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PubMed2005

Evaluation of resin composite materials. Part I: in vitro investigations.

PURPOSE: To evaluate different resin-based composites using a variety of in vitro investigation methods to predict their clinical behavior. METHODS: Materials selected for this study were Heliomolar radiopaque (microfilled), Tetric Ceram, Pertac II (minifilled hybrids), Ariston pHc (ion releasing hybrid), and Solitaire I (hybrid with porous fillers). The evaluated in vitro criteria were three-body wear according to the ACTA method, microtensile bond strengths to enamel and dentin, flexural strength (four-point bending strength), flexural fatigue behavior (flexural fatigue limit), and calcium ion release (for Ariston pHc). RESULTS: Concerning wear resistance, Ariston pHc (20.5 microm after 200,000 cycles) was inferior to the other materials (13.7-15.9 microm). Microtensile bond strengths to dentin were similar for Heliomolar (32.0 MPa), Tetric Ceram (30.4 MPa; both bonded with Syntac Classic), and Pertac II (30.8 MPa; bonded with EBS Multi) being above Solitaire I (22.5 MPa; bonded with Solidbond) being above Ariston pHc (13.2 MPa; bonded with Ariston Liner). Enamel bond strengths for Heliomolar (40.0 MPa), Tetric Ceram (36.5 MPa), and Pertac II (38.9 MPa) were significantly higher than for Solitaire I (26.6 MPa) which was above Ariston pHc (7.2 MPa). Heliomolar, Tetric Ceram, and Pertac II revealed higher micro-TBS to enamel than to dentin, Ariston showed the contrary, and Solitare exhibited no difference between enamel and dentin micro-TBS. Solitaire I exhibited a lower initial flexural strength than the other materials, the computed fatigue strength of the material even dropped to the level of glass ionomer cements (17.9 MPa). Long-term calcium release data for Ariston exhibited a continuously high calcium release becoming lower at the end of the observation beyond 21 months.

Acrylic Resins↗
PubMed2005

Microtensile bond strength of total-etch and self-etch adhesives to the enamel walls of Class V cavities.

PURPOSE: To determine the difference in microtensile bond strengths (MTBS) of resin-based composite bonded to the enamel of cavity preparations using a conventional or a self-etching adhesive. METHODS: Buccal and lingual Class V cavities were prepared in each of 12 caries-free human molars. Six teeth were randomly selected to be restored with Spectrum TPH resin-based composite and Prime & Bond NT adhesive. The remaining six teeth were restored with the same composite and Prompt L-Pop self-etching adhesive. Enamel/composite sticks were cut from each specimen and subjected to microtensile bond testing. Each debonded specimen was evaluated by SEM to determine the mode of failure. RESULTS: The mean MTBS for Prime & Bond NT specimens was 15.2+/-13.1 MPa. The mean MTBS for Prompt L-Pop self-etching adhesive samples was 18.2+/-14.3 MPa. ANOVA demonstrated no statistically significant difference between the mean MTBS associated with the two adhesives (P> 0.05). The results of SEM analysis revealed that the bonding failures occurred primarily at the interface between the adhesive and the enamel, suggesting a primarily adhesive failure.

Acid Etching, Dental↗
PubMed2005

A microleakage study of single-bottle adhesives applied to enamel and cementum and aged by both occlusal loading and thermocycling.

OBJECTIVE: To compare enamel and dentin microleakage of three single-bottle dentin-bonding agents (DBA) (One-Step, Single Bond, and Dentamed P&B) on teeth that were then subjected to thermocycling and occlusal loading. METHOD AND MATERIALS: Class 5 cavities were prepared on the buccal and lingual surfaces of 30 extracted human molars and divided into three groups. The occlusal margins were in enamel, and the cervical margins were in cementum. DBA were applied strictly according to the manufacturers' recommendations, and the preparations were restored with resin composite. Specimens were subjected to 2,000 intermittent occlusal loads and 3,000 thermocycles and then immersed in 0.5% basic fuchsin dye for 72 hours. Four consecutive sections were cut for each specimen and examined under a stereomicroscope. The extent of dye penetration was measured and recorded using a nonparametric scale from 0 to 4. RESULTS: The Mann-Whitney U test showed a significant difference at cementum margins between One-Step and Dentamed P&B, as well as between Single Bond and Dentamed P&B, and an insignificant difference between Single Bond and One-Step. There was no significant difference in dye penetration at enamel margins between the three DBA. CONCLUSION: Under combined use of occlusal loads and thermocycling, the sealing ability of single-bottle DBA at dentin margins ranged from good for One-Step to moderate for Single Bond to poor for Dentamed P&B. At enamel margins, all materials performed equally well.

