Mechanical fatigue degradation of ceramics versus resin composites for dental restorations.

PubMed

Belli, Renan; Geinzer, Eva; Muschweck, Anna; Petschelt, Anselm; Lohbauer, Ulrich

2014-04-01

For posterior partial restorations an overlap of indication exists where either ceramic or resin-based composite materials can be successfully applied. The aim of this study was to compare the fatigue resistance of modern dental ceramic materials versus dental resin composites in order to address such conflicts. Bar specimens of five ceramic materials and resin composites were produced according to ISO 4049 and stored for 14 days in distilled water at 37°C. The following ceramic materials were selected for testing: a high-strength zirconium dioxide (e.max ZirCAD, Ivoclar), a machinable lithium disilicate (e.max CAD, Ivoclar), a pressable lithium disilicate ceramic (e-max Press, Ivoclar), a fluorapatite-based glass-ceramic (e.max Ceram, Ivoclar), and a machinable color-graded feldspathic porcelain (Trilux Forte, Vita). The composite materials selected were: an indirect machinable composite (Lava Ultimate, 3M ESPE) and four direct composites with varying filler nature (Clearfil Majesty Posterior, Kuraray; GrandioSO, Voco; Tetric EvoCeram, Ivoclar-Vivadent; and CeramX Duo, Dentsply). Fifteen specimens were tested in water for initial strength (σin) in 4-point bending. Using the same test set-up, the residual flexural fatigue strength (σff) was determined using the staircase approach after 10(4) cycles at 0.5 Hz (n=25). Weibull parameters σ0 and m were calculated for the σin specimens, whereas the σff and strength loss in percentage were obtained from the fatigue experiment. The zirconium oxide ceramic showed the highest σin and σff (768 and 440 MPa, respectively). Although both lithium disilicate ceramics were similar in the static test, the pressable version showed a significantly higher fatigue resistance after cyclic loading. Both the fluorapatite-based and the feldspathic porcelain showed equivalent initial and cyclic fatigue properties. From the composites, the highest filled direct material Clearfil Majesty Posterior showed superior fatigue performance

Finite element calculation of residual stress in dental restorative material

NASA Astrophysics Data System (ADS)

Grassia, Luigi; D'Amore, Alberto

2012-07-01

A finite element methodology for residual stresses calculation in dental restorative materials is proposed. The material under concern is a multifunctional methacrylate-based composite for dental restorations, activated by visible light. Reaction kinetics, curing shrinkage, and viscoelastic relaxation functions were required as input data on a structural finite element solver. Post cure effects were considered in order to quantify the residual stresses coming out from natural contraction with respect to those debited to the chemical shrinkage. The analysis showed for a given test case that residual stresses frozen in the dental restoration at uniform temperature of 37°C are of the same order of magnitude of the strength of the dental composite material per se.

Fabrication and characterization of biomimetic ceramic/polymer composite materials for dental restoration.

PubMed

Petrini, Morena; Ferrante, Maurizio; Su, Bo

2013-04-01

Conventional dental composites with randomly dispersed inorganic particles within a polymer matrix fail to recapitulate the aligned and anisotropic structure of the dentin and enamel. The aim of the study was to produce a biomimetic composite consisting of a ceramic preform with graded and continuously aligned open pores, infiltrated with epoxy resin. The freeze casting technique was used to obtain the hierarchically structured architecture of the ceramic preforms. Optical and scanning electron microscopy (SEM) and differential thermal analysis and thermogravimetry (TG-DTA) were used to characterize the samples. Three point bending test and compression test were also performed. All analysis confirmed that the biomimetic composite was characterized by a multi-level hierarchical structure along the freezing direction. In the bottom layers close to the cooling plate (up to 2mm thick), a randomly packed ceramic with closed pores were formed, which resulted in incomplete infiltration with resin and resultant poor mechanical propertiesof the composite. Above 2mm, all ceramic samples showed an aligned structure with an increasing lamellae spacing (wavelength) and a decreasing wall thickness. Mechanical tests showed that the properties of the composites made from ceramic preforms above 2mm from cooling plate are similar to those of the dentin. The fabrication processing reported in this work offers a viable route for the fabrication of biomimetic composites, which could be potentially used in a range of dental restorations to compete with the current dental composites and ceramics. Copyright © 2012 Academy of Dental Materials. All rights reserved.

Direct Placement Composite: the Treatment Modality of Choice to Restore the Worn or Eroded Dentition in Primary Dental Care.

PubMed

Milosevic, Alex

2016-08-01

Tooth wear is increasing in severity and prevalence, partly because of an ageing population and partly because of modern lifestyles. Management of the worn dentition with 'full mouth rehabilitation' is outmoded. This clinical paper aims to review the literature on composite restorations and give general dental practitioners the confidence to restore the worn dentition with dental composite. Composite is a versatile and widely available material that can be successfully applied within the existing occlusal vertical dimension (OVD) or at an increased OVD using a Dahl approach. Cases illustrate what is achievable, and clinical tips will help dentists optimise their results.

Bacterial adhesion on direct and indirect dental restorative composite resins: An in vitro study on a natural biofilm.

PubMed

Derchi, Giacomo; Vano, Michele; Barone, Antonio; Covani, Ugo; Diaspro, Alberto; Salerno, Marco

2017-05-01

Both direct and indirect techniques are used for dental restorations. Which technique should be preferred or whether they are equivalent with respect to bacterial adhesion is unclear. The purpose of this in vitro study was to determine the affinity of bacterial biofilm to dental restorative composite resins placed directly and indirectly. Five direct composite resins for restorations (Venus Diamond, Adonis, Optifil, Enamel Plus HRi, Clearfil Majesty Esthetic) and 3 indirect composite resins (Gradia, Estenia, Signum) were selected. The materials were incubated in unstimulated whole saliva for 1 day. The biofilms grown were collected and their bacterial cells counted. In parallel, the composite resin surface morphology was analyzed with atomic force microscopy. Both bacterial cell count and surface topography parameters were subjected to statistical analysis (α=.05). Indirect composite resins showed significantly lower levels than direct composite resins for bacterial cell adhesion, (P<.001). No significant differences were observed within the direct composite resins (P>.05). However, within the indirect composite resins a significantly lower level was found for Gradia than Estenia or Signum (P<.01). A partial correlation was observed between composite resin roughness and bacterial adhesion when the second and particularly the third-order statistical moments of the composite resin height distributions were considered. Indirect dental restorative composite resins were found to be less prone to biofilm adhesion than direct composite resins. A correlation of bacterial adhesion to surface morphology exists that is described by kurtosis; thus, advanced data analysis is required to discover possible insights into the biologic effects of morphology. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Synchrotron-radiation-based X-ray micro-computed tomography reveals dental bur debris under dental composite restorations.

PubMed

Hedayat, Assem; Nagy, Nicole; Packota, Garnet; Monteith, Judy; Allen, Darcy; Wysokinski, Tomasz; Zhu, Ning

2016-05-01

Dental burs are used extensively in dentistry to mechanically prepare tooth structures for restorations (fillings), yet little has been reported on the bur debris left behind in the teeth, and whether it poses potential health risks to patients. Here it is aimed to image dental bur debris under dental fillings, and allude to the potential health hazards that can be caused by this debris when left in direct contact with the biological surroundings, specifically when the debris is made of a non-biocompatible material. Non-destructive micro-computed tomography using the BioMedical Imaging & Therapy facility 05ID-2 beamline at the Canadian Light Source was pursued at 50 keV and at a pixel size of 4 µm to image dental bur fragments under a composite resin dental filling. The bur's cutting edges that produced the fragment were also chemically analyzed. The technique revealed dental bur fragments of different sizes in different locations on the floor of the prepared surface of the teeth and under the filling, which places them in direct contact with the dentinal tubules and the dentinal fluid circulating within them. Dispersive X-ray spectroscopy elemental analysis of the dental bur edges revealed that the fragments are made of tungsten carbide-cobalt, which is bio-incompatible.

Effect of dental restorative materials on total antioxidant capacity and calcium concentration of unstimulated saliva.

PubMed

Ramezani, Gholam H; Moghadam, Mona-Momeni; Saghiri, Mohammad-Ali; Garcia-Godoy, Franklin; Asatourian, Armen; Aminsobhani, Mohsen; Scarbecz, Mark; Sheibani, Nader

2017-01-01

To evaluate the effect of dental amalgam and composite restorations on total antioxidant capacity (TAC) and calcium (Ca) ion concentration of unstimulated saliva. Forty-eight children aged 6-10 years selected and divided into three groups of sixteen (8 males, 8 females). In group A and B, samples consisted of two class II dental composite or amalgam restorations, while in group C samples were caries-free (control group). Unstimulated saliva from all samples was collected and TAC was measured by spectrophotometry using an adaptation of 2, 2'-azino-di-(3-ethylbenzthiazoline-6-sulphonate) (ABTS) assay. The Ca ion level was estimated by an auto- analyzer. Data were analyzed with one- and two-way ANOVA test, at a p <.05 level of significance. Composite samples showed significantly higher TAC and lower Ca ion levels compared to amalgam and caries-free samples ( p <.05). The TAC values showed only significant difference between groups ( p <.05), while the Ca ion results showed significant differences within and between groups ( p <.05). Dental composite restorations increased TAC and decreased Ca ion levels more than amalgam restorations in saliva. Gender is an effective factor in changes induced in oral cavity as females showed more emphatic reaction to dental filling materials than males. Patients who have dental restorations, especially dental composites, should pay more attention to their dental hygiene, because dental restorations can increase oxidative stress and decrease Ca ion level in saliva, which might jeopardize remineralization process of tooth structures after demineralization. Key words: Amalgam, caries, composite, saliva, total antioxidant capacity.

Calculation of the shrinkage-induced residual stress in a viscoelastic dental restorative material

NASA Astrophysics Data System (ADS)

Grassia, Luigi; D'Amore, Alberto

2013-02-01

A procedure able to describe the curing process of a particulate composite material used in a dental restoration is developed in the ANSYS environment. The material under concern is a multifunctional methacrylate-based composite for dental restoration, activated by visible light. The model accounts for the dependence of the viscoelastic functions on temperature and degree of cure. Three geometries have been considered in the analysis that are representative of three different classes of dental restoration and mainly differ by the C (constrained)-factor, (i.e. the bounded to unbounded surface ratio). It was found that the temperature could give a necrosis in the vicinity of the tooth nerve and that the average stress at the interface between the composite and the tooth scales exponentially with the C-factor. The residual stress at the dental restoration interface is also compared with the uniaxial tensile strength of twelve commercially available composite materials: it clearly appears that the level of residual stress may overcome the strength of the composite, especially at high C-factors.

Non-thermal Atmospheric Plasma Treatment for Deactivation of Oral Bacteria and Improvement of Dental Composite Restoration

NASA Astrophysics Data System (ADS)

Yu, Qing Song; Li, H.; Ritts, A. C.; Yang, B.; Chen, M.; Hong, L.; Xu, C.; Yao, X.; Wang, Y.

This paper reviews our recent research results of using non-thermal ­atmospheric plasmas for oral bacterial deactivation and for composite restoration improvement. Oral bacteria of Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus) with an initial bacterial population density between 1.0 × 108 and 5.0 × 108 cfu/ml were seeded on various media and their survivability with plasma exposure was examined. The plasma exposure time for a 99.9999% cell reduction was less than 15 s for S. mutans and within 5 min for L. acidophilus. To evaluate the dentin/composite interfacial bonding, extracted unerupted human third molars were used by removing the crowns and etching the exposed dentin surfaces with 35% phosphoric acid gel. After dental composite application and light curing, the teeth were then sectioned into micro-bars as the specimens for microtensile test. Student Newman Keuls (SNK) tests showed that the bonding strength of the composite restoration to peripheral dentin was significantly increased (by 64%) after 30 s plasma treatment of the dentin surfaces. These findings indicated that non-thermal atmospheric plasma technology is very promising for dental clinical applications.

Surface Morphology and Tooth Adhesion of a Novel Nanostructured Dental Restorative Composite

PubMed Central

Salerno, Marco; Loria, Patrizia; Matarazzo, Giunio; Tomè, Francesco; Diaspro, Alberto; Eggenhöffner, Roberto

2016-01-01

Recently, a novel dental restorative composite based on nanostructured micro-fillers of anodic porous alumina has been proposed. While its bulk properties are promising thanks to decreased aging and drug delivery capabilities, its surface properties are still unknown. Here we investigated the surface morphology and the adhesion to tooth dentin of this composite as prepared. For comparison, we used two commercial composites: Tetric EVO Flow (Ivoclar) and Enamel HRi Plus (Micerium). The surface morphology was characterized by atomic force microscopy and the adhesion strength by tensile tests. The experimental composite is rougher than the commercial composites, with root mean square roughness of ~549 nm against 170–511 nm, and presents an adhesion strength of ~15 MPa against 19–21 MPa. These results show at the same time some proximity to the commercial composites, but also the need for optimization of the experimental material formulation. PMID:28773327

Dental Composite Restorations and Neuropsychological Development in Children: Treatment Level Analysis from a Randomized Clinical Trial

PubMed Central

Maserejian, Nancy N.; Trachtenberg, Felicia L.; Hauser, Russ; McKinlay, Sonja; Shrader, Peter; Bellinger, David C.

2012-01-01

Background Resin-based dental restorations may intra-orally release their components and bisphenol A. Gestational bisphenol A exposure has been associated with poorer executive functioning in children. Objectives To examine whether exposure to resin-based composite restorations is associated with neuropsychological development in children. Methods Secondary analysis of treatment level data from the New England Children’s Amalgam Trial, a 2-group randomized safety trial conducted from 1997–2006. Children (N=534) aged 6–10 y with >2 posterior tooth caries were randomized to treatment with amalgam or resin-based composites (bisphenol-A-diglycidyl-dimethacrylate-composite for permanent teeth; urethane dimethacrylate-based polyacid-modified compomer for primary teeth). Neuropsychological function at 4- and 5-year follow-up (N=444) was measured by a battery of tests of executive function, intelligence, memory, visual-spatial skills, verbal fluency, and problem-solving. Multivariable generalized linear regression models were used to examine the association between composite exposure levels and changes in neuropsychological test scores from baseline to follow-up. For comparison, data on children randomized to amalgam treatment were similarly analyzed. Results With greater exposure to either dental composite material, results were generally consistent in the direction of slightly poorer changes in tests of intelligence, achievement or memory, but there were no statistically significant associations. For the four primary measures of executive function, scores were slightly worse with greater total composite exposure, but statistically significant only for the test of Letter Fluency (10-surface-years β= −0.8, SE=0.4, P=0.035), and the subtest of color naming (β= −1.5, SE=0.5, P=0.004) in the Stroop Color-Word Interference Test. Multivariate analysis of variance confirmed that the negative associations between composite level and executive function were not

Synthesis and characterization of dental composites

NASA Astrophysics Data System (ADS)

Djustiana, Nina; Greviana, Nadia; Faza, Yanwar; Sunarso

2018-02-01

During the last few decades, the increasing demands in esthetic dentistry have led to the development of dental composites material that provide similar appearance to the natural teeth. Recently, esthetic trend was an issue which increase the demand for teeth restorations that is similar with the origin. The esthetics of dental composite are more superior compared to amalgam, since its color look similar with natural teeth. Various dental composites have been developed using many type of fillers such as amorphous silica, quartz), borosilicate, Li-Sr-Ba-Al glass and oxide: zirconia and alumina. Researchers in Faculty of Dentistry University of Padjadjaran have prepared dental composites using zirconia-alumina-silica (ZAS) system as the filler. The aim is to improve the mechanical properties and the esthetic of the dental composites. The ZAS was obtained from chemical grade purity chemicals and Indonesia's natural sand as precursors its characterization were also presented. This novel method covers the procedure to synthesis and characterize dental composites in Padjadjaran University and some review about dental composites in global research.

Selective removal of esthetic composite restorations with spectral guided laser ablation

NASA Astrophysics Data System (ADS)

Yi, Ivana; Chan, Kenneth H.; Tsuji, Grant H.; Staninec, Michal; Darling, Cynthia L.; Fried, Daniel

2016-02-01

Dental composites are used for a wide range of applications such as fillings for cavities, adhesives for orthodontic brackets, and closure of gaps (diastemas) between teeth by esthetic bonding. Anterior restorations are used to replace missing, diseased and unsightly tooth structure for both appearance and function. When these restorations must be replaced, they are difficult to remove mechanically without causing excessive removal or damage to enamel because dental composites are color matched to teeth. Previous studies have shown that CO2 lasers have high ablation selectivity and are well suited for removal of composite on occlusal surfaces while minimizing healthy tissue loss. A spectral feedback guidance system may be used to discriminate between dental composite and dental hard tissue for selective ablation of composite material. The removal of composite restorations filling diastemas is more challenging due to the esthetic concern for anterior teeth. The objective of this study is to determine if composite spanning a diastema between anterior teeth can be removed by spectral guided laser ablation at clinically relevant rates with minimal damage to peripheral healthy tissue and with higher selectivity than a high speed dental handpiece.

General dental practitioners' knowledge of polymerisation of resin-based composite restorations and light curing unit technology.

PubMed

Santini, A; Turner, S

2011-09-23

Clinical successful use of resin-based composite restorations (RBCs) depends on knowledge of material and light curing unit (LCU) related factors. The purpose of this study was to evaluate general dental practitioners' knowledge of polymerisation of RBCs and LCU technology. Members of the Active Research Group of the Faculty of General Dental Practice (UK) in England, Scotland and Wales engaged in primary dental care were sent a letter introducing the study and asking for their cooperation, followed by an email containing a link to the online survey questionnaire, hosted on Surveymonkey.com. The questionnaire enquired about current LCUs, and asked a series of questions on material science. Sixty-six percent of the 274 members contacted responded. Fifty-seven percent used LED units, 25% quartz tungsten halogen (QTH), and 1% plasma arc (missing: 17%). Thirty percent reported having access to a radiometer. Appropriate responses regarding the degree of conversion of composite and adhesive materials were given by 32% and 23% respectively, and 22% agreed that LED and QTH LCUs had comparable efficiency in polymerising composites. Thirty-three percent were aware that RBCs eluted substances that may have adverse local or systemic consequences. Fifty-eight percent stated that if polymerisation of RBC is slowed down, polymerisation stress will be lower, and 43% said that polymerisation shrinkage will be reduced if the degree of conversion is reduced. Knowledge (measured by appropriate responses to these questions) was not related to years since qualification (r=-0.05, n=168, p=0.53). The study suggests that dentists' knowledge of curing RBC restorations and LCUs is poor. This indicates that there is a need for training and guidance in this aspect of primary dental care.

Systematic approach to preparing ceramic-glass composites with high translucency for dental restorations.

