A fiber composite laminate endodontic post and core

The goals of endodontic post and core procedures are to provide maximum retention of the post and resistance to fracture of the roots. Presented is a recently developed fiber composite laminate (FCL) post and core technique which results in a bonded structure that is conservative, morphologic, retentive, versatile, esthetic, and helps resist root fracture. To ascertain the durability of FCL posts and cores, an in vitro pilot study with stress testing is included. The results of the study are compared to other post and core materials to show how well this technique approaches the ideal characteristics for endodontic post and cores.     

-Apatite rheumatism, unusual aspects-

OBJECTIVES: The goal of this study was to evaluate the effects of cryopreservation of teeth on dentin bond strength as a function of remaining dentin thickness. METHODS: Flat occlusal surfaces of human dentin were prepared in 54 freshly extracted teeth and 54 thawed, cryopreserved teeth. In each group, 18 bonds were performed in superficial dentin, 18 in mid-coronal, and 18 in deep dentin. A resin composite cylinder, 3 mm in diameter and in height, was bonded orthogonally to the surface. After storage in distilled water at room temperature for 1 wk, the bonded cylinders underwent shear testing at a crosshead speed of 0.5 mm min-1. The mean remaining dentin thickness was calculated after longitudinally sectioning the debonded samples through the center of the bonded area. Non-parametric statistical analyses were used to correlate the shear bond strength with the remaining dentin thickness among the storage modes and within the different dentin regions. RESULTS: The lowest shear bond strength values were found in the deep dentin of both fresh and cryopreserved dentin, while the values in deep and mid-coronal dentin were not significantly different in fresh and cryopreserved dentin. In the superficial and mid-coronal dentin of cryopreserved samples, the shear bond strength values were identical. There was a significant difference between the shear bond strength values in the superficial dentin of fresh teeth compared to the values for cryopreserved teeth. SIGNIFICANCE: According to the experimental conditions, tooth cryopreservation shows some promise as a substitute for freshly extracted teeth, provided that the experiments are performed in midcoronal and deep dentin.     

Diffuse glomerulosclerosis without tubular injury does not directly manifest renal dysfunction in nephrotic mice (ICGN strain)

An in vitro nondestructive fatigue test was applied to adhesive posts and cores made on endodontically treated human teeth. Five post-and-core systems were evaluated: one zircon oxide post, two titanium posts (with resinous or ceramic coating), and two resin-fiber posts. Each test specimen was intermittently loaded and thermocycled. The scanning electron microscope observation of sample sections showed that only the interfaces between restorative materials and dentin exhibited substantial deficiencies. The Komet ER (Brasseler) exhibited the greatest percentages of continuity at the coronal (83.88%) or the radicular (78.12%) dentin levels, while the Zircon experimental post presented insufficient adaptation to the radicular (21.25% continuity) and to the coronal (53.25% continuity) dentin. Seven of eight samples in the Komet group showed root fractures. The carbon-fiber post (Composipost) behaved satisfactorily (67.38% radicular continuity), in spite of the use of an older bonding agent formulation.     

Porcelain-fused-to-metal post and core: an esthetic alternative

Custom cast metal post and cores used to retain all-ceramic restorations are indicated in endodontically treated teeth when little clinical crown remains. The metal cores of these post and core restorations block light transmission and create a graying effect when used in support of all-ceramic restorations. This article describes a technique to minimize this effect using custom cast porcelain-fused-to-metal post and cores to achieve a more natural esthetic result.     

Changes in Thy-1 antigen immunoreactivity in the rat retina during pre- and postnatal development

This paper reports the findings of a survey of a group of general dental practitioners (GDPs) from one region of the United Kingdom. The practitioners were asked to complete a questionnaire investigating their approach to the restoration of root-filled teeth. A high response rate was achieved and the replies indicated that most practitioners restore teeth within 1 month of completing the root filling. Nonprecious cast alloys cores were popular as was amalgam for core build-ups. Most practitioners opted for a post which was two-thirds the length of the root and zinc phosphate was the most popular luting material. Almost one-quarter of respondents believed that a root is strengthened by a post retained restoration and a similar number have never attended a postgraduate meeting on the subject of the restoration of root-filled teeth.     

Adhesion of a compomer to dental structures

The objective of this study was to evaluate the bond strength of a compomer to dental enamel, dentin, and cementum. Flat surfaces of these tissues were obtained from recently extracted human teeth. The different substrates were either treated with PSA (a primer and adhesive) or acid etched (35% phosphoric acid gel) and treated with PSA. Cylindrical specimens of compomer were then bonded to the substrates. Shear bond strength was determined after a 24-hour immersion in 37 degrees C water. Significant differences were found between both treatments on enamel, while none were found on dentin or cementum. The use of acid etchant on enamel as a surface-conditioning step previous to priming with PSA allowed a better bond between Dyract compomer and that substrate; acid etching was not particularly needed on dentin and cementum.     

