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PubMed2001

In vitro bond strengths of resin modified glass ionomer cements and composite resin self-cure adhesives: introduction of an adhesive system with increased bond strength and inhibition of decalcification.

This study evaluated the shear bond strength and adhesive remnant index of 5 self-cure adhesives to comparatively evaluate a new adhesive system. Extracted human incisors were randomly divided into 7 test groups of 20 each. Incisor mesh-backed brackets were bonded to the tooth specimens in each group with their respective adhesive according to the manufacturer's instructions. The specimens were thermocycled for 2 weeks at temperatures from 5 degrees to 55 degrees C to simulate oral conditions and debonded using an Instron machine. Acceptable bond strength parameters were present with the Contacto No-Mix (composite resin containing glass ionomer 8.75 MPa) and Fuji Ortho SC with acid conditioning (6.98 MPa). Contacto No-Mix had a higher bond strength (11.2 MPa) when microetching and Megabond were employed than when these adjuncts were not employed. When FUJI Ortho SC specimens were conditioned with polyacrylic acid, they showed a higher bond strength (6.98 MPa) than when bonded to unetched teeth (5.41 MPa). In test 3, EXPT-fluoride adhesive (AF) demonstrated a higher bond strength (13.44 MPa) than both resin composite Contacto No-Mix (8.8 MPa, GAC 7.4 MPa) and FUJI Ortho SC (5.41 MPa). Expt AF (Test 3) and Concise had equal bond strengths, however, the former can potentially release fluoride from the glass ionomer. Although the Ex

Adhesiveness↗
PubMed2003

Occupational stress among Canadian orthodontists.

The occupational stress associated with many professions, including general dentistry, has been well researched. An anonymous, self-administered, mail-out survey was distributed to Canadian orthodontists. The survey included 67 potential stressors, an overall occupational stress score, an overall job satisfaction scale, and items addressing various characteristics of the respondents. The response rate was 51.2% (335/654). Pronounced differences were found between the respondents in the evaluation of potential stressors and the overall occupational stress score. The category of stressors with the highest mean severity of stress scores was time-related stressors. The stressors with high mean severity scores and high mean frequency scores were as follows: falling behind schedule, trying to keep to a schedule, constant time pressures, patients with broken appliances, and motivating patients with poor OH and/or decalcification. Stepwise multiple regression determined a model, involving overall job satisfaction, age, participation in a study group, hours worked per week, part-time academics, days of continuing education per year, and participation in stress management, to account for 35.9% of the variation in overall occupational stress scores. The results indicate the importance of time-management skills in reducing occupational stress, but other factors seem to have more effect on reported occupational stress than do the characteristics addressed by this survey.

Age Factors↗
PubMed1999

Protection of dentin by triclosan toothpaste in a bacterial demineralisation model.

The effect of the addition 0.3% triclosan to a non-fluoride and fluoride toothpaste was tested in an in vitro demineralisation model. This model comprised bovine dentin specimens overlaid with acidogenic Streptococcus mutans suspensions in agarose at two different concentrations of cells. Before the experiments, subsurface lesions were made in the dentin specimens in a methylcellulose gel system. In a first set of experiments, the toothpastes were diluted in the S. mutans suspensions at w/v dilutions of 1:100, 1:1,000, and 1:10,000, respectively. After 22 h of incubation at 37 degrees C, the suspensions were removed and assessed for calcium, lactate and pH. In this set of experiments, an additive protective effect of triclosan to the non-fluoride toothpaste was found at the lowest concentration of S. mutans cells and when the toothpaste was relatively undiluted (1:100 w/v). No additive effect was observed to the fluoride toothpaste. In the second set of experiments, the specimens were immersed daily for 3 min in 30% (w/v) slurries of the toothpastes before the 22-h incubations with the S. mutans suspensions. At the lowest concentration of S. mutans cells, triclosan had an additional protective effect to the non-fluoride and fluoride toothpaste. It is concluded that triclosan may contribute to the protection of dentin under a mild acid attack both when it is present in dental plaque and when it has been adsorbed to the dentin.

Adsorption↗
PubMed1999

The use of gamma irradiation for the sterilization of enamel for intra-oral cariogenicity tests.

