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At least 433 records · Page 24Linked to original sources
PubMed1997

Mapping of tubule and intertubule surface areas available for bonding in Class V and Class II preparations.

OBJECTIVES AND METHODS: The aim of this in vitro study was to evaluate the morphology of dentine in Class V and the Class II preparation walls in terms of tubule orientation, density and increase in surface area after conditioning. Six circular V-shaped preparations were cut at the cementum-enamel junction (CEJ) of anterior teeth and six Class II cavities with the cervical margin 1 mm below the CEJ were prepared in posterior teeth. The preparations were conditioned with 10% maleic acid. The samples were directly studied by SEM. The observations were organized according to location in the preparation, tubule density was counted and the increase in area available for bonding after acid etching was calculated. RESULTS: Dentine morphology of Class V and Class II preparation walls was mostly regular according to predictable patterns. Between the tubules, along the walls of the cavity, the etched dentine surface exhibited a porous network of collagen fibers. More than 50% of Class V and Class II cavity surface presented oblique or parallel tubule orientation with respect to the cut surface. Because of the presence of a structureless cementum layer. the morphology of the cervical area turned out to be less predictable. The tubule density varied considerably in different regions of the preparations. The intertubular dentine surface area increased after conditioning in Class V preparations from 20.9% to 50.3% on the walls where tubules were cut parallel to their long axis, and from 5.8% to 47.8% where tubules were cut perpendicularly. These same values for Class II preparations ranged from 0.6% to 46.4% on the walls where tubules were cut parallel to their long axis, and 29.8% of the tubules were cut perpendicularly. CONCLUSIONS: Based on this morphological investigation, the increase in intertubular dentine surface area might very well be responsible for the enhanced bond strength after acid etching of dentine, but not all areas exhibited equal responses to etching. In particular, the bonding substrate at the gingival margins may contribute little in terms of micromechanical retention.

Acid Etching, Dental↗
PubMed1998

Marginal integrity and postoperative sensitivity in Class 2 resin composite restorations in vivo.

INTRODUCTION: Problems that may arise in resin composite Class 2 restorations include microleakage and postoperative sensitivity. However, limited in-vivo research is conducted to evaluate these processes. AIM: The aim of this study was to assess postoperative sensitivity, microleakage and the pooling of adhesives in relation to Class 2 box-type composite restorations placed in vivo using various adhesive systems and application techniques. MATERIALS AND METHODS: One hundred and forty-four Class 2 box restorations were placed in the mesial and distal surfaces of 72 premolar teeth in-vivo using one of three combinations of adhesive systems and three filling techniques. After 6 weeks of clinical service postoperative sensitivity was recorded. The teeth were then extracted, immersed in a dye solution and sectioned. Microleakage and pooling of the adhesive was recorded. Statistical analysis involved logistic regression and chi2 tests to identify differences between groups at p < 0.05. RESULTS: Of the 144 restorations, 65 showed minimal cervical leakage in enamel, 5 suffered leakage into dentin and 74 were free of microleakage. No statistically significant differences were found in cervical microleakage between the adhesive systems or between filling procedures. Occlusal microleakage in the enamel was present in 16 of the 160 restorations. Liner Bond 2 restorations leaked significantly more at the occlusal surface (p < 0.05). Pooling of the adhesive was significantly less when PhotoBond was used. No spontaneous postoperative sensitivity was reported. Twenty-eight restorations were sensitive to loading. Postoperative sensitivity was significantly less in patients with Liner Bond 2 restorations. CONCLUSIONS: The adhesive systems used in this study showed minimal leakage into dentin in vivo. Using Liner Bond 2, restorations exhibited more occlusal leakage but were significantly less sensitive to loading.

Adhesives↗
PubMed1999

Marginal adaptation of direct composite and sandwich restorations in Class II cavities with cervical margins in dentine.

