Single crowns versus conventional fillings for the restoration of root filled teeth

BackgroundEndodontic treatment, involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to structural differences between vital and non-vital root filled teeth. Direct restoration involves placement of a restorative material e.g. amalgam or composite directly into the tooth. Indirect restorations consist of cast metal or ceramic (porcelain) crowns. The choice of restoration depends on the amount of remaining tooth which may influence long term survival and cost. The comparative in service clinical performance of crowns or conventional fillings used to restore root filled teeth is unclear.ObjectivesTo assess the effects of restoration of endodontically treated teeth (with or without post and core) by crowns versus conventional filling materials.Search methodsWe searched the following databases: the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, CINAHL via EBSCO, LILACS via BIREME and the reference lists of articles as well as ongoing trials registries. There were no restrictions regarding language or date of publication. Date of last search was 13 February 2012.Selection criteriaRandomised controlled trials (RCTs) or quasi-randomised controlled trials in participants with permanent teeth which have undergone endodontic treatment. Single full coverage crowns compared with any type of filling materials for direct restoration, as well as indirect partial restorations (e.g. inlays and onlays). Comparisons considered the type of post and core used (cast or prefabricated post), if any.Data collection and analysisTwo review authors independently assessed trial quality and extracted data.Main resultsOne trial judged to be at high risk of bias due to missing outcome data, was included. 117 participants with a root filled premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration. At 3 years there was no reported difference between the non-catastrophic failure rates in both groups. Decementation of the post and marginal gap formation occurred in a small number of teeth.Authors' conclusionsThere is insufficient evidence to support or refute the effectiveness of conventional fillings over crowns for the restoration of root filled teeth. Until more evidence becomes available clinicians should continue to base decisions on how to restore root filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.

Cytotoxicity of monomers, plasticizer and degradation by-products released from dental hard chairside reline resins

Objectives. The aim of this study was to evaluate the cytotoxic effect of the monomers isobutyl methacrylate (IBMA) and 1,6-hexanediol dimethacrylate (1,6-HDMA), the plasticizer di-n-butyl phthalate (DBP), and the degradation by-products methacrylic acid (MA) and benzoic acid (BA) on L929 cells. Based on previous investigations on the release of these compounds from hard chairside reline resins, a range of concentrations (mu mol/L) were selected for the cytotoxicity tests (IBMA, 5.491406.57; 1,6-HDMA, 1.2239.32; DBP, 1.12143.8; MA, 9.07581; BA, 3.19409).Methods. Cytotoxic effects were assessed using MTT and 3H-thymidine assays after the cells had been exposed to the test compounds at the given concentrations for 24h. Cytotoxicity was rated based on cell viability relative to controls (cells exposed to medium without test substances).Results. DNA synthesis activity was inhibited by all compounds. Mitochondrial dehydrogenase activity decreased in cells treated with monomers, plasticizer and MA by-product, whereas no cytotoxic effect was observed on contact with BA at the majority of concentrations tested. The ranges of suppression for 3H-thymidine assay were: IBMA, 2595%; 1,6-HDMA, 9598%; DBP, 4098%; MA, 9799%; BA, 5471%. For MTT assay, the ranges of suppression were: IBMA, 096%; 1,6-HDMA, 2689%; DBP, 1780%; MA, 5266%; BA, 027%. The 3H-thymidine assay was more sensitive than the MTT assay.Significance. This study evaluated the cytotoxicity of a wide range of concentrations of monomers (IBMA and 1,6-HDMA), plasticizer (DBP) and degradation by-products (MA and BA), including those expected to be released from hard chairside reline resins. The differences observed in the cytotoxicity of these compounds, along with other properties, may assist the dental practitioners in the selection of reline materials with improved service life performance and low risk of adverse reactions in patients who wear relined dentures.

Location of the mandibular foramen according to the amount of dental alveoli

The aim of this study was to analyze the anatomotopographic location of the mandibular foramen in the right and left ramus, and to verify the influence of the amount of dental alveoli on the foramen position. Thirty-five adult dry human mandibles of Araraquara Dental School, UNESP - São Paulo State University were assessed, with or without dental alveoli. Measurements were obtained, using a ruler and a digital caliper. The following distances were measured: Fl - distance between the lowest point of the mandibular incisure and the mandibular foramen (F point); FB - distance between the mandibular base and F point; FP - distance between the posterior margin of the ramus and F point; FA - distance between the anterior margin of the ramus and F point; FT - distance between the apex of the retromolar trigone and F point. The Mann-Whitney test was used to compare each measurement according to hemi-arch, and the Kruskal-Wallis test was used to analyze the influence of the presence of alveoli on the measures. For multiple comparison, Dunn's method was used. There was no statistically significant difference in the location of the mandibular foramen when compared to the right and left hemi-arches. The amount of dental alveoli influenced, significantly, only on FA and FP distances. Thus, it was concluded that the right and left mandibular ramus showed symmetry in the location of the mandibular foramen, and the amount of alveoli influenced on the distances of the anterior and posterior margins of the mandibular rams, in relation to the mandibular foramen.

