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Porosity in the base metal removable partial denture casting alloys relative to observable metallographic features.

A series of tensile test pieces of the dimensions stated in the American Dental Association Specification No. 14 were produce using both nickel-base and cobalt-base removable partial denture casting alloys. Normal dental casting techniques were employed. Appropriate sections from each specimen were sectioned to half of their original thicknesses, embedded in heat-and pressure-cured conducting mounts, and polished for metallurgical examination. A double electrolytic etching technique was used, employing serially two solutions, in order to maximize the amount of metallographic detail visible. The method proved particularly valuable in the case of the nickel-base alloy as it indicated the presence of considerable interdendritic segregation. The incidence of porosity was evaluated throughout all sections of the specimens and, although found to be especially prevalent in those regions where gross shrinkage effects might be expected to occur, it was also shown to have a diffuse intergranular and interdendritic distribution.

Chromium Alloys↗

Standardization of orthodontic products--does it make sense?

Since 1994, the DIN (Deutsches Institut für Normung e.V.) has had a German working group named "Orthodontic Products" working toward establishing standardized norms for orthodontic products. In the USA, a similar working group called "Orthodontic Materials" was established in 1996 at the ADA (American Dental Association). Working at the ISO level since 1997, an international team has been in charge of unifying the standards already set at national levels. It is the aim of this article to report on the current state of standardization in Germany and internationally. The standards already published for wires (DIN 13971, ADA Spec. 32), for brackets and tubes (DIN 13971-2, ADA Spec. 100) and for elastomeric elements (DIN 13901) have been considered, as have problems occurring with ISO standards (ISO/CD 15841 and ISO/CD 15841-2) and DIN 13904-1. We demonstrate that the demands made of these products by the orthodontists who use them have lead to reasonable quality standards. Thanks to clearly-defined testing methods, orthodontic products can now be tested and their compliance with these minimum standards can be compared. In fact, the standards that have been agreed upon help both the product manufacturers and their users to improve product quality and, ultimately, the success of orthodontic treatment.

Dental Materials↗

Clinical performance of a packable resin composite for posterior teeth after 3 years.

There is a wide range of materials suitable for posterior resin-composite restorations. The objective of this clinical study was to evaluate the clinical performance of a packable resin composite (Solitaire, Heraeus-Kulzer, Hanau, Germany) in stress-bearing posterior cavities according to the Ryge criteria every 6 months over a 3-year period. A total of 250 class I (28%) and II (72%) restorations were placed in 120 patients using adhesive-bonding techniques without the use of rubber dam. After 3 years, 165 restorations (66%) were still in place during the follow-up investigation. Twelve restorations (4.8% out of the baseline number) had to be replaced due to postoperative sensitivity over the 3-year evaluation period. After 3 years, 65.5% of the restorations were scored Alpha for Marginal Adaptation, 18.2% Bravo, 2.4% Charlie, and 13.9% Delta. For the Ryge criteria Anatomic Form 70.9% of the restorations were scored Alpha, 15.2% Bravo, and 13.9% Charlie. Secondary caries was documented in 3.5% of the restorations. A Bravo score for Marginal Discoloration was determined in 26.1% of the restorations; 2.1% were scored Charlie. After 3 years, only 79.0% (summation effect of negative scores) of the restorations were still performing at clinically acceptable levels. Therefore, the packable resin composite Solitaire failed the criteria of the American Dental Association for resin restoratives. Bulk fractures (14 molar and 9 premolar restorations = 9.2% of the baseline number) due to poor physical properties of the material were the main reason for clinical failure.

Adult↗

Comparison of bending and tension tests for orthodontic wires.

