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PubMed1992

Three-year evaluation of effect of surface conditioning on bonding of glass ionomer cement in cervical abrasion lesions.

Cervical abrasion/erosion lesions were restored without any form of mechanical cavity preparation with an anhydrous glass ionomer cement. To study the effect of dentin pretreatment on the bonding between dentin and glass ionomer cement three cleaning methods were tested: 1) mechanical cleaning with a prophylaxis paste, 2) scrubbing with a surface active cavity cleanser (Tubulicid) for 60 seconds, or 3) a 10-15 s application of a 40% polyacrylic acid solution. During a 3-yr period, 193 restorations were evaluated every 6 months. Cumulative loss rates after 3 yr were 11.6%, 12.3%, and 17.9% respectively. One restoration showed secondary caries during the evaluation period.

Acrylic Resins↗
PubMedDate not supplied

Simulated oral wear of packable composites.

Wear resistance has been a problem for the posterior application of resin composites. This study evaluated and compared the wear characteristics of two conventional and two packable composites. Opposing enamel wear was also measured. One traditional hybrid composite-Herculite XR (HXR), one micro-filled composite-Heliomolar (HM) and two packable composites-Filtek P60 (P60) and Surefil (SF) were formed into disks (n = 10) and used as substrates for the wear test. Enamel was harvested from extracted human third molars and machined into cusps with a 5-mm spherical radius (n = 40). The Oregon Health Sciences University oral wear simulator was used to evaluate abrasive wear and attrition of the composite materials and wear of the opposing enamel. The resulting enamel wear facets were measured and recorded in mm2 using optical scanning methods and a computer graphics program. Abrasion and attrition of the composite substrates were measured using a profilometer. Both sets of data were subjected to ANOVA and multiple comparison tests to determine significant differences. After wear testing, scanning electron micrographs were made using representative composite samples from each group. The packable composites showed significantly less attrition and abrasive wear (p < 0.001) than the conventional controls. The microfilled composite HM resulted in significantly lower enamel wear (p < 0.001) than the materials HXR and P60 but was not significantly different from the packable composite SF at the alpha = 0.05 level. The results of this in-vitro study suggest that packable composites may have improved wear resistance over some conventional composites. Clinical studies are needed to evaluate packable composites over time.

Acrylic Resins↗
PubMed2006

Influence of rotating-oscillating, sonic and ultrasonic action of power toothbrushes on abrasion of sound and eroded dentine.

OBJECTIVE: This in vitro study aimed to evaluate the susceptibility of sound and eroded dentine to brushing abrasion performed by different rotating-oscillating, sonic and ultrasonic toothbrushes. METHODS: Toothbrushing abrasion (20 cycles, each 30 s) was applied to bovine dentine samples (each subgroup n = 10) exhibiting both a demineralized (each cycle: 1% citric acid, pH: 2.3, 60 s; 30 min remineralization in artificial saliva) and a sound surface area. Toothbrushing was performed in an automatic brushing machine with the rotating-oscillating, sonic and ultrasonic toothbrushes either (a) activated, supplemented by 20 strokes/min of the brushing machine, (b) inactivated, supplemented by 20 strokes/min of the brushing machine or (c) inactivated, supplemented by 80 strokes/min of the brushing machine. A manual toothbrush was applied with 20, 80 or 100 linear strokes/min. Specimens of the control group were not brushed after erosion. After each cycle, the samples were stored in artificial saliva for 4 h. After 20 cycles, loss of sound and softened dentine was determined by profilometry. Mann-Whitney-Wilcoxon test and Bonferroni corrections were applied to the data (p < 0.05). RESULTS: For all groups, demineralized dentin areas exhibited significantly higher abrasion values than the respective sound dentine surfaces. However, mean dentine loss of both softened and sound dentine was higher after use of the rotating-oscillating, sonic and ultrasonic brushes with the activated regime [(a) eroded dentine: 9.94-16.45 microm; sound dentine: 3.31-5.47 microm] than after brushing with the inactivated regimes [(b) eroded dentine: 5.10-5.62 microm; sound dentine: 1.16-1.81 microm; (c) eroded dentin: 7.64-8.89 microm; sound dentine: 1.38-1.69 microm]. CONCLUSION: The results indicate that rotating-oscillating, sonic or ultrasonic action of the power toothbrushes leads to an increased loss of demineralized and sound dentine.

Animals↗
PubMed2006

An evaluation of wear when enamel is opposed by various ceramic materials and gold.

