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.

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.

Effect of different dental composite resins on the polymerization process

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

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.

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.

The influence of an abdominal support for a dental stool in the distributions and electrical activity of the longissimus and the superior trapezius muscle in dentists

This study evaluated the influence an abdominal support attached to a traditional stool, of those used by dentists, has on the body's distribution of the electrical activity of the superior trapezius and the longissimus thoracic muscles of dental students during the execution of a clinical procedure. The results showed no significant difference in the body's distribution in the seat and backrest, but did reveal there was a weight discharge of 3.1 +/- 1.9% of dentist's body weight in the abdominal support. The 9 o'clock position proved to be the best position to perform clinical procedures. It was also observed that the position was closer to the body's axis.

Strain Gauge Analysis of the Effect of Porcelain Firing Simulation on the Prosthetic Misfit of Implant-Supported Frameworks

Objectives: This study investigated the effect of porcelain firing on the misfit of implant-supported frameworks and analyzed the influence of preheat treatment on the dimensional alterations.Materials and Methods: Four external-hex cylindrical implants were placed in polyurethane block. Ten frameworks of screw-retained implant-supported prostheses were cast in Pd-Ag using 2 procedures: (1) control group (CG, n = 5): cast in segments and laser welded; and test group (TG, n = 5): cast in segments, preheated, and laser welded. All samples were subjected to firing to simulate porcelain veneering firing. Strain gauges were bonded around the implants, and microstrain values (mu epsilon = 10(-6)epsilon) were recorded after welding (M1), oxidation cycle (M2), and glaze firing (M3). Data were statistically analyzed (2-way analysis of variance, Bonferroni, alpha = 0.05).Results: The microstrain value in the CG at M3 (475.2 mu epsilon) was significantly different from the values observed at M1 (355.6 mu epsilon) and M2 (413.9 mu epsilon). The values at M2 and M3 in the CG were not statistically different. Microstrain values recorded at different moments (M1: 361.6 mu epsilon/M2: 335.3 mu epsilon/M3: 307.2 mu epsilon) did not show significant difference.Conclusions: The framework misfit deteriorates during firing cycles of porcelain veneering. Metal distortion after porcelain veneering could be controlled by preheat treatment. (Implant Dent 2012;21:225-229)

The effect of porcelain thickness and surface liner application on the fracture behavior of a ceramic system

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

In vitro study of the Nd : YAG laser effect on human dental enamel: Optical and scanning electron microscope analysis

Objective: the Nd:YAG laser irradiation of dental enamel was evaluated in enamel demineralization experiments in a Streptococcus mutans culture media. Summary Background Data: Previous studies had shown that a continuous wave Nd:YAG laser at an energy of approximately 67 mJ may induce an increased acid resistance in human dental enamel when exposed to severe demineralization conditions. Methods: Enamel windows of 3 x 4 cm in the buccal surface were irradiated with a continuous wave Nd:YAG laser at a wavelength of 1,064 Ecm using energy densities of from 83.75 to 187.50 J/cm(2), Enamel windows of 3 x 4 cm on the lingual surface served as control (without the laser irradiation). The enamel windows were then exposed to a Streptococcus mutans culture media at a temperature of 37 degrees C for 15 and 21 days. The laser effects and demineralization were examined both by optical microscopy and scanning electron microscopy (SEM), Results: A comparison between the lased and the unlased windows of enamel showed fusion and recrystalization of the enamel and increased acid-resistance in all groups irradiated with the Nd:YAG laser, on the other hand, the 3 x 4 delimited enamel surfaces from the control group (not irradiated with the Nd:YAG laser) showed 100% deminerization, Conclusions: These findings are consistent with the finding that laser irradiation of dental results in significant reduction of the effective solubility of enamel mineral.

