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PubMed1991

Microleakage of three cement bases.

The purpose of this study was to evaluate the ability of a glass-ionomer cement-base material to prevent bacterial penetration along the dentin interface and to compare it with two conventional cement-base materials. A total of 107 Class 5 restorations was placed in Rhesus monkey teeth by means of three test materials [zinc oxide-eugenol (ZOE), copalite varnish + zinc phosphate cement base (V + ZP), and a glass-ionomer lining cement (GI)], with unetched and unbonded resin composite used alone as a control material and as a final restoration over the test base materials. Following disinfection, Class 5 cavities were prepared on the buccal surfaces of the teeth to the inner one-half of dentin. A sterile filter-paper disk was then placed on the axial wall and covered with a Teflon disk. Next, the cavities were based to the dento-enamel junction with one of the test base materials and finally restored with unetched and unbonded resin composite. After five and 16 weeks, the filter-paper disks were retrieved and cultivated for the presence and type of bacteria. The five-week results showed positive growth in two groups: the composite-only controls and the V + ZP group. The 16-week results showed growth in all of the test groups, but only one of nine teeth showed growth in the zinc oxide-eugenol group and one of 16 teeth in the glass-ionomer group. The results of this study indicate that under the conditions tested, a glass-ionomer base was capable of minimizing bacterial penetration along the material-tooth interface.

Animals↗
PubMedDate not supplied

Amalgam restorations: postoperative sensitivity as a function of liner treatment and cavity depth.

The purpose of this clinical study was to assess the sensitivity reported by patients following the insertion of class 1 or class 2 amalgam restorations in the treatment of primary carious lesions of different depths. Ninety subjects with previously untreated teeth requiring restorations due to caries lesions were selected: 32 teeth had lesions that were clinically and radiographically judged to be located in the outer one-third of dentin, 30 were located in the middle one-third of dentin, and 28 were located in the inner one-third of dentin. Four different lining regimens were employed: Group 1--no linear; Group 2--two coats of Copalite liner; Group 3--a dentin adhesive resin liner (Scotchbond Multi-Purpose); Group 4--a resin-modified glass ionomer (Fuji Bond LC). Patients were contacted on days 2 and 7 postoperatively and questioned regarding the presence or absence of sensitivity, the stimuli that created the sensitivity, if any, the duration of any sensitivity, and the intensity of any sensitivity using a rating from None to Severe. If sensitivity was experienced on day 7, patients were also contacted on days 14, 30, and 90 to assess the sensitivity at those intervals. The chi-square test of independence showed no significance at the 0.05 level between the different dentin treatments and cavity depths. By day 2, 19% of lesions located in the outer one-third, 27% of lesions located in the middle one-third, and 29% of lesions located in the inner one-third of dentin were sensitive. On day 30, four teeth were still sensitive, two located in the middle one-third and two located in the outer one-third of dentin. On day 90 all teeth were without sensitivity.

Adolescent↗
PubMed1997

Marginal seal composition in amalgam restored teeth of varying marginal leakage.

An in vitro study was performed to ascertain the marginal seal elemental composition of amalgam restored extracted teeth of known marginal leakage. Occlusal cavities were cut in 400 caries free extracted teeth and left unlined or lined with one of 5 bases. A varnish was applied to half the cavities followed by restoration with a low copper or high copper amalgam to produce 20 restoration combinations. The teeth were stored in 1 per cent NaCl and thymol for 3 and 12 months at 20 degrees C whereafter a standard fluorescent dye marginal leakage test was performed on 320 specimens (eight teeth per treatment). Restoration combinations were grouped into 4 seal classes depending on percentage marginal seal achieved for each combination: 0-25 per cent; 26-50 per cent; 51-75 per cent and 76-100 per cent. The 80 remaining teeth (2 teeth per treatment) were fractured to expose the restoration and cavity surface, covered with marginal seal material and this was analysed by energy dispersive X-ray analysis. Elemental seal composition was compared to percentage marginal seal achieved using ANOVA and Tukey's test with significance set at p < 0.05. Numbers of elemental analysis specimens falling into each marginal seal class was 0-25 per cent = 48; 26-50 per cent = 18; 51-75 per cent = 10; 76-100 per cent = 4. Of the 16 elements detected, nine were significantly linked to sealing/leakage: Ca, Cl, Cu, Mg, Hg, P, Ag, Sn and Zn. The findings have a bearing on the improved longevity of amalgam restorations.