OBJECTIVES: The aim of this study was to evaluate the marginal adaptation of direct Class II sandwich restorations with resin-modified glass-ionomer cements and compomers in comparison to base and total bond restorations. For sandwich restorations with a triple cure resin-modified glass-ionomer cement the influence of different light curing techniques was also evaluated. METHODS: Large butt-joint class II cavities with cervical margins 1 mm below the cemento-enamel junction were cut into 120 extracted human molars. The cavities (15 groups, n = 8) were filled using a sandwich, base or total bond technique with materials from five different manufacturers. A three-sited light curing technique was used in 13 groups. For the material combination Vitremer/Z100 two additional groups with a different wand positioning and a metal matrix were evaluated. After water storage for 21 days and thermocycling (2000x, 5-55 degrees C), replicas were quantitatively analysed in the SEM. Statistical analysis was performed with the Kruskal-Wallis test and the Bonferroni test at p < 0.05. RESULTS: The marginal adaptation of vertical enamel margins was not dependent on the restorative technique. For margins in dentine, marginal adaptation was significantly better with the sandwich technique than with a base or total bond technique for all materials. There were no significant differences between the base and total bond technique. Overall, resin-modified glass-ionomer cements showed somewhat better results than compomers in sandwich restorations, though differences were not significant for some criteria. Vitremer/Z100 sandwich restorations applied with a metal matrix showed the highest mean percentage of excellent margins of all experimental groups. CONCLUSIONS: Both resin-modified glass-ionomer cements and compomers can improve the marginal quality when used in a sandwich technique. Further research is necessary to determine the ideal material combination for sandwich restorations.

Compomers↗
PubMed2000

Effect of finishing technique on the microleakage and surface texture of resin-modified glass ionomer restorative materials.

PURPOSE: The purpose of this study was to evaluate the effects of wet and dry finishing/polishing procedures on the microleakage and surface texture of resin-modified glass ionomer (RMGI) restorative materials. MATERIALS AND METHODS: Class V cavity preparations were made at the cemento-enamel junction (CEJ) on the buccal and lingual surface of 30 extracted human molars. The teeth were restored in three groups of 10 (20 preparations in each group) using Fuji II LC and Vitremer, both RMGIs, and Fuji II, a capsulated conventional glass ionomer cement (control). One restoration per tooth was finished/polished with copious applications of water and the other was finished/polished without water. All restorations were finished/polished using a sequence of four abrasive disks. Finishing/polishing was initiated according to manufacturers' instructions-immediately after light-curing Fuji II LC and Vitremer, and 15min after placement for Fuji II. The specimens were thermocycled and subjected to a silver nitrate leakage test. Each tooth was sectioned buccolingually and examined with an optical microscope at 40x to determine the extent of microleakage at enamel and dentin margins. The data were subjected to a non-parametric statistical analysis. To evaluate surface roughness after polishing, three disks each of Vitremer and Fuji II LC were fabricated in Teflon molds. One disk of each material was not finished/polished (control). The others were finished/polished using Sof-Lex abrasive disks. One specimen of each material was kept wet during all finishing/polishing procedures, while the other was kept dry. Atomic force microscopy was used to determine the average roughness (R(a)) of the specimens. RESULTS: For each material, microleakage at the enamel margin was very slight. Leakage of the conventional glass ionomer Fuji II was severe at dentin margins. Statistical analysis indicated that both Vitremer and Fuji II LC had significantly less leakage than Fuji II, and that Vitremer had significantly less leakage than Fuji II LC (p<0.05). Leakage at enamel margins was significantly less than at dentin margins. Differences related to wet and dry polishing were not statistically significant. Profilometry data indicated that polished specimens were rougher than those cured against a Mylar strip. Wet polishing created greater surface roughness than dry polishing. CONCLUSIONS: RMGIs rather than conventional glass ionomers should be used in Class V cavity sites to allow immediate finishing and to reduce the incidence of microleakage. Dry finishing of RMGIs with abrasive disks is recommended because it produces a smoother surface and does not contribute to microleakage. However, wet finishing of conventional glass ionomers is still recommended to avoid desiccation.

Composite Resins↗
PubMed2000

Enamel pearls and cervical enamel projections on 2 maxillary molars with localized periodontal disease: case report and histologic study.

Presented here is an unusual case of teeth with aberrant enamel. One small and 3 large enamel pearls were identified in 2 maxillary third molars of a patient. One long enamel projection was connected to one of the large enamel pearls, along with 2 short cervical enamel projections. The ectopic enamel was associated with advanced localized periodontal destruction. After extraction, the molars were investigated radiographically and under the scanning electron microscope. The 3 large pearls contained distinct dentinal cones. The enamel of the pearls and the long cervical projection exhibited most of the structural attributes of crown enamel but were somewhat irregular, with variable shape and course of the prisms. Morphologic considerations suggest that these enamel pearls were aberrations and should not be regarded as attempts at new cusp or new tooth formation.

