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Effect of a resin lining and rebonding on the marginal leakage of amalgam restorations.

This in vitro study compared microleakage in Class V amalgam restorations with three different lining agents and with no lining agent, with and without resin rebonding of the margins. Eight groups of ten molars were divided into four pairs of groups. Class V preparations were cut in the facial surfaces of each molar so that the occlusal margin was in enamel and the gingival margin in dentine. The preparations in one pair of groups received no lining agent; the preparations in the remaining three pairs of groups were lined with one of the following: Copalite, Universal Bond 3 (UB3) Primer and Adhesive, or UB3 Primer only. The enamel walls of the preparations receiving the UB3 Primer and Adhesive were etched prior to applying the lining material. Amalgam was hand condensed into each preparation. In one of each pair of groups, the margins of restorations were treated with 37% phosphoric acid gel, rinsed and dried, and UB3 Adhesive was applied over amalgam and tooth margins and polymerized (rebonded). Specimens were thermocycled, stained and sectioned. Microleakage was graded using a stereomicroscope. Mean microleakage scores for occlusal and gingival margins were calculated and analysed. At enamel margins, non-rebonded Copalite and all rebonded specimens showed less microleakage than the other non-rebonded groups. The group lined with UB3 Primer only and rebonded showed significantly less (P < 0.01) microleakage at enamel margins than all the other groups except the group lined with Copalite and rebonded. At cementum/dentine margins, restorations lined with UB3 Primer and rebonded showed significantly less microleakage than the other groups.

Acid Etching, Dental↗

Stress analysis techniques in complete dentures.

The fracture of acrylic resin dentures remains an unresolved problem. It is known that eventual fracture of an appliance occurs due to crack initiation and propagation from areas of high stress concentration. In order to understand and overcome the problem of fracture, it is important to identify the regions of stress concentration. A number of different methods are used in stress analysis. However, the finite element method, a numerical technique, appears to overcome most of the problems associated with the earlier experimental methods. This article reviews the different techniques and their application to examining stresses in dentures.

Birefringence↗

A tape-stripping method for measuring dermal exposure to multifunctional acrylates.

Current methods for measuring dermal exposure to skin irritants and allergens, such as acrylates, have significant drawbacks for exposure assessment. A noninvasive sampling method has been developed and tested for measuring dermal exposure to a multifunctional acrylate employing a tape stripping of the nonviable epidermis (stratum corneum). Samples were subsequently extracted and a gas chromatographic method was employed for quantitative analysis of tripropylene glycol diacrylate (TPGDA). This method was tested in 10 human volunteers exposed to an a priori determined amount of TPGDA or a UV-radiation curable acrylate coating containing TPGDA (UV-resin) at different sites on hands and arms. On the average, the first tape stripping removed 94% (coefficient of variation 16%) of the theoretical quantity of deposited TPGDA and 89% (coefficient of variation 15%) of the theoretical quantity of deposited TPGDA in UV-resin 30min after exposure. Quantities of TPGDA recovered from two consecutive tape strippings accounted for all of the test agent, demonstrating both the efficiency of the method to measure dermal exposure and the potential to determine the rate of absorption with successive samples over time. In general, the amount removed by the first stripping was greater for TPGDA than for UV-resin while the second stripping removed approximately 6 and 21% of TPGDA and UV-resin, respectively. However, when the amounts removed with the first tape stripping for TPGDA or UV-resin from the five different individual sites were compared, no significant differences were observed (P=0.111 and 0.893, respectively). No significant difference was observed in recovery between TPGDA and UV-resin for the first tape stripping when calculated as a percentage of the theoretical amount (P=0.262). The results indicate that this tape-stripping technique can be used to quantify dermal exposure to multifunctional acrylates.

Acrylates↗

Practitioner's guide to fluoride.

The current health care trend is to provide evidence-based recommendations and treatment. Many literature reviews have shown fluoride's effectiveness against caries. The current use of fluoride in the prevention of dental caries is based on community, professional, and individual strategies. Personalized fluoride regimens should include a risk analysis and a review of the patient's current fluoride exposure. The future of fluoride may be found in its slow release and retention in the oral cavity through various modalities. Because of the many uncertainties still associated with fluoride, further research is needed.

