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Microleakage of endodontic temporary restorative materials.

This study compared the sealing of Caviton, Cavit, and IRM at two powder to liquid ratios of 6 g/ml and 2 g/ml. Standard endodontic access preparations were made in 140 noncarious, nonrestored crowns of extracted human molars. They were divided into six groups, including positive and negative controls. Microleakage assessment was evaluated by basic fuchsin dye penetration after thermal cycling (5 to 55 degrees C for 100 cycles). The results indicated that Caviton provided the best seal, followed by Cavit. Cavit demonstrated better sealing than IRM at the powder to liquid ratio of 6 g/ml and 2 g/ml. There was a statistically significant difference in leakage between the Cavit group and IRM (powder to liquid = 6 g/ml), between the Cavit group and IRM (powder to liquid = 2 g/ml) group (p < 0.05). However, no statistically significant difference between the two different powder to liquid ratio groups of IRM was disclosed.

Analysis of Variance↗

Rehabilitation of young patients with amelogenesis imperfecta: a report of two cases.

This paper presents a method for the rehabilitation of young patients with amelogenesis imperfecta, illustrated by two cases. The method comprises a temporary phase and a transitory phase. The aim of the temporary phase, which involves the use of temporary resin and NiCr crowns during primary or mixed dentition, is to reestablish the esthetic, occlusal and masticatory features of the child's dentition. It must respect the integrity of the pulp so as not to compromise the development of the dentition, and must be capable of adapting to any changes occurring during development. The transitory phase, which is undertaken on the permanent teeth, ensures an esthetic quality that lasts until adulthood. It entails the use of laboratory designed composite prostheses.

Amelogenesis Imperfecta↗

[Clinical study of the effect of preventing dentine hypersensitiveness by using Fluor Protector and Green Or on the prepared vital pulp abutment teeth].

PURPOSE: To study and evaluate the effect preventing dentine hypersensitiveness by using Fluor Protector or Green Or on the prepared vital pulp abutment teeth of PFM bridges. METHODS: 118 cases, 246 prepared vital pulp abutment teeth, were randomly divided into three groups: Experimental Group A--treated with the Fluor Protector and temporary crown; Experimental Group B--treated with the Green Or and temporary crown, and Control Group--only using temporary crown. The results of desensitization in 3 groups were evaluated. F test was used for analysis (DSPV6.01). RESULTS: Significant differences were found between experimental Group A, B and the control group after 1 week (when cementing the PFM bridges); and also after 1 month (P<0.05). But no significant difference was found between experimental Group A and B (P>0.05). CONCLUSIONS: The effect of preventing dental hypersensitiveness by using Fluor Protector or Green Or on the prepared vital pulp abutment teeth of PFM bridges is ideal. It is easy to use and worth being widely applied.

Calcium Compounds↗

Influence of dietary simulating solvents on the hardness of provisional restorative materials.

OBJECTIVE: To evaluate the influence of dietary simulating solvents on surface hardness of chemical, light and dual-cure provisional restorative materials. METHODS: The provisional materials evaluated were Temporary Bridge Resin (TBR) (Dentsply), Protemp Garant (PG) (ESPE-3M), Luxatemp Automix (LA) (DMG), Unifast LC (UF) (GC), Luxatemp Solar Plus (LS) (DMG) and Provipoint DC (PP) (Vivadent). Materials were manipulated according to manufacturers' instructions and placed in customized molds. Immediately after setting/light-polymerization, the materials were stored in the following dietary simulating solvents at 37 degrees C for 1 week: (a) heptane, (b) 100% ethanol solution (ES), (c) 75% ES, (d) 50% ES, (e) 25% ES, and (f) distilled water. Specimens stored in air were used as control. After the one-week conditioning period, hardness testing (KHN; n = 6) was carried out with a digital microhardness tester (load=100 gf; dwell time=15 s). Hardness ratios were plotted against the solubility parameter of the solvents and the Environmental Index was subsequently computed. Data were subjected to ANOVA/Scheffe's test at significance level 0.05. RESULTS: For all materials, conditioning in the various ES resulted in significantly lower KHN values compared to conditioning in air and water. TBR, UF and PP were also significantly softened by conditioning in heptane. Ranking of Environmental Index was as follows: LS>LA>PG>TBR>UF>PP. SIGNIFICANCE: All provisional materials were significantly softened by aqueous ethanol solutions. Materials based on bis-acryl resins were generally more resistant to damage from dietary solvents.

