Resin modified glass ionomer cements. In vitro microleakage in direct class V and class II sandwich restorations

Microleakage of conventional chemically cured and resin modified glass ionomer cements (GIC), a compomer and a composite resin was studied in vitro in direct class V and class II GIC/composite sandwich fillings. None of the restorative techniques investigated completely resisted microleakage at both the occlusal and gingival margins. The dentinal gingival margins exhibited the highest leakage pattern. The compomer and the resin modified GIC showed a better seal than the chemically cured GIC's. The use of a liner as separating agent between composite resin and GIC in the class II sandwich fillings did not improve the seal. The results suggest that the initial bond obtained immediately after light curing of the resin modified GIC's is stronger than that for chemically cured GIC's. The contradictory results of dye leakage studies reported in the literature are discussed and in vivo evaluations are suggested necessary to predict clinical performance.     

An effective technique for extended proximal contacts in composite resin restorations

Obtaining a firm anatomic contact has been a difficult criteria in placing Class II posterior composite restorations. Various techniques have been developed and a number of products marketed to accomplish this task, but none have combined the necessary qualifications of ease, simplicity, and effectiveness for consistent and predictable results. To address this challenge, two innovative devices--a precontoured (biplanar concave) sectional matrix band and a light--focusing tip-have been developed. Using a clinical case presentation, this article describes the application of these devices to obtain high quality proximal contacts, even in widely separated teeth. The learning objective of this article is to familiarize clinicians with this procedure. The technique is simple and universally applicable with a variety of posterior composite materials and placement methods.     

ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years

Preliminary investigations have been made in normally hearing alert adults to establish whether the 40 Hz modulation-following response (MFR) can be used to predict 400 Hz uncomfortable loudness levels (ULLs). The MFR stimulus was a 400 Hz carrier, amplitude- and frequency-modulated by a 40 Hz sine function. Subjective ULLs were obtained using standard procedures. Objective ULLs were obtained from MFR parameter intensity functions using rms amplitude, phase angle and magnitude-squared coherence (40 Hz components). The best predictions of the subjective ULL were made using objective ULLs calculated from the gradients of linear best-fit lines for individual phase-intensity functions (80 per cent predicted within 10 dB of the subjective ULL; maximum deviation=16 dB). Poorest predictions were based on inter-subject average rms amplitude-intensity functions, where as few as 14 per cent were within 10 dB of the subjective value. The best predictions were considered sufficiently accurate to warrant further investigation using a variety of modulation and carrier frequencies in different age groups and with varying degrees of hearing loss.     

Pulp response in primary teeth with deep residual caries treated with silver fluoride and glass ionomer cement ('atraumatic' technique)

Histological assessment of the dental pulps of 55 carious primary teeth was carried out 3 to 58 months after treatment by the 'atraumatic' technique involving application of 40 per cent silver fluoride to residual caries followed by restoration with glass ionomer cement. Fifty of the 55 teeth examined showed a favourable pulpal response, inducing presence of abundant reparative dentine and a wide odontoblast layer. Histological comparisons were made between these teeth and others not treated with silver fluoride but restored with glass ionomer cement, amalgam or zinc oxide and eugenol. Possible mechanisms of the action of silver fluoride in arresting residual caries are discussed. The question of whether or not treatment of carious dentine with silver fluoride represents a biologically acceptable clinical procedure cannot be answered on the basis of pulpal histology alone. The very high concentration of fluoride in commercial preparations of silver fluoride raises several questions concerning its clinical safety.     

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.     

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.     

In vivo color stability of resin composite veneers and acrylic resin teeth in removable partial dentures

A new core-in-cup tablet that is manufactured from a novel adjustable punch, has been formulated and evaluated for its ability to release with subsequent absorption of theophylline via a zero-order rate of absorption. The core-in-cup tablets were compared with core only tablets and immediate release capsules. Pharmacokinetic parameters used to test the effectiveness of the formulations included, elimination rate, rate and kinetic order of absorption, relative availability as compared with an immediate release capsule of pure theophylline, and percentage area under the curve fluctuation (%AUCF) at steady state. The correlation coefficient, Akaike's information criterion (AIC) and the F-ratio probability were used to test the applicability of a zero-order, first-order, or square root of time model, for the rate of release of theophylline from the core-in-cup and core only tablets. The zero-order rate model was most applicable to the core-in-cup tablet, whereas the square root of time release model was most applicable to the core only tablet. The average %AUCF for the core-in-cup tablet was 9.26+/-3.15 while that for the core only tablet was 16.19+/-2.37 (p = 0.0545). The results of this study suggest that the core-in-cup tablet is a versatile zero-order release rate dosage form that are simple to produce.     

