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The statistical analysis demon- Panvavia F light-cured The biax- liquid media would not affect the mechanical properties ial flexure strength specimens, including controls, were of the RBC. The remaining specimen distribution is shown in Table 2. After the equilibration agents. At the first measuring time after long-term effects. First, they provide micro-retention, primarily preparations, the initial sealing capability of existing through the peritubular dentin, for bonding to the com- bonding resins may be improved.❿
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It has five and 11 after baseline. This avoided any dehydration Because of the half-mouth design used for this study, effect from being included erroneously in the color all comparisons were within-subject and the standard evaluation data. Changes were measured before the deviations shown in the tables were between- subject. This design helps to reduce patient variations. One must be careful when comparing results from different bleaching studies. It is gener- ally believed that peroxide concentration is related to efficacy.
Zekonis and others reached 4. The first concept is that the dehydration effect was included in the color evaluation data when the data was recorded 15 minutes after the bleaching treat- ment in the previously mentioned study. Figure 7. Clinical picture at baseline. Figure 8. Clinical picture after the first in-office bleaching appli- cation. This means that two weeks are needed for the color to stabilize after the bleaching treatments have been completed.
Therefore, practitioners are recom- mended to wait at least two weeks post-bleaching when making a good color match, if they are planning to place a tooth-colored restorative material in the anterior teeth. It is interesting to note that the shade guide rank difference was —3. Clinical picture after the second in-office bleaching Opalescence Xtra Boost and —3. Wattanapayungkul and others resented a decrease in yellowness. Wattanapayungkul and others found that there was a mean of 2.
It is difficult to compare between factor of The authors determined by chemical analy- by Zekonis and others Matis , has shown that the labeled concen- Two independent evaluators performed the subjective tration is not always the actual concentration. Tests slide evaluation. The Kappa k inter-evaluator relia- were accomplished in triplicate and showed that the bility was determined to be 0. A trend of Opalescence Color relapse began after the bleaching treat- ments were finished and continued until the fifth week, after which there were no signifi- cant changes.
Also, there was no statistical dif- ference between products regarding gingival irritation and tooth sensitivity. Within the bounds of this study, the peroxide composition is the most important component of the bleaching materials. Other formula compo- nents are much less significant.
Acknowledgements The authors thank Dr Sergio T Freitas for his assis- tance with the statistical analysis. Figure Received 4 November Barghi N Making a clinical decision for vital tooth bleaching: At-home or in-office? Compendium Continuing Education in Dentistry 19 8 , quiz Recommendations on uniform color space, color All participants started with no gingival irritation or terms Supplement 2 to publication 15 Paris Bureau tooth sensitivity before any bleaching treatment.
However, it took only procedures Journal of Prosthetic Dentistry 24 2 This pattern and a commercially available tooth-bleaching agent in rats could be explained by the acute exposure to high con- Journal of Dental Research 74 2 Rehabilitation 27 9 Clinical Relevance Sequential applications of solutions that form amorphous calcium phosphates are effective for rapidly decreasing dentin hypersensitivity.
Amorphous Dentin hypersensitivity is a transient condition calcium phosphates ACP can be formed in situ that often resolves with the natural sclerotic by the sequential application of calcium and obturation of dentin tubules. A method of rapidly phosphate solutions. In this clinical study, 30 forming calcium phosphate compounds within patients with reported dentin hypersensitivity these tubules can mimic sclerosis and lead to were randomly assigned to parallel treatment or placebo groups.
However, the ACP treatment ; e-mail: frederick. Eichmiller nist. The change in sensi- mum of two sensitive teeth in a minimum of two differ- tivity was much more apparent using the air ent quadrants. All subjects exhibited good dental care stimulus than the tactile stimulus.
These results and had their last oral hygiene treatment within the show that topical placement of ACP can rapidly last six months. Patients were randomly assigned to a reduce dentin hypersensitivity.
No hazards or The clinical condition of dentin hypersensitivity is a sig- deleterious side effects were observed in previous stud- nificant problem in the adult population. Gingival ies of this material and none were anticipated in this recessions, root surface debridement or periodontal sur- study. The Helsinki Committee of Tel-Aviv University gical procedures often cause the exposure of orifices of approved the study. Each subject signed a consent form the dentin tubules at the root surface.
The treatments mentioned above generally 1. Many treatments are not compatible with ongoing den- sequentially applied: Solution PA containing 1.
For both the experimental and control treatments, the two Calcium phosphate minerals are the main inorganic solutions were applied successively over the root sur- constituents of dentin, and mineral rich deposits faces of each quadrant using a cotton pellet saturated obstruct tubule orifices in the physiological process of with the solution and rubbing the material on the sen- dentin sclerosis Frank, A method of mimicking sitive tooth surface for five seconds.
Cotton rolls were this natural process may provide an effective clinical used to isolate the treatment area. After rubbing, the treatment for dentin hypersensitivity. Of the available solutions stayed undisturbed on the tooth surface for 60 calcium phosphate compounds, amorphous calcium seconds.
The patients were then asked not to rinse, eat phosphate ACP has the highest rate of formation and or drink for 30 minutes after treatment.
