Endodontics

Endodontics

Restorative Materials

Restorative dental materials are used to prevent or repair damage to teeth caused by oral disease or trauma. Though the currently available restorative materials like glass ionomer cements, resin restorations etc. may serve the purpose by restoring the form and function of the tooth however they lack the bioactivity.Secondary caries caused by polymerization shrinkage and micro leakage are other major contributing factors for the failure of restorations. A micro gap formed due to the shrinkage may widen over a period of time due to changes in mechanical properties of materials and tooth making it inaccessible for maintaining oral hygiene thus making it favourable milieu for bacterial growth leading to secondary caries.

The longevity of dental restorations can be achieved by creating a tight bond to the tooth and a hostile environment for bacteria. Bonding agents with bioactive glass properties may provide a sealed interface by hydroxyapatite precipitation. Bioactive glass has shown to induce dentin remineralisation. 
The longevity of dental restorations can be achieved by creating a tight bond to the tooth and a hostile environment for bacteria. Bonding agents with bioactive glass properties may provide a sealed interface by hydroxyapatite precipitation. Bioactive glass has shown to induce dentin remineralisation. 
Reference:
Skallevold HE, Rokaya D, Khurshid Z, Zafar MS. Bioactive Glass Applications in Dentistry. Int J Mol Sci. 2019 Nov 27;20(23):5960. doi: 10.3390/ijms20235960. PMID: 31783484; PMCID: PMC6928922

Bond Strength with Dentoclude™ F in restorations

Bond Strength with Dentoclude™ F in restorations

In-vitro study demonstrated that Bioactive glass (less than .5 micron) added to the resin-dentin bonded interface that previously has been shown to reduce mico-leakage does not decrease the bond strength. Indeed, it showed superior bond strength compared to the control by three times. No adhesive failure were observed in Cumberland studies to date.

A Study was conducted to compare the effect of bioactive glass, hydroxyapatite, and diode laser desensitization on shear bond strength of resin composites to dentin at different time intervals. Seventy-two caries-free maxillary premolars were selected. Buccal surfaces were flattened to expose dentin. Teeth were divided into four groups according to treatment modality (control with no pretreatment, Toothpaste with bioactive glass, Hydroxyapatite Desensitizer, diode laser). Bonding was performed using self-etch adhesive followed by composite buildup. Universal testing machine was used to determine shear bond strengths immediately after bonding, after 3 months, and 5 months storage in artificial saliva. Pretreatment with bioactive glass (BG) and hydroxyapatite desensitizers increased, whereas diode laser decreased mean shear bond strength of composite to dentin as compared to control group. No statistically significant difference in shear bond strength values was seen in groups after storage.
Reference:
Gupta T, Nagaraja S, Mathew S, Narayana IH, Madhu KS, Dinesh K. Effect of Desensitization Using Bioactive Glass, Hydroxyapatite, and Diode Laser on the Shear Bond Strength of Resin Composites Measured at Different Time Intervals: An In vitro Study. Contemp Clin Dent. 2017 Apr-Jun;8(2):244-247. doi: 10.4103/ccd.ccd_155_17. PMID: 28839410; PMCID: PMC5551329.

Usage in Inlays and Onlays

Dentoclude™ F is a USFDA approved novel/proprietary finely ground bioactive glass formula and is indicated to use as a desensitizing agent for dentin surfaces by blocking dentin tubules to help prevent micro-leakage and to use under direct or indirect restorations following dentin etch and prior to dentin adhesive application. 

Inlays and onlays are cemented in the mouth using adhesive resin luting cement. These materials are placed in the in-lay/ on-lay and placed onto the prepared tooth.  Bonding agents can be applied to dentine before cementation of inlays and onlays. 
Literature supports the usage of bioactive glasses in various aspects of dentistry including dental restorative materials. Many luting cements and dental adhesives were enhanced with bioactive glass for its biocompatibility and to decrease the microleakage and improve the bond strength without compromising their mechanical properties.

Studies on Depth of the Penetration.

Energy-dispersive x-ray analysis/EDX maps of a study conducted to test the hypothesis that the presence of bioactive glass, which is known to precipitate hydroxyapatite when placed in aqueous environments that contain calcium and phosphate, will reduce leakage of resin-bonded dentin showed that bioactive glass particles were embedded in the dentin to a depth of 5-10 µm below the surface. The maps further suggested that the materials are present in both the adhesive and the dentin itself.
Reference:
Gupta T, Nagaraja S, Mathew S, Narayana IH, Madhu KS, Dinesh K. Effect of Desensitization Using Bioactive Glass, Hydroxyapatite, and Diode Laser on the Shear Bond Strength of Resin Composites Measured at Different Time Intervals: An In vitro Study. Contemp Clin Dent. 2017 Apr-Jun;8(2):244-247. doi: 10.4103/ccd.ccd_155_17. PMID: 28839410; PMCID: PMC5551329.

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