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).     

Effect of restored and unrestored non-carious cervical lesions on the fracture resistance of previously restored maxillary premolar teeth

OBJECTIVES: The effect of non-carious cervical lesions (NCCL) on tooth fracture resistance has not previously been investigated. The aims of this in vitro study were to examine the fracture resistance of a group of extracted maxillary premolar teeth with mesio-occlusal-distal (MOD) restorations of amalgam, and restored or unrestored simulated NCCL. METHOD: Forty sound maxillary, premolar teeth were divided at random into four groups, each of 10 teeth, which were fixed crown uppermost and long axis vertical in stainless steel moulds. Groups 1,2,3 and 4 were prepared with standardized parallel-sided MOD cavities, then restored with amalgam. Groups 1, 2 and 3 were further prepared with standardized NCCL. The NCCL in Group 1 were restored using a resin-modified polyalkenoate (glass-ionomer) cement, and the NCCL in Group 2 were restored with an adhesive composite resin system. The NCCL in Group 3 were left unrestored. The specimens were loaded compressively at 1 mm min-1 using a universal testing machine. RESULTS: Mean fracture loads (KN) of 1.08, 1.03, 0.98 and 1.14, respectively, were recorded for Groups 1, 2, 3 and 4. Two-way ANOVA and Scheffe's Multiple Range Test showed no statistically significant difference between the groups. CONCLUSIONS: It is concluded that the presence of a standardized NCCL in an extracted maxillary premolar tooth does not reduce the fracture resistance of the tooth when loaded compressively at 1 mm min-1. The restoration of NCCL with the materials tested did not result in an increase in the fracture resistance of the previously restored premolar teeth, when loaded compressively at 1 mm min-1.     

Comparison of marginal fit and microleakage of ceramic and composite inlays: an in vitro study

The purpose of this in vitro study was to evaluate the marginal fit and microleakage of four types of ceramic or resin composite inlays. Sixty extracted human third molar teeth were randomly assigned into four groups. MOD cavities without bevels were prepared. The mesiogingival margin was cut in enamel, whereas the distogingival margin was placed below the amelocemental junction. The preparations and inlays were made according to the manufacturers' instructions. After acid-etching and treatment with a dentine bonding agent the inlays were cemented with dual curing CEREC resin composite luting material. After placement and polishing 10 teeth of each group were thermocycled 2500 times between 14 degrees C and 62 degrees C. Each tooth was bisectioned and from each part, one occlusal and three proximal sections of 75-100 microns thickness were cut and ground (EXAKT Cutting and Grinding system). The marginal discrepancy and the thickness of the luting cement were measured microscopically at each section and an average for each tooth was calculated. Considerable variation of marginal fit was seen, within inlays, and among different types of inlays. In general, the Vita Dur N inlays showed the best fit, e.g. the thickness of the luting cement for Vita Dur N was 114 microns occlusally and 119 microns mesiogingivally compared to 199 microns occlusally for CEREC and 219 microns mesiogingivally for Estilux. At enamel margins, a tendency of less microleakage was seen for ceramic inlays compared to composite inlays.     

Strength of core build-up materials in endodontically treated teeth

PURPOSE: To compare the in vitro strength of a reinforced glass ionomer and a light-cured glass ionomer used as an alternative to amalgam in core construction to restore endodontically treated mandibular molar teeth. MATERIALS AND METHODS: The root canals of 120 extracted human mandibular molar teeth were prepared chemomechanically and obturated with laterally condensed cold gutta-percha. The crown of each tooth was sectioned leaving only one cusp standing. Gutta-percha was removed from the pulp chamber in all teeth. The volume of the pulp chamber was measured and the teeth ranked in ascending order of chamber volume. The specimens were divided into six groups of 20, allocating teeth with similar chamber volumes into each group. In three of the groups, gutta-percha was removed from the coronal 3-4 mm of each root canal. The teeth were restored with one of three materials, a cermet cement (Ketac-Silver), a resin-reinforced glass ionomer (Vitremer), or amalgam (Contour). Core preparation was carried out after 48 hours, reducing each core height to 6 mm. The specimens were thermocycled for 24 hours and then mounted in dental stone. A control group of 20 unrestored human mandibular molars was mounted in cold cure acrylic. Each tooth was tested in a Nene machine with a compressive load applied at 90 degrees to the occlusal surface at a crosshead speed of 5 mm/minute. RESULTS: There was no statistically significant difference between the experimental groups (P > 0.05), but the control group was significantly stronger (P < 0.001). Extension of core material into the coronal root canal system did not increase the fracture resistance of any of the experimental materials. Regression analysis of the results revealed no correlation between the volume of the pulp chamber and the load to fracture.     

