Increased apoptotic cells in bone marrow biopsies from patients with aplastic anaemia

PURPOSE: To evaluate the 2-year clinical performance of two polyacid-modified resin composites and two resin-modified glass ionomers in Class V carious cavities. MATERIALS AND METHODS: A total of 120 Class V cavities were selected and 30 cavities were restored with one of two resin-modified glass ionomer materials (Fuji II LC Improved and Vitremer) and two polyacid-modified resin composites (Dyract and Compoglass) in Class V carious cavities after 2 years. The restorations were clinically evaluated after 1 and 2 years using the USPHS criteria. RESULTS: One-year findings revealed a significant difference in color match between Vitremer and other materials (P < 0.05) and no significant difference was found for the other criteria. Two-year results indicated a significant difference between resin-modified glass ionomers and polyacid-modified resin composite materials. The difference between Compoglass and Dyract was not statistically significant whereas the difference between Vitremer and Fuji II LC was statistically significant. Caries was not recorded at any evaluation period.     

Low-frequency ultrasound treatment of chronic venous leg ulcers in an outpatient therapy

An in vitro dye leakage study was performed to compare the sealing ability of glass ionomer, composite resin and glass ionomer/resin cement when used as restorative materials for G.V. Black class V cavities. In this research, standard Class V cavities were prepared in sound premolar teeth extracted for orthodontic reasons. The cavities were randomly divided into 3 groups. After filling the cavities with glass ionomer cement, composite resin and light curing glass ionomer/resin cement, the specimens were immersed in silver nitrate solution. Marginal microleakage at the interface between the cavity wall and restoration was evaluated. The results were analyzed by using Kruskal-Wallis and Mann Whitney U tests. Result of this in vitro study indicate that composite resin and glass ionomer/resin cement provide a better seal than glass ionomer cement.     

Tunnel restorations. A 3 1/2-year follow up study of Class I and II tunnel restorations in permanent and primary teeth

During 1988-89, 224 patients with approximal caries in the premolar/molar regions were provided with 318 tunnel restorations. In case of perforation of the enamel in the enamel/dentin border, (23%), complete Class II-tunnel restorations with glass ionomer cement and composite resin were made. In case of "intact" enamel, (77%), partial Class I-tunnel restorations were made. The restorations were controlled at annual routine recalls and the success rate after 3 1/2 years was 74% for permanent teeth, and 10% for primary teeth. Restorations in permanent teeth, made during the second year of the study were successful in 82%, as compared with 62% for restorations made during the first year, indicating a learning effect. Failures in the permanent dentition were due to marginal ridge fracture (35%), cavitation in the approximal enamel (31%), and recurrent caries (38%). Failures in primary teeth were predominantly due to marginal ridge fractures (84%). A comparison with the longevity of conventional Class II restorations is made and the possible advantages of the present method are presented.     

The effect of a resin-modified glass ionomer restorative material on artificially demineralised dentine caries in vitro

OBJECTIVES: Recurrent caries is one of the most common reasons for the replacement of restorations. One method of reducing the frequency of this problem may be by using fluoride-releasing restorative materials. The aim of this in vitro study was to evaluate the progression of artificial lesions around resin-modified glass ionomer (Vitremer) restorations placed in root surfaces. Class V cavities were prepared on the mesial and distal surfaces of 28 human premolar teeth. Artificial carious wall lesions were created in all cavities. The root of each tooth was then hemisected through the middle of the two cavities, before being restored with either the glass ionomer or amalgam, while the opposing cavities on the same root portion were varnished as negative controls. Forty-eight specimens were pH-cycled in remineralising and demineralising solutions for 20 h and 4 h, respectively, each day for 4 weeks, whilst in a smaller control group of eight specimens, the demineralising solution was replaced with deionised water. Mineral changes in the carious lesions were evaluated using contact microradiography. RESULTS: Results showed that varying degrees of subsurface demineralisation and remineralisation were evident, with a laminated appearance in lesions adjacent to the glass ionomer. There was higher remineralisation in the glass ionomer-filled cavities compared with the amalgam-filled cavities. In the water-cycled group, glass ionomer showed an increase in mineral content (p < 0.05), while no changes were observed in the amalgam-filled cavities. CONCLUSIONS: This model has shown that glass ionomer has a greater potential than amalgam for remineralisation of artificially created wall lesions within an acidic environment.     