PubMed

Yoshimura, Humberto N; Chimanski, Afonso; Cesar, Paulo F

2015-10-01

Ceramic composites are promising materials for dental restorations. However, it is difficult to prepare highly translucent composites due to the light scattering that occurs in multiphase ceramics. The objective of this work was to verify the effectiveness of a systematic approach in designing specific glass compositions with target properties in order to prepare glass infiltrated ceramic composites with high translucency. First it was necessary to calculate from literature data the viscosity of glass at the infiltration temperature using the SciGlass software. Then, a glass composition was designed for targeted viscosity and refractive index. The glass of the system SiO2-B2O3-Al2O3-La2O3-TiO2 prepared by melting the oxide raw materials was spontaneously infiltrated into porous alumina preforms at 1200°C. The optical properties were evaluated using a refractometer and a spectrophotometer. The absorption and scattering coefficients were calculated using the Kubelka-Munk model. The light transmittance of prepared composite was significantly higher than a commercial ceramic-glass composite, due to the matching of glass and preform refractive indexes which decreased the scattering, and also to the decrease in absorption coefficient. The proposed systematic approach was efficient for development of glass infiltrated ceramic composites with high translucency, which benefits include the better aesthetic performance of the final prosthesis. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Discrimination of tooth layers and dental restorative materials using cutting sounds.

PubMed

Zakeri, Vahid; Arzanpour, Siamak; Chehroudi, Babak

2015-03-01

Dental restoration begins with removing carries and affected tissues with air-turbine rotary cutting handpieces, and later restoring the lost tissues with appropriate restorative materials to retain the functionality. Most restoration materials eventually fail as they age and need to be replaced. One of the difficulties in replacing failing restorations is discerning the boundary of restorative materials, which causes inadvertent removal of healthy tooth layers. Developing an objective and sensor-based method is a promising approach to monitor dental restorative operations and to prevent excessive tooth losses. This paper has analyzed cutting sounds of an air-turbine handpiece to discriminate between tooth layers and two commonly used restorative materials, amalgam and composite. Support vector machines were employed for classification, and the averaged short-time Fourier transform coefficients were selected as the features. The classifier performance was evaluated from different aspects such as the number of features, feature scaling methods, classification schemes, and utilized kernels. The total classification accuracies were 89% and 92% for cases included composite and amalgam materials, respectively. The obtained results indicated the feasibility and effectiveness of the proposed method.

Status report on microfilled composite restorative resin. Council on Dental Materials, Instruments, and Equipment.

PubMed

Dennison, J B

1982-09-01

Microfilled resins generally have physical properties inferior to those of conventional composites. A lower in organic filler content or higher polymer/filled ratio results in a lower modulus of elasticity, greater thermal dimensional change, less resistance to indentation and abrasion, and greater water sorption. The ability to finish and to maintain a smooth surface texture is a major advantage, although it has not been proved clinically that microfilled resin restorations result in less plaque adherence nor do they enhance soft tissue response. Early clinical trials, after two to three years in vivo, indicate a greater wear resistance for these materials than for conventional composites. At this time, current evidence suggests that a decrease in filler particles size to less than 1 micrometer and a lower filler loading of the resin matrix permit the clinical development and maintenance of a smooth surface texture on restoration surfaces. There is no published evidence that the decrease in many of the physical properties leads to early signs of clinical deterioration and failure. In vivo studies extended for longer periods are necessary to make a knowledgeable judgment on the true clinical value of these composites. A classification system for composite restorative resins is being prepared by the Council on Dental Materials, Instruments, and Equipment. It will be published in a future issue of The Journal.

Resin-composite blocks for dental CAD/CAM applications.

PubMed

Ruse, N D; Sadoun, M J

2014-12-01

Advances in digital impression technology and manufacturing processes have led to a dramatic paradigm shift in dentistry and to the widespread use of computer-aided design/computer-aided manufacturing (CAD/CAM) in the fabrication of indirect dental restorations. Research and development in materials suitable for CAD/CAM applications are currently the most active field in dental materials. Two classes of materials are used in the production of CAD/CAM restorations: glass-ceramics/ceramics and resin composites. While glass-ceramics/ceramics have overall superior mechanical and esthetic properties, resin-composite materials may offer significant advantages related to their machinability and intra-oral reparability. This review summarizes recent developments in resin-composite materials for CAD/CAM applications, focusing on both commercial and experimental materials. © International & American Associations for Dental Research.

Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries.

PubMed

Dorri, Mojtaba; Martinez-Zapata, Maria José; Walsh, Tanya; Marinho, Valeria Cc; Sheiham Deceased, Aubrey; Zaror, Carlos

2017-12-28

Dental caries is a sugar-dependent disease that damages tooth structure and, due to loss of mineral components, may eventually lead to cavitation. Dental caries is the most prevalent disease worldwide and is considered the most important burden of oral health. Conventional treatment methods (drill and fill) involve the use of rotary burs under local anaesthesia. The need for an electricity supply, expensive handpieces and highly trained dental health personnel may limit access to dental treatment, especially in underdeveloped regions.To overcome the limitations of conventional restorative treatment, the Atraumatic Restorative Treatment (ART) was developed, mainly for treating caries in children living in under-served areas of the world where resources and facilities such as electricity and trained manpower are limited. ART is a minimally invasive approach which involves removal of decayed tissue using hand instruments alone, usually without use of anaesthesia and electrically driven equipment, and restoration of the dental cavity with an adhesive material (glass ionomer cement (GIC), composite resins, resin-modified glass-ionomer cement (RM-GICs) and compomers). To assess the effects of Atraumatic Restorative Treatment (ART) compared with conventional treatment for managing dental caries lesions in the primary and permanent teeth of children and adults. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 22 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 1), MEDLINE Ovid (1946 to 22 February 2017), Embase Ovid (1980 to 22 February 2017), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 22 February 2017) and BBO BIREME Virtual Health Library (Bibliografia Brasileira de Odontologia; 1986 to 22 February 2017). The US National Institutes of Health Trials Registry (Clinical

Posterior composite restoration update: focus on factors influencing form and function

PubMed Central

Bohaty, Brenda S; Ye, Qiang; Misra, Anil; Sene, Fabio; Spencer, Paulette

2013-01-01

Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient’s caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth–restoration bond, and the ability of the restorative material to produce a sealed tooth–restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of posterior composite restorations, the emphasis must remain on advancing our understanding of the clinical variables that impact the formation of a durable seal at the restoration–tooth interface. This paper presents an update of existing technology and underscores the mechanisms that negatively impact the durability of posterior composite restorations in permanent teeth. PMID:23750102

Dental sealants and flowable composite restorations and psychosocial, neuropsychological, and physical development in children.

PubMed

Maserejian, Nancy N; Shrader, Peter; Trachtenberg, Felicia L; Hauser, Russ; Bellinger, David C; Tavares, Mary

2014-01-01

Dental sealant materials may intraorally release their components, including bisphenol-A (BPA), but long-term health effects are uncertain. The New England Children's Amalgam Trial (NECAT) found that composite restorations were associated with psychosocial, but not neuropsychological or physical, outcomes. The previous analysis did not consider sealants and preventive resin restorations (PRRs), which were routinely placed. The purpose of this analysis was to examine sealant/PRR exposure in association with psychosocial and other health outcomes. NECAT recruited 534 six- to 10-year-olds and provided dental care during a five-year follow-up. Annually, examiners conducted psychosocial and neuropsychological tests and measured body mass index (BMI) and fat percentage (BF%). Associations between surface years (SY) of sealants/PRRs and outcomes were tested using multivariable models. Cumulative exposure level to sealants and/or PRRs was not associated with psychosocial assessments (eg, total problems: Child Behavior Checklist, 10-SY β=-0.2 ± 0.3, P=.60) or neuropsychological tests (eg, full-scale IQ, 10-SY β=0.1 ± 0.2, P=.60). There were no associations for changes in BMI-for-age z-score (P=.40), BF% (girls 10-SY β=-0.2 ± 0.3; boys 10-SY β=-0.1 ± 0.3), or menarche (10-SY hazard ratio=0.91, 95% confidence interval=0.83-1.01, P=.08). This study showed no associations between exposure level of dental sealants or PRRs and behavioral, neuropsychological, or physical development in children over 5-years.

Reinforcement of flowable dental composites with titanium dioxide nanotubes.

PubMed

Dafar, Manal O; Grol, Matthew W; Canham, Peter B; Dixon, S Jeffrey; Rizkalla, Amin S

2016-06-01

Flowable dental composites are used as restorative materials due to their excellent esthetics and rheology. However, they suffer from inferior mechanical properties compared to conventional composites. The aim of this study was to reinforce a flowable dental composite with TiO2 nanotubes (n-TiO2) and to assess the effect of n-TiO2 surface modifications on the mechanical properties of the reinforced composite. n-TiO2 were synthesized using an alkaline hydrothermal process and then functionalized with silane or methacrylic acid (MA). Nanotubes were characterized by scanning and transmission electron microscopy, X-ray diffraction, energy-dispersive X-ray spectroscopy and Fourier transform infrared spectroscopy. Commercially available flowable composite (Filtek™ Supreme Ultra Flowable Restorative, 3M ESPE) was reinforced with varying amounts of nanotubes (0-5wt%). Flowability of the resulting composites was evaluated using a Gillmore needle method. Dynamic Young's modulus (E) was measured using an ultrasonic technique. Fracture toughness (KIc) was assessed using a notchless triangular prism and radiopacity was quantified. Viability of NIH/3T3 fibroblasts was evaluated following incubation on composite specimens for 24h. Electron microscopy revealed a tubular morphology of n-TiO2. All reinforced composites exhibited significantly greater values of E than unreinforced composite. Composites reinforced with 3wt% n-TiO2 functionalized with MA exhibited the greatest values of E and KIc. Cytotoxicity assays revealed that reinforced composites were biocompatible. Taken together, flowable composites reinforced with n-TiO2 exhibited mechanical properties superior to those of unreinforced composite, with minimal effects on flowability and radiopacity. n-TiO2-reinforced flowable composites are promising materials for use in dental restorations. Copyright © 2016 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Assessment of exposures and potential risks to the US adult population from wear (attrition and abrasion) of gold and ceramic dental restorations.

PubMed

Richardson, G Mark; Clemow, Scott R; Peters, Rachel E; James, Kyle J; Siciliano, Steven D

2016-01-01

Little has been published on the chemical exposures and risks of dental restorative materials other than from dental amalgam and composite resins. Here we provide the first exposure and risk assessment for gold (Au) alloy and ceramic restorative materials. Based on the 2001-2004 US National Health and Nutrition Examination Survey (NHANES), we assessed the exposure of US adults to the components of Au alloy and ceramic dental restorations owing to dental material wear. Silver (Ag) is the most problematic component of Au alloy restorations, owing to a combination of toxicity and proportional composition. It was estimated that adults could possess an average of four tooth surfaces restored with Au alloy before exceeding, on average, the reference exposure level (REL) for Ag. Lithium (Li) is the most problematic component of dental ceramics. It was estimated that adults could possess an average of 15 tooth surfaces restored with ceramics before exceeding the REL for Li. Relative risks of chemical exposures from dental materials decrease in the following order: Amalgam>Au alloys>ceramics>composite resins.

Reasons for Placement of Restorations on Previously Unrestored Tooth Surfaces by Dental PBRN Dentists

PubMed Central

Nascimento, Marcelle M.; Gordan, Valeria V.; Qvist, Vibeke; Litaker, Mark S.; Rindal, D. Brad; Williams, O.D.; Fellows, Jeffrey L.; Ritchie, Lloyd K.; Mjör, Ivar A.; McClelland, Jocelyn; Gilbert, Gregg H.

2010-01-01

Objective To identify and quantify the reasons for placing restorations on unrestored permanent tooth surfaces and the dental materials used by Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org) dentists. Methods A total of 229 DPBRN practitioner-investigators collected data on 9,890 consecutive restorations from 5,810 patients. Information included: (1) reasons for restoring; (2) tooth and surfaces restored; and (3) restorative materials employed. Results Primary caries (85%) and non-carious defects (15%), which included abrasion/ abfraction/ erosion lesions and tooth fracture, were the main reasons for placement of restorations. Restorations due to caries were frequently placed on occlusal surfaces (49%), followed by distal, mesial, buccal/facial, lingual/palatal, and incisal surfaces. Amalgam was used for 46% of the molar and 45% of the premolar restorations. Directly placed resin-based composite (RBC) was used for 48% of the molar, 49% of the premolar, and 92% of the anterior restorations. Conclusion Dental caries on occlusal and proximal surfaces of molar teeth are the main reasons for placing restorations on previously unrestored tooth surfaces by DPBRN practitioner-investigators. RBC is the material most commonly used for occlusal and anterior restorations. Amalgam remains the material of choice to restore proximal caries in posterior teeth, although there are significant differences by DPBRN region. PMID:20354094

Matching the optical properties of direct esthetic dental restorative materials to those of human enamel and dentin

NASA Astrophysics Data System (ADS)

Ragain, James Carlton, Jr.

One of the goals of the restorative dentist is to restore the appearance of the natural dentition. Clinical matching of teeth and restorative materials are seldom accurate and shade selection techniques are subjective. The first specific aim of this research was to characterize the optical absorption and scattering that occurs within enamel, dentin, and composite resin and compomer restorative materials and to relate those phenomena to translucency and color. The second aim was to evaluate small color differences among composite restorative materials which would be detectable by humans. The last aim was to lay the foundation for developing an improved model of specifying layers of dental restorative materials in order to match the translucency and color to those of human enamel. The Kubelka-Munk theory was validated for enamel, dentin, and the restorative materials. These tissues and materials were then characterized in terms of their color parameters. Tooth cores were also characterized in terms of color space parameters. Human subjects were evaluated for their abilities to discriminate small color differences in the dental composite resin materials. The following conclusions were derived from this study: (1) Kubelka-Munk theory accurately predicts the diffuse reflectance spectra of enamel, dentin, and the direct esthetic dental restorative materials studied. (2) Scattering and absorption coefficients of the dental tissues and esthetic restorative materials can be directly calculated from diffuse reflectance measurements of a uniformly thick slab of tissue/material using black and white backings and the appropriate refractive index. (3) For tooth cores, there is a positive correlation between L* and b* and a negative correlation between L* and a*. (4) The range of translucency parameters for the restorative materials studied does not match those of enamel and dentin. (5) None of the shades of the dental composite resin restorative materials studied fit into the

Current Insights into the Modulation of Oral Bacterial Degradation of Dental Polymeric Restorative Materials

PubMed Central

Zhang, Ning; Ma, Yansong; Weir, Michael D.; Xu, Hockin H. K.; Bai, Yuxing; Melo, Mary Anne S.

2017-01-01

Dental polymeric composites have become the first choice for cavity restorations due to their esthetics and capacity to be bonded to the tooth. However, the oral cavity is considered to be harsh environment for a polymeric material. Oral biofilms can degrade the polymeric components, thus compromising the marginal integrity and leading to the recurrence of caries. Recurrent caries around restorations has been reported as the main reason for restoration failure. The degradation of materials greatly compromises the clinical longevity. This review focuses on the degradation process of resin composites by oral biofilms, the mechanisms of degradation and its consequences. In addition, potential future developments in the area of resin-based dental biomaterials with an emphasis on anti-biofilm strategies are also reviewed. PMID:28772863

Adhesive/Dentin Interface: The Weak Link in the Composite Restoration

PubMed Central

Spencer, Paulette; Ye, Qiang; Park, Jonggu; Topp, Elizabeth M.; Misra, Anil; Marangos, Orestes; Wang, Yong; Bohaty, Brenda S.; Singh, Viraj; Sene, Fabio; Eslick, John; Camarda, Kyle; Katz, J. Lawrence

2010-01-01

Results from clinical studies suggest that more than half of the 166 million dental restorations that were placed in the United States in 2005 were replacements for failed restorations. This emphasis on replacement therapy is expected to grow as dentists use composite as opposed to dental amalgam to restore moderate to large posterior lesions. Composite restorations have higher failure rates, more recurrent caries, and increased frequency of replacement as compared to amalgam. Penetration of bacterial enzymes, oral fluids, and bacteria into the crevices between the tooth and composite undermines the restoration and leads to recurrent decay and premature failure. Under in vivo conditions the bond formed at the adhesive/dentin interface can be the first defense against these noxious, damaging substances. The intent of this article is to review structural aspects of the clinical substrate that impact bond formation at the adhesive/dentin interface; to examine physico-chemical factors that affect the integrity and durability of the adhesive/dentin interfacial bond; and to explore how these factors act synergistically with mechanical forces to undermine the composite restoration. The article will examine the various avenues that have been pursued to address these problems and it will explore how alterations in material chemistry could address the detrimental impact of physico-chemical stresses on the bond formed at the adhesive/dentin interface. PMID:20195761

Complex layered dental restorations: Are they recognizable and do they survive extreme conditions?

PubMed

Soon, Alistair S; Bush, Mary A; Bush, Peter J

2015-09-01

Recent research has shown that restorative dental materials can be recognized by microscopy and elemental analysis (scanning electron microscopy/energy dispersive X-ray spectroscopy and X-ray fluorescence; SEM/EDS and XRF) and that this is possible even in extreme conditions, such as cremation. These analytical methods and databases of dental materials properties have proven useful in DVI (disaster victim identification) of a commercial plane crash in 2009, and in a number of other victim identification cases. Dental materials appear on the market with ever expanding frequency. With their advent, newer methods of restoration have been proposed and adopted in the dental office. Methods might include placing multiple layers of dental materials, where they have different properties including adhesion, viscosity, or working time. These different dental materials include filled adhesives, flowable resins, glass ionomer cements, composite resins, liners and sealants. With possible combinations of different materials in these restorations, the forensic odontologist is now confronted with a new difficulty; how to recognize each individual material. The question might be posed if it is even possible to perform this task. Furthermore, an odontologist might be called upon to identify a victim under difficult circumstances, such as when presented with fragmented or incinerated remains. In these circumstances the ability to identify specific dental materials could assist in the identification of the deceased. Key to use of this information is whether these new materials and methods are detailed in the dental chart. Visual or radiographic inspection may not reveal the presence of a restoration, let alone the possible complex nature of that restoration. This study demonstrates another scientific method in forensic dental identification. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[The stamp technique for direct composite restoration].

PubMed

Perrin, Philippe; Zimmerli, Brigitte; Jacky, Daniel; Lussi, Adrian; Helbling, Christoph; Ramseyer, Simon

2013-01-01

The indications for direct resin composite restorations are nowadays extended due to the development of modern resin materials with improved material properties. However, there are still some difficulties regarding handling of resin composite material, especially in large restorations. The reconstruction of a functional and individual occlusion is difficult to achieve with direct application techniques. The aim of the present publication was to introduce a new "stamp"-technique for placing large composite restorations. The procedure of this "stamp"-technique is presented by three typical indications: large single-tooth restoration, occlusal rehabilitation of a compromised occlusal surface due to erosions and direct fibre-reinforced fixed partial denture. A step-by-step description of the technique and clinical figures illustrates the method. Large single-tooth restorations can be built-up with individual, two- piece silicone stamps. Large occlusal abrasive and/or erosive defects can be restored by copying the wax-up from the dental technician using the "stamp"-technique. Even fiber-reinforced resin-bonded fixed partial dentures can be formed with this intraoral technique with more precision and within a shorter treatment time. The presented "stamp"-technique facilitates the placement of large restoration with composite and can be recommended for the clinical use.