Analysis of Variance↗
PubMedDate not supplied

Three different methods to evaluate microleakage of packable composites in Class II restorations.

This in vitro study compared three different methods to evaluate detectable levels of microleakage in Class II restorations placed with five commercially available packable resin composites: Alert, Glacier, Pyramid, Solitaire 2 and SureFil. A flowable resin composite, Flow-It, was used to line all packable composites. The hybrid resin composite Z100 was also included. The adhesive system used with all groups was Scotchbond MultiPurpose Plus. Standard Class II cavities were prepared on the mesial (enamel margins) and distal (dentin margins) sides of the teeth with no communication between them. Based on a power analysis, 180 permanent human molars were randomly assign to each of six groups with 30 specimens per group. All restorative materials were placed following manufacturers' recommendations. Following restoration and thermocycling, the specimens were stored at room temperature in solutions of 45Ca, methylene blue and rhodamine B, sequentially. Microleakage was ordinal scored as 1 (no penetration), 2 (penetration up to one-third of the cervical floor), 3 (penetration beyond one-third of the cervical floor to the axial wall) and 4 (penetration along the axial wall) by two independent evaluators. Analysis of the occlusal surfaces was also accomplished following the same scheme. In this study, tracers/dyes were evaluated for differences in penetration using generalized estimating equation methodology applied to cumulative logistic regression models. The results showed that Rhodamine B detected more microleakage than 45Ca or methylene blue, and 45Ca generally detected more microleakage than methylene blue.

Calcium Radioisotopes↗
PubMed2004

Self-etching adhesives and postoperative sensitivity.

PURPOSE: To test the hypothesis that the prevention of postoperative sensitivity in resin-based composite restorations is better achieved with a self-etching/self-priming (SE/SP) dentin bonding system without lining than with an early generation total-etch (TE) bonding system. METHODS: Over a 4-year period, clinical follow-ups were conducted on patients who had received composite restorations. The depth of each cavity was categorized as being shallow, medium or deep, and an evaluation was made regarding the need for pulpal protection for each restoration. Three different self-etching/self-priming (SE/SP) adhesive systems were compared to three different total-etch (TE) adhesive systems. The incidences of postoperative sensitivity (IPS) were examined by a standardized procedure 1 week after placement of the restoration. Patients' ages varied between 16-83 years. RESULTS: The total number of restorations placed in vital teeth were 330 for 150 patients in the SE/SP group, and 126 for 70 patients in the TE group. Incidences of IPS in the total number of restorations stratified for depth were 14% in deep cavities, 6% in medium depth cavities and 5% in shallow cavities in the SE/SP group, and 35% in deep cavities, 16% in medium and 4% in shallow cavities in the TE group. Fisher's exact test showed the incidence of IPS was significantly higher in cases of deep (P< 0.05) and medium (P< 0.05) cavities. The test also revealed that in restorations placed with the SE/SP adhesive systems, the presence or absence of a protective liner or base made no significant difference in the IPS in medium and shallow cavities, while the use of such protective layers produced a significantly higher IPS (21%), compared with no protection (0%), in deep cavities (P< 0.05). The absence of protective liners or bases did not result in postoperative sensitivity in deep cavities, when the SE/SP dentin bonding systems were used.

Acid Etching, Dental↗
PubMed1990

Etched glass ionomer liners: surface properties and interfacial profile with composite resins.