Stainless steel, cobalt-chromium-nickel (Elgiloy), nitinol, and beta titanium wires with diameters from 0.010 to 0.040 inch and in rectangular sizes from 0.017 X 0.025 to 0.019 X 0.025 inch were evaluated with the American Dental Association specification no. 32 bending test and the conventional tension test. The modulus of elasticity (E) and yield strength (YS) obtained with the two mechanical testing procedures are reported for as-received wires and after heat treatment at 900 degrees F for the stainless steel and selected Elgiloy wires. Measured values of E and YS in bending were almost invariably higher than the corresponding values obtained in tension. The only general agreement between the modulus of elasticity in bending and tension was for the 0.040-inch diameter stainless steel wires. Anomalously high values of E in bending were also found for most of the heat-treated stainless steel and Elgiloy groups. Difficulties with the bending test are attributed to loading effects at both ends of the test span and deviation of the bent specimen from a circular arc. Improved procedures are described for performing the tension test on the relatively small cross-section orthodontic wires.

Alloys↗

Elastomeric impression materials: effect of bulk on accuracy.

Impression trays were fabricated providing 2, 4, and 6 mm spaces to determine the stability and accuracy of nine elastomeric impression materials on a simulated full crown preparation steel die. The interface space of 2 mm produced the most accurate impressions for all of the materials tested. All impression materials except one fell within the revised American Dental Association Specifications. The clinical-type tests, using castings on dies poured from these materials, corroborated the acceptance of those materials and techniques exhibiting the least dimensional change.

Dental Impression Materials↗

An evaluation of the film thickness of resin luting agents.

Acid-etched cast metal resin-bonded retainers require resin luting agents with film thicknesses similar to dental cements to allow complete seating of frameworks without the need for post-bonding adjustments. Conventional cements, restorative resins, and resin cements were compared in terms of film thickness by using the American Dental Association Specification No. 8 for zinc phosphate cement. Most of the resin luting agents had film thicknesses of 20 to 40 microns. Working time was seen to affect film thickness. The particle size of one resin was also examined under scanning electron micrograph.

Dental Cements↗

The seating of one-piece and soldered fixed partial dentures.

This laboratory study compared the seating of one-piece castings with that of soldered fixed partial dentures. Two investments were investigated, five American Dental Association type III and five metal ceramic alloy fixed partial dentures were made by using the conventional indirect technique. The investing and casting protocol was designed to produce an ideal fit of the individual complete crown abutments, not the fixed partial denture. Independent seating of each retainer provided a baseline measurement for complete seating and was compared with fixed partial denture seating. Fixed partial dentures were then sectioned and reassembled by soldering twice, using a low- and high-expansion investment. Statistical evaluation identified significant differences between the metals and the techniques. Marginal discrepancies with one-piece casting and lower (0.6%) thermal-expansion soldering were clinically unacceptable. A clinically acceptable fit was obtained with the higher (1%) thermal-expansion soldering investment.

Dental Abutments↗

Predoctoral fixed prosthodontics education.

All current prosthodontic services will be needed well into the 21st century because millions of people are still without complete dentitions. However, knowledge of current and projected dental health needs indicates that the extent of usage of certain prosthodontic procedures will change because the number of edentulous patients will decrease. Presently there is considerable need and demand for extensive prosthodontic services and the need has been projected to grow. The demand for fixed prosthodontic services will likely increase in the future, particularly with the increased usage of new materials and treatment modalities. Recent data obtained from the American Dental Association Commission on Dental Accreditation indicate that failure rates on Part II of the National Board Dental Examinations and the prosthodontics section of Part II have remained relatively constant from 1980 to 1987. Total Part II failure rates for this time period have only ranged from 8.31 to 9.91 and on the prosthodontics section from 2.10 to 2.74. While these data do not predictably reflect clinical and technical skills or a knowledge of the most current didactic information, they do indicate that adequate knowledge had been provided to predoctoral students regarding the fundamental principles of prosthodontics. However, reductions have been made in prosthodontic curricular time. With the current escalation of knowledge in prosthodontics and allied areas and the increasing time constraints, it is becoming increasingly difficult to teach a thorough understanding of the basics and exposure to new developments. Any further reductions in curricular time will significantly compromise educational quality.

Curriculum↗

The effect of immersion disinfection of elastomeric impressions on the surface detail reproduction of improved gypsum casts.

