Allergic contact dermatitis from bisphenol-A-glycidyldimethacrylate during application of orthodontic fixed appliance.
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Adolescent↗
Biomedical subjects
A J Ireland
Publications and source records attributed to A J Ireland.
An investigation into the use of a single component self-etching primer adhesive system for orthodontic bonding: a randomized controlled clinical trial.
OBJECTIVE: This study assessed the in vivo bond failure of the single component orthodontic self-etching primer system, Ideal 1 (GAC Orthodontic Products) and compared it with the conventional acid etching using a conventional 37% o-phosphoric acid, rinsing and drying regimen when bonding stainless steel orthodontic brackets to enamel. DESIGN: Prospective randomized, controlled clinical trial. SETTING: Orthodontic Department, Bristol Dental School. MATERIAL AND METHODS: Twenty consecutive patients undergoing upper and lower fixed orthodontic treatment entered this cross-mouth control study. Diagonally opposite quadrants were randomly allocated to either the self-etching primer group or the conventional etching group. A total of 339 teeth were bonded with Ideal 1 light-cured adhesive. Bond failures and locus of bond failure were then recorded at 1, 6 and 12 months. RESULTS: Significantly more bond failures occurred at each of the 3 time intervals, 1, 6 and 12 months, where the enamel was pretreated with the Ideal I self-etching primer, than when the enamel was treated with the conventional etchant, 37% o-phosphoric acid. With the latter the cumulative bond failure rates were 3.0, 5.3 and 14.8%, respectively. With the self-etching primer the cumulative failure rates were 29.4, 56.5 and 72.4%. CONCLUSION: The study found that enamel pre-treatment with the Ideal 1 self-etching primer system prior to orthodontic bonding results in an unacceptably high bond failure rate when compared with conventional enamel acid etching.
Acid Etching, Dental↗
An in-vitro investigation into the use of a single component self-etching primer adhesive system for orthodontic bonding: a pilot study.
OBJECTIVE: This pilot study assessed force to debond (N); time, and site of bond failure of a single component self-etching primer (SEP) and adhesive system, Ideal 1 (GAC International Inc., USA) and compared it with the conventional acid etch and rinse regimen using 37% o-phosphoric acid solution and either Transbond XT (3M Unitek) or Ideal 1 adhesive. DESIGN: In vitro laboratory study. SETTING: Bristol Dental Hospital, UK. Sept 2003-Sept 2004. MATERIAL AND METHODS: Nine groups of 20 premolars were bonded using metal orthodontic brackets using three protocols: (1) 37% o-phosphoric acid etch and Transbond XT adhesive; (2) 37% o-phosphoric acid and Ideal 1 adhesive; (3) Ideal 1 SEP and Ideal 1 adhesive. Force to debond and locus of bond failure were determined at three time intervals. RESULTS: Enamel pre-treatment prior to bonding, namely SEP versus conventional etching had no significant effect on the median force to debond with the Ideal 1 adhesive. Similarly, when the enamel was conventionally etched, the adhesive type, namely Ideal 1 or Transbond XT, had no significant effect on the measured force to debond. However, there appeared to be differences in the locus of bond failure: failure predominated at the enamel/adhesive interface for the Transbond XT conventional etch group and at adhesive/bracket interface for the Ideal 1 SEP and adhesive group and the Ideal 1 adhesive conventional etch group. CONCLUSION: These results suggested that the complete Ideal 1 SEP and adhesive system might be successful in vivo leading therefore to a clinical trial. However, implications for clean up time are discussed and improvements to in vitro study designs are advised.
Acid Etching, Dental↗
An investigation into the use of two polyacid-modified composite resins (compomers) and a resin-modified glass poly(alkenoate) cement used to retain orthodontic bands.
The aim of this investigation was to determine the effectiveness of a conventional glass poly(alkenoate) cement (Intact) and newer polyacid-modified composite resin cements (Transbond Plus and Ultra Band-Lok) to retain orthodontic bands. In the in vitro part of this study, stainless steel bands were cemented to 240 extracted third molar teeth in three test groups comprising Intact, Transbond Plus and Ultra Band-Lok. The force to deband (N) for all three cements was recorded using an Instron universal testing machine after the following observation periods: 20 minutes and 3, 6 and 12 months. The results indicated that all three cements increased their median force to deband after 12 months. Of the two compomers, Transbondtrade mark Plus demonstrated the highest median force to deband at all four time intervals. In the in vivo part of the study, 30 patients participated in a randomized cross-mouth clinical trial where the molar bands were cemented in place using either Intact or Transbond Plus. Ultra Band-Lok was not used in the clinical part of the study. The results showed there to be no clinically significant difference in band failure rates between the two cements. When patients were asked to score each for taste, there was a significant difference, with the glass poly(alkenoate) cement (Intact) being more acceptable than the polyacid-modified composite Transbond Plus (P < 0.001). No significant differences were observed in the in vitro median force to deband or in vivo band failure rates between the glass poly(alkenoate) cement and the polyacid-modified composite resins. The choice of cementing agent can therefore be made on patient factors, e.g. taste, or operator factors, e.g. ease of handling, cost and shelf life.
