Retention of three fissure sealants and a dentin bonding system used as fissure sealant in caries prevention: 12-month follow-up results.

Med Oral Patol Oral Cir Bucal. 2007 Oct;12(6):E459-63

Authors: Baca P, Bravo M, Baca AP, Jiménez A, González-Rodríguez MP

BACKGROUND: Bonding agents could be used as fissure sealants. This study compares the retention three fissure sealants (Delton, Delton Plus and Concise) and a filled dentin bonding system (Optibond Solo). METHODS. Fifty-six children aged 7-8 years received fissure sealants either in the four permanent first molars, in the four deciduous second molars, or in all eight of these teeth. Every child received a different sealing material in each quadrant on a random basis. Clinical evaluation at 12 months was performed by a single blind examiner, and the retention was classified as either a success (total retention) or a failure (partial retention or not present). RESULTS: There were no statistically significant differences among the four materials in permanent maxillary molars or deciduous molars. In permanent mandibular molars, Optibond Solo showed a lower percentage of retention (40.9%), significantly different (p=0.002) to that of Delton (89.5%), Delton Plus (87.5%) and Concise (76.5%). CONCLUSION: One bottle dentin bonding system used as a sealant does not improve the retention of conventional fissure sealants. CLINICAL IMPLICATION: Because of the scarcity of studies on the use of dental adhesives as sealants, further studies are warranted for the final support of that conclusion.

PMID: 17909514 [PubMed - indexed for MEDLINE]

Degree of conversion of adhesive systems light-cured by LED and halogen light.

Braz Dent J. 2007;18(1):54-9

Authors: Arrais CA, Pontes FM, Santos LP, Leite ER, Giannini M

This study evaluated the effect of blue light emitting diode (LED) and quartz tungsten halogen (QTH) on the degree of conversion (DC) of an etch-and-rinse Single Bond adhesive system (SB) and a mixture composed of primer solution and resin bond from Clearfil SE Bond self-etching adhesive system (CB) using Fourier transform infrared analysis (FTIR). Adhesives were applied to potassium bromide pellet surfaces and FTIR analyses were performed before and after photo-activation for 10 s with either LED (Freelight 1 - 400 mw/cm(2)) or QTH (XL 3000 - 630 mw/cm(2)) light-curing units (n=8). Additional FTIR spectra were obtained from photo-activated samples stored in distilled water for 1 week. The DC was calculated by comparing the spectra obtained from adhesive resins before and after photo-activation. The results were analyzed by two-way split-plot ANOVA and Tukey's test (p<0.05). Both adhesive systems exhibited low DC (%) immediately after photo-activation (SB/QTH: 18.7 +/- 3.9; SB/LED: 13.5 +/- 3.3; CF/QTH: 13.6 +/- 1.9; CF/LED: 6.1 +/- 1.0). The DC of samples light-cured with LED was lower than DC of those light-cured with QTH, immediately after light curing and after 1 week (SB/QTH: 51.3 +/- 6.6; SB/LED: 50.3 +/- 4.8; CF/QTH: 56.5 +/- 2.9; CF/LED: 49.2 +/- 4.9). The LED curing unit used to photo-activate the adhesive resins promoted lower DC than the QTH curing unit both immediately after light curing and 1 week after storage in water.

PMID: 17639202 [PubMed - indexed for MEDLINE]

Comparative evaluation of the marginal sealing ability of Fuji VII and Concise as pit and fissure sealants.

J Contemp Dent Pract. 2007;8(4):10-8

Authors: Ganesh M, Shobha T

AIM: The anatomical pits and fissures of the teeth have long been recognized as susceptible areas for the initiation of dental caries. The extreme vulnerability to decay of these pits and fissures on the occlusal surfaces has prompted dental scientists to seek methods of caries prevention. Motivated by the role of pit and fissure sealants in caries prevention, the aim of this study was to compare the efficacy of Fuji VII glass ionomer sealant and Concise resin-based sealant. METHODS AND MATERIALS: An in vitro study was undertaken using forty premolars extracted for orthodontic reasons. The teeth were divided into two groups and sealants were applied. One was an experimental group using Fuji VII as a pit and fissure sealant and the other a control group using Concise. The teeth were kept in gentian violet dye for 24 hours, the sectioned samples were observed for the extent of dye penetration, and scores were based on established scoring criteria. RESULTS: The comparison of the performance of the two groups showed a statistically significant difference. CONCLUSION: The Concise resin-based sealant performed better in terms of sealing ability than did the Fuji VII glass ionomer sealant.

PMID: 17486182 [PubMed - indexed for MEDLINE]

Effect of centripetal and incremental methods in Class II composite resin restorations on gingival microleakage.

J Contemp Dent Pract. 2007;8(2):113-20

Authors: Ghavamnasiri M, Moosavi H, Tahvildarnejad N

AIM: The aim of this study was to evaluate the microleakage at gingival margins below the cementoenamel junction (CEJ) of Class II composite restorations using various placement techniques. METHODS AND MATERIALS: Sound human maxillary premolars were selected. Eighty slot-style cavities on the mesial or distal surfaces were prepared with the cervical margins located apical to the CEJ. The specimens were divided into two groups based on the restorative technique utilized (centripetal or incremental). Each group was then categorized into two subgroups according to the type of matrix used resulting in a total of four experimental groups as follows: IP=Incremental and Palodent matrix, IT = Incremental and Transparent matrix, CP= Centripetal and Palodent matrix, and CT = Centripetal and Transparent matrix. Following restoration with a total etch adhesive (Single Bond) and a resin composite (Z100), the teeth were thermocycled. Then specimens were immersed in 0.5% basic fuchsin dye for 24 hours at a temperature of 37 degrees C. Sectioned restorations were examined under a stereomicroscope (40X magnification), and the extent of the microleakage was scored and recorded. Data were analyzed using the Kruskal-Wallis non-parametric statistical test (P=0.05). RESULTS: In the four groups of the study no significant differences in the mean rank of microleakage were observed (p>0.05). CONCLUSION: When the gingival margin was located on cementum, the kind of matrix and filling technique did not reduce the microleakage.

PMID: 17277834 [PubMed - indexed for MEDLINE]

Morphological characterization of the tooth/adhesive interface.

Braz Dent J. 2006;17(3):179-85

Authors: Moura SK, Santos JF, Ballester RY

The purpose of this study was to assess the morphological characteristics of the tooth/adhesive interface using different adhesive systems in MOD restorations under scanning electron microscopy (SEM). The tested hypothesis was that the morphology of the bonding interface would vary in different areas of MOD restorations for the three adhesive systems. MOD cavities were prepared in 12 sound extracted human third molars and restored with Filtek Z250 composite resin and one of the following adhesive systems: Experimental ABF (n=4), Clearfil SE Bond (n=4) self-etching primers and Single Bond etch-and-rinse adhesive system (n=4). After 24-h storage in distilled water at 37 degrees C, teeth were sectioned and prepared for SEM. The interfacial morphology varied depending on the adhesive system and also on the evaluated area. The null hypothesis was accepted because the morphology of the tooth/adhesive interface reflected the characteristics of both the dental substrate and the adhesive systems.

PMID: 17262121 [PubMed - indexed for MEDLINE]

Chemomechanical caries removal in children: efficacy and efficiency.

J Am Dent Assoc. 2006 Dec;137(12):1658-66; quiz 1729-30

Authors: Peters MC, Flamenbaum MH, Eboda NN, Feigal RJ, Inglehart MR

BACKGROUND: The authors investigated the effectiveness of chemomechanical caries removal (CMCR) compared with the traditional method (TM) of caries removal using a round bur when treating dentinal-depth occlusal lesions with minimal enamel access in primary molars. The authors also compare CMCR with TM to determine if it had a higher efficacy and could be used more frequently without the subject's having to undergo local anesthesia. METHODS: The authors collected data from 50 children during operative appointments at which caries was removed using one of the two methods. RESULTS: Complete caries removal within 15 minutes was achieved in only 57.7 percent of the CMCR-treated teeth. In 42.3 percent of these teeth, residual caries was removed using TM. CMCR was almost eight times more time-consuming than was TM when used to excavate dentinal-depth occlusal lesions with minimal cavitation. There was no significant difference between CMCR and TM in the number of subjects who needed to undergo local anesthesia. CONCLUSIONS: The authors found no direct clinical advantage in using CMCR over using TM for treating occlusal dentinal lesions with minimal cavitation in pediatric patients.

PMID: 17138710 [PubMed - indexed for MEDLINE]

One-year clinical evaluation of two resin composites, two polymerization methods, and a resin-modified glass ionomer in non-carious cervical lesions.

