Response of human dental pulp capped with MTA and calcium hydroxide powder

Objectives: To compare the response of human dental pulp capped with a mineral trioxide aggregate (MTA) and Ca(OH)(2) powder. Methods and Material: Pulp exposures were performed on the occlusal floor of 40 permanent premolars. The pulp was then capped with either Ca(OH)(2) powder (CH) or MTA and restored with resin composite. After 30 days (groups CH30 and MTA30) and 60 days (groups CH60 and MTA60), the teeth were extracted and processed for HE and categorized in a histological score system. The data were subjected to Kruskal-Wallis and Conover tests (alpha=0.05). Results: In regard to dentin bridge formation, CH30 showed a tendency towards superior performance compared to MTA30 (p>0.05), although the products showed comparable results at day 60. In the item ""Inflammation"" and ""General State of the Pulp"" (p>0.05), CH showed a tendency towards presenting a higher inflammatory response. In the item ""Other Pulpal Findings,"" MTA and Ca(OH)(2) showed equal and excellent performance after 30 and 60 days (p>0.05). Conclusion: After 30 days, Ca(OH)(2) powder covered with calcium hydroxide cement showed faster hard tissue bridge formation compared to MTA. After 60 days, Ca(OH)(2) powder or NITA materials showed a similar and excellent histological response with the formation of a hard tissue bridge in almost all cases with low inflammatory infiltrate.

pH, Calcium Ion Release, and Setting Time of an Experimental Mineral Trioxide Aggregate-based Root Canal Sealer

Introduction: An experimental mineral trioxide aggregate sealer (MTAS) has been developed for use as a root canal sealer. The aim of this study was to evaluate the setting time, pH, and calcium ion release of MTAS compared with white Portland cement (CPB-40; Votorantin Cimentos, Camargo Correa SA, Pedro Leopoldo, MG, Brazil), white MTA Angelus (MTA; Angelus, Londrina, PR, Brazil), and AH Plus (Dentsply DeTrey, Konstanz, Germany). Methods: For the evaluation of setting time, each material was analyzed using Gilmore-type needles. Polyethylene tubes with the materials were immersed in distilled water for the measurement of pH (digital pH meter) and calcium release (atomic absorption spectrophotometry). The evaluations were performed at 3, 6, 12, 24, and 48 hours and 7, 14, and 28 days. Data were analyzed by analysis of variance and the Tukey test at 5% significance level. Results: MTAS showed higher calcium release at all experimental periods, a greater increase in pH up to 48 hours and the longest setting time. Conclusions: MTAS presented favorable properties for its indication as a root canal sealer. (J Endod 2011;37:844-846)

Effect of erosive pH cycling on different restorative materials and on enamel restored with these materials

This in vitro study evaluated the effect of erosive pH cycling on the percentage of surface micro-hardness change (%SMHC) and wear of different restorative materials and bovine enamel restored with these materials. Eighty enamel specimens were randomly divided into eight groups according to the restorative materials and immersion media used: GI/GV-resin-modifled glass-ionomer, GII/GVI-conventional glass-ionomer, GIII/GVII-resin composite and GIV/GVIII-amalgam. Over a period of seven days, groups GI to GIV were immersed in a cola drink (ERO) for 5 minutes, 3x/day and kept in artificial saliva between erosive cycles. Groups GV to GVIII were immersed in artificial saliva (SAL) throughout the entire experimental period (control). Data were tested for significant differences using ANOVA and Tukey`s tests (p < 0.05). For %SMHC, considering the restorative materials, no significant differences were detected among the materials and immersion media. Mean wear was higher for the resin modified glass ionomer cement when compared to conventional cement, but those materials did not significantly differ from the others. For enamel analyses, erosive pH cycling promoted higher wear and %SMHC compared to saliva. There were no significant differences in wear and %SMHC of enamel around the different restorative materials, regardless of the distance from the restorative material (50, 150 or 300 mu m). In conclusion, there were only subtle differences among the materials, and these differences were not able to protect the surrounding enamel from erosion.

Evaluation of the physical and chemical properties of two commercial and three experimental root-end filling materials