Antenatal sonographic diagnosis of club foot with particular attention to the implications and outcomes of isolated club foot

OBJECTIVE: This study assessed the clinical performance of dentin-bonded crowns, in which ceramic crowns are bonded to underlying dentin with a resin composite-based luting material and a dentin bonding agent. METHOD AND MATERIALS: Twenty-five patients who had received such restorations more than 1 year previously were recalled for evaluation of their crowns. RESULTS: Sixty dentin-bonded complete-coverage restorations were assessed. Forty-one of the crowns had been placed on incisor teeth. The mean time since placement of the restorations was 2.43 years. Fifty-seven of the 60 restorations were intact. The three failures had resulted from cracks in the restorations, which had not clinically debonded. No secondary caries was detected at the crown margins, and anatomic form was assessed as excellent for 56 crowns. Root canal treatment had been required in one case. Color match was rated very good for 47 crowns. All 25 patients were satisfied with their restorations. CONCLUSION: Dentin-bonded crowns may be found to have a low rate of failure and to provide a high level of patient satisfaction.     

Bond strength to crown and root dentin

PURPOSE: To investigate (1) the tensile bond strengths of four commercial dentin bonding systems to bovine crown and root dentin and (2) the structure of the hybrid layers for each system bonded to the two dentin substrates. MATERIALS AND METHODS: Superficial surfaces were exposed in bovine crown and root dentin. The teeth were embedded in plaster and a 3 mm diameter bonding area was demarcated. The four bonding systems used were All-Bond 2, Super-Bond D-Liner Plus, Clearfil Liner Bond II, and ProBond. Bonding procedures followed the manufacturers' instructions with the exception of Super-Bond D-Liner Plus where the primer was left in situ for 60 seconds. Tensile bond strengths were tested after 24-hour storage in 37 degrees C deionized water. Specimens were also prepared for SEM observation of the hybrid layer, after treatment with 10% phosphoric acid, and 10% phosphoric acid and 5% sodium hypochlorite. RESULTS: Statistically lower bond strengths to crown dentin when compared with root dentin were observed for All-Bond 2, whereas Liner Bond II showed the opposite (P < 0.01). Both ProBond and Super-Bond D-Liner Plus showed no statistical differences between crown and root dentin (P > 0.05). Hybrid layers could be observed for All-Bond 2, Liner Bond II and Super-Bond D-Liner Plus, with no apparent differences between the hybrid layers of crown and root dentin. In the case of ProBond, where the smear layer was not removed during the priming stage, it appeared that the primer had infiltrated and caused hybridization of the smear layer. The differences in bond strength were thought to be related to the different bonding mechanisms of each material, as well as possible variations in the crown and root dentin substrates.     

Recombinant human osteogenic protein-1 induces dentin formation: an experimental study in miniature swine

It was the aim of the present study to investigate the induction of dentin formation by recombinant human osteogenic protein-1 (hOP-1). In 4 adult miniature pigs a total of 16 teeth with artificially exposed dental pulps were capped with 3 mg of a complex of recombinant hOP-1 in collagen matrix (2.5 micrograms/mg), collagen matrix alone, or calcium hydroxide paste. Teeth were removed in block section after a healing period of 5 weeks. Decalcified sections were processed for light microscopy and histomorphometric analysis. In hOP-1 treated teeth substantial amounts of hard tissue formation (osteodentin and tubular dentin) had consistently led to a complete bridging of the defects. Less dentin formation was seen after calcium hydroxide application. In control defects collagen matrix alone failed to form complete dentin bridges. Recombinant human osteogenic protein-1 in a collagen carrier matrix appeared to be suitable as a bio-active capping agent for surgically exposed dental pulps.     

Wrought aluminum truss core sandwich structures

Wrought metallic sandwich structures with open cell truss cores are a relatively new class of multifunctional material systems that can be made using affordable deformation, assembly, and joining processes. Here, the design and fabrication of these types of structures from wrought, heat-treatable aluminum alloys is reported. Tetrahedral truss cores were made by bending perforated aluminum alloy sheets. Plain square weave truss cores were made by stacking and aligning precrimped aluminum alloy weaves. Both core types were metallurgically bonded between braze clad aluminum alloy facesheets using a vacuum brazing approach. With this method, affordable truss core sandwich structures can be made from a variety of wrought aluminum and other alloys. Design methodology and multifunctional applications are discussed.     

