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In vitro comparison of intact endodontically treated teeth with and without endo-post reinforcement.

In an in vitro experiment, the failure loads of 59 intact endodontically treated teeth with and without Kerr Endo-Post reinforcement were compared. Fifty-eight teeth fractured below the cementoenamel junction. One tooth fractured through the pulp chamber with a chisel fracture involving both the crown and root. Teeth without posts fractured through the middle or coronal one third of the root. Teeth with posts fractured through the body of the post. No statistically significant reinforcement was demonstrated by cementing a Kerr Endo-Post No. 100 into a sound endodontically treated tooth.

Crowns↗

IPS Empress crown system: three-year clinical trial results.

The IPS Empress system is a highly esthetic hot pressed glass ceramic material for fabrication of single crowns. Adhesive cementation of the system not only contributes to the esthetics but is necessary for increased strength of the crown. The purpose of this prospective clinical trials was to evaluate the longevity of 75 adhesively cemented Empress full crowns. An additional aim was to assess the adhesive cementation methodology and potential side effects. At the three-year point, one molar crown fractured for a 1.3 percent failure rate. The resin cementation technique that was employed exhibited a low incidence of microleakage with few clinical side effects. There was a 5.6 percent incidence of post-cementation sensitivity, with all symptoms subsiding by eight weeks. None of the crowns in the study required endodontic therapy.

Adolescent↗

Wet cement: a poorly recognized cause of full-thickness skin burns.

Cement is a rare cause of full-thickness burns. We have examined the aetiology, frequency and severity of these burns, and assessed public awareness of the potential of cement as a caustic agent. Of patients, 95 per cent were unaware of the potential of cement to cause burns, and none had seen precautionary warnings on cement bags or delivery dockets. Factors important in burn production appear to be alkalinity, duration of contact and the abrasive nature of the cement particles. It is concluded that doctors, especially casualty officers, should know of the potential of progressive full-thickness burns from wet cement. General public awareness should be increased. The cement manufacturers were asked to comment on the content of this paper.

Adult↗

Marginal leakage in class II-restorations after use of ceramic-inserts luted with different materials.

The efficiency of using prefabricated ceramic inlays to prevent microleakage has been discussed in different investigations. The purpose of this study was to evaluate the marginal microleakage of a new glass ceramic inlay system in combination with two different composite luting materials and one polyacid-modified composite, respectively. Standardized class II cavities (n = 60) were filled with (1) Empress inlays fixed with a highly viscous luting composite as a control group, and with glass ceramic inlays (Cerana) in combination with (2) a highly viscous luting composite, (3) a low-viscous luting composite and (4) a polyacid-modified composite, respectively. After thermocycling the marginal quality was analysed with scanning electron microscopy, and the dye penetration along the cavity walls was measured. The use of the Cerana inlays with a polyacid-modified composite resin did not reveal a good marginal adaptation. However, the combination of the Cerana and the Empress inlays with the highly viscous composite exhibited a comparable marginal fit. Within the limitations of an in vitro study it is concluded that the combination of the new glass ceramic inlays with a polyacid-modified composite cannot be recommended for clinical use.

Aluminum Silicates↗

[Clinical pattern of secondary dental caries in relation to tissue defect class and type of filling material].

The purpose of the study was assessment of the development of secondary caries in relation to filling type in various classes of carietic dental tissue defects. The study was carried out in 320 patients aged 16 to 55 years and 3884 teeth were examined. Out of this material 2423 teeth were filled: with amalgam--853, with silica cement--1197, with composites--373. Secondary caries was found in 1341 teeth (56.34%). In teeth filled with amalgam in classes I and II of carietic defect in women secondary caries was noted in 27.26% and 47.73% of cases respectively. In case of composite filling secondary caries was found in 72.12% and 81.82% of fillings. In class III of carietic defects in women with fillings with composite materials secondary caries developed in 48.8%, and after filling with silica preparations in 55%. In class IV secondary caries was present at 45% of composite fillings and 77.78% of silica cement fillings. In class V secondary caries was found at 11.42% of amalgam fillings and 36.67% of composite fillings, and in 45% at silica cement fillings. Similar values were found in men.

