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Marginal adaptation of self-etching adhesives in Class II cavities.

PURPOSE: An in vitro dye-penetration study was performed on 2 different self-etching adhesives (Prompt L-Pop II, 3M-Espe; NRC, Prime&Bond NT Quix, Dentsply/DeTrey) in comparison to conventional conditioning of the cavity with phosphoric acid (Conditioner 36, P&B NT Quix, Dentsply/DeTrey). MATERIALS AND METHODS: Standardized mod cavities (one cervical margin in cementum, one in enamel) were prepared in 80 extracted human teeth (n = 20/group). Prompt L-Pop II was employed in two different sequences: A: placing the matrix band first, then applying the adhesive, B: first applying the adhesive, then placing the matrix band. The adhesive was cured in both cases. Conditioning and application of P&B NT Quix was carried out after placement of the matrix band in both procedures. The compomer Dyract AP was used as a restorative material in all cavities. After thermocycling, the median percentages of dye-penetrated (2% methylene blue) margins were determined separately for the cementum and enamel margins of the approximal boxes and for the lateral enamel margins of the boxes. RESULTS: The results showed that when using Prompt L-Pop II in Class II cavities, the adhesive should be applied before placing the matrix band (p < 0.0001). When the matrix band was placed first, P&B NT Quix showed superior results at a statistically significant level (p < 0.0001) in comparison to Prompt L-Pop II. There was no significant difference in the use of P&B NT Quix in combination with NRC or phosphoric acid in these Class II cavities. CONCLUSION: It is strongly recommended that Prompt L-Pop be applied prior to placement of the matrix band. Prime & Bond NT Quix seems to provide clinically relevant marginal seal in Class II cavities, regardless of whether NRC or phosphoric acid is used for conditioning.

Acid Etching, Dental↗

Localization in band random matrix models with and without increasing diagonal elements.

It is shown that localization of eigenfunctions in the Wigner band random matrix model with increasing diagonal elements can be related to localization in a band random matrix model with random diagonal elements. The relation is obtained by making use of a result of a generalization of Brillouin-Wigner perturbation theory, which shows that reduced Hamiltonian matrices with relatively small dimensions can be introduced for nonperturbative parts of eigenfunctions, and by employing intermediate basis states, which can improve the method of the reduced Hamiltonian matrix. The latter model deviates from the standard band random matrix model mainly in two aspects: (i) the root mean square of diagonal elements is larger than that of off-diagonal elements within the band, and (ii) statistical distributions of the matrix elements are close to the Lévy distribution in their central parts, except in the high top regions.

Journal Article↗

Microleakage of cavit in varnish-lined, matrix-supported endodontic access preparations.

The effect of the application of a matrix band and the use of cavity varnish on the microleakage of Cavit in endodontic access preparations was investigated. Sixty human upper premolars were divided into six groups of ten specimens each. Access cavities with proximal extensions were prepared and filled with 1, Cavit only; 2, Cavit after application of varnish; 3, Cavit with the use of a matrix band; 4, Cavit with a matrix band and varnish; 5, incremental deposition of Cavit with the use of a matrix band and varnish; and 6, gutta percha stopping. The specimens were placed in 2% methylene blue dye, thermocycled, and evaluated for both proximal and occlusal linear leakage. The experimental group in which Cavit was incrementally deposited in varnish-lined and matrix-supported cavities exhibited significantly (p < 0.05) less proximal microleakage than those groups in which cavities were filled without the application of both a matrix band and a cavity varnish.

Bicuspid↗

Characterization of matrix-bound Band 3, the anion transport protein from human erythrocyte membranes.

Band 3 (Mr = 95,000), the anion transport protein of human erythrocyte membranes exists primarily as a dimer in solutions of nonionic detergents such as octaethylene glycol mono-n-dodecyl ether (C12E8). The role of the oligomeric structure of Band 3 in the binding of [14C]4-benzamido-4'-aminostilbene-2,2'-disulfonate (BADS), an inhibitor of anion transport (Ki = 1-2 microM), was studied by characterizing the interaction of BADS with dimers and monomers of Band 3 covalently attached to p-mercuribenzoate-Sepharose 4B. BADS bound to matrix-bound Band 3 dimers with an affinity of approximately 3 microM at a stoichiometry of 1 BADS molecule/Band 3 monomer, in agreement with the BADS binding characteristic of Band 3 in the membrane and in solutions of C12E8. Band 3 dimers could be attached to the matrix via one subunit by limiting the amount of p-chloromercuribenzoate on the Sepharose bead. Matrix-bound monomers were formed by dissociation of the dimers with dodecyl sulfate or guanidine hydrochloride. Complete removal of the denaturants allowed formation of refolded Band 3 monomers since the matrix-bound subunits could not reassociate. These refolded Band 3 monomers were unable to bind BADS. Release of the monomers from the matrix with 2-mercaptoethanol allowed reformation of dimers with recovery of the BADS binding sites. These results suggest that the dimeric structure of Band 3 is required for BADS binding and that the BADS binding sites may be at the interface between the two halves of the Band 3 dimer.

