April 2011
Research Article
Wear of resin composites and primary
enamel and their applicability
Kanae Wada, dds, Michiyo Miyashin, dds, phd, Nobuhito Nango, phd & Yuzo Takagi,
dds, phd
Abstract:
Purpose: To
determine whether resin composites are appropriate for full crown restoration
of primary molars by evaluating their wear characteristics. Specifically, the
wear properties of resin composite specimens and the opposing enamel surfaces
were characterized by means of impacting-sliding wear testing. Methods: Three types of light-cured
resin composites (Estelite Σquick,
Litefill IIP, and Metafil
C), one type of chemical-cured resin composite (Clearfil
FII), and a hybrid composite (Estenia C&B) were
tested in this study. The enamel sample was used as the control. The hemispherically prepared specimens were subjected to
impacting-sliding wear testing against the flattened enamel of primary molars.
The worn surfaces were examined by laser scanning microscopy and scanning
electron microscopy. The volumetric loss was estimated by using micro-CT
images. The areas of worn enamel surfaces were measured by 3D color laser
microscopy. On most of the worn enamel surfaces, cracks appeared. Scatter plot
analyses between their width and depth were carried out. Data for each specimen
were statistically analyzed by multiple comparisons among the means of
treatment by Bonferroni’s method (P< 0.01). Results: Clearfil
showed significantly higher surface area wear, volumetric loss, and worn enamel
surface area than did the other resin composites and the control enamel (P< 0.01).
There was no significant difference among the worn surface areas of Estelite, Litefill, Metafil, and Estenia (P< 0.01).
The control enamel showed significantly lower worn surface area than did the
resin composites (P< 0.01). There was no significant difference in
volumetric loss and worn enamel surface areas among Estelite,
Litefill, Metafil, Estenia, and the control enamel (P< 0.01). Cracks larger
than that on the control enamel were seen on the worn enamel surface opposing Estenia. (Am J Dent
2011;24:67-73).
Clinical
significance: Light-cured
resin composites should be added to the list of choices as materials for full
crown restoration of primary molars since they are wear resistant and do not
cause wear damage to the enamel of opposing primary molars.
Mail: Dr. Kanae Wada,
Division of Development Oral Health Science, Graduate School, Tokyo Medical and
Dental University, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
E-mail: kan978.dohs@tmd.ac.jp
Research Article
Detection of cavitated or
non-cavitated approximal
enamel caries lesions
Peter Bottenberg, dds, phd,
Wolfgang Jacquet,
msc, phd, Vitus Stachniss, dds, phd,
Johann Wellnitz,
dds
Abstract: Purpose: To determine the ability of
digital sensors (CMOS and CCD sensors) and D and F-speed films to detect cavitated and non-cavitated
enamel caries lesions at different exposure conditions compared to a gold
standard. Methods: 100 extracted
human molars and premolars were selected and mounted in a block between two
neighboring teeth. Sensors or films were exposed with voltages of 60 or 70 kVp at varying times. Three observers assessed each approximal site independently. Lesion depth was rated
according to an anatomical five-point scale (0 = no lesion to 4 = lesion
reaching inner half of dentin). Serial sections of resin-embedded teeth were
prepared. Gold-standard scores were established by consensus based on
histological sectioning. A carious lesion was present at scores of 1 and
higher. Statistical evaluation (sensitivity, specificity and receiver-operating
curves) was based on caries-free surfaces and those presenting enamel caries
(n=116). Results: The ROC curves had
“area under the curve” values (Az)
from 0.50 (F-speed, 70 kVp, 0.20 seconds) to 0.58
(CCD 60 kVp, 0.08 seconds). The detection percentage
of cavitated lesions was generally higher (0-52%,
depending on technique and observer) than that of non-cavitated
lesions (3-32%). The CMOS sensor showed Az
values comparable to the CCD sensors but required higher exposure times. There
was no significant difference between 60 and 70 kVp. (Am J Dent 2011;24:74-78).
Clinical significance: Digital radiography using CMOS
sensors is at least comparable to conventional radiography for the detection of
enamel lesions and neither system was sufficiently effective in the detection
of approximal enamel lesions.
Mail: Prof. Dr. Peter Bottenberg, Dept. of Operative Dentistry, Free University of
Brussels, Laarbeeklaan 103, B-1090 Brussels, Belgium.
