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Effect of hydrostatic pressure on regional bond strengths of compomers to dentine.

OBJECTIVES: The aim of this study was to evaluate the effect of hydrostatic pressure on the regional bond strengths of compomers to dentine. METHODS: Thirty freshly extracted molars were ground flat to expose the dentine and randomly divided into two groups for bonding: no hydrostatic pressure and hydrostatic pressure of 15cm H(2)O. Xeno CF, Dyract AP and F 2000 were applied to dentine surfaces pretreated by the respective bonding systems following the manufactures' instructions, and then restored with Clearfil AP-X. After 24h storage in water, the teeth were sectioned into 0.7-mm thick slabs and visually divided into three regional subgroups: the region communicating with the pulp through dentinal tubules (pulp horn); the region between the pulp horns (center); and the region between the pulp horn and DEJ (periphery). The specimens were trimmed to a cross-sectional area of 1mm(2) and subjected to the micro-tensile bond test. The data were analyzed by one- and three-way ANOVA, and Fisher's PLSD (p<0.05). RESULTS: There were no significant regional differences of bond strengths for all the compomers tested (p>0.05). However, hydrostatic pressure significantly decreased the bond strength of F 2000 to all regions (p<0.05), while the bond strength of Dyract AP significantly decreased only at the pulp horn region (p<0.05). On the other hand, the bond strengths of Xeno CF seemed not to be affected by hydrostatic pressure (p>0.05). For Dyract AP and F 2000, the fracture modes were affected by hydrostatic pressure, while, for Xeno CF, there were no significant differences between the fracture modes with non- or positive hydrostatic pressure. SIGNIFICANCE: Simulated pulpal pressure of 15cm H(2)O had a greater influence on the bond strengths of compomers to dentine than did dentine regions. Therefore, when measuring the bond strengths of compomers to dentine under the simulated in vivo conditions, the wetness of the dentine surface, as well as the intrinsic properties of each material should be seriously considered.

Analysis of Variance↗

Clinical evaluation of paired compomer and glass ionomer restorations in primary molars: final results after 42 months.

OBJECTIVES: To undertake a clinical trial comparing the efficiency of a compomer restoration with a glass ionomer restoration in the management of caries in primary molar teeth. DESIGN: Subjects were admitted to the trial if they required at least one pair of restorations in primary molar teeth. SETTING: Department of Child Dental Health, Newcastle Dental Hospital and School. SUBJECT: Twenty nine children, aged 4-9 years, had 56 pairs of restorations placed between January 1995 and November 1997. METHOD: The durability of the restorations was assessed during a 42-month follow-up period using modified United States Public Health Service criteria. Survival analysis and the McNemar paired test were used to compare the performance of the two restorative materials. RESULTS: The compomer restorations had a higher mean survival time (42 months, SE 1.40) compared with 37 months (SE 1.90) for the glass ionomer restorations and this was significant at the 5% level. The compomer also performed significantly better in terms of anatomical form, marginal integrity, cavo surface discoloration and maintenance of interproximal contact. CONCLUSIONS: The present trial demonstrated that Dyract compomer performed significantly better than Chemfil Superior a glass ionomer cement for all modified United States Public Health Service criteria over a period of 42 months.

Aluminum Silicates↗

Laboratory evaluation of a compomer and a resin-modified glass ionomer cement for orthodontic bonding.

The mean shear debonding force of stainless steel orthodontic brackets with microetched bases bonded with either a compomer or a resin-modified glass ionomer cement was assessed. In addition, the amount of cement remaining on the enamel surface following bracket removal was evaluated. Finally, survival time of orthodontic brackets bonded with these materials was assessed following simulated mechanical stress in a ball mill. Debonding force and survival time data were compared with those obtained for brackets bonded with a chemically cured resin adhesive, a light-cured resin adhesive, and a conventional glass ionomer cement. There were no significant differences in mean shear debonding force of brackets bonded with the compomer, resin-modified glass ionomer, chemically cured resin adhesive, or the light-cured resin adhesive. Brackets bonded with a conventional glass ionomer cement had a significantly lower mean shear debonding force than that recorded for the other materials. The Adhesive Remnant Index (ARI) mode score indicated that significantly less cement remained on the enamel following debonding of brackets cemented with resin-modified or conventional glass ionomers compared with other adhesives. The median survival time for brackets cemented with the compomer, resin-modified glass ionomer, chemically cured resin, or light-cured resin were significantly longer than for brackets cemented with conventional glass ionomer. The compomer and the resin-modified glass ionomer adhesive appear to offer viable alternatives to the more commonly used resin adhesives for bracket bonding.