STATEMENT OF PROBLEM: Ceramic restorations have been known to cause wear of opposing enamel. PURPOSE: The purpose of this study was to evaluate enamel wear caused by 3 ceramic substrates in the glazed and polished conditions. MATERIAL AND METHODS: Sixty ceramic discs (10 x 2 mm)-20 each of Finesse, All-Ceram, and IPS-Empress-were prepared and glazed. Each group of 20 was divided into 2 groups of 10. The surfaces of one group were ground and polished using a porcelain polishing kit (Dialite). The remaining 10 were left as glazed. Ten specimens of a type III gold alloy were cast into rectangular shapes of 10 x 12 x 2 mm and polished. Seventy human cusps were prepared from sound, caries-free, extracted teeth and abraded against the substrates in a wear machine for a total of 10,000 cycles. The cusp height loss was traced before and after the wear test using a profile projector. Mean surface roughness (R(a)) values for the substrates were also recorded with a profilometer before testing. Differences in R(a) were evaluated using 1- and 2-way ANOVA and the Scheffe post hoc test (alpha = .05). RESULTS: One-way ANOVA indicated that enamel height loss was significantly different by material (P < .001) and surface condition (glazed and polished or glazed; P < .05). Gold, polished Finesse, and polished All-Ceram were the least abrasive, whereas glazed IPS-Empress was the most abrasive. There was no significant interaction effect between substrate type and surface condition. Significant differences were found when R(a) of the substrate condition was compared with enamel wear (P < .01). CONCLUSIONS: Gold, polished Finesse, and polished All-Ceram caused the least enamel wear, whereas IPS-Empress caused the most wear. Cast gold was significantly different than glazed IPS-Empress (P < .05), whereas other groups overlapped. There was significant correlation between R(a) and enamel wear (P < .01).

Aluminum Oxide↗
PubMed2005

Toothbrush abrasions and noncarious cervical lesions: evolving concepts.

Toothbrush abrasion at the cervical areas of teeth is generally thought to be a result of frequent or forceful toothbrushing, faulty or vigorous technique, filament stiffness or design, dominant hand dexterity, or abrasive dentifrices. However, a review of the evidence-based literature cannot conclusively establish any one factor as the primary etiology of cervical abrasions because of inherent methodological limitations and conflicting results. Rather, a variety of factors related to toothbrushing may act in concert with dental erosion and, possibly, occlusal loading in the creation of noncarious cervical lesions. Individual variation also may make some individuals more susceptible to development and may modify the progression of those lesions. Individual variations may involve oral and dental anatomy, periodontal status or phenotype, and periodontal disease history and treatment. Further research is needed to clearly assess the interaction of all those factors in the development of cervical lesions. Therefore, awareness of a multifactorial etiology in noncarious cervical lesions may help the clinician to formulate an appropriate treatment plan for the patient.

Acids↗
PubMed1996

Clinical performance of two dentine adhesives: 2-year results.

Scotchbond MP and ART Bond were used without intentional enamel etching to bond a total of 43 resin composite restorations in Class V 'abrasion/ erosion' lesions. The cumulative loss rates after 6 months, 1 year, and 2 years, respectively, were Scotchbond MP: 9, 14, 27 per cent; and ART Bond: 0, 5, 5 per cent. These data were not compared because each material was used on different patients. The results support the higher bond strength to dentine in the laboratory of Scotchbond MP compared with its predecessor Scotchbond 2. There was a slight but clinically insignificant amount of enamel marginal staining for both products after 2 years, confirming the necessity to etch the enamel for effective marginal sealing.

Acid Etching, Dental↗
PubMed1995

Clinical evaluation of resin-modified glass-ionomer restorative cements in cervical 'abrasion' lesions: one-year results.

Sixty non-undercut Class V "abrasion" lesions in 13 patients were restored with light-cured Type IIa glass-ionomer cements in accordance with the manufacturer's instructions, 20 each with Fuji II LC, Photac-Fil, and Vitremer. Patients were recalled for examination and photographs 1 week, 6 months, and 1 year posttreatment. Color, marginal discoloration, and retention of the restorations were assessed at each recall period. At 1 year, no loss of restorations was found. Analysis revealed statistically significant darkening in color of the Vitremer restorations, no significant change in color of the Fuji II LC and Photac-Fil restorations, and statistically significant but clinically negligible development of marginal discoloration of all materials.

Color↗
PubMed1997

Clinical evaluation of hybrid ionomer restoratives in Class V abrasion lesions: two-year results.