An in-vitro investigation of microleakage and gap size of glass ionomer/composite resin "sandwich" restorations in primary teeth

Eighty extracted primary molars were divided into four groups of twenty teeth. Class II cavities were prepared in all teeth with equal numbers of proximal boxes having cavosurface margins either in enamel, or dentin/cementum. Each group was allocated to an open or closed sandwich technique using glass ionomer as a lining. Following the placement of the composite resin restorations, the gap size measured at the proximal box was greatest for the closed sandwich group with the cavosurface margin on enamel (0.203 microns) or dentin/cementum (0.174 microns). Microleakage scores were measured at the proximal box and were greatest for the closed sandwich group with the cavosurface margin on dentin/cementum. The best result was obtained for the open sandwich group with the cavosurface margin on enamel.     

New England eye care survey

Amalgambond Plus with a high-performance additive was evaluated for its ability to bond a resin composite or an amalgam alloy to deep dentin in primary teeth with nonretentive cavity preparations. The clinical performance of amalgam and resin composite mesio-occlusodistal restorations bonded with Amalgambond Plus was evaluated at 15 months and 2 and 3 years. There was no statistically significant difference in the retention, marginal adaptation, secondary caries, and post-operative sensitivity over the times of the evaluation or between amalgam and resin composite restorations. After 3 years, most of the teeth were extracted because it was their exfoliation time, and 29 restorations limited within buccal and lingual cusps were evaluated for marginal leakage. There were no significant differences in microleakage between amalgam and resin composite restorations lined with Amalgambond Plus. Amalgambond Plus has the potential for serving successfully as a cavity liner with either amalgam or resin composite restorations.     

Artificial caries formation around fluoride-releasing restorations in roots

Secondary caries is one of the most important factors leading to replacement of dental restorations. This investigation assessed the capacity of fluoride-releasing restorative materials to resist caries in vitro when used in roots. Class 5 cavities were prepared in the buccal and lingual surfaces of 30 extracted premolars. The six materials used were: glass-ionomer cement (Fuji), glass-ionomer cement with silver particles added (Ketac-silver), fluoride-containing composite resin (Tetric), composite resin (Silux plus), fluoride-containing amalgam (Fluor-Alloy) and high-copper amalgam (Dispersalloy). After 5 weeks in an acid gel for caries-like lesion formation, the teeth were sectioned longitudinally and examined with polarized light. The results showed that repair with glass-ionomer materials of a carious lesion may be of great importance in the prevention of secondary caries around the restorations in roots.     

Fracture resistance in conservative Class II cavity preparation: box vs tunnel

A total of 40 extracted human maxillary premolar teeth were used in this study. Teeth were randomly distributed between two main groups. In group A conservative class II Box preparations were cut in each tooth. In group B the proximal cavity was prepared through the occlusal surface and the proximal marginal ridge was left intact (tunnel preparation). Group A and group B were randomly subdivided into two subgroups (a & b). In groups Aa and Bb a posterior composite resin material was used to restore the prepared cavities (no base was used). While in groups Aa & Bb the posterior composite resin was used with a glass ionomer cement base. The teeth were tested on an Instron testing machine for their resistance to fracture, force being applied equally to buccal and lingual cusps. Mean fractures values were: Gp. Aa 285 LB.: Gr. Bb 245 lb. Bb 240 lb. One way analysis of variance showed no statistical difference between the four groups. The tunnel preparation did not increase the resistance to fracture of the restored tooth compared to a box preparation.     

