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Updates in dental materials--Part 4. Ceramic materials.

Recent years have seen a number of innovations and developments with respect to dental materials and their applications in clinical dentistry. This series of short articles considers the more important aspects of these developments under the general term 'Updates in Dental Materials'. Dental composite systems and bonding to tooth material were discussed in Part I. Resin cements were treated in Part 2 and dental amalgams in Part 3. Part 4 deals with advances in ceramic materials.

Ceramics↗

[The evaluation of the adhesive properties of dental materials by using radioactive-labelled bacteria].

Dental materials with different surfaces were incubated with 111In-oxine-labelled bacteria Streptococcus mutans 20 min respectively 2 h, 6 h and 24 h. To determine the amount of the bacteria accumulated on the specimens we measured the radioactivity with a scintillation counter. The same measuring was done after decontamination by the help of ultrasonication. The comparison of activities shows that different dental material surfaces adhere different amounts of bacteria. The adhesive properties are material and time dependent, but the surface processing has a lower influence on the bacterial adherence. The lowest degree of bacterial adherence has the cobalt base alloy Gisadent KCM 83. On the other hand the highest remaining activity was found after decontamination of cobalt base alloy and PMMA resin Kallocryl A.

Adhesiveness↗

A method of determining the radiopacity of dental materials and foreign bodies.

The desirability of radiopacity in dental materials and other materials that may become foreign bodies is documented. No simple, reliable methods are available for the determination of radiopacity, and no standard specifications have been devised with regard to the radiopacity of dental materials. A method that enables radiopacity to be determined is described. The theoretical aspects of radiopacity in relation to the method are considered. Possible applications of this method in the development of standards for radiopacity are suggested.

Absorptiometry, Photon↗

Evaluation of mutagenicity of restorative dental materials using the Ames Salmonella/microsome test.

Compounds of five commercially available dental material kits were examined for mutagenic potential by use of the Ames Salmonella/microsome test. Dimethyl sulfoxide (DMSO) was used as the solvent for all materials, except MONO-LOK2 Primer and Right-On Activator, which were dissolved in 95% ethanol. The Tenure, Fuji, and Gluma materials were initially screened at 2 mg (solids) or 2 microL (liquids) per plate, without S9 (Aroclor 1254-induced rat liver microsomes), and dose-response studies were conducted for those materials showing potential mutagenicity. The components of three dental kits, MONO-LOK2, Right-On, and Gluma, were further examined, both with and without S9 activation, at doses of 0.2, 4, 20, 100, 500, and 2500 micrograms (nL for liquid components) per plate. The data showed no mutagenic potential for the components of Fuji Glass Ionomer (Type III), Tenure Dentin Bonding System, and MONO-LOK2 kits, or Right-On Paste. However, Gluma 3, a component of the Gluma/Lumifor Bonding System, exhibited mutagenic activity in a dose-response manner. The mutagenicity of Gluma 3 was demonstrated in repeated experiments. Gluma 4 and the resin of the Gluma dental kit, as well as Right-On Activator, caused a slight increase in the number of revertants, and judgment regarding their mutagenicity could not be made conclusively. The results of this study indicate that some commercial dental materials may not have been adequately tested for mutagenicity, and that a reliable test program for evaluation of mutagenicity of dental materials is needed so that their safe use in dental practice can be ensured.

Aldehydes↗

Nanoindentation derived stress-strain properties of dental materials.

OBJECTIVES: The aim of the study is to investigate the stress-strain response of different dental materials, especially dental brittle materials, and compare them with enamel. METHODS: A nano-based indentation system (Ultra Micro-Indentation System, UMIS-2000, CSIRO, Australia) was used to determine the indentation stress-strain response of two kinds of dental ceramics (Cerec 2 Mark II and Vita VM9), one kind of dental alloy (Wiron 99) and healthy enamel. A spherical indenter was used to test the materials with nanometer and micro-Newton displacement and force resolution. Assuming the elastic modulus remained constant, a plot of contact pressure versus contact strain, H-a/R, of each material was obtained. RESULTS: By comparing the H-a/R curve of the different materials with enamel, it can be concluded that only the metallic alloy, has similar stress-strain response as enamel. Dental ceramics showed much higher yield stress response than enamel. VM9, a porcelain veneer component of crown/bridge structure, is slightly softer than its core, Mark II. The yield point for Mark II and VM9 are nearly 10 and 7GPa, respectively, and approximately 2GPa for Wiron alloy and enamel. SIGNIFICANCE: H-a/R curves provide a new method to compare the mechanical properties of different dental materials. From the standpoint of structural reliability, strong and tough materials with primarily elastic response, such as toughened ceramics are required to enable dental crown/bridges to have long term reliability. On the other hand, materials with too high hardness or yield response may damage opposing teeth during occlusal contact. Future studies may establish a relationship between stress and strain property and abrasive wear of dental material.

Dental Alloys↗

Videotaping to enhance communication about the use of dental materials.