Cementation↗
Enamel loss at bond-up, debond and clean-up following the use of a conventional light-cured composite and a resin-modified glass polyalkenoate cement.
The aim of this study was to determine whether there was any difference in the degree of enamel loss at bond-up, debond and enamel clean-up when two different adhesive systems were tested and with four different methods of enamel clean-up. The adhesive systems were 37 per cent o-phosphoric acid with Transbond XT (group 1) and 10 per cent poly(acrylic acid) conditioner with Fuji Ortho LC (group 2). Using flattened enamel specimens, enamel loss at each stage was determined using a planer surfometer. These stages were: prior to treatment, at pumice prophylaxis, following enamel etching or conditioning and following enamel clean-up. The four clean-up methods were a high-speed tungsten carbide bur, a slow-speed tungsten carbide bur, an ultrasonic scaler and debanding pliers. The results, analysed using non-parametric tests, demonstrated that significantly more enamel loss occurred following the use of 37 per cent o-phosphoric acid than poly(acrylic acid) conditioner (P = 0.001). At debond and prior to clean-up, more adhesive remained on the enamel surface in group 1 than in group 2 (P = 0.005). During the subsequent enamel clean-up and with both adhesive systems, the least enamel loss occurred following the use of the slow-speed tungsten carbide bur and the greatest loss was seen with the ultrasonic scaler or high-speed tungsten carbide bur.Overall, the lowest enamel loss was observed with the poly(acrylic acid) conditioner and Fuji Ortho LC system (group 2) and where enamel clean-up was performed using the slow-speed tungsten carbide bur.
Acrylic Resins↗
Building a learning community on-line: the first step towards a national virtual learning environment in orthodontics.
Virtual learning environments (VLEs) are attractive solutions for the delivery of education on-line. Orthodontic education online has the potential to alleviate some of the problems caused by increasing demands on academic staff, the impact of the European work time directives and changes in junior doctors' hours. All act to constrain the effective training of orthodontic postgraduates. The design of a VLE is driven by modern concepts in learning and teaching, the structure, content and assessment methods will help determine the range of behaviours any programme hopes to encourage. This paper aims to provide information on how a modular specialist-training programme in the United Kingdom has been developed and enhanced by a VLE.
Computer-Assisted Instruction↗
Management of inhaled and swallowed foreign bodies.
Although accidental inhalation or ingestion episodes are very rare, the consequences can be very serious for the patient, so it is important when the total number of courses of dental treatment performed each year are considered. This article discusses the causes, likely sequelae and management strategies adopted following such incidents.
Deglutition↗
An in vivo study to compare a plasma arc light and a conventional quartz halogen curing light in orthodontic bonding.
The purpose of this study was to compare the effectiveness of a plasma arc lamp with a conventional tungsten quartz halogen lamp in orthodontic bonding. Twenty consecutive patients had their brackets bonded either with Transbond XT (n = 10) or Fuji Ortho LC (n = 10). In total, 352 teeth were bonded, 176 in each group. Using a randomized cross-mouth control study design, where diagonally opposite quadrants were assigned a particular treatment, the bonds were then either cured with the control light, namely a halogen lamp, or a plasma arc lamp. The halogen light was used for 20 seconds per tooth and the plasma arc lamp for 3 seconds per tooth. The measurement parameter used was bond failure and the patients were monitored for a period of 6 months following initial bond placement. In the Transbond XT group, the proportion of bond failures was 3.41 per cent for both the halogen and the plasma arc lamp. For the Fuji Ortho LC group, the proportions were 11.4 and 10.2 per cent, respectively. No difference was observed with respect to in-service bond failure proportions between bonds cured with the plasma arc or the conventional halogen lamp, irrespective of the bonding agent. Use of the plasma arc lamp could therefore lead to considerable savings in clinical time. However, this must be weighed against the increased purchase price of the plasma arc lamp.
Adhesives↗
An in vivo and ex vivo study to evaluate the use of a glass polyphosphonate cement in orthodontic banding.