Eighty Class V abrasion cavities were selected, and 20 cavities were restored with one of three resin-modified glass-ionomer materials (Fuji II LC, Photac-Fil, and Vitremer) or a polyacid-modified resin composite (Dyract). The restorations were clinically evaluated after 1 and 2 years with the US Public Health Service criteria. The results revealed a statistically significant difference in the percentage of restorations rated Alfa for color match at 2 years. No statistically significant difference was found in the percentage of alfa rating for anatomic form. Restorations of all materials showed some marginal discrepancies that were not statistically significant.

Compomers↗
PubMed1993

A comparative analysis of techniques of restoring cervical lesions.

There are several methods of restoring cervical abrasion or erosion lesions, including the use of composite resin, glass-ionomer cement, or a combination of these materials. This paper reports the effectiveness of three different materials and techniques in restoring cervical lesions, using marginal leakage as the means of comparison. Wedge-shaped cervical cavities were prepared so that the gingival cavosurface margin of each cavity involved dentin. Half of the specimens in each group were thermocycled. Differences in marginal leakage were more pronounced at the gingival margin. There was no significant difference between the leakage of thermocycled and nonthermocycled specimens. Microleakage can be expected to be minimal in cavities restored with the "sandwich" technique, in which a glass-ionomer cement liner and composite resin restorative material are placed.

Composite Resins↗
PubMed1990

Microleakage of two new dentinal bonding systems.

Class V abrasion and erosion lesions restored with composite resin seem to be more susceptible to microleakage, because the gingival margin is usually placed in cementum and/or dentin. The purpose of this study was to evaluate the microleakage, in vitro, of two new dentinal bonding systems along with a positive and negative control. This study was accomplished using extracted human teeth and a calcium-45 radioisotope technique. The teeth were examined for microleakage at periods of 1 week, 6 months, and 1 year. The results at all time intervals indicated that the cavities restored with the new bonding agents and their respective composite resins leaked more than did the negative control, glass-ionomer cement.

Composite Resins↗
PubMed2005

Toothbrush abrasion, simulated tongue friction and attrition of eroded bovine enamel in vitro.

OBJECTIVES: Enamel erosion results in the formation of a softened layer that is susceptible to disruption by mechanical factors such as brushing abrasion, tongue friction and attrition. The aim of this study was to investigate the individual contribution of those mechanical insults to the enamel loss caused by dental erosion. METHODS: Forty two bovine enamel samples were randomly divided into seven groups (n=6 per group) that were submitted to 3cycles of one of the following regimes: erosion and remineralization (er/remin); toothbrush abrasion and remineralization (abr/remin); erosion, toothbrush abrasion and remineralization (er/abr/remin); attrition and remineralization (at/remin); erosion, attrition and remineralization (er/at/remin); simulated tongue friction and remineralization (tg/remin); erosion, simulated tongue friction and remineralization (er/tg/remin). Erosion took place in a demineralization solution (50mM citric acid, pH 3) for 10min under agitation. Brushing abrasion, tongue friction and attrition were simulated for 1min using a home-made wear device. Remineralization was carried out in artificial saliva for 2h. Enamel loss was quantified using optical profilometry. RESULTS: One-way ANOVA indicated a significant difference between the amounts of enamel lost due to the different wear regimes (p<or=0.001). Multiple comparisons with Bonferroni procedure showed that the wear depths found for the er/at/remin (p<or=0.001) and er/tg/remin (p<or=0.001) were significantly higher than the amount found for the er/remin group (4.4+/-0.7microm). This was not the case for er/abr/remin group (p=0.075). CONCLUSIONS: The results suggest that the three forms of mechanical insults remove to varying extent the softened layer formed by the erosion challenges.

Animals↗
PubMed2004

The effect of a triclosan/copolymer/fluoride liquid dentifrice on interproximal enamel remineralization and fluoride uptake.