Composite Resins↗

Detection of in vitro demineralization adjacent to restorations using quantitative light induced fluorescence (QLF).

AIM: Quantitative light-induced fluorescence (QLF) is a technique for the detection, quantification, and longitudinal monitoring of early carious lesions. The technique is non-destructive and can be used in vivo. Using the natural fluorescence of teeth, and the loss of such fluorescence in demineralized enamel, QLF is a repeatable and valid optical caries monitor. Previously used in smooth and occlusal surfaces, the purpose of this pilot study was to determine if QLF could detect, and longitudinally monitor, demineralization adjacent to a range of restorative materials. METHODS: Fifteen previously extracted lower third molars were selected based upon the lack of any visible demineralization. A single burr hole was placed on the buccal surface and the cavity restored with amalgam, composite, compomer, glass ionomer or a temporary filling material. The buccal surface was then coated in an acid resistant nail varnish leaving an exposed area around the restoration and also a similar sized control region. The teeth had QLF images taken at baseline and were then subjected to a demineralizing buffer, further QLF images were subsequently taken at 72 and 144 h. Transverse microradiography was used to confirm the presence of early, subsurface lesions at the completion of the cycle (144 h). QLF images were analyzed by a single blinded examiner and values for change in radiance fluorescence were computed. These values were recorded as loss of radiance fluorescence loss integrated over area of lesion and expressed as DeltaQ. RESULTS: The appearance of each material under QLF and the change in fluorescence is described. Amalgam, glass ionomer and the temporary material all exhibited reduced fluorescence, while composite and compomer showed increased fluorescence, when compared with surrounding enamel. There was no change in fluorescence of the materials when subjected to experimental demineralizing conditions. Readings at 72 and 144 h demonstrated demineralization adjacent to the restorations and at the exposed control. Significant differences were detected between baseline, 72 and 144 h using ANOVA on all restorations with the exception of compomer where significance was noted between baseline and 144 h, p>0.05. CONCLUSIONS: This pilot study has demonstrated the ability for QLF to detect and monitor secondary caries. Analysis techniques should be based upon the subtraction of baseline DeltaQ scores from subsequent images. Further research is required to assess the ability of QLF to detect secondary lesions in vivo.

Analysis of Variance↗

Cytotoxicity of temporary crown and bridge materials.

In vitro cytotoxicity of freshly prepared temporary crown and bridge materials was studied using mouse fibroblasts prelabelled with 3H-thymidine grown in shake flask cultures. Cytotoxicity was measured as (1) lack of cell multiplication, (2) stainability with Trypan blue and (3) release of 3H-labelled material to the culture medium. All the materials tested (zinc oxide-eugenol cement (ZOE), Scutan and Sevriton) were cytotoxic in this system, ZOE most strongly. This finding favours the view that the in vitro cytotoxicity of dental materials should not be used alone as a screening test for their biological compatibility under clinical conditions since clinical experience and previous in vivo findings have established that ZOE is biologically well tolerated by the dental tissues.

Animals↗

Bacterial microleakage of Cavit, IRM, and TERM.

In this in vitro study, a model system was developed and tested to evaluate the sealing ability of temporary restorative materials used in endodontic access preparations. The materials studied, Cavit, IRM, and TERM, were tested on 40 premolars against a known bacterial species, Streptococcus sanguis. The leakage of bacterial cells was checked 4 and 8 days after initial immersion in the culture. Thermocycling was introduced on the fourth day. After 8 days the cement thicknesses were measured after the teeth had been longitudinally sectioned. Before and after thermocycling, IRM was less leakproof than Cavit (p < 0.05) and TERM (p < 0.05). Thermocycling aggravated percolation in the case of IRM, and decreased the tightness of Cavit, whereas TERM remained leakproof. The thicknesses were as follows: Cavit, 3.73 mm; IRM, 3.45 mm; and TERM, 5.49 mm. There was no statistically significant relationship between thickness and tightness.

Analysis of Variance↗

[Temporary restoration using light-cured resin].

