Ghavamnasiri et al Histopathologic Study on Pulp Response to Glass Ionomer …

Original Article

A Histopathologic Study on Pulp Response to Glass Ionomer

Cements in Human Teeth
M. Ghavamnasiri 1~, M. Mousavinasab 2, N. Mohtasham 3
1
Associate Professor, Department of Operative Dentistry, Faculty of Dentistry and Dental Research Center, Mashhad University
of Medical Sciences, Mashhad, Iran
2
Assistant Professor, Department of Operative Dentistry, Yazd Dental school, Yazd University of Medical Sciences, Yazd, Iran
3
Assistant Professor, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry and Dental Research Center,
Mashhad University of Medical Sciences, Mashhad, Iran

Abstract:
Statement of Problem: Despite the wide range of new dental materials, there is still a
need for biomaterials demonstrating high biocompatibility, antimicrobial effects and
ideal mechanical properties.
Purpose: The aim of this study was to histologically evaluate the pulpal response to a
conventional glass ionomer, a resin modified glass ionomer and a calcium hydroxide in
human teeth.
Materials and Methods: Fifty five deep class V cavities were prepared in premolars of
31 patients and were divided into 3 groups based on application of the following liners:
resin modified glass ionomer (Vivaglass Liner), conventional glass ionomer (Chembond
Superior) and calcium hydroxide (Dycal). After applying varnish, teeth were filled with
amalgam. Each group was further divided into three subgroups according to time
intervals of 7, 30 and 60 days. Teeth were then extracted and their crowns were fixed in
formalin. Each sample was assessed microscopically for odontoblastic changes,
inflammatory cell infiltration, reactionary dentin formation, remaining dentinal
thickness and presence of microorganisms. Statistical analysis including Kruskal Wallis
and Mann Whitney was carried out for comparison of mean ranks. (P=0.05).
Results: In the Vivaglass Liner group, pulpal response was significantly higher on day
7 as compared to days 30 and 60 (P<0.05). Reactionary dentin production was
significantly lower after 7 days than after 60 days for all materials (P<0.05). There was
~
no statistically significant difference in pulpal responses among the three groups during
Corresponding author: the same time intervals (P>0.05). There was no correlation between pulpal responses
M. Ghavamnasiri, Department
of Operative Dentistry, Faculty
with micro-organisms and remaining dentin thickness (P>0.05).
of Dentistry, Mashhad Univer- Conclusion: According to the results of this study, light-cured glass ionomer as well as
sity of Medical Sciences, the other tested lining materials were determined to be biologically compatible with
Daneshgah St., Post Code: vital pulps in deep cavities of sound human teeth.
9138813944, Mashhad, Iran.
dr_marjaneh@yahoo.com
Key Words: Pulp response; Inflammatory cell response; Glass ionomer
Received: 7 March 2005
Accepted: 19 October 2005 Journal of Dentistry, Tehran University of Medical Sciences, Tehran, Iran (2005; Vol: 2, No.4)

INTRODUCTION these advances, there is still a need for

Continuous development of new materials biomaterials demonstrating high
provides a wide range of new dental materials biocompatibility, antimicrobial effects and
with improved mechanical and physical ideal mechanical properties. Among the
properties and biological compatibility, for recently developed materials, glass ionomer
various clinical applications. However, despite cements (GIC) have gained popularity since

