David H Pashley’s research while affiliated with Augusta University and other places

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Publications (919)


Mechanical Stability and Proteolytic Activity of Resin–dentin Bonds Using the Cross-linked Dry Bonding Technique
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December 2021

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78 Reads

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1 Citation

Operative Dentistry

M Citta

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FG Basso

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Objective: To evaluate the mechanical stability and the proteolytic activity of bonds created by a two-step, etch-and-rinse adhesive applied to cross-linked and air-dried etched dentin. Methods: Flat dentin surfaces were produced in 64 extracted sound human molars. The dentin was etched with 35% phosphoric acid for 15 seconds, and then the teeth were divided into groups according to the cross-linking solution applied on the etched dentin. Group 1: 5% grape seed extract (GSE), Group 2: 5% glutaraldehyde, Group 3: Gluma Desensitizer, or Group 4: deionized water (control). Solutions were applied for 60 seconds, followed by rinse and blot drying. Then, the teeth were separated into two subgroups where the etched dentin was kept moist or air-dried. The adhesive was applied followed by a composite resin buildup. After 24 hours, the teeth were cut into beams (0.81 mm2) that were tested for microtensile strength immediately or after 12 months of aging in a 37°C saliva-like buffer. Additional teeth (n=32) were bonded as described and cut into 0.5-mm-thick slabs. The slabs were prepared for nanoleakage (scanning electron microscopy) and in situ zymography (EnzChek Protease Assay Kit). Bond strength data were submitted to ANOVA and Tukey tests (α=0.05). Results: Significant reduction in immediate bond strength (ca 65%) and increase in proteolytic activity was seen when the etched dentin was air dried without previous cross-linking biomodification. Conversely, bond strengths did not differ from those produced on wet dentin when collagen was cross-linked before air drying, irrespective of the solution applied. For both moist and air-dried etched dentin, collagen cross-linking resulted in mechanically stable bonds and reduced proteolytic activity after 12 months of storage. Conclusion: Bonds produced by the application of a two-step, etch-and-rinse adhesive to cross-linked, air-dried, etched dentin were mechanically stable and revealed reduced proteolytic activity after 1 year of aging.


Figure 1-Dry mass loss (%) of human and bovine dentin matrices after up to 21 days of storage in saliva-like buffer solution. The mean initial mass (n=15) was considered 100% and was used to estimate the subsequent values. Letters allow comparisons within each substrate, while connectors indicate comparisons between the substrates for each period of storage. Different letters, as well as the presence of a connector and asterisk (*), indicate that the groups are significantly different (Bonferroni, p<0.05)
Figure 2-Percentage (by weight) of water, mineral and organic fractions of bovine and human dentin. p-values compare the same fraction of both substrates. Values <0.05 indicate statistically significant difference (t-test)
Figure 3-Amount of hydroxyproline (HYP) released from bovine and human dentin matrices up to 21 days of storage in saliva-like buffer solution. Letters allow comparisons within each substrate, while connectors indicate comparisons between the substrates for each period of storage. Different letters, as well as the presence of a connector and asterisk (*), indicate that the groups are significantly different (Bonferroni, p<0.05)
Proteolytic activity and degradation of bovine versus human dentin matrices
  • Article
  • Full-text available

