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Retention of a resin-modified glass ionomer adhesive in non-carious cervical lesions. A 6-year follow-up.

OBJECTIVES: The purpose of this study was to evaluate the clinical retention of a new resin-modified glass ionomer cement based adhesive combined with a hybrid resin composite or a poly-acid modified resin composite in non-carious cervical lesions during a 6-year period. METHODS: The resin-modified glass ionomer adhesive (Fuji Bond LC), was placed in 73 cervical lesions, 36 with a universal hybrid resin composite (Tetric Ceram) and 37 with a poly-acid modified resin composite (Hytac). Fifty-one in lesions with sclerotic dentin and 22 in non-sclerotic ones. Of the sclerotic lesions 38 were slightly roughened with a diamond bur before conditioning. The restorations were evaluated with slightly modified USPHS criteria every six months during a 6-year period. RESULTS: All except six restorations were evaluated during the 6 years. Twelve (17.9%) were lost, four Tetric Ceram (11.8%) and eight Hytac (24.2%) (p<0.05). Four were found in non-sclerotic lesions (20.0%) and eight in sclerotic lesions (17.0%). The differences between the sclerotic and non-sclerotic and the roughened and non-roughened lesions were not significant. CONCLUSIONS: The resin-modified glass adhesive showed a superior clinical retention combined with the resin composite material, with an annual failure rate of 2%.

Adult↗

Effect of CPP-ACP paste on mechanical properties of bovine enamel as determined by an ultrasonic device.

OBJECTIVE: The purpose of this study was to determine the effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) paste on demineralization of bovine enamel by measuring changes in the ultrasound transmission velocity. METHODS: The enamel specimens were prepared by cutting bovine teeth into blocks. The specimens were stored in 0.1 M lactic acid buffer solution (pH 4.75, Ca 0.75 mM, P 0.45 mM) for 10 min twice a day, and then stored in the artificial saliva (pH 7.0). Other specimens were stored in a 10-times diluted solution of CPP-ACP paste and a placebo paste without CPP-ACP for 10 min, followed by 10 min immersion into a demineralization solution twice a day before storage in the artificial saliva. The propagation time of longitudinal ultrasonic waves was measured by a Pulser-Receiver (Model 5900, Panametrics) with a transducer (V112, Panametrics). Six specimens were used for each condition, and one-way ANOVAs followed by the Tukey HSD tests (alpha = 0.05) were done. RESULTS: The sonic velocity was found to decrease with time for specimens stored in the demineralization solution. On the other hand, a significant increase in sonic velocity was found for specimens stored in the CPP-ACP solution. CONCLUSIONS: From the result of this study, it was suggested that the conditions of de- and remineralization of the enamel structure could be measured non-destructively by using an ultrasonic pulse method. It could be concluded that the inorganic components contained in high concentrations in CPP-ACP acted to enhance remineralization of the enamel structure.

Animals↗

In vivo correlation of noncarious cervical lesions and occlusal wear.

STATEMENT OF PROBLEM: The etiology of noncarious cervical lesions is not well understood. An understanding of the etiology helps the clinician determine appropriate treatment and management strategies. Purpose This study evaluated the relationship between noncarious cervical lesions and occlusal (or incisal) wear. MATERIAL AND METHODS: Casts (n = 299) made from dental students were articulated in a semi-adjustable articulator and evaluated. Data included the presence and contour of noncarious cervical lesions (NCLs) and the presence, location, and severity of any occlusal/incisal wear facets. Also included were Angle's classification, occlusal guidance patterns, midline, presence of tori, tooth restoration, reverse articulation (crossbite), open occlusal relationship, and posterior excursive contacts where present. Following a calibration procedure, 2 evaluators made independent observations on the casts. The first evaluator recorded for each tooth in each subject: presence and severity of NCLs, presence and extent of occlusal/proximal restorations, and presence of reverse articulation and open occlusal relationship. Following the first evaluation red rope wax was placed at the cervical margins of each tooth for the purpose of blinding the second evaluator from NCL observations. The second evaluator recorded severity and location of occlusal/incisal wear, presence or absence of posterior excursive contacts, Angle's classification, occlusal guidance pattern, any midline discrepancy, and presence or absence of tori. The Spearman correlation coefficient and chi 2 tests were used to analyze the data (alpha=.05). RESULTS: There was no relationship between noncarious cervical lesions and occlusal/incisal wear. There was also no correlation between NCLs and other parameters examined. CONCLUSIONS: Under the conditions of this study, noncarious cervical lesions are not related to occlusal wear.

Adult↗

Effects of Bartter's syndrome on dentition and dental treatment: a clinical report.

Bartter's syndrome is an autosomal recessive form of severe volume depletion due to renal salt wasting. This clinical report describes the prosthodontic treatment for a 24-year-old man who suffers from Bartter's syndrome. The treatment plan included endodontic treatment of the maxillary anterior incisors and placement of cast dowel-and-core restorations because of reduced crown height. The patient's remaining teeth were restored with metal-ceramic crowns.

Adult↗

A study of the classification and treatment of noncarious cervical lesions by general practitioners.