2005; Vol. 2, No. 4 135

Journal of Dentistry, Tehran University of Medical Sciences Ghavamnasiri et al

their conception in 1972 by Wilson and Kent for orthodontic reasons (Quota sampling was
[1]. Conventional glass ionomer cements used for this study). The participants and their
present biocompatibility [2], non–shrinking parents or guardians, received an adequate
setting reaction, chemical adhesion to tooth explanation concerning the experimental
structure, and fluoride release. New rationale, clinical procedure and possible risks.
formulations have been successively The parents and all volunteers were then asked
developed to overcome some clinical to read and sign a written consent form
drawbacks of the previous ones, especially explaining the research protocol approved by
aiming to improve physical properties [3]. In the ethic committee.
many clinical situations the resin-modified Patients were required to meet the following
galss–ionomer cements (RMGICs) are an criteria:
alternative to the conventional glass ionomer ●Permanent first premolars scheduled for
cements. orthodontic extraction before applying
To evaluate the biocompatibility of dental brackets or orthodontic forces.
materials a sequence of tests must be ●Scores of 2 or less using the community
performed including in-vitro assays for periodontal index for treatment needs
mutagenesis and cytotoxicity (initial tests), (evaluation consisted of examining the
local toxicity reactions by intraosseous or premolars with a periodontal probe).
subcutaneous implantation of the material in ●Completed root formation
small laboratory animals (secondary tests) and Tooth exclusion criteria were as follows:
finally the usage tests [4]. ●Presence of caries
Several studies on cultured cells have shown ●Presence of restorations
that the light activated glass ionomer cements ●Presence of abrasions or erosions
exhibit poor biocompatibility and greater ●Presence of pulpal symptoms or radiographic
cytotoxicity than the conventional ones [5]. periapical lesions
In vitro studies of Vitrebond and Vitremer After local anesthesia, the teeth were isolated
have shown some cytotoxic and mutagenic with a rubber dam. A class V cavity was
effects leading the investigators to conclude prepared on the buccal surface of each
that they may cause pulp irritation [5,6]. tooth with a 440 diamond point (Shofu Inc,
Indirect pulp capping employing a RMGIC, Kyoto 605-0983, Japan) in a high speed
has been evaluated in two recent studies; one handpiece under copious water spray coolant.
reported acceptable pulpal response, [7,8] and New diamond points and burs were employed
the other described a less favorable pulpal on every fourth cavity preparation. The axial
reaction [9]. wall was excavated using a carbide round bur
This in vivo study histologically evaluated at low speed until a pink discoloration was
pulp tissue reactions to light-cured resin observed due to pulp proximity.
modified glass ionomer and compared it with a The fifty five experimental teeth were divided
conventional glass ionomer and a calcium into three groups. In the first group, Vivaglass
hydroxide lining material in deep cavities. Liner (Ivoclar Vivadent AG, Schaan,
Liechtenstein) was applied to the axial wall of
MATERIALS AND METHODS the cavity and then was light cured for 20
The study population consisted of 19 females seconds. In the second group, Chembond
and 12 males, aged between 13 to 32 years Superior (Dentsply, Detry, UK) was applied as
old, with a mean age of 18. All patients a cavity liner on the axial wall of the cavity,
required the extraction of permanent premolars and in the third group (control), Dycal

136 2005; Vol. 2, No. 4

Ghavamnasiri et al Histopathologic Study on Pulp Response to Glass Ionomer …

(Dentsply, Milford, DE, USA) was applied. hematoxylin and eosin for routine histological
All materials were used according to the evaluation and Taylor’s modification of
manufacturer’s instructions. After application Gram’s staining technique for detection of
of two layers of a copal varnish, Copalite micro-organisms [10]. Pulpal responses and
(Cooley & Cooley LTD,Houston, Texas), the the presence of bacteria in their cavities were
cavities were restored with a high copper evaluated using a light microscope (Zeiss,
amalgam (Oralloy (Coltene Whaledent, USA). Germany). The Remaining Dentin Thickness
After 7, 30 and 60 days, the teeth were (RDT) between the cavity floor and pulp tissue
extracted under local anesthesia. The mesial was measured for each specimen and was
and distal surfaces of the teeth were reduced divided into three groups as follows: deep (0-
with a high speed diamond bur under spray 0.4 mm), moderate (0.4-0.7mm) and shallow
coolant until the pulp became almost visible (more than 0.7 mm). Criteria used for the
through the remaining dentin in order to evaluation of odontoblastic changes,
facilitate the penetration of the fixative inflammatory cell infiltration and reactionary
solution. Afterwards, they were fixed with dentin formation are shown in Table I [11].
10% neutral buffered formalin solution for one The results of odontoblastic changes,
week. The teeth were demineralized in 10% inflammatory cell infiltration and reactionary
Ethylene-Diamine Tetracetic Acid (ETDA) dentin formation were statistically analyzed
with a pH between 7-7.4 at 25oC for sixty days using the Kruskal Wallis and Mann-Whitney
and then were embedded in paraffin. Five-µm- tests at a 95% level of confidence. The
thick serial sections were prepared through the correlation between pulpal responses with
cavities and pulp, obtaining approximately 80- micro organisms and remaining dentin
100 sections per cavity, which were placed on thickness in each group was assessed by
glass microslides and stained with Fisher’s Exact test (α = 0.05).

Table I. Evaluation criteria according to Sonoda [11].

