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PubMed1996

2-year clinical evaluation of a gallium restorative alloy.

PURPOSE: To assess the clinical performance of 2-year old gallium alloy restorations. Parameters evaluated include: (1) fracture at the margins, (2) tarnish, (3) surface roughness, (4) tooth fracture, (5) fracture through the body of the restoration, and (6) any medical or dental conditions arising during the study. MATERIALS AND METHODS: Nine patients received 30 Class I restorations of Galloy gallium alloy. These were placed as conservatively as possible under a rubber dam. Fifteen of the preparations were lined with a Bis-GMA resin to seal the restoration from moisture. The other 15 preparations were sealed with Amalgambond. After placement of the gallium alloy, the exposed surfaces of all restorations were sealed with the Bis-GMA resin, and the occlusion was checked. The restorations were examined at 2 weeks, 3 months, 6 months, 1 year and 2 years. RESULTS: At the 2-year recall, all restorations were intact with the exception of one tooth fracture (cause unknown). Forty-five percent of the restorations exhibited tarnish and 60% had a rough surface. The fracture at the margins of these restorations was minimal, and no significant difference could be found between those using Amalgambond and those sealed with the resin system. No medical problems were reported by the patients, and postoperative sensitivity was minimal.

Bisphenol A-Glycidyl Methacrylate↗

PubMed1995

Influence of amalgams, bases, and varnish on seal composition at restoration tooth interfaces.

Eighty extracted, noncarious premolars were restored with one of 20 different combinations of restorative materials: a high- or low-copper amalgam, unlined or lined with one of five bases, and varnished or unvarnished. The teeth were aged in 1% NaCl and after 3 months and 1 year the seal material deposited on the cut tooth cavity surface and the surface of the amalgam restoration was analyzed by use of energy dispersive x-ray analysis. Atomic weight percentages of marginal seal elements were statistically examined with ANOVA and Tukey's test with significance set at p < 0.05. The results indicated that only one type of seal was formed centered around tin. More marginal seal material was present in the 1-year specimens. Restoration materials used affected the deposition rate of marginal seal material. Low-copper amalgam-restored teeth formed more seal material with significantly greater amounts of chlorine and tin. Less marginal seal material was found in varnished cavities. A calcium hydroxide base produced a thick marginal seal with a significantly different composition of elements compared with the unlined and zinc-based specimens. Tin in Poly-F Plus polycarboxylate cement did not significantly increase the tin content of the marginal seal. Base materials can play a role in determining crevice pH. The findings have bearing on improved longevity of amalgam restorations.

Analysis of Variance↗

PubMed1998

Secondary caries adjacent to amalgam restorations lined with a fluoridated dentin desensitizer.

PURPOSE: To determine the in vitro effect of a fluoridated dentin desensitizer solution (DentinBloc) on (1) secondary caries formation, and (2) the interfacial adaptation when used as a cavity liner before amalgam (Dis-persalloy) placement. MATERIALS AND METHODS: 24 macroscopically caries-free molars were selected. Class V cavity preparations on mesial and distal surfaces were placed along the cemento-enamel junction, providing an enamel margin and a root surface margin. DentinBloc was applied prior to alloy restoration in the experimental group for 60 s (the excess was removed with cotton pellets), while a copal cavity varnish (Copalite) was used before alloy restoration in the control group. Polarized light evaluation was performed on longitudinal sections (24 caries risk sites for enamel and dentin margins in each group). Alloy-tooth interfaces were evaluated by SEM. RESULTS: Wall lesions were present in 100% of caries-risk sites for the control group, while 58% of enamel risk sites and 50% of root risk sites had wall lesions in the DentinBloc group. Surface lesion depth was reduced 13% at enamel margins and by 18% at root margins in the experimental group when compared to the control group. Relatively small interface gaps between the alloy and tooth surfaces were seen in both groups, but these were less for the root surface margins (2-5 microns) than for the enamel margins (5-15 microns).

Analysis of Variance↗

PubMedDate not supplied

Marginal leakage of Class II glass-ionomer-silver restorations, with and without posterior composite coverage: an in vitro study.