The treatment dissolution under physiologic oral conditions. This com- was repeated at 7- and day recalls, for a total of pound is also capable of rapid conversion into hydrox- three treatments. Both the ACP and placebo solutions yapatite crystals under these same conditions, which were coded and were unknown to the patient or the can precipitate in the lumen of open dentinal tubules examiner during the experiment.
Previous research by Tung and Sensitivity Test others established the concentrations and mode The level of sensitivity was evaluated at the initial visit of application for clinically applying ACP as a topical and at recalls after one week seven days , four weeks desensitizer, and preliminary clinical investigations 28 days and six months days.
At the 7- and indicated that this might provide an efficient treatment day recalls, sensitivity measurements were made prior for dentin hypersensitivity. This study clinically to re-treatment. No treatment was delivered at the assessed the effect of topical application of ACP forming day recall. The patient was asked to define the degree calcium phosphate solutions on dentin hypersensitivity. The results were coded and recorded for further statistical clinical history of all the candidates was documented, analysis.
Tactile sensitivity was evaluated by meas- and those suffering any illness or allergies or those uring the response to the contact of an explorer over the receiving any kind of medication were excluded. Each tooth was isolated during measurement by whether significant correlations could be found placing cotton rolls over the adjacent teeth.
Standard Deviations SD whether previous periodontal surgery was done; were calculated for all analyses. The statistical analysis whether a six month recall had been completed; and was performed using the SPSS program. No significant correlations were found, indicating that the patients were fairly bal- anced over the study groups. Applying ACP to the root surfaces resulted in a rapid decrease in air sensitivity. Within seven days after treatment, air sensitivity was reduced from the initial mean value of Examination of these same patients three weeks later revealed a further decrease in sensitivity, reaching val- ues of The con- trol treatment, where no significant change was noted from Figure 1.
The visual analog means and standard deviations for air sensitiv- Examination of tactile sensitivity Figure 2 revealed ity measurements made at 1, 7, 28 and days. The standard deviation is a slower reduction in sensitivity after applying ACP given as the estimated standard uncertainty of the mean for these meas- from The control group showed a nearly parallel reduction, but with a higher sensitivity starting value at the initial measurement Figure 2.
Figure 2. The visual analog means and standard deviations for tactile sen- Most current strategies for treating dentin hypersensi- sitivity measurements made at 1, 7, 28 and days. The standard devia- tivity are by occlusion of tubular orifices at the tooth tion is given as the estimated standard uncertainty of the mean for these surface.
In order to create an efficient, long lasting seal, measurements. Combe and Douglas pro- application of calcium and phosphate-containing solu- posed that developing a biomimetic material that is tions that can form amorphous calcium phosphate in structurally similar to the dental hard tissue could pos- situ will more rapidly and more effectively reduce sibly provide a solution for treating dentin hypersensi- dentin hypersensitivity than a placebo treatment.
Tung and others has postulated that since calcium phosphate is the main inorganic component of the tooth, calcium phosphate minerals are ideal candi- Acknowledgements dates for the obstruction of dentinal tubules. Tung and Certain commercial materials and equipment are identified in others have also shown that calcium phosphate this paper to specify the experimental procedure. In this study, the effectiveness of ACP was evaluated clinically as a possible therapeutic agent for the treat- ment of dentin hypersensitivity.
The results demon- strated an immediate relief of sensitivity tactile and air Received 21 November stimulation after topical application of ACP. The allevi- ation was noted after 7 and 28 days, with further reduc- tion in sensitivity after each repeated treatment. Beyond 28 days, the effect leveled off, and at days, References the difference between ACP and the placebo treatment was less notable. Alleviating sen- 1 4 A possible Dental Update 25 9 Immediate contact of the explorer at Lukomsky EH Fluorine therapy for exposed dentin and the surface causes a pressure that is exerted on the alveolar atrophy Journal of Dental Research 20 It is also difficult to sodium fluoride on tooth hypersensitivity with and without ion- precisely stimulate the same area of the tooth from one tophoresis Journal of Periodontology 55 5 Tung and others also reported greater Dentistry 12 2 No prior Comparison of in vivo vs in vitro bonding of composite resin to surface conditioning was used other than normal the dentin of canine teeth Journal of Dental Research 67 2 brushing and flossing.
The solutions were easily placed The precipita- Clinics of North America 34 3 Clinics of North America 34 3 Laboratory Research. Clinical Relevance Fracture resistance of teeth weakened with MOD preparations was only obtained with hybrid composite, packable composite and ormocer restorations, and it was determined to be similar to intact, unprepared teeth when compared to bonded amalgam restora- tions.
The means of force required to frac- This study compared the cuspal fracture resist- ture the teeth in each of the five groups was ana- ance of posterior teeth restored with four differ- lyzed using one-way ANOVA and Tukey Test. Fifty sound, maxillary The difference between the mean cuspal frac- human premolars were randomly divided into a ture resistance of the unprepared control teeth control group and four experimental groups with and those restored with amalgam groups was 10 teeth in each.
