Eroded dentin does not jeopardize the bond strength of adhesive restorative materials

This in vitro study evaluated the bond strength of adhesive restorative materials to sound and eroded dentin. Thirty-six bovine incisors were embedded in acrylic resin and ground to obtain flat buccal dentin surfaces. Specimens were randomly allocated in 2 groups: sound dentin (immersion in artificial saliva) and eroded dentin (pH cycling model - 3x / cola drink for 7 days). Specimens were then reassigned according to restorative material: glass ionomer cement (Ketac (TM) Molar Easy Mix), resin-modified glass ionomer cement (Vitremer (TM)) or adhesive system with resin composite (Adper Single Bond 2 + Filtek Z250). Polyethylene tubes with an internal diameter of 0.76 mm were placed over the dentin and filled with the material. The microshear bond test was performed after 24 h of water storage at 37 degrees C. The failure mode was evaluated using a stereomicroscope (400x). Bond strength data were analyzed with two-way ANOVA and Tukey's post hoc tests (alpha = 0.05). Eroded dentin showed bond strength values similar to those for sound dentin for all materials. The adhesive system showed the highest bond strength values, regardless of the substrate (p < 0.0001). For all groups, the adhesive/mixed failure prevailed. In conclusion, adhesive materials may be used in eroded dentin without jeopardizing the bonding quality. It is preferable to use an etch-and-rinse adhesive system because it shows the highest bond strength values compared with the glass ionomer cements tested.

A comparative study between crack analysis and a mechanical test for assessing the polymerization stress of restorative composites

Objectives. To verify the hypothesis that crack analysis and a mechanical test would rank a series of composites in a similar order with respect to polymerization stress. Also, both tests would show similar relationships between stress and composite elastic modulus and/or shrinkage. Methods. Soda-lime glass discs (2-mm thick) with a central perforation (3.5-mm diameter) received four Vickers indentations 500 mu m from the cavity margin. The indent cracks were measured (500x) prior and 10 min after the cavity was restored with one of six materials (Kalore/KL, Gradia/GR, Ice/IC, Wave/WV, Majesty Flow/MF, and Majesty Posterior/MP). Stresses at the indent site were calculated based on glass fracture toughness and increase in crack length. Stress at the bonded interface was calculated using the equation for an internally pressurized cylinder. The mechanical test used a universal testing machine and glass rods (5-mm diameter) as substrate. An extensometer monitored specimen height (2 mm). Nominal stress was calculated dividing the maximum shrinkage force by the specimen cross-sectional area. Composite elastic modulus was determined by nanoindentation and post-gel shrinkage was measured using strain gages. Data were subjected to one-way ANOVA/Tukey or Kruskal-Wallis/Mann-Whitney tests (alpha: 5%). Results. Both tests grouped the composites in three statistical subsets, with small differences in overlapping between the intermediate subset (MF, WV) and the highest (MP, IC) or the lowest stress materials (KL, GR). Higher stresses were developed by composites with high modulus and/or high shrinkage. Significance. Crack analysis demonstrated to be as effective as the mechanical test to rank composites regarding polymerization stress. (c) 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Effect of different restorative procedures on the fracture resistance of teeth submitted to internal bleaching

The aim of this study was to evaluate the influence of different restorative procedures on the fracture resistance of endodontically treated teeth submitted to intracoronal bleaching. Fifty upper central incisors were distributed into 5 groups: GI - healthy teeth; GII - endodontically treated teeth sealed with Coltosol; GIII - endodontically treated teeth bleached and sealed with Coltosol; GIV - endodontically treated teeth bleached and restored with composite resin; and GV - endodontically treated teeth bleached and restored with a fiberglass post and composite resin. In the bleached specimens, a cervical seal was made prior to bleaching with 38% hydrogen peroxide. The gel was applied on the buccal surface and in the pulp chamber, and was then light-activated for 45 s. This procedure was repeated three times per session for four sessions, and each group was submitted to the restorative procedures described above. The specimens were submitted to fracture resistance testing in a universal testing machine. There were statistically significant differences among the groups (p < 0.05). The mean value found for GIII was the lowest (0.32 kN) and was significantly different from the values found for GI (0.75 kN), GII (0.67 kN), GIV (0.70 kN), and GV (0.72 kN), which were not significantly different from each other (p > 0.05). The restorative procedures using composite resin were found to successfully restore the fracture resistance of endodontically treated and bleached teeth.