Acid Etching, Dental↗

Reactions of connective tissue to compomers, composite and amalgam root-end filling materials.

AIM: To evaluate the subcutaneous connective tissue reaction to compomers, composite and amalgam root-end filling materials. METHODOLOGY: This study was conducted in 30 Wistar albino rats. The materials were mixed or light-cured according to the manufacturer's directions and placed in polyethylene tubes. Group 1 - Dyract compomer (Dentsply); group 2 - F2000 compomer (3M); group 3 - Valux Plus composite (3M); group 4 - Oralloy high-copper amalgam (Coltene). The tubes containing the materials were implanted into the dorsal connective tissue of rats, which were killed 7, 15, 30, 60 and 90 days after the implantation procedure. Thirty extra empty tubes were also placed as controls. The implant sites were excised and prepared for histological evaluation. Sections of 6-microm thickness were stained with haematoxylin and eosin and assessed under light microscopy. The presence of inflammation, predominant cell type and thickness of fibrous connective tissue adjacent to each implant were recorded. Reactions were scored as: 0: none or few cells and no reaction; 1: less than 25 cells and mild reaction; 2: between 25 and 125 cells and moderate reaction; 3: 125 and more cells and severe reaction. Fibrous capsules were considered to be thin if their thickness was less than 150 microm and thick if it was more than 150 microm. Necrosis and formation of calcification were categorized as 'yes' or 'no'. RESULTS: All four materials caused moderate or severe inflammatory reactions in the first 7-day period, but these reactions decreased by the 60th and 90th days. No significant difference in inflammatory cell numbers between the materials could be detected at the 90th day. CONCLUSIONS: Valux Plus composite, Dyract and F2000 compomers and Oralloy amalgam were biocompatible.

Analysis of Variance↗

Relative solubilities of hybrid ionomers and compomers by acid impingement.

The purpose of this investigation was to determine the relative erosion/solubility for hybrid glass-ionomers and a compomer using the jet-impingement technique with lactic acid of various molarities. The materials studied included Dyract, Duet, Vitremer, Advance, Fuji-II LC, and Fuji-I, Ketac Cem and Modern Tenacin as the control. Data were analysed using ANOVA and Tukey's comparison test. Results indicated that depth of erosion/solubility with hybrid glass-ionomers and compomers was not measurable by the normal procedure. Similarly, weight changes were not detectable at 0.002, 0.02 and 0.05 M (except for Advance at 0. 05 M). All glass-ionomers materials and the compomer revealed weight changes at 0.1 M after 24 h, in the following increasing order: Dyract < Fuji-II LC=Duet < Advance < Vitremer. It was concluded that weight loss is a better parameter to characterize these new hybrids glass-ionomers and compomers for erosion/solubility by jet-impingement. In addition, a lactic acid of minimum 0.1 M as a test solution is required to generate 24 h-data that can be measured in most laboratories and thus used for statistical comparison.

Analysis of Variance↗

Effect of alcoholic and low-pH soft drinks on fluoride release from compomer.