The purpose of this study was to assess the surface alterations induced by acid etching on two glass ionomer lining cements (Ketac Bond, G-C lining cement) and to evaluate their interface with a composite resin (Herculite XR) following various surface treatments. The changes in the surface composition and topography of the etched liners were studied by electron microprobe and ESCA analyses. The interfacial treatments performed on the ionomer surfaces were: (i) application of a bonding resin; (ii) 20-s acid etching and application of a bonding resin; (iii) application of a dental adhesive based on a chlorophosphate ester of BisGMA (Scotch-bond LC), without acid etching. The interfacial sealing efficiency of these treatments was studied by the silver nitrate microleakage technique combined with optical and electron microscopy. According to the results the etched surfaces of both the liners present excessive porosity with glass and matrix dissolution. Significant changes in the surface chemistry of the liners were detected indicating severe degradation. The microleakage study revealed interfacial gaps and fractures in the etched samples. The best results were obtained from the non-etched ionomer liners which were subjected to the adhesive treatment. The efficiency of acid etching as a necessary step in the 'layered' technique is seriously questioned.

Acid Etching, Dental↗
PubMedDate not supplied

Microleakage of Class II packable resin composites lined with flowables: an in vitro study.

Flowable resin materials have been suggested as liners beneath packable composites to improve marginal integrity. This investigation evaluated the effect of low-viscosity liners on microleakage in Class II packable composite restorations. Twenty Class II cavities were prepared in extracted third molars for each of four packable composites (Heliomolar HB, Prodigy Condensable, Surefil and Tetric Condense). Ten restorations were placed for each material with their corresponding bonding agent per manufacturer's suggestion; in addition, 10 were placed with the flowable liner recommended by the manufacturer for that material. Samples were finished, stored in distilled water for at least 24 hours and thermocycled for 1,000 cycles between 5 degrees and 55 degrees C with a one-minute dwell time. Apices were sealed with epoxy cement and the teeth were varnished to within 1 mm of the margins. Samples were placed in 0.5% basic fuschin dye for 24 hours, rinsed, embedded in resin and sectioned to produce multiple sections. Microleakage was rated (0-4 ordinal scale) at both the occlusal and cervical margins. Data were analyzed with Kruskal-Wallis ANOVA for main effect and ranked sum analysis for pairwise testing (alpha = 0.05). All materials, either separately or in combination with a flowable liner, had greater leakage scores at the cervical margin compared to the occlusal margin. All packable systems tested did not yield a reduction in microleakage with the use of a flowable liner in vitro; however, the packable system with the flowable compomer used as a liner yielded significantly less overall microleakage compared to the three systems that used a resin composite liner.

Acrylic Resins↗
PubMed1992

Dentin surface treatment and shear bond strength of a light-cured glass ionomer.

This study evaluated the effect of dentin surface treatment with polyacrylic acid on the shear bond strength of Fuji Lining LC light-cured glass ionomer lining cement (GIC). A total of 40 human, noncarious extracted permanent molars stored in distilled water were used. A flat buccal dentin surface was ground wet on 600-grit silicon carbide paper. The teeth were then randomly distributed into four groups of 10 teeth each: Group 1: dentin rinsed with distilled water, dried with oil-free compressed air, placement of cylindrical GIC samples and sheared at 15 minutes post-curing. Group 2: same as group 1, but sheared 7 days post-curing. Group 3: dentin treated with GC Conditioner for 10 seconds, rinsed with distilled water, dried with oil-free compressed air, placement of the GIC and sheared 15 minutes post-curing. Group 4: same as group 3, but sheared 7 days post-curing. The GIC was mixed in a 1:1 powder-liquid ratio. The samples were stored in distilled water until sheared with an Instron. The results revealed that dentin surface treatment with the polyacrylic acid significantly increased the shear bond strength to dentin when tested at 7 days post-curing.

Acid Etching, Dental↗
PubMedDate not supplied

Retentive strength of an amalgam bonding agent: chemical vs light vs dual curing.