In spite of various problems involved in chemically cured resin (self-curing resin), e.g., irritability, and heat and shrinkage at polymerization, it has traditionally been the material of choice in the production of temporary restorations. However, light-cured resin, which does not have the disadvantages of chemically cured resin, has recently been developed and applied to clinical treatment. The present study was conducted to examine the clinical application of light-cured resin to temporary crowns. Two types of light-cured resin and one type of chemically cured resin were examined for their mechanical properties. The properties involved in handling and setting, and the methods of producing crowns were also studied. The results were as follows: 1) In the tensile strength test, there was no significant difference between the two types of light-cured resin, i.e., Triad and Unifast LC. The tensile strength of Unifast, a chemically cured resin, was slightly greater than the others, the difference being significant. 2) The Vickers hardness test showed no significant differences between the three types of resin. 3) The mechanical properties of Triad were not influenced by differences in the curing unit (the unit for general oral use or exclusive use) used for polymerization. 4) The test of setting properties revealed that Unifast LC needed longer than Unifast from the 2nd through the 4th clinical stage. In particular, Unifast LC required about 2.5 times the duration needed by Unifast at the 2nd stage in the tray method. 5) The heat generation test showed that the exothermic temperature in Unifast was significantly higher than in the two types of light-cured resin. 6) Heat generation associated with light curing was noted during the use of a light-curing unit for oral use.

Dental Restoration, Temporary↗

A microleakage study of temporary restorative materials used in endodontics.

The purpose of this study was to quantitatively evaluate the sealing properties of various temporary restorative materials used in standard endodontic access preparations by using a newly introduced fluid filtration method. The materials tested were Cavit, Cavit-G, TERM, glass ionomer cement, zinc phosphate cement, polycarboxylate cement, and IRM. Extracted human incisor, canine, and premolar teeth were used, and each tooth served as its own control by testing for microleakage prior to access preparation. Following access preparation, cotton pellets were placed in the pulp chamber so that the space remaining for the restoration was 4 mm. Immediately after placement of the restoration, the teeth were immersed in Ringer's solution and incubated at 37 degrees C. Microleakage was measured after various time intervals. The results indicated that Cavit, Cavit-G, TERM, and glass ionomer cement provided leakproof seals during the 8-wk testing period, while leakage was observed in 4 of the 10 teeth restored with zinc phosphate cement. IRM and polycarboxylate cement were the least effective of the materials tested for preventing microleakage.

Calcium Sulfate↗

Effect of restoration thickness on the sealing ability of TERM.

An in vitro study was done using a fluid filtration device to compare microleakage of Temporary Endodontic Restorative Material (TERM) at various thicknesses. Forty-four extracted mandibular molars had their roots removed at the cementoenamel junction, occlusal table flattened, and a standardized endodontic access made in the crown. The teeth were restored with TERM in thicknesses of 1, 2, 3, and 4 mm, and quantitatively measured for leakage (microliters/min) at intervals of 1 and 24 h and 1, 3, and 5 wk. Thermocycling was accomplished at the 5-wk interval. Positive controls received 4-mm-thick IRM or gutta-percha restorations and were measured at 24 h only. Repeated measures of analysis of variance found no significant difference (p < 0.05) in leakage values in any group over time or between any of the different thicknesses. Positive controls showed significantly more leakage than all other groups. TERM maintained as tight a seal at 1-, 2-, and 3-mm thicknesses as it did at 4 mm and may be suited for clinical situations where less than 4 mm of restorative space exists.

Analysis of Variance↗

Evaluation of temporary restorations' microleakage by means of electrochemical impedance measurements.

The aim of this study was to quantify the changes in the watertightness of three temporary filling materials over 1 wk with a new electrochemical technique: the impedance a measurement technique. Forty sound extracted human maxillary teeth were selected and prepared for the measurements. They were divided into three groups in addition to positive and negative controls. The resistance, and therefore the watertightness, of the intact crown and the resistance after preparation of an endodontic access cavity were registered. After a randomization procedure, 12 teeth were obturated with Cavit G, 12 teeth with Fermit-N, and 12 teeth with Intermediate Restorative Material (IRM). The changes in the resistance were measured first just after obturation (time 0), then after days 1, 2, 3, 4, and 7. The results showed that the IRM group was significantly more watertight than the Fermit-N group (p < 0.05) and much more than the Cavit G group (p < 0.005).

Bicuspid↗

Coronal microleakage of three temporary restorative materials: an in vitro study.