PURPOSE: The purpose of this study was to evaluate the amount of fluoride released from compomer restorative materials after immersion in various media. MATERIALS AND METHODS: In this test, four materials were used: three compomers (Dyract, Dentsply, Konstanz, Germany; Compoglass, Vivadent, Schaan, Principality of Liechtenstein; and Xeno, Sankins, Tochigi, Japan) and one resin-modified glass ionomer cement (Fuji II LC, GC, Tokyo, Japan). There were four test solutions: one alcoholic (whiskey), two low-pH drinks (Coca-Cola, orange juice), and one deionized water. Over a period of 60 days, the tested specimens were immersed in the test solution for 3 hours every day, then kept in deionized water. The fluoride released was detected by using a fluoride ion selective electrode connected to a microprocessor ion analyzer. The fluoride ion concentration (ppm) of the test solutions and deionized water was recorded after 1, 2, 3, 4, 7, 30, and 60 days. Electron probe microanalysis was used for surface analysis of the fluoride released. RESULTS: When immersed in low-pH soft drinks, compomer showed a significantly higher fluoride release than when immersed in deionized water (p < .0001). For specimens immersed in Coca-Cola, the fluoride release levels (microgram/cm2, mean +/- SD) at 1, 7, and 60 days for Dyract (91.6 +/- 1.8, 39.3 +/- 3.1, 10.5 +/- 0.9), Compoglass (129.5 +/- 0.9, 66.5 +/- 2.7, 19.0 +/- 0.3), Fuji II LC (147.0 +/- 4.2, 50.8 +/- 3.1, 27.6 +/- 3.0), and Xeno (73.6 +/- 3.2, 27.3 +/- 2.1, 6.6 +/- 0.6) demonstrated the trend of significantly lower releases with time in water solution. Over a 60-day period, materials immersed in 100% orange juice released the highest amount of fluoride, which could be attributable to the erosive effect of the medium. Materials immersed in deionized water released the least amount of fluoride. Among the tested compomers, Compoglass released the most fluoride.

Alcoholic Beverages↗

Residual monomer/additive release and variability in cytotoxicity of light-curing glass-ionomer cements and compomers.

In previous studies, light-cured glass-ionomer cements have been shown to evoke cytotoxic reactions. It was the purpose of this investigation (a) to determine the nature of the ingredients released into an aqueous medium from 2 light-cured glass-ionomer cements (GICs) and 3 compomers; (b) to evaluate the cytotoxicity of these extracts; and (c) to correlate the extent of the cytotoxic effects with eluted substances. Specimens of 2 light-cured GICs and 3 compomers were prepared and extracted in distilled water or cell culture medium for 24 hrs (surface-liquid ratio 42.4 mm2/mL). The aqueous eluates were analyzed by gas chromatography/mass spectrometry (GC/MS). The relative amounts of the components released from various products were compared by means of an internal caffeine standard [%CF]. For evaluation of cytotoxic effects, permanent 3T3 fibroblasts were incubated with medium extracts for 24 hrs. In addition, the ED50 concentration of the photoinitiator diphenyliodoniumchloride (DPICl) was determined. In all extracts, several water-elutable organic substances were found: (Co)monomers (especially HEMA and ethylene glycol compounds), additives (e.g., camphorquinone and diphenyliodoniumchloride), and decomposition products. The extracts of 3 products inhibited cell growth only moderately, whereas the light-cured GIC Vitrebond and the compomer Dyract Cem revealed severe cytotoxic effects. Vitrebond liberated the initiator DPICl, whereas Dyract Cem segregated a relatively high quantity [2966 %CF] of the comonomer TEGDMA in comparison with the other products. The present data show that TEGDMA and DPICl may be regarded as the prime causes for cytotoxic reactions evoked by the investigated light-cured glass-ionomer cements or compomers. Therefore, leaching of these substances should be minimized or prevented.

3T3 Cells↗

Flexural properties and swelling after storage in water of polyacid-modified composite resin (compomer).

The flexural properties, flexural strength, flexural modulus and modulus of resilience, of four commercially available compomers, and one resin-modified glass ionomer cement and one microfilled resin comosite (as controls) immediately after light-activation and after 1 week of water storage were tested to assess the mechanical properties. The water swelling after storage in water was also tested to assess the characteristics in water of compomers. The flexural test showed compomers to be statistically stronger and more resilient than the resin-modified glass ionomer cement or the microfilled composite, when tested immediately after light-activation and after 1 week of water storage. Water swelling of compomers was statistically less than the resin-modified glass ionomer cement after 1 week of water storage.

Analysis of Variance↗

Influence of 30% hydrogen peroxide bleaching on compomers in their surface modifications and thermal expansion.

The surface modifications and the coefficient of thermal expansion of compomers after treatment with a 30% hydrogen peroxide bleaching agent were investigated. Three compomers (Compoglass F, Elan and F2000) were nonbleached and bleached for 1 and 3 days. The surface modification and the coefficient of thermal expansion of each bleached compomer were evaluated using a scanning electron microscope and a thermomechanical analyzer, respectively. As a result, Compoglass F and Elan showed slight surface degradation, whereas F2000 showed many cracks on its surface and these cracks were not observed in Compoglass F and Elan. Bleached Elan and F2000 has changed to the extent where their the coefficient of thermal expansion increased compared with those of nonbleached specimens. In addition, bleached compomers showed a strong inverse correlation between the coefficient of thermal expansion and the volume percent of filler.

