each specimen through a cycle of demineralization-remineralization. Samples were then incubated in human saliva for 7 days at 37 ° C. After surface cleaning, lesions and the peripheral sound enamel were etched with 37% orthophosphoric acid for 20 seconds. One lesion of each specimen was treated with 5.25% sodium hypochlorite (NaOCl) for one minute. The other lesion of each specimen was used as a control. Experimental and control lesions were sealed with a fluid resin marked with Rhodamine B. Lesions were sectioned for microscopic observation by epifluorescence and polarized light. The images obtained were analyzed morphometrically. The micrometer measurements were made with ImageJ ® software. The level of significance was assessed at p<0.05.. The average sealant depth penetration in the control group was 94.9 ± 28.6 μm versus 122.8 ± 25.3 μm in the experimental group. This represents Δ 20.1% significantly greater penetration when using sodium hypochlorite (p<0.001).. The results demonstrated a significant penetration of the sealing resin when the conventional technique is complemented with the application of 5.25% sodium hypochlorite for one minute in artificial enamel carious lesions.

Topics: Acid Etching, Dental; Acrylates; Acrylic Resins; Adolescent; Dental Caries; Dental Enamel; Dental Materials; Fluorescent Dyes; Humans; Image Processing, Computer-Assisted; Microscopy, Fluorescence; Microscopy, Polarization; Phosphoric Acids; Protein Denaturation; Rhodamines; Saliva; Sodium Hypochlorite; Temperature; Time Factors; Young Adult

Uncontrolled bacteria of dental plaque generate formation of oral biofilm located on teeth and subgingival surfaces. It may induce local inflammation (gingivitis) with further development of periodontal diseases. A variety of oral bacteria such as Streptococcus mutans and Porhyromonas gingivalis are involved in pathogenesis of dental carries and periodontitis. Very often bacterial infections are associated with candidiasis (Candida albicans). Chlorhexidine (CHX) is the most commonly used antiseptic in dentistry due to its strong antibacterial activity and capacity to reduce the accumulation of oral biofilms. However, other antiseptics, especially endodontic irrigants, are still tested to improve their preventive and therapeutic effects in oral cavity infections. In this in vitro study we have compared antimicrobial activity of CHX with that of taurine chloramine (TauC1) and taurine bromamine (TauBr), natural taurine derivatives with known antibacterial and anti-inflammatory properties.. Antimicrobial activity of CHX, TauC1 and TauBr was tested by incubation of the compounds with S. mutans, P gingivalis and C. albicans. The agents were incubated in low (105/ml) and high (108/ml) density microbe suspensions, related to early and late biofilm infections, respectively. In some experiments bacteria were incubated with a combination of CHX + NaOCl and CHX + TauBr. MIC was determined by the pour-plate method.. CHX showed the strongest antimicrobial activity against all tested pathogens. On the contrary, TauC1 was the weakest antiseptics used without effect on the growth of C. albicans. TauBr at non-cytotoxic concentrations inhibited the growth of S. mutans and P gingivalis with slight effect on the low density C. albicans. All tested agents showed weaker antiseptic properties in the presence of serum. Moreover, we have shown that interactions between CHX and sodium hypochlorite (NaOC1), the main endodontic irrigant, but not between CHX and TauBr,resulted in precipitation. Therefore, it may restrict their simultaneous application in root canal treatment. However, in spite of this unwanted reaction, the mixture of CHX with NaOCl kills pathogens more effectively then CHX alone.. The results confirmed CHX exceptional potential as primary antiseptic in dentistry, especially in prevention and treatment of dental carries, periodontal diseases and mouth candidiasis. Moreover, our study shows that TauBr may be used alternatively or in combination with CHX in killing of oral pathogens, due to its strong antibacterial and anti-inflammatory properties.