Videotape interviews in 23 private dental offices were compiled at the University of Michigan School of Dentistry to enhance communication between academic, clinical and manufacturing personnel regarding the use of dental amalgam. This paper discusses the rationale for videotaping the interviews and the results of the interviews, and comes to some conclusions on how the information gathered may be used to improve teaching and research in dental materials.

Dental Materials↗

Incidence of adverse effects of dental materials.

Acute and long-standing adverse effects from dental materials used in the treatment of 13,325 patients in 15,820 appointments were recorded by 137 dentists. Twenty-four suspected side effects were reported by the patients and 22 by the clinicians; 7 were classified as "probable" or "possible" acute reactions and 15 as long-standing effects, 13 being "verified" and 2 "probable". In another survey, 31 dentists representing a total of 387 years of practice recollected 113 patients with side effects from dental materials.

Composite Resins↗

Potential teratogenic and carcinogenic effects of dental materials.

Public awareness of potential health hazards from drugs and chemicals is increasing. Doubts about dental materials are also being raised. However, there is a fundamental difference in the magnitude of exposure from potent drugs and from dental materials, which are designed to be as inert and stable as possible; the risk to health could a priori be considered very low. The risk to the patient and to dental personnel should be evaluated separately and based on relevant conditions of exposure and available toxicological data for the specific chemicals released from the dental materials in question. This paper also reviews, briefly, the theories for chemically-induced teratogenic and carcinogenic effects in general, in order to put into perspective suspected adverse reactions to dental materials.

Animals↗

Dental materials citations: Part A, January to June 1996.

OBJECTIVE: A search was conducted to identify the dental materials publications that appeared in biomedical journals from January 1996 to June 1996 and to compare the frequency of citations among the different categories. METHODS: The tables of contents of 16 primary journals and 48 secondary journals were examined to identify dental materials articles that were published from January to June 1996. These citations were divided into 17 categories and the numbers of citations in each category were compared. To assess the usefulness of the citation listing, a survey of Academy of Dental Materials subscribers was conducted (n = 153 of 382 or 40.1% have responded to date). RESULTS: As in previous years, the greatest number of citations were found in categories of bonding (n = 83) and resin-based restorative materials such as composites and resin-reinforced glass ionomers (n = 80). Results of the reader survey indicated that 84.3% of the respondents have used the citations lists, and 95.4% feel that its publication should be continued. SIGNIFICANCE: The literature compiled in this list serves to supplement the electronic indexing mechanisms so that academicians and researchers can have ready access to the current literature in the field of dental materials.

Animals↗

Side-effects of dental materials reported in Scandinavian countries.

Dental treatment usually involves a wide range of materials which continue to grow in number and complexity. During the last decade there has been an increasing demand for safety evaluation and control of dental materials. Since it is the members of the dental staff who handle the materials in their most reactive states they constitute the main risk category. Bearing this in mind reported side-effects in both patients and dental personnel in Scandinavia are presented. Data from the only two existing national registers for side-effects of dental materials, i.e. those in Norway and Sweden, are thus elucidated. Furthermore, recent mainly Scandinavian publications dealing with the side-effects of dental materials are presented. It can be concluded that a national register on the side-effects of dental materials, apart from revealing information regarding their frequency and nature, may detect changes in the profiles of adverse reactions and also serve as a tool for the post-marketing surveillance of dental materials.

Adult↗

[Oral lichen planus and dental materials. Etiopathogenetic and clinical relations].

The oral mucosa may be the site of lesions attributable to contact allergy with dental material. Studies carried out show that in oral LP dental materials may represent a factor of by no means negligible importance in determining the lesion as they might be the triggering cause and subsequently influence course and development. On the basis of these observations, an interpretative model of the aetiopathogenetic relationship between dental materials and oral LP is proposed and the problem is also addressed from the clinical viewpoint. The essential aspects are outlined and a diagnostic-therapeutic protocol proposed that differentiates patients suffering from oral LP with presence of dental materials and those without.

Corrosion↗

Updates in dental materials--Part 2: Resin cements.

Recent years have seen a number of innovations and developments with respect to dental materials and their applications in clinical dentistry. This series of short articles considers the more important aspects of these developments under the general term 'Updates in Dental Materials'. Dental composite systems and bonding to tooth material were discussed in Part I. Resin cements are treated in this article. Part 3 presents dental amalgams and Part 4 deals with advances in ceramic materials.

Dental Bonding↗

Aerobic bacterial contamination in dental materials.

Current concern about disease transmission points out the need for better infection control in dentistry. The purpose of this study was to test samples of dental materials in factory-sealed containers for aerobic bacterial contamination. Multiple unopened containers of 12 different dental materials were obtained from the dental school dispensary. Samples were removed from each container and incubated at 38 degrees C in standard broth medium for 1 week. Those that exhibited visual signs of possible bacterial growth were subjected to a Gram stain for verification. The results of that test indicated that 20% to 30% of the samples of alginate, glass ionomer cement and base powders, and retraction cord contained bacterial contamination. The remaining eight dental materials exhibited no apparent bacterial growth. Thus viable aerobic organisms were found in samples from 4 of 12 dental material products.