No were intact teeth that were tested as unpre- significant differences in resistance to cuspal pared. The use of adhesive materials to reinforce weakened Currently, there is no report in the literature that teeth was first proposed by Denehy and Torney in This study determined whether using a hybrid com- However, the use of traditional direct composites as a posite resin, a packable composite resin, an ormocer substitute for amalgam in restorating posterior teeth and a bonded amalgam restoration could increase the has been problematic Leinfelder, Stress-bearing fracture resistance of posterior teeth with MOD cavity posterior areas have poor wear resistance when com- preparations.
Those with from the cavity wall when a placement instrument is apparent cracks were excluded from the study. Teeth of withdrawn. Fifty Recently, several manufacturers have introduced sound, maxillary premolars were selected and included. The roots of the teeth were They are mainly characterized as having less stickiness embedded in acrylic resin to 2 mm below the cementum or higher viscosity compared to traditional composites.
An application technique similar the load during testing. The teeth were randomly divided to the manipulation of amalgam can be used for the into five groups. One group served as the intact control placement. These materials were expected to exhibit Group 1 and the remaining four groups were prepared superior physical and mechanical properties in addition and restored in the following manner.
Tooth Preparation Ormocer, another tooth-colored restorative material, has arisen from the progressive development of materi- Standardized MOD cavity preparations were made in als.
A new bur was ormocer composites as the dental restorative materials employed for each five teeth. The floor of the approximal boxes application with Filtek Z A metal matrix band was was maintained at 1 mm above the cementoenamel placed in a Tofflemire matrix retainer Union Brocach junction and the gingival seat width was 1. The composites were then placed incrementally. The proximal boxes were filled in three layers and the Tooth Restorations occlusal boxes in two. Each layer was polymerized for 20 seconds using a visible light-curing unit Hilux Expert, Table 1 lists the restorative materials tested.
Care was taken to keep the depth of Group I: Unprepared, intact teeth Control. Then, the matrix band was removed. The preparation was rinsed with water spray, fol- had been cured adequately, each restoration was cured lowed by slightly drying the cavities. Then, the with a brush to the enamel and dentin walls and left to restoration surface was finished and polished sequen- diffuse through the conditioned substrate for 20 sec- tially with a finishing diamond, gray politip finisher sil- onds.
After 20 seconds, the teeth were dried and a sec- icon rubber and green politip-polisher silicon rubber ond coat of single component was applied and immedi- Vivadent-Liechtenstein in a low-speed handpiece. One Intact Teeth The hybrid composite teeth were dried and light cured for 10 sec- Restored with The same procedure was repeated twice packable composite more.
Definite was placed and cured in the Restored with ormocer Compressive loading using steel rods, Figure 2. Illustrative graphic of mean and standard deviations for the fracture resistance test. Figure 3. Fracture at the interfacial area Figure 4. Fracture at the interfacial area Figure 5. Bulk fracture of restorative materials.
Occsionally, a small fragment of resin compos- ite was found attached to the tooth. The same investigator performed all restorative procedures throughout the study. The instrument developed by Blaser and others and Joynt and others appears to provide precision in loading the specimen and, with modifi- cation, it was used as a model for this Figure 6.
Fracture involving only tooth struc- Figure 7. Fracture involving the tooth structure investigation. Two metal rods, each ture. A bidirectional joint was well, applied to the enamel and dentin walls for 30 sec- also added to the shaft between the crosshead and the onds and rinsed and air dried.
Three drops of base, one metal rods to allow for appropriate adjustment to the drop of catalyst and one scoop of HPA High various occlusal surfaces. The use of two rods instead of Performance Additive were dispensed into a mixing one assured contact with tooth structure alone without well and gently stirred. The mixture was applied in a loading the restorative material during the test proce- thin layer to the cavity walls.
Each tooth was restored dure Figure 1. The specimens were placed on a foam immediatelly following adhesive application with a cushion on the Instron platen, which permitted even spherical lathe-cut amalgam A metal matrix band was seating of the load. The teeth were preloaded to a max- placed in the same way as the other restorations.
The plastic amalgam was times before testing to failure. The preloading proce- hand condensed into the cavity while the adhesive liner dure was introduced to simulate intraoral forces and was still wet. The teeth were then tested to failure at a speed of 5 of teeth using five adhesive systems.
Fractured tooth and restoration sur- than the unprepared group. Table 2 and Figure 2. The Tukey multiple com- restorations has generally been accepted. This suggests parison tests showed that there were no statistically that in teeth that are etched, bonded and restored with significant differences among the means of the unpre- resin composite, the cusps are mechanically splinted pared group and the group restored with hybrid com- together.
The reaction of these teeth to a load was simi- posite, packable composite and ormocer. Also, no statis- lar to the reaction of unprepared teeth. However, statistically sig- hybrid composite, packable composite and ormocer nificant differences were noted between the restored materials were not statistically significant compared to group with amalgam and the unrestored control group the unprepared control group.
Occasionally, small frag- In this study, the Tukey multiple comparison tests ments of resin composite were found attached to the revealed no significant differences between the restora- tooth Figure 3. The amalgam group showed lower cuspal fracture resistance compared to all the other between the tooth and the restorations were found in a groups. However, this difference was not statistically small number of ormocer and amalgam specimens significant.
Also, the unprepared group showed higher Figure 4 compared to hybrid and packable composite cuspal fracture resistance than the teeth restored with specimens. Fewer fractures were observed in all tion were restored with hybrid composite, packable com- restored groups that involved only the tooth structure posite, ormocer and bonded amalgam.