Anion Exchange Protein 1, Erythrocyte↗

Amalgam matrix for class II and class V preparations connected at the proximal box.

BACKGROUND: The authors present a technique for placing and reinforcing an amalgam matrix around combined Class II and Class V preparations that connect at the proximal box. OVERVIEW: First, the dentist fills the Class V aspect of the preparation, using a temporary resin-based composite wall at the line angle to support amalgam condensation. The dentist then removes the wall and places a matrix band around the tooth, internally reinforcing the band with smaller pieces of matrix band and resin-saturated cotton balls that are light-polymerized and externally reinforcing the band with fast-polymerizing vinyl polysiloxane. Finally, the dentist condenses the line angle amalgam through the proximal box and condenses the proximal box and occlusal aspects. CONCLUSION: For connected Class II and Class V preparations, this matrix technique permits controlled amalgam condensation, even at the line angle aspect, where it is difficult to condense amalgam without voids or microleakage. CLINICAL IMPLICATIONS: This technique allows dentists to provide a stable, inexpensive direct restoration for teeth with connected Class II and Class V preparations, providing an alternative for patients who do not wish to have crowns placed.

Composite Resins↗

Fracture resistance of complex amalgam restorations.

This study evaluated fracture resistance provided to complex amalgam restorations by adhesive and mechanical resistance features. The occlusal surfaces of 30 extracted molar teeth of similar size were ground flat to approximately 2 mm coronal to the CEJ. The teeth were divided into three groups. Roots were notched and embedded in acrylic resin. In two groups, four TMS Minim stainless steel pins were placed into dentin at the line angles. A copper band matrix was applied to each specimen and reinforced with compound. After applying either Copalite or Amalgambond Plus, Tytin amalgam was condensed into the matrix. The bands and excess amalgam were removed 10 minutes later, and each amalgam occlusal surface was ground flat to give the amalgam restoration a 4 mm occlusal height. Specimens were thermocycled for 2500 cycles at 6-60 degrees C with a 30-second dwell time. They were then stored in deionized water for 1 month at room temperature. A 1 mm 45 degrees bevel was placed on the facio-occlusal angle of the amalgam. Each specimen was loaded to failure in compression at 45 degrees in an Instron Testing Machine at a crosshead speed of 5 mm/min. The groups were: Group 1, four Minim pins and Copalite; Group 2, four Minim pins and Amalgambond Plus; and Group 3, Amalgambond Plus only. The data were analyzed using a one-factor ANOVA and a Tukey B post hoc test. There was no significant difference between Groups 1 and 3. The Amalgambond Plus combined with pins provided significantly greater resistance to fracture than pins or Amalgambond Plus alone (P < 0.05).

Analysis of Variance↗

Clinical evaluation of proximal contacts of Class II esthetic direct restorations.

OBJECTIVE: This study evaluated the effectiveness of proximal contacts in Class II restorations using two types of matrix bands (steel and polyester) with two different restoration techniques (incremental and with prepolymerized particles). METHOD AND MATERIALS: Eighty-eight Class II adjacent restorations using Prodigy resin composite were performed: 44 with the incremental technique (22 with steel matrix bands, 22 with polyester matrix bands) and 44 utilizing prepolymerized resin particles (22 steel matrix, 22 polyester matrix). The restorations were clinically evaluated at baseline and at 6, 12, and 18 months. Proximal contacts obtained immediately after restoration procedure in all restorations were satisfactory. RESULTS: No statistically significant alterations were found in 18 months of evaluation. CONCLUSION: Regardless of the utilized resin composite, there were no differences in the amount of proximal contact variations with respect to tested techniques and matrices.

Acid Etching, Dental↗

Predictive ability of level A in vitro-in vivo correlation for ringcap controlled-release acetaminophen tablets.

