• Restorative Dentistry and Endodontics
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• v.18 no.1
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• pp.73-83
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• 1993

The purpose of this study was to evaluate the effect of various acid treatments on dentin bonding. Freshly extracted human teeth were uprightly embedded in self curing acrylic resin, and their occlusal surfaces were grinded to expose flat dentin surfaces. The specimens were divided into 4 groups. Specimens of one group were not treated so as to be a control and those of the other three groups were threated with 10% polyacrylic acid, 10% phosphoric acid, and 10-3 solution(10% citric acid/3% ferric chloride) respectively. Primer, bonding resin and composite resin were applied over the treated dentin surfaces sequentially. All specimens were stored in $37^{\circ}C$ distilled water for 24 hours, then the tensile bond strength was measured and the treated dentin surfaces and fracured dentin surfaces were examined under a scanning electron microscope. The results were as follows: Bond strengths of acid-treated groups were higher than those of the untreated group. In the acid-treated groups, bond strength was found to be the highest in the 10-3 solution group followed by the 10% phosphoric acid group and the 10% polyacrylic acid group(P<0.01). On SEM examination of dentin surfaces, the untreated dentin surface showed a remaining smear layer and closed dentinal tubules. Dentin surfaces treated with 10 % polyacrylic acid showed a clean dentin surface without the smear layer, but showed remaining smear plugs in dentinal tubules. A dentin surface treated with 10% phosphoric acid or 10-3 solution showed open dentinal tubules without the smear layer or smear plugs. On SEM observation of the fractured dentin-resin interface, the untreated group showed that failure occurred in the smear layer. The group treated with 10% polyacrylic acid showed no resin tag remained in the dentinal tubules, but resin tags in the dentinal tubules were observed in the group treated with the 10% phosphoric acid or the 10-3 solution. On the failure mode examination, the higher the bond strength of the group, the higher the frequency of cohesive failure. The coefficient between bond strength and cohesive failure rate was 0.71.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.303-314
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• 2002

This study was performed to evaluate the usability of Er:YAG laser for periodontal therapy. Forty dental root slabs ($5{\times}5{\times}2mm^3$) were prepared from human periodontally diseased extracted teeth and grouped into 4 groups: 1) control (root planing only), 2) root planing and irradiated with laser at 30mJ, 3) root planing and irradiated with laser at 60mJ, and 4) root planing and irradiated with laser at 100mJ. The root slabs were embedded in resin block before laser treatment. Er:YAG laser was irradiated under water irrigation with the tip held perpendicular to the root surface in contact mode. After Er:YAG laser irradiation or planing on the root surface, morphological changes have been observed under SEM, and the micro-hardness and Ca/P ratio were compared. 1. In the Control group, the root surface showed the directional change caused by root planing instrumentation, and the presence of smear layer, and no exposure of dentinal tubule was observed. Laser irradiated group showed surface changes with rough dentin surface of niche and depression and dentinal tubule exposure by the elimination of smear layer. 2. The micro-hardness of root surface in the laser irradiated group was higher than the control group. The higher energy output was applied, the higher micro-hardness on root surface was resulted. 3. The higher energy output was applied, the higher Ca/P ratio was observed. The higher Ca/P ratio in 60mJ group and 100mJ group was statistically significantly compared to the control group and the 30mJ group. These results suggest that Er:YAG laser irradiation on the periodontally diseased root surface could remove smear layer and increase the micro-hardness on root surface and Ca/P ratio which contribute to enhance the acid resistance of periodontally treated root surface.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.457-463
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• 2013