Dentin bonding agents have been shown to enhance retention of amalgam restorations by mechanical means. Little research is available on which mode of curing may optimize amalgam bonding. This in vitro study compared the bond strengths exhibited by three variations of a bonding agent, each using a different curing mode, with two earlier versions of amalgam resin liners and cavity varnish. The six test groups of lining agents for amalgam restorations included [C] chemical-cured, [L] light-cured and [D] dual-cured versions of one filled adhesive resin (Clearfil Liner Bond 2V), [LF] Light-cured, Filled resin (Clearfil Liner Bond 2, Kuraray Co.); [LCF] Light- and Chemical-cured, Filled resin Clearfil Liner Bond + Protect Liner, Kuraray Co) and [V] Varnish (Copalite, Cooley & Cooley, Ltd). For each group, 20 Class V cavity preparations were cut in human molars. The preparations were 2.5 mm deep and 3 mm wide at the pulpal floor, with a slightly divergent taper. After treating the preparation with the bonding agent, a 3/4 inch, 18 gauge flat-headed wire nail was seated in the cavity with its head at the pulpal floor of the preparation, and Tytin amalgam (Kerr Corp, Romulus, MI) was condensed into the preparation around the nail. All restorations were stored for 24 hours in distilled water at 37 degrees C, then subjected to 2500 thermal cycles (8 degrees C to 58 degrees C). After one week the samples were tested to failure in tension using an Instron Universal Testing Machine (crosshead speed = 2 mm/min) and peak load (kg) was recorded. Significant differences in retention were found using ANOVA and the Games & Howell post hoc test (p = 0.05). The mean loads at failure (+/- SD) were C 13.1 (+/- 2.4), L 21.8 (+/- 6.1), D 26.8 (+/- 7.4), LCF 23.8 (+/- 7.4), LF 21.4 (+/- 3.3) and V 2.0 (+/- 1.8). All dentin-bonding agents exhibited significantly greater retention than the varnish. While the bond strengths of the dual cured (D) and the light-cured (L) liners were not significantly different from one another, both were significantly higher than the chemically-cured (C) resin liner in terms of retention.

Analysis of Variance↗
PubMed1996

Secondary caries formation in vitro around glass ionomer-lined amalgam and composite restorations.

The aim of this in vitro secondary caries study was to examine the glass-ionomer liner's effect on wall-lesion inhibition when a conventional and a light-cured glass ionomer liner was placed under amalgam and composite resin restorations. Class V preparations in extracted upper premolars were used and ten restorations were used for each of the following groups: (i) two layers of copal varnish and amalgam; (ii) conventional glass-ionomer and amalgam; (iii) light-cured glass-ionomer and amalgam; (iv) bonding agent and light-cured composite resin; (v) conventional glass-ionomer, bonding agent and light-cured composite resin; (vi) light-cured glass-ionomer, extended 0.3 mm short of the enamel margin bonding agent and light-cured composite resin; and (vii) light-cured glass-ionomer, extended 1 mm short of the enamel margin, bonding agent and light-cured composite resin. The teeth were thermocycled and artificial caries were created using an acid-gel. The results of this study showed that artificial recurrent caries can be reduced significantly (P < 0.05) with a glass-ionomer liner under amalgam restorations. The results also showed that when the light-cured glass-ionomer liner was placed 0.3 mm from the cavosurface margin under composite resin restoration, the artificial recurrent caries reduced significantly (P < 0.05).

Acids↗
PubMedDate not supplied

Bonding of amalgam restorations: existing knowledge and future prospects.

