Pulpotomy of human primary molars with MTA and Portland cement: a randomised controlled trial

Objective This study compared the clinical and radiographic effectiveness of mineral trioxide aggregate (MTA) and Portland cement (PC) as pulp dressing agents in carious primary teeth. Methodology Thirty carious primary mandibular molars of children aged 5-9 years old were randomly assigned to MTA or PC groups, and treated by a conventional pulpotomy technique. The teeth were restored with resin modified glass ionomer cement. Clinical and radiographic successes and failures were recorded at 6, 12, 18 and 24-month follow-up. Results All pulpotomised teeth were clinically and radiographically successful at all follow-up appointments. Six out of 15 teeth in the PC group and five out of 14 teeth in the MTA group exfoliated throughout the follow-up period. No statistically significant difference regarding dentine bridge formation was found between both groups throughout the follow-up period. As far as pulp canal obliteration is concerned, a statistically significant difference was detected at 6-month follow-up (p < 0.05), since the beginning of mineralised material deposition could be radiographically detected in 100% and 57.14% of the teeth treated with PC and MTA, respectively. Conclusions PC may serve as an effective and less expensive MTA substitute in primary molar pulpotomies. Further studies and longer follow-up assessments are needed.

In situ effect of an erosive challenge on different restorative materials and on enamel adjacent to these materials

Objectives: This in situ study evaluated the effect of an erosive challenge on different restorative materials and on enamel restored with these materials, as well as the ability of these materials to protect the adjacent enamel against erosion. Methods: Ten volunteers wore palatal devices with eight bovine enamel blocks, randomly selected and distributed into two vertical rows, corresponding to the following groups: GI/GV, resin-modified glass ionomer; GII/GVI, conventional glass ionomer; GIII/GVII, composite resin; GIV/GVIII, amalgam. one row (corresponding to groups I-IV) was immersed in a cola drink and the other row (corresponding to groups V-VIII) was subjected to saliva only. The palatal device was continuously worn for 7 days and only half of the appliance (groups I-IV) was immersed in the soft drink (Coca-Cola (R), 150 mL) for 5 min, three times a day. The study variables comprised the wear (profilometry, mu m) and the percentage of surface microhardness change (%SMHC). Data were tested for significant differences by two-way ANOVA and Tukey`s tests (p < 0.05). Results: Considering the restorative materials, for %SMHC and wear, there were no differences among the materials and between the saliva and the erosive challenge. For enamel analyses, the erosive challenge promoted a higher wear and %SMHC of the enamel than did the saliva. There were no significant differences in wear and %SMHC of the enamel adjacent to the different restorative materials. Conclusion: This research data suggest that there is little %SMHC and wear of the studied restorative materials and none of them had a preventive effect against erosion on adjacent enamel, which showed a pronounced wear. (c) 2007 Elsevier Ltd. All rights reserved.

Effect of curing protocol on the polymerization of dual-cured resin cements

Objectives. The purpose of this study was to evaluate how curing protocol affects the extent of polymerization of dual-cured resin cements. Methods. Four commercial resin cements were used (DuoLink, Panavia F 2.0, Variolink II and Enforce). The extent of polymerization of the resin cements cured under different conditions was measured using a (1)H Stray-Field MRI method, which also enabled to probe molecular mobility in the kHz frequency range. Results. Resin cements show well distinct behaviours concerning chemical cure. Immediate photo-activation appears to be the best choice for higher filler loaded resin cements (Panavia F 2.0 and Variolink). A photo-activation delay (5 min) did not induce any significant difference in the extent of polymerization of all cements. Significance. The extent of polymerization of dual-cured resin cements considerably changed among products under various curing protocols. Clinicians should optimize the materials choice taking into account the curing characteristics of the cements. (C) 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Microhardness of resin cements in the intraradicular environment: Effects of water storage and softening treament

