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Influence of temporary cement remnant and surface cleaning method on bond strength to dentin of a composite luting system.

The aim of the current study was to evaluate the influence of polycarboxylate temporary cement remaining on the dentin surface on the bond strength of a composite luting system. An acrylic resin plate was luted to bovine dentin with a polycarboxylate temporary cement (HY-Bond Temporary Cement Hard, HYB). The temporary cement was not used for the control groups. After removing the temporary cement with an excavator, dentin specimens were divided into five groups; 1) no subsequent treatment, 2) cleaning with a rotational brush (RTB), 3) cleaning with a rotational brush and non-fluoridated flour of pumice, 4) sweeping with an air scaler, and 5) treated with a sonic toothbrush. A silane-treated ceramic disk (IPS Empress) was bonded to each dentin specimen with a composite luting system (Panavia F). Shear testing results showed that the RTB groups exhibited the highest bond strength regardless of the use of temporary cement (P < 0.05). The use of a rotational brush with water coolant is recommended to achieve ideal bond strength between the Panavia F luting system and dentin to which HYB temporary cement was primarily applied.

Aluminum Silicates↗

Techniques for aesthetic enhancement of porcelain laminate veneer restorations: a case report.

The article is a clinical report of various techniques to enhance the aesthetic outcome of porcelain veneer restorations. Color and contour evaluation, increase in shade value, bleaching, and the use of temporary veneer restorations are presented and discussed. A case is used to illustrate the procedures. The learning objective of this article is to expand and update the knowledge of variations in current porcelain veneer restoration techniques.

Adult↗

Effect of eugenol and non-eugenol containing temporary cement on permanent cement retention and microhardness of cured composite resin.

This present study had three aims: 1) to evaluate the bond strengths of carboxylate and resin cements in cementing cast Co-Cr crowns to pretreatment of composite resin cores with eugenol and non-eugenol containing temporary cements, 2) to determine the microhardness of composite resin treated with temporary cement, 3) to view the surface differences of composite resin with SEM. The composite cores were divided into three experimental groups for the following pretreatments: Group 1, No treatment was provided, Group 2, The external walls of the composite cores were covered with eugenol-containing temporary cement, Group 3, The external walls of the composite cores were covered with non-eugenol containing temporary cement. Analysis of variance results showed that there was a significant difference between all three groups. Temporary cement with eugenol was significantly reduced the bond strength of full crown casting with resin cement compared with non-eugenol. The resin specimens treated with the eugenol-containing temporary cement showed the lowest microhardness values, the non-eugenol-containing temporary cement was not significantly different from those of the control groups.

Analysis of Variance↗

Polymerization shrinkage-strain kinetics of temporary crown and bridge materials.

OBJECTIVE: The purpose of this study was to measure the polymerization shrinkage kinetics of four commercially available polymer-based temporary crown and bridge materials, including the effect of ambient temperature. METHODS: Three dimethacrylate-based materials and one monomethacrylate-based material were investigated. The polymerization shrinkage-strains were measured by using the Bonded-disk method with initial specimen temperature at both 23 and 37 degrees C, with values particularly noted at 5, 10, and 120 min after mixing. Five recordings were taken for each material. The progress of the setting reaction and its temperature-dependence were evaluated by the kinetic curves, and net shrinkage and total shrinkage (inclusive of expansion magnitude) of each material were compared by independent sample t-test and one-way ANOVA. RESULTS: Most shrinkage occurred in the first 10 min after mixing although there was an early expansion especially with the monomethacylate in the first 5 min. At 120 min, the net shrinkage-strain at 23 and 37 degrees C of the materials used in this test ranged from 3.54 to 4.13%. The fastest setting dimethacrylate-based material and the monomethacrylate-based material showed higher shrinkage-strain than other materials. No significant differences of net shrinkage-strain were found between 23 and 37 degrees C, but higher shrinkage rates were measured at 37 degrees C than at 23 degrees C. SIGNIFICANCE: The Bonded-disk method is a suitable method for measuring temperature-dependence of shrinkage-strain of polymer-based temporary materials. The dimethacrylate-based materials are preferable to monomethacrylates for temporary restoration as judged by the magnitude of polymerization shrinkage-strain, the majority of which is apparent within 10 min from the start of mixing and may affect the clinical outcome.

