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Suppression of caries-related microorganisms in dentine lesions after short-term chlorhexidine or antibiotic treatment.

This study investigated the efficiency of a chlorhexidine varnish and an antibiotic paste in suppressing the cultivable microflora of deep dentine cavities in a stepwise excavation procedure. Subsequent to enamel preparation and removal of the central biomass, infected dentine was sampled from the cavity floor. Ten cavities each were either covered with the 1% chlorhexidine- and 1% thymol-containing varnish Cervitec (CE), the demeclocycline hydrocortisone-containing ointment Ledermix (LE) or received no treatment as control (CO). A compomer composite was used as intermediate restorative. Cavities were reassessed after 6 weeks and again dentine samples were microbiologically investigated for total viable counts, mutans streptococci and lactobacilli. After 6 weeks a significant reduction of the total viable counts was observed in the LE group (p = 0.011) compared to the control, whereas no differences were found in the CE group (p > 0.05). Mutans streptococci were rarely recovered at baseline and after 6 weeks. Compared to the CO group counts of lactobacilli were significantly reduced in the CE and LE groups (p < 0.05). Lactobacillus species were frequently recovered at baseline and after 6 weeks of observation. Lactobacillus rhamnosus was the predominant species in all samples investigated. Application of CE or LE resulted in reduced counts of lactobacilli after a period of 6 weeks. Although none of the materials completely eliminated the viable microorganisms, the use of LE was more effective than CE in reducing the total anaerobic microorganisms associated with carious dentine.

Actinomyces↗

The glass-ionomer phase in resin-based restorative materials.

Glass-ionomer (GI) fillers are added to restorative materials, but it is unclear if they truly react with these materials. This TEM study evaluated the existence of the GI phase in a conventional GIC (ChemFlex), a resin-modified GIC (Fuji II LC), a giomer (Reactmer Paste), a compomer (Dyract AP), and a composite (SpectrumTPH), before and after water uptake. Wafers were stored at 100% RH for 24 hrs, or in water for 7 or 84 days. ChemFlex glass particles were surrounded by 300-nm-thick silica gel layers. In Fuji II LC, we found thinner hydrogel layers (100 nm) that became thicker upon water storage. No appreciable change occurred in Reactmer Paste. Only a very thin hydrogel layer occurred in Dyract AP, and none was seen in SpectrumTPH after water storage for 84 days. We conclude that the variable extent of the GI phase is determined by differences in the resin composition of the restoratives.

Biocompatible Materials↗

Fracture mechanics analysis of the dentine-luting cement interface.

The objectives of this study were to determine the fracture toughness of adhesive interfaces between dentine and clinically relevant, thin layers of dental luting cements. Cements tested included a conventional glass-ionomer, F (Fuji 1), a resin-modified glass-ionomer, FP (Fuji Plus) and a compomer cement, D (DyractCem). Ten miniature short-bar chevron notch specimens were manufactured for each cement, each comprising a 40 microm thick chevron of lute, between two 1.5 mm thick blocks of bovine dentine, encased in resin composite. The interfacial K(IC) results (MN/m3/2) were median (range): F; 0.152 (0.14-0.16), FP; 0.306 (0.27-0.37), D; 0.351 (0.31-0.37). Non-parametric statistical analysis showed that the fracture toughness of F was significantly lower (p <0.05) than those of FP or D, and all were significantly lower than values for monolithic cement specimens. Scanning electron microscopy of the specimens suggested crack propagation along the interface. However, energy dispersive X-ray analysis indicated that failure was cohesive within the cement. It is concluded that the fracture toughness of luting cement was lowered by cement-dentine interactions.

Animals↗

When to use fillers, build-ups or posts and cores.

After preliminary tooth preparation for crowns, all previously placed tooth restorative material should be removed from teeth before making final tooth preparations. Small areas of missing teeth should be replaced with fillers (compomer); larger pieces of missing teeth should be replaced with build-ups (bonded composite resin or bonded amalgam); and endodontically treated teeth with half or more of the coronal tooth structure missing should receive a titanium or titanium alloy post and core and a bonded composite resin or bonded amalgam build-up.

Compomers↗

A simplified technique for the restoration of severely mutilated primary anterior teeth.