The data showed Figure 6 and also involved tooth structure and that the fracture resistance of teeth restored with etched restoration Figure 7. Static loading of the amalgam restoration, irre- amalgam.
Composites, therefore, may transmit less of versible deformation and crack propagation risk on the the applied load to the underlying tooth structure. Several in vitro studies have reported that weakened teeth restored with resin composite and teeth restored with amalgam bonded to etched enamel placed with a bulk and an incremental technique that with resin cement have a significantly greater fracture may reduce the effects of polymerization shrinkage.
In fracture than posterior resin placed with a bulk tech- this study, intact teeth had a significantly greater frac- nique. Since polymerization contraction stresses of the ture resistance than teeth restored with amalgam using packable composite and ormocer materials were higher Amalgam Bond Plus. These findings of failure were sim- posite resins Dental Materials 17 3 For ormocer and through micromechanical bonding Journal of Prosthetic amalgam, the number of fractures seen in the tooth and Dentistry 36 2 Fracture resistance of teeth restored with the bonded amalgam technique Operative Dentistry 26 5 In view of the reinforcing ability of all the tooth-colored Eakle WS a Fracture resistance of teeth restored with restorative materials hybrid, packable, ormocer stud- Class II bonded composite resin Journal of Dental Research ied, it is suggested that where cavity cusp width is one- 65 2 A statistically significant difference was found strates Dental in Japan 36 FDI Commission Project restored with bonded amalgam.
International Dental Journal 48 1 Review. Differences among the unprepared teeth and Effects of composite restorations on resistance to cuspal frac- those restored with hybrid composite, packable ture in posterior teeth Journal of Prosthetic Dentistry 57 4 composite and ormocer were not statistically Journal of Dentistry 13 Journal 12 Operative Dentistry 21 3 Prosthetic Dentistry 61 2 Clinical Relevance Significant variations in radiopacity values were found among esthetic restorative mate- rials when compared to enamel.
All materials except for the microfilled resin composite Filtek A had radiopacity values greater than dentin. The results showed statisti- materials with reference to an aluminum step cally significant differences among materials. A total of samples measuring 6 and was higher than enamel. All materials except mm in diameter and 1 mm in thickness, with for the microfilled resin composite Filtek A eight samples of each material, were prepared had radiopacity values greater than dentin and from restorative materials.
Enamel and dentin possessed sufficient radiopacity to meet ISO samples 1-mm thick were also prepared by longi- standard. Significant differences were found tudinally sectioning eight extracted human per- among materials of the same composition when manent molars using a microslicing machine. Up-to-date The optical density values of the specimens were resin composites and glass ionomer cements may be used to determine the aluminum thickness equiv- the most refined materials, as new versions are rou- tinely being developed.
Of these, radiopacity is a valuable property that Although many new esthetic restorative materials allows the clinician to assess the adequacy of restora- have been introduced to the dental market, there have tions, distinguish secondary caries and evaluate mar- been only a few recent studies regarding their ginal adaptation, voids and interfacial gaps.
This study, therefore, determined the proximal contours, contacts and overhangs and serves radiopacity values of esthetic restorative materials an important role in detecting aspirated or dislocated and compared them to enamel and dentin. Table 1 lists the 21 esthetic restorative materials used According to the International Standards in this study. All samples were polished using , , and one tooth section. Enamel and an aluminum step wedge This step wedge was used to enable accurate correlation of the optical density of the images of the speci- mens to that of the aluminum step wedge.
Films were exposed for 0. Optical densities of aluminum step wedge. A min- imum of four readings was Dyract AP 1. A Compoglass F 1. Filtek Z 1. Heliomolar Flow 1.
Pyramid Dentin 1. Marginal defects and secondary caries materials. One-way analysis of variance ANOVA are usually located on the gingival part of Class II indicated significant differences both for the optical restorations.
Heliomolar RO had a radiopacity value 2. A radiograph of all the tested materials along with a tooth section and the aluminum A had radiopacity values 1. All materials except Filtek A 0. Figure 3 shows the bar chart repre- sentation of optical densities and Figure 4 shows the aluminum thick- ness equivalents of all tested materi- als with enamel and dentin.
Heliomolar RO. Solitaire 2. Enamel Vitremer. Heliomolar Flow. Filtek Z Pyramid Dentin. F Ariston pHc. Compoglass F Dentin. Chem Flex Syringeable. P Filtek. Adequate radiopacity has been considered a prerequisite for diagno- sis of secondary caries and marginal defects since it facilitates evaluating.
Bar chart representation of optical density values of all materials. Whether a restorative mate- for posterior restorative materials. It has been recom- ground of enamel and dentin since the contrast facili- mended that the radiopacity of resin composites tates the evaluation of restorations in every region of should be equal to or greater than enamel Van Dijken, the mouth.
Of the Materials with a radiopacity less than enamel microfilled resin composites, Heliomolar RO had a were reported not to be suitable for use, especially as radiopacity greater than enamel. In this study, there was considerable variation in the In addition to being used in permanent dentition, radiopacity values of esthetic posterior restorative glass ionomer cements and hybrid versions have materials. Syringeable, and the polyacid-modified resin compos- The popular materials for posterior esthetic restora- ites, Dyract AP, Compoglass F and F, had a tions, the packable resin composites, also showed dif- radiopacity higher than enamel but the resin-modified ferent radiopacity values.