Dental Enamel↗
PubMed1998

Periodontitis detection efficacy of film and digital images.

OBJECTIVE: The objective of this study was to evaluate the accuracy of alveolar crestal bone detection in a comparison of unenhanced and enhanced Sidexis (Siemens Medical Systems, Inc., Bensheim, Germany) digital images with Ektaspeed Plus (Eastman Kodak, Rochester, N.Y.) films by means of receiver operating characteristic analysis. STUDY DESIGN: More than 100 proximal and furcal areas in the anterior and posterior areas of the mandible and maxilla of each of three tissue-equivalent human skull phantoms were imaged with film, direct digital images, and contrast- and brightness-enhanced digital images. Alveolar crest status was assessed by a consensus panel of three experts who used the Delphi method and evaluated information from all of the imaging modalities concurrently. Five observers assessed all images for the presence or absence of crestal bone loss using a five-point confidence scale. Receiver operating characteristic curves were generated, and calculated areas (Az) were analyzed by means of analysis of variance. RESULTS: The expert panel determined that of 106 crestal areas, 48 were disease free and 58 exhibited bone loss greater than 2 mm apical to the cemento-enamel junction. Analysis of variance of observer Az scores showed significant differences among readers (p < 0.001) and among readings (p = 0.027), but not among modalities (p = 0.435). Mean Az values for the different modalities were as follows: Sidexis, 0.70; enhanced Sidexis, 0.71; Ektaspeed Plus films, 0.735. CONCLUSION: The Sidexis digital imaging system was not significantly different from Ektaspeed Plus film for crestal bone evaluation in this in vitro study.

Alveolar Bone Loss↗
PubMed2003

Biomechanical stress in bone surrounding an implant under simulated chewing.

The concept of reducing nonaxial loading of dental implants has been widely regarded as the standard procedure. The aim of this study was to reveal the biomechanical stress distribution in supporting bone around an implant and a natural tooth under chewing function. Three-dimensional finite element models of the mandibular first molar and the titanium implant both with the mandible in the molar region were constructed. The directions of displacement constraints were determined according to the angles of the closing pathways of chopping type and grinding type chewing patterns. The tooth model showed smooth stress distribution in the supporting bone with low stress concentration around the neck of the tooth. The implant model showed stress concentration in the supporting bone around the neck of the implant, especially in the buccal area. The grinding type model of the implant showed higher tensile stress concentration than the chopping type model at the lingual neck of the implant. The results of this study suggested the importance of considering occlusion under chewing function for understanding the biomechanics of oral implants.

Adult↗
PubMed1999

Digital radiography of interproximal bone loss; validity of different filters.

The aim of the present study was to compare linear measurements of interproximal bone loss on digitized radiographic images after application of different filters to the gold standard of intrasurgical measurements. Immediately before surgery, 50 radiographs of 50 periodontally-diseased teeth exhibiting interproximal bone loss, were obtained by a standardized technique in 33 patients. Intrasurgically, the distances from the cementoenamel junction (CEJ) to the alveolar crest (AC) and from the CEJ to the deepest extension of the bony defect (BD) were assessed. All radiographs were digitized with a flatbed scanner (resolution: 600x1200 dpi). Using the FRIACOM-soft-ware, the linear distances CEJ to AC and CEJ to BD were measured at 50 interproximal lesions from the digitized but unchanged radiographic images and also after use of 7 different basic image-processing modes (enhancement of contrast [dynamics], inversion, high-pass, enhancement of gray-level differences, mean value, histogram correction, spreading of grey values) with 11-fold magnification. Neither the measurement of the distance CEJ to AC on the unchanged images nor assessments with any of the filters revealed significant differences from the gold standard. Multivariate analysis of variance showed the respective filter (p=0.009), intrasurgical and radiographic assessments (p<0.0001), to statistically significantly, influence the difference between intrasurgical and radiographic measurements of the distance CEJ to BD. The underestimation of the intra-surgically assessed distance CEJ to BD by radiographic measurements ranged from 0.3+/-2.0 to 0.8+/-1.9 mm. The filter "mean value" underestimated interproximal bone loss statistically significantly more than the digitized but unchanged radiograph (p=0.05). In this study, basic digital manipulations (filters) of radiographic images failed to result in statistically significantly more valid measurements of interproximal bone loss when compared to the unchanged but digitized images. All radiographic assessments on the digitized images except for use of one filter (mean value) came close to the intrasurgical gold standard.