The purpose of this study was to examine the effectiveness of a new glass polyphosphonate cement (Diamond) for orthodontic banding. Thirty-one subjects underwent in vivo testing to compare the failure rate of bands cemented using the test cement and bands cemented using a conventional glass polyalkenoate cement (Ketac-Cem) over a 6-month period at the beginning of active appliance therapy. In an ex vivo experiment 60 extracted teeth were banded using either the test cement or a glass polyalkenoate cement, and subjected to a debanding force using a Lloyd universal testing machine until failure. In the in vivo study the overall proportion of failure of the bands cemented with each cement was identical at 0.048. However, in the ex vivo study the probability of failure for the glass polyphosphonate cement was significantly higher than for the glass polyalkenoate cement, and the force to deband the glass polyalkenoate cement was greater than that of the glass polyphosphonate cement. In the clinical setting the new glass polyphosphonate cement performed as well as a conventional glass polyalkenoate cement, and these results suggest that it could be used as an alternative cement for orthodontic banding. The results of the ex vivo test bring into question the usefulness of this laboratory test as an indicator of clinical performance.
Dental Bonding↗
Decontamination of tried-in orthodontic molar bands.
Molar bands are commonly used to retain orthodontic attachments on posterior teeth and due to the variation in the size of such teeth, it is usually necessary to 'try in' several bands before the correct one is selected. A possible concern with re-using such bands is the lack of cross-infection control, even following autoclaving, due to the presence of one or more small bore lumen (the archwire and headgear tubes). The aim of this experiment was, therefore, to determine whether such bands could be successfully decontaminated so that they could be re-used without a cross-infection risk. Two hundred orthodontic molar bands that had previously been tried in patients' mouths, but not cemented into place, were tested. Each band was decontaminated using an enzymatic cleaner/disinfectant and then sterilized using either a downward displacement (n = 100) or a vacuum cycle autoclave (n = 100). Following autoclaving each band was inoculated into brain heart infusion culture broth and incubated at 37 degrees C for 5 days. None of the decontaminated bands exhibited growth after 5 days. It would appear that, using this methodology, there is little risk of a cross-infection hazard occurring with the re-use of previously tried-in and decontaminated molar bands.
Cross Infection↗
The effect of pumicing on the in vivo use of a resin modified glass poly(alkenoate) cement and a conventional no-mix composite for bonding orthodontic brackets.
OBJECTIVE: Pumicing of the enamel prior to direct bonding with conventional diacrylate bonding agents has been shown to be unnecessary. It is not known whether this is also the case with resin-modified glass poly(alkenoate) cements. The aims of this study were two-fold: (a). to determine whether pumicing prior to bonding has an effect on the in vivo failure of brackets bonded with either Right-On or Fuji II LC; (b). to determine whether there is a difference in the in vivo failure of brackets bonded with either Right-On or Fuji II LC. Design A cross-mouth controlled clinical trial was performed on a total of 60 patients in which the variables under test were pumicing or not pumicing of the enamel prior to bonding using two different bonding agents. MAIN OUTCOME MEASURES: The measurement variable was bond failure over an 18-month period. RESULTS AND CONCLUSIONS: Prior pumicing of the enamel has no effect on in vivo failure when using either a conventional diacrylate or a resin modified glass poly(alkenoate) cement. A greater number of bonds failed with the resin-modified glass poly(alkenoate) cement.
Dental Bonding↗
Take home naloxone for opiate addicts. Drug misusers may benefit from training in cardiopulmonary resuscitation.
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Cardiopulmonary Resuscitation↗
Ingested foreign bodies associated with orthodontic treatment: report of three cases and review of ingestion/aspiration incident management.
Foreign body ingestion/aspiration episodes are potential complications in all branches of dentistry. The handling of small orthodontic components requires particular care, especially where the patient is supine or semi-recumbent. Three cases of foreign body ingestion are presented, involving patients undergoing orthodontic treatment. Once the foreign bodies had been located, all instances were treated using a combination of serial radiography and 'watchful waiting'. All patients remained asymptomatic during this period, although none of the foreign bodies were retrieved. No active intervention was deemed necessary, and the patients were able to resume their orthodontic treatment. The potential complications of ingestion/aspiration episodes are discussed and a management regime suggested.
Adolescent↗
Radiographic diagnosis of root resorption in relation to orthodontics.
The literature regarding external root resorption in relation to orthodontics and its radiographic diagnosis is reviewed, including a summary of the more common radiographic techniques available. Sample cases are presented which demonstrate the need for good radiographic technique and an awareness of the limitations of certain radiographs. A provisional diagnosis of external root resorption may need to be confirmed by further radiographic views where appropriate.
Humans↗
Phosphoric acid and copper (II) sulphate as a combined etchant and activator prior to the use of an anaerobic adhesive.