A number of laboratory and clinical studies over the last 15 years have explored the potential advantages of bonding amalgam to tooth surfaces. Bond strengths have been reported to range from 2 to 20 MPa, with higher bond strengths reported for filled adhesives. Most studies agree that the use of bonding results in a considerable reduction of microleakage, when compared with copal varnish or no lining. The use of bonding provides retention in vitro that is equivalent to, or better than, the use of mechanical undercuts. Most studies on strength of restored teeth report an improvement in resistance to fracture or cuspal flexing as measured by strain gauges. Penetration of secondary caries along the interface has been found to be inhibited by bonding. The mode of failure of bonded amalgams has generally been reported to be mixed, but predominantly between the resin and amalgam. In vitro studies have reported one potential problem in the incorporation of resin into amalgam, which may cause a decrease in strength of the restoration. The clinical studies of bonded amalgams that have been published to date are of short duration, indicating that when traditional preparations are used, no problems are seen with bonding, but also no advantages, as measured by clinical assessment criteria. However, some studies show that bonded amalgam may be useful for procedures where non-bonded amalgams would be expected to be lost, namely in preparations with little, if any, mechanical retention. It was concluded that, while there are various in vitro studies demonstrating that bonded amalgams have advantages of improved retention and tooth reinforcement and decreased marginal microleakage and secondary caries, the operative technique is more complicated and there are few advantages yet evident from clinical studies in conventional preparations having mechanical retentive features. However, there is evidence accruing from clinical studies that bonding of amalgam can be favorably used to extend the range of usage of amalgam to non-retentive conservative preparations, and toward the other extreme, as an adjunct to other forms of retention in large compound restorations.

Adhesives↗
PubMedDate not supplied

Influence of bonded amalgam restorations on the fracture strength of teeth.

This study evaluated the effect of bonded amalgam on the fracture strength of teeth using five adhesive systems: Panavia 21, Amalgambond Plus, Imperva Dual Bond, All-Bond 2 Primer/Bonding Resin, and All-Bond 2 Primer/Liner F. Intact teeth and amalgam lined with Copalite were used as control groups. Large MOD preparations were made in 20 extracted maxillary premolars for each group. The teeth were restored with Tytin. All groups were stored in water at 37 degrees C for 15 days and thermocycled 2500 times, over 8-48 degrees C. The specimens were preloaded five times in compression to 10 kg using a 5 mm-in-diameter, cylindrical steel indenter that contacted the teeth only on the cuspal inclines. Then the teeth were loaded to failure at 5.0 mm/min. The failure mode was recorded (amalgam failure, cusp fracture, or failure at the tooth/amalgam interface). The mean fracture strengths were analyzed using ANOVA and Newman-Keuls multiple comparisons. The Imperva Dual Bond group showed the highest mean forces followed by All-Bond 2 Primer/Bonding Resin. The All-Bond 2 Primer/Liner F and Amalgambond Plus groups demonstrated lower means and were not significantly different from the Copalite group. The Panavia 21 group was in between these two groups and was not statistically different from either group. The mean strength of intact teeth was the highest, but its very large coefficient of variation (60%) prevented effective use of these data for statistical comparison. Analysis of the mode of fracture showed that Panavia 21, All-Bond 2 Primer/Bonding Resin, and Amalgambond Plus failed cohesively in the amalgam in 35%, 25%, and 15% of the specimens respectively. This fracture type is a good indication of effective bonding between tooth and amalgam. The most common type of fracture for all the restored groups was the one that occurred at the tooth/restoration interface. This would suggest that current bonding procedures could be improved.

Analysis of Variance↗
PubMedDate not supplied

Microleakage after thermocycling of 4 etch and rinse and 3 self-etch adhesives with and without a flowable composite lining.