Criterion Description
none Remarkable changes were not observed in the pulp.

slight Disarrangement of odontoblasts was noted slightly below the cut dentinal tubules.
Odontoblastic
changes Disarrangement of odontoblasts was seen through most of the cut dentinal
moderate
tubules.
severe Disarrangement of odontoblasts was noted below the remaining dentin.
none None or a few inflammatory cells were observed through-out the pulp

Inflammatory cell slight A few inflammatory cells were noted below the cut dentinal tubules.
infiltration moderate Remarkable inflammatory cell infiltration observed below the remaining dentin.

severe Severe inflammatory cell infiltration was seen through-out the pulp.
none No abnormal or reparative dentin observed.

Reactionary Slight A small amount of reactionary dentin was noted.

dentin formation moderate Reactionary dentin was observed below the cut dentin.

severe A complete and large bulk of reactionary dentin was noted.

2005; Vol. 2, No. 4 137

Journal of Dentistry, Tehran University of Medical Sciences Ghavamnasiri et al

RESULTS three intervals. Slight odontoblastic changes

Bacterial penetration was observed in 6 cases were seen in each test period (Fig. 3).
(5 cases in cavity walls and only 1 case in the In the Chembond Superior group, there was a
pulp) and microorganisms were found in only significant difference only in reactionary
one specimen in each of the six groups. Pulpal dentin formation among the three intervals
responses did not correlate with dentinal (P<0.05). The mean rank of reactionary dentin
thickness and the presence of micro-organisms formation in the 7-days group was
(P>0.05). significantly lower than the 60–days group
In the Vivaglass Liner group a statistically (P<0.05) (Fig. 4).
significant difference was observed in The results of the Dycal group were similar to
inflammatory cell response among the three that of Chembond Superior.
intervals (P<0.05). Inflammatory cell reaction According to Kruskal Wallis test, statistically
in the 7-days group was significantly higher significant difference was not observed in
than the 30- and 60-days groups (Figs 1 and odontoblastic changes, reactionary dentin and
2). There was no statistically significant inflammatory cell response, among the three
difference in odontoblastic changes among the groups for the same time intervals (P>0.05).

Fig.1: Cavity preparation, remaining dentin thickness

and pulp tissue (H & E; 40X). The odontoblast layer is Fig.2: Moderate to severe aggregation of chronic
disrupted and the cells are displaced into the dentinal inflammatory cells under the remaining dentin
tubules. Mild and scattered inflammatory cells are thickness. (Vivaglass Liner, 7 days) (H & E; 200X)
present. (Vivaglass Liner, 7 days)

Fig.3: A sample of Chembond Superior, 7days. Fig.4: Reactionary dentin formation (R) under the
Remnant of Liner (L) and remaining dentin thickness remaining dentin thickness (D). Remnants of the Liner
(D) can be seen. The odontoblast layer is disrupted. (H (L) and pulp (P) are also present. (Vivaglass Liner 60
& E; 40X) days) (H & E; 40X)

