[Experience with the fluoride lacker Duraphat].
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OBJECTIVE: The purpose of this study was to evaluate the effectiveness of various surface treatments for resin-modified glass-ionomer restorative materials by determining dye uptake spectrophotometrically. METHOD AND MATERIALS: Two hundred twenty-four specimens, 4.1 mm in diameter and 2.0 mm thick, were made of 3 materials: Vitremer, Fuji II LC, and Photac-Fil Aplicap. Specimens were divided into 15 groups. The positive and negative control specimens remained unprotected, while the experimental specimens were protected with Heliobond light-activated bonding resin, Colorama nail varnish, or surface coatings indicated by the manufacturers of the glass-ionomer materials: Finishing Gloss for Vitremer, Fuji Varnish for Fuji II LC, and Ketac Glaze for Photac-Fil. The disks were immersed in 0.05% methylene blue for 24 hours except for the negative control group, which was immersed in deionized water. After 24 hours, the disks were removed, washed, and individually placed in 1 mL of 65% nitric acid for 24 hours. The solutions were centrifuged and the spectrophotometric absorbance was determined at 606 nm. The dye uptake was expressed in micrograms of dye per milliliter, and the results were analyzed with the Kruskal-Wallis test. RESULTS: There were no differences in dye uptake among the 3 resin-modified glass-ionomer restorative materials; however, all of them required surface protection. CONCLUSION: The best surface protection for the 3 evaluated materials was obtained with Heliobond light-activated bonding resin.
The use of ultraviolet radiation-curable coatings (UV-coatings) has increased rapidly in the parquet and furniture industry. Work with UV-coatings involves risk from skin exposure to chemically reactive, concentrated acrylates that are known skin contact irritants and sensitizers. Yet, the methods and tools for measuring and quantifying dermal exposure from hazardous chemicals directly on the skin are limited and methods to measure skin exposure to UV-coatings in occupational or environmental settings have been lacking. Skin exposure to UV-coatings was measured employing a quantitative tape stripping method that we have developed for this purpose. A pilot study was performed at three workplaces. In the main study, workers' skin exposure to uncured UV-coatings was measured at seven workplaces and on two separate workdays (rounds 1 and 2) within a six-month period to determine exposure variation. Skin exposure was measured at four standardized sites on the hand, 3-4 times per work shift. The forehead was sampled once. A questionnaire was carried out with the workers in both rounds to find out factors that can affect skin exposure to UV-coatings. The pilot study indicated that both skin and surface contamination to TPGDA-containing UV-coatings were common and varied up to 2110 microgram on the sampling area of 10cm(2). In the main study skin contamination due to TPGDA was found on 16 of 23 workers, at 6 out of the 7 workplaces, and from 36 (5. 4%) of the 664 samples. In round one 8.6% (n=383) of the samples contained TPGDA and in round two 1.1 % (n=281). The average TPGDA mass on all the positive samples (n=36) was 30.4+/-77.0 microgram for the first and second rounds alone this mass was 30.6+/-80 (n=33) and 28.3+/-16.5 microgram (n=3), respectively. Despite the limited sampling area and sampling sites, we could find residues of TPGDA at all sampling times, even at the beginning of the work shift. This may be due to transfer of UV-coatings through contaminated equipment, shoes and surfaces. Our study indicates that there is a risk of harmful skin exposure to UV-coatings in the furniture and parquet industry.
A number of laboratory and clinical studies over the last 15 years have explored the potential advantages of bonding amalgam to tooth surfaces. Bond strengths have been reported to range from 2 to 20 MPa, with higher bond strengths reported for filled adhesives. Most studies agree that the use of bonding results in a considerable reduction of microleakage, when compared with copal varnish or no lining. The use of bonding provides retention in vitro that is equivalent to, or better than, the use of mechanical undercuts. Most studies on strength of restored teeth report an improvement in resistance to fracture or cuspal flexing as measured by strain gauges. Penetration of secondary caries along the interface has been found to be inhibited by bonding. The mode of failure of bonded amalgams has generally been reported to be mixed, but predominantly between the resin and amalgam. In vitro studies have reported one potential problem in the incorporation of resin into amalgam, which may cause a decrease in strength of the restoration. The clinical studies of bonded amalgams that have been published to date are of short duration, indicating that when traditional preparations are used, no problems are seen with bonding, but also no advantages, as measured by clinical assessment criteria. However, some studies show that bonded amalgam may be useful for procedures where non-bonded amalgams would be expected to be lost, namely in preparations with little, if any, mechanical retention. It was concluded that, while there are various in vitro studies demonstrating that bonded amalgams have advantages of improved retention and tooth reinforcement and decreased marginal microleakage and secondary caries, the operative technique is more complicated and there are few advantages yet evident from clinical studies in conventional preparations having mechanical retentive features. However, there is evidence accruing from clinical studies that bonding of amalgam can be favorably used to extend the range of usage of amalgam to non-retentive conservative preparations, and toward the other extreme, as an adjunct to other forms of retention in large compound restorations.