Of the five packable compos- glass ionomer cement Vitremer had a lower radiopacity. Pyramid Dentin, Pyramid Enamel and Solitaire 2 had It was suggested that in order to fulfill clinical lower values than enamel. The marginal defects. Heliomolar Flow, the flowable com- posite used in the study, was higher in radiopacity compared to enamel, but in contrast, Composan LCM Flow was lower. The radiopacity of a resin depends on selection of the polymer matrix, chemical nature of Solitaire 2 Ariston pHc Chem Flex Condensable.
Composan LCM. TPH Spectrum. Pyramid Enamel. Filtek A F This resulted in considerable varia- tions in radiopacity values of the restorative materials used in the study. Bar chart representation of aluminum thickness equivalents of all materials. A caries lesion near the buccal or lingual resin composite Filtek A were found to have margin of a Class II restoration may be masked by a radiopacity values greater than dentin and possessed highly radiopaque restorative material.
Moderate sufficient radiopacity standards of ISO This found among materials when compared to enamel. Prosthetic Dentistry 70 4 Although Akerboom and light-cured posterior composite resin: Results of a 3-year clini- others suggested using human teeth as a stan- cal evaluation Journal of the American Dental Association dard, they reported that variations in radiopacity of 5 Association 81 4 It was reported that variability in radiopacity values Cook WD An investigation of the radiopacity of composite restorative materials Australian Dental Journal 26 2 Clinical Relevance With respect to the adhesion properties of carbon fiber posts and glass fiber posts used in the restoration of endodontically-treated teeth, they perform equally well if used in combination with chemically cured luting cements or with light activated ones.
The post is Fiber posts are widely used in the restoration of cemented inside the root canal using low mod- endodontically treated teeth. Scientific evidence ulus elastic polymer resins. In this study, the demonstrates that the mechanical performance mechanical resistance of four different post- of teeth restored with fiber posts in combination cement systems was assessed by means of a with resin luting cements is improved with micro-mechanical pull-out test assisted by a sim- ulation using the finite element methodology.
The post is cemented inside the root canal and the Luigi Ambrosio, full professor, Institute of Composite Materials Technology, National Research Council and Interdisciplinary core is retained by an apical extension of the post.
The use of post and core restoration will Luigi Nicolais, full professor, Institute of Composite Materials continue to increase because of the current trend to pre- Technology, National Research Council and Interdisciplinary serve natural tooth structure in the mature years of life Research Center in Biomaterials CRIB, University of Naples, Christensen, Fiber posts are generally used with low modulus resin The stress distribution in the cement layer was studied cements in combination with dentin adhesive systems.
Four different combinations of mechanical viewpoint, the post acts as a bypass, con- fiber post—luting cement were used: carbon fiber posts centrating the chewing stresses at the root tip. Carbon fiber posts were initially used in combination with low modulus chemically cured luting cements. Biomaterials research introduced new materials for post manufacturing, for example, E-glass or quartz fiber embedded in transparent epoxy-resin matrix, to be used with newly developed light cured luting cements.
The mechanical properties of fiber posts and data on adhesive retention strength of cemented fiber posts in root canals are widely reported in the scientific litera- ture. However, little information is available regarding the interface between the fiber post and the resin lut- ing cement. In fact, the direct measurement of the bond strength between the fiber posts and cement has been Figure 1. Mechanical pull-out test set-up. This Table 1 shows the average recorded maximum load and was done in order to investigate whether the adhesion the average bond shear strength for each post-cement properties were improved by photopolymerization.
During the that the load increases quasi-linearly, then levels up, preparation, all samples were stored for no more than reaching the ultimate load F before drastically dropping 24 hours in an isotonic 0.
Coupled ANOVA statistical analysis suggests that there are no Teflon molds were used to keep each fiber post coaxial significant differences among samples at a probability with the dentin hole during the curing of the cement, level of 0.
In the first case, the upper surface of layer the part in contact with the steel frame, see the dentin was constrained, while the cement was free Figure 1. The axial- the other systems being very similar. Since the state of symmetry of the geometry led to the development of a stress in the relevant parts of the cement is generally two-dimensional model that was solved using the pack- three-dimensional, the FEM analysis produced graphs age ANSYS 5.
The The pull-out tests were performed with an INSTRON distributions of the von Mises equivalent stresses in the testing machine and the pulling load was cement layer for each of the four post-cement systems increased at a cross-head speed of 2. The axial displacement of the check for the locations where critical stress values were post was monitored using an INSTRON extensometer reached and are shown in Figure 4.
As can be seen, the positioned between the dentin slice and the post-cement interface the left side of each distribution post Figure 1. The load and the extensometer dis- is more loaded by about a factor of 2 than the dentin- placement were acquired at a sampling rate of 10 points cement interface the right side of each distribution.
Ultimate strength The manufacturers provided all the N St dev 78 70 84 68 relevant data concerning the posts and Ultimate shear stress MPa St dev 6. The axial load-axial displacement graph obtained from the FEM analysis is shown in Figure 2, where it can be compared with the experimental data. Thus, regarding the mechanical integrity of the restored tooth, Figure 2.
