Comparative chemical study of MTA and Portland cements.

Braz Dent J. 2007;18(1):3-7

Authors: Oliveira MG, Xavier CB, Demarco FF, Pinheiro AL, Costa AT, Pozza DH

Portland cement has been analyzed and compared to mineral trioxide aggregate (MTA) because of their chemical similarity. The possibility of using this material as a less expensive alternative to MTA in dental practice should be considered. In view of this, the present study compared the components of a Portland cement (Votoran) to two commercial brands of MTA (Pro-Root and MTA-Angelus). Twelve specimens of each material were fabricated and examined by scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) to obtain their percentage of chemical elements. The means of the chemical elements found in each material was compared by descriptive statistics. Bismuth was present only in MTA cements to provide radiopacity. In conclusion, the tested cements have similar components, which supports, as far as composition is concerned, the possible clinical use of Portland as an option to MTA.

PMID: 17639192 [PubMed - indexed for MEDLINE]

Chlorhexidine's effect on sealing ability of composite restorations following Er:YAG laser cavity preparation.

J Contemp Dent Pract. 2007;8(5):26-33

Authors: Geraldo-Martins VR, Robles FR, Matos AB

AIM: The aim of this study was to evaluate the influence of chlorhexidine on microleakage of composite restorations in class V cavities prepared with a carbide bur (CB) and a erbium:yttrium-aluminum-garnet (Er:YAG) laser. METHODS AND MATERIALS: Cavity preparations were created on the buccal surfaces of 48 bovine incisors using different methods then equally dividing them into four groups. Groups I and II were prepared with a #56 CB in a high speed handpiece while Groups III and IV were prepared with a Er:YAG laser at 350m J/4Hz on enamel and at 80.24 J/cm2 on dentin. The cavity preparations were rinsed with 2% chlorhexidine solution before the application of Clearfill SE Bond system and placement of a Z100 composite resin restoration. After 24 hours, the teeth were polished, thermocycled, and sealed with cosmetic varnish. The samples were then immersed in 2% methylene blue for four hours and sectioned in the buccolingual direction to determine the degree of microleakage. RESULTS: After statistical analysis (Kruskal-Wallis, p<0.05), no significant differences were verified among the tested groups and between the evaluated cervical or incisal margins of the restoration. CONCLUSION: The use of the chlorhexidine did not interfere with the adhesion process regardless of whether a CB or the Er:YAG laser were used to prepare class V cavities when restored with the tested self-etching adhesive system.

PMID: 17618327 [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]

Silane based concepts on bonding resin composite to metals.

J Contemp Dent Pract. 2007;8(2):1-8

Authors: Matinlinna JP, Vallittu PK

INTRODUCTION: The longevity of silane promoted adhesion of surface conditioned metallic materials is of concern in dentistry and poses both a functional and esthetic dilemma for the patient and dental professionals. Several methods for surface conditioning exist, but some are employed more frequently in clinical practice. AIM OF THE REVIEW: This overview aims to characterize and discuss the most commonly used surface conditioning methods based on silanization. The primary chemical features in silane treatment will also be presented. METHOD OF REVIEW: The literature regarding silane utilization was systematically selected and 68 cited references published during 1967-2005 were reviewed. Technical descriptions of different silica-coating (silicatization) methods are presented and some comparative clinical and in vitro experiences are reported. Some other surface condition methods applied in dental laboratories were also selected for presentation. CONCLUSION: It is concluded in this overview tribochemical silica-coating followed by a mandatory silane coupling agent application is a clinically proved, relevant adhesion promotion method to enhance the bonding of resin composites to metallic dental materials.

PMID: 17277821 [PubMed - indexed for MEDLINE]

Sealer penetration and marginal permeability after apicoectomy varying retrocavity preparation and retrofilling material.

Braz Dent J. 2006;17(4):323-7

Authors: Winik R, Araki AT, Negr&#xE3;o JA, Bello-Silva MS, Lage-Marques JL

Apicoectomy failure is generally related to inappropriate marginal sealing of the retrocavity, which allows percolation of microorganisms and their products from root canal system to periapex. This study evaluated tubular penetration of canal sealers and marginal permeability after retrocavity irradiation with Er;Cr:YSGG laser and retrofilling with MTA or cyanoacrylate. Twenty-two single-rooted teeth were decoronated and endodontically treated, their apical 3 mm were resected and the root ends were retroprepared with a low-speed bur. Twenty roots were randomly assigned to 4 groups (n=5): GI and GII--retrofilling with MTA and cyanoacrylate, respectively; GIII and GIV--retrocavity irradiation with Er;Cr:YSGG laser (2.78 microm, 4 W, 20 Hz, 70.8 J/cm(2)) and retrofilling with MTA and cyanoacrylate, respectively. The remaining 2 roots served as positive and negative controls. The analysis of rhodamine B dye infiltration (p=0.05) demonstrated that laser irradiation and MTA retrofilling presented significantly higher permeability rates (p<0.05). Retrofilling with cyanoacrylate showed significantly lower permeability, either when laser was used or not on retrocavity. SEM analysis depicted more cyanoacrylate penetration through dentinal tubules when compared to MTA, suggesting a more efficient marginal sealing. Based on these results, it may be concluded that cyanoacrylate provided a less permeable retrofilling regardless of the retropreparation method, suggesting a more favorable condition to the establishment of the periapical healing.

PMID: 17262147 [PubMed - indexed for MEDLINE]

Er:Yag laser irradiation of the microbiological apical biofilm.

Braz Dent J. 2006;17(4):296-9

Authors: Araki AT, Ibraki Y, Kawakami T, Lage-Marques JL

One problem in cases of healing-resistant periapical lesions is to eradicate the contamination at the periapical area. This contamination is due to the microbiological biofilm formed by microorganisms and their subproducts lodged in apical third of the root, on both cementum and dentin surface. Paraendodontic surgery consists of the mechanical removal of harmful agents to promote healing and periapical health. The purpose of this study was to assess the results of Er:YAG laser irradiation on the apical root third of newly extracted teeth to eliminate microbial contamination on root apex surface. Apical irradiation was performed with an Er:YAG laser device using an experimental contact tip, at 100 mJ, 10 Hz, 1 W, 39 J/cm(2), 3 times on the target area. SEM analysis showed the elimination of part of the irradiated cementum and the formation of small roughened without exposing the subjacent dentin. Vaporization of the remaining periodontal tissue and removal of microbiological apical biofilm (MAB) were also observed on the irradiated areas. Under the tested conditions and based on the findings of this study, Er:YAG laser may be considered effective for removal of microbiological apical biofilm.

PMID: 17262142 [PubMed - indexed for MEDLINE]

Polishing methods of an alumina-reinforced feldspar ceramic.