138 2005; Vol. 2, No. 4

Ghavamnasiri et al Histopathologic Study on Pulp Response to Glass Ionomer …

DISCUSSION same time intervals, Vivaglass liner showed a

Certain controversy persists regarding the significantly higher inflammatory response on
biocompatibility of various RMGIC systems. day 7 as compared to days 30 and 60.
Some studies have reported an innocuous According to Geurtsen et al, HEMA and
histologic pulp response to RMGICs in class V TEGDMA may be released from RMGI in the
cavities [12,13], but in vitro studies often first 24 hours after polymerization [5].
showed some cytotoxicity [5,6]. Buillaguet et al also demonstrated the
The purpose of this study was to evaluate and diffusion of HEMA through dentinal tubules
compare the in vivo pulpal response to a resin even against internal pressure [24].
modified glass ionomer and a conventional Cytototxicity of glass ionomer is reduced with
glass ionomer and to assess the correlation time [6] as seen in the present study. RMGIC
between the pulpal responses with the has a burst release of fluoride and also may
presence of bacteria and the remaining dentin have a burst release of monomers that decrease
thickness. The pulpal responses to these with time. This finding agrees with the results
materials were compared with Ca(OH)2 at observed by About et al [9].
three time intervals according to the Criag and All tested materials in the present study
Powers protocol [4]. showed slight to moderate inflammatory
According to a number of previous studies, reactions, and with the exception of six cases,
each subgroup consisted of 5 to 8 samples none of them exhibited bacterial penetration.
[12,14] and amalgam was used as a filling Bacterial-staining profiles indicated that the
material [15,16]. Although many studies studied lining and filling materials provided an
claimed that pulp tissue response is caused almost complete seal against microleakage
only by the presence of bacteria, in vitro through all time intervals. There was only a
studies have demonstrated that resin reversible slight to moderate pulpal response,
monomers diffuse through the dentinal tubules which was due to the excellent biological seal
and cause cytotoxicity [5,17,18]. Pervious provided by the tested materials. This
studies have demonstrated that cellular acceptable pulpal response depended on the
compatibility of RMGICs, varies significantly prevention of bacterial penetration or the lack
[19,20]. Schmalz et al showed that Vitrebond of toxicity of glass ionomers.
causes a very strong cytotoxic effect when The results of this study indicate that there was
evaluated by dentin barrier tests [21]. no correlation between the presence of micro-
Nascimento et al applied Vitrebond as a pulp organisms and remaining dentin thickness with
capping agent in sound human teeth; neither pulpal response. This is probably because of
pulp repair nor dentin bridge formation was the minimal changes in the dentinal thickness
observed even after 300 days [22]. They prepared in this study and also due to the
concluded that Vitrebond is not an appropriate perfect seal which prevented bacterial
pulp capping agent to be used in mechanically penetration through the pulpal tissue. This
exposed sound human pulps. However, it has finding corroborates with the results of a study
been reported that the pulpal response to conducted by Sonoda et al [11].
visible light activated glass ionomer cements If the pulpal response to resin modified glass
may be quite favorable when applied as a ionomer had been evaluated after the
cavity liner [7, 23]. elimination of carious lesions, the results could
The present study demonstrated that despite have better imitated clinical conditions. It is
the fact that pulpal response did not differ recomended that further studies be performed
significantly among the tested materials in the in the future, to evaluate pulpal response to

2005; Vol. 2, No. 4 139

Journal of Dentistry, Tehran University of Medical Sciences Ghavamnasiri et al

glass ionomer in deep carious lesions. cytotoxicity of light-cured glass-ionomer cements

and compomers. J Dent Res 1998; 77(12):2012-9.
CONCLUSION 6- Sidhu SK, Schmalz G. The biocompatibility of
Within the limitation of this study, the glass-ionomer cement materials. A status report for
following conclusions were drawn: the American Journal of Dentistry. Am J Dent
1- The tested glass ionomer systems provided 2001; 14(6): 387-96.
an almost complete seal against bacterial 7- Costa CA, Giro EM, do Nascimento AB,
microleakage through all time intervals. No Teixeira HM, Hebling J. Short term evaluation of
serious inflammatory reaction was observed in the pulpo-dentin complex response to a resin-
the pulp. The pulpal response to the Vivaglass modified glass- ionomer cement and a bonding
Liner on day 7 was significantly higher than agent applied in deep cavities. Dent Mater 2003;
the other intervals. 19:739-746.
2- In all groups, reactionary dentin formation 8- Murray PE, Hafez AA, Smith AJ, Cox CF.
was higher after 60 days as compared to all Bacterial microleakage and pulp inflammation
other time intervals. There was no significant associated with various restorative materials. Dent
difference in odontoblastic change, reactionary Mater 2002; 18(6): 470-8.
dentin formation, and inflammatory cell 9- About I, Murray PE, Franquin JC, Remusat M,
response among the groups for the same Smith AJ. The effect of cavity restoration variables
intervals. Pulpal responses did not correlate on odontoblast cell numbers and dental repair. J
with dentinal thickness and the presence of Dent 2001; 29(2):109-17.
micro-organisms. 10- Rosai J. Ackerman’s Surgical Pathology, 8th
ed Quintessence Int publishing Co; 1996.29.
AKNOWLEDGMENT 11- Sonoda H, Sasafuchi Y, Kitasako Y, Arakawa
This study was supported by a grant from the M, Otsuki M, Tagami J. Pulpal response to a
Research Council of Mashhad University of fluoride–releasing all-in–one resin bonding system.
Medical Sciences, Iran. The authors wish to Oper Dent 2002; 27:271-277.
thank Dr. Shokoufeh Shahrabi Farahani for her 12- Kinawi NA. The effect of different reinforced
assistance in histologic assessment and glass ionomer restorative cement on vital tooth
technical support. structure. Egypt Dent J 1995; 41(4):1479-84.
13- Six N, Lasfargues JJ, Goldberg M. In vivo
REFERENCES study of the pulp reaction to fuji IX, a glass
1- Wilson AD, Kent BE. A new translucent cement ionomer cement. J Dent 2000; 28:413-422.
for dentistry .The glass ionomer cement. Br Dent J 14- Tarim B, Hafez AA, Cox CF. Pulpal response
1972; 132:133-5. to a resin – modified glass- Ionomer material on
2- Sasanaluckit P, Albustany KR, Doherty PJ, nonexposed and exposed monkey pulps.
Williams DF. Biocompatibility of glass ionomer Quintessence Int 1998; 29:535-542.
cements. Biomaterials 1993, 14:906-16. 15- Subay RK, Cox CF, Kaya H, Tarim B, Subay
3- Mount GJ. Some physical and biological AA, Nayir M. Human pulp reaction to dentin
properties of glass ionomer cement. Int Dent J bonded amalgam restorations: a histologic study. J
1995;45:135-140. Dent 2000; 28(5):327-332.
4- Craig RG, Powers JM. Restorative Dental 16- Fitzgerald M, Heys RJ. A clinical and
Materials. 11th ed. London, Mosby Pub; 2002;126- histological evaluation of conservative pulpal
142. therapy in human teeth. Oper Dent 1991; 16(3):
5- Geurtsen W, Spahl W, Leyhausen G. Residual 101-112.
monomer/additive release and variability in 17- Gerzina TM, Hume WR. Diffusion of

