Shear bond strength fatigue limit of rest seats made with dental restoratives

Purpose: This study compared the shear bond strength (SBS) to enamel of rest seats made with a glass-ionomer cement (Fuji IX GP Fast), a resin-modified glass-ionomer cement (Fuji II LC), and a composite resin (Z100 MP) under monotonic and cyclic loading. Materials and Methods: Rest seats were built up onto the lingual surfaces of 80 intact human mandibular incisors. Specimens (n=10) were stored in distilled water at 37°C for 30 days and subjected to shear forces in a universal testing machine (0.5 mm/min) until fracture. The SBS values were calculated (MPa) using the bonding area (9.62 mm2) delimited by adhesive tags. A staircase approach was used to determine the SBS fatigue limit of each material. Specimens were submitted to either 10,000 cycles (5 Hz) or until specimen fracture. A minimum of 15 specimens was tested for each material. Scanning electron microscopy was used to examine the mode of failure. Data were statistically analyzed with one-way ANOVA and Tukey HSD tests (α = 0.05). Results: Z100 MP yielded higher (p < 0.05) SBS (12.25 MPa) than Fuji IX GP Fast (7.21 MPa). No differences were found between Fuji II LC (10.29 MPa) and the other two materials (p > 0.05). Fuji II LC (6.54 MPa) and Z100 MP (6.26 MPa) had a similar SBS limit. Fuji IX GP Fast promoted the lowest (p < 0.05) SBS fatigue limit (2.33 MPa). All samples showed cohesive failure patterns. Conclusion: Fatigue testing can provide a better means of estimating the performance of rest seats made with dental restoratives.

Interaction between total-etch and self-etch adhesives and conventional and self-adhesive resin cements

The aim of this study was to compare the bond strength to enamel between resin cements combined with total-etch and self-etch adhesive systems and a self-adhesive cement. Eighty bovine incisors had their buccal surface ground flat exposing a plane area in the enamel. Eighty Artglass resin cylinders measuring 3 mm in diameter and 4 mm in height were fabricated. The teeth were divided into eight groups of 10 teeth each and the resin cylinders were cemented with different adhesive systems and resin cements; G1: RelyX Unicem (self-adhesive cement); G2: H 3PO 4 + Single Bond + RelyX ARC; G3: AdheSE + Variolink II; G4: H 3PO 4 + Excite + Variolink II; G5: Xeno III + Enforce; G6: H 3PO 4 + Prime&Bond NT + Enforce; G7: Biatite Primers 1 and 2 + Bistite II DC; G8: H 3PO 4 + Bistite Primers 1 and 2 + Bistite II DC. After application of the adhesives, the cylinders were cemented according to manufacturer instructions. The specimens were submitted to 2000 thermal cycles at a temperature ranging from 5±5°C to 55±5°C, and shear bond strength was then tested at a variety of 1 mm/min. The data were analyzed by ANOVA and the Tukey's test (á=5%), obtaining a p value of 0.00. The following mean (±standard deviation) bond strength values were observed for each group: G1: 5.14(±0.99)a; G3: 16.23(±4.69)b; G7: 17.82(±3.66)b; G5: 18.48(±2.88)bc; G8: 20.15(±4.12)bc; G4: 22.85(±3.08)cd; G2: 24.96(±2.89)d; G6: 26.07(±1.69)d. Groups followed by the same letters did not differ significantly. For most of the resin cements tested, the application of adhesive systems using acid etching resulted in a higher bond strength when compared to the self-etch adhesive systems and to the self-adhesive cement.

Root trunk height as a risk factor for periodontal furcation involvement in maxillary first molars: an in vitro study.

The aim of this study was to correlate the root trunk height from the furcation openings on the buccal, mesial and distal surfaces to the cemento-enamel junction in upper first permanent molars in human beings with risk for periodontal disease progression. One hundred extracted maxillary first molars were used. Reference points and demarcations were determined from the entrance of the buccal (F1), mesial (F2) and distal (F3) furcations to the cemento-enamel junction in millimeters. The mean distances found were 3.50 mm, 4.44 mm and 4.26 mm for the buccal, mesial and distal furcations, respectively, in relation to the cemento-enamel junction. The statistical analyses were Student's t-test and Chi-square (X2). With periodontal disease progression, the buccal furcation presents a greater compromising risk due to its proximity to the cemento-enamel junction, while the mesial furcation is the most distant, comprising a lesser risk.