Endocrown restorations: Influence of dental remnant and restorative material on stress distribution.

PubMed

Tribst, João Paulo Mendes; Dal Piva, Amanda Maria de Oliveira; Madruga, Camila Ferreira Leite; Valera, Marcia Carneiro; Borges, Alexandre Luiz Souto; Bresciani, Eduardo; de Melo, Renata Marques

2018-06-20

The goal of this study was to evaluate the stress distribution in a tooth/restoration system according to the factors "amount of dental remnant" (3 levels) and "restorative material" (2 levels). Three endodontically treated maxillary molars were modeled with CAD software for conducting non-linear finite element analysis (FEA), each with a determined amount of dental remnant of 1.5, 3, or 4.5mm. Models were duplicated, and half received restorations in lithium disilicate (IPS e.max CAD), while the other half received leucite ceramic restorations (IPS Empress CAD), both from Ivoclar Vivadent (Schaan, Liechtenstein). The solids were imported to analysis software (ANSYS 17.2, ANSYS Inc., Houston, TX, USA) in STEP format. All contacts involving the resin cement were considered no-separation, whereas between teeth and fixation cylinder, the contact was considered perfectly bonded. The mechanical properties of each structure were reported, and the materials were considered isotropic, linearly elastic, and homogeneous. An axial load (300N) was applied at the occlusal surface (triploidism area). Results were determined by colorimetric graphs of maximum principal stress (MPS) on tooth remnant, cement line, and restoration. MPS revealed that both factors influenced the stress distribution for all structures; the higher the material's elastic modulus, the higher the stress concentration on the restoration and the lower the stress concentration on the cement line. Moreover, the greater the dental crown remnant, the higher the stress concentration on the restoration. Thus, the remaining dental tissue should always be preserved. In situations in which few dental remnants are available, the thicker the restoration, the higher the concentration of stresses in its structure, protecting the adhesive interface from potential adhesive failures. Results are more promising when the endocrown is fabricated with lithium disilicate ceramic. Copyright © 2018 The Academy of Dental Materials

Optical properties of composite restorations influenced by dissimilar dentin restoratives.

PubMed

Marjanovic, Jovana; Veljovic, Djordje N; Stasic, Jovana N; Savic-Stankovic, Tatjana; Trifkovic, Branka; Miletic, Vesna

2018-05-01

To evaluate optical properties (color and translucency) of 'sandwich' restorations of resin-based composites and esthetically unfavorable dentin restoratives. Cylindrical 'dentin' specimens (8mm in diameter and 2mm thick, N=5/group) were prepared using EverX Posterior (GC), Biodentine (Septodont), experimental hydroxyapatite (HAP) or conventional composites (Gradia Direct Posterior, GC; Filtek Z250 and Filtek Z500, 3M ESPE). Capping 'enamel' layers were prepared using composites (Gradia Direct Posterior, Filtek Z250 or Z550) of A1 or A3 shade and the following thickness: 0.6, 1 or 2mm. Color (ΔE) and translucency parameter (TP) were determined using a spectrophotometer (VITA Easyshade Advance 4.0, VITA Zahnfabrik). Data were statistically analyzed using analysis of variance with Tukey's post-hoc tests (α=0.05). TP was greatly affected by layer thickness, whilst ΔE depended on shade and layer thickness of the capping composite. HAP and Biodentine showed significantly lower TP and higher ΔE (deviation from 'ideal white') than composites (p<0.05). Greater TP was seen in EverX_composite groups than in corresponding control groups of the same shade and thickness. TP of composites combined with Biodentine or HAP was below 2, lower than the corresponding control groups (p<0.05). Within-group differences of ΔE were greatest in HAP_composite groups. EverX_Gradia and EverX_FiltekZ250 combinations showed the most comparable ΔE with the control groups. A 2mm thick layer of composite covering dentin restoratives with unfavorable esthetics is recommended for a final 'sandwich' restoration that is esthetically comparable to a conventional, mono-composite control restoration. Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

Seventeen Years of Using Flowable Resin Restoratives--A Dental Practitioner's Personal Clinical Review.

PubMed

Firla, Markus Th

2015-04-01

Seen through the author's eyes on the basis of his practising dentistry for almost three decades, light-activated flowable resin restoratives (FRCs) or, in common clinical dental terminology, flowable composites have gradually gained major importance in restorative dentistry. Inputs to this ongoing trend are coming from continuous improvements in material properties and the favourable handling characteristics experienced with this particular group of restoratives. Intended to be used in direct adhesive filling procedures, the number and variety of recent generations of flowable composites for lining, restoration of all cavity classes (I-V), core build-ups and, more recently, 'bulk-fill-restorations', however, necessitates a profound clinical understanding of the selective use of flowable composites to ensure clinical success and guarantee long-term high quality results. Clinical relevance: Today's flowable composites allow for reliable restoration of all kinds of defects. However, both the handling characteristics and the material properties of FRCs must be fully understood before taking advantage of their potentially excellent clinical performance.

Esthetics and Biocompatibility of Composite Dental Laminates.

PubMed

D'Souza, Dsj; Kumar, M

2010-07-01

Advances in modern dental materials provide patients with a choice of natural looking veneers to provide esthetic restorations. These may be directly fabricated composite resin veneers or indirectly fabricated veneers. This study was carried out to evaluate the clinical effect of new generation indirect veneering composites and to compare them with veneers fabricated from direct composite restorations. The present study was carried out in the Prosthodontics department of a medical college. A total of forty patients requiring restoration of the anterior teeth using composite veneers were selected and either of the two materials was used to fabricate the veneers. Clinical evaluation was done for esthetics and periodontal health. Statistical analysis showed that there were no significant changes to the periodontal health during the period of the study. The evidence obtained from this study indicates that both direct as well as indirect composite materials had clinically acceptable outcomes in terms of restoration of esthetics. Biocompatibility with the periodontal tissues of both materials was also evident by the improvement in oral health indices used in the study.

Changes in Urinary Bisphenol A Concentrations Associated with Placement of Dental Composite Restorations in Children and Adolescents

PubMed Central

Maserejian, Nancy N.; Trachtenberg, Felicia L.; Wheaton, Olivia Brown; Calafat, Antonia M.; Ranganathan, Gayatri; Kim, Hae-Young; Hauser, Russ

2016-01-01

Background BisGMA-based dental composites may release bisphenol A (BPA). Our purpose was to assess changes in urinary BPA concentrations over 6-months follow-up in children and adolescents receiving bisGMA-based restorations. Methods We collected urine and interviewed parents/guardians for BPA-related exposure information before and approximately one-day, 14-days, and 6-months post-treatment among 91 participants aged 3–17 years needing composite restorations. We used multivariable linear regression models to test associations between number of surface-restorations placed and changes in urinary BPA concentrations. Results Participants had on average 1.4 (sd=1.0) surfaces filled with composite at the first treatment visit and a cumulative 2.3 (sd=1.6) surfaces filled during the study. Mean change in BPA between pretreatment and next-day was 1.71 ng/mL (sd=9.94) overall and 0.87 (sd=5.98) after excluding one participant with 8 surfaces filled at the visit. Overall, a greater number of composite surface-restorations placed was associated with higher BPA in the next-day sample (posterior-occlusal eβ=1.47, 95% CI 1.18–1.83; P<0.001), but this was attenuated after restricting to the 88 participants with ≤4 fillings (eβ=1.19, 95% CI 0.86, 1.64), and no association was observed using 14-day (eβ=0.94, 95% CI 0.75–1.18) or 6- month (eβ=0.88, 95% CI 0.74–1.04) samples. Conclusions Placement of bisGMA-based restorations in children and adolescents may produce transient increases in urinary BPA concentration, which are no longer detectable approximately 14-days or 6-months post-treatment in urine samples. When few restorations are placed, increases in urinary BPA concentrations may not be detectable owing to high inter-individual variation in BPA exposure. Practical Implications These results suggest that leaching of BPA from newly placed composites ceases being detectable in urine within 2 weeks of restoration placement. The potential human health impact of such

Resin Composites Reinforced by Nanoscaled Fibers or Tubes for Dental Regeneration

PubMed Central

Li, Xiaoming; Liu, Wei; Sun, Lianwen; Aifantis, Katerina E.; Yu, Bo; Fan, Yubo; Cui, Fuzhai; Watari, Fumio

2014-01-01

It has been stated clearly that nanofillers could make an enhancement on the mechanical performances of dental composites. In order to address current shortage of traditional dental composites, fillers in forms of nanofibers or nanotubes are broadly regarded as ideal candidates to greatly increase mechanical performances of dental composites with low content of fillers. In this review, the efforts using nanofibers and nanotubes to reinforce mechanical performances of dental composites, including polymeric nanofibers, metallic nanofibers or nanotubes, and inorganic nanofibers or nanotubes, as well as their researches related, are demonstrated in sequence. The first purpose of current paper was to confirm the enhancement of nanofibers or nanotubes' reinforcement on the mechanical performances of dental restorative composite. The second purpose was to make a general description about the reinforcement mechanism of nanofibers and nanotubes, especially, the impact of formation of interphase boundary interaction and nanofibers themselves on the advanced mechanical behaviors of the dental composites. By means of the formation of interface interaction and poststretching nanofibers, reinforced effect of dental composites by sorts of nanofibers/nanotubes has been successfully obtained. PMID:24982894

Restorative Rehabilitation of a Patient with Dental Erosion

PubMed Central

AlShahrani, Mohammed Thamer; Alqarni, Mohammed

2017-01-01

Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition. PMID:28828189

Restorative Rehabilitation of a Patient with Dental Erosion.

PubMed

AlShahrani, Mohammed Thamer; Haralur, Satheesh B; Alqarni, Mohammed

2017-01-01

Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition.

Rubber dam isolation for restorative treatment in dental patients.

PubMed

Wang, Yan; Li, Chunjie; Yuan, He; Wong, May Cm; Zou, Jing; Shi, Zongdao; Zhou, Xuedong

2016-09-20

that analysed 1270 participants (among which 233 participants were lost to follow-up). All the included studies were at high risk of bias. We excluded one trial from the analysis due to inconsistencies in the presented data.The results indicated that dental restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). It also showed that the rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations. We found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.

[Studies on the dynamic durability of dental restorative materials. Part 4. Materials evaluation of initial and fatigue specimen for composite resins by acoustic emission method].

PubMed

Kondo, S; Okawa, S; Hanawa, T; Sugawara, T; Ota, M

1981-10-01

Present study is directed towards development for a method of materials evaluation of the static and dynamic properties for dental restorative materials and nondestructive inspection of the dental restorations in oral cavity by acoustic emission (AE) method. AE characteristics and deformation-fracture behavior of hour commercial composite resins under three points bending test are examined in order to evaluate initial and fatigue specimen for conventional and microfilled composite resins. Experimental results obtained are as follows: (1) Deformation-fracture behavior of conventional and microfilled composite resins exhibits different mode, corresponding to relatively brittle and ductile fracture behavior, respectively. Therefore, the primary sources of AE for conventional and microfilled composite resins under bending test are related mainly to the nucleation and propagation of cracks and plastic deformation, respectively. (2) In conventional composite resins under bending test, the burst type AE signal of higher amplitude and shorter decay time and more many AE total counts tend to be observed. In microfilled composite resins under bending test, the burst type AE signal of lower amplitude and longer decay time and more a few total counts tend to be observed. (3) Composite resins, particularly conventional composite resins under unload and repeated bending load are indicative of different AE characteristics. Accordingly, application of AE method for composite resins offers a method to evaluate the static and dynamic strength of composite resins. (4) In conventional composite resins under bending test, as characteristic AE are observed in a few stress regions before fracture, it may be possible to monitor nondestructively the restorations in oral cavity by using AE method.

Fracture Resistance of Teeth Restored with Direct and Indirect Composite Restorations

PubMed Central

Torabzadeh, Hassan; Ghasemi, Amir; Dabestani, Atoosa; Razmavar, Sara

2013-01-01

Objective: Tooth fracture is a common dental problem. By extension of cavity dimensions, the remaining tooth structure weakens and occlusal forces may cause tooth fracture. The aim of this study was to evaluate and compare the fracture resistance of teeth restored with direct and indirect composite restorations. Materials and Methods: Sixty-five sound maxillary premolar teeth were chosen and randomly divided into five groups each comprising thirteen. Fifty-two teeth received mesio-occluso-distal (MOD) cavities with 4.5mm bucco-lingual width, 4mm pulpal depth and 3mm gingival depth and were divided into the following four groups. G-1: restored with direct composite (Z-250, 3M/ESPE) with cusp coverage, G-2: restored with direct composite (Z-250) without cusp coverage, G-3: restored with direct composite (Gradia, GC-international) with cusp coverage, G-4: restored with indirect composite (Gradia, GC-International) with cusp coverage. Intact teeth were used in G-5 as control. The teeth were subjected to a compressive axial loading using a 4 mm diameter rod in a universal testing machine with 1 mm/min speed. Data were analyzed using one-way ANOVA and Tukey tests. Results: The mean fracture strength recorded was: G-1: 1148.46N±262, G-2: 791.54N±235, G-3: 880.00N±123, G-4: 800.00N±187, G-5: 1051.54N±345. ANOVA revealed significant differences between groups (p<0.05). Tukey test showed significant difference between group 1 and the other groups. There was no significant difference among other groups. Conclusion: Direct composite (Z-250) with cusp coverage is a desirable treatment for weakened teeth. Treatment with Z-250 without cusp coverage, direct and indirect Gradia with cusp coverage restored the strength of the teeth to the level of intact teeth. PMID:24910649

Non-destructive evaluation of teeth restored with different composite resins using synchrotron based micro-imaging.

PubMed

Fatima, A; Kulkarni, V K; Banda, N R; Agrawal, A K; Singh, B; Sarkar, P S; Tripathi, S; Shripathi, T; Kashyap, Y; Sinha, A

2016-01-01

Application of high resolution synchrotron micro-imaging in microdefects studies of restored dental samples. The purpose of this study was to identify and compare the defects in restorations done by two different resin systems on teeth samples using synchrotron based micro-imaging techniques namely Phase Contrast Imaging (PCI) and micro-computed tomography (MCT). With this aim acquired image quality was also compared with routinely used RVG (Radiovisiograph). Crowns of human teeth samples were fractured mechanically involving only enamel and dentin, without exposure of pulp chamber and were divided into two groups depending on the restorative composite materials used. Group A samples were restored using a submicron Hybrid composite material and Group B samples were restored using a Nano-Hybrid restorative composite material. Synchrotron based PCI and MCT was performed with the aim of visualization of tooth structure, composite resin and their interface. The quantitative and qualitative comparison of phase contrast and absorption contrast images along with MCT on the restored teeth samples shows comparatively large number of voids in Group A samples. Quality assessment of dental restorations using synchrotron based micro-imaging suggests Nano-Hybrid resin restorations (Group B) are better than Group A.

The Post-Amalgam Era: Norwegian Dentists' Experiences with Composite Resins and Repair of Defective Amalgam Restorations.

PubMed

Kopperud, Simen E; Staxrud, Frode; Espelid, Ivar; Tveit, Anne Bjørg

2016-04-22

Amalgam was banned as a dental restorative material in Norway in 2008 due to environmental considerations. An electronic questionnaire was sent to all dentists in the member register of the Norwegian Dental Association (NTF) one year later, to evaluate dentists' satisfaction with alternative restorative materials and to explore dentists' treatment choices of fractured amalgam restorations. Replies were obtained from 61.3%. Composite was the preferred restorative material among 99.1% of the dentists. Secondary caries was the most commonly reported cause of failure (72.7%), followed by restoration fractures (25.1%). Longevity of Class II restorations was estimated to be ≥10 years by 45.8% of the dentists, but 71.2% expected even better longevity if the restoration was made with amalgam. Repair using composite was suggested by 24.9% of the dentists in an amalgam restoration with a fractured cusp. Repair was more often proposed among young dentists (p < 0.01), employees in the Public Dental Service (PDS) (p < 0.01) and dentists working in counties with low dentist density (p = 0.03). There was a tendency towards choosing minimally invasive treatment among dentists who also avoided operative treatment of early approximal lesions (p < 0.01). Norwegian dentists showed positive attitudes towards composite as a restorative material. Most dentists chose minimally- or medium invasive approaches when restoring fractured amalgam restorations.

The Post-Amalgam Era: Norwegian Dentists’ Experiences with Composite Resins and Repair of Defective Amalgam Restorations

PubMed Central

Kopperud, Simen E.; Staxrud, Frode; Espelid, Ivar; Tveit, Anne Bjørg

2016-01-01

Amalgam was banned as a dental restorative material in Norway in 2008 due to environmental considerations. An electronic questionnaire was sent to all dentists in the member register of the Norwegian Dental Association (NTF) one year later, to evaluate dentists’ satisfaction with alternative restorative materials and to explore dentists’ treatment choices of fractured amalgam restorations. Replies were obtained from 61.3%. Composite was the preferred restorative material among 99.1% of the dentists. Secondary caries was the most commonly reported cause of failure (72.7%), followed by restoration fractures (25.1%). Longevity of Class II restorations was estimated to be ≥10 years by 45.8% of the dentists, but 71.2% expected even better longevity if the restoration was made with amalgam. Repair using composite was suggested by 24.9% of the dentists in an amalgam restoration with a fractured cusp. Repair was more often proposed among young dentists (p < 0.01), employees in the Public Dental Service (PDS) (p < 0.01) and dentists working in counties with low dentist density (p = 0.03). There was a tendency towards choosing minimally invasive treatment among dentists who also avoided operative treatment of early approximal lesions (p < 0.01). Norwegian dentists showed positive attitudes towards composite as a restorative material. Most dentists chose minimally- or medium invasive approaches when restoring fractured amalgam restorations. PMID:27110804

Temperature excursions at the pulp-dentin junction during the curing of light-activated dental restorations.

PubMed

Jakubinek, Michael B; O'Neill, Catherine; Felix, Chris; Price, Richard B; White, Mary Anne

2008-11-01

Excessive heat produced during the curing of light-activated dental restorations may injure the dental pulp. The maximum temperature excursion at the pulp-dentin junction provides a means to assess the risk of thermal injury. In this investigation we develop and evaluate a model to simulate temperature increases during light-curing of dental restorations and use it to investigate the influence of several factors on the maximum temperature excursion along the pulp-dentin junction. Finite element method modeling, using COMSOL 3.3a, was employed to simulate temperature distributions in a 2D, axisymmetric model tooth. The necessary parameters were determined from a combination of literature reports and our measurements of enthalpy of polymerization, heat capacity, density, thermal conductivity and reflectance for several dental composites. Results of the model were validated using in vitro experiments. Comparisons with in vitro experiments indicate that the model provides a good approximation of the actual temperature increases. The intensity of the curing light, the curing time and the enthalpy of polymerization of the resin composite were the most important factors. The composite is a good insulator and the greatest risk occurs when using the light to cure the thin layer of bonding resin or in deep restorations that do not have a liner to act as a thermal barrier. The results show the importance of considering temperature increases when developing curing protocols. Furthermore, we suggest methods to minimize the temperature increase and hence the risk of thermal injury. The physical properties measured for several commercial composites may be useful in other studies.

