Biomedical subjects

J Manhart

Publications and source records attributed to J Manhart.

At least 19 recordsLinked to original sources

PubMed2003

Polymerization contraction stress in light-cured compomer restorative materials.

OBJECTIVE: The magnitude and kinetics of polymerization contraction stress build-up may be potential predictors of bond failure of adhesive restorations. The present study determined these properties of seven commercial compomers (Dyract, Dyract AP, F2000 Rasant, Hytac, Compoglass F, Luxat, Glasiosite). METHODS: Polymerization shrinkage was generated by 40 s light curing the test materials (800 mW/cm2). The contraction force induced was recorded for 300 s at room temperature (23-24 degrees C) by means of a Stress-Strain-Analyzer (C factor=0.33). Maximum contraction stress (MPa), coefficient of near linear fit of contraction force/time (gradient) and relative force rate (%/s) of each material were compared with that of two hybrid composites (Tetric Ceram, Prodigy). The statistical analysis was conducted by ANOVA (alpha=0.05) and post hoc Tukey's test. RESULTS: No statistically significant differences in the maximum stress between Glasiosite (2.27+/-0.06 MPa), Hytac (2.31+/-0.07 MPa) and Tetric Ceram (2.21+/-0.11 MPa), and between Compoglass F (2.60+/-0.18 MPa) and Prodigy (2.70+/-0.06 MPa) were found. The contraction stress of F2000 Rasant (3.41+/-0.09 MPa) and Luxat (3.33+/-0.08 MPa) were significantly highest, whilst Dyract exhibited the significantly lowest shrinkage stress (1.27+/-0.08 MPa) among the tested materials. SIGNIFICANCE: High contraction stress, early start of stress build-up and rapid contraction force development may lead to failure of bond to tooth structure. This study suggested that the contraction stress and kinetic behavior of compomers are generally similar to those of hybrid composites in a dry condition. Dyract might be superior in maintaining the bond with cavity walls compared to conventional hybrid composites in view of its low shrinkage stress.

Analysis of Variance↗

PubMed2002

Biological clearance of HEMA in guinea pigs.

No toxicokinetic data are available about the dental composite component 2-hydroxyethylmethacrylate (HEMA) in vivo in the literature. Therefore, the excretion of HEMA in feces and urine in vivo and, using the pendular perfusion technique with segments of jejunum and colon, in the biliary and enteric excretion in situ were investigated in anesthetized guinea pigs. In the in situ experiments, guinea pigs (n = 4) received HEMA (0.02 mmol/kgbw labelled with a tracer dose 14C-HEMA 0.3 kBq/gbw) injected into the jugular vein. In the in vivo experiments, guinea pigs (n = 4) received HEMA (+ 14C-HEMA, same dose as above) via gastric tube. Urine and feces were collected for 24h. In the in situ experiments, organs from guinea pigs were removed 60 min after the beginning of the experiment, and then the 14C-radioactivity was measured. During the 60 min perfusion period the calculated amount of 14C-activity excreted into the total jejunum and colon was 6.0 +/- 1.0% and 2.7 +/- 0.7% of the dose administered, respectively (mean +/- sem). Of the 14C-HEMA dose, 5.3 +/- 0.3% was found in the bile. Significantly (p < 0.05) higher bile/blood concentration ratios were found at 10-40 min after the injection of HEMA, as compared to the ratio at 60 min. The total 14C-recovery in all organs tested was 20.0 +/- 2.6%. During 24h the amounts of 14C-activity excreted in the feces and urine were 1.1 +/- 0.1% or 17.1 +/- 1.50% of the dose administered, respectively (mean +/- sem). The total 14C-recovery in all organs tested was 11.6 +/- 0.6%. In a second series of in vivo experiments, exhaled air from the animals was captured during the 24h experimental period. 14C was exhaled to 63.6 +/- 2.11% of the administered 14C-HEMA dose (mean +/- sem; n = 4) as 14C-carbondioxide. The results indicate a rapid clearance of 14C-HEMA and/or 14C-HEMA metabolite(s) from the organism, exhalation being the major route of elimination.

