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PubMed2002

The morphology and stability of resin-modified glass-ionomer adhesive at the dentin/resin-based composite interface.

PURPOSE: To evaluate the interface with tooth structure, mode of failure and stability of Fuji Bond LC (FBLC) resin-modified glass-ionomer bonding system. MATERIALS AND METHODS: The study was in three main parts. The first part with interfacial characteristics of FBLC. The micropermeability of the FBLC/dentin interface of restored cavities in extracted teeth, after fluorescent dye was introduced into the pulp chamber, was assessed by confocal microscopy. In other teeth, confocal microscopy was also used to examine trhe failure of FBLC bonded to flat dentin surfaces, on shear loading. In the second part, cervical cavities restored with FBLC (with and without light-curing) and a resin-based composite were examined for stability of the interface over the first 15 minutes. In the last part of the study, a new fluorescent dye was mixed with FBLC for restoration of cavities and subsequent examination using 2-photon imaging techniques. RESULTS: FBLC adapted well to tooth structure, had an interface with dentin that was permeable to fluid and displayed the absorption layer. Shear loading at the dentin interface resulted in complex failure with areas of cohesive failure where the absorption layer was present. Light-curing of FBLC seemed to produce a stable restorative while "co-curing" resulted in an unstable situation, with the appearance of an emmisable exudate from the FBLC. Advanced fluorescent imaging of the material itself seemed to suggest that there was a movement of aluminum ions in a manner similar to other glass-ionomer cements. The presence of HEMA in the matrix of the cement associated with the absorption layer was also demonstrated.

Absorption↗
PubMedDate not supplied

Effect of thickness of flowable resins on marginal leakage in class II composite restorations.

Despite limited scientific evaluation, there is an increased use of low elastic modulus flowable resin composite (FRC) as a stress-relieving gingival increment in Class II restorations. This study compared marginal leakage in preparations with gingival margins in enamel or dentin/cementum (sub-CEJ and supra-CEJ) after FRC was used as a gingival increment to hybrid resin composite used alone. In addition, the extent of leakage around restorations with or without the use of FRC gingival increments when light curing the resin composites from occlusal direction only or buccal, lingual and occlusal directions was compared. Sixty extracted human molars were prepared with two identical Class II (MO and OD) preparations (30 were 1 mm sub-CEJ and 30 were 1 mm supra-CEJ) and randomly assigned to six groups. After etching, dentin-bonding agent was applied to all prepared tooth surfaces according to the manufacturer's specifications. One of three different thicknesses of FRC (0.5 mm, 1 mm or 2 mm) was placed on the gingival floor, cured and a hybrid resin composite was placed occlusally to complete the restoration. The control preparation on each tooth was restored in the same manner, except that a hybrid resin composite was used for both the gingival and occlusal increments. The restored teeth were thermocycled (300 cycles), then immersed in 50% silver nitrate prior to the hemi-section and measured for leakage under a light microscope. The data were evaluated using paired measures analysis of variance (ANOVA). Most of the occlusal margins showed no leakage, while almost every gingival margin demonstrated some silver nitrate penetration regardless of whether it was located sub or supra-CEJ, although significantly less leakage was found in restorations with supra-CEJ margins (p=0.0001). Among supra-CEJ restorations, there was a pronounced reduction in leakage as FRC thickness increased (p=0.0005). In the teeth restored with the gingival-margin located supra-CEJ, the 2 mm thickness FRC gingival increment showed significantly less leakage (p<0.01) compared with the 0.5 mm thickness of FRC gingival increment. The direction of the curing light did not affect the extent of leakage (p>0.05). The use of FRC material as a gingival increment sub-CEJ in posterior hybrid resin restorations produced no significant difference in leakage (p>0.05). The results of this study indicated that restorations located supra-CEJ (with gingival margins in enamel) with 2 mm thick FRC gingival increments demonstrated significantly less leakage than did those with 0.5 mm FRC. When the margin of the restoration was located sub-CEJ (in dentin/cementum), neither the thickness nor the presence of FRC as a gingival increment significantly influenced the marginal leakage.

Acid Etching, Dental↗
PubMedDate not supplied

A clinical comparison of glass ionomer, resin-modified glass ionomer and resin composite restorations in the treatment of cervical caries in xerostomic head and neck radiation patients.