This investigation examined improved gypsum casts for surface roughness and line-detail reproduction after the immersion disinfection of elastomeric impression materials in an acid glutaraldehyde, an alkaline glutaraldehyde, and a phenol. Impressions were made of a surface roughness standard (Ra = 3.08 microns) that was custom made to include engraved grooves following American Dental Association specification No. 19. Mean surface roughness (Ra) values for all casts of all combinations of disinfectant treatments, impression materials, and improved gypsum stones were obtained with a surface analyzer. Untreated impressions served as controls. Data examined by an analysis of variance indicated that the addition silicone and polyether impression materials provided a surface roughness similar to the precision displacement specimen standard. The acid glutaraldehyde disinfectant demonstrated enhanced line-detail reproduction compared with the standard. Addition silicone and polyether impression materials combined with the acid glutaraldehyde provided the model system closest to the mean surface roughness of the reference standard. These combinations revealed differences in the surface roughness reproduction among the represented improved dental stones.

Calcium Sulfate↗

Radiographic examination of edentulous mouths.

Many dentists routinely make radiographs of edentulous patients who request replacement dentures. In the American Dental Associations' Guide to Dental Health, the public is informed that "an x-ray examination is performed only when necessary, not as a routine procedure, and only when the dentist believes such an examination will benefit your health." In light of the changing patterns of the incidence of disease and the cumulative effects of radiation exposure, a study was made of 300 edentulous ridges of dental patients. The study was confined to patients who were treated elsewhere with maxillary and mandibular dentures and who requested new dentures. Patients who had some clinically apparent finding that required radiographic investigation were excluded from the study. Only one impacted tooth that required extraction was found. The diagnosis of edentulous patients seeking treatment with replacement dentures should include a thorough patient history and clinical examination. When radiographs are indicated, they should be made but their routine use in such patients should be discouraged.

Aged↗

Retentive strength, disintegration, and marginal quality of luting cements.

This study evaluated the retention of complete crowns by using five different methods of cementation. Complete crowns were prepared with standardized dimensions on extracted human molars. Metal crowns were cast with a high noble gold ceramic alloy and were cemented with zinc phosphate cement, glass ionomer cement, composite resin cement, composite resin cement with a dentinal bonding agent, and adhesive resin cement. The retention was measured by subjecting the specimens to tensile load until fracture occurred. The disintegration was measured according to American Dental Association Specification No. 8, and the condition of the cements at the margins of crowns was analyzed by use of a scanning electron microscope. Kruskal-Wallis one-way analysis of variance revealed statistically significant differences between the mean retentive strengths. The retention of the zinc phosphate and the glass ionomer groups was significantly different from that of the adhesive resin group. The retention of the adhesive resin cement was 65% greater than the retention of the composite resin and the composite resin/dentinal bonding agent group, but the Mann-Whitney Wilcoxon rank sum test did not depict this difference as significant. The mean +/- SD of the disintegration for the zinc phosphate, the glass ionomer cement, and the composite resin cement was 0.025 +/- 0.013, 0.023 +/- 0.011, and 0.017 +/- 0.001, respectively. The scanning electron microscope analysis of the margins revealed that the composite resin cement was almost intact, the zinc phosphate was subjected to limited disintegration, and the glass ionomer displayed the worst marginal integrity.

Adhesives↗

Mechanical properties of heat-treated composite resin restorative materials.

Clinical methods for heat treating composite resin restorations have been developed. In this investigation, the effect of heat treatments on the diametral tensile strength of composite resin was determined. The composite resin restorative materials were selected according to the manufacturers' suggested use for anterior or posterior teeth, filler particle composition, and light-cured or chemical polymerization. Samples were prepared according to American Dental Association specification No. 27, and heat treatments were accomplished with a Coltene DI 500 oven for curing at approximately 120 degrees C for 7 minutes. Heat treatment substantially increased the diametral tensile strength tested, with the exception of the anterior hybrid particle (p less than 0.05). Composite resins with fine-particle inorganic fillers were significantly stronger than hybrid and microfilled composite resins.

Analysis of Variance↗

Crown pattern waxes: a study of their behavior on heating and cooling.