Topics: Anti-Infective Agents, Local; Anti-Inflammatory Agents; Chlorhexidine; Dental Caries; Dental Plaque; Drug Interactions; Drug Therapy, Combination; Humans; Microbial Sensitivity Tests; Microbiota; Periodontitis; Porphyromonas gingivalis; Sodium Hypochlorite; Streptococcus mutans; Taurine

A sodium hypochlorite accident is a rare event in adults, but even more so in children. The purposes of this paper were to: report the case of a one-year, 10-month-old toddler who was treated under general anesthesia for early childhood caries, incurred a sodium hypochlorite accident following attempted pulpectomy in his primary maxillary central incisors, but made a full recovery without any sequelae after a typical four to six weeks course of disease; review the pertinent literature; and give recommendations on how to minimize the potential occurrence of such incidents.

Topics: Anesthesia, Dental; Anesthesia, General; Dental Caries; Dental Pulp Exposure; Ecchymosis; Edema; Facial Dermatoses; Humans; Incisor; Infant; Maxilla; Pulpectomy; Pulpitis; Root Canal Irrigants; Sodium Hypochlorite; Tooth, Deciduous

Caries-affected dentin is covered with a thicker and organically enriched smear layer than normal dentin. This may affect the demineralization ability and the infiltration of self-etch adhesives, thus reducing the efficacy of bonding to caries-affected dentin. This study evaluated the adhesion of a two-step self-etching adhesive to normal and caries-affected dentin after pretreatment with mildly acidic hypochlorous acid (HOCl) solutions. We used a microtensile bond strength (μTBS) test to compare the μTBS of Clearfil SE Bond to either caries-affected dentin or to normal dentin, after pretreatment for 5 s with one of three solutions (806 mM NaOCl, or 0.95 or 1.91 mM HOCl). The μTBS of the self-etch adhesive was significantly lower to caries-affected dentin than to normal dentin. Pretreatment with 0.95 mM HOCl improved the μTBS of the self-etch adhesive to caries-affected dentin, but there was no significant difference compared with normal dentin. On the other hand, pretreatment with 806 mM NaOCl or 1.91 mM HOCl did not demonstrate a significant improvement in the μTBS to caries-affected dentin. None of the pretreatments demonstrated a negative effect on adhesion to normal dentin.

Topics: Acid Etching, Dental; Analysis of Variance; Dental Bonding; Dental Caries; Dental Stress Analysis; Dentin; Dentin-Bonding Agents; Humans; Hypochlorous Acid; Materials Testing; Molar; Resin Cements; Smear Layer; Sodium Hypochlorite; Tensile Strength

Dentine carious lesions can be remineralized under optimal conditions, while the surface characteristics of the caries-attacked area may play an important role in the remineralization process. To understand such a surface mechanism, we examined the microstructures of the remineralized area pretreated with different methods. It was found that dentinal tubules on the remineralized surface orientated differently from intrinsic dentine tubules, with the specific alignment angle determined by different surface treatments. Various surface treatments included in this study were 37% phosphoric acid treatment (the etched group), 37% phosphoric acid etching followed by the application of 10% sodium hypochlorite treatment (the deproteinized group), and untreatment (the control group). These findings are helpful for understanding the non-restorative repair of dentine lesions and the remineralization process of the caries-affected dentin surface.

Topics: Dental Caries; Dentin; Humans; Phosphoric Acids; Sodium Hypochlorite

To evaluate the effect of sodium hypochlorite pretreatment on adhesion to normal and caries-affected dentin using self-etch adhesives.. Forty extracted human molars with coronal carious lesions were used in this experiment. The occlusal dentin surfaces including the caries-affected dentin in each group were treated as follows: group 1, rinsed with water; group 2, treated with 6% NaOCl for 15s; group 3, treated with 6% NaOCl for 30 s; group 4, application with Accel for 30 s after NaOCl-30 s pretreatment. After rinsing with water and air-drying, the treated dentin surfaces were applied with self-etch systems (Bond Force and Clearfil Protect Bond) according to the manufacturers' instructions, and built-up with resin composite. After 37 degrees C water storage for 24 h, the bonded normal or caries-affected dentin areas were isolated to create an hourglass configuration with a cross-sectional area of approximately 1 mm(2). The specimens were subjected to tensile stress at a cross-head speed of 1.0 mm/min.. NaOCl-15 s pretreatment significantly improved the muTBS of both self-etch adhesives to caries-affected dentin, while the 30 s pretreatment did not affect them. For normal dentin, NaOCl-30 s pretreatment significantly reduced the muTBS of both self-etch adhesives although the 15s pretreatment did not alter them. Furthermore, the application of Accel with a reducing effect increased the muTBS to normal and caries-affected dentin treated with NaOCl for 30 s.. The effects of NaOCl pretreatment on bonding of both self-etch adhesives were dependent upon type of dentin (normal and caries-affected dentin) and the treatment time.