The left and right side of each distribution represent the post-cement and the cement-dentin interfaces, respectively. The upper part of each distribution is the region of the cement that is in contact with the stainless steel frame, as represented in Figure 1.
As retention properties are essential from a clinical The mechanical tests demonstrated that all the vari- perspective, it is important to study the properties of ous systems withstood loads up to N, suggesting the interfaces involved in the restoration.
The differences cement and another between the cement and the among the various post-cement combinations were not dentin substrate. Moreover, as it is well stress distribution within the luting cement layer. The shear stress calculated using are higher. In the case of fiber post restorations, the equation 1 is an average value obtained, assuming highest differences are between the post and the luting that the shear stress distribution within the cement cement; thus, it is particularly important to investi- layer is uniform.
This value is basically equal to the average shear stress calculated using equation 1. The left side and the right side of each distribution represent the post-cement and the cement-dentin interfaces respectively. The upper part of each dis- tribution is the region of the cement that is in contact with the stainless steel frame, as represented in Figure 1. Acknowledgements Thus, it can be concluded that using equation 1 leads to a gross underestimation of the maximum shear The financial support of POP Regione Campania Azione 5.
The authors also mechanical reliability of this interface in the fiber post acknowledge Mr Antonio Maggio for matching the specimens and restorations. Dr Fulvio Anselmi of Cabon-Denit Spa for supplying technical The non-uniform stress distribution obtained with information. FEM suggests that the post-luting cement system likely fails when a crack starts on the upper part of the Received 16 August cement layer Figure 1 and propagates downward along the post-cement interface.
The difference This is consis- tion modalities in structurally compromised premolars tent with the clinical observation of post debonding International Journal of Prosthodontics 8 3 Further Microtensile bond strength and confocal microscopy of dental studies should focus on the influence of these factors adhesives bonded to root canal dentin American Journal of on the strength of the fiber post cement interface.
Dentistry 14 4 Prosthetic Dentistry 78 1 Clinical Relevance Dentin surface topography created by various bur designs may influence the surface sealing quality of resin bonding agents and, therefore, affect post-operative sensitivity and microleakage associated with composite bonding procedures. Dentin bonding agents do not appear to routinely seal the pulpal wall before application of resin composite and creation of polymerization shrinkage stress.
A flow system was established through This study investigated the effects of bur cutting the pulp chamber and gravity pressurized phos- surface roughness and bonding systems on phate buffered saline PBS was forced into the dentin permeability.
Burs were used to prepare flat sur- sively serrated bur were utilized with two differ- faces in dentin, and after etching with phos- ent bonding systems. After applying the dentin bonding the permeability of dentin sealing after applica- agents, fluid flow from the pulp chamber into tion of bonding agents. This study incorporated a dentin was again measured. The percentage of fluid flow model for measuring dentin permeabil- reduction in permeability following bonding ity. Seventy caries-free extracted molars were agent application was then calculated.
The specimens were straight-edged bur. No significant differences were mounted to plexiglass plates using cyanoacrylate detected between bonding systems and no combi- nation of surface topography or bonding agent Tanya Vaysman, year IV dental student, UMDNJ New Jersey completely sealed the surface.
D, professor and chair, Biomaterials ciated with postoperative sensitivity. Causes of The cynaoacrylate cement was applied to the milled post-operative sensitivity after bonding procedures apical portion of the cut crown segment, taking care include incomplete caries removal, desiccation of tooth not to introduce any cement into the root canal cham- structure by over-drying, over-etching the dentin, bac- ber.
A flow system was established using two gauge terial contamination, improper restorative placement, hollow stainless steel cylinders connected through the incomplete polymerization and occlusal interferences pulp chamber.
The specimens were coated with a thin Hornbrook, This fluid is a filtrate of plasma tions. While there is provide intrapulpal pressure to tooth specimen. Eick and others Hume, Other of bonding resins is the surface topography of the pre- investigators have reported that intrapulpal pressure pared dentin and that a roughened surface creates a is known to vary in magnitude, is significantly higher greater surface area.
The left side of the circuit consisted of This study compared the effects of dentin surface the fluid reservoir joined to the specimen with roughness on dentin permeability using a fluid flow gauge polyurethane tubing.
As men- to the prepared dentin surface. A millimeter ruler tioned above, incomplete sealing of dentin tubules by approximated to the polyurethane tubing allowed for the bonding system has been implicated in the etiology visual measurements of air bubble travel. They were then stored in a phosphate buffered saline solution PBS until used for sample preparation. The specimens were sectioned 2 mm apical to the CEJ using a high-speed handpiece with copi- ous water.
The specimens were mounted with cyano- acrylate cement to 50 x 50 mm plexiglass plates. Schematic diagram of fluid flow apparatus. The connections were examined to ensure a surface. The thin layer of cyanoacrylate cement sealed fluid system and minimize visible leaks. After the equilibration agents. The flow through establish a baseline sealed measurement.
This allowed the etched surface was recorded over 15 minutes to each tooth to act as its own control. A flat surface was establish initial dentin permeability of the crown seg- then prepared on the dentin at a depth of 1.
