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Effect of bonded amalgam restorations on microleakage.

The purpose of this study was to evaluate quantitatively the effectiveness of adhesive dentin bonding systems in decreasing microleakage at the tooth-amalgam restoration interface. The results indicated that microleakage was significantly reduced when Amalgambond Plus or All-Bond 2 was used as liners in comparison to either Copalite varnish or no linear under amalgam restorations. No significant difference was found between the two dentin bonding systems at all time periods studied.

Analysis of Variance↗

Quantitative microleakage evaluation around amalgam restorations with different treatments on cavity walls.

The purpose of this in vitro study was to evaluate the dye penetration around amalgam restorations in dentin cavities by a quantitative test. Standardized circular cavities were prepared on the facial surface of 75 extracted human single-rooted teeth, and restored with dental amalgam. Different bonding/sealing treatments were used on the cavity walls before the restorations were placed. The specimens were thermo-cycled between 5 +/- 2 degrees C and 55 +/- 2 degrees C for 500 cycles with 1-minute dwell times, followed by immersion in a 2% methylene blue solution for 12 hours at 37 degrees C. The quantitative microleakage was evaluated by spectrophotometry and was expressed by microgram dye per tooth structure. The results showed that the use of bonded amalgam restorations was more effective in reducing microleakage.

Dental Amalgam↗

Total bonding vs selective bonding: marginal adaptation of Class 2 composite restorations.

For improving the marginal integrity of composite restorations, a total bonding method has been advocated besides the conventional selective bonding method. Total bonding avoids the placement of a base. The entire internal cavity surface is available for the adhesive bond. Selective bonding involves the placement of a base covering the pulpal floor as well as the pulpoaxial wall. In this study, five dentin/enamel bonding system/composite combinations were used to restore 60 class 2 cavities with their cervical margins below the cementoenamel junction (CEJ); six teeth per material were restored according to the total bonding and the selective bonding methods. Before and after simultaneous thermo-cycling and mechanical loading (TCML) marginal adaptation was evaluated on replicas in the SEM. Microleakage was determined by dye penetration on the original samples after TCML. The data were statistically evaluated with the Mann-Whitney U-test and the Wilcoxon test. The error rates method was applied. In SEM analysis the error rates method indicated a significant difference between the two restoration methods in general. In the pairwise comparisons, no significant differences between the selective bonding and total bonding methods were found for Syntac/Tetric, Gluma 2000/Pekafill, and Gluma/Pekafill. With Scotchbond Multi-Purpose (SBMP) and All-Bond 2 (AB2), total bonding revealed significantly (P < or = 0.01) less gap formation before and after TCML than selective bonding. Accordingly, total bonding showed significantly less (P < or = 0.01) dye penetration with Scotch-bond Multi-Purpose and All-Bond 2 compared to selective bonding. In conclusion, the reduction of microleakage by application of the total bonding method depended upon the bonding system used. Total bonding could be an alternative procedure for the adhesive restoration of class 2 cavities when their gingival margins are apical to the cementoenamel junction, provided the proper system is used and pulp damage is prevented.

Composite Resins↗

Biological basis for clinical success: pulp protection and the tooth-restoration interface.

This article provides biological and technological information that strengthens clinicians' understanding of cohesive hybridization and pulp therapy in order to support their routine use of bonding and resin systems. Utilizing cohesive systems, clinicians should experience several advantages over traditional water-soluble base and liner systems. When properly applied, cohesive hybridization of vital dentin prevents immediate postoperative hypersensitivity under all restorations and completely seals the entire tooth-restoration interface, which provides a reduction in recurrent caries.

Animals↗

In vitro evaluation of marginal leakage of corrosion-resistant amalgam alloy.

