Maximizing aesthetics of debilitated maxillary central incisors: a clinical case

With the advent of true "adhesive dentistry," practitioners have at their disposal new multi-purpose adhesive agents which bond to most dental substrates. These new adhesives have a high affinity for roughened or "microetched" surfaces, penetrating and wetting the surfaces to increase the bonding strength. The improved adhesion has altered treatment plans from previous years and has enabled clinicians to practice more constructive dentistry and replace only defective or missing tooth structure. The objective of this article is to present a case report to illustrate the utilization of one of the new bonding agents in an especially difficult clinical situation.     

Three-year clinical evaluation of the Clearfil Liner Bond system

Modern dental adhesive systems have improved the bond of restorative materials to mineralized tooth structures. The purpose of this study was to evaluate the clinical performance of composite restorations placed in abrasion and erosion lesions using the Clearfil Liner Bond dental adhesive system. Following ADA clinical guidelines for dentin and enamel adhesive materials, 62 facial class 5 smooth surface erosion or abrasion lesions with no undercuts and involving primarily root surfaces were restored in 25 adult male and female patients. The teeth were restored without preparations using Clearfil Liner Bond and Clearfil Photo Anterior composite resin. The clinical performance of the restorations was assessed by two examiners at baseline, 6 months, 1, 2, and 3 years using the following evaluative parameters: color match, marginal discoloration, and marginal integrity according to modified Ryge criteria; the presence or absence of recurrent decay; pre- and postoperative sensitivity; and restoration failure due to loss of retention or other causes. At the end of 3 years, four of the 55 restorations remaining in the study failed due to lack of retention (92.7% retention rate). The evaluations of the other clinical parameters demonstrated excellent performance by this system.     

Random amplified polymorphic DNA analysis and variation of essential oil components of Atractylodes plants

Recently, air-abrasion technology has been examined for potential applications within dentistry, including the field of orthodontics. The purpose of this study was to compare the traditional acid-etch technique with an air-abrasion surface preparation technique, with two different sizes of abrading particles. The following parameters were evaluated: (a) shear bond strength, (b) bond failure location, and (c) enamel surface preparation, as viewed through a scanning electron microscope. Sixty extracted human third molars were pumiced and divided into three groups of 20. The first group was etched with a 37% phosphoric acid gel for 30 seconds, rinsed for 30 seconds, and dried for 20 seconds. The second and third groups were air-abraded with (a) a 50 microm particle and (b) a 90 microm particle of aluminum oxide, with the Micro-etcher microabrasion machine (Danville Engineering Inc.). All three groups had molar stainless steel orthodontic brackets bonded to the buccal surface of each tooth with Transbond XT bonding system (3M Unitek). A Zwick Universal Testing Machine (Calitek Corp.) was used to determine shear bond strengths. The analysis of variance was used to compare the three groups. The Adhesive Remnant Index (ARI) was used to evaluate the residual adhesive on the enamel after bracket removal. The chi square test was used to evaluate differences in the ARI scores among the groups. The significance for all tests was predetermined at p < or = 0.05. The results indicated that there was a significant difference in shear bond strength among the three groups (p = 0.0001). The Duncan Multiple Range test showed a significant decrease in shear bond strength in the air-abraded groups. The chi square test revealed significant differences among the ARI scores of the acid-etched group and the air-abraded groups (chi(2) = 0.0001), indicating no adhesive remained on the enamel surface after debonding when air-abrasion was used. In conclusion, the current findings indicate that enamel surface preparation using air-abrasion results in a significant lower bond strength and should not be advocated for routine clinical use as an enamel conditioner at this time.     

Design of a Test Specimen to Assess the Effective Bond Length of Carbon Fiber-Reinforced Polymer Strips Bonded to Fatigued Steel Bridge Girders

Single-lap and double-lap specimens have been widely used to determine the shear strength of epoxy adhesives for many applications, including mechanical joints and retrofit of wing skins. Although it has been known that the stress state in the adhesive is not uniform in shear, but rather a combined stress state of peeling stress and shear stress, these specimens are useful to determine the bond strength if the application of the adhesive is similar in shape and material properties to the test setup. However, when the application does not have a shape similar to the single-lap or double-lap specimens, the test results of the lap specimens may not be applicable to the practical application. This is often the case for the use of epoxy adhesives in structural engineering applications. In this paper, one example of an application in which a single-lap or double-lap specimen is not appropriate for determination of the bond strength of the epoxy adhesive will be presented. The application of the epoxy adhesive discussed herein involves rehabilitation with bonded carbon fiber-reinforced polymer (CFRP) strips of the tension flanges of fatigued steel I-griders used in bridges. This application provides a cost-effective means of repairing these bridge girders, so long as the effective bond strength of the CFRP and adhesive are sufficient. In this work, the stress distribution in the adhesive layer is analyzed and compared between a prototype repaired bridge girder and various specimen models to determine an appropriate specimen and test setup for assessing the effective bond length of the adhesive. This study points out the strengths and weaknesses of standard single-lap and double-lap specimens and proposes that the new test setup is a suitable alternative for a wide range of applications in which the adherend is subjected to tension plus flexure.     