This study evaluated the microleakage of composite fillings prepared with 4 etch and rinse and 3 self-etch adhesive systems after thermocycling. Also evaluated was the potential improvement of cavity sealing when utilizing a low charged resin lining for cavity preparations. Seventy recently extracted teeth were randomly allocated to 7 experimental adhesive systems: two 3-step etch and rinse adhesive systems, Scotchbond Multipurpose (SBMP) and Optibond Solo Plus (OS); two 2-step etch and rinse adhesive systems, referred to as "one-bottle," Scotchbond 1 (SB1) and Gluma Comfort Bond + Desensitizer (G); and 3 self-etch "all-in-one" adhesives, Adper Prompt-L-Pop (PLP), Xeno III (X-III) and iBond (iB). On each tooth, 2 rectangular cavities were prepared at the cemento-enamel junction: 1 cavity was prepared with adhesive and the hybrid composite and the second was filled with the same adhesive and a thin layer of flowable composite (Filtek Flow) under the resin composite (Z100). All teeth were thermocycled for 800 cycles (5 degrees C-55 degrees C, 30 seconds dwell time). Leakage was evaluated on a 6-point (0-5) severity scale for enamel and dentin on 4 interfaces for each restoration. The results are expressed as means +/- standard deviation (SD). Microleakage scores were analyzed by means of generalized linear mixed models (GLMM), assuming an ordinal logistic link function. Covariates in the model were: (1) adhesives, (2) fluid composite and (3) interface. The model also accounts for repeated measurements on the various teeth. The authors found that the mean score of microleakage per tooth was significantly higher at the enamel rather than at the dentin interfaces (1.21 +/- 0.51 and 0.87 +/- 0.48; p<0.0001). In this study, there was no significant difference among the 4 etch and rinse adhesive systems. On the other hand, these adhesives yielded smaller mean scores of microleakage than the 3 self-etch systems (respectively, 0.85 +/- 0.2 and 1.3 +/- 0.5; p<0.0001). Among the self-etch adhesives, microleakage was significantly greater for PLP (1.74 +/- 0.46) than for the other self-etch products (p<0.0001), while X-III, an intermediary strong self-etch, was found to be as good as the etch and rinse systems, with a mean score of 0.97 +/- 0.27. In addition, results have also shown that an under layer of flowable composite significantly improved the water tightness of the PLP adhesive restorations (p=0.042). This in vitro study concluded that the self-etch adhesives remain less effective than etch and rinse. Nevertheless, X-III, a self-etch adhesive, showed acceptable performance in accordance with this study's 6-point severity scale of microleakage, but this needs to be confirmed in further clinical studies. On the other hand, this study failed to reveal that the addition of a thin layer of fluid composite improved the water tightness of the restoration, except for PLP.

Acid Etching, Dental↗
PubMed1997

The process and results of revolution in dental caries treatment.

The traditional system devised by G.V. Black for dental caries treatment has been fundamentally changed by the development of new knowledge about dental caries pathology and chemically adhesive resin composite. The scientific background is first discussed, together with the process of the development of new materials, following which the essence of the latest clinical techniques are described and illustrated. The system of minimal tissue reduction is extremely simple and painless, not requiring anaesthesia and is able to secure maximal longevity of restored teeth. The author describes his personal record in the development of acid etched dentine and composite restoration systems.

Acid Etching, Dental↗
PubMed2005

In vivo interfacial adaptation of class II resin composite restorations with and without a flowable resin composite liner.

The aim of this study was to evaluate in vivo the interfacial adaptation of class II resin composite restorations with and without a flowable liner. In 24 premolars scheduled to be extracted after 1 month, 48 box-shaped, enamel-bordered class II cavities were prepared and restored with a flowable liner (FRC, Tetric Flow/Tetric Ceram/Syntac Single-Component) or without (TRC), cured with three different curing modes: soft start and 500- or 700-mW/cm2 continuous irradiation. Interfacial adaptation was evaluated by quantitative scanning electron microscopic analysis using replica method. Gap-free adaptation in the cervical enamel (CE) was observed for FRC and TRC in 96.2 and 90.2%, for the dentin (D) in 63.6 and 64.9%, and for occlusal enamel (OE) in 99.7 and 99.5%, respectively. The difference between the two restorations was not statistically significant (ns). Significant better adaptation was observed for OE than CE and D (p<0.01), and for CE than D (p<0.01). Gap-free adaptation with the soft-start and 500- and 700-mW/cm2 continuous-curing modes was observed for CE: 88.7%, 92.7%, 97.9% (ns); OE: 99.8%, 98.7%, 100% (ns); and D: 64.0%, 63.9%, and 64.6% (ns), respectively. It can be concluded that neither the use of flowable resin composite liner nor the curing mode used influenced the interfacial adaptation.

Adolescent↗