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PubMed1997

An evaluation of microbial coronal leakage in the restored pulp chamber of root-canal treated multirooted teeth.

This in vitro study investigated the effect of a resin-reinforced glass ionomer lining material on the coronal leakage of a mixed obligate microbial marker in maxillary molars obturated with lateral condensation of cold gutta-percha and Tubliseal sealer, after 2 years' storage. Forty maxillary first molars were prepared chemomechanically to a size 30-40 master apical file. The teeth were divided into an experimental group (30 teeth) and control group (10 teeth). In the experimental group, the floor of pulp chamber and the root-canal opening of 15 teeth were covered with Vitrebond as a lining; the remaining 15 teeth received no lining. These teeth were tested for leakage using a microbiological marker consisting of anaerobic streptococci and Fusobacterium nucleatum. The teeth were checked daily for bacterial leakage for 60 days. All positive control teeth leaked within 48 h, while the negative control teeth remained uncontaminated throughout the test period. The teeth restored with Vitrebond liner showed no leakage whilst 60% of the specimens with no Vitrebond liner showed leakage after 60 days.

Dental Cavity Lining↗
PubMed2000

Coronal microleakage.

The microbiological aetiology of periapical periodontitis of endodontic origin is generally accepted. Therefore, bacterial entry into the tooth both initially and secondarily to endodontic therapy is not desirable. Dental restorations and then root fillings in series are intended to prevent recurrent bacterial entry by blocking the access cavity and pulp canal system. This paper reviews whether this intent is realized practically, and what effect an incomplete seal might have on expressed recurrent disease. The aim is to communicate more recent research findings to a wider clinical audience.

Animals↗
PubMed1998

Effect of tubule orientation in the cavity wall on the seal of dental filling materials: an in vitro study.

Dentinal tubules are oriented perpendicularly to the root canal walls but parallel to the lateral walls of class I occlusal preparation. It was hypothesized that the contact surface area of the material may depend on the tubule orientation in the cavity wall to which the material is applied, and that the difference in contact surface may affect the seal provided by the filling material. Standard central lumens, 2.6 mm in diameter and 3 mm high, were machined in human crown or root specimens. After removal of the smear layer with a conditioner, the specimens in each experimental group, consisting of 20 crown and 20 root specimens, were filled with amalgam, Fuji II glass ionomer (with or without varnish), or gutta-percha with Ketac-Endo root canal sealer. A modified fluid transport model was used to test the leakage along the fillings. Selected specimens were then split longitudinally and observed in a scanning electron microscope. The micrographs showed that all the test materials were pressed into the dentinal tubules. The contact surface of the material was calculated to be at least 45% larger in root specimens than in crown specimens, depending on the depth of the tubular penetration of the test material. The leakage results showed that all the test materials leaked less in root specimens than in crown specimens (P = 0.0000 for amalgam, P = 0.0374 for Fuji II with varnish, P = 0.0088 for Fuji II without varnish, P = 0.002 for gutta-percha with sealer). It was concluded that the tubule orientation in the cavity wall may influence the seal provided by certain dental filling materials.

Dental Alloys↗
PubMed2001

Post-operative sensitivity in glass-ionomer versus adhesive resin-lined posterior composites.

PURPOSE: To compare objective and subjective assessments of post-operative sensitivity when class 1 cavities, lined with glass-ionomer or adhesive bonding system, were restored with resin-based composite (RBC). MATERIALS AND METHODS: Occlusal cavities on homologous contra-lateral posterior teeth in 44 male patients attending primary health centers in Riyadh, Saudi Arabia were restored with RBC after a cavity lining of either a light cured glass-ionomer cement (Vitrebond) or an adhesive bonding system (One-Step). RESULTS: Cold response measurements 24 hrs, 7 days and 1 month post-operatively showed that the threshold of pulpal response was significantly lower (P< 0.05) in the restored teeth when the adhesive bonding system served as cavity liner. In addition, based on the patients' subjective assessments, the prevalence of mild or severe post-operative sensitivity was significantly higher (P< 0.05), 24 hrs and 7 days post-operatively, in the teeth with the adhesive bonding system as a cavity liner. After a post-operative period of 1 month, however, there was no significant difference (P> 0.05) between the prevalence of post-operative sensitivity when the restored teeth received a lining of either glass-ionomer or adhesive bonding system.