E-mail: pbottenb@vub.ac.be
Research
Article
Evaluation of silica-coating techniques
for zirconia bonding
Liang Chen, phd, Byoung In Suh, phd,
Jongryul Kim, phd
& Franklin R. Tay, dds,
phd
Abstract:
Purpose: To
evaluate silica-coating/silane treatment techniques
for zirconia bonding. Methods: 19 groups of zirconia disks were
subjected to different surface treatments: polished or sandblasted by CoJet or alumina, and treatment with silane
or zirconia primers (containing phosphate- or phosphonate-monomer). After surface treatments, the zirconia disks were cemented with resin cements and stored
in deionized water for 2 hours at 37°C prior to shear
bond strength testing. Zirconia surface (polished and
unpolished), CoJet sand, Cojet-treated
zirconia surface (before and after water rinsing) and
representative debonded surfaces were examined by
scanning electron microscopy (SEM). The zirconia
surface after silica-coating was examined by Fourier Transform
Infrared-Attenuated Total Reflectance (FTIR-ATR) spectroscopy. Results: A
non-phosphate-containing resin cement (Choice 2) had almost no bond
strength on polished zirconia, while MDP-containing
cements (Panavia F2.0) had mild bond strength. After zirconia was sandblasted with CoJet
or alumina, bond strengths were slightly increased. Silane
treatment did not increase bond strength, while phosphate/carboxylate-based
primer (i.e. Exp Z-Prime) doubled the
bond strengths. Silica nanoparticles identified by
FTIR-ATR spectra, were observed by SEM on the zirconia
surface after CoJet treatment. However, these nanoparticles were removed by forceful water stream. (Am J Dent 2011;24:79-84).
Clinical
significance:
Currently employed silica-coating technique (CoJet
System) was able to attach silica to zirconia
surfaces, but the silica was removed by forceful water stream. Although the
pressurized water-rinse might not be clinically relevant, it indicated no
stable chemical bond was formed between silica and zirconia.
The silica-coating technique improved the bond strength of non-adhesive resin
cements to zirconia, while it did not increase bond
strength of phosphate-containing resin cement.
Mail: Dr.
Liang Chen, BISCO, Inc., 1100 W. Irving Park Road, Schaumburg, IL 60193, USA. E-mail: lchen@bisco.com
Research Article
Clinical effectiveness of a desensitizing system on
dentin hypersensitivity
Aikaterini Patsouri, dds, ms, Afroditi Mavrogiannea, dds, ms, Eudoxie Pepelassi, dds, ms, dr
dent,
Abstract: Purpose: To evaluate the efficacy of the DenShield desensitizing system, based on calcium sodium phosphosilicate, in the hypersensitivity reduction for a
6-month period in periodontitis patients previously subjected to periodontal
treatment and to compare the combination of the in-office paste and at-home
dentifrice use to the at-home dentifrice use alone. Methods: A total of 248 teeth (eight teeth in each subject) in 31
periodontitis patients (mean age 48 ± 8 years) previously subjected to
periodontal treatment were studied. 193 (77.8%) teeth had been treated with
phase I periodontal treatment alone (non-surgical treatment) and 55 (22.2%) had
been additionally subjected to periodontal surgery. Periodontal clinical
parameters were recorded for each subject. Hypersensitivity was assessed by
tactile and air-blast stimuli. The hypersensitive teeth of each of two
quadrants in each subject were randomly assigned with split-mouth design to
in-office application of DenShield Starter paste
(four teeth) or placebo (distilled water) (four teeth). After the in-office
application each patient used the DenShield
dentifrices (Builder and Saver) for 6 months. The final evaluation was at 6
months. Results: The prevalence and
the degree of baseline hypersensitivity was significantly higher for the
surgically than the non-surgically-treated teeth (83.6% versus 68.4%) and it was greater in teeth with attachment loss. The
dentin hypersensitivity observed after periodontal treatment was significantly
reduced in periodontitis patients who used the DenShield
system for 6 months. There was no difference in hypersensitivity reduction
between the additional in-office application of the DenShield
and the at-home use of the DenShield dentifrices
alone. (Am J Dent 2011;24:85-92).
Clinical significance: The dentin hypersensitivity was
reduced in therapeutically managed periodontitis patients who used the
desensitizing DenShield system, based on calcium
sodium phosphosilicate, for 6 months. Τhe hypersensitivity reduction did not differ between
the additional in-office application of the DenShield
paste and the at-home use of the DenShield
dentifrices alone.
Mail: Dr. Eudoxie
Pepelassi, Department of Periodontology,
School of Dentistry, University of Athens, Greece. E-mail:
kgkostop@netscape.net
Research Article
Bond strengths of a silorane
composite to various substrates
Lee W.
