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.

The composite Euler method for stiff stochastic differential equations

In this paper we present the composite Euler method for the strong solution of stochastic differential equations driven by d-dimensional Wiener processes. This method is a combination of the semi-implicit Euler method and the implicit Euler method. At each step either the semi-implicit Euler method or the implicit Euler method is used in order to obtain better stability properties. We give criteria for selecting the semi-implicit Euler method or the implicit Euler method. For the linear test equation, the convergence properties of the composite Euler method depend on the criteria for selecting the methods. Numerical results suggest that the convergence properties of the composite Euler method applied to nonlinear SDEs is the same as those applied to linear equations. The stability properties of the composite Euler method are shown to be far superior to those of the Euler methods, and numerical results show that the composite Euler method is a very promising method. (C) 2001 Elsevier Science B.V. All rights reserved.

Fracture resistance of endodontically treated teeth with different heights of crown ferrule restored with prefabricated carbon fiber post and composite resin core by intermittent loading

This study evaluated the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber posts and varying quantities of coronal dentin. Sixty freshly extracted upper canines were randomly divided into groups of 10 teeth each. The specimens were exposed to 250,000 cycles in a controlled chewing simulator. All intact specimens were subjected to a static load (N) in a universal testing machine at 45 degrees to the long axis. Data were analyzed by 1-way analysis of variance and Tukey test (alpha = .05). Significant differences (P < .001) were found among the mean fracture forces of the test groups (positive control, 0 mm, 1 mm, 2 mm, 3 mm, and negative control groups: 1022.82 N, 1008.22 N, 1292.52 N, 1289.19 N, 1255.38 N, and 1582.11, respectively). These results suggested that the amount of coronal dentin did not significantly increase the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber post and composite resin core. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e52-e57)

A 24-month randomized clinical trial of a two- and three-step etch-and-rinse technique

Purpose This 24-month randomized paired tooth clinical study evaluated the performance of All Bond 3 used in the simplified (2-step) and full (3-step) versions Methods 33 patients, with at least two similar sized non-carious cervical lesions participated in this study A total of 66 restorations were placed, half using the 2-step All Bond 3 (AB3-2) and the other half using 3-step All Bond 3 (AB3-3) The restorations were placed incrementally using the composite resin Aelite The restorations were evaluated at baseline and after 6, 12 and 24 months following the modified USPHS criteria Statistical differences between the adhesive were tested using with McNemar`s test and clinical performance over time for each material with the Fisher`s exact test (alpha= 0 05) Results After 24 months, six AB3-2 and four AB3-3 were rated as bravo for marginal discoloration but did not differ from each other significantly (P> 0 05) The retention rates at 24 months of AB3-2 and AB3-3 were 90 9% and 97 0%, respectively (P> 0 05) (Am J Dent 2010,23 231-236)

Mechanical Testing of Indirect Composite Materials Directly Applied on Implant Abutments

Purpose: To test the strength to failure and fracture mode of three indirect composite materials directly applied onto Ti-6Al-4V implant abutments vs cemented standard porcelain-fused-to-metal (PFM) crowns. Materials and Methods: Sixty-four locking taper abutments were randomly allocated to four groups and were cleaned in ethanol in an ultrasonic bath for 5 min. After drying under ambient conditions, the abutments were grit blasted and a custom 4-cusp molar crown mold was utilized to produce identical crowns (n = 16 per group) of Tescera (Bisco), Ceramage (Shofu), and Diamond Crown (DRM) according to the manufacturer`s instructions. The porcelain-fused-to-metal crowns were fabricated by conventional means involving the construction and a wax pattern and casting of a metallic coping followed by sintering of increasing layers of porcelain. All crowns were loaded to failure by an indenter placed at one of the cusp tips at a 1 mm/min rate. Subsequently, fracture analysis was performed by means of stereomicroscopy and scanning electron microscopy. One-way ANOVA at 95% level of significance was utilized for statistical analysis. Results: The single load to failure (+/- SD) results were: Tescera (1130 +/- 239 N), Ceramage (1099 +/- 257 N), Diamond Crown (1155 +/- 284 N), and PFM (1081 +/- 243 N). Stereomicroscopy analysis showed two distinct failure modes, where the loaded cusp failed either with or without abutment/metallic coping exposure. SEM analysis of the fractures showed multiple crack propagation towards the cervical region of the crown below a region of plastic deformation at the indenter contact region. Conclusion: The three indirect composites and PFM systems fractured at loads higher than those typically associated with normal occlusal function. Although each material had a different composition and handling technique, no significant differences were found concerning their single load to fracture resistance among composite systems and PFM.