The restoration of severely carious primary anterior teeth is a challenge to the pediatric dentist. The introduction of new materials and technologies makes re-evaluation of existing treatment philosophies necessary. A technique involving the placement of an omega shaped stainless steel wire extension into the entrance of the root canal prior to restoring the crown with a compomer material is described. 96 restorations were placed in 25 children. After 18 months 81.2% of the 96 restorations, which were available for evaluation, 60 (79.9%) were intact. The technique for restoring primary anterior teeth was simple, quick and effective.

Child, Preschool↗

Clinical evaluation of three different materials used as pit and fissure sealant: 24-months results.

To evaluate the retention and caries experience effects of three different materials used as fissure sealants after 24 months of clinical application: a resin-modified glass ionomer cement (A), a flowable resin composite (B) and a compomer (C). One hundred and seventeen (117) teeth were sealed with material A, 119 teeth with material B and 120 teeth with material C. Children were randomly assigned. Each one received only one of the materials studied. Plaque index, dmft score and socioeconomic level were scored at baseline. The clinical exams were conducted 6, 12 and 24 months after application of the sealant. Statistical analysis (Kruskal-Wallis) revealed that there were statistically significant differences between the retention rates of groups A and B and between groups B and C after 2 years, with material B showing better results. After 2 years, 3.1% of the teeth of group A, 4.3% of group B and 6.7% of group C were Carious+Filled. There was no evidence of association between caries presence after 2 years and plaque index, dmft score and socioeconomic level. These results suggest that flowable resin composite had a satisfactory retention after this period of evaluation and all three materials were effective on occlusal caries prevention.

Cariostatic Agents↗

Correlation between the amount of linear polymerization shrinkage and cuspal deflection.

This study evaluated the relationship between the amount of cuspal deflection and linear polymerization shrinkage in resin composites and polyacid modified resin composites (compomers). Materials included were Dyract AP, Compoglass F, Z100, SureFil, Pyramid, Synergy Compact, Heliomolar and Heliomolar HB. To measure polymerization shrinkage, a custom-made linometer (R&B, Daejon) was used. Ten measurements were made for each group, and the amount of linear shrinkage that occurred in 60 seconds was statistically compared by one-way ANOVA analysis and Tukey's test. To measure the cuspal deflection of teeth, standardized MOD cavities were prepared in extracted maxillary premolars. After a self-etching adhesive was applied, the cavities were bulk filled with one of the filling materials. Fifteen teeth were used for each material. Cuspal deflection was measured by a custom-made cuspal-deflection measuring device. One-way ANOVA analysis and Tukey's test were used to determine differences between the materials. The correlation of polymerization shrinkage vs cuspal deflection was analyzed by regression analysis. The amount of polymerization shrinkage from least to greatest was Heliomolar, SureFil < Heliomolar HB < Z100, Synergy Compact < Dyract AP < Pyramid, Compoglass F (p < 0.05). The amount of cuspal deflection from least to greatest was Z100, Heliomolar, Heliomolar HB, Synergy Compact, SureFil, < Compoglass F < Pyramid, Dyract AP (p < 0.05). Both the amount of polymerization shrinkage and cuspal deflection were highly correlated (p < 0.001).

Acrylic Resins↗

Fluoride release and antibacterial properties of new-generation tooth-colored restoratives.

The aim of this study was to compare the amounts and pattern of fluoride release and antibacterial properties of new-generation restoratives over a 35-day period. Materials evaluated included fluoride-releasing composites (Tetric, Experimental X), compomers (Dyract, Compoglass), and a resin-modified glass-ionomer cement (Fuji II LC). A conventional glass ionomer (Fuji II Cap) was used as a control for fluoride-release testing. Five samples of each restorative material were evaluated for daily fluoride release over a 35-day period by means of ion chromatography. Ranking of materials from least to greatest total fluoride release over 35 days was as follows: Tetric < Experimental X < Dyract < Fuji II LC < Compoglass < Fuji II Cap. Fuji II Cap had significantly greater fluoride release than all other materials evaluated. Fuji II Cap, Fuji II LC, and Compoglass had similar patterns of fluoride release characterized by a high initial release that was many times that released later. The fluoride-releasing composites evaluated stopped releasing fluoride by day 14. Antibacterial testing was conducted using the agar diffusion inhibitory test. Five samples of each restorative were assessed at baseline and weekly intervals up to 35 days. The microorganisms used were Lactobacillus casei, Streptococcus mutans, and Streptococcus sobrinus. IRM, a zinc oxide/eugenol cement, was used as the baseline control. None of the restorative materials evaluated affected the growth of L casei, S sobrinus, or S mutans at all time periods including baseline, where fluoride was detected in the agar beneath the specimen disks. There was no correlation noted between fluoride-release potential and antibacterial properties.