This study examined the effect of thermal cycling on the microleakage of bonded amalgam restorations. Three dental amalgam alloys and a gallium alloy were tested with two adhesive resin systems and copal varnish as a control. Class V cavity preparations were prepared on 168 freshly extracted premolars or molars. The preparations were placed parallel to and 1.0 mm occlusal to the cementoenamel junction (CEJ). Four groups of 42 teeth each were treated with one of the following adhesive dentin systems: Bond-It, All-Bond 2/Resinomer or a copal varnish (Copalite). The four groups of 42 teeth each were then restored with one of three dental amalgams: Orosphere Plus, Indiloy, Oralloy or a Gallium alloy (Galloy), resulting in 12 test groups of 14 teeth each. The specimens were stored in double distilled water at 37 degrees C for 24 hours. Final contouring and polishing of the restorations were performed under water spray. Half of the restorations in each group were thermocycled for 3000 cycles (5 degrees C-37 degrees C-55 degrees C-37 degrees C) with a dwell time of 15 sec at each temperature. The other half were stored in double distilled water at 37 degrees C for 24 hours. Then all 168 restorations were stained with dye, sectioned and scored for microleakage. Results showed that the adhesive dentin systems reduced microleakage in amalgam restorations compared to copal varnish only in non-thermocycled specimens. Statistical analysis of the results showed that there was an extremely significant difference (p < 0.001) in microleakage between the non-thermocycled and the thermocycled specimens in all test groups, whereas, there was no significant difference (p > 0.05) among thermocycled specimens. The reduction of microleakage was not significantly different between Bond-It and All-Bond 2/Resinomer in non-thermocycled specimens. Oralloy showed the most microleakage in the non-thermocycled groups when compared to the other alloys using the same adhesive liner.
OBJECTIVES: To review the current literature regarding the anti-caries efficacy of fluoride varnishes. To analyse a series of studies designed to detect the caries preventive efficacy of fluoride varnishes by means of meta-analysis. MATERIALS AND METHODS: Current literature on fluoride varnishes has been reviewed. An evaluation of the results of the available in vitro, animal and human studies on the anti-caries efficacy of these preventive agents was performed. A systematic literature search and a meta-analysis were also performed to assess the caries preventive effects of fluoride varnishes. The purpose of this analysis was to calculate the overall preventive efficacy of clinical fluoride varnishes treatment studies, based on defined methodological criteria. RESULTS: The efficacy of fluoride varnishes in caries prevention is clearly demonstrated in several experimental studies. Clinical trials show caries incidence reduction ranging approximately from 18% to 70%. Nevertheless, available studies show a high degree of heterogeneity and only three were found to meet a series of defined methodological criteria. All the three studies were based on a comparison between 0.2% NaF rinses and a fluoride varnish. The meta-analysis showed no significant differences between the two treatments. CONCLUSIONS: Available data suggest that fluoride varnishes are a useful tool in caries prevention. One may conclude that fluoride varnishes, when applied regularly, demonstrate good caries preventive properties.
