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Dentin shear bond strength of compomers and composites.

OBJECTIVE: The aim of this study was to compare the shear bond strengths and fracture characteristics of two compomers bonded with a single step bonding agent with two modern composites, a microfil and hybrid, bonded with a fourth generation bonding agent. METHODS: Freshly extracted human third molars were sectioned parallel to the occlusal surface to expose midcoronal dentin, prepared with 320-grit surface finish, and bonded (N = 11 samples/group) following manufacturer's directions with the compomers (Dyract, DeTrey Konstanz, Germany or Compoglass, Vivadent, Schaan Liechtenstein) or the dentin bonding agent SMP+ (Scotchbond Multi-Purpose Plus, 3M Dental Products, St. Paul MN) with Silux Plus or Z100 (3M Dental Products, St. Paul, MN). The samples were tested using a single plane lap shear bond strength test at 5 mm/min until failure. Statistical analysis was performed using ANOVA with Scheffe multiple comparison testing. Fracture surfaces of the debonded surfaces were examined using SEM to determine the failure mode of each specimen. RESULTS: Bond strengths for the compomers were 12.7 +/- 2.9 MPa for Dyract and 8.9 +/- 4.1 MPa for Compoglass and were not significantly different. Bond strengths for the dentin bonded composites were significantly stronger than the compomer Compoglass, but were not different from one another, despite the use of different composites. The averages values for SMP + /Silux Plus and SMP + /Z100 were 15.7 +/- 4.5 MPa and 15.2 +/- 5.6 MPa, respectively. SEM analysis showed that all materials exhibited mixed failure patterns. Compoglass specimens exhibited 5 of 11 failures classified as adhesive, while each of the other materials showed only 1 of 11 adhesive failures. SIGNIFICANCE: Compomers have undergone rapid development over the last several years, but their bond strengths have not yet reached the same level as modern dentin bonded composites. Difference in composite filler type and amount had little influence on the bond strength determined in this work.

Analysis of Variance↗

Shear bond strengths produced by composite and compomer light cured orthodontic adhesives.

OBJECTIVES: To test the shear bond strengths obtained when orthodontic brackets were bonded ex vivo using a composite resin and a compomer orthodontic adhesive. METHODS: Specimens were tested in a special jig made to fit an Instron testing machine. After debonding, the adhesive remaining on bracket bases and enamel surfaces was mapped. RESULTS: Bond strengths ranged from 8 to 23 MPa with the composite resin producing higher strengths than the compomer for similar combinations of variables. Bond strength was increased by longer curing and a longer debond interval and was higher for brackets with mesh bases than undercut bases. More compomer remained on the enamel surface after debonding than did the composite resin. CONCLUSION: The compomer produced bond strengths within the range considered to be clinically acceptable in other studies. If it was clinically successful as an orthodontic adhesive a compomer would confer the advantage that fluoride release would help to minimize the onset of early caries around bonded brackets.

Acrylic Resins↗

Changes in properties of polyacid-modified composite resins (compomers) following storage in acidic solutions.

The interaction of three polyacid-modified composite resins (compomers) with various acidic storage solutions, and also water, over periods of time up to 6 months has been studied and compared with those of a glass-ionomer and a composite resin. This interaction has been shown to vary in a complex way with length of storage and nature of the acid, and citric acid was found to be the most aggressive storage medium for glass-ionomer cement, and also for the compomers. The pure composite resin, by contrast, was relatively unaffected by all of the acid solutions examined. In all acids, the compomers showed a distinct buffering effect, i.e. they increased the pH towards neutral, as did the glass-ionomer. The extent of this also varied with duration of storage and nature of the acid. The biaxial flexure strength was determined and found to be essentially unaffected by the complex chemical interactions with acidic storage solutions. Values obtained for the compomers were lower than those of the composite resin, but above those of the glass-ionomer. Fourier-transform infrared (FT-IR) spectroscopy was employed to study the changes in the compomers following storage in the aqueous media, but bands were broad and no detailed assignments could be made. There were changes in the region of the spectra associated with metal carboxylates however, and this indicates that the secondary acid-base reaction had occurred following water uptake.

