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PubMed2006

Shade selection performed by novice dental professionals and colorimeter.

The objective of this study was to test inter-observer variability in shade selection for porcelain restorations, using three different shade guides: Vita Lumin Vacuum, Vita 3D-Master and Procera. Nineteen young dental professionals acted as observers. The results were also compared with those of a digital colorimeter (Shade Eye Ex; Shofu, Japan). Regarding repeatability, no significant differences were found between the three shade guides, although repeatability was relatively low (33-43%). Agreement with the colorimetric results was also low (8-34%). In conclusion, shade selection shows moderate to great inter-observer variation. In teaching and standardizing the shade selection procedure, a digital colorimeter may be a useful educational tool.

Adult↗
PubMed2006

Stress distribution in a post-restored tooth using the three-dimensional finite element method.

Clinicians are opting ever more frequently for restorative materials which have an elastic modulus similar to that of dentin when reconstructing endodontically treated teeth. Metallic posts, which are capable of causing dangerous and non-homogenous stresses in root dentin, are slowly being abandoned. Ideal posts may be those made of various types of fibre (carbon, mineral and glass) and which are adhesively luted into the canal. Among the different methods for evaluating the mechanical behaviour of posts in root canals (progressive loads and photo-elastic technique) the finite element method (FEM) presents many advantages. The aim of this paper is to evaluate, utilizing three-dimensional analysis of the finite elements, what the effect of material rigidity, depth of insertion and post diameter could be on the stress distribution in the different components of the single tooth-post-core reconstruction unit. The results of the FEM analyses, expressed as the distribution of Von Mises stress values, has allowed us to conclude that (i) fibreglass-reinforced composite distributes stress better than titanium alloy or stainless steel; (ii) fibreglass-reinforced composite posts should be inserted as deeply as possible (but maintaining 5-6 mm of gutta-percha apical seal); (iii) fibreglass-reinforced composite post diameter does not affect stress distribution, therefore, as much radicular dentin as possible should be preserved.

Compressive Strength↗
PubMed2005

Shear bond strengths of two composite core materials after using all-in-one and single-bottle dentin adhesives.

PURPOSE: The purpose of this study was to compare the shear bond strengths of 2 composite core materials after using all-in-one and single-bottle dentin bonding materials. MATERIAL AND METHODS: The occlusal surfaces of 100 extracted, intact human third molars were ground to expose a flattened area of dentin and polished with 600-grit silicon carbide paper. Specimens were divided into 5 main groups (n= 20). Three all-in-one (AQ Bond, One-Up Bond, Xeno-CF Bond) and 2 single-bottle adhesives (Single Bond, One-Step Plus) were used. Each group was further divided into 2 subgroups. Ti-Core and Built-it F.R. core materials were applied using a translucent plastic ring (diameter: 3 mm, height: 5 mm). After storage in 37 degrees C water for 24 hours, shear bond strengths were measured using a Universal testing machine with a crosshead speed of 0.5 mm/min. Debonded dentin surfaces were examined with SEM. Two-way analysis of variance (ANOVA) and multiple comparison (Tukey) tests were used for statistical analysis of data. RESULTS: Two-way ANOVA revealed that the type of core material did not significantly influence the shear bond strength (p > 0.05), whereas there were significant differences in shear bond strength among the types of bonding agents (p < 0.0001). Shear bond strengths for single-bottle adhesive systems were significantly higher than those for all-in-one adhesive systems (p < 0.05). Furthermore, the interaction of these 2 parameters was not significant (p > 0.05). The fracture modes were predominantly adhesive for all-in-one adhesives and cohesive for single-bottle adhesives. CONCLUSION: Bonding of composite core materials with the newly developed all-in-one dentin adhesives produced lower shear bond strengths as compared with single-bottle adhesives.

Analysis of Variance↗
PubMedDate not supplied

Preloads generated with repeated tightening in three types of screws used in dental implant assemblies.

