Biomedical subjects

J W van Dijken

Publications and source records attributed to J W van Dijken.

At least 19 recordsLinked to original sources

PubMed2001

Analysis of factors affecting failure of glass cermet tunnel restorations in a multi-center study.

The aim of this study was to analyze factors influencing the failures of tunnel restorations performed with a glass cermet cement (Ketac Silver). Caries activity, lesion size, tunnel cavity opening size, partial or total tunnel, composite lamination or operating time showed no significant correlation to failure rate. Twelve dentists in eight clinics clinically experienced and familiar with the tunnel technique placed 374 restorations. The occlusal sections of fifty percent of the restorations were laminated with hybrid resin composite. The results of the yearly clinical and radiographic evaluations over the course of 3 years were correlated to factors that could influence the failure rate using logistic regression analysis. At the 3-year recall a cumulative number of 305 restorations were available. The cumulative replacement rate was 20%. The main reasons for replacement were marginal ridge fracture (14%) and dentin caries (3%). Another 7% of the restorations which had not been replaced were classified as failures because of untreated dentin caries. The only significant variable observed was the individual failure rate of the participating dentists varying between 9 and 50% (p=0.013).

Adolescent↗

PubMed2001

Restorations with extensive dentin/enamel-bonded ceramic coverage. A 5-year follow-up.

The durability of restorations with extensive dentin/enamel-bonded posterior partial and complete ceramic coverages were investigated. The effect of luting with a dual-cured and a self-cured luting agent was also studied. In 110 patients, 182 ceramic coverages (IPS Empress) were placed. In 58 restorations, Syntac was used in combination with the dual-cured resin composite Variolink. In the other restorations luted with the chemically cured resin composite Bisfil 2B, 25 were bonded with Gluma, 57 with Allbond 2, and 42 with Syntac. Of the 182 ceramics, 13 (7.1%) were assessed as non-acceptable after a mean observation period of 4.9 yr (range 4.3 7.5 yr). The reasons for failure were fracture (5), lost restorations (4), secondary caries (3) and endodontic treatment (1). No significant differences in failure rate were seen between the two luting agents or between the three dentin-bonding agents. Ceramic coverages placed on non-vital teeth failed in 9.7% of cases (3/31) and on vital teeth in 6.6% (10/151). The success rate of the dentin-enamel-bonded ceramic coverages reduces the need for a traditional full-coverage therapy and/or post or pin(s) and core placement. The technique investigated showed many clinical advantages such as less destruction of healthy tissue, and avoidance of endodontic treatment and/or deep cervical placement of restoration margins.

Adult↗

PubMed2001

Durability of new restorative materials in Class III cavities.

PURPOSE: The aim of this study was to evaluate the durability of new hybrid tooth-colored restorative materials in Class III cavities. MATERIALS AND METHODS: 154 large-sized Class III restorations were placed in 50 patients. The patients received one of each of the three following materials: a resin composite (RC, Pekafill), a polyacid-modified resin composite (PMRC, Dyract) (compomer), and a resin-modified glass-ionomer cement (RMGIC, Fuji II LC). The restorations were evaluated yearly with slightly modified USPHS criteria. RESULTS: Of 141 restorations evaluated at 6 years, 16 were estimated as unacceptable. Seven of these were replaced: 2 fractures, 3 recurrent caries, and 2 due to unacceptable color match. In 9 other restorations with unacceptable color match, the patients did not request replacements. No significant differences were seen between the materials concerning the occurrence of recurrent caries. The RC showed significantly better color match. Significantly higher surface roughness was seen for the aged RMGIC restorations. Fracture of the incisal enamel corner was observed contiguous to ten restorations in the 6-year evaluation. None of the restorative techniques resulted in postoperative sensitivity or loss of vitality. CONCLUSION: The resin composite showed the best durability.

Analysis of Variance↗

PubMed2000

Clinical evaluation of three adhesive systems in class V non-carious lesions.