The values of the critical physical properties, flow and linear thermal expansion, of crown pattern waxes were determined and compared with those reported by previous investigators. The method is one proposed by the American Dental Association, and measurements were conducted in the temperature range of 27 to 52 degrees C. At temperatures higher than 37 degrees C most of the materials tested exhibited flow values that although rather low seem to be suitable for laboratory use. As expected, the linear thermal expansion was considerable, ranging from 1% to 1.5% or more as the temperature was increased from 27 degrees to 47 degrees C. The arrest points of the cooling curves, which are indicative of the composition of the materials, were recorded and studied. The possibility of correlating the arrest points with the transition points observed on the flow and expansion curves was investigated. Although attempts have been made to improve them, the commonly used dental waxes are not yet entirely free of their known drawback of large and perhaps uncontrollable thermal expansion.

Chemical Phenomena↗

Distribution of prosthodontists: 1982 through 1991.

A review of the 1982 and 1991 American Dental Association studies on the distribution of dentists provides specific information on the evolving numbers of prosthodontists at the national, regional, and state levels.

Adult↗

Sorption and solubility of 12 soft denture liners.

The long-term stability of a soft denture liner depends to a large extent on the sorption and solubility of the liner. Because sorption and solubility are accompanied by a volumetric change, bacterial infestation, hardening, and color change, it is a physical property of importance. The purpose of this investigation was to determine the sorption and solubility of 12 soft denture liners (Verno-Soft, Super Soft, ProTech, Soft-Pak, Flexor, Novus, Molloplast-B, Durosoft, Justi Soft, Velvesoft, VinaSoft and Prolastic). They include nine copolymers, two silicones and one polyphosphazene fluoroelastomer. The sorption and solubility test was performed as outlined in American Dental Association (ADA) specification 12 for denture base polymers. Five specimens of each material were tested and data were collected at 1 week, 1 month, 3 months, 6 months, and 1 year. Sorption data varied from 0.2 to 5.6 mg/cm2 at 1 week; 0.3 to 12.5 mg/cm2 at 1 month; 0.1 to 22.0 mg/cm2 at 3 months; 0.1 to 13.6 mg/cm2 at 6 months; and 0.1 to 35.7 mg/cm2 at 12 months. Solubility data varied from 0.0 to 0.4 mg/cm2 at 1 week; 0.1 to 0.8 mg/cm2 at 1 month; +0.1 to 1.2 mg/cm2 at 3 months; 0.0 to 1.9 mg/cm2 at 6 months; and +0.2 to 2.3 mg/cm2 at 1 year. A statistical analysis of the data by two-way ANOVA and calculated Tukey intervals showed significant differences between materials at all time intervals. The results of this study have clinical implications because the sorption and solubility may affect the long-term life expectancy of the soft denture liner.

Absorption↗

Chairside disinfection of radiographs.

Routine disinfection of materials that have contacted human blood products and body fluids during patient care is recommended by the American Dental Association and the Centers for Disease Control. The purpose of this study was to determine whether surface disinfection with sodium hypochlorite would be an effective means for disinfection of radiographic film packets used in chairside developers. Disinfection of exposed radiographic film packets for 30 seconds in 5.25% sodium hypochlorite has been found to be a simple procedure suitable for routine use. A suggested disinfection protocol for the use of chairside developing boxes is described. This procedure should be considered for adoption as an infection control guideline.

Communicable Disease Control↗

Survey of the medical history questionnaire.

The purpose of this study was to examine and to compare the type of information requested on representative health history questionnaires commonly used by the dental profession. Samples of medical history questionnaires were obtained from American and Canadian dental schools, commercial vendors, and the American Dental Association. Results indicated that more than 140 questions have been included on questionnaires and more than 92% of these appeared in some type of yes-or-no format. The number of questions per form ranged from 32 to 88, with an average of 58 items. Although there was wide variation in the range of information requested, the 25 most frequently asked questions occurred in 70% of the forms. The majority of questions focused on noninfectious disease conditions that affect the cardiovascular system and major organ functions, allergies, and blood disorders; infectious diseases such as hepatitis, tuberculosis, mumps, and venereal disease; and health care status and special treatment considerations.

Health Status Indicators↗