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Biomedical subjects

Steven A Aquilino

Publications and source records attributed to Steven A Aquilino.

5 recordsLinked to original sources

In vitro fracture resistance of endodontically treated central incisors with varying ferrule heights and configurations.

STATEMENT OF PROBLEM: The in vitro effectiveness of a uniform circumferential ferrule has been established in the literature; however, the effect of a nonuniform circumferential ferrule height on fracture resistance is unknown. PURPOSE: This in vitro study investigated the resistance to static loading of endodontically treated teeth with uniform and nonuniform ferrule configurations. MATERIAL AND METHODS: Fifty extracted intact maxillary human central incisors were randomly assigned to 1 of 5 groups: CRN, no root canal treatment (RCT), restored with a crown; RCT/CRN, no dowel/core, restored with a crown; 2 FRL, 2-mm ferrule, cast dowel/core and crown; 0.5/2 FRL, nonuniform ferrule (2 mm buccal and lingual, 0.5 mm proximal), cast dowel/core and crown; and 0 FRL, no ferrule, cast dowel/core and crown. The teeth were prepared to standardized specifications and stored for 72 hours in 100% humidity prior to testing. Testing was conducted with a universal testing machine with the application of a static load, and the load (N) at failure was recorded. Statistical analysis was performed with a 1-way analysis of variance and the Tukey Honestly Significant Difference test (alpha=.05). The mode of fracture was noted by visual inspection for all specimens. RESULTS: There was strong evidence of group differences in mean fracture strength ( P <.0001). Following adjustment for all pairwise group comparisons, it was found that the lack of a ferrule resulted in a significantly lower mean fracture strength (0 FRL: 264.93 +/- 78.33 N) relative to all other groups. The presence of a nonuniform (0.5 to 2-mm vertical height) ferrule (0.5/2 FRL: 426.64 +/- 88.33 N) resulted in a significant decrease ( P =.0001) in mean fracture strength when compared with the uniform 2-mm vertical ferrule (2 FRL: 587.23 +/- 110.25 N), the group without RCT (CRN: 583.67 +/- 86.09 N), and the RCT-treated tooth with a crown alone (CRN/RCT: 571.04 +/- 154.86 N). The predominant mode of failure was an oblique fracture extending from the lingual margin to the facial surface just below the insertion of the tooth into the acrylic resin. CONCLUSION: The results demonstrated that central incisors restored with cast dowel/core and crowns with a 2-mm uniform ferrule were more fracture resistant compared to central incisors with nonuniform (0.5 to 2 mm) ferrule heights. Both the 2-mm ferrule and nonuniform ferrule groups were more fracture resistant than the group that lacked a ferrule.

Crowns↗

Interim restorations.

Interim restorations are a critical component of fixed prosthodontic treatment, biologically and biomechanically. Interim restoration serves an important diagnostic role as a functional and esthetic try-in and as a blueprint for the design of the definitive prosthesis. When selecting materials for any interim restoration, clinicians must consider physical properties, handling properties, patient acceptance, and material cost. Although no single material meets all the requirements and material classification alone of a given product is not a predictor of clinical performance, bis-acryl materials are typically best suited to single-unit restorations, and poly(methylmethacrylate) interim materials are generally ideal for multi-unit, complex, long-term, interim fixed prostheses. As with most dental procedures, the technique used for fabrication has a greater effect on the final result than the specific material chosen.

Biomechanical Phenomena↗

Relationship between crown placement and the survival of endodontically treated teeth.

STATEMENT OF PROBLEM: Crowns have been considered the restoration of choice for endodontically treated teeth, but their selection has been based primarily on anecdotal evidence. PURPOSE: This study tested the hypothesis that crown placement (coronal coverage) is associated with improved survival of endodontically treated teeth when preaccess, endodontic, and restorative factors are controlled. MATERIAL AND METHODS: A University of Iowa College of Dentistry treatment database was used to identify permanent teeth that had undergone initial obturation between July 1, 1985, and December 31, 1987. Study patients were restricted to persons with at least 1 dental visit in each 2-year interval from 1985 to 1996; a simple random sample of 280 patients (n = 400 teeth) was selected. Dental charts, radiographs, and computerized databases were examined to ascertain variables of interest and to verify study inclusion criteria. Kaplan-Meier survival estimates were generated for the 203 teeth that satisfied study inclusion criteria. Multivariate Cox proportional hazards regression models were developed, with standard errors adjusted to account for clustering of teeth within patients. RESULTS: When tooth type and radiographic evidence of caries at access were controlled, the final Cox model showed that endodontically treated teeth not crowned after obturation were lost at a 6.0 times greater rate than teeth crowned after obturation (95% confidence interval: 3.2 to 11.3). CONCLUSION: Within the limitations of this study, a strong association between crown placement and the survival of endodontically treated teeth was observed. These results may impact treatment planning if long-term tooth retention is the primary goal.