The dose of gamma irradiation sufficient to sterilize enamel samples to be used for intra-oral cariogenicity tests (ICT) without alteration to the structure or solubility of the enamel was determined. Each bovine incisor used was cut vertically into eight portions and each portion assigned to one of eight groups. Group 1 was used as control while other groups were subjected to respective doses of gamma irradiation from a cobalt-60 source. Following sterilization, both control and experimental groups were incubated in nutrient broth for 7 days at 37 degrees C under aerobic and anaerobic conditions. Caries-like lesions were subsequently produced in each specimen using acidic buffer solution, and mineral loss quantified using transverse microradiography. Data were analysed statistically. There was no significant difference in mineral loss between the control and experimental groups, but the numerical value of mineral loss was lower in groups irradiated with> 4080 Gy, in addition to full sterilization and enamel discoloration to cream colour observed in these groups. Microbial growth was observed in the control group and in groups irradiated with <4080 Gy but no discoloration. With 4080 Gy full sterilization without discoloration was observed. It was concluded that 4080 Gy of gamma irradiation is optimal for sterilization of enamel samples for use in ICT.

Analysis of Variance↗
PubMed2001

Comparative assessment of light-cured resin-modified glass ionomer and composite resin adhesives: in vitro study of a new adhesive system.

The ideal adhesive system is one that prevents decalcifications and has sufficient bond strength to withstand untimely impact forces on bonded brackets. The purpose of this investigation was to study and compare the bond strengths and adhesive remnant indexes of light-cured resin-modified glass ionomer and conventional resin adhesives. A new light-cured resin-modified glass ionomer adhesive was compared with the conventional adhesive systems. The effects of the new adhesive, with a system of etching and using adhesive promoters on the tooth enamel, as well as microetching the brackets, were analyzed. Comparisons were made (analysis of variance and the Tukey method) between this and other adhesive systems. The new adhesive system is indicated where prevention of decalcification and increased bond strength in noncompliant patients are indicated.

Acid Etching, Dental↗
PubMed2002

The effects of argon laser irradiation on enamel decalcification: An in vivo study.

Enamel decalcification is a significant problem in orthodontic patients. The argon laser has been shown to reduce decalcification during an acidic challenge in vitro. The purpose of this study was to investigate the in vivo effects of argon laser irradiation on enamel decalcification during orthodontic treatment. Nine volunteers whose treatment plans included 4 first premolar extractions were enrolled in the study. The 36 extracted premolars were assigned to 1 of the following 4 groups: group 1, control group with no treatment; group 2 (pumice-laser), teeth were pumiced for 3 seconds and treated with a 325 mW, 5-mm diameter laser beam for 60 seconds; group 3 (pumice-etch-laser), teeth were pumiced for 3 seconds, acid-etched with 30% phosphoric acid for 30 seconds, and treated for 60 seconds with laser; and group 4 (laser only), teeth were treated for 60 seconds with laser. A specially designed (oversized) orthodontic band was fitted on each of the premolars to create a pocket for decalcification. The bands were cemented in place for 5 weeks. After extraction, the teeth were sectioned and examined under polarized light microscopy. Images of lesions were digitally analyzed and measured. Average lesion depths were calculated from 3 depth measurements recorded 10 microm apart. Average lesion area was calculated with the aid of imaging analysis software. Data were analyzed with analysis of variance (P <.05) and Student t tests. Significant differences were found in lesion depth (P <.001) and lesion area (P <.01) among the 4 test groups. The average lesion depths were 15.93 +/- 9.31 microm (control), 6.45 +/- 8.70 microm (pumice-laser), 1.71 +/- 4.82 microm (pumice-etch-laser), and 1.34 +/- 3.80 microm (laser only). The average lesion areas were 1028.67 +/- 725.68 microm (2) (control), 555.49 +/- 948.20 microm (2) (pumice-laser), 79.91 +/- 226.03 microm (2) (pumice-etch-laser), and 55.71 +/- 157.59 microm (2) (laser only). The average lesion depth in the laser-only group was reduced by 94.1% and the average lesion area was reduced by 94.4% when compared with the control group. In the pumice-etch-laser group, the average lesion depth was reduced by 89.1% and the average lesion area was reduced by 92.2% when compared with the control group. There were no significant differences in lesion depth and lesion area between maxillary and mandibular teeth (P <.06 and P <.08, respectively) and between the teeth on the right and left sides (P <.68 and P <.55, respectively). These results show that argon laser irradiation is effective in reducing enamel decalcification during orthodontic treatment. Pumicing and etching do not appear to reduce the effect of laser on enamel solubility.

