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PubMed2005

The color differences between different thicknesses of resin veneered over amalgam.

STATEMENT OF PROBLEM: Composites and compomers are popular in dental practice. However, little is known about their esthetic appearance as veneering restorative materials over amalgam restorations. PURPOSE: This in vitro study was designed to assess the color differences of composite and compomer restorative materials, placed in thicknesses of 1 mm and 2 mm over amalgam. MATERIAL AND METHODS: Thirty six cylindrical Teflon molds were filled with amalgam (13 mm diameter, 2 mm thickness) and stored at 37 degrees C and 100% relative humidity for 7 days. Nine veneers (for each thickness of 1 and 2 mm) were fabricated from four types of tooth-colored restorative material, Dyract AP (DYR), Compoglass F (COMP), Herculite XRV (XRV), and Vitalecense (VIT), over amalgam specimens using Teflon-split molds and following the manufacturers' instructions. A spectrophotometer was used to measure the color difference DeltaE* between the two thicknesses. RESULTS: Color difference DeltaE* values for 1 mm thickness veneers [XRV (2.52), Comp (5.46), VIT (6.73), and DYR (6.88)] were statistically significantly higher than the 2 mm thickness [XRV (1.32), Comp (3.24), VIT (4.89), and DYR (4.83)]. Although the XRV material had the lowest DeltaE* values, no statistically significant difference was found between the two thicknesses. The color measurements at L*, a*, and b* showed most materials became darker in color at either thickness. CONCLUSION: The thicker veneer specimens were found to be closer in color to the controls than the thinner specimens. Only XRV had color differences (DeltaE*) small enough to be considered clinically acceptable (2.52 and 1.32 at 1 mm and 2 mm, respectively). CLINICAL IMPLICATIONS: In this in vitro study the color of XRV was affected the least when veneered on amalgam. Opaquers may be needed to be used with thinner veneers to minimize the effect of amalgam background.

Analysis of Variance↗
PubMed2005

The controlled placement and delayed polymerization technique for the direct Class 2 posterior composite restoration.

Adhesion dentistry and its application to the direct posterior composite restoration is the most controversial topic in dentistry today. The concepts behind this procedure are now the backbone of restorative dentistry. Adhesion dentistry influences basic fillings, crown buildups, post-and-core restorations, cementation, orthodontics, and endodontics. Yet, controversy remains about the correct way to place a direct Class 2 posterior composite restoration. This article will examine the scientific evidence to determine which materials and placement techniques will achieve the optimum direct Class 2 posterior composite restoration at or below the cementoenamel junction using the controlled placement and delayed polymerization technique.

Bicuspid↗
PubMedDate not supplied

Restoring the incisal edge.

Restorative dentistry evolves with each development of new material and innovative technique. Selection of improved restorative materials that simulate the physical properties and other characteristics of natural teeth, in combination with restorative techniques such as the proximal adaptation and incremental layering, provide the framework that ensures the optimal development of an esthetic restoration. These advanced placement techniques offer benefits such as enhanced chromatic integration, polychromatism, ideal anatomical form and function, optimal proximal contact, improved marginal integrity and longer lasting directly placed composite restorations. The purpose of this article is to give the reader a better understanding of the complex restorative challenge in achieving true harmonization of the primary parameters in esthetics (that is, color, shape and texture) represented by the replacement of a single anterior tooth. The case presented demonstrates the restoration of a Class IV fracture integrating basic adhesive principles with these placement techniques and a recently developed nanoparticle hybrid composite resin system (Premise, Kerr/Sybron, Orange, CA). The clinical presentation describes preoperative considerations, tooth preparation, development of the body layer, internal characterization with tints, development of the artificial enamel layer, shaping and contouring, and polishing of a Class IV composite restoration. The clinical significance is that anterior tooth fractures can be predictably restored using contemporary small particle hybrid composite resin systems with the aforementioned restorative techniques. These placement techniques when used with proper attention to preparation design, adhesive protocol and finishing and polishing procedures, allow the clinician to successfully restore form, function and esthetics to the single anterior tooth replacement.

Adult↗
PubMedDate not supplied

Dental attrition and associated factors in adolescents 14 to 19 years of age: a pilot study.