Comparative study of two filling techniques using glass-ionomer (Ketac-endo) root canal cement on fracture resistance of endodontically treated roots (in vitro)

Forty freshly single rooted teeth were selected for this study. The coronal part of teeth were decapitated and the root canals were prepared by modified step-back technique with K-flex files to size 35# at the apex, five ml of 5.25% NaOCl was used as irrigating solution. According to the dentin thickness at the mesio-distal direction of the prepared roots, roots were divided into two groups: Group (I), dentin and cementum thickness from 1.5-2 mm, and Group (II), dentin and cementum thickness 1 mm. According to the filling technique used the teeth were subdivided into four subgroups each of five teeth; Subgroup (A) single gutta-percha cone and Ketac-endo root canal sealer, Subgroup (B) lateral condensation technique with gutta-percha and Ketac-endo sealer, Subgroup (C) laterally condensed gutta-percha with Roth 801 cement and Subgroup (D) teeth left unfilled as negative controls. The prepared roots were placed into acrylic resin so that 10 mm of the root was exposed. A slowly increasing force was applied vertically using a blunt punch with 1 mm tip thickness attached to Instron testing machine. The results showed that group (I) with 1.5-2mm dentin thickness required greater force to fracture in all experimental groups, than that of group (II) with 1 mm dentin thickness. So the amount of remaining dentin thickness significantly affected the resistance to fracture of the prepared roots.     

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.     

Cosleeping (bedsharing) among infants and toddlers

This study was designed to investigate the effect of retaining coronal tooth substance on the performance of post-retained core materials, and to compare the fracture resistance of the system with an intact tooth prepared to similar dimensions. Ten teeth restored with post-retained silver amalgam, and 10 teeth restored with silver-glass cermet, all with a retained single wall of coronal tooth substance, were compared with 10 unrestored teeth prepared to similar dimensions when subjected to a shearing load. The results showed no statistically significant difference between the unrestored teeth and those restored with a silver-glass cermet. Whilst the teeth restored with silver amalgam had a significantly higher fracture resistance (P > 0.01) there was greater tendency to root fracture.     

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.     

Defective expression of early activation genes in cartilage-hair hypoplasia (CHH) with severe combined immunodeficiency (SCID)

PURPOSE OF STUDY: To examine factors which may predispose to tooth fracture, and to assess the compressive strengths of foods and sweets which are associated with tooth fracture in vivo. POPULATION STUDIED: Consecutive dental patients presenting with one or more fractured posterior teeth at the surgeries of three general dental practitioners, over a four-month period. METHOD: A pro forma was designed to elicit information on the factors associated with tooth fracture and the nature and extent of such fractures. Three general dental practitioners were requested to complete a pro forma for each patient presenting with a fractured posterior tooth over a four-month period. Foods and sweets considered to be associated with tooth fracture were identified and their compressive strengths tested. FINDINGS: A total of 129 cases of fractured posterior teeth were recorded, of which 48% occurred in the mandibular arch and 52% in the maxillary arch. In the mandible, 75% of tooth fractures occurred in molars while in the maxillary arch 50% occurred in molars. In 57% of cases assessed, no identifiable causative item was noted. Forty-five per cent of fractures were in teeth which had been restored on three or more surfaces. Compressive forces of 0.16KN to 2.2KN were obtained for food items implicated in tooth fractures. CONCLUSION: As mesio-occlusodistal restorations were identified as a major predisposing factor to tooth fracture in this study, with mandibular first molar teeth particularly affected, placement of cuspal coverage restorations may be considered to be a justifiable preventative measure in teeth identified as being at risk.     