The sealing properties of three temporary restorative materials, Cavit, IRM, and a polycarboxylate-based cement, Ultratemp Firm, were investigated in vitro. Standardized access cavities were prepared in 45, intact, extracted, human molars. The teeth were randomly assigned to three groups and the access openings filled with one of three temporary filling materials. In five teeth (negative control), no restorative material was placed but the preparations were coated entirely with sticky wax. The five teeth of the positive control group had no restorative material and no sticky wax applied. After thermocycling for 500 cycles (5-55 degrees C), the experimental teeth were dipped in molten sticky wax to the CEJ. The coronal enamel was subsequently coated with two layers of nail varnish, leaving an area of 1 mm around the filling material uncovered. The samples were then immersed in 2% methylene blue dye solution for leakage assessment. The teeth were sectioned and the greatest depth of dye penetration was recorded. Positive control sections exhibited complete dye penetration, whereas negative controls had none. There was no statistically significant difference in marginal leakage between Cavit, IRM, and Ultratemp Firm (p > 0.05). All materials leaked at the interface material-dentin, whereas some IRM specimens absorbed the dye into the bulk of the material.

Acid Etching, Dental↗

Leaching of plasticizers from temporary denture soft lining materials.

The loss of the plasticizers dibutylphthalate, butylphthalylbutyl glycolate, benzylbenzoate, methylsalicylate, and benzylsalicylate from four soft lining materials was measured. A 0.1% aqueous solution of triton X-100, reduced was used as immersion medium, since the solubility of plasticizer in this medium was close to that of saliva. The loss of plasticizer was monitored up to 30 d after mixing. For two of the materials, the average amount of leached dibutylphthalate within the first day exceeded the proposed tolerable daily intake (TDI) by about 11 and 32 times, respectively, for an average adult person. Similarly, for these two materials, the average daily amount within the first 30 d of leached dibutylphthalate was 2.2 and 6.6 times larger, respectively, than the TDI limit. The cumulative amount leached over 30 d for each of the four materials was 128-253 mg plasticizer g(-1). The results indicate the need for further biological evaluations of these products.

Adult↗

Leakage in roots coronally sealed with different temporary fillings.

This study was aimed at determining the ability of different coronal temporary fillings to prevent corono-apical penetration of bacteria. A total of 103 human teeth, including three controls, were instrumented, obturated with gutta-percha, coronally sealed with either Cavit, Intermediate Restorative Material (IRM), glass-ionomer cement, Cavit/glass-ionomer cement, or IRM/glass-ionomer cement, respectively. Each root was fixed with wax between two chambers: the coronal chamber harboring soy broth with 10(8) colony-forming units of Streptococcus mutans/ml, the apical chamber containing sterile soy broth. The latter was checked daily for turbidity, indicating corono-apical penetration of bacteria. The Cavit group, the IRM group, and the Cavit/glass-ionomer cement group showed significantly more leakage than the glass-ionomer cement group of the IRM/glass-ionomer cement group. If a sample leaked, all except one (IRM/glass-ionomer cement) leaked before day 12. This in vitro study seems to indicate that only glass-ionomer cement and IRM combined with glass-ionomer cement may prevent bacterial penetration to the periapex of root-filled teeth over a 1-month period.

Calcium Sulfate↗

Immediate restoration of single implants placed immediately after tooth extraction.

BACKGROUND: Some of the original surgical protocols for implant surgery have been reassessed to satisfy the patient's continuously increasing expectation for shorter rehabilitation time, improved esthetics, and increased comfort. The aim of this study was to evaluate the 12-month clinical success of 18 single-tooth implants inserted immediately after tooth extraction and restored the same day with non-functional loading. METHODS: A total of 18 patients (12 women and six men), 22 to 60 years old, were enrolled in this study. Eighteen single implants were inserted in fresh extraction sockets and immediately restored with temporary abutments and crowns. All experimental sites showed an absence of fenestrations or dehiscences of the bone walls and a residual gap between implant surfaces and surrounding bone walls < or =2 mm. All temporary prostheses were positioned the same day of surgery and were not in occlusal contact with opposing arches. The comparison between the baseline and 12-month visits was performed with the Student t test for paired data (statistically significant at a level of alpha = 0.05). RESULTS: During the 12-month follow-up period, one fixture was removed 4 weeks after implant placement following an abscess. All remaining implants healed uneventfully with no complications and were assessed as stable and successful at the 12-month checkup. No technical complications such as screw loosening, resin fracture, or pain during chewing were registered during the 12-month period. CONCLUSIONS: Within the limits of the data from this study, it can be suggested that immediate placement and restoration of a single implant can be a valid and successful option of treatment in the case of single compromised teeth. Moreover, this treatment protocol eliminates the need for removable provisional restoration and seems to maintain the preexisting architecture of soft and hard tissues in most cases. Nonetheless, further prospective and long-term studies are required to obtain a better insight into the limitations of this protocol.