Adult↗
PubMed1999

Measurement of clinical attachment levels using a constant-force periodontal probe modified to detect the cemento-enamel junction.

The handpiece of a Florida sleeve probe was modified to create a flange with the capability to detect the cemento-enamel junction (CEJ). This new instrument (the Pressure-controlled, Automated, Standardised Handpiece or Florida PASHA probe) was used to determine whether (a) the CEJ could be reproducibly detected in dried, human skulls and (b) clinical attachment levels could be reliably measured in human subjects. When using the Florida PASHA probe to detect the CEJ at 157 different sites in four dried, human skulls, there were no statistically significant (p > or = 0.15) differences in mean CEJ detection measurements for any of the three participating examiners; either when the CEJ was visualised or obscured. The mean differences between first and second replicates ranged from 0.00 to 0.08 mm. Intraclass correlation coefficients (ICCs) of repeated measures in both conditions ranged from 0.70 to 0.83 for tactile CEJ detection (CEJ obscured), and from 0.95 to 0.96 for visual detection (CEJ visible). In human studies, the Florida PASHA probe was used by two examiners to determine clinical attachment levels (CAL) at 660 sites in 5 human subjects undergoing supportive periodontal therapy. Intra-examiner agreement of replicate measurements recorded by the probe, as measured by calculating ICCs, ranged from 0.79 to 0.85 for the 2 examiners, respectively. A statistically significant inter-examiner difference in mean CAL measurements when using the Florida PASHA probe was found (p<0.001). Notwithstanding this difference, inter-examiner agreement was good, with an ICC of 0.83. These data suggest that the Florida PASHA probe can reproducibly detect the CEJ and is proposed as a tool for measuring CAL in humans.

Alveolar Bone Loss↗
PubMed2000

Comparisons of clinical and radiographic measurements of inter-proximal vertical defects before and 1 year after surgical treatments.

BACKGROUND: Radiographic measurements are often used as a substitute for direct clinical measurements requiring re-entry surgery for follow-up outcome studies. AIMS: (1) To assess the reliability of clinical and radiographic measurements of periodontal defects as compared to direct bone measurements during surgical procedures, and (2) to assess the associations between selected clinical and radiographic measurements of periodontal inter-proximal defects. METHODS: 57 inter-proximal periodontal defects were measured at baseline and at 12 months after surgical treatment. Direct measurements during surgery of the distance between the CEJ to the bottom of defects (ABL) were compared with probing to bone (PB), probing attachment level (PAL), and radiographic measurements. RESULTS: Probing to bone is an accurate measure to assess inter-proximal bone level as compared to ABL (mean difference: 0.1 mm) and that intra-oral standardized radiographs underestimate bone level and defect depth by approximately 1.4 mm. The interpretation of periodontal changes between baseline and 12 months after treatment by probing to bone, or PAL measurements, or from radiographic images yield almost identical results (mean difference< or =0.2 mm). For the assessments of changes over time using PB change as the standard, intra-class correlation (ICC) coefficients varied between 0.52 to 0.90. The best ICC coefficient was found for relative attachment level change assessed by the Florida probe (0.90), and with an ICC value of 0.61 for changes assessed from intra-oral radiographs. Two-way analysis of variance failed to demonstrate differences between sets of comparisons. CONCLUSIONS: Both radiographic interpretations of changes over time, and measurements of attachment level changes are reliable in assessing the treatment outcome of inter-proximal intra-bony defects when compared to probing to bone changes as the standard method.

Absorbable Implants↗
PubMed2002

Clinical evaluation of cervical dentin sensitivity (CDS) in patients attending general dental clinics (GDC) and periodontal specialty clinics (PSC).

