Compomers and glass ionomers: bond strength to dentin and mechanical properties

Twenty-six patients with newly diagnosed ALL (age range 15-49 years, median 32 years) received treatment comprising: cycles 1 and 2: adriamycin 30 mg/m2 days 1-3, vincristine: 2 mg days 1, 8, and 15, with prednisolone 40 mg daily, given until complete remission (CR). L-asparaginase 10000 units/m2, days 1-14, was given only with the first cycle. Cycle 3 consisted of 100 mg/m2 etoposide orally, days 1-5, and 1 gm/m2 bd cytosine arabinoside (ara-C) days 1-5. Cycles 1-3 were then repeated. Intrathecal methotrexate (MTX) 12.5 mg was given on day 1 of each treatment cycle. The first 12 consecutive patients received this chemotherapy alone, the subsequent 14 received, in addition, 3 micrograms/kg GM-CSF subcutaneously, from day 4 of cycles 1,2,4 and 5 (and from day 6 of cycles 3 and 6) until the absolute neutrophil count had reached 0.5 x 10(9)/1. All patients in whom CR was achieved then received prophylactic cranial irradiation. With the exception of those with T-ALL, this was followed by oral maintenance therapy consisting of 6-mercaptopurine, MTX, and cyclophosphamide for 3 years. Patients receiving GM-CSF did not have shorter intercycle times or a lower incidence of documented infections than those who did not receive it. The CR rate was 89% overall-uninfluenced by GM-CSF, but higher than that achieved previously at St Bartholomew's Hospital in an equivalent age-group.     

Initial tensile bond strength of resin-modified glass ionomers and polyacid-modified resins on perfused primary dentin

The objective of this study was to evaluate the initial tensile bond strength of a resin-modified glass ionomer (Photac-Fil) and two polyacid-modified composite resins (Compoglass, Dyract) to primary dentin. A hybrid composite resin (Tetric) and two chemical cured glass ionomers (BaseLine, Hi-Dense) served as controls. Ninety caries-free dentinal discs were ground flat and perfused with Ringer's solution. Dentinal surfaces were conditioned (except for Base Line). From each material, fifteen standardized specimens were attached to the dentin. Light-curing of the respective materials followed (1 min), and adhesion was tested with a universal testing machine 15 min after application. The highest initial bond strength was observed with Tetric (5.17 MPa). Closed test procedure (Kruskal-Wallis) showed significant differences between all materials (P < 0.05), except for Compoglass (1.82 MPa) vs. Dyract (2.35 MPa), and BaseLine (0.37 MPa) vs. Photac-Fil (0.42 MPa). The condensable glass ionomer Hi-Dense revealed a mean tensile bond strength of 0.79 MPa. Adhesion of (polyacid-modified) composite resins is superior to the other tested glass ionomer materials, when applied to perfused primary dentin.     

In vitro toothbrush-dentifrice abrasion of resin-modified glass ionomers

OBJECTIVES: The three purposes of this study are to: (1) describe the relationship between the prevalence of coronal caries and root caries; (2) describe the relationship between the three-year incidence of coronal caries and root caries; and (3) if the two conditions are associated, develop a multiple regression model that identifies characteristics distinguishing people who had increments of both root caries and coronal caries from people who had increments of either coronal caries or root caries, or who had no new caries. METHODS: Dental examinations and interviews were conducted in the homes of a randomly selected, stratified sample of people over the age of 65 years in five North Carolina counties. The relationships between coronal and root D and DF were analyzed through contingency table analyses, and ordinal logistic regression was used to identify characteristics that differentiated people who had both coronal and root D over the three years from people who had either coronal or root D and people who had no new disease. RESULTS: Evidence of root and coronal caries in whites was much more likely to be in the form of fillings, while for blacks, it was more likely to be in the form of untreated decay. Prevalence rates of coronal and root D and DF were significantly associated for both blacks and whites. Incidence rates based on DF indicated that root and coronal caries were not associated in whites, but were associated in blacks. People more likely to experience both types of caries had more gingival recession at baseline, greater average attachment loss over the three years, and lactobacilli at baseline. In addition, the presence of Porphymonas gingivalis at three years was important for whites. CONCLUSIONS: It appears that coronal and root caries do tend to appear together in the same individuals, but fillings attenuate that relationship. The impact of dental treatment on the epidemiology of dental caries appears to be considerable and calls into question whether the F component of the caries index is related to disease as defined by epidemiologic criteria.     