应用龈色树脂修复前牙颈部缺损的临床评价

目的:评价采用龈色树脂修复前牙颈部缺损的临床效果.方法:选择北京大学口腔医院第一门诊部 2007年6月至2008年10月前牙唇侧颈部缺损患者80例,先单纯使用牙色树脂模拟充填,然后用龈色树脂配合牙色树脂按照前牙美学标准模拟充填.采用视觉模拟评分法,由患者从整体印象、龈位置和牙齿轮廓3个方面对两种充填方法的美学效果满意度分别进行评价.用龈色树脂配合牙色树脂充填缺损,在术后1周、6个月、1年、2年,根据改良的美国公共卫生署标准对充填体进行纵向临床评价.结果:(1)患者对两种充填方法的美学效果满意度评价结果:配合使用牙龈色树脂修复法和单纯牙色树脂修复法的患者满意度在整体印象、龈位置和牙齿轮廓方面的差异均有统计学意义(P<0.1),配合使用龈色树脂充填法可获得更理想的美学效果.(2)纵向临床评价结果:术后1周、6个月、1年、2年,龈色树脂充填体在色彩匹配性、修复体表面形态、边缘密合性、边缘着色、继发龋及术后敏感性等方面差异均无统计学意义(P>0.1).结论:龈色树脂用于前牙颈部缺损的美学修复不但能满足牙体缺损的治疗要求,还能达到良好的美学效果,该技术值得临床推广.     

An investigation of fracture and fatigue in a metal/polymer composite

This article presents the results of a combined experimental and analytical study of the fatigue and fracture behavior of a polymer/metal composite which was developed recently for self-lubricating applications in automotive engines that utilize liquefied natural gas as fuel. For comparison, the microstructure and the fatigue and fracture behavior of a nonpolymer-containing “matrix” material are also presented. Since the crack profiles observed in both systems under monotonic or cyclic loading reveal significant components of ligament bridging, micromechanics models are presented for the modeling of crack bridging. The resulting predictions of resistance-curve behavior are compared with measured resistance curves. The shielding effects of ligament bridging are also quantified under cyclic loading. The implications of the work are also discussed for the modeling of fatigue damage and fracture in polymer/metal coatings.     

Direct composite resin restorations of the anterior single tooth: clinical implications and practical applications

Modern technology has continued to improve composite resins to the point where they are commonly used in restorative dentistry. In spite of some drawbacks, such as polymerization shrinkage, incomplete conversion and cross-linking, and undesirable water sorption, the expected time of service of these restorations is extended continuously due to physical and chemical improvements. The improved handling and excellent optical properties of the latest generation of composite resins can provide the appearance of natural dentition. Sophisticated effects can be obtained through the use of direct intraoral applications of stratification techniques. This article discusses common indications for direct restoration of anterior teeth and their treatment in order to be biocompatible with the adjacent hard and soft tissues and to meet the requirements of form, function, and phonetics.     

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.     

Current materials and techniques for direct restorations in posterior teeth. Part 2: Resin composite systems

Despite many years of research and speculation, the precise mechanisms underlying atrial fibrillation remain elusive. Prevalent understanding relies on assumptions, which are based on two-dimensional numerical simulations and on the idea that atrial fibrillation is the result of total disorganization of electrical activity, with multiple wavelets wandering randomly throughout the atria. However, recent studies both clinical and basic, have suggested that focal mechanisms, either re-entrant or automatic, may explain fibrillatory activity in some cases. Here we review the major hypotheses that have prevailed at one time or another to explain this complex arrhythmia and discuss some recent experimental results that strongly suggest that, whatever the electrophysiological basis of atrial fibrillation may be, it must involve complex patterns of propagation through the intricate multidimensional anatomical structure of the atria.     

Histological evaluation of the response of apical tissues to glass ionomer and zinc oxide-eugenol based sealers in dog teeth after root canal treatment

The object of the study was to compare two commercial root canal sealers: Ketac-Endo (a glass ionomer cement) and Fill Canal (a zinc oxide-eugenol cement). A total of 34 root canals from dog premolars with vital pulps were used. After instrumentation, the root canals were sealed with Ketac-Endo and Fill Canal cements using gutta-percha and a lateral condensation technique. After 270 days the animals were sacrificed with an anesthetic overdose and the maxillae and mandibles were removed and fixed in formalin for 48 h. After routine histological processing the sections were stained with hematoxylin-eosin and Mallory trichrome stains. Microscopic analysis revealed that Ketac-Endo cement presented better results than Fill Canal cement.     

In vitro evaluation of marginal and internal adaptation of class II resin composite restorations after thermal and occlusal stressing

The aim of this in vitro trial was to evaluate the external and internal adaptation of class II composite restorations to tooth structure by means of replica scanning electron microscope (SEM) observation. Standard MOD preparations were cut in human extracted teeth with margins located above and below the cementoenamel junction. Cavities were restored with either a direct multilayered technique, inlays (using conventional or dual DBA application) or prepolymerized composite inserts, using similar restorative material (Syntac, Variolink and Tetric). Evaluations were performed after mechanical and thermocycling. For the marginal adaptation in enamel, the bevelled margins of the direct group resulted in higher percentages of "continuity" (92.5% mesially and 94.6% distally), while the "marginal tooth fracture" was the most commonly found defect in groups with a butt preparation (up to 29.4%, with inserts). For the marginal adaptation in dentin, "continuity" percentages varied from 59% (inlay) to 87.9% (insert). As regards the internal adaptation, results for the whole dentin interface varied from 43.1% (inlay) to 63.9% (inlay with dual bonding) of "continuity". No regional difference in internal adaptation was found between the different preparation areas, except between gingival dentin and gingival enamel (44.9% vs. 80.7% of continuity, all group pooled data). Debonding occurred only at the dentin-restoration interface and consistently took place at the top of the hybrid layer. In the present experimental conditions, the inlay or insert techniques, which make use of the Dual bonding concept, proved to have the best potential to maintain the integrity of dentin-restoration interface.     

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.     

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.