PURPOSE: Abutment screw loosening, especially in the case of cemented single tooth restorations, is a cause of implant restoration failure. This study compared three screws (titanium alloy, gold alloy, and gold-coated) with similar geometry by recording the preload induced when torques of 10, 20, and 35 Ncm were used for fixation. MATERIALS AND METHODS: Two abutment types were used-prefabricated preparable abutments and cast-on abutments. A custom-designed rig was used to measure preload in the abutment-screw-implant assembly with a strain gauge. Ten screws of each type were sequentially tightened to 10, 20, and 35 Ncm on ten of the two abutment types. The same screws were then loosened and re-tightened. This procedure was repeated. Thus, each screw was tightened on three occasions to the three insertion torques. A linear regression model was used to analyze the effects on preload values of screw type and abutment type for each of the three insertion torques. RESULTS: The results indicated that the gold-coated screw generated the highest preloads for all insertion torques and for each tightening episode. Further analysis focused on the effects of screw type and abutment type for each episode of tightening and for each fixation torque. The gold-coated screw, fixed to the prefabricated abutment, displayed higher preloads for the first tightening at 10, 20, and 35 Ncm. Conversely, the same screw fixed to the cast-on abutment showed higher values for the second and third tightening for all fixation torques. All screws showed decay in preload with the number of times tightened. Given the higher preloads generated using the gold-coated screw with both abutment types, it is more likely that this type of screw will maintain a secure joint when tightened for the second and third time. CONCLUSION: All screw types displayed some decay in preload with repeated tightening, irrespective of abutment type and insertion torque. The gold-coated screw showed markedly higher preloads for all insertion torques and for all instances of tightening when compared with the uncoated screws.

Analysis of Variance↗
PubMed1979

Amalgam restorations, plaque removal and periodontal health.

A total of 156 approximal subgingival amalgam overhanging margins were assessed in the buccal segments of 13 patients for plaque accumulation, gingival inflammation, pocket depth and gingival shrinkage. Recordings were made immediately before and 2, 4 and 8 weeks following scaling, removal of overhangs, and oral hygiene instruction. Surfaces with overhangs were compared with control surfaces, which were either intact or contained supragingival amalgams. Initially it was found that gingival inflammation and pocket depth were more extensive adjacent to subgingival amalgam overhangs than to sound teeth or those with supragingivally located amalgams. This appeared to be due to preferential plaque accumulation in relation to subgingival overhangs. For all parameters compared, differences apparent at the baseline had disappeared by the end of the 8-week study period. Contouring of defective subgingival restorations, followed by effective scaling and oral hygiene instruction produced approximately 1 mn of gingival shrinkage, sufficient in most cases to produce clinical gingival health. Of the 156 subgingival fillings 83 (53%) became supragingival and 43 (28%) reached the gingival crest by the end of the 8-week study period.

Dental Amalgam↗
PubMed1989

The effect of ultrasonic cleaning and air polishing on the marginal integrity of radicular amalgam and composite resin restorations. An in vitro study.

This study attempts to put at ease some uncertainty of a possible damaging effect of ultrasonic scaling and air polishing procedures on dental restorations (amalgam and composite resin). Under optimal in vitro conditions, the margins of 120 restorations were subject to thorough ultrasonic and air polishing instrumentation in order to mimic those extensively used in periodontal treatments. Light-cure composite resin and Dispersalloy amalgam alloy were used to restore class V cavities at the CEJ. After being exposed to ultrasonic scaling and air polishing, cleaning, and thermocycling, clinical evaluation of the cavity margins and microleakage examination showed no detrimental effects of these procedures.

Air↗
PubMed1997

Therapy-resistant periodontitis (I). Clinical and treatment characteristics.

The aim of this study was to evaluate the clinical criteria for classification of 2 different patient groups. From retrospective comparisons of pocket probing depth (PPD) charts, we classified 22 patients as either non-responding or responding to periodontal treatment. The non-responding patient group, in comparison with the responding patient group, showed a profile over time of less PPD reduction in response to periodontal treatment. Information registered in each patient's file regarding clinical periodontal conditions, as well as treatment procedure characteristics, was gathered. Bivariate analyses were performed. 3 clinical variables (frequency of mean PPD > or = 6 mm during the treatment period; at final registration; and the mobility score at the final registration) indicated that 2 separate patient groups had been identified. Although the patient groups exhibited advanced periodontitis at the beginning of treatment, both groups at the end of treatment had lost very few (1-2) teeth, probably as a result of regular supportive treatment. The characteristics of the selected clinical criteria warrant the use of these 2 patient groups in further analysis of the relation of psychosocial stress and microbiological characteristics of therapy-resistant periodontitis.

Adult↗
PubMed2004

Surface wear on cervical restorations and adjacent enamel and root cementum caused by simulated long-term maintenance therapy.