Acids↗

The influence of configuration factors on cavity adaptation in compomer restorations.

The effect of configuration factor (C-factor) on cavity adaptation was investigated in three compomer and one resin composite restorations. Eighty-four cylindrical dentin cavities (C-factor: approximately 2.5, 3.0 or 4.0) prepared on flat coronal dentin surfaces were filled with the materials in combination with their proprietary adhesive systems. Cavity adaptation was microscopically examined after 15 minutes storage in water at the top surface and at other four sites along the cavity walls. Additionally, indentation testing was performed for each material at 20 minutes and 24 hours after irradiation. Regression analysis revealed no relationship between C-factor and gap dimension in compomer restorations at any of the measuring sites, while a logarithmic relation was found only at the cavity floor of the composite fillings. All materials showed maturation of mechanical properties. The elastic component of the indentation was smaller in compomers than in the composite. It was concluded that C-factor had no influence on the cavity adaptation for compomer restorations. This might be due to reduced stress generation at the bonding interface caused by relatively low mechanical properties immediately after curing, less elasticity, and water absorption in compomers.

Compomers↗

Marginal adaptation of compomers in Class I and V cavities in primary molars.

PURPOSES: To evaluate in primary molars (1) the adaptation of three compomers in Class I and V cavities at the cavosurface margins and inside the cavity, and (2) the effect of cavity etching on such adaptation. MATERIALS AND METHODS: The three compomers used were Compoglass, Dyract and Hytac. Sixty exfoliated primary molars were divided for the three compomers, which were subdivided into Class I and V (10 each) and subdivided again into etched and non-etched (5 each). Standard Class I and Class V cavities with the gingival margins at cementum were prepared. The cavities were restored with the three compomers used with or without etching the cavity. The restored cavities were finished and polished. The cavosurface margins were inspected under the light microscope. Then the restored teeth were sectioned into two halves. The cut halves were fixed in glutaraldehyde and the cut surfaces smoothed, polished and inspected under the light microscope for adaptation of the restorative material inside the cavities. One halve of each molar was prepared for SEM. RESULTS: The three compomers showed good adaptation at the cavosurface margin except the non-etched Class V cavities restored with Dyract. Compoglass and Dyract were well adapted inside the cavity better than Hytac. Cavity angles were common sites for adhesive pooling for all materials. SEM examination showed good adaptation of the restorative at enamel and cementum interface especially in etched cavities. The dentin-restorative interface showed consistent hybrid layer with resin tags in the etched cavities. However this layer was inconsistent in the non-etched cavities.

Acid Etching, Dental↗

Effect of adhesives on the inhibition of secondary caries around compomer restorations.

This study evaluated the effect of adhesives on the inhibition of secondary caries around compomer restorations in vitro. Two adhesive systems with a Bis-GMA resin, Scotch bond Multi-purpose (MP) and Single Bond (SB), and one adhesive system with no Bis-GMA resin, F2000 compomer primer/adhesive (PA), were used prior to placement of the compomer (F2000), and non-fluoride releasing resin composite (Z100) was used as a control. Class V cavities prepared on extracted human premolars were restored with various combinations of materials: F2000/MP, F2000/SB, F2000/PA, Z100/MP, Z100/SB and Z100/PA. The restored teeth were incubated in bacterial medium containing sucrose with Streptococcus mutans for two weeks after storage for 14 days. On microradiographs, the radio-opaque layers adjacent to the F2000 restorations were thick and clear, while the layers in the Z100 restorations were unclear. In the F2000 restorations, the mean thickness of the radio-opaque layers in the PA group was significantly greater than that of the MP and SB groups. In fluoride-releasing measurement, F2000 coated with PA showed a significantly higher amount of fluoride release than MP and SB, and no significant difference in the amount of fluoride release from uncoated F2000. These results indicated that applying an adhesive without Bis-GMA resin to compomer restoration has no suppressive effect on the fluoride release from compomer and might be beneficial for inhibiting secondary caries in vitro.

Analysis of Variance↗

Clinical evaluation of a compomer and an amalgam primary teeth class II restorations: a 2-year comparative study.