Acid Etching, Dental↗
PubMedDate not supplied

Penetrability of dentinal tubules in adhesive-lined cavity walls.

This study investigated the penetrability of dentinal tubules in cavity walls lined with different dentin bonding systems. Occlusal Class I cavities were prepared in 93 premolars. The cavities in the control group had an intact smear layer without a lining, while those in the experimental group were lined with Gluma CPS, Scotchbond Multi-Purpose Plus or One-Step. The penetrability of the dentinal tubules was tested with a dye (basic fuchsin) or bacteria (S faecalis) immediately after adhesive lining and after one-month storage in water at 37 degrees C. Some of the lined samples were sectioned and examined under the SEM. In some samples in the experimental group, the dye penetrated to the pulp and bacteria up to 125 microm into the dentinal tubules immediately after lining. The Kruskal Wallis ANOVA and Tukey test showed the depth of dye and bacterial penetration to be significantly less in teeth with bonding systems than those in the control group (p<0.05). However, there was no statistically significant difference between the control and experimental groups after storage in water (p>0.05). SEM examination showed that the hybrid layer and resin tags were present in the cavity walls immediately after lining but absent after storage in water. Therefore, adhesive linings under the experimental conditions were ineffective in preventing dye or bacterial penetration of the dentinal tubules.

Analysis of Variance↗
PubMed2001

Restorative pulpal and repair responses.

BACKGROUND: Each year, about 90 million new restorations are placed in the United States and 200 million are replaced. Controversy surrounds the pulpal reactions and frequency of bacterial microleakage associated with common restorative materials. The authors investigated and compared pulpal reactions to different types of restorative materials. METHODS: Two hundred seventy-two teeth with standardized rectangular Class V unexposed cavities were restored with resin-based composite bonded to dentin; resin-based composite bonded to enamel; resin-modified glass ionomers, or RMGI; amalgam lined with zinc polycarboxylate, or ZnPC; amalgam lined with calcium hydroxide, or Ca(OH)2; or zinc oxide-eugenol, or ZnOE. Teeth were extracted for orthodontic reasons between 20 and 381 days later. The authors categorized pulpal responses according to standards set by the Federation Dentaire Internationale and the International Organization for Standardization. Bacteria were detected using Brown-Brenn-stained sections. Pulpal responses were evaluated using histomorphometric analysis and analysis of variance statistics. RESULTS: The results showed that RMGI was the best material for preventing bacterial microleakage, and resin-based composite bonded to enamel was the worst. In regard to minimizing pulpal inflammatory activity, ZnOE was the best material and resin-based composite bonded to enamel was the worst. In terms of maximizing odontoblast survival beneath deep cavity preparations, Ca(OH)2, was the best material and RMGI was the worst. CONCLUSIONS: The results show that bacterial microleakage, pulpal injury and repair responses varied widely with different restorative materials. CLINICAL IMPLICATIONS: The authors recommend that RMGI be used to restore teeth with cavities that are shallow to moderate in depth, with the floor of deep cavities being lined with Ca(OH)2 before the teeth are restored with RMGI.

Adolescent↗
PubMedDate not supplied

Review of bonded amalgam restorations, and assessment in a general practice over five years.

This study reviewed the literature on bonded amalgam restorations and assessed the failure, marginal fracture and marginal staining behavior of 366 Permite C amalgam restorations lined with five dentin bonding resins (Scotchbond 2, Panavia Ex, Amalgambond, Amalgambond Plus, Geristore) and a polyamide cavity varnish (Barrier). The restorations were placed in the posterior permanent teeth of 190 adult patients and examined at intervals over periods of up to five years. There were five restoration failures (1.4%), usually from tooth fracture, involving Class II preparations in molar teeth. No instances of persistent pulpal sensitivity or recurrent caries were reported. The marginal deterioration of the restorations was assessed indirectly using photographs for comparison with two standard sets of enlarged color transparencies. Most of the marginal fracture and marginal staining scores were low, with little difference between the six lining materials at any period.