PURPOSE. The purpose of this study was to compare the effect of a diode laser and traditional irrigants on the bond strength of self-adhesive cement. MATERIALS AND METHODS. Fifty-five incisors extracted due to periodontal problems were used. All teeth were instrumented using a set of rotary root canal instruments. The post spaces were enlarged for a No.14 (diameter, 1.4 mm) Snowlight (Abrasive technology, OH, USA) glass fiber reinforced composite post with matching drill. The teeth were randomly divided into 5 experimental groups of 11 teeth each. The post spaces were treated with the followings: Group 1: 5 mL 0.9% physiological saline; Group 2: 5 mL 5.25% sodium hypochlorite; Group 3: 5 mL 17% ethylene diamine tetra acetic acid (EDTA), Group 4: 37% orthophosphoric acid and Group 5: Photodynamic diode laser irradiation for 1 minute after application of light-active dye solution. Snowlight posts were luted with self-adhesive resin cement. Each root was sectioned perpendicular to its long axis to create 1 mm thick specimens. The push-out bond strength test method was used to measure bond strength. One tooth from each group was processed for scanning electron microscopic analysis. RESULTS. Bond strength values were as follow: Group 1 = 4.15 MPa; Group 2 = 3.00 MPa; Group 3 = 4.45 MPa; Group 4 = 6.96 MPa; and Group 5 = 8.93 MPa. These values were analysed using one-way ANOVA and Tukey honestly significant difference test (P<.05). Significantly higher bond strength values were obtained with the diode laser and orthophosphoric acid (P<.05). There were no differences found between the other groups (P> .05). CONCLUSION. Orthophosphoric acid and EDTA were more effective methods for removing the smear layer than the diode laser. However, the diode laser and orthophosphoric acid were more effective at the cement dentin interface than the EDTA, Therefore, modifying the smear layer may be more effective when a self-adhesive system is used.

• Journal of Periodontal and Implant Science
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• v.40 no.6
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• pp.257-264
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• 2010

Purpose: Connective tissue reattachment to periodontally damaged root surfaces is one of the most important goals of periodontal therapy. The aim of this study was to develop a root conditioning agent that can demineralize and detoxify the infected root surface. Methods: Dentin slices obtained from human teeth were treated with a novel root planing agent for 2 minutes and then washed with phosphate-buffered saline. Smear layer removal and type I collagen exposure were observed by scanning electron microscopy (SEM) and type I collagen immunostaining, respectively. Cell attachment and lipopolysaccharides (LPS) removal demonstrated the efficiency of the root conditioning agent. Results: SEM revealed that the smear layer was entirely removed and the dentinal tubules were opened by the experimental gel. Type I collagen was exposed on the surfaces of the dentin slices treated by the experimental gel, which were compared with dentin treated with other root planing agents. Dentin slices treated with the experimental gel showed the highest number of attached fibroblasts and flattened cell morphology. The agar diffusion assay demonstrated that the experimental gel also has effective antimicrobial activity. Escherichia coli LPS were effectively removed from well plates by the experimental gel. Conclusions: These results demonstrated that this experimental gel is a useful tool for root conditioning of infected root surfaces and can also be applied for detoxification of ailing implant surface threads.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.536-545
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• 1997

The purposes of this study were to evaluate the degree of cavity cleanliness and to observe cavity wall morphology when root-end retrograde cavity preparation was done with ultrasonics. Root resections were done on 20 extracted human maxillary central incisors after canal filling with gutta-percha, and retrocavities were prepared using a slow-speed round bur as a control, and stainless steel ultrasonic tips of power settings of 2 and 6 ($Miniendo^{TM}$, EIE, SA, USA) as experimentals. The degree of the remaining cavity debris and smear layer, and wall morphology were evaluated under the scanning electron microscope. The results were as follows : Cavity prepared with ultrasonics of either power setting showed significantly less smear layer than did slow-speed preparations (p<0.01). However, there was no significant difference in canal debris (p<0.05). Cavity prepared with ultrasonics showed hatcheted appearance of wall, while slow-speed preparation showed relatively plain one.