Acrylic Resins↗

Effect of dentin adhesives used as sealers and provisional cementation on bond strength of a resin cement to dentin.

PURPOSE: To evaluate the effects of dentin adhesives employed as resin sealers and provisional cementation on the bond strengths of a resin cement to dentin. METHODS: A two-step etch-and-rinse adhesive (Excite DSC--Group 1) and two-step self-etch adhesive (AdheSE--Group 2) were applied to exposed dentin surfaces prepared from human molars (N=4). Water was used instead of a resin sealer in control Groups 3 and 4. A eugenol-free provisional cement (except for Group 4) was applied to the treated surfaces. After storing in distilled water for 1 week, the provisional cement was removed and cylindrical composite blocks were luted with a resin cement (Variolink II). 0.9 x 0.9 mm sticks were produced from these luted specimens for microtensile bond testing and SEM examination. RESULTS: One-way ANOVA revealed that neither the resin sealer nor the temporary eugenol-free cement had a negative effect on the final bond strength (P> 0.05). Mixed failures were predominantly identified from SEM.

Acrylic Resins↗

Facial shell temporary veneers: reducing chances for misunderstanding.

With increasing demand for esthetically pleasing porcelain veneers, dentists face the challenge of delivering final restorations that fulfill patients' expectations. Given that "beauty is in the eye of the beholder," dentists need a method of determining the cosmetic outcomes that the patient hopes to achieve. This article presents procedures that allow patients to "preview" the veneers before the final restorations are fabricated. This provisional restorative method can clarify patient expectations and reduce the need for costly remakes.

Cuspid↗

Immediate loading with mini dental implants in the fully edentulous mandible.

The use of immediate loaded prostheses is not recommended for at least 2 weeks to prevent implants from premature loading. In addition, immediate removable prostheses are negated for at least 4 weeks at the site of guided bone regeneration or bone graft. However, patients are often not pleased with limited diets and the unaesthetic appearance during the healing period without a denture between implant placement and final prosthesis. Mini dental implants provide stable and esthetic temporary prostheses immediately after implant placement and bone grafts. The use of mini dental implants is simple and cost effective because the patient's old denture is used as a provisional prosthesis. This article shows the success of 27 mini dental implants that were placed for 11 mandibular fully edentulous patients.

Adult↗

Trends in indirect dentistry: 6. Provisional restorations, more than just a temporary.

The provision of well-fitting, functional provisional restorations is important for a wide variety of reasons, including maintenance of the stability of inter- and intra-arch relationships and positional stability of prepared teeth, and the preservation of occlusal function of anterior provisional restorations by providing appropriate protrusive and lateral guidance. Provisional restorations should be of sufficient strength to resist the forces of occlusion and should be luted with a cement that will resist the forces of removal, yet allow easy removal at the fit appointment without leaving a residue on the prepared tooth. This paper describes the use of provisional restorations in indirect restorative dentistry and suggests some specific techniques for clinical use.

Crowns↗

Bonding porcelain laminate veneer provisional restorations: An experimental study.

STATEMENT OF PROBLEM: Minimal tooth preparation is required for porcelain laminate veneers, but an interim restoration is anticipated by patients to protect their teeth against thermal insult, chemical irritation, and to provide esthetics. Cement remaining after the removal of the provisional restoration can impair the etching quality of the tooth surface and the fit and final bonding of the porcelain laminate veneer. PURPOSE: This in vitro study inspected the tooth surface for remaining debris from cement after removal of a provisional restoration. MATERIAL AND METHODS: Seventy-two extracted natural anterior teeth were prepared for porcelain laminate veneers. For half of the teeth, the smear layer was removed before luting provisional restorations. Veneer provisional restorations were fabricated and luted to teeth with 3 bonding methods: temporary eugenol-free cement, spot etching combined with dual-curing luting cement, and polyurethane adhesive combined with dual-curing luting cement. After removal of provisional restorations 1 week later, the tooth surface was examined for residual luting material with an SEM. RESULTS: Traces of cement debris were found on provisionally prepared teeth for all 3 material methods. CONCLUSION: The use of polyurethane adhesive combined with the dual-curing cement revealed significantly less teeth with debris than the other methods. This difference was less distinct when the smear layer was removed.