Topics: Composite Resins; Dental Bonding; Dental Caries; Dental Etching; Dental Restoration, Permanent; Dental Stress Analysis; Dentin; Dentin Permeability; Dentin-Bonding Agents; Humans; Molar; Oxidants; Reducing Agents; Smear Layer; Sodium Hypochlorite; Tensile Strength; Time Factors

This in vitro study was undertaken to assess the effects of Galla chinensis extract on inhibition of enamel caries-like demineralization and to elucidate the role of the organic matrix of enamel in this process.. Either regular or enamel disposed of its organic matrix both of bovine origin were exposed to a demineralizing solution for 3 days (pH 4.5). Specimes were additionally treated with either 4 g/L of G. chinensis extraction (GCE) or double distilled water (DDW) four times daily for 5 min each time. Regular enamel exposed accordingly to sodium fluoride (1g/L) during the demineralizing period served as positive control. After exposure mineral loss and lesion depth of all samples were analysed by transversal microradiography. One-way ANOVA and Student-Newman-Keuls test were used to compare the differences amongst groups. A factorial ANOVA was chosen to test the interaction between GCE and enamel organic matrix.. Mineral loss and lesion depth of specimens in the positive control group were significantly lower compared to all other groups. Regular enamel treated with GCE showed significantly lower values compared to regular enamel treated with DDW or to enamel disposed of its organic matrix (p<0.05). These three groups revealed similar values (p>0.05). Significant interaction between GCE and enamel organic matrix with respect to both outcomes could be observed (p<0.05).. G. chinensis inhibits enamel caries-like demineralization in vitro. However, its potential seems to be weaker compared to sodium fluoride. The organic matrix of enamel was shown to play a substantial role in the observed mechanism.

Topics: Animals; Aphids; Cariostatic Agents; Cattle; Dental Caries; Dental Enamel; Dental Enamel Proteins; Dental Enamel Solubility; Drugs, Chinese Herbal; Hardness; Hydrogen-Ion Concentration; Materials Testing; Microradiography; Plant Extracts; Rhus; Sodium Fluoride; Sodium Hypochlorite; Solvents; Time Factors; Tooth Demineralization

Pulp capping in carious teeth has been considered unpredictable and therefore contraindicated. A recently developed material, mineral trioxide aggregate (MTA), resists bacterial leakage and may provide protection for the pulp, allowing repair and continued pulp vitality in teeth when used in combination with a sealed restoration.. Forty patients aged 7 to 45 years accepted pulp-capping treatment when they received a diagnosis no more severe than reversible pulpitis after undergoing cold testing and radiographic examination. The primary author removed caries using a caries detector dye and sodium hypochlorite solution for hemostasis and placed MTA over the exposures and all surrounding dentin. The operator then restored the teeth provisionally with unbonded Clearfil Photocore (Kuraray Medical, Okayama, Japan). During a second visit, the operator restored the teeth with bonded composite after sensibility testing and confirmed MTA curing. At recall appointments, patients were evaluated for reparative dentin formation, pulpal calcification, continued normal root development and evidence of pathosis.. Over an observation period of nine years, the authors followed 49 of 53 teeth and found that 97.96 percent had favorable outcomes on the basis of radiographic appearance, subjective symptoms and cold testing. All teeth in younger patients (15/15) that initially had open apexes showed completed root formation (apexogenesis).. MTA can be a reliable pulp-capping material on direct carious exposures in permanent teeth when a two-visit treatment protocol is observed.. Vital pulp therapy using MTA is a treatment option for teeth diagnosed with a condition no more severe than reversible pulpitis.