PURPOSE: This study presented a survey to determine what general practitioners in Nova Scotia perceived to be the cause of noncarious cervical lesions, and to ascertain their most frequent method of treatment. METHODS: The survey was completed by 63% of the 343 dentists polled. RESULTS: Ninety-four percent classified the lesion as abrasion, and 66% rated toothbrushing as the most likely cause. Treatment methods were varied, with no clear preference. CONCLUSION: The most frequently used restorative materials were GI/composites (29%) and composites (27%). The results of the survey suggest that treatment provided for noncarious cervical lesions may not be based on the correct diagnosis.

Clinical Competence↗

Bioengineering seeds of contemplation: a private practitioner's perspective.

In a precise semantic sense, the most significant biomaterial in dentistry is the human tooth. How it reacts, changes and is affected during the dynamics of occlusal loading should be reexamined in light of modern technology. Much is known about the embryology, histology, biochemistry, anatomy, and the microbiology affecting teeth; however, there are areas of biomechanics, biochemistry, and bioelectricity which also affect dental hard tissues that remain largely unexplored. Technological advances enable us to use more sophisticated instrumentation to measure and quantify changes that occur during the dynamics of occlusal activity. Armed with this information, dentistry can better understand how teeth interact with restorative materials in order to increase the longevity of both.

Biomechanical Phenomena↗

Marginal adaptation and retention of a glass-ionomer, resin-modified glass-ionomers and a polyacid-modified resin composite in cervical Class-V lesions.

OBJECTIVES: An 18-month follow-up clinical trial of one conventional glass-ionomer (HIFI Master Palette), three resin-modified glass-ionomers (Fuji II LC, Vitremer, 3M Exp. 155) and one polyacid-modified resin composite (Dyract) was conducted to evaluate their clinical effectiveness in Class-V cervical lesions. In addition, the interface between dentin and two resin-modified glass-ionomers and one polyacid-modified resin composite was examined by scanning electron microscopy (SEM). METHODS: After evaluation of the restorations immediately following placement (baseline), all patients were subjected to a strict recall schedule with controls at 6, 12 and 18 months. The clinical effectiveness was recorded in terms of retention and marginal integrity, clinical microleakage, caries recurrence, and tooth vitality. A chi 2-test (p < 0.05) was used to test for significant differences between materials. In case of restoration loss or special defects, a replica was made to examine the surface texture and restoration margins by SEM. In vitro, the interface was examined by SEM after an argon-ion-beam etching technique was used to enhance surface relief and disclose interfacial substructures. RESULTS: Retention appeared to be good for all the materials tested. Marginal discrepancies were localized at the incisal enamel and/or the cervical dentin margin, except for the polyacid-modified resin composite that showed most of the defects at the incisal enamel margin. None of the systems could guarantee margins free of microleakage for a long time. In vitro, the type of dentin pre-treatment defines to a great extent the morphology of the resultant interface between dentin and the restorative material tested. SIGNIFICANCE: In this clinical study, the retention rate of the tested materials was good and even excellent for some products. Perfect marginal adaptation deteriorated too fast. The marginal adaptation of the polyacid-modified resin composite at the enamel site would probably have been better by the use of selective enamel or total acid etching. Marginal sealing remains a problem. Future research should concentrate on improving the marginal adaptation and sealing capacities before a broader clinical use can be advocated.

Acrylic Resins↗

Eighteen-month clinical evaluation of a filled and unfilled dentin adhesive.

OBJECTIVE: The purpose of this study was to evaluate the performance of a filled (OptiBond Solo) and an unfilled (Prime & Bond 2.1) "one-bottle" adhesive in Class V restorations after 18 months of clinical service. METHODS: Thirty-three patients with non-carious cervical lesions were enrolled in the study. A total of 101 lesions were restored using one of the adhesives and a hybrid composite resin. Enamel was not beveled, nor was any mechanical retention placed. The restorations were evaluated at baseline, and at 6 and 18 months after placement using modified USPHS criteria. RESULTS: Cumulative 18-month retention rates were 93.6% for OptiBond Solo and 98.0% for Prime & Bond 2.1. The difference in retention rates was not statistically significant. For OptiBond Solo, the only notable problems were interfacial staining and marginal adaptation, both of which were less than ideal in 9% of restorations. Marginal problems were slightly less frequent for Prime & Bond 2.1 restorations, but the difference was not significant. CONCLUSIONS: Both adhesives provided Class V retention rates exceeding the 18-month, full acceptance guidelines set by the American Dental Association. Any additional benefit provided by the use of a filled adhesive was not detected in this 18-month clinical trial.

Adhesives↗

In vitro approach to evaluate potential harmful effects of beer on teeth.