OBJECTIVES: The purpose of this study was to evaluate the clinical retention of three new adhesive systems in non-carious cervical lesions during a 3-year period. METHODS: The adhesive systems, a three-step (EBS/Pertac Hybrid), a one-bottle resin bonding agent (One-Step/Pertac Hybrid) and a resin-modified glass ionomer cement (Fuji II LC) were placed in 148 non-carious cervical lesions, 87 with sclerotic dentin and 61 non-sclerotic. Of the sclerotic lesions treated with the two resin bonding systems, 37 were slightly roughened with a diamond bur before conditioning. The restorations were evaluated every 6 months during a 3-year period. RESULTS: All except six restorations were evaluated during the 3 years. The cumulative loss rates for EBS, One-Step and Fuji II LC were, at 1 year: 2, 24 and 2% and at 3 years: 10, 49, 7%, respectively. The one-bottle adhesive showed significantly more failures. The five lost EBS restorations were found in non-sclerotic lesions, while the three lost Fuji II LC restorations had been placed in sclerotic lesions. For the One-Step material the loss frequency for non-sclerotic versus sclerotic lesions was 31.8 and 65.2%, respectively. Slight roughening of the sclerotic dentin surfaces with a diamond bur did not increase retention of the restorations. SIGNIFICANCE: The three-step resin adhesive and the RMGIC showed clinically acceptable retention rates, while a high failure rate was registered for the one-bottle adhesive.

Adult↗

PubMed2000

Direct resin composite inlays/onlays: an 11 year follow-up.

OBJECTIVES: The aim of this study was to present an 11-year assessment of direct resin composite inlays/onlays. METHODS: One-hundred Class II direct resin composite inlays and 34 direct resin composite restorations were placed in 40 patients. The restorations were evaluated clinically, according to modified USPHS criteria, annually over a 11-year period. RESULTS: Of the 96 inlays/onlays and 33 direct restorations evaluated at 11 years, 17. 7% in the inlay/onlay group and 27.3% in the direct restorations group were assessed as unacceptable. The differences in longevity were not statistically significant. The main reasons for failure for the inlays/onlays and direct restorations were fracture (8.3 and 12. 1%, respectively), occlusal wear in contact areas (4.2 and 6.1%, respectively) and secondary caries (4.2 and 9.1%, respectively). Eight of the non-acceptable inlays/onlays and five of the direct restorations were replaced, while the other ones were repaired with resin composite. Unacceptable wear was observed in occlusal contact areas of six restorations, in patients who were severe bruxers. For the other restorations occlusal wear was not found to be a clinical problem and no difference was observed between the inlays/onlays and direct composite restorations. The marginal adaptation of the inlays/onlays was still good at the end of the study. Ditching was only observed in a few inlays. A higher failure rate was observed in molar teeth than in premolar teeth. CONCLUSIONS: Good durability was observed for the direct resin composite inlay/onlay technique. Excellent marginal adaptation and low frequency of secondary caries in patients with high caries risk were shown. No apparent improvement of mechanical properties was obtained by the secondary heat treatment of the inlays. Also, the difference in failure rate between the resin composite direct technique and the inlay technique was not large, indicating that the more time-consuming and expensive inlay technique may not be justified. The direct inlay/onlay technique is recommended to be used in Class II cavities of high caries risk patients with cervical marginal placed in dentin.

Adult↗

PubMed2000

An 8-year evaluation of sintered ceramic and glass ceramic inlays processed by the Cerec CAD/CAM system.