Controversy exists as to whether there is less secondary caries at the margins of glass ionomer restorations compared with other materials that do not release fluoride. This study examined the incidence of secondary caries for three types of restorative materials in Class V restorations in xerostomic patients. The study group consisted of 45 high caries-risk adult patients who had undergone head and neck irradiation for the treatment of cancer. All were substantially xerostomic and in need of at least three restorations in the same arch. Every patient received a restoration with each of the test materials, a conventional glass ionomer (GI), a resin modified glass ionomer (RMGI) and a resin composite (C). Patients were instructed in the daily use of a neutral pH sodium fluoride gel in custom trays. Recall appointments were made at 6, 12, 18 and 24 months, and the restorations were examined for material loss, marginal integrity and recurrent caries at the restoration margin. Fluoride compliance was determined at each recall period and recorded as the percentage of recommended use during that interval. Patients were categorized at the end of the study as fluoride non-users if their average compliance was 50% or less. Those with greater than 50% compliance were categorized as fluoride users. In the latter group, no recurrent caries was found for any of the restorations, whereas a material-dependent incidence of recurrent caries was found in the fluoride non-user group. None of the GI, one RMGI and eight C restorations failed due to recurrent caries. For the fluoride non-user patients, Fishers exact test (p=0.05) showed no statistical difference between GI and RMGI but statistical differences were found among those materials and resin composite at each recall period. Recurrent caries reductions for GI and RMGI relative to C were greater than 80% in xerostomic patients not using topical fluoride supplementation.

Adult↗
PubMedDate not supplied

Micromorphological study of resin-dentin interface of non-carious cervical lesions.

This study examined the interfaces between two dentin adhesives, namely, One Coat Bond, Clearfil SE Bond and a resin-modified glass ionomer cement (Fuji II LC) and the dentin of non-carious cervical lesions (NCCLs) with FE-SEM, and compared them with the interfaces produced with "normal" dentin. Fifteen human premolars each with a buccal NCCL were used. Cervical cavities were prepared on the lingual surface of the same teeth for the normal (control) dentin. All lesions and prepared cavities were cleaned with a slurry of pumice and water. The teeth were randomly divided among the three products that were applied according to the manufacturers' instructions. For the resin-bonded specimens, the cavities were restored with resin composite. All specimens were stored in 37 degrees C tap water. Resin-bonded specimens were observed using FE-SEM after treatment with 10% phosphoric acid, and 10% phosphoric acid and 5% sodium hypochlorite (NaOCl). The resin-modified glass ionomer cement (RM-GIC) specimens were observed after 10% phosphoric acid and 5% NaOCl treatment. The hybrid layer could be observed for the two adhesive systems in all specimens, but the thickness varied depending on the bonding system used and the dentin substrate. The results suggested that the hybrid layer produced in normal dentin was slightly thicker than that of NCCLs. Further, the hybrid layer thickness decreased in all specimens after NaOCl treatment.

Bicuspid↗
PubMedDate not supplied

Technique on restoring cervical lesions.

This paper describes a technique of placing a semi-rigid cervical matrix slightly past the cervical border of a lesion that extends below (apical to) the gingival crest and inserting the glass ionomer cement through an opening cut in the matrix above the soft tissue level.

Dental Restoration, Permanent↗
PubMed2002

Microleakage in class II composite resin restorations: total bonding and open sandwich technique.

PURPOSE: The objective of this in vitro study was to evaluate gingival microleakage in Class II total bond resin restorations in comparison to open sandwich technique restorations using different materials. MATERIALS AND METHODS: Forty-eight human molar teeth were disinfected and stored in a 0.9% saline solution. In each tooth, two standardized Class II cavities (3 mm x 6 mm x 2 mm) were prepared with the gingival cavosurface margins located 1 mm below the cementoenamel junction. The teeth were divided into 4 equally sized groups (n = 12), and the proximal boxes were treated as follows: in Group 1, no base material was used and the cavity was restored using SyntacSprint (SS) and Tetric Ceram (TC); in Groups 2, 3, and 4 the gingival portion of the cavity was restored with different base materials (Group 2, Dyract; Group 3, Vitremer; Group 4, Chelon-fil) prior to the placement of the composite resin. After a storage time of 7 days, the restorations were finished and polished. Then, specimens were submitted to thermocycling (500 cycles, 5 degrees C to 55 degrees C, 15 s dwell time) and immersed in a 0.5% methylene blue solution for 24 h. After washing, they were sectioned in a mesio-distal direction. Each restoration was evaluated under a stereomicroscope at 20x by 2 examiners and scored on a 0 to 3 scale according to the marginal leakage. Kappa statistics were used to evaluate the agreement between the examiners. Given the ordinal nature of the scoring system, data were submitted to a nonparametric repeated measures ANOVA. The results were confirmed with a parametric repeated measures ANOVA. RESULTS: Significant differences (p < 0.001) among the four groups with respect to dye penetration were detected, with the association Vitremer/Tetric showing the best results. CONCLUSION: The use of Vitremer in the open sandwich technique presents the lowest degree of microleakage among the treatments considered in this study.