Marginal leakage of amalgam restorations pretreated with various liners

PURPOSE: To evaluate and compare the microleakage of amalgam restorations lined with four different liners. MATERIALS AND METHODS: Cylindrical occlusal cavities were prepared in extracted human molars and the teeth were then divided into four groups and lined with one of four liners: Amalcoden, AM (glass-metal ionomer), FujiDuet, FD (glass ionomer), Amalgambond, AB (adhesive resin), or copal varnish, CV. Each cavity was then restored with a high-copper amalgam alloy and aged for 7 days in 37 degrees C distilled water. The specimens were then thermocycled for 300 cycles followed by immersion in 0.5% basic fuchsin dye solution for 24 hours. The teeth were then embedded in resin, sectioned, and dye penetration at the tooth/amalgam interface evaluated microscopically at x 100 and scored from 0 to 4 (0 = no leakage and 4 = greatest leakage). RESULTS: The median values were: AM = 1.0; FD = 0.5; AB = 1.1; and CV = 4.0. Statistical analysis using Kruskal-Wallis and Mann-Whitney U indicated no significant differences between AM and AB or FD and AB. CV was however, significantly worse at P < 0.01.     

Selection of restorative materials, reasons for replacement, and longevity of restorations in Florida

The purpose of the present study was to obtain information relating to the types of restorative materials used, the main reason for replacement of restorations, and the age of failed restorations. Dentists in general dental practice in Florida were invited to record details from their own work pertaining to restorations. The diagnostic criteria were described and coded. The clinicians were not calibrated in the use of the criteria but they could call in for further explanation if needed. The 27 clinicians involved placed 2,035 restorations of which 53% were replacements of failed restorations. The increased use of resin based restorative material was clearly evident including posterior composites. The clinical diagnosis secondary caries was the most common reason for replacement of amalgam (56%) and composite (59%) restorations. Only discoloration showed a statistically significant difference in the reason for replacement of the two types of materials. The median age of the replaced amalgam restoration was 15 years and that of composite restoration was 8 years.     

Replacements of restorations in the primary and young permanent dentition

The present study focused on the type of restorative material used and the reasons for replacements of restorations in the primary and the young permanent dentition. All patients with restorations and who were 8 and 19 years of age in 1995 and were regularly treated at 11 Public Dental Health clinics in J?nk?ping County, Sweden, participated in the study. Data were extracted from the records for all types of restorations in canines and molars for the preceeding of 5 years for the 8-year-olds (i.e. from 3 to 8 years of age; n = 546) and for approximal restorations in premolars and molars for the preceeding 13 years for the 19-year-olds (i.e. from 6 to 19 years of age; n = 606). In all, 6012 restorations were evaluated. The two most common restorative materials used in the primary dentition were compomer and glass ionomer cement and in the young permanent dentition composite and amalgam. In the primary dentition, 29% of the restorations had been replaced and 4% of the teeth with restorations had been extracted. Thus, 33% of the restorations in the primary dentition failed. The corresponding figure for the young permanent dentition was 13%. The most common reason for replacements in the permanent dentition was secondary caries. That restorations often fail because of caries and that the development of secondary caries is not prevented by replacement of an old restoration indicate that more attention should be paid to preventive dental care for patients with restorations in the primary as well as in the young permanent dentition.     