Microhardness of a dental restorative composite resin containing nanoparticles polymerized with argon ion laser

The objective of this study was to compare the microhardness of two resin composites (microhybrid and nanoparticles). Light activation was performed with argon ion laser 1.56J (L) and halogen light 2.6J (H) was used as control. Measurements were taken on the irradiated surfaces and those opposite them, at thicknesses of 1, 2 and 3 mm. To evaluate the quality of polymerization, the percentages of maximum hardness were calculated (PMH). For statistical analysis the ANOVA and Tukey tests were used (p <= 0.05). To microhybrid was shown that the hardness with laser was inferior to the hardness achieved with halogen light, for both the 1 mm and 2 mm. The nanoparticles polymerized with laser, presented lower hardness even on the irradiated surface, than the same surface light activated with halogen light. The microhybrid attained a minimum PMH of 80% up to the thickness of 2 mm with halogen light, and with laser, only up to 1 mm. The nanoparticles attained a minimum PMH of 80% up to 3 mm thickness with halogen light and with laser this minimum was not obtained at any thickness. Based on these results, it could be concluded that light activation with argon ion laser is contra-indicated for the studied nanoparticles. Published by Elsevier GmbH.

Proctocolectomy and ileal J-pouch anal anastomosis on the surgical treatment of familial adenomatous polyposis and ulcerative colitis: analysis of 49 cases

OBJECTIVE: To evaluate the results of ileal J-pouch anal anastomosis in ulcerative colitis and familial adenomatous polyposis. METHOD: Retrospective analysis of medical records of 49 patients submitted to ileal J-pouch anal anastomosis. RESULTS: Ulcerative colitis was diagnosed in 65% and familial adenomatous polyposis in 34%. Mean age was 39.5 years. 43% were male. Among familial adenomatous polyposis, 61% were diagnosed with colorectal cancer. Thirty-one percent of patients with ulcerative colitis was submitted to a previous surgical approach and 21% of these had toxic megacolon. Average hospital stay was 10 days. Post-operative complications occurred in 50% of patients with ulcerative colitis and 29.4% with familial adenomatous polyposis. Intestinal diversion was performed in 100% of ulcerative colitis and 88% of familial adenomatous polyposis. Pouchitis occurred in eight cases (seven ulcerative colitis and one FAP), requiring excision of the pouch in three ulcerative colitis. Mortality rate was 7.6%: two cases of carcinoma on the pouch and two post-operative complications. Late post-operative complications occurred in 22.4%: six familial adenomatous polyposis and five ulcerative colitis). Two patients had erectile dysfunction, and one retrograde ejaculation. One patient with severe perineal dermatitis was submitted to excision of the pouch. Incontinence occurred in four patients and two reported soil. Mean bowel movement was five times a day. CONCLUSION: Ileal J-pouch anal anastomosis is a safe surgery with acceptable morbidity and good functional results, if well indicated and performed in referral centers.

Fire victim identification by post-mortem dental CT: Radiologic evaluation of restorative materials after exposure to high temperatures

The aim of this study was to evaluate the use of high resolution CT to radiologically define teeth filling material properties in terms of Hounsfield units after high temperature exposure.