AIM: The objective of this study was to compare the prevalence, severity and distribution of CDS in patients attending general dental clinics (GDC) and periodontal specialty clinics (PSC) and to correlate them to possible causal factors. MATERIAL AND METHODS: 2 groups of patients aged 20-60 years recruited from GDC (144) and PSC (151) were evaluated for CDS by means of a questionnaire and intraoral clinical examinations. Furthermore, gingival recession and plaque scores were recorded at the same visit. RESULTS: The results showed that patients referred to PSC had a significantly higher prevalence of CDS (60.3%) than those examined at GDC (42.4%) (p<0.001). Also, mean plaque scores of PSC patients (1.87 +/- 0.88) was found to be significantly higher than that of GDC (1.44 +/- 0.7) (p<0.01). The occurrence and extent of gingival recession associated with hypersensitive teeth was significantly higher in PSC than GDC patients (p<0.01), with a 5% incidence of severe recession (5 mm) in PSC only. The association of periodontal disease and periodontal treatment to the high prevalence of CDS and gingival recession in PSC patients would suggest their role in predisposition to hypersensitivity. The distribution of CDS in tooth types revealed that upper molars and lower anteriors of PSC patients were mainly affected, and followed by, to a lesser extent, lower right canine and right first molars of GDC patients. CONCLUSION: The prevalence of CDS among our periodontal patients appears somewhat lower than that reported in periodontal specialty clinics of earlier studies but still higher than those reported in other dental populations. This indicates that periodontal disease and its treatments may increase the occurrence of hypersensitivity.

Adult↗
PubMed2002

Cervical external root resorption in vital teeth.

External resorptions associated with inflammation in marginal tissues present a difficult clinical situation. Many times, lesions are misdiagnosed and confused with caries and internal resorptions. As a result inappropriate treatment is often initiated. This paper provides three-dimensional representations of cervical external resorption, based on X-ray microfocus-tomographical scanning of a case, which will aid the dental practitioner in recognizing characteristic features during clinical inspection. In addition, histopathological examination reveals the cellular morphology of the adjacent tissues.

Adult↗
PubMed2000

Impact of treatment provision on the epidemiological recording of root caries.

The estimation of root caries prevalence and the identification of risk factors for decay depend upon the successful identification of carious lesions in epidemiological studies. Root surface restorations can either be placed to manage decay or cervical wear/sensitivity. The handling of data for restorations during epidemiological surveys is critical to the accurate assessment of caries prevalence. The objective of this study was to determine the relative frequency of dentists' placing root surface restorations according to their reason for placement. Data for 696 restorations were recorded from 35 dentists. Forty-five % of restorations were placed because of decay compared with 55% for cervical wear/sensitivity. There were no significant differences in proportion of placement of restoration with age of the patient or between regular and irregular attenders of different ages. Using these data a correction factor was developed for inclusion in the Root Caries Index (RCI) to make allowance for the proportion of restorations placed because of wear/sensitivity. When this correction factor was introduced into an existing data-set for root caries, the RCI was reduced for all groups. This reduction was greatest in regular attenders. When these data were analysed without making allowance for treatment effects, there was a significant difference in RCI between regular and irregular attenders. When the correction factor was applied to these data, this difference was eliminated.

Adult↗
PubMed2000

Effects of hypothalamic-pituitary-adrenal axis reactivity on periodontal tissue destruction in rats.

The aim of this study was to test the hypothesis of an association between hypothalamic-pituitary-adrenal (HPA) axis reactivity and progression of periodontal disease. Histocompatible Lewis and Fischer 344 rats respond to stressful stimuli with low and high HPA axis reactivity, respectively. Experimental periodontitis was induced by tying a silk ligature around the neck of maxillary 2nd right molar teeth in 10 Lewis and 10 Fischer 344 rats with contralateral non-manipulated teeth as controls. Twenty non-manipulated animals were included. Also, experimental periodontitis was induced in 10 adrenalectomized Wistar rats and in 10 sham-operated rats. Furthermore, corticosterone pellets were subcutaneously implanted in 9 Lewis rats, while placebo pellets were implanted in 8 animals. Disease progression was evaluated histometrically and radiographically. The low-responding Lewis rats developed significantly less periodontal breakdown than did the high-responding Fischer 344 rats. Administration of corticosterone increased the disease development. while adrenalectomy reduced the disease severity. Our findings demonstrate the importance of genetic factors in the development of periodontal disease, and suggest that HPA axis hyper-activation is one mechanism by which periodontal disease susceptibility may be increased.