PURPOSE: The goal of this study was to establish and validate an in vitro-in vivo correlation (IVIVC) for two sustained-release formulations (i.e., a matrix tablet and a RingCap banded matrix tablet) containing 750 mg of acetaminophen. METHODS: The in vitro dissolution and in vivo disposition of these formulations were examined by using a USP type III dissolution apparatus and a single-dose, three-way, crossover study that included an immediate-release acetaminophen dosage form, respectively. An IVIVC was established by using the mean fraction dissolved (FD) and mean fraction absorbed (FA) and used to simulate the plasma concentration-time profile of acetaminophen after administration of the matrix tablet (i.e., internal validation) and RingCap banded matrix tablet (i.e., external validation). RESULTS: A statistically significant relationship (r2 = 0.997, P < 0.001) existed between the FD and FA for matrix tablets and was best described by the equation (FA) = 0.984 x (FD) + 0.0133. The percent predictions errors in CMAX and AUCL were <10% when predicting the plasma concentration-time profiles for the two formulations, validating the internal and external predictability of the IVIVC. CONCLUSIONS: The data (i) show that in vitro dissolution data are a good predictor of in vivo fraction absorbed for acetaminophen, (ii) support the general use of in vitro dissolution data for readily soluble and readily absorbed drugs, (iii) suggest that acetaminophen may serve as a model drug for evaluating novel sustained-release delivery systems, and (iv) provide a tangible example of the limitations of current methods for predicting and validating IVIVC.

Acetaminophen↗

A novel filling technique for packable composite resin in Class II restorations.

UNLABELLED: The use of composite resin restorations in posterior teeth has increased considerably in the past few years. Specific composite resins for posterior teeth, as well as new operative techniques, have been developed to overcome some clinical difficulties. The present article describes a new technique to reconstitute the interproximal contour and contact of Class II restorations using a packable composite resin. Two lower first molars from the same patient are reported in detail, illustrating the technique step by step. The technique indicates the use of a metallic matrix band and wood wedges to provide an interproximal contour and contact with the adjacent tooth as well as to provide an adequate cervical adaptation. The first increment of the packable composite resin is applied on the gingival wall of the proximal box, packed cervically near the axial wall and, automatically, the resin climbs up in contact with the inner surface of the matrix band. This increment is sculpted and light-cured and the metallic matrix band is removed. Thus, the Class II cavities are transformed into Class I, with free access for light-curing. Small incremental layers of composite fill the remaining cavities. This technique is faster than conventional techniques and permits appropriate embrasure, better contour, and contact points. CLINICAL SIGNIFICANCE: Packable composite resins present primarily new handling characteristics that permit the development of novel filling techniques. The technique proposed in this article allows easier Class II buildup, with proper proximal contact and proximal smooth surfaces, once there are no irregularities among the composite increments. Another advantage is that there is adequate light exposure for polymerization, because the metal matrix can be removed during the restorative procedure.

Bicuspid↗

Intensity of bacteraemia associated with conservative dental procedures in children.

OBJECTIVES: To explore the individual dento-gingival manipulative procedures that together lead to the placement of a restoration and to estimate the associated intensity of bacteraemia. PATIENTS AND METHODS: Healthy children receiving dental treatment under general anaesthesia provided blood samples 30 seconds after one of four dento-gingival manipulative procedures: 1. Placement of rubber dam, 2. Use of the high speed drill, 3. Use of the slow speed drill, and 4. Placement of matrix band and wedge. Blood cultures were processed to give the percentage prevalence of bacteraemia, the intensity of organisms per millilitre of blood and the identity of the organisms cultured. RESULTS: A total of 257 children were recruited to the study. The percentage positive prevalence of blood cultures was baseline--9.3%, rubber dam placement--31.4%, slow drill--12.2%, fast drill--4.3%, and matrix band and wedge--32.1%. The intensity of bacteraemia was baseline--1.2 cfu, rubber dam placement--1,962 cfu, slow drill--0.3 cfu, fast drill--1.9 cfu, matrix band and wedge--4.8 cfu. CONCLUSIONS: These data indicate that dento-gingival manipulative procedures comprising a simple dental restoration can lead to a bacteraemia comparable to that from dental extractions. It is suggested that these data may indicate the need for antibiotic prophylaxis for some aspects of conservative dentistry.

Adolescent↗

Influence of curing methods and matrix type on the marginal seal of class II resin-based composite restorations in vitro.