Bonding of restorative materials to dentin with various luting agents

The aim was to compare eight types of luting agents when used to bond six indirect, laboratory restorative materials to dentin. Cylinders of the six restorative materials (Esteticor Avenir [gold alloy], Tritan [titanium], NobelRondo [feldspathic porcelain], Finesse All-Ceramic [leucite-glass ceramic], Lava [zirconia], and Sinfony [resin composite]) were ground and air-abraded. Cylinders of feldspathic porcelain and glass ceramic were additionally etched with hydrofluoric acid and were silane-treated. The cylinders were luted to ground human dentin with eight luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], and RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37°C for one week, the shear bond strength of the specimens (n=8/group) was measured, and the fracture mode was stereomicroscopically examined. Bond strength data were analyzed with two-factorial analysis of variance (ANOVA) followed by Newman-Keuls' Multiple Range Test (?=0.05). Both the restorative material and the luting agent had a significant effect on bond strength, and significant interaction was noted between the two variables. Zinc phosphate cement and glass ionomer cements produced the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements. Generally, the fracture mode varied markedly with the restorative material. The luting agents had a bigger influence on bond strength between restorative materials and dentin than was seen with the restorative material.

Halogen lamp and led activation of resin-modified glass ionomer restorative material. In vitro microhardness after long term storage

AIM: The purpose of this study was to evaluate the activation of resin-modified glass ionomer restorative material (RMGI, Vitremer-3M-ESPE, A3) by halogen lamp (QTH) or light-emitting diode (LED) by Knoop microhardness (KHN) in two storage conditions: 24hrs and 6 months and in two depths (0 and 2 mm). MATERIALS AND METHODS: The specimens were randomly divided into 3 experimental groups (n=10) according to activation form and evaluated in depth after 24h and after 6 months of storage. Activation was performed with QTH for 40s (700 mW/cm2) and for 40 or 20 s with LED (1,200 mW/scm2). After 24 hrs and 6 months of storage at 37°C in relative humidity in lightproof container, the Knoop microhardness test was performed. Statistics Data were analysed by three-way ANOVA and Tukey post-tests (p<0.05). RESULTS: All evaluated factors showed significant differences (p<0.05). After 24 hrs there were no differences within the experimental groups. KHN at 0 mm was significantly higher than 2 mm. After 6 months, there was an increase of microhardness values for all groups, being the ones activated by LED higher than the ones activated by QTH. CONCLUSION: Light-activation with LED positively influenced the KHN for RMGI evaluated after 6 months.

Restorative therapy of erosion

When substance loss caused by erosive tooth wear reaches a certain degree, oral rehabilitation becomes necessary. Prior to the most recent decade, the severely eroded dentition could only be rehabilitated by the provision of extensive crown and bridge work or removable overdentures. As a result of the improvements in composite restorative materials, and in adhesive techniques, it has become possible to rehabilitate eroded dentitions in a less invasive manner. However, even today advanced erosive destruction requires the placement of more extensive restorations such as ceramic veneers or overlays and crowns. It has to be kept in mind that the etiology of the erosive lesions needs to be determined in order to halt the disease, otherwise the erosive process will continue to destroy tooth substance. This overview presents aspects concerning the restorative materials as well as the treatment options available to rehabilitate patients with erosion, from minimally invasive direct composite reconstructions to adhesively retained all-ceramic restorations. Restorative treatment is dependent on individual circumstances and the perceived needs and concerns of the patient. Long-term success is only possible when the cause is eliminated. In all situations, the restorative preparations have to follow the principles of minimally invasive treatment.

Restorative neuroscience: concepts and perspectives

There is increasing interest in the search for therapeutic options for diseases and injuries of the central nervous system (CNS), for which currently no effective treatment strategies are available. Replacement of damaged cells and restoration of function can be accomplished by transplantation of cells derived from different sources, such as human foetal tissue, genetically modified cell lines, embryonic or somatic stem cells. Preclinical and clinical trials have shown promising results in neurodegenerative disorders, like Parkinson's and Huntington's disease, but also ischaemic stroke, intracerebral haemorrhage, demyelinating disorders, epilepsy and traumatic lesions of the brain and spinal cord. Other studies have focused on finding new ways to activate and direct endogenous repair mechanisms in the CNS, eg, by exposure to specific neuronal growth factors or by inactivating inhibitory molecules. Neuroprotective drugs may offer an additional tool for improving neuronal survival in acute or chronic CNS diseases. Importantly however, a number of scientific issues need to be addressed in order to permit the introduction of these experimental techniques in the wider clinical setting.