OBJECTIVE: To promote denture retention and denture comfort, denture materials should possess adequate wettability. This in vitro study investigated the wettability of nine commercially available dental materials. METHOD AND MATERIALS: Four denture base materials, two denture hard lining materials, and three denture soft lining materials (with and without varnish treatment) were tested. The wettability measurements were made using the dynamic contact angle analysis technique. The equilibrium and hysteresis angles obtained were used for the comparisons. RESULTS: The equilibrium contact angle (thetae) ranged from 63.9 (Permaflex + varnish) to 81.0 degrees (Mollosil + varnish). The differences observed among the materials tested were statistically significant. The contact angle hysteresis ranged from 16.0 (SR 3/60 Triplex) to 51.2 degrees (Mollosil), and there was a statistically significant difference among the materials. CONCLUSION: The heat-polymerized soft lining materials exhibited the greatest equilibrium contact angle, the autopolymerized soft liner had the lowest value, and the denture base materials had intermediate values. The soft liners showed greater contact angle hysteresis than all other materials. The use of varnish altered the wetting characteristics.
The effectiveness of four surface protectors for resin-modified glass ionomer cements was evaluated by spectrophotometrically determining dye uptake. Ninety specimens, 3.0 mm in diameter and 1.0 mm in height, were made with Photac-Fil, Fuji II LC and Vitremer and divided into six groups for each material. Positive and negative controls were not protected while experimental specimens were protected with proprietary glaze, nail varnish, flowable resin and glaze. The discs were immersed in 0.1% methylene blue solution for 10 minutes after mixing, except for those negative control specimens that were immersed in deionized-water. After 24 hours, the specimens were washed and the protectors trimmed with Sof-Lex discs. The specimens were then removed from the matrixes and individually placed in 1.5 mL of 65% nitric acid for five hours. The absorbance was determined spectrophotometrically at 590 nm. Dye uptake was expressed in microgram dye/specimen. The data were analyzed by two-way ANOVA and Tukey-Kramer tests. All surface protectors tested were effective. For Fuji II LC and Vitremer no differences were observed among tested protections. For Photac-Fil, nail varnish showed better performance than the proprietary glaze.
This paper summarizes and rates the evidence for the effectiveness of methods available to dental professionals for their use in the primary prevention of dental caries. It reviews operator-applied therapeutic agents or materials and patient counseling. Evidence of effectiveness is extracted from published systematic reviews. A search for articles since publication of these reviews was done to provide updates, and a systematic review of the caries-inhibiting effects of fluoride varnish in primary teeth is provided. Good evidence is available for the effectiveness of fluoride gel and varnish, chlorhexidine gel, and sealant when used to prevent caries in permanent teeth of children and adolescents. The evidence for effectiveness of fluoride varnish use in primary teeth, chlorhexidine varnish, and patient counseling is judged to be insufficient. Use of fluoride, chlorhexidine and sealant according to tested protocols and for the populations in which evidence of effect is available can be recommended. However, they may need to be used selectively. Estimates for the number of patients or tooth surfaces needed to treat to prevent a carious event suggest that the effects of these professional treatments are low in patients who are at reduced risk for dental caries. The literature on use of these preventive methods in individuals other than school-aged children needs expansion.
This study was conducted to compare the caries preventive efficacy of Fluoritop - SR; the first fluoride varnish manufactured in India with Fluor Protector and Bifluorid 12, the two commercially available fluoride varnishes which have to be imported from other countries and are cost prohibitive. The demineralization inhibitory effects and the antibacterial effects on Streptococcus mutans were studied (in vitro). Calcium and Phosphorus dissolutions were estimated as a measure of the demineralization inhibitory effect. Antibiotic sensitivity tests using the serial tube dilution method and disk diffusion method were used to evaluate the antibacterial effects of the fluoride varnishes. Of the three varnishes, Fluor Protector was seen to exhibit the highest demineralization inhibitory effect, while Fluoritop-SR was found to be comparable to Bifluorid 12 in its caries protective effects.
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PURPOSE: To evaluate the suppressive effect of four different chlorhexidine (CHX) regimens on the interdental levels of mutans streptococci (MS) on enamel and various restorative materials in a group of adults. MATERIALS AND METHODS: 128 subjects with high salivary MS counts were allocated to (A) a single professional tooth cleaning with a 1% CHX gel, (B) duplicate applications of a dental varnish containing 1% CHX and 1% thymol, (C) a single application of a 40% CHX varnish, (D) daily tooth brushing with a 1% CHX gel for 2 weeks . Interdental plaque samples were collected at baseline, 1 week, and 3 months after termination of CHX treatment. RESULTS: The baseline MS levels were significantly higher in plaque from composite surfaces than in plaque from enamel surfaces. All methods decreased the interdental MS levels compared with the baseline on enamel, composite and amalgam surfaces. On both clinically sound enamel and amalgam surfaces, the outcomes in Groups B, C and D were similar and significantly better than in Group A. On composite surfaces, the 40% CHX varnish (C) and the CHX brushing (D) were significantly more effective in decreasing MS than the low-CHX varnish (B) and the professional CHX cleaning (A).