Braz Dent J. 2006;17(4):285-9

Authors: Bottino MC, Valandro LF, Kantorski KZ, Bressiani JC, Bottino MA

The purpose of this study was to test the hypothesis that mechanical polishing methods of ceramic surfaces allow similar superficial roughness to that of glazed surfaces. Twenty-five Vitadur Alpha ceramic discs (5 mm x 2 mm) were prepared according to the manufacturer's specifications. All specimens were glazed and randomly assigned to 5 groups (n=5), according to finishing and polishing protocols: G1: glazed (control); G2: diamond bur finishing; G3: G2 + silicon rubber tip polishing; G4: G3 + felt disc/diamond polishing paste; G5: G3 + felt disc impregnated with fine-particle diamond paste. Next, surface roughness means (Ra - microm) were calculated. Qualitative analysis was made by scanning electron microscopy. Surface roughness data were submitted to ANOVA and Tukey's test at 5% significance level. G1 and G4 were statistically similar (p>0.05). G2 presented the highest roughness means (p<0.05) followed by groups G3, G5, G4 and G1 in a decreasing order. The hypothesis was partially confirmed as only the mechanical polishing (G4) produced similar superficial roughness to that of surface glazing, although finishing and polishing are technically critical procedures.

PMID: 17262140 [PubMed - indexed for MEDLINE]

Surface roughness of a dental ceramic after polishing with different vehicles and diamond pastes.

Braz Dent J. 2006;17(3):191-4

Authors: Camacho GB, Vinha D, Panzeri H, Nonaka T, Gon&#xE7;alves M

During fabrication of bonded ceramic restorations, cervical adaptation, occlusal adjustment and final finishing/polishing are procedures to be performed at the dental office after adhesive cementation. Final adjustments may result in loss of ceramic glaze, which requires new polishing of the ceramic surface, with special attention for selection of adequate materials and instruments. The purpose of this study was to evaluate the efficiency of different vehicles associated with diamond pastes indicated for dental ceramic polishing. Two polishing pastes (Crystar Paste and Diamond Excell) associated with four vehicles (rubber cup, Robinson bristle brush, felt wheel and buff disc) were evaluated. Disc-shaped specimens were fabricated from Ceramco II dental ceramic. Surface roughness means (Ra) of the ceramic specimens were determined with a rugosimeter. Data were analyzed statistically by two-way ANOVA and Tukey's test at 5% significance level. There was no statistically significant difference (p>0.01) between the polishing pastes. However, there were statistically significant differences (p<0.01) among the tested vehicles. Vehicle-paste interaction showed statistically significant difference (p<0.05) as well. It may be concluded that: 1) Robinson bristle brush, felt wheel and buff disc were efficient vehicles to be used in association with a diamond polishing paste; 2) The use of rubber cup as a vehicle showed poor efficiency for mechanical polishing of the ceramic surfaces; 3) Both pastes provided similar and efficient polishing and may be recommended for use with an appropriated vehicle.

PMID: 17262123 [PubMed - indexed for MEDLINE]

Antagonist enamel wears more than ceramic inlays.

J Dent Res. 2006 Dec;85(12):1097-100

Authors: Krämer N, Kunzelmann KH, Taschner M, Mehl A, Garcia-Godoy F, Frankenberger R

Wear phenomena of ceramic inlays are not fully understood. The aim of the present study was to evaluate ceramic wear, antagonist enamel wear, and luting cement wear over 8 years. The two-fold null hypothesis was that there would be (1) no difference in wear behavior between ceramic and enamel, and (2) no influence of filler content of luting composites on composite wear. From 96 restorations, 36 Class II inlays from 16 participants were selected. For inlays with opposing enamel cusps (n=17), replicas of inlays and enamel were scanned with a 3-D laser scanner. Luting gaps of inlays (n=36) were analyzed with a profilometer, including 3-D data analysis. Ceramic and enamel wear increased between 4 and 8 years, with significantly higher values for enamel after 6 years (p<0.05). Luting gap wear increased continuously up to 8 years (p<0.05), with no influence of luting composites (p>0.05) and location of teeth (p>0.05).

PMID: 17122161 [PubMed - indexed for MEDLINE]

Biological response of pulps submitted to different capping materials.

Braz Oral Res. 2006 Jul-Sep;20(3):219-25

Authors: Briso AL, Rahal V, Mestrener SR, Dezan Junior E

Pulp capping is a procedure that comprises adequate protection of the pulp tissue exposed to the oral environment, aiming at the preservation of its vitality and functions. This study evaluated the response of the dental pulps of dog teeth to capping with mineral trioxide aggregate (MTA) or calcium hydroxide P.A. For that purpose, 37 teeth were divided into two groups, according to the capping material employed. Two dogs were anesthetized and, after placement of a rubber dam, their pulps were exposed in a standardized manner and protected with the experimental capping materials. The cavities were then sealed with resin-modified glass ionomer cement and restored with composite resin. After sixty days, the animals were killed and the specimens were processed in order to be analyzed with optic microscopy. It was observed that MTA presented a higher success rate compared to calcium hydroxide, presenting a lower occurrence of infection and pulp necrosis.

PMID: 17119704 [PubMed - indexed for MEDLINE]

Apparent interfacial fracture toughness of resin/ceramic systems.

J Dent Res. 2006 Nov;85(11):1037-41

Authors: Della Bona A, Anusavice KJ, Mecholsky JJ

We suggest that the apparent interfacial fracture toughness (K(A)) may be estimated by fracture mechanics and fractography. This study tested the hypothesis that the K(A) of the adhesion zone of resin/ceramic systems is affected by the ceramic microstructure. Lithia disilicate-based (Empress2-E2) and leucite-based (Empress-E1) ceramics were surface-treated with hydrofluoric acid (HF) and/or silane (S), followed by an adhesive resin. Microtensile test specimens (n = 30; area of 1 +/- 0.01 mm(2)) were indented (9.8 N) at the interface and loaded to failure in tension. We used tensile strength (sigma) and the critical crack size (c) to calculate K(A) (K(A) = Ysigmac(1/2)) (Y = 1.65). ANOVA and Weibull analyses were used for statistical analyses. Mean K(A) (MPa.m(1/2)) values were: (E1HF) 0.26 +/- 0.06; (E1S) 0.23 +/- 0.06; (E1HFS) 0.30 +/- 0.06; (E2HF) 0.31 +/- 0.06; (E2S) 0.13 +/- 0.05; and (E2HFS) 0.41 +/- 0.07. All fractures originated from indentation sites. Estimation of interfacial toughness was feasible by fracture mechanics and fractography. The K(A) for the systems tested was affected by the ceramic microstructure and surface treatment.

PMID: 17062746 [PubMed - indexed for MEDLINE]

Influence of surface roughness on crack formation in a glass-ceramic bonded to a resin composite base.

J Oral Sci. 2006 Sep;48(3):125-30

Authors: Yamamoto T, Nishiura R, Momoi Y

The objective of the present study was to assess the influence of the roughness of a loaded surface on crack formation in a mica-based glass-ceramic bonded to a resin composite base. Five different surface roughnesses were created on glass-ceramic discs by serial wet-grinding with silicone carbide abrasives. The thicknesses of the ceramic discs were 1.50 +/- 0.01 mm. Resin composite discs were bonded to the ceramic surfaces opposite to the ground surfaces using an adhesive resin composite cement and a silane coupling agent. A compressive load was then applied at the center of the ground ceramic surface. The loads at initial radial and cone crack formations in the ceramic were measured macroscopically. In three of the five groups, the initial radial crack formations could not be observed due to the high roughness of these surfaces. Statistical analysis was performed using Student's t test for initial radial cracks and one-way ANOVA for the cone cracks. There were no significant differences between the two groups for the initial radial cracks or among the five groups for the cone cracks (P < 0.05). The roughness of the loaded surface had no influence on crack formation in the bonded mica-based glass-ceramic.

