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Longevity of new hybrid restorative materials in class III cavities.

The aim of this study was to evaluate the durability of two new tooth-colored restorative materials, a polyacid-modified resin composite (compomer) and a resin-modified glass ionomer cement. In an intra-individual comparison with a resin composite, the materials were studied during a 5-yr period. In 50 patients, 154 large class III restorations were placed. Most patients received one of each of the three materials. The restorations were evaluated by modified United States Public Health Service (USPHS) criteria. Of the 144 restorations evaluated, 15 were found unacceptable. No significant differences were seen between the materials concerning recurrent caries incidence. The resin composite showed a significantly better color match. No difference was found between resin composite fillings in enamel- or total-etched cavities. Significantly higher surface roughness was found in the aged resin-modified glass ionomer cement restorations. Fracture of the incisal enamel corner was observed adjacent to 10 restorations. None of the three total-etch techniques resulted in postoperative sensitivity or loss of vitality. All the restorative techniques showed a low failure rate during the 5-yr follow-up.

Acid Etching, Dental↗

Sealing ability of super EBA and Dyract as root-end fillings: a study in vitro.

The purpose of this study was to compare, in vitro, the sealing ability of Super EBA and a compomer, Dyract, as root-end filling materials. Forty-eight single-rooted human teeth were cleaned, shaped and obturated with gutta-percha. The root apices were resected and root-end cavities were prepared. Twenty teeth were retrofilled with Super EBA and Dyract; eight teeth served as positive and negative controls. Half of the teeth in each group were immersed in basic fuschin for 4 weeks, the other half for 12 weeks. The teeth were then embedded in resin, sectioned, and the maximum extent of dye penetration measured. Statistical analysis (ANOVA) did not reveal a significant difference between the two materials at 4 weeks. At 12 weeks, the extent of dye penetration was statistically significant with Super EBA leaking more than Dyract (P = 0.002). Moreover, the extent of the dye penetration was statistically significantly different for Super EBA between the 4- and 12-week groups (P = 0), whereas no such difference was found for Dyract. Thus, the sealing ability of Dyract was found to be better than Super EBA at 12 weeks.

Compomers↗

Fluoride release from aesthetic dental materials.

The objective of the study was to compare the amounts of fluoride released by two glass-ionomer cements, a resin-modified glass-ionomer cement, a compomer and a fluoride-containing composite into deionized water and artificial saliva. Disc samples of each of the materials were fabricated and placed in either water or artificial saliva. Fluoride analysis of the media was performed periodically over 64 days. The data were analysed to show the rate of fluoride release per cm2 per hour for each material. The results showed that the fluoride release rate for all the materials in both solutions decreased dramatically after 24 h. The release rate in artificial saliva was significantly less than in water (P < 0.001). The resin-modified glass-ionomer cement consistently displayed the highest fluoride release rate per hour into both media.

Acrylic Resins↗

Fluoride recharge of aesthetic dental materials.

The objective of the study was to compare the potential for fluoride recharge of two glass-ionomer cements, a resin-modified glass-ionomer cement, a compomer and a fluoride-containing composite in artificial saliva. Disc samples of each of the materials were placed into artificial saliva. The fluoride content of the artificial saliva was determined at various intervals up to 57 days. The discs were subjected to a 2 min exposure of NaF (500 parts/106). This recharge procedure was repeated at 64 and 120 days. The fluoride release was measured before and after recharge. The fluoride release for all of the materials increased after each exposure to NaF; however, the amount for the composite was very low. The resin-modified glass-ionomer cement displayed the greatest potential for fluoride recharge at 57 and 64 days (P<0.05). By 120 days, the amount of fluoride released in the 24 h post-recharge interval had decreased in all the materials. All the materials showed a potential for fluoride recharge. This effect, however, was minimal in the fluoride-containing composite.

Acrylic Resins↗

Finite element analysis of strength characteristics of various resin based restorative materials in Class V cavities.