Genetic association study between Interleukin 10 gene and dental implant loss

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Deposition of Lead and Cadmium Released by Cigarette Smoke in Dental Structures and Resin Composite

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influence of light guide tip used in the photo-activation on degree of conversion and hardness of one nanofilled dental composite

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of light-curing units on microleakage under dental composite resins

The aim of this study was to determine the effect of two light-curing units (QTH and LED) on microleakage of Class II composite resin restorations with dentin cavosurface margins. Twenty extracted mandibular first premolars, free of caries and fractures were prepared two vertical slot cavities in the occluso-mesial and -destal surfaces (2 mm buccal-lingually, 2 mm proximal-axially and cervical limit in enamel) and divided into 4 equal groups (n = 8): GI and GII: packable posterior composite light-activated with LED and QTH, respectively; GIII and GIV: micro-hybrid composite resin light-activated with LED and QTH, respectively. The composite resins were applied following the manufacturer's instructions. After 24 h of water storage specimens were subjected to thermocycling for a total of 500 cycles at 5 and 55A degrees C and the teeth were then sealed with impermeable material. Teeth were immersed in 0.5% Basic fuchsin during 24 h at room temperature, and zero to three levels of penetration score were attributed. The Mann-Whitney and Kruskal-Wallis tests showed significant statistically similar (P > 0.05) from GI to GII and GIII to GIV, which the GII (2.750) had the highest mean scores and the GIII and GIV (0.875) had lowest mean scores. The use of different light-curing units has no influence on marginal integrity of Class II composite resin restorations and the proprieties of composite resins are important to reduce the microleakage.

Effect of different dental composite resins on the polymerization process

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of the Light-Curing Unit, Storage Time and Shade of a Dental Composite Resin on the Fluorescence

The aim of this study was to determine the influence of three light-curing units, storage times and colors of the dental composite resin on the fluorescence. The specimens (diameter 10.0 +/- 0.1 mm, thickness 1.0 +/- 0.1 mm) were made using a stainless steel mold. The mold was filled with the microhybrid composite resin and a polyethylene film covered each side of the mold. After this, a glass slide was placed on the top of the mold. To standardize the top surface of the specimens a circular weight (1 kg) with an orifice to pass the light tip of the LCU was placed on the top surface and photo-activated during 40 s. Five specimens were made for each group. The groups were divided into 9 groups following the LCUs (one QTH and two LEDs), storage times (immediately after curing, 24 hours, 7 and 30 days) and colors (shades: A(2)E, A(2)D, and TC) of the composite resin. After photo-activation, the specimens were storage in artificial saliva during the storage times proposed to each group at 37 C and 100% humidity. The analysis of variance (ANOVA) and Tukey's post-hoc tests showed no significant difference between storage times (immediately, 24 hours and 30 days) (P > 0.05). The means of fluorescence had difference significant to color and light-curing unit used to all period of storage (P < 0.05). The colors had difference significant between them (shades: A2D < A2E < TC) (P < 0.05). The Ultraled (LED) and Ultralux (QTH) when used the TC shade showed higher than Radii (LED), however to A2E shade and A2D shade any difference were found (P > 0.05).

Determination of the properties of an experimental glass polyalkenoate cement prepared from niobium silicate powder containing fluoride

Objectives. The purpose of this paper is to modify the conventional calcium fluoro-aluminosilicate glass, which is used in the formation of glass ionomer cements (CIGs) by the niobium addition and to study the properties of GICs obtained.Materials and methods. Sol-gel process was used to prepare the powder at lower temperature than fusion method. Glass-ceramic powder obtained in this way was used to prepare the GICs. The properties such as working and setting times, microhardness and diametral tensile strength were evaluated for the experimental GICs and a commercial luting cement.Results. The ideal powder:liquid (P:L) ratio determined to prepare the experimental GICs was equal to 1:1. The cements prepared using this ratio showed working and setting times similar to the commercial GICs. in mechanical tests it was observed that microhardness and diametral tensile strength of the experimental GICs decreased significantly with the reduction of P:L ratio. on the other hand, the results obtained in microhardness tests indicated that the presence of niobium was a positive factor.Significance. The chemical process allows the development of glass-ceramic powder at 600 degrees C which is the goal of the present paper. It was concluded that GICs containing niobium might be used in dental applications and these results encourage further researches on other compositions. (c) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Comparative assessment of the organization of the colors of the Vita Classical color pallet by digital images and visual analysis for dental bleaching

