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In vitro microleakage associated with posterior composite restorations used with different base/bonding system combinations.

The study aimed to determine the base/restoration combination which allowed the least microleakage in Class II cavities. One hundred premolar teeth were prepared with a standardized, minimal two-surface cavity and randomly ascribed to ten equal groups. The cavities were restored by use of one of ten different material/technique combinations. Restored teeth were sealed to within 1 mm of the restoration margins with nail varnish prior to the immersion of the crowns in 5% (buffered) eosin for 48 h. The teeth were then hemisected longitudinally, in a mesio-distal plane, through the midline of the restoration by means of a diamond disc with water coolant, and one half of each tooth was then photographed. The transparencies were examined by image analysis programmed to facilitate calculation of the percentage of the tooth/restoration interface and of the crown dentin exhibiting dye penetration. Light- and chemically-cured glass-ionomer-based restorations showed similar amounts of leakage when expressed as a percentage area of crown dentin. This was significantly (p less than 0.05) less than that shown by cavities both etched and bonded. Cavities restored without enamel etching or involving the use of a bonding system exhibited significantly (p less than 0.05) greatest leakage.

Acid Etching, Dental↗

Fluoride release and uptake by glass-ionomers and related materials and its clinical effect.

The anticariogenic effect of silicate cement is well known and considered a result of fluoride release. In several studies a similar fluoride release from conventional glass-ionomer cement (GIC) has been established. Therefore, an anticariogenic effect may be predicted from the GICs too. In my studies the fluoride release was studied by exposing the test specimens to a continuous flow of running tap water. At certain time periods the specimens were transferred for 1 week in a small amount of deionized water (5 ml). The determination of the fluoride content of the solution showed the fluoride release of the material at that time. There was an initial 'burst' effect of fluoride release and then the release gradually decreased, settling at a constant level. The long-term release from conventional GICs was shown to remain on the same level for at least 8 years. The amount of the constant release did not differ much between different brands. Resin-modified GICs released fluoride to the same extent and in the similar way as conventional GICs whereas polyacid-modified composites ('compomers') did not show an initial fluoride 'burst' effect. To study the fluoride binding ability of GICs, specimens which had been exposed to running water for different periods of time were treated with a 50 ppm fluoride solution. After this 'recharging' GIC and resin-modified GIC specimens released more than twice the amount of fluoride released before the treatment. The fluoride treatment had no effect on polyacid-modified composites or on fluoride-containing composites or on the amalgams. To get an impression of the clinical effect of GICs a questionnaire was handed out to practitioners attending courses in the Nordic countries and in Australia during the period 1991-1992 which resulted in 954 answers. Among other questions, the dentists were asked if they had observed caries and gingival inflammation in association with GIC and composite fillings. According to the opinion of most dentists caries and gingival inflammation had never or only seldom been observed in association with GIC fillings whereas most dentists had observed these complications often in connection with composite restorations.

Biocompatible Materials↗

Relationship between filler and matrix resin characteristics and the properties of uncured composite pastes.

The relationships between filler type, filler content, matrix resin composition and viscosity and the flow characteristics of composite paste formulations have been investigated. BIS-GMA and 10 experimental BIS-GMA analogues were diluted as needed with TEGDMA to produce 1000 and 2000 cp solutions corresponding to the viscosity range of commercial composite matrices. All of these resins were mixed with a silanated hybrid-filler and a silanated micro-filler. For each combination the maximum filler content was determined, as well as the paste consistencies (plasticities) at a series of filler contents. Paste consistencies were measured by a modification of the ADA specification methods developed for determining standard test consistencies for zinc phosphate and silicate cements. For each monomer-filler combination increasing filler contents resulted in monotonically reduced plasticities. The maximum filler contents appeared to be an attribute of the particular filler rather than matrix resin characteristics. For the materials used, the maximum contents were approximately 86 wt% (83 vol%) filler for the hybrid filler, and 36% wt% (24 vol%) for the microfilled material. At lower filler contents, plasticity differences unexpectedly existed even at equal filler contents and matrix viscosities. Evidence was found that the plasticity varied both with the base monomer composition and the amount of TEGDMA present. The results imply that compositional interactions between the filler and matrix influence the results when all known mechanical factors are controlled.

