Comparação in vitro do desgaste dental em função da dureza de três diferentes tipos de materiais antagonistas

O objetivo deste estudo foi comparar in vitro o desgaste dental de pré-molares (PM) e molares (M) e sua relação com o valor de dureza Vickers dos materiais utilizados como antagonistas em uma máquina de abrasão simulada para provocar o desgaste nos dentes testados. Os materiais antagonistas utilizados foram VeraBond II (liga de Ni-Cr), Solidex (resina composta) e IPS Empress 2 (cerâmica). Para cada ensaio de dureza, foram preparados seis corpos-de-prova de cada material, os quais foram polidos sob refrigeração, com ciclo de 20 min para cada granulação. Num microdurômetro (HMV-2), foram realizadas três mossas por quadrante, cada uma sob carga de 19,614 N por 30 s, totalizando 12 mossas de base quadrada com ângulo de 136 entre os planos. O teste de abrasão foi realizado numa máquina simuladora de abrasão, freqüência de 265 ciclos/min e 4,4 Hz, com um percurso do antagonista de 10 mm à velocidade de 88 mm/s. Cada dente foi testado em oposição a um antagonista (foram 6 pares dente/material para cada grupo), em água deionizada, sob carga de 5 N, por 150 min, num total de 39.750 ciclos. Foram utilizados dezenove dentes 1 pré-molares, dezenove 3 molares e confeccionados doze antagonistas em cada material em forma de pastilha. Cada grupo de seis dentes foi testado em oposição a seis antagonistas do mesmo material. Ademais, um dente 1 pré-molar (PM) e um dente 3 molar (M) foram testados em oposição ao Plexiglass. Com relação ao desgaste do esmalte dentário (PM+M) segundo o material antagonista, o teste de Kruskal-Wallis evidenciou diferença significativa com p-valor < 0,001 e o teste de Mann-Whitney evidenciou diferença significativa nas comparações PM+M/resina X PM+M/metal (p-valor < 0,001), PM+M/resina X PM+M/cerâmica (p-valor < 0,001) e PM+M/metal X PM+M/cerâmica (p-valor = 0,002). A análise isolada, considerando pré-molares e molares separadamente, encontrou diferença significativa em relação ao desgaste do esmalte dentário no teste de Kruskall-Wallis, porém não detectou diferença significativa no teste de comparação múltipla Mann-Whitney quando comparou o desgaste sofrido pelo PM/metal em relação ao PM/cerâmica. Em relação à dureza Vickers detectou-se diferença significativa da dureza dos materiais no teste de Kruskall-Wallis (p-valor < 0,001) e também no teste de Mann-Whitney nas comparações múltiplas com p-valor = 0,002. Comparando-se a dureza com a perfilometria, observou-se uma correlação estatisticamente significativa (p ≤ 0,05) na correlação negativa (ρ= -0,829) entre a dureza do metal como material antagonista e o desgaste do esmalte dentário do dente molar. Os resultados sugeriram que todo material restaurador indireto estudado causou desgaste ao esmalte dentário quando submetido a forças de simulação de abrasão com carga. Embora tenha sido observada correlação entre dureza e resistência à abrasão, essa correlação foi pouco significativa.

Coal-burning roasted corn and chili as the cause of dental fluorosis for children in southwestern China

To find the pathologic cause of the children's dental fluorosis in southwestern China, diet structure before the age of 6 and prevalence rate of dental fluorosis (DF) of 405 children were investigated, and the fluorine and arsenic content of several materials were determined. The prevalence rate of DF of children living on roasted corn before the age of 6 is 100% with nearly 95% having the mild to severe DF; while that of children living on non-roasted corn or rice is less than 5% with all having very mild DF. The average fluorine and arsenic concentration are 20.26 mg/kg and 0.249 mg/kg in roasted corn, which are about 16 times and 35 times more than in non-roasted corn, respectively. The average fluorine concentration is 78 mg/kg in coal, 1116 mg/kg in binder clay and 313 mg/kg in briquette (coal mixed with clay). The average arsenic concentration of coal is 5.83 mg/kg, the binder clay is 20.94 mg/kg, with 8.52 mg/kg in the briquette. Living on roasted corn and chili is the main pathologic cause of endemic fluorosis in southwestern China. The main source of fluorine and arsenic pollution of roasted corn and chill is the briquette of coal and binder clay. (C) 2010 Elsevier B.V. All rights reserved.

Effect of immersion in various media on the sorption, solubility, elution of unreacted monomers, and flexural properties of two model dental composite compositions

Immersion in various media has different effect on the properties of dental composites, such as sorption, solubility, elution of unreacted monomers, flexural strength, and flexural elastic modulus. In the present work, the effect of immersion in various media and the relationship between the variation of these properties and the components of dental composite were investigated.