Topics: Adolescent; Adult; Aluminum Compounds; Calcium Compounds; Child; Dental Caries; Dental Pulp Capping; Dental Restoration, Permanent; Dentin, Secondary; Drug Combinations; Hemostatics; Humans; Kaplan-Meier Estimate; Life Tables; Middle Aged; Oxides; Pulpitis; Silicate Cement; Silicates; Sodium Hypochlorite; Treatment Outcome

The hypothesis that ozone promotes remineralization of dentinal lesions was tested in vitro. Artificial caries-like lesions in dentin were treated with ozone gas, with another potent oxidizer (sodium hypochlorite, NaOCl, 10%) or with water. The specimens were then remineralized and subsequently demineralized again. Mineral content was assessed by transverse microradiography. NaOCl-treated samples showed damaged surface and, after being remineralized, demineralized significantly more than water- or ozone-treated groups. No difference was found between ozone and water groups. The exposure to ozone had thus no effect on remineralization and subsequent demineralization of remineralized dentinal lesions.

Topics: Animals; Cariostatic Agents; Cattle; Dental Caries; Dentin; Image Processing, Computer-Assisted; Microradiography; Oxidants; Ozone; Sodium Hypochlorite; Surface Properties; Tooth Demineralization; Tooth Remineralization

The objective of this study was to evaluate the effect of in vitro degradation and mechanical loading on microtensile bond strength (MTBS) and microleakage (ML) of a resin composite to dentin using a self-etching primer adhesive [Clearfil SE Bond (SEB)] under two hydration statuses. Twenty-four flat dentin surfaces were divided in groups: 1) blot-dried, 2) air-dried. SEB was applied and resin buildups were performed with Tetric Ceram. Specimens were divided in four subgroups: a) sectioned into beams, b) load cycled, c) beams were immersed in NaOCl for 5 h, d) load cycled and immersed in NaOCl. Beams were tested in tension. For ML testing, 80 Class V cavities were prepared and molars divided in subgroups as described above (in group c and d, specimens were kept in distilled water for 1 year, instead of the 5-h NaOCl immersion). ML was assessed by dye penetration. Analysis of variance and multiple comparisons tests were used for MTBS. For ML, Mann-Whitney U and Wilcoxon matched pairs signed ranked were used (p<0.05). SEB applied to completely dehydrated dentin produced the highest MTBS, at 24-h evaluation. In vitro degradation always decreased MTBS, and fatigue loading only diminished MTBS on dehydrated dentin. Load cycling increased dye penetration on dentin margins. Degradation always increased ML in both enamel and dentin margins.

Topics: Dental Caries; Dentin-Bonding Agents; Humans; Materials Testing; Molar, Third; Permeability; Resin Cements; Sodium Hypochlorite; Surface Properties; Tensile Strength; Water

The aim of this study was to compare the effectiveness of Carisolv with that of two other alkaline substances: NaOCl and Ca(OH)2. Sixty extracted teeth were randomly divided into three groups and split down the center of a carious lesion. In group I, one half of the cavity was excavated with NaOCl (0.5%, pH 11.7), the corresponding half with Ca(OH)2 (pH 12.4); in group II with NaOCl and Carisolv; and in group III with Ca(OH)2 and Carisolv (n = 20 in each case). Carisolv hand instruments were used. Histological specimens were subsequently produced from all cavities and analyzed with a light-microscope following Mallory-Azan staining. The thickness of the remaining caries was measured (< 1 mm or > 1 mm) and the locations were recorded. The data were statistically evaluated using the chi-square test. In group I, 50.5% of the specimens treated with NaOCI and 48.7% treated with Ca(OH)2 were evaluated to be caries-free. The results in group II were NaOCl 61.5% and Carisolv 75.4% caries-free, and in group III Ca(OH)2 61.2% and Carisolv 73.9%. No statistically significant differences were found between NaOCl and Ca(OH)2 excavation (group I: p = 0.89). Compared to NaOCl and Ca(OH)2, Carisolv produced significantly better results for chemo-mechanical caries removal (groups II + III: p < 0.05). In the NaOCl and Ca(OH)2 treated specimens, carious layers with a thickness >1 mm were found significantly more often than in the Carisolv-treated specimens (groups II + III: p < 0.05), whereas there were no differences between NaOCl and Ca(OH)2 excavation (p = 0.06). There were no statistically significant differences in the location of the remaining caries in any of the groups (p > 0.05).