The aims of this in vitro investigation were: 1) to assess marginal leakage around three types of class II restorations, using: a) a composite resin with a glass ionomer lining; b) a glass ionomer cerment with composite resin coverage; c) a glass ionomer cermet without composite resin coverage and 2) to study the effect of thermocycling on marginal defects, by means of radiographs and SEM micrographs of the margins. Fifty-eight class II cavities were prepared in extracted primary molars. The teeth were divided into three groups and restored as follows: Group A--Ketac Bond (liner) and P-30; Group B--Ketac Silver and P-30(sandwich); Group C--Ketac Silver only. The restored teeth were thermocycled and marginal leakage was assessed from the degree of dye penetration on the sections. Dye penetration at the occlusal margins increased in the sequence A less than B less than C. The differences between group C and Groups A and B were statistically significant. Severe penetration of the dye was observed at the cervical margins with no statistically differences between the groups. Deterioration of margins due to thermocycling was observed for all groups, but these defects were not evident on the radiographs. Ketac Silver with and without composite coverage did not prevent marginal leakage when utilized in class II restorations in vitro.

Cermet Cements↗

PubMedDate not supplied

Marginal and internal adaptation of stratified compomer-composite Class II restorations.

Different approaches have been proposed to improve the adaptation of Class II restorations, including applying low-elasticity modulus base liners. This in vitro fatigue test (or study) evaluated the influence of the compomer base-lining configuration on restoration adaptation. Direct Class II MOD box-shaped composite restorations with or without base and lining (n=3x8) were placed on intact human third molars with proximal margins 1 mm above or under the CEJ. The compomer (Dyract) was applied as a 1 mm-thick lining or as a base, closing proximo-gingival margins. Marginal adaptation was assessed before and after each phase of mechanical loading (250,000 cycles at 50N, 250,000 cycles at 75N and 500,000 cycles at 100N); internal adaptation was evaluated after test completion. Gold-sputtered resin replicas were observed in the SEM and restoration quality evaluated in percentages of continuity (C) at the margins and within the internal interface after sample section. Mechanical loading did not influence adaptation to enamel, while it adversely affected restoration adaptation to dentin for the full composite and compomer-base restorations (C varied, respectively, from 95.2 to 75.3% and from 98.0 to 10.6%). The internal adaptation quality showed the same general trend, however, with reduced scores of continuity. In this experimental condition, application of a low elasticity modulus layer under the restorative material proved advantageous but the compomer should not contact the gingival margins.

Bisphenol A-Glycidyl Methacrylate↗

PubMed2005

The influence of some dentin primers on calcium hydroxide lining cement.

UNLABELLED: Dentin primer is applied as a routine procedure prior to bonding to improve the sealing properties of direct polymerizing resins. Some primers contain acetone or alcohol that may affect the properties of calcium hydroxide liner which is placed as a direct or indirect pulp cap. If calcium hydroxide is softened or smeared over the cavity walls, the bonding will be impaired. Therefore, if this occurs, the cement must be removed, the walls must be cleansed, and the procedure must be repeated with careful application of dentin primer. OBJECTIVE: The purpose of this study was to determine the wear and compressive strength of a calcium hydroxide liner after exposure to different kinds of dentin primers for different periods of time. METHODS: The calcium hydroxide used in this study was Dycal. It was mixed according to the manufacturer's instructions and placed in plastic rings of 0.5 mm x 5 mm and allowed to set at 37 degrees C for 15 min under 500 gm load. To determine erosion, the height for each sample before and after application of primers was recorded using a Digital Height Measuring Instrument "Digmar" 817. Compressive strength specimens were also prepared. RESULTS: Calcium hydroxide treated with Optibond (alcohol based) or Syntac (acetone based) for 1 min or 5 min had the highest erosion values and the lowest compressive strength values. Gluma CPs (water based primer) had the least effect on calcium hydroxide values.

Analysis of Variance↗

PubMed2006

Effect of fluoride-releasing liner on demineralized dentin.