Facetas de Porcelana VS Facetas de Resina Composta

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Zinc polycarboxylate dental cement for the controlled release of an active organic substance: proof of concept

The potential of employing zinc polycarboxylate dental cement as a controlled release material has been studied. Benzalkonium chloride was used as the active ingredient, and incorporated at concentrations of 1, 2 and 3% by mass within the cement. At these levels, there was no observable effect on the speed of setting. Release was followed using an ion-selective electrode to determine changes in chloride ion concentration with time. This technique showed that the additive was released when the cured cement was placed in water, with release occurring by a diffusion mechanism for the first 3 h, but continuing beyond that for up to 1 week. Diffusion coefficients were in the range 5.62 × 10(−6) cm(2) s(−1) (for 1% concentration) to 10.90 × 10(−6) cm(2) s(−1) (for 3% concentration). Up to 3% of the total loading of benzalkonium chloride was released from the zinc polycarboxylate after a week, which is similar to that found in previous studies with glass-ionomer cement. It is concluded that zinc polycarboxylate cement is capable of acting as a useful material for the controlled release of active organic compounds.

A revised classification for direct tooth-colored restorative materials

Composite resins and glass-ionomer cements were introduced to dentistry in the 1960s and 1970s, respectively. Since then, there has been a series of modifications to both materials as well as the development other groups claiming intermediate characteristics between the two. The result is a confusion of materials leading to selection problems. While both materials are tooth-colored, there is a considerable difference in their properties, and it is important that each is used in the appropriate situation. Composite resin materials are esthetic and now show acceptable physical strength and wear resistance. However, they are hydrophobic, and therefore more difficult to handle in the oral environment, and cannot support ion migration. Also, the problems of gaining long-term adhesion to dentin have yet to be overcome. On the other hand, glass ionomers are water-based and therefore have the potential for ion migration, both inward and outward from the restoration, leading to a number of advantages. However, they lack the physical properties required for use in load-bearing areas. A logical classification designed to differentiate the materials was first published by McLean et al in 1994, but in the last 15 years, both types of material have undergone further research and modification. This paper is designed to bring the classification up to date so that the operator can make a suitable, evidence-based, choice when selecting a material for any given situation.

Review paper: role of aluminum in glass-ionomer dental cements and its biological effects

The role of aluminum in glass-ionomers and resin-modified glass-ionomers for dentistry is reviewed. Aluminum is included in the glass component of these materials in the form of Al(2)O(3) to confer basicity on the glass and enable the glass to take part in the acid-base setting reactions. Results of studies of these reactions by FTIR and magic-angle spinning (MAS)-NMR spectroscopy are reported and the role of aluminum is discussed in detail. Aluminum has been shown to be present in the glasses in predominantly 4-coordination, as well as 5- and 6-coordination, and during setting a proportion of this is converted to 6-coordinate species within the matrix of the cement. Despite this, mature cements may contain detectable amounts of both 4- and 5-coordinate aluminum. Aluminum has been found to be leached from glass-ionomer cements, with greater amounts being released under acidic conditions. It may be associated with fluoride, with which it is known to complex strongly. Aluminum that enters the body via the gastro-intestinal tract is mainly excreted, and only about 1% ingested aluminum crosses the gut wall. Calculation shows that, if a glass-ionomer filling dissolved completely over 5 years, it would add only an extra 0.5% of the recommended maximum intake of aluminum to an adult patient. This leads to the conclusion that the release of aluminum from either type of glass-ionomer cement in the mouth poses a negligible health hazard.

The kinetics of water loss from zinc phosphate and zinc polycarboxylate dental cements

The water desorption behaviour of three different zinc oxide dental cements (two polycarboxylates, one phosphate) has been studied in detail. Disc-shaped specimens of each material were prepared and allowed to lose water by being subjected to a low humidity desiccating atmosphere over concentrated sulfuric acid. In all three cements, water loss was found to follow Fick's second law for at least 6 h (until M(t)/M(infinity) values were around 0.5), with diffusion coefficients ranging from 6.03 x 10(-8 )cm(2 )s(-1) (for the zinc phosphate) to 2.056 x 10(-7 )cm(2 )s(-1) (for one of the zinc polycarboxylates, Poly F Plus). Equilibration times for desorption were of the order of 8 weeks, and equilibrium water losses ranged from 7.1% for zinc phosphate to 16.9% and 17.4% for the two zinc polycarboxylates.

