Clinical Evaluation of Dimethyl Sulfoxide Dentin Pre-treatment
Condition: Dental Diseases
MeSH terms: Stomatognathic Diseases
Study type: Interventional

Summary: 
      This study is conducted in order to evaluate the clinical effectiveness of 1% DMSO dentin
      pre-treatment on the clinical performance of etch and rinse adhesive.
    

Detailed description: 
      Despite substantial advances in resin-dentin bonding over the past decades, reduction in
      bonding effectiveness of currently available dental adhesives remains a major limitation in
      modern adhesive dentistry. Hydrolysis of both organic and resin constituents of hybrid layer
      persists as impediments in dentin bonding longevity. Since bonding is directly related to the
      quality of the formed polymer the resin components play an important role in proper
      resin-dentin interaction and in the mechanical properties of the material.

      In face of the limitations of most current clinically-feasible bonding protocols and inherent
      drawbacks of the etch-and-rinse approach an ideal resin-enveloped collagen scaffold is
      unlikely to be produced in a consistent manner. In dentin hybridization, adhesive
      infiltration is far from perfect resulting in poorly formed hybrid layers. Replacement of all
      70 vol% residual water in etched-dentin with monomers is hardly achieved. For this reason,
      the hybrid layer may be considered as the weak link in resin-dentin bonds.

      DMSO [(CH3)2SO] is a polar aprotic solvent that dissolves both polar and non-polar compounds.
      It is a polyfunctional molecule, with a highly polar S O group and two hydrophobic methyl
      groups, fully miscible in most solvents and monomers used in adhesive dentistry. DMSO is
      perhaps the best currently known penetration enhancer for medical purposes with the ability
      to dissociate the highly crosslinked collagen into a sparser network of apparent fibrils.

      The rationale for testing a bonding resin with relatively low DMSO-content is that
      incorporation of high DMSO concentrations may hamper the mechanical properties of
      dimethacrylate bonding polymers, which in turn could compromise the bonded interface. DMSO's
      ability to "biomodify" collagen structure, increasing spaces between collagen microfibrils
      and improving dentin wettability support the improved bonding effectiveness even under
      dry-conditions. It is evident that this simplified use of DMSO or, to a better extent, its
      use as a dentin pretreatment reduced technique sensitivity of the etch-and-rinse approach
      concomitantly allowing water removal from the bonded interface by the proposed dry-bonding
      technique. Optimized bonding efficiency combined with reduced water-content during dentin
      hybridization could greatly contribute to clinical long-term durability.

      Nevertheless, further studies are necessary to test such hypothesis. Specially that there is
      no clinical study support this theory yet even DMSO had taken the FDA approval many years ago
      as a pharmaceutical solvent and has been used in several medications. DMSO caused no or minor
      cytotoxic effects on the pulp tissue repair-related activity of odontoblast-like cells.
    

Intervention name(s): Dimethyl Sulfoxide; 3M ESPE Single bond 2; Filtek Z350 XT, 3 M ESPE, St Paul, MN, USA); 3m ESPE etch
Intervention type(s): Other; Other; Other; Other
Intervention description(s): DMSO [(CH3)2SO] is a polar aprotic solvent that dissolves both polar and non-polar compounds.; Total etch adhesive bond; Composite Resin; 32% phosphoric acid
Other intervention name(s): 1% DMSO
Intervention MeSH terms: Dimethyl Sulfoxide
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: DMSO