J Contemp Dent Pract. 2006 Nov 1;7(5):42-53

Authors: Koubi S, Raskin A, Bukiet F, Pignoly C, Toca E, Tassery H

AIM: The aim of this study was to examine clinically relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data. METHODS AND MATERIALS: Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study. A total of 56 restorations (14 with each material) were placed by three experienced, calibrated dental practitioners. Two other experienced and calibrated practitioners, under single-blind conditions, followed up on all restorations for a period of one year. Three materials were randomly placed: a micro-hybrid composite with two polymerization methods (G1 and G2), a flowable micro-hydrid composite (G3), and a resin-modified glass ionomer (G4). Statistical analysis was performed using the Kruskall-Wallis test (p<0.05) and a Mann-Whitney U modified test with a corrected significance level. RESULTS: At the one year evaluation time, there were no restorations with secondary caries and the retention rates in G1 (IntenS with a hard polymerization), G2 (IntenS with a soft polymerization), G3 (Filtek flow), and G4 (Fuji II LC) were 85.7% (two losses), 92.8% (one loss), 100%, and 100%, respectively. The total visual comparison of the results at baseline (15 days later) showed significant differences only with the clinical acceptance criterion: G1 was different from G2, with a soft polymerization device (p<0.05). In terms of surface quality at one year, G1, G2, and G3 exhibited a statistically significant difference from G4, p<0.05. The digital analysis at baseline showed significant differences only with the clinical acceptance criterion: G1=G2 was different from G3=G4, p<0.05. At one year, only the microporosity criterion showed any statistical differences: G1=G2=G3 was different from G4, p<0.05. CONCLUSIONS: The resin-modified glass ionomer was easier to use and had a high retention rate, but it failed in terms of surface quality (visual mode) and porosity (digital mode) criteria compared to the others groups. Overall results showed no difference between groups G1 (hard-polymerized) and G2 (soft-polymerized), and only G1 was affected by the marginal edge (p<0.03) and integrity criteria (p<0.02) at one year.

PMID: 17091139 [PubMed - indexed for MEDLINE]

Effect of the number of coats of simplified adhesive systems on microleakage of dentin-bordered composite restorations.

J Contemp Dent Pract. 2006 Nov 1;7(5):34-41

Authors: Harada TS, Pazinatto FB, Wang L, Atta MT

AIM: This study tested the null hypothesis that there is no difference on microleakage of dentin-bordered composite restorations using single or double coats of adhesive from one-bottle adhesive systems. METHODS AND MATERIALS: The enamel surface was removed from freshly extracted bovine teeth, and standardized Class V cavities (3 x 3 x 1.5 mm) were made at the cervical areas of buccal surfaces. Teeth were restored and grouped according to type of adhesive systems [Prime Bond 2.1 (PB2.1), Prime & Bond NT (PBNT), and Single Bond (SB)] and to the number of coats (one or two) to be used. The restorations were polished and immersed in a 0.5% aqueous solution of basic fuchsin for four hours. Teeth were then sectioned and the most infiltrated section of each tooth was selected under magnification, scanned, and quantitatively analyzed using a computer program. Data were analyzed using two-way analysis of variance (ANOVA) and Student-Newman-Keuls (a=0.05). RESULTS: Groups without filler content (PB2.1 and SB) showed no difference in microleakage using single or double coats. However, PBNT (with nanofiller) showed statistically less microleakage when only one coat was applied. The influence of the number of coats of the adhesive systems on dentin margin microleakage was material dependent. CONCLUSION: All adhesive systems demonstrated microleakage, however, it could be minimized using two coats of non-filled or one coat of a filled adhesive system.

PMID: 17091138 [PubMed - indexed for MEDLINE]

The effect of two different polishing techniques on microleakage of new composites in Class V restorations.

J Contemp Dent Pract. 2006 Nov 1;7(5):18-25

Authors: Yal&#xE7;in F, Korkmaz Y, Başeren M

AIM: The purpose of this study was to investigate the effect of polishing systems on the microleakage of a nanofill, a nanohybrid, and a microhybrid composite in Class V cavities. METHODS AND MATERIALS: Preparations were made at the cemento-enamel junction (CEJ) of 36 extracted human premolars. The teeth were randomly divided into three groups and restored with new resin composites according to the manufacturers' instructions as follows: Group 1, Filtek Supreme & Single Bond; Group 2, Grandio & Solobond; and Group 3, Artemis & Excite. The restorations were finished with diamond finishing burs. The restored/finished teeth were randomly divided into two groups and polished using the following systems: Super-Snap (Al2O2 coated, abrasive disc system, fine grit, and extra fine grit) and Astropol/Astrobrush (silicon-based abrasive polisher point and polisher brush). All specimens were thermocycled 1000 times with a 10 second dwell time. They were immersed in 0.5% aqueous basic fuchsin dye for 24 hours and then sectioned buccal-lingual-longitudinally through the center of both restorations of each tooth and evaluated under a stereomicroscope at 30X magnification. The degree of dye penetration was quantified. RESULT: No significant difference in leakage scores was observed in enamel margins (p=0.456, Kruskall Wallis test), but dentin margins were significantly affected by the different polishing systems (p=0.037, Kruskall Wallis test). The lower leakage scores were recorded for Astropol/Astrobrush polishing systems. The nanofill composite showed the least leakage among the test groups in this study. The most leakage was observed in nanohybrid composite resin (p<0.05, Mann Whitney U test). CONCLUSIONS: Under the conditions of this in vitro study: the microleakage resistance of composites at enamel margins is not significantly affected by the different polishing systems; the lowest leakage scores were recorded for Astropol/Astrobrush polishing techniques in different types of composites; and the ranking of the composite materials from most to least leakage at the dentin margins according to polishing techniques was Grandio >Artemis > Filtek Supreme.

PMID: 17091136 [PubMed - indexed for MEDLINE]

Short fiber reinforced composite: the effect of fiber length and volume fraction.

J Contemp Dent Pract. 2006 Nov 1;7(5):10-7

Authors: Garoushi SK, Lassila LV, Vallittu PK

AIM: The aim of this study was to determine the effect of short fiber volume fraction and fiber length on some mechanical properties of short fiber-reinforced composite (FRC). METHODS AND MATERIALS: Test specimens (2 x 2 x 25 mm3) and (9.5 x 5.5 x 3 mm3) were made from short random FRC and prepared with different fiber volumes (0%-22%) and fiber lengths (1-6 mm). Control specimens did not contain fiber reinforcement. The test specimens (n=6) were either dry stored or thermocycled in water (x10.000, 5-55 degrees C) before loading (three-point bending test) according to ISO 10477 or statically loaded with a steel ball (Ø 3.0 mm) with a speed of 1.0 mm/min until fracture. A universal testing machine was used to determine the flexural properties and the load-bearing capacity. Data were analyzed using analysis of variance (ANOVA) (p=0.05) and a linear regression model. RESULTS: The highest flexural strength and fracture load values were registered for specimens with 22 vol% of fibers (330 MPa and 2308 N) and with 5 mm fiber length (281 MPa and 2222 N) in dry conditions. Mechanical properties of all test specimens decreased after thermocycling. ANOVA analysis revealed all factors were affected significantly on the mechanical properties (p<0.001). CONCLUSIONS: By increasing the volume fraction and length of short fibers up to 5 mm, which was the optimum length, the mechanical properties of short FRC were improved.

PMID: 17091135 [PubMed - indexed for MEDLINE]

A two-year clinical evaluation of pit and fissure sealants placed with and without air abrasion pretreatment in teenagers.

J Am Dent Assoc. 2006 Oct;137(10):1401-5

Authors: Yazici AR, Kiremit&#xE7;i A, Celik C, Ozgünaltay G, Dayangaç B

BACKGROUND: Long-term retention of pit and fissure sealants is essential for their success. The aim of this study was to compare the retention rates of sealants placed with acid-etching and air abrasion followed by acid etching. METHODS: Sixteen subjects aged 16 and 17 years were included in the study. Using a half-mouth design, the authors performed fissure preparation with phosphoric acid gel on randomly assigned maxillary and mandibular permanent premolars and molars from one side of the mouth (Group I) and performed air abrasion followed by acid etching on the contralateral side of the mouth (Group II). The authors applied sealant material on 162 teeth, and they evaluated the sealants as complete retention, partial loss or total loss at six, 12 and 24 months. RESULTS: While fissure sealant retention rates were not significantly different for the two techniques at six months (P = .97), the retention rates for the teeth in Group II were significantly higher at 12 (P = .025) and 24 months (P = .002). Molar retention rates were significantly less than those for premolars at each evaluation period (P < .05). CONCLUSION: The sealant retention rates at 12 and 24 months were higher in Group II (air abrasion followed by acid etching). CLINICAL IMPLICATIONS: As air abrasion followed by acid etching resulted in significantly higher sealant retention rates, this method could be a good choice for fissure preparation before sealant placement for long-term success.

PMID: 17012719 [PubMed - indexed for MEDLINE]

A message from the division of science.

J Am Dent Assoc. 2006 Sep;137(9):1210, 1212; author reply 1214

Authors:

PMID: 16946417 [PubMed - indexed for MEDLINE]

Effects of a glass-ionomer cement on the remineralization of occlusal caries--an in situ study.