The interaction of zinc oxide-based dental cements with aqueous solutions of potassium fluoride

The ability of zinc oxide-based dental cements (zinc phosphate and zinc polycarboxylate) to take up fluoride from aqueous solution has been studied. Only zinc phosphate cement was found to take up any measurable fluoride after 5 h exposure to the solutions. The zinc oxide filler of the zinc phosphate also failed to take up fluoride from solution. The key interaction for this uptake was thus shown to involve the phosphate groups of the set cement. However, whether this took the form of phosphate/fluoride exchange, or the formation of oxyfluoro-phosphate groups was not clear. Fluoride uptake followed radicaltime kinetics for about 2 h in some cases, but was generally better modelled by the Elovich equation, dq(t)/dt = alpha exp(-beta q(t)). Values for alpha varied from 3.80 to 2.48 x 10(4), and for beta from 7.19 x 10(-3) to 0.1946, though only beta showed any sort of trend, becoming smaller with increasing fluoride concentration. Fluoride was released from the zinc phosphate cements in processes that were diffusion based up to M(t)/M(infinity) of about 0.4. No further release occurred when specimens were placed in fresh volumes of deionised water. Only a fraction of the fluoride taken up was re-released, demonstrating that most of the fluoride taken up becomes irreversibly bound within the cement.

Evaluation of sources of uncertainties in microtensile bond strength of dental adhesive system for different specimen geometries

Objective: The aim of this research is to use finite element analysis (FEA) to quantify the effect of the sample shape and the imperfections induced during the manufacturing process of samples on the bond strength and modes of failure of dental adhesive systems through microtensile test. Using the FEA prediction for individual parameters effect, estimation of expected variation and spread of the microtensile bond strength results for different sample geometries is made. Methods: The estimated stress distributions for three different sample shapes, hourglass, stick and dumbbell predicted by FEA are used to predict the strength for different fracture modes. Parameters such as the adhesive thickness, uneven interface of the adhesive and composite and dentin, misalignment of axis of loading, the existence of flaws such as induced cracks during shaping the samples or bubbles created during application of the adhesive are considered. Microtensile experiments are performed simultaneously to measure bond strength and modes of failure. These are compared with the FEA results. Results: The relative bonding strength and its standard deviation for the specimens with different geometries measured through the microtensile tests confirm the findings of the FEA. The hourglass shape samples show lower tensile bond strength and standard deviation compared to the stick and dumbbell shape samples. ANOVA analysis confirms no significant difference between dumbbell and stick geometry results, and major differences of these two geometries compared to hourglass shape measured values. Induced flaws in the adhesive and misalignment of the angle of application of load have significant effect on the microtensile bond strength. Using adhesive with higher modulus the differences between the bond strength of the three sample geometries increase. Significance: The result of the research clarifies the importance of the sample geometry chosen in measuring the bond strength. It quantifies the effect of the imperfections on the bond strength for each of the sample geometries through a systematic and all embracing study. The results explain the reasons of the large spread of the microtensile test results reported by various researchers working in different labs and the need for standardization of the test method and sample shape used in evaluation of the dentin-adhesive bonding system. © 2007 Academy of Dental Materials.

Analysis of the compressive behaviour of the three-dimensional printed porous titanium for dental implants using a modified cellular solid model

A set of cylindrical porous titanium test samples were produced using the three-dimensional printing and sintering method with samples sintered at 900 °C, 1000 °C, 1100 °C, 1200 °C or 1300 °C. Following compression testing, it was apparent that the stress-strain curves were similar in shape to the curves that represent cellular solids. This is despite a relative density twice as high as what is considered the threshold for defining a cellular solid. As final sintering temperature increased, the compressive behaviour developed from being elastic-brittle to elastic-plastic and while Young's modulus remained fairly constant in the region of 1.5 GPa, there was a corresponding increase in 0.2% proof stress of approximately 40-80 MPa. The cellular solid model consists of two equations that predict Young's modulus and yield or proof stress. By fitting to experimental data and consideration of porous morphology, appropriate changes to the geometry constants allow modification of the current models to predict with better accuracy the behaviour of porous materials with higher relative densities (lower porosity).