140 2005; Vol. 2, No. 4

Ghavamnasiri et al Histopathologic Study on Pulp Response to Glass Ionomer …

monomers from bonding resin-resin composite 21- Schmalz G, Schweikl H , Esch J, Hiller KA.
combinations through dentin invitro. J Dent 1996; Evaluation of a dentin barrier test by cytotoxicity
24:125-128. testing of various dental cements. J Endod 1996;
18- Hanks CT, Strawn SE, Wataha JC, Craig RG. 22:112-5.
Cytotoxic effects of resin components on cultured 22- do Nascimento AB, Fontana UF, Teixeira HM,
mammalian fibroblasts. J Dent Res 1991 costa CA. Biocompatibility of a resin- modified
Nov;70(11):1450-5. glass ionomer cement applied as pulp capping in
19- Heil J, Reifferscheid G, Waldmann P, human teeth. Am J Dent 2000; 13(1):28-34.
Leyhausen G, Geurtsen W. Genotoxicity of dental 23- Hilton TJ. Cavity sealers, liners, and bases:
materials. Mutat Res 1996;368:181-94. current philosophies and indications for use. Oper
20- Leyhausen G, Abtahi M, Karbakhsch M, Dent 1996; 21:134-46.
Sapotnick A, Geurtsen W. Biocompatibility of 24- Bouillaguet S, Wataha JC, Hanks CT, Ciucchi
various light-curing and one conventional glass- B, Holz J. In vitro cytotoxicity and dentin
ionomer cement. Biomaterials 1998; 19:559-64. permeability of HEMA. J Endod 1996;22:244-248.