PURPOSE: This study was performed to compare the clinical performance between the compomer F2000 and amalgam Dispersalloy in Class II restorations in primary molars over a 2-year period. METHODS: Seventy-five amalgam and 75 compomer restorations were placed in 75 children based on a split-mouth design. The restorations were evaluated after 1 week and after 6, 12, 18, and 24 months of oral function. The evaluation consisted of a clinical assessment according to modified Ryge criteria, a radiographic examination using bite-wing radiographs, and an observation of epoxy casts under scanning electron microscopy. RESULTS: The results showed statistically significant differences in the marginal adaptation and anatomic form between amalgam and compomer restorations. A higher number of compomer restorations were rated as Bravo, while a higher number of amalgam restorations were rated as Alpha at 24 months. Significant differences in the failure of the restoration and development of secondary caries were not found between the materials. CONCLUSIONS: The use of compomer F2000 in Class II resorations in primary molars, although it presents a significantly higher number of restorations rated as Bravo regarding the marginal adaptation and anatomic form vs the amalgam, does not increase the risks of developing secondary caries and failure of the restoration over a period of 2 years.

Child↗

An in vitro investigation to optimize the quality of compomer-based fissure sealants.

PURPOSE: To evaluate if the in vitro quality of preventive fissure sealants made with compomer-based materials can be improved by modifying the method of application. METHODS: Delton resin-based sealant, Dyract Flow and Dyract Seal compomers were used. The manufacturer's instructions were modified by prolonging the application time of the materials used and by applying the sealer in two layers. Extracted caries-free human molars were fissure sealed under standardized conditions and then exposed to a thermocycling procedure and a dye penetration test. Following the preparation of ground slices the samples were assessed by means of a light microscope and a scanning electron microscope. Statistical analysis of the results was done using a chi-square test. RESULTS: The modified application of the two-compomer-based fissure sealers improved distinctly the quality of such fissure sealants. This was observed with respect to the criteria sealing ability, absence of pores in the sealant and complete filling of the fissure in wide as well as in narrow fissures. Compomer-based fissure sealants applied with the modified technique were equal to conventional resin-based composite fissure sealants regarding sealing ability and complete filling of the fissure. With respect to absence of pores, compomer-based sealants were superior to resin-based composite sealants.

Chi-Square Distribution↗

Marginal adaptation of commercial compomers in dentin cavity.

The dentin cavity adaptation and setting characteristics of four commercial compomers were evaluated by measuring the wall-to-wall contraction gap width in the cylindrical dentin cavity and measuring the compressive strength for a maximum of 14 days after setting. The dentin cavity wall was pretreated by the dentin adhesives according to each manufacturer's instructions or the experimental contraction gap-free dentin bonding system. Complete marginal integrity was obtained in only one compomer and two resin composites which were combined with the experimental dentin bonding system. The compressive strength of two resin composites and two compomers ten minutes after setting was comparable to that after 14 days which indicated that the compomers exhibited setting characteristics as rapidly as the resin composite. It was concluded that a high efficacy dentin bonding system is required for commercial compomers to prevent gap formation during irradiation caused by the rapid setting shrinkage.

Analysis of Variance↗

Surface antibacterial properties of compomers.

AIM: This was to evaluate the antibacterial properties of four different compomers, using direct contact test (DCT) and agar diffusion test (ADT). Compomers (Polyacid Modified Composite Resin) form a group of dental restorative materials which were developed in order to improve conventional glass-ionomer and are widely used by pediatric dentists in primary dentition. Microorganisms captured under restorations or penetrating through the micro-gap at the tooth-restoration interface are the cause of secondary caries and pulpal pathology. METHODS: For the DCT, 8 samples of Freedom (SDI), F2000 (3M-ESPE), Dyract (Dentsply) and Hytac Hplitip (3M-ESPE) were placed on the sidewalls of wells in 96 microtiter plate. After polymerization, freshly grown streptococcus mutans cells (1x10(6)) were placed on the surface of each sample for one hour at 37 degrees C, fresh media was then added to each well and bacterial growth was followed for 16 hours by temperature controlled spectrophotometer. Similarly prepared samples were aged in phosphate buffered saline for 1, or 7 days and the DCT was repeated. The ADT was performed by placing samples in uniform wells punched in agar plates. RESULTS: In the DCT, freshly polymerized samples of F2000 showed the most potent antibacterial properties, while those of Hytac Hplitip showed moderate antibacterial phenomena. Dyract and Freedom did not show any antibacterial activity relative to the control material. None of the four aged materials showed antibacterial activity in the DCT after 1 or 7 days. In the ADT the halo in the bacterial lawn was measured after 48 hours and only F2000 demonstrated an inhibition zone of 2.15+/-0.3 mm. Statistics. Two way ANOVA indicated a significant difference in the growth rate of bacteria placed both on the different compomers (P<0.001) and in different tested time points (P<0.001). CONCLUSION: None of the compomers tested provided significant long term antibacterial activity.