The purpose of this study was to evaluate Cerec CAD/CAM inlays processed of two industrially made machinable ceramics during an 8-yr follow-up period. Each of 16 patients received two similar ceramic inlays. Half the number of the inlays were made of a feldspathic (Vita Mark II) and the other of a glass ceramic (Dicor MGC) block. The inlays were luted with a dual resin composite and evaluated clinically using modified USPHS criteria at baseline, 8 months, 2, 3, 5, 6 and 8 yr, and indirectly using models. At baseline, 84% of the inlays were estimated as optimal and 16% as acceptable. Postoperative sensitivity was reported by one patient for 8 months. Of the 32 inlays evaluated during the 8 yr, 3 failed due to fracture of the material. No secondary caries was found adjacent to the inlays. No significant differences in the clinical performance were found between inlays made of the two ceramics. It can be concluded that the CAD/CAM inlays processed of the two ceramics functioned well during the 8-yr follow-up period.

Adult↗

PubMed2000

Interfacial adaptation of a Class II polyacid-modified resin composite/resin composite laminate restoration in vivo.

The aim of this in vivo study was to evaluate the interfacial adaptation of Class II resin composite open sandwich restorations with a polyacid-modified resin composite as a stress-absorbing layer (PMRC/RC). Twenty Class II box-shaped, enamel-bordered cavities were prepared in 10 premolars scheduled to be extracted for orthodontic reasons. An open PMRC/RC sandwich restoration was placed in 1 of the cavities of each tooth. The first layer, PMRC, in the proximal box extended to the periphery in the cervical part of the cavity. The following RC layers were placed with a horizontally incremental technique. The PMRC was excluded from the control cavity. The teeth were extracted after 1 month and the interfacial adaptation of the restorations was studied with quantitative scanning electron microscope analysis using a replicate technique. Gap-free interfacial adaptation was observed for the PMRC/RC and RC restorations in cervical enamel in 97% and 73%, respectively (P = 0.006). The gap-free scores for dentin were 87% and 64%, respectively (P = 0.022). Excellent interfacial adaptation was observed in both groups for the occlusal enamel 99% and 100%, respectively. The adaptation to occlusal enamel for the direct resin composite restorations was significantly better than to dentin or cervical enamel. A higher frequency of enamel fractures was observed parallel to the cervical margins compared to the occlusal. No dentin fractures were observed in the experimental groups. The PMRC/RC sandwich technique showed a statistically significant improved interfacial adaptation to dentin and cervical enamel in Class II enamel-bordered cavities. The clinical significance of the differences has to be evaluated.

Absorption↗

PubMed1999

Clinical performance of pressed ceramic inlays luted with resin-modified glass ionomer and autopolymerizing resin composite cements.

STATEMENT OF PROBLEM: Several in vitro studies have been published showing the incapability of the chemical cure of dual-cured resin composite luting agents to compensate for absence of visible light activation. PURPOSE: This study evaluated and compared pairs of Empress ceramic inlays luted with 2 chemical-cured luting agents: a resin-modified glass ionomer cement and a resin composite within individual patients. MATERIAL AND METHODS: Seventy-nine ceramic inlays were placed in class II cavities in 29 patients. In each patient half of the inlays were luted with a resin-modified glass ionomer cement and the other half with a chemical-cured resin composite cement. The inlays were evaluated clinically, according to modified USPHS criteria, at baseline, after 6 months, and 1 and 2 years. RESULTS: No failed inlays were observed during the 2-year follow-up. A slight ditching of the cement margins was observed in both luting groups. No significant difference was seen between the 2 luting techniques. CONCLUSION: IPS Empress inlays luted with both chemical-cured luting agents functioned satisfactorily in the short-term follow-up. Longer observation periods are necessary to evaluate the long-term clinical behavior of both luting techniques.

Adult↗

PubMed1999

Longevity of new hybrid restorative materials in class III cavities.