2005; Vol. 2, No. 4 141

 ‫ﻣﻄﺎﻟﻌﻪ ﻫﻴﺴﺘﻮﭘﺎﺗﻮﻟﻮژﻳﻚ ﭘﺎﺳﺦ ﭘﺎﻟﭗ ﺑﻪ ﺳﻴﻤﺎن ﮔﻼسآﻳﻨﻮﻣﺮ‬
‫در دﻧﺪان اﻧﺴﺎن‬

‫‪3‬‬
‫م‪ .‬ﻗﻮامﻧﺼﻴﺮي‪ -1‬م‪ .‬ﻣﻮﺳﻮيﻧﺴﺐ‪ -2‬ن‪ .‬ﻣﺤﺘﺸﻢ‬

‫‪ ١‬ﻧﻮﻳﺴﻨﺪﻩ ﻣﺴﺌﻮﻝ؛ ﺩﺍﻧﺸﻴﺎﺭ ﮔﺮﻭﻩ ﺩﻧﺪﺍﻧﭙﺰﺷﻜﻲ ﺗﺮﻣﻴﻤﻲ‪ ،‬ﺩﺍﻧﺸﻜﺪﻩ ﺩﻧﺪﺍﻧﭙﺰﺷﻜﻲ‪ ،‬ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﻜﻲ ﻣﺸﻬﺪ‪ .‬ﺗﻬﺮﺍﻥ‪ ،‬ﺍﻳﺮﺍﻥ‬
‫‪ ٢‬ﺍﺳﺘﺎﺩﻳﺎﺭ ﮔﺮﻭﻩ ﺩﻧﺪﺍﻧﭙﺰﺷﻜﻲ ﺗﺮﻣﻴﻤﻲ‪ ،‬ﺩﺍﻧﺸﻜﺪﻩ ﺩﻧﺪﺍﻧﭙﺰﺷﻜﻲ‪ ،‬ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﻜﻲ ﻳﺰﺩ‪ .‬ﻳﺰﺩ‪ ،‬ﺍﻳﺮﺍﻥ‬
‫‪ ٣‬ﺍﺳﺘﺎﺩﻳﺎﺭ ﮔﺮﻭﻩ ﺁﺳﻴﺐﺷﻨﺎﺳﻲ ﺩﻫﺎﻥ ﻓﻚ ﻭ ﺻﻮﺭﺕ ﺩﺍﻧﺸﻜﺪﻩ ﺩﻧﺪﺍﻧﭙﺰﺷﻜﻲ‪ ،‬ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﻜﻲ ﻣﺸﻬﺪ‪ .‬ﻣﺸﻬﺪ‪ ،‬ﺍﻳﺮﺍﻥ‬