Monolithic CAD/CAM Lithium Disilicate Versus Veneered Y-TZP Crowns: Comparison of Failure Modes and Reliability After Fatigue

Purpose: The aim of this research was to evaluate the fatigue behavior and reliability of monolithic computer-aided design/computer-assisted manufacture (CAD/CAM) lithium disilicate and hand-layer-veneered zirconia all-ceramic crowns. Materials and Methods: A CAD-based mandibular molar crown preparation, fabricated using rapid prototyping, served as the master die. Fully anatomically shaped monolithic lithium disilicate crowns (IPS e.max CAD, n = 19) and hand-layer-veneered zirconia-based crowns (IPS e.max ZirCAD/Ceram, n = 21) were designed and milled using a CAD/CAM system. Crowns were cemented on aged dentinlike composite dies with resin cement. Crowns were exposed to mouth-motion fatigue by sliding a WC-indenter (r = 3.18 mm) 0.7 mm lingually down the distobuccal cusp using three different step-stress profiles until failure occurred. Failure was designated as a large chip or fracture through the crown. If no failures occurred at high loads (> 900 N), the test method was changed to staircase r ratio fatigue. Stress level probability curves and reliability were calculated. Results: Hand-layer-veneered zirconia crowns revealed veneer chipping and had a reliability of < 0.01 (0.03 to 0.00, two-sided 90% confidence bounds) for a mission of 100,000 cycles and a 200-N load. None of the fully anatomically shaped CAD/CAM-fabricated monolithic lithium disilicate crowns failed during step-stress mouth-motion fatigue (180,000 cycles, 900 N). CAD/CAM lithium disilicate crowns also survived r ratio fatigue (1,000,000 cycles, 100 to 1,000 N). There appears to be a threshold for damage/bulk fracture for the lithium disilicate ceramic in the range of 1,100 to 1,200 N. Conclusion: Based on present fatigue findings, the application of CAD/CAM lithium disilicate ceramic in a monolithic/fully anatomical configuration resulted in fatigue-resistant crowns, whereas hand-layer-veneered zirconia crowns revealed a high susceptibility to mouth-motion cyclic loading with early veneer failures. Int J Prosthodont 2010; 23: 434-442.

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).

Bone cell responses to the composite of Ricinus communis polyurethane and alkaline phosphatase

The aim of this study was to evaluate the response of osteoblastic cells to the composite of Ricinus cominunis polyurethane (RCP) and alkaline phosphatase (ALP) incubated in synthetic body fluid (SBF). RCP pure (RCPp) and RCP blended with ALP 6 mg/mL polymer (RCP+ALP) were incubated in SBF for 17 days. Four groups of RCP were tested: RCPp, RCP+ALP, and RCPp and RCP+ALP incubated in SBF (RCPp/SBF and RCP+ALP/SBF). Stem cells from rat bone marrow were cultured in conditions that allowed osteoblastic differentiation on RCP discs and were evaluated: cell adhesion, culture growth, cell viability, total protein content, ALP activity, and bone-like nodule formation. Data were compared by ANOVA or Kruskal-Wallis test. The group RCP-A P was highly cytotoxic and, therefore, was not considered here. Cell adhesion (p = 0.14), culture growth (p = 0.39), viability (p = 0.46) and total protein content (p = 0.12) were not affected by either RCP composition or incubation in SBE ALP activity was affected (p = 0.0001) as follows: RCPp < RCPp/SBF < RCP+ALP/SBF. Bone-like nodule formation was not observed on all evaluated groups. The composite RCP+ALP prior to SBF incubation is cytotoxic and must not be considered as biomaterial, but the incorporation of ALP to the RCP followed by SBF incubation could be a useful alternative to improve the biological properties of the RCP. (c) 2007 Wiley Periodicals, Inc.