BACKGROUND: The authors measured the enamel remineralization of dental interproximal surfaces by a triclosan/copolymer/fluoride liquid dentifrice to test its performance against that of a standard toothpaste. METHODS: In a randomized, crossover, blinded, in situ protocol, the authors fitted 19 healthy adult subjects with mandibular appliances holding bilateral, interproximal bovine enamel slabs. They measured initial abrasion levels and fluoride content. In a two-phase crossover protocol, they evaluated the percentage of surface mineral recovery, or SMR, and fluoride uptake caused by the experimental dentifrice and a fluoride-containing traditional control toothpaste. RESULTS: Abrasion depths were similar and not different statistically (P > .05). The interproximal blocks exposed to the triclosan-containing liquid dentifrice had a mean fluoride uptake that was nearly 100 parts per million (13.1 percent) greater than that achieved with the American Dental Association-accepted control dentifrice. This finding, while not statistically significant, may indicate enhanced performance of the experimental dentifrice because the initial enamel slab abrasion depths were shown to be quite uniform. Moreover, the blocks exposed to the experimental toothpaste had a 49.8 percent SMR, while the positive control blocks had an SMR of only 36.9 percent. This enhanced remineralization performance was statistically significant (P < .05). CONCLUSIONS: This is the first study to show enhanced performance of a triclosan-containing liquid dentifrice in preventing interproximal dental caries. The difference in percentage of SMR was statistically significant and is likely to be clinically relevant. CLINICAL IMPLICATION: The results of this preliminary study offer evidence supporting clinicians' recommendation of the new liquid dentifrice to patients who are prone to developing interproximal carious lesions.

Adolescent↗
PubMed2003

[An in vitro model for the simulation of approximal wear].

Several methods have been developed to evaluate attritional wear of restorative materials. A distinction was made between attritional wear in occlusal contact areas (OCA) and wear in contact-free occlusal areas (CFOA). Only limited data dealing with approximal wear in vitro are available. Using a new configuration of the computer-controlled masticator, approximal wear of two composites (P-50, 3M and Tetric Ceram, Ivoclar-Vivadent) was assessed in a two-body wear test after thermo-mechanical loading. Wear was quantified using a profilometer. In addition, micromorphology was assessed by SEM. Wear showed a non-linear pattern, which was comparable to occlusal abrasion. After the first loading cycle, wear increased significantly (p < or = 0.05), and subsequently decreased. After a 5-year-equivalent, the mean substance loss for composite specimens was 20.3 +/- 15.6 microns for P-50 und 17.5 +/- 3.1 microns for Tetric Ceram. Approximal wear between enamel surfaces was 3.9 +/- 4.3 microns. In another experiment, the influence of the approximal wear on an enamel bonding agent was assessed. After thermo-mechanical loading, specimens were immersed in a demineralisation gel. The protective potential of the sealant was assessed under a polarized light microscope. The results suggested that partial sealant loss could lead to caries-like demineralisation in the affected areas.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1991

Posteruptive changes in human dental fluorosis--a histological and ultrastructural study.

The aim of the present study was to describe the structural features characterizing the severe grades of human fluorotic enamel (TF scores 5-9) with particular emphasis on the posteruptive changes in severely fluorosed teeth. Dental fluorosis is a subsurface hypomineralized lesion deep to a well-mineralized outer enamel surface, which in severe cases breaks apart shortly after eruption. Early signs of posteruptive changes comprise small defects corresponding to the opening of striae of Retzius. The enamel pits which develop after eruption in more severe cases exhibit an increase in mineral content at their base which correspond to the exposed subsurface hypomineralized lesions. Likewise, the extensive removal of surface enamel in the most severe cases of human fluorosis results in a highly varying uptake of mineral into the exposed subsurface hypomineralized lesions. The uptake varies greatly within apparently similar degrees of hypomineralized lesions. In approximal abrasion facets, however, where the subsurface lesions are also exposed, no evidence of mineral uptake was found. At the ultrastructural level, the well-mineralized surface zone consists of large hexagonal enamel crystals separated by rather large intercrystalline spaces in which numerous irregular small crystals are observed. Moreover, the large crystals may exhibit central and peripheral dissolution. In addition, mineral appeared to be deposited into such defects as well as along the side of the crystals, often with the lattices being continuous from the original crystal into the apparently posteruptive formed crystal material. It is concluded that a substantial mineral uptake can take place in exposed porous hypomineralized fluorotic enamel after eruption, but is most likely to be associated with the presence of microbial deposits, the metabolic activity of which may play a keyrole in mineral exchange.

Crystallography↗
PubMedDate not supplied

An alternative hypothesis from veterinary science for the pathogenesis of noncarious cervical lesions.

An alternative hypothesis to abrasion and erosion for the pathogenesis of noncarious cervical lesions was put forward in 1984; the so-called occlusal theory suggested that tensile stresses from occlusal overload could be involved in the pathogenesis of noncarious cervical lesions and that bending stresses applied to teeth could cause disruption of the surface enamel, resulting in increased susceptibility to dissolution and abrasion at the affected sites and in the development of wedge-shaped lesions. This theory has gained increased acceptance in recent years, although absolute scientific evidence has been scant. These lesions also occur in animals, in particular, the domestic cat, in which they are called feline odontoclastic resorptive lesions. A variety of theories about pathogenesis of these lesions have been put forward, but there is some evidence that occlusal overload may be a contributory factor in the development of an inflammatory response in the periodontal membrane and the presence of enzymes associated with resorption in the gingival crevice. Further investigation may help define a common etiology between the pathogenesis of feline odontoclastic resorptive lesions and noncarious cervical lesions.

