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At least 19 recordsLinked to original sources

[Sensitivity of the tooth cervix. A new therapeutic alternative].

The cervical hypersensitivity tooth was analysed and treated by application of a varnish with high fluoride ions content (Duraphat) and of a glass ionomer cement usually indicated to cavity lining (XR-ionomer-Kerr). This technique was applied in sixty-seven teeth of Clinic Graduation patients (Faculdade de Odontologia de Araçatuba) and demonstrated a high index of satisfactory results. The clinical findings of this study relate that, this technique is more one method of choose by clinicians.

Dentin Sensitivity

Fluoride distribution in human dental calculus obtained from different sites on the tooth surface.

We examined the site specificity of fluoride (F) distribution in human dental calculus. Teeth with supra- and subgingival calculus were obtained from patients who resided in non-fluoridated areas in Japan and China. Sequential layers of the dental calculus (30 microns thick) were abraded by an abrasive micro-sampling technique and fluoride and phosphorus in the powdered samples were analyzed. Fluoride concentrations were highest in the outer, lowest in the middle and intermediate in the inner layers of dental calculus in general. In the outermost layers fluoride concentrations were highest in calculus found near the tooth cervix both in supra- and subgingival calculus. Fluoride concentrations decreased markedly toward the apical region in subgingival calculus, while it did not change toward the incisal or occlusal region in supragingival calculus. In the inner layers, fluoride concentrations in both supra- and subgingival calculus were not affected by position on the teeth. Fluoride concentrations in subgingival calculus near the apex were lower than in supragingival calculus near the incisal or occlusal region. It was concluded that the fluoride concentrations differ in different regions of dental calculus, probably due to their different mechanisms of formation.

Calcium Phosphates

Endodontic pathogens: propagation of infection through patent dentinal tubules in traumatized monkey teeth.

Periapical pathology indicating endodontic infection, when present in marginal periodontitis-affected teeth, has recently been shown to be an aggravating factor in progression of marginal destruction. This has been associated with patency of dentinal tubules in the tooth cervix, an area normally devoid of cementum following periodontal therapy. These studies are, however hampered by that only circumstantial evidence such as presence of periapical destruction have been applied as criteria of endodontic infection. The purpose of the present investigation was to study to what extent a predefined selection of endodontic pathogens inoculated in the root canal can influence periodontal pathology and healing in areas of the root covered by or devoid of cementum, using root resorption as a histomorphometric marker. Exposed dentine surfaces, in the present study showed significantly larger areas of resorption in infected roots compared to non-infected roots, while cementum surfaces showed an almost identical distribution of tissue reactions regardless of root canal infection or not. It was concluded that endodontic pathogens or their products were not able to penetrate the cementum barrier. The significantly larger areas of resorption on exposed dentine surfaces in infected roots compared to non-infected roots indicated that endodontic pathogens or their products could spread through dentinal tubules to a root surface void of cementum. Extrapolated to the marginal situation this indicated that endodontic pathogens in the root canal might be able to aggravate marginal infection in areas of root devoid of cementum.

Animals

Regional bond strengths of resins to human root dentine.

OBJECTIVES: The demand for restoration of root dentine defects such as cervical erosion and root caries has significantly increased recently, but there is limited information on the performance of the adhesive resins to radicular dentine. The purpose of this study was to measure the regional tensile bond strength (TBS) of composite bonded to human root and coronal dentine, and to observe the interface between resin and root dentine by SEM. METHODS: Human extracted cuspid teeth were used to measure TBS with a new microtensile bond test. Enamel and cementum were removed from the labial tooth surfaces to form a long cavity preparation into dentine from the mid-crown to the apex of the root within the same tooth. All Bond 2 (all etch technique) or Imperva Bond (no etch) was bonded to dentine surfaces and covered with Protect Liner resin composite. The resin-bonded teeth were serially sliced into 16 sections at right angles to the long axis of the tooth, and the bonded surfaces were trimmed to give a bonded surface area of 1 mm2 for TBS testing. RESULTS: All Bond 2 bond strengths to coronal and apical dentine showed high values (23.5 MPa) but the bond strength was significantly lower on cervical root dentine. Imperva Bond produced a relatively high tensile bond strength to all regional areas. SEM showed that the thickness of the resin-infiltrated layer formed by All Bond 2 in root dentine was less than coronal areas. Resin infiltration with Imperva Bond was always less than 0.5 micron. The results suggest that high TBS values can be obtained with minimal resin infiltration in root dentine.