December 2021

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87 Reads

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6 Citations

Journal of Applied Oral Science

Objective: Non-human teeth have been commonly used in research as replacements for human teeth, and potential dissimilarities between the dental tissues should be considered when interpreting the outcomes. To compare the proteolytic activity and degradation rate of bovine and human dentin matrices. Methodology: Dentin beam specimens were obtained from human molars (n=30) and bovine incisors (n=30). The beams were weighed hydrated and after complete dehydration to obtain the mineralized wet and dry masses. Then, the beams were demineralized in 10 wt% phosphoric acid. Next, 15 beams from each substrate were randomly selected and again dehydrated and weighed to obtain the initial demineralized dry mass (DM). Then, the beams were stored in saliva-like buffer solution (SLBS) for 7, 14 and 21 days. SLBS was used to evaluate hydroxyproline (HYP) release after each storage period. The remaining beams of each substrate (n=15) were tested for initial MMP activity using a colorimetric assay and then also stored in SLBS. DM and MMP activity were reassessed after 7, 14 and 21 days of incubation. The data were subjected to two-way ANOVA tests with repeated measures complemented by Bonferroni's tests. Unpaired two-tailed t-tests were also used (p<0.05). Results: Similar water and inorganic fractions were found in human and bovine dentin, while human dentin had a higher protein content. The most intense proteolytic activity and matrix deterioration occurred short after dentin was demineralized. Both substrates exhibited a sharp reduction in MMP activity after seven days of incubation. Although human dentin had higher MMP activity levels, greater HYP release and DM loss after seven days than bovine dentin, after 14 and 21 days, the outcomes were not statistically different. Conclusion: Bovine dentin is a suitable substrate for long-term studies involving the degradation of dentin matrices.

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Figure 1. TEM micrographs of the resin-dentin interfaces in (A) Clearfil SE Bond and (B) Clearfil Protect Bond that were bonded in vitro after 24 hrs. Both adhesives created 0.5-µm-thick, partially demineralized hybrid layers (between open arrows) that contained sporadic areas of nanoleakage that were identified as silver deposits (pointer) within the hybrid layer. Fumed silica clusters (arrow) can be seen in both adhesives (A). Sodium fluoride crystals (open arrowhead) are additionally present in Clearfil Protect Bond. D: mineralized dentin.
Figure 2. TEM micrographs of the resin-dentin interfaces in Clearfil SE Bond after (A) 1 yr of in vitro storage in artificial saliva and (B) 1 yr of in vivo clinical service. In both the in vitro and in vivo specimens, nanoleakage (pointer) can be identified from the top of the hybrid layer (between open arrows). In addition, water trees (arrows) are present in the adhesive layer (A), most of which originated from the surface of the hybrid layer. Void-like structures that were surrounded by a halo of silver deposits (black arrowhead) can also be observed in the adhesive. C, lining composite; D, mineralized dentin.
Figure 3. High-magnification view of the resin-dentin interfaces in Clearfil Protect Bond after (A) 1 yr of in vitro storage in artificial saliva and (B) 1 yr of in vivo clinical service. Apart from the presence of nanoleakage (pointer) in the hybrid layer (H), water trees (arrow) are observed only along the surface of the hybrid layer and are not seen within the bulk of the adhesive layer. Additional isolated silver grains (open arrowhead) can be seen in the adhesive. D: mineralized dentin.
Ultrastructural Correlates of in vivo/in vitro Bond Degradation in Self-etch Adhesives

June 2021

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173 Reads

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1 Citation

Journal of Dental Research

ABSTRACT The morphologic correlates of bond degradation in self-etching primers have not been fully elucidated. We hypothesized that there is no difference between the mechanism of degradation of self-etching primers in vivo and in vitro. Class I cavities prepared in vivo in 24 caries-free human molars were bonded with Clearfil SE Bond or Clearfil Protect Bond, and restored with resin composites. Eight teeth were extracted after 24 hrs, and the rest after 1 yr. The same protocol was repeated in vitro with extracted molars. Degradation of resin-dentin bonds was assessed by microtensile bond testing and TEM of interfaces after tracer immersion. Both in vivo and in vitro bond strengths decreased with time for SE Bond but not for Protect Bond, with more pronounced water treeing observed in the former adhesive under both aging conditions. There is no difference between the mechanism of degradation of self-etch adhesives in vivo or in vitro. KEY WORDS: self-etch adhesives, aging, microtensile bond strength, water trees


Tissue response to white mineral aggregate-based cement containing barium sulfate as alternative radiopacifier: A randomized controlled animal study

October 2020

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37 Reads

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5 Citations

Microscopy Research and Technique

The purpose of this study was to investigate the tissue reaction stimulated by BaSO 4-and Bi 2 O 3-containing White MTA Angelus, in comparison with Bi 2 O 3-containing white Portland cement, and white ProRoot MTA. Thirty-six adult male Wistar rats (Rattus norvegicus), weighing between 250 and 300 g, were distributed into three groups (n = 12) in accordance with the period of sacrifice (15, 30, and 60 days). Four polyethylene tubes filled with the tested cements were implanted into the dorsum of each rat. Lateral wall of the tubes served as the negative control. After the experimental periods, the animals were euthanized by overdose of pentobarbital anesthetic solution, and the specimens were prepared for microscopic analysis under