Resin-modified glass ionomers: a new option in restorative dentistry

In this study, which won the NBC Fellowship Project, the author measured expansion and contraction in two soldering and six casting investments to determine which are most accurate (defined as marginal gap less than 50 micrometers and lack of movement with alternating finger pressure) under a number of manipulated parameters, including water/powder ratio, setting time, span length and burnout temperature. It was determined that all investments demonstrated slight expansion between initial and final set. Substantial contraction occurred in all investments when subjected to heat. Vestra, CB-30 and Cera-Fina demonstrated the greatest contraction at 1500 degrees F. Hi-Heat (soldering), Quick Set, High Span, Vivest, and Hi-Temp (casting) demonstrated greatest contraction at 2000 degrees F. The purpose of the study and the methods and materials used were explained in part one, published in March. The results and conclusions are presented here. An introduction to elevated fixturing and a verification of the study results will be presented in part three.     

The formulation of glass ionomers and their degree of fluoride

The glass-ionomer cements (GIC) were developed in the late sixties. The set cement is the result of an acid-base reaction between an ion-leachable glass (the base) and a poly (alkenoic acid). Through the years, the number of applications of these GIC has increased steadily. The evolution has to be referred to the fact that the composition of both acid and base can be changed considerably. This has resulted in the marketing of GIC with different physical and chemical formulations. Furthermore resin-modified GIC were introduced in the late eighties. One of the major GIC advantages remains the fluoride release. The fluoride in GIC is a component of the material itself and is not added afterwards. Beneficial for the GIC in this respect is that the released fluoride is not of structural importance in the set cement. Furthermore the fluoride release does not result on itself in a reduction of physical properties or an increase in porosity.     

Marginal adaptation of resin in relation to application technique and use of a dental adhesive system

Class V abrasion, erosion and caries lesions restored with composite resin seem to be more susceptible to microleakage, because the gingival margin is usually placed in cementum and/or dentine. The purpose of this study was to evaluate the microleakage, in vitro, of a dentinal bonding system using a technique of restoration with a positive and a negative control. This study was accomplished using extracted human teeth and dye penetration technique. The teeth were examined for microleakage after one month. It was concluded that in the gingival wall of the cavity microleakage was significantly reduced when the dentinal bonding agent and composite resin was placed and polymerized incrementally from enamel, to cementum.     

Enamel and dentine shear bond strength of two resin modified glass ionomers and two resin based adhesives

OBJECTIVES: The purpose of this in vitro study was to compare the shear bond strength to enamel and dentine of two resin modified glass ionomers (Fuji Bond L.C. and Vitrebond) and two resin based adhesives (Prime&Bond 2.1 and Scotchbond Multi-Purpose). METHODS: A total of 120 bond sites were prepared on either enamel (n = 60) or dentine (n = 60) on human molars by grinding the teeth flat with a 600 grit sandpaper. Each tooth substrate group was divided into four groups (n = 15) to match each material. Each of the four material systems was applied, according to the manufacturers instructions, to the bond sites. On top of the placed material, a microfilled composite was placed in a 2.5 mm diameter matrix and light-cured for 40 s. All specimens were thermocycled 500 times (5-55 degrees C). Shear bond strength values were determined 120 h after bonding using a Zwick testing machine. One-way ANOVA was used to determine whether significant differences (p < 0.05) existed among the material groups on enamel and dentine. Pairwise comparisons were used to determine significant differences (p < 0.05) among the four products. RESULTS: The ANOVA revealed strong significant differences on enamel (p = 0.0001) and dentine (p = 0.0172). The enamel bond strength values of the two resin based adhesives were significantly higher than one of the resin modified glass ionomers (Vitrebond), while the other resin modified glass ionomers did not differ from Scotchbond Multi-Purpose. On dentine, however, Vitrebond performed significantly better than the two resin based adhesives. CONCLUSIONS: The investigated resin modified glass ionomers bonded better to dentine surfaces than to enamel surfaces, while the investigated resin based adhesive systems bonded better to enamel than to dentine.     