This study investigated the strength characteristics of various composites (Tetric Ceram, Tetric Flow, Prisma AP.H, Synergy Duo Shade, Synergy Compact, and Z 100) and compomers (Compoglass, Compoglass F, Dyract AP, F 2000) that were applied in a Class V cavity of a maxillary central incisor. The study was conducted by using a 3-dimensional finite element approach and in the study ansys package program was used. The tooth model had 294 elements and 420 nodes. The teeth considered were assumed to be subjected to an incisal load of 200 N acting at an angle of 26 degrees with the longitudinal axis of the tooth but the effects of different loading angles and different loads were also analysed. Hence, the loads of 100 and 400 N and the loading angles of 0 degrees representing bruxism and 90 degrees representing a traumatic load were also taken into consideration. The effects of the cavity preparation size were also studied. It was determined that any increase in the loading angle and/or the amount of the load resulted in a proportional increase in the stresses developed in the tooth. Furthermore it was also verified that, as a cavity weakens the tooth structure by creating a discontinuity in an intact tooth, the larger sized cavity preparations inevitably cause larger stresses to be developed in the tooth. Strictly from the mechanical point of view, the stresses developed in the restored teeth were determined to be inversely proportional with the modulus of elasticity of the restorative materials. Therefore within the scope of the study Z 100 was found to be superior to the other materials concerned.

Compomers↗

Influence of dentinal regions on bond strengths of different adhesive systems.

This in vitro study assessed comparatively the shear bond strengths of three composite resins, 3M Valux Plus (3MVP), Herculite (H), Clearfil AP-X (CAP-X), a polyacid modified composite resin Dyract (D), and a resin modified glass-ionomer materials Vitremer (V), to cervical and buccal dentine regions of extracted human molar teeth. Four different bonding systems, 3M ScotchBond Multipurpose (SB), Clearfil Liner Bond 2 (LB2), Opti Bond (OB), and Prime & Bond 2.1 (PB 2.1) were used with the manufacturer's respective composite and compomer materials. One hundred freshly extracted mandibular molar teeth were selected for this study. Flat buccal dentine surfaces were created on 50 teeth and cylindrical rods of the five materials were bonded to the dentine surfaces. For assessment of cervical bond strengths, the materials were bonded to mesial and distal enamel bordered occlusal dentinal surfaces of the remaining 50 teeth. The five groups of restorative procedures were applied as follows; Group 1: SB + 3MVP, Group 2: LB2 + CAP-X, Group 3: OB + H, Group 4: PB2.1 + D, Group 5: Vitremer primer (VP) VP + V. Each restorative procedure thus had 20 specimens (10 buccal + 10 cervical). After 24 h of water storage (37 degrees C), the specimens were tested on a Universal Testing machine in shear with a cross head speed of 0.5 mm min-1. The bond strength values were calculated in MPa and the results were evaluated statistically using Kruskal-Wallis one-way/anova and Mann-Whitney U-tests. It was found that the bond strengths of SB + 3MVP, LB2 + CAP-X and VP + V to buccal dentine surfaces were significantly stronger (P < 0.05) than those to the occluso-cervical dentine floors. When the bond strengths to the occluso-cervical dentine and buccal dentine surface were compared, there was no significant difference between the materials (P > 0.05). Vitremer was found the least successful adhesive material in terms of shear bond strength on both buccal and occluso-cervical dentine surfaces.

Acrylic Resins↗

Resistance of core materials against torsional forces on differently conditioned titanium posts.