Acid Phosphatase↗
PubMedDate not supplied

A randomized, controlled trial evaluating the three-year clinical effectiveness of two etch & rinse adhesives in cervical lesions.

A three-year randomized, controlled prospective study evaluated the clinical performance of two three-step etch & rinse adhesives (OptiBond FL, Kerr: O-FL; PermaQuick, Ultradent: PMQ) in Class V cervical erosion-abrasion lesions. The latter adhesive was also tested with two restorative composites with contrasting stiffness in order to evaluate the effect composite stiffness might have on the clinical longevity of cervical restorations. A total of 150 lesions were randomly restored in pairs of the three adhesive/composite combinations (PMQ combined with Amelogen Hybrid: PMQ/A-Hy, Ultradent; PMQ combined with Amelogen Microfill: PMQ/A-Mi, Ultradent; O-FL combined with Prodigy: O-FLJPro, Kerr) per patient and evaluated at baseline, after six months, one year, two years and three years of clinical service. After three years, the retention rate was 100% for O-FL/Pro and 98% for both PMQ/A-Hy and PMQ/A-Mi, thereby, satisfying the "full acceptance" guidelines specified by the American Dental Association. A pairwise comparison showed no significant difference in adhesive performance between restorations made using the microfilled and hybrid composite for any evaluation criteria (p>0.05).

Chi-Square Distribution↗
PubMedDate not supplied

Attritional wear and abrasive surface alterations of composite resin materials in vitro.

OBJECTIVES: A laboratory study was performed with 232 specimens and 72 human enamel, 24 gold, 24 ceramic and 12 composite antagonists in 22 groups to test attritional and abrasive wear behavior of composite materials compared to wear behavior of human enamel. METHODS: Belleglass HP, Concept Inlay/Onlay, Targis and Targis Upgrade 99 composite resin for lab-made restorations was tested as well as Tetric Ceram and FHC Merz light as resins for direct restorations. Natural human enamel specimens served as control. All specimens were subjected to long-term thermo-mechanical loading in a computer-controlled masticator, chemical degradation and toothbrush/toothpaste abrasion. Wear of specimen in occlusal contact area (OCA), contact-free occlusal area and wear of natural enamel cusps as well as antagonists made of gold, ceramic and composite in identical form was measured after 120,000, 240,000, 640,000 and 1200,000 load cycles. A qualitative SEM analysis was performed to support quantitative data. RESULTS: Belleglass HP and Targis Upgrade 99 restorative materials showed wear resistance comparable to human enamel when loaded with enamel cusps. Wear of Targis versus composite and gold antagonists was significantly higher (p<0.0001). Analysis of surface alterations showed hygroscopic expansion in all composite resins during the test. CONCLUSIONS: As a consequence of this study, necessity to further improve physical properties of composites for long lasting restorations was obvious. Beside of attritional wear in OCA, attention must be given to stable filler-matrix interfaces and prevention of water sorption.

Analysis of Variance↗
PubMed1996

Three-year clinical effectiveness of four total-etch dentinal adhesive systems in cervical lesions.

A 3-year follow-up clinical trial of two experimental Bayer total-etch adhesive systems and two commercial total-etch systems. Clearfil Liner Bond System and Scotchbond Multi-Purpose, was conducted to evaluate their clinical effectiveness in Class V cervical lesions. Four hundred twenty abrasion-erosion lesions were restored randomly using the four adhesive systems. There were two experimental cavity designs, in which the adjacent enamel margins either were or were not beveled and acid etched. Clearfil Liner Bond System and Scotchbond Multi-Purpose demonstrated high retention rates in both types of cavity design at 3 years. The two experimental Bayer systems scored much lower retention rates in both cavity designs at 3 years. None of the systems guaranteed margins free of microleakage for a long time. At 3 years, superficial, localized marginal discolorations were observed, the least for Clearfil Liner Bond System, followed by Scotchbond Multi-Purpose and the two experimental systems. Small marginal defects were recorded at the cervical dentin and the incisal enamel margin. Retention of Clearfil Liner Bond and Scotchbond Multi-Purpose appears to be clearly improved over earlier systems, but marginal sealing remains problematic. The two Bayer systems were found to be clinically unreliable.

Acid Etching, Dental↗