Analysis of Variance↗

Solubility and fluoride release in ionomers and compomers.

OBJECTIVE: The degree of solubility and the fluoride release of glass-ionomer cements and "compomers" were determined as a function of time. METHOD AND MATERIALS: Three conventional glass-ionomer cements, three hybrid ionomers, and two compomers were included in the study. Disk-shaped specimens were prepared and immersed in a lactic acid solution. Solubility was evaluated from determinations of loss of mass as a function of time. To evaluate fluoride release, similar specimens were immersed in 50 mL of deionized water to which 50 mL of buffer solution was added. A fluoride ion detector was used to read the concentration of fluoride ion in the overall solution at different times after immersion. RESULTS: Material and time factors had a significant influence on results. The compomers showed less corrosion and fluoride release than the ionomers. Some correlation was found between solubility and fluoride leakage values. CONCLUSION: Components of both the ionomers and compomers that were studied can dissolve in water. The materials leak fluoride ions in amounts that differ according to the characteristics of the individual products.

Analysis of Variance↗

Laboratory strength of glass ionomer cement, compomers, and resin composites.

PURPOSE: The study evaluates the compressive, flexural, and diametral tensile strengths of 8 core build-up materials from different material classes (highly viscous glass ionomer cement, autocured resin composite, and compomers). MATERIALS AND METHODS: All materials were manipulated according to the manufacturers' recommendations for use as core materials. At a temperature of 23.0 +/- 1.0 degrees C the properties of compressive, diametral tensile and flexural strength were determined using a universal testing machine at 15 minutes, 1 hour, and 24 hours after material preparation. Using one-way analysis of variance (ANOVA), multiple mean value comparisons were performed to determine significant differences (p< or =.05) between the core restoration materials. RESULTS: The values for compressive strength varied from 40.3 +/- 5.2 MPa (compomer) to 237.4 +/- 37.3 MPa (autocured resin composite) for the 3 measurement times. At 15 minutes, 1 hour, and 24 hours after first mixing, the ANOVA showed significant differences (p < or =.05) between the resin composite Core Paste and all of the other materials. Diametral tensile strengths ranged from 5.5 +/- 1.1 MPa for glass ionomer cement to 39.1 +/- 2.9 MPa for composite core material. Three-point flexural strength showed values ranging from 12.1 +/- 2.5 MPa for glass ionomer cement to 92.1 +/- 9.7 MPa for compomer between the 3 measurement times. CONCLUSIONS: Setting time influences the mechanical properties of the materials tested in this study. Autopolymerizing resin composite Core Paste demonstrated greater compressive and flexural strengths at the 3 measurement times than the other materials tested. Reinforced composites, in comparison to the autocured resin composites, yielded no improvement in tensile strength. Flexural and tensile strengths of the glass ionomer cement were lower than those of autocured resin composites and compomers.

Analysis of Variance↗

Marginal and internal adaptation of stratified compomer-composite Class II restorations.

Different approaches have been proposed to improve the adaptation of Class II restorations, including applying low-elasticity modulus base liners. This in vitro fatigue test (or study) evaluated the influence of the compomer base-lining configuration on restoration adaptation. Direct Class II MOD box-shaped composite restorations with or without base and lining (n=3x8) were placed on intact human third molars with proximal margins 1 mm above or under the CEJ. The compomer (Dyract) was applied as a 1 mm-thick lining or as a base, closing proximo-gingival margins. Marginal adaptation was assessed before and after each phase of mechanical loading (250,000 cycles at 50N, 250,000 cycles at 75N and 500,000 cycles at 100N); internal adaptation was evaluated after test completion. Gold-sputtered resin replicas were observed in the SEM and restoration quality evaluated in percentages of continuity (C) at the margins and within the internal interface after sample section. Mechanical loading did not influence adaptation to enamel, while it adversely affected restoration adaptation to dentin for the full composite and compomer-base restorations (C varied, respectively, from 95.2 to 75.3% and from 98.0 to 10.6%). The internal adaptation quality showed the same general trend, however, with reduced scores of continuity. In this experimental condition, application of a low elasticity modulus layer under the restorative material proved advantageous but the compomer should not contact the gingival margins.