Influence of resin composite insertion technique in preparations with a high C-factor

Objective: To evaluate the marginal microleakage in enamel and dentin/cementum walls in preparations with a high C-factor, using 3 resin composite insertion techniques. The null hypothesis was that there is no difference among the 3 resin composite insertion techniques. Method and Materials: Standardized Class 5 cavities were prepared in the lingual and buccal aspects of 30 caries-free, extracted third molars. The prepared teeth were randomly assigned to 3 groups: (1) oblique incremental placement technique, (2) horizontal incremental placement technique, and (3) bulk insertion (single increment). The preparations were restored with a 1-bottle adhesive (Single Bond, 3M ESPE) and microhybrid resin composite (Z100, 3M ESPE). Specimens were isolated with nail varnish except for a 2-mm-wide rim around the restoration and thermocycled (1,000 thermal cycles, 5°C/55°C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50 wt% silver nitrate for 24 hours, followed by 8 hours in a photo-developing solution and evaluated for microleakage using an ordinal scale of 0 to 4. The microleakage scores obtained from occlusal and gingival walls were analyzed with Wilcoxon and Kruskal-Wallis nonparametric tests. Results: The null hypothesis was accepted. The horizontal incremental placement technique, the oblique incremental technique, and bulk insertion resulted in statistically similar enamel and dentin microleakage scores. Conclusion: Neither the incremental techniques nor the bulk placement technique were capable of eliminating the marginal microleakage in preparations with a high C-factor.

Anticariogenic effect of fluoride-releasing elastomers in orthodontic patients

This in vivo experimental study evaluated the efficacy of fluoride-releasing elastomers in the control of Streptococcus mutans levels in the oral cavity. Forty orthodontic patients were recruited and divided into two groups of 20. Fluoride-releasing elastomeric ligature ties (Fluor-I-Ties, Ortho Arch Co. Inc., USA) were used in the experimental group, and conventional elastomeric ligature ties (D. Morelli, Brazil), in the control group. Two initial samples of saliva were collected at a 14-day interval to determine the number of colony forming units (CFU) of Streptococcus mutans. Immediately after collecting the second sample, fluoride-releasing elastomeric ligature ties were placed in the patients of the experimental group, and conventional ligature ties, in the patients of the control group. Seven, 14 and 28 days after placement of the elastomeric ligature ties, saliva and plaque surrounding the orthodontic appliance were collected for microbiologic analysis. There were no significant differences in the number of Streptococcus mutans CFUs in saliva or plaque in the area surrounding the fluoride-releasing or conventional elastomeric ligature ties. Thus, fluoride-releasing elastomeric ligature ties should not be indicated to reduce the incidence of enamel decalcification in orthodontic patients. Since there was no significant reduction in S. mutans in saliva or plaque, other means of prevention against enamel decalcification should be indicated for these patients.

Prevalence of dental trauma in patients with cerebral palsy

This study presents the findings of a record review that evaluated the prevalence of dental trauma in patients with cerebral palsy and evaluated its possible relationship with age, type of palsy, and epilepsy. The dental records of 2,200 patients with special needs admitted to the special care clinic of the School of Dentistry of Araçatuba/UNESP, Brazil, between 1998 and 2003 were reviewed. Of the records that were analyzed, 500 patients who had cerebral palsy were selected for this study. Information regarding age, gender, type of palsy and dental trauma was collected and statistically analyzed. It was observed that 10.6% of the subjects (n = 53) had sustained dental trauma. The number of traumatized teeth was 84. Enamel or enamel/dentin fractures were the most frequent types of traumatic injury (84.9%). The permanent maxillary central incisors were the most commonly affected teeth (50%). The frequency of traumatic injuries showed no significant correlation (p>.05) with the type of cerebral palsy or gender and they were more frequent in subjects between the ages of 0 and 12 years. Having epilepsy was not a statistically significant risk factor (p>.05) for dental trauma. © 2008 Special Care Dentistry.

Length of resin tags in pit-and-fissure sealants: all-in-one self-etching adhesive vs phosphoric acid etching.

PURPOSE: To investigate the penetration (tags) of adhesive materials into enamel etched with phosphoric acid or treated with a self-etching adhesive, before application of a pit-and-fissure sealant. MATERIALS AND METHODS: The sample comprised six study groups with six specimens each. Before pit-and-fissure sealing with the materials Clinpro SealantTM (Groups I and II), Vitro Seal ALPHA (Groups III and IV) and Fuji II LC (Groups V and VI), the teeth in Groups I, III, and V were etched with 35% phosphoric acid for 30 seconds. Teeth in Groups II, IV, and VI received application of the self-etching adhesive Adper Prompt L-Pop. The treated teeth were sectioned buccolingually, ground to 100-microm thickness, decalcified, and analyzed by conventional light microscopy at 400x magnification. RESULTS: The teeth etched with phosphoric acid exhibited significantly greater penetration than specimens treated with self-etching adhesive. CLINICAL SIGNIFICANCE: When compared with enamel treated with a self-etching adhesive, the penetration (tags) of adhesive materials into enamel was greater when applied on enamel etched with phosphoric acid.