Animals↗

PubMed2001

Polymerization contraction stress in light-cured packable composite resins.

OBJECTIVE: Determination of the polymerization contraction stress of packable composites (ALERT, Surefil, Solitaire, Solitaire 2) and a packable ORMOCER material (Definite) in comparison with a conventional hybrid composite (Tetric Ceram). METHODS: Contraction force generated by the test materials (10 replications each) was measured by polymerizing the composites filled in a plastic tray between two aluminum attachments mounted in a Stress-Strain-Analyzer testing machine (specimen size: 4x4x2 mm, C-factor=0.33). Contraction force was recorded for 300s under a standard exposure condition (40s, 800mW/cm(2)). Maximum contraction stress (MPa), force rate (N/s), relative force rate (%/s) of each material were statistically analyzed by ANOVA (alpha=0.05) and post-hoc Tukey's test. RESULTS: Maximum contraction stresses of the packable materials were 4.60 +/- 0.32MPa (ALERT), 4.16 +/- 0.18MPa (Definite), 3.36 +/- 0.08MPa (Solitaire 2), 3.33 +/- 0.23MPa (Solitaire) and 3.13 +/- 0.18MPa (Surefil), which were significantly higher than that of Tetric Ceram (2.51 +/- 0.14MPa). Tetric Ceram exhibited the significantly lowest force rate. Force/time curves were S-shaped. Solitaire especially showed a longer pre-gelation phase before contraction force was recorded. SIGNIFICANCE: High contraction stress and rapid contraction force development can lead to failure of bond to tooth structure. This study suggested that, packable composite resins are less capable of reducing the contraction stress during the early setting stage, thus not superior in maintaining the bond with cavity walls to conventional hybrid composite Tetric Ceram.

Analysis of Variance↗

PubMed2001

Marginal quality and microleakage of adhesive class V restorations.

OBJECTIVES: The aim of this in vitro study was to determine the marginal quality and microleakage of composite resin class V restorations. METHODS: Standardized mixed class V cavities (diameter: 4mm, depth: 2mm) with half of the finish lines limited within dentin were cut in 90 freshly extracted human molars and randomly assigned to nine groups (n=10). After etching enamel and dentin, the cavities were restored with nine different restorative systems (Syntac Sprint/Tetric Ceram=SS, Syntac Single-Component/Tetric Ceram=SC, Onestep/Aeliteflo=OS, Aquaprep+Onestep/Aeliteflo=OA, Prime & Bond 2.1/TPH=PB, Optibond Solo/Prodigy=OP, Singlebond/Z100=SB, Tenure Quik/Marathon=TQ, Solobond M/Arabesk=SM) using a wet-bonding procedure. After finishing and polishing, the teeth were stored for 24h in distilled water at 37 degrees C before they were subjected to thermocycling (5/55 degrees C, 1000x). Epoxy replicas were made for margin analysis in the SEM. Specimens were stained in methylene blue, sectioned, and evaluated for microleakage. Dye penetration was scored on a 0-3 ordinal scale. RESULTS: Statistical analysis (Kruskal-Wallis H-test, Mann-Whitney U-test) revealed significant differences (P<0.05) among the groups at dentin and enamel margins for the microleakage scores as well as for the results of the quantitative SEM margin analysis. SC revealed a significantly higher percentage of perfect margins in the SEM than OS and SM in enamel and dentin, respectively. OA exhibited significantly more leakage in enamel than all other groups. CONCLUSIONS: None of the tested restorative systems achieved a perfect seal in dentin and enamel of mixed class V cavities. Marginal quality and sealing ability of adhesive systems to dentin, using a wet-bonding procedure, is still inferior compared with enamel margins.

Barium Compounds↗

PubMed2001

The suitability of packable resin-based composites for posterior restorations.