In vivo and in vitro radiotherapy increased dentin enzymatic activity

July 2020

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42 Reads

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12 Citations

Journal of Dentistry

Objectives The present study investigated the effects of in vitro and in-vivo radiotherapy on endogenous enzymatic activity in dentin using gelatin zymography and in-situ zymography. Methods Gelatin zymographic assays were performed on protein extracts obtained from dentin powder of sound non-irradiated (NRT), in vitro irradiated (VTRT) and in vivo irradiated (VIRT) human teeth. Their proteolytic activities were quantified using band densitometric evaluation. For in-situ zymography, dentin specimens from NRT, VIRT and VTRT were covered with fluorescein-conjugated gelatin and examined with confocal laser-scanning microscopy. Fluorescence intensity emitted by the hydrolyzed fluorescein-conjugated gelatin was quantified and statistically analyzed. In-situ zymography data were statistically analyzed using Kruskal-Wallis ANOVA and Dunn’s multiple comparison procedures (α = 0.05). Results No difference between in vitro and in vivo radiotherapy treatment was found. Both VTRT and VIRT groups showed increase in MMP-9 expression when compared to NRT group. Significant increases (p < 0.05) in gelatinolytic activity (26% for VTRT; 55% for VIRT) were observed when compared to the NRT group. Conclusion Radiotherapy increase endogenous enzymatic activity in non-restored dentin.


Insights into Cathepsin-B Activity in Mature Dentin Matrix

July 2020

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63 Reads

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5 Citations

Archives of Oral Biology

Objective Cysteine proteases are lysosomal enzymes that, under specific circumstances, may be secreted into the extracellular space and participate in protein turnover. This study investigated the involvement of cathepsin B in the gelatinolytic activity of mature dentin matrices at neutral pH. Design Human dentin fragments were made into powder and enzymes were extracted using guanidine-HCl/EDTA. Host-derived dentin proteases (cathepsin B, MMP-2 and MMP-9) were identified by immunoblotting, and their activities were evaluated spectrofluorimetrically using fluorogenic substrates. Proteases activities were monitored by measuring the rate of hydrolysis of substrates in the presence/absence of MMP- or cysteine cathepsin inhibitors, at neutral pH (7.4). Mass spectroscopy was used to determine the substrates’ cleavage points. Reverse zymography was performed to examine the gelatinolytic activity of cathepsin B. Results Western-blots of dentin extracts yielded strong bands at 95, 72 and 30 kDa, corresponding respectively to MMP-9, MMP-2 and Cathepsin B. Greater fluorogenic substrates hydrolysis occurred in the absence of MMP and cysteine cathepsin inhibitors than in their presence. Cathepsin B exhibited significant gelatinolytic activity. Conclusions Together with MMP-2 and MMP-9, cathepsin B also account for the host-derived gelatinolytic activity and matrix turnover of mature dentin at physiological, neutral pH.