Physical Properties of a New Sonically Placed Composite Resin Restorative Material

DTIC Science & Technology

2013-06-06

General Dentistry Residency (AEGD-2) 3. School/DepartmenUCenter: Air Force Postgraduate Dental School (AFPDS) 4. Phone: 210-671-9822 5. Type of...9. Date of submission for USU approval: 7 June 2013 CHAIR OR DEPARTMENT HEAD APPROVAL 1. Name: Kraig S. Vandewalle, Director, Dental Research 2...claim of 5mm. INTRODUCTION Composite resin was first introduced in the 1960’s as an alternative to acrylic resins for esthetic dental restorations.1

Progress in dimethacrylate-based dental composite technology and curing efficiency.

PubMed

Leprince, Julian G; Palin, William M; Hadis, Mohammed A; Devaux, Jacques; Leloup, Gaetane

2013-02-01

This work aims to review the key factors affecting the polymerization efficiency of light-activated resin-based composites. The different properties and methods used to evaluate polymerization efficiency will also be critically appraised with focus on the developments in dental photopolymer technology and how recent advances have attempted to improve the shortcomings of contemporary resin composites. Apart from the classical literature on the subject, the review focused in particular on papers published since 2009. The literature research was performed in Scopus with the terms "dental resin OR dimethacrylate". The list was screened and all papers relevant to the objectives of this work were included. Though new monomer technologies have been developed and some of them already introduced to the dental market, dimethacrylate-based composites still currently represent the vast majority of commercially available materials for direct restoration. The photopolymerization of resin-based composites has been the subject of numerous publications, which have highlighted the major impact of the setting process on material properties and quality of the final restoration. Many factors affect the polymerization efficiency, be they intrinsic; photoinitiator type and concentration, viscosity (co-monomer composition and ratio, filler content) and optical properties, or extrinsic; light type and spectrum, irradiation parameters (radiant energy, time and irradiance), curing modes, temperature and light guide tip positioning. : This review further highlights the apparent need for a more informative approach by manufacturers to relay appropriate information in order for dentists to optimize material properties of resin composites used in daily practice. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Low shrinkage light curable nanocomposite for dental restorative material.

PubMed

Chen, Min-Huey; Chen, Ci-Rong; Hsu, Seng-Haw; Sun, Shih-Po; Su, Wei-Fang

2006-02-01

The aim of this study was to develop a low shrinkage visible light curable nanocomposite dental restorative material without sacrificing the other properties of conventional materials. This nanocomposite was developed by using an epoxy resin 3,4-epoxycyclohexylmethyl-(3,4-epoxy)cyclohexane carboxylate (ERL4221) matrix with 55% wt of 70-100 nm nanosilica fillers through ring-opening polymerization. GPS (gamma-glycidoxypropyl trimethoxysilane) was used to modify the surfaces of silica nanoparticles. The nanocomposite was shown to exhibit low polymerization shrinkage strain, which is only a quarter of currently used methacrylate-based composites. It also exhibited a low thermal expansion coefficient of 49.8 microm/m degrees C which is comparable to that of the methacrylate based composites (51.2 microm/m degrees C). The strong interfacial interactions between the resin and fillers at nanoscales were demonstrated by an observed high strength and high thermal stability of the nanocomposite. A microhardness of 62 KHN and a tensile strength of 47 MPa were reached. A high degree of conversion ( approximately 70%) can be obtained after less than 60 s of irradiation upon the nanocomposite. A transmission electron microscope (TEM) study of the nanocomposite showed no aggregation of fillers. Comparable results to the methacrylate based composites were obtained from the one day MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide) cytotoxicity test. The developed epoxy resin based nanocomposite demonstrated low shrinkage and high strength and is suitable for dental restorative material applications.

Bioinspired Catecholic Primers for Rigid and Ductile Dental Resin Composites.

PubMed

Shin, Eeseul; Ju, Sung Won; An, Larry; Ahn, Eungjin; Ahn, Jin-Soo; Kim, Byeong-Su; Ahn, B Kollbe

2018-01-17

In the construction of dental restorative polymer composite materials, surface priming on mineral fillers is essential to improve the mechanical performance of the composites. Here we present bioinspired catechol-functionalized primers for a tougher dental resin composite containing glass fillers. The catecholic primers with different polymerizable end groups were designed and then coated on glass surfaces using a simple drop-casting or dip-coating process. The surface binding ability and possible cross-linking (coupling or chemical bridging between the glass substrate and the dental resin) of the catecholic bifunctional primers were evaluated using atomic force microscopy, contact angle measurements, and the knife shear bonding test and compared to a state-of-the-art silane-based coupling agent. Various mechanical tests including shrinkage and compression tests of the dental resin composites were also conducted. Compression tests of the composites containing the catecholic primed fillers exhibited enhanced mechanical properties, owing to the bidentate hydrogen bonding of catechol moieties to the oxide mineral surface. Furthermore, the superior biocompatibility of the primed surface was confirmed via cell attachment assay, thus providing applicability of catecholic primers for practical dental and biomedical applications.

Physical-chemical properties of dental composites and adhesives containing silane-modified SBA-15.

PubMed

Martim, Gedalias Custódio; Kupfer, Vicente Lira; Moisés, Murilo Pereira; Dos Santos, Andressa; Buzzetti, Paulo Henrique Maciel; Rinaldi, Andrelson Wellington; Rubira, Adley Forti; Girotto, Emerson Marcelo

2018-04-01

The aim of this study was to synthesize and characterize mesoporous materials SBA-15 and SBA-15 modified with 3-(methacryloxy)-propyl-trimethoxysilane (MPS) to be used as inorganic filler in restorative dental composites and adhesives, and evaluate the main physical-chemical properties of the resulting material. The SBA-15 and SBA-15/MPS were characterized by FTIR, BET and X-Ray and combined with TEGDMA, bis-GMA and commercial spherical silica to produce dental composites. Afterwards, the mesoporous materials were combined with TEGDMA, bis-GMA and HEMA to make adhesives. To compare the results, composites and adhesives containing only commercial spherical silica were investigated. Some physical-chemical properties such as degree of conversion (DC), flexural strength (FS) and modulus (FM), water sorption and solubility (W sp and W sl ), specific area (BET), and the leachable components were evaluated. The SBA-15/MPS can be used to prepare dental restorative materials, with some foreseeable advantages compared with pure SBA-15 dental materials and with improved properties compared with commercial spherical silica dental materials. An important improvement was that the dental materials based on modified SBA-15 presented a reduction of approximately 60% in leaching of unreacted monomers extracted by solvent compared to the control group. Copyright © 2018 Elsevier Ltd. All rights reserved.

Efficient digitalization method for dental restorations using micro-CT data

NASA Astrophysics Data System (ADS)

Kim, Changhwan; Baek, Seung Hoon; Lee, Taewon; Go, Jonggun; Kim, Sun Young; Cho, Seungryong

2017-03-01

The objective of this study was to demonstrate the feasibility of using micro-CT scan of dental impressions for fabricating dental restorations and to compare the dimensional accuracy of dental models generated from various methods. The key idea of the proposed protocol is that dental impression of patients can be accurately digitized by micro-CT scan and that one can make digital cast model from micro-CT data directly. As air regions of the micro-CT scan data of dental impression are equivalent to the real teeth and surrounding structures, one can segment the air regions and fabricate digital cast model in the STL format out of them. The proposed method was validated by a phantom study using a typodont with prepared teeth. Actual measurement and deviation map analysis were performed after acquiring digital cast models for each restoration methods. Comparisons of the milled restorations were also performed by placing them on the prepared teeth of typodont. The results demonstrated that an efficient fabrication of precise dental restoration is achievable by use of the proposed method.

The demand for preventive and restorative dental services.

PubMed

Meyerhoefer, Chad D; Zuvekas, Samuel H; Manski, Richard

2014-01-01

Chronic tooth decay is the most common chronic condition in the United States among children ages 5-17 and also affects a large percentage of adults. Oral health conditions are preventable, but less than half of the US population uses dental services annually. We seek to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. Using data from the 2001-2006 Medical Expenditure Panel Survey and an American Dental Association survey of dental procedure prices, we jointly estimate the probability of using preventive and both basic and major restorative services through a correlated random effects specification that controls for endogeneity. We found that dental coverage increased the probability of preventive care use by 19% and the use of restorative services 11% to 16%. Both conditional and unconditional on dental coverage, the use of dental services was not sensitive to out-of-pocket costs. We conclude that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants. Copyright © 2013 John Wiley & Sons, Ltd.

Morphological characterization of ceramic fillers made from Indonesian natural sand as restorative dental materials

NASA Astrophysics Data System (ADS)

Karlina, E.; Susra, S.; Fatmala, Y.; Hartoyo, H. M.; Takarini, V.; Usri, K.; Febrida, R.; Djustiana, N.; Panatarani, C.; Joni, I. M.

2018-02-01

Dental composite as restorative dental materials can be reinforced using ceramic fillers. Homogeneous distribution of filler particles shall improve its mechanical properties. This paper presents the results of the preliminary study on the ZrO2-Al2O3-SiO2 ceramic fillers made from Indonesian natural sand that can increase the mechanical properties of dental composite. The synthesis was done using zirconium silicate sand (ZrSiO4) and aluminium oxide (Al2O3) precursors, which dissolved together with 70:30 weight ratios. Two types of sand were used: (1) manufactured sand (mesh #80) and (2) natural sand (mesh #400). The samples then heated in the furnace at 1100 °C for 8 hours. The morphological characterization was then evaluated using JEOL Scanning Electron Microscope (SEM) for the surface structure that analyze particles size and distribution. Ceramic fillers made from natural sand is homogenous, well distributed with average particle size of 5-10 µm. Comparably, ceramic filler made from the manufactured sand is heterogeneous, poorly distributed and appear as agglomerates with average particle size are 30-50 µm. The results suggest that ceramic fillers made from natural sand demonstrate better character to represent as a functional restorative dental material.

Restorative Management of Intrinsic and Extrinsic Dental Erosion.

PubMed

Al-Salehi, Samira Kathryn

2014-12-01

The restorative management of tooth surface loss is highlighted through the presentation of two advanced cases of dental erosion. On presentation, the causes of the dental erosion in both patients had been previously diagnosed and stopped. The first patient was a 67 year old with intrinsic erosion and an element of attrition where a multidisciplinary approach was used. The other, a 17 year old patient with extrinsic erosion managed via adhesive restorations. Adhesive techniques are a relatively simple, effective and conservative method for the treatment of dental erosion. The two treatment modalities (conventional versus contemporary) are compared and discussed.

Effect of Industry Sponsorship on Dental Restorative Trials.

PubMed

Schwendicke, F; Tu, Y-K; Blunck, U; Paris, S; Göstemeyer, G

2016-01-01

Industry sponsorship was found to potentially introduce bias into clinical trials. We assessed the effects of industry sponsorship on the design, comparator choice, and findings of randomized controlled trials on dental restorative materials. A systematic review was performed via MEDLINE, CENTRAL, and EMBASE. Randomized trials on dental restorative and adhesive materials published 2005 to 2015 were included. The design of sponsored and nonsponsored trials was compared statistically (risk of bias, treatment indication, setting, transferability, sample size). Comparator choice and network geometry of sponsored and nonsponsored trials were assessed via network analysis. Material performance rankings in different trial types were estimated via Bayesian network meta-analysis. Overall, 114 studies were included (15,321 restorations in 5,232 patients). We found 21 and 41 (18% and 36%) trials being clearly or possibly industry sponsored, respectively. Trial design of sponsored and nonsponsored trials did not significantly differ for most assessed items. Sponsored trials evaluated restorations of load-bearing cavities significantly more often than nonsponsored trials, had longer follow-up periods, and showed significantly increased risk of detection bias. Regardless of sponsorship status, comparisons were mainly performed within material classes. The proportion of trials comparing against gold standard restorative or adhesive materials did not differ between trial types. If ranked for performance according to the need to re-treat (best: least re-treatments), most material combinations were ranked similarly in sponsored and nonsponsored trials. The effect of industry sponsorship on dental restorative trials seems limited. © International & American Associations for Dental Research 2015.

Biomonitoring of DNA damage in peripheral blood lymphocytes of subjects with dental restorative fillings.

PubMed

Di Pietro, Angela; Visalli, Giuseppa; La Maestra, Sebastiano; Micale, Rosanna; Baluce, Barbara; Matarese, Giovanni; Cingano, Luciano; Scoglio, Maria Elena

2008-02-29

Dental fillings provide a major iatrogenic exposure to xenobiotic compounds due to the high prevalence of surface restorations in developed countries. Experimental data suggest that both amalgams, which contain mercury, and resin-based dental materials cause an impairment of the cellular pro- and anti-oxidant redox balance. The aim of this study was to assess the potential genotoxicity of dental restorative compounds in peripheral blood lymphocytes of young exposed subjects compared with controls. The study examined, by use of the comet assay, 68 carefully selected subjects taking into account the major known confounding factors. In the 44 exposed subjects, the mean numbers of restored surfaces was 3.0 and 3.8 in males and females, respectively. Tail length, percentage of DNA in the tail, tail moment or Olive tail moment were twofold higher in the exposed group than in unexposed controls, with significant differences. No significant difference was observed between amalgam and composite fillings. Furthermore, as shown by multivariate analysis, the association between dental fillings and DNA damage was enhanced by the number of fillings and by the exposure time. Among the lifestyle variables, a moderate physical activity showed a protective effect, being inversely correlated to the DNA damage parameters evaluated. On the whole, the use of DNA-migration allowed us to detect for the first time the potential adverse impact on human health of both kinds of dental filling constituents, the amalgams and the methacrylates. The main mechanism underlying the genotoxicity of dental restorative materials of various nature may be ascribed to the ability of both amalgams and methacrylates to trigger the generation of cellular reactive oxygen species, able to cause oxidative DNA lesions.

Antibacterial Activity of Dental Composites Containing Zinc Oxide Nanoparticles

PubMed Central

Sevinç, Berdan Aydin; Hanley, Luke

2010-01-01

The resin-based dental composites commonly used in restorations result in more plaque accumulation than other materials. Bacterial biofilm growth contributes to secondary caries and failure of resin-based dental composites. Methods to inhibit biofilm growth on dental composites have been sought for several decades. It is demonstrated here that zinc oxide nanoparticles (ZnO-NPs) blended at 10% (w/w) fraction into dental composites display antimicrobial activity and reduce growth of bacterial biofilms by roughly 80% for a single-species model dental biofilm. Antibacterial effectiveness of ZnO-NPs was assessed against Streptococcus sobrinus ATCC 27352 grown both planktonically and as biofilms on composites. Direct contact inhibition was observed by scanning electron microscopy and confocal laser scanning microscopy while biofilm formation was quantified by viable counts. An 80% reduction in bacterial counts was observed with 10% ZnO-NP-containing composites compared with their unmodified counterpart, indicating a statistically significant suppression of biofilm growth. Although, 20% of the bacterial population survived and could form a biofilm layer again, 10% ZnO-NP-containing composites maintained at least some inhibitory activity even after the third generation of biofilm growth. Microscopy demonstrated continuous biofilm formation for unmodified composites after one day growth, but only sparsely distributed biofilms formed on 10% ZnO-NP-containing composites. The minimum inhibitory concentration of ZnO-NPs suspended in S. sobrinus planktonic culture was 50 μg/ml. 10% ZnO-NP-containing composites qualitatively showed less biofilm after one day anaerobic growth of a three-species initial colonizer biofilm after when compared to unmodified composites, but did not significantly reduce growth after three days. PMID:20225252

A comparison of stresses in molar teeth restored with inlays and direct restorations, including polymerization shrinkage of composite resin and tooth loading during mastication.

PubMed

Dejak, Beata; Młotkowski, Andrzej

2015-03-01

Polymerization shrinkage of composites is one of the main causes of leakage around dental restorations. Despite the large numbers of studies there is no consensus, what kind of teeth reconstruction--direct or indirect composite restorations are the most beneficial and the most durable. The aim was to compare equivalent stresses and contact adhesive stresses in molar teeth with class II MOD cavities, which were restored with inlays and direct restorations (taking into account polymerization shrinkage of composite resin) during simulated mastication. The study was conducted using the finite elements method with the application of contact elements. Three 3D models of first molars were created: model A was an intact tooth; model B--a tooth with a composite inlay, and model C--a tooth with a direct composite restoration. Polymerization linear shrinkage 0.7% of a direct composite restoration and resin luting cement was simulated (load 1). A computer simulation of mastication was performed (load 2). In these 2 situations, equivalent stresses according to the modified von Mises criterion (mvM) in the materials of mandibular first molar models with different restorations were calculated and compared. Contact stresses in the luting cement-tooth tissue adhesive interface around the restorations were also assessed and analyzed. Equivalent stresses in a tooth with a direct composite restoration (the entire volume of which was affected by polymerization shrinkage) were many times higher than in the tooth restored with a composite inlay (where shrinkage was present only in a thin layer of the luting cement). In dentin and enamel the stress values were 8-14 times higher, and were 13 times higher in the direct restoration than in the inlay. Likewise, contact stresses in the adhesive bond around the direct restoration were 6.5-7.7 times higher compared to an extraorally cured restoration. In the masticatory simulation, shear contact stresses in the adhesive bond around the direct

A useful and non-invasive microanalysis method for dental restoration materials

NASA Astrophysics Data System (ADS)

Hosoki, M.; Satsuma, T.; Nishigawa, K.; Takeuchi, H.; Asaoka, K.

2012-12-01

The elemental analysis of intraoral dental restorations provides considerable information for the treatment of dental metal allergy. Elemental analyses require specific instruments and complicated procedures, so this examination is not commonly carried out in private dental clinics. We describe a novel, simple and useful micro-analytical method for dental metal restorations. Micro metal dust was obtained by polishing the surface of restorative metal material with an unused silicone point (SUPER-SNAP). The metal dust on the silicone point was then rubbed onto adhesive tape, and this tape was covered with polyethylene film. The amount of metal dust material was <20 μg. An energy dispersive X-ray fluorescence spectrometer was used to carry out the elementary analysis of the metal dust on the polyethylene film. Three types of dental metal alloy materials of known components were examined. The results of elementary analyses were compared with the specifications provided by the manufacturer. The same procedure was carried out for three dental metal restorations of an adult female volunteer in vivo. The results of elemental analyses for five alloy materials exactly matched the product specification. Three metal samples obtained from intraoral restoration were also available for elemental analyses. The distinct advantage of this method is that it enables sample extraction without an invasive effect for the restoration. The metal sample is in a polyethylene film, so it is easy to mail it for inspection at specialist institutes yet it can be also be used in general dental clinics.