Adult↗
PubMed1989

Rate of formation of tertiary dentin in dogs' teeth in response to lining materials.

The rate of tertiary dentin produced in response to four lining materials placed in standardized cavities in dogs' teeth was measured over a period of 119 days. Sterile denatured dentin ash was used as a control material in an attempt to quantify tertiary dentin formation in response to cavity preparation. In all periods the amounts of tertiary dentin formed beneath the control material were significantly smaller than those formed beneath any of the four lining materials. In the first 98 days the rate of formation of tertiary dentin beneath calcium hydroxide (Calxyl) was significantly greater than that beneath the material containing corticosteroid (Ledermix cement). In the last 21 days there was no difference in daily rates of tertiary dentin production beneath all of the lining materials. With all the lining materials there was a highly significant difference between the daily amounts of tertiary dentin formed in the first 6 weeks and those in the last 11 weeks.

Animals↗
PubMedDate not supplied

The effect of flowable resin composite on microleakage and internal voids in class II composite restorations.

This in vitro study evaluated the influence of two flowable resin composites on marginal microleakage and internal voids in Class II composite restorations with the margins below the cementoenamel junction (CEJ). Class II cavities randomly divided into four groups: Group I-Filtek with Filtek Flow lining; Group II-Filtek; Group III-Tetric Ceram with Tetric Flow lining; Group IV-Tetric Ceram. After thermocycling tests (5-60 x 1500) and dye soaking, the teeth were sectioned in a mesiodistal direction along their longitudinal axis. Gingival-marginal microleakage and internal voids in three separate portions of the restoration (interface, cervical and occlusal voids) were observed with a microscope. Statistical analyses indicated that the use of flowable resin composites (Groups I and III) provided a reduction in marginal microleakage and a reduction in some parts of the internal voids or total voids (p<0.05). The condensable material (Filtek) in combination with the flowable liner showed fewer voids (interface, occlusal, total) than the hybrid resin (Tetric) (p<0.05). There was a correlation between the number of internal voids or total voids and the marginal microleakage (p<0.05). It was concluded that a composite lining in a Class II resin composite with margins below the cementoenamel junction may reduce marginal microleakage and voids in the interface and the total number of voids in the restoration.

Bisphenol A-Glycidyl Methacrylate↗
PubMed2001

Effects of flowable composite lining and operator experience on microleakage and internal voids in class II composite restorations.

STATEMENT OF PROBLEM: When inexperienced clinicians perform class II composite restorations, improper placement techniques can lead to problems, including marginal adaptation and void formation. PURPOSE: The aim of this study was to determine the influence of flowable composite linings on marginal microleakage and internal voids in class II composite restorations performed by practitioners with different levels of experience. MATERIAL AND METHODS: Eighty extracted molars were prepared with mesial and distal class II cavity preparations and divided into 4 groups. Each group was restored separately with the following materials: Prodigy/Revolution lining (group I), Prodigy (group II), Tetric Ceram/Tetric Flow lining (group III), and Tetric Ceram (group IV). Each group was equally divided and restored by 2 practitioners, one experienced and another untrained in composite restorations. After restoration, all teeth were stored for 24 hours, thermocycled (at 5 degrees C to 60 degrees C) 1500 times, and soaked in 2% basic Fuchsin dye for 24 hours. After soaking, the teeth were sectioned, and gingival marginal microleakage and internal voids (at the gingival wall interface and in the cervical and the occlusal parts) were recorded. Data were analyzed with the Kruskal-Wallis test. RESULTS: There was no significant reduction in microleakage for either practitioner. There were fewer interface voids within pairs with or without flowable composite linings made by the experienced practitioner (P<.05). CONCLUSION: When flowable composite lining was placed at the gingival floor of a class II composite restoration by an experienced practitioner, voids in the restored interface were reduced. Gingival marginal sealing was not improved by the same technique.

Composite Resins↗
PubMedDate not supplied

Class I composite resin restoration.