Adolescent↗

Influence of amalgams, bases, and varnish on seal composition at restoration tooth interfaces.

Eighty extracted, noncarious premolars were restored with one of 20 different combinations of restorative materials: a high- or low-copper amalgam, unlined or lined with one of five bases, and varnished or unvarnished. The teeth were aged in 1% NaCl and after 3 months and 1 year the seal material deposited on the cut tooth cavity surface and the surface of the amalgam restoration was analyzed by use of energy dispersive x-ray analysis. Atomic weight percentages of marginal seal elements were statistically examined with ANOVA and Tukey's test with significance set at p < 0.05. The results indicated that only one type of seal was formed centered around tin. More marginal seal material was present in the 1-year specimens. Restoration materials used affected the deposition rate of marginal seal material. Low-copper amalgam-restored teeth formed more seal material with significantly greater amounts of chlorine and tin. Less marginal seal material was found in varnished cavities. A calcium hydroxide base produced a thick marginal seal with a significantly different composition of elements compared with the unlined and zinc-based specimens. Tin in Poly-F Plus polycarboxylate cement did not significantly increase the tin content of the marginal seal. Base materials can play a role in determining crevice pH. The findings have bearing on improved longevity of amalgam restorations.

Analysis of Variance↗

Long-term sealing efficacy of four root surface sealing materials used in endodontic leakage studies.

Fifty extracted human maxillary anterior teeth were biomechanically instrumented and divided into five equal groups, four experimental and a control. The teeth in the experimental groups had their root surface coated with one of four sealants; epoxy, casting resin, sticky wax, or nail polish. The roots of the remaining teeth were not coated and served as controls. All of the teeth were mounted in the caps of scintillation vials. Five microliters of [3H]uridine were deposited in the root canal space and disintegration counts were obtained over time periods of 1, 4, 8, 12, and 36 wk. At the conclusion of the experiment, sticky wax was demonstrated to provide a superior seal (p < 0.0001).

Analysis of Variance↗

The combined occluding effect of sodium fluoride varnish and Nd:YAG laser irradiation on human dentinal tubules.

Various methods and materials used in the treatment of dentin hypersensitivity are thought to achieve a therapeutic benefit by tubule occlusion. The aim of the present study was to evaluate the combined occluding effect of sodium fluoride varnish and Nd:YAG laser irradiation on human dentinal tubules. Thirty-six dentin specimens with exposed dentinal tubule orifices were used in this study. The samples were randomly divided into four groups. Groups A, B, and C were varnished by sodium fluoride, whereas group D served as a control. Then, group C was lased by 30 mJ of Nd:YAG laser, 10 pulses/s for 2 min by light painting. Three hours later, groups B and C were brushed by an electrical toothbrush for 30 min. Under SEM observation, the control group showed numerous exposed dentinal tubule orifices, and the sodium fluoride varnished specimens showed closure of exposed dentinal tubule orifices. After electrical toothbrushing, most of the sodium fluoride varnish was brushed away, except in the specimens that were irradiated by Nd:YAG laser. Over 90% of the dentinal tubule orifices were occluded by sodium fluoride varnish combined with Nd:YAG laser irradiation.

Combined Modality Therapy↗

Surface coating and leakage of dentin-bonded resin composite restorations.

OBJECTIVES: To compare the marginal leakage of dentin-bonded resin composite restorations in tooth sections coated with nail varnish and similarly restored sections coated with cyanoacrylate cement. METHODS: MO and DO cavities were prepared with the gingival floor below the CEJ in 11 non-carious extracted human molars. Each cavity was restored with a dentin adhesive and resin composite. Sectioning yielded four specimens per tooth (N=44). One specimen from each restoration was coated with varnish. The other specimen was coated with cyanoacrylate cement. The coatings were applied to all surfaces except that a 1mm window on either side of the interproximal gingival margin was left uncoated. Specimens were thermocycled and stained with silver nitrate. Silver penetration into the gingival margin of each section was measured with a measuring microscope. The predominant leakage path for each coating type was determined by scanning electron microscopy. RESULTS: There was no significant difference between the leakage of the varnish-coated and cyanoacrylate-coated specimens. No marginal gaps were observed either by optical or by electron microscopy. However, the both optical and electron microscopy revealed leakage in nearly all specimens. This leakage was confined to either the dentin/hybrid layer interface or the adhesive resin/hybrid layer interface. CONCLUSIONS: The results suggest that these coating materials are not confounding factors in laboratory investigations of marginal leakage along dentin-bonded interfaces of resin composite restorations. Although marginal gaps were undetectable even at high magnification, leakage was observed along the gingival margin of almost all of these Class II resin composite restorations.