Strength of roots before and after endodontic treatment and restoration

The resistance to fracture of mandibular premolar roots before and after endodontic and restorative procedures was tested. Seven treatment groups were evaluated. A Universal testing machine was used to apply vertical and lateral (45-degree) forces. Overall, the untreated roots showed the highest resistance to fracture. Factors of importance to prevent fracture were found to be (a) the amount of remaining tooth structure; (b) strength of post and core; and (c) bonding between core material and dentin. These factors suggest that a composite core following the use of EDTA to remove the smear layer may be a successful treatment when sufficient tooth structure remains.     

Chewing performance before and after rehabilitation of post-canine teeth in man

Missing teeth are often replaced by fixed or removable prosthodontic appliances to improve masticatory function. However, there have been few studies directly determining the influence of prosthodontic treatment on masticatory function. Our aim was to obtain information on the objective and subjective masticatory function of partially edentulous subjects before and after prosthetic restoration. In this way, the improvement of the masticatory function as a result of the treatment could be quantified. The objective and subjective masticatory function of a group of 15 subjects was determined before and after replacement of an average of 3.1 post-canine teeth. The results were compared with data from a control group of 26 subjects having a complete dentition. The total number of occluding post-canine teeth increased as a result of the prosthodontic treatment, yielding a significantly improved objective masticatory function. The average masticatory performance was found to approach the level of the control group if all occlusal units of the longest posterior side were replaced. Subjects with an incomplete dentition tended to chew predominantly on the side of the longest posterior arch. The average subjective masticatory function improved as a result of the treatment. The appreciation of the masticatory function after treatment was equal to that of the control group, despite an average of 2.7 missing teeth. However, no correlation was found between the additional number of occlusal units and the change in subjective masticatory performance. Rehabilitation of post-canine teeth restores some objective masticatory function and leads to an increased appreciation of the masticatory function, although no correlation was found between the changes in objective and subjective masticatory function.     

Trans-surgical restoration of extensive Class IV defects in the anterior dentition

Direct bonding is the most commonly utilized treatment for conservative aesthetic restoration of the anterior dentition. Class IV defects require special attention due to their high incidence, particularly in young patients. One of the major challenges for the clinician in treating defects in this category is selecting the appropriate restorative composite resin material that emulates the physical and optical characteristics of dentin and enamel and conceal the fracture line at the tooth/composite interface. Class IV defects with margins violating the biologic width present another concern, since this violation often impedes the attainment of the correct anatomic contours. The learning objective of this article is to describe a technique for achieving a correct integration of the periodontium, the tooth structure, and the restorative composite resin material to achieve a high level of aesthetic excellence.     

1997 Sir William Refshauge Lecture. Skeletal muscle glucose metabolism during exercise: implications for health and performance

The shear bond strengths of an amalgam (Permite C) and a gallium alloy (Galloy) to dentin, mediated by four dentin adhesives (Super-Bond D-Liner, Super-Bond D-Liner II, Paama 2, and Panavia 21), were investigated. Flat labial dentin surfaces were prepared from bovine lower incisor teeth. A 3 mm-in-diameter area of dentin was bonded according to each manufacturer's directions before placement of Permite C or Galloy. The bonds were stressed in shear at a crosshead speed of 1 mm/min. The mean shear bond strengths were analyzed using one-way ANOVA and Student's t-test, and fracture modes were assessed under X20 magnification and analyzed using Kruskal-Wallis and Mann-Whitney U tests. Scanning electron micrographs were taken of the bond interface of separate samples. The results showed no significant difference among the bond strengths of Super-Bond D-Liner (2.79 MPa, 2.69 MPa), Super-Bond D-Liner II (3.41 MPa, 2.65 MPa), and Paama 2 (0.70 MPa, 0.50 MPa) bonded to Permite C and Galloy (respective values in parentheses); however, Panavia gave a significantly better bond with Permite C (0.42 MPa) than with Galloy (0 MPa). Super-Bond D-Liner and Super-Bond D-Liner II gave stronger bonds than Paama 2 and Panavia with both Permite C and Galloy. For each dentin adhesive, there was no difference in fracture mode between Permite C and Galloy. It was concluded that, since all bond strengths were very low, none of the dentin adhesives tested would enhance the clinical retention of Permite C or Galloy. However, although the use of Paama 2 with Galloy was originally recommended by the manufacturer for dentin sealing purposes, no adhesion was claimed.     