Braz Oral Res. 2006 Apr-Jun;20(2):91-6

Authors: Amaral MT, Guedes-Pinto AC, Chevitarese O

This work evaluated the remineralization of demineralized enamel of pits and fissures of human third molars sealed with a glass ionomer cement (Fuji IX, GC Corporation--Japan) or with a Bis-GMA sealant (Delton--Dentsply). Ten volunteers participated in this in situ study that consisted of two thirty-day periods using intra-oral devices, with a weeks interval in between. Four experimental treatment procedures and one control were randomly assigned to the volunteers specimens: Group I, no treatment, control; Group II, artificial caries process; Group III, same treatment as Group II, but sealed with Delton (Dentsply); Group IV, same treatment as Group II, but sealed with Fuji IX (GC Corporation--Japan); Group V, same treatment as Group II and no sealing. Groups I and II were not submitted to the oral environment and served as controls. After a period of 30 days in the oral environment, the specimens were removed from the devices, embedded in acrylic resin, ground flat and polished. Then, Knoop hardness tests were performed, with a 25 g static load applied for 15 seconds. The measurements were made from the base of the fissure up to an opening of 600 microm, pre-established between the inclines of the cusps. Three indentations were then made, located at 25, 75, and 125 microm in depth from the outer enamel margin and 100 microm apart from each other (Micromet 2003). The Brieger F and Bonferronis tests were applied to the measurements. It was concluded that sealing with the glass ionomer cement Fuji IX was capable of making the enamel of pits and fissures more resistant by increasing the value of Knoop hardness.

PMID: 16878198 [PubMed - indexed for MEDLINE]

Characterization of photopolymerization of dentin adhesives as a function of light source and irradiance.

J Biomed Mater Res B Appl Biomater. 2007 Feb;80(2):440-6

Authors: Ye Q, Wang Y, Williams K, Spencer P

Manufacturers have attempted to address the limitations associated with dentin bonding by eliminating as many steps as possible in the bonding protocol. Theoretically, this approach increases the efficiency of the procedure and reduces technique sensitivity. These trends are reflected in the introduction of all-in one, single-step adhesive systems; the increased concentration of acidic resin monomers in these systems allows for simultaneous etching and priming of the prepared dentin surface. Ideally, the degree of monomer conversion would be high enough that the acidic reaction would be self-limiting. The purpose of this study was to investigate the effect of light irradiance and source on the photopolymerization of three commercial dental adhesives by monitoring the double bond conversion as a function of time during and after irradiation. The photopolymerization curing efficiency of the commercial adhesives investigated in this study varied as a function of light source and distance. The use of LED performed better than the halogen light in terms of polymerization rate and degree of conversion for the commercial single-step, sixth generation adhesive, Adper Prompt. In contrast, polymerization of commercial single-bottle, fifth generation adhesive, Single Bond and One-Up Bond F, was mainly a function of exposure time, irrespective of the two light units or intensities.

PMID: 16850459 [PubMed - indexed for MEDLINE]

Effect of enamel preparations on fracture resistance of composite resin buildup of fractures involving dentine in anterior bovine teeth: an in vitro study.

J Indian Soc Pedod Prev Dent. 2006 Jun;24(2):69-75

Authors: Gandhi K, Nandlal B

Sixty bovine teeth with simulated mesio-incisal angle fracture were randomly and equally divided in one untreated (control) group and three experimental groups (Bevel, Chamfer and newly introduced Stair-step Chamfer preparation group) to evaluate the effect of enamel preparations on the fracture resistance of composite resin. Post restoration, fracture mechanics approach was used to quantify the failure of composite resins in testing the samples in Instron testing machine. Mean peak failure load (Newton) of composite amongst experimental groups was observed in the order; Chamfer (326.09 +/- 72.73), Stair-step chamfer (315.21 +/- 81.77) and Bevel (253.83 +/- 67.38). Results of the One-Way ANOVA revealed significant difference in the mean peak failure load values of the four different groups. (P<0.001) Scheffe's Post-Hoc comparison test (Subset for alpha = 0.05) revealed that there was no significant difference in the mean peak failure load values of the bevel, stair-step chamfer and chamfer preparation when considered together, but the mean peak values of control group (605.22 +/- 48.96) were observed significantly higher. Failure mode evaluation revealed, majority of failures occurred as cohesive and mixed type for all the experimental groups. Adhesive type failure was observed maximum (33%) in the bevel group. Stair-step chamfer preparation showed greatest potential for application and use as it no only demonstrated comparable values to Chamfer preparation ['t' value (0.39) (P > 0.05)] but also involved sacrificing less amount of tooth structure adjacent to fractured edge.

PMID: 16823230 [PubMed - indexed for MEDLINE]

Bond strength of total-etch and self-etch dentin adhesive systems on peripheral and central dentinal tissue: a microtensile bond strength test.

J Contemp Dent Pract. 2006 May 1;7(2):26-36

Authors: Ye&#x15F;ilyurt C, Bulucu B

OBJECTIVE: The purpose of this study was to evaluate the microtensile bond strength (mu TBS) of four total-etch adhesives [Excite (EB), Prime&Bond NT (PBNT), Single Bond (SB), and One Coat Bond (OCB)] by comparing them to five self-etching adhesives (Clearfil SE Bond (CSEB), Xeno III (X III), Prompt L-Pop (PLP), AQ Bond (AQB), and Tyrian/One Step plus (TOSP)] at different dentinal areas. In addition the interface between the adhesive resins and dentin was examined using scanning electron microscopy (SEM). METHODS AND MATERIALS: Superficial occlusal dentin of extracted human molars was exposed and finished with wet 800-grit silicon carbide paper. A block of composite resin was then bonded to the molar samples with the above adhesives according to the manufacturers' instructions. After 24 hours in water at 37 degrees C, the specimens were sectioned into 1 mm thick slices and divided into two regional subgroups according to their relationship to pulp tissue using visual criteria: pulp center and pulp periphery. The slices were then trimmed for the microtensile bond test and subjected to a tensile force and crosshead speed of 1 mm/min. Two-way analysis of variance was performed for statistical analyses. In addition the bond strengths for nine adhesive systems for each dentinal area were compared using the Post-Hoc test. The resin-dentin interfaces for each adhesive system were observed under a SEM. RESULTS: Mean mu TBS ranged from (25.2 MPa) for TOSP to (48.9 MPa) for PBNT. The bond strengths of total-etch adhesive systems were not significantly different, and were higher than self-etch adhesive systems, except for CSEB (p<0.05). No significant regional difference was observed for all of the nine adhesive systems (p>0.05). SEM observation showed there is not a standard hybridization for adhesive systems. CONCLUSION: Different dentinal areas may not exhibit as great an influence on bond strengths using new adhesive systems.

PMID: 16685292 [PubMed - indexed for MEDLINE]

Clinical evaluation of posterior composite restorations in endodontically treated teeth.

J Contemp Dent Pract. 2006 May 1;7(2):17-25

Authors: Can Say E, Kayahan B, Ozel E, Gokce K, Soyman M, Bayirli G

OBJECTIVE: The purpose of this study was to evaluate the two year clinical performance of posterior composite restorations in endodontically treated premolars and molars using a hybrid composite (Filtek Z-250, 3M ESPE) and a total etch bonding system (Single Bond, 3M ESPE). METHOD AND MATERIALS: Thirty-nine class II restorations in endodontically treated premolars (n=11) and molars (n=28) of 27 patients (14 female, 13 male, mean age 36.51) in 16 maxillar and 23 mandibular teeth were placed by one operator. Restorations were evaluated by two experienced investigators at baseline, 12 months, and 24 months according to the modified United States Public Health Service (USPHS) criteria that included retention, color match, marginal discoloration, secondary caries, anatomic form, marginal adaptation, and surface texture. All restorations were able to be evaluated at baseline, 12 months, and 24 months. RESULTS: Paired samples t-test showed only marginal discoloration showed a statistically significant difference (p<0.05) at the end of 24 months, and no other significant differences were observed for the other variables examined over the duration of the study. None of the restored teeth showed periapical pathology at the end of 24 months. CONCLUSION: At two years, limited deterioration in marginal discoloration was detected. The clinical performance of posterior composite restorations in endodontically treated teeth using Filtek Z250 was found clinically acceptable after two years.

PMID: 16685291 [PubMed - indexed for MEDLINE]

Evaluation of shear bond strength and SEM observation of all-in-one self-etching primer used for bonding of fissure sealants.

J Contemp Dent Pract. 2006 May 1;7(2):9-16

Authors: Al-Sarheed MA

OBJECTIVES: To evaluate and compare enamel shear bond strength of an all-in-one self-etching primer (Prompt L-Pop) to regular acid etch material when bonded to two-fissure sealant systems (Concise and Dyract Seal). METHOD AND MATERIALS: Forty newly extracted non-carious first permanent molars were embedded in a Teflon mold. The teeth were divided into four groups and each consisted of ten specimens. The bonding surfaces were treated with either Prompt L-Pop as recommended by the manufacturer or etched with phosphoric acid. After 24 hours of water storage, the specimens were evaluated for shear bond strength using an Instron testing machine. Scanning electron microscope (SEM) examinations were carried out to evaluate the failure sites of the sealants. RESULTS: The mean shear bond strengths using Prompt L-Pop were Concise: 23.46 MPa and Dyract Seal: 20.34 MPa. These values were higher than and statistically different from those of Dyract Seal (9.99 MPa) and Concise (8.85 MPa) when phosphoric acid was used. The failure was predominantly of the adhesive type. The SEM examination showed the failure of debonding was predominantly related to the type of etching systems used rather than the type of fissure sealants. CONCLUSION: The use of the all-in-one self-etching adhesive Prompt L-Pop improves the mean enamel shear bond strength of fissure sealants.

PMID: 16685290 [PubMed - indexed for MEDLINE]

Exposure to bisphenol A from bis-glycidyl dimethacrylate-based dental sealants.