New formularizations, techniques and devices have become the dental whitening most safe and with better results. Although this, the verification of the levels whitening is being continued for visual comparison, that is an empirical, subjective method, subject to errors and dependent of the individual interpretation. Normally the result of the whitening is express for the amplitude of displacement between the initial and the final color, being take like reference the tonalities of a scale of color commanded of darkest for more clearly. Although to be the most used scale, the ordinance of the Vita Classical (R) - Vita, according to recommendations of the manufacturer, reveals inadequate for the evaluation of the whitening. From digital images and of algorithm OER (ordinance of the reference scale), especially developed for the ScanWhite (C), the ordinance of the tonalities of the scale Vita Classical (R) was made. For such, the values of the canals of color R, G, and B of medium part average of the crowns was adopted as reference for evaluation. The images had been taken with the camera Sony Cybershoot DSC F828. The results of the computational ordinance had been compared with the sequence proposal for the manufacturer and with the earned one for the visual evaluation, carried through by 10 volunteers, under standardized conditions of illumination. It statistics analyzes demonstrated significant differences between the ordinances.

A Thermal Investigation of Dental Bleaching In Vitro

Objective: Our goal was to investigate the surface temperature variations in the cervical region via infrared thermography, as well as the temperature within the pulp chamber via thermocouples, of mandibular incisors when subjected to dental bleaching using two different 35% hydrogen peroxide gels, red (HP) and green (HPM), when activated by halogen light (HL) and LED light.Background Data: Temperatures increases of more than 5.5 degrees C are considered to be potentially threatening to pulp vitality, while those higher than 10 degrees C can result in periodontal injury.Materials and Methods: Tooth samples were randomly divided into four groups (n = 10 each), according to the bleaching agent and catalyst light source used.Results: Mean values and standard deviations of the temperature increases inside the pulp chamber in the HL groups were 4.4 degrees +/- 2.1 degrees C with HP, and 4.5 degrees +/- 1.2 degrees C with HPM; whereas in the groups using LED light, they were 1.4 degrees +/- 0.3 degrees C for HP, and 1.5 degrees +/- 0.2 degrees C for HPM. For the root surfaces, the maximum temperature increases in the groups irradiated with HL were 6.5 degrees +/- 1.5 degrees C for HP, and 7.5 degrees +/- 1.1 degrees C with HPM; whereas in the groups irradiated with LED light, they were 2.8 degrees +/- 0.7 degrees C with HP, and 3 degrees +/- 0.8 degrees C with HPM. There were no statistically significant differences in pulp and surface temperature increases between the groups using different gels, although the mean temperature increases were significantly higher for the groups irradiated with HL when compared with those irradiated with the LED light (p < 0.05 with Tukey's test).Conclusion: LED light may be safe for periodontal and pulp tissue when using this method, but HL should be used with care.

Comparative scanning electron microscopic study of the effect of different dental conditioners on dentin micromorphology

This study evaluated comparatively by scanning electron microscopy (SEM) the effect of different dental conditioners on dentin micromorphology, when used according to the same protocol. Forty dentin sticks were obtained from 20 caries-free third human molars and were assigned to 4 groups corresponding to 3 conditioners (phosphoric acid 37%, Clearfil SE Bond and iBond) and an untreated control group. After application of the conditioners, the specimens were immersed in 50% ethanol solution during 10 s, chemically fixed and dehydrated to prepare them to SEM analysis. In the control group, dentin surface was completely covered by smear layer and all dentinal tubules were occluded. In the phosphoric acid-etched group, dentin surface was completely clean and presented exposed dentinal tubule openings; this was the only group in which the tubules exhibited the funnel-shaped aspect. In the groups conditioned with Clearfil SE Bond primer and iBond, which are less acidic than phosphoric acid, tubule openings were occluded or partially occluded, though smear layer removal was observed. SE Bond was more efficient in removing the smear layer than iBond. In the Clearfil SE Bond group, the cuff-like aspect of peritubular dentin was more evident. It may be concluded all tested conditioners were able to change dentin morphology. However, it cannot be stated that the agent aggressiveness was the only cause of the micromorphological alterations because a single morphological pattern was not established for each group, but rather an association of different aspects, according to the aggressiveness of the tested conditioner.