PMID: 17023744 [PubMed - indexed for MEDLINE]

Residual stress in composites with the thin-ring-slitting approach.

J Dent Res. 2006 Oct;85(10):945-9

Authors: Park JW, Ferracane JL

During polymerization, dental composites develop residual stresses that may compromise the marginal integrity and properties of the restorative. The objective of this study was to use the thin-walled ring-slitting method to measure and compare residual stresses. The hypotheses to be tested were that composites would generate different levels of residual stress based on their specific formulations and slitting times. Rings made from composites (Z100, Herculite, and Heliomolar) were cut at different times (10 min, 1 and 24 hrs) after being light-cured, and stress was measured. Residual stress was higher at the earlier cutting times, except for Heliomolar (alpha < 0.05). For the 10-minute and one-hour cutting groups, stress followed this order: Z100 > Herculite > Heliomolar. Early slitting was better to capture residual stress, and the thin-walled rings showed higher values than thick-walled rings and were better able to discriminate residual stress in composites.

PMID: 16998138 [PubMed - indexed for MEDLINE]

Dentin penetrability evaluation of three different dyes in root-end cavities filled with mineral trioxide aggregate (MTA).

Braz Oral Res. 2006 Apr-Jun;20(2):132-6

Authors: Vogt BF, Xavier CB, Demarco FF, Padilha MS

The purpose of this study was to evaluate the penetration of three dyes in MTA root-end fillings. In 30 single-rooted teeth, cavities for retrofilling were prepared with an ultrasound appliance and filled with MTA. The specimens were randomly assigned to three groups (n = 10) and immersed in the following solutions: 2% methylene blue (MET), 50% silver nitrate (NIT) and 0.2% rhodamine B (ROD). Two transversal slices (1 mm) of the retrofilling region were obtained and evaluated using the Image Tool 3.0 software to obtain a quantitative evaluation (in mm2) of the dye penetration around the retrofillings. Data were submitted to statistical analysis using Students t-test. The lowest degree of dye penetration was observed for the NIT group, in both slices (p < 0.05). Dye penetration was significantly larger in the ROD group when compared to the NIT group, in both slices (p < 0.05), and to the MET group, only in slice 1 (p < 0.05). Within the limitations of this study, it was concluded that the choice of dye could influence the penetration evaluation in root-end filling studies, and that the NIT had the lowest penetration capacity in the apical dentine.

PMID: 16878206 [PubMed - indexed for MEDLINE]

Penetration of fluids into periodontal pockets using a powered toothbrush/irrigator device.

J Contemp Dent Pract. 2006 Jul 1;7(3):30-9

Authors: Brackett MG, Drisko CL, Thompson AL, Waller JL, Marshall DL, Schuster GS

This study was a single-blind, randomized, controlled clinical trial. The researchers evaluated a powered brush/irrigating device (HydraBrush Oral Health System; OHS) for its safety and ability to deliver a solution to the bottom of 5-6 mm pockets, compared to rinsing alone with a solution following brushing with a powered toothbrush (Sonicare Elite 7800; SE). An evaluation technique to measure the quantity and quality of solution able to enter the pocket was also introduced in this project. METHODS: Subjects were randomized in one of two-groups: brush plus simultaneous irrigation (OHS) versus brush plus rinsing (SE). Subjects used their devices at home for two weeks. At the measurement visit, subjects used the OHS to irrigate and brush simultaneously for 1 minute (30 seconds per each side of the mouth) with a 0.01% erythrosine disclosing solution in 10 oz of distilled water. Control subjects brushed for 2 minutes with a SE followed by a 1 minute rinse with an identical disclosing solution. A blinded evaluator collected six samples of approximately of 1 microL of sucular fluid from six 5-6 mm evaluation sites. This was accomplished by inserting a microcapillary tip with a 20 microL micropipette in the sulcus. Two-group repeated measures ANOVA was used to examine differences in two measures of the disclosing solution between OHS and SE subjects; the spectrometer reading of the disclosing solutions, and by visual inspection of the samples (positive/negative) to determine the presence or absence of solution in the samples. Subjects' diaries were collected. Bleeding and discomfort during the evaluation period was reported. RESULTS: Visually, OHS had a significantly greater proportion of solution taken from the base of 5-6 mm sites than the SE (p=0.0001). However, there was no statistical difference between the two groups (p=.1359) in the spectrophotometer readings. CONCLUSION: The experimental device is more efficient in delivering a solution to the base of 5-6 mm pockets than rinsing following use of a control powered toothbrush. Both devices have demonstrated they are safe and well accepted by patients. The technique developed provides a useful method for quantitative and qualitative studies of solutions from the base of periodontal pockets.

PMID: 16820805 [PubMed - indexed for MEDLINE]

A 24-hour dental plaque prevention study with a stannous fluoride dentifrice containing hexametaphosphate.

J Contemp Dent Pract. 2006 Jul 1;7(3):1-11

Authors: White DJ, Kozak KM, Gibb R, Dunavent J, Klukowska M, Sagel PA

Recently, a novel antibacterial fluoride dentifrice containing stannous fluoride and sodium hexametaphosphate (CrestPRO-HEALTH) was introduced. A digital plaque image analysis (DPIA) technique was used to quantify in situ plaque formation in a population carrying out a phased intervention protocol that included: (1) an initial treatment regimen including toothbrushing with standard sodium fluoride dentifrice in conventional bid brushing, (2) a second treatment regimen where a modified hygiene regimen was applied using standard sodium fluoride dentifrice including a period of 24 hours of non-brushing, and (3) a third treatment regimen where the 24-hour non-brushing regimen was continued using the antimicrobial stannous fluoride/sodium hexametaphosphate dentifrice. The quantitative evaluation of plaque formation was assessed in morning measurements following either standard evening hygiene (treatment period 1) or 24 hours since brushing (treatment periods 2 and 3). Post-brushing plaque measurements were also taken in each treatment regimen. Sixteen subjects completed all three treatment regimens with no side effects or oral complaints. Morning plaque coverage in treatment period 1 was 13.3%. Plaque coverage significantly increased in treatment period 2 when pre-bedtime brushing was discontinued, with 24-hour growth covering 18.4% of the dentition. Intervention of the antimicrobial stannous fluoride/hexametaphosphate dentifrice in treatment period 3 provided significant inhibition of plaque regrowth over 24 hours (15.2% coverage, a 17% reduction vs. sodium fluoride dentifrice control). These results support the strong retention and lasting antimicrobial efficacy of high stabilized stannous fluoride/sodium hexametaphosphate dentifrices.

PMID: 16820802 [PubMed - indexed for MEDLINE]

An in vitro assessment of prefabricated fiber post systems.