J Am Dent Assoc. 2006 Mar;137(3):353-62

Authors: Joskow R, Barr DB, Barr JR, Calafat AM, Needham LL, Rubin C

BACKGROUND: Bisphenol A (BPA) is a common component of composites and dental sealants. The potential exists for human exposure after sealant placement. METHODS: The authors prospectively enrolled 15 men in an exposure assessment study; 14 completed the study. After placement of clinically appropriate amounts of one of two sealants, the authors measured BPA in saliva and urine samples collected at prescribed intervals after the sealants were placed. They used selective and sensitive isotope-dilution mass-spectrometry-based methods for BPA measurements, thus providing the most reliable results. RESULTS: Helioseal F (Ivoclar Vivadent, Amherst, N.Y.) leached negligible amounts of BPA. Urinary and salivary BPA levels in subjects who received these sealants were similar to baseline levels. Delton Light Cure (LC) Opaque pit-and-fissure sealant (Dentsply/Ash, York, Pa.) leached more BPA, resulting in low-level BPA exposures similar to those used in laboratory animal testing. BPA exposure after Delton LC sealant placement was significantly higher than exposure after placement of Helioseal F. Patients treated with Delton LC had significantly higher doses of BPA (110 microg) than did those treated with Helioseal F (5.5 microg) (P < .0001). CONCLUSIONS: Placement of clinically relevant amounts of Delton LC sealant resulted in low-level BPA exposure; however, exposure was negligible after placement of Helioseal F. Saliva collection after sealant placement likely reduced systemic absorption of BPA from dental sealants. Sealants should remain a useful part of routine preventive dental practice, especially those that leach negligible amounts of BPA. CLINICAL IMPLICATIONS: Dental sealants may be a point source for low-level BPA exposure at levels that show health effects in rodents. Further research is required to determine whether human exposure to BPA at these levels causes adverse effects.

PMID: 16570469 [PubMed - indexed for MEDLINE]

Influence of cavity dimensions, insertion technique and adhesive system on microleakage of Class V restorations.

J Am Dent Assoc. 2006 Feb;137(2):197-202

Authors: Costa Pfeifer CS, Braga RR, Cardoso PE

BACKGROUND: The authors evaluated the influence of cavity dimensions, insertion technique and adhesive system on microleakage of Class composite restorations. METHODS: The authors prepared cylindrical cavities with enamel margins of 3-millimeter diameter by 1-mm depth or 6-mm diameter by 2-mm depth on the labial surface of bovine incisors. They defined experimental groups (n = 15) according to cavity size, insertion technique (bulk or incremental) and adhesive system applied (Single Bond, 3M ESPE, St. Paul, Minn., or Excite, Ivoclar Vivadent, Amherst, N.Y.). They restored preparations with Tetric Ceram (Ivoclar Vivadent). After 36 hours' storage in distilled water at 37 C, specimens were submitted to microleakage using 50 percent silver nitrate as tracer. Teeth were sectioned twice and dye penetration on the axial wall was determined in millimeters. RESULTS: The authors analyzed the data using analysis of variance/Tukey test (a = .05). For large restorations, the use of Single Bond resulted in higher microleakage than Excite (1.56 +/- standard deviation [SD] 0.26 mm and 0.63 +/- SD 0.56 mm, respectively; P < .001), whereas for small restorations there was no statistical difference between adhesives (Excite: 0.47 +/- SD 0.28 mm; Single Bond: 0.46 +/- SD 0.28 mm). CONCLUSION: The choice of adhesive system influenced microleakage only for large restorations. Incremental insertion of the composite did not affect dye penetration. CLINICAL IMPLICATIONS: Microleakage of composite restorations cannot be predicted only on the basis of the restorations' dimensions. In large restorations, it also depends on the choice of adhesive system, whereas in small restorations, the adhesive used does not seem to be an influential factor. Incremental insertion did not seem to reduce restorations' microleakage.

PMID: 16521386 [PubMed - indexed for MEDLINE]

Evaluation of a self-limiting concept in dentinal caries removal.

J Dent Res. 2006 Mar;85(3):282-6

Authors: Silva NR, Carvalho RM, Pegoraro LF, Tay FR, Thompson VP

The mechanical removal of dentinal caries traditionally involves the use of tactile sensation and/or caries-indicating dyes. This study tested the hypothesis that self-limiting polymer burs are as effective as conventional carbide burs in creating substrates for dentin bonding. Carious dentin from extracted human molars was removed with carbide or polymer burs, with dental explorer hardness as the end-point for caries removal. Dentin substrates were bonded with etch-and-rinse or self-etch adhesives and prepared for microtensile bond testing and transmission electron microscopy. For each bur type, there was no difference in bond strength between adhesives. However, the polymer bur surface exhibited significantly lower bond strengths than the carbide bur, and both were lower than flat, non-carious dentin controls. TEM revealed areas of incompletely removed, denatured caries-infected dentin in the polymer bur specimens. These first-generation polymer burs might best be utilized for deep caries removal where pulpal exposure is a concern.

PMID: 16498079 [PubMed - indexed for MEDLINE]

Clinical performance evaluation of a packable posterior composite in bulk-cured restorations.

J Am Dent Assoc. 2006 Jan;137(1):71-80

Authors: Sarrett DC, Brooks CN, Rose JT

BACKGROUND: The authors evaluated the clinical performance of Prodigy Condensable (Kerr, Orange, Calif.) composite placed and cured in increments up to 5 millimeters thick. METHODS: The authors placed 57 Class II restorations in 32 patients in composite increments up to 5 mm thick. Using this technique, they placed the majority of restorations in one increment and then carved the occlusal and proximal anatomy before light curing. The authors evaluated the restorations at three, six, 12, 24 and 36 months. RESULTS: No restorations required replacement; however, 11 developed a defect requiring repair or continued observation. Of these 11, nine restorations developed defects on the margins of the restorations and two developed secondary caries. The Kaplan-Meier estimate of probability that a restoration would develop a defect during 36 months that would require immediate repair was 0.13. Postoperative sensitivity was not significantly different from preoperative sensitivity. CONCLUSIONS: The authors found that no restorations required replacement and no increased postoperative sensitivity occurred. CLINICAL IMPLICATIONS: The authors suggest that this composite material can be placed in a single increment up to 5 mm thick for Class II restorations.

PMID: 16457002 [PubMed - indexed for MEDLINE]

Early biofilm formation and the effects of antimicrobial agents on orthodontic bonding materials in a parallel plate flow chamber.

Eur J Orthod. 2006 Feb;28(1):1-7

Authors: Chin MY, Busscher HJ, Evans R, Noar J, Pratten J

Decalcification is a commonly recognized complication of orthodontic treatment with fixed appliances. A technology, based on a parallel plate flow chamber, was developed to investigate early biofilm formation of a strain of Streptococcus sanguis on the surface of four orthodontic bonding materials: glass ionomer cement (Ketac Cem), resin-modified glass ionomer cement (Fuji Ortho LC), chemically-cured composite resin (Concise) and light-cured composite resin (Transbond XT). S. sanguis was used as it is one of the primary colonizers of dental hard surfaces. Artificial saliva was supplied as a source of nutrients for the biofilms. The effects of two commercially available mouthrinses (i.e. a fluoride containing rinse and chlorhexidine) were evaluated. Initial colonization of the bacterium was assessed after 6 hours of growth by the percentage surface coverage (PSC) of the biofilm on the disc surfaces. There were statistically significant differences in bacterial accumulation between different bonding materials (P < 0.05), Concise being the least colonized and Transbond XT being the most colonized by S. sanguis biofilms. All materials pre-treated with 0.05 per cent sodium fluoride mouthrinse showed more than 50 per cent reduction in biofilm formation. The 0.2 per cent chlorhexidine gluconate mouthrinse caused significant reduction of biofilm formation on all materials except Ketac Cem. This in vitro study showed that the use of a chemically-cured composite resin (Concise) reduced early S. sanguis biofilm formation. Also, fluoride had a greater effect in reducing the PSC by S. sanguis biofilms than chlorhexidine. Rinsing with 0.05 per cent sodium fluoride prior to placement of orthodontic appliances is effective in reducing early biofilm formation.

PMID: 16373451 [PubMed - indexed for MEDLINE]

Clinical pearl: LingLock--the flossable fixed retainer.

J Orthod. 2005 Dec;32(4):241-3

Authors: Amundsen OC, Wisth PJ

The present article describes a new product for long-term retention of the lower dental arch. The LingLock is a fixed bonded retainer from canine to canine in the lower front made up of separate, but co-working retention elements in the ceramic material aluminium oxide (Al2O3). The LingLock retainer enables the patient to floss the teeth in a regular manner in the actual retention area.

PMID: 16333044 [PubMed - indexed for MEDLINE]

Sealant and fluoride varnish in caries: a randomized trial.