Adolescent↗

Mortality and cancer morbidity among cement workers.

OBJECTIVE: To explore associations between exposure to cement dust and cause specific mortality and tumour morbidity, especially gastrointestinal tumours. DESIGN: A retrospective cohort study. SUBJECTS AND SETTING: 2400 men, employed for at least 12 months in two Swedish cement factories. MAIN OUTCOME MEASURES: Cause specific morality from death certificates (1952-86). Cancer morbidity from tumour registry information (1958-86). Standardised mortality rates (SMRs; national reference rates) and standardised morbidity incidence rates (SIRs; regional reference rates) were calculated. RESULTS: An increased risk of colorectal cancer was found > or = 15 years since the start of employment (SIR 1.6, 95% confidence interval (95% CI) 1.1-2.3), mainly due to an increased risk for tumours in the right part of the colon (SIR 2.7, 95% CI 1.4-4.8), but not in the left part (SIR 1.0, 95% CI 0.3-2.5). There was a numerical increase of rectal cancer (SIR 1.5, 95% CI 0.8-2.5). Exposure (duration of blue collar employment)-response relations were found for right sided colon cancer. After > or = 25 years of cement work, the risk was fourfold (SIR 4.3, 95% CI 1.7-8.9). There was no excess of stomach cancer or respiratory cancer. Neither total mortality nor cause specific mortality were significantly increased. CONCLUSIONS: Diverging risk patterns for tumours with different localisations within the large bowel were found in the morbidity study. Long term exposure to cement dust was a risk factor for right sided colon cancer. The mortality study did not show this risk.

Cause of Death↗

Evaluating the antagonistic wear of restorative materials when placed against human enamel.

Several clinical and laboratory studies have reported data on the nature of tooth wear against restorative materials (that is, amalgam, gold, glass ceramic and various composite resin systems). Several antagonistic substrates are known to cause various in vitro wear rates when placed in opposition to enamel. In this study, the authors evaluated 10 commercially available posterior composite resin systems and a gold alloy control. The findings showed that posterior composite resins containing zirconium silicate or quartz fillers caused greater antagonistic enamel wear than did microfilled or barium silicate-filled composite resins.

Analysis of Variance↗

Extractability and fractionation of heavy metals in chemically treated sewage sludges.

Four chemically treated sludges, lime-treated (LS), lime/sodium silicate-treated (LSS), cement-treated (CS), and cement/sodium silicate-treated (CSS) were produced form the chemical treatment of aerobic digested sewage sludge cake, using lime, cement, and sodium silicate as additives. Ex tractability and fractionation of the heavy metals (Cu, Pb, Cr, and Zn) in these products and untreated sludge (S) were investigated using sequential extraction, single extraction, and 13C cross-polarization magic angle spinning nuclear magnetic resonance analysis (13C-NMR). These approaches revealed that chemical treatment of sewage sludge makes sludge Cu, Pb, and Cr more extractable. It was attributed to the irreversible dissolution of a portion of organics at very high pH during chemical treatment of sludge. The enhanced extraction of some metals having higher affinity to organics, e.g. Cu and Pb, from the chemically treated sludges was due to their complexion with the above soluble organics.

Biological Availability↗

Localized wear and marginal integrity of posterior resin composites.

In vitro localized wear testing was completed on several commercially available and experimental resin composites to evaluate the loss of occlusal contact wear. Marginal deterioration after localized stressing was also evaluated by SEM observation. The compositions containing zirconium silicate and quartz exhibited the least amount of wear. However, an experimental 4-META bonding resin exhibited the best marginal integrity.

Acrylic Resins↗

Color communication, laboratory fabrication, and cementation.

Once considered to be revolutionary, porcelain veneers are now the foundation of most aesthetic dental practices. Requiring only conservative preparations, porcelain veneers can dramatically change a smile. This article discusses the technique necessary to prepare and place porcelain veneers, using a new pressed-ceramic system. Close and thorough cooperation and communication between the clinician and the laboratory are essential throughout the procedure, and this article is coauthored by a dentist and a ceramist.