J Am Dent Assoc. 2006 Jul;137(7):1006-12

Authors: Teixeira EC, Teixeira FB, Piasick JR, Thompson JY

BACKGROUND: The authors conducted a study to characterize the in vitro retention, fracture and light transmission behavior of four different fiber-reinforced resin-based composite root canal posts. METHODS: The authors divided 44 teeth into four groups according to the type of post they would receive: parallel fiberglass posts, double-tapered fiber quartz posts, tapered fiberglass posts and two different types of parallel fiberglass posts. They prepared teeth and cemented posts with dual-cured resin cement. After the specimens aged, the authors conducted pull-out tests. For fracture testing, they loaded posts at 45 degrees in a universal testing machine. They determined load-to-fracture values and relative stiffness. They measured percentage of light transmission by means of a light microscope coupled with a spectrometer. RESULTS: Both tapered posts showed lower retention than did the parallel posts. Scanning electron microscropic analysis indicated that more cement adhered to the surfaces of the parallel fiberglass post than to those of the tapered fiberglass post. All posts demonstrated some plastic behavior, with the double-tapered fiber quartz post being stiffer than the others. CONCLUSION: Parallel fiber-reinforced composite posts showed better retention than did tapered posts when a dual-cured resin-based cement was used. Translucent prefabricated posts have limited light transmission. CLINICAL IMPLICATIONS: Parallel prefabricated fiber posts luted with dual-cured resin-based cement seem to be suitable for clinical application in endodontically treated teeth that require post-and-core restoration, showing good retention and acceptable fracture resistance.

PMID: 16803828 [PubMed - indexed for MEDLINE]

Treatment of pulp floor and stripping perforation by mineral trioxide aggregate.

J Formos Med Assoc. 2006 Jun;105(6):522-6

Authors: Tsai YL, Lan WH, Jeng JH

Mineral trioxide aggregate (MTA) has been widely used to repair various kinds of tooth perforations, but its use for obturation of the entire root canal has not been reported. We report two cases of tooth perforation successfully repaired with MTA. The first patient was a 78-year-old male with calcified canal and pulp floor perforation in the left maxillary first premolar. After bypass of the calcified palatal canal, both buccal and palatal canals were filled with gutta percha, and the pulp floor perforation was repaired with MTA. Clinical success with no evident radicular lesion was found at the 18-month follow-up. The second patient was a 51-year-old female with a stripping perforation in a C-shaped root canal of the right mandibular second molar detected after removal of a post. Following root canal debridement and calcium hydroxide therapy to control inflammation at the stripping perforation site, apical and furcation bone healing were observed by radiographic examination. The stripping perforation was repaired by obturation of the entire C-shaped root canal with MTA. Observation at the 9-month follow-up revealed bone healing without any clinical symptoms and signs. These cases suggest that MTA is an alternative root canal obturation material for treatment of stripping perforation in a C-shaped root canal and for repair of pulp floor perforation.

PMID: 16801043 [PubMed - indexed for MEDLINE]

Mineral trioxide aggregate pulpotomies: a case series outcomes assessment.

J Am Dent Assoc. 2006 May;137(5):610-8

Authors: Witherspoon DE, Small JC, Harris GZ

BACKGROUND: The greatest threats to developing teeth are dental caries and traumatic injury. A primary goal of all restorative treatment is to maintain pulp vitality so that normal root development or apexogenesis can occur. If pulpal exposure occurs, then a pulpotomy procedure aims to preserve pulp vitality to allow for normal root development. Historically, calcium hydroxide has been the material of choice for pulpotomy procedures. Recently, an alternative material called mineral trioxide aggregate (MTA) has demonstrated the ability to induce hard-tissue formation in pulpal tissue. The authors describe the clinical and radiographic outcome of a series of cases involving the use of MTA in pulpotomy procedures. METHODS: Twenty-three cases in 18 patients were treated with MTA pulpotomy procedures in an endodontic private practice. All of the patients had been referred to the practice for diagnosis and treatment of a symptomatic tooth. All of the authors provided treatment. Pulpal exposures were either due to caries or complicated enamel dentin fractures. RESULTS: Nineteen teeth in 14 patients were available for recall. The mean time of recall was 19.7 months. Of the 19 cases, 15 involved healed teeth, and three involved teeth that were healing. One of 19 cases involved a tooth with persistent disease. CONCLUSIONS: MTA may be useful as a substitute for calcium hydroxide in pulpotomy procedures. Further research, however, is required to clarify this conclusion. CLINICAL IMPLICATIONS: MTA conceivably could replace calcium hydroxide as the material of choice for pulpotomy procedures, if future research continues to show promising results.

PMID: 16739540 [PubMed - indexed for MEDLINE]

The 'new' operative dentistry.

J Am Dent Assoc. 2006 Apr;137(4):531-3

Authors: Christensen GJ

During the past few decades, life expectancy has increased significantly. As a result, mature patients often have receding gingival tissues, physical and mental debilitation, less energy and motivation, and the resultant Class V carious lesions. In this article, I suggest the use of high-level fluoride in toothpastes, remineralizing pastes and high-level fluoride gels for topical application in trays to reduce the progression of caries. To accompany fluoride therapy, high-fluoride-releasing restorative materials are indicated for Class V carious lesions. Adequate caries-preventive and restorative concepts for mature patients require planning, patient education and close patient supervision.

PMID: 16637483 [PubMed - indexed for MEDLINE]

Microleakage of restorative materials: an in vitro study.

J Indian Soc Pedod Prev Dent. 2006 Mar;24(1):15-8

Authors: Mali P, Deshpande S, Singh A

The present study was conducted with the aim of evaluating and comparing the microleakage of glass ionomer, composite resin and compomers. Class V cavities were made in thirty intact caries free premolars and restored with restorative materials to be tested respectively. The teeth were thermocycled and subjected to silver nitrate dye penetration. They were subsequently sectioned buccolingually. Microleakage was evaluated under a stereomicroscope and data subjected to statistical analysis. The study concluded that microleakage was evident in all restorative materials, with glass ionomer showing maximum leakage followed by composite resin. Compomer demonstrated the best results with minimum leakage.

PMID: 16582525 [PubMed - indexed for MEDLINE]

Anatomical redesign for the treatment of dens invaginatus type III with open apexes: a literature review and case presentation.

J Am Dent Assoc. 2006 Feb;137(2):180-5

Authors: Silberman A, Cohenca N, Simon JH

BACKGROUND: Dens invaginatus is a rare dental anomaly that may give rise to many complex anatomical forms. The complexity of the internal anatomy may create challenges for the complete removal of the diseased pulpal tissue and the subsequent sealing of the canal system. CASE DESCRIPTION: The authors discuss the modification of the internal anatomy under the operating microscope, allowing the clinician better access to treat predictably the canal system with conventional or alternative techniques. CONCLUSION AND CLINICAL IMPLICATIONS: Considering the anatomical variations and the challenges that a dens invaginatus may present, a practitioner may consider a modification of the internal anatomy of the canal system to gain better access for proper instrumentation, disinfection and sealing of the root canal system using conventional or contemporary techniques.

PMID: 16521383 [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]

Effects of cleaning agents on bond strength to dentin.