• Restorative Dentistry and Endodontics
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• v.40 no.3
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• pp.195-201
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• 2015

Objectives: The use of chitosan nanoparticles (CNPs) in endodontics is of interest due to their antibiofilm properties. This study was to investigate the ability of bioactive CNPs to remove the smear layer and inhibit bacterial recolonization on dentin. Materials and Methods: One hundred bovine dentin sections were divided into five groups (n = 20 per group) according to the treatment. The irrigating solutions used were 2.5% sodium hypochlorite (NaOCl) for 20 min, 17% ethylenediaminetetraacetic acid (EDTA) for 3 min and 1.29 mg/mL CNPs for 3 min. The samples were irrigated with either distilled water (control), NaOCl, NaOCl-EDTA, NaOCl-EDTA-CNPs or NaOCl-CNPs. After the treatment, half of the samples (n = 50) were used to assess the chelating effect of the solutions using portable scanning electronic microscopy, while the other half (n = 50) were infected intra-orally to examine the post-treatment bacterial biofilm forming capacity. The biovolume and cellular viability of the biofilms were analysed under confocal laser scanning microscopy. The Kappa test was performed for examiner calibration, and the non-parametric Kruskal-Wallis and Dunn tests (p < 0.05) were used for comparisons among the groups. Results: The smear layer was significantly reduced in all of the groups except the control and NaOCl groups (p < 0.05). The CNPs-treated samples were able to resist biofilm formation significantly better than other treatment groups (p < 0.05). Conclusions: CNPs could be used as a final irrigant during root canal treatment with the dual benefit of removing the smear layer and inhibiting bacterial recolonization on root dentin.

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.463-486
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• 1995

The effect of moistening and air-drying of acid-conditioned dentin before priming on the formation of resin-dentin hybrid zone was investigated, Freshly extracted human molars were used and divided at random into 5 groups, Groups 1 - 3 consisted of specimens conditioned with 10 % phosphoric acid for 20 seconds; Group 1 served as a control in which the conditioned dentin was simply blot-dried with a damp facial tissue; Group 2 was air dried for 30 seconds ; Group 3 was air dried for 30 seconds and immediately remoistened for 10 seconds with air-water syringe. and then the specimen was blot-dried with a damp facial tissue. Groups 4-5 were not acid conditioned ; In group 4, the smear layer on the dentin was blot dried before primer placement; Group 5 was air dried only for 30 seconds, The acetone-based primer and bonding agent of All Bond 2 (Bisco. Inc., USA) and composite resin (Z-100, 3M Dental products, USA) were applied for acid conditioned dentin and non-conditioned dentin. The morphologic ultrastructure of resin-dentin hybrid zone was examined by the use of SEM and TEM. and the existence of inorganic material and analysis of Ca/P weight-percent ratio in the resin-dentin hybrid zone were revealed by the EDAX, The results were as follows : 1. In the moistened specimens from acid-conditioned groups, the resin penetrated about 3-$4{\mu}m$ into dentin and the denatured collagen smear layer was not present at the surface. The resin tag was formed to a thickeness of 3-$4{\mu}m$ at the upper part of dentinal tubule and compactively connected to each other by means of many lateral branching. 2. In the air-dried specimens from acid-conditioned groups, the resin penetrated about 2.0-$2.5\;{\mu}m$ into dentin and an upper thin black layer to a thickness of 30-35nm was identified between adhesive resin and demineralized collagen layer. The resin tag to have a diameter of $2.5{\mu}m$ was formed at the upper part of dentinal tubule. However the funnel shape of the tag was not notable compared to the moistened specimens. 3. In the remoistened specimens from acid conditioned groups, the resin penetrated about 2.0-$2.5{\mu}m$ into dentin and an upper black layer was not present. The resin tag at the upper part of dentinal tubule was formed less than $2{\mu}m$ and was weakly connected to each other by means of few lateral branching. 4. In the non-conditioned groups, the smear layer was formed to a thickness of $0.5{\mu}m$ at dentin surface. However, the resin-dentin hybrid zone was not identified by TEM. The evidence of resin penetration into intertubular and intratubular dentin did not show. 5. All the acid-conditioned groups showed that the detected calcium and phosphorus weight percent ratios at the $2{\mu}m$ upper portion from the resin-dentin interface into the resin were much higher than that at the $2{\mu}m$ lower portion from the resin-dentin interface to dentin. (P<0.01).