Acid Etching, Dental↗
PubMed2004

Deletion of dentin matrix protein-1 leads to a partial failure of maturation of predentin into dentin, hypomineralization, and expanded cavities of pulp and root canal during postnatal tooth development.

The dentin matrix protein-1 (DMP-1) gene is identified in odontoblasts during both embryonic and postnatal development. In vitro study suggests that this noncollagen acidic phosphoprotein plays a role in mineralization. However, deletion of the Dmp-1 gene has little effect on tooth development during embryogenesis. To address the role of DMP-1 in tooth during postnatal development, we analyzed changes of dentinogenesis in Dmp-1 null mice from 3 days after birth to 1 year. Here we show that Dmp-1 null mice postnatally develop a profound tooth phenotype characterized by a partial failure of maturation of predentin into dentin, enlarged pulp chambers, increased width of predentin zone with reduced dentin wall, and hypomineralization. The tooth phenotype of these mice is strikingly similar to that in dentin sialophosphoprotein (Dspp) null mice and shares some features of the human disease dentinogenesis imperfecta III. We have also demonstrated that DSPP levels are reduced in Dmp-1 null mice, suggesting that DSPP is probably regulated by DMP-1 during dentinogenesis. Finally, we show the absence or delayed development of the third molar in Dmp-1 null mice, which is probably secondary to defects in Dmp-1 null bone. Taken together, these studies suggest that DMP-1 is essential for later dentinogenesis during postnatal development.

Animals↗
PubMed2006

Inhibition of mineral loss at the enamel/sealant interface of fissures sealed with fluoride- and non-fluoride containing dental materials in vitro.

OBJECTIVE: In this in vitro study we evaluated the enamel mineral loss effect of fluoride-containing and non-fluoride-containing materials at different distances from the sealant margin, and verified the fluoride-releasing capability of these materials. MATERIAL AND METHODS: Extracted molars were randomly assigned into nine groups (n = 12): Concise (C), FluroShield (F), Helioseal Clear Chroma (H), Vitremer (V), Fuji II-LC (FII), Ketac Molar (KM), Fuji IX (FIX), Single Bond (SB), and Clearfil Protect Bond (CF). All groups were subjected to thermo and pH cycling. Enamel mineral loss was evaluated by cross-section micro-hardness analysis at distances: -100 microm, 0 microm, 100 microm, 200 microm. The mineral loss data were analyzed using a multi-factor ANOVA with split-plot design, and fluoride-released data were submitted to ANOVA and Tukey tests. RESULTS: FIX demonstrated a lower mineral loss than C, F, and H, but did not differ from the SB, CF, V, FII, and KM groups, which also demonstrated no difference among them. C, F, H, and V presented the highest mineral loss, with no difference among them. V did not differ from the other groups (p > 0.05). Regarding the different distances from the sealant margin, -100 microm presented the lowest mineral loss. FIX showed the highest fluoride release on the 7th and 14th days of evaluation, while CF showed high fluoride release only on the 7th day. CONCLUSION: Resin sealant did not prevent enamel mineral loss, contrary to glass-ionomer cement, which showed the highest capacity for fluoride release. It is not exclusively the presence of fluoride in a material's composition that indicates its capability to interfere with the development of enamel caries-like lesions.

Bisphenol A-Glycidyl Methacrylate↗
PubMed2005

Change of enamel after Er:YAG and CO2 laser irradiation and fluoride treatment.