Braz Oral Res. 2005 Apr-Jun;19(2):127-33

Authors: Rosin C, Arana-Chavez VE, Netto NG, Luz MA

The cleaning of cavity walls aims to improve adhesive restorative procedures and longevity of restorations. This study has compared the effect of three cleaning agents--sodium bicarbonate jet (Profi II, Dabi Atlante, S&#xE3;o Paulo, Brazil); pumice paste plus a biologic detergent (Tergestesim, Probem, São Paulo, Brazil); air water spray--on the bond strength between dentin and two different adhesive systems: Clearfil SE Bond (Kuraray, Kioto, Japan) and Scotchbond Multi-Purpose Plus (3M-ESPE, São Paulo, Brazil). Six groups (n: 10) of dental fragments obtained from young adult extracted teeth were prepared, and each one received one of the listed surface cleaning techniques. After the adhesive application, a cone-shaped test body was built with AP-X (Kuraray, Kioto, Japan) or Z100 (3M-ESPE, S&#xE3;o Paulo, Brazil) composite resins, using a Teflon matrix. The specimens were tested for tensile bond strength after one-week storage in distilled water at 37 degrees C. Two pairs of fractured specimens of each group were randomly chosen and processed for scanning electron microscopy (SEM) analysis. ANOVA test of the bond strength values showed no statistical differences among the cleaning agents and neither between their interactions with the bonding systems. Upon SEM analysis, most surfaces showed mixed fractures of adhesive and cohesive failures in bonding resin to dentin. Based on statistical and SEM analysis, it was concluded that the cleaning agents studied did not interfere with the bond strength of the adhesive systems used to dentin.

PMID: 16292446 [PubMed - indexed for MEDLINE]

Effect of different dye solutions on the evaluation of the sealing ability of Mineral Trioxide Aggregate.

Braz Oral Res. 2005 Apr-Jun;19(2):119-22

Authors: Tanomaru Filho M, Figueiredo FA, Tanomaru JM

Alkaline materials have shown incompatibility with methylene blue dye in leakage experiments. The goal of the present study was to analyze the effect of different dyes on the evaluation of the apical sealing ability of Mineral Trioxide Aggregate root-end fillings. Fifty-six extracted human canines were submitted to root canal instrumentation and obturation. After apical resection, retrograde cavities were prepared and teeth were randomly divided into four experimental (n = 13) and two control groups (n = 2). The following root-end filling materials were used: groups 1 and 2--Pro Root MTA (Dentsply), groups 3 and 4--zinc oxide-eugenol cement (ZOE). Teeth in groups 1 and 3 were immersed in 2% methylene blue solution, while teeth in groups 2 and 4 were immersed in 0.2% rhodamine B in a reduced pressure environment for 48 hours. Teeth were then longitudinally sectioned and leakage was evaluated. Results were submitted to statistical analysis (ANOVA and Tukey's test). Group 1 presented the least leakage (p < 0.05). It was concluded that the evaluation of the sealing ability of MTA is influenced by the dye used, since this material presented better sealing ability when evaluated with Methylene Blue, but was similar to ZOE when evaluated with rhodamine B.

PMID: 16292444 [PubMed - indexed for MEDLINE]

Toughness in synthetic and biological multilayered systems.

Philos Transact A Math Phys Eng Sci. 2002 Feb 15;360(1791):199-209

Authors: Calvert P, Cesarano J, Chandra H, Denham H, Kasichainula S, Vaidyanathan R

Toughness in hard biological tissues is associated with fibrous or lamellar structures that deflect or stop growing cracks. In some cases, such as nacreous shell, protein interlayers absorb much of the crack energy. In other tissues, such as tooth enamel, the toughness derives from the mineral microstructure, and the small amount of residual protein apparently has little effect. There have been a number of efforts to make tough synthetic materials using layered structures. In this work, freeform fabrication has been used to make layered structures with a view to introducing similar toughness into brittle materials. Results are presented for epoxy-glass composites with glass fabric interlayers, porous alumina back-filled with aluminium metal, and layered glass-ceramic/silver materials.

PMID: 16210177 [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]

Global Voices of Science. Of stones and health: medical geology in Sri Lanka.

Science. 2005 Aug 5;309(5736):883-5

Authors: Dissanayake C

PMID: 16081722 [PubMed - indexed for MEDLINE]

The influence of accelerating the setting rate by ultrasound or heat on the bond strength of glass ionomers used as orthodontic bracket cements.

Eur J Orthod. 2005 Oct;27(5):472-6

Authors: Algera TJ, Kleverlaan CJ, de Gee AJ, Prahl-Andersen B, Feilzer AJ

Conventional glass ionomer cements (GICs) may be a viable option for bracket bonding when the major disadvantages of these materials, such as the slow setting reaction and the weak initial bond strength, are solved. The aim of this in vitro study was to investigate the influence of ultrasound and heat application on the setting reaction of GICs, and to determine the tensile force to debond the brackets from the enamel. A conventional fast-setting GIC, Fuji IX Fast, and two resin-modified glass ionomer cements (RMGICs), Fuji Ortho LC and Fuji Plus, were investigated. Three modes of curing were performed (n = 10): (1) according to the manufacturer's prescription, (2) with 60 seconds application of heat, or (3) with 60 seconds application of ultrasound. The tensile force required to debond the brackets was determined as the tension 15 minutes after the start of the bonding procedure. The mode of failure was scored according to the Adhesive Remnant Index (ARI) to establish the relative amount of cement remnants on the enamel surface. Curing with heat and ultrasound shortened the setting reaction and significantly (P < 0.05) increased the bond strength to enamel. The ARI scores showed an increase for all materials after heat and ultrasound compared with the standard curing method, most notably after heat application.

PMID: 16049039 [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]

An in vitro comparison of the shear bond strength of a resin-reinforced glass ionomer cement and a composite adhesive for bonding orthodontic brackets.

Eur J Orthod. 2005 Oct;27(5):477-83

Authors: Movahhed HZ, Ogaard B, Syverud M

The shear bond strength (SBS) of a light-cured, resin-reinforced glass ionomer and a composite adhesive in combination with a self-etching primer was compared after different setting times to evaluate when orthodontic wires could be placed. Additionally, the fracture site after debonding was assessed using the Adhesive Remnant Index (ARI). Eighty freshly extracted human premolars were used. Twenty teeth were randomly assigned to each of four groups: (1) brackets bonded with Transbond XT with a Transbond Plus etching primer and debonded within 5 minutes; (2) brackets bonded with Fuji Ortho LC and debonded within 5 minutes; (3) brackets bonded as for group 1 and debonded within 15 minutes; (4) brackets bonded as for group 2 and debonded within 15 minutes. The SBS of each sample was determined with an Instron machine. The mean SBS were, respectively: (1) 8.8 +/- 2 MPa; (2) 6.6 +/- 2.5 MPa; (3) 11 +/- 1.6 MPa and (4) 9.6 +/- 1.6 MPa. Interpolating the cumulative fracture probability by means of a Weibull analysis, the 10 per cent probabilities of fracture for the groups were found to be attained for shear stresses of 6.1, 3.1, 8.3 and 7.1 MPa, respectively. Chi-square testing of the ARI scores revealed that the nature of the remnant did not vary significantly with time, but the type of bonding material could generally be distinguished in leaving more or less than 10 per cent of bonding material on the tooth. After debonding, the Transbond system was likely to leave adhesive on at least 10 per cent of the bonded area of the tooth. The present findings indicate that brackets bonded with either Transbond XT in combination with Transbond Plus etching primer and Fuji Ortho LC had adequate bond strength at 5 minutes and were even stronger 15 minutes after initial bonding.