Anti-Infective Agents, Local↗

The effectiveness of compomer as a root-end filling: a clinical investigation.

OBJECTIVE: This study investigates the treatment outcome of a root-end filling technique that uses a light-cured compomer combined with a light-cured dental adhesive. STUDY DESIGN: The study used 34 single-rooted teeth restored with post, core, and crowns. A shallow concave apical preparation was filled with a light-cured compomer with a light-cured dental adhesive. As a control, a chemically cured glass ionomer was used with a conventional root-end preparation. A follow-up clinical and radiographic evaluation of the treatment result was conducted after 1 year. RESULTS: A significantly higher success rate (P<.015) was observed in the treatment group that used a compomer (89% complete healing) compared to glass ionomer (44% complete healing). CONCLUSIONS: When used as a retrograde root filling in a shallow concave preparation, a light-cured compomer and a dental adhesive improves healing regardless of the quality of the remaining root filling.

Adult↗

Effect of hydrostatic pressure on regional bond strengths of compomers to dentine.

OBJECTIVES: The aim of this study was to evaluate the effect of hydrostatic pressure on the regional bond strengths of compomers to dentine. METHODS: Thirty freshly extracted molars were ground flat to expose the dentine and randomly divided into two groups for bonding: no hydrostatic pressure and hydrostatic pressure of 15cm H(2)O. Xeno CF, Dyract AP and F 2000 were applied to dentine surfaces pretreated by the respective bonding systems following the manufactures' instructions, and then restored with Clearfil AP-X. After 24h storage in water, the teeth were sectioned into 0.7-mm thick slabs and visually divided into three regional subgroups: the region communicating with the pulp through dentinal tubules (pulp horn); the region between the pulp horns (center); and the region between the pulp horn and DEJ (periphery). The specimens were trimmed to a cross-sectional area of 1mm(2) and subjected to the micro-tensile bond test. The data were analyzed by one- and three-way ANOVA, and Fisher's PLSD (p<0.05). RESULTS: There were no significant regional differences of bond strengths for all the compomers tested (p>0.05). However, hydrostatic pressure significantly decreased the bond strength of F 2000 to all regions (p<0.05), while the bond strength of Dyract AP significantly decreased only at the pulp horn region (p<0.05). On the other hand, the bond strengths of Xeno CF seemed not to be affected by hydrostatic pressure (p>0.05). For Dyract AP and F 2000, the fracture modes were affected by hydrostatic pressure, while, for Xeno CF, there were no significant differences between the fracture modes with non- or positive hydrostatic pressure. SIGNIFICANCE: Simulated pulpal pressure of 15cm H(2)O had a greater influence on the bond strengths of compomers to dentine than did dentine regions. Therefore, when measuring the bond strengths of compomers to dentine under the simulated in vivo conditions, the wetness of the dentine surface, as well as the intrinsic properties of each material should be seriously considered.

Analysis of Variance↗

Clinical evaluation of paired compomer and glass ionomer restorations in primary molars: final results after 42 months.