Objective. The aim of this study was to evaluate the pH, calcium release, setting time, and solubility of two commercially available mineral trioxide aggregate (MTA) cements (white MTA Angelus and MTA Bio), and of three experimental cements (light-cured MTA, Portland cement with 20% bismuth oxide and 5% calcium sulfate, and an epoxy resin-based cement). Study design. For evaluation of pH and calcium ion release, polyethylene tubes with 1.0 mm internal diameter and 10.0 mm length were filled with the cements and immediately immersed in flasks containing 10 mL deionized water. After 3, 24, 72, and 168 hours, the tubes were removed and the water from the previous container was measured for its pH and calcium content with a pH meter and an atomic absorption spectrophotometer. For analysis of the setting time, Gilmore needles weighing 100 g and 456.5 g were used, in accordance with the American Society for Testing and Materials specification no. C266-03. Solubility of each cement was also tested. Results. All the cements were alkaline and released calcium ions, with a declining trend over time. After 3 hours, Portland cement + bismuth oxide and MTA Bio had the highest pH and light-cured MTA the lowest. After 1 week, MTA Bio had the highest pH and light-cured MTA and epoxy resin-based cement the lowest. Regarding calcium ion release, after 3 hours, Portland cement + bismuth oxide showed the highest release. After 1 week, MTA Bio had the highest. Epoxy resin-based cement and light-cured MTA had the lowest calcium release in all evaluation periods. Regarding setting times, white MTA Angelus and MTA Bio had the shortest, Portland cement + bismuth oxide had an intermediate setting time, and the epoxy resin-based cement had the longest. The materials that showed the lowest solubility values were the epoxy resin-based cement, Portland cement + bismuth oxide, and light-cured MTA. The highest solubility values were presented in white MTA Angelus and MTA Bio. Conclusions. The white MTA Angelus and MTA Bio had the shortest setting times, higher pH and calcium ion release, and the highest solubility. In contrast, the epoxy resin-based cement and light-cured MTA showed lower values of solubility, pH, and calcium ion release. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: 250-256)

Evaluation of the radiopacity of some commercial and experimental root-end filling materials

Objective. The aim of the present study was to evaluate the radiopacity of 5 root end filling materials (white MTA Angelus, MTA Bio, light-cured MTA, Sealepox RP, and Portland cement clinker with bismuth oxide and calcium sulfate). Method. Five specimens, 10 mm in diameter and 1 mm in thickness according to specification ISO 6876: 2001 were fabricated from each material and radiographed using Insigth occlusal films close to a graduated aluminum step-wedge (2 to 16 mm in thickness). Radiographs were digitized and compared to the aluminum step-wedge. The radiographic density data were converted into millimeters of aluminum (mm Al), using the Digora 1.51 software. Results were evaluated statistically using the analysis of variance (ANOVA) followed by Tukey test. The level of significance was set at 5% (P<.05%). Results. Radiopacity values ranged from 1.21 mm Al (light-cured MTA) to 6.45 mm Al (MTA Angelus). Comparison between materials showed significant difference (P<.05) between MTA Angelus and all other materials, between Sealepox RP and MTA Bio, and between light-cured MTA and Portland cement clinker. Light-cured MTA was significantly less radiopaque than all other materials. No significant difference (P>.05) was found between MTA Bio and Portland cement clinker. Conclusions. All retrograde filling materials evaluated showed greater radiopacity than dentin. All the materials, except light-cured MTA met the minimum radiopacity standards of 3 mm Al recognized by the ISO 6876: 2001 and ADA n.57. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e35-e38)

Evaluation of pH and Calcium Ion Release of Root-end Filling Materials Containing Calcium Hydroxide or Mineral Trioxide Aggregate

Introduction: To evaluate calcium ion release and pH of Sealer 26 (S26) (Dentsply, Rio de Janeiro, RJ, Brazil), white mineral trioxide aggregate (MTA), Endo CPM Sealer (CPM1) (EGEO SRL Bajo licencia MTM Argentina SA, Buenos Aires, Argentina), Endo CPM Sealer in a thicker consistency (CPM 2), and zinc oxide and eugenol cement (ZOE). Methods: Material samples (n = 10) were placed in polyethylene tubes and immersed in 10 mL of distilled water. After 3, 6,12,24, and 48 hours and 7,14, and 28 days, the water pH was determined with a pH meter, and calcium release was assessed by atomic absorption spectrophotometry. An empty tube was used as the control group. Results: The control group presented a pH value of 6.9 at all studied periods and did not show the presence of calcium ion. S26 presented greater hydroxyl ion release up to 12 hours (p < 0.05). From 24 hours until 28 days, S26, MTA, CPM1, and CPM2 had similar results. in ail periods, ZOE presented the lowest hydroxyl ion release. CPM1, followed by CPM2, released the most calcium ions until 24 hours (p < 0.05). Between 48 hours and 7 days, CPM1 and CPM2 had the highest release. A greater calcium ion release was observed for CPM2, followed by CPM1 at 14 days and for S26, CPM1, and CPM2 at 28 days. ZOE released the least calcium ions in all periods. Conclusion: Sealer 26, MTA, and Endo CPM sealer at normal or thicker consistency release hydroxyl and calcium ions. Endo CPM sealer may be an alternative as root-end filling material. (J Endod 2009;35:1418-1421)