Bond strength of permanent soft denture liners bonded to the denture base

The purpose of this study was to characterize denture and soft liner adhesion and to determine the adhesive and/or cohesive strength of different soft tissue liners bonded to the denture base by use of a new technique. Two groups of five permanent soft liners (dry or exposed to water for 6 months) were tested by use of a tensile mode to characterize the failure characteristics of soft liners bonded to denture base resin. The method differed from previous test methods because of the specimen's ability to align axially during the test. The results indicated significant differences in the bonding of liners to the denture base, and light-cure systems exhibited the greatest amount of stress needed for failure. Low bond strength was observed when the adhesion was poor or when the cohesive strength of the soft liner was low and lead to pure adhesive or cohesive failure. When both adhesive and cohesive bonds were strong, failure occurred at high stresses. Combinations of adhesive and cohesive failures (mixed mode) were also observed in intermediate cases.     

Bond strengths and SEM evaluation of Clearfil Liner Bond 2

PURPOSE: To evaluate a dental adhesive system that uses a single conditioning/primer agent. MATERIALS AND METHODS: Twenty-five flat enamel and dentin bonding sites were prepared to 600 grit on human molar teeth. The Clearfil Liner Bond 2 adhesive system was used to bond Clearfil AP-X composite to both enamel and dentin. After 24 hours of water storage, shear bond strengths were determined using an Instron testing machine. Fifty V-shaped cavity preparations were prepared in human molar teeth with an enamel and cementum margin. Composite restorations were placed using the new adhesive system. The teeth were stored for 24 hours, thermocycled, stained with AgNO3 , sectioned and examined for microleakage. SEM examinations were also completed to evaluate the effects of the treatment steps on enamel and dentin surfaces. RESULTS: Mean shear bond strengths for the experimental adhesive to enamel and dentin were 28.2 +/- 4.9 and 19.4 +/- 3.1 MPa. A t-test revealed that the enamel bond strength was significantly greater (P<0.05) than the dentin strength. No marginal leakage was observed from the enamel margins of the restorations. Three restorations showed minimal leakage from the cementum margins. SEM examinations showed resin penetration into both the conditioned enamel and dentin surfaces. The adhesive system produced high bond strengths to both enamel and dentin, exhibited very minimal microleakage and was easy to use.     

Wet bonding: effect of drying time and distance

PURPOSE: To examine the effect of various drying times and air syringe-to-tooth distances on the shear bond strength of a dentin adhesive that requires a wet surface for maximum effectiveness. MATERIALS AND METHODS: Seventy extracted human molars were acid etched. The surface of the etched dentin was rinsed and dried with compressed air for 1, 3, or 5 seconds from a distance from either a distance of 1 or 10 cm. The adhesive One-Step was then applied, composite cylinders were attached and shear bond strengths were obtained. RESULTS: Drying time and distance had a significant impact on the resultant shear bond strengths. Longer drying times and shorter syringe-to-tooth distances negatively affected the bond strength of the adhesive studied.     

Effect of primers on bonding agent polymerization

The aim of the present study was to evaluate the effect of primers on the polymerization of bonding agent. We measured the degree of conversion (radical production) and mechanical properties (surface hardness and direct tensile strength) of various adhesives/primers mixed at different ratios and the effect of varying the visible-light curing time. With and without primer treatment, the tensile bond strength of adhesive resin to micacious glass ceramic and human enamel was measured. After the tensile bond test, using the Image Capture System, the failure patterns of adhesive resin bonded to micacious glass-ceramic were analysed. The results show that the mixtures containing the higher amounts of primer yielded a lower degree of conversion and inferior mechanical properties when compared with the mixtures containing a lower proportion of primer, except in the experimental bonding system. The adhesive/primer mixtures inhibited free radical polymerization. The value for the Knoop hardness number and the direct tensile strength of the adhesive/primer mixtures were significantly decreased compared with those of the adhesive bonding agent alone with no primer added. The tensile bond strength of adhesive resin bonded to micacious glass-ceramic or human enamel without primer treatment was significantly greater than that of adhesive resin with primer treatment in certain cases. Most of the fractures of ceramic surfaces were cohesive (within resins) and/or interface (at the ceramic surface) failure.     

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.     