Boushell, dmd, ms, George Getz,
dds, Edward J. Swift,
Jr., dmd, ms &
Ricardo Walter, dds, ms
Abstract:
Purpose: To
evaluate the shear bond strength (SBS) of a novel low-shrink posterior resin
composite (Filtek LS) to various substrates. Methods: The dedicated LS System
Adhesive was used to bond Filtek LS to bovine dentin,
ground bovine enamel, resin-modified glass-ionomer
liner (Vitrebond Plus), conventional glass-ionomer restorative material (Fuji IX GP Extra), and bovine
dentin previously exposed to zinc oxide-eugenol (IRM)
(n=10 for each group). Vitrebond Plus and Fuji IX GP
Extra substrates were fabricated by filling standardized preparations that had
been made in epoxy resin. Adper Scotchbond
SE/Filtek Z250 was used as a control. Composites were
applied using the Ultradent specimen former. The
bonded specimens were stored in water at 37°C for 24 hours, and SBS testing was
done using an Instron universal testing machine. The
data were analyzed using ANOVA and Tukey-Kramer HSD
test at a significance level of 0.05. Results:
The mean SBS values of the Filtek LS system were
generally somewhat lower than the values of Adper Scotchbond SE/Filtek Z250 to the
various substrates, but the differences were not statistically significant.
Exposure of dentin to IRM resulted in a statistically significant reduction in
the mean SBS values of Adper Scotchbond
SE/Z250 and a slight but statistically insignificant reduction for the Filtek LS system. (Am
J Dent 2011;24:93-96).
Clinical significance: The Filtek
LS system is a low-shrink resin composite system that demonstrates bond
strengths to various substrates similar to those obtained with the methacrylate-based Adper Scotchbond SE and Filtek Z250.
Mail:
Dr. Ricardo Walter, Department of Operative Dentistry, 433 Brauer
Hall, CB# 7450, School of Dentistry, University of North Carolina, Chapel Hill,
NC 27599-7450, USA. E-mail: rick_walter@dentistry.unc.edu
Research Article
Polymerization characteristics, flexural modulus and
microleakage
Abstract: Purpose: To compare
the behavior of a new low-shrinkage silorane-based
composite (P90) with two conventional methacrylate-based
composites, in terms of polymerization shrinkage, polymerization stress, gel
point, flexural modulus and microleakage. Methods: The materials tested were P90
(
Clinical
significance:
The low-shrinkage silorane-based composite (P90)
tested seemed to represent an improvement in terms of extending the gel point
and reducing polymerization shrinkage and stress. However, compared with
conventional methacrylate-based composite AP-X, P90
did not show significantly better interfacial integrity, suggesting that
factors other than polymerization stress influenced the microleakage,
for instance, adhesive system and stiffness of uncured filling materials.
Mail:
Dr. Gang Zheng, Department of Dental Materials,
Peking University School and Hospital of Stomatology,
Beijing, P.R. China. E-mail:
zhengang101@126.com
Research Article
Influence of laboratory degradation methods and
bonding application
Maria
Abstract: Purpose: To evaluate
the laboratory resistance to degradation and the use of different bonding
treatments on resin-dentin bonds formed with three self-etching adhesive
systems. Methods: Flat, mid-coronal
dentin surfaces from extracted human molars were bonded according to
manufacturer’s directions and submitted to two challenging regimens: (A)
chemical degradation with 10% NaOCl immersion for 5
hours; and (B) fatigue loading at 90 N using 50,000 cycles at 3.0 Hz.
Additional dentin surfaces were bonded following four different bonding
application protocols: (1) according to manufacturer’s directions; (2)
acid-etched with 36% phosphoric acid (H3PO4) for 15
seconds; (3) 10% sodium hypochlorite (NaOClaq)
treated for 2 minutes, after H3PO4-etching; and (4)
doubling the application time of the adhesives. Two one-step self-etch
adhesives (an acetone-based: Futurabond/FUT and an
ethanol-based: Futurabond NR/FNR) and a two-step
self-etch primer system (Clearfil SE Bond/CSE) were
examined. Specimens were sectioned into beams and tested for microtensile bond strength (µTBS). Selected debonded specimens were observed under scanning electron
microscopy (SEM). Data (MPa) were analyzed by ANOVA
and multiple comparisons tests (α= 0.05). Results: µTBS significantly decreased after chemical and mechanical
challenges (P< 0.05). CSE showed higher µTBS than the other adhesive
systems, regardless the bonding protocol. FUT attained the highest µTBS after
doubling the application time. H3PO4 and H3PO4
+ NaOCl pretreatments significantly decreased bonding
efficacy of the adhesives. (Am J Dent 2011;24:103-108).