Acid Etching, Dental

A scanning electron-microscopic study of developing human deciduous enamel on the dependence of the outline of surface pits on the angle of observation.

On the developing enamel surfaces of fetal human deciduous teeth, many of the surface pits were arcade-shaped with the arcade preferentially pointing in a cervical direction. The configuration of the interprism ridges between the pits contributed to this appearance. Surface cracks allowed verification of an incisal inclination of the subsurface prisms. This apparent paradox was solved when the specimens were tilted so that the pits were viewed in the directions of the prisms, giving the pits a compressed arcade-shape with the arcades pointing incisally. It is recommended that care should be exercised and due attention paid to the angle of observation when determining the orientation of pit arcades. Pit entry direction seems to be a more reliable feature for inferring the direction of tangential ameloblast movement.

Ameloblasts

Root reinforcement with a resin-bonded preformed post.

PURPOSE: This study evaluated the ability of resin-bonded posts to reinforce teeth that are structurally weak in the cervical area against fracture. MATERIAL AND METHODS: Forty canine roots were endodontically treated and randomly distributed into four groups of 10. Parallel-sided preformed posts were cemented into the roots of these teeth after their crowns were removed. The cervical third of the canals were flared to simulate teeth weakened in this area as a result of caries or endodontic therapy. Three resin cements and a zine-phosphate cement, which was used as the control, were used to secure the posts into the roots. Cemented posts were loaded in an Instron testing machine with a gradually increasing force at a 60-degree angle to the long axis of the root until the root fractured. RESULTS: Roots in which the posts were cemented with Panavia were significantly more resistant to fracture than those where zinc phosphate was used (p < 0.05). Because of the inability to determine exactly the point of failure of the zinc-phosphate cement, no statistically significant difference was found when compared with the other two resin cements (ANOVA and Student-Newman-Keuls test).

Analysis of Variance

A scanning electron microscopic study of tooth surface changes induced by tannic acid.

STATEMENT OF PROBLEM: Exposing the tooth structure to chemicals used in displacing the gingival tissue is inevitable. PURPOSE: This study was undertaken to microscopically examine the effect of tannic acid on the prepared dentin surface. MATERIAL AND METHODS: Forty recently extracted intact human teeth were mounted for buccal surface preparation. Teeth were equally divided into 10 groups. One group was kept as a control and the other teeth received a topical application of 15%, 20%, and 25% aqueous tannic acid solutions each for 5, 10, and 15 minutes at room temperature. All samples were washed, air-dried, then prepared for scanning electron microscopic examination. Two different areas in the cervical region were randomly selected and examined under magnifications of x1000 and x2000, then photographed. The assessment of the changes was performed qualitatively. RESULTS: The results showed an incomplete removal of the smear layer in all experimental samples. The astringent action of the tannic acid solution on both the smear layer and the surface peritubular dentin around the orifices of dentinal tubules had contributed to their constriction. The degree of constriction of the orifices of dentinal tubules increased as higher concentrations of tannic acid solutions were used and as the application time was further increased at each concentration. CONCLUSION: The tannic acid had an incomplete action on the removal of the smear layer. It also seemed to have an astringent action on both the smear layer and the peritubular dentin.

Astringents

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

pH changes at the surface of root dentin when using root canal sealers containing calcium hydroxide.

The purpose of this study was to investigate long-term pH changes in cavities prepared in root surface dentin of extracted teeth after obturation of the root canal with gutta-percha and a variety of sealers containing calcium hydroxide. After cleaning and shaping, root canals in 50 recently extracted, human single-rooted teeth were divided into five groups. Each of four groups was obturated with gutta-percha and either Sealapex, Sealer 26, Apexit, or CRCS, all of which contain calcium hydroxide. The remaining group served as the control and was not obturated with gutta-percha or sealer. Cavities were prepared in the facial surface of the roots in the cervical and middle regions. The pH was measured in these dentinal cavities at the initiation of the experiment, and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days after obturation. Results indicate that the pH at the surface of the root does not become alkaline when calcium hydroxide cements are used as root canal sealers. Regardless of the sealer used, the observed pattern of pH change was not different from that seen in the control group of roots that were not treated with sealer. It is concluded that calcium hydroxide-containing cements, although suitable for use as root canal sealants, do not produce an alkaline pH at the root surface. If such a pH change is related to treatment of root resorption, these sealants do not contribute to this treatment.