OBJECTIVE: The aim of this study was to evaluate the remineralization of residual demineralized dentin underneath restorations by fluoride-releasing liners in vitro. METHOD AND MATERIALS: Two glass-ionomer cement liners, Lining Cement (GC) and RK-141A (GC), and two light-cured resin liners with and without 5 wt% NaF were used in this study. The resin liners were made by mixing TEGDMA and bis-GMA. Class 5 cavities were prepared on extracted human premolars. Demineralized dentin was promoted by using a bacterial caries induction system at the cavity floor. Cavities were restored with a resin composite following application of each liner. Specimens were then stored for 4 weeks at 37 degrees C and 100% humidity. After storage, the specimens were cut through the restorations, and axial sections of about 80-microm thickness were prepared. Contact microradiographs were taken, and the radiopacity of the demineralized dentin layer underneath the liner was analyzed. RESULTS: The ratios of radiopacity of demineralized dentin under the fluoride-releasing liners were significantly higher than those under the resin liner without fluoride release. Although the amounts of fluoride release from the glass-ionomer cement liners were lower than that from the resin liner with fluoride release, there were no significant differences in the ratios of radiopacity in demineralized dentin layers among the 3 liners with fluoride release. CONCLUSION: Although the fluoride released from liners can enhance remineralization of demineralized dentin, the amount of fluoride release does not affect the ratio of radiopacity in the remineralized dentin.

Bisphenol A-Glycidyl Methacrylate↗

PubMed1991

Microleakage in alloy-glass ionomer lined amalgam restorations after thermocycling.

Marginal microleakage was measured around amalgam restorations lined with alloy-glass ionomer cement and coated with a glass ionomer varnish. Preparations were made in 48 human extracted mandibular molar teeth. Alloy-glass ionomer liners and varnishes were placed into selected preparations. Tytin amalgam was inserted into all of the teeth and left unburnished and unpolished. Half of the total samples were thermocycled for 5 days and the remainder were left in deionized water. The teeth were immersed in a 0.5% methylene blue dye and sectioned vertically with a diamond saw. Microleakage was scored visually at x100 magnification, and the data were analysed using the Mann-Whitney U-test (P less than or equal to 0.05). Thermocycling did not have a significant effect on microleakage, except when both an alloy-glass ionomer liner and varnish were used. Overall, the use of an alloy-glass ionomer liner made the most significant difference in reducing microleakage.

Coloring Agents↗

PubMed1991

Materials techniques for lining composite resin restorations: a critical approach.

Composite resin restoration of posterior teeth necessitates a reassessment of cavity insulation and dentine conditioning. The primary function of cavity insulation under composite resin restorations is to prevent the formation of a bacterial, fluid-filled gap nearest the cavity walls. Gap formation can contribute not only to sensitivity to cold but also to pulpal complications and secondary caries. Unfortunately, none of the currently available systems for cavity insulation fulfil this basic requirement. The evidence suggests, however, that the most effective insulator is a very thin liner which does not pool in retention grooves and which can cover the entire cervical wall as well as the remaining cavity walls, except for etched enamel. Such a liner should not bond to composite resin and thus be detached from the dentine during polymerization contraction of the composite. Nor should it be leached away by the oral fluids. In order to preserve the liner, the air-filled contraction gap which forms between liner and composite should be impregnated with resin immediately after the major setting contraction of the composite. In this context the use of retention grooves in Class II and Class V cavities is recommended, to minimize the effect of thermal and occlusal stress. Combined with etched enamel walls, well-placed retention grooves can reduce the risk of gap formation and creep due to mechanical stress and the deformation potential of the tooth structure and the filling. The smear layer can disappear entirely and be replaced by fluid and bacteria. It should therefore be removed, but the smear plugs blocking the apertures of the dentinal tubules should be left undisturbed and reinforced by impregnation with fluoride.(ABSTRACT TRUNCATED AT 250 WORDS)

Composite Resins↗

PubMed2000

Microleakage and SEM interfacial micromorphology of amalgam restorations using three adhesive systems.