Anti-Infective Agents, Local↗

Some principles in the selection and use of some tooth-coloured materials and techniques--1998.

In an era when many clinicians are confused or almost overwhelmed by the rapidity of change in the field of conservative dentistry, the purpose of this presentation/paper is to identify briefly, with 'bottom line' statements, the research evidence in many topics within this field. The fields to be covered are glass ionomer restorations, 'compomer' restorations, composite resins, 'posterior composites', post-restoration sensitivity, direct pulp therapy, resin bonding to enamel and to dentine.

Bicuspid↗

[A comparative analysis of the efficacy of different types of filling materials in the surgical elimination of tooth perforations (experimental morphological research)].

Based on the experimental morphological findings, the authors compare the efficiency of tooth perforation repair in experimental animals by surgical method using Dyract compomer, Base Line glass ionomeric cement, and Ostim-100 osteoplastic material. The data indicate a high efficiency of this method. Base Line material is preferable for filling the perforation in dental wall, as it reliably performed the isolating function under experimental conditions.

Animals↗

Comparative in vivo and in vitro investigation of interfacial bond variability.

This comparative in vivo/in vitro study investigated the interfacial adaptation between dentin and composite resins in totally bonded adhesive restorations placed under clinical and laboratory conditions in the same tooth. Cavities were prepared in buccal or lingual surfaces of 47 third-molar teeth scheduled for extraction and randomly assigned for treatment with the following bonding systems/restorative materials: Clearfil Liner Bond 2/Clearfil AP-X (Group I, n = 10), Resulcin AquaPrime + Monobond/MFR Merz (Group II, n = 9), Prime&Bond 2.1/Dyract AP (Group III, n = 9), Scotchbond Multi-Purpose/Z-100 (Group IV, n = 10), and Ecusit Primer AB-Mono/Ecusit (Group V, n = 9). In Group V, a thin layer of a low-viscous compomer (Primaflow) was interposed between the dentin and the composite resin during restoration placement (according to the manufacturer's directions). After extraction a second filling was placed in each tooth with identical materials in the same manner as in vivo. The restoration-dentin interface was evaluated in longitudinally cut sections of the specimens by SEM-analysis, and the frequency of gap formation between restoration and dentin was calculated. Median percentages for the in vivo/in vitro frequency of interfacial gap formation were 29.2%/13.9% in Group I, 33.3%/20.0% in Group II, 40%/5.3% in Group III, 53.9%/30.4% in Group IV and 13.8%/0% in Group V. Comparison of gap formation frequency between fillings placed in vivo and in vitro revealed significant differences (p < 0.05) in Groups II, III and IV. However, in Groups I and V the internal adaptation was not significantly different between in vivo and in vitro applied restorations. A significant (p < 0.01) correlation (Spearman-Rho rank correlation coefficient) was found for the corresponding in vivo and in vitro fillings placed in the individual teeth with regard to interfacial gap formation. It was concluded that achievement of a completely gap-free internal adaptation between restorative material and dentin in totally bonded composite resin restorations is difficult to predict under in vivo as well as in vitro conditions.

Bisphenol A-Glycidyl Methacrylate↗

Bond strengths of a porcelain material to different abutment substrates.

The study evaluated the bond strength values of a single-unit all-porcelain material luted with an adhesive-resin cement to different abutment substrates: amalgam, compomer, traditional glass ionomer cement, microhybrid resin composite, two resin composites for abutment build-up, gold, sandblasted gold, dentin and enamel. Syntac enamel-dentin bonding system, in combination with IPS-Empress porcelain material, was used. After thermal cycling, the samples were inserted into a Bencor jig device and sheared in a Controls testing machine. The statistical analysis of the differences between the bond strength values obtained was performed by ANOVA and the Student-Newman-Keuls multiple-comparison test. The type of failure at the interface was evaluated using scanning electron microscopy. The type of failure, such as adhesive, cohesive and adhesive-cohesive, was correlated with bond strength values. Enamel, dentin and the two resin composites for crown build-up showed the highest bond strength values, while amalgam and gold samples showed the lowest.