OBJECTIVE: Our aim was to compare acquired acid resistance in dental enamel after Er:YAG and CO(2) laser irradiation in vitro with additional fluoride treatment. BACKGROUND DATA: The application of lasers in dental hard tissue can impact dental constituents and fluoride with complex interactions. METHODS: Bovine enamels were divided into four groups according to their surface condition: unlased, Er:YAG laser-ablated, fluoridetreated after Er:YAG laser ablation, and CO(2) laser-irradiated after Er:YAG laser and fluoride treatment. Calcium distribution in enamel after pH-cycling process and crystallographical change after laser treatment were evaluated. RESULTS: The crystallinity of enamel was much improved after Er:YAG laser ablation. The CO(2) laser irradiation in the fluoride-treated laser enamel formed alpha-TCP and fluorapatite. The change of calcium distribution in enamel was least in the CO(2) laser-irradiated specimens; the fluoride-treated specimen after Er:YAG laser ablation was next. Additional fluoride treatment both after Er:YAG and before CO(2) laser irradiation improved the acid resistance of enamel. CONCLUSION: Both external treatment of fluoride and irradiation of CO(2) laser after Er:YAG laser ablation greatly reduced calcium loss in enamel during the pH cycling process.

Acids↗
PubMed1994

Enamel sealants: a clinical evaluation of their value during fixed appliance therapy.

A clinical trial was undertaken to evaluate the effectiveness of two new enamel sealing systems in the prevention of enamel decalcification following bracket bonding. Eighty patients undergoing fixed appliance therapy were included. Of these, 40 were treated with a viscous chemically-cured sealant and bonding system (Maximum Cure), while 40 patients were treated using a non-viscous visible light-cured sealant and bonding agent (Transbond resin). Alternate teeth were used as controls where no sealant was used. A total of 289 experimental and 282 control teeth were included in the chemically-cured sealant group, the figures for the light-cured sealant group being 306 and 305, respectively. Enamel decalcification incidence and distribution were recorded using a modified index by direct clinical observation. The results showed that 75 per cent of patients were affected by some decalcification. The viscous sealant reduced the extent of decalcification of tooth zones by 13 per cent. The non-viscous sealant produced no significant difference. Over 60 per cent of decalcification occurred in the gingival areas. Maxillary lateral incisors and canines, and mandibular canines and second premolars were the teeth most severely affected, and the most likely to benefit from sealing. Further research is needed to develop a material which provides greater enamel protection.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1997

White spot reduction when using glass ionomer cement for bonding in orthodontics: a longitudinal and comparative study.

The aim of this clinical study was to test the benefit from using glass ionomer cement (GIC) instead of a conventional diacrylate in bracket bonding for the prevention of white spot formation. Before treatment 7.2 per cent of all examined surfaces (n = 222) were classified as having white spots. No additional fluoride treatment other than fluoride toothpaste was prescribed. At debonding 8-39 months later, white spots were found in 24 per cent of the surfaces bonded with the cement, significantly lower than the 40.5 per cent bonded with the diacrylate (P < 0.01). At recall 12 months after debonding (examined surfaces n = 214) the frequency of surfaces with white spots was reduced to 22 and 24 per cent respectively. Re-examination after a further 12 months (n = 160) showed that white spot surfaces were less frequent with the cement (16 per cent compared with the diacrylate 29 per cent), but still significantly more frequent in both groups than before treatment. With longer treatment time (17 months) teeth bonded with diacrylate were more frequently affected with white spots (P < 0.05). Neither sex nor age affected the results. It is concluded that the use of a GIC for orthodontic bonding will result in a significant reduction in the number of white spot surfaces at debonding compared with the use of conventional diacrylate. Although markedly reduced in both groups, the number of affected surfaces was still higher 2 years after debonding than before treatment.

Acrylates↗
PubMed1997

A clinical evaluation of the effectiveness of including fluoride into an orthodontic bonding adhesive.

A clinical trial was undertaken to assess the value of incorporating fluoride released from a commercially available bonding adhesive (Rely-a-Bond) to determine the extent of any protection provided against enamel decalcification. Fifty patients undergoing fixed appliance therapy were included in the trial. Contralateral quadrants were used as controls where no fluoride was present in the adhesive. Enamel decalcification after treatment and bond failure rates during treatment were investigated. A total of 366 experimental and 371 control teeth were included in the study. The results showed that 50 per cent of patients and 13.5 per cent of teeth exhibited post-treatment decalcification. The addition of fluoride to the adhesive did not significantly reduce the incidence of enamel decalcification. Bond failure rates were satisfactory for both experimental and control teeth (all under 5 per cent).