Nanotechnology-based restorative materials for dental caries management

PubMed Central

Melo, Mary A.S.; Guedes, Sarah F.F.; Xu, Hockin H.K.; Rodrigues, Lidiany K.A.

2013-01-01

Nanotechnology has been applied to dental materials as an innovative concept for the development of materials with better properties and anticaries potential. In this review we discuss the current progress and future applications of functional nanoparticles incorporated in dental restorative materials as useful strategies to dental caries management. We also overview proposed antimicrobial and remineralizing mechanisms. Nanomaterials have great potential to decrease biofilm accumulation, inhibit the demineralization process, to be used for remineralizing tooth structure, and to combat caries-related bacteria. These results are encouraging and open the doors to future clinical studies that will allow the therapeutic value of nanotechnology-based restorative materials to be established. PMID:23810638

Effectiveness of the DHMAI monomer in the development of an antibacterial dental composite.

PubMed

Cherchali, Fatima Zohra; Mouzali, Mohamed; Tommasino, Jean Bernard; Decoret, Dominique; Attik, Nina; Aboulleil, Hazem; Seux, Dominique; Grosgogeat, Brigitte

2017-12-01

Development of antibacterial dental composites is the ultimate goal to decrease carious disease occurrence and increase the restoration longevity. For this purpose, the quaternary ammonium dimethyl-hexadecyl-methacryloxyethyl-ammonium iodide (DHMAI) and the methacryloyloxyethylphosphorylcholine (MPC) have been incorporated in experimental methacrylate-based composite resins. This aims to first investigate the effect of each alone and then their combined effect. Synthesized DHMAI and commercial MPC were added either alone or combined at different concentrations to experimental dental composite. Flexural strength (FS) and modulus (FM) were tested to select the optimal concentrations. Only selected composites were evaluated for Vickers hardness (HV) and the degree of conversion (DC) using fourier transform infrared spectroscopy analysis (FTIR-ATR). Antibacterial activity was assessed using tests on colony-forming unit (CFU), scanning electron microscopy (SEM) and Alamarblue assay to measure the metabolic activity. Streptococcus mutans biofilm was chosen to be grown on the composite surfaces during 96h at 37°C. Incorporation of 7.5% DHMAI in composite improved the degree of conversion and gave a strong antibacterial effect with a reduction of (∼98%) in CFU and (∼50%) of metabolic activity with acceptable mechanical properties. Addition of MPC to DHMAI affects mechanical properties of composites without providing a better antibacterial activity. Composites with DHMAI greatly reduced S. mutans biofilm and improved the degree of conversion without scarifying the composites' mechanical properties. DHMAI may have wide applicability to other dental materials in order to inhibit caries and improve the longevity of restorations. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Core-shell quantum dots tailor the fluorescence of dental resin composites.

PubMed

Alves, Leandro P; Pilla, Viviane; Murgo, Dírian O A; Munin, Egberto

2010-02-01

We characterized the optical properties, such as absorbance and fluorescence, of dental resins containing quantum dots (QD). We also determined the doping level needed to obtain a broad and nearly flat emission spectrum that provides the perception of white color. The samples studied were resin composites from Charisma (Heraeus Kulzer) prepared with CdSe/ZnS core-shell QD (0.05-0.77 mass%). The results showed that the fluorescence of dental resin composites can be tailored by using CdSe/ZnS core-shell quantum dots. QD core incorporation into dental resins allows the fabrication of restorative materials with fluorescence properties that closely match those of natural human teeth. Copyright 2009 Elsevier Ltd. All rights reserved.

Hydrogen peroxide bleaching induces changes in the physical properties of dental restorative materials: Effects of study protocols.

PubMed

Yu, Hao; Zhang, Chang-Yuan; Wang, Yi-Ning; Cheng, Hui

2018-03-01

The purpose of this study was to evaluate the influence of study protocols on the effects of bleaching on the surface roughness, substance loss, flexural strength (FS), flexural modulus (FM), Weibull parameters, and color of 7 restorative materials. The test materials included 4 composite resins, 1 glass-ionomer cement, 1 dental ceramic, and 1 polyacid-modified composite. The specimens were randomly divided into 4 groups (n = 20) according to different study protocols: a bleaching group at 25°C (group 25B), a bleaching group at 37°C (group 37B), a control group at 25°C (group 25C), and a control group at 37°C (group 37C). The specimens in the bleaching group were treated with 40% hydrogen peroxide for 80 min at the respective environmental temperatures. The surface roughness, substance loss, FS, FM, and color of the specimens were measured before and after treatment. FS data were also subjected to Weibull analysis, which was used to estimate of the Weibull modulus (m) and the characteristic strength (σ 0 ). Surface roughness increased and significant color changes were observed for all tested specimens after bleaching treatment, except for the ceramic. After bleaching at 37°C, the polyacid-modified composite showed significantly reduced FS, FM, m, and σ 0 values in comparison to the control specimens stored at 37°C in whole saliva. Significant differences were also found between the 37B and 25B polyacid-modified composite groups in terms of surface roughness, FS, m, σ 0 , and color changes. Varying effects of bleaching on the physical properties of dental restorative materials were observed, and the influences of the study protocols on bleaching effects were found to be material-dependent. The influence of study protocols on the effects of bleaching on the surface roughness, flexural properties, and color of dental restorative materials are material-dependent and should be considered when evaluating the effects of bleaching on dental restorative

Utilizing optical coherence tomography for CAD/CAM of indirect dental restorations

NASA Astrophysics Data System (ADS)

Chityala, Ravishankar; Vidal, Carola; Jones, Robert

Optical Coherence Tomography (OCT) has seen broad application in dentistry including early carious lesion detection and imaging defects in resin composite restorations. This study investigates expanding the clinical usefulness by investigating methods to use OCT for obtaining three-dimensional (3D) digital impressions, which can be integrated to CAD/CAM manufacturing of indirect restorations. 3D surface topography `before' and `after' a cavity preparation was acquired by an intraoral cross polarization swept source OCT (CP-OCT) system with a Micro-Electro-Mechanical System (MEMS) scanning mirror. Image registration and segmentation methods were used to digitally construct a replacement restoration that modeled the original surface morphology of a hydroxyapatite sample. After high resolution additive manufacturing (e.g. polymer 3D printing) of the replacement restoration, micro-CT imaging was performed to examine the marginal adaptation. This study establishes the protocol for further investigation of integrating OCT with CAD/CAM of indirect dental restorations.

Development of novel self-healing and antibacterial dental composite containing calcium phosphate nanoparticles

PubMed Central

Wu, Junling; Weir, Michael D.; Melo, Mary Anne S.; Xu, Hockin H. K.

2015-01-01

Objectives Fracture and secondary caries are the primary reasons for dental restoration failure. The objective of this study was to develop a self-healing composite to heal cracks, while containing dimethylaminohexadecyl methacrylate (DMAHDM) for antibacterial function and nanoparticles of amorphous calcium phosphate (NACP) for remineralization. Methods Microcapsules were synthesized with poly(urea-formaldehyde) (PUF) shells containing triethylene glycol dimethacrylate (TEGDMA) and N,N-dihydroxyethyl-p-toluidine (DHEPT) as healing liquid. Composite contained 20 mass% of NACP and 35% glass fillers. In addition, composite contained 0%, 2.5%, 5%, 7.5%, or 10% of microcapsules. A single edge V-notched beam method measured fracture toughness (KIC) and self-healing efficiency. A dental plaque microcosm biofilm model was used to test the antibacterial properties. Results Incorporation of microcapsules up to 7.5% into the composite did not adversely affect the mechanical properties (p > 0.1). Successful self-healing was achieved, with KIC recovery of 65–81% (mean ± sd; n = 6) to regain the load-bearing capability after composite fracture. The self-healing DMAHDM-NACP composite displayed a strong antibacterial potency, inhibiting biofilm viability and lactic acid production, and reducing colony-forming units by 3–4 orders of magnitude, compared to control composite without DMAHDM. Conclusions A dental composite was developed with triple benefits of self-healing after fracture, antibacterial activity, and remineralization capability for the first time. Clinical significance The self-healing, antibacterial and remineralizing composite may be promising for tooth cavity restorations to combat bulk fracture and secondary caries. The method of using triple agents (self-healing microcapsules, DMAHDM, and NACP) may have wide applicability to other dental composites, adhesives, sealants and cements. PMID:25625674

State-of-the-art techniques in operative dentistry: contemporary teaching of posterior composites in UK and Irish dental schools.

PubMed

Lynch, C D; Frazier, K B; McConnell, R J; Blum, I R; Wilson, N H F

2010-08-14

Advances of composite systems and their application have revolutionised the management of posterior teeth affected by caries, facilitating a minimally invasive approach. Previous surveys have indicated that the teaching of posterior composites within dental schools was developing, albeit not keeping pace with clinical evidence and the development of increasingly predictable techniques and materials. Concurrently, surveys of dental practice indicate that dental amalgam still predominates as the 'material of choice' for the restoration of posterior teeth within UK general dental practice. In light of such considerations, the aim of this study was to investigate current teaching of posterior composites in Irish and UK dental schools. An online questionnaire which sought information in relation to the current teaching of posterior composites was developed and distributed to the 17 established Irish and UK dental schools with undergraduate teaching programmes in late 2009. Completed responses were received from all 17 schools (response rate = 100%). All 17 schools taught the placement of occlusal and two-surface occlusoproximal composites in premolar and permanent molar teeth. Two schools did not teach placement of three-surface occlusoproximal composites in either premolars or molars. In their preclinical courses, ten schools taught posterior composites before teaching dental amalgams. Fifty-five percent of posterior restorations placed by dental students were of composite (range = 10-90%) and 44% amalgam (range = 10-90%), indicating an increase of 180% in the numbers of posterior composites placed over the past five years. Diversity was noted in the teaching of clinical techniques and students at different schools are trained with different composites and bonding systems. Some cause for concern was noted in the teaching of certain techniques that were not in keeping with existing best evidence, such as the teaching of transparent matrix bands and light

The frequency of replacement of dental restorations may vary based on a number of variables, including type of material, size of the restoration, and caries risk of the patient.

PubMed

Roumanas, Eleni D

2010-03-01

The authors analyzed the dental records of 2780 Navy (cohort 1 = 1078 entered the Navy in 1997) and US Marine Corps recruits (cohort 2 =1053 entered the USMC in 1999-2000; cohort 3 = 649 entered the USMC in 2002-2005). The records were reviewed at 16 US Navy dental treatment facilities at the following time periods: cohort 1, 2001; cohort 2, 2002-2003; and cohort 3, 2005-2006. The mean age of the subjects was 20 years, and 85% were men. Only posterior teeth (not third molars) with amalgam or resin-based composite (including glass ionomer restorations) were evaluated. Teeth that had been restored with more than one material and restorations that did not involve the occlusal surface were excluded. The minimum follow-up time was 2 years with at least 2 periodic exams following the initial exam. The primary factor of interest was the type of restorative material (amalgam versus resin-based composite). Secondary factors included tooth number, number of restored surfaces (single or multiple), and caries risk of the patient. Caries risk status was defined using the Navy Dental Corps Oral Disease Risk Management protocol. The primary outcome measure of interest was the determination of the relative risk of replacement of an initially intact restoration during the subject's first years of military service. Restorations were classified as clinically acceptable or requiring replacement either as a result of new primary caries, secondary caries, defective restorations, or endodontic therapy. At the initial exam, 964 (15.2%) of the amalgam restorations and 199 (17.4%) of the resin-based composites required replacement and were excluded from further analysis. Of the remaining restorations, an additional 14.2% of the amalgam and 16.7% of the composite restorations required replacement during the observation period. The mean follow-up time was 3.0 years (cohort 1, 3.4 years; cohort 2, 3.1 years; cohort 3, 2.3 years). Replacement rates for resin-based composite restorations

Scattering and Absorption Properties of Biomaterials for Dental Restorative Applications

NASA Astrophysics Data System (ADS)

Fernandez-Oliveras, A.; Rubiño, M.; Pérez, M. M.

2013-08-01

The physical understanding of the optical properties of dental biomaterials is mandatory for their final success in restorative applications.Light propagation in biological media is characterized by the absorption coefficient, the scattering coefficient, the scattering phase function,the refractive index, and the surface conditions (roughness). We have employed the inverse adding-doubling (IAD) method to combine transmittance and reflectance measurements performed using an integrating-sphere setup with the results of the previous scattering-anisotropygoniometric measurements. This has led to the determination of the absorption and the scattering coefficients. The aim was to optically characterize two different dental-resin composites (nanocomposite and hybrid) and one type of zirconia ceramic, and comparatively study them. The experimental procedure was conducted under repeatability conditions of measurement in order to determine the uncertainty associated to the optical properties of the biomaterials. Spectral variations of the refraction index and the scattering anisotropy factor were also considered. The whole experimental procedure fulfilled all the necessary requirements to provide optical-property values with lower associated uncertainties. The effective transport coefficient presented a similar spectral behavior for the two composites but completely different for the zirconia ceramic. The results demonstrated that the scattering anisotropy exerted a clearly distinct impact on the optical properties of the zirconia ceramic compared with those of the dental-resin composites.

Radiopacity of 28 Composite Resins for Teeth Restorations.

PubMed

Raitz, Ricardo; Moruzzi, Patrizia Dubinskas; Vieira, Glauco; Fenyo-Pereira, Marlene

2016-02-01

Radiopacity is a fundamental requisite to check marginal adaptation of restorations. Our objective was to assess the radiopacity of 28 brands of light-cured composite resins and compare their radiopacity with that of enamel, dentin, and aluminum of equivalent thickness. Composite resin disks (0.2, 0.5, and 1 mm) were radiographed by the digital method, together with an aluminum penetrometer and a human tooth equivalent tooth section. The degree of radiopacity of each image was quantified using digital image processing. Wilcoxon nonparametric test was used for comparison of the mean thickness of each material. All of the materials tested had an equal or greater radiopacity than that of aluminum of equivalent thickness. Similar results for enamel were found with the exception of Durafill, which was less radiopaque than enamel (p < 0.05). All the specimens were more radiopaque than dentin, except for P90 (which was equally radiopaque) and Durafill (which was less radiopaque). The thickness of the specimens may influence the similarity to the enamel's radiopacity. All of the composite resins comply with specification #27 of the American Dental Association. The radiopacity of Amelogen Plus, Aph, Brilhiante, Charisma, Concept Advanced, Evolux X, Exthet X, Inten S, Llis, Master Fill, Natural Look, Opallis, P60, Tetric, Tph, Z100, and Z250 was significantly higher than that of enamel (p < 0.05). With these composites, it is possible to observe the boundaries between restoration and tooth structure, thus allowing clinicians to establish the presence of microleakage or restoration gap. Suitable radiopacity is an essential requisite for good-quality esthetic restorative materials. We demonstrate that only some composites have the sufficient radiopacity to observe the boundaries between restoration and tooth structure, which is the main cause of restoration failure.

Polymeric dental composites based on remineralizing amorphous calcium phosphate fillers

PubMed Central

Skrtic, Drago; Antonucci, Joseph M.

2017-01-01

For over two decades we have systematically explored structure-composition-property relationships of amorphous calcium phosphate (ACP)-based polymeric dental composites. The appeal of these bioactive materials stems from their intrinsic ability to prevent demineralization and/or restore defective tooth structures via sustained release of remineralizing calcium and phosphate ions. Due to the compositional similarity of the ACP to biological tooth mineral, ACP-based composites should exhibit excellent biocompatibility. Research described in this article has already yielded remineralizing sealants and orthodontic adhesives as well as a prototype root canal sealer. Our work has also contributed to a better understanding on how polymer matrix structure and filler/matrix interactions affect the critical properties of these polymeric composites and their overall performance. The addition of antimicrobial compounds to the formulation of ACP composites could increase their medical and dental regenerative treatment applications, thereby benefiting an even greater number of patients. PMID:29599572

The effect of bleaching agents on the microhardness of dental aesthetic restorative materials.

PubMed

Türker, S B; Biskin, T

2002-07-01

This study investigated the effects of three home bleaching agents on the microhardness of various dental aesthetic restorative materials. The restorative materials were: feldspatic porcelain, microfilled composite resin and light-cured modified glass-ionomer cement and the bleaching agents Nite-White (16% carbamide peroxide), Opalescence (10% carbamide peroxide and carbapol jel) and Rembrandt (10% carbamide peroxide jel). A total of 90 restorative material samples were prepared 1 cm diameter and 6 mm thick and kept in distilled water for 24 h before commencing bleaching which was carried out for 8 h day-1 for 4 weeks. Microhardness measurements were then made using a Tukon tester. Statistically significant differences with respect to unbleached controls were found only for the feldspatic porcelain and microfilled composite resins (P <0.05) for Nite-White and Opalescence. All the bleaching agents decreased the microhardness of the porcelain and increased that of the light cured modified glass-ionomer cement. For the composite resin, whereas Nite-White increased its microhardness, the other bleaching agents decreased it. There were no significant differences between the bleaching agents for any of the restorative materials.

Clinical Investigation of a New Bulk Fill Composite Resin in the Restoration of Posterior Teeth

ClinicalTrials.gov

2017-09-14

Dental Restoration Failure of Marginal Integrity; Dental Caries; Unrepairable Overhanging of Dental Restorative Materials; Poor Aesthetics of Existing Restoration; Secondary Dental Caries Associated With Failed or Defective Dental Restorations; Fractured Dental Restorative Materials Without Loss of Materials; Fracture of Dental Restorative Materials With Loss of Material

Modeling dental composite shrinkage by digital image correlation and finite element methods

NASA Astrophysics Data System (ADS)

Chen, Terry Yuan-Fang; Huang, Pin-Sheng; Chuang, Shu-Fen

2014-10-01

Dental composites are light-curable resin-based materials with an inherent defect of polymerization shrinkage which may cause tooth deflection and debonding of restorations. This study aimed to combine digital image correlation (DIC) and finite element analysis (FEA) to model the shrinkage behaviors under different light curing regimens. Extracted human molars were prepared with proximal cavities for composite restorations, and then divided into three groups to receive different light curing protocols: regular intensity, low intensity, and step-curing consisting of low and high intensities. For each tooth, the composite fillings were consecutively placed under both unbonded and bonded conditions. At first, the shrinkage of the unbonded restorations was analyzed by DIC and adopted as the setting of FEA. The simulated shrinkage behaviors obtained from FEA were further validated by the measurements in the bonded cases. The results showed that different light curing regimens affected the shrinkage in unbonded restorations, with regular intensity showing the greatest shrinkage strain on the top surface. The shrinkage centers in the bonded cases were located closer to the cavity floor than those in the unbonded cases, and were less affected by curing regimens. The FEA results showed that the stress was modulated by the accumulated light energy density, while step-curing may alleviate the tensile stress along the cavity walls. In this study, DIC provides a complete description of the polymerization shrinkage behaviors of dental composites, which may facilitate the stress analysis in the numerical investigation.