The aim of this study was to evaluate the durability of two new tooth-colored restorative materials, a polyacid-modified resin composite (compomer) and a resin-modified glass ionomer cement. In an intra-individual comparison with a resin composite, the materials were studied during a 5-yr period. In 50 patients, 154 large class III restorations were placed. Most patients received one of each of the three materials. The restorations were evaluated by modified United States Public Health Service (USPHS) criteria. Of the 144 restorations evaluated, 15 were found unacceptable. No significant differences were seen between the materials concerning recurrent caries incidence. The resin composite showed a significantly better color match. No difference was found between resin composite fillings in enamel- or total-etched cavities. Significantly higher surface roughness was found in the aged resin-modified glass ionomer cement restorations. Fracture of the incisal enamel corner was observed adjacent to 10 restorations. None of the three total-etch techniques resulted in postoperative sensitivity or loss of vitality. All the restorative techniques showed a low failure rate during the 5-yr follow-up.

Acid Etching, Dental↗

PubMed1999

Five year evaluation of class III composite resin restorations in cavities pre-treated with an oxalic- or a phosphoric acid conditioner.

An oxalic acid solution has been proposed as a conditioning agent for resin composite restorations in two commercial adhesive systems. The durability of 163 class III restorations, including 12 class IV restorations, in cavities pre-treated with an oxalic acid total etch technique or an enamel etch with phosphoric acid was studied. Each of 52 patients received at least one of each of three experimental restorations. The restorations were evaluated yearly with slightly modified United States Public Health Service (USPHS) criteria. After 5 years 95% of the restorations were evaluated as acceptable. Reasons for failure were the fracture of four fillings, including three class IV, secondary caries contiguous to two fillings and a non-acceptable colour match for one restoration. For eight class III restorations a fracture of the incisal tooth structure was registered. No differences were seen between the three experimental restorations.

Acid Etching, Dental↗

PubMed1999

Durability of tunnel restorations in general practice: a three-year multicenter study.

Twelve dentists, clinically experienced and familiar with the tunnel technique, placed 374 tunnel restorations in permanent teeth. Mean age of the patients was 19.1 years (range 10-74). The filling material used was a glass cermet cement, Ketac Silver. After 1, 2 and 3 years the teeth were controlled by the dentists. The bitewing radiographs from baseline, 1, 2 and 3 years were also analyzed by 2 of the authors, independently. The baseline radiographs showed technical defects in 6% and indicated remaining dentin caries in 8% of the restorations. After 3 years, 305 restorations were accessible for examination. The cumulative replacement rate was 20%. The main reasons for replacement were marginal ridge fracture (14%) and dentin caries (3%). The number of restorations showing untreated progressive caries increased during the study. After 3 years, untreated dentin caries was seen in 28 cases (11%) and almost half of the left enamel lesions showed progression.

Adolescent↗

PubMed1999

Longevity of extensive class II open-sandwich restorations with a resin-modified glass-ionomer cement.

Several new techniques have been introduced for use in the esthetic restoration of posterior cavities to substitute for the presumed toxicity of amalgam. Composite-laminated glass-ionomer cement restorations, the sandwich technique, have been recommended for caries-risk patients. Clinical evaluation of the use of conventional glass-ionomer cements in the open-sandwich restoration has shown a high failure rate. The aim of this study was to evaluate the durability and cariostatic effect of a modified open-sandwich restoration utilizing a resin-modified glass-ionomer cement (RMGIC) in large cavities. The materials consisted of 274 mostly extensive Class II Vitremer/Z100 restorations performed by four dentists in 168 adults. Six experimental groups were investigated. In four groups a thick and in two groups a thin layer of cement was placed. Cavity conditioning before application of the RMGIC self-etching primer was done in 3 groups with polyacrylic acid and in one group with maleic acid; in two groups, only water rinsing was performed. The restorations were evaluated at baseline and after 6, 12, 24, and 36 months according to modified USPHS criteria (van Dijken, 1986). After 3 years, 239 restorations were evaluated. Twelve (5%) were estimated as non-acceptable. Two were replaced, and seven were repaired with resin composite. Tooth fractures were observed in 2.5%. Slight erosion of the RMGIC part was seen in 4%, and in one case operative treatment was indicated. Post-operative sensitivity was reported for 9 teeth. Forty-three percent of the patients were considered as caries-risk patients. Only one restoration showed secondary caries. The three-year results indicated that the modified open-sandwich restoration is an appropriate alternative to amalgam including extensive restorations.