Bismuth

Changes in pH at the dentin surface in roots obturated with calcium hydroxide pastes.

The purpose of this study was to determine the pH, after defined periods of time, in cavities prepared in the facial surface of the cervical, middle, and apical regions of roots obturated with calcium hydroxide pastes. Root canal instrumentation was performed on 40 recently extracted, single-rooted human teeth. Cavities 1.5 mm in diameter and 0.75 mm in depth were prepared in the cervical, middle, and apical regions of the facial surface of each root. Teeth were randomly divided into four groups. One group was left unobturated and served as a control. The three remaining groups were obturated with either aqueous calcium hydroxide, calcium hydroxide mixed with camphorated monochlorophenol. or Pulpdent pastes. Access cavities and apical foramina were closed with Cavit. Each tooth was stored individually in a vial containing unbuffered isotonic saline. pH at the surface was measured in the cervical, middle, and apical cavities at 0 and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days. Results indicate that hydroxyl ions derived from calcium hydroxide pastes diffused through root dentin at all regions over the experimental period of 120 days. The pattern of pH change at the tooth surface was similar in all regions of the root, regardless of the type of calcium hydroxide paste used. This was a rapid rise in pH from a control value of pH 7.6, to greater than pH 9.5 by 3 days, followed by a small decline to pH 9.0 over the next 18 days, before finally rising and remaining at, or above pH 10.0 for the remainder of the experimental period. Pulpdent paste in the apical region was the only exception in this pattern, producing a pH rise nearly one full unit below the other pastes, pH 9.3. These results indicate that, for all pastes tested, a high pH is maintained at the root surface for at least 120 days.

Analysis of Variance

Strengthening immature teeth during and after apexification.

The purpose of this study was to evaluate the strengthening effect of an internal resin bonding technique. One hundred central incisors were endodontically treated and divided equally into five groups. Group 1, without any cervical preparation and with access repaired with bonded resin, served as the positive control. Teeth in groups 2 to 5 were cervically prepared to simulate the thin dentinal wall of immature teeth, and obturation material was removed to 3 mm below the cementoenamel junction (CEJ). In group 2, the negative control, the access was restored with bonded composite to the level of the CEJ. In group 3, access was restored with composite resin 3 mm apical to the CEJ using a clear post system. Group 4 was treated similarly to group 3, but an opaque post replaced the clear post. Group 5 was treated like group 3, after which a metal post was cemented into the channel left after removal of the clear post. All teeth were subjected to compression testing and the force required to fracture the teeth cervically was recorded for each group and the Kruskal-Wallis analysis performed to detect intergroup differences. All of the bonded resin techniques significantly strengthened the teeth against fracture, compared with the negative control group (p < 0.05). None of the experimental groups (3-5) were significantly different from the positive control group.

Composite Resins

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

Effect of restored and unrestored non-carious cervical lesions on the fracture resistance of previously restored maxillary premolar teeth.

OBJECTIVES: The effect of non-carious cervical lesions (NCCL) on tooth fracture resistance has not previously been investigated. The aims of this in vitro study were to examine the fracture resistance of a group of extracted maxillary premolar teeth with mesio-occlusal-distal (MOD) restorations of amalgam, and restored or unrestored simulated NCCL. METHOD: Forty sound maxillary, premolar teeth were divided at random into four groups, each of 10 teeth, which were fixed crown uppermost and long axis vertical in stainless steel moulds. Groups 1,2,3 and 4 were prepared with standardized parallel-sided MOD cavities, then restored with amalgam. Groups 1, 2 and 3 were further prepared with standardized NCCL. The NCCL in Group 1 were restored using a resin-modified polyalkenoate (glass-ionomer) cement, and the NCCL in Group 2 were restored with an adhesive composite resin system. The NCCL in Group 3 were left unrestored. The specimens were loaded compressively at 1 mm min-1 using a universal testing machine. RESULTS: Mean fracture loads (KN) of 1.08, 1.03, 0.98 and 1.14, respectively, were recorded for Groups 1, 2, 3 and 4. Two-way ANOVA and Scheffe's Multiple Range Test showed no statistically significant difference between the groups. CONCLUSIONS: It is concluded that the presence of a standardized NCCL in an extracted maxillary premolar tooth does not reduce the fracture resistance of the tooth when loaded compressively at 1 mm min-1. The restoration of NCCL with the materials tested did not result in an increase in the fracture resistance of the previously restored premolar teeth, when loaded compressively at 1 mm min-1.