Objectives. To analyze the microhardness of four dual-cure resin cements used for cementing fiber-reinforced posts under the following conditions: after 7 days of storage in water, after additional 24 h of immersion in 75% ethanol, and after 3 months of storage in water. Hardness measurements were taken at the cervical, middle and apical thirds along the cement line. Methods. Root canals of 40 bovine incisors were prepared for post space. Fibrekor (R) glass fiber-reinforced posts (Jeneric/Pentron) of 1 mm in diameter were cemented using Panavia F 2.0 (Kuraray), Variolink (Ivoclar-Vivadent), Rely X Unicem (3M ESPE) or Duolink (Bisco) (N = 10). After 7 days of water storage at 37 degrees C, half the sample (N = 5) was longitudinally sectioned and the initial microhardness measured along the cement line from cervical to apex. These same samples were further immersed in 75% ethanol for 24 h and reassessed. The remaining half (N = 5) was kept unsectioned in deionized water at 37 degrees C for 3 months, followed by sectioning and measuring. Data were analyzed by a series of two-way ANOVA and Tukey tests at alpha = 5%. Results. Statistically significant differences were identified among the cements, thirds and conditions. Significant interactions were also observed between cements and thirds and between cements and conditions. Panavia F exhibited significantly higher initial microhardness than the other three cements, which showed no statistical difference among themselves. Variolink and Duolink showed significantly higher microhardness values in the cervical third, without significant difference among the thirds for the other cements. Immersion in ethanol significantly reduced the hardness values for all cements, regardless of the thirds. Storage in water for 3 months had no influence on the hardness of most of the cements, with the exception of Unicem that showed a significant increase in the hardness values after this period. Results showed heterogeneity in the microhardness of the cements inside the canal. All cements presented some degree of softening after ethanol treatment, which suggests instability of the polymer. The quality of curing of resin cements in the root canal environment seems unpredictable and highly material dependent. (C) 2009 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

SEM observation of the bond integrity of fiber-reinforced composite posts cemented into root canals

Objectives. To test the null hypothesis that continuity of resin cement/dentin interfaces is not affected by location along the root canal walls or water storage for 3 months when bonding fiber posts into root canals. Methods. Fiber posts were luted to bovine incisors using four resinous luting systems: Multilink, Variolink II, Enforce Dual and Enforce PV. After cementation, roots were longitudinally sectioned and epoxy resin replicas were prepared for SEM analysis (baseline). The original halves were immersed in solvent, replicated and evaluated. After 3 months water storage and a second solvent immersion, a new set of replicas were made and analyzed. The ratio (%) between the length (mm) of available bonding interface and the actual extension of bonded cement/dentin interface was calculated. Results. Significant lower percent values of bond integrity were found for Multilink (8.25%) and Variolink 11 (10.08%) when compared to Enforce Dual (25.11%) and Enforce PV (27.0%) at baseline analysis. The same trend was observed after immersion in solvent, with no significant changes. However, bond integrity was significantly reduced after 3 months water storage and a second solvent immersion to values below 5% (Multilink = 3.31%, Variolink=1.87%, Enforce Dual=1.20%, and Enforce PV=0.75%). The majority of gaps were depicted at the apical and middle thirds at baseline and after immersion in solvent. After 3 months, gaps were also detected at the cervical third. Significance. Bond integrity at the cement/dentin interface was surprisingly low after cementation of fiber posts to root canals with all resin cements. That was not significantly altered after immersion in solvent, but was further compromised after 3 months water storage. Gaps were mainly seen at middle and apical thirds throughout the experiment and extended to the cervical third after water storage for 3 months. Bond integrity of fiber posts luted to root canals was affected both by location and water storage. (C) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Caries-preventive Efficacy and Retention of a Resin-modified Glass lonomer Cement and a Resin-based Fissure Sealant: A 3-year Split-mouth Randomised Clinical Trial

Purpose: This prospective clinical trial compared the retention rate and caries-preventive efficacy of two types of sealant modalities over a 3-year period. Materials and Methods: Using a split-mouth randomised design, 1280 sealants were randomly applied on sound permanent second molars of 320 young patients aged between 12 and 16 years. Half of the teeth (n = 640) were sealed with a resin-modified glass ionomer cement (RMGIC) (Vitremer (TM), 3M ESPE) and the other half (n = 640) with a conventional light-cure, resin-based fissure sealant (LCRB) (Fluoroshield (R), Dentsply Caulk). Teeth were evaluated at baseline, 6-, 12-, 18-, 24-, 30- and 36-month intervals with regard to retention and new caries development. Results: On the sealed occlusal surfaces after 3 years, 5.10% of RMGIC and 91.08% of LCRB sealants were totally intact and 6.37% of RMGIC and 7.65% of LCRB sealants were partially intact. New caries lesions were found in 20.06% of RMGIC sealed occlusal surfaces, compared to 8.91% for LCRB sealants. Conclusions: The findings of the present clinical study suggest that RMGIC should be used only as a transitional sealant that can be applied to newly erupting teeth throughout the eruptive process, whereas LCRB sealants are used to successfully prevent occlusal caries lesions once an effective rubber dam can be achieved. It can be concluded that there are differences between the RMGIC and LCRB sealants over a 3-year period in terms of the retention rate and caries-preventive efficacy. RMGIC can serve as a simple and economic sealing solution, however provisional. Due to its poor retention rate, periodic recalls are necessary, even after 6 months, to eventually replace the lost sealant.