Effects of designs of Class 2 preparations on resistance of teeth to fracture

This study was designed to evaluate the effect of isthmus width on the strength of the remaining tooth structure in maxillary first premolars restored with class 2 silver amalgam restorations. One hundred ten sound maxillary first premolars freshly extracted as a part of orthodontic treatment were collected. The teeth were then divided into 10 groups of 11 teeth each. Ideal class 2 mesio-occlusal, disto-occlusal and mesio-occlusodistal cavities with different isthmus widths i.e. one half the intercuspal distance, one third the intercuspal distance and one fourth the intercuspal distance and one fourth the intercuspal distance were prepared. Compressive forces were applied using a Universal Testing Machine and load to the point of fracture was determined. Intact teeth produced the best tooth fracture resistance i.e. 105.4 MPa, followed by preparations with isthmus width of one fourth, one third and one half intercuspal distance in the order.     

Fracture resistance of endodontically treated roots after restoration

This study evaluated the shear strength resistance of endodontically treated roots that were restored by two different techniques. Twenty-seven recently extracted single-rooted teeth with similar anatomic characteristics were sectioned to obtain the same length for all specimens. Group I (GI) consisted of 14 roots restored with cast post-core (nickel-chromium alloy) and cemented using zinc phosphate cement; group II (GII) consisted of 13 roots restored with steel prefabricated posts (FKG) cemented with zinc phosphate cement and rotated with caution for anchorage. The crown portion of this group was made using a hybrid composite resin (Prisma APH). Results showed that on all specimens of GI the fracture occurred in the cervical root structure while in GII the composite resin fractured in all specimens. Statistical analysis showed a significantly higher resistance to fracture for GI than GII. The specimens were sectioned longitudinally for stereoscopic microscope analysis (63x) and did not show fracture lines in the dentin anchorage post area for any of the specimens.     

Progress in the pathology of uterine smooth muscle neoplasms

To investigate the factors that influence the probability of clinical cavitation at radiolucent areas of proximal surfaces of posterior teeth, 108 molars and premolars with varying depths of proximal radiolucency were examined clinically, after cavity preparation on the carious contiguous tooth surfaces. The data obtained were subjected to logistic regression analysis with cavitation as the dependent variable, while age, tooth type and past caries experience (DMFT and DFS) were independent variables. When proximal radiolucency was confined to the outer half of enamel, there was no cavitation, but when it extended to the amelodentinal junction and the outer and inner half of dentine, there was cavitation in 19.3, 79.1 and 100% of cases, respectively. Moreover, there was a statistically significant relationship between the probability of cavitation, depth of radiolucency and age, suggesting that these should be among the main factors considered when restorative management of a radiolucent proximal surface of a posterior tooth is contemplated.     

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.     

Bond strength and interfacial morphology of adhesives to primary teeth dentin

PURPOSES: To evaluate (1) the shear bond strength to the dentin of primary teeth and failure site of hydrophilic dentin bonding agents, (2) the interfacial micromorphology of these adhesives on primary teeth. MATERIALS AND METHODS: Seventy-six primary noncarious molars 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 superficial dentin to which the adhesives and resin composite could be applied. After preparing the dentin surface, the teeth were stored in distilled water for 48 hours. They were then rinsed and dried with compressed air and divided at random into four groups of 16 specimens each: Group 1: Dentastic; Group 2: One-Step; Group 3: Prime & Bond 2.0; Group 4: Compoglass SCA. Z100 resin was used in all groups. All specimens were thermocycled (500x) and sheared in an Instron machine. After shear testing, the debonding sites of all samples were examined with a stereomicroscope and selected samples were also examined with the scanning electron microscope. Three additional samples per group were used to evaluate the resin adaptation to dentin. RESULTS: The results in MPa were: Dentastic 19.62 (4.67); One-Step 11.24 (3.67), Prime & Bond 22.38 (6.47), Compoglass SCA 18.88 (4.04). ANOVA (P < 0.0001) revealed that there was a significant difference between the groups. The Student-Newman-Keuls test (P < 0.05) showed no statistically significant difference between Dentastic, Prime & Bond and Compoglass SCA. However, these three groups were statistically significantly higher than One Step. In the Dentastic group, 14 of 16 samples revealed resin cohesive failure (resin fracture) while two of 16 displayed dentin cohesive failure (dentin fracture). In the One Step group, 15 samples failed at the resin and one sample showed dentin cohesive failure. In the Prime & Bond group, 12 specimens revealed resin cohesive failure while four displayed dentin cohesive failure. In the Compoglass SCA group, 13 samples had resin cohesive failures while three had dentin cohesive failures. All samples revealed an intimate adaptation to the dentin displaying resin tag formation.     