This study determined the influence of light curing protocols and matrix type on the margin quality and marginal seal of Class II resin-based composite restorations. In extracted human molars, box-shaped MOD cavities with 1 mm wide interproximal bevels were prepared with cervical margins located at least 1 mm coronal to the cemento-enamel junction. The prepared teeth were mounted in a jig featuring artificial training teeth that served as adjacent teeth. A contoured sectional metal matrix band was placed in one interproximal area, and a section of a contoured transparent matrix band was placed in the opposite interproximal area. Both were kept in position using wooden wedges. After etching (35% H3PO4 gel) and the application of a three-step etch & rinse dentin adhesive (Optibond FL, Kerr), a thin layer of flowable resin-based composite (Revolution, Kerr) was applied to the interproximal margins. The cavities were restored by placing one horizontal and two oblique increments of a fine hybrid resin-based composite (Herculite XRV, Kerr). The curing protocols included one standard halogen protocol (Elipar Trilight, 3M ESPE, 40 seconds @ 800 mW/cm2), 3 halogen soft-start protocols (Step: Elipar HiLight, 3M ESPE; 10 seconds @ 150 mW/cm2, 30 seconds @ 850 mW/cm2; Ramp: Elipar TriLight, 3M ESPE, 5 seconds @ 100 mW/cm2, exponential increase for 10 seconds, 25 seconds @ 800 mW/cm2; Pulse delay: VIP Light, BISCO, cervical increment: 10 seconds @ 500 mW/cm2, occlusal increments: 3 seconds @ 200 mW/cm2, final irradiation after a 5 minute interval: 30 seconds @ mW/cm2) and 2 plasma arc high intensity protocols (PAC: Lightning Cure, ADT, 10 seconds @ 1400 mW/cm2; APO: Apollo 95E, DMDS, 2 x 3 seconds @ 1570 mW/cm2). The restored teeth were stored in 0.9% saline at 37 degrees C for 4 weeks and submitted to thermal cycling [TC] with 2500 cycles between 5 degrees C and 55 degrees C after 2 weeks. The margin quality before and after TC was analyzed in SEM using the replica technique, and the marginal seal was determined using the dye penetration test (50% AgNO3, 2 hours) at the end of the study. The matrix type did not significantly influence the quality and seal of the respective margins. For the complete restoration margin, one of the high intensity protocols (APO) produced a higher percentage of "continuous margin" compared to pulse delay irradiation after TC and lower percentages of "marginal opening" compared to halogen standard irradiation before and after TC. Halogen step irradiation produced a superior marginal seal compared to pulse delay curing at the occlusal margins; equivalent results were observed for all curing modes at the cervical margins. Neither a general advantage of soft-start irradiation nor a general disadvantage of high intensity curing was confirmed.

Acid Etching, Dental↗

Measurement of band displacement: a methodology to determine composite packability.

OBJECTIVE: A posterior composite should be able to maintain its shape when packed against a matrix band. The objective of this study was to develop an in vitro methodology to determine composite packability by measuring the displacement of a matrix band. METHOD AND MATERIALS: The experimental setup consisted of a sectional matrix system secured for the restoration of an occlusodistal cavity preparation. The distance the band was displaced was measured from superimposed digital images. First, band displacements were measured under applied forces of 25, 50, and 75 g for different loading orders. Different forces resulted in different band displacements. Loading order significantly affected band displacements. Thus, the reproducibility of the experimental setup is ensured provided the band is replaced after each test. The cavity was filled with a universal composite (Z100, 3M ESPE) or a posterior composite (Filtek P60, 3M) at 37 degrees C. RESULTS: The band displacements were 32 +/- 28 pm vs 107 +/- 38 microm for Z100 and Filtek P60, respectively. CONCLUSION: The present study proposed measuring band displacement as an in vitro methodology to determine the packability of dental composite. Based on the result, the posterior composite should help in forming contact better than the universal composite tested.

Analysis of Variance↗

One-year evaluation of an Ormocer restorative-a multipractice clinical trial.