OBJECTIVES: Previous work has shown that steel attachments can be bonded to etched human enamel using anaerobic adhesives, following treatment with a solution of 0.05M copper (II) sulphate. The objectives of this experiment were to determine whether simultaneous etching and activation could be performed with a combined solution of o-phosphoric acid and copper (II) sulphate. METHOD: Stainless steel attachments were bonded to human enamel using an anaerobic adhesive. In each case the enamel was etched and activated using a solution of 37% o-phosphoric acid containing various concentrations of copper (II) sulphate. After bench curing for one hour, the specimens were shear bond tested to failure and the load at debond recorded in each case. Following determination of the optimum copper (II) sulphate concentration the experiment was repeated, but this time the acid was made into a gel using colloidal silica. The effect of rinse time after etching was also investigated with the gel. RESULTS: The results were analysed using mean force to debond (N) and 95% confidence intervals. Kaplan-Meier survival probabilities and log rank tests were also performed. Under the conditions of this experiment the optimum concentration of copper (II) sulphate was found to be 1M. When the acid was made into a gel the optimum rinsing time was found to be 60s. SIGNIFICANCE: This experiment demonstrates that steel attachments can be bonded to enamel using anaerobic adhesives where the enamel has been simultaneously etched and activated. A combined o-phosphoric acid and copper (II) sulphate solution or gel can be used, but a conventional etch pattern is not produced.
Acid Etching, Dental↗
An in vitro investigation into the use of resin-modified glass poly(alkenoate) cements as orthodontic bonding agents.
This in vitro study was designed to determine the effect of time on the measured mean force to debond when brackets were bonded using resin-modified glass poly(alkenoate) cements and to compare them with a light-cured diacrylate. Changes in surface topography and composition of the cements were also investigated. Stainless steel orthodontic brackets were bonded to 160 upper premolar teeth in four test groups: Transbond, Fuji Ortho LC, and 3 M Multi-Cure with and without enamel etching. Shear bond testing to failure was performed after 1 hour, 1 week, 1 month, and 1 year. The first three groups were then rebonded and stored for the same time periods before being shear tested again. Debond force was recorded in Newtons and the locus of bond failure was scored using the Adhesive Remnant Index (ARI). Surface topography and composition of the test materials were also studied at time periods of 1 day, and 1, 6, and 18 months, using scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDAX). The mean force to debond (N) was observed to increase with time in all four test groups, with there being little significant difference between the groups. When the same brackets were rebonded, the mean force to debond reduced. Surface topography and compositional changes over time were only observed with the resin-modified glass poly(alkenoate) cements. Resin-modified glass poly(alkenoate) cements have a mean force to debond comparable with diacrylate bonding agents. However, unlike diacrylates they undergo surface changes with time, the significance of which is unknown.
Acrylic Resins↗
An in vivo investigation into the use of resin-modified glass poly(alkenote) cements as orthodontic bonding agents.
The aim of this study was to investigate the in vivo bonding of orthodontic brackets using two resin-modified glass poly(alkenoate) cements and to compare them with a conventional light-cured diacrylate bonding agent. Twenty consecutive patients attending for bond up appointments took part in this randomized cross-mouth control study. Alternate quadrants were bonded with either Fuji Ortho LC or 3 M Multi-Cure. Transbond [Adhesive Pre-Coated Brackets (APC)] acted as the control in the other quadrants. Failed brackets were rebonded with the same material. Bond failure rates were collected over a 1-year period. The bond failure rates over 1 year were 7.2 per cent for Transbond (APC), 5.9 per cent for 3 M Multi-Cure, and 5.8 per cent for Fuji Ortho LC. Statistically, there was no significant difference between the bond failure rates of the materials and there was no effect of time. This clinical investigation confirmed the suitability of the resin-modified glass poly(alkenoate) cements under test as orthodontic bonding agents.
Acrylic Resins↗
An ex vivo investigation into the use of a plasma arc lamp when using a visible light-cured composite and a resin-modified glass poly(alkenoate) cement in orthodontic bonding.
OBJECTIVE: To determine the usefulness of the plasma arc lamp in orthodontic bonding when used with both a light curable diacrylate and a resin modified glass poly(alkenoate) cement. DESIGN: Ex-vivo study. METHOD: 160 second premolar teeth were divided into 2 groups. 80 teeth had steel brackets bonded using Transbond XT and 80 were bonded using Fuji Ortho LC. One of four light curing regimes were used, with 20 specimens in each group: (i) 20 seconds curing with a halogen lamp; (ii) 1 second; (iii) 2 seconds or; (iv) 3 seconds with the plasma lamp. OUTCOMES: Shear bond tested to failure and the force to debond (N) and locus of bond failure recorded in each case. RESULTS: Force to debond increases in the case of both bonding materials as the curing time with the plasma lamp increases. The force to debond with 1 and 2 seconds with the plasma lamp was significantly lower in each case. In all instances the force to debond was lower in the case of the resin modified glass poly(alkenoate) cement specimens. Locus of bond failure was unaffected by the method and length of light curing and was generally mixed mode. CONCLUSIONS: Use of the plasma arc lamp in orthodontic bonding could result in significant time saving.
Acrylic Resins↗