Bioactive glass fillers reduce bacterial penetration into marginal gaps for composite restorations

PubMed Central

Khvostenko, D.; Hilton, T. J.; Ferracane, J. L.; Mitchell, J. C.; Kruzic, J. J.

2015-01-01

Objectives Bioactive glass (BAG) is known to possess antimicrobial and remineralizing properties; however, the use of BAG as a filler for resin based composite restorations to slow recurrent caries has not been studied. Accordingly, the objective of this study was to investigate the effect of 15 wt% BAG additions to a resin composite on bacterial biofilms penetrating into marginal gaps of simulated tooth fillings in vitro during cyclic mechanical loading. Methods Human molars were machined into approximately 3 mm thick disks of dentin and 1.5–2 mm deep composite restorations were placed. A narrow 15–20 micrometer wide dentin-composite gap was allowed to form along half of the margin by not applying dental adhesive to that region. Two different 72 wt% filled composites were used, one with 15 wt% BAG filler (15BAG) and the balance silanated strontium glass and one filled with OX-50 and silanated strontium glass without BAG (0BAG – control). Samples of both groups had Streptococcus mutans biofilms grown on the surface and were tested inside a bioreactor for two weeks while subjected to periods of cyclic mechanical loading. After post-test biofilm viability was confirmed, each specimen was fixed in glutaraldehyde, gram positive stained, mounted in resin and cross-sectioned to reveal the gap profile. Depth of biofilm penetration for 0BAG and 15BAG was quantified as the fraction of gap depth. The data were compared using a Student’s t-test. Results The average depth of bacterial penetration into the marginal gap for the 15BAG samples was significantly smaller (~61%) in comparison to 0BAG, where 100% penetration was observed for all samples with the biofilm penetrating underneath of the restoration in some cases. Significance BAG containing resin dental composites reduce biofilm penetration into marginal gaps of simulated tooth restorations. This suggests BAG containing composites may have the potential to slow the development and propagation of secondary tooth

Effects of high temperature on different restorations in forensic identification: Dental samples and mandible

PubMed Central

Patidar, Kalpana A; Parwani, Rajkumar; Wanjari, Sangeeta

2010-01-01

Introduction: The forensic odontologist strives to utilize the charred human dentition throughout each stage of dental evaluation, and restorations are as unique as fingerprints and their radiographic morphology as well as the types of filling materials are often the main feature for identification. The knowledge of detecting residual restorative material and composition of unrecovered adjacent restoration is a valuable tool-mark in the presumptive identification of the dentition of a burned victim. Gold, silver amalgam, silicate restoration, and so on, have a different resistance to prolonged high temperature, therefore, the identification of burned bodies can be correlated with adequate qualities and quantities of the traces. Most of the dental examination relies heavily on the presence of the restoration as well as the relationship of one dental structure to another. This greatly narrows the research for the final identification that is based on postmortem data. Aim: The purpose of this study is to examine the resistance of teeth and different restorative materials, and the mandible, to variable temperature and duration, for the purpose of identification. Materials and Methods: The study was conducted on 72 extracted teeth which were divided into six goups of 12 teeth each based on the type of restorative material. (Group 1 - unrestored teeth, group 2 - teeth restored with Zn3(PO4)2, group 3 - with silver amalgam, group 4 with glass ionomer cement, group 5 - Ni-Cr-metal crown, group 6 - metal ceramic crown) and two specimens of the mandible. The effect of incineration at 400°C (5 mins, 15 mins, 30 mins) and 1100°C (15 mins) was studied. Results: Damage to the teeth subjected to variable temperatures and time can be categorized as intact (no damage), scorched (superficially parched and discolored), charred (reduced to carbon by incomplete combustion) and incinerated (burned to ashes). PMID:21189989

Prevalence and distribution of dental restorative materials in US Air Force veterans.

PubMed

Albertini, T F; Kingman, A; Brown, L J

1997-01-01

Millions of restorative procedures are performed annually in the United States, yet very little is known about their distribution in the general population. With increasing concern about potential adverse health effects of some restorative materials, a better understanding of the extent of exposure to these materials in the population is important. The purpose of this study is to report the prevalence, patterns, and distribution of dental restorative materials in a population of male veterans. This collaborative study with the US Air Force examined 1,166 male veterans to assess exposure to dental amalgam and other restorative materials. An inventory of dental materials in the study population was obtained through oral examinations. Dental materials were classified into five categories: (1) amalgam; (2) resin; (3) porcelain, cement, or temporary, including ionomer (PCT); (4) cast gold alloys/direct filling gold; and (5) other metals (OM). The mean age of the study participants was 52.9 years. Over 94 percent of the study participants were dentate. The study participants averaged 45.8 restored/replaced surfaces. Restored/replaced surfaces increased with age while the number of teeth decreased with age. The most frequently used restorative material was amalgam, averaging 19.89 surfaces per subject, followed by PCT (9.38), resins (8.99), OM (5.52), and gold (4.91). The distributions of restorative materials varied by age, arch type, and location in the mouth. The study population experienced substantial exposure to dental materials.

Can pulpal floor debonding be detected from occlusal surface displacement in composite restorations?

PubMed

Novaes, João Batista; Talma, Elissa; Las Casas, Estevam Barbosa; Aregawi, Wondwosen; Kolstad, Lauren Wickham; Mantell, Sue; Wang, Yan; Fok, Alex

2018-01-01

Polymerization shrinkage of resin composite restorations can cause debonding at the tooth-restoration interface. Theory based on the mechanics of materials predicts that debonding at the pulpal floor would half the shrinkage displacement at the occlusal surface. The aim of this study is to test this theory and to examine the possibility of detecting subsurface resin composite restoration debonding by measuring the superficial shrinkage displacements. A commercial dental resin composite with linear shrinkage strain of 0.8% was used to restore 2 groups of 5 model Class-II cavities (8-mm long, 4-mm wide and 4-mm deep) in aluminum blocks (8-mm thick, 10-mm wide and 14-mm tall). Group I had the restorations bonded to all cavity surfaces, while Group II had the restorations not bonded to the cavity floor to simulate debonding. One of the proximal surfaces of each specimen was sprayed with fine carbon powder to allow surface displacement measurement by Digital Image Correlation. Images of the speckled surface were taken before and after cure for displacement calculation. The experiment was simulated using finite element analysis (FEA) for comparison. Group I showed a maximum occlusal displacement of 34.7±6.7μm and a center of contraction (COC) near the pulpal floor. Group II had a COC coinciding with the geometric center and showed a maximum occlusal displacement of 17.4±3.8μm. The difference between the two groups was statistically significant (p-value=0.0007). Similar results were obtained by FEA. The theoretical shrinkage displacement was 44.6 and 22.3μm for Group I and II, respectively. The lower experimental displacements were probably caused by slumping of the resin composite before cure and deformation of the adhesive layer. The results confirmed that the occlusal shrinkage displacement of a resin composite restoration was reduced significantly by pulpal floor debonding. Recent in vitro studies seem to indicate that this reduction in shrinkage displacement

Fiber-reinforced composite fixed dental prostheses: two clinical reports.

PubMed

Zarow, Maciej; Paisley, Carl Stuart; Krupinski, Jerzy; Brunton, Paul Anthony

2010-06-01

Various options are available in clinical practice for the replacement of a single missing tooth, ranging from conventional fixed and removable dental prostheses to a single implant-supported crown. There are situations in which a semipermanent fixed dental prosthesis may be desirable, particularly for patients who have completed orthodontic treatment but are too young to embark on implant therapy. Following advances in fiber-reinforcement technology, fiber-reinforced composite resin (FRC) now represents a lower-cost alternative to traditional metal-ceramic for the construction of resin-bonded prostheses. Two case reports illustrate the use of FRC prostheses as fixed semipermanent_restorations.

[Dental implant restoration abutment selection].

PubMed

Bin, Shi; Hao, Zeng

2017-04-01

An increasing number of implant restoration abutment types are produced with the rapid development of dental implantology. Although various abutments can meet different clinical demands, the selection of the appropriate abutment is both difficult and confusing. This article aims to help clinicians select the appropriate abutment by describing abutment design, types, and selection criteria.

Nanotechnology strategies for antibacterial and remineralizing composites and adhesives to tackle dental caries.

PubMed

Cheng, Lei; Zhang, Ke; Weir, Michael D; Melo, Mary Anne S; Zhou, Xuedong; Xu, Hockin H K

2015-03-01

Dental caries is the most widespread disease and an economic burden. Nanotechnology is promising to inhibit caries by controlling biofilm acids and enhancing remineralization. Nanoparticles of silver were incorporated into composites/adhesives, along with quaternary ammonium methacrylates (QAMs), to combat biofilms. Nanoparticles of amorphous calcium phosphate (NACP) released calcium/phosphate ions, remineralized tooth-lesions and neutralized acids. By combining nanoparticles of silver/QAM/NACP, a new class of composites and adhesives with antibacterial and remineralization double benefits was developed. Various other nanoparticles including metal and oxide nanoparticles such as ZnO and TiO2, as well as polyethylenimine nanoparticles and their antibacterial capabilities in dental resins were also reviewed. These nanoparticles are promising for incorporation into dental composites/cements/sealants/bases/liners/adhesives. Therefore, nanotechnology has potential to significantly improve restorative and preventive dentistry.

Nanotechnology strategies for antibacterial and remineralizing composites and adhesives to tackle dental caries

PubMed Central

Cheng, Lei; Zhang, Ke; Weir, Michael D; Melo, Mary Anne S; Zhou, Xuedong; Xu, Hockin HK

2015-01-01

Dental caries is the most widespread disease and an economic burden. Nanotechnology is promising to inhibit caries by controlling biofilm acids and enhancing remineralization. Nanoparticles of silver were incorporated into composites/adhesives, along with quaternary ammonium methacrylates (QAMs), to combat biofilms. Nanoparticles of amorphous calcium phosphate (NACP) released calcium/phosphate ions, remineralized tooth-lesions and neutralized acids. By combining NAg/QAM/NACP, a new class of composites and adhesives with antibacterial and remineralization double benefits was developed. Various other nanoparticles including metal and oxide nanoparticles such as ZnO and TiO2, as well as polyethylenimine nanoparticles and their antibacterial capabilities in dental resins were also reviewed. These nanoparticles are promising for incorporation into dental composites/cements/sealants/bases/liners/adhesives. Therefore, nanotechnology has potential to significantly improve restorative and preventive dentistry. PMID:25723095

Understanding dental CAD/CAM for restorations--accuracy from a mechanical engineering viewpoint.

PubMed

Tapie, Laurent; Lebon, Nicolas; Mawussi, Bernardin; Fron-Chabouis, Hélène; Duret, Francois; Attal, Jean-Pierre

2015-01-01

As is the case in the field of medicine, as well as in most areas of daily life, digital technology is increasingly being introduced into dental practice. Computer-aided design/ computer-aided manufacturing (CAD/CAM) solutions are available not only for chairside practice but also for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental practice can be considered as the handling of devices and software processing for the almost automatic design and creation of dental restorations. However, dentists who want to use dental CAD/CAM systems often do not have enough information to understand the variations offered by such technology practice. Knowledge of the random and systematic errors in accuracy with CAD/CAM systems can help to achieve successful restorations with this technology, and help with the purchasing of a CAD/CAM system that meets the clinical needs of restoration. This article provides a mechanical engineering viewpoint of the accuracy of CAD/ CAM systems, to help dentists understand the impact of this technology on restoration accuracy.

Multispectral Near-Infrared Imaging of Composite Restorations in Extracted Teeth.

PubMed

Logan, Cooper M; Co, Katrina U; Fried, William A; Simon, Jacob C; Staninec, Michal; And, Daniel Fried; Darling, Cynthia L

2014-02-20

One major advantage of composite restoration materials is that they can be color matched to the tooth. However, this presents a challenge when composites fail and they need to be replaced. Dentists typically spend more time repairing and replacing composites than placing new restorations. Previous studies have shown that near-infrared imaging can be used to distinguish between sound enamel and decay due to the differences in light scattering. The purpose of this study was to use a similar approach and exploit differences in light scattering to attain high contrast between composite and tooth structure. Extracted human teeth with composites (n=16) were imaged in occlusal transmission mode at wavelengths of 1300-nm, 1460-nm and 1550-nm using an InGaAs image sensor with a tungsten halogen light source with spectral filters. All samples were also imaged in the visible range using a high definition 3D digital microscope. Our results indicate that NIR wavelengths at 1460-nm and 1550-nm, coincident with higher water absorption yield the highest contrast between dental composites and tooth structure.

Multispectral near-infrared imaging of composite restorations in extracted teeth

NASA Astrophysics Data System (ADS)

Logan, Cooper M.; Co, Katrina U.; Fried, William A.; Simon, Jacob C.; Staninec, Michal; Fried, Daniel; Darling, Cynthia L.

2014-02-01

One major advantage of composite restoration materials is that they can be color matched to the tooth. However, this presents a challenge when composites fail and they need to be replaced. Dentists typically spend more time repairing and replacing composites than placing new restorations. Previous studies have shown that near-infrared imaging can be used to distinguish between sound enamel and decay due to the differences in light scattering. The purpose of this study was to use a similar approach and exploit differences in light scattering to attain high contrast between composite and tooth structure. Extracted human teeth with composites (n=16) were imaged in occlusal transmission mode at wavelengths of 1300-nm, 1460-nm and 1550-nm using an InGaAs image sensor with a tungsten halogen light source with spectral filters. All samples were also imaged in the visible range using a high definition 3D digital microscope. Our results indicate that NIR wavelengths at 1460-nm and 1550-nm, coincident with higher water absorption yield the highest contrast between dental composites and tooth structure.

Preparing and Restoring Composite Resin Restorations. The Advantage of High Magnification Loupes or the Dental Surgical Operating Microscope.

PubMed

Mamoun, John

2015-01-01

Use of magnification, such as 6x to 8x binocular surgical loupes or the surgical operating microscope, combined with co-axial illumination, may facilitate the creation of stable composite resin restorations that are less likely to develop caries, cracks or margin stains over years of service. Microscopes facilitate observation of clinically relevant microscopic visual details, such as microscopic amounts of demineralization or caries at preparation margins; microscopic areas of soft, decayed tooth structure; microscopic amounts of moisture contamination of the preparation during bonding; or microscopic marginal gaps in the composite. Preventing microscope-level errors in composite fabrication can result in a composite restoration that, at initial placement, appears perfect when viewed under 6x to 8x magnification and which also is free of secondary caries, marginal staining or cracks at multi-year follow-up visits.

Translucency of human teeth and dental restorative materials and its clinical relevance

NASA Astrophysics Data System (ADS)

Lee, Yong-Keun

2015-04-01

The purpose was to review the translucency of human teeth and related dental materials that should be considered for the development of esthetic restorative materials. Translucency is the relative amount of light transmission or diffuse reflection from a substrate surface through a turbid medium. Translucency influences the masking ability, color blending effect, and the degree of light curing through these materials. Regarding the translucency indices, transmission coefficient, translucency parameter, and contrast ratio have been used, and correlations among these indices were confirmed. Translucency of human enamel and dentine increases in direct proportion to the wavelength of incident light in the visible light range. As for the translucency changes by aging, limited differences were reported in human dentine, while those for enamel proved to increase. There have been studies for the adjustment of translucency in dental esthetic restorative materials; the size and amount of filler and the kind of resin matrix were modified in resin composites, and the kind of ingredient and the degree of crystallization were modified in ceramics. Based on the translucency properties of human enamel and dentine, those of replacing restorative materials should be optimized for successful esthetic rehabilitation. Biomimetic simulation of the natural tooth microstructure might be a promising method.

Structural optimization of dental restorations using the principle of adaptive growth.

PubMed

Couegnat, Guillaume; Fok, Siu L; Cooper, Jonathan E; Qualtrough, Alison J E

2006-01-01

In a restored tooth, the stresses that occur at the tooth-restoration interface during loading could become large enough to fracture the tooth and/or restoration and it has been estimated that 92% of fractured teeth have been previously restored. The tooth preparation process for a dental restoration is a classical optimization problem: tooth reduction must be minimized to preserve tooth tissue whilst stress levels must be kept low to avoid fracture of the restored unit. The objective of the present study was to derive alternative optimized designs for a second upper premolar cavity preparation by means of structural shape optimization based on the finite element method and biological adaptive growth. Three models of cavity preparations were investigated: an inlay design for preparation of a premolar tooth, an undercut cavity design and an onlay preparation. Three restorative materials and several tooth/restoration contact conditions were utilized to replicate the in vitro situation as closely as possible. The optimization process was run for each cavity geometry. Mathematical shape optimization based on biological adaptive growth process was successfully applied to tooth preparations for dental restorations. Significant reduction in stress levels at the tooth-restoration interface where bonding is imperfect was achieved using optimized cavity or restoration shapes. In the best case, the maximum stress value was reduced by more than 50%. Shape optimization techniques can provide an efficient and effective means of reducing the stresses in restored teeth and hence has the potential of prolonging their service lives. The technique can easily be adopted for optimizing other dental restorations.

Catechol-Functionalized Synthetic Polymer as a Dental Adhesive to Contaminated Dentin Surface for a Composite Restoration.

PubMed

Lee, Sang-Bae; González-Cabezas, Carlos; Kim, Kwang-Mahn; Kim, Kyoung-Nam; Kuroda, Kenichi

2015-08-10

This study reports a synthetic polymer functionalized with catechol groups as dental adhesives. We hypothesize that a catechol-functionalized polymer functions as a dental adhesive for wet dentin surfaces, potentially eliminating the complications associated with saliva contamination. We prepared a random copolymer containing catechol and methoxyethyl groups in the side chains. The mechanical and adhesive properties of the polymer to dentin surface in the presence of water and salivary components were determined. It was found that the new polymer combined with an Fe(3+) additive improved bond strength of a commercial dental adhesive to artificial saliva contaminated dentin surface as compared to a control sample without the polymer. Histological analysis of the bonding structures showed no leakage pattern, probably due to the formation of Fe-catechol complexes, which reinforce the bonding structures. Cytotoxicity test showed that the polymers did not inhibit human gingival fibroblast cells proliferation. Results from this study suggest a potential to reduce failure of dental restorations due to saliva contamination using catechol-functionalized polymers as dental adhesives.

Catechol-Functionalized Synthetic Polymer as a Dental Adhesive to Contaminated Dentin Surface for a Composite Restoration

PubMed Central

2015-01-01

This study reports a synthetic polymer functionalized with catechol groups as dental adhesives. We hypothesize that a catechol-functionalized polymer functions as a dental adhesive for wet dentin surfaces, potentially eliminating the complications associated with saliva contamination. We prepared a random copolymer containing catechol and methoxyethyl groups in the side chains. The mechanical and adhesive properties of the polymer to dentin surface in the presence of water and salivary components were determined. It was found that the new polymer combined with an Fe3+ additive improved bond strength of a commercial dental adhesive to artificial saliva contaminated dentin surface as compared to a control sample without the polymer. Histological analysis of the bonding structures showed no leakage pattern, probably due to the formation of Fe–catechol complexes, which reinforce the bonding structures. Cytotoxicity test showed that the polymers did not inhibit human gingival fibroblast cells proliferation. Results from this study suggest a potential to reduce failure of dental restorations due to saliva contamination using catechol-functionalized polymers as dental adhesives. PMID:26176305

Understanding dental CAD/CAM for restorations--dental milling machines from a mechanical engineering viewpoint. Part B: labside milling machines.