J Dent Res. 2005 Dec;84(12):1138-43

Authors: Bravo M, Montero J, Bravo JJ, Baca P, Llodra JC

Little is known about the effect of discontinuation of sealant or fluoride varnish. The purpose of this study was to compare sealant with fluoride varnish in the prevention of occlusal caries in permanent first molars of children over a nine-year period: 4 yrs for program evaluation plus 5 yrs of discontinuation. A clinical trial was conducted on three groups of six- to eight-year-old schoolchildren: a control group (n = 45); a group (n = 37) in which sealant was applied and reapplied up to 36 mos; and a group (n = 38) in which fluoride varnish was applied and re-applied up to 42 mos. Percent caries reduction was studied in these initially healthy molars with complete occlusal eruption: 129 (control), 113 (sealant), and 129 (varnish) molars met inclusion criteria. Of these, 76.7%, 26.6%, and 55.8% had developed occlusal caries at 9 yrs, which implies caries reductions of 65.4% (SE = 8.5%) for sealants vs. control and 27.3% (SE = 10.2%) for varnish vs. control. Furthermore, the varnish program was not effective during the discontinuation period.

PMID: 16304443 [PubMed - indexed for MEDLINE]

Effect of placement techniques on the marginal adaptation of Class V composite restorations.

J Contemp Dent Pract. 2005 Nov 15;6(4):17-25

Authors: Sensi LG, Marson FC, Baratieri LN, Monteiro Junior S

STATEMENT OF THE PROBLEM: Several techniques are proposed for the restoration of Class V cavities but there is no agreement in the literature as to which technique is more effective. PURPOSE: To evaluate the effect of different techniques of composite increment placement on the marginal adaptation of Class V restorations. METHODS AND MATERIALS: Twenty-four human molars were selected and prepared with standardized saucer-shaped cavity dimensions of 3.0 mm (occlusal-gingival), 2.0 mm (mesial-distal), and 2.0 mm (depth). The margins are in reference to the cemento-enamel junction with 1.5 mm being located on enamel and 1.5 mm on dentin. The cavities were randomly assigned into three groups (n=8) and restored with composites as follows: Group 1, the occlusal increment was placed and cured first followed by the gingival increment; Group 2, the gingival increment was placed and cured first followed by the occlusal increment; and Group 3, the cavities were restored with one bulk increment. Restorations were immediately finished and stored for 24 h in tap water. Specimens were subjected to thermocycling (1000 cycles, 5 degrees C to 55 degrees C, 30 s dwell time) and immersed in 0.5% basic fuchsin solution for 24 h in room temperature. After rinsing with running water, the restorations were sectioned longitudinally and enamel and dentin margins were evaluated and scored according to the microleakage on a 0-3 scale. Data were subjected to Kruskal-Wallis test at p<0.05. RESULTS: Median of microleakage scores for all evaluated groups was zero. No statistical difference was observed among the three groups both in enamel (p = 0.5929) and dentin (p = 0.3679) margins CONCLUSION: The placement technique did not influence the marginal adaptation of moderate Class V restorations. CLINICAL SIGNIFICANCE: No differences on marginal adaptation were observed when restoring conservative Class V cavities using incremental or bulk placement techniques.

PMID: 16299603 [PubMed - indexed for MEDLINE]

An investigation into the bonding of orthodontic attachments to porcelain.

Eur J Orthod. 2006 Feb;28(1):74-7

Authors: Larmour CJ, Bateman G, Stirrups DR

This study assessed bonding of orthodontic brackets to porcelain teeth using two different surface preparation techniques and comparing two bonding systems, Fuji Ortho L.C. and Transbond. Four groups of 20 porcelain premolar teeth were bonded with metal orthodontic brackets (0.022 inch Minitwin, 3M Unitek) according to the following protocol: Transbond with a phosphoric acid etch (group 1), Transbond with a hydrofluoric acid etch (group 2), Fuji Ortho L.C. with a hydrofluoric acid etch (group 3), and Fuji Ortho L.C. with a phosphoric acid etch (group 4). All groups were bonded with a silane coupling agent. The teeth were debonded with an Instron universal testing machine. Bond strength, site of bond failure and adhesive remnant index (ARI) were recorded for each group. Differences between groups were analysed statistically. The composite resin groups (groups 1 and 2) had the highest mean bond strength values at 7.9 and 9.7 MPa, respectively. The resin-modified glass ionomer cement groups (RMGIC; groups 3 and 4) had the lowest mean bond strength values at 6.3 and 1.8 MPa, respectively. The mean bond strength of group 3 was significantly lower than all other groups (P < 0.0001). The Fuji groups had also significantly (P < 0.001) lower ARI scores than the composite groups (groups 1 and 2). Most samples experienced porcelain surface damage, except group 4. In conclusion, the highest bond strength levels were achieved with a conventional composite resin cement (groups 1 and 2). No significant differences in bond strength were found between the hydrofluoric and phosphoric acid etch technique.

PMID: 16199411 [PubMed - indexed for MEDLINE]

How to ... place a lower bonded retainer.

J Orthod. 2005 Sep;32(3):206-10

Authors: Shah AA, Sandler PJ, Murray AM

Post-orthodontic relapse of lower incisors is a common phenomenon. Sometimes a bonded retainer is fitted to prevent this relapse. In this article, we suggest a handy clinical technique of fitting a lower bonded retainer, which is convenient and easy to carry out.

PMID: 16170063 [PubMed - indexed for MEDLINE]

Surface roughness of new microhybrid resin-based composites.

J Am Dent Assoc. 2005 Aug;136(8):1106-12

Authors: Gedik R, H&#xFC;rmüzlü F, Coşkun A, Bektaş OO, Ozdemir AK

BACKGROUND: Rough, poorly polished resin-based composite (RBC) surfaces contribute to staining, plaque accumulation, gingival irritation and recurrent caries. Proper finishing and polishing enhance both the esthetics and the longevity of restored teeth. METHODS: The authors evaluated the influence of various finishing and polishing techniques on the surface roughness of four microhybrid RBCs. Thirty samples of each material were cured under Mylar matrix strips (Yates and Bird/Motloid, Chicago). All microhybrid RBC specimens were finished with multifluted carbide burs, except for the Mylar matrix strip samples, and then were polished using one of four finishing systems: Sof-Lex contouring and polishing disks (3M ESPE, St. Paul, Minn.); Enhance Finishing System (Dentsply-Caulk, Milford, Del.) followed by Prisma Gloss (Dentsply-Caulk) polishing paste application; Astropol finishing, polishing and high-gloss polishing system (Ivoclar Vivadent, Schaan, Liechtenstein); and Astrobrush polishing system (Ivoclar Vivadent). The authors tested the samples to obtain average surface roughness and analyzed the values. RESULTS: The use of the Astrobrush technique caused the greatest roughness on all RBC specimens. The smoothest surface was produced with a carbide bur followed by aluminum oxide disks, Astropol technique and Enhance technique. Overall, there were differences in surface quality among the materials. InTen-S (Ivoclar Vivadent) had statistically lower surface roughness values after finishing and polishing with the Astrobrush technique, compared with the other RBCs. CONCLUSION: The highest surface roughness values were achieved after the Astrobrush technique was used. The Sof-Lex aluminum oxide disks, and Enhance and Astropol techniques provided the smoothest surface. CLINICAL IMPLICATIONS: The Sof-Lex, Enhance and Astropol techniques produced a smooth surface after the finishing and polishing of materials, while the Astrobrush technique yielded the least favorable results.

PMID: 16161365 [PubMed - indexed for MEDLINE]

Fracture resistance of premolar teeth restored with different filling techniques.

J Contemp Dent Pract. 2005 Aug 15;6(3):62-9

Authors: França FM, Worschech CC, Paulillo LA, Martins LR, Lovadino JR

The aim of this study is to verify the fracture resistance of premolars with large mesiocclusodistal (MOD) preparations with composite resin using different incremental techniques when subjected to an occlusal load. Forty maxillary premolar teeth were randomly divided into four groups (n=10). Class II MOD cavities were prepared in all specimens with parallel walls and no approximal boxes. The resulting isthmus width was 1/3 the distance between the cusp tips and (3/4) the height of the crown. Teeth in group I, the control group, were not restored. Specimens in group II were restored in three incremental vertical layers. Group III specimens were restored in three horizontal layers, and finally, specimens in group IV were restored in oblique layers. With exception of the placement technique, specimens in groups II, III and IV were restored using the Single Bond adhesive system and P60 composite resin following manufacturer's recommendations. A 4 mm diameter steel sphere contacted the buccal and lingual cusps of the tested teeth at a crosshead speed of 0.5 mm/min until fracture occurred. The values obtained in this study were subjected to Analysis of Variance (ANOVA) and a Tukey-Kramer test. Only group I (non-restored) obtained a minor means of fracture resistance. No significant differences among groups II, III, and IV were found. This study shows on large MOD cavities the incremental filling techniques do not influence the fracture resistance of premolar teeth restored with composite resin.

PMID: 16127473 [PubMed - indexed for MEDLINE]

Impact of curing protocol on conversion and shrinkage stress.

J Dent Res. 2005 Sep;84(9):822-6

Authors: Lu H, Stansbury JW, Bowman CN

Since considerable shrinkage stress develops during the curing of dental composites, various soft-start photocuring protocols, aiming to lower stress but not compromise conversion, have been proposed. We hypothesized that utilizing soft-start photocuring will result in not only reduced stress, but also decreased conversion. We evaluated the impact of 3 protocols (soft-start, pulse, and standard) on the stress development and polymerization extent of an experimental composite. A novel set-up capable of simultaneous shrinkage stress, conversion, and temperature measurements on the same specimen was utilized. Analysis of the data shows that stress rises dramatically as a function of conversion in the vitrified state, and the utilization of soft-start or pulse curing results in specimens with reduced final conversion and shrinkage stress, compared with specimens cured according to the standard full-intensity protocol. Finally, this study demonstrates that the predominant reason for the reduced shrinkage stress attained with soft-start or pulse curing is a modest decrease in final conversion.