Topics: Calcium Hydroxide; Cariostatic Agents; Chi-Square Distribution; Dental Caries; Dental Cavity Preparation; Fibrillar Collagens; Glutamic Acid; Humans; Leucine; Lysine; Random Allocation; Sodium Hypochlorite

To observe the ultrastructure of the dentin-adhesive interface after in vitro sequential challenge by acidic and basic chemicals around adhesive restorations.. Box-shaped cavities were prepared in bovine root dentin and restored as follows: Reactmer Bond and Reactmer Paste (RB/RP), Clearfil SE Bond and Clearfil AP-X (SE/APX), ABF (experimental) and APX (ABF/APX), Single Bond and APX (SB/APX). After the specimens were stored in water for 1 week, the integrity of the bonds tested by sequential immersion were placed in an artificial demineralizing solution (pH 4.5) for 20 min and in 5% NaOCl for 20 min. The specimens were sectioned, polished, then argon-ion etched for 7 min, and gold sputter coated for SEM examination of the dentin-adhesive interface.. The morphological results indicated tight bonding between the cavity wall dentin and the adhesive. For the fluoride-releasing restoration, RB/RP, a thick acid-resistant zone was clearly observed adjacent to the restoration; however, the bonding resin, RB, was partially degraded by the acid-base challenge. For SE/APX, ABF/APX and SB/APX, the bonding resins were resistant to the acid-base challenge. With the self-etching adhesive systems, SE and ABF, a thin band of acid-base resistant dentin less than 1 microm thick was observed beneath the hybrid layer. With the wet bonding system, SB, the hybrid layer was partially degraded by the acid-base challenge.. SEM observation is useful for observing the reactions of adhesives to acid-base challenge. Prevention of secondary caries around a restoration may be influenced by the physical properties of the restorative and adhesive materials, quality of the hybrid layer, and fluoride-release.

Topics: Acetic Acid; Animals; Bisphenol A-Glycidyl Methacrylate; Cattle; Composite Resins; Dental Bonding; Dental Caries; Dental Restoration, Permanent; Dentin; Dentin Permeability; Dentin-Bonding Agents; Glass Ionomer Cements; Methacrylates; Microscopy, Electron, Scanning; Pyridinium Compounds; Resin Cements; Sodium Hypochlorite

In chemo-mechanical caries removal procedures, chloramines are typically used for chemical softening of carious dentin. However, the specific effect of chloramines to be compared to sodium hypochlorite has not been sufficiently clarified. In present study, the effect of chloramines used in the Carisolv-system on carious dentin mechanical properties and morphology were investigated, using Vickers hardness test and scanning electron microscopy (SEM). Sections of permanent teeth with dentin caries were treated with chloramines, prepared by mixing amino acids (glutamic acid, lysine, and leucine) with sodium hypochlorite or with sodium hypochlorite alone or with purified water. There was a tendency that the application of the sodium hypochlorite solution softened the sound dentin and/or inner layer of carious dentin more than the application of the chloramines solution did. In SEM observations, the application of chloramines resulted in opening dentinal tubules in the outer layer of carious dentin: Occluded dentinal tubules were seen after sodium hypochlorite application. There is a possibility that the amino acids in the Carisolv-system decrease the aggressive effect of sodium hypochlorite on sound dentin and/or inner layer of carious dentin and also would enhance the disrupting effect on degenerated collagen in carious dentin outer layer.