STATEMENT OF THE PROBLEM: The separation of core materials from titanium posts, which have a low modulus of elasticity, has been identified as a problem in restorative dentistry. PURPOSE: This study evaluated the resistance to torsional forces of various core materials adapted to differently conditioned titanium posts. MATERIAL AND METHODS: Seven hundred and twenty specimens were tested consisting of: 6 core materials and 5 surface conditioning techniques for 2 kinds of opaquers with 10 specimens in each group (6 x 5 x 2 x 10=600) plus 6 core materials and 2 opaquers were tested and considered as control groups on nonconditioned titanium posts, each group containing 10 specimens (6 x 2 x 10=120). The custom-made pure titanium posts were conditioned with the following products: Silicoater Classical, Silicoater MD, Rocatec, Kevloc, and Siloc surface-conditioning systems. Subsequently, 6 core materials with different compositions (Durafill, Adaptic, Coradent, Ti-Core, Hytac Aplitip, and Photac-Fil Aplitip) were applied to titanium posts that were previously coated with 2 types of light-polymerized opaquers, either Artglass or Dentacolor. Sixty air-abraded titanium posts (250 microm, 30 seconds) were used as controls for each core material. Following thermocycling (5 degrees -55 degrees C, 30 seconds, 5,000 cycles), maximum torsional forces were determined with an electronic torque movement key. Data were statistically analyzed by 1-way analysis of variance followed by 2-way analysis of variance (P<.05). RESULTS: Significantly higher mean torsional forces were observed with respect to Siloc (20.4 Newton decimeter [dNm]), Silicoater Classical (18.6 dNm), Silicoater MD (18.2 dNm), and Rocatec (17.0 dNm) systems compared with the mean for the untreated control group (14.6 dNm) (P<.001). The Kevloc system (10.4 dNm) demonstrated no significant difference compared with the control group (P>.001). The Kevloc system in combination with the Artglass opaquer and Photac-Fil Aplitip (0.00 dNm) core material showed no resistance against torsional forces. Significant differences were observed between hybrid core materials and microfilled composite, compomer, or resin-modified glass ionomer core materials (P<.001). CONCLUSION: Within the limitations of this study, the resistance to torsional forces for the core materials on titanium posts increased with the use of chemical surface-conditioning techniques and varied in accordance with the opaquer type. Type of core material also significantly influenced the resistance after thermocycling.

Acrylonitrile↗

Reasons for restorative therapy and the longevity of restorations in adults.

The aim of this study was to obtain information on the restorative dental care of adults in Finland. A random sample of private dentists was drawn from the register, and in spring 2000 they were sent a questionnaire requesting them to record information for each restoration placed during one ordinary working day. A total of 800 dentists were contacted and 548 responded. The dentists reported placement of 3,455 restorations. Of these, 5% were Class I, 36% were Class II, 13% were Class III, 9% were Class IV, 21% were Class V, and 16% were extensive restorations including 4 or more surfaces. Overall, composite resin was the most common restorative material, and it was used in 79% of the restorations, whereas amalgam was used in 50%, compomers in 4%, and glass ionomers (either conventional or resin-modified) in 7% of cases. In 5%, of the cases, the tooth was restored with indirect restorative methods, using either gold or ceramic materials. Of the treatments, 65% were replacements of previous restorations. Secondary caries was the most common reason for replacement (36%, 52%, and 41% for composite, glass ionomer, and amalgam, respectively). Other common reasons were fractures of the tooth or restoration (23%, 11%, and 22% for composite, glass ionomer, and amalgam, respectively) and lost composite restorations (16%). The median age of failed restorations was 15 years for amalgam, 6 years for composite, and 7 years for conventional glass ionomer. Although the longevity of tooth coloured restorations was shorter than that of amalgam, comparisons with our previous studies indicate improved survival periods for tooth coloured materials.

Adolescent↗

Orthodontic adhesives: a systematic review.

OBJECTIVES: To evaluate which orthodontic adhesives (a). bond orthodontic brackets to teeth more reliably and (b). are more effective at preventing decalcification. DATA SOURCES: The search strategy for the literature review was carried out according to the standard Cochrane systematic review methodology. The Cochrane Clinical Trials Register and the Cochrane Oral Health Group Specialized Register were searched for randomized clinical trials and controlled clinical trials. All volumes that had not already been assessed by the Oral Health Group in the European Journal of Orthodontics, American Journal of Orthodontics, Journals of Orthodontics, and Angle Orthodontist were hand-searched. Inclusion and exclusion criteria were applied when considering the studies to be included in this review. DATA SELECTION: The primary outcome measure was the failure of the orthodontic adhesive. A secondary outcome of decalcification occurring around the orthodontic bracket was also recorded, if data were available. DATA EXTRACTION: Two randomized clinical trials and one controlled clinical trial were identified that fulfilled all the inclusion and exclusion criteria. The trials compared: (a). light- and chemically-cured composite; (b). chemically-cured composite and conventional glass ionomer cement; and (c). chemically-cured composite and light-cured compomer. DATA SYNTHESIS: Each paper was quality assessed by two people independently. A qualitative analysis of the trials in the review is presented. The data presentation, for the majority of the trials, precluded the use of suggested Cochrane Health Group statistical analysis. CONCLUSIONS: It is difficult to draw any conclusions from this review; however, suggestions are made for methods of improving future research involving orthodontic adhesives.