Analysis of Variance

Pathohistology of undecalcified primary teeth in vitamin D-resistant rickets: review and report of two cases.

The basic dental defects in vitamin D-resistant rickets seem to be manifested in dentin. Enamel is usually reported to be normal. This histologic examination showed the penetration of microorganisms through the calcified structures of the enamel layer without visible caries. The microorganisms passed through the dentinoenamel junction and invaded dentin, which was characterized by calcospherites and large amounts of interglobular dentin. Furthermore, microorganisms could be detected in dentinal tubules, which were exposed to the oral cavity when enamel was removed. However, large areas of tertiary dentin extended between such tubules and the pulp. These light microscopic results suggest that clinical manifestations, such as, pulp recrosis and periapical lesions (without carious defects) may be caused by the penetration of microorganisms through microclefts of the enamel layer as well as pathologically altered enamel microstructures of affected teeth.

Adult

Pulpal thermal responses to an erbium,chromium: YSGG pulsed laser hydrokinetic system.

PROBLEM: Laser systems are known to raise pulpal temperatures when applied to tooth surfaces. Dental biocalcified tissues can be cut with an erbium,chromium:yttrium-scandium-gallium-garnet laser-powered hydrokinetic system. This device is effective for caries removal and cavity preparation in vitro. Pulpal monitoring of temperature changes during hard tissue cutting by a hydrokinetic system have not been reported. OBJECTIVES: This study compared the effects of hydrokinetic system, dry bur, and wet bur tooth cutting on pulpal temperature. STUDY DESIGN: In vivo thermocouple intrapulpal measurements were made on cuspid teeth in anesthetized beagle dogs. In vitro measurements were made on extracted human molar teeth preserved in high-salt solution and later rinsed in phosphate-buffered saline (pH 7.4) to simulate in vivo conditions. The hydrokinetic system was compared with conventional air-turbine-powered bur cutting. The hydrokinetic system cuts and bur preparations were randomly made on the buccal surfaces at the cervical one third of the crown and extended until exposure of the pulp was confirmed clinically. RESULTS: Pulpal temperatures associated with the hydrokinetic system either showed no change or decreased by up to 2 degrees C. Wet bur preparations resulted in a 3 degrees to 4 degrees C rise. With dry bur preparations, a 14 degrees C rise in temperature was recorded. CONCLUSIONS: Under the conditions of this study, the erbium,chromium:yttrium-scandium-gallium-garnet laser-powered hydrokinetic system, when used for cavity preparation, had no apparent adverse thermal effect as measured in the pulp space.

Aluminum Silicates

Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review.

OBJECTIVE: To review the use of calcium hydroxide for induction of apical barrier formation and healing in immature permanent teeth. INTRODUCTION: Pulp necrosis is a frequent complication of dental trauma in immature permanent teeth. Endodontic treatment of these teeth is often complicated. The walls of the root canals are frequently divergent and the apices immature, making debridement and obturation difficult. The aim of treatment is induction of apical healing which may be defined as apical closure through formation of mineralised tissue and repair of the periapical tissues. Calcium hydroxide is the material of choice for apical barrier formation and healing. RESULTS: The use of calcium hydroxide for apical barrier formation is successful in 74-100% of cases irrespective of the proprietary brand used. The average length of time for apical barrier formation is approximately 5 to 20 months. Control of infection and adequate cleaning of the root canal are very important for apical healing. CONCLUSIONS: While the success rate of apical barrier formation using calcium hydroxide is high, long-term follow-up of these teeth is necessary. Problems such as failure to control infection, recurrence of infection and cervical root fracture may occur. The latter is more frequent in immature luxated teeth with the least root development.

Bacterial Infections