Adhesiveness↗

Color stability of fluoride-containing restorative materials.

Six fluoride-releasing materials of shade A3 were tested: one glass ionomer (Fuji IX), one resin-modified glass ionomer (Photac-Fil), two compomers (F 2000 and Dyract AP) and two composites (Tetric Ceram and Solitaire). Disk-shaped specimens of each material were prepared according to manufacturer's instructions, polished and L*a*b* baseline measurements taken. Specimens were randomly divided into two groups and given four different treatments of UV light exposure and immersion in a staining solution. Chromo Meter color measurements were taken following each treatment. Two-way ANOVA and Duncan Multiple Range post-hoc tests were used to compare color changes as a function of the four treatment conditions and one-way ANOVA was used to compare materials for each treatment separately. The results showed significant difference in shade A3 between products. In general, the hydrophobic materials showed greater color stability and stain resistance than the hydrophilic materials. Tetric ceram had the best color stability and stain resistance, while Fuji IX had the least.

Analysis of Variance↗

Fluoride release from a polyacid-modified resin composite and 3 resin-modified glass-ionomer materials.

OBJECTIVES: The purposes of this study were to compare the fluoride ion release from a freshly mixed polyacid-modified resin composite, or "compomer" (Dyract), and 3 resin-modified glass-ionomer cements (Fuji II LC, Photac-Fil, and Vitremer) and to compare the use of 3 units for measuring fluoride release. METHOD AND MATERIALS: Five specimens (3.0 x 2.7 mm) of each material were prepared. The specimens were placed in polypropylene vials with 2 mL of deionized water and stored at 37 degrees C. The solutions were replaced weekly and the levels of fluoride ions were analyzed at days 1, 7, and 30 and subsequently every 28 days for 253 days. Fluoride measurements were carried out using a fluoride ion-selective electrode connected to a pH ion-selective electrode meter. Fluoride ion release was measured in parts per million, micrograms per square centimeter, and micrograms per cubic millimeter. RESULTS: Fuji II LC, Photac-Fil, and Vitremer showed high initial release values, which decreased exponentially and then showed a slow decline during the ensuing time. Dyract released significantly less fluoride ions during the first 84 days than did the 3 resin-modified glass-ionomer cements and maintained this low level of release throughout the study period. The amounts of fluoride ion release measured at any time interval varied with the units of measurement chosen, but the pattern of release remained the same. CONCLUSION: There was a wide variation in the amounts of fluoride ions released from related products, but the patterns of release were similar and unaffected by the units of measurement used.

Cariostatic Agents↗

Durability of new restorative materials in Class III cavities.

PURPOSE: The aim of this study was to evaluate the durability of new hybrid tooth-colored restorative materials in Class III cavities. MATERIALS AND METHODS: 154 large-sized Class III restorations were placed in 50 patients. The patients received one of each of the three following materials: a resin composite (RC, Pekafill), a polyacid-modified resin composite (PMRC, Dyract) (compomer), and a resin-modified glass-ionomer cement (RMGIC, Fuji II LC). The restorations were evaluated yearly with slightly modified USPHS criteria. RESULTS: Of 141 restorations evaluated at 6 years, 16 were estimated as unacceptable. Seven of these were replaced: 2 fractures, 3 recurrent caries, and 2 due to unacceptable color match. In 9 other restorations with unacceptable color match, the patients did not request replacements. No significant differences were seen between the materials concerning the occurrence of recurrent caries. The RC showed significantly better color match. Significantly higher surface roughness was seen for the aged RMGIC restorations. Fracture of the incisal enamel corner was observed contiguous to ten restorations in the 6-year evaluation. None of the restorative techniques resulted in postoperative sensitivity or loss of vitality. CONCLUSION: The resin composite showed the best durability.

Analysis of Variance↗

Analysis of sealing vs tensile bond strength of eight adhesive restorative material systems.