Adhesives↗
PubMed2005

Evaluation of varied repair protocols applied to aged composite resin.

PURPOSE: This paper aims to examine varied surface treatments combined with adhesive bonding to ascertain the highest bond strength of the composite resin repair. MATERIALS AND METHODS: A total of 100 specimens was made using an increment technique. The prepared specimens were aged for 20 days in 37 degrees +/- 20 degrees C water and then kept for 24 h at room temperature. The samples were separated into 5 groups of 20, and each group then received a different surface treatment (control group, phosphoric acid, diamond bur, air abrasion, silane primer combined with a diamond bur treatment). The effect of each surface treatment on the bond strength was determined by a shear bond test. RESULTS: Specimens that received surface treatment with a diamond bur exhibited higher shear bond strengths than any of the other repaired groups (p < 0.05). Those treated with air abrasion had the second highest shear bond strengths, but without a statistically significant difference when compared to the control group (p > 0.05). Specimens treated with phosphoric acid showed virtually no difference compared to the specimens of the control group (p > 0.05). CONCLUSION: Statistical analysis revealed that surface treatment with a diamond bur results in higher shear bond strength than other tested methods.

Air Abrasion, Dental↗
PubMed2005

The effect of bleaching agents on the surface hardness of tooth colored restorative materials.

AIM OF THE STUDY: The aim of this study was to evaluate the effect of at-home (Opalesence/Dr. kit 15%, Ultradent, Products, Inc. South Jordan, UT, USA) and in-office (Superoxol 35%, Sultan Chemists, Inc., Englewood, NJ, USA) bleaching on the surface hardness of the following tooth colored restorative materials: composite resin, Point-4 (P4), Kerr Corporation, Orange, CA, USA; ormocer, Admira (AD),VOCO, Germany; compomer Dyract AP (DY), Dentsply DeTrey GmbH, Germany; and resin modified glass ionomer cement, Fuji II LC (FL), GC Corporation, Japan. METHODOLOGY: Sixty specimens were prepared; 15 specimens of each material (each group n = 5, control after 15 days, at-home and in-office). All specimens were stored in distilled water at room temperature for 24 hrs before testing. A universal testing machine (Micromet 2100 series micro hardness testers) was used for testing Vicker's surface hardness for the three groups for every tested material. All results were statistically analyzed with one way analysis of variance (ANOVA), Post hoc Tukey HSD tests (P < 0.05), and percentage changes for Tukey. RESULTS: All the tested materials showed an increase in Vicker's surface hardness between base line (24 hrs) and the control group after 15 days storage in distilled water except DY which showed a decrease in surface hardness. All tested materials showed a decrease in surface hardness from control group after 15 days and both at-home and in-office bleaching agents except DY which showed increased values. SIGNIFICANCE: At-home as well as in-office bleaching agents have a softening effect on some tooth colored restorative material, and the patient must be aware before using them.

Analysis of Variance↗
PubMed2005

Treatment of extended anterior crown fractures using Type IIIA bonded porcelain restorations.

Novel-design bonded porcelain restorations, the so-called Type IIIA BPRs, represent a reliable and effective procedure when restoring large parts of the coronal volume and length in the anterior dentition. While traditional treatment approaches involve the removal of large amounts of sound tooth substance (with adverse effects on the pulp, gingivae and crown biomechanics, as well as serious financial consequences), the use of adhesive technology instead can provide maximum preservation of tissues and limited costs. Considerable advantages, such as the economical and noninvasive treatment of crown-fractured teeth, are inherent to Type IIIA bonded porcelain restorations, reducing the need for preprosthetic interventions (e.g., root canal therapy and crown-lengthening) and the use of intraradicular posts. This article, illustrated with cases with up to eight and 10 years' follow-up, sets the scientific foundations of this concept, as well as important considerations about function, strength, tooth preparation, laboratory technique, and bonding optimization.

Adolescent↗
PubMed2005

Techniques used to fabricate all-ceramic restorations in the dental practice.

Porcelain is an increasingly popular material to use for restorations. This article will discuss the 3 main ways to fabricate porcelain restorations. The first method involves waxing up the restoration to the proper form and casting it in molten porcelain similar to the lost wax technique for gold. The second technique requires the use of porcelain in a powder form to be stacked on top of a refractory die or a platinum foil and then fired in the oven. The third main technique is the use of a CAD/CAM system to mill the porcelain restoration from a solid block of porcelain. All 3 techniques are valid and the clinician should have a thorough understanding of which techniques are appropriate in various clinical situations.

Ceramics↗
PubMed2005

Fracture resistance of premolar teeth restored with different filling techniques.