Topics: Cariostatic Agents; Chloramines; Dental Caries; Dental Cavity Preparation; Dentin; Drug Interactions; Glutamic Acid; Hardness; Humans; Leucine; Lysine; Microscopy, Electron, Scanning; Sodium Hypochlorite

The purpose of this study was to investigate the chemical influence of chemo-mechanical caries removal (CMCR) on surface topography of dental ceramic materials. Thirty samples of three different types of ceramics (Vita Omega, Vita Alpha, and Procera AllTitan) were manufactured and used. With an optical profilometer, designed with a confocal setting of its optics, (CLSP). and an atomic force microscope (AFM) the surface topography of the specimens was investigated at two different resolutions. The specimens were exposed to a solution (64 mm NaOCl, 27 mM amino acids, pH = 11) supposed to be more aggressive than Carisolv (34 mm NaOCl, 53mM amino acids, pH = 11), a CMCR system commercially available. After exposure for 5, 10, and 20 min, respectively, areas measured were relocated and the surface topography was reinvestigated. Parameters describing the amplitude, spatial, and hybrid topographical variation were calculated. In general, after 20 min CMCR solution exposure, the AFM topographical parameters were reduced for Vita Omega, and increased for Vita Alpha", whereas the CLSP topographical parameters of Procera AllTitan were slightly reduced. Thus, the results of this study showed minor influence on surface topography after exposure to CMCR solution for 20 min on the dental ceramics Vita Omega, Vita Alpha, and Procera AllTitan.

Topics: Dental Caries; Dental Cavity Preparation; Dental Materials; Dental Porcelain; Enamel Microabrasion; Equipment Design; Glutamic Acid; Hydrogen-Ion Concentration; Leucine; Lysine; Materials Testing; Metal Ceramic Alloys; Microscopy, Atomic Force; Microscopy, Confocal; Sodium Hypochlorite; Time Factors; Titanium

The Chemo-mechanical caries removal technique involves the application of chemical agents, to cause a selective softening of the carious dentine and facilitate removal by gentle excavation. Carisolv is one such new chemical agent used in this minimal invasive technique of carious dentine removal. The present study was, therefore, undertaken to evaluate the efficacy of Carisolv in the chemo-mechanical removal of carious dentine, the time taken for caries removal, the perception of the treatment by the patient, and to evaluate the restorations, radiographically. Accordingly, fifty primary and permanent molars with dentinal carious lesions were excavated using this technique of caries removal. The chemo-mechanical caries removal technique using Carisolv proved to be an effective atraumatic treatment modality with potential interest for use in clinical pediatric dentistry.

Topics: Child; Dental Caries; Dental Cavity Preparation; Dental Marginal Adaptation; Dental Restoration, Permanent; Dentin; Erythrosine; Fluorescent Dyes; Follow-Up Studies; Glutamic Acid; Humans; Leucine; Lysine; Molar; Oxidants; Patient Satisfaction; Radiography; Sodium Hypochlorite; Statistics, Nonparametric; Time Factors; Tooth, Deciduous

The minimum inhibitory concentrations (MIC) of eight common dental antibacterial agents against three genera of bacteria which have been implicated in dentine caries, namely streptococci, lactobacilli and actinomycetes were investigated. The ultimate aim was to determine the most appropriate antibacterial agent which could be added to dental restorative materials for filling cavities where there was residual dentine caries. The antibacterial agents tested were chlorhexidine diacetate, chlorhexidine dihydrochloride, chlorhexidine gluconate, benzalkonium chloride, cetrimide, cetylpyridinium chloride, thymol and sodium hypochlorite. Thymol and sodium hypochlorite did not inhibit microbial growth at any of the concentrations tested. For the active antibacterial agents tested the MIC values against lactobacilli and streptococci were 0.25 microg/ml to 8.0 microg/ml and for actinomycetes 0.125 to 8.0 microg/ml. These results illustrate the wide spectrum of sensitivity of caries associated bacteria against dental antibacterial agents. From the MIC values alone, it is difficult to recommend which of the active antibacterial agents would be most effective in eliminating cariogenic organisms.