Acid Etching, Dental↗

Influence of ZOE temporary restorations on microleakage in composite restorations.

This study investigated the influence of zinc-oxide eugenol (ZOE) temporary restorations on microleakage in composite restorations. Class V cavities were prepared on the buccal surfaces of 32 freshly extracted, non-carious human premolars. The teeth were randomly divided into four groups of eight teeth. Specimens in Group 1 (control) received no temporary restoration. Group 2 and 3 specimens were covered with IRM (Type III ZOE cement) mixed at powder:liquid (P:L) ratio of 10g:1g and 10g:2g, respectively. Specimens in Group 4 were covered with poly-carboxylate cement (eugenol-free) mixed at a P:L ratio of 2.85g:1g. The temporary restorations were removed mechanically with an ultrasonic scaler after one week storage in distilled water at 37 degrees C. The preparations were washed and restored with Scotchbond Multi-Purpose Plus and Z100 according to manufacturers' instructions. The restorations were finished, thermally stressed for 400 cycles and subjected to dye penetration testing. Results were analyzed using Kruskal-Wallis and Mann-Whitney tests at a significance level of 0.05. At both enamel and dentin margins, the microleakage associated with Group 3 was significantly greater than for Groups 1, 2 and 4. For Groups 1 and 4, leakage at the dentin margins was significantly greater than in enamel margins. For the groups pretreated with IRM, no significant difference in dye penetration scores was observed between enamel and dentin. Pre-treatment with IRM mixed at a P:L ratio of 10g:2g significantly increased microleakage and is not recommended clinically.

Acid Etching, Dental↗

Effect of repeated vertical loads on microleakage of IRM and calcium sulfate-based temporary fillings.

Temporary fillings are commonly used to seal endodontic access cavities between visits. IRM and Cavidentin were selected to represent two widely used groups of temporary filling materials. The first is a reinforced zinc oxide-eugenol preparation that is mixed at chairside, whereas the second is a ready-to-use calcium sulfate-based material that gained popularity due to its convenience of application. The seal provided by the aforementioned materials was studied using a radioactive tracer quantitative assay. When compared as passive temporary filling, the two provided a similar quality of seal. However, when subjected to repetitive "occlusal" cyclic loading of 4 kg, IRM was clearly superior to the calcium sulfate-based material. Whereas IRM maintained a reasonable seal, the calcium sulfate-based fillings deteriorated and lost the ability to seal. These results suggest that even though calcium sulfate-based materials may be useful when not subjected to any occlusal forces, IRM should be preferred whenever occlusal loads may be applied. Furthermore it is demonstrated that testing such materials for microleakage with no reference to mastication forces may be of limited value.

Bite Force↗

Histologic evaluation of bone-implant contact of immediately loaded transitional implants after 6 to 27 months.

PURPOSE: Transitional implants (TIs) were developed as a method of providing fixed provisional restorations for the implant patient who wishes to avoid removable temporary restorations during implant healing. Success of TIs depends on achieving sufficient osseointegrated bone-to-implant contact (BIC) during the provisional prosthesis phase. To date, little data are available on the degree of BIC of these implants in function. The purpose of this study was to histologically evaluate the BIC of TIs following various periods of loading. MATERIALS AND METHODS: Histologic analysis of 33 immediately loaded implants from 21 patients was performed. All TIs had turned machined surfaces and were made of commercially pure titanium (grade 1). These transitional implants were in function for an average of 10.8 months (range: 6 to 27 months). Before the definitive restoration was provided, all of the TIs were removed with trephine drills and sent for hard tissue histomorphometric analysis. RESULTS: The average percentage of BIC was 52.9% +/- 13.81% (range 25.1% to 83%). DISCUSSION: Although TIs are traditionally removed when the definitive implants are restored, the BIC and clinical integration of the TIs in the present study may suggest a change in TI protocol. Studies are indicated to examine long-term use of TIs as sole support or in conjunction with definitive implants in definitive implant-supported restorations. CONCLUSION: The percentage of BIC achieved with TIs was similar to that documented in the literature for conventional turned, machine-surfaced implants.