Analysis of Variance↗
PubMed2002

Effect of accelerated restorative techniques on the microleakage of Class II composites.

PURPOSE: To assess the marginal seal of Class II resin-based composite restorations cured by a high intensity halogen light or a plasma arc light. MATERIALS AND METHODS: Class II cavities were prepared in extracted molar teeth with cervical margins located apical to the cemento-enamel junction. Cavities were restored with a posterior resin-based composite (Tetric Ceram) using either a two-increment or a bulk placement and cure restorative technique after application of bonding agent (Excite). Test parameters included light unit type/curing mode, application of flowable composite and restorative technique. After thermocycling, the teeth were immersed in basic fuchsin dye. Sectioned restorations were examined under a stereomicroscope (x 25) and extent of microleakage (mm) was recorded using an image analysis system. Data was analyzed by non-parametric statistical tests. RESULTS: No leakage was observed at the occlusal enamel margin of a nyrestoration. Median gingival leakage values for the different test groups ranged from 0.02-2.51 mm. Light unit type had a highly significant effect on leakage (P=0.0002). The highest leakage scores were recorded with the plasma arc light used in standard curing mode and the lowest with the halogen light in turbo-boost mode.

Acid Etching, Dental↗
PubMed2002

Microleakage of four simplified adhesive systems under thermal and mechanical stresses.

PURPOSE: To evaluate microleakage at the dentin margins of Class II resin-based composite restorations using four simplified adhesive systems: Etch & Prime 3.0, Prime & Bond NT, Clearfil Liner Bond 2V and Clearfil SE Bond, upon thermal and mechanical stresses. MATERIALS AND METHODS: Forty slot preparations (5mm x 3mm x 1.5mm) were cut in sound human molars with gingival margins below the cement/enamel junction. All adhesive systems were applied strictly according to manufacturers' instructions. Cavities were restored using Clearfil AP-X composite resin. After finishing and polishing, teeth were submitted to thermal (x700, 5-55 degrees C, 60-second dwell time) and consecutively mechanical cycling (100,000 cycle; 8 Kgf load). Specimens were coated with nail polish, immersed in silver nitrate for 2 hours and sectioned longitudinally with a diamond disc. The extent of leakage was ranked using a 0-4 scale. RESULTS: Statistical analysis was performed using Kruskal-Wallis test. Minimal leakage occurred with Clearfil SE Bond. There was a statistically significant difference (P<0.01) between this system and Clearfil Liner Bond 2V, although the latter also showed low values of dye penetration. No statistically significant difference was found between Etch & Prime 3.0 and Prime & Bond NT. Both showed statistically greater leakage than the two other systems (P<0.01).

Composite Resins↗
PubMed2002

Microleakage of adhesively bonded cervical amalgam restorations.

PURPOSE: To evaluate dye penetration in adhesively bonded cervical amalgam restorations. MATERIALS AND METHODS: The specimens were randomly divided into four groups and the adhesives Prime & Bond 2.1, Prime & Bond 2.1 Dual Cure, Scotchbond Multi Purpose Plus and Amalgambond Plus were tested. After being restored and polished, the teeth were thermocycled 1,000 times at temperatures varying between 5 degrees C +/- 2 degrees C and 55 degrees C +/- 2 degrees C. Statistical analysis was carried out using the Kruskal-Wallis test and multiple comparisons. RESULTS: Scotchbond Multi-Purpose Plus demonstrated lower levels of microleakage in enamel and dentin. The dual adhesives were more effective than the "one bottle" adhesive.

Acetone↗
PubMed2002

The influence of cervical lesion on the stress state and strength of tooth with occlusal restoration: a numerical model study.

This paper is concerned with bio-engineering problems in dentistry. The analysis of stress in a lower premolar with a deep non-carious cervical lesion and restored occlusal Class I cavity under occlusal load of 100 N was shown. Finite element method was used for the analysis of a two-dimensional model of a human tooth. In order to facilitate the evaluation of the loads, four cross-sections in characteristical points of the model were made. The model was generated and the calculations were done on IBM Pentium III personal computer. The principal and equivalent stresses were calculated and used in qualitative and quantative evaluation of tooth tissue and tooth restoration strength. The results are shown in figures and charts. The analysis of the cross-sections distant to the cervical area has proved that the presence or absence of cervical lesion has no significant influence on the values and stress distribution. Only in the region of sharp-shaped notch in the bottom of defect (4-4) high stresses in the tooth tissues occur. The values of stress did not exceed the compressive and tensile strength in any case under investigation. The study has shown that the presence of cervical angular lesion does not affect the mechanical strength of a tooth with a properly restored occlusal cavity. Clinically, the situation is safe from the biomechanical point of view.