Evaluation of pH and calcium ion release of new root-end filling materials

Objective. The purpose of this study was to evaluate the pH and calcium ion release of 6 materials used for root-end filling and perforation repair. Study design. Gray ProRoot MTA, gray MTA-Angelus, white MTA-Angelus, and CPM were compared to 2 experimental ones: MTA-exp, also based in Portland cement with a modified mixing liquid, and MBPc, an epoxy-resin based cement containing calcium hydroxide. After 3, 24, 72, and 168 hours the water in which each sample had been immersed was tested to determine the ph and calcium ion release. Results. All the analyzed materials showed alkaline pH and capacity to release calcium ions; however, a tendency of reduction of these characteristics was noted for all the analyzed materials, except for the MBPc, which showed a slight increase of pH among the 3 initial periods. Conclusion. The results suggest that all materials investigated presented alkaline pH and ability of release of calcium ions. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 135-139)

Effect of Conventional and Resin-modified Glass-Ionomer Liner on Dentin Adhesive Interface of Class I Cavity Walls After Thermocycling

Objective: The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling. Materials and Methods: Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5 degrees C-55 degrees C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 nun x 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p < 0.05). Results: There was no detectedstatistical difference on bond strength among groups (alpha < 0.05). Confocal microscopy analysis showed a higher mean gap size in group 4(12.5 mu m) and a higher percentage of marginal gaps in the thermocycled groups. The RNIGIC liner groups showed the lowest percentage of marginal gaps. Conclusions: Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.

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.

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.

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)

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.

Coupling of composite resin cements to quartz fiber posts: A comparison of industrial and ""chairside"" treatments of the post surface

Purpose: To evaluate the influence of surface treatments on microtensile bond strength of luting resin cements to fiber posts. Materials and Methods: Forty-two quartz fiber posts (Light Post, RTD) were divided into 7 groups (n = 6) according to the surface treatment. I and 11: experimental patented industrial treatment consisting of zirconium oxide coating and silanization (RTD); III: industrial treatment followed by adhesive application (XPBond, Dentsply Caulk); IV: adhesive (XPBond); V: adhesive (Prime&Bond NT, Dentsply Caulk); VI: silane (Calibra Silane, Dentsply Caulk); VII: no treatment. Adhesives were used in the self-curing mode. Two cements (Sealbond, RTD - group 1, and Calibra, Dentsply Caulk - groups 11 to VII) were applied on the posts to produce cylindrical specimens. Post/cement interfaces were evaluated under SEM. The surface of the industrially coated posts was examined using energy dispersive analysis by x-ray. Cylinders were cut to obtain microtensile sticks that were loaded in tension at a crosshead speed of 0.5 mm/min until failure. Statistical analysis was performed using Kruskal-Wallis analysis of variance followed by Dunn`s multiple range test for post-hoc comparisons (p < 0.05). Weibull analysis was also performed. Results: The post/cement bond strength was significantly higher on fiber posts treated industrially (I: 23.14 +/- 8.05 MPa; II: 21.56 +/- 7.07 MPa; III: 22.37 +/- 7.00 MPa) or treated with XPBond adhesive (IV: 21.03 +/- 5.34 MPa) when compared to Prime&Bond NT application (V: 14.05 +/- 5.06 MPa), silanization (VI: 6.31 +/- 4.60 MPa) or no treatment (VII: 4.62 +/- 4.31) of conventional fiber posts (p < 0.001). Conclusion: The experimental industrial surface treatment and the adhesive application enhanced fiber post to resin cement interfacial strength. Industrial pretreatment may simplify the clinical luting procedure.

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).

Effects of light exposure time on composite resin hardness after root reinforcement using translucent fibre post

Objectives: The purpose of this in vitro study was to evaluate the Vickers hardness (VHN) of a Light Core (Bisco) composite resin after root reinforcement, according to the light exposure time, region of intracanal reinforcement and lateral distance from the light-transmitting fibre post. Methods: Forty-five 17-mm long roots were used. Twenty-four hours after obturation, the root canals were emptied to a depth of 12 mm and the root dentine was artificially flared to produce a 1 mm space between the fibre post and the canal walls. The roots were bulk restored with the composite resin, which was photoactivated through the post for 40 s (G1, control), 80 s (G2) or 120 s (G3). Twenty-four hours after post-cementation, the specimens were sectioned transversely into three slices at depths of 2, 6 and 10 mm, corresponding to the coronal, middle and apical regions of the reinforced root. Composite VHN was measured as the average of three indentations (100 g/15 s) in each region at lateral distances of 50, 200 and 350 mu m from the cement/post-interface. Results: Three-way analysis of variance (alpha = 0.05) indicated that the factors time, region and distance influenced the hardness and that the interaction time x region was statistically significant (p = 0.0193). Tukey`s test showed that the mean VHN values for G1 (76.37 +/- 8.58) and G2 (74.89 +/- 6.28) differed significantly from that for G3 (79.5 +/- 5.18). Conclusions: Composite resin hardness was significantly lower in deeper regions of root reinforcement and in lateral areas distant from the post. Overall, a light exposure time of 120 s provided higher composite hardness than the shorter times (40 and 80 s). (C) 2008 Elsevier Ltd. All rights reserved.