Fig. 1 -Resin-dentin interfaces incubated with quenched fluorescein-labeled gelatin. (a) Image acquired in the green channel, showing fluorescence (identifying intense endogenous enzymatic activity) in dentinal tubules and within the HL created with SB1XT without CHX pre-treatment at T 0 . (b) Image of SB1XT without CHX pre-treatment, obtained by merging the differential interference contrast (DIC) image (showing optical density of the resin-dentin interface) and the image acquired in the green channel. (c) Image acquired in green channel of the HL created by the application of SB1XT to acid-etched dentin with CHX pre-treatment at T 0 , showing lower level of fluorescence. (d) Image of HL created with SB1XT without CHX pre-treatment obtained by merging the DIC image and image acquired in the green channel at T 0 . (e) Image acquired in green channel, showing fluorescence in the HL created with SB1XT without CHX pre-treatment at T 10-yr . (f) Image of SB1XT with CHX pre-treatment at T 10-yr , obtained by merging the DIC image and image acquired in green channel. (g) Image acquired in green channel of the HL created by the application of SB1XT to acid-etched dentin with CHX pre-treatment at T 10-yr showing lower level of fluorescence compared to the control group. (h) Image of HL created with SB1XT with CHX pre-treatment obtained by merging the DIC image and image acquired in the green channel at T 10-yr ; SB1XT: Adper Scotchbond 1 XT; CHX: chlorhexidine D: dentin; HL: hybrid layer; R: resin composite.
Fig. 2 -Quantification of the gelatinolytic activity within the resin-dentin interfaces of the tested groups. Groups marked with asterisks are significantly different (p < 0.05).
Fig. 3 -Transmission electron microscopy images of the resin-dentin interface. Specimens were completely-demineralized and sections were stained intact after 10 years of water storage. Upper row: specimens bonded without a CHX-containing separate primer (SB1XT). Lower row: specimens bonded with the application of a CHX-containing separate primer (CHX + SB1XT). Bar widths (a) 1 m; (b) 500 nm; (c) 500 nm; (d) 1 m; (e) 500 nm; (f) 100 nm. Abbreviations -H: hybrid layer; A: adhesive; C: resin composite; D: intertubular dentin; T: dentinal tubule; Symbols -Asterisk: collagen fibrils within the hybrid layer that degraded completely (a) or partially (d); Black arrows: a thin layer of collagen that remained at the top (b) and bottom (c) of the partially-degraded hybrid layers; Open arrowheads: (e) polyalkenoic acid copolymer component of the adhesive, (f) the open arrowheads represent a high magnification of the asterisked region in (d) where in the collagen fibrils have unraveled and degraded into microfibrils.
Fig. 4 -Micro-Raman line-spectra acquired at the adhesive-dentin interface created by SB1XT without CHX (SB1XT) and with a CHX primer (CHX + SB1XT). The relative peaks associated with methacrylate monomers, mineralized and demineralized dentin in the hybrid layer were observed in both groups. The peak of chlorhexidine diacetate was only evident in the CHX + SB1XT groups (T 0 and T 10-yr ).
Chlorhexidine preserves the hybrid layer in vitro after 10-years aging

April 2020

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1,780 Reads

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54 Citations

Dental Materials

Objective The present study investigated the ability of a chlorhexidine (CHX)-containing primer (0.2% aqueous solution) to inhibit dentinal enzymes, preserve the hybrid layer (HL) and remain within the HL, after 10 years of aging in artificial saliva at 37 °C. Methods Non-carious extracted molars were assigned to two groups, cut into slabs exposing middle/deep dentin, etched and bonded with Adper Scotchbond 1XT (SB1XT) with or without 0.2% CHX aqueous solution pretreatment. Composite build-ups were made, and the specimens were cut in 1-mm thick bonded sticks. In situ zymography was performed on freshly prepared specimens (T0) and specimens aged for 10 years (T10-yr) at 37 °C in artificial saliva, to investigate endogenous gelatinolytic activity within the HL. At T10-yr, specimens were also decalcified and embedded in epoxy resin for TEM analysis. Micro-Raman spectroscopy was performed at T0 and T10-yr to evaluate the chemical profiles in intertubular dentin and the HL. Results In situ zymography showed less pronounced enzymatic activity in the CHX-pretreated group (p < 0.05) regardless of aging, maintaining a similar level of fluorescence at T0 and T10-yr (p > 0.05). TEM results showed that 98% of the HL had been degraded in the control group, while 95% of the HL was intact in the experimental group. Moreover, all the Raman spectra peaks assigned to CHX could be identified only in the CHX-pretreated group (T0 and T10-yr). Significance In vitro, CHX remains in the HL after 10 years with its inhibitory effect preserved. This may be the underlying factor for HL preservation after this long aging period.