Resin cement thickness in oval-shaped canals: Oval vs. circular fiber posts in combination with different tips/drills for post space preparation

Purpose: To evaluate the cement thickness around oval and circular posts luted in oval post spaces prepared with different drills/tips. Methods: Extracted premolars were endodontically treated and obturated, then randomly divided into three groups (n = 5) according to the tips/drills used for post-space preparation and to the type of fiber post luted: medium grit oval tip + oval posts, fine grit oval tip + oval posts, Mtwo Post File drill + circular posts. The specimens were sectioned in horizontal slices; one slice per canal third was chosen for each post-space, resulting in three slices for each specimen. The distances between the canal wall and the post perimeter were measured on SEM images of each slice. Results: The fine grit tip + oval post group obtained statistically significant lower cement thicknesses than the other groups (P < 0.05), in particular in the apical third. The MtwoPF + circular post group showed the highest cement thickness, comparable to that of the medium tip + oval post group. A good post fitting in oval-shaped canals can be obtained using a fine grit oval tip combined with oval posts. (Am J Dent 2009;22:290-294).

Clinical evaluation of two packable posterior composites A five-year follow-up

Background. Research has suggested that packable resin-based composites inserted with a placement technique similar to amalgam condensation can reduce the sensitivity associated with posterior restorations. The authors evaluated the clinical performance, including associated sensitivity, of two packable composites in a randomized five-year clinical trial. Methods. A single operator randomly placed two restorations in each of 33 patients: one restoration consisting of Alert (Jeneric/Pentron, Wallingford, Conn.) and the other consisting of SureFil (Dentsply/Caulk, Milford, Del.). There were 30 Class I and 36 Class II restorations. Two independent evaluators evaluated the restorations by using modified U.S.; Public Health Service criteria. The authors analyzed data by means of the Fisher, chi(2) and McNemar tests at P < .05. Results. Of 60 restorations evaluated at five years, two Class II restorations (one SureFil, one Alert) failed. All other restorations received the highest score possible for sensitivity and vitality. The only difference between the composites at the five-year recall was the significantly better surface texture of SureFil. The authors observed significantly different scores between the baseline and at five years for marginal discoloration (Alert and SureFil), surface texture (Alert and SureFil) and color (SureFil). Conclusions. Both packable resin-based composites showed excellent durability during the five-year follow-up. Clinical Implications. The investigated resin-based composites are suitable for posterior restorations.

Push-out Bond Strength of Fiber Posts Luted with Unfilled Resin Cement

Purpose: The study evaluates the behavior of different adhesive systems and resin cements in fiber post placement, with the intent to clarify the possible role of unfilled resin as a luting material for fiber posts. Materials and Methods: Two luting agents (Dual-Link and Unfilled Resin) for cementing fiber posts into root canals were applied either with All-Bond 2 or One-Step Plus, or without an adhesive system, and challenged with the push-out test. Slices of roots restored with posts were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under SEM. Results: Push-out strength was significantly influenced by the luting agent (p < 0.05), but not by the bonding strategy (p > 0.05). The best results were obtained in combination with Unfilled Resin with One-Step Plus. Dual-Link groups failed mainly cohesively within the cement, while Unfilled Resin demonstrated more adhesive fracture at the post interface. Conclusion: The results of this study support the hypothesis that adhesive unfilled resin application is essential for achieving high bond strength to radicular dentin.