PMID: 16043469 [PubMed - indexed for MEDLINE]

Intensity of quartz-tungsten-halogen light-curing units used in private practice in Toronto.

J Am Dent Assoc. 2005 Jun;136(6):766-73; quiz 806-7

Authors: El-Mowafy O, El-Badrawy W, Lewis DW, Shokati B, Kermalli J, Soliman O, Encioiu A, Encioiu A, Zawi R, Rajwani F

BACKGROUND: The authors conducted a study to determine light intensity and heat/glare measurements of quartztungsten-halogen (QTH) light polymerization units used in dental offices. METHODS: Research assistants visited 100 dental offices and assessed 214 QTH light units. They recorded each unit's model, age, service history, light intensity and heat/glare emissions. RESULTS: Mean light intensity was 526 milliwatts per square centimeter (120-1,000 mW/cm2), with 26 units having intensity less than 300 mW/cm2. The mean light unit age was 5.6 years. Light units older than three years had significantly lower output intensities than those that were one, two or three years old. The authors found a wide range of heat/glare measurements (3-300 mW/cm2), with 4.6 percent of the units having values greater than 50 mW/cm2, including three with values of more than 200 mW/cm2. The mean light intensity of units serviced in the preceding year was 539 mW/cm2; it was 418 mW/cm2 for units serviced from one to six years previously. CONCLUSIONS: Light intensity and heat/glare values varied among the 214 units; some units had values well outside the recommended levels. Each unit's age and service history significantly affected its intensity. An awareness campaign is needed to promote testing, repair or replacement of light polymerization units. Periodic testing of light polymerization units should be considered by regulatory bodies to ensure optimum quality of composite restorations. CLINICAL IMPLICATIONS: Light polymerization units in some private dental offices in Toronto had intensities that may result in composites restorations with inferior properties. Dentists need to regularly monitor the intensity of the light polymerization units and maintain the units to ensure quality composite restorations.

PMID: 16022041 [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]

Influence of temporary cement remnant and surface cleaning method on bond strength to dentin of a composite luting system.

J Oral Sci. 2005 Mar;47(1):9-13

Authors: Kanakuri K, Kawamoto Y, Matsumura H

The aim of the current study was to evaluate the influence of polycarboxylate temporary cement remaining on the dentin surface on the bond strength of a composite luting system. An acrylic resin plate was luted to bovine dentin with a polycarboxylate temporary cement (HY-Bond Temporary Cement Hard, HYB). The temporary cement was not used for the control groups. After removing the temporary cement with an excavator, dentin specimens were divided into five groups; 1) no subsequent treatment, 2) cleaning with a rotational brush (RTB), 3) cleaning with a rotational brush and non-fluoridated flour of pumice, 4) sweeping with an air scaler, and 5) treated with a sonic toothbrush. A silane-treated ceramic disk (IPS Empress) was bonded to each dentin specimen with a composite luting system (Panavia F). Shear testing results showed that the RTB groups exhibited the highest bond strength regardless of the use of temporary cement (P < 0.05). The use of a rotational brush with water coolant is recommended to achieve ideal bond strength between the Panavia F luting system and dentin to which HYB temporary cement was primarily applied.

PMID: 15881223 [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]

Histomorphological response of dogs' dental pulp capped with white mineral trioxide aggregate.

Braz Dent J. 2004;15(2):104-8

Authors: Faraco Junior IM, Holland R

This study was conducted to observe the response of dogs' dental pulp to white mineral trioxide aggregate (MTA) when used as pulp capping material. The pulp of 15 dogs' teeth was experimentally exposed and capped with white MTA. The animals were sacrificed two months later and the specimens were prepared for histomorphological study. The pulp capped with white MTA showed a healing process with complete dentin bridge formation in all samples. In some cases, there was not a tubular dentin shape, but only a structure with an interesting morphological aspect sealing the exposure site. Only 2 specimens exhibited pulp inflammation. In conclusion, the data obtained in this study showed that white MTA has the necessary properties of a pulp capping material.

PMID: 15776191 [PubMed - indexed for MEDLINE]

An ex vivo evaluation of resin-modified glass polyalkenoates and polyacid-modified composite resins as orthodontic band cements.

J Orthod. 2004 Dec;31(4):323-8; discussion 301-2

Authors: Knox J, Chye KY, Durning P

OBJECTIVES: The objective of this ex vivo study was to assess the use of resin-modified glass polyalkenoates and polyacid-modified composite resins, as orthodontic band cements. MATERIALS AND METHOD: Plain stainless steel bands were cemented to 350 human extracted third molar teeth using 1 of 7 different cements. Following complete cement cure, half of each sample group was exposed to mechanical stress in a ball mill. Stressed and unstressed samples were tested in tension and the stress at which initial cement failure recorded. The mode of failure was recorded using an adhesive remnant evaluation. RESULTS: The mean band retention stresses offered by the cements studied ranged from 0.96 to 1.56 MPa. Fuji Ortho provided the highest mean band retention stress in "stressed" (1.56 MPa) and "unstressed" (1.45 MPa) states. Exposure to mechanical stress did not appear to significantly influence band retention or mode of cement failure for most cements. Fuji Ortho cement recorded the highest Weibull modulus for all cements tested. Virtually all samples failed at either the cement/enamel or cement band interface. CONCLUSIONS: Significant differences in band displacement stress values and mode of failure were demonstrated between the cements studied. However, generic comparisons were difficult to make.

PMID: 15608348 [PubMed - indexed for MEDLINE]

Survey of dental prophylaxes rendered by pediatric dentists in New England.

J Contemp Dent Pract. 2004 Nov 15;5(4):14-22

Authors: Nainar SM, Redford-Badwal DA

BACKGROUND: The objective of this anonymous postal survey was to assess the provision of dental prophylaxis by pediatric dentists in New England. METHODS: The questionnaire survey was sent by first class mail in September, 2001 to all 217 American Academy of Pediatric Dentistry (AAPD) members in active private practice in the six New England States of Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, and Vermont. A self-addressed, stamped envelope was provided to facilitate the returned response. RESULTS: The survey had a response rate of 70%. Most practitioners (93%) routinely recommended dental prophylaxis for their recall patients. The proportion of practitioners who considered the following indications for recommending dental prophylaxis was: plaque, stain, and/or calculus removal - 99%; caries prevention - 75%; prior to topical fluoride application - 82%; prior to sealant application - 58%; and for behavioral modification - 68%. Almost two thirds of the practitioners (62%) defined dental prophylaxis as referring to both rubber cup pumice prophylaxis as well as to toothbrush prophylaxis. However, only one in four practitioners (26%) had modified her/his clinical practice to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. CONCLUSION: Pediatric dentists in New England routinely provide dental prophylaxis to their recall patients.

PMID: 15558086 [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]

A 12 month clinical study of bond failures of recycled versus new stainless steel orthodontic brackets.