Resin-modified glass ionomers for luting posterior ceramic restorations

OBJECTIVES: Until recently, esthetic inlay restorations in posterior teeth have been limited to cavities surrounded by enamel. Dentin adhesive systems in combination with luting composites and light-cured resin-modified glass ionomer cements offer a possibility for bonding ceramic inlays to cavities when the cervical margin is in dentin. This study was designed to compare in vitro marginal integrity of ceramic inlays bonded to dentin to restorations placed in cavities with margins located entirely in the enamel. METHODS: In the present in vitro study, the sealing abilities of a dentin bonding agent/luting composite combination (Syntac/Dual Cement, Vivadent) and resin-modified glass ionomers (Photac Fil, Photac Bond, ESPE; Dyract, De Trey Dentsply; Fuji II LC, GC Dental Industrial Corp.; and Vitremer, 3M Dental Products) used as luting agents in cavities extending beyond the cemento-enamel junction, were compared to the sealing abilities of a conventional luting composite (Vita Cerec Duo Cement, Vita) in cavities within sound enamel. SEM analysis and dye penetration were performed to evaluate marginal integrity at the cervical cavity margins. RESULTS: The dentin bonding agent/luting composite combination (Syntac/Dual Cement) rendered a marginal seal within the dentin similar to the quality obtained with the conventional luting procedures within sound enamel. When three out of the five resin-modified glass ionomers were used as luting agents (Dyract, Fuji II LC and Vitremer), the results were comparable to those reported for the dentin bonding agents and the conventional method. SIGNIFICANCE: Light-cured resin-modified glass ionomer cements may be considered as an alternative to dentin bonding agents when the cavity margins of ceramic inlay restorations are within the dentin. However, further studies, e.g., wear resistance, must be performed.     

Race, life style and renal disease in South Africa

PURPOSE: Clinical evaluation of repairing old amalgam restorations using composite inlays cemented with two different bonding agents. MATERIALS AND METHODS: Occluso-proximal Class II inlay cavities were prepared in 50 old defective amalgam restorations. Extra oral system (EOS) composite inlays were cemented with two different bonding agents (All-Bond 2 or Geristore). After final finishing and polishing of each restoration, evaluation was carried out at baseline, 6 months, 12 months, and 24 months using US Public Health Service criteria. The data were collected and statistically analyzed using Chi-square test. RESULTS: No significant difference was found between the two bonding materials at any time interval.     

Marginal adaptation of resin-bonded light-cured glass ionomers in dentin cavities

PURPOSE: To investigate the marginal adaptation of resin-modified glass ionomer cements in dentin cavities placed with or without additional application of resin bonding systems. MATERIALS AND METHODS: Three resin-modified materials (Fuji II LC, Photac-Fil, Vitremer), one compomer (Dyract) and as reference an adhesively bonded resin composite system (Gluma CPS-Pekafill) were used. Flat peripheral dentin surfaces on human molar teeth were produced by wet grinding on SiC paper. Cylindrical cavities, 3.5 mm wide, were prepared in these dentin areas and restored with the individual materials. Sixty cavities were pretreated and restored as requested by the respective manufacturers. Following water storage of the specimens for 15 minutes or 24 hours, excess was gently removed by wet grinding for microscopic inspection of the marginal area. Additionally, in 30 cavities an experimental one-component adhesive resin system, a proprietary dimethacrylate and HEMA mixture dissolved in acetone, was combined with each of the restoratives for evaluation after 15-minutes water storage. Finally, in six cavities each, Dyract was combined with Prime and Bond 2.0, and Vitremer with Scotchbond Multi-Purpose Plus for assessment after 15 minutes. Maximum marginal gap widths (MGW) were measured. One-way ANOVA by ranks (Kruskal-Wallis-Test) followed by Wilcoxon's Two-Sample test were used to study the statistical difference of MGW among the treatment groups at a rejection level P = 0.05. RESULTS: Neither the conventionally placed material systems nor the restorations in combination with adhesives showed consistently gap-free margins after 15-minute water storage. After 24-hour storage with Vitremer 4 of the 6 restorations were gap-free, whereas with all other materials only perfect margins were registered. There was, however, no significant difference between the groups. Application of the experimental and/or the specific resin bonding agents had no effect on early MGW except for the Photac-Fil group, which was significantly reduced.     