Ozone therapy in medicine and dentistry

Aim: The purpose of this review is to present the potential for the incorporation of ozone therapy into the practice of dentistry. Background: Ozone gas has a high oxidation potential and is 1.5 times greater than chloride when used as an antimicrobial agent against bacteria, viruses, fungi, and protozoa. It also has the capacity to stimulate blood circulation and the immune response. Such features justify the current interest in its application in medicine and dentistry and have been indicated for the treatment of 260 different pathologies. It can be used for the treatment of alveolitis as a replacement for antibiotic therapy, as a mouthwash for reducing the oral microflora, as well as the adherence of microorganisms to tooth surfaces. Ozone has been shown to stimulate remineralization of recent caries-affected teeth after a period of about six to eight weeks. Conclusion: The future of ozone therapy must focus on the establishment of safe and well-defined parameters in accordance with randomized, controlled trials to determine the precise indications and guidelines in order to treat various medical and dental pathologies. Scientific support, as suggested by demonstrated studies, for ozone therapy presents a potential for an atraumatic, biologically-based treatment for conditions encountered in dental practice.

The influence of zero-value subtraction on the performance of two laser fluorescence devices for detecting occlusal caries in vitro

Background. The aim of this study was to evaluate the influence of zero-value subtraction on the performance of two laser fluorescence (LF) devices developed to detect occlusal caries. Methods. The authors selected 119 permanent molars. Two examiners assessed three areas (cuspal, middle and cervical) of both mesial and distal portions of the buccal surface and one occlusal site using an LF device and an LF pen. For each tooth, the authors subtracted the value measured in the cuspal, middle and cervical areas in the buccal surface from the value measured in the respective occlusal site. Results. The authors observed differences among the readings for both devices in the cuspal, middle and cervical areas in the buccal surface as well as differences for both devices with and without the zero-value subtraction in the occlusal surface. When the authors did not perform the zero-value subtraction, they found statistically significant differences for sensitivity and accuracy for the LF device. When this was done with the LF pen, specificity increased and sensitivity decreased significantly. Conclusions. For the LF device, the zero-value subtraction decreased the sensitivity. For this reason, the authors concluded that clinicians can obtain measures with the LF device effectively without using zero-value subtraction. For the LF pen, however, the absence of the zero-value subtraction changed both the sensitivity and specificity, and so the authors concluded that clinicians should not eliminate this step from the procedure. Clinical Implications. When using the LF device, clinicians might not need to perform the zero-value subtraction; however, for the LF pen, clinicians should do so.

In vitro-evaluation of secondary caries formation around restoration.

The objective of this in vitro study was to evaluate demineralization around restorations. Class V preparations were made on the buccal and lingual surfaces of each tooth. TPH (Group 1), Fuji II LC (Group 2), Tetric (Group 3), Dyract (Group 4), GS 80 (Group 5) and Chelon Fil (Group 6) were randomly placed in equal numbers of teeth. The teeth were submitted to a pH-cycling model associated with a thermocycling model. Sections were made and the specimens were examined for the presence of demineralization under polarized light microscopy. Demineralization was significantly reduced with Chelon Fil (Group 6). Furthermore, a similar inhibitory effect on the development of demineralization was observed in Groups 2, 4 and 5.

Root surface treatment with vitamin C in tooth replantation: microscopic study in rats

AIM: Late tooth replantation is a worthy procedure, especially in growing patients, being the best option for tooth avulsion. This study evaluated the effects of root surface treatment with 2% acidulated phosphate sodium fluoride and effervescent vitamin C (Redoxon) in late replantation. METHODS: Twenty rat teeth (Rattus norvegicus, albinus, Wistar) were extracted and left on a table for 6 h. Then, the dental papilla and enamel organ were sectioned and the pulp was removed through the apex. After removal of the periodontal ligament with a blade, the animals were divided into 2 groups: Group I teeth were immersed in 2% acidulated phosphate sodium fluoride solution for 10 min and obturated with Ca(OH)(2) paste. Group II teeth were immersed in effervescent vitamin C solution (Redoxon 2 g) for 10 min and obturated as for Group I. After these procedures, teeth were replanted and animals were killed after 60 days. RESULTS: The study revealed a larger amount of replacement resorption in Group I and larger amount of ankylosis in Group II, with statistically significant difference and absence of inflammatory resorption. CONCLUSION: The substances used for root surface treatment were unable to prevent replacement resorption and ankylosis, which are expected when the periodontal ligament has been lost.