PMID: 16109991 [PubMed - indexed for MEDLINE]

Enamel loss at bond-up, debond and clean-up following the use of a conventional light-cured composite and a resin-modified glass polyalkenoate cement.

Eur J Orthod. 2005 Aug;27(4):413-9

Authors: Ireland AJ, Hosein I, Sherriff M

The aim of this study was to determine whether there was any difference in the degree of enamel loss at bond-up, debond and enamel clean-up when two different adhesive systems were tested and with four different methods of enamel clean-up. The adhesive systems were 37 per cent o-phosphoric acid with Transbond XT (group 1) and 10 per cent poly(acrylic acid) conditioner with Fuji Ortho LC (group 2). Using flattened enamel specimens, enamel loss at each stage was determined using a planer surfometer. These stages were: prior to treatment, at pumice prophylaxis, following enamel etching or conditioning and following enamel clean-up. The four clean-up methods were a high-speed tungsten carbide bur, a slow-speed tungsten carbide bur, an ultrasonic scaler and debanding pliers.The results, analysed using non-parametric tests, demonstrated that significantly more enamel loss occurred following the use of 37 per cent o-phosphoric acid than poly(acrylic acid) conditioner (P = 0.001). At debond and prior to clean-up, more adhesive remained on the enamel surface in group 1 than in group 2 (P = 0.005). During the subsequent enamel clean-up and with both adhesive systems, the least enamel loss occurred following the use of the slow-speed tungsten carbide bur and the greatest loss was seen with the ultrasonic scaler or high-speed tungsten carbide bur.Overall, the lowest enamel loss was observed with the poly(acrylic acid) conditioner and Fuji Ortho LC system (group 2) and where enamel clean-up was performed using the slow-speed tungsten carbide bur.

PMID: 16043478 [PubMed - indexed for MEDLINE]

Tensile bond strength of brackets after antioxidant treatment on bleached teeth.

Eur J Orthod. 2005 Oct;27(5):466-71

Authors: Bulut H, Kaya AD, Turkun M

Various studies have reported a significant reduction in tensile bond strength of brackets when bonding is carried out immediately after bleaching. The purpose of this investigation was to determine the effect of an antioxidant agent on the tensile bond strength values of metal brackets bonded with composite resin to human enamel after bleaching with carbamide peroxide (CP). A total of 80 extracted premolar teeth were randomly divided into three bleaching groups of 10 per cent CP and an unbleached control group. The specimens in group 1 were bonded immediately after bleaching; group 2 were stored in an artificial saliva solution for 7 days after bleaching; group 3 were treated with 10 per cent sodium ascorbate, immediately before bonding, whereas the unbleached specimens in group 4 had no treatment before bonding. Tensile bond strengths were established in MPa. To evaluate the amount of resin left on the enamel surfaces after debonding, the adhesive remnant index (ARI) scores were used. The tensile bond strength data were analyzed with the Kruskal-Wallis test and pairwise comparisons were made by the Mann-Whitney U test at a significance level of P < 0.05. The brackets bonded immediately after bleaching revealed significantly lower tensile bond strengths than those of unbleached enamel (P = 0.000). No statistically significant differences in tensile bond strength were noted when the delayed-bonding (P = 6.000) and antioxidant-treated (P = 0.2757) groups were compared with the control group. The antioxidant treatment immediately after bleaching was effective in reversing the tensile bond strength of brackets.

PMID: 16043470 [PubMed - indexed for MEDLINE]

Chlorhexidine arrests subclinical degradation of dentin hybrid layers in vivo.

J Dent Res. 2005 Aug;84(8):741-6

Authors: Hebling J, Pashley DH, Tj&#xE4;derhane L, Tay FR

The recent paradigm that endogenous collagenolytic and gelatinolytic activities derived from acid-etched dentin result in degradation of hybrid layers requires in vivo validation. This study tested the null hypothesis that there is no difference between the degradation of dentin bonded with an etch-and-rinse adhesive and that in conjunction with chlorhexidine, an MMP inhibitor, applied after phosphoric-acid-etching. Contralateral pairs of bonded Class I restorations in primary molars of clinical subjects were retrieved after a six-month period of intra-oral functioning and processed for transmission electron microscopy. Hybrid layers from the chlorhexidine-treated teeth exhibited normal structural integrity of the collagen network. Conversely, abnormal hybrid layers were seen in the control teeth, with progressive disintegration of the fibrillar network, to the extent that it was beyond detection by collagen staining. Self-destruction of collagen matrices occurs rapidly in resin-infiltrated dentin in vivo and may be arrested with the use of chlorhexidine as an MMP inhibitor.

PMID: 16040733 [PubMed - indexed for MEDLINE]

EDTA treatment improves resin-dentin bonds' resistance to degradation.

J Dent Res. 2005 Aug;84(8):736-40

Authors: Osorio R, Erhardt MC, Pimenta LA, Osorio E, Toledano M

The existence of unprotected collagen fibrils within the hybrid layer compromises the longevity of restorations. This phenomenon may be avoided if solutions other than strong acids are used for dentin demineralization. The hypothesis to be tested is that bond durability may be improved by EDTA demineralization. Dentin surfaces (human and bovine) were bonded: (1) after phosphoric-acid-etching, and after EDTA demineralization with (2) a total-etch adhesive and (3) a self-etching adhesive. After the teeth were sectioned into beams, half of the specimens were immersed in NaOCl, while the other half was immersed in water. Beams were tested to failure in tension. ANOVA and multiple-comparisons tests were used (P < 0.05). No differences in bond strength were found among the 3 bonding procedures, although bonds made to human molars were 43-61% higher than those to bovine incisors. After NaOCl immersion, only specimens subjected to EDTA demineralization maintained the initial bond strength. We conclude that the collagen network is better-preserved after EDTA demineralization.

PMID: 16040732 [PubMed - indexed for MEDLINE]

Making fixed provisional restorations for patients hypersensitive to acrylic resin.

J Am Dent Assoc. 2005 Jun;136(6):779-80

Authors: Cohen MD

PMID: 16022043 [PubMed - indexed for MEDLINE]

Light curing time reduction: in vitro evaluation of new intensive light-emitting diode curing units.

Eur J Orthod. 2005 Aug;27(4):408-12

Authors: Mavropoulos A, Staudt CB, Kiliaridis S, Krejci I

The aim of the present in vitro study was to establish the minimum necessary curing time to bond stainless steel brackets (Mini Diamond Twin) using new, intensive, light-emitting diode (LED) curing units. Seventy-five bovine primary incisors were divided into five equal groups. A standard light curing adhesive (Transbond XT) was used to bond the stainless steel brackets using different lamps and curing times. Two groups were bonded using an intensive LED curing lamp (Ortholux LED) for 5 and 10 seconds. Two more groups were bonded using another intensive LED curing device (Ultra-Lume LED 5) also for 5 and 10 seconds. Finally, a high-output halogen lamp (Optilux 501) was used for 40 seconds to bond the final group, which served as a positive control. All teeth were fixed in hard acrylic and stored for 24 hours in water at 37 degrees C. Shear bond strength (SBS) was measured using an Instron testing machine. Weibull distribution and analysis of variance were used to test for significant differences.The SBS values obtained were significantly different between groups (P < 0.001). When used for 10 seconds, the intensive LED curing units achieved sufficient SBS, comparable with the control. In contrast, 5 seconds resulted in significantly lower SBS. The adhesive remnant index (ARI) was not significantly affected.A curing time of 10 seconds was found to be sufficient to bond metallic brackets to incisors using intensive LED curing units. These new, comparatively inexpensive, curing lamps seem to be an advantageous alternative to conventional halogen lamps for bonding orthodontic brackets.

PMID: 15961571 [PubMed - indexed for MEDLINE]

Microtensile bond strength of a total-etching versus self-etching adhesive to caries-affected and intact dentin in primary teeth.

J Am Dent Assoc. 2005 Apr;136(4):477-83

Authors: Nakornchai S, Harnirattisai C, Surarit R, Thiradilok S

BACKGROUND: The objec tives of this study were to determine microtensile bond strengths of two dentin adhesives and to compare the micromorphological structure of the resin/dentin interface in caries-affected dentin with that of intact dentin. METHODS: The authors randomly divided 40 proximal dentinal carious primary teeth and 40 noncarious anterior primary teeth into two groups (self-etching and total-etching). They used a caries-detecting dye as an indicator of the need to remove the outer carious dentin. The authors restored the teeth with a hybrid resin-based composite. After 24 hours' storage in 37 C water, specimens were sectioned and shaped to form a curved section with a cross-sectional area of 1 square millimeter, then tension was applied until they fractured. The authors prepared the resin/dentin interfaces for the two bonding systems and examined them in 10 occlusal carious and 10 noncarious teeth. STATISTICAL ANALYSIS: The bond strengths for intact and caries-affected dentin within the same group were analyzed via a t test. The authors compared the remaining dentin thickness (RDT) and dentin hardness using analysis of variance and the least significant difference test at the .05 level of significance. RESULTS: The self-etching adhesive demonstrated no statistical difference in bond strength between intact and caries-affected dentin. However, the total-etching adhesive demonstrated different bond strengths for intact and caries-affected dentin. Moreover, the RDT of specimens with intact and caries-affected dentin was not significantly different, whereas the dentin hardness of caries-affected dentin was significantly lower than that of intact dentin. The authors found a thicker hybrid layer in intact and caries-affected dentin of specimens in the total-etching group. CONCLUSION: The adhesives exhibited significantly different bond strengths in intact dentin of primary teeth. However, they exhibited similar bond strengths in caries-affected dentin.