PubMed

Lebon, Nicolas; Tapie, Laurent; Duret, Francois; Attal, Jean-Pierre

2016-01-01

Nowadays, dental numerical controlled (NC) milling machines are available for dental laboratories (labside solution) and dental production centers. This article provides a mechanical engineering approach to NC milling machines to help dental technicians understand the involvement of technology in digital dentistry practice. The technical and economic criteria are described for four labside and two production center dental NC milling machines available on the market. The technical criteria are focused on the capacities of the embedded technologies of milling machines to mill prosthetic materials and various restoration shapes. The economic criteria are focused on investment cost and interoperability with third-party software. The clinical relevance of the technology is discussed through the accuracy and integrity of the restoration. It can be asserted that dental production center milling machines offer a wider range of materials and types of restoration shapes than labside solutions, while labside solutions offer a wider range than chairside solutions. The accuracy and integrity of restorations may be improved as a function of the embedded technologies provided. However, the more complex the technical solutions available, the more skilled the user must be. Investment cost and interoperability with third-party software increase according to the quality of the embedded technologies implemented. Each private dental practice may decide which fabrication option to use depending on the scope of the practice.

Rubber dam may increase the survival time of dental restorations.

PubMed

Keys, William; Carson, Susan J

2017-03-01

Data sourcesCochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, SciELO, Chinese BioMedical Literature Database, VIP, China National Knowledge Infrastructure, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online databases. Handsearches in a number of journals.Study selectionRandomised controlled trials, including split-mouth studies assessing the effects of rubber dam isolation for restorative treatments in dental patients.Data extraction and synthesisTwo review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies.ResultsFour studies involving a total of 1,270 patients were included. The studies were at high risk of bias. One trial was excluded from the analysis due to inconsistencies in the presented data. Restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). The rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations.ConclusionsWe found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct

Improving the competency of dental hygiene students in detecting dental restorations using quantitative light-induced fluorescence technology.

PubMed

Oh, Hye-Young; Jung, Hoi-In; Lee, Jeong-Woo; de Jong, Elbert de Josselin; Kim, Baek-Il

2017-03-01

The purpose of this study was to determine the usefulness of a quantitative light-induced fluorescence (QLF) technology in detecting dental restorations by comparing the detection ability of dental hygiene students between using conventional visual inspection alone and visual inspection combined with QLF technology. The subjects of this study comprised 92 dental hygiene students. The students assigned to the control group only used white-light images to visually assess the mouth environment, while those in the experimental group additionally used fluorescence images. Using the test results of an experienced inspector as a reference value, the agreement between the reference value and the evaluation results of the students in the experimental and control groups was evaluated using Cohen's kappa and the percentage agreement. The subjects were then classified into groups covering three percentage ranges according to the score distribution and agreement values of the three groups were compared. The percentage agreement was calculated according to the type of dental restorations. The mean kappa value was significantly higher in the experimental group than the control group (0.70 vs 0.60, p<0.001), as was the percentage agreement (80.06% vs 72.64%, p<0.001). The agreement rate when using QLF technology increased by 8% more in the middle and bottom percentage groups than in the top percentage group (p<0.001). The agreement rate also varied with the type of restoration, being significantly higher for a sound tooth or tooth-colored restoration in the experimental group (p<0.001). Combining QLF technology with conventional visual inspections could improve the ability to detect dental restorations and distinguish sound teeth from aesthetic restorations. Copyright © 2016 Elsevier B.V. All rights reserved.

School league tables: a new population based predictor of dental restorative treatment need.

PubMed

Crowley, Evelyn; O'Brien, Graham; Marcenes, Wagner

2003-06-01

To test whether dental restorative treatment need was related to the school league tables and level of social deprivation of the school ward. An ecological study using clinical data aggregated at school level, collected in the school dental screening examinations (1996-97), National Census (1991) and the results of the UK school league tables--Key Stage 2 SATs (1996-97). State primary schools in the Greenwich District of SE London, UK (1996-97). 12,854 pupils (6-11 years of age) in 62 schools. The percentage of 6 to 11 year old pupils per school requiring dental restorative treatment. Deprivation as measured by the overall Jarman Under Privileged Area Index (UPA) of the school ward was not associated with dental restorative treatment need (p > 0.05). Only two components of the Jarman Index, level of unemployment and the number of lone parent families in the school ward were found to be significantly associated with dental restorative treatment need (p < 0.05). Results of stepwise multiple linear regression analysis showed that the association with the school league table results in all three subjects, English, Mathematics and Science remained statistically significant after adjusting for levels of unemployment and single parents. Results of multiple linear regression analysis showed that a high level of dental restorative treatment need was significantly associated with poor school league table results in English, Mathematics and Science (p < 0.05) after adjusting for the overall Jarman score of the school ward. A separate analysis for the 11-year-old pupils aggregated by school (n = 46 schools) gave similar results. Aggregate measures of academic achievement may be a potential indicator of dental restorative treatment need.

Evaluation of Four Different Restorative Materials for Restoration of the Periodontal Condition of Wedge-Shaped Defect: A Comparative Study.

PubMed

Ruan, Jian-Yong; Gong, Zheng-Lin; Zhang, Rui-Zhi; Zhang, Zhe; Xu, Ran; Li, Da-Xu; Ren, Le; Tao, Hong

2017-09-16

BACKGROUND This study aimed to conduct a clinical evaluation of four restorative materials for restoration of dental wedge-shaped defect (WSD) and their impacts on periodontal tissues. MATERIAL AND METHODS A total of 280 maxillary premolars with dental WSD were selected from 106 patients; the patient cases were divided into eight groups according to different combinations of restorative materials (flowable resin composites, Dyract compomers, glass ionomer cement (GIC), light-curing composite resin), and WSD positions (approaching gingival and subgingival positions). Gingival crevicular fluid (GCF) volume, levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), and interleukin-1β (IL-1β) in GCF were analyzed, while probing depth (PD), plaque index (PLI), and sulcus bleeding index (SBI) were also measured. The periodontal conditions of all patients were followed prior to restoration, as well as six months and 12 months after restoration. RESULTS After six months of restoration, the overall clinical success rates of flowable resin composites, Dyract compomers, and light-curing composite resin were greater than those of GIC. GCF volume, GCF-AST, IL-1β levels, PD, PLI, and SBI of cases restored by GIC were higher than those restored by the other three materials. After 12 months of restoration, the overall clinical success rates of flowable resin composites and Dyract compomers were greater than those of light-curing composite resin and GIC. GCF volume, GCF-AST, GCF-ALP, IL-1β levels, PD, PLI, and SBI of cases restored by GIC were higher than those restored by the other three materials. CONCLUSIONS Our study provided evidence that the clinical efficacy of flowable resin composites, Dyract compomers, and light-curing composite resin was greater than that of GIC for restoration of dental WSD.

Evaluation of Four Different Restorative Materials for Restoration of the Periodontal Condition of Wedge-Shaped Defect: A Comparative Study

PubMed Central

Ruan, Jian-Yong; Gong, Zheng-Lin; Zhang, Rui-Zhi; Zhang, Zhe; Xu, Ran; Li, Da-Xu; Ren, Le; Tao, Hong

2017-01-01

Background This study aimed to conduct a clinical evaluation of four restorative materials for restoration of dental wedge-shaped defect (WSD) and their impacts on periodontal tissues. Material/Methods A total of 280 maxillary premolars with dental WSD were selected from 106 patients; the patient cases were divided into eight groups according to different combinations of restorative materials (flowable resin composites, Dyract compomers, glass ionomer cement (GIC), light-curing composite resin), and WSD positions (approaching gingival and subgingival positions). Gingival crevicular fluid (GCF) volume, levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), and interleukin-1β (IL-1β) in GCF were analyzed, while probing depth (PD), plaque index (PLI), and sulcus bleeding index (SBI) were also measured. The periodontal conditions of all patients were followed prior to restoration, as well as six months and 12 months after restoration. Results After six months of restoration, the overall clinical success rates of flowable resin composites, Dyract compomers, and light-curing composite resin were greater than those of GIC. GCF volume, GCF-AST, IL-1β levels, PD, PLI, and SBI of cases restored by GIC were higher than those restored by the other three materials. After 12 months of restoration, the overall clinical success rates of flowable resin composites and Dyract compomers were greater than those of light-curing composite resin and GIC. GCF volume, GCF-AST, GCF-ALP, IL-1β levels, PD, PLI, and SBI of cases restored by GIC were higher than those restored by the other three materials. Conclusions Our study provided evidence that the clinical efficacy of flowable resin composites, Dyract compomers, and light-curing composite resin was greater than that of GIC for restoration of dental WSD. PMID:28917087

Polymerization shrinkage of a dental resin composite determined by a fiber optic Fizeau interferometer

NASA Astrophysics Data System (ADS)

Arenas, Gustavo; Noriega, Sergio; Vallo, Claudia; Duchowicz, Ricardo

2007-03-01

A fiber optic sensing method based on a Fizeau-type interferometric scheme was employed for monitoring linear polymerization shrinkage in dental restoratives. This technique offers several advantages over the conventional methods of measuring polymerization contraction. This simple, compact, non-invasive and self-calibrating system competes with both conventional and other high-resolution bulk interferometric techniques. In this work, an analysis of the quality of interference signal and fringes visibility was performed in order to characterize their resolution and application range. The measurements of percent linear contraction as a function of the sample thickness were carried out in this study on two dental composites: Filtek P60 (3M ESPE) Posterior Restorer and Filtek Z250 (3M ESPE) Universal Restorer. The results were discussed with respect to others obtained employing alternative techniques.

Influence of the isolation method on the 10-year clinical behaviour of posterior resin composite restorations.

PubMed

Raskin, A; Setcos, J C; Vreven, J; Wilson, N H

2000-09-01

The aims of this prospective randomised clinical study were to clinically evaluate a radiopaque, highly filled, hybrid, light-activated resin-based composite for posterior teeth (Occlusin, ICI Dental, Macclesfield, UK and GC Dental, Tokyo, Japan) and compare the performance of restorations placed using rubber dam or cotton roll isolation. One clinician placed 100 (42 Class I and 58 Class II) restorations of the material under investigation. The isolation mode for each restoration was determined randomly: 52 preparations were protected from contamination with cotton rolls and aspiration, and 48 preparations were isolated under rubber dam. At baseline and periodically thereafter (0.5, 1, 2, 3, 4, 5, 6, and 10 years), each composite was evaluated by two practitioners using a modified (USPHS) rating system. After 10 years, 37 restorations were reviewed. The results showed satisfactory clinical performance with and without rubber dam after 10 years. A concern was the number of failures at 10 years due to unsatisfactory proximal contact. The evaluations for the surviving restorations were acceptable but with a large reduction in the percentage with ideal occlusal and proximal anatomy. The 10-year comparison of isolation modes showed no statistically significant differences (Kruskal-Wallis test) for each of the evaluation criteria. Furthermore, survival analysis showed no significant difference between the groups (Mantel-Haenszel method). It was concluded that the 10-year clinical behaviour of the restorations of a posterior composite placed under well-controlled, effective isolation with cotton rolls and aspiration, was not significantly different from the behaviour of restorations placed using rubber dam isolation.

Fiber optics reflectance spectroscopy (45°x: 45°) for color analysis of dental composite.

PubMed

Gargano, Marco; Ludwig, Nicola; Federighi, Veronica; Sykes, Ros; Lodi, Giovanni; Sardella, Andrea; Carrassi, Antonio; Varoni, Elena M

2016-08-01

To evaluate the application of a fiber optic reflectance spectroscopy (FORS) prototype probe for 45°x: 45° FORS for determining color of dental materials. A portable spectrophotometer with a highly manageable fiber optics co-axial probe was used to apply 45°x: 45° FORS for color matching in restorative dentistry. The color coordinates in CIELAB space of two dental shade guides and of the corresponding photopolymerized composites were collected and compared. The 45°x: 45° FORS with the co-axial probe (test system), the integrating sphere spectroscopy (reference system) and a commercial dental colorimeter (comparator system) were used to collect data and calculate color differences (ΔE and ΔE00). FORS system displayed high repeatability, reproducibility and accuracy. ΔE and ΔE00 values between the shade-guide, each other, and the corresponding composites resulted above the clinically acceptable limit. The 45°x: 45° FORS test system demonstrated suitable in vitro performance for dental composite color evaluation. 45°x: 45° fiber optic reflectance spectroscopy allows reliable color analysis of small surfaces of dental composites, favoring the color matching of material with the closely surrounding dental tissue, and confirming significant color differences between shade guide tabs and photo-polymerized composites.

Degradation, fatigue and failure of resin dental composite materials

PubMed Central

Drummond, James L.

2008-01-01

The intent of this article is to review the numerous factors that affect the mechanical properties of particle or fiber filler containing, indirect dental resin composite materials. The focus will be on degradation due to aging in different media, mainly water and water and ethanol, cyclic loading, and mixed mode loading on the flexure strength and fracture toughness. Next several selected papers will be examined in detail with respect to mixed and cyclic loading and then an examination of 3D tomography using multiaxial compression specimens. The main cause of failure, for most dental resin composites, is the breakdown of the resin matrix and or the interface between the filler and the resin matrix. In clinical studies, it appears that failure in the first 5 years is a restoration issue (technique or material selection) and after that time period from secondary decay. PMID:18650540

Degradation, Fatigue, and Failure of Resin Dental Composite Materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Drummond, J.L.

The intent of this article is to review the numerous factors that affect the mechanical properties of particle- or fiber-filler-containing indirect dental resin composite materials. The focus will be on the effects of degradation due to aging in different media, mainly water and water and ethanol, cyclic loading, and mixed-mode loading on flexure strength and fracture toughness. Several selected papers will be examined in detail with respect to mixed and cyclic loading, and 3D tomography with multi-axial compression specimens. The main cause of failure, for most dental resin composites, is the breakdown of the resin matrix and/or the interface betweenmore » the filler and the resin matrix. In clinical studies, it appears that failure in the first 5 years is a restoration issue (technique or material selection); after that time period, failure most often results from secondary decay.« less

A comparative study of additive and subtractive manufacturing for dental restorations.

PubMed

Bae, Eun-Jeong; Jeong, Il-Do; Kim, Woong-Chul; Kim, Ji-Hwan

2017-08-01

Digital systems have recently found widespread application in the fabrication of dental restorations. For the clinical assessment of dental restorations fabricated digitally, it is necessary to evaluate their accuracy. However, studies of the accuracy of inlay restorations fabricated with additive manufacturing are lacking. The purpose of this in vitro study was to evaluate and compare the accuracy of inlay restorations fabricated by using recently introduced additive manufacturing with the accuracy of subtractive methods. The inlay (distal occlusal cavity) shape was fabricated using 3-dimensional image (reference data) software. Specimens were fabricated using 4 different methods (each n=10, total N=40), including 2 additive manufacturing methods, stereolithography apparatus and selective laser sintering; and 2 subtractive methods, wax and zirconia milling. Fabricated specimens were scanned using a dental scanner and then compared by overlapping reference data. The results were statistically analyzed using a 1-way analysis of variance (α=.05). Additionally, the surface morphology of 1 randomly (the first of each specimen) selected specimen from each group was evaluated using a digital microscope. The results of the overlap analysis of the dental restorations indicated that the root mean square (RMS) deviation observed in the restorations fabricated using the additive manufacturing methods were significantly different from those fabricated using the subtractive methods (P<.05). However, no significant differences were found between restorations fabricated using stereolithography apparatus and selective laser sintering, the additive manufacturing methods (P=.466). Similarly, no significant differences were found between wax and zirconia, the subtractive methods (P=.986). The observed RMS values were 106 μm for stereolithography apparatus, 113 μm for selective laser sintering, 116 μm for wax, and 119 μm for zirconia. Microscopic evaluation of the surface

Laboratory tests for assessing adaptability and stickiness of dental composites.

PubMed

Rosentritt, Martin; Buczovsky, Sebastian; Behr, Michael; Preis, Verena

2014-09-01

Handling (stickiness, adaptability) of a dental composite does strongly influence quality and success of a dental restoration. The purpose was to develop an in vitro test, which allows for evaluating adaptability and stickiness. 15 dentists were asked for providing individual assessment (school scores 1-6) of five dental composites addressing adaptability and stickiness. Composites were applied with a dental plugger (d=1.8 mm) in a class I cavity (human tooth 17). The tooth was fixed on a force gauge for simultaneous determination of application forces with varying storage (6/25°C) and application temperatures (6/25°C). On basis of these data tensile tests were performed with a dental plugger (application force 1N/2N; v=35 mm/min) on PMMA- or human tooth plates. Composite was dosed onto the tip of the plugger and applied. Application and unplugging was performed once and unplugging forces (UF) and length of the adhesive flags (LAF) were determined at different storage (6/25°C) and application temperatures (25/37°C). Unplugging work (UW) was calculated from area of UF and LAF data. The individual assessment revealed significantly different temperature-dependent application forces between 0.58 N and 2.23 N. Adaptability was assessed between 2.1 and 2.8 school scores. Stickiness varied significantly between the materials (scores: 2-3.2). UW differed significantly between the materials with values between 3.20 N mm and 37.83 N mm. Between PMMA substrate or tooth slides and between 1N or 2N application force only small UW differences were found. The presented in vitro unplugging work allows for an in vitro estimation of the handling parameters adaptability and stickiness. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Use of restorative procedures by allied dental health professionals in Minnesota.

PubMed

Post, Jennifer J; Stoltenberg, Jill L

2014-10-01

In 2003, the Minnesota legislature revised the Dental Practice Act to include restorative procedures in the scope of practice for registered dental assistants (RDAs) and registered dental hygienists (RDHs). The authors examined these practitioners' characteristics and made comparisons on the basis of their use of restorative function (RF) training and their practices' locations. They also examined practice type, models of implementation and perceived outcomes. The authors mailed a survey to all RF-certified RDAs and RDHs in Minnesota (N = 387). They used descriptive statistics to summarize the data and t tests and Fisher exact tests (P <.0001) to make comparisons between groups. The authors received 243 surveys (63 percent). Less than one-half (38 percent) of the RF-certified practitioners performed RFs. Of these, 29 percent were RDHs and 71 percent were RDAs. These practitioners performed RFs most often by working with a dentist or when time allowed. They perceived increased access to dental care and an increase in the number of patients treated to be outcomes of performing RFs. The results of this survey indicated use of restorative procedures varied greatly by practitioner type. The perceptions of those who performed RFs indicated they had a positive effect on dental practice. The addition of RF-certified personnel to the dental team has the potential to increase the number of patients seen in practice and the job satisfaction of team members.