‫ﭼﻜﻴﺪه‬
‫ﺑﻴﺎن ﻣﺴﺄﻟﻪ‪ :‬ﻋﻠﻲﺭﻏﻢ ﺗﻤﺎﻣﻲ ﭘﻴﺸﺮﻓﺘﻬﺎﻳﻲ ﻛﻪ ﺩﺭ ﺯﻣﻴﻨﻪ ﻣﻮﺍﺩ ﺩﻧﺪﺍﻧﭙﺰﺷﻜﻲ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺍﺳﺖ‪ ،‬ﻫﻨﻮﺯ ﻫﻢ ﻧﻴﺎﺯ ﺑﻪ ﻣﻮﺍﺩﻱ ﺑﺎ ﺳﺎﺯﮔﺎﺭﻱ ﺯﻳﺴﺘﻲ ﺑﺎﻻ‪،‬‬
‫ﺍﺛﺮﺍﺕ ﺿﺪﻣﻴﻜﺮﻭﺑﻲ ﻭ ﺧﻮﺍﺹ ﻣﻜﺎﻧﻴﻜﻲ ﺍﻳﺪﻩﺁﻝ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‪.‬‬
‫ﻫﺪف‪ :‬ﻫﺪﻑ ﺍﺯ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺍﺭﺯﻳﺎﺑﻲ ﻫﻴﺴﺘﻮﻟﻮﮊﻳﻚ ﭘﺎﺳﺦ ﭘﺎﻟﭗ ﺑﻪ ﻳﻚ ﻧﻮﻉ ﮔﻼﺱﺁﻳﻨﻮﻣﺮ ﻣﻌﻤﻮﻟﻲ‪ ،‬ﻳﻚ ﻧﻮﻉ ﺭﺯﻳﻦ ﮔﻼﺱﺁﻳﻨﻮﻣﺮ ﻣﺪﻳﻔﺎﻱ ﺷﺪﻩ‬
‫ﻭ ﻳﻚ ﻧﻮﻉ ﻛﻠﺴﻴﻢ ﻫﻴﺪﺭﻭﻛﺴﺎﻳﺪ ﺩﺭ ﺩﻧﺪﺍﻧﻬﺎﻱ ﺍﻧﺴﺎﻥ ﺍﺳﺖ‪.‬‬
‫روش ﺗﺤﻘﻴﻖ‪ :‬ﭘﻨﺠﺎﻩ ﻭ ﭘﻨﺞ ﺣﻔﺮﻩ ﻋﻤﻴﻖ ‪ cl v‬ﺑﺮ ﺭﻭﻱ ﺩﻧﺪﺍﻧﻬﺎﻱ ﭘﺮﻣﻮﻟﺮ ‪ ٣١‬ﺑﻴﻤﺎﺭ ﺗﻬﻴﻪ ﻭ ﺟﻬﺖ ﻛﻒﺑﻨﺪﻱ ﺑﺎ ﺳﻪ ﻧﻮﻉ ﻻﻳﻨﺮ )‪ (liner‬ﺑﻪ ﺳﻪ‬
‫ﮔﺮﻭﻩ ﺗﻘﺴﻴﻢ ﺷﺪﻧﺪ‪ .‬ﺩﺭ ﮔﺮﻭﻩ ﺍﻭﻝ ﺍﺯ ﺭﺯﻳﻦ ﮔﻼﺱﺁﻳﻨﻮﻣﺮ ﻣﺪﻳﻔﺎﻱ ﺷﺪﻩ )‪ (Viva glass liner‬ﺩﺭ ﮔﺮﻭﻩ ﺩﻭﻡ ﺍﺯ ﮔﻼﺱﺁﻳﻨﻮﻣﺮ ﻣﻌﻤﻮﻝ‬
‫)‪ (Chembond superior‬ﻭ ﺩﺭ ﮔﺮﻭﻩ ﺳﻮﻡ ﺍﺯ ﻛﻠﺴﻴﻢ ﻫﻴﺪﺭﻭﻛﺴﺎﻳﺪ )‪ (Dycal‬ﺍﺳﺘﻔﺎﺩﻩ ﺷﺪ‪ .‬ﭘﺲ ﺍﺯ ﺯﺩﻥ ﻭﺍﺭﻧﻴﺶ‪ ،‬ﺗﺮﻣﻴﻢ ﺩﻧﺪﺍﻧﻬﺎ ﺑﺎ ﺁﻣﺎﻟﮕﺎﻡ‬
‫ﺻﻮﺭﺕ ﮔﺮﻓﺖ‪ .‬ﻧﻤﻮﻧﻪﻫﺎ ﺑﺮﺍﺳﺎﺱ ﺩﻭﺭﻩﻫﺎﻱ ﻫﻔﺖ‪ ٣٠ ،‬ﻭ ‪ ٦٠‬ﺭﻭﺯ ﺑﻪ ﺳﻪ ﺯﻳﺮﮔﺮﻭﻩ ﺗﻘﺴﻴﻢ ﺷﺪﻧﺪ ﺳﭙﺲ ﺩﻧﺪﺍﻧﻬﺎ ﻛﺸﻴﺪﻩ ﺷﺪﻩ ﻭ ﺩﺭ ﻓﺮﻣﺎﻟﻴﻦ ﺛﺎﺑﺖ‬
‫ﮔﺮﺩﻳﺪﻧﺪ‪ .‬ﺗﻤﺎﻣﻲ ﻧﻤﻮﻧﻪﻫﺎ ﺍﺯ ﺟﻬﺖ ﺷﺎﺧﺼﻬﺎﻱ ﺗﻐﻴﻴﺮﺍﺕ ﺍﺩﻧﺘﻮﺑﻼﺳﺘﻴﻚ‪ ،‬ﺍﺭﺗﺸﺎﺡ ﺳﻠﻮﻝﻫﺎﻱ ﺁﻣﺎﺳﻲ‪ ،‬ﺷﻜﻞﮔﻴﺮﻱ ﻋﺎﺝ ﺗﺮﻣﻴﻤﻲ‪ ،‬ﺿﺨﺎﻣﺖ ﻋﺎﺝ‬