Compomers↗

In vivo evaluation of two new moisture-resistant orthodontic adhesive systems: a comparative clinical trial.

OBJECTIVE: To evaluate and compare the clinical performance of two new moisture-resistant orthodontic adhesive systems: a chemically-cured composite resin (Unite, 3M Unitek, Monrovia, California, USA) in conjunction with a special moisture-resistant primer (Transbond MIP, 3M Unitek, Monrovia, California, USA); and a fluoride-releasing light-cured compomer (Assure, Reliance Orthodontic Products, Inc., Itasca, Illinois, USA). DESIGN: Randomized controlled clinical trial using the 'split-mouth' technique. SETTING: Department of Orthodontics, Aristotle University of Thessaloniki. SUBJECTS (MATERIALS) AND METHODS: Twenty-five consecutively started patients (13 females and 12 males) requiring fixed appliance orthodontic treatment. INTERVENTIONS: Four-hundred-and-thirty-six stainless steel brackets bonded to all teeth except molars using two different moisture-resistant orthodontic adhesive systems. MAIN OUTCOME MEASURES: Bond failure rates during a period of 9 months were estimated for each adhesive system and the corresponding bracket survival curves were plotted using the Kaplan- Meier product-limit estimate. Bracket survival distributions with respect to adhesive material, tooth location, patient's gender and operator, were then compared by means of a log-rank test. Bond failure interface was determined using the Adhesive Remnant Index. RESULTS: Assure recorded a higher bond failure rate (13.8 per cent) than Unite & MIP (7.3 per cent). The corresponding bracket survival curves were found to be significantly different (P < 0.05). Premolars exhibited higher bond failures than incisors and canines (P < 0.001), while half (49.8 per cent) of the total bond failures occurred during the first 2 months of treatment. The predominant mode of failure was within the bonding material. CONCLUSION: The new moisture-resistant adhesive systems under study were found to be clinically efficient, though Assure exhibited a significantly higher bond failure rate than Unite and Transbond MIP. The higher frequency of adhesive failures observed with Assure might indicate a possible weak point at the adhesive-bracket interface.

Adhesives↗

Antibacterial effects of resinous retrograde root filling materials.

The effect of three resinous retrograde root filling materials on the growth of four obligate anaerobic bacteria associated with endodontic infections was determined by using the agar diffusion inhibitory test. Samples of the following resinous materials (resin-modified, glass-ionomer cement, Fuji II LC; compomer, Dyract; and composite resin, Spectrum) were incubated for 1 week with the following anaerobic bacteria: Fusobacterium nucleatum, Porphyromonas gingivalis, P. endodontalis, and Prevotella intermedia. The freshly mixed and set resinous materials were placed into the prepared wells of agar plates inoculated with the test microorganisms for 1 week. After the end of the incubation period, the zone of growth inhibition was observed and measured. Analysis of variance of the mean diameter of the zone of inhibition indicated no statistically significant overall differences in the response of the black-pigmented Bacteroides species (p > 0.05). For F. nucleatum, Spectrum had more antibacterial effect against this bacteria than Dyract (p < 0.05). Additionally, Fuji II LC was ineffective against F. nucleatum (p < 0.05). However, positive control plates showed bacterial growth in all cases. Our data suggest that the antibacterial potency of polymerized materials varied considerably, depending on the type and the product tested.

Analysis of Variance↗

Clinical performance of a non-rinse conditioning sealant in three paediatric dental practices: a retrospective study.