This study evaluated the influence of the pulp protection technique on clinical performance of amalgam restorations after three years, with particular reference to post-operative sensitivity and secondary caries. One hundred and twenty (120) Class II amalgam restorations (68 premolars, 52 molars; 78 MOD, 42 OD/MO) were placed in 30 participants (four restorations per participant). The restorations were divided into four groups according to the pulp protection technique used: copal varnish; 2% neutral sodium fluoride; adhesive resin and no pulp protection. The parameters evaluated were post-operative sensitivity, staining of the dental structure, tooth vitality, partial or total loss of the restoration and secondary caries. One hundred and eight (108) restorations were available for evaluation after three years. No partial or total loss of restorations had occurred; all teeth were vital, no tooth structure staining or secondary caries was detected in any of the restored teeth. Post-operative sensitivity was observed only in two restorations at baseline and at seven-days. The three-year clinical performance of teeth restored with a high copper dispersed phase amalgam was not affected by the choice of pulp protection technique.
Fluoride varnishes are available in the United States, and the Federal Drug Administration has approved a fluoride varnish for use as a cavity preparation lining varnish and as a tooth desensitizing agent. The literature, however, supports the use of fluoride varnishes to inhibit tooth demineralization and enhance remineralization. The purpose of this paper is to present an overview of literature and make recommendations according to the available scientific evidence. Findings support the use of fluoride varnishes as a safe and effective topical fluoride agent.
To combat dental caries, a chemical has been sought that possesses stronger antimicrobial properties than fluoride in support of its physicochemical tooth-protecting properties. These searches have led to several agents, of which chlorhexidine (CH) appears most effective. To reduce local side effects of the well-known 0.2% CH mouthwash, a 0.05% CH gluconate + 0.04% NaF solution, pH 5.9, has been developed. Use of this combination over a 2-year period resulted in a 53% reduction in caries increment and a 75% reduction in gingival bleeding, i.e. a clear duality of prevention of oral disease (Luoma et al. 1978). Staining of teeth was minimal and easily removable in about one third of the subjects. To lessen the contribution of patients, chlorhexidine gels, without but more especially with fluoride have been professionally administered. Reductions in salivary mutans streptococci after short periods of gel applications have been found to persist longer than reductions after brief periods of mouthwashing. Reductions of approximal caries increment by about 50% in children, and root surface caries in adults have been obtained through use of CH gels. The effect on root surface caries in adults was equal to that obtained through use of local fluoride applications. Dental CH varnish seems promising, especially because a very short contact time with a tooth may be sufficient to reduce mutans streptococci. No simultaneous effects against caries and gingivitis of CH gels or varnishes has been reported. Comparisons of CH solutions, gels and varnishes, with or without fluoride, in relation to their potentials for preventing oral disease in subjects at risk remain to be accomplished.
This clinical study evaluated the microleakage effectiveness of a cavity varnish when used in combination with two types of amalgam: a spherical particle and a dispersed phase alloy. Calcium hydroxide was utilized as the microleakage detection agent. Copalite showed a reduction in microleakage when it was employed with the spherical particle alloy used in this study. This study clinically demonstrated that Copalite is not totally effective in eliminating microleakage.
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Historically glass-ionomer samples have been coated with a varnish to protect the material from the effect of water on the surface. However, varnishes have been shown to peel from this surface. The set cement matrix may become chalky and can erode rapidly. Light-cured glazing agents may demonstrate the ability to limit water movement across the setting-cement surface. In this in vitro study samples were investigated colorimetrically to evaluate the effect of water contamination. Perceivable differences were not found, particularly when a coating of light-cured bonding or glazing agents was applied. We conclude that the color stability of glass-ionomer cements is enhanced with the use of a protective coating of light-cured bonding or glazing agents.