BACKGROUND: In an in vitro study, the surface wear on cervical restorations and adjacent enamel and root cementum caused by different tooth-cleaning methods in simulated long-term therapy was investigated. METHODS: Cervical restorations of amalgam (Oralloy), modified composite resin (Dyract), glass-ionomer cement (ChemFill Superior), and composite (Tetric) were instrumented by POL (polishing), CUR+POL (curette and polishing), US+POL (ultrasonic device with polishing) and the polishing agents Cleanic and Proxyt in a computer-controlled test bench. Treatment time corresponding to a real-time period of 5 or 10 years. Substance loss from instrumented surfaces was measured with a digital gauge. A three-way anova was used in the statistical evaluation. RESULTS: The results showed that POL led to slight substance loss, which was greater using Cleanic (27 microm) than Proxyt (5 microm). CUR+POL produced a significantly greater substance loss than did US+POL, with 186 microm versus 35 microm on glass-ionomer cement, respectively, and 123 microm versus 18 microm, respectively, on root cementum, followed by composite (111 microm versus 27 microm, respectively), polyacid modified composite resin/compomer (89 microm versus 36 microm), amalgam (75 microm versus 19 microm), and enamel (32 microm versus 23 microm). CONCLUSIONS: As opposed to the use of US+POL or POL, substance loss on cervical restorations and especially root cementum must be expected to result from tooth-cleaning during long-term maintenance treatment using CUR+POL.

Analysis of Variance↗
PubMed1979

Microleakage around preventive composite fillings in loaded teeth.

The purpose of this study was to evaluate the microleakage around preventive composite fillings in teeth subjected to mechanical loading and thermal cycling, and to assess the influence of the consistency of the composite resin upon the leakage. The fissure enamel was partially removed without dentin exposure in 30 extracted maxillary pre-molars. The cavities were etched with phosphoric acid and filled with undiluted composite (Adaptic) or composite diluted with varying amounts of liquid resin (Adaptic Bonding Agent). Five teeth were not acid etched and served as a control group. All teeth were mechanically loaded and unloaded, simulating masticatory forces, and subsequently thermally cycled between two dye solutions. Extensive leakage was seen around all fillings in the control group, while slight leakage, restricted to the feather-edge margin, was seen in five teeth with acid etched cavities. Three of these contained undiluted composite fillings. Twenty teeth showed no leakage. The results show that preventive composite filling provides good sealing of occlusal fissures, and that the seal is resistant to those thermal and mechanical stresses which may be expected in vivo. The use of diluted composite resin in preventive composite fillings is recommended.

Acid Etching, Dental↗
PubMed1991

Marginal adaptation of a restorative resin polymerized at reduced rate.

The aim of this study was to investigate the effect of reduced rate of polymerization on the marginal adaptation of a composite resin inserted in dentin cavities treated with a simplified Gluma system. The effect on bonding strength to dentin and compressive strength was also investigated. The light intensity of the polymerization unit was lowered by the use of a transformer, and thus the rate of polymerization of the composite resin. When the resin was irradiated for 30 s at 110 V followed by 30 s at 220 V, the marginal adaptation was significantly improved. This condition resulted in acceptable values of bonding strength to dentin and diametral compressive strength. It is suggested that the reduced rate of polymerization may allow for increased flow of the material, decreasing the contraction stress in the filling.

Aluminum Oxide↗
PubMed2006

Class II restorations: influence of a liner with rubbery qualities on the occurrence and size of cervical gaps.

The aim of this study was to evaluate the ability of new rubbery liners, used as a cervical increment, to relieve contraction stress and thereby reduce the formation of cervical gaps in class II composite restorations. The investigated liners were made of polyester-acrylate (PE(1), PE(2) or PE(3)) or silicone-acrylate (S), mixed with UDMA, without (A, B, C, D) or with HEMA (AH, BH, CH, DH). A silanized filler was added to the mixture, DH, to give composites with 20, 40, 60, and 70% (w/w) of filler (DHF20, DHF40, DHF60, DHF70, respectively). The presence and width of cervical gaps were determined using a light microscope. Statistical analysis showed that six of the 12 rubbery liners (AH-DH, DHF20-DHF40) significantly decreased gap formation in comparison with the control group. In addition, the polymerization shrinkage, flow, and strain capacity of these liners were measured and the influence of these factors on gap formation was examined. Two- and three-dimensional regression analyses showed significantly negative linear correlations between gap formation and strain capacity, and between gap formation and flow, and a significantly positive linear correlation between gap formation and shrinkage.