Absorption↗

Marginal adaptation and fracture resistance of adhesively luted glass fibre-composite reinforced molar crowns with different inner crown surfaces.

OBJECTIVES: This study compared the influence of different inner crown surfaces on the fracture resistance and marginal adaptation of adhesively fixed glass fibre-reinforced molar crowns. MATERIALS AND METHODS: Vectris/Targis crowns were constructed with an inner framework of glass fibres (directly on the tooth) or an inner veneering composite layer between the fibre-framework and the tooth-substance. Both groups were sandblasted inside using Al(2)O(3); 50 microm grain size (200 kPa, 20 s) and silane coated. A control group had the inner fibre framework, but was neither sandblasted nor silane coated. The crowns were adhesively cemented on extracted human teeth, and thermally cycled and mechanically loaded (TCML: 6000 x 5 degrees C/55 degrees C; 1.2 x 10(6) x 50 N, 1.66 Hz). The marginal adaptation before and after TCML was evaluated and the fracture resistance was investigated using a Zwick universal testing machine. RESULTS: After TCML the proportion of 'perfect margin' of the control group decreased significantly at the interface crown/cement. For the variations with an inner fibre framework or inner composite layer the marginal adaptation or fracture resistance did not decrease significantly after ageing. The fracture resistance values were control: 1509N+/-486; inner fibre framework: 1896N+/-342; inner composite layer: 1754N+/-340. CONCLUSIONS: In the case of the investigated fibre framework and veneering composite, the inner surface of glass fibre-reinforced molar crowns can be covered with a composite layer or with a glass fibre framework. Both methods achieve comparable high fracture strengths and reliable marginal adaptation.

Aluminum Oxide↗

In-vitro study of fracture strength and marginal adaptation of fibre-reinforced adhesive fixed partial inlay dentures.

The aim of this study was to examine in-vitro whether adhesive fixed posterior inlay dentures (AFPID) made with the fibreglass-reinforced Vectris/Targis system (Ivoclar, Schaan, FL) have a fracture strength and a satisfactory marginal adaptation which can occur under clinical conditions. Extracted human third molars were embedded in a PMMA resin 10 mm apart to represent a molar gap. Two preparation methods were used: a box-shaped preparation technique (n = 8) and a tub-shaped preparation technique (n = 8). All AFPIDs were adhesively inserted using the dual curing composite cement, Variolink-high-viscosity (Vivadent, Schaan, FL). After thermocycling and mechanical loading (TCML: 6000 x 5 degrees C/55 degrees C, 1.2 Mio x 50 N, 1.66 Hz) in an artificial environment, the bridges were loaded to failure. Marginal adaption was investigated before and after TCML with the replica technique. After TCML, no significant difference was found in fracture strength between tub-shaped-preparation (median = 722 N, bending median = 0.9 mm) and box-shaped preparation (median = 696 N, bending median = 1.2 mm). A 'perfect margin' was observed in more than 60% of the investigated areas in both preparation techniques. With these values, the bridges can occur under clinical conditions and thus a clinical employment should be considered.

Acid Etching, Dental↗

Another continental pool in the terrestrial silicon cycle.

Silicon is the second most abundant element on Earth. It is an important nutrient for phytoplankton and is readily absorbed by terrestrial vegetation; it also assists the removal of carbon dioxide from the atmosphere through the weathering of silicates. But the continental cycle of silicon is not well known, and only a few studies have attempted to use silicon stable isotopes (28Si, 29Si and 30Si) to quantify the continental silicon reservoirs. Dissolved silicon in sea and river waters forms a reservoir of mean isotopic value +1.1 per thousand (refs 7, 10). It is enriched in 30Si with respect to the igneous rocks reservoir, which has a mean isotopic value of -0.3 per thousand (refs 4, 9). This enrichment can only be produced by a major fractionation during weathering, and should result in the formation of a continental 30Si-depleted reservoir. Such a reservoir, however, has not been identified to date. Here we analyse silicon isotopes of in situ quartz from a sandstone series in France, using a new-generation secondary ion mass spectrometry apparatus. We show that quartz that precipitates as siliceous cements forms a strongly 30Si-depleted reservoir with isotopic values down to -5.7 per thousand, a more negative value than any previously published for terrestrial samples. Our findings suggest that quartz re-precipitation plays an important role in the biogeochemical cycle of silicon.

Chemical Precipitation↗

A comparative study of some dental cements used in orthodontics.

It is suggested that decalcification occurring beneath orthodontic bands is, among other factors, related to the tensile bond strength of the cement to the enamel surface, its marginal leakage at the enamel-cement interface, and its solubility and and disintegration. Under the laboratory conditions described in this study the composite cement exhibited the greatest tensile bond strength to both enamel and band material. The composite cement also displayed no marginal leakage at the enamel-cement interface and showed no solubility or disintegration under the experimental conditions. It could therefore be anticipated that, of the four cements evaluated in this study, the composite cement would have the greatest potential for eliminating pathologic enamel decalcification occurring beneath orthodontic bands.

Composite Resins↗

Water sorption and solubility of dental composites and identification of monomers released in an aqueous environment.

Water sorption and solubility of six proprietary composite resin materials were assessed, and monomers eluted from the organic matrix during water storage identified. Water sorption and solubility tests were carried out with the following storage times: 4 h, 24 h and 7, 60 and 180 days. After storage, water sorption and solubility were determined. Eluted monomers were analysed by high performance liquid chromatography (HPLC). Correlation between the retention time of the registered peak and the reference peak was observed, and UV-spectra confirmed the identity. The results showed an increase in water sorption until equilibrium for all materials with one exception. The solubility behaviour of the composite resin materials tested revealed variations, with both mass decrease and increase. The resin composition influences the water sorption and solubility behaviour of composite resin materials. The HPLC analysis of eluted components revealed that triethyleneglycol dimethacrylate (TEGDMA) was the main monomer released. Maximal monomer concentration in the eluate was observed after 7 days. During the test period, quantifiable quantities of urethanedimethacrylate (UEDMA) monomer were observed, whereas 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy)-phenyl]propane (Bis-GMA) was only found in detectable quantities. No detectable quantities of bisphenol-A were observed during the test period.

Analysis of Variance↗

Fracture resistance of posterior metal-free polymer crowns.

STATEMENT OF PROBLEM: Improved mechanical properties of contemporary composites has resulted in the extended use of composites for the restoration of posterior teeth. Although the indication of polymers was extended to metal-free individual crowns, the influence of tooth preparation design and cementation methods on the stability of these artificial crowns remains unknown. PURPOSE: This in vitro study evaluated the effect of axial tooth preparation design, occlusal dimension, and cementation technique on the fracture resistance of metal-free posterior Artglass crowns. MATERIAL AND METHODS: Seventy-two extracted human third molars, assigned to experimental groups by size, received standardized tooth preparation. Axial tooth preparation included an invasive approach with 1-mm deep shoulder and a less invasive 0.5-mm chamfer preparation, whereas occlusal reduction was either 0.5 mm or 1.3 mm. Artglass crowns that restored the original tooth contour were cemented with 3 cements: zinc phosphate cement (ZnP), glass ionomer cement (GIC), or a resinous cement in combination with a dentinal bonding agent. After 10,000 thermal cycles between 5 degrees C and 55 degrees C, artificial crowns were vertically loaded until compression to failure. Significant differences of fracture loads between experimental groups were assessed by paired Mann-Whitney U tests. RESULTS: Minimal fracture resistance for all combinations excluded 500 N. However, 9 of 24 Artglass crowns cemented with ZnP loosened after thermocycling. Adhesive cementation resulted in a significantly greater fracture resistance compared with GIC and ZnP (P=.02). Increased occlusal thickness (0.5 to 1.3 mm) resulted in greater stability, whereas a 1-mm deep shoulder tooth preparation did not improve durability compared with a 0.5-mm chamfer finishing line. CONCLUSION: A minimally invasive 0.5-mm axial chamfer tooth preparation combined with sufficient occlusal reduction and adhesive cementation recorded the greatest stability for posterior metal-free Artglass crowns.

Cementation↗

Influence of shade and storage time on the flexural strength, flexural modulus, and hardness of composites used for indirect restorations.

STATEMENT OF PROBLEM: Fracture resistance, elastic modulus, and hydrolytic degradation resistance are important properties of indirect composite restorations. Composite systems developed specifically for indirect application are said to have enhanced mechanical properties due to their elevated monomer conversion. PURPOSE: This study evaluated the influence of shade and the effect of 30-day water storage on the flexural strength, flexural modulus, and hardness of 4 commercially available indirect composite systems and 1 composite used with the direct technique. MATERIAL AND METHODS: A variety of commercially available indirect resin composites (Artglass, Belleglass, Sculpture, and Targis) and 1 directly placed composite (Z100, control) were used. Specimens made with either incisal or dentin shade (n = 10) were fractured with a 3-point bending test. Pre-failure loads corresponding to specific displacements of the crosshead were used for flexural modulus calculation. Knoop hardness was measured on fragments (n = 3) obtained after the flexural test. Tests were performed after 24 hours and after a 30-day water storage at 37 degrees C. Flexural strength data were analyzed with the Weibull distribution. Flexural modulus and Knoop hardness data were analyzed with 3-way ANOVA and Tukey's post-hoc test (alpha=0.05). RESULTS: In general, the directly placed composite (Z100) demonstrated flexural strength similar to that of Artglass, Targis, and Sculpture. Belleglass presented the highest flexural strength (221.7 MPa for incisal shade after 24 hours storage; 95% confidence interval: 208.3-235.4). Z100 demonstrated the highest flexural modulus (range: 10.9 +/- 0.6 to 12.0 +/- 0.9 GPa) and Targis the lowest (range: 5.1 +/- 0.5 to 5.9 +/- 0.9 GPa). Sculpture was the only material that showed differences in flexural strength with respect to shade (incisal-24 hours: 149.8 MPa; incisal-30 days: 148.7 MPa; dentin-24 hours: 200.0 MPa; dentin-30 days: 177.9 MPa). The flexural modulus and hardness of the dentin shade of Sculpture were higher than those of the incisal shade after 30 days. Belleglass also showed a significant difference in flexural modulus (dentin-24 hours: 11.1 GPa; incisal-24 hours: 9.6 GPa). The effect of water storage was more evident on hardness since all composite systems softened after 30 days. Prolonged water storage decreased flexural strength only for Artglass-dentin and Z100, both incisal and dentin shades. Water aging did not affect the flexural modulus of any composite tested. CONCLUSION: In general, indirect composites did not show enhanced mechanical properties compared to the directly placed composite. Property differences due to shade were more evident for Sculpture. Prolonged water storage had a deleterious effect on the hardness of all composites tested. However, water storage did not affect the flexural strength of most of the indirect composites or the flexural modulus of any composite tested.

Analysis of Variance↗

Marginal adaptation of inlay-retained adhesive fixed partial dentures after mechanical and thermal stress: an in vitro study.