Restorations placed without coating the cavity walls with cavity varnish exhibited significant marginal leakage at all time intervals; however, there appears to be some reduction of leakage after six months. Restorations placed after coating the cavity walls with cavity varnish demonstrated no leakage at forty-eight hours and three months. Velvalloy and Dispersalloy restorations exhibited no leakage at six months, although there was a slight leakage at one year. Spheraloy restorations with cavity varnish demonstrated some leakage at six months and one year. The results of this study appear to correlate with previous studies using the same technique to determine marginal leakage. Apparently, the corrosion resistance of the dispersed phase alloy does not increase the marginal leakage, when compared with the conventional and spherical alloys.

Autoradiography↗

[The effect of chlorhexidine varnish system on Streptococcus mutans in fissure plaques].

A chlorhexidine varnish system and a controlled releasing varnish were prepared by the authors. The release rate of chlorhexidine in vitro and the effects on S. mutans and S. sanguis in vivo were determined. The results showed that the system could selectively inhibit the growth of S. mutans in fissure plaque and had no effect on S. sanguis. The period of interaction between the layer of varnish and plaque was prolonged by the control-releasing reagent. The study suggests that the chlorhexidine varnish system is effective of anticaries and can maintain microflora balance in oral bacteria.

Adolescent↗

Microleakage of a condensable resin composite: an in vitro investigation.

OBJECTIVE: The purpose of this investigation was to evaluate microleakage in Class II cavities restored with the condensable resin composite SureFil, placed with or without a liner and 1 of 2 different dentin bonding agents. METHOD AND MATERIALS: Extracted noncarious human teeth were randomly divided into 4 groups of 15 each and restored according to manufacturer's instructions: group 1, SureFil and Prime & Bond NT; group 2, SureFil and PQ1; group 3, SureFil, PermaFlow, and PQ1; group 4, Heliomolar and Syntac Single-Component (control). Specimens were stored in 37 degrees C water for 24 hours. All specimens were thermocycled between 5 degrees C and 55 degrees C for 500 cycles. Each specimen was immersed in 0.2% basic fuchsin dye for 24 hours and then sectioned longitudinally and horizontally. Dye penetration at enamel and cementum margins were viewed at x30 magnification by 2 independent, calibrated evaluators. Specimens exhibiting dye penetration > or = 0.1 mm beyond the cavosurface margin were considered to have leakage. RESULTS: Chi-square tests revealed no statistically significant differences in the presence of microleakage when all groups were analyzed together. However, 2 by 2 comparisons revealed that group 3 had significantly fewer specimens with microleakage than did group 1, 2, or 4. CONCLUSION: To limit microleakage, a flowable composite should be used as a liner when a condensable composite material is used.

Acid Etching, Dental↗

Teaching of posterior resin-based composite restorations in Brazilian dental schools.

OBJECTIVE: The purpose of this study was to evaluate the teaching program of Class I and Class II resin-based composite (RBC) restorations in Brazilian dental schools and to observe if any differences were found from similar surveys conducted in North American, European, and Japanese dental schools. METHOD AND MATERIALS: A questionnaire containing 15 questions was distributed to 92 Brazilian dental schools, and 64 (70%) schools returned the questionnaire. The questions inquired the amount of time the curriculum dedicated to teaching of posterior RBC restorations, future expectation regarding the teaching time, limitation in extension of the occlusal width and the proximal box in Class II, contraindications for placing posterior RBC restorations, protocol for using bases and liners, brand of bonding agents and RBC used, instruments and techniques employed for finishing, cost relative to amalgam restorations, and biologic reactions related to the use of posterior RBC. The responses were calculated as percentages based on the number of schools that responded to the questionnaire. Where appropriate, the Chi-squared test and the Fisher exact test were used for statistical analysis. RESULTS: Of the dental schools that responded, 88% dedicated 10% to 50% of the teaching time in operative dentistry to posterior RBC restorations. A significant correlation (P = 0.041) was found between the percentage of time dedicated to the teaching of posterior RBC restorations and the higher cost of posterior RBC compared to amalgam restorations. Resin-based composite restorations cost 30% to 70% more than amalgam restorations in the 40% of dental schools that charged a fee. Posterior composites for large restorations in molars were used by 14% of the dental schools. Base and liner were not placed by 10% of dental schools in deep Class I or Class II RBC restorations. One school did not recommend acid etching of the dentin. CONCLUSION: No major differences were found in the teaching philosophy of posterior RBC restorations by comparing the Brazilian data to the data from similar surveys done in North America, Japan, and Europe.