Adherence of Streptococcus mutans to uncoated and saliva-coated glass-ceramics and composites

This study sought to investigate the surface roughness and the adherence of Streptococcus mutans (in the presence and absence of saliva) to ceramics and composites. The early dental biofilms formed in situ on the materials were illustrated, using scanning electron microscopy (SEM). Feldspathic and leucite/feldspathic ceramics and microhybrid and microfilled composites were evaluated. Human dental enamel was used as the control. Standardized specimens of the materials were produced and surface roughness was analyzed. The adhesion tests were carried out in 24-well plates and colony forming units (CFU/mL) were evaluated. Values of roughness (μm) and adherence (CFU/mL) were analyzed statistically. Of all the surfaces tested, enamel was the roughest. Leucite/feldspathic ceramics were rougher than the feldspathic ceramic, while composites were similar statistically. Enamel offered the highest level of adherence to uncoated and saliva-coated specimens, while the leucite/feldspathic ceramic demonstrated greater adherence than the feldspathic ceramic and the composites were similar statically. The rougher restorative materials increased the adherence of S, mutans on the material surfaces.

Smoking enhances bone loss in anterior teeth in a Brazilian population: A retrospective cross-sectional study

The aim of the present study was to radiographically evaluate the effect of smoking on bone loss resulting from chronic periodontitis. Periapical radiographs were analyzed of 80 patients with chronic periodontitis (40 current or former smokers and 40 never-smokers) that attended a private periodontal practice. The smokers or former-smokers with a minimum consumption of 10 cigarettes/day for a period of over 10 years were selected. Interproximal radiographic bone loss was considered as the distance between the cementum-enamel junction and the alveolar bone crest. Bone loss for smokers was higher than that observed in never-smokers (p < 0.05) (3.33 ± 1.09 mm and 2.24 ± 0.76 mm; mean ± standard deviation for smokers and non-smokers, respectively). When each region of the mouth was comparatively evaluated, it was observed that the smokers' incisors presented the highest bone loss when compared with the other groups of teeth (p < 0.01). Within the limits of the present investigation it can be concluded that smoking enhances the bone loss resulting from periodontitis and that the incisors are the teeth most affected.

Comparative analysis of human and bovine teeth: Radiographic density

Since bovine teeth have been used as substitutes for human teeth in in vitro dental studies, the aim of this study was to compare the radiographic density of bovine teeth with that of human teeth to evaluate their usability for radiographic studies. Thirty bovine and twenty human teeth were cut transversally in 1 millimeter-thick slices. The slices were X-rayed using a digital radiographic system and an intraoral X-ray machine at 65 kVp and 7 mA. The exposure time (0.08 s) and the target-sensor distance (40 cm) were standardized for all the radiographs. The radiographic densities of the enamel, coronal dentin and radicular dentin of each slice were obtained separately using the histogram tool of Adobe Photoshop 7.0 software. The mean radiographic densities of the enamel, coronal dentin and radicular dentin were calculated by the arithmetic mean of the slices of each tooth. One-way ANOVA demonstrated statistically significant differences for the densities of bovine and human enamel (p < 0.05) and for bovine and human coronal dentin (p < 0.05). No statistically significant differences were found for the bovine and human radicular dentin (p > 0.05). Based on the results, the authors concluded that: a) the radiographic density of bovine enamel is significantly higher than that of human enamel; b) the radiodensity of bovine coronal dentin is statistically lower than the radiodensity of human coronal dentin; bovine radicular dentin is also less radiodense than human radicular dentin, although this difference was not statistically significant; c) bovine teeth should be used with care in radiographic in vitro studies.

Microhardness assessment of different commercial brands of resin composites with different degrees of translucence

Owing to improvements in its mechanical properties and to the availability of shade and translucence resources, resin composite has become one of the most widely used restorative materials in present day Dentistry. The aim of this study was to assess the relation between the surface hardness of seven different commercial brands of resin composites (Charisma, Fill Magic, Master Fill, Natural Look, Opallis, Tetric Ceram, and Z250) and the different degrees of translucence (translucid, enamel and dentin). Vickers microhardness testing revealed significant differences among the groups. Z250 was the commercial brand that showed the best performance in the hardness test. When comparing the three groups assessed within the same brand, only Master Fill and Fill Magic presented statistically significant differences among all of the different translucencies. Natural Look was the only one that showed no significant difference among any of the three groups. Charisma, Opallis, Tetric Ceram and Z250 showed significant differences among some of the tested groups. Based on the results found in this study, it was not possible to establish a relation between translucence and the microhardness of the resin composites assessed. Depending on the material assessed, however, translucence variation did affect the microhardness values of the resin composites.