PURPOSE: This cross-sectional study evaluated the relationship between attrition and diverse variables in 390 Mexican adolescents aged 14 to 19 years. MATERIALS AND METHODS: An ordinal scoring system was used to describe the severity of attrition. RESULTS: Attrition prevalence was 33.3% and was associated with older age, presence of defective restorations, Class II malocclusion, and perception of stress level. CONCLUSION: Our results suggest that attrition is present in 1 of every 3 adolescents.

Adolescent↗
PubMedDate not supplied

Effects of elevated temperatures on various restorative materials: an in vitro study.

In cases of mass disasters associated with fire, identification of the burnt victims can be a real challenge to the forensic team. Teeth and their restorations play a significant role to aid in the identification process, as various restorative materials have varying resistance to high temperatures. A study was undertaken to evaluate the changes taking place on teeth restored with amalgam, composites, glass ionomers, heat cure acrylic, and ceramics. The specimens were placed in a furnace and heated to predetermined temperatures of 200, 400, 600, 800, and 1000 degrees C and the changes were examined using a digital camera and stereomicroscope. Our observations show that while some restorations were able to withstand elevated temperatures, others were reduced to an unrecognizable mass at relatively low temperatures.

Acrylic Resins↗
PubMed2005

[Eating disorders (II)--dental aspects].

Patients suffering from eating disorders exhibit oral symptoms indicative to the otherwise concealed illness. The most striking features are the intrinsic erosions due to the regular surreptitious vomiting. They occur in very typical locations within the dental arches and have been termed "perimolysis". Dental professionals are often the first to discover and diagnose eating disorders by detecting perimolysis and consequently face the difficult task to motivate the patients--who often deny their illness--to seek psychiatric help and dental care. Such motivation must be done while respecting the patients' integrity and sense of self-worth. The primary goal of dental care is to preserve the remaining teeth and to prevent further erosive loss of dental hard tissue. The key elements of a dental preventive programme based on pathophysiologic grounds are to enhance local defence mechanisms, to offer chemical and mechanical protection and to diminish abrasive and erosive challenges. Dental restorative therapy must be part of a combined medical and dental treatment plan and should not be started before the eating disorder has been treated and the patients are considered to have stable prognosis. In view of the young age of the patients, the large extension of the erosive lesions and in order to avoid endodontological treatment of mostly sound pulps, non-invasive restorative concepts using adhesive technology should be preferably used. Prophylactic measures and restorative treatment are covered by health insurance (KGV; KLV 18c, 7) if the patients undergo psychiatric or similar adequate treatment.

Adolescent↗
PubMed2005

Clinical long-term results with 617 Cerec veneers: a nine-year report.

There are no long-term clinical studies concerning the treatment outcome of CAD/CAM generated porcelain laminate veneers. The objective of this study was to conduct a longitudinal evaluation of CAD/CAM fabricated porcelain laminate veneers. A single practitioner placed 715 CAD/CAM generated porcelain laminate veneers produced chairside with the Cerec system on 307 patients between December 1989 and December 1997. 260 patients with 617 veneers were available for recall examination. Forty-seven patients with 98 veneers (13.7%) were unable to be located or return for recall examination. Fourteen restorations had been lost. The Kaplan-Meier survival rate was 94% after up to 9 years (95% confidence interval: 90.7 to 97.8%). Of the surviving restorations, 98% were classified as clinically acceptable after 9 years. 97.3% of the teeth examined tested vital, 96.2% of the veneers were asymptomatic since their production, 98.8% of the veneers were considered successful by the patient. CAD/CAM veneers fabricated with the Cerec System achieved comparable long-term clinical results to those reported for laboratory processed porcelain laminate veneers. The high survival rate and favorable clinical results would support the use of CAD/CAM porcelain laminate veneers in clinical situations similar to those for laboratory processed porcelain veneers. CAD/CAM generated porcelain laminate veneers may provide equally good clinical results and longevity as conventional laboratory-processed porcelain laminate veneers.

Acid Etching, Dental↗
PubMed2005

Effect of cavity form on adhesion to cavity floor.