BACKGROUND: Packable composites, promoted for the restoration of stress-bearing posterior teeth, have captured clinicians' interest. METHODS: The authors tested three packable composites (Alert, Jeneric/Pentron; Solitaire, Heraeus Kulzer, Wehrheim, Germany; SureFil, Dentsply De Trey, Konstanz, Germany); a new packable organically modified ceramic, or ormocer (Definite, Degussa AG, Hanau, Germany); a hybrid composite (Tetric Ceram, Ivoclar Vivadent, Schaan, Liechtenstein) and an ion-releasing composite (Ariston pHc, Ivoclar Vivadent, Schaan, Liechtenstein). They determined modulus of elasticity according to EN 24049:1993 of the European Committee for Standardization. They measured Vickers hardness using a 200-gram load for 40 seconds. To determine the materials' depth of cure, they used both a scraping method (International Standards Organization standard CD 4049:1997) and a hardness profiling method. RESULTS: The authors calculated means and standard deviations from 10 replications of each test and used one-way analysis of variance and post hoc Tukey tests (alpha = .05). The materials had significant differences (P < .001) in all characteristics. Solitaire had the significantly lowest elastic modulus and microhardness; Alert had the highest values for these characteristics. Ariston pHc exhibited the significantly lowest depth of cure. There was a significant correlation between the two methods of measuring depth of cure (r2 = 0.9945; P = .021). CONCLUSIONS: The material group of packable composites is rather inhomogeneous in terms of mechanical and physical data. Our data suggest that bulk curing of packable composites in deep cavities still is not recommendable. CLINICAL IMPLICATIONS: The clinician needs to select packable composites carefully, as it seems that not all of these materials quality for stress-loaded posterior restorations.

Analysis of Variance↗

PubMed2001

Longevity of restorations in posterior teeth and reasons for failure.

PURPOSE: This article compiles a survey on the longevity of restorations in stress-bearing posterior cavities and assesses possible reasons for failure. MATERIALS AND METHODS: The dental literature predominantly of the last decade was reviewed for longitudinal, controlled clinical studies and retrospective cross-sectional studies of posterior restorations. Only studies investigating the clinical performance of restorations in permanent teeth were included. Longevity and annual failure rates of amalgam, direct composite restorations, glass ionomers and derivative products, composite and ceramic inlays, and cast gold restorations were determined for Class I and II cavities. RESULTS: Annual failure rates in posterior stress-bearing restorations are: 0% to 7% for amalgam restorations, 0% to 9% for direct composites, 1.4% to 14.4% for glass ionomers and derivatives, 0% to 11.8% for composite inlays, 0% to 7.5% for ceramic restorations, 0% to 4.4% for CAD/CAM ceramic restorations, and 0% to 5.9% for cast gold inlays and onlays. CONCLUSION: Longevity of dental restorations is dependent upon many different factors that are related to materials, the patient, and the dentist. The principal reasons for failure were secondary caries, fracture, marginal deficiencies, wear, and postoperative sensitivity. A distinction must be made between factors causing early failures and those that are responsible for restoration loss after several years of service.

Bicuspid↗

PubMed2001

Three-year clinical evaluation of composite and ceramic inlays.

PURPOSE: To evaluate the 3-yr clinical performance of composite and ceramic inlays in posterior teeth. MATERIALS AND METHODS: 47 composite inlays (Tetric, Blend-a-Lux, Pertac) and 24 ceramic inlays (Empress) were placed by seven student operators under supervision of an experienced dentist. Clinical assessment of 58 inlays (81.7%) was performed after 3 yrs using amodified USPHS criteria and statistically analyzed with Mann-Whitney U test and Fisher's exact test. RESULTS: A total of 100% of the ceramic inlays and 89% of the composite inlays were assessed to be clinically excellent or acceptable. Three composite inlays failed during the first yr and one had to be replaced during the second evaluation period. All composite inlay failures were recorded on molars, revealing a significantly higher failure rate compared with premolars (Fisher's test, P = 0.041). Ceramic inlays revealed a significantly better "anatomic form of the surface" (P = 0.027) and "integrity of the restoration" (P = 0.035). Inlays in small cavities performed better for "marginal integrity" (P = 0.033) and "discoloration at the margin" (P = 0.038).