OBJECTIVES: To undertake a clinical trial comparing the efficiency of a compomer restoration with a glass ionomer restoration in the management of caries in primary molar teeth. DESIGN: Subjects were admitted to the trial if they required at least one pair of restorations in primary molar teeth. SETTING: Department of Child Dental Health, Newcastle Dental Hospital and School. SUBJECT: Twenty nine children, aged 4-9 years, had 56 pairs of restorations placed between January 1995 and November 1997. METHOD: The durability of the restorations was assessed during a 42-month follow-up period using modified United States Public Health Service criteria. Survival analysis and the McNemar paired test were used to compare the performance of the two restorative materials. RESULTS: The compomer restorations had a higher mean survival time (42 months, SE 1.40) compared with 37 months (SE 1.90) for the glass ionomer restorations and this was significant at the 5% level. The compomer also performed significantly better in terms of anatomical form, marginal integrity, cavo surface discoloration and maintenance of interproximal contact. CONCLUSIONS: The present trial demonstrated that Dyract compomer performed significantly better than Chemfil Superior a glass ionomer cement for all modified United States Public Health Service criteria over a period of 42 months.

Aluminum Silicates↗

Laboratory evaluation of a compomer and a resin-modified glass ionomer cement for orthodontic bonding.

The mean shear debonding force of stainless steel orthodontic brackets with microetched bases bonded with either a compomer or a resin-modified glass ionomer cement was assessed. In addition, the amount of cement remaining on the enamel surface following bracket removal was evaluated. Finally, survival time of orthodontic brackets bonded with these materials was assessed following simulated mechanical stress in a ball mill. Debonding force and survival time data were compared with those obtained for brackets bonded with a chemically cured resin adhesive, a light-cured resin adhesive, and a conventional glass ionomer cement. There were no significant differences in mean shear debonding force of brackets bonded with the compomer, resin-modified glass ionomer, chemically cured resin adhesive, or the light-cured resin adhesive. Brackets bonded with a conventional glass ionomer cement had a significantly lower mean shear debonding force than that recorded for the other materials. The Adhesive Remnant Index (ARI) mode score indicated that significantly less cement remained on the enamel following debonding of brackets cemented with resin-modified or conventional glass ionomers compared with other adhesives. The median survival time for brackets cemented with the compomer, resin-modified glass ionomer, chemically cured resin, or light-cured resin were significantly longer than for brackets cemented with conventional glass ionomer. The compomer and the resin-modified glass ionomer adhesive appear to offer viable alternatives to the more commonly used resin adhesives for bracket bonding.

Acid Etching, Dental↗

Reactions of connective tissue to compomers, composite and amalgam root-end filling materials.

AIM: To evaluate the subcutaneous connective tissue reaction to compomers, composite and amalgam root-end filling materials. METHODOLOGY: This study was conducted in 30 Wistar albino rats. The materials were mixed or light-cured according to the manufacturer's directions and placed in polyethylene tubes. Group 1 - Dyract compomer (Dentsply); group 2 - F2000 compomer (3M); group 3 - Valux Plus composite (3M); group 4 - Oralloy high-copper amalgam (Coltene). The tubes containing the materials were implanted into the dorsal connective tissue of rats, which were killed 7, 15, 30, 60 and 90 days after the implantation procedure. Thirty extra empty tubes were also placed as controls. The implant sites were excised and prepared for histological evaluation. Sections of 6-microm thickness were stained with haematoxylin and eosin and assessed under light microscopy. The presence of inflammation, predominant cell type and thickness of fibrous connective tissue adjacent to each implant were recorded. Reactions were scored as: 0: none or few cells and no reaction; 1: less than 25 cells and mild reaction; 2: between 25 and 125 cells and moderate reaction; 3: 125 and more cells and severe reaction. Fibrous capsules were considered to be thin if their thickness was less than 150 microm and thick if it was more than 150 microm. Necrosis and formation of calcification were categorized as 'yes' or 'no'. RESULTS: All four materials caused moderate or severe inflammatory reactions in the first 7-day period, but these reactions decreased by the 60th and 90th days. No significant difference in inflammatory cell numbers between the materials could be detected at the 90th day. CONCLUSIONS: Valux Plus composite, Dyract and F2000 compomers and Oralloy amalgam were biocompatible.

Analysis of Variance↗

Relative solubilities of hybrid ionomers and compomers by acid impingement.