Acid Etching, Dental↗

Treatment of traumatic injuries in the front teeth: restorative aspects in crown fractures.

Crown fractures are the most common form of traumatic dental injuries encountered in permanent dentition. Restorative treatment modalities incorporate adhesive materials to effectively maintain function and aesthetics. While uncomplicated injuries of the enamel and/or dentin can be treated solely with adhesive procedures, complicated trauma that involves pulp exposure requires the incorporation of a multidisciplinary treatment approach. Fragment reattachment is facilitated by the utilization of bonding agents that enhance retention and aesthetics. This article discusses the application of provisional and permanent restorative options for the treatment of complications following traumatic injuries.

Adhesives↗

Effect of liners on cusp deflection and gap formation in composite restorations.

This study measured deformation of cusps and gap formation associated with MOD resin composite restorations in maxillary premolars with and without the use of low elastic modulus liners. Low elastic modulus liners may reduce the deformation by absorbing polymerization shrinkage stress. Forty maxillary premolars were mounted in stone and slot MOD cavities were prepared. Teeth were randomized into four groups. In Group A, cavities were etched, Single Bond was applied and the cavities were restored with Z-100 composite. In Group B, the same was done except that a layer of flowable composite (Revolution) was place and cured after the bonding agent. In Group C, the same steps were followed as Group A but a layer of glass ionomer (Vitrebond) was placed and cured before the bonding agent. In Group D, a thin layer of composite was placed (after the bonding agent) as a base and cured and the cavities were filled. The distance between indexed cusp tips was measured before the restorations were finished and five minutes and 24 hours after the restorations were completed. The samples were then sectioned mesiodistally and epoxy resin replicas were made and prepared for SEM evaluation of gap formation. The mean contraction of the cusps in microm at 5 minutes and 24 hours, respectively, for each group was A) 47 and 30, B) 35 and 21, C) 23 and 8 and D) 40 and 28. Groups A and D resulted in the highest deformation, B was intermediate and C was the lowest. There was no statistically significant difference in gap formation between the groups.

Analysis of Variance↗

A clinical study of adhesive amalgam in pediatric dental practice.

This clinical study and 3-year follow-up evaluated the efficacy of adhesive amalgam restorations for pediatric dental practice. The original goal of the study was to determine when bonding of amalgam restorations should be performed. After the initial set of study restorations were placed, it appeared that the bonding should always be performed and that the study should concentrate on the modes of restoration failure.

Calcium Hydroxide↗

Microleakage in primary teeth restored by conventional or bonded amalgam technique.

The aim of this in vitro study was to evaluate marginal leakage in class V restorations in primary teeth restored with amalgam, using three different techniques. Thirty maxillary anterior primary teeth, clinically sound and naturally exfoliated, were used. In group 1 (n = 10), two thin layers of a copal varnish (Cavitine) were applied. In group 2 (n = 10), Scotchbond Multi-Purpose Plus, a dual adhesive system, was used according to manufacturer instructions. In group 3 (n = 10), One-Step adhesive system in combination with a low-viscosity resin (Resinomer) were used according to manufacturer instructions. All samples were restored with a high-copper dental amalgam alloy (GS 80, SDI). After restoration, the samples were stored in normal saline at 37 degrees C for 72 h. The specimens were polished, thermocycled (500 cycles, 5 degrees and 55 degrees C, 30-s dwell time) and impermeabilized with fingernail polish to within 1.0 mm of the restoration margins. The teeth were then placed in 0.5% methylene blue for 4 h. Finally, the samples were sectioned and evaluated for marginal leakage. The Kruskal-Wallis test showed that the filled adhesive resin (group 3) had the least microleakage. There was no significant difference between groups 1 and 2.

Composite Resins↗