Aluminum Silicates↗

IPS Empress veneers. Color communication, laboratory fabrication, and cementation.

Once considered to be revolutionary, porcelain veneers are now the foundation of most aesthetic dental practices. Requiring only conservative preparations, porcelain veneers can dramatically change a smile. This article discusses the technique necessary to prepare and place porcelain veneers, using a new pressed-ceramic system. Close and thorough cooperation and communication between the clinician and the laboratory are essential throughout the procedure, and this article is coauthored by a dentist and a ceramist.

Adult↗

Biological tests of a silicophosphate cement.

The biological compatibility of a silicophosphate cement (Fluoro-Thin) and a zinc phosphate cement (de Trey's Improved) has been assessed in in vitro (cell culture) and in vivo (monkey teeth) tests. In the in vitro tests both materials were toxic when freshly prepared. In experiments with prolonged cell-material contact time, with set specimens of the materials, the zinc phosphate cement appeared to be non-toxic, whereas the silicophosphate cement was clearly toxic. The in vivo experiments confirmed that a possible pulp reaction cauded by zinc phosphate cement is of a mild nature. The silicophosphate cement, however, cauded a moderate or severe reaction in the pulp after 8 days of observation, and there was chronic inflammation in most teeth after 36 or 72 days. It was concluded, therefore, that Fluoro-Thin should not be used as a luting agent or for restorative purposes in direct contact with vital dentine.

Animals↗

The effect of maturation on in-vitro erosion of glass-ionomer and other dental cements.

The clinical durability of restorations made using water-based materials depends upon the type of material used. Current specification tests cannot predict durability, possibly because these are carried out on samples matured for 24 hours whereas longer maturation times may be more relevant. The lactic acid jet test was selected as a test method, being believed capable of ranking materials in the same order of erosion resistance in vitro as found in vivo. The powder/liquid interaction (glass or zinc oxide with polymeric or phosphoric acid) was investigated by selecting glass-ionomer, zinc polycarboxylate, silicate and zinc phosphate cements, with emphasis placed on glass ionomers. Two test times, 24 hours and 2 months, were chosen, with eight samples for each material tested at each time. All glass ionomers showed a significant reduction in erosion rate with time; two zinc polycarboxylates also showed some reduction but not to a significant degree. The silicate and zinc phosphate cements increased in erosion rate but not significantly. It was concluded that materials using polymeric acids had erosion rates which reduced with time, significantly so for glass ionomers. This might explain their longevity over silicate cements.

Dental Cements↗

Short-term results of IPS-Empress full-porcelain crowns.

PURPOSE: A leucite-reinforced, glass-ceramic material was recently introduced for clinical use. In this clinical trial, IPS-Empress material was tested in the form of full-porcelain crowns. MATERIALS AND METHODS: Thirty-four patients were restored with 78 full-porcelain crowns. After etching the crowns with hydrofluoric acid, they were silanized and luted using dentin bonding agents and resin composite cement, which was primarily a dual-cured type. The 41 anterior and 37 posterior crowns were evaluated clinically with a mirror and probe, radiographically, and using clinical photographs, according to the modified United States Public Health Service criteria. Restorations having neither charlie nor delta criteria were defined as successful, and their survival rate was calculated according to Kaplan-Meier analysis. RESULTS: The mean observation period for the 78 restorations was 19.7 +/- 8.5 months. Seventy-four crowns were defined as successful. Four restorations failed because of fractures. Three of the four failures occurred in the first 2 months after cementation. The survival rate was estimated to be 95% successful after 2 years in service. Eighty percent of the crowns demonstrated an excellent esthetic result. CONCLUSIONS: The initial clinical results of this esthetic full-porcelain crown system are encouraging. However, because of fatigue phenomena for all ceramic materials, a longer observation period is needed to provide a definitive prognosis about the long-term clinical behavior.

Aluminum Silicates↗

Remakes of Colorlogic and IPS Empress ceramic restorations in general practice.