OBJECTIVE: The purpose of the present work was to examine some properties of different brands of beer manufactured in Brazil that may be important to oral health. METHODS: Samples from seven different beer brands were analyzed for pH, titratable acidity, calcium and phosphate concentrations. Demineralization experiments were carried out by incubating samples with crown tooth particles (40-80 mesh) at 37 degrees C under agitation (100 strokes/min). RESULTS: The pH was lower than 4.0 for three of the seven samples and higher than 4.0 for the others. The amount of titratable acidity, expressed as the volume of 0.1N NaOH solution consumed to raise the initial pH to 7.0, and the concentrations of calcium and phosphate varied. Calcium concentration ranged from 0.21 to 1.59 micromol/ml, while phosphate concentration varied from 0.048 to 0.094 micromol/ml. Calcium released to the incubation medium was proportional to the time of incubation up to 5min. Maltose, a disaccharide, was detected in all samples studied. CONCLUSION: Differences in the properties examined indicated that some brands of beer studied may have potential dental effects.

Beer↗

Health and production aspects of feeding sweetpotato to cattle.

If certain guidelines are followed when feeding sweetpotatoes to livestock it is possible to minimize health hazards. Careful herd management and the recognition of specific biomarkers such as excessive dental deterioration could aid in the early identification of feed problems. Where these tubers are produced locally in abundance there can be an economic and environmental incentive to divert waste sweetpotato by-products toward livestock feed. The feeding of culled sweetpotatoes and processed sweetpotato waste by-products can have three major benefits. First, expensive disposal costs are reduced. Second, negative environmental impacts from landfill dumping and crop spreading are limited. Third, the culled sweetpotatoes and SPCW offer an inexpensive and nutritious alternative feed ration for livestock that may increase economic returns.

Animal Feed↗

The dental implications of chronic use of acidic medicines in medically compromised children.

OBJECTIVE: Liquid oral medicines form a significant proportion (11%) of the medicines used by the population as a whole, either prescribed or over the counter. The active agent, as well as some of the other ingredients, can pose a threat to oral health. METHOD: Eight liquid oral medicines and two effervescent preparations routinely prescribed for long-term use by paediatric renal patients were assessed for titratable acidity and pH values. RESULTS: All of the medicines tested were acidic and the majority were well below the critical pH of 5.5 at which enamel demineralisation takes place. The titratable acidity values, at a pH of 6.7, ranged between 0.01 and 1.54 for the liquid preparations but were 8.4 and 10.6 for the two effervescent tablets tested. CONCLUSION: Surplus acid in effervescent preparations while ensuring palatability of medicines and thus compliance, may produce unwanted dental side effects in children who are already medically compromised.

Acids↗

Determination of changes on tooth-colored cervical restorations in vivo using a three-dimensional laser scanning device.

The present study aimed at the determination of changes of tooth-colored cervical restorations in vivo using an optical 3-dimensional laser scanning device. The study was performed on 197 cervical restorations placed on incisors, canines, and premolars. Four different tooth-colored restoration materials, a composite, a polyacid-modified resin composite, and two resin-modified glass ionomer cements, were used for the restoration of the lesions. For the determination of changes, images were taken at baseline and 15, 24 and 36 months after the placement of the fillings using a 3D-laser scanning device. The images were superimposed automatically, and digital subtraction was made by a specially developed image analysis software. The total substance loss on the entire filling surface at 36 months for the resin-modified glass ionomer Photac-Fil was 44 (+/-23) microm, for Fuji II LC 45 (+/-26) microm, for Dyract 71 (+/-47) microm and for Tetric 18 (+/-12) microm. Differentiating between the class of lesion, a higher wear rate was observed at 36 months on restorations which had been placed in erosion/non-carious cervical cavities (66 (+/-33) microm). In conclusion, the composite material demonstrated a distinctly lower surface wear rate over time in comparison to the resin-modified glass ionomer cements and the polyacid-modified resin composite.

Adult↗

Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease.

OBJECTIVE: An assessment of oral symptoms and signs in patients with inflammatory bowel disease (IBD). METHODS: Fifty-four patients with IBD, 34 with Crohn's disease (CD) and 20 with ulcerative colitis (UC) participated in the study. Forty-two patients without gastrointestinal disease or complaints attending the orthopedic clinic served as controls. Each patient completed a written questionnaire and was subjected to an oral examination. RESULTS: The main findings of this study were the higher prevalence of halitosis (50% vs 10% P < 0.0008), nausea (30% vs 7%, P < 0.017) and reflux (regurgitation) (45% vs 17%, P < 0.017) in patients with UC, and nausea (50% vs 7%, P < 0.026), dry mouth and halitosis (29% vs 10%, P < 0.026) and vomiting (41% vs 5%, P = 0.01) in patients with CD, compared with controls. Patients with active CD had a higher prevalence of dry mouth, nausea and vomiting compared with controls (46, 69 and 54% vs 10, 7 and 5%, respectively, P < 0.001) and of reflux compared with non-active CD (46% vs 5%, P < 0.001). Patients with active UC had a higher prevalence of halitosis and regurgitation (50 and 60% vs 10 and 17%, P < 0.001) compared with controls. CONCLUSIONS: The present study demonstrates increased frequency of oral signs and symptoms in patients with IBD. Patients with active CD had more oral signs compared with non-active CD patients. Manifestations such as nausea, vomiting, regurgitation and dry mouth may have detrimental effects on teeth and soft tissues of the oral cavity. Communication between gastroenterologists and dentists is imperative for success of the overall treatment of their patients.

Adult↗