OBJECTIVE: This study evaluated the microleakage and interfacial micromorphology of Class V cervical amalgam restorations lined with OptiBond, AElitebond, or Panavia 21. METHODS: Unlined amalgams served as control. Cavities were treated with each dentin bonding system according to the manufacturers' instructions and restored with Tytin non-gamma 2 spherical amalgam. After one week of storage in tap water at 37 degrees C, the specimens were thermocycled (1000 cycles, 6-60 degrees C, 30s dwell time). Microleakage was assessed by means of basic fuchsin dye penetration and recorded according to an ordinal scale. RESULTS: None of the systems tested in this study completely eliminated microleakage. Kruskal-Wallis one-way ANOVA and Mann-Whitney U test found that on the occlusal wall, Panavia 21 and the control group had the least leakage (P<0.05). No statistically significant differences were found at dentin margins (P>0.05). Wilcoxon matched pairs signed rank test found that Panavia 21 and the control group had less leakage at the occlusal than at the dentin margins (P<0.05); when AElitebond and OptiBond groups were evaluated, microleakage at the enamel and at the dentin margins was similar for each group. With the adhesive systems, perhaps the hydrophilic bonding agents incorporated the dye during specimen immersion and/or sectioning. CONCLUSIONS: The use of adhesives may not be as worthy as resin cements for sealing and bonding amalgam restorations to enamel and dentin.

Adhesives↗

PubMedDate not supplied

Physical properties of proprietary light-cured lining materials.

Physical parameters of four photopolymerized lining materials were evaluated for comparative purposes and to contribute to the understanding of these novel materials. Properties investigated included compressive, diametral and flexural strength, modulus of elasticity, fluoride and calcium release for four weeks, and pH values for 24 hours. In general Cavalite and TimeLine were significantly stronger than Vitrabond and XR-lonomer and were essentially neutral in pH. All the materials exhibited a yield upon compressive strength testing. The fluoride release was intermediate for TimeLine and negligible with Cavalite. Vitrabond and XR-lonomer released significant amounts of fluoride at all time periods. XR-lonomer was the only material investigated to have significant calcium release, and this may have been related to its visible dissolution in water. This material also showed a low initial pH of 2.2. It, along with Vitrabond, demonstrated a gradual increase in pH over time. The behavior of TimeLine and Cavalite is therefore more consistent with that of a modified composite resin, whereas Vitrabond and XR-lonomer are similar in nature to glass-ionomer liners.

Acrylic Resins↗

PubMed2004

One-year clinical evaluation of a flowable resin liner associated with a microhybrid resin in noncarious cervical lesions.

The aim of this study was to compare the clinical performance over 1 year of a microhybrid composite resin for class V restorations both lined and not lined with a flowable composite resin. Nineteen patients having at least two pairs of cervical noncarious lesions under occlusion were enrolled in this study. A total of 38 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250, and Single-Bond + Filtek Z250). Two calibrated operators placed all restorations according to the manufacturers' instructions. Two other independent examiners evaluated the restorations at baseline and after a 12-month period according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test and McNemar's test (P=0.05). One restoration was lost after 12 months for each group (retention rate 95% for each group). After 12 months, 18 restorations showed a trend towards dark yellowing (color match A2). The use of Filtek Flow as a liner under Filtek Z250 restorations did not improve the clinical performance of class V restorations after 6 and 12 months of evaluation.

Acrylic Resins↗

PubMed2004

Effects of flowable resin on bond strength and gap formation in Class I restorations.

