The selection and properties of materials for dental practice.
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A thorough dental prophylaxis before acid-etching of enamel is often recommended. In the method most commonly used, a slurry of pumice is applied with a rubber cup. Oil-based and fluoride-containing prophylaxis pastes are not generally recommended because of fears that they might hinder the etching process. This study assessed the 24-hour shear strength of resin (Scotchbond 2/Silux Plus) bonded to etched enamel which had been cleaned before acid-etching with a slowly rotating rubber cup loaded with: (1) wet pumice; (2) fluoride-containing non-oil-based pastes (En-De-Kay fluoride paste, Nupro fluoride paste); (3) non-fluoride oil-based paste (Kemdent); and (4) nonfluoride non-oil-based pastes (Nupro, Orapol). The bond strength values obtained after using the various cleaning agents were similar. Furthermore, bond failure in all the test groups was of the cohesive type. It therefore appears that prophylaxis pastes containing fluoride or oil may be used to clean the enamel before acid-etching.
This in vitro study reports on the cleaning effect of different soaps on the shear bond strength of various dentine-bonding agents. Human teeth were coated with provisional cements for 24 h or for 14 days. After removing the provisional cements with a scaler, the dentinal surface was cleaned with a cotton pellet and non-fluoridated flour of pumice and soap for 10 sec. Different dentine-bonding agents and a luting resin were bonded to the dentinal surface according to manufacturers' instructions with the bonding agent and the composite material being light-cured at the same time. The bonding agents were tested under intrapulpal pressure and with thermal cycling to imitate physiological conditions. Compared with cleaning the dentine with water and pumice, all soaps investigated in this study decreased the shear bond strength values of the tested dentine-bonding agents considerably.
The differences in polishability of modified and conventional glass-ionomers were studied following different polishing procedures. Specimens of conventional glass-ionomer (Fuji II(R)), resin modified glass-ionomer (Vitremer(R)) and compomer (Dyract(R)) were prepared and polished using either Soflex(R) or Enhance(R) discs with either aluminum oxide or poly(acrylic acid) gel as polishing agents. Surface roughness of the specimens was evaluated by profilometric measurements and electron microscopic examination. It was shown that Soflex(R) discs manifest superior polishing effect on glass-ionomers and resin modified glass-ionomers compared to the Enhance(R) system, although no significant differences were found for the compomer specimens. Addition of poly(acrylic acid) gel as a polishing agent reduced surface roughness of conventional glass-ionomer and resin modified glass-ionomer specimens and did not significantly affect the compomer specimens.
Specimens of light-curable dental restoratives have been prepared using either a conventional dental curing lamp (for 20 or 30 s) or a plasma light (for 1 or 2 s). The specimens were then stored in water until their mass equilibrated, then dried to constant mass. Most specimens lost material in this process but the losses in all specimens cured with the plasma light were significantly greater than those cured with the conventional lights (P < 0.05). Longer cure times gave slightly reduced losses in water in most cases. The specimens were then returned to water and allowed to re-equilibrate and their equilibrium water uptake determined. There was no simple trend in this latter property because elution of loosely bound hydrophilic species may have resulted in a less hydrophilic specimen, whose equilibrium water content was therefore correspondingly lower. Overall, the losses through dissolution in water suggest that plasma curing is less effective for these materials than conventional light curing, as it probably results in material with lower molar mass. The losses for the resin-modified glass-ionomer were much greater than for other materials, and it was concluded that the more rapid polymerization with plasma light caused a significant inhibitation of the acid-base part of the setting process. These findings suggest that long-term durability of materials may be compromised by employing plasma light cure rather than a conventional cure system and further studies of this point are recommended.