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.121-130
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• 2014

Purpose: To assess the surface profile of dentinal wall, dentin chips and smear layer during the canal shaping with rotary (ProTaper) and ProFile and reciprocating (WaveOne) nickel-titanium file. Materials and Methods: Sixty human extracted mandibular premolars and incisors with single canals were randomly selected. Three experimental groups (n = 20) were instrumented with ProTaper (F2), ProFile (25/.06), WaveOne (25/.08) with irrigation of 2.5% NaOCl. The dentin chips were collected from flute of file during each canal preparation. After canal preparation, roots were grinded and each group was divided into two subgroups (n = 10) for surface profile and smear layer of dentinal wall of shaped root canal. Each specimen was observed under scanning electron microscope for evaluating size of dentin chips, root canal surface recessions and smear layer. Scores of Smear layer were statistically analyzed using Kruskal Wallis test and Mann Whitney test at P = 0.05 level. Results: The size of dentin chips from ProFile, ProTaper and WaveOne was up to $7{\mu}m$, $6.5{\mu}m$, and$4{\mu}m$, respectively. In the surface profile, the width of surface irregularity was measured and Profile, ProTaper and WaveOne was up to $150{\mu}m$, $70{\mu}m$, and $80{\mu}m$, respectively. Completely cleaned root canals were not found. In the middle and apical third of the canals, WaveOne group showed higher smear layer score than ProFile and ProTaper groups (P < 0.05). Conclusion: Within limits of this study, reciprocating motion WaveOne group was not significant difference of shaping ability with the full-sequence ProFile and ProTaper systems except canal clearness of middle and apical third of root canal. When using WaveOne to shaping root canal, thorough root canal irrigation is recommended.

• Restorative Dentistry and Endodontics
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• v.31 no.5
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• pp.378-389
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• 2006

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCl group and NaOCl-6 group were irrigated with 3% NaOCl. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wane obturation technique NaOCl group and EDTA group were immersed in methylene blue solution for 84hours. NaOCl-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mn (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated inter-face and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0. 1. The mean leakage ratio was decreased cervically. 2. NaOCl group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p < 0.05). 3. NaOCl-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p < 0.05). 4. NaOCl-6 group showed higher mean leakage ratio than NaOCl group at each level. But there was significant difference at level 1 only (p < 0.05). 5. EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference. 6. In NaOCl group and NaOCl-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules. The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.

• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.76-88
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• 1995

The purpose of this was to evaluate the in vitro effects of different application modes of tetracycline HCI on dentin root surfaces. The study group was comprised of 30 teeth with advanced periodontal disease extracted before the start of periodontal therapy. The diseased root surface was vigorously root planed to expose dentin. The teeth were sectioned and cotton pellets. soaked in a saturated solution of tetracycline HCI, were either "placed" or "burnished" on the prepared root surface for 3, 5 min. respectively. Control surfaces were similarly treated with root planing only. Following the various treatments, teeth were fixed. dehydrated, critical point dried, and coated for scanning electron microscopic(SEM) evaluation. The surfaces of tetracycline HCI treated specimens considerably differed from specimens treated with root planing only. Results demonstrated that root-planed, no-tetracycline HCI specimens had amorphous, irregular surface which corresponded to a smear layer. Tetracycline HCI specimens exhibited collagen fibers and dentinal tubules exposed by the removal of the smear layer. Although some differences were seen in surface structures among some specimens. "burnished" application causes more extensive change than "placed" application, and application time of the tetracycline HCl did not seem to have any major impact on the surface morphology.