Adult↗

PubMed2000

Mechanical properties of new composite restorative materials.

OBJECTIVE: Determination of flexural strength, flexural modulus, fracture toughness, Vickers hardness, and wear resistance of condensable composites (Solitaire, Surefil, Alert) and an ormocer (Definite) in comparison with a hybrid composite (Tetric Ceram) and an ion-releasing composite (Ariston pHc). METHODS: Flexural strength, flexural modulus, and fracture toughness were determined in 3-point bending. Single-edge notched-bend specimens were used to evaluate fracture toughness. Microhardness was measured with a Vickers indenter. Wear was determined in a pin-on-block-design with a Degusit antagonist at 50 N load and quantified by a replica technique after 6000, 10000, 30000, and 50000 load cycles using a 3D-laser scanner. All results were statistically analyzed with ANOVA and post hoc Tukey HSD tests. RESULTS: Alert exhibited the highest flexural modulus, K(IC), and hardness, but lowest wear resistance. Solitaire presented the highest wear resistance, but significantly lower flexural strength, flexural modulus, K(IC), and hardness than all other materials. No significant correlation could be detected between hardness and wear of the tested composites with Pearson's correlation coefficient. SIGNIFICANCE: The condensable composites differed significantly in their mechanical properties. This study suggested that, besides the filler content level and filler size, other factors like matrix-filler interactions highly influence the fracture and wear behavior of the materials.

Composite Resins↗

PubMed2000

A 2-year clinical study of composite and ceramic inlays.

Objective long-term clinical data are necessary to evaluate the performance of dental restorations. This prospective clinical trial evaluated composite and ceramic inlays for clinical acceptability as restorative materials in posterior teeth and provided 2-year results. The study involved 7 student operators placing 47 composite inlays (Tetric, blend-a-lux, Pertac) and 24 ceramic inlays (Empress) under the supervision of an experienced dentist. Clinical assessment of 56 inlays (78.9%) was performed after 2 years with modified USPHS criteria and statistically analyzed using the Mann-Whitney U test and Fisher's exact test. All the ceramic inlays and 90% of the composite inlays were considered clinically excellent or acceptable. During the first year 3 composite inlays failed and during the second evaluation period 1 had to be replaced. Ceramic inlays produced significantly better "anatomic form of the surface" (P = 0.038) and "integrity of the restoration" values (P = 0.043). Inlays in small cavities exhibited superior "marginal integrity" (P = 0.026) and "marginal discoloration" values (P = 0.034). Fisher's test revealed a significantly higher failure rate in molars than in bicuspids (P = 0.034). Posterior tooth-colored inlays exhibited a success rate of 100% for ceramic inlays and 90% for composite inlays even if placed by relatively inexperienced but supervised student operators.

Adult↗

PubMed2000

Mechanical properties and wear behavior of light-cured packable composite resins.