Effects of Self-Etching Adhesive Systems Used in the Dental Modelling Technique on the Cohesive Strength of Composite Resin

This study evaluated the cohesive strength of composite using self-etching adhesive systems (SE) in the lubrication of instruments between layers of composite. The specimens were made by using a Teflon (R) device. SE were used at the interface to lubricate the instruments: Group 1(G1) - control group, no lubricant was used; Group 2(G2) -Futurabond (R) M; Group 3(G3) - Optibond (R) All-In-One; Group 4(G4) - Clearfil (R) SE Bond; Group 5(G5) - Futurabond (R) NR; Group 6(G6) - Adper (R) SE Plus; Group 7(G7) - One Up Bond (R) F. Specimens were submitted to the tensile test to evaluate the cohesive strength. Data were submitted to the ANOVA and Tukey tests. ANOVA showed a value of p = 0.00. The average means (SD): G2 = 11.33(+/-3.44) a, G3 = 15.36(+/-4.06) ab, G4 = 18.9(+/-4.72) bc, G7 = 19.62(+/-4.46) bc, G5 = 21.02(+/-5.09) bc, G6 = 23.39(+/-4.17) cd, and G1 = 28.49(+/-2.89) d. All SE decreased the cohesive strength of the composite, except for Adper (R) SE Plus.

Assessment of the effectiveness of light-emitting diode and diode laser hybrid light sources to intensify dental bleaching treatment

Objective. To evaluate the effectiveness of the color change of hybrid light-emitting diode (LED) and low-intensity infrared diode laser devices for activating dental bleaching and to verify the occurrence of a color regression with time. Material and methods. A total of 180 specimens obtained from human premolars were immersed in a coffee solution for 15 days for darkening and then divided into eight experimental groups (n = 20 in each) as follows: G1, bleaching without light; G2, bleaching with halogen light; G3, bleaching with a blue LED (1000 mW/470 nm) and a laser device (120 mW/795 nm) simultaneously; G4, bleaching with an LED emitting blue light (1000 mW/470 nm); G5, bleaching with a blue LED (800 mW/470 nm) and a laser device (500 mW/830 nm) simultaneously; G6, bleaching with a blue LED device (800 mW); G7, bleaching with a green LED (600 mW/530 nm) and a laser device (120 mW/795 nm) simultaneously; and G8, bleaching with a green LED (600 mW). Three measurements were performed (at baseline and 14 days and 12 months after bleaching) using a Vita Easyshade spectrophotometer. The data were submitted to two-way ANOVA and a Tukey test. Results. All groups showed significantly higher Delta E values than Group G1, with the exception of Group G8. Variations in the Delta E values at 14 days were significant when compared with those obtained at baseline and after 12 months. Conclusions. Light activation of the bleaching gel provided faster and more intense bleaching than use of the bleaching gel without light activation. Combinations of low-intensity diode lasers are ineffective as a bleaching gel activator. Color regression was observed after 12 months of storage.

The Effectiveness of Low-Intensity Red Laser for Activating a Bleaching Gel and Its Effect in Temperature of the Bleaching Gel and the Dental Pulp

Statement of the Problem: The effectiveness of low-intensity red laser for activating a bleaching gel and its effect in pulp temperature was not investigated in dental literature. Purpose: The objective of this study was to assess the effectiveness of low-intensity red laser for activating a bleaching gel, as well as its effect in temperature of the bleaching gel and the dental pulp. Materials and Methods: Forty extracted bovine teeth were immersed in a solution of coffee 14 days for darkening. The initial colors were recorded by spectrophotometric analysis. The specimens were randomly distributed into two groups (N = 20): the control, which did not receive light and the experimental group that received light from an appliance fitted with three red light-emitting laser diodes (? = 660 nm). A green-colored, 35% H2O2based bleaching gel was applied for 30 minutes, and changed three times. After bleaching, the colors were again measured to obtain the L*a*b* values. Color variation was calculated (?E) and the data submitted to the non-paired t-test (5%). To assess temperature, 10 human incisors were prepared, in which one thermocouple was placed on the bleaching gel applied on the surface of the teeth and another inside the pulp chamber. Results: There was a significant difference between the groups (p = 0.016), and the experimental group presented a significantly higher mean variation (7.21 +/- 2.76) in comparison with the control group (5.37 +/- 1.76). There was an increase in pulp temperature, but it was not sufficient to cause damage to the pulp. Conclusion: Bleaching gel activation with low-intensity red laser was capable of increasing the effectiveness of bleaching treatment and did not increase pulp temperature to levels deleterious to the pulp. CLINICAL SIGNIFICANCE The application of a low-intensity red laser was effective for activating a bleaching gel with green dye, without any deleterious increases in pulpal temperature. (J Esthet Restor Dent 24:126134, 2012)