Proteolytic activity, degradation, and dissolution of primary and permanent teeth

February 2020

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75 Reads

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9 Citations

International Journal of Paediatric Dentistry

Background: Primary and permanent teeth composition may influence dissolution and degradation rates. Aim: To compare the dissolution and degradation of primary and permanent teeth. Design: Enamel and dentin powders were obtained from primary molars and premolars and incubated within different pH buffers. Calcium and inorganic phosphate release was quantified in the buffers by atomic absorption and light spectrophotometry. A colorimetric assay was used to assess the MMP activity of primary (PrD) and permanent dentin (PeD). Collagen degradation was assessed by dry mass loss, change in elastic modulus (E), ICTP and CTX release. Data were submitted to ANOVA and Tukey tests (α=0.05). Results: Similar dissolution was found between PrD and PeD after 256 h. At pH 4.5 enamel released more minerals than dentin while at pH 5.5 the inverse result was observed. MMP activity was similar for both substrates. PrD showed higher dry mass loss after 1 week. In general, greater reduction in E was recorded for PrD. Higher quantities of ICTP and CTX were released from PrD after 1 week. Conclusions: Primary and permanent teeth presented similar demineralization rates. However, collagen degradation was faster and more substantial for PrD.



Ultra-high-speed videography of resin–dentin interface failure dynamics under tensile load

May 2019

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123 Reads

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6 Citations

Dental Materials

Objectives: Ultra-high-speed (UHS) videography was used to visualize the fracture phenomena at the resin-dentin interface during micro-tensile bond strength (μTBS) test. We also investigated whether UHS videography is applicable for failure-mode analysis. Methods: Ten human mid-coronal dentin surfaces were bonded using Clearfil SE Bond either in self-etching (SE) or etch-and-rinse (ER) mode. After 24-h water storage, the samples were cut into beams for μTBS test and tested at a cross-head speed of 1 mm/min. The fracture phenomena at the bonded interface were captured using a complementary metal-oxide-semiconductor digital UHS camera at 299,166 frames per second. The failure modes were classified using UHS videography, followed by scanning electron microscopy (SEM) analysis. The failure-mode distributions determined by UHS videography and SEM analysis were statistically analyzed using Fisher's exact test with Bonferroni correction. Results: The crack-propagation speed exceeded 1,500 km/h. No significant difference was found between the SEM and UHS videography failure-mode distributions in the SE mode. A significant difference appeared between them in the ER mode. Significant differences in the incidence of cohesive failures within the adhesive and at the adhesive-composite interface between the SE and ER modes were identified by both SEM and UHS videography. Significance: UHS videography enabled visualization of the fracture dynamics at the resin- dentin interfaces under tensile load. However, the resolution at such high frame rate was insufficient to classify the failure mode as precisely as that of SEM. Nevertheless, UHS videography can provide more detailed information about the fracture origin and propagation.


Citations (86)


... Perhaps as a result of the strong bonding that universal adhesives have created with dentin because of the improved wettability of adhesive agents which enables the chemical interaction between the acidic monomer in the adhesive agent and the dentinal calcium for superior micromechanical retention. (21) In addition, Richler et.al. (22) in 2024 also explained that self-adhesive composite showed the tiniest shear bond strength values because the area was not wholly dry. ...

Reference:

Laboratory Evaluation of Shear Bond Strength of Self-Adhesive Bulk Fill Composite in Comparison with Bulk Fill Composite.
Bonding of universal adhesives to dentine -Old wine in new bottles?
  • Citing Article
  • May 2015

Journal of Dentistry

... The larger size of bovine incisor teeth, compared to single-rooted human teeth, facilitated the preparation of dentin specimens with suitable flat surfaces for use in the AAA-model and for conducting the microhardness test. Acquiring a significant number of human teeth in appropriate conditions for experimentation may raise substantial ethical concerns [27]. Both human and bovine teeth have been employed in numerous studies [28,29], primarily due to their morphological and histological similarities. ...

Proteolytic activity and degradation of bovine versus human dentin matrices

Journal of Applied Oral Science

... Cold Ceramic (SJM co, Yazd, Iran; CC) is a newly introduced bioceramic with similar applications of other CSCs, to overcome the shortcomings of previous materials. The radiopacifier of this cement is barium sulfate, which has shown non-toxic properties [7]. According to the manufacturer, the initial and final setting times are 15 min and 24 h, respectively [8]. ...