Cariostatic Agents↗
PubMed2000

Fluoride-releasing elastomerics--a prospective controlled clinical trial.

A prospective controlled clinical trial was undertaken to evaluate the effectiveness of stannous fluoride-releasing elastomeric modules (Fluor-I-Ties) and chain (Fluor-I-Chain) in the prevention of enamel decalcification during fixed appliance therapy. Forty-nine patients (782 teeth) were included in the experimental group, where the fluoride-releasing elastomerics were used. Forty-five patients (740 teeth) who received non fluoride-releasing elastomerics formed the control group. All patients had their elastomerics replaced at each visit. Enamel decalcification incidence and distribution were recorded using an index by direct clinical observation. In the control group enamel decalcification occurred in 73 per cent of patients and in 26 per cent of all teeth. In the experimental group the corresponding incidence was 63 and 16 per cent, respectively. The overall reduction in score per tooth produced by the fluoride-releasing elastomerics was 49 per cent, a highly significant difference (P < 0.001). A significant difference was seen in all but the occlusal enamel zones. The majority (over 50 per cent) of lesions occurred gingivally. The teeth most severely affected were the maxillary lateral incisors and mandibular second premolars. There was no difference in treatment duration between groups.

Adolescent↗
PubMed2001

A resin veneer for enamel protection during orthodontic treatment.

The aims of this study were to test the tensile bond strength of a recently developed veneer. Sound premolar teeth (120) extracted for orthodontic purposes were divided into two experimental and two control groups. In one experimental group (V1) 4-META/MMA-TBB resin (4META) was used on the surface veneer prepared with micro particle filled resin (MFR) as an adhesive for bracketing and in the second group (V2) 4META was applied on the surface veneer with the trial resin. For the controls, in group R 4META was used on the enamel surface without veneer and in group G light-cured glass ionomer cement was applied. The 30 samples in each group were divided into three groups of 10 samples and thermal cycled (TC) at 3000, 10,000 or left uncycled. Tensile testing was carried out using an Instron machine. After tensile testing the bond failures in the experimental groups were recorded using a stereomicroscope. Statistical analysis was performed using ANOVA. In group V2 the resin veneer was able to maintain sufficient bond force to enamel during clinical use. The bond strength of group V1 was significantly higher than that of groups R (P < 0.05) and G (P < 0.01) at TC 0, but for both TC 3000 and 10,000, the bond strength of group V1 was lower than groups R and G, respectively. There were significant differences between groups V1 and R (P < 0.01) for TC 3000, and between groups V1 and R and G (P < 0.01) at TC 10,000. The bond strength of group V2 was almost equal to that of group R at TC 0. At TC 3000, group V2 showed significantly lower bond strength than group R (P < 0.05), but no significant difference was found compared with group G. At TC 10,000, there were no significant differences between groups V2, R or G. When comparing groups V1 and V2, the bond strength of group V1 was significantly higher than that of group V2 (P < 0.01) at TC 0, but the bond strength of group V1 was significantly lower than that of group V2 for both TC 3000 (P < 0.05) and TC 10,000 (P < 0.01). Comparison between groups R and G, showed that the bond strength of group R was significantly higher than that of group G for both TC 0 (P < 0.01) and TC 3000 (P < 0.01), but no significant difference was found for TC 10,000. In group V2, nine samples showed adhesive failure between the veneer surface and bracket adhesive before thermal cycling. There were significant differences between the MFR and both trial resin and glass ionomer cement (P < 0.01) when examining thermal expansion. No significant difference was found between the trial resin and glass ionomer cement. It is suggested that application of a resin veneer prior to bracket bonding is suitable for clinical application to protect the teeth and to prevent decalcification and caries.

Acrylic Resins↗
PubMed2001

Fluoride-releasing elastomeric modules reduce decalcification: a randomized controlled trial.