Diffusion of monomers from bonding resin-resin composite combinations through dentine in vitro

OBJECTIVES: Previous work has demonstrated diffusion of the monomer triethylene glycol dimethacrylate (TEGDMA) from resin composite through dentine in vitro. The objective of the present work was to examine monomer diffusion from bonding resins and resin composites used in combination. METHODS: Occlusal cavities were prepared in tooth crowns and restored with bonding resin-resin composite combinations. Aqueous samples from the 'pulpal chamber' of each tooth were removed at timed intervals for analysis by reversed phase-high performance liquid chromatography and mass spectrometry. RESULTS: Bonding resins contributed to monomer diffusion. A TEDGMA-containing bonding resin used in combination with a TEGDMA-containing resin composite hastened and increased TEGDMA diffusion through dentine. A 2-hydroxyethyl methacrylate (HEMA)-containing bonding resin used in combination with a TEGDMA-containing resin composite reduced TEGDMA diffusion only slightly compared with the resin composite alone and added substantial diffusion of HEMA. CONCLUSION: The bonding resins tested contributed to monomer passage to the pulp space and did not prevent movement of monomer from resin composites to the pulp.     

Ten-year longitudinal clinical evaluation of a visible light cured posterior composite resin

Using modified USPHS criteria, we evaluated annually for ten years 91 cases restored with visible light cured posterior composite resin LFP (Base resin: UDMA; filler: micro crushed type, alumino-silicate, barium glass and silica, 85 wt%, 74 vol%). The 91 cases restored with LFP decreased to 68 in ten years. Of the 23 cases that were lost, one resulted from a pulpal reaction immediately following restoration, four were extracted owing to periodontal disease or extrusion of third molars, two became abutments owing to loss of an adjacent tooth, eight had recurrent caries, and eight were lost owing to caries on a surface having no relationship to the composite resin restoration. Because we observed comparatively little wear, good marginal adaptability, and no discoloration, we concluded that the ten-year clinical success of LFP was on the whole very good, and that this resin has adequate clinical merit as a restorative material for posterior teeth when restricted to restorations covering comparatively small areas.     

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.     

Strain profiles in molars restored with posterior composite resins: effect of cavity size & restorative technique

The objective of the study was to quantitatively compare peak strain in buccal & lingual aspects of human molar teeth restored with composite res in polymers as a function of: 1) cavity size, 2) restorative material, 3) restorative technique. Two composite resin materials were investigated: Herculite (sub micron filler particle) & P 50 (supra micron filler particle). Performance was compared to two different types of high copper amalgams. A total of 48 freshly extracted human molar teeth free from cracks or caries were used. MOD cavities were prepared with three different cavity sizes: 1 mm, 2.5 mm & 5 mm. Rectangular rosette strain gauges were applied centrally on the buccal & lingual surfaces of the prepared teeth. Strain measurements were recorded during subsequent cavity restoration procedures and curing cycles. A comparison of peak strains in the amalgam vs composites using bulk-pack technique showed significantly higher strain in the composite series. Highest strains were noted in the largest cavity size (5 mm). Slot preparation following restoration reduced strains in the composite materials. Subsequent re-filling of the slot increased strain, but still less than the initial value.     

The effect of eugenol containing and non-eugenol temporary cements on the resin-enamel bond

This study was undertaken to compare the effect of eugenol containing and non-eugenol temporary cements on the bond strength of three brands of luting cements to enamel. Flat enamel surfaces were prepared on 90 surgically removed, unerupted, human third molar teeth. The teeth were randomly divided into three groups of thirty. The flat enamel surfaces in two of the groups were treated with either a eugenol containing or non-eugenol temporary cement and the third group was left untreated. The teeth were stored in water for 7 days and the cements then removed and all surfaces etched. The teeth were divided into 9 sub-groups of 10 each and one of the three resin cements was then bonded to each sub-group. The relevant shear bond strengths were determined after 7 days. The results indicated that prior use of a eugenol containing temporary cement reduced the resin cement-enamel bond strengths. No differences were found between the bonds achieved by the three brands. It was concluded that eugenol containing temporary cements should not be used prior to bonding with resin luting cements.     

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.