Aged↗

Relative translucency of six all-ceramic systems. Part I: core materials.

STATEMENT OF PROBLEM: All-ceramic restorations have been advocated for superior esthetics. Various materials have been used to improve ceramic core strength, but it is unclear whether they affect the opacity of all-ceramic systems. PURPOSE: This study compared the translucency of 6 all-ceramic system core materials at clinically appropriate thicknesses. MATERIALS AND METHODS: Disc specimens 13 mm in diameter and 0.49 +/- 0.01 mm in thickness were fabricated from the following materials (n = 5 per group): IPS Empress dentin, IPS Empress 2 dentin, In-Ceram Alumina core, In-Ceram Spinell core, In-Ceram Zirconia core, and Procera AllCeram core. Empress and Empress 2 dentin specimens also were fabricated and tested at a thickness of 0.77 +/- 0.02 mm (the manufacturer's recommended core thickness is 0.8 mm). A high-noble metal-ceramic alloy (Porc. 52 SF) served as the control, and Vitadur Alpha opaque dentin was used as a standard. Sample reflectance (ratio of the intensity of reflected light to that of the incident light) was measured with an integrating sphere attached to a spectrophotometer across the visible spectrum (380 to 700 nm); 0-degree illumination and diffuse viewing geometry were used. Contrast ratios were calculated from the luminous reflectance (Y) of the specimens with a black (Yb) and a white (Yw) backing to give Yb/Yw with CIE illuminant D65 and a 2-degree observer function (0.0 = transparent, 1.0 = opaque). One-way analysis of variance and Tukey's multiple-comparison test were used to analyze the data (P<.05). RESULTS: Contrast ratios in order of most translucent to most opaque were as follows: Vitadur Alpha 0.60 +/- 0.03, Empress (0.5 mm) 0.64 +/- 0.01, In-Ceram Spinell 0.67 +/- 0.02, Empress 2 (0.5 mm) 0.68 +/- 0.02, Empress (0.8 mm) 0.72 +/- 0.01, Procera 0.72 +/- 0.01, Empress 2 (0.8 mm) 0.74 +/- 0.01, In-Ceram Alumina 0.87 +/- 0.01, In-Ceram Zirconia 1.00 +/- 0.01, and 52 SF alloy 1.00 +/- 0.00. CONCLUSION: Within the limitations of this study, there was a range of ceramic core translucency at clinically relevant core thicknesses. In order of decreasing translucency, the ranges were Vitadur Alpha dentin (standard) > In-Ceram Spinell > Empress, Procera, Empress 2 > In-Ceram Alumina > In-Ceram Zirconia, 52 SF alloy.

Aluminum Oxide↗

Relative translucency of six all-ceramic systems. Part II: core and veneer materials.

UNLABELLED: STATEMENT OF PROBLEM All-ceramic core materials with various strengthening compositions have a range of translucencies. It is unknown whether translucency differs when all-ceramic materials are fabricated similarly to the clinical restoration with a veneered core material. PURPOSE: This study compared the translucency of 6 all-ceramic materials veneered and glazed at clinically appropriate thicknesses. MATERIALS AND METHODS: Core specimens (n = 5 per group) of Empress dentin, Empress 2 dentin, In-Ceram Alumina, In-Ceram Spinell, In-Ceram Zirconia, and Procera AllCeram were fabricated as described in Part I of this study and veneered with their corresponding dentin porcelain to a final thickness of 1.47 +/- 0.01 mm. These specimens were compared with veneered Vitadur Alpha opaque dentin (as a standard), a clear glass disc (positive control), and a high-noble metal-ceramic alloy (Porc. 52 SF) veneered with Vitadur Omega dentin (negative control). Specimen reflectance was measured with an integrating sphere attached to a spectrophotometer across the visible spectrum (380 to 700 nm); 0-degree illumination and diffuse viewing geometry were used. Measurements were repeated after a glazing cycle. Contrast ratios were calculated from the luminous reflectance (Y) of the specimens with a black (Yb) and a white backing (Yw) to give Yb/Yw with CIE illuminant D65 and a 2-degree observer function (0.0 = transparent, 1.0 = opaque). One-way analysis of variance and Tukey's multiple-comparison test were used to analyze the data (P<.05). RESULTS: Significant differences in contrast ratios were found among the ceramic systems tested when they were veneered (P<.0001) and after the glazing cycle (P<.0001). Significant changes in contrast ratios (P<.0001) also were identified when the veneered specimens were glazed. CONCLUSION: Within the limitations of this study, a range of translucency was identified in the veneered all-ceramic systems tested. Such variability may affect their ability to match natural teeth. The glazing cycle resulted in decreased opacity for all test materials except the completely opaque In-Ceram Zirconia and metal-ceramic specimens.

Aluminum Oxide↗