Based on this initial dentin permeability, speci- half the cutting length of a carbide bur from the mens were assigned to each of the six experimental central fossa using a diamond bur on a high-speed groups so that each group received a variety of initial handpiece.
The bur was held perpendicular to the long dentin permeabilities. The flow was measured over 15 minutes and recorded as the etched system measure- ment. After establishing the etched system permeability, the pressure in the fluid reservoir was reduced to zero to avoid moisture contamination during the bonding pro- cedure.
Photographs of burs used in the study. All sam- ples were stored in an air-tight, moist environment before and after the testing procedure. Removing these samples necessitated having unequal samples groups.
The remaining specimen distribution is shown in Table 2. Post-hoc t-tests were used to compare groups where a significant omnibus f-test was found. Experiment-wise error rates were controlled in these post-hoc tests by means of Tukey HSD pro- cedure Kirk, For scanning electron microscopy SEM , the spec- imens were removed from their plexiglass plates and the undersurfaces were further milled to facili- tate placement in the SEM chamber.
The samples were mounted on stainless steel studs and vacuum desiccated for approximately four days, then carbon coated. Measuring dentin permeabilites in this extracted tooth model yielded significant variability. Typical permeabilities of etched open tubules ranged from 0. Once the etched dentin was bonded with DBA, typical permeabilities ranged between zero and 0. Using the formula described above, mean PPD values ranged from a low of Post-hoc t-tests showed that the average PPD for both serrated type burs was signifi- cantly more effective than the straight fissure bur, therefore, indicating that samples prepared with the Figure 4a.
Fissure bur FB. Figure 4b. Cross-cut bur CC. Figure 4c. Extensively serrated bur ES. Bonded samples with lower PPD measurements were considered to have areas of unsealed etched dentin, causing localized fluid flow of the PBS solu- tion.
Specimens with initial etched permeability less than 2. Very high initial flow volumes were thought to result from microcracks or from limited dentin thickness in specimens pre- Figure 5. Specimens producing very low etched permeability, baseline flow 2. Since shallow restorations to higher values with increased serration was evident, exhibit little post-operative sensitivity, this elimi- the cross-cut fissure bur was not different from the nation was thought to be inconsequential to the extensively serrated bur.
The effect of the two bonding outcome of the study. No interaction between bur and bonding sys- pressure was introduced at a pressure significantly tem was detected. In addition, no group exhibited higher than what exists in a healthy tooth. SEM observation revealed a relatively post-operatively sensitive tooth , the authors felt that smooth surface with limited surface roughness when a creating an increased pressure environment may more fissure bur was employed as depicted in Figure 4a.
It has been Cross-cut serrated burs created serrations and shown that polymerization shrinkage of resin compos- grooves that appeared uniform and widely separated ites during direct placement causes dimensional strains Figure 4b. A higher magnifi- as gaps at the tooth-restorative material interface due cation SEM examination of the extensively serrated to the separation of the resin-bonding agent from the surface revealed orientation of the grooves, peaks and underlying dentin, especially along the pulpal wall.
The valleys in the dentin, and patent dentin tubules volume of these internal gaps has been reported to be as Figure 5. Carvalho and others reported these poly- Examination of the dentin prepared with cross-cut merization stresses and resulting strain are expected serrated burs followed by application of Clearfil SE in Class I preparations where there is a high ratio of Bond revealed that the bonding agent covered the bonded to unbonded surfaces high C-factor peaks and valleys created by the bur.
In addition, bonds to the appeared uniform with some irregularities Figure pulpal floor are often lower because deep dentin is 6a. The presence of these gaps, regardless of the from the underlying dentin, especially in the region of bonding agent polymerization method or whether flow- irregularities.
This resulted in separation of polymer- able or heavily filled resin composite formulations were ized resin tags and exposed dentin tubules Figure employed, was recently demonstrated in Class I dentin 6b. One pos- sible explanation is that increased surface area on the dentin allows for a better infiltration of the bonding resins.
In addition, the bur-cre- ated surface topogra- phy, if extended to the pulpal wall prepara- tion, may help to with- stand the polymeriza- Figure 6a. Arrow points to micro-cracks in bonded resin Figure 6b. SEM image of a micro-crack. Arrow points to a tion shrinkage stress layer. Resin bond- The results of this study indicate that if a uniform ing agents have a dual role when used under resin com- roughness could be created on the pulpal floor of cavity posites.
First, they provide micro-retention, primarily preparations, the initial sealing capability of existing through the peritubular dentin, for bonding to the com- bonding resins may be improved. In clinical practice, posite restorative. Therefore, an pulpal floor topography playing a role in improving ideal resin bonding agent should provide effective per- dentin bonding agent sealing ability.
While many pro- itubular bonding to facilitate retention of the composite cedures and techniques have been proposed to improve and complete sealing of the dentinal tubules to prevent bonding procedures, cavity surface topography is gen- permeability of dentinal fluid that may cause post-oper- erally not considered.
As a result of this study, future ative sensitivity. In clinical practice, amalgam restorations are seldom associated with post-operative sensitivity. The authors thank Malvin Janal, PhD for his assistance in sta- The results of this study indicated that samples pre- tistics and Elizabeth Clark, MS, for her technical assistance.