Development and Validation of a Constitutive Model for Dental Composites during the Curing Process

NASA Astrophysics Data System (ADS)

Wickham Kolstad, Lauren

Debonding is a critical failure of a dental composites used for dental restorations. Debonding of dental composites can be determined by comparing the shrinkage stress of to the debonding strength of the adhesive that bonds it to the tooth surface. It is difficult to measure shrinkage stress experimentally. In this study, finite element analysis is used to predict the stress in the composite during cure. A new constitutive law is presented that will allow composite developers to evaluate composite shrinkage stress at early stages in the material development. Shrinkage stress and shrinkage strain experimental data were gathered for three dental resins, Z250, Z350, and P90. Experimental data were used to develop a constitutive model for the Young's modulus as a function of time of the dental composite during cure. A Maxwell model, spring and dashpot in series, was used to simulate the composite. The compliance of the shrinkage stress device was also taken into account by including a spring in series with the Maxwell model. A coefficient of thermal expansion was also determined for internal loading of the composite by dividing shrinkage strain by time. Three FEA models are presented. A spring-disk model validates that the constitutive law is self-consistent. A quarter cuspal deflection model uses separate experimental data to verify that the constitutive law is valid. Finally, an axisymmetric tooth model is used to predict interfacial stresses in the composite. These stresses are compared to the debonding strength to check if the composite debonds. The new constitutive model accurately predicted cuspal deflection data. Predictions for interfacial bond stress in the tooth model compare favorably with debonding characteristics observed in practice for dental resins.

An acoustic emission study on interfacial debonding in composite restorations.

PubMed

Liu, Xiaozhou; Li, Haiyan; Li, Jianying; Lu, Peijun; Fok, Alex Siu-Lun

2011-09-01

This paper studied in vitro the effect of the C-factor on interfacial debonding during curing of composite restorations using the acoustic emission (AE) technique. Finite element (FE) analyzes were also carried out to evaluate the interfacial stresses caused by shrinkage of the composite resin in restorations with different C-factors. Twenty extracted third molars were divided into 4 groups of 5. They were cut to form Class-I (Groups 1 and 2) and Class-II (Groups 3 and 4) cavities with different C-factors. The average C-factors of the four groups were 3.37, 2.88, 2.00, and 1.79, respectively. The cavities were then applied with an adhesive and restored with a composite, which was cured by a halogen light for 40 s. A 2-channel AE system was used to monitor the interfacial debonding, caused by shrinkage stress, between the tooth and restoration through an AE sensor attached to the surface of the specimen. Recording of the AE started at the same time as curing of the composite and lasted 10 min. Simplified FE models were used to evaluate the interfacial stresses in restorations with different C-factors, with a thermal load (temperature decrease) being applied to the composite resin to simulate its shrinkage. The mean and standard deviation of the total number of AE events for the four groups were 29.6±15.7, 10.0±5.8, 2.6±1.5, and 2.2±1.3, i.e. the number of AE events increased with an increase in the C-factor. The FE results also showed that, the higher the C-factor of the restoration, the higher the interfacial tensile stress between the tooth and restoration. From the results of the AE tests and FE simulations, it can be concluded that, the higher the C-factor, the higher the shrinkage stress and the more likely is interfacial debonding. Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

A Review of Developments in Computer-Based Systems to Image Teeth and Produce Dental Restorations

PubMed Central

Rekow, E. Dianne; Erdman, Arthur G.; Speidel, T. Michael

1987-01-01

Computer-aided design and manufacturing (CAD/CAM) make it possible to automate the creation of dental restorations. Currently practiced techniques are described. Three automated systems currently under development are described and compared. Advances in computer-aided design and computer-aided manufacturing (CAD/CAM) provide a new option for dentistry, creating an alternative technique for producing dental restorations. It is possible to create dental restorations that are automatically produced and meet or exceed current requirements for fit and occlusion.

Effect of in-office bleaching agents on physical properties of dental composite resins.

PubMed

Mourouzis, Petros; Koulaouzidou, Elisabeth A; Helvatjoglu-Antoniades, Maria

2013-04-01

The physical properties of dental restorative materials have a crucial effect on the longevity of restorations and moreover on the esthetic demands of patients, but they may be compromised by bleaching treatments. The purpose of this study was to evaluate the effects of in-office bleaching agents on the physical properties of three composite resin restorative materials. The bleaching agents used were hydrogen peroxide and carbamide peroxide at high concentrations. Specimens of each material were prepared, cured, and polished. Measurements of color difference, microhardness, and surface roughness were recorded before and after bleaching and data were examined statistically by analysis of variance (ANOVA) and Tukey HSD post-hoc test at P < .05. The measurements showed that hue and chroma of silorane-based composite resin altered after the bleaching procedure (P < .05). No statistically significant differences were found when testing the microhardness and surface roughness of composite resins tested (P > .05). The silorane-based composite resin tested showed some color alteration after bleaching procedures. The bleaching procedure did not alter the microhardness and the surface roughness of all composite resins tested.

Mechanical and Thermal Properties of Dental Composites Cured with CAD/CAM Assisted Solid-State Laser

PubMed Central

De Santis, Roberto; Gloria, Antonio; Maietta, Saverio; Martorelli, Massimo; De Luca, Alessandro; Spagnuolo, Gianrico; Riccitiello, Francesco; Rengo, Sandro

2018-01-01

Over the last three decades, it has been frequently reported that the properties of dental restorative composites cured with argon laser are similar or superior to those achieved with conventional halogen and light emitting diode (LED) curing units. Whereas laser curing is not dependent on the distance between the curing unit and the material, such distance represents a drawback for conventional curing units. However, a widespread clinical application of this kind of laser remains difficult due to cost, heavy weight, and bulky size. Recently, with regard to the radiation in the blue region of the spectrum, powerful solid-state lasers have been commercialized. In the current research, CAD (computer-aided design)/CAM (computer-aided manufacturing) assisted solid-state lasers were employed for curing of different dental restorative composites consisting of micro- and nanoparticle-reinforced materials based on acrylic resins. Commercial LED curing units were used as a control. Temperature rise during the photopolymerisation process and bending properties were measured. By providing similar light energy dose, no significant difference in temperature rise was observed when the two light sources provided similar intensity. In addition, after 7 days since curing, bending properties of composites cured with laser and LED were similar. The results suggested that this kind of laser would be suitable for curing dental composites, and the curing process does not suffer from the tip-to-tooth distance. PMID:29584683

Repair of dimethacrylate-based composite restorations by a silorane-based composite: a one-year randomized clinical trial.

PubMed

Popoff, D A V; Santa Rosa, T T A; Ferreira, R C; Magalhães, C S; Moreira, A N; Mjör, I A

2012-01-01

To investigate clinical performance of a low-shrinkage silorane-based composite resin when used for repairing conventional dimethacrylate-based composite restorations. Despite the continued development of resin-based materials, polymerization shrinkage and shrinkage stress still require improvement. A silorane-based monomer system was recently made available for dental restorations. This report refers to the use of this material for making repairs and evaluates the clinical performance of this alternative treatment. One operator repaired the defective dimethacrylate-based composite resin restorations that were randomly assigned to one of two treatment groups: control (n=50) repair with Adper SE Plus (3M/ESPE) and Filtek P60 Posterior Restorative (3M/ESPE), and test (n=50) repair with P90 System Adhesive Self-Etch Primer and Bond (3M/ESPE) and Filtek P90 Low Shrink Posterior Restorative (3M/ESPE). After one week, restorations were finished and polished. Two calibrated examiners (Kw≥0.78) evaluated all repaired restorations, blindly and independently, at baseline and one year. The parameters examined were marginal adaptation, anatomic form, surface roughness, marginal discoloration, postoperative sensitivity, and secondary caries. The restorations were classified as Alpha, Bravo, or Charlie, according to modified US Public Health Service criteria. Mann-Whitney and Wilcoxon tests were used to compare the groups. Of the 100 restorations repaired in this study, 93 were reexamined at baseline. Dropout from baseline to one-year recall was 11%. No statistically significant differences were found between the materials for all clinical criteria, at baseline or at one-year recall (p>0.05). No statistically significant differences were registered (p>0.05) for each material when compared for all clinical criteria at baseline and at one-year recall. The hypothesis tested in this randomized controlled clinical trial was accepted. After the one-year evaluations, the silorane

[Evaluation of labial surface root filling combined with porcelain dental restoration].

PubMed

Liu, Yuan-qiao; Huang, Zhi-hua; Hu, Huan-yu

2015-04-01

To analyze the effect of porcelain dental restoration combined with labial surface root filling for the anterior teeth. One hundred cases with anterior teeth protrusion treated in our department from January 2010 to January 2014 underwent porcelain dental restoration combined with labial surface root filling. The measurements in cephalometric X-ray films before and after treatment were compared, and porcelain dental appearance and function were evaluated. The data was statistically analyzed with SPSS18.0 software package. After treatment, U1-SN, U1-X, U1-Y were significantly lower than before treatment (P<0.01). U1-L1 was significantly higher after treatment (P<0.01). The incidence of gingivitis after treatment decreased significantly (X(2)=16.2749,P=0.0000<0.01). The excellent rate of outline of porcelain teeth after treatment, correction of protruding anterior teeth, fitting with adjacent teeth and alleviation of deep overbite and deep cover was 96.00%, 95.00%, 98.00% and 91.00%, respectively. Porcelain dental restoration after root canal treatment can effectively improve anterior teeth protrusion and increase the aesthetic appearance, which is worthy of clinical application.

Shrinkage stress compensation in composite-restored teeth: relaxation or hygroscopic expansion?

PubMed

Meriwether, Laurel A; Blen, Bernard J; Benson, Jarred H; Hatch, Robert H; Tantbirojn, Daranee; Versluis, Antheunis

2013-05-01

Polymerization of composite restorations causes shrinkage, which deforms and thus stresses restored teeth. This shrinkage deformation, however, has been shown to decrease over time. The objective was to investigate whether this reduction was caused by hygroscopic expansion or stress relaxation of the composite/tooth complex. Extracted molars were mounted in rigid stainless steel rings with four spherical reference areas. Twelve molars were prepared with large mesioocclusodistal slots, etched, bonded, and restored with a composite material (Filtek Supreme, 3M ESPE) in two horizontal layers. Ten intact molars were the controls. The teeth were stored either in deionized water or silicone oil. They were scanned after preparation (baseline), restoration (0-week), and after 1, 2, and 4 weeks storage. Scanned tooth surfaces were aligned with the baseline using the unchanged reference areas. Cuspal flexure was calculated from lingual and buccal surface deformation. To verify that the restorations had remained bonded, dye penetration at the interfaces was assessed using basic fuchsin dye. Statistical assessment was done by ANOVA followed by Student-Newman-Keuls post hoc test (p=0.05). Substantial cuspal contraction was found for restored teeth after the composite was cured (13-14 μm cuspal flexure). After 4 weeks cuspal contraction decreased significantly for restored teeth stored in water (7.3 ± 3.2) but not for those stored in silicone oil (11.4 ± 5.0). Dye penetration of the occlusal interface was minimal in both groups (106 ± 87 and 21 ± 28 μm in water and silicone oil, respectively). The results suggest that hygroscopic expansion was the main mechanism for shrinkage stress compensation. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Near-infrared imaging of secondary caries lesions around composite restorations at wavelengths from 1300-1700-nm.

PubMed

Simon, Jacob C; A Lucas, Seth; Lee, Robert C; Darling, Cynthia L; Staninec, Michal; Vaderhobli, Ram; Pelzner, Roger; Fried, Daniel

2016-04-01

Current clinical methods for diagnosing secondary caries are unreliable for identifying the early stages of decay around restorative materials. The objective of this study was to access the integrity of restoration margins in natural teeth using near-infrared (NIR) reflectance and transillumination images at wavelengths between 1300 and 1700-nm and to determine the optimal NIR wavelengths for discriminating composite materials from dental hard tissues. Twelve composite margins (n=12) consisting of class I, II and V restorations were chosen from ten extracted teeth. The samples were imaged in vitro using NIR transillumination and reflectance, polarization sensitive optical coherence tomography (PS-OCT) and a high-magnification digital microscope. Samples were serially sectioned into 200-μm slices for histological analysis using polarized light microscopy (PLM) and transverse microradiography (TMR). Two independent examiners evaluated the presence of demineralization at the sample margin using visible detection with 10× magnification and NIR images presented digitally. Composite restorations were placed in sixteen sound teeth (n=16) and imaged at multiple NIR wavelengths ranging from λ=1300 to 1700-nm using NIR transillumination. The image contrast was calculated between the composite and sound tooth structure. Intensity changes in NIR images at wavelengths ranging from 1300 to 1700-nm correlate with increased mineral loss measured using TMR. NIR reflectance and transillumination at wavelengths coincident with increased water absorption yielded significantly higher (P<0.001) contrast between sound enamel and adjacent demineralized enamel. In addition, NIR reflectance exhibited significantly higher (P<0.01) contrast between sound enamel and adjacent composite restorations than visible reflectance. This study shows that NIR imaging is well suited for the rapid screening of secondary caries lesions. Copyright © 2016 Academy of Dental Materials. Published by Elsevier

An analysis of the timing and materials associated with pulp disease following restorative dental treatment.

PubMed

Yong, J B; Sivarajan, S; Abbott, P V

2018-05-19

To assess whether the timing of pulp disease after tooth restoration was associated with type of restorative dental material used, extent of the restoration, or tooth type. A comprehensive search and analysis of data using the Titanium Oral Health Management software program at The Oral Health Centre of Western Australia was performed to correlate procedural codes for teeth that had restorations placed and subsequently developed pulp disease requiring endodontic treatment or extraction from 1 st January 2009 to 31 st December 2013. Manual analysis of paper and/or electronic patient record cards was also performed. Data collected included restoration type, restored tooth surfaces, tooth type, and the dates of restoration and subsequent endodontic intervention or extraction. Of 330 teeth that met the inclusion criteria, 84 (26%) had composite resin restorations, 80 (24%) had amalgams, 119 (36%) had GICs and 47 (14%) had crowns. The average time between restoration and further intervention was 330 days with a range from 3 days to 1,775 days (approx. 5 years). Teeth restored with crowns or five-surface restorations were significantly more likely to require earlier intervention than other restorations. Premolar and anterior teeth were also more likely to require earlier intervention. Teeth that developed pulp disease requiring further intervention that were restored with crowns and five-surface GIC developed the disease sooner than teeth that were restored with amalgam or composite. In teeth with five surface restorations that developed pulp disease requiring further intervention, premolar and anterior teeth developed the pulp disease sooner than molars. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

SU-E-T-89: Characterization of Dental Restoration Material for Cs-137 Radiation Dosimetry.

PubMed

Ratliff, S; Gustafson, B; Barry, K

2012-06-01

The purpose of this work is to characterize the radiation-induced thermoluminescence properties of a dental restoration material and to see if the material might be feasible for use in retrospective radiation dosimetry. Retrospective, or accidental, dosimetry is the study of using nearby materials to measure radiation received by individuals. In this project we obtained samples of Ivoclar Vivadent e.max CAD material, a glass-ceramic used for making dental restorations such as full or partial crowns. The samples were machined into square chips .32 cm × .32 cm × .089 cm and annealed in the same furnace used by the dentist. The samples were exposed to a Cs-137 source using a PMMA source holder and then read in a Harshaw 3500 TLD reader. The samples were read without nitrogen gas flux using heating rates of 5 degrees C/s or 10 degrees C/s up to a maximum temperature of 400 degrees Celsius. The glow curves were analyzed using Systat PeakFIT peak-fitting software and Microsoft Excel spreadsheets. The authors gratefully thank Dr. Aaron Imdieke and the staff of River City Dental, St. Cloud, MN for the dental restoration materials and the use of their dental furnace. A sample subjected to a radiation exposure of .04 C/kg exhibits a glow curve with a prominent peak at approximately 140 degrees Celsius, which is well-modeled by the first order glow curve deconvolution formula developed by Kitis, Gomez-Ros, and Tuyn. The activation energy corresponding to this peak is approximately 1 eV. The thermoluminescent signal fades with time after exposure. Ivoclar Vivadent e.max CAD dental restoration material has the potential to be used as a material for retrospective Cs-137 radiation dosimetry. Future work could look at its thermoluminescent dosimetry properties in more detail and also at other dental restoration materials. The authors would like to thank Dr. Aaron Imdieke and the staff of River City Dental, St. Cloud, MN, for the donation of scrap dental restoration materials and

Selective removal of dental composite using a rapidly scanned carbon dioxide laser

NASA Astrophysics Data System (ADS)

Chan, Kenneth H.; Fried, Daniel

2011-03-01

Dental restorative materials are color matched to the tooth and are difficult to remove by mechanical means without excessive removal or damage to peripheral enamel and dentin. Lasers are ideally suited for selective ablation to minimize healthy tissue loss when replacing existing restorations, sealants or removing composite adhesives such as residual composite left after debonding orthodontic brackets. In this study a carbon dioxide laser operating at high laser pulse repetition rates integrated with a galvanometer based scanner was used to selectively remove composite from tooth surfaces. A diode array spectrometer was used to measure the plume emission after each laser pulse and determine if the ablated material was tooth mineral or composite. The composite was placed on tooth buccal and occlusal surfaces and the carbon dioxide laser was scanned across the surface to selectively remove the composite without excessive damage to the underlying sound enamel. The residual composite and the damage to the underlying enamel was evaluated using optical microscopy. The laser was able to rapidly remove the composites rapidly from both surfaces with minimal damage to the underlying sound enamel.

An overview of development and status of fiber-reinforced composites as dental and medical biomaterials

PubMed Central

Vallittu, Pekka K.

2018-01-01

Abstract Fibr-reinforced composites (FRC) have been used successfully for decades in many fields of science and engineering applications. Benefits of FRCs relate to physical properties of FRCs and versatile production methods, which can be utilized. Conventional hand lamination of prefabricated FRC prepregs is utilized still most commonly in fabrication of dental FRC devices but CAD-CAM systems are to be come for use in certain production steps of dental constructions and medical FRC implants. Although metals, ceramics and particulate filler resin composites have successfully been used as dental and medical biomaterials for decades, devices made out of these materials do not meet all clinical requirements. Only little attention has been paid to FRCs as dental materials and majority of the research in dental field has been focusing on particulate filler resin composites and in medical biomaterial research to biodegradable polymers. This is paradoxical because FRCs can potentially resolve many of the problems related to traditional isotropic dental and medical materials. This overview reviews the rationale and status of using biostable glass FRC in applications from restorative and prosthetic dentistry to cranial surgery. The overview highlights also the critical material based factors and clinical requirement for the succesfull use of FRCs in dental reconstructions. PMID:29707613

An overview of development and status of fiber-reinforced composites as dental and medical biomaterials.

PubMed

Vallittu, Pekka K

2018-01-01

Fibr-reinforced composites (FRC) have been used successfully for decades in many fields of science and engineering applications. Benefits of FRCs relate to physical properties of FRCs and versatile production methods, which can be utilized. Conventional hand lamination of prefabricated FRC prