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The success of a dental restoration can be altered by the amount of residual bacteria present under the cavity which over time cause deterioration of adhesive cement by microleakage or secondary caries. Cavity disinfectant application on the cavity walls performs a cleansing ac-tion to decrease the bacterial load and improve the longevity of restorations. Although a wide variety of such chemical disinfectants have been in use, their cytotoxic effects have led to the increasing popularity of natural agents. These materials possess antimicrobial, antioxidant and anti-inflammatory properties, which effectively disinfect cavity walls while, at the same time, being cheaper, less toxic, and more patient-friendly. Some of these agents have also been proven to improve the bond strength of resin to dentin by preventing collagen degradation and MMP inhibition. Propolis, aloe vera, chitosan, green tea, liquorice etc., are derived from parts of plants or animals and have been tested to be efficacious and, in some cases, superior to chemical alternatives without any erosive effect on dentin. Although there is a lack of enough in-vivo evidence to advocate the use of these products as an adjunct in dental therapy, recent studies have yielded promising results, which increases the scope for future clinical research. This review aims to highlight the properties and effectiveness of a few of such natural agents as potential cavity disinfectants.
The success of a dental restoration can be altered by the amount of residual bacteria present under the cavity which over time cause deterioration of adhesive cement by microleakage or secondary caries. Cavity disinfectant application on the cavity walls performs a cleansing ac-tion to decrease the bacterial load and improve the longevity of restorations. Although a wide variety of such chemical disinfectants have been in use, their cytotoxic effects have led to the increasing popularity of natural agents. These materials possess antimicrobial, antioxidant and anti-inflammatory properties, which effectively disinfect cavity walls while, at the same time, being cheaper, less toxic, and more patient-friendly. Some of these agents have also been proven to improve the bond strength of resin to dentin by preventing collagen degradation and MMP inhibition. Propolis, aloe vera, chitosan, green tea, liquorice etc., are derived from parts of plants or animals and have been tested to be efficacious and, in some cases, superior to chemical alternatives without any erosive effect on dentin. Although there is a lack of enough in-vivo evidence to advocate the use of these products as an adjunct in dental therapy, recent studies have yielded promising results, which increases the scope for future clinical research. This review aims to highlight the properties and effectiveness of a few of such natural agents as potential cavity disinfectants.
SUMMARY Purpose: This study's purpose was to evaluate the effect of simulated in vitro hydrostatic pulpal pressure (HPP) on microleakage. Methods and Materials: Extracted third molars (n=12) were sectioned 5 mm below the cementoenamel junction, pulp tissue removed, and the sectioned crowns mounted on a Plexiglas plate penetrated by an 18-gauge stainless steel tube. The mounted specimen mesial surface received a 2×4×6 mm Class V preparation followed by restoration with a strongly acidic, one-step dental adhesive and a flowable microfilled resin, following all manufacturers’ instructions. Restorations were finished to contour, and tubing was attached to a 20-cm elevated, 0.2% rhodamine G reservoir to the specimen steel tube for 48 hours. Specimens then received a nail polish coating to within 1 mm of the restoration margins and were placed in 2% methylene blue (MB) dye for 24 hours, followed by rinsing, embedding in epoxy resin, and sectioning into 1 mm slices using a diamond saw. Controls were intact molars (n=12) processed as above but without HPP. Specimen slices were evaluated using laser confocal microscopy with images exported to ImageJ software with microleakage assessed as the MB linear penetration as a percentage of the total interfacial wall length. Mean values were evaluated with the Kruskal Wallis/Dunn test at a 95% confidence level. Results: The control specimens demonstrated significantly greater (p<0.0001) MB penetration than experimental specimens with simulated HPP. Under this study's conditions, simulated HPP significantly decreased MB dye penetration. Conclusion: Studies accomplished without simulated HPP may overestimate microleakage results.
Purpose: The aim of this in vitro study was to evaluate the effect of material selection and chlorhexidine digluconate (CHX) pretreatment on microleakage in Class V cavities restored with 3 different restorative materials. Materials and Methods: Thirty freshly extracted sound human molars were cleaned and stored in distilled water. Sixty standard Class V cavities were prepared on gingival 1/3 of buccal and lingual surfaces of each tooth. Teeth were randomly assigned into 3 groups corresponding to the selected restorative material (Fuji II LC Capsule/FC, GC; Beautifil Flow Plus/BF, Shofu; and GrandioSo Flow/GF, VOCO). Lingual cavities were pre-treated with CHX (Cavity Cleanser, Bisco). The cavities were restored according to manufacturer's instructions using the materials' own adhesive systems. Teeth were stored in distilled water (24°C) for 6 months for aging. Specimens were immersed in 2% methylene blue solution for 1 h and sectioned longitudinally in buccolingual direction. Occlusal/gingival margins were examined for dye penetration and scored under x8 and x20 magnification using stereomicroscope (Leica MZ7.5, Leica Microsystems). Statistical analysis was performed using chi-square test with a significance level of p0.05). There was no statistically significant difference between the amount of microleakage of GF, FC and BF restorations in CHX-treated and untreated cavities (p>0.05). Conclusion: Application of CHX as cavity cleaner could not prevent dye penetration in Class V cavities restored with giomer, glass ionomer, and resin composites. Key Words: Chlorhexidine gluconate, composite resin, glass ionomer, microleakage.
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