PURPOSE: The aim of this article was to study frequencies and distribution of remakes of all-ceramic inlays/onlays, veneers, and crowns occurring before and after cementation. MATERIALS AND METHODS: A total of 2,069 sintered feldspathic ceramic restorations (Colorlogic) and 1,136 pressure-molded ceramic restorations (IPS Empress 1 and 2) were produced during the study period by one dental laboratory. The laboratory gave an unqualified and unlimited guarantee for their ceramic restorations. The outcome variable was reports from the clinicians to the dental laboratory about any problems related to the restoration, necessitating remake. RESULTS: Problems occurring before cementation occurred in 4.4% of the restorations. Veneers were remade more frequently than the other types of restorations (6.6%). After cementation, the overall 2-year rate of remakes was 1%, indicating a survival rate of the ceramic restorations of 99%, with inlays/onlays exhibiting the highest (99.8%) and crowns the lowest (98.4%) rates. This difference in rates was significant. No significant differences in remakes between ceramics or tooth categories were found. CONCLUSION: There were few problems in a short- to medium-term perspective that, in the opinion of general practitioners, necessitated remakes of all-ceramic restorations.

Aluminum Silicates↗

[Preliminary clinical results of a prospective study of IPS e.max Press- and Cerec ProCAD- partial coverage crowns].

UNLABELLED: It was the aim of this prospective clinical splitmouth investigation to evaluate the survival rate and long-term behavior of all-ceramic partial coverage restorations (PCR) on molars. Pressed ceramic (IPS e.max Press) and CAD/CAM made (ProCAD) PCR were compared. 80 vital molars of 25 patients were restored with all-ceramic PCR (40 IPS e.max Press* and 40 ProCAD*). All PCR were adhesively luted with a light-polymerizing composite (Syntac*/Tetric*) (*Ivoclar-Vivadent AG, Schaan, Liechtenstein). The ProCAD PCR were produced with Cerec 3 and Cerec Inlab CAD/CAM system (Sirona Dental Systems, Bensheim, Germany). IPS e.max Press PCR were heat-pressed following the lost-wax IPS-Empress method. Clinical recall was arranged in average 8, 14, 20 and 28 months after cementation of the restoration. PCR were classified by USPHS criteria. The prospective survival rate of ProCAD PCR was 97% and 100% for IPS e.max Press PCR after an observation period of 24 months. After fracture, one ProCAD restoration had to be replaced after nine months. The clinical accuracy of the marginal fit of ProCAD PCR and IPS e.max Press PCR was recorded "Alfa". Limitations were recognized with respect to the color matching of both types of PCR ("Bravo"). CONCLUSION: Within the limits of the present clinical results, the tested all-ceramic materials IPS e.max Press und ProCAD seem to be indicated for partial coverage restorations on molars.

Aluminum Silicates↗

Evaluation of the marginal accuracy of different all-ceramic crown systems after simulation in the artificial mouth.

The in vitro marginal fit of five different all-ceramic crown systems (In-Ceram, Empress staining technique, Empress veneering technique, Celay feldspathic system, Celay In-Ceram system) was evaluated before and after cyclic preloading in an artificial mouth. The crowns were adhesively luted to extracted natural maxillary incisors prepared with a 90 degrees shoulder. The results were compared to those for porcelain-fused-to-metal (PFM) crowns with circular porcelain-butt margins which were cemented with zinc phosphate cement. The analysis of the marginal discrepancies showed significant (P < 0.001) differences among the groups. Crown cementation increased the marginal gaps significantly (P < 0.01). Empress staining technique crowns showed the smallest marginal gaps (median 47 microm), followed by conventional In-Ceram crowns (median 60 microm) and Empress veneer technique crowns (median 62 microm). Celay In-Ceram crowns displayed marginal openings with a median of 78 microm, followed by Celay feldspathic crowns with a median of 99 microm. The marginal gap of the PFM control crowns showed a median of 64 microm. Ageing in the chewing simulator had no significant influence on the marginal fit of all specimens. The study indicates that all the tested all-ceramic crowns have clinically acceptable margins. However, in vivo investigations of all all-ceramic crown systems should be made before clinical routine.

Aluminum Oxide↗