The aim of this study is to verify the fracture resistance of premolars with large mesiocclusodistal (MOD) preparations with composite resin using different incremental techniques when subjected to an occlusal load. Forty maxillary premolar teeth were randomly divided into four groups (n=10). Class II MOD cavities were prepared in all specimens with parallel walls and no approximal boxes. The resulting isthmus width was 1/3 the distance between the cusp tips and (3/4) the height of the crown. Teeth in group I, the control group, were not restored. Specimens in group II were restored in three incremental vertical layers. Group III specimens were restored in three horizontal layers, and finally, specimens in group IV were restored in oblique layers. With exception of the placement technique, specimens in groups II, III and IV were restored using the Single Bond adhesive system and P60 composite resin following manufacturer's recommendations. A 4 mm diameter steel sphere contacted the buccal and lingual cusps of the tested teeth at a crosshead speed of 0.5 mm/min until fracture occurred. The values obtained in this study were subjected to Analysis of Variance (ANOVA) and a Tukey-Kramer test. Only group I (non-restored) obtained a minor means of fracture resistance. No significant differences among groups II, III, and IV were found. This study shows on large MOD cavities the incremental filling techniques do not influence the fracture resistance of premolar teeth restored with composite resin.

Analysis of Variance↗
PubMed2005

Longevity of occlusally-stressed restorations in posterior primary teeth.

PURPOSE: To compile a survey of the longevity and reasons for failure of stainless steel crowns, amalgam, glass-ionomer, composite and compomer restorations in stress-bearing cavities of primary molars. METHODS: This work reviewed the dental literature of 1971 up to July 2003 for longitudinal, controlled clinical studies and retrospective cross-sectional studies. Only studies investigating the clinical performance of restorations in primary teeth with an observation period of at least 2 years were included. Annual failure rates of stainless steel crowns, amalgam, glass-ionomer, composite and compomer restorations were determined and failure reasons were discussed. RESULTS: Annual failure rates in stress-bearing cavities of primary molars were determined to be: 0-14% for stainless steel crowns, 0-35.3% for amalgam restorations, 0-25.8% for glass-ionomer restorations, 2-29.1% for atraumatic restorative treatments, 0-15% for composite restorations, and 0-11 for compomer restorations. Main reasons for failure were secondary caries, marginal deficiencies, fracture, and wear.

Compomers↗
PubMed2005

Minimally invasive dentistry: bond strength of different sealant and filling materials to enamel.

PURPOSE: The purpose of this study was to evaluate the shear bond strength of different sealant and filling materials, used in minimally invasive dentistry, to human enamel. MATERIALS AND METHODS: Thirty-five sound extracted third molars were selected. The crowns were longitudinally sectioned, embedded in polystyrene resin, and grounded until a flat enamel surface was reached. The samples were assigned into seven groups (n = 10), according to the materials: G1-Fluoroshield; G2-Clinpro; G3-Dyract AP; G4-F2000; G5-Vitremer; G6-Fuji IX; G7-Vidrion F. All materials were applied according to the manufacturer's instructions. The samples were stored in distilled water at 37 degrees C for 24 h and submitted to a shear bonding strength test in a universal testing machine with a crosshead speed of 0.5 mm/min. The failure sites were observed in Scanning Electron Microscopy (SEM). The data were submitted to ANOVA and Tukey's tests (p < 0.05). RESULTS: The mean values (MPa) of shear bond strength were for Fluroshield (25.92 +/- 8.83), Vitremer (20.41 +/- 13.34), Dyract AP (17.08 +/- 6.38), Clinpro (12.82 +/- 8.38), F2000 (8.71 +/- 3.74), Fuji IX (7.64 +/- 2.57), and Vidrion F (4.54 +/- 2.11). Fluroshield resin sealant and Vitremer resin modified glass-ionomer showed statistically higher shear bond strength values than the conventional glass ionomer (GIC) cements. Clinpro and F2000 showed bond strength values with statistical difference only from Fluroshield. The failure mode varied among the groups. The majority of samples presented mixed failure. CONCLUSION: FluroShield and Vitremer showed better performance of shear bond strength to enamel than conventional GIC.

Analysis of Variance↗
PubMed2005

Composite resin layering and placement techniques: case presentation and scientific evaluation.

UNLABELLED: Composite resin technology has evolved, providing clinicians with the ability to deliver more natural-looking restorations for their dental patients. The evolution of layering techniques and internal staining procedures has further improved composite resins' potential for optimal results. This article discusses difficulties associated with traditional composite layering and staining, and it presents in vitro research that supports a novel layering approach. Specifically, the cut-back, etch, bond, and layer technique (CEBL) is introduced as an alternative to freehand layering. LEARNING OBJECTIVES: This article presents current concepts for composite resin layering and bonding technology. Upon reading this article, the reader should: Understand the clinical protocol for resin layering and bonding. Recognize the scientific advantages associated with composite layering with the CEBL technique.