The purpose of this ongoing prospective long-term study was to evaluate the clinical performance of Ormocer restorative material in combination with a self-conditioning adhesive. Five operators at five clinics placed 356 restorations (48 class I, 150 class II, 63 class III, 32 class IV, and 63 class V) in 117 patients aged 17 to 65 years. All fillings were placed with cotton roll isolation and clear matrix bands for class III and IV restorations, and metal matrix bands and an incremental placement technique were used for class II restorations. In follow-up examinations after 6 and 12 months, modified Ryge criteria were recorded on all restorations. With 33 randomly selected class I and II restorations, measurements of occlusal wear (via 3D laser scanner) and qualitative and quantitative marginal analysis (via scanning electron microscope) were performed using a replica technique. After placing the fillings, patients reported postoperative hypersensitivity corresponding to B scores in 19 cases and to C scores in four cases. At 12-month recall, 328 restorations were available for evaluation. Losses in the five cavity classes (I, II, III, IV, V) numbered 0, 2, 0, 1, and 6, respectively. The percentages of retained restorations for clinical parameters in four categories (Alpha, Beta, Charlie, Delta) were: 94.7, 5, 0.3, and 0 (marginal integrity), 81.2, 18.8, 0, and 0 (marginal discoloration), 75.2, 24.8, 0, and 0 (anatomic form), and 95, 4.7, 0.3, and 0 (fracture), respectively. Marginal analysis showed 48.7% "continuous margin" initially and 17.7% at 12 months (difference statistically significant, P=0.05). The occlusal wear at 12 months was 10.0 microm (SD 11.6) for premolars and 22.0 microm (SD 24.1) for molars. Over the 12-month observation period, the Ormocer restorative was clinically effective in combination with a self-conditioning adhesive, and concern persists related to the marginal quality and retention of class V restorations.

Adolescent↗

Comparison of proximal contacts of Class II resin composite restorations in vitro.

This study investigated the tightness of the proximal contact when placing posterior resin composite restorations with circumferential and sectional matrix systems in an in vitro model using a special measuring device (Tooth Pressure Meter). A manikin model was used with an artificial first molar in which an MO-preparation was ground, simulating the clinical situation of an amalgam replacement. This preparation was duplicated, resulting in 160 identically prepared teeth. These teeth were divided into 8 groups (n=20). In 2 groups, circumferential matrix bands (flat or contoured) in a Tofflemire retainer were applied. In the remaining 6 groups, 3 different separation rings were combined with 2 types of sectional matrix bands. All the cavities were restored using Clearfil Photo Bond and Clearfil AP-X. The tightness of the proximal contact was measured using the Tooth Pressure Meter. Data were statistically analyzed using SPSS 12. ANOVA was used to find differences in proximal contact tightness between the groups. Tukey tests were used to find differences between the homogeneous subgroups. The use of sectional matrices combined with separation rings resulted in tighter proximal contacts compared to when circumferential systems were used (p<0.001). The use of these devices is therefore recommended when posterior resin composite restorations are placed.

Analysis of Variance↗

Geriatric problem solving with adhesive dentistry, using the Contour Strip and direct composite placement.

The ability to create periodontally sound gingival and non-staining or plaque retaining interproximal margins on spacious carious lesions is a daunting challenge in many situations. The case as presented will illustrate the use of a unique matrix system, The Contour Strip from Vivadent, which will encompass the entire outline margins of the upper right lateral incisor of an elderly patient. The age of the patient has no bearing on the use of the technique, but merely reenforces the value of the system in all other situations mimicking a similar restorative obstacle. The use of this custom shaped matrix band, eliminate the free-hand placement and then the laborious creation and finishing of the restoration. LEARNING OBJECTIVES: After reading this paper the reader will understand the manipulation and use of a new labial matrix band which can totally surround the gingival and proximal margins of any anterior and pre-molar teeth. TECHNIQUE CONSIDERATIONS: There are four rules to follow when using adhesive dentistry: Proper preparation of tooth surfaces, both dentin and enamel through mechanical and/or chemical means. Creation of matrix formed molds. Injecting all resins, from the lowest to the highest viscosity. Polymerizing thoroughly through trans-enamel polymerization thus controlling shrinkage.

Acid Etching, Dental↗

Two-step provisional technique for onlay preparations.

Compared to full crown temporization, direct autocured resin provisional technique for intracoronal onlay preparations is more complicated and less predictable. Clinical concerns include possible pulpal irritation, extra chair time for contouring proximal and marginal excess, and a critically short time constraint to remove the curing resin in the "rubbery stage" to avoid distortion or "locking" into the preparation. A two-step direct technique using two new light-cured provisional resins addresses these problems. First, a light-cured, elastic resin is condensed against the internal preparation walls and confined within a wedged metal matrix band. Then, using a clear template matrix, the elastic foundation is overlaid with a strong and esthetic light-cured provisional resin.

Acrylic Resins↗