Air Microbiology↗

[The abrasion resistance of dental materials. 2. Improvement of abrasion resistance of tooth-colored plastics by means of combination with dental ceramics].

On the abrasion resistance of dental materials. Part II: Reduction of the abrasion of tooth-colored plastics as achieved by the simultaneous use of dental ceramic materials In vitro experiments showed that dental plastics being in contact with dental ceramic materials are abraded to a lesser extent than dental plastics in contact with dental plastics.

Dental Materials↗

Hypersensitivity to mercury, nickel and chromium in relation to dental materials.

Three metals which are used in dental materials are recognized as causing sensitization sufficiently frequently to consider whether problems might arise from their use in dentistry. These metals are, mercury, nickel and chromium. Nickel is by far the commonest sensitizer, 10 per cent of women are allergic to nickel; sensitization usually occurs through jewellery or fasteners on articles of clothing. Chromium (as chromate) is a much less common sensitizer for several reasons. Sensitization only occurs through hexavalent salts of chromate and the degree of exposure of humans to these salts is much less than to either nickel or mercury. The true incidence of mercury sensitization is difficult to ascertain because many of the materials which were used for patch testing previously and on which statistics were based, contained unnecessarily high concentrations of mercury, and the pattern of mercury allergy is changing because many substances which contain mercury and were used frequently are not now employed. Although metallic mercury can sensitize the evidence would suggest that if dental amalgams ever cause people to become allergic to mercury, it is an extremely rare occurrence. Problems with mercury-containing amalgams in those sensitized are also rare, only 28 cases have been recorded in the literature. Thus, it is likely that at the present time sensitization to mercury is uncommon and decreasing. There is even less evidence that nickel or chromate in dental materials actively sensitize and it is exceptionally rare to have problems with these metals in a prosthesis in someone who is already sensitized.(ABSTRACT TRUNCATED AT 250 WORDS)

Chromium↗

Potential hazards and artifacts of ferromagnetic and nonferromagnetic surgical and dental materials and devices in nuclear magnetic resonance imaging.

The risks to patients with metal surgical implants who are undergoing nuclear magnetic resonance (NMR) imaging and the artifacts caused by such implants were studied. Twenty-one aneurysm and other hemostatic clips and a variety of other materials (e.g., dental amalgam, 14 karat gold) were used. Longitudinal forces and torques were found to be exerted upon 16 of the 21 clips. With five aneurysm clips, forces and torques sufficient to produce risk of hemorrhage from dislocation of the clip from the vessel or aneurysm, or cerebral injury by clip displacement without dislodgement were identified. The induced ferromagnetism was shown to be related to the composition of the alloys from which the clips were manufactured. Clips with 10-14% nickel are evidently without sufficient induced ferromagnetism to cause hazard. The extent of NMR imaging artifacts was greater for materials with measurable ferromagnetic properties, but metals without measurable ferromagnetism in our tests also resulted in significant artifacts. Dental amalgam and 14 karat gold produced no imaging artifacts, but stainless steels in dentures and orthodontic braces produced extensive artifacts in the facial region.

Aneurysm↗

Effect of enamel matrix proteins on the phenotype expression of periodontal ligament cells cultured on dental materials.

Cells within the periodontal ligament have the potential to regenerate a periodontal connective tissue attachment on pathologically exposed root surfaces as well as on several material surfaces including titanium. However, rather than a periodontal connective tissue attachment, a fibrous encapsulation or chronic inflammatory response has been reported at the material connective tissue interface for most dental materials. Cementum is the first tissue of the periodontal connective tissue attachment to develop and the secretion of enamel matrix related proteins on the newly mineralized dentin surface precedes and is thought to induce cementum formation. Enamel matrix-related proteins may also function in the adult because the application of an acid extract of porcine enamel protein matrix (Emdogain(R), EMD) on pathologically exposed root surfaces has been shown to result in cementum regeneration. Therefore, the objective of the present study was to determine whether the application of EMD to materials that do not normally support cementogenesis in vivo would alter the in vitro phenotype of periodontal ligament (PDL) cells including the synthesis of cementum-associated extracellular matrix proteins. Primary PDL cells were established from 21-day-old Sprague-Dawley rats, and were cultured on four materials commonly encountered in dental practice (gutta percha, calcium hydroxide, amalgam, and super EBA cement) with and without the application of EMD. After 7 or 14 days of culture, total-DNA content, collagen synthesis, alkaline phosphatase activity, and the synthesis of a 42-kDa cementum-associated extracellular matrix protein were determined. PDL cells cultured on all materials had decreased total DNA content. The application of EMD further decreased total DNA content. PDL cells cultured on gutta percha and calcium hydroxide with the application of EMD had similar levels of collagen synthesis and alkaline phosphatase activity but also expressed a 42-kDa cementum extracellular matrix-associated protein when compared to the other groups. These results suggest that EMD can alter the phenotype of PDL cells when cultured on these dental materials.

Alkaline Phosphatase↗