The use of resin-bonded porcelain crowns for primary molars in infra-occlusion

Infra-occluded primary molars without permanent successors may require restorative treatment to maintain occlusal stability and periodontal health in addition to creating an aesthetic result. This paper describes the use of two resin-bonded porcelain crowns to provide a simple, minimally invasive technique using a material with good wear resistance and high strength to create an aesthetic and functional occlusion.     

Development of sensory innervation in dentin

We have labeled dental nerves of 3-week- to 1-year-old rats by axonal transport of radioactive protein in order to detect nerves in developing dentin by autoradiography. We found that, in addition to nerve growth, two processes determine adult dentinal nerve location: (1) enclosure of nerves within circumpulpal dentinal tubules during the last few weeks of dentinogenesis, beginning at the tip of the pulp horn and spreading to include most coronal dentin; and (2) gradual loss of the nerves near the tip of the cusp because of dentinal attrition and replacement by noninnervated, reparative dentin. Several days before a molar erupts, nerves at the tip of the cusp have already begun to be enclosed by dentin; 2-3 weeks later, when dentinogenesis at the cusp tip slows down, most of the innervation for that region has been established, nerves extend up to 160 micron into dentin, and the molar has reached the stage of functional occlusion. Soon after initial occlusion, the process of dentinal attrition and replacement by noninnervated reparative dentin begins; however, simultaneous dentinogenesis in more apical regions produces new innervated dentin. We studied nerve position in relation to dentin growth lines and found that there is a long-term association of nerve endings with specific sites in the dentinal tubules. The similarities between the development of dentinal innervation in rat molars and in human permanent teeth are discussed; it is found that as teeth mature and become more sensitive to painful stimuli, the density of dentinal nerves increases.     

Prevalence and depth of artificial caries-like lesions adjacent to cavities prepared in roots and restored with a glass ionomer or a dentin-bonded composite material

One potential advantage of glass-ionomer materials for the treatment of root caries is their ability to release fluoride and so resist cariogenic attack. A commercially available composite material has also been reported to release fluoride which reduced caries lesions in the tooth tissue adjacent to it. The aim of this study was to assess the effectiveness of a conventional glass-ionomer restoration compared with a dentin-bonded, fluoride-releasing, composite restoration when exposed to a microbial artificial caries system. Artificial caries-like lesions produced in relation to the restorations were examined and classified either as outer (surface) lesions or as wall lesions. A split-unit experimental design allowed for within-tooth comparisons of the 2 experimental restorations at different sites on the root surface. These were either totally within the root surface or positioned at the amelo-cemental junction. Outer lesion depths were significantly (p < 0.001) shallower at all sites adjacent to the glass ionomer when compared with the composite restorations. Wall lesions were significantly (p < 0.01) more prevalent adjacent to the composite material. In addition, the cavity margin position significantly (p < 0.05) affected the incidence of wall lesions, particularly in the composite group. In conclusion, glass ionomer was successful in reducing the caries-like lesion production in the adjacent root surface. This resulted from improved marginal integrity and fluoride release from this material when compared with the composite bonding system used.     

Malignant tumors of the pleura in the post-pneumothoracic cavities

The single nephron glomerular filtration rate (SNGFR) was determined in superficial (S) and juxtamedullary (JM) nephrons of 10 anesthetized rabbits by the 14C ferrocyanide infusion technique. The length of the proximal tubules and the volume of the glomeruli were also determined for the same nephrons. SNGFR was higher in JM than in S: 28.6 +/- 3.4 versus 22.6 +/- 3.0 nl/min, P less than 0.001. In JM nephrons, glomeruli were larger than in S: 1.3 +/- 0.1 versus 0.9 +/- 0.1 nl, P less than 0.001, whereas there was no difference between proximal tubule length in either category (s, 8.7 +/- 0.3 and JM, 8.9 +/- 0.5 mm). In 6 out of 8 animals, SNGFR was significantly correlated to glomerular volume. Lack of correlation was observed between SNGFR and length of proximal tubule in all animals but one. These results show that the rabbit, as well as small rodents and the dog, has a higher SNGFR in juxtamedullary than superficial glomeruli. Although this functional difference is not related to the length of the proximal tubule in each individual animal, the ratio between the mean SNGFR value and the mean length of the proximal tubule in superficial rabbit nephrons is similar to the ratio found in other species.