Bisphenol A-Glycidyl Methacrylate↗

Surface hardness and wear of glass ionomers and compomers.

PURPOSE: To determine the surface hardness and in vitro wear of glass ionomer cements (GIC) and compomers in comparison with a resin composite and to test for a possible correlation between the determined hardness and wear values. MATERIALS AND METHODS: Samples were made of conventional GIC (Ketac-Fil, Fuji II, Fuji IX, Ketac-Prototype = Ketac-Molar), resin-modified GIC (Photac-Fil, Fuji II LC, Vitremer), compomers (Dyract, Compoglass) and resin composite (Z100) for the hardness test (n = 10) and for the wear test (n = 3). The materials were handled according to the manufacturers' instructions. The samples were stored in deionized water for 48 hours at 37 degrees C prior to the determination of Rockwell hardness and three-body in vitro wear. RESULTS: Hardness could not be measured on Ketac-Fil and Fuji II as the samples fractured before a reading was obtainable. Statistically significant differences were found in hardness and wear between brands and between the four types of material. Surface hardness: resin-modified GIC < conventional GIC = compomers < resin composite. In vitro wear: resin-modified GIC > compomers > conventional GIC > resin composite. A negative correlation between hardness and wear was recorded.

Analysis of Variance↗

Compomers and glass ionomers: bond strength to dentin and mechanical properties.

PURPOSE: To compare compomers and conventional and resin-modified glass ionomer cements (GIC) with respect to bond strength to dentin and mechanical properties. MATERIALS AND METHODS: Seven conventional GICs (BaseLine, ChemFil Superior, Fuji II, Fuji IX, Ketac-Fil, Ketac-Silver, and Miracle Mix), three resin-modified GICs (Fuji II LC, Photac-Fil, and Vitremer), and two compomers (Dyract and Compoglass) were investigated. Bond strength was determined to untreated as well as pre-treated human dentin. The mechanical properties tested were flexural strength and flexural modulus. RESULTS: Mean bond strengths to untreated dentin ranged from 0.0 MPa (Photac-Fil) to 8.5 MPa (Fuji IX). Generally, the bond strengths of the compomers and resin-modified GICs were lower than those of the conventional GICs. Mean bond strengths to pre-treated dentin ranged from 0.5 MPa (Photac-Fil) to 13.7 MPa (Compoglass). No clear-cut bond strength pattern was observed for the three types of materials. Pretreatment improved the bond strength of nine out of 12 materials. Flexural strengths ranged from 13 MPa (Miracle Mix) to 180 MPa (Dyract). Generally, the compomers were stronger than the resin-modified GICs, which were much stronger than the conventional GICs. Flexural moduli ranged from 4.0 GPa (Miracle Mix) to 7.2 GPa (Fuji IX and Dyract) with no typical variations between the three categories of materials.

Analysis of Variance↗

Retention and marginal adaptation of a compomer placed in non-stress-bearing areas used with the total-etch technique: a 3-year retrospective study.

The aim of this clinical study was to evaluate class V and class III cavities restored with a polyacid-modified resin composite (compomer) restorative material in association with two different dentin-enamel bonding systems: Dyract-PSA (Primer Sealer Adhesive-DentSply, Germany) and Prime & Bond 2.0 (DentSply, Germany). The control group was a hybrid composite used with ProBond bonding system (DentSply, Germany). A total of 116 restorations (79 class V, 37 class III) were made and reevaluated after 1, 2 and 3 years in 55 patients in two private practices and in a university department. Class V nonretentive cavities were located at the CEJ level and class III at interproximal level close to CEJ. Each cavity was prepared using a water-cooled, high-speed handpiece with a fine diamond burr. A small bevel was prepared along enamel margin. Cavity dimensions were no more than 3.5 x 3.5 mm (using burr as reference point). Each restoration was finished immediately with fine diamond burrs and Sof-Lex disks (3 M, USA). The criteria that were evaluated by the USPHS method included: retention, color match, marginal integrity, marginal discoloration, and secondary caries. Results indicated that all compomer restorations were fully retained at 3 years, and that no secondary caries detected. Seven composite restorations were lost during the 3-year study. No statistical differences were observed between class III and class V or among other conditions (e.g., upper-lower arc, sex, age). This study demonstrates that compomers are suitable restorative materials for class III-V restorations. They may represent a clinical alternative to composites in class V and III restorations.