PURPOSE: Using a simulated perfusion system, the intent was to determine: 1) the sealing ability of eight restorative materials (five composite resins and three compomers) used together with their corresponding dentin bonding systems, 2) their tensile bond strength, and 3) the correlation (if any) between both parameters. MATERIALS AND METHODS: Permeability in crown segments from sound human third molars (n = 140) subjected to simulated perfusion (32 cm of distilled water) was measured before and after restoring with each material, and the percentage of decrease in permeability (PPD) was recorded. Specimens were later subjected to tensile tests to determine the tensile bond strength (TBS) of the interface. Finally, parameters were analyzed for correlation. RESULTS: For the eight adhesive systems, the percentage of reduction in permeability was relatively high [mean in %, (SD)]: F2000 93.6 (5.7), SB1 88.6 (11.3), SSC 86.0 (5.7), PB20 81.1 (15.9), COM 77.5 (10.8), OPTS 75.3 (20.6), DYR 73.7 (12.7), SSPR 65.5 (19.8). TBS values were relatively low [mean (SD)], in MPa: F2000 1.8 (0.7), SB1 4.9 (1.4), SSC 2.6 (1.4), PB20 4.3 (1.2), COM 2.4 (1.1), OPTS 4.5 (1.7), DYR 1.6 (0.6), SSPR 4.2 (1.5). We could not demonstrate any statistically significant correlation between both parameters for these results (maximum significance [F2000]: r = 0.39, p = 0.206). CONCLUSION: No material completely ceased to filtrate through the interface. The low TBS values were probably due to the large size of adhesive areas. No significant correlation was found between PPD and TBS for the materials tested. There was a statistically significant relationship (r2 = 0.063, p = 0.018) between TBS and TBA (total bonded area), described by the equation TBS = 5.9 - 0.03.TBA.

Adhesives↗

Three-year follow up assessment of Class II restorations in primary molars with a polyacid-modified composite resin and a hybrid composite.

PURPOSE: To evaluate the 3-year success rate of Class II restorations in primary molars performed with Compoglass, a polyacid-modified resin-based composite (compomer) and TPH-Spectrum, a hybrid resin-based composite. MATERIAL AND METHODS: In a dental practice, in each of 52 children at least two primary molars were restored. 96 primary molars were restored with TPH-Spectrum using the total-etching-technique and 94 with Compoglass without acid etching prior to application of the bonding adhesive. The restorations were assessed at baseline (1996) and after 1 and 2 yrs according to the Ryge criteria. After 3 yrs the restorations (46 Compoglass, 46 TPH-Spectrum) of 35 children were re-evaluated. RESULTS: After 3 yrs the cumulative success rate according to the Kaplan-Meier-estimation was 79.5% for the Compoglass and 85.8% for the TPH-Spectrum restorations. No significant differences were observed between the two materials with respect to color matching, cavosurface discoloration, anatomic form, margin integrity and caries assessment. The present investigation revealed that TPH-Spectrum and Compoglass are suitable materials for restoring primary molars. CLINICAL SIGNIFICANCE: After an observation period of 3 years, both TPH-Spectrum and Compoglass demonstrated acceptable clinical results.

Acid Etching, Dental↗

The teaching of Class I and II restorations in primary molars: a survey of North American dental schools.

PURPOSE: The purpose of this study was to obtain an overview of materials and restoratives techniques taught for Class I and Class II restorations in primary molars in different pediatric dentistry departments in North America. METHODS: A form with response alternatives was mailed to 63 dental schools in the United States and Canada. The forms were addressed to the chairman/undergraduate program director of the department of pediatric dentistry. Questions regarding the restorative materials taught, indications and contraindications for the use of tooth-colored materials and the type of cavity preparation indicated for those materials were among the topics assessed. RESULTS: Eighty-six percent of the dental schools responded to the survey. Amalgam continues to be the material of choice for Class I and II restorations in primary molars, although hybrid composites and compomers are gaining some popularity. When tooth-colored materials were indicated, the slot-type of cavity preparation was the preferred one. CONCLUSIONS: The diversity in teaching may reflect uncertainty related to requirements for optimal restorations of primary teeth. Data from dental schools of other countries may be important to obtain to establish universally accepted criteria and standards for restorative techniques of primary teeth.

Canada↗