OBJECTIVES: Determination of flexural strength, flexural modulus, fracture toughness and wear resistance of three packable composites (Solitaire, Surefil, ALERT) and a packable ormocer (Definite) in comparison with an advanced hybrid composite (Tetric Ceram) and an ion-releasing composite (Ariston pHc). METHODS: Flexural strength, flexural modulus and fracture toughness of each material were determined in three-point bending (each test n = 10). Single-edge notched-bend specimens were used to evaluate the fracture toughness (K1C). Wear of the materials (n = 8) was determined in a pin-on-block-design with a spherical Degusit antagonist at 50 N vertical load and quantified by a replica technique using a 3D-laser scanner. Replicas were made after 6000, 10,000, 30,000 and 50,000 load cycles. The mean wear rate (MWR (micron 3 cycle-1)) was obtained by a linear regression analysis in the steady-state of the time-wear-curve. All results were statistically analyzed with ANOVA and post hoc Tukey HSD tests (p < 0.05). RESULTS: ALERT exhibited the highest flexural modulus (12.5 +/- 2.1 GPa) and K1C (2.3 +/- 0.2 MN m-3/2), but the lowest wear resistance (8275 micron 3 cycle-1). Solitaire presented the highest wear resistance (1591 micron 3 cycle-1), but significantly lower flexural strength (81.6 +/- 10.0 MPa), flexural modulus (4.4 +/- 0.3 GPa), and K1C (1.4 +/- 0.2 MN m-3/2) than all other materials. Surefil revealed a significantly higher flexural modulus (9.3 +/- 0.9 GPa) and wear resistance (3028 micron 3 cycle-1) than Tetric Ceram (6.8 +/- 0.5 GPa; 5417 micron 3 cycle-1) and Ariston pHc (7.3 +/- 0.8 GPa; 7194 micron 3 cycle-1). SIGNIFICANCE: The tested packable composite resins differed significantly in their mechanical properties. This study suggested that fracture and wear behavior of the composite resins are highly influenced by the filler system. Overall, Surefil demonstrated good fracture mechanics parameters and a low wear rate.

Analysis of Variance↗

PubMed2000

Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth.

STATEMENT OF THE PROBLEM: Objective long-term clinical data are necessary to assess the performance of modern posterior composites as direct and indirect restorations. PURPOSE: This prospective, long-term clinical trial evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface cavities and provided a survey on the 3-year results. MATERIAL AND METHODS: Under the supervision of an experienced dentist, 9 dental students placed 88 composite restorations (Tetric, blend-a-lux, Pertac-Hybrid Unifil), 43 direct composite restorations, and 45 indirect inlays. Clinical evaluation was performed at baseline and in yearly intervals after placement by 2 other experienced dentists, using modified USPHS criteria. A third follow-up of 60 restorations took place within 33 to 36 months after placement. RESULTS: A total of 93% of indirect and 87% of direct restorations were assessed to be clinically excellent or acceptable. During the third year, 1 direct restoration in a molar failed because of margin opening. Indirect inlays exhibited a significantly better anatomic form of the surface than direct composite restorations. Premolars revealed a significantly better marginal integrity and anatomic form of the surface than molars. Restorations in molars exhibited a significantly higher failure rate compared with premolars. CONCLUSION: Posterior composite restorations provided a satisfactory clinical performance over a 3-year period, even if placed by relatively inexperienced but supervised students.

Bicuspid↗

PubMed2000

Clinical results and new developments of direct posterior restorations.

PURPOSE: To (1) review the literature and analyze the longevity and reasons for failure of direct resin-based composite (RBC), amalgam, and glass-ionomer cement (GIC) restorations in stress-bearing posterior cavities and (2) to assess new material developments and treatment techniques to restore these cavities. MATERIALS AND METHODS: This work reviewed the dental literature predominately of the last decade for longitudinal, controlled clinical studies and retrospective cross-sectional studies. Only studies investigating the clinical performance of restorations in permanent teeth were included. Annual failure rates of direct resin-based composite, amalgam, and GIC restorations were determined and failure reasons were discussed. RESULTS: Annual failure rates in posterior stress-bearing cavities were determined to be: 0-9% for direct RBC restorations, 0-7% for amalgam restorations, and 1.9-14.4% for GIC restorations. The median annual failure rate of longitudinal studies for amalgam was calculated with 1.1%, for RBCs 2.1% and for GICs 7.7%. GIC is significantly worse compared with amalgam and RBC. Main reasons for failure were secondary caries, marginal deficiencies, fracture, and wear. Longitudinal studies showed a strong trend towards a higher longevity compared with cross-sectional investigations.

Composite Resins↗

PubMed1999

Bond strength of a compomer to dentin under various surface conditions.