Adult↗

Microleakage of temporary endodontic restorations in overdenture tooth abutments.

PURPOSE: The sealing of provisional filling material in overdenture tooth abutments during provisional rehabilitation is of primary importance to the long-term success of roots bearing gold casting copies. The aim of this in vivo study was to evaluate the microleakage of four different provisional filling materials after a period of 1 week. MATERIALS AND METHODS: Five patients needing treatment with overdenture prostheses and scheduled for the extraction of at least four teeth were chosen. After performing endodontic treatment on the roots to be extracted, a standardized cavity preparation 3 mm in depth was made using a diamond bur. Each cavity was filled with one of the four provisional materials selected for the evaluation (Cavit-W, IRM Caps, Guttapercha, Fermit-N), and the interim prostheses were delivered to the patients. After 1 week, the roots were extracted and stored for 24 hours in 0.5% basic fuchsin at 37 +/- 1 degrees C for 24 hours. Subsequently, the roots were severed and observed under a stereomicroscope for microleakage evaluation. RESULTS: The materials showed different degrees of microleakage, but none allowed dye penetration to the bottom of the cavity. IRM Caps showed the lowest mean value of dye penetration (168 microns), while Fermit-N showed the highest (1,475 microns). All materials differed from each other (P < .05). CONCLUSION: Within a period of 1 week, the materials provided acceptable to good sealing properties. All of the materials may be considered suitable for provisional fillings if they do not remain in the oral cavity for more than 1 week.

Analysis of Variance↗

Changes in the cultivable flora in deep carious lesions following a stepwise excavation procedure.

This study examined the cultivable microflora before and after stepwise excavation procedures in deep carious lesions in 9 permanent teeth, categorized according to degrees of proximal surface destruction. The final excavation was performed 4-6 months after the initial treatment, which included peripheral dentine excavation and removal of the central cariogenic biomass and the superficial necrotic dentine. Dentine colour and consistency were assessed by means of standardized scales before the application of a Ca(OH)(2) compound and temporary sealing. Reassessments were performed before and after the final excavation. Microbiological samples of the central demineralized dentine were obtained with a sterile bur before and after the first excavation, as well as before and after the final excavation. After anaerobic cultivation on enriched non-selective tryptic soy agar, 30 colonies from a representative area were identified by standardized biochemical and physiological tests. Before temporary restoration, a yellowish and light brown demineralized soft dentine was typically observed, and gram-positive rods accounted for 70% and lactobacilli for 50% of the total colony-forming units. Lactobacillus casei subsp. rhamnosus and Actinomyces naeslundii dominated the lactobacilli and the other gram-positive rods, respectively. Gram-negative rods were the next most frequent isolates, followed by streptococci, each group accounting for about 20% of the colony-forming units in positive samples. Before the final excavation, which did not cause exposure of the pulp in any of the cases, the retained demineralized dentine had changed into a darker and harder tissue, and the total colony-forming units, as well as the frequency and proportions of lactobacilli were substantially reduced. Gram-negative rods also declined, and the flora was dominated by A. naeslundii and various streptococci. In conclusion, the cultivable flora detected following the treatment interval had declined substantially, and the distribution of bacterial species did not represent a typical cariogenic microbiota of deep lesions, confirming the clinical findings of arrested caries progression.

Actinomyces↗

Cytotoxicity of provisional crown and bridge restoration materials: an in vitro study.

There are numerous materials used to provide temporary coverage for teeth while permanent restorations are being fabricated. The biocompatibility of these materials is important for the protection of teeth and gingiva, but there is little information on this subject. This study aimed to examine possible time-dependent toxic effects of provisional crown and bridge restoration materials, manipulated intraorally or extraorally, on epithelia cells. A total of 20 discs, 4 sample discs from each product having dimensions of 4 mm diameter and 2 mm thickness, were prepared. After sterilization, toxicity of these discs was evaluated in the Madin Darby Bovine Kidney (MDBK) cell line. Morphological cell changes were observed microscopically at the 3rd, 6th, 12th, and 24th hours by the filter diffusion test method. After the 3rd hour, Artglass and Structur produced cytotoxic symptoms. Temdent had the least toxic effects at the end of the 12th hour. However, after the 24th hour, the toxic values were similar for all materials. The results of this study show that although the toxicity response of chemically and light curing materials had changed in different time periods, all of them had the same toxic effects at the end of the 24th hour.

Animals↗