Alloplastic sternal replacement in malignant sternal tumors. Case report and review of the literature

Although not seldom as a palliative procedure, the preferred treatment of locally recurrent breast cancer or chest wall involvement by metastases is full-thickness chest wall resection. For closure and coverage of the defect various techniques are described. Autoplastic reconstruction is indicated for smaller defects, while larger defects usually require alloplastic materials, especially in case of chest instability after resection. We report the case of a 55-year-old female who developed a locally recurrent breast cancer with infiltration of the sternum 4 years after left sided ablation. En bloc resection of the chest wall including the complete sternum was followed by replacement with a computer-aided custom made polyethylene sternal prosthesis. With this procedure we stabilized the chest wall with protection of the underlying organs, avoided prolonged postoperative ventilation and achieved a satisfying cosmetic result.     

The effect of dentin disinfectants on shear bond strength of resin-modified glass-ionomer materials

The purpose of this study was to investigate the effect of dentinal disinfection with a 2% chlorhexidine or a 0.11% I2-KI/CuSO4 solution on the shear bond strength of three resin-modified glass-ionomer cements: Fuji II LC, Photac-Fil, and Vitremer. The occlusal surfaces of extracted human teeth were flattened to dentin. Specimens were randomly assigned to one of nine treatment groups (n = 12). For each glass-ionomer material, there was a control group and two treatment groups in which the dentin was treated with either a 2% chlorhexidine or a 0.11% I2-KI/CuSO4 solution before the dentin was treated with the recommended dentin conditioner prior to glass-ionomer bonding. Specimens were stored for 1 day in water, thermocycled, and tested in shear until failure. The chlorhexidine solution did not significantly affect the shear bond strengths of any of the cements, but the I2-KI/CuSO4 solution significantly lowered the bond strengths of Vitremer and Fuji II LC compared to the controls.     

The role of plastic surgery in the treatment of malignant melanoma

For the majority of patients with melanoma today, surgical extirpation with primary closure or skin grafting is the optimal mode of treatment. The more complex plastic surgery techniques are particularly useful for reconstruction of the head and neck region and for the extensive surgical defects that require more than the conventional methods of reconstruction.     

Who suffers when ignorance prevails? Stories about thalassaemia

As the average age of the population increases, we are seeing a significant rise in root caries and in the need for restorative procedures associated more often with an older population. This paper describes the subgingival placement of a resin-ionomer for several restorative procedures, including root caries, resorption, endodontic perforation and root fracture. After endodontic therapy, full thickness flaps may be used to gain access to the lesion or root defect. The defects may be prepared with ultrasonic instruments and the preparations treated with a dentin conditioner. The preparations are then washed and lightly air-dried and treated with a dentin bonding agent. A resin-ionomer may then be syringed into the preparations and either light-activated or allowed to undergo a chemical set. No untoward effect has been observed during the time frame of this project. The cases presented indicate that a resin-ionomer may be used as a subgingival restorative and may be placed in lesions originally thought to be unrestorable. Thus, teeth may be saved that were previously designated for extraction.     

A randomized prospective trial comparing 45 and 90-ml oral sodium phosphate with X-Prep in the preparation of patients for colonoscopy

Incontinentia pigmenti is an uncommon genodermatosis that occurs in female infants. The characteristic dental defects are partial anodontia and the presence of some peg-shaped teeth. This report describes a patient with incontinentia pigmenti who exhibited multiple missing teeth in both arches. The patient had malpositioned teeth and decreased occlusal vertical dimension associated with the missing teeth. Orthodontic treatment was required for prosthetic purposes. The dental anomalies of incontinentia pigmenti and the treatment procedure are presented.     

Presurgical prosthetic management of the periodontal patient--a modern adhesive approach

The comprehensive management of the periodontal prosthetic patient requires that treatment be provided in a logical sequence; initial therapy, presurgical prosthetic management, surgical management of hard and soft tissue lesions, post-surgical prosthetics, followed by maintenance therapy. This article focuses on some of the most perplexing challenges encountered during the presurgical prosthetic management phase of periodontal diagnosis and therapy, including the stabilization of mobile teeth, the immediate replacement of teeth that require removal due to advanced attachment loss, and the correction of visual defects created by soft tissue loss. A number of creative treatment modalities are described that utilize silane-treated etched-glass fiber ropes and tapes (GlasSpan, GlasSpan, Inc.) for the internal reinforcement of periodontal splints and for the attachment of composite and natural tooth pontics as transitional tooth replacements. Gingival-colored composite (Gingiblend, Jeneric Pentron) and its importance as a diagnostic aid during the early stages of periodontal therapy and as an esthetic permanent restorative material are also examined.