PURPOSE: To investigate the influence of cavity form, namely the C-factor, on adhesion at the interface on the cavity floor using light-cured resin-based composite. METHODS: Black ABS resin molds were used and were formed into five types of cavities having configuration factors that ranged from 0.5 to 5.0. The cavity size was standardized to cubes of 5 x 5 x 5 mm. Each cavity was treated using a bonding system (Clearfil SE Bond) and was filled with resin-based composite (Clearfil Photo Core). The composite was irradiated in the cavity and then cured for 40 seconds using a halogen light unit. Specimens were subjected to the microtensile test at a cross-head speed of 1 mm/minute. RESULTS: There was no significant difference in bond strength among the five different cavity forms. It was concluded that the difference of cavity forms had little effect on the adhesion to the cavity floor when using light-cured composites.

Acrylic Resins↗
PubMedDate not supplied

In vitro pulp chamber temperature rise during composite resin polymerization with different curing lights.

The damaging effect of temperature increase on the pulp tissue during restorative treatment has been a matter of concern in dentistry for many years. Aesthetic restorative dentistry relies on polymerization of light-activated resin composites which can cause damaging effects to the dental pulp as a result of temperature rise caused by both the exothermic reaction process and the energy absorbed during irradiation. This in vitro study was carried out to measure the increase in pulp chamber temperature induced during composite resin-polymerization with various light curing units in three different and common clinical situations (Veneer, Class II, Class III) and the clinical implications of the results. Measurement of pulp temperature changes during polymerization was performed with a Al-Cr Thermocouple positioned at the pulp-dentin junction. Mean values were calculated from six measurements with each light curing unit.

Body Temperature↗
PubMed2006

Fracture resistance of fragmented incisal edges restored with fiber-reinforced composite.

PURPOSE: The aim of this study was to determine the static load-bearing capacity of fractured incisors restored with the conventional adhesive-composite technique or by using fiber-reinforced composites (FRC). MATERIALS AND METHODS: Twelve extracted sound maxillary incisors per group were prepared by cutting the incisal (one-third) part of the crown horizontally. Restorations were made using three techniques. Group A (control group) was restored by reattaching the original incisal edge to the tooth. Group B was restored using particulate filler composite (PFC). Group C was restored with PFC and FRC by adding a thin layer of FRC on the palatal surface of tooth. The bonding system used was the conventional etch system with primer and adhesive. All restored teeth were stored in water at room temperature for 24 h before they were statically loaded until fracture in a universal testing machine. Data were analyzed using ANOVA (p = 0.05). Failure modes were visually examined. RESULTS: Group A (reattaching fractured incisal edge) revealed the lowest load-bearing values, whereas preparation of the new incisal part with PFC revealed 148% higher load-bearing values compared to Group A. Group C (teeth restored with FRC) revealed a 254% higher load-bearing capacity than the control group. ANOVA revealed that the restoration technique significantly affected load-bearing capacity (p < 0.001). The failure mode in Groups A and B was debonding of the restoration from the adhesive interface, while in group C, 50% of the teeth fractured below the cementoenamel junction. CONCLUSION: These results suggest that an incisally fractured tooth restored with a combination of PFC and FRC provide the highest load-bearing capacity.

Acid Etching, Dental↗
PubMed2006

Selection of luting agents, part 1.

The clinical success of indirect restorations is dependent on multiple factors that include preparation design, mechanical forces, restorative material selection, oral hygiene, and selection of a proper luting agent. The selection of the luting agent is dependent on the specific clinical situation, the type of restoration utilized and the physical, biologic, and handling properties of the luting agent. Although it is important to choose the best luting agent for each clinical situation, far greater variations in physical properties result from improper manipulation of a given luting agent than exist between different types of cements. One study listed loss of retention as the third-leading cause of prosthetic replacement, with failure occurring after only 5.8 years in service. The primary purpose of the luting procedure is to achieve a durable bond and to have good marginal adaptation of the luting material to the restoration and tooth. Conventional cements have always relied upon retention and resistance forms in tooth preparations; Adhesive-type luting agents offer the clinician an added advantage by bonding to the tooth structure. Three main types of conventional "cements" are commonly used, zinc phosphate and the polyelectrolyte cements polycarboxylate, and glass ionomer cements. Because of its long history of successful clinical use, zinc phosphate is considered the gold standard against which all other luting agents are compared because of its long clinical history of successful use. Currently, two additional types of luting agents have gained considerable popularity. These include the resin-modified glass ionomer cements and resin cements. The resin cement category includes light-cured, dual-cured and chemically cured agents. The purpose of this article is to discuss the ideal attributes of a luting agent and make clinical recommendations for their use.

Adhesiveness↗