This study determined the influence of different dentin pretreatments on the shear bond strength of an adhesive system and corresponding compomer material. One hundred and twenty freshly extracted human molars were ground with wet SiC paper to expose flat oral/buccal surfaces of superficial dentin. The teeth were assigned to 12 treatment groups (n = 10) based on dentin surface finish (600-grit SiC vs. air abrasion vs. 40 microns diamond bur), surface conditioning (acid etching vs. no etching), and moisture content of the dentin (moist vs. dry). Cylinders of Compoglass F compomer were bonded to the dentin with Syntac Single-Component. After 24-h storage in distilled water, the specimens were debonded in shear mode. Bond strengths in MPa (SD) were calculated and bonding sites were analyzed for the mode of failure. Three-way ANOVA revealed significantly higher bond strength values for acid etched specimens (P = 0.001). Moisture content of the dentin surface (P = 0.614) and mechanical surface finish (P = 0.367) had no significant influence on the results. Debonding in unetched groups ranged from 94 to 100% adhesively. Acid etched groups showed adhesive failures ranging from 56 to 100%. To obtain a more reliable bond it is recommended that dentin is acid etched prior to the bonding of a compomer.

Acid Etching, Dental↗

PubMed1999

Two-year clinical evaluation of direct and indirect composite restorations in posterior teeth.

STATEMENT OF PROBLEM: Few long-term clinical studies have reported data of modern posterior composites as direct and indirect restorations. PURPOSE: This prospective, long-term clinical trial (1) evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface carious teeth and (2) provided a survey on the 2-year results. MATERIAL AND METHODS: Nine dental students placed 88 composite restorations (Tetric, blend-a-lux, Pertac-Hybrid Unifil), 43 direct composite restorations and 45 indirect inlays, under the supervision of an experienced dentist. The first clinical evaluation was performed 11 to 13 months after placement by 2 other experienced dentists, using modified USPHS criteria. A second follow-up of 60 restorations took place within 20 to 26 months after placement. RESULTS: A total of 93% of indirect and 90% of direct composite restorations were assessed to be clinically excellent or acceptable. Two restorations (1 indirect composite inlay and 1 margin of a direct composite restoration) failed during the second year because of fracture. Indirect inlays demonstrated a significantly better "anatomic form of the surface" than direct composite restorations. Premolars revealed a significantly better margin integrity and postoperative symptoms than molars. CONCLUSION: Posterior composite restorations provided a satisfactory clinical performance over a 2-year period when placed by relatively inexperienced but supervised students.

Bicuspid↗

PubMed1999

Esthetic compomer restorations in posterior teeth using a new all-in-one adhesive: case presentation.

UNLABELLED: Compomers have continually gained in importance since their introduction in 1993, especially because of their ease of handling. The main indications are cervical lesions, Class III restorations, and restorations in the primary dentition. To extend the indications of compomers to esthetic Class I and II restorations in the permanent dentition, improvements in wear resistance and bond strength need to be accomplished. Studies have shown an improved bond strength and less marginal gap formation between compomers and enamel and dentin with acid etching of the tooth before application of conventional mild self-etching adhesives. Newly formulated, improved self-etching adhesives with a higher demineralization potential recently have been developed. The objective of this case presentation is to demonstrate step-by-step the clinical procedure for the application of a newly developed self-etching adhesive with high demineralization potential in combination with a compomer material in occlusal cavities. CLINICAL SIGNIFICANCE: Improved self-etching adhesives provide a faster and simplified application technique and allow effective conditioning and priming of enamel and dentin in one step, without waiving sufficient bond strengths. With limited indications, compomers are used in combination with these self-etching primers to restore occlusal cavities in posterior teeth. Evidence-based dentistry requires exact scientific data to evaluate whether this new trend results in benefits for patients. However, until clear evidence from controlled clinical studies supports the use of improved compomer systems in Class I and II cavities in the permanent dentition, dentists should be careful with this indication.

Bicuspid↗

PubMed1998

One-year clinical evaluation of composite and ceramic inlays in posterior teeth.