Clinical significance: Although resin-dentin bond
strength of all adhesives fell after the challenging regimens, bond degradation
can be minimized when using the two-step self-etch adhesive CSE. The limited
efficacy of the acetone-based one-step self-etch adhesive FUT may be defeated
by doubling the adhesive’s application time.
Mail: Prof. Manuel Toledano, Avda. de
las Fuerzas Armadas 1, 1B, 18014 Granada, Spain. E-mail:
Research Article
Occlusal caries prevention in high and low risk
schoolchildren.
Elaine Pereira da Silva
Tagliaferro, phd, Vanessa Pardi, phd, GlÁucia
Maria Bovi Ambrosano, phd,
Abstract: Purpose: To evaluate the caries-preventive effect of a
resin-modified glass-ionomer cement used as occlusal sealant (Vitremer)
compared with fluoride varnish (Duraphat) application
on occlusal surfaces of permanent first molars
(OSPFM) in 6-8 year-old schoolchildren (n=268) at high (HR) and low (LR) caries
risk. Methods: The children were
followed-up for 24 months after being systematically allocated into six groups
as follows: Control Groups HRC and LRC: children receiving oral health
education (OHE) every 3 months; Groups HRV and LRV: children receiving OHE plus
varnish application biannually; and Groups HRS and LRS: children receiving OHE
plus a single sealant application). The
baseline and follow-up examinations were performed by the same calibrated
dentist under natural light, using CPI probes and mirrors, after toothbrushing and air-drying. The DMFS was used to record
dental caries, in addition to the detection of initial lesions (IL). Data
analysis was performed with two primary outcome measures: DMF and DMF+ IL on
the OSPFM. Results: After 24 months,
only the HRS group showed statistically lower DMF and DMF+IL increments on
OSPFM compared with HRC group. HRV group did not differ from HRC and HRS
groups. For LR groups, no statistical difference (P> 0.05) was observed
among the treatments. (Am J Dent 2011;24:109-114).
Clinical significance: For preventing occlusal caries in permanent first molars of high risk
children, sealant application in addition to oral health education was
considered the best strategy.
Mail: Prof. Dr. Antonio Carlos Pereira, Av. Limeira 901 - 13414-903,
Piracicaba, SP, Brazil. E-mail: apereira@fop.unicamp.br
Research Article
Influence of curing rate on softening in
ethanol, degree of conversion,
Ana Raquel Benetti, dds,
ms, phd, Anne Peutzfeldt,
dds, phd,
dr odont, Erik Asmussen, ms, dr odont,
Abstract:
Purpose: To
investigate the effect of curing rate on softening in ethanol, degree of
conversion, and wear of resin composites. Methods:
With a given energy density and for each of two different light-curing units
(QTH or LED), the curing rate was reduced by modulating the curing mode. Thus,
the irradiation of resin composite specimens (Filtek
Z250, Tetric Ceram, Esthet-X) was performed in a continuous curing mode
and in a pulse-delay curing mode. Wallace hardness was used to determine the
softening of resin composite after storage in ethanol. Degree of conversion was
determined by infrared spectroscopy (FTIR). Wear was assessed by a three-body
test. Data were submitted to Levene’s test, one and
three-way ANOVA, and Tukey HSD test (α= 0.05). Results: Immersion in ethanol, curing
mode, and material all had significant effects on Wallace hardness. After
ethanol storage, resin composites exposed to the pulse-delay curing mode were
softer than resin composites exposed to continuous cure (P< 0.0001). Tetric Ceram was the softest material followed by Esthet-X and Filtek Z250 (P<
0.001). Only the restorative material had a significant effect on degree of
conversion (P< 0.001): Esthet-X had the lowest
degree of conversion followed by Filtek Z250 and Tetric Ceram. Curing mode (P= 0.007) and material (P<
0.001) had significant effect on wear. Higher wear resulted from the
pulse-delay curing mode when compared to continuous curing, and Filtek Z250 showed the lowest wear followed by Esthet-X and Tetric Ceram. (Am J Dent 2011;24:115-118).
Clinical
significance:
Clinicians should be aware that the curing mode may influence the properties of
resin composites.