Adrenal Cortex Hormones↗
PubMed2002

Immunohistochemical study on pulpal response in rat molars after cavity preparation by Er:YAG laser.

While Er:YAG laser systems are in extensive use for caries removal and cavity preparation, the effects of such treatment on pulp tissue remain unclear. This study evaluates these systems using immunohistochemical methods and compares the results with information gained from treatment using conventional burs. Cervical cavities were prepared in the upper first molars of rats, using either an Er:YAG laser or a conventional tungsten-carbide bur. At intervals of 5 min, 6 h, 12 h, 1 d, 3 d and 7 d after cavity preparation, the teeth were processed for immunohistochemical analyses of tissue non-specific alkaline phosphatase, OX6-positive major histocompatibility complex class II antigen-expressing cells and PGP 9.5-immunoreactive nerve fibers. DNA fragmentation was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method. Tissue non-specific alkaline phosphatase was observed mainly in the subodontoblastic layer under the cavity lesion, from 5 min, in both groups. The immunoreactivity was more pronounced in the laser group, but by 7 d no significant differences were recognizable. At 12 h, TUNEL-positive cells were detected around the odontoblastic layer in both groups. From 3 d to 7 d, a limited number of positive cells were still visible in the group that underwent standard treatment. Clear similarities in the distribution patterns of OX6-immunopositive cells and PGP 9.5-immunoreactive nerve fibers were also noted. From 12 h to 1 d, OX6-positive cells accumulated along the pulp-dentin border, extending their processes into the dentinal tubules. Numerous bead-like PGP 9.5-immunoreactive nerve fibers were observed under the odontoblastic layer at 7 d. These results demonstrated that there was no appreciable difference in the manner in which pulp tissue responded to treatment with either Er:YAG laser or a conventional drill. This would seem to indicate the usefulness of the Er:YAG laser system in the removal of caries and cavity preparation.

Alkaline Phosphatase↗
PubMed2003

Abfraction lesion formation in maxillary incisors, canines and premolars: a finite element study.

Abfraction lesions are angular, wedge-shaped defects found at the cervical region of teeth and are caused by mechanical overloading initiated by cuspal flexure. Clinically, these lesions are more prevalent on the labial aspect of maxillary incisors. The aim of this study was to provide a biomechanical explanation for this clinical variation. Two-dimensional plane strain finite element models of an maxillary incisor, canine and first premolar were developed and the cervical stress profiles were examined along a horizontal plane 1.1 mm above the amelo-cemental junction. The local X (horizontal) stress on the labial/buccal side was 176.4 MPa for the incisor, 57.8 MPa for the premolar, and 3.4 MPa for the canine. Similarly, the maximum labial/buccal principal stress was 181.4 MPa for the incisor, 25.2 MPa for the premolar, and 66.8 MPa for the canine. The labial/buccal stress profile in the cervical region of an maxillary incisor was always greater than that found in an maxillary canine or premolar tooth. These findings provide a biomechanical explanation for the clinical variation seen in the prevalence of cervical abfraction lesions.

Bicuspid↗
PubMed2002

Effects of hippocampal lesioning on experimental periodontitis in Wistar rats.

The hippocampus, which is a brain structure involved in learning and memory processes, plays a key role in the feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic sympathetic nervous system, and the subsequent secretion of immuno-modulatory hormones in response to pathogenic microorganisms. Dysregulation of these brain-neuroendocrine-immune regulatory networks, which act in concert to maintain homeostasis, is found to be of critical importance to the host defence against pathogens, as well as susceptibility to diseases, including periodontal disease. The present study was designed to determine the effects of hippocampal lesioning on the progression of periodontitis. Experimental ligature-induced periodontitis was induced in 16 Wistar rats, which were bilaterally lesioned in their hippocampal region with an aspiration technique that is well documented to impair learning and memory, as well as in 15 sham-operated control rats. The disease progression was evaluated radiographically and histometrically. The results revealed that the hippocampal lesioned rats developed significantly more destruction of the periodontium than did the sham-operated controls. This finding supports recent studies that indicate that inappropriate brain-neuroendocrine regulation of inflammatory responses to infectious agents may play an important role in disease susceptibility and progression.

Alveolar Bone Loss↗