The purpose of this investigation was to determine the relative erosion/solubility for hybrid glass-ionomers and a compomer using the jet-impingement technique with lactic acid of various molarities. The materials studied included Dyract, Duet, Vitremer, Advance, Fuji-II LC, and Fuji-I, Ketac Cem and Modern Tenacin as the control. Data were analysed using ANOVA and Tukey's comparison test. Results indicated that depth of erosion/solubility with hybrid glass-ionomers and compomers was not measurable by the normal procedure. Similarly, weight changes were not detectable at 0.002, 0.02 and 0.05 M (except for Advance at 0. 05 M). All glass-ionomers materials and the compomer revealed weight changes at 0.1 M after 24 h, in the following increasing order: Dyract < Fuji-II LC=Duet < Advance < Vitremer. It was concluded that weight loss is a better parameter to characterize these new hybrids glass-ionomers and compomers for erosion/solubility by jet-impingement. In addition, a lactic acid of minimum 0.1 M as a test solution is required to generate 24 h-data that can be measured in most laboratories and thus used for statistical comparison.

Analysis of Variance↗

Compomers in restorative therapy of children: a literature review.

OBJECTIVE: The restoration of carious primary teeth plays an underestimated role in paediatric dentistry. This is astonishing for many reasons, not least because many new materials have been introduced in recent years. New or modified techniques and materials, with better aesthetics and flexural properties, allow minimally invasive treatment. A transfer of techniques between different dentitions, however, may be problematic because of both micromorphological differences and compliance. Therefore, this paper deals with options for restoring primary teeth and the early stages of the mixed dentition using polyacid-modified composites, the so-called compomers. METHODS: Medline and Embase were scanned from 1990 through 2006. Furthermore, a hand-search of nonlisted but peer-reviewed papers was performed. The search items were compomer*, dent*, primary* and deciduous*, which identified 109 relevant publications. CONCLUSIONS: Based on high clinical success rates, compomers are now an effective alternative to other materials for restorative therapy in the anterior and posterior primary teeth. A minimum amount of compliance is still mandatory in order to allow for a few minutes of adhesive pretreatment and layering without contamination. If this is not the case, compomers make no sense. Stainless steel crowns are still the most effective from of restoration for severely decayed primary molars.

Child↗

Effect of alcoholic and low-pH soft drinks on fluoride release from compomer.

PURPOSE: The purpose of this study was to evaluate the amount of fluoride released from compomer restorative materials after immersion in various media. MATERIALS AND METHODS: In this test, four materials were used: three compomers (Dyract, Dentsply, Konstanz, Germany; Compoglass, Vivadent, Schaan, Principality of Liechtenstein; and Xeno, Sankins, Tochigi, Japan) and one resin-modified glass ionomer cement (Fuji II LC, GC, Tokyo, Japan). There were four test solutions: one alcoholic (whiskey), two low-pH drinks (Coca-Cola, orange juice), and one deionized water. Over a period of 60 days, the tested specimens were immersed in the test solution for 3 hours every day, then kept in deionized water. The fluoride released was detected by using a fluoride ion selective electrode connected to a microprocessor ion analyzer. The fluoride ion concentration (ppm) of the test solutions and deionized water was recorded after 1, 2, 3, 4, 7, 30, and 60 days. Electron probe microanalysis was used for surface analysis of the fluoride released. RESULTS: When immersed in low-pH soft drinks, compomer showed a significantly higher fluoride release than when immersed in deionized water (p < .0001). For specimens immersed in Coca-Cola, the fluoride release levels (microgram/cm2, mean +/- SD) at 1, 7, and 60 days for Dyract (91.6 +/- 1.8, 39.3 +/- 3.1, 10.5 +/- 0.9), Compoglass (129.5 +/- 0.9, 66.5 +/- 2.7, 19.0 +/- 0.3), Fuji II LC (147.0 +/- 4.2, 50.8 +/- 3.1, 27.6 +/- 3.0), and Xeno (73.6 +/- 3.2, 27.3 +/- 2.1, 6.6 +/- 0.6) demonstrated the trend of significantly lower releases with time in water solution. Over a 60-day period, materials immersed in 100% orange juice released the highest amount of fluoride, which could be attributable to the erosive effect of the medium. Materials immersed in deionized water released the least amount of fluoride. Among the tested compomers, Compoglass released the most fluoride.

Alcoholic Beverages↗