Dental Implantation, Endosseous↗

Syncrystallization: a technique for temporization of immediately loaded implants with metal-reinforced acrylic resin restorations.

BACKGROUND: Rigid temporization has been recognized to have a significant impact on the peri-implant tissue response in immediate implant loading since it reduces the mechanical stress exerted on each implant. PURPOSE: A successful protocol for immediate loading of multiple implants depends on an adequate fixation and immobility of the implants to prevent the risk of micromovements in relation to the surrounding bone. The objective of this article was to evaluate a prosthetic concept for an accelerated rigid splinting of multiple implants for same-day immediate loading with metal-reinforced provisional restorations using a technique of welding temporary implant abutments with a prefabricated titanium bar directly in the oral cavity (syncrystallization). MATERIALS AND METHODS: Between June 2004 and January 2005, immediate loading of threaded implants with a metal- reinforced acrylic resin provisional restoration at stage 1 surgery was evaluated in 40 consecutive patients. A total of 192 implants were placed in selected edentulous or partially edentulous patients using the syncrystallization technique. Once the titanium bar was welded intraorally to the abutments, opaque was applied and the provisional restoration was relined and screw-retained the same day. In addition, a comparison of deformations and stress distributions in implant-supported, metal-reinforced and nonmetal-reinforced resin provisional restorations was analyzed in the edentulous mandible by a three-dimensional finite element model (FEM). RESULTS: All of the 192 rigidly temporized immediately loaded implants osseointegrated. An implant success rate of 100% was achieved over a period of 6 months postplacement. No fracture or luting cement failure of the provisional restoration occurred during the observation time. Compared to mere acrylic superstructures, a significant reduction of deformation and strain within metal-reinforced provisional restorations was detected by FEM analysis. CONCLUSION: The results of this study indicate that the syncrystallization technique allows an expedite and adequate rigid splinting of multiple immediately loaded implants. The advantages of the technique are: (1) reduction of treatment time for immediate temporization at stage 1 surgery; (2) predictable fixation and immobility of implants in the early stages of bone healing; and (3) less time for repairing provisional restorations as a result of no or rare fracture.

Acrylic Resins↗

Influence of temporary cements on bond strength between resin-based luting agents and dentin.

PURPOSE: To examine the influence of temporary cements on the strength of the bond formed between resin-based luting agents and dentin. METHODS: An acrylic resin plate was luted to bovine dentin using one of three temporary cements; HY-Bond Temporary Cement Hard (HYB), Freegenol Temporary Pack (FTP), or Neodyne T (NDT). The control group (CON) was not treated with cement. Following the removal of the temporary cement, each dentin substrate was bonded to a silane-treated ceramic material (IPS Empress) with one of four luting agents; Super-Bond C&B (SCB), Panavia F (PAF), Nexus II (NEX), or Fuji Luting S (FLS). The specimens were immersed in water for 24 hours and the strength of the bond to shearing forces was determined. RESULTS: The bond strengths (in MPa), with statistical categories shown in parentheses were: HYB (25.7, a), CON (23.5, a, b), FTP (19.8, b, c), and NDT (16.8, c, d) for the SCB system; FTP (13.8, d, e), CON (12.9, d, e), NDT (10.6, e, f), and HYB (7.8, f, g, h) for the PAF system; FTP (9.2, e, f, g), CON (7.9, f, g, h), HYB (7.7, f, g, h), NDT (7.1, f, g, h) for the NEX agent; and FTP (5.2, g, h, i), CON (3.7, h, i), NDT (3.0, h, i), HYB (1.6, i) for the FLS agent, (P< 0.05).

Analysis of Variance↗

Influence of zinc-oxide eugenol, formocresol, and ferric sulfate on bond strength of dentin adhesives to primary teeth.