Tissue response to white mineral aggregate-based cement containing barium sulfate as alternative radiopacifier: A randomized controlled animal study
  • Citing Article
  • October 2020

Microscopy Research and Technique

... It has been reported that radiation may exhibit a more substantial impact on the organic phase of dentin, such as collagen when compared to the inorganic matrix [77]. Radiotherapy also enhanced the expression of matrix metalloproteinases (MMPs), increasing gelatinolytic activity ranging from 26 to 55% [78]. These factors could lead to the disappearance of a tubular structure, tubule obliteration, and crack formation. ...

In vivo and in vitro radiotherapy increased dentin enzymatic activity
  • Citing Article
  • July 2020

Journal of Dentistry

... Cathepsins are also synthesized as proenzymes, their activity is regulated by pH and endogenous inhibitors, and a mildly acidic pH is required for the activity of most cathepsins [42]. Identified in dentin, pulp, saliva, and odontoblasts [18,37,43,44], cathepsins were shown to have their expression and activity remarkably augmented in carious dentin in comparison to healthy teeth [18,37]. ...

Insights into Cathepsin-B Activity in Mature Dentin Matrix
  • Citing Article
  • July 2020

Archives of Oral Biology

... The literature indicates that the use of exogenous MMP inhibitors, such as tetracycline (an antibiotic) and chlorhexidine, improves the clinical outcome of resin restorations, as they can preserve the hybrid layer and maintain bond strength (Guirado, George, 2021). Therefore, chlorhexidine remains the most commonly found and studied inhibitor agent in the literature, possibly due to its abundant use in dental clinical practice (Breschi et al., 2020). ...

Chlorhexidine preserves the hybrid layer in vitro after 10-years aging

Dental Materials

... Resin-based composites with adhesives are widely used to reconstruct the morphology and functionality of defected primary teeth. Nevertheless, the degradation of hybrid layer at resin-dentin interfaces mainly leads to weak bond durability [43]. The complicated oral environment with a changeable temperature inevitably influences the mechanical properties of restorative materials for maintaining the bonded interface stability [44,45]. ...

Proteolytic activity, degradation, and dissolution of primary and permanent teeth
  • Citing Article
  • February 2020

International Journal of Paediatric Dentistry

... The mean value in the high intake sub group was always significantly higher in all age groups ( Table 2). The over lap in values noted in the children group and the group of adults without fluorosis could be due to various factors (31,32) including variations in urinary flow rate or pH, as well as differences in fluoride deposition/retention by the skeleton due to individual differences in bone metabolism, such as may occur during growth and development. In fact, the lowest values in the children's high intake sub group were found in children with above average weight and height for age, indicating possible increased fluoride retention due to growth spurt. ...

The Effect of Body Fluid pH on Fluoride Distribution, Toxicity, and Renal Clearance
  • Citing Chapter
  • June 2019

... These fibers improve their strength but are techniquesensitive and susceptible to long-term degradation [7,8,29]. This challenge could be partially addressed through "Super Enamel formation," a mechanically and chemically reinforced enamel bonding interface [12,30,31]. Despite their growing popularity, directly placed composite resin materials are generally less rigid and more prone to wear than ceramic alternatives, emphasizing the clinical importance of case selection. ...

Ultra-high-speed videography of resin–dentin interface failure dynamics under tensile load
  • Citing Article
  • May 2019

Dental Materials

... Therefore, the calcified collagen matrix maintains its morphological integrity and mechanical properties, producing a rigid and rough surface without exposing the collagen matrix or activating protein enzymes similar to those on acid-etched enamel surfaces, resulting in less technique sensitivity [8,[19][20][21]. Some studies have reported promising findings by using the calcium ion chelators with the molecular weight larger than 40 kDa, such as polyacrylic acid sodium salt (PAAN) [19], carboxymethyl chitosan [22,23], EDTA-chitosan [24] and EDTA-glycol chitosan [25]. ...

Polymer conjugation optimizes EDTA as a calcium-chelating agent that exclusively removes extrafibrillar minerals from mineralized collagen
  • Citing Article
  • April 2019

Acta Biomaterialia