Operative Dentistry 12 3 Journal of Dentistry 11 5 Dentin permeability: Effects of cavity varnishes and liners Analysis of sealing vs tensile bond strength of eight adhesive Journal of Prosthetic Dentistry 53 Clinical Relevance The effect of food-simulating liquids on the shear strength of resin-based filling mate- rials was product dependent. Composites based on BisEMA may be more resistant to degradation by alcohol.
After conditioning, the speci- [EX], Dentsply , a conventional Compoglass [CG], mens were restrained within the test apparatus Vivadent and a posterior polyacid-modified and subjected to shear punch strength testing Dyract Posterior [DP], Dentsply composite. All materials with the excep- Dentistry, National University of Singapore, Republic of tion of EX were significantly weakened by Singapore ethanol solution.
Composites may be defined as three-dimen- strength values, while glass ionomers and polycarboxy- sional combinations of at least two chemically different late provided the lowest. Polyacid-modified composite materials with a distinct interface Phillips, This and coloring pigments. Polyacid-modified composites or study investigated the effects of food-simulating liquids compomers are resin composites that contain either or on the shear-punch strength of composites and poly- both of the essential components of glass ionomer acid-modified composites, including a recently intro- cements but at a level insufficient to promote acid-base duced posterior polyacid-modified composite material.
Composites are recommended for restoring all ious mediums was also performed. Konstanz, Germany , a conventional Compoglass Composites, conventional and resin-modified glass [CG], Vivadent and a posterior polyacid-modified ionomer cements are all susceptible to various modes of Dyract Posterior [DP], Dentsply composite were chemical degradation in vitro. Reduction in hardness, selected for the study.
Table 1 shows the technical pro- wear, fracture toughness and flexural strength had been files of the materials and their manufacturers. All reported after exposure to various food-simulating liq- materials were of the A2 shade. In an in vivo situation, it can be assumed that by glass slides. A second glass slide was placed on top saliva, food components and beverages can degrade and of the washers and gentle pressure was applied to age dental restorations.
Wu and others reported extrude excess material. The mean intensity of the light degradation of these materials. Thirty-two dental restorations. Although the effects of food-simulat- specimens of each material were made and randomly ing liquids on composites had been widely investigated, divided into four groups of eight.
Dental amalgams At the end of the conditioning period, the shear ISO and water-based cement ISO are punch strength of the materials was assessed. A special evaluated using a compression test, while resin-based shear punch apparatus was designed and fabricated in filling materials ISO and light-activated water- collaboration with Instron, Singapore. The apparatus based cements ISO are evaluated using a flexural Figure 1 allowed for restraining the specimens during test.
A single standard test for all dental restorative testing, self-location of the specimens and testing in a materials is desirable. The shear punch test has previ- thermally-controlled liquid environment. The shear strength of TC to fracture the test specimens.
The thickness of each and CG were significantly reduced after conditioning in specimen was measured with a digital vernier calliper ethanol solution. For DP, a significant increase in shear prior to placement in the shear punch apparatus. The strength was observed after conditioning in water. The specimens tioning in water. No significant difference in shear were subsequently restrained by tightening the screw strength was observed between Group 1 air and Group clamp on top of the specimens.
An M2 tool steel punch 3 ethanol solution specimens for DP. For EX, no signif- with a flat end 3. A small disc from the center of each The shear strengths of EX, TC and CG were signifi- specimen was punched out and the maximum load cantly greater than DP after conditioning in air Group recorded. Shear strength was then computed using the 1. In addition, EX was significantly stronger than TC. All statistical analysis was carried out at significance level 0.
Results of the statistical analyses are shown in Tables 3 and 4. The effect of conditioning mediums on shear strength was Figure 1. Diagrammatic representation of the shear punch apparatus. The shear strength of study the effects of solvent and environmental degra- EX was also significantly greater than CG after condi- dation on material properties in dental research tioning in ethanol solution. Heptane simulates butter, fatty the simplicity of specimen preparation.
Results of flex- meats and vegetable oils, while the ethanol solution ural, diametral and compression testing are highly simulates certain beverages, including alcohol, vegeta- dependent on the production of high quality specimens.
The by saliva and water. The solubility parameters for these quality of the edges of the disc around the circumfer- organic food simulating liquids were 1.
The only requirement is and water, respectively. They hypothesized that unrestrained specimens are able to bend on application of the punch, creating localized stress concentration that leads to prema- ture failure. Although a cm kg increase in screw clamp torque resulted in an increase in shear Shear Strength MPa.
Tetric Ceram Esthet X strength, the increase was not sta- 80 Compoglass tistically significant. The punch Dyract Posterior diameter 3. The shear punch apparatus used in 0 this experiment gave highly repro- Air Distilled Water Ethanol Solution Heptane Conditioning Mediums ducible results, and the standard deviations observed were generally Figure 2. Mean shear strength of the materials.
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Props go out to Weston Ruter and his team of dedicated developers who helped make this feature a reality. Instead, the team opted to generalize this functionality so that any feature utilizing the customizer controls can do partial preview updates. Widgets still get live previews, but the window will refresh in an unobtrustve way as you make changes.
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