Adult↗
PubMed1992

Using posterior composites appropriately.

The success rates of posterior composite restorations vary depending on whether they are used in clinical studies or by practitioners. This article offers a guide to determining when to use these materials.

Bicuspid↗
PubMed2005

Fracture resistance of maxillary premolars restored with direct and indirect adhesive techniques.

OBJECTIVE: To evaluate the fracture resistance of teeth restored using 2 intracoronal direct and indirect adhesive techniques. METHODS: Forty maxillary premolars were divided randomly into 4 groups of 10: group 1, intact teeth; group 2, mesio-occlusodistal (MOD) cavity preparation associated with endodontic therapy (unrestored); group 3, MOD cavity preparation and restoration with direct composite resin (Z100, 3M ESPE); and group 4, MOD cavity preparation and restoration with indirect ceramic inlay (IPS Empress, Ivoclar-Vivadent). Specimens were subsequently submitted to an axial compression test, using an 8-mm diameter steel ball at a loading speed of 0.5 mm per minute, until their fracture. RESULTS: The average compression force causing cuspal fracture in the 4 experimental groups was group 1, 138.4 kg; group 2, 49.0 kg; group 3, 105.4 kg; and group 4, 82.7 kg. ANOVA analysis and Tukey tests showed that cavity preparation significantly weakened the remaining tooth structure. The fracture resistance of teeth restored using direct composite resin was not significantly different from that of teeth restored with ceramic inlays (p > 0.05). None of the materials tested was able to restore completely the fracture resistance lost during cavity preparation. CONCLUSIONS: Cavity preparation significantly weakens the remaining tooth structure. Direct and indirect intracoronal adhesive restorations can partly restore fracture resistance of teeth weakened by wide cavity preparation.

Aluminum Silicates↗
PubMedDate not supplied

Clinical effect of different shade guide systems on the tooth shades of ceramic-veneered restorations.

PURPOSE: The objective of this study was to investigate whether a systematically arranged shade guide system (Vita 3D-Master) allows clinicians to achieve a better shade match of a restoration, as compared to a conventional shade guide with a design based on empirical values (Vita Classical). MATERIALS AND METHODS: Fifty-nine restorations in 42 patients being treated by student clinicians were assessed. Using 1 of the 2 shade systems assigned randomly, each student independently determined the tooth shade. With the aid of a visual rating scale, the accuracy of the shade match of the finished restoration was assessed. RESULTS: All restorations whose shades had been determined with the 3D-Master could be placed without any further shade corrections. In contrast, almost 17% of restorations determined with the conventional system required subsequent shade modifications. The match of the shades selected with the 3D-Master was judged significantly better by the clinicians. CONCLUSION: Within the limitations of the study, clinicians with less clinical experience who use a system that guides them through the shade-taking procedure in a relatively systematic manner will be more successful in selecting the correct tooth shade and in avoiding shade corrections. Clinical assessment of the restoration shades showed significant differences between the shade guide with a systematic design and that based on empirical values.

Color↗
PubMed2005

Influence of cavity configuration on the adhesion of two resin-based composites to pulpal floor dentin.

PURPOSE: To evaluate the effect of cavity configuration on microtensile bond strengths of two resin composites for core build-up to pulpal floor dentin. METHODS: Access cavity preparation and root canal filling with gutta percha were performed on extracted human molars. Following this, the gutta percha in the pulp chamber was completely removed to expose pulpal floor dentin. The cavity walls remained as a control group (Cavity). For another group, the cavity walls were removed to create a flat surface for bonding (Flat). For the Cavity group, Clearfil SE Bond was applied to the cavity according to the manufacturer's instructions, and either a light-cured resin composite (PH, Clearfil Photo Core) or a dual-cured resin composite (DC, Clearfil DC Core), was placed in the bonded cavity. Clearfil Photo Core was placed in three increments while bulk-filling was used for Clearfil DC Core. The application of the bonding system and the composites to the flat dentin surface was the same as that for cavity. Specimens were stored in water for 1 week, then sectioned vertically into 2 or 3 slabs (0.7 mm thick) and trimmed for the microtensile bond strength (MTBS) test. The MTBSs were measured with a universal testing machine at a crosshead speed of 1.0 mm/minute. RESULTS: The results (mean +/- SD, MPa, n=10) of PH/Cavity, PH/Flat and DC/Flat were 21.9 +/- 3.4, 28.9 +/- 4.0, and 27.6 +/- 6.1 respectively. The MTBS could not be determined in DC/Cavity because of debonding occurred during sample preparation.

Analysis of Variance↗