Eur J Orthod. 2004 Aug;26(4):449-54

Authors: Cacciafesta V, Sfondrini MF, Melsen B, Scribante A

The purpose of this prospective longitudinal randomized study was to compare the clinical performance of recycled brackets with that of new stainless steel brackets (Orthos). Twenty patients treated with fixed appliances were included in the investigation. Using a 'split-mouth' design, the dentition of each patient was divided into four quadrants. In 11 randomly selected patients, the maxillary left and mandibular right quadrants were bonded with recycled brackets, and the remaining quadrants with new stainless steel brackets. In the other nine patients the quadrants were inverted. Three hundred and ten stainless steel brackets were examined: 156 were recycled and the remaining 154 were new. All the brackets were bonded with a self-cured resin-modified glass ionomer (GC Fuji Ortho). The number, cause, and date of bracket failures were recorded over 12 months. Statistical analysis was performed by means of a paired t-test, Kaplan-Meier survival estimates, and the log-rank test. No statistically significant differences were found between: (a) the total bond failure rate of recycled and new stainless steel brackets; (b) the upper and lower arches; (c) the anterior and posterior segments. These findings demonstrate that recycling metallic orthodontic brackets can be of benefit to the profession, both economically and ecologically, as long as the orthodontist is aware of the various aspects of the recycling methods, and that patients are informed about the type of bracket that will be used for their treatment.

PMID: 15366391 [PubMed - indexed for MEDLINE]

In vitro inhibition of caries-like lesions with fluoride-releasing materials.

J Oral Sci. 2004 Mar;46(1):45-50

Authors: Yaman SD, Er O, Yetmez M, Karabay GA

The aim of this study was to compare the in vitro caries inhibition of various resin-based materials. Class V cavities were prepared in twenty-five freshly extracted human premolar teeth which were then restored with glass-ionomer cement (Chemfill II), compomer (Compoglass F, Dyract AP) and composite resin (Tetric Ceram and Z 100). The teeth were submerged in an acid gel for 6 weeks. Each specimen was sectioned. These sections were left in water for 24 hours, and then examined using polarized light microscopy. The lesion consisted of two parts, the outer surface lesion and the cavity wall lesion. There was no significant difference in the body depth of the outer lesion and in the depth of the wall lesion among teeth restored with Compoglass F, Dyract AP and Chemfill II (P > 0.05). There was a significant difference between those restored with Z 100 and Tetric Ceram (P < 0.05). The length of the wall lesion for the teeth restored with Chemfill II was significantly smaller than that in the remaining groups (P < 0.05). The length of the wall lesion for teeth restored with Tetric Ceram and Z 100 was significantly higher than in the remaining groups (P < 0.05). These results suggest that composite materials and compomer provide less caries inhibition than glass-ionomer cements.

PMID: 15141723 [PubMed - indexed for MEDLINE]

A clinical study of glass ionomer cement.

Eur J Orthod. 2004 Apr;26(2):185-9

Authors: Oliveira SR, Rosenbach G, Brunhard IH, Almeida MA, Chevitarese O

The aim of this investigation was to compare the clinical performance of a glass ionomer cement (GIC) with a composite resin when used for direct bonding of standard edgewise orthodontic brackets. Fourteen patients (10 females, four males), in whom 242 teeth were bonded with brackets, were divided into two groups: GIC (121 teeth) and composite (121 teeth). The brackets were allocated to alternate quadrants and first-time failures were recorded over a period of 24 months. Data were analysed statistically (non-parametric chi-squared test). The results demonstrated a significantly lower unpreviewed debonding index (UDI) (15.7 per cent) for the composite than for the GIC (28.1 per cent) (P = 0.042). The use of heavy archwires was largely responsible for this difference. No difference was observed when light and medium archwires were used. GIC may be a viable alternative to composite for use with light archwires and with limited treatment objectives.

PMID: 15130042 [PubMed - indexed for MEDLINE]

Root-end filling materials alter fibroblast differentiation.

J Dent Res. 2004 May;83(5):408-13

Authors: Bonson S, Jeansonne BG, Lallier TE

Root-end filling materials are commonly used following endodontic surgical procedures; however, their effect on adjacent soft tissues is poorly understood. We predict that, due to the differences in their chemical composition, these materials will have profoundly different effects on the survival and differentiation of fibroblasts. Many of the root-end filling materials examined were initially cytotoxic to both PDL and gingival fibroblasts in co-culture experiments; however, this was reduced after the materials were washed in either mineral trioxide aggregate (MTA) or hybrid ionomere composite resin (HICR) for 2 wks. Additionally, PDL fibroblasts displayed enhanced proliferation on MTA and survival on amalgam when compared with gingival fibroblasts. MTA preferentially induced alkaline phosphatase expression and activity in both PDL and gingival fibroblasts. In contrast, HICR inhibited alkaline phosphatase expression and activity. In addition, MTA and HICR repressed pleiotrophin in PDL fibroblasts, while HICR repressed periostin in both fibroblasts. Thus, root-end filling materials differentially affect periodontal fibroblast differentiation. Abbreviations: mineral trioxide aggregate (MTA), zinc-oxide eugenol cement (ZOEC), hybrid ionomer composite resin (HICR), reverse-transcriptase polymerase chain-reaction (RT-PCR).

PMID: 15111634 [PubMed - indexed for MEDLINE]

In vivo versus in vitro microtensile bond strength of axial versus gingival cavity preparation walls in Class II resin-based composite restorations.

J Am Dent Assoc. 2004 Feb;135(2):185-93; quiz 228

Authors: Purk JH, Dusevich V, Glaros A, Spencer P, Eick JD

BACKGROUND: Gingival margins in Class II composite restorations are a site of frequent failure. The purpose of the authors' study was to compare the microtensile dentin bond strength of gingival and axial restored cavity preparation walls of Class II composite restorations under in vivo and in vitro conditions. METHODS: After obtaining informed consent, the authors placed Class II resin-based composite restorations in 14 premolar teeth from five patients, under in vivo or in vitro conditions. The teeth were sectioned to obtain rectangular specimens from axial and gingival walls with a surface area of approximately 0.5 square millimeter. The authors tested 85 microtensile adhesive samples from the 14 teeth on a testing instrument (Universal Instron, Model 125, Instron, Canton, Mass.) until failure. RESULTS: The mean (+/- standard deviation) mircotensile dentin bond strengths in mega-pascals were as follows: in vivo axial, 36.5 (14.9); in vivo gingival, 17.6 (11.6); in vitro axial, 49.5 (13.9); in vitro gingival, 34.0 (13.1). A two-way analysis of variance found a statistically significant difference between in vitro and in vivo conditions and between the axial and gingival walls (P < or = .001). Eighty-eight percent of the fractured samples involved the adhesive layer as observed under scanning electron microscopy up to x2,500. Seventeen of the gingival samples and two of the axial samples debonded during the preparation phase and could not be tested. CONCLUSION: The dentinal microtensile strength of adhesive/resin-based composite bonded to the gingival wall was significantly weaker than the bond to the axial wall, and in vivo conditions produced significantly weaker bond strengths than did in vitro conditions. CLINICAL IMPLICATIONS: The dentinal adhesive bond of resin-based composite to gingival walls is significantly weaker and thus more subject to failure than the bond to axial walls. In vitro bond strength studies may overestimate the bond strength of adhesives in in vivo applications.