Evaluation of several protocols for the application of ultrasound during the removal of cast intraradicular posts cemented with zinc phosphate cement

To evaluate several protocols for the application of ultrasound during removal of cast posts with varying core configurations cemented with zinc phosphate. Sixty maxillary canines were distributed into three groups (n = 20): group 1 - core with 5 mm diameter/height and post diameter of 1.3 mm; groups 2 and 3 - core with the same diameter as the post (1.3 mm) and heights of 5 mm and 3 mm, respectively. Posts/cores were cemented using a standard technique with zinc phosphate cement. Each group was divided into two subgroups according to the ultrasonic vibration mode: point vibration - ultrasonic vibration applied to the core surface for 5 s, on each face totalling 25 s; alternate vibration - intermittent application of ultrasonic vibration for 10 s to the labial and lingual surfaces, 10 s to the mesial and distal surfaces and 5 s to the incisal surface, totalling 25 s. The specimens were submitted to the tensile test using an Instron machine (1 mm min(-1)) and results were analysed by anova and t-test. The failure type was also analysed. Statistical analysis showed significant differences between groups relating to the core preparations (P < 0.05). The lowest mean values of traction force were obtained for group 3 (46.1 +/- 7.7 N), followed by group 2 (89.0 +/- 2.7 N) and group 1 (160.4 +/- 7.5 N). Regarding ultrasonic vibration, the lowest mean was observed with alternate vibration (81.1 +/- 10.1 N), which was significantly lower than the point vibration (115.9 +/- 9.5 N) (P < 0.05). Cohesive failure occurred in all cases. A reduction in core diameter/height and intermittent ultrasonic application improved the removal of cast posts cemented with zinc phosphate.

Effect of a bleaching agent on abrasion of resin-based restoratives

Purpose: To evaluate the effect of a 10% carbamide peroxide-containing bleaching agent on brushing abrasion of esthetic restorative materials. Methods: Using a randomized complete block design, 150 specimens (n = 15) measuring 3 x 3 x 2 mm were fabricated into acrylic resin cylinders, using one of the restorative materials: a microfilled resin composite (At), a hybrid resin composite (Ch), a flowable resin composite (Wa), a resin-modified glass-ionomer cement (Fj) and a polyacid-modified resin composite (Dy). The bleaching agent or artificial saliva (control) was applied for 2 hours/day. After that, 120 brushing strokes were simulated automatically and the samples were kept in artificial saliva. Such bleaching/brushing cycle was performed daily for 21 days. Wear depth was assessed using profilometry. Results: Bleaching did not show significant effect on wear depth. There was a significant difference among the restorative materials. Tukey`s test showed that (Al=Ch) < (Wa) < (Fj) and that Dy was only different from Fj. (Am J Dent 2009;22:171-174).

Photoelastic Stress Analysis of Different Designs of Cement-Retained Fixed Partial Dentures on Morse Taper Oral Implants

There is no consensus in literature regarding the best plan for prosthetic rehabilitation with partial multiple adjacent implants to minimize stress generated in the bone-implant interface. The aim of this study was to evaluate the biomechanical behavior of cemented fixed partial dentures, splinted and nonsplinted, on Morse taper implants and with different types of coating material (ceramic and resin), using photoelastic stress analysis. A photoelastic model of an interposed edentulous space, missing a second premolar and a first molar, and rehabilitated with 4 different types of cemented crowns and supported by 2 adjacent implants was used. Groups were as follows: UC, splinted ceramic crowns; IC, nonsplinted ceramic crowns; UR, splinted resin crowns; and IR, nonsplinted resin crowns. Different vertical static loading conditions were performed: balanced occlusal load, 10 kgf; simultaneous punctiform load on the implanted premolar and molar, 10 kgf; and alternate punctiform load on the implanted premolar and molar, 5 kgf. Changes in stress distribution were analyzed in a polariscope, and digital photographs were taken of each condition to allow comparison of stress pattern distribution around the implants. Cementation of the fixed partial dentures generated stresses between implants. Splinted restorations distributed the stresses more evenly between the implants than nonsplinted when force was applied. Ceramic restorations presented better distribution of stresses than resin restorations. Based on the results obtained, it was concluded that splinted ceramic restorations promote better stress distribution around osseointegrated implants when compared with nonsplinted crowns; metal-ceramic restorations present less stress concentration and magnitude than metal-plastic restorations.