Adult↗

Bond strength of a compomer to dentin under various surface conditions.

This study determined the influence of different dentin pretreatments on the shear bond strength of an adhesive system and corresponding compomer material. One hundred and twenty freshly extracted human molars were ground with wet SiC paper to expose flat oral/buccal surfaces of superficial dentin. The teeth were assigned to 12 treatment groups (n = 10) based on dentin surface finish (600-grit SiC vs. air abrasion vs. 40 microns diamond bur), surface conditioning (acid etching vs. no etching), and moisture content of the dentin (moist vs. dry). Cylinders of Compoglass F compomer were bonded to the dentin with Syntac Single-Component. After 24-h storage in distilled water, the specimens were debonded in shear mode. Bond strengths in MPa (SD) were calculated and bonding sites were analyzed for the mode of failure. Three-way ANOVA revealed significantly higher bond strength values for acid etched specimens (P = 0.001). Moisture content of the dentin surface (P = 0.614) and mechanical surface finish (P = 0.367) had no significant influence on the results. Debonding in unetched groups ranged from 94 to 100% adhesively. Acid etched groups showed adhesive failures ranging from 56 to 100%. To obtain a more reliable bond it is recommended that dentin is acid etched prior to the bonding of a compomer.

Acid Etching, Dental↗

Sealing ability of two "compomers" applied with and without phosphoric acid treatment for Class V restorations in vivo.

STATEMENT OF PROBLEM: "Compomers" are being used with increasing frequency in Europe and North America. PURPOSE: This study evaluated the marginal seal of two compomers in vivo. MATERIAL AND METHODS: Periodontally involved teeth, scheduled for extraction, were selected. Four groups of a combination of materials were used (Dyract with Dyract-PSA primer, group 1; Dyract with Prime and Bond 2.0, group 2; Compoglass with SCA primer, group 3; and Compoglass with Syntac Single Component, group 4). The restorations were made in a standardized shaped cavity, across the cementoenamel junction, and the teeth were extracted after 2 to 3 months of clinical service. The specimens were kept in a solution of 2% methylene blue for 24 hours. After being embedded in epoxy resin, sections were made with a low speed saw along the longitudinal axis of the teeth. The examination of dye penetration was made with a microscope at a magnification of x20 and scoring was done at both coronal and apical sites. Kruskal-Wallis statistical analysis was performed at 5% significance level. RESULTS: Groups 2 and 4 scored significantly less than groups 1 and 3 and for groups 2 and 4, 30% of the restorations exhibited leakage. CONCLUSION: These restoration systems did not completely prevent leakage either at the incisal or the cervical margins. Therefore the use of an enamel-dentin bonding system in combination with the proprietary compomer is recommended.

Acid Etching, Dental↗

Microleakage of Class V compomer and light-cured glass ionomer restorations.

STATEMENT OF PROBLEM: Resin-modified (light-cured) glass ionomer and polyacid-modified composite resin (compomer) restorations are popular choices for the restoration of root caries and cervical abrasion/erosion lesions, but clinical studies are relatively few and have been published primarily as abstracts. PURPOSE: In the absence of adequate clinical data, the marginal integrity of restorations of the above two types of material was compared in vitro. The microleakage of restorations of two light-cured glass ionomer restorative materials and of one compomer material was evaluated. METHODS AND MATERIAL: Restorations of the three materials were placed in facial and lingual Class V cavity preparations in bovine incisors. All preparations were centered on the cementoenamel junction and were prepared with 45-degree enamel bevels. After thermal cycling, teeth were immersed in methylene blue dye, then sections of the restorations (n = 16) were visually evaluated. RESULTS: Dye penetration was observed at approximately 20% of restoration margins for all three materials, with the greatest incidence of severe leakage in the compomer restorations. CONCLUSION: No significant difference in microleakage among the three materials (ANOVA; p > 0.05) was found.

Animals↗