Acid Etching, Dental↗

PubMed1999

Resin-modified glass ionomer cement restorations in primary molars.

The aim of this multicenter study was to evaluate the 3-year performance of a resin-modified glass ionomer cement in primary molars. A total of 174 class II restorations were placed in 85 children by 6 dentists. The restorations were evaluated during a 3-year period using slightly modified USPHS criteria (van Dijken 1986). Of the 174 restorations 161 were evaluated after 1 year, 121 after 2 years and 68 after 3 years. A total of 81, restorations exfoliated or was extracted during the study. The cumulative failure rate after 1, 2 and 3 year was 8.1%, 11.7% and 19.8% respectively. The main reasons for failure were secondary caries and loss of retention.

Child↗

PubMed1999

All-ceramic restorations: classification and clinical evaluations.

In the search for alternative and esthetic restorative materials, many all-ceramic systems have been introduced for the general practitioner. They are used as veneers, inlays/onlays, crowns, and as enamel/dentin bonded partial or total coverage without macroretention. This article describes a classification of the different commercial all-ceramic systems and gives a review of their clinical durability. Reasons for failures are given for the different restorations. Fracture is the main reason for failure, especially for all-ceramic crowns and inlays. The frequency of secondary caries contiguous to resin composite luted ceramics is very low. Wear of the luting agent, called ditching, is not an enduring clinical problem. The use of certain ceramic materials as well as luting agents have been shown to be contraindicated, especially in molar teeth. Newer reinforced ceramics showed better durability then the earlier fired ceramic reconstructions.

Cementation↗

PubMed1998

Development of gingivitis around aged restorations of resin-modified glass ionomer cement, polyacid-modified resin composite (compomer) and resin composite.

Resin-modified glass ionomer cements (RMGIC) and polyacid-modified resin composites (PMC, compomers) are two recently introduced material groups supposed to replace traditional cements in operative dentistry. The new restoratives release initially fluoride in different relatively high concentrations, which decrease gradually during the first weeks in vivo. Earlier studies showed a stronger subclinical inflammatory reaction around different conventional tooth colored restorative materials than around intact enamel. The aim of this study was to compare intra-individually the initiation of gingival inflammation around, aged RMGIC, PMC and resin composite restorations. Subgingivally located Class III restorations were placed in 17 patients. Each patient received one of each of the experimental materials. All patients were placed on an oral hygiene regime 1-year after finishing of the restorations. Gingivitis was induced during a one-week period without oral hygiene. The gingival condition was assessed by sampling of gingival crevicular fluid (GCF), registration of the amount of bacterial plaque and by registration of bleeding after gentle probing of the entrance of the gingival sulcus (SBI) on the experimental filling- and control-enamel surfaces at days 0 and 7. No differences were seen in plaque and gingival index scores between the materials at both days. The GCF increased significantly for all surfaces during the experimental gingivitis period. At day 7 significantly lower GCF was sampled around the enamel surfaces. In conclusion, the differences between the materials did not result in measurable differences concerning clinical or subclinical signs of gingivitis.

Adult↗

PubMed1998

Interfacial adaptation of in vivo aged polyacid-modified resin composite (compomer) restorations in primary molars. A SEM evaluation.