OBJECTIVES: This study measured resin/dentin bond strengths and evaluated gap formation at the pulpal floor of occlusal composite restorations using a flowable resin as a liner with either bulk or incremental placement of the restorative composite. METHODS: Class I occlusal preparations were made in 16 extracted molars, and were randomly divided into two groups for restoration using either One-Step adhesive (OS, BISCO) and Renew composite (RW, BISCO) or OptiBond SOLO adhesive (SOLO, Kerr) and Herculite XRV composite (XRV, Kerr). A flowable resin [AEliteFlo (AE, BISCO) or Revolution (RV, Kerr)] was applied as a liner in half of the specimens of each group. The lined and unlined groups were restored with composite cured in bulk, or cured in 1.5 mm increments. After 24 h in water, the teeth were sectioned into 0.7-mm thick slabs and were examined with an optical microscope (400 x) to determine the presence of internal resin-dentin gaps. The gap-free specimens were trimmed and were subjected to microtensile bond strength testing. Specimens that contained gaps had Knoop hardness of the restorative material measured. RESULTS: All incrementally filled restorations were well adapted to the pulpal floor but nearly all bulk-cured specimens had gaps between the flowable and the hybrid composites. The use of a flowable resin increased the bond strength of OS, but not SOLO. SIGNIFICANCE: The incremental technique prevented gap formation regardless of the use of a flowable resin. In contrast, the use of a flowable composite did not guarantee gap-free restorations or improved bond strength of resin to dentin in bulk-filled restorations.

Barium Compounds↗

PubMed1996

SEM observations of the reactions of the components of a light-activated glass polyalkenoate (ionomer) cement on bovine dentine.

OBJECTIVES: Glass ionomer cements are used in clinical dentistry as lining, luting and restorative materials. The precise nature of their bonding mechanism to dentine is unclear. This study is an SEM examination of the effect of the liquid contained in Vitrebond cement (3M Co., MN) on the surface of bovine dentine, with respect to delays in photocuring and washing off with water under pressure or as a gentle stream. The effects of delaying photocuring of the mixed and applied cement for up to 120 s were also examined. RESULTS: The results of this study demonstrated that the liquid component of Vitrebond reacts chemically with dentine in a manner suggestive of an effervescent chemical reaction. This reaction produces plugs in the dentinal tubules which are resistant to dislodgement by water under pressure or by gentle washing. Similarly, a delay in photocuring the mixed and applied cements results in porosity of the cement at the dentine interface. CONCLUSION: The findings in this study suggest that the adhesion of Vitrebond to dentine is primarily chemical in nature and that its mechanical strength is compromised if there are substantial delays in photocuring.

Adhesiveness↗

PubMed2003

Longevity of direct resin composite restorations in posterior teeth.

This review is a survey of prospective studies on the clinical performance of posterior resin composites published between 1996 and 2002. Material, patient- and operator-specific data, observation periods, isolation methods of the operative field, and failure rates are detailed in tables. The data were evaluated statistically in order to assess the role of materials (filler size, bonding system, base materials [e.g. glass ionomer cements], and lining materials), study design, and personnel on failure rates. The primary reasons for composite failure were secondary caries, restoration fracture, and marginal defects. The influence of different commercial material brands on failure rates was not evaluated due to the great variety of test substances and the lack of material-specific documentation. Effects of the isolation method of the operative field (rubber dam or cotton rolls) and the professional status of operators (university or general dentist) on composite failure rates were not found to be significant. Observation periods varied from 1 to 17 years, and failure rates ranged between 0% and 45%. A linear correlation between failure rate and observation period was found (P<0.0001). Thirteen of 24 studies were terminated after 3 years, while seven studies continued for more than 10 years, indicating that favourable results for composite materials are frequently based on short-term results, despite higher dropout rates in longer studies. To determine accurately the risk for patients, long-term, randomised, controlled clinical trials of treatment outcomes with composites used in posterior teeth are clearly needed.

Bicuspid↗

PubMed1996

The quantification of tertiary dentine formation in response to materials commonly placed in deep cavities in general practice in the UK.