Bisphenol A-Glycidyl Methacrylate↗

Effect of 6-monthly applications of chlorhexidine varnish on incidence of occlusal caries in permanent molars: a 3-year study.

OBJECTIVES: The aim of this study was to assess the effect of a chlorhexidine varnish on occlusal caries incidence when applied 6-monthly into the fissures of erupting and freshly erupted permanent molars. METHODS: In a double-blind clinical trial, 332 children aged 5/6 and 11/12 years attending a Child Dental Health Centre were randomly assigned to a control and an experimental group. Criteria for inclusion in the study were that all first permanent molars in 5-6-year-olds and all second permanent molars in 11-12-year-olds either had recently erupted, or were in a stage of eruption, or would erupt within half a year. At baseline, counts of dmfs/DMFS and mutans streptococci in saliva were recorded. During a maximum of 3 years, every 6 months the occlusal surfaces of molars in the experimental group received a 40% chlorhexidine varnish application, whereas those in the control group received a placebo varnish application. RESULTS: Data of 316 children were analysed and ANOVA showed no significant occlusal caries reduction in this sample of Dutch 5/6- and 11/12-year-old children. After stratification into low and high caries risk groups, a statistically significant caries-reducing effect on occlusal caries in permanent molars was found in the group of children with > or = 10(6) mutans streptococci per ml saliva (P < 0.05). CONCLUSION: Six-monthly application of chlorhexidine varnish has no caries-reducing effect on occlusal caries in recently erupted permanent molars in a population with low caries prevalence.

Analysis of Variance↗

Microbiological and clinical effects of an antiseptic dental varnish after mechanical periodontal therapy.

The aim of this study was to explore the microbiological and clinical effects of an antiseptic dental varnish when applied to periodontally diseased teeth after mechanical therapy. 20 subjects participated in this placebo controlled, double blind prospective longitudinal study. 2 experimental sites with a pocket probing depth > or =5 mm were chosen in each subject. The control varnish, consisting of ethanol, ethylacetate and polyvinylbutyral, was applied to one of the selected teeth and the test varnish, containing 1% chlorhexidine and 1% thymol in addition, was applied to the other one. Clinical parameters were assessed, and microbiological samples were obtained from the two study sites at baseline (6-10 weeks after completion of conventional periodontal therapy), and 2, 4 and 12 weeks thereafter. The mean PLI at baseline was very low and, therefore, only a minimal potential for a further improvement existed. During the 12-week observation period, the mean PLI increased significantly at sites treated with the placebo varnish, while no similar trend for an increase in PLI was detected in the test sites. The bleeding tendency seemed to remain unaffected by the application of the varnish. On the microbiological level, no relevant differences could be detected between placebo and test sites at baseline, or during the follow-up period. In conclusion, the application of a dental varnish with antimicrobial properties after mechanical periodontal therapy had little effect in subjects with good oral hygiene.

Adult↗

Effectiveness of chlorhexidine-thymol varnish for caries reduction in permanent first molars of 6-7-year-old children: 24-month clinical trial.

OBJECTIVES: To determine the effect of chlorhexidine varnish on the prevention of caries in permanent first molars. METHODS: Two groups of 6-7-year-old school children were followed up in a clinical trial, a group of 86 children whose teeth were treated with a chlorhexidine-thymol varnish (Cervitec) and a control group of 95 children. The varnish was reapplied every 3 months and the caries increments were compared at 24 months. RESULTS: The DFS (decayed and filled surfaces in permanent first molars) increment in the control group (mean = 1.85; SD = 2.27) was higher than in the test group (mean = 0.95; SD = 1.38), resulting in a 48.6% caries reduction. This difference was statistically significant (P = 0.032). CONCLUSIONS: Chlorhexidine-thymol varnish is effective in preventing caries in permanent first molars.