The present clinical retrospective study describes the retention rates of a compomer sealant (Dyract Seal, Dentsply-De Trey, Germany) with non-rinse conditioning (NRC) placed in three paediatric dentistry practices. Three hundred and seventeen sealants were applied in 220 primary and 97 permanent molars of 176 children aged 2.5-13 years. The tooth surface was freshened with a #1/2 round bur mounted on a slow speed engine, and isolated with cotton rolls. Application of the NRC and Dyract Seal followed the manufacturer's instructions. Sealant retention was classified as A (fully retained), B (partially lost) or C (completely missing). From a total of 220 sealants placed in primary molars, 38 were in the mouth between 12 and 18 months, 29 functioned between 19 and 24 months and 46 were followed up between 25 and 36 months. One hundred and thirteen (51%) were fully retained (A), 73 (33%) scored B (27 for 12-18 months; 20 for 19-24 months, 26 for 25-36 months) and 34 (16%) were lost and scored C (12 for 12-18 months; 12 for 19-24 months; 10 for 25-36 months). From a total of 97 sealed permanent molars, 45 (46%) were fully retained (score A). Of these, 25 were followed up for 12-18 months, 10 for 19-24 months and 10 for 25-36 months. Thirty-eight sealed permanent molars (19%) scored B [17 for 12-18 months, 10 for 19-24 months and seven for 25-36 months and 14 (15%) were completely lost (score C: 6 for 12-18 months, seven for 19-24 months and two for 25-36 months)]. Dyract Seal has a lower retention rate than conventional sealants. It may be appropriate for sealing primary molars of very young children for a limited period of time and for permanent molars of children with pronounced gag reflex, where rinsing can become a problem and lead to disruptive behaviour.

Acid Etching, Dental↗

Freeman-Sheldon syndrome: a case report.

BACKGROUND: Freeman-Sheldon Syndrome is a rare craniofacial syndrome that has not been described in the dental literature to date. The main feature of relevance is severe microstomia, which limits access for routine dental care. CASE REPORT: Dental treatment was carried out successfully under local anaesthetic for a young child with Freeman-Sheldon syndrome. A novel coloured compomer material was helpful in the management of the case. CONCLUSION: The importance of early referral of children with rare craniofacial anomalies to Specialist Paediatric Dental services is highlighted.

Child, Preschool↗

Effect of resin-based material combination on the compressive and the flexural strength.

The mechanical properties, elasticity and compressive strength, of restorative materials play a crucial role during mastication for clinical performance of materials in particular stress bearing areas at posterior regions. This in vitro study was objected to evaluate the changes in the compressive and flexural strength of tooth-coloured resin-based dental restorations placed on flowable composites. Specimens in the control group were produced in cylindrical form for testing compressive strength and in quadrangular prism form for flexural strength test. Tetric Ceram, Charisma, Surefil, Admira and two compomers; Dyract AP and Compoglass F in test group specimens were fabricated by placing the control materials on different flowables. The material combinations were as follows: Tetric Ceram/Tetric Flow Charisma/Flowline, Surefil/Dyract Flow, Admira/Admira Flow, Dyract AP/Dyract Flow, Compoglass F/Compoglass Flow. Compressive strength values were measured at the Instron Testing Machine with a cross-head speed of 10 mm min(-1) while flexural strength were determined in three-point bending with a cross-head speed of 1 mm min(-1). One-way anova and Tukey's multiple comparison tests were performed for the statistical analysis. The flexural strength values of Tetric Ceram/Tetric Flow (135.9 +/- 3.2), Charisma/Flowline (120.4 +/- 5.6) and Compoglass F/Compoglass Flow (108.2 +/- 5.2) combinations were statistically greater than Tetric Ceram (110.8 +/- 10.5), Charisma (95.3 +/- 5.3) and Compoglass F (86.9 +/- 4.9). The results of the present study support the idea that the placement of flowable composite as a liner under the resin-based composite restoratives increase the flexural strength.

Compomers↗

Effects of the Nd:YAG laser, air-abrasion, and acid-etchant on filling materials.