Topics: Actinomycetales; Anti-Infective Agents, Local; Benzalkonium Compounds; Cetrimonium Compounds; Cetylpyridinium; Chlorhexidine; Dental Caries; Disinfectants; Gram-Positive Bacteria; Humans; Lactobacillus; Microbial Sensitivity Tests; Sodium Hypochlorite; Streptococcus; Thymol

The purpose of this study was to determine the relative contributions of the mineral and organic phases of dentin to its total buffering capacity and to compare the buffering abilities of normal and caries-affected dentin for acids used in adhesive dentistry.. Disks of normal and caries-affected human coronal dentin 0.6 mm thick were prepared. Fifty microL of various acids were applied to the surface of mineralized or completely demineralized dentin for varying lengths of time. They were collected from the surface and combined with water rinses to permit titration of the total amount of acid applied, the amount recovered, the total amount that was taken up by the dentin, and the amount that diffused across dentin into 1 mL of water. Equal volumes of acids were applied to mineralized or demineralized dentin powder or hydroxyapatite powder.. About 88% to 90% of applied acid was recovered from the surface; only 10% to 12% of the acid was taken up by dentin. Of the H+ that was taken up, only 1% to 2% actually diffused across 0.6 mm of dentin. Increasing the application time of 37% phosphoric acid did not increase the amount of H+ that diffused across dentin. Increasing the concentration of phosphoric acid from 10% to 65% produced only slight increases in H+ diffusion across dentin. There was no difference in the buffering capacity of normal vs caries-affected dentin disks. Almost all of the buffering capacity of dentin is due to its mineral phase.. The high buffering capacity of dentin and the high reactivity of H+ insure that little H+ diffuses through dentin more than 0.6 mm thick.

Topics: Analysis of Variance; Buffers; Chlorides; Citric Acid; Confidence Intervals; Dental Caries; Dentin; Diffusion; Durapatite; Ferric Compounds; Humans; Hydrogen-Ion Concentration; Minerals; Oxidants; Phosphoric Acids; Protons; Sodium Hypochlorite; Statistics as Topic; Time Factors

The aim of this project was to determine the effectiveness of sterilisation methods for dental enamel for use in intra-oral cariogenicity tests, and their possible effect on the degree of demineralisation of enamel. Bovine incisors were cut vertically into five portions and each assigned to one of five groups. Group 1 was used as a control while the other four groups were subjected, respectively, to gamma irradiation ( congruent with 25kGy), steam autoclaving (121 degrees C for 15 min), sodium hypochlorite (12% w/v for 24h) and povidone-iodine (7.5% w/v for 24h). Total viable counts of microorganisms remaining following sterilisation of the specimens were performed following incubation of the specimens for 24h at 37 degrees C. Caries-like lesions were produced in each specimen using an acidic buffer solution (pH4.5). Sections were cut from each specimen, ground to 80-microgram thickness, and microradiographed. Mineral loss and lesion depth were quantified using transverse microradiography. Statistical analysis was by ANOVA. Dunnett's and Tukey's tests. Microbial growth (Staphylococcus aureus and bacilli) was observed only in control specimens in both brain heart infusion broth and on blood agar plates. The sterilisation methods affected the enamel surface as follows: gamma irradiation (cream discolouration), NaOCl (bleaching), and povidone-iodine (white spot-like lesion). Compared with the control, there was no significant difference in mineral loss and lesion depth with any of the groups, but the numerical values of mineral loss and lesion depth in groups can be ranked as follows: gamma irradiation

Topics: Acids; Analysis of Variance; Animals; Anti-Infective Agents, Local; Bacillus; Buffers; Cattle; Colony Count, Microbial; Dental Caries; Dental Enamel; Disinfectants; Gamma Rays; Microradiography; Minerals; Povidone-Iodine; Sodium Hypochlorite; Staphylococcus aureus; Steam; Sterilization; Tooth Demineralization; Tooth Discoloration