PMID: 15884317 [PubMed - indexed for MEDLINE]

Fluoride-releasing capacity and cariostatic effect provided by sealants.

J Oral Sci. 2005 Mar;47(1):35-41

Authors: Lobo MM, Pecharki GD, Tengan C, da Silva DD, da Tagliaferro EP, Napimoga MH

This study evaluated the effect of sealants on enamel demineralization, focusing on physical protection of the sealed enamel and fluoride protection of the adjacent unsealed enamel. Occlusal fissures with areas measuring 12 mm2 were delimited in 48 extracted molars, randomly divided into 4 groups (n =12): 1) no sealing; 2) sealing with a resin-modified glass-ionomer (Vitremer, 3M ESPE); 3) sealing with a fluoride-releasing composite sealant (Clinpro Sealant, 3M ESPE); and 4) sealing with a non-fluoridated composite sealant (Concise, 3M ESPE). A 4-mm2 window was outlined on the buccal enamel for analysis of fluoride uptake. Following treatment, groups 2, 3 and 4 were subjected to 5-days of pH-cycling, while group 1 was kept in a moist environment at 37 degrees C. Fluoride uptake was assessed by dental biopsy, and the amount of fluoride released to the cycling solutions was determined by ion analysis. Enamel demineralization around the sealants was evaluated by cross-sectional micro-hardness analysis. Group 2 showed higher levels of fluoride release (P < 0.01) and uptake by enamel (P < 0.05), and lower levels of demineralization (P < 0.05) than groups 3 and 4. Group 3 exhibited reduced demineralization on unsealed enamel and provided fluoride uptake in a distant enamel area, while group 4 did not.

PMID: 15881227 [PubMed - indexed for MEDLINE]

A three-year clinical evaluation of two-bottle versus one-bottle dentin adhesives.

J Am Dent Assoc. 2005 Mar;136(3):311-22

Authors: Aw TC, Lepe X, Johnson GH, Mancl LA

BACKGROUND: The authors conducted an in vivo investigation to compare the clinical performance of two commercial one-bottle adhesives and a two-bottle adhesive for restoration of noncarious cervical lesions (NCCLs). METHOD: The patient pool consisted of 57 patients and 171 teeth (three teeth per patient), with one NCCL per tooth. Each patient received three resin-based composite restorations, each with a different adhesive: one tooth with a two-bottle, water-based adhesive as the control; another tooth with a one-bottle, ethanol-based adhesive; and a third tooth with a one-bottle, solvent-free adhesive. The authors assessed restorations in terms of retention, marginal integrity, margin discoloration and air sensitivity at baseline, six months, one year, two years and three years after initial placement. RESULTS: The retention rates at 36 months were 88 percent for the first adhesive, 81 percent for the second adhesive and 90 percent for the third adhesive. No statistically significant differences in retention rates could be shown, with 86 percent of restorations retained overall. Measures of marginal integrity, marginal discoloration and sensitivity also had no statistically significant differences between the three adhesives (P > .05). CONCLUSIONS: All three adhesives performed with acceptable outcomes after a 36-month period, with small differences between the one- and two-bottle systems and between the various solvents. Retention rate was moderately high and air sensitivity was markedly reduced; however, superficial marginal discoloration and marginal degradation was notable. Certain lesion, tooth and patient characteristics may predispose restorations to retention failure. CLINICAL IMPLICATIONS: The type of solvent may not be a major factor in retention of Class V restorations in NCCLs. Both single-bottle adhesives and conventional two-bottle adhesives performed acceptably.

PMID: 15819344 [PubMed - indexed for MEDLINE]

Discontinuous fiber-reinforced composites above critical length.

J Dent Res. 2005 Apr;84(4):365-70

Authors: Petersen RC

Micromechanical physics of critical fiber length, describing a minimum filament distance for resin impregnation and stress transfer, has not yet been applied in dental science. As a test of the hypothesis that 9-micron-diameter, 3-mm-long quartz fibers would increase mechanical strength over particulate-filled composites, photocure-resin-pre-impregnated discontinuous reinforcement was incorporated at 35 wt% into 3M Corporation Z100, Kerr Corporation HerculiteXRV, and an experimental photocure paste with increased radiopaque particulate. Fully articulated four-point bend testing per ASTM C 1161-94 for advanced ceramics and Izod impact testing according to a modified unnotched ASTM D 256-00 specification were then performed. All photocure-fiber-reinforced composites demonstrated significant improvements over particulate-filled compounds (p < 0.001) for flexural strength, modulus, work of fracture, strain at maximum load, and Izod toughness, with one exception for the moduli of Z100 and the experimental reinforced paste. The results indicate that inclusion of pre-impregnated fibers above the critical aspect ratio yields major advancements regarding the mechanical properties tested.

PMID: 15790745 [PubMed - indexed for MEDLINE]

Isocyanato- and methacryloxysilanes promote Bis-GMA adhesion to titanium.

J Dent Res. 2005 Apr;84(4):360-4

Authors: Matinlinna JP, Lassila LV, Kangasniemi I, Vallittu PK

In dentistry, adhesion promotion with 3-methacryloyloxypropyltrimethoxysilane is usually sufficient, but its hydrolytic stability is a continuous concern. The hydrolytic stability of an alternative, 3-isocyanatopropyltriethoxysilane, was compared with that of conventional 3-methacryloyloxypropyltrimethoxysilane. Two silanes, both in 0.1 and 1.0 vol-% in ethanol-water, were evaluated in the attachment of an experimental bis-phenol-A-diglycidyldimethacrylate (Bis-GMA) resin to grit-blasted (with two different systems) titanium. Silane hydrolysis was monitored by FTIR spectrometry. Bis-GMA resin was applied and photo-polymerized on titanium. The specimens were thermocycled (6000 cycles, 5-55 degrees C). Surface analysis was carried out with scanning electron microscopy. Statistical analysis (ANOVA) showed that the highest shear bond was achieved with 0.1% 3-isocyanatopropyltriethoxysilane (12.5 MPa) with silica-coating, and the lowest with 1.0% 3-methacryloyloxypropyltrimethoxysilane (3.4 MPa) with alumina-coating. The silane, its concentration, and the grit-blasting method significantly affected the shear bond strength (p < 0.05). SEM images indicated cohesive failure of bonding, and, in conclusion, 3-isocyanatopropyltriethoxysilane is a potential coupling agent.

PMID: 15790744 [PubMed - indexed for MEDLINE]

Influence of photopolymerization light source on enamel shear bond strength after bleaching.

Braz Dent J. 2004;15(2):133-7

Authors: Loretto SC, Braz R, Lyra AM, Lopes LM

This study evaluated the influence of 3 different photopolymerization sources on enamel shear bond strength after bleaching with 10% carbamide peroxide. Seventy-two incisive bovine teeth were randomly divided into 6 groups (n=12) according to bleaching treatment and photopolymerization source used: G1 -- Bleached / Halogen lamp; G2 -- Not bleached / Halogen lamp (control); G3 -- Bleached / Light-emitting diodes (LED); G4 -- Not bleached / Light-emitting diodes (LED) (control); G5 -- Bleached / Xenon plasma arc; G6 -- Not bleached / Xenon plasma arc (control). Experimental groups were exposed to bleaching agent for a period of 14 days, with a daily contact of 4 h and then stored in artificial saliva at 37 degrees C. Control groups were stored in artificial saliva at 37 degrees C for same period of bleaching treatment. Procedures for bonding composite resin to enamel were carried out according to manufacturer instructions. After storage in distilled water at 37 degrees C for 24 hours, all samples were submitted to shear bond strength test. G2 had the highest mean value (14.86 MPa) while G5 had the lowest (12.32 MPa). The comparison of groups by 2-way ANOVA showed that there were no significant differences for either of the factors considered in this study (bleaching and photopolymerization source), hence the interaction between these factors. It was therefore possible to conclude that neither enamel bleaching nor the photopolymerization source used had any influence on enamel shear bond strength.

PMID: 15776196 [PubMed - indexed for MEDLINE]

In vivo fluid movement through dentin adhesives in endodontically treated teeth.

J Dent Res. 2005 Mar;84(3):223-7

Authors: Chersoni S, Acquaviva GL, Prati C, Ferrari M, Grandini S, Pashley DH, Tay FR

Fluid transudation through simplified dentin adhesives can occur in bonded vital crown dentin, since these adhesives behave as permeable membranes after polymerization. The effect of adhesive permeability in endodontically treated teeth is unknown. This study examined the hypothesis that in vivo fluid movement through simplified adhesives occurs when they are applied to root canals. Dowel spaces were prepared in endodontically treated teeth with single root canals. Six adhesives were applied to the intra-radicular dentin of canal walls. Impressions were obtained with polyvinyl siloxane, and replicas were fabricated with the use of polyether impression material. Replica hemisections were gold-coated for SEM examination. Fluid transudation was evident on the adhesive surfaces of all simplified total-etch and self-etch adhesives. Conversely, most of the specimens bonded with the control three-step total-etch adhesive were devoid of fluid droplets. Permeability of simplified adhesives results in water movement, even in root-treated dentin. This may adversely affect the coupling of auto-/dual-cured resin cements.