The purpose of this study was to determine any inadvertent effects of the neodymium: yttrium-aluminium-garnet (Nd:YAG) laser, air-abrasion, and ortho-phosphoric acid on some conventionally used dental filling materials [amalgam, composite resin, compomer, glass-ionomer cement (GIC), and ceromer], when they were used for purposes of margin etching and assessed according to standard enamel etching parameters using a total of five fillings. The surfaces of the filling materials were polished. One sample from each material group was exposed to laser (at 0.75 J, 15 pps) and air abrasion (with Al-oxide powder, 60 psi) for 2 s and to the 37% ortho-phosphoric acid for 60 s. The exposed materials were examined under Scanning Electron Microscopy (SEM). After laser treatment most specimens showed recrystallized areas, the GIC surface being the most affected. There were some pores and cavities on the amalgam surface following laser treatment. The abraded surfaces showed mechanical abrasions. The acid etchant showed the least effect. During the application of laser or air-abrasion, the adjacent tooth or filling surface must be protected or the dentist must be careful.

Air Abrasion, Dental↗

Resin-modified glass ionomer cements: fluoride release and influence on Streptococcus mutans growth.

The aims of the present study were to measure the fluoride release of 1 glass ionomer cement, 1 cermet, 3 resin-modified glass ionomer cements and 1 compomer, and to determine the influence of each material on bacterial growth. Test specimens were eluted in saline for 180 days. Every 2 days, the specimens were transferred into fresh saline and the fluoride content of the solution was measured. Furthermore, 48-h, 14-d, 90-d, and 180-d eluates were inoculated with Streptococcus mutans and bacterial growth was recorded nephelometrically. Fluoride release dropped significantly over time for each material with values between 6.2 (Ketac-Silver) and 29.3 (Photac-Fil) ppm after 48 h to values between 0.6 (Ketac-Silver) and 1.7 (Ketac-Fil, Vitremer) ppm after 180 days. Each material reduced bacterial growth at each time of examination, but the effect decreased significantly over time with a maximum growth of 71.7% (Ketac-Fil) to 85.6% (Ketac-Silver) after 48 h and 94.7 (Vitremer) to 99.0% (Ketac-Silver) after 180 days (growth control = 100%). Both Ketac-Silver and Dyract showed a significantly lower inhibiting effect on bacterial growth than the other materials. The tested materials showed a good correlation between fluoride release and influence on bacterial growth. However, both effects dropped dramatically over the 180-days period.

Cariostatic Agents↗

Resin-ionomer restorative materials for children: a review.

Hybrid restorative materials comprising resins and components of conventional glass ionomers have been widely introduced and accepted by the dental profession in recent years. These include the resin-modified glass ionomer cements and the polyacidmodified resin composites or compomers. They are developed in an attempt to overcome the problems of traditional restoratives, such as moisture sensitivity and reduced early strength, while at the same time maintaining their clinical advantages of command setting, adhesion to tooth structures, adequate strength to occlusal load, fluoride release and aesthetics. This paper reviews the development, composition and properties of these new materials. Their clinical performance appears to be promising and they should be considered as good alternatives to amalgam and other conventional restorative materials in the future.

Biocompatible Materials↗

Fluoride-containing restorative materials.

Dental practitioners are exposed to an increasing number of dental materials, which claim the benefits of fluoride release. The purpose of this paper is to critically review the literature of these materials. Glass ionomers, resin modified glass ionomers, compomers, resin composites, fissure sealants and amalgam are discussed. It is clear that a long-term measurable release of fluoride can be observed from certain restorative materials, in vitro, particularly glass ionomer cement, resin modified glass ionomer cement, fluoridated cements, fluoridated dental amalgam and certain fissure sealants. In general, the rate of fluoride release is not constant but exhibits a relatively rapid initial rate, which decreases with time. However, the fluoride release profiles may be dependent on specific formulation and on experimental design and sampling methods. These materials may feature greater longevity, a reduced incidence of marginal failure, an elevated concentration of fluoride in contingent plaque, together with an antibacterial action when compared with non-fluoride releasing materials. In addition, fluoride-releasing materials may perform better in caries inhibition in artificial caries model studies than non-fluoridated materials. While any, or all, of these anti-cariogenic effects may be associated with fluoride release, a direct relationship between fluoride release profiles and such effects has not been determined in vivo.

Cariostatic Agents↗