To improve the conditioning of cavity walls resulting from minimal mechanical preparation of carious lesions, such as is done in modified Class II tunnel preparations.. Proximal carious lesions in premolars and molars were excavated manually and the cavity walls studied using a stereomicroscope and by scanning electron microscopy (SEM) following treatment with either polyacrylic acid, sodium hypochlorite, the enzyme preparation Pronase, or sequential combinations of the agents. Polyacrylic acid (10%) was used according to the manufacturer's instructions, while concentrated sodium hypochlorite (5.25%) was applied with either intermittent scrubbing or with ultrasonic energy for 5-10 minutes, or the cavity wall was incubated with the agent at +/- 37 degrees C for periods up to 24 hours. Incubation with the proteolytic enzyme preparation Pronase was carried out at 37 degrees C for a period up to 48 hours.. Manual excavation did not remove all carious dentin, neither did treatment with polyacrylic acid. Scrubbing or sonication with ample amounts of sodium hypochlorite, followed by treatment with polyacrylic acid, or prolonged incubation with sodium hypochlorite, removed most of the remaining carious dentin. However, the "cleanest" surfaces were obtained after 48 hours of incubation with Pronase. Spots of thicker, soft layers of decayed dentin that were left intentionally at some locations could be disintegrated only by the Pronase treatment. It was concluded that treatment with sodium hypochlorite and polyacrylic acid in tandem, or with Pronase may represent potential supplements to conventional cavity cleaning that deserve further investigation. In the clinic more efficient cavity cleaning may improve the bonding ability and thus reduce the risk of marginal ridge fracture in teeth with Class II tunnel restorations.

Topics: Acrylic Resins; Dental Caries; Dental Cavity Preparation; Dental Disinfectants; Dentin; Detergents; Humans; In Vitro Techniques; Microscopy, Electron, Scanning; Pronase; Sodium Hypochlorite

The effect of 2-O-stearoyl glycerol-1,3-bisphosphate (Glydip) on caries lesion formation in root surfaces of sound human third molars was investigated in vitro. For this purpose parts of the root surfaces were treated with Glydip. Adjacent parts of the surfaces were not treated and served as control. Lesions were obtained by demineralization with an acetate buffer of pH 5.0. It was found that Glydip had no inhibiting effect on the rate of lesion formation. Additionally, pretreatments were performed with lauryl sulphate, a chloroform-methanol mixture, an aqueous solution of sodium hypochlorite, and collagenase prior to the treatment with Glydip to enhance the accessibility of the tissue for Glydip. None of these pretreatments or combinations of them revealed an inhibiting effect of Glydip on the rate of caries lesion formation. This result is in contrast to the effect of Glydip on the demineralization of enamel.

Topics: Acid Etching, Dental; Chloroform; Dental Caries; Humans; Methanol; Microbial Collagenase; Phospholipid Ethers; Phosphoric Acids; Sodium Dodecyl Sulfate; Sodium Hypochlorite; Surface-Active Agents; Time Factors; Tooth Demineralization; Tooth Root

It has been proposed that the so-called intact surface zone of carious lesions of enamel could restrict the ingress of mineral ions and hinder remineralisation. The present study was intended to determine the role of organic (proteinaceous) material in restricting the movement of mineral ions into carious lesions in vitro. Natural carious lesion surfaces were divided into two halves. The experimental half was de-proteinised using hypochlorite, the control half remained untreated. The whole tooth was exposed to 45Ca in solution, and 45Ca uptake into experimental and control tissue was measured by image analysis of autoradiographs prepared from lesion sections. The results indicated that uptake was improved by removal of organic material.

Topics: Acid Etching, Dental; Adolescent; Autoradiography; Calcium; Calcium Radioisotopes; Child; Dental Caries; Dental Deposits; Dental Enamel; Humans; Image Processing, Computer-Assisted; Microradiography; Proteins; Sodium Hypochlorite; Specimen Handling

Topics: Adhesives; Aminobutyrates; Composite Resins; Dental Bonding; Dental Caries; Dental Cavity Preparation; Dentin; Humans; Materials Testing; Sodium Hypochlorite; Stress, Mechanical

Topics: Aminobutyrates; Dental Caries; Dental Cavity Preparation; Humans; Sodium Hydroxide; Sodium Hypochlorite

Topics: Acetaminophen; Adult; Brompheniramine; Dental Caries; Edema; Female; Humans; Iatrogenic Disease; Oral Hemorrhage; Periapical Tissue; Periodontal Diseases; Pulpectomy; Root Canal Obturation; Root Canal Therapy; Sodium Hypochlorite; Tetracycline; Therapeutic Irrigation