Anti-Infective Agents, Local↗

Caries incidence in permanent first molars after discontinuation of a school-based chlorhexidine-thymol varnish program.

OBJECTIVES: To determine whether the cessation for 3 years of a 24-month program of chlorhexidine-thymol varnish applications would affect caries incidence in the first permanent molars of a population of schoolchildren of middle and lower-middle socioeconomic level. METHODS: Two groups of 6-7-year-old schoolchildren, randomized by school-class, were followed up in a clinical trial. One group received applications of chlorhexidine-thymol varnish every 3 months and the other group acted as controls. The program ended after 24 months and its effects were evaluated. Three years later, 55.5% of the schoolchildren were re-examined and the caries increments were documented. RESULTS: At the end of the 24-month program, the treated children had significantly fewer decayed and filled surfaces in permanent molars (lower DFS index) versus the controls. At 3 years after the discontinuation of the program, this difference had disappeared; there were no differences in the incidence of decayed, missing and filled surfaces (DMFS) index in permanent molars between the treated children and the controls. CONCLUSION: The cessation for 3 years of a 3-month program of chlorhexidine-thymol varnish applications resulted in a nonsignificant increase in the prevalence of dental caries in the permanent first molar.

Anti-Infective Agents, Local↗

Protective effect of Copalite surface coating on mercury release from dental amalgam following treatment with carbamide peroxide.

The effect of Copalite coating on mercury release from dental amalgam following treatment with 10%, 20%, 30% and 40% carbamide peroxide was assessed in vitro, using a cold-vapour atomic absorption Mercury Analyzer System. Eighty samples of dental amalgam were automatically mixed in a dental amalgamator and condensed into silicon embedding molds. Forty amalgam samples were coated with three uniform layers of Copalite intermediary varnish and the other 40 samples were left uncoated. The coated and non-coated amalgam samples were exposed for 24 h to 10%, 20%, 30% or 40% carbamide peroxide preparations and compared with samples exposed to phosphate buffer. In the non-coated samples a significant increase of mercury concentration in solution was found following exposure to all carbamide peroxide preparations tested. Mercury concentration was directly related to carbamide peroxide concentration. In the Copalite-coated samples, significantly lower concentrations of mercury in solution were found as compared to the non-coated samples (P < 0.01). In conclusion, exposure of amalgam restorations to 10%-40% carbamide peroxide-based bleaching agents increased the mercury release. Pre-coating of the external amalgam surfaces with Copalite significantly reduced the release of mercury.

Analysis of Variance↗

The adhesive amalgam--fact or fiction?

Forty molar and premolar teeth had non-retentive cavities prepared and restored with amalgam using (1) copal varnish (control), (2) a pin, (3) Amalgambond or (4) Panavia-Ex. The forces and energy required to dislodge the restorations were recorded and compared, and the mode of failure noted for each group. Although the pinned restorations required significantly higher loads to dislodge them, the mode of failure and energy required to dislodge the restorations in the Amalgambond and Panavia-Ex groups indicated that these types of restorations had significant advantages over pinned restorations, particularly where the pulp might be compromised. The film thickness of the retentive systems in these two groups, however, indicated a substantial operator or technique sensitivity.

Adhesives↗

Occupational exposure to airborne solvents during nail sculpturing.

This study describes occupational exposure to acrylates and other solvents during nail sculpturing, including comparative measurements of the exposure using four different sculpturing methods: The acrylic method, the UV-gel method, the acrylic powder method and the resin method. Thirty-two nail technicians working in 22 different salons participated in the study. In total, 92 measurements were performed, comprising 70 solvent measurements and 22 measurements of ethyl 2-cyanoacrylate. The solvents most frequently present in all samples were acetone, ethyl acetate, toluene and n-butyl acetate, measured in 96%, 94%, 91% and 81% of the samples, respectively. The study shows that the overall solvent exposure was low, with all measurements calculated as the additive effect (n = 70) below 20% of the OEL (arithmetic mean 0.06 and range 0.01-0.19). No statistically significant difference between sculpturing methods were observed (p = 0.05).

Acetates↗