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Evaluation of a Self-limiting Concept in Dentinal Caries Removal

¹ Department of Prosthodontics and Biomaterials, New York University College of Dentistry, 345 East 24th Street, Room 804, New York, NY 10010, USA;
² Department of Prosthodontics and Operative Dentistry, Bauru School of Dentistry, University of São Paulo, Brazil; and
³ Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China

View larger version (206K): [in this window] [in a new window]   Figure 1. TEM micrographs of unbonded dentin substrate following caries removal with the self-limiting polymer bur. (A) Unstained, undemineralized section showing incomplete removal of the caries-infected dentin (asterisk). Loosely arranged smear layer remnants (S) were often identified on top of this layer. Dentinal tubules within the underlying transparent zone (TZ) were almost completely filled with electron-dense mineral deposits (open arrowhead). Patent dentinal tubules were occasionally present within this zone (arrow). E, epoxy resin. (B) Stained, demineralized section from the zone of incompletely removed caries-infected dentin, showing complete denaturation of the dentin collagen network into a gelatinized mass of microfibrils (open arrowhead). (C) Stained, demineralized section from the transition zone, showing a generalized retention of collagen fibrillar structure, despite the absence of cross-banding from individual collagen fibrils (pointer). Derangement of some collagen fibrils into microfibrillar stands could also be recognized (open arrowhead). (D) Stained, demineralized section from the sound dentin (not shown) beneath the transition zone, showing the presence of a dense collagen network with intact banding identified from individual collagen fibrils.

View larger version (106K): [in this window] [in a new window]   Figure 2. TEM micrographs illustrating the application of the total-etch adhesive Single Bond to the dentin surface that was left behind after caries removal with the polymer bur. (A) Stained demineralized section showing the notches (open arrows) created by the flutes of the polymer bur on the surface of the soft, incompletely removed caries-infected dentin. Loose dentin chips (open arrowhead) were trapped within these notches. The damage extended as roughly perpendicular cracks (pointers) into the subsurface transparent dentin zone (TZ). The stained hybrid layer (H) was approximately 12–15 µm thick, Arrow:, dentinal tubules; A, adhesive. (B) Silver-impregnated, unstained, undemineralized section showing the presence of a similar crack (open arrowheads) that extended into the transparent zone (TZ). Dentinal tubules within the transparent dentin were almost completely filled with mineral deposits (arrow). Porosities within the dentin substrate were demarcated by discontinuous islands of silver deposits (pointer). P, polyalkenoic acid copolymer component of the adhesive.

View larger version (111K): [in this window] [in a new window]   Figure 3. TEM micrographs illustrating the application of the mild self-etch adhesive Clearfil SE Bond to the dentin surface that was left behind after caries removal with the polymer bur. (A) Stained, demineralized section showing the presence of an 8- to 12-µm-thick, stained hybrid layer (H) in the incompletely removed caries-infected dentin (asterisk). Adjacent dentinal tubules in this zone were deformed and filled with bacteria. Bacteria were also identified (open arrowhead) from the undeformed portion of the dentinal tubule within the underlying transparent dentin zone (TZ). A, filled adhesive. (B) Silver-impregnated, unstained, undemineralized section showing the presence of deformed dentinal tubules within the incompletely removed caries-infected dentin (asterisk), and partially blocked tubules within the underlying translucent zone (TZ). The latter was highly porous, as can be seen by the discontinuous islands of silver deposits (pointer). Conversely, the overlying zone of incompletely removed caries-infected dentin was probably better-infiltrated with the self-etching primer component of the adhesive, and exhibited fewer silver deposits. A, filled adhesive.

Journal of Dental Research, Vol. 85, No. 3, 282-286 (2006)
DOI: 10.1177/154405910608500315


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