PMID: 15005434 [PubMed - indexed for MEDLINE]

Shear bond strengths and microleakage of four types of dentin adhesive materials.

J Contemp Dent Pract. 2004 Feb 15;5(1):63-73

Authors: Ateyah NZ, Elhejazi AA

The aim of this investigation was to compare the microleakage of composite resin (Z-100) and shear bond strength to bovine dentin using different types of adhesive systems (Scotch Bond Multi-Purpose, All-Bond 2, One-Step, and Perma Quick) to compare and correlate microleakage to shear bond strength. For the microleakage aspect of the study, 20 class V were prepared (bovine incisors) with 90-degree cavosurface margins and were located at the cemento-enamel junction using a template. Each dentin bonding system was applied to five cavities following the manufacturer's instructions and restored with Z-100 composite resin. After 24 hours of storage in distilled water at 37 degrees C, the teeth were immersed in 2% basic fuchsin dye. All teeth were sectioned in a mesiodistal direction using a diamond saw, and each section was then inspected under a stereomacroscope. For the shear bond strength aspect of the study, 20 bovine incisors were centrally horizontally mounted in Teflon mold with cold cure acrylic resin. Flat labial dentin surfaces were prepared using different grit silicon carbide abrasive wheels. Five specimens were used for each of the bonding agent systems. Each specimen was bonded with restorative composite resin (Z-100) and applied to the treated dentinal surface through a split Teflon mold. All specimens were stored in distilled water at 37 degrees C for 24 hours. The bonds were stressed using shear forces at a crosshead speed of 0.5mm/min using an Instron Universal testing machine. Findings indicate none of the systems tested in this study were free from microleakage. Scotch bond multi-purpose achieved the best seal, with One-Step being second best, while All-Bond 2 and Perma Quick had the poorest seal. However, there were significant differences among the shear bond strengths of the four bonding systems tested. Scotch Bond Multi-Purpose has a higher bond strength to composite resin when compared to the other dentin adhesives. The study also concluded there is no association between microleakage and shear bond strength.

PMID: 14973561 [PubMed - indexed for MEDLINE]

Resin-modified glass ionomer, modified composite or conventional glass ionomer for band cementation?--an in vitro evaluation.

Eur J Orthod. 2003 Dec;25(6):609-14

Authors: Millett DT, Cummings A, Letters S, Roger E, Love J

The aims of this study were to compare the mean shear-peel bond strength and predominant site of bond failure of micro-etched orthodontic bands cemented with resin-modified glass ionomer cement (RMGIC; Fuji Ortho LC or 3M Multi-Cure), a modified composite or a conventional GIC. The survival time of bands was also assessed following simulated mechanical stress in a ball mill. One hundred and twenty molar bands were cemented to extracted human third molars. Eighty bands (20 cemented with each cement) were used to assess the debonding force and 40 bands (10 cemented with each cement) were used to determine survival time. The specimens were prepared in accordance with the manufacturers' instructions for each cement. After storage in a humidor at 37 degrees C for 24 hours, the shear debonding force was assessed for each specimen using a Nene M3000 testing machine with a crosshead speed of 1 mm/minute. The predominant site of band failure was recorded visually for all specimens as either at the band/cement or cement/enamel interface. Survival time was assessed following application of mechanical stress in a ball mill. There was no significant difference in mean shear-peel bond strength between the cement groups (P = 0.816). The proportion of specimens failing at each interface differed significantly between cement groups (P < 0.001). The predominant site of bond failure for bands cemented with the RMGIC (Fuji Ortho LC) or the modified composite was at the enamel/cement interface, whereas bands cemented with 3M Multi-Cure failed predominantly at the cement/band interface. Conventional GIC specimens failed mostly at the enamel/cement interface. The mean survival time of bands cemented with either of the RMGICs or with the modified composite was significantly longer than for those cemented with the conventional GIC. The findings indicate that although there appears to be equivalence in the mean shear-peel bond strength of the band cements assessed, the fatigue properties of the conventional GIC when subjected to simulated mechanical stress seem inferior to those of the other cements for band cementation.

PMID: 14700267 [PubMed - indexed for MEDLINE]

[Using mineral trioxide aggregate as a direct pulp-capping material in dogs]

Shanghai Kou Qiang Yi Xue. 2003 Feb;12(1):44-6

Authors: Zhu YQ, Xia L

OBJECTIVE: The purpose of this study was to compare the dental pulp responses in dogs after MTA (Mineral Trioxide Aggregate) and a calcium hydroxide (Dycal) were applied as pulp-capping materials. METHODS: Twelve cuspids in three healthy adult beagle dogs were divided into two groups randomly. MTA or Dycal was used to repair the exposed site which was created with a fissure bur in a high-speed handpiece with copious water spray at the labial cervical access. Then the cavity was filled with glass ionomer cement (GIC). Four months later, the specimens were processed for histologic examination to observe the pulpal inflammation and dentin bridge formation. RESULTS: Five of six samples capped with MTA were free of pulpal inflammation, and all of samples in this group had dentin bridge formation. In contrast, all of samples capped with Dycal showed pulpal inflammation, and dentin bridge formation occurred in only 2 samples. CONCLUSION: MTA is a biocompatible material which can promote dentin bridge formation. It can be used as a direct pulp-capping material during vital pulp therapy.

PMID: 14661463 [PubMed - indexed for MEDLINE]

Effect of surface roughness on flexural strength of veneer ceramics.

J Dent Res. 2003 Dec;82(12):972-5

Authors: Fischer H, Sch&#xE4;fer M, Marx R

The strength of ceramic restorations depends on the occlusal surface roughness of the veneering porcelain, which is influenced by the final preparation. The hypothesis of the study was that roughnesses below a critical microscopic defect size--based only on fracture mechanics considerations--also affect flexural strength. The bending failure stress was evaluated on standard specimens of 4 veneer ceramics with 4 different surfaces of defined roughnesses, respectively. A linear correlation was found between roughness and failure stress. A "roughness-free" failure stress value was predicted for each tested material. This theoretical value can represent the "true" strength of the respective ceramic material. We conclude from our results that the final preparation of a ceramic restoration is critical to the strength of the material, and that ceramic veneering materials can be compared more objectively with respect to their strength by means of roughness-free strength values.

PMID: 14630897 [PubMed - indexed for MEDLINE]

Origin and migration of the Alpine Iceman.

Science. 2003 Oct 31;302(5646):862-6

Authors: Müller W, Fricke H, Halliday AN, McCulloch MT, Wartho JA

The Alpine Iceman provides a unique window into the Neolithic-Copper Age of Europe. We compared the radiogenic (strontium and lead) and stable (oxygen and carbon) isotope composition of the Iceman's teeth and bones, as well as 40Ar/39Ar mica ages from his intestine, to local geology and hydrology, and we inferred his habitat and range from childhood to adult life. The Iceman's origin can be restricted to a few valleys within approximately 60 kilometers south(east) of the discovery site. His migration during adulthood is indicated by contrasting isotopic compositions of enamel, bones, and intestinal content. This demonstrates that the Alpine valleys of central Europe were permanently inhabited during the terminal Neolithic.

PMID: 14593178 [PubMed - indexed for MEDLINE]