OBJECTIVE: To determine whether fluoride releasing elastomeric modules reduced the incidence of decalcification around orthodontic brackets during a complete course of orthodontic treatment. DESIGN: A randomised controlled, split mouth design. SETTING: The study was carried out in the orthodontic department of Newcastle-upon-Tyne Dental Hospital, UK. SUBJECT AND METHODS: 21 consecutive patients (126 teeth) undergoing fixed appliance therapy were studied. A split mouth technique was adopted to examine the upper labial segment, where one side (left or right) was randomly assigned to the experimental group, and the opposite side served as a control throughout their course of orthodontic treatment. INTERVENTIONS: The control teeth were ligated to the archwire using conventional modules. The experimental teeth were ligated to the archwire using Fluoride releasing elastomeric modules. OUTCOME MEASURES: Standardised photographs were taken of the upper labial segment before and after completion of orthodontic treatment, and the degree of decalcification assessed in each tooth quadrant, using a modification of the Enamel Defect Score. RESULTS: Decalcification was found to occur in both treatment groups, though to a significantly greater degree on the control side (p = 0.002). The fluoride module side showed significantly fewer serious decalcified lesions than the control (p = 0.013). No patients withdrew from the study. CONCLUSIONS: It would appear that the use of fluoride releasing elastomeric modules reduces the degree of decalcification experienced during orthodontic treatment.

Fluorides↗
PubMed2002

Orthodontic adhesives: a systematic review.

OBJECTIVES: To evaluate which orthodontic adhesives (a). bond orthodontic brackets to teeth more reliably and (b). are more effective at preventing decalcification. DATA SOURCES: The search strategy for the literature review was carried out according to the standard Cochrane systematic review methodology. The Cochrane Clinical Trials Register and the Cochrane Oral Health Group Specialized Register were searched for randomized clinical trials and controlled clinical trials. All volumes that had not already been assessed by the Oral Health Group in the European Journal of Orthodontics, American Journal of Orthodontics, Journals of Orthodontics, and Angle Orthodontist were hand-searched. Inclusion and exclusion criteria were applied when considering the studies to be included in this review. DATA SELECTION: The primary outcome measure was the failure of the orthodontic adhesive. A secondary outcome of decalcification occurring around the orthodontic bracket was also recorded, if data were available. DATA EXTRACTION: Two randomized clinical trials and one controlled clinical trial were identified that fulfilled all the inclusion and exclusion criteria. The trials compared: (a). light- and chemically-cured composite; (b). chemically-cured composite and conventional glass ionomer cement; and (c). chemically-cured composite and light-cured compomer. DATA SYNTHESIS: Each paper was quality assessed by two people independently. A qualitative analysis of the trials in the review is presented. The data presentation, for the majority of the trials, precluded the use of suggested Cochrane Health Group statistical analysis. CONCLUSIONS: It is difficult to draw any conclusions from this review; however, suggestions are made for methods of improving future research involving orthodontic adhesives.

Compomers↗
PubMed1997

Wavelet representations for monitoring changes in teeth imaged with digital imaging fiber-optic transillumination.

Digital imaging fiber-optic transillumination (DI-FOTI) is a novel method to detect and monitor dental caries, using light, a charge-coupled device (CCD) camera, and computer-controlled image acquisition. The advantages of DIFOTI over radiography include: no ionizing radiation, no film, real-time diagnosis, and higher sensitivity in detection of early lesions not apparent to X-ray, as demonstrated in vitro. Here, we present a method of processing DIFOTI images, acquired at different times, for monitoring changes. Of central importance to this application is pattern matching of image frames that is invariant to translation and rotation of a tooth, relative to the field of view of the imaging camera, and that is robust to changes in illumination source intensity. Our method employs: 1) wavelet modulus maxima representations for segmentation of teeth images; 2) first and second moments of gray level representations of DIFOTI images in the spatial domain, to estimate tooth location and orientation; and 3) multiresolution wavelet magnitude representations for quantitative monitoring. Even with illumination source intensity variation, it is demonstrated in vitro that such wavelet representations can facilitate detection of simulated clinical changes in light transmission that cannot be detected in the spatial domain.

Algorithms↗