Composite Resins↗
PubMed2006

Analysis of 154 cases of teeth with cracks.

It is well known that cracked teeth occur most frequently in the mandibular molars with large or poor restorations, in those over 50 years of age. However, with increasing knowledge and experience with cracks of teeth, cracks appear to be found frequently in intact teeth without restorations. The aim of this study is to analyze the cases of tooth cracks in a dental hospital in a year, and to find out the characteristic features of cracks of teeth. For 1 year, each tooth that were identified as a cracked tooth was recorded and analyzed in terms of the classification of cavity and restorative material, the nature of opposing tooth, the location in the arch, the age and gender, and the clinical signs and symptoms, and treatment result. Cracked teeth were observed most frequently in the teeth with no restorations (60.4%) and with class I restorations (29.2%). The most prevalent age was in those over 40 years of age (31.2% in their 40s, 26.6% in their 50s) and the prevalence was similar in men (53.9%) and women (46.1%). Cracked teeth were found most frequently in the maxillary molars (33.8% in first molar, 23.4% in second molar) than in the mandibular molars (20.1% in first molar, 16.2% in second molar). 96.1% of the cracked teeth responded to the bite test, and 81.1% of the cracked teeth were observed in the mesiodistal direction. The prevalence of cracked tooth was highest in the intact teeth with no restoration, in maxillary molars, and in those over 40 years of age. When examining a intact maxillary posterior tooth that is sensitive to a bite and thermal change, crack in the mesiodistal direction need to be considered one of the causes.

Adult↗
PubMed2006

Effect of deproteinization on composite bond strength in hypocalcified amelogenesis imperfecta.

OBJECTIVE: The aim of this study was to evaluate the effect of the treatment of sodium hypochlorite (NaOCl) after acid conditioning of the enamel and dentin of the primary teeth affected with hypocalcified amelogenesis imperfecta (HCAI) on the shear bond strength of the composite material. MATERIALS AND METHODS: Primary teeth from a 12-year-old girl affected with HCAI and primary teeth collected from apparently healthy children were used. A total of four groups, experimental and control with and without NaOCl treatment were specified. In the control group conventional composite procedure was performed and in the treatment group 5% NaOCl was applied after acid conditioning and then the procedure continued as in the control group. RESULTS: In teeth affected with HCAI, enamel shear bond strengths were significantly enhanced in the treatment group compared with the conventional procedure. CONCLUSION: Deproteinization could be attributed as effective in enhancing the enamel bonding in HCAI teeth and could be used to overcome the high failure rates of adhesive restorations in HCAI cases.

Acid Etching, Dental↗
PubMedDate not supplied

Bleaching and/or porcelain veneers: case reports.

Four case studies are presented in which the concept that bleaching, porcelain veneer restorations, or a combination of both constitute a conservative treatment approach for discolored, malformed, malaligned, and worn dentition. These treatments can be used effectively not only for aging dentitions, but also for the very young, which makes them an attractive treatment modality.

Adult↗
PubMedDate not supplied

Restoring the worn dentition.

Strong dental materials and dental porcelains are providing dentists with restorative opportunities that are more conservative because they require less destruction of healthy tooth structure and yield a more esthetic result. In cases of severe wear due to attrition, abrasion, and erosion, this process can be stopped, restoring the esthetics and function by using proper techniques and materials. The case report described in this article demonstrates the conservative restoration of severe wear due to attrition and erosion. Teeth were lengthened, wear was restored, and further wear was ceased by using a combination of bonded porcelain, a heat, light, and self-cure resin system, and a new glass-ionomer restorative material. The result was a strong, durable restoration (that required no anesthesia) with high esthetics.

Adult↗
PubMedDate not supplied

Indirect porcelain veneer technique for restoring intrinsically stained teeth.

Indirect porcelain veneers are often the ideal restoration for intrinsically stained teeth. This article details a step-by-step procedure for esthetically restoring discolored teeth. Porcelain laminate veneers are often indicated when teeth bleaching or direct composite bonding procedures cannot provide the desired esthetic result. Veneers are more appealing to many patients than full coverage crowns because of the more conservative tooth preparation required. If technique details are followed meticulously and cases are appropriately selected, porcelain veneers are not only durable but also promote marvelous gingival health and may be the most esthetic anterior dental restoration.

Adult↗