PURPOSE OF STUDY: To determine the rate of formation of tertiary dentine in dogs' teeth, in response to five commonly used lining materials. Also, to record the resulting differences in quality of the formed dentine. MATERIALS AND METHODS: Representatives of five types of materials commonly used in general practice in the UK were placed in deep standardised cavities with a remaining dentine thickness of 400-500 microns, and sealed to the cavo-surface with zinc oxide-eugenol. The daily rate of tertiary dentine formed in response to each material was measured over a period of 119 days using a tetracycline staining method. A concomitant study to show the quality of the formed dentine was undertaken using the same materials and experimental conditions. RESULTS: There was a significant difference between the rates of tertiary dentine formation for all materials except zinc oxide-eugenol and Ledermix paste. For each material there was a increased rate of tertiary dentine formation in the second period (29-49 days) compared to the first period (0-28 days). This is considered to be due, in part, to a lag period when damaged odontoblasts are differentiating from mesenchymal elements. The rate of tertiary dentine formation in response to all the test materials was always greater than that of normal physiological dentine formation in unprepared teeth. Qualitatively, there was difference in the formed tertiary dentine beneath each material. All the materials caused odontoblast destruction, altered ground substance production and alterations in the calcification process. CONCLUSION: None of the materials routinely used at present can be considered to be 'ideal' as odontoblast destruction, altered ground substance production and altered calcification occur beneath zinc oxide-eugenol preparations, calcium hydroxide preparations as well as in response to corticosteroid-containing materials such as Ledermix paste and cement.

Analysis of Variance↗

PubMedDate not supplied

Fracture resistance of complex amalgam restorations.

This study evaluated fracture resistance provided to complex amalgam restorations by adhesive and mechanical resistance features. The occlusal surfaces of 30 extracted molar teeth of similar size were ground flat to approximately 2 mm coronal to the CEJ. The teeth were divided into three groups. Roots were notched and embedded in acrylic resin. In two groups, four TMS Minim stainless steel pins were placed into dentin at the line angles. A copper band matrix was applied to each specimen and reinforced with compound. After applying either Copalite or Amalgambond Plus, Tytin amalgam was condensed into the matrix. The bands and excess amalgam were removed 10 minutes later, and each amalgam occlusal surface was ground flat to give the amalgam restoration a 4 mm occlusal height. Specimens were thermocycled for 2500 cycles at 6-60 degrees C with a 30-second dwell time. They were then stored in deionized water for 1 month at room temperature. A 1 mm 45 degrees bevel was placed on the facio-occlusal angle of the amalgam. Each specimen was loaded to failure in compression at 45 degrees in an Instron Testing Machine at a crosshead speed of 5 mm/min. The groups were: Group 1, four Minim pins and Copalite; Group 2, four Minim pins and Amalgambond Plus; and Group 3, Amalgambond Plus only. The data were analyzed using a one-factor ANOVA and a Tukey B post hoc test. There was no significant difference between Groups 1 and 3. The Amalgambond Plus combined with pins provided significantly greater resistance to fracture than pins or Amalgambond Plus alone (P < 0.05).

Analysis of Variance↗

PubMed2006

Effect of resin liners and photoactivation methods on the shrinkage stress of a resin composite.

PURPOSE: This study was undertaken to evaluate the effect of three different photoactivation methods on the polymerization shrinkage stress of a resin composite using different resin liners. MATERIALS AND METHODS: Three photoactivation methods using a quartz-tungsten-halogen light were evaluated: continuous light, soft start, and intermittent light. Three lining groups were tested: one or three coats of adhesive, and flowable composite. The stress was measured using a universal testing machine. After the stress measurement, Knoop hardness numbers (KHNs) were evaluated to verify indirectly the degree of conversion of the composite using the three photoactivation methods. The data were submitted to analysis of variance and Tukey's test (p < .05). RESULTS: Intermittent light was always associated with statistically lower stress values when compared with continuous light. Statistical differences were not observed when continuous light and soft start were compared. The use of a flowable composite liner significantly reduced the stress generation when compared with the use of one adhesive coat. The three adhesive coats groups showed intermediate stress values. The hardness test showed no statistical difference between that achieved with continuous light and soft start. These two methods showed statistically higher KHNs when compared with results with intermittent light. CLINICAL SIGNIFICANCE: Photoactivation using intermittent light may lead to a significant reduction in shrinkage stress levels. This effect could be attributed to a significant reduction of the polymerization rate and/or a decrease in the degree of conversion. The use of a flowable composite liner reduced the stress levels when compared with levels when one coat of adhesive was used. This is possibly related to the higher thickness of the flowable composite layer.

Analysis of Variance↗