STATEMENT OF PROBLEM: There are only a few studies available that deal with the clinical behavior of composite and ceramic inlay systems as potential substitutes for amalgam restorations. PURPOSE: This prospective clinical trial evaluated composite and ceramic inlay systems for clinical acceptability as restorative materials in single or multisurface cavities of posterior teeth and provided 1-year results. MATERIAL AND METHODS: Forty-seven composite inlays (Tetric, Blend-a-lux, Pertac) and 24 heat-pressed ceramic inlays (IPS Empress) were placed in 45 patients by 7 student operators under the supervision of an experienced dentist. The first clinical evaluation was performed 11 to 13 months after placement of the restorations and used modified United States Public Health Services criteria. RESULTS: Satisfactory results over this period were found, as 100% of ceramic inlays and 94% of composite inlays were assessed to be clinically excellent and acceptable. Only 3 composite inlay restorations were scored delta (unacceptable). Two inlays exhibited secondary caries and 1 demonstrated loss of pulp vitality. For the criteria "anatomic form of the surface" and "marginal integrity," ceramic inlays were significantly better than composite inlays. CONCLUSION: Posterior tooth-colored inlays provided acceptable and excellent clinical service, even if they are placed by relatively inexperienced student operators.

Adult↗

PubMed1997

One-year clinical evaluation of composite fillings and inlays in posterior teeth.

In the course of a prospectively designed long-term clinical trial, composite fillings and inlays were evaluated for clinical acceptability as restorative materials in one, two or more surface cavities of posterior teeth over a 1-year period. In 45 patients, 88 restorations were placed by nine student operators, under the supervision of an experienced dentist, to compare the two half sides using the composite resins Tetric (Vivadent), blend-a-lux (Blend-a-med), and Pertac-Hybrid Unifil (Espe). The first clinical follow-up check took place within a time period of 11-13 months after placement of the restorations using modified USPHS criteria. The interpretation of the clinical criteria showed satisfactory results over this time period: more than 85% of the inlays and direct fillings were rated "alpha" or "bravo", using the parameters of assessment defined in this study. Only three restorations (two fillings, one inlay), all in molars, were rated "delta", i.e., unacceptable. The reasons for their replacement were marginal opening, secondary caries, and loss of sensitivity. For the criteria "surface texture", "anatomical form of the surface", and "occlusion", composite inlays were significantly better than composite fillings. These results indicate that posterior composite restorations provide acceptable and excellent clinical service, even if they are placed by relatively inexperienced student operators.

Adult↗

PubMedDate not supplied

Toxicokinetic of HEMA in guinea pigs.

OBJECTIVE: Unconverted 2-hydroxyethylmethacrylate (HEMA) can be released from dental resin materials and can enter the body in humans. In the present study the uptake, distribution and excretion of 14C-HEMA applied via different routes were examined in vivo in guinea pigs. METHODS: HEMA (0.02 mmol/kg bw labelled with a tracer dose 14C-HEMA 0.3 Bq/g bw) was administered by gastric tube or by subcutaneous injection. Urine, feces, and exhaled carbon dioxide were collected for 24 h after administration. Guinea pigs were killed 24 h after the beginning of the experiment and various organs removed and 14C radioactivity measured. RESULTS: Low fecal 14C levels (about 2% of the dose) and urinary levels of about 15% after 24 h were noted with either route of administration. Direct measurement of exhaled CO(2) showed that about 70% of the dose left the body via the lungs. Two pathways for the metabolism of 14C-HEMA can be described. It is likely that 14C-pyruvate is formed in vivo resulting in the formation of toxic 14C-HEMA intermediates. 14C-HEMA was taken up rapidly from the stomach and small intestine after gastric administration and was widely distributed in the body following administration by each of the routes. CONCLUSIONS: Clearance from most tissues following gastric and intradermal administration was essentially complete within one day. The peak HEMA levels in all tissues examined after 24 h were at least onemillion-fold less than known toxic levels.

Acrylic Resins↗