Biomechanical Phenomena↗
PubMedDate not supplied

The effect of a "resin coating" on the interfacial adaptation of composite inlays.

The relatively low bond strengths of resin cements to dentin may result in poor interfacial adaptation of composite inlays. This study determined whether the interfacial adaptation of composite inlays could be improved by applying an adhesive system and a low viscosity microfilled resin to the prepared cavity walls before making an impression. Ten MOD cavities were prepared on extracted human premolars with gingival margins located above and below the cemento-enamel junction. A "resin coat" consisting of a self-etching primer system (Clearfil SE Bond) and a low viscosity microfilled resin (Protect Liner F) was applied to the cavities of half of the prepared teeth, while the remaining teeth served as non-coated control specimens. All the teeth were restored with composite inlays (Estenia) fabricated by the indirect method and cemented with a dual-cured resin cement (Panavia F). After finishing the margins with superfine burs, the bonded inlays were thermocycled between 4 degrees C and 55 degrees C for 400 cycles. Specimens were sectioned with a diamond saw and the tooth-restoration interfaces were observed with a confocal laser scanning microscope. The data were analyzed with two-way ANOVA and Fisher's PLSD test (p < 0.05). The percentage length of gap formation at the dentin-restoration interface of the "resin coated" teeth (7.1 +/- 3.5) was significantly less than that of the non-coated teeth (85.7 +/- 6.7) (p < 0.05). The concept of coating the prepared cavity with an adhesive system and a low viscosity microfilled resin resulted in observing fewer gaps at the internal dentin-restoration interface compared with the non-coated specimens.

Analysis of Variance↗
PubMedDate not supplied

The effect of current-generation bonding systems on microleakage of resin composite restorations.

OBJECTIVE: The aim of this study was to determine the microleakage of current-generation dentin bonding systems in Class II resin composite restorations. METHOD AND MATERIALS: Class II (occlusodistal or occlusomesial) cavity preparations with a gingival margin 2 mm apical to the cementoenamel junction were prepared on 70 noncarious, extracted human premolar teeth. Teeth were randomly divided into five groups and treated with different-generation bonding systems (Optibond FL, Gluma One Bond, Clearfil SE Bond, acid etching plus Clearfil SE Bond, and Prompt-L-Pop). All cavities were restored in a posterior resin composite and subjected to 200 thermocycles (at 5 degrees C to 55 degrees C; 30-second dwell time). After immersion in 0.5% basic fuchsin dye for 24 hours, the teeth were sectioned longitudinally and evaluated for dye penetration using a binocular stereomicroscope. RESULTS: There was no statistically significant differences among bonding systems in the degree of microleakage in the occlusal walls. For gingival walls, statistically significant differences were found only between the Clearfil SE Bond and Prompt-L-Pop groups and the Clearfil SE Bond with acid etching and Prompt-L-Pop groups. The greatest microleakage was observed in Prompt-L-Pop specimens. CONCLUSION: Most of the tested dentin bonding systems were able to eliminate microleakage completely in the occlusal walls, but some systems exhibited statistically significant differences in leakage in the gingival walls.

Acid Etching, Dental↗
PubMed2002

Microleakage of Class V composites using different placement and curing techniques: an in vitro study.

PURPOSE: To evaluate microleakage at enamel and dentin margins of two composite resins, using bulk and incremental placement techniques, "rebonding", and facial and lingual curing methods. MATERIALS AND METHODS: One hundred standardized Class V cavity preparations were made on the facial surface of extracted human premolars and were randomly assigned to 10 groups. Single Bond was used as the dentin/enamel adhesive. A heavily filled composite resin, Z250, and a microfill, Silux Plus, were inserted and polymerized using five different techniques: (1) incremental placement and facial curing; (2) incremental placement, facial curing and rebonding; (3) bulk placement and facial curing; (4) bulk placement, facial curing and rebonding; (5) incremental placement and lingual and facial curing. After the restorations were finished and polished, the margins of those in the rebonded groups were etched, rinsed, and dried. The adhesive resin, Single Bond, was applied at the composite resin-tooth interface and light-cured. All the specimens were thermocycled, stained with 1% methylene blue, sectioned, and evaluated for leakage (0-4 scale) by two examiners. RESULTS: Almost no leakage occurred at enamel margins. At the cementum margins, differences in microleakage related to restorative material or technique were not statistically significant. However, leakage at the cementum margins was significantly greater than at the enamel margins for both composite resin materials.