Dual NF1-requiring effect of human neurotropic JC virus composite pentanucleotide repeat elements on early and late viral gene expression

OBJECTIVE: The purpose of this study was to prepare a light-cured adhesive applicable for orthodontics by mixing monomers and a polymerized reactive organic composite filler (prepolymerized trimethylolpropane trimethacrylate-filler, TMPT-filler). METHODS: The monomer component was a mixture of 3.0 wt% 2-hydroxy-3-(2-naphthoxy)propyl methacrylate (HNPM) in triethylene glycol dimethacrylate. This was applied to extracted bovine tooth enamel after acid etching with 65 wt% phosphoric acid for 30 s. After 24 h in 37 degrees C water, the tensile bond strength was measured, and the data were analyzed with Duncan's new multiple range test (p < 0.01 or 0.05). RESULTS: The tensile bonding strength to enamel etched with 65 wt% phosphoric acid was 13.1 +/- 0.5 MPa, and the thermal stability of the bond was excellent. SEM examination of the cross-sectioned specimens modified with HCl demineralization showed that when the diffusion time prior to light irradiation was only 1 min, a well-developed resin honeycomb-like structure was created in the enamel surface in the formulation containing HNPM. SIGNIFICANCE: Monomer impregnation beyond the etched enamel surface was important for resin-enamel bonding, increasing bonding strength and thermal stability. HNPM was effective in enhancing monomer diffusion and impregnation of the etched enamel surface.     

The effect of air abrasion on shear bond strength to dentin with dental adhesives

This study compared the effects of different dentin surface treatments on the shear bond strengths of three adhesive systems. The adhesive systems included a resin-modified glass ionomer, Fuji II LC, and two dentin bonding systems, One Step and Scotchbond Multi-Purpose Plus. The surface treatments compared for each adhesive system were as follows: 1) the controls, which were conditioned, 2) air abrasion at 120 psi without conditioning, 3) air abrasion at 160 psi without conditioning, 4) air abrasion at 120 psi with conditioning, and 5) air abrasion at 160 psi with conditioning. The KCP 1000 Whisperjet was used for all air-abrasive specimens. Controls for each adhesive material (Fuji II LC, One Step, Scotchbond Multi-Purpose Plus) were bonded using manufacturers' recommendations. Results showed that air abrasion significantly lowered bond strength of the resin-modified glass ionomer, conditioned or nonconditioned (P < 0.01). Air abrasion alone significantly lowered bond strengths of the dentin bonding agent systems (P < 0.01). However, air abrasion plus conditioning of the dentin surface resulted in bond strengths that were similar to the conditioned-only specimens (P < 0.01).     

Polymerisation shrinkage around composite resin restorations--an in vitro study

The aim of this study was to determine the degree of penetration of a fluorescent adhesive at the margins of 3 brands of posterior composite resin restorative materials. Seventy-eight extracted human premolar teeth were used. Class II cavities were prepared on both approximal surfaces of each tooth in such a manner that the gingival wall was situated apical to the amelo-cemental junction. The enamel of the cavity walls was bevelled, etched and treated with the enamel bonding agent recommended by the manufacturer. The 3 brands of composite resin used were: Fulfil, Estilux Posterior and P 50. The teeth were divided at random into 3 groups of 26 premolars each. The mesial and distal cavities of each tooth in the group were filled with the same brand. The resin was inserted in two increments in both the mesial and distal cavities and polymerised. The margins of one restoration in each tooth was coated with fluorescent adhesive and cured. All the restored teeth were embedded in clear epoxy resin and then sectioned. The mounted sections were examined at 100X magnification with fluorescent light. The polymerisation contraction gap at different areas of the tooth/restoration interface and the degree of penetration of the fluorescent adhesive into the gap was determined. The fluorescent adhesive penetrated the contraction gaps in all 3 posterior restorative materials to varying degrees. The defects observed were similar in all 3 brands and the differences in degree of penetration were not statistically significant (p > 0.05).     

Pre-hospitalization management of evolving myocardial infarction. 2d conference of south-eastern region emergency medicine experts

Since the development of advanced adhesive technology, the use of amalgam has declined significantly. The search for amalgam substitutes, i.e., restorative materials which maintain similar clinical function and cost-effectiveness as amalgam, has so far been unsuccessful. It has also become evident that a considerable confusion prevails regarding the objectives of restorative procedures. In absence of national and international standards, the products--the restorations--are assessed according to varied criteria. In placing restorations, three objectives are attained, at most: a) tooth preservation, b) tooth preservation and function, and c) tooth preservation, function, and imperceptible restitution. The learning objective of this article is to discuss the positive effects that could be attained by defining the standards, terminology, and the quality assessment criteria for operative dentistry in regard to the patients and the dental profession.     

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.     