Enamel decalcification is a significant problem in orthodontic patients. The argon laser has been shown to reduce decalcification during an acidic challenge in vitro. The purpose of this study was to investigate the in vivo effects of argon laser irradiation on enamel decalcification during orthodontic treatment. Nine volunteers whose treatment plans included 4 first premolar extractions were enrolled in the study. The 36 extracted premolars were assigned to 1 of the following 4 groups: group 1, control group with no treatment; group 2 (pumice-laser), teeth were pumiced for 3 seconds and treated with a 325 mW, 5-mm diameter laser beam for 60 seconds; group 3 (pumice-etch-laser), teeth were pumiced for 3 seconds, acid-etched with 30% phosphoric acid for 30 seconds, and treated for 60 seconds with laser; and group 4 (laser only), teeth were treated for 60 seconds with laser. A specially designed (oversized) orthodontic band was fitted on each of the premolars to create a pocket for decalcification. The bands were cemented in place for 5 weeks. After extraction, the teeth were sectioned and examined under polarized light microscopy. Images of lesions were digitally analyzed and measured. Average lesion depths were calculated from 3 depth measurements recorded 10 microm apart. Average lesion area was calculated with the aid of imaging analysis software. Data were analyzed with analysis of variance (P <.05) and Student t tests. Significant differences were found in lesion depth (P <.001) and lesion area (P <.01) among the 4 test groups. The average lesion depths were 15.93 +/- 9.31 microm (control), 6.45 +/- 8.70 microm (pumice-laser), 1.71 +/- 4.82 microm (pumice-etch-laser), and 1.34 +/- 3.80 microm (laser only). The average lesion areas were 1028.67 +/- 725.68 microm (2) (control), 555.49 +/- 948.20 microm (2) (pumice-laser), 79.91 +/- 226.03 microm (2) (pumice-etch-laser), and 55.71 +/- 157.59 microm (2) (laser only). The average lesion depth in the laser-only group was reduced by 94.1% and the average lesion area was reduced by 94.4% when compared with the control group. In the pumice-etch-laser group, the average lesion depth was reduced by 89.1% and the average lesion area was reduced by 92.2% when compared with the control group. There were no significant differences in lesion depth and lesion area between maxillary and mandibular teeth (P <.06 and P <.08, respectively) and between the teeth on the right and left sides (P <.68 and P <.55, respectively). These results show that argon laser irradiation is effective in reducing enamel decalcification during orthodontic treatment. Pumicing and etching do not appear to reduce the effect of laser on enamel solubility.
The aim of this study was to assess the quality of the marginal seals of 7 restoratives by means of a bacterial penetration test in vitro. Sixty intact premolars and third molars that were scheduled for extraction were used in the test. There were 2 experimental groups of teeth, as follows: (1) A class V conventional cavity and a wedge erosion cavity were prepared on the buccal surface and the lingual surface, respectively, of each tooth. (2) A class V conventional cavity and a wedge erosion cavity were prepared on the buccal surface and the lingual surface, respectively, of each tooth with a completely removed enamel layer. The cavities were then reconstructed with different restorative materials. The quality of the marginal seals was evaluated by submerging the teeth in a bacterial suspension and incubating them in an anaerobic milieu at 37 degrees C for 20 hours. The teeth were subsequently processed for histologic data and bacterial staining. The best marginal sealing in both the wedge erosion and the class V cavities was provided by the Herculite/Optibond system and the Valux Plus/Scotchbond Multipurpose system. Bacterial penetration was slightly greater with the Luxat compomer and the Dyrect compomer, as well as with Vitremer glass ionomer cement and Fuji LC glass ionomer cement. The bacterial penetration test showed that the use of restorative material does not entirely eliminate microleakage.