Polyacid-modified resin composite (PMC) restorations are being increasingly used in class II cavities in primary teeth. The aim of this study was to evaluate the interfacial adaptation of 1-month- and 30-month-old in vivo restorations by quantitative scanning electron microscopy (SEM) evaluation. Twelve PMC restorations were performed under clinically controlled conditions in primary molars planned for extraction 1 month later for orthodontic reasons. Eleven other PMC restorations, aged 30 months (range 1.5-3 years) and part of a multicenter study, were collected after exfoliation. To observe the interfacial adaptation of each restoration at several levels a thin layer of the proximal surface was ground off 2-3 times. Replica impressions of each level were prepared for SEM. The interfaces of the replicas were evaluated at x200 and x1000. In the 1-month-old restorations gap-free adaptation to enamel was found in 87% and to dentin in 84% of the total interfacial length investigated. For the 30-month-old restorations gap-free adaptation was registered in 59 and 63%, respectively. The interfacial quality was significantly better in the 1-month-old restorations than in those 30 months of age. Adaptation to enamel was significantly better in the cervical part of the 1-month-old restorations than in the axial walls, whereas there was no significant difference in dentin. No significant difference was found between the cervical and axial cavity walls of the 30-month-old restorations. Enamel fractures were registered in 31 and 24%, respectively of the interfacial length of the 1-month- and 30-month-old restorations. The corresponding findings in dentin were 0 and 0.9%. It can be concluded that restorations aged for a short time showed a high percentage of sealing, which decreased significantly for the 30-month-old ones.

Analysis of Variance↗

PubMed1998

The effect of pretreatment with an oxalic acid solution on marginal adaptation to enamel in vivo.

STATEMENT OF PROBLEM: New acids such as oxalic acid have been introduced as a conditioning agent in the total-etch technique. There is concern about long-term retention of the acid on enamel in relation to the superficial etch effect. PURPOSE: This in vivo study evaluated the marginal adaptation to enamel conditioned with either and oxalic acid solution or a phosphoric acid with SEM replica technique. MATERIAL AND METHODS: Twenty-four patients received one of each of three class III restorations. Two cavity preparations were pretreated with aluminum nitrate/oxalic acid/glycine solution 1 of the Gluma 2000 system. The first cavity was primed and sealed with Gluma 2000 solution 2, the second cavity with Gluma 3 and 4. The third cavity was conditioned with phosphoric acid (Gluma 1) and sealed with the bonding resin Gluma 4. All three cavities were restored with a hybrid resin composite (Pekafill). At baseline and after 1 year, replica impressions were made to study the margins with SEM. Semiquantitative analysis of the enamel interfaces was performed (x200 and x1000 magnifications). Marginal quality of the three restorative systems were compared and tested intraindividually. RESULTS: The three restorations exhibited good enamel marginal adaptation and a high percentage of gap-free margins at baseline, 96% to 97% of the total length of margins investigated. Marginal quality decreased significantly after 1 year for all three groups. Gap-free margins were observed in 81% to 85% of the marginal length. No significant differences were found among the groups. CONCLUSION: Despite a less pronounced etch pattern created by conditioning of enamel with the oxalic acid solution, a good enamel marginal quality was observed at both evaluation times, comparable to the marginal adaptation of the phosphoric acid conditioned cavities.

Acid Etching, Dental↗

PubMed1998

Fired ceramic inlays: a 6-year follow up.

OBJECTIVES: The aim of this study was to evaluate feldspathic ceramic inlays luted with dual-cured resin composite or glass polyalkenoate (ionomer) cement (GIC) during a 6-year follow-up. METHODS: One-hundred and eighteen Class II fired feldspathic ceramic inlays were placed in 50 patients. In each patient half of the inlays were luted with a dual-cured resin composite and the other half with a conventional glass ionomer cement. The inlays were evaluated clinically, according to modified USPHS criteria, at baseline, after 6 months and then annually over a 6-year period. RESULTS: Of the 115 inlays evaluated at 6 years, 12% in the resin composite group and 26% in the GIC group were assessed as having failed. The main reason for failure in both groups was partial fracture or total loss of the inlays. Secondary caries was found to be associated with three inlays in one high caries risk patient. One inlay was replaced because of postoperative sensitivity. CONCLUSION: A relatively high and increasing failure rate was observed over the 6-year period of the study. The failure rate was more pronounced in the GIC group.

Adult↗