Accelerated evolution and molecular surface of venom phospholipase A2 enzymes

The objective of this study was to determine the in vitro shear bond strength (in megapascals) and location of bond failure with two light-cured glass ionomer resin systems. One system was a hybrid glass ionomer cement with resin (GC Orthodontics, Aslip, Ill), and the other system a glass-filled resin system (Reliance Orthodontic Products, Inc, Itasca, Ill). These systems, Fuji Ortho LC (GC Orthodontics) and Ultra Band Lok (Reliance), respectively, were compared to a light-cured composite resin. Maxillary premolar brackets (n = 200) were bonded to the facial surface of human premolar teeth. The two glass ionomer resin systems were each evaluated by two protocols, one according to the manufacturers' direction plus a variation of their respective technique. The five distinct groups (n = 40) were stored in 37 degreesC distilled water for 30 days and subjected to thermocycling before shear bond strength testing. The findings indicated that large variations existed between the bond strengths of the materials tested. The laboratory shear bond strength of the glass-filled resin glass ionomer cement (Reliance), whether tested in a dry or moist field, was similar to the composite control with all of the previous materials being significantly (P <.01) higher than both the hybrid glass ionomer cement groups (Fuji Ortho LC). However, the hybrid glass ionomer cement with enamel conditioner demonstrated a clinically acceptable mean megapascal value. The Adhesive Remnant Index values ranged from 0.53 to 1.62. The hybrid glass ionomer cement without enamel conditioning recorded the lowest mean adhesive remnant index score and the lowest mean megapascal score. Although both products are glass ionomer resin systems, their individual chemistries vary; this affects their clinical performance. Clinically, it may be suggested that glass ionomers used in a dry field may be beneficial for orthodontic bonding, and that glass ionomer resin systems used in a moist environment need an enamel conditioner.     

Benefits and disadvantages of tooth-coloured alternatives to amalgam

OBJECTIVES: To give the practising dentist scientifically based data to assist him/her in the responsible decision-making process necessary to weigh the options available to the patient if she/he prefers not to have an amalgam placed. DATA SOURCES: Based on the literature and on the research work, which was done in the author's department, the indications and limitations of the known alternatives of amalgam were formulated. DESCRIPTION OF ALTERNATIVES TO AMALGAM: With the exception of cast gold restorations, all alternatives require the strict use of adhesive techniques. When compared with similar amalgam restorations, placing composite restorations (if they are indicated) takes approximately 2.5 times longer because complex incremental techniques are needed. Despite all the efforts, direct composite restorations placed in large cavities still show unacceptable amounts of marginal openings. Tooth-coloured inlays are a better alternative for large restorations. These restorations must be inserted with adhesive techniques. With composite inlays it is difficult to achieve a composite-composite bond. Ceramic inlays may be micromechanically bonded to the luting composite. They all show clinically a good marginal behaviour and the use of ultrasonic energy may further simplify the application technique of aesthetic inlays. STUDY SELECTION: Papers describing the different techniques were used as a base for the corresponding chapter. To assess and compare the longevity of the different restoration types, literature data were used. We limited ourselves to papers reporting at least 5-year clinical data. Longitudinal, clinically controlled studies were preferred. However, to be more complete, retrospective, cross sectional studies were also included. LONGEVITY OF POSTERIOR RESTORATIONS: Amalgam shows excellent longevity data with studies up to 20 years. The average annual failure rate is 0.3-6.9%. Posterior composites are in the same range (0.5-6.6%), however, the study times are much shorter (max. 10 years). For tooth-coloured inlays much less data are available. Longevity is reported up to 6 years with annual failure rates of 0.6-5%. CONCLUSIONS: All aesthetic alternatives to amalgam require more complex procedures and more time. If cost benefit considerations are a concern, amalgam is still the most convenient restorative material for posterior teeth.     