In vitro biocompatibility of poly(vinylidene fluoride-trifluoroethylene)/barium titanate composite using cultures of human periodontal ligament fibroblasts and keratinocytes

The mm of this work was to evaluate the biocompatibility of poly(vinylidene fluoride-trifluoroethylene)/barium titanate (P(VDF-TrFE)/BT) membrane to be used in guided tissue regeneration (GTR) Fibroblasts from human periodontal ligament (hPDLF) and keratinocytes (SCC9) were plated on P(VDF-TrFE)/BT and polytetrafluorethylene membranes at a cell density of 20.000 cells well(-1) and Cultured for up to 21 days Cell morphology, adhesion and proliferation were evaluated in hPDLF and keratinocytes, while total protein content and alkaline phosphatase (ALP) activity were assayed only for hPDLF Using a higher cell density. real-time polymerase chain reaction (PCR) was performed to assess the expression of typical genes of hPDLF, such as periostin, PDLs17, S100A4 and fibromodulin, and key phenotypic markers of keratinocytes, including involucrin, keratins 1. 10 and 14 Expression of the apoptotic genes bax, bcl-2 and Survivin was evaluated for both cultures hPDLF adhered and spread more oil P(VDF-TrFE)/BT, whereas keratinocytes showed a round shape on both membranes. hPDLF adhesion was greater oil P(VDF-TrFE)/BT at 2 and 4 h, while keratinocyte adhesion was similar for both membranes. Whereas proliferation was significantly higher for hPDLF on P(VDF-TrFE)/BT at days 1 and 7. no signs of keratinocyte proliferation could be noticed for both membranes Total protein content was greater on P(VDF-TrFE)/BT at 7, 14 and 21 days, and higher levels of ALP activity were observed oil P(VDF-TrFE)/BT at 21 days. Real-time PCR revealed higher expression of phenotypic markers of hPDLF and keratinocytes as well as greater expression of apoptotic genes in cultures grown on P(VDF-TrFE)/BT. These results indicate that, by favoring hPDLF adhesion. spreading. proliferation and typical mRNA expression, P(VDF-TrFE)/BT membrane should be considered an advantageous alternative for GTR (C) 2009 Acta Materialia Inc Published by Elsevier Ltd All rights reserved

Composite filling removal with erbium:yttrium-aluminum-garnet laser: morphological analyses

Considering the increase in esthetic restorative materials and need for improvement in unsatisfactory restoration substitution with minimal inadvertent removal of healthy tissues, this study assessed the efficacy of erbium:yttrium-aluminum-garnet (Er:YAG) laser for composite resin removal and the influence of pulse repetition rate on the morphological analyses of the cavity by scanning electron microscope. Composite resin fillings were placed in cavities (1.0 mm deep) prepared in bovine teeth, and the 75 specimens were randomly assigned to five groups according to the technique used for composite filling removal (high-speed diamond bur, group I, as a control, and Er:YAG laser, 250 mJ output energy and 80 J/cm(2) energy density, using different pulse repetition rates: group II, 2 Hz; group III, 4 Hz; group IV, 6 Hz; group V, 10 Hz). After the removal, the specimens were split in the middle, and we analyzed the surrounding and deep walls to check for the presence of restorative material. The estimation was qualitative. The surfaces were examined with a scanning electron microscope. The results revealed that the experimental groups presented bigger amounts of remaining restorative material. The scanning electron microscopy (SEM) analyses showed irregularities of the resultant cavities of the experimental groups that increased proportionally with increase in repetition rate.

Bond strength of Epiphany (TM) Sealer combined with different adhesive systems photo-activated with LED and QTH

The Epiphany (TM) Sealer is a new dual-curing resin-based sealer and has been introduced as an alternative to gutta-percha and traditional root canal sealers. The canal filling is claimed to create a seal with the dentinal tubules within the root canal system producing a `monoblock` effect between the sealer and dentinal tubules. Therefore, considering the possibility to incorporate the others adhesive systems, it is important to study the bond strength of the resulting cement. Forty-eight root mandibular canines were sectioned 8-mm below CEJ. The dentine discs were prepared using a tapered diamond bur and irrigated with 1% NaOCl and 17% EDTA. Previous the application Epiphany (TM) Sealer, the Epiphany (TM) Primer, AdheSE, and One Up Bond F were applied to the root canal walls. The LED and QTH (Quartz Tungsten Halogen) were used to photo-activation during 45 s with power density of 400 and 720 mW/cm(2), respectively. The specimens were performed on a universal testing machine at a cross-head speed of 1 mm/min until bond failure occurred. The force was recorded and the debonding values were used to calculate Push-out bond strength. The analysis of variance (ANOVA) and Tukey`s post-hoc tests showed significant statistical differences (P < 0.05) to Epiphany (TM) Sealer/Epiphany (TM) Primer/QTH and EpiphanyTM Sealer/AdheSE/QTH, which had the highest mean values of bond strength. The efficiency of resin-based filling materials are dependent the type of light curing unit used including the power density, the polymerization characteristics of these resin-based filling materials, depending on the primer/adhesive used.

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).