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Four types of resin composites (Dyract AP (DYR), Definite (DEF), Ariston pHc (ARI), and Spectrum TPH (SPE)) were tested after water storage for up to 180 days. The test parameters were flexural strength, flexural modulus, and marginal gaps at fillings in cylindrical cavities. The cavity tests were performed in two ways. One series of filings was finished shortly after curing and the maximal gaps were followed with time during water storage. Another series was finished immediately before gap size measurement and after water storage for various periods. Absence of or reduced gap sizes at 180 days compared to 1 h or 1 day was obsenred for all materials and with both methods. At 180 days, DYR and ARI showed significantly smaller gap sizes than those observed with DEF and SPE. No significant differences in flexural strength were observed when means at 180 days were compared to those observed at 1 day. DEF, ARI, and SPE showed a significant increase in flexural moduli at 180 days compared to 1 day, while DYR showed none. It is concluded that fillings made of Dyract AP or Ariston pHc may show absence of or very small gap sizes between filling and cavity wall after 6 months and with no significant reduction in mechanical strength.
The purpose of this prospective longitudinal randomized study was to compare the clinical performance of recycled brackets with that of new stainless steel brackets (Orthos). Twenty patients treated with fixed appliances were included in the investigation. Using a 'split-mouth' design, the dentition of each patient was divided into four quadrants. In 11 randomly selected patients, the maxillary left and mandibular right quadrants were bonded with recycled brackets, and the remaining quadrants with new stainless steel brackets. In the other nine patients the quadrants were inverted. Three hundred and ten stainless steel brackets were examined: 156 were recycled and the remaining 154 were new. All the brackets were bonded with a self-cured resin-modified glass ionomer (GC Fuji Ortho). The number, cause, and date of bracket failures were recorded over 12 months. Statistical analysis was performed by means of a paired t-test, Kaplan-Meier survival estimates, and the log-rank test. No statistically significant differences were found between: (a) the total bond failure rate of recycled and new stainless steel brackets; (b) the upper and lower arches; (c) the anterior and posterior segments. These findings demonstrate that recycling metallic orthodontic brackets can be of benefit to the profession, both economically and ecologically, as long as the orthodontist is aware of the various aspects of the recycling methods, and that patients are informed about the type of bracket that will be used for their treatment.
Electrothermal bonding is based on acceleration of the setting reaction of a bonding: resin by the selective application of heat to the orthodontic bracket through the passage of a low voltage electric current. The purpose of this study was to compare the shear bond strength of nine resins comprising chemically-cured, light-cured, and glass ionomer types, 14 days after electrothermal and conventional bonding. Mean shear and bond strengths ranged from a low of 7.4 MPa for Sequence (electrothermally bonded) to a high of 15.4 MPa Concise (control). There was no statistically significant difference between the electrothermal and conventional bonding methods. All the resins produced bond strengths adequate for clinical orthodontics at 14 days.
It is thought that externally applied bleaching agents may penetrate into the pulp chamber. This study was conducted to evaluate the diffusion of peroxide bleaching agents into the pulp chamber of teeth restored with various restorative materials. Sixty-five human extracted anterior maxillary teeth were separated into the 13 groups containing 5 teeth. Five teeth (control group) were not subjected to any cavity preparation and restoration. Standardized class V cavities were prepared in the other 60 teeth and restored using composite resin (Charisma), polyacid modified composite resin (Dyract), or resin-modified glass ionomer cement (Vitremer). All teeth were sectioned 3 mm apical to the cementoenamel junction to remove the intracoronal pulp tissue, and the pulp chamber was filled with acetate buffer to absorb and stabilize any peroxide that might penetrate. Vestibular crown surfaces of teeth in the experimental groups were subjected to four different bleaching agents for 30 min at 37 degrees C, whereas the teeth in the control groups were exposed only to distilled water. Then the acetate buffer solution in the pulp chamber of each tooth was removed, and the pulp chamber of each tooth was rinsed with 100 ml of distilled water twice. Leukocrystal violet and enzyme horseradish peroxidase were added to the mixture of the acetate buffer and rinse water. The optical density of the resulting blue solution was determined spectrophotometrically and converted into microgram equivalents of hydrogen peroxide. Higher hydrogen peroxide concentrations resulted in a higher pulpal peroxide penetration. The highest pulpal peroxide penetration was found in resin-modified glass ionomer cement groups, whereas composite resin groups showed the lowest pulpal peroxide penetration.
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