Radiopacity Evaluation of Calcium Aluminate Cement Containing Different Radiopacifying Agents

Introduction: The aim of this study was to evaluate the radiopacity of calcium aluminate cement (Endo Binder) with 3 different radiopacifiers (bismuth oxide, zinc oxide, or zirconium oxide) in comparison with gray mineral trioxide aggregate (GMTA), white MTA, and dental structures (enamel and dentin). Methods: Eighteen test specimens of each cement with thicknesses of 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm (n = 3) were made by using a stainless steel matrix and were adapted to a standardizing device (8 x 7 cm) with a graduated aluminum stepwedge varying from 2.0-16.0 mm in thickness. To compare the radiopacity of the cements with that of dental structures, slices of first molars with a thickness increasing from 0.5-3.0 mm were obtained and placed on the standardizing device. One occlusal radiograph for each tested cement was taken, with exposure time of 0.1 seconds and focus-film distance of 20 cm. Films were processed in an automatic device, and the mean radiopacity values were obtained by using a photodensitometer. Results: Mean values showed that the thicker the specimen was, the greater was its radiopacity. Only EndoBinder + bismuth oxide (EBBO) and GMTA demonstrated radiopacity values greater than 3.0 mm of the aluminum scale for all thicknesses. When zinc oxide was used as radiopacifier agent, EndoBinder only reached the desired radiopacity with a thickness of 2.0 mm, and with zirconium oxide it was 2.5 mm. Conclusions: Bismuth oxide was the most efficient radiopacifier for EndoBinder, providing adequate radiopacity in all studied thicknesses, as recommended by ISO 6876, being similar to GMTA. (J Endod 2011;37: 67-71)

Color stability of silorane-based composites submitted to accelerated artificial ageing-An in situ study

Objectives: To assess the in situ color stability, surface and the tooth/restoration interface degradation of a silorane-based composite (P90, 3M ESPE) after accelerated artificial ageing (AAA), in comparison with other dimethacrylate monomer-based composites (Z250/Z350, 3M ESPE and Esthet-X, Dentsply). Methods: Class V cavities (25 mm(2) x 2 mmdeep) were prepared in 48 bovine incisors, which were randomly allocated into 4 groups of 12 specimens each, according to the type of restorative material used. After polishing, 10 specimens were submitted to initial color readings (Easyshade, Vita) and 2 to analysis by scanning electronic microscopy (SEM). Afterwards, the teeth were submitted to AAA for 384 h, which corresponds to 1 year of clinical use, after which new color readings and microscopic images were obtained. The values obtained for the color analysis were submitted to statistical analysis (1-way ANOVA, Tukey, p < 0.05). Results: With regard to color stability, it was verified that all the composites showed color alteration above the clinically acceptable levels (Delta E >= 3.3), and that the silorane-based composite showed higher Delta E (18.6), with a statistically significant difference in comparison with the other composites (p < 0.05). The SEM images showed small alterations for the dimethacrylate-based composites after AAA and extensive degradation for the silorane-based composite with a rupture at the interface between the matrix/particle. Conclusion: It may be concluded that the silorane-based composite underwent greater alteration with regard to color stability and greater surface and tooth/restoration interface degradation after AAA. (C) 2011 Elsevier Ltd. All rights reserved.

Modelling cement grinding circuits

Modelling and simulation studies were carried out at 26 cement clinker grinding circuits including tube mills, air separators and high pressure grinding rolls in 8 plants. The results reported earlier have shown that tube mills can be modelled as several mills in series, and the internal partition in tube mills can be modelled as a screen which must retain coarse particles in the first compartment but not impede the flow of drying air. In this work the modelling has been extended to show that the Tromp curve which describes separator (classifier) performance can be modelled in terms of d(50)(corr), by-pass, the fish hook, and the sharpness of the curve. Also the high pressure grinding rolls model developed at the Julius Kruttschnitt Mineral Research Centre gives satisfactory predictions using a breakage function derived from impact and compressed bed tests. Simulation studies of a full plant incorporating a tube mill, HPGR and separators showed that the models could successfully predict the performance of the another mill working under different conditions. The simulation capability can therefore be used for process optimization and design. (C) 2001 Elsevier Science Ltd. All rights reserved.