STATEMENT OF PROBLEM: There are no studies that analyze the long-term durability of minimally invasive fixed partial dentures (FPDs) by comparing different methods of adhesive bonding. PURPOSE: This in vitro study examined the influence of cavity design and operative technique on the marginal adaptation of resin-bonded composite FPDs. MATERIAL AND METHODS: Slot-inlay tooth preparations with cavity margins located in enamel were prepared in 18 maxillary canines and 18 maxillary first molars designated as abutments. The specimens were divided equally into 3 experimental groups. In all groups, butt joint tooth preparations were created in canines and molars. In group 2, canines were prepared additionally with a 1.5-mm wide palatal bevel in enamel. After pretests with modification spaces of 11 and 17 mm (length), 2 missing premolars were replaced by the ceromer Targis and reinforced with the glass-fiber material Vectris. The prostheses were inserted with Tetric Ceram with use of an ultrasonic-supported, high-viscosity technique. Restorations were selectively bonded to cavity finish lines in groups 1 and 2 ("selective bonding"). In group 3, restorations were bonded totally to the whole cavity surface ("total bonding"). The restorations were stressed in a computer-controlled masticator. Marginal quality was examined with an SEM at x 200. RESULTS: The percent area of optimal margins after thermomechanical loading between composite and enamel in each group was as follows: group 1, 86.2% +/- 12.3% for canines and 95.5% +/- 3.5% for molars; group 2, 95.3% +/- 2.1% for canines and 96.2% +/- 2.7% for molars; and group 3, 95% +/- 0.9% for canines and 86.4% +/- 3.2% for molars. The marginal quality for molars inserted with total bonding was significantly lower (P< or =.05). CONCLUSION: Within the limitations of this study, the selective bonding technique for slot inlay-retained fixed partial dentures resulted in a negligible loss of marginal quality after extensive mechanical and thermal stress. The selective bonding technique is recommended for box-shaped cavity preparations.

Acid Etching, Dental↗

Cytotoxicity studies of dental restorative materials using human periodontal ligament cells in vitro.

A model that simulates conditions of clinical practice in vivo and allows extended exposure of test cells to test substances, was evaluated in vitro by screening the toxicity of seven dental restorative cements. Millipore filter discs, 0.45 micron pore size, or preserved dentine slices were used as diffusion barriers between test cells and test substances. Cytotoxicity was assessed by estimating cell loss from monolayers and by evaluating cytopathic changes in cultured cells. After 24 h exposure to the test materials results were in general agreement with reported observations from similar studies. However, extended exposure to composite resins gave rise to severe cytotoxicity, which has not been reported previously. In addition, monitoring of cultures by inverted microscopy demonstrated attempts at recovery in damaged monolayers with viable cells migrating and proliferating into areas of earlier cell loss. This supports observations in vivo of transient pulpal injury associated with the corresponding materials.

Acrylic Resins↗

A new laboratory method for evaluating the relative solubility and erosion of dental cements.

A method for accelerating the dissolution and erosion of 'acidic' dental cements has been developed which gave relative solubilities in accordance with in vivo observations, in contrast to the conventional test. It involves subjecting 24-h-old specimens to a jet of dilute acid (lactic or citric) and determining weight loss. The relative ranking for 'acidic' cements in the apparatus and in vivo was: glass ionomer less than silicophosphate less than zinc phosphate less than polycarboxylate. The method was not valid for reinforced zinc oxide/eugenol/EBA cements. Of the two polycarboxylate cements studied, a brand which has the acid in the powder was found to be more soluble than the conventional material. It is proposed that the method be the basis of a new solubility/erosion test in national and international standards for 'acidic' dental cements.

Chemical Phenomena↗

A laboratory and clinical evaluation of three dental luting cements.

The loss of material from specimens of three luting cements was measured after continuous erosion cycling in the laboratory. The glass ionomer luting cement showed significantly less material loss than the zinc polycarboxylate and zinc phosphate luting cements. Two hundred and fifty restorations cemented with one of the three materials were studied clinically for marginal integrity and retention over 3.5 years. The data were tested using survival analysis. Zinc phosphate cement gave the best clinical performance. Possible explanations for the poor correlation between the findings in the laboratory and clinical study are discussed.

Dental Cements↗