This study evaluated in vitro the influence of a temporary filling {zinc oxide-eugenol (ZOE)} and two pulpotomy agents {formocresol (FC) and ferric sulfate (FS)} on shear bond strength (SBS) of two dentin adhesives to the dentin of primary molars. A total of 80 dentin surfaces were prepared and randomly allocated into 10 groups of 8 specimens each. Groups were subjected to different treatments, which included covering with a paste of ZOE mixed at different powder:liquid (P:L) ratios, placement on a gauze soaked in FC or FS, or they received no pretreatment and served as a control. XRV Herculite composite cylinders were bonded to dentin surfaces using Prime and Bond NT adhesive resin or Opti Bond Solo Plus adhesive resin. SBSs were determined using the lnstron testing machine running at a crosshead speed of 0.5 mm/min. The use of ZOE mixed at the lower P:L ratio of 10g:2g significantly decreased the values of SBS of the two adhesives. The use of two pulpotomy agents (FC and FS) significantly decreased the SBS of the two adhesives. The bond strength to dentin of primary teeth was influenced by the pulpotomy agents used and the ZOE P:L ratio but not by the adhesive system used.

Dental Bonding↗

Direct implant loading in the edentulous maxilla using a bone density-adapted surgical protocol and primary implant stability criteria for inclusion.

BACKGROUND: Long healing periods and submerged implant placement are commonly used in the maxilla. This extends the time of oral handicap and makes the use of immediate loading protocols an attractive option. The current clinical literature on direct loading of dental implants in the maxilla is limited. PURPOSE: The purpose of this prospective clinical study was to evaluate the clinical outcome and stability of directly loaded Brånemark System or Replace Select Tapered implants (Nobel Biocare AB, Göteborg, Sweden) after using a modified surgical protocol and inclusion by primary implant stability. In addition, a reference group treated according to a two-stage protocol was used for comparison. MATERIALS AND METHODS: Twenty patients planned for prosthetic rehabilitation with implant-supported bridges in the edentulous maxilla participated in the study group. The final decision on immediate loading was made after implant placement using insertion torque and resonance frequency analysis (RFA) as acceptance criteria. All patients were included, and 123 oxidized implants (TiUnite, Nobel Biocare AB) were placed using a surgical protocol for enhanced primary stability. A screw-retained temporary bridge was delivered within 12 hours and a final bridge within 3 months of implant placement. The patients were monitored through clinical and radiographic follow-up examinations from implant placement to at least 12 months. Marginal bone level was measured at bridge delivery and after 12 months of loading. Additional RFA measurements were made after 6 months of loading. A reference group comprising 20 patients with 120 implants treated according to a two-stage protocol was used for comparison. RESULTS: One (0.8%) of the 123 implants in the study group failed, and no implant was lost in the reference group. The cumulative survival rates after 12 months of loading were thus 99.2% and 100% for immediate and delayed loading protocols, respectively. The marginal bone resorption was 0.78 (SD 0.9) in the study group and 0.91 (SD 1.04) in the reference group. RFA showed a mean value of 62.9 (SD 4.9) implant stability quotient (ISQ) at placement and 64.5 (SD 4.8) ISQ after 6 months for immediately loaded implants (not significant). The corresponding figures for the reference groups were 61.3 (SD 8.8) ISQ and 62.6 (SD 7.0) ISQ (not significant). There were no statistically significant differences between the groups at any time point. CONCLUSION: The use of six to seven implants for immediate loading of a fixed provisional bridge is a viable option for implant treatment of the edentulous maxilla, at least when good primary implant stability can be ensured.

Aged↗

Effects of thermocycling and occlusal force on the margins of provisional acrylic resin crowns.

Transitional acrylic crowns were examined for changes in axial contour and increases in marginal gap width after simultaneous thermocycling and occlusal loading. Two groups of 10 crowns--one with a shoulder finish line and another with a chamfer finish line--were treated with 3400 thermocycles and 50,000 load cycles simultaneously within an artificial oral environment chamber in an MTS Dental Materials Testing System. The marginal gaps were increased for both groups after treatment. However, the group of crowns with the shoulder finish lines demonstrated a smaller gap width (x = 90 microns) after treatment than the crowns with chamfer finish lines (x = 210 microns). A statistical comparison identified a significant difference in gap width between groups (p < 0.01). Changes in the axial profile of the groups were similar, but one crown with a chamfer finish line exhibited a cracked margin.

Acrylic Resins↗