Marginal integrity and postoperative sensitivity in Class 2 resin composite restorations in vivo

INTRODUCTION: Problems that may arise in resin composite Class 2 restorations include microleakage and postoperative sensitivity. However, limited in-vivo research is conducted to evaluate these processes. AIM: The aim of this study was to assess postoperative sensitivity, microleakage and the pooling of adhesives in relation to Class 2 box-type composite restorations placed in vivo using various adhesive systems and application techniques. MATERIALS AND METHODS: One hundred and forty-four Class 2 box restorations were placed in the mesial and distal surfaces of 72 premolar teeth in-vivo using one of three combinations of adhesive systems and three filling techniques. After 6 weeks of clinical service postoperative sensitivity was recorded. The teeth were then extracted, immersed in a dye solution and sectioned. Microleakage and pooling of the adhesive was recorded. Statistical analysis involved logistic regression and chi2 tests to identify differences between groups at p < 0.05. RESULTS: Of the 144 restorations, 65 showed minimal cervical leakage in enamel, 5 suffered leakage into dentin and 74 were free of microleakage. No statistically significant differences were found in cervical microleakage between the adhesive systems or between filling procedures. Occlusal microleakage in the enamel was present in 16 of the 160 restorations. Liner Bond 2 restorations leaked significantly more at the occlusal surface (p < 0.05). Pooling of the adhesive was significantly less when PhotoBond was used. No spontaneous postoperative sensitivity was reported. Twenty-eight restorations were sensitive to loading. Postoperative sensitivity was significantly less in patients with Liner Bond 2 restorations. CONCLUSIONS: The adhesive systems used in this study showed minimal leakage into dentin in vivo. Using Liner Bond 2, restorations exhibited more occlusal leakage but were significantly less sensitive to loading.     

Hematological changes in infectious diseases. Hematological consequences of bacterial, protozoal and spirochetal infections (2)

Thirty-six Class V amalgam restorations were placed in 29 patients. Prior to insertion of the amalgam in 12 cavities the walls were treated with Amalgam Liner and in another 12 cavities with Copalite. The remaining 12 cavities were not treated before amalgam insertion. The margin quality was determined quantitatively with the SEM using replicas obtained immediately after the polishing of the restorations and 6 months later. At baseline the cavities treated with Copalite showed a margin quality identical to the untreated cavities. Cavities treated with Amalgam Liner showed an inferior margin quality. After 6 months the margin quality of the three groups showed no statistical differences. With neither of the liners tested was it possible to improve the margin quality of amalgam restorations.     

Clinical comparison between a glass ionomer cement and a composite for direct bonding of orthodontic brackets

The clinical performance of a glass ionomer cement for direct bonding of orthodontic brackets was compared with a composite resin routinely used in this procedure. Brackets were bonded, using both materials, in alternate quadrants of 16 patients of the Orthodontic Clinic of the State University of Rio de Janeiro. A total of 225 teeth, 112 in the glass ionomer cement group and 113 in the composite group, were tested. Bond failure frequencies were recorded for 12 months, and chi-square statistical test was carried out comparing the failure rates of the materials. The composite showed a statistically significant lower failure rate (7.96%) than the glass ionomer cement (50.89%), regardless of the dental arch tested. Although the glass ionomer cement presents important properties not observed in the composite, it is necessary to increase its cohesive strength to permit its clinical use for direct bonding of orthodontic brackets.     

In vitro inhibition of caries around a resin composite restoration containing antibacterial filler

Class V cavities were prepared and restored with resin composite containing antibacterial filler powder (Apacider-AW, Ap-AW) using experimental restorations. The restored teeth were incubated in vitro with the cariogenic bacteria Streptococcus mutans IFO 13955. Ground sections were then prepared and examined using macrophotography. Lesions of the outer and inner wall were noted, and the depths of which the lesions penetrated were measured. We found that, in restorations containing 1-5 wt% Ap-AW, caries penetrated the marginal area, while in restorations containing 10 wt% Ap-AW the margin remained free of caries out to a distance of about 1.1 and 1.8 mm on the occlusal and gingival sides, respectively.