‫ﺑﺎﻗﻴﻤﺎﻧﺪﻩ ﻭ ﺣﻀﻮﺭ ﻣﻴﻜﺮﻭﺍﺭﮔﺎﻧﻴﺴﻢﻫﺎ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻣﻴﻜﺮﻭﺳﻜﻮﭘﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ‪.‬‬
‫ﺟﻬﺖ ﻣﻘﺎﻳﺴﻪ ‪ Mean ranks‬ﺍﺯ ﺁﺯﻣﻮﻥﻫﺎﻱ ﺁﻣﺎﺭﻱ ‪ kruskal-wallis‬ﻭ ‪ Mann-whitney‬ﺑﺎ ﺩﺭﻧﻈﺮ ﮔﺮﻓﺘﻦ ‪ ∝=٠/٠٥‬ﺍﺳﺘﻔﺎﺩﻩ ﺷﺪ‪.‬‬
‫ﻳﺎﻓﺘﻪﻫﺎ‪ :‬ﺩﺭ ﮔﺮﻭﻩ ‪ Viva glass‬ﭘﺎﺳﺦ ﭘﺎﻟﭙﻲ ﺩﺭ ﺭﻭﺯ ﻫﻔﺘﻢ ﺑﻪ ﻃﻮﺭ ﻣﻌﻨﺎﺩﺍﺭﻱ ﺑﻴﺶ ﺍﺯ ﺭﻭﺯﻫﺎﻱ ﺳﻲﺍﻡ ﻭ ﺷﺼﺘﻢ ﺑﻮﺩ )‪ .(P<٠/٠٥‬ﺷﻜﻞﮔﻴﺮﻱ‬
‫ﻋﺎﺝ ﺩﺭ ﺗﻤﺎﻣﻲ ﻣﻮﺍﺩ ﺩﺭ ﺭﻭﺯ ﻫﻔﺘﻢ ﺑﻪ ﻃﻮﺭ ﻣﻌﻨﺎﺩﺍﺭﻱ ﻛﻤﺘﺮ ﺍﺯ ﺭﻭﺯ ﺷﺼﺘﻢ ﺑﺪﺳﺖ ﺁﻣﺪ )‪ .(P<٠/٠٥‬ﻫﻴﭻﮔﻮﻧﻪ ﺍﺧﺘﻼﻑ ﺁﻣﺎﺭﻱ ﻣﻌﻨﺎﺩﺍﺭﻱ ﺑﻴﻦ ﻣﻴﺰﺍﻥ‬
‫ﭘﺎﺳﺦ ﭘﺎﻟﭙﻲ ﺩﺭ ﺳﻪ ﻧﻮﻉ ﻣﺎﺩﻩ ﺩﺭ ﺯﻣﺎﻧﻬﺎﻱ ﻳﻜﺴﺎﻥ ﺩﻳﺪﻩ ﻧﺸﺪ )‪ .(P>٠/٠٥‬ﺍﺭﺗﺒﺎﻁ ﺁﻣﺎﺭﻱ ﻣﻌﻨﻲﺩﺍﺭﻱ ﺑﻴﻦ ﻣﻴﺰﺍﻥ ﻣﻴﻜﺮﻭﺍﺭﮔﺎﻧﻴﺴﻢﻫﺎ ﻭ ﺿﺨﺎﻣﺖ‬
‫ﻋﺎﺝ ﺑﺎﻗﻴﻤﺎﻧﺪﻩ ﻭﺟﻮﺩ ﻧﺪﺍﺷﺖ )‪.(P>٠/٠٥‬‬
‫ﻧﺘﻴﺠﻪﮔﻴﺮي‪ :‬ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻧﺘﺎﻳﺞ ﻣﻄﺎﻟﻌﻪ ﺍﺧﻴﺮ‪ ،‬ﮔﻼﺱﺁﻳﻨﻮﻣﺮ ‪ light cure‬ﻫﻤﭽﻮﻥ ﺩﻳﮕﺮ ﻣﻮﺍﺩ ‪ liner‬ﺍﺯ ﻧﻈﺮ ﺑﻴﻮﻟﻮﮊﻳﻚ ﺳﺎﺯﮔﺎﺭﻱ ﻣﻨﺎﺳﺒﻲ ﺑﺎ‬
‫ﺑﺎﻓﺖ ﭘﺎﻟﭗ ﺯﻧﺪﻩ ﺩﺭ ﺣﻔﺮﺍﺕ ﻋﻤﻴﻖ ﺩﻧﺪﺍﻧﻬﺎﻱ ﺳﺎﻟﻢ ﺍﻧﺴﺎﻧﻲ ﺩﺍﺭﺩ‪.‬‬
‫واژهﻫﺎي ﻛﻠﻴﺪي‪ :‬ﺯﻳﺴﺖ ﺳﺎﺯﮔﺎﺭﻱ؛ ﮔﻼﺱ ﺁﻳﻨﻮﻣﺮ؛ ﻛﻠﺴﻴﻢ ﻫﻴﺪﺭﻭﻛﺴﺎﻳﺪ؛ ﭘﺎﺳﺦ ﭘﺎﻟﭙﻲ‬
‫ﻣﺠﻠﻪ دﻧﺪاﻧﭙﺰﺷﻜﻲ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ و ﺧﺪﻣﺎت ﺑﻬﺪاﺷﺘﻲ‪ ،‬درﻣﺎﻧﻲ ﺗﻬﺮان )دوره ‪ ،2‬ﺷﻤﺎره ‪ ،4‬ﺳﺎل ‪(1384‬‬