Mail:
Dr. Ana Raquel Benetti, University North of Paraná (UNOPAR) Center of
Biological and Health Sciences, Av. Paris 675, Jd. Piza, 86041-140, Caixa Postal
401, Londrina PR, Brazil. E-mail: anabenetti@hotmail.com
Research Article
Effect of CPP-ACP and APF on Streptococcus mutans biofilm:
Arzu Pinar Erdem, dds, phd,
Elif Sepet, prof dr, Tam Avshalom, msc, Vitaly Gutkin, msc
Abstract: Purposes: (1) To determine the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and
acidulated phosphate fluoride (APF) on S.
mutans viability, (2) to observe their effects on
biofilm structure, and (3) to examine the element
content of the hydroxyapatite (HA) surfaces after
exposure to CPP-ACP and APF. Methods:
HA discs were coated with: CPP-ACP (GC Tooth-Mousse), APF, CPP-ACP+APF (1/1).
Uncoated HA discs were used as control. Following application of the materials,
the discs were immersed in human saliva and incubated with S. mutans ATCC (27315) for 24 hours.
Growth of bacteria on the discs was evaluated by microbial culturing methods.
The structure of the biofilm was examined with confocal laser scanning microscope (CLSM). The change in
element content of HA surfaces (without biofilm) was
evaluated with energy-dispersive x-ray spectroscopy (EDS). The values were
statistically analyzed using Kruskal-Wallis and
Dunn’s test. Results: The total
number of bacteria of APF and CPP-ACP+APF applied groups were found
significantly lower than the control group (P< 0.05).
All specimens showed similar microbial colonization structure. No statistically
significant differences were observed in O, F, Na, P, Ca content on HA surfaces
after exposure to the tested agents, although fluoride concentration of the APF
treated HA surfaces were increased compared to CPP-ACP, CPP-ACP +APF. (Am J Dent 2011;24:119-123).
Clinical significance: CPP-ACP
demonstrated a small reduction in bacterial viability of S. mutans in biofilm,
but without a statistical significance. As the use of CPP-ACP supplemented with
APF was better than each agent alone, it could be considered as an alternative
prophylactic application in order to reduce bacterial viability and biofilm biomass.
Mail: Dr. Arzu Pinar Erdem,
Research Article
Strength and wear resistance of
a dental glass-ionomer
cement with a novel nanofilled resin coating
Ulrich Lohbauer, msc,
phd, Norbert KrÄmer,
dmd, phd,
Gustavo Siedschlag,
dmd, Edward W.
Schubert, dmd,
Abstract: Purpose: To evaluate the influence of different resin coating
protocols on the fracture strength and wear resistance of a commercial glass-ionomer cement (GIC). Methods:
A new restorative concept [Equia (GC Europe)] has
been introduced as a system application consisting of a condensable GIC (Fuji
IX GP Extra) and a novel nanofilled resin coating
material (G-Coat Plus). Four-point fracture strength (FS, 2 x 2 x 25 mm, 14-day
storage, distilled water, 37°C) were produced and measured from three
experimental protocols: no coating GIC (Group 1), GIC coating before water
contamination (Group 2), GIC coating after water contamination (Group 3). The
strength data were analyzed using Weibull statistics.
Three-body wear resistance (Group 1 vs.
Group 2) was measured after each 10,000 wear cycles up to a total of 200,000
cycles using the ACTA method. GIC microstructure and interfaces between GIC and
coating materials were investigated under SEM and CLSM. Results: The highest FS of 26.1 MPa and
the most homogenous behavior (m = 7.7) has been observed in Group 2. The coated
and uncoated GIC showed similar wear resistance until 90,000 cycles. After
200,000 wear cycles, the coated version showed significantly higher wear rate
(ANOVA, P< 0.05). The coating protocol has been shown to determine the GIC
fracture strength. Coating after water contamination and air drying is leading
to surface crack formation thus significantly reducing the FS. The resin
coating showed a proper sealing of GIC surface porosities and cracks. In terms
of wear, the coating did not improve the wear resistance of the underlying
cement as similar or higher wear rates have been measured for Group 1 versus Group 2. (Am J Dent 2011;24:124-128).
Clinical significance: The results
have shown the need for resin coating of a GIC restoration in order to improve
its mechanical strength. Clinically, contamination of a cement surface with any
oral fluids or water should be avoided until a coating is applied and
polymerized. A perfect sealing of surface porosities and cracks is attainable
using the investigated Equia system.
Address:
Dr. Raluca Pecie, Division
of Cariology and Endodontology,
University of Geneva, Rue Barthélemy-Menn 19, CH-1205
Geneva, Switzerland. Email: raluca.pecie@unige.ch
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