Composite resin materials and methods for their use have improved to the extent that long lasting Class I carious lesions on stress-bearing surfaces can be restored with predictable results. This article demonstrates a step-by-step clinical technique for placement of a Class I composite resin restoration lined with a light-hardened glass-ionomer dentin replacement foundation. Emphasis is placed on tooth isolation, thoughtful handling of the respective materials, and the importance of final sealing of the resin/enamel margins.

Composite Resins↗
PubMed2001

Effect of cavity varnish, amalgam liner or dentin bonding agents on the marginal leakage of amalgam restorations.

The purpose of this in vitro study was to compare marginal leakage of Class II amalgam restorations lined with different agents (two new generation dentin bonding systems, a cavity varnish and an amalgam liner). Forty freshly extracted human molar teeth were divided into five groups. Class II preparations were prepared in the mesial and distal surfaces of each molar. While the cavities in two groups were lined with two new generation bonding systems, the other two groups were treated with an amalgam lining material and a cavity varnish. Fifth group was used as control, without any lining. Amalgam* was hand-condensed into each preparation. Specimens were thermocycled, stained and sectioned. Microleakage was graded using a stereomicroscope. Mean microleakage scores for occlusal and cervical margins were calculated and analysed. For the leakage values on occlusal margins, Kruskal-Wallis test indicated no significant difference in all groups. For the leakage values on cervical margins, Kruskal-Wallis test indicated significant difference in four groups when compared with controls (P < 0.001). On the other hand, there was no significant difference between the occlusal and cervical leakage values in each group.

Calcium Fluoride↗
PubMed1993

11-year assessment of Class-III resin restorations completed with two restorative procedures.

This randomized clinical trial was initiated to study the effect of two restorative procedures on the clinical quality and longevity of class-III resin restorations. The material consisted of 52 pairs of class-III restorations in the microfilled resin Silar completed with two modifications of the conventional acid-etch restorative procedure: A) beveling of the margins of the cavity preparations, and B) treatment of the etched butt-joint cavities before filling with the dentin-adhesive NPG-GMA/ethanol together with re-etching and surface coating of the finished restorations with low viscous resin. The restorations were examined at base line and after 2, 4, 6, and 11 years. The cumulative 11-year survival rate for both types of restorations was 84%. Marginal discolorations, marginal discrepancies, and secondary caries were most often recorded corresponding to the beveled type-A restorations, whereas the esthetic quality of the two types of restorations was almost identical. Surface discolorations were most often recorded among smokers, and significant correlations were found between the patients' consumption of alcoholic beverages and corpus discoloration, surface discoloration, and surface wear of restorations.

Acid Etching, Dental↗
PubMed1992

Microleakage of indirect inlays placed on different kinds of glass ionomer cement linings.

The objective of this study is to compare the marginal seal of Class II cavities restored with indirect inlays constructed on glass ionomer cement linings having different curing properties. Also the effect of acid-etching of these liners on microleakage was investigated. Mesio-occlusal and disto-occlusal cavities in 80 extracted human molars having the cervical floor below the cementoenamel junction were prepared (n:160). Half of the preparations were restored with Ceramco II porcelain and the rest with SR-Isosit resin inlay material. Liners as light curing Ionoseal light+chemically curing LCL 8 and Zionomer and chemically curing Ketac-Bond glass ionomer cements (GICs) were used. On mesial preparations GICs were acid-etched but were not on distal preparations. All inlays were cemented with Ultrabond composite material. After thermocycling the teeth were placed in a basic fuchsin dye solution for 24 h, then each tooth was sectioned. By using a stereomicroscope the extent of marginal leakage was scored and statistically evaluated. Microleakage was observed beneath all GIC linings and was more extensive between light curing GIC/dentine interface. By acid-etching of GICs the microleakage between GIC/dentine interface was increased significantly. Whether acid-etching was applied or not a significantly increased microleakage was recorded between chemically curing GIC/composite interfaces. Although the marginal microleakage was witnessed in both inlays, it appeared that porcelain inlays provided a better marginal seal, in comparison to SR-Isosit inlays.

Acid Etching, Dental↗