Interleukin-2 regulates monoamine and opioid peptide release from the hypothalamus

The purpose of this investigation was to evaluate the tensile bond strength of one type of impression material adhesive to three different custom tray materials: one autopolymerizing (Fastray) and two light-polymerizing (Triad and Extoral). The effect of different surface treatments was evaluated for each of the materials. No significant difference in impression material adhesive mean tensile bond strengths was exhibited for any of the materials as the result of variations in the surface treatment. It was observed that the Triad tray material groups, with different surface treatments, exhibited significantly higher impression material adhesive mean tensile bond strengths than the autopolymerizing tray resin and the Extoral light-polymerizing material.     

Post-war changes in the outcome of pregnancy in Maternity Hospital, Kuwait

To develop a non-polymerization shrinkage adhesive resin, the effects of the contents varying 0-20 wt% radical polymerizable spirocyclic monomers of 2-methylene-1, 4, 6-trioxyaspiro [4, 6] undecane (MTSU) and 2-methylene-8, 9-benzo-1, 4, 6 trioxyaspiro [4, 4] nonane (BTSN) together with three kinds of initiator systems in adhesive resin on bonding to both Ni-Cr alloy and unetched enamel were investigated. Tensile bond strength to either Ni-Cr alloy or unetched enamel was affected by the inclusion of MTSU or BTSN, and indicated that increased contents of MTSU or BTSN resulted in decreased bond strength to the metal in the negative correlations. Regarding the bond strength to Ni-Cr alloy, however, the effective concentration of BTSN was found to be 5 wt%, and the mean bond strength was 58.5 and 58.6 MPa, respectively. The data of differential scanning calorimeter measurement, on the other hand, showed that the copolymerization of MTSU with conventional methacrylate monomers was not completely achieved.     

Dentastic bond strength to dentin

PURPOSE: To evaluate the shear bond strength to the dentin of permanent teeth and failure site of Dentastic hydrophilic dentin bonding agent. MATERIALS AND METHODS: Forty permanent noncarious molar teeth stored in distilled water were obtained. The teeth were cleaned with pumice and a rubber cup. The mesio-buccal surface of the teeth was ground flat with hand pressure with a series of SiC paper ending with the 600 grit to provide a uniform surface on dentin to which the resin composite could be applied. After preparing the tooth surface, the teeth were stored in distilled water for 48 hours. They were then divided at random into four groups of 10 specimens each: Group 1: Dentastic, five coats of primer; Group 2: Dentastic, three coats of primer; Group 3: Dentastic, five coats of primer, light-cured adhesive before resin bonding; Group 4: Dentastic, three coats of primer, light-cured adhesive before resin bonding. All specimens were thermocycled (500x) and sheared in a testing machine. After shear testing, the debonded sites of all samples were examined with a stereomicroscope and a scanning electron microscope. RESULTS: The results in MPa were: Group 1: 22.63 +/- 6.24; Group 2: 23.35 +/- 5.14; Group 3: 23.58 +/- 5.66; Group 4: 27.26 +/- 8.22. ANOVA and Student-Newman-Keuls showed no statistically significant difference between the groups. In all groups, all specimens failed at the dentin (dentin cohesive failure = dentin fracture) or at the resin (resin cohesive failure = resin fracture). This means that the bond strength of the product is stronger than the cohesive strengths of the dentin and the resin.     

Splenic irradiation for hairy cell leukaemia

In vitro studies show that the adhesive amalgam technique is superior to the nonadhesive technique. Also, early clinical results indicate that the adhesive technique can eliminate the microspace between amalgam and tooth. And, it can retain amalgam on unprepared occlusal surfaces of molars and premolars, sealing the fissures. Moreover, amalgam can be retained in preparations without undercuts. Early results indicate in traditional preparations, the adhesive technique appears to be at least equivalent to nonadhesive technique.     

A method for testing denture adhesives

An in vitro test is described that simulates the in vivo fate of a denture adhesive, namely destruction, dilution, and dissolution of the adhesive, by repeated measurement of tensile bond strength for the adhesive in isotonic saline over time. The bond strengths were measured under two different settings of the testing machine. The main compositions of three denture adhesive pastes, Fittydent, Fixodent, and Super Poli-Grip and one powder adhesive, Super Wernet's, were determined by infrared spectroscopy. The tensile bond strengths of these adhesives and those of pure tragacanth gum were subjected to a three-way analysis of variance. The Fittydent and Super Poli-Grip adhesives exhibited the best results over time. The most appropriate of the described methods for testing denture adhesives seem useful; however, when seen in relation to the results of a published clinical study where the patients were asked to evaluate the retention and the duration of some of these adhesives, there are indications that the clinical validity of the method might be improved if paste adhesives are tested at temperatures above 35 degrees C.