Restorative dentistry and restorative materials over the next 20 years: A Delphi survey

OBJECTIVES The aim of this study was to forecast trends in restorative dentistry over the next 20 years and to identify treatment goals and corresponding properties of restorative materials. METHODS Using the Delphi method, a panel of 3 experts identified 8 key questions, which were sent to experts in restorative and preventive dentistry. In round 1 of this survey, 15 international experts devised a clearer semantic definition of the key questions and the completion of respective items for two additional rounds. In round 2, 125 experts from 35 countries rated the items developed in round 1 using a Likert scale. In round 3, the same 125 experts received the ratings of round 2 and were asked to agree or disagree to these ratings by re-voting on all key questions and items. A total of 105 experts re-voted and finally took part in the complete survey. Among the 8 key questions, two questions were selected for the present report: (Q1) "What will be the future role of restorative treatment?" and (Q6) "What will be the key qualities for clinical success of restorations?" For both questions and the respective items, the experts were asked to evaluate the importance and the feasibility for later calculation of the scientific value (i.e. the opportunity, where opportunity=importance+[importance-feasibility]). RESULTS The three items of highest importance for Q1 were "preservation of existing enamel and dentin tissue," "prevention of secondary caries," and "maintenance of the pulp vitality," and for Q6 they were "optimization of adhesion," "biocompatibility," and "minimizing technical sensitivity." SIGNIFICANCE Bioactivity toward the pulp-dentin complex and prevention of secondary caries were the items generally rated as having the highest opportunity.

Restorative therapy of erosive lesions.

When substance loss caused by erosive tooth wear reaches a certain degree, oral rehabilitation becomes necessary. Until some 20 years ago, the severely eroded dentition could only be rehabilitated by the provision of extensive crown and bridge work or removable overdentures. As a result of the improvements in resin composite restorative materials, and in adhesive techniques, it has become possible to rehabilitate eroded dentitions in a less invasive manner. However, even today advanced erosive destruction requires the placement of more extensive restorations such as overlays and crowns. It has to be kept in mind that the etiology of the erosive lesions needs to be determined in order to halt the disease, otherwise the erosive process will continue to destroy tooth substance. This overview presents aspects concerning the restorative materials as well as the treatment options available to rehabilitate patients with erosive tooth wear, from minimally invasive direct composite reconstructions to adhesively retained all-ceramic restorations. Restorative treatment is dependent on individual circumstances and the perceived needs and concerns of the patient. Long-term success is only possible when the cause is eliminated. In all situations, the restorative preparations have to follow the principles of minimally invasive treatment.

The applicability of using different energy levels in CT imaging for differentiation or identification of dental restorative materials.

PURPOSE The goal of this study was to investigate whether different computed tomography (CT) energy levels could supply additional information for the differentiation of dental materials for forensic investigations. METHODS Nine different commonly used restorative dental materials were investigated in this study. A total of 75 human third molars were filled with the restorative dental materials and then scanned using the forensic reference phantom in singlesource mode. The mean Hounsfield unit values and standard deviations (SDs) of each material were calculated at 120, 80 and 140 kVp. RESULTS Most of the dental materials could be differentiated at 120 kVp. We found that greater X-ray density of a material resulted in higher SDs and that the material volume could influence the measurements. CONCLUSION Differentiation of dental materials in CT was possible in many cases using single-energy CT scans at 120 kVp. Because of the number of dental restorative materials available and scanner and scan parameter dependence, as well as the CT imaging artifacts, the identification (in contrast to differentiation) was problematic.

Implementing balanced and restorative justice : victim, offender, community : a guide for law enforcement officers /

This publication is one in a series of guides designed to assist in the statewide promotion of balanced and restorative justice. BARJ is a philosophy of justice that can guide the work of individuals who deal with juvenile offenders, their victims, and the communities in which they live.