Bicuspid↗
PubMed2002

A comparative study of microleakage below cemento-enamel junction using light cure and chemically cured glass ionomer cement liners.

Posterior composite resins have gained considerable importance over last few years. However, improper placement techniques continue to be a prime cause of failure of these restorations. This study was done to compare the microleakage at the tooth restoration interface extending below cementoenamel junction when posterior composite restorations were placed directly in the cavity or when placed over a glass ionomer cement liner, both chemically cured and light cured. The results have shown that light cured glass ionomer when used as a liner under a composite restoration used below gingival cementum/dentin margin has the best sealing capability.

Acid Etching, Dental↗
PubMedDate not supplied

An in vitro comparison of metal and transparent matrices used for bonded class II resin composite restorations.

This study compared excess formation of direct bonded Class II restorations using different matrix systems-metal or transparent. Sixty freshly extracted, non-carious, posterior human teeth were used. In all of the teeth, standardized MOD-cavities were prepared with the gingivoproximal margins located 1.0-1.5 mm cervical to the cemento-enamel junction. The prepared teeth were randomly assigned to six groups. Half were restored using metal matrices and wooden wedges; the other half were restored using transparent matrices and reflective wedges. Three different material systems were used to fill the cavities: 1) a hybrid composite (Tetric) plus an adhesive bonding agent (Syntac Classic), 2) a flowable composite (Tetric Flow) plus Syntac Classic and 3) a compomer (Dyract AP) together with an adhesive bonding agent designed for compomers (Prime & Bond NT). After the specimens were preserved in saline solution, scanning electron microscopy (SEM) assessed the amount of overhang formation at the restoration margins. The data collected indicated the use of transparent matrices resulted in significantly higher amounts of excess material at the restoration margins compared with metal matrices. Moreover, there was no significant difference between the materials when the same matrix was used. All of the dental restorations examined displayed material overhang. Based on these findings, the authors concluded that the type of matrix exerts a major impact on overhang formation, with metal matrices resulting in significantly less excess material buildup.

Compomers↗
PubMedDate not supplied

Influence of curing methods and materials on the marginal seal of class V composite restorations in vitro.

The study tests the hypothesis that soft-start irradiation improves, whereas, high intensity irradiation compromises the margin quality and marginal seal of Class V resin based composite [RBC] restorations. Box-shaped Class V cavities were prepared in extracted, human third molars with cervical margins located apical to the CEJ. Cavities were restored using a multi-step bonding agent (Optibond FL, Kerr), a thin layer of flowable resin composite and two increments of fine hybrid resin composite (Filtek Flow/Filtek Z250, 3M ESPE; Revolution f2/Herculite XRV, Kerr). Light irradiation was performed using either the standard (40 seconds) or the soft-start mode (40 seconds with exponential increase) of a quartz tungsten halogen or an LED curing light (Elipar Trilight, Elipar Freelight, 3M ESPE); for high intensity irradiation, a Plasma Are curing unit was used with three irradiations of three seconds (Apollo 95E, DMDS). After 30 days of water storage and thermal cycling (n = 2500, 5-55 degrees C), margin quality was assessed in the SEM using the replica technique and marginal seal was evaluated using dye penetration (AgNO3 50%). Few differences were observed between the light curing protocols. However, less leakage was observed in the case of the lower shrinking RBC Filtek Z250.

Composite Resins↗
PubMed2003

Prevalence of cervical enamel projection and its correlation with furcation involvement in eskimos dry skulls.

The objectives of this study were to investigate the prevalence of cervical enamel projection (CEP) in molars of Eskimo dry skulls and to study the correlation of CEP with furcation involvement (FI). The material consisted of 834 upper and lower first and second permanent molars from 133 Eskimo dry skulls. CEPs were investigated from the buccal aspect of the tooth and classified according to a system modified from Masters & Hoskins (12). FI was measured horizontally from the buccal aspect into the furcation with a graduated probe to the nearest mm. Any measurement > or = 2 mm was considered to have positive FI. The result showed a presence of 72% of CEPs among the examined molars. Grade III was found in 53%, Grade II in 9% and Grade I in 11% of the 834 molars. Lower molars had a higher prevalence of CEPs (78%) than upper molars (67%). With the individual skull used as the unit for analysis, a statistically significant correlation of CEP with FI was found in upper right 2nd molar, upper left 1st molar, lower left 1st and 2nd molars and lower right 1st molar. These results may be of clinical importance since the impact of CEPs to periodontal treatment of FIs has been discussed.

Chi-Square Distribution↗