Proportioning variability in the dispensation of hand-mixed dental cements

Objectives: The purpose of this investigation was to determine for dispensed multiples (1 through 4) of powder (P) and liquid (L) in hand-mixed dental cement whether: (1) the mean (P/L) ratio (m/m) and (2) the maximum difference in (P/L) ratio is dependent on the number of multiples dispensed. The Null hypotheses were: (a) mean (P/L) ratio is independent of the number of multiples dispensed and (b) maximum difference in (P/L) ratio is independent of the number of multiples dispensed.
Methods: The materials investigated are listed in the Table. The masses of dispensed aliquots of powder and liquid were measured by a single operator (n=10, for multiples 1 through 4) on a 4-place analytical balance. All measurements were made independently and all possible (P/L) ratios calculated for each sample. The effect of multiple dispensations on (P/L) ratios and maximum (P/L) differences was by one-way ANOVA and linear regression, respectively, with the Tukey post-hoc correction for multiple comparisons.MULTIPLE DISPENSEDDISPENSED MU(x1)(x2)(x3)(x4)Zinc phosphateHeraeus12.271(0.691)a13.051(1.269)b13.215(0.824)b13.118(1.149)bFuji IXGC4.209(0.373)a4.085(0.275)b4.095(0.226)b4.095(0.217)bIRMDentsply7.933(0.767)a7.430(0.451)b7.977(0.729)a8.186(0.929)aKetac-Cem3M Espe9.6206(0.613)a9.714(0.523)a9.298(0.314)b9.321(0.292)bMean (SD) powder/liquid ratio (m/m). Superscript letters represent significances (α = 0.05) within each material
Results: Mean (SD) (P/L) ratios are presented in the Table. Null hypothesis (a) is rejected: either (x1) or (x2) dispensation yields a different (P/L) ratio to (x3) or (x4) (p < 0.05). Null hypothesis (b) is rejected: a negative correlation is observed in max (P/L) ratio difference with dispensed multiple for Ketac Cem (p = 0.029).
Conclusion: For hand-mixed dental cements: (1) more consistent (P/L) ratios may be observed with multiple dispensations of powder & liquid; (2) maximum differences in (P/L) ratio may be negatively correlated with dispensation multiple in some materials.

Accuracy of medical subject heading indexing of dental survival analyses

PURPOSE: To assess the Medical Subject Headings (MeSH) indexing of articles that employed time-to-event analyses to report outcomes of dental treatment in patients.

MATERIALS AND METHODS: Articles published in 2008 in 50 dental journals with the highest impact factors were hand searched to identify articles reporting dental treatment outcomes over time in human subjects with time-to-event statistics (included, n = 95), without time-to-event statistics (active controls, n = 91), and all other articles (passive controls, n = 6,769). The search was systematic (kappa 0.92 for screening, 0.86 for eligibility). Outcome-, statistic- and time-related MeSH were identified, and differences in allocation between groups were analyzed with chi-square and Fischer exact statistics.

RESULTS: The most frequently allocated MeSH for included and active control articles were "dental restoration failure" (77% and 52%, respectively) and "treatment outcome" (54% and 48%, respectively). Outcome MeSH was similar between these groups (86% and 77%, respectively) and significantly greater than passive controls (10%, P < .001). Significantly more statistical MeSH were allocated to the included articles than to the active or passive controls (67%, 15%, and 1%, respectively, P < .001). Sixty-nine included articles specifically used Kaplan-Meier or life table analyses, but only 42% (n = 29) were indexed as such. Significantly more time-related MeSH were allocated to the included than the active controls (92% and 79%, respectively, P = .02), or to the passive controls (22%, P < .001).

CONCLUSIONS: MeSH allocation within MEDLINE to time-to-event dental articles was inaccurate and inconsistent. Statistical MeSH were omitted from 30% of the included articles and incorrectly allocated to 15% of active controls. Such errors adversely impact search accuracy.

Will your article be found? Authors choose a confusing variety of words to describe dental survival analyses

OBJECTIVES: Identify the words and phrases that authors used to describe time-to-event outcomes of dental treatments in patients.

MATERIALS AND METHODS: A systematic handsearch of 50 dental journals with the highest Citation Index for 2008 identified articles reporting dental treatment with time-to-event statistics (included "case" articles, n = 95), without time-to-event statistics (active "control" articles, n = 91), and all other articles (passive "control" articles n = 6796). The included and active controls were read, identifying 43 English words across the title, aim and abstract, indicating that outcomes were studied over time. Once identified, these words were sought within the 6796 passive controls. Words were divided into six groups. Differences in use of words were analyzed with Pearson's chi-square across these six groups, and the three locations (title, aim, and abstract).

RESULTS: In the abstracts, included articles used group 1 (statistical technique) and group 2 (statistical terms) more frequently than the active and passive controls (group 1: 35%, 2%, 0.37%, P < 0.001 and group 2: 31%, 1%, 0.06%, P < 0.001). The included and active controls used group 3 (quasi-statistical) equally, but significantly more often than the passive controls (82%, 78%, 3.21%, P < 0.001). In the aims, use of target words was similar for included and active controls, but less frequent for groups 1-4 in the passive controls (P < 0.001). In the title, group 2 (statistical techniques) and groups 3-5 (outcomes) were similar for included and active controls, but groups 2 and 3 were less frequent in the passive controls (P < 0.001). Significantly more included articles used group 6 words (stating the study duration) (54%, 30%, P = 0.001).

CONCLUSION: All included articles used time-to-event analyses, but two-thirds did not include words to highlight this in the abstract. There is great variation in the words authors used to describe dental time-to-event outcomes. Electronic identification of such articles would be inconsistent, with low sensitivity and specificity. Authors should improve the reporting quality. Journals should allow sufficient space in abstracts to summarize research, and not impose unrealistic word limits. Readers should be mindful of these problems when searching for relevant articles. Additional research is required in this field.