Protection of sound enamel and artificial enamel lesions against demineralisation: Caries infiltrant versus adhesive

Abstract

OBJECTIVE: To compare the protective potential of a conventional adhesive, a caries infiltrant and a combination of both against acidic challenge in vitro. METHODS: One-hundred-and-fifty discs from bovine lower central incisors were fabricated. Seventy-five samples remained untreated, whereas the other half was subjected to a demineralisation process (14 days, acidic buffer, and pH 5) to create artificial enamel lesions. Specimens were then radioactively irradiated, and each 15 sound and demineralised specimens were treated with a caries infiltrant (Icon, DMG), an unfilled adhesive (Heliobond, IvoclarVivadent) or a combination of infiltrant and adhesive. Specimens treated with the adhesive followed by a flowable composite (TetricEvoFlow, IvoclarVivadent) served as positive control, while untreated specimens served as negative control. All samples were then subjected to lactic acid for 3 weeks at pH 4. Loss of apatite was determined using the radiochemical method of liquid scintillation. Data were statistically analysed by Kruskal-Wallis-test, one-way ANOVA and Scheffe's post hoc tests (p .05). RESULTS: In both sound enamel and artificial caries lesions, untreated specimens showed the highest rate of apatite loss, whereas enamel treated with the adhesive and the flowable composite showed almost complete protection surface against dissolution. The caries infiltrant, the adhesive and the combination of both were able to decrease enamel dissolution, but the adhesive and the combination of adhesive and infiltrant were more effective than the infiltrant alone. CONCLUSION: Within the limitations of this in vitro study, the application of an adhesive (alone or in combination with the caries infiltrant) is more effective to protect enamel dissolution than the infiltrant alone. Methods: One-hundred-and-fifty discs from bovine lower central incisors were fabricated.Seventy-five samples remained untreated, whereas the other half was subjected to a demineralisation process (14 days, acidic buffer, pH 5) to create artificial enamel lesions.Specimens were then radioactively irradiated, and each 15 sound and demineralised specimens were treated with a caries infiltrant (Icon, DMG), an unfilled adhesive (Heliobond, Ivoclar Vivadent) or a combination of infiltrant and adhesive. Specimens treated with the adhesive followed by a flowable composite (Tetric EvoFlow, Ivoclar Vivadent) served as positive control, while untreated specimens served as negative control. All samples were then subjected to lactic acid for 3 weeks at pH 4. Loss of apatite was determined using the radiochemical method of liquid scintillation. Data were statistically analysed by KruskalWallis-test, one-way ANOVA and Scheffe`s post-hoc tests (p < =.05).Results: In both sound enamel and artificial caries lesions, untreated specimens showed the highest rate of apatite loss, whereas enamel treated with the adhesive and the flowable composite showed almost complete protection surface against dissolution. The caries infiltrant, the adhesive and the combinat...

Caries infiltrant combined with conventional adhesives for sealing sound enamel in vitro

“…5,11 Recently, a low-viscosity caries infiltrant with high penetration ability has been shown to increase the protective capacity of conventional adhesives against demineralization. 12 This new resin has been originally developed to arrest WSL progression and to prevent further demineralization by forming a resistant condensed layer via infiltrating the demineralized enamel. 13 In contrast to conventional sealants, where the physical barrier remains on the enamel surface as a covering coat, this infiltrant presents rapid capillary penetration into the pores creating a diffusion barrier within the enamel with very low-viscosity and superior surface wetting abilities.…”

“…In addition, new retention areas for plaque accumulation at the sealed margins are being avoided. 12,13 However, in spite of the deeper penetration of carious lesions where there is a porous structure for the resin to infiltrate, it has not been shown if this resin can infiltrate phosphoric acid etched sound enamel where only limited capillary diffusion is imaginable.…”

Protective Effect of Adhesive Systems associated with Neodymium-doped Yttrium Aluminum Garnet Laser on Enamel Erosive/Abrasive Wear

“…17 The use of adhesives to reduce enamel dissolution after carious acid challenge has also been tested. 18 The adhesives tested in our study were chosen because they are self-etching and do not require prior application of a strong acid for getting retention, which would result in an additional wear on the already eroded surface, thus being more aggressive. Hermsen and Vrijhoef 33 showed that application of 37% phosphoric acid for 15 seconds on the enamel surface promotes removal of about 4.9 μm.…”

“…[15][16][17] Another study has applied the adhesive over the enamel, and its results showed decreased dissolution of enamel after acid challenge. 18 The treatment of cavity walls with Nd:YAG laser has been investigated to improve the bond strength. However, it was shown that it reduces the bond strength to enamel and dentin.…”

Protection and Reinforcement of Tooth Structures by Dental Coating Materials

“…Recently, approaches have been made to extend this preventive concept to smooth enamel surfaces [31,32]. The superficial penetration and surface coating of the adhesive and/or caries infiltrant is considered as a treatment option for protecting enamel dissolution [33].…”