PMID: 15723860 [PubMed - indexed for MEDLINE]

Effects of one versus two-layer applications of a self-etching adhesive to dentin of primary teeth: a SEM study.

J Contemp Dent Pract. 2005 Feb 15;6(1):18-25

Authors: Ozta&#x15F; N, Olmez A

Resin composite is increasingly the material of choice for the restoration of primary teeth, and new materials with simplified procedures are increasingly being offered. Self-etching primers have been developed to simplify the bonding procedures. Some manufacturers recommend the application of these materials in two layers. However little is known about the application times. Therefore, this study evaluated the quality of the interfacial seal and the micromorphology of the hybrid layer in composite restorations bonded with one or two layer applications of a self-etching adhesive to the dentin of the primary teeth. The superfacial dentin (within 1-2 mm of dentinoenamel junction (DEJ)) on the occlusal surfaces of fourteen primary molars was exposed by a flat cut perpendicular to the long axis of the tooth. The occlusal surfaces were divided into two halves by a 1 mm deep groove in the labial-lingual orientation. The teeth were randomly divided into two groups: Group 1: Single Bond (control group) was applied according to the manufacturer's instructions on one half of the surface. On the other half of the same tooth, one layer of Prompt-L-Pop (experimental group) was applied according to the manufacturer's instructions. Group 2: the teeth received the same bonding regimes as group 1, but the experimental group had two layer application of Prompt-L-Pop. All samples were analyzed in SEM. Student's t-test was used to compare the width of the gap and hybrid layer thickness generated by experimental groups and control. There was a statistically significant difference between control (Single Bond) and the experimental groups (one or two layer application of Prompt-L-Pop) (p<0.05). Single Bond showed the best results. Two layer application of Prompt-L-Pop showed better sealing ability than one layer application of it (p<0.05). Only Single Bond presented a visible hybrid layer that had an average thickness of 3.7microm.

PMID: 15719073 [PubMed - indexed for MEDLINE]

Inhibition of root caries progression by an antibacterial adhesive.

J Dent Res. 2005 Jan;84(1):89-93

Authors: Kuramoto A, Imazato S, Walls AW, Ebisu S

A dentin primer containing the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) has been shown to penetrate and kill the bacteria in artificially demineralized dentin. We hypothesized that an experimental adhesive system, which incorporates the MDPB-containing primer, would be effective in inhibiting the progression of root caries in vitro. Artificial caries lesions were prepared by either an acid-gel or a Streptococcus mutans culture technique on the roots of extracted human teeth. The progression of these lesions after the application of the experimental or proprietary adhesive system was examined. Further demineralization was completely prevented by the experimental adhesive system, while lesions managed with the proprietary materials showed limited ability to inhibit further demineralization. We conclude that the experimental adhesive system can inhibit the progression of root-surface caries in vitro, through a combination of its antimicrobial activity and sealing of the demineralized dentin.

PMID: 15615883 [PubMed - indexed for MEDLINE]

Flowable composites as "filled adhesives:" a microleakage study.

J Contemp Dent Pract. 2004 Nov 15;5(4):32-41

Authors: Sensi LG, Marson FC, Monteiro S, Baratieri LN, Caldeira de Andrada MA

OBJECTIVE: The purpose of this in vitro study was to investigate the microleakage at dentin margins of a flowable resin composite associated with an adhesive, either light cured separately or co-cured, in Class V cavities. MATERIALS AND METHODS: Twenty four recently extracted human molars were prepared with standardized box-shaped Class V cavities of 3.0 mm (mesial-distal), 2.0 mm (occlusal-gingival), and 2.0 mm depth with margins located on enamel and dentin/cementum on the buccal or lingual surfaces. The cavities were randomly assigned into three groups (n=8): Group I - Single Bond + Filtek Z250 (control); Group II - Single Bond + Filtek Flow (light cured separately) + Filtek Z250; and Group III - Single Bond + Filtek Flow co-cured (light cured simultaneously) + Filtek Z250. After being immersed in tap water for 24 h, the specimens were thermocycled (1000x, 5 degrees -55 degrees C, 30 sec dwell time) and immersed in a 0.5% basic fuchsine solution for 24 h. The restorations were sectioned longitudinally and gingival margins were evaluated for microleakage using a 0-4 scale. Data were subjected to the Kruskal-Wallis test at p<0.05. RESULTS: A statistically significant difference at p = 0.0044 between Groups 1 and 3 and Groups 2 and 3 was observed. Although Group 2 performed slightly better than Group 1, no significant difference was observed. CONCLUSION: The use of a flowable resin composite cured simultaneously with an adhesive yielded the worst results in this study. As no statistical differences were seen between Groups 1 and 2, the use of a flowable composite as a means of minimizing microleakage at dentin margins may be questioned.

PMID: 15558088 [PubMed - indexed for MEDLINE]

Wear and mechanical properties of nano-silica-fused whisker composites.

J Dent Res. 2004 Dec;83(12):930-5

Authors: Xu HH, Quinn JB, Giuseppetti AA

Resin composites must be improved if they are to overcome the high failure rates in large stress-bearing posterior restorations. This study aimed to improve wear resistance via nano-silica-fused whiskers. It was hypothesized that nano-silica-fused whiskers would significantly improve composite mechanical properties and wear resistance. Nano-silicas were fused onto whiskers and incorporated into a resin at mass fractions of 0%-74%. Fracture toughness (mean +/- SD; n = 6) was 2.92 +/- 0.14 MPa.m(1/2) for whisker composite with 74% fillers, higher than 1.13 +/- 0.19 MPa.m(1/2) for a prosthetic control, and 0.95 +/- 0.11 MPa.m(1/2) for an inlay/onlay control (Tukey's at 0.95). A whisker composite with 74% fillers had a wear depth of 77.7 +/- 6.9 mum, less than 118.0 +/- 23.8 microm of an inlay/onlay control, and 172.5 +/- 15.4 microm of a prosthetic control (p < 0.05). Linear correlations were established between wear and hardness, modulus, strength, and toughness, with R = 0.95-0.97. Novel nano-silica-fused whisker composites possessed high toughness and wear resistance with smooth worn surfaces, and may be useful in large stress-bearing restorations.

PMID: 15557400 [PubMed - indexed for MEDLINE]

The effect of mechanical undercuts on the strength of composite repair.

J Am Dent Assoc. 2004 Oct;135(10):1406-12; quiz 1467-8

Authors: Shen C, Mondragon E, Gordan VV, Mj&#xF6;r IA

BACKGROUND: The authors conducted an in vitro study to test the hypothesis that undercuts prepared in old composite restorations could improve the strength between the restoration and a flowable composite as repair material. METHODS: The authors used three composites to fabricate cylinders as repair substrates. The etched-only group was ground, etched, dried and built up with a flowable composite. For the undercut group, the authors introduced arrays of fissures on the surfaces before preparing the specimens for subsequent buildup in the manner described for the etched-only group. They made nonrepaired cylinders for baseline measures of strength. They sliced all finished cylinders into slender bars with a diamond saw. Flexure strength values were determined by a three-point-bending test. RESULTS: Nonrepaired bars exhibited statistically significantly higher flexure strength values than did repaired bars, as determined by Wilcoxon rank sum test. Two-way general linear model showed that both material (P < .0001) and undercut (P = .0207) exhibited a statistically significant influence on the repaired flexure strength. Repair substrate with elastic modulus close to that of repair material exhibited a greater percentage of recovery of the respective cohesive strength. Compared with the etched-only group, the undercut group yielded a higher mean flexure strength with one composite but a lower mean flexure strength with the other two. Examination of the fractured surfaces showed that a significant number of undercuts were filled only partially. CONCLUSION: Flexure strengths of repaired specimens always were lower than the cohesive flexure strengths of the materials being repaired. Undercuts did not generally improve repair strength. CLINICAL IMPLICATIONS: Small undercuts on the surface of composite often are difficult to fill completely, resulting in areas of stress concentration that result in no improvement in the repair strength.

PMID: 15551981 [PubMed - indexed for MEDLINE]

Clinical/photographic evaluation of a single application of two sealants after eleven years.

Bull Tokyo Dent Coll. 2004 May;45(2):67-75

Authors: Sundfeld RH, Mauro SJ, Briso AL, Sundfeld ML

The clinical behavior of Concise and Prisma Shield sealants for pit and fissure was analyzed by clinical/photographic evaluation. A hematoxylin-based staining solution was applied to the occlusal surface 7 days, 18 months, 36 months, and 11 years after the occlusal sealing, thus allowing the sealant material on the surface to be checked. At each analysis time, each occlusal surface was photographed, and the photographs corresponding to each time were submitted to clinical/photographic evaluation. Although the sealant materials showed marginal alterations over time, they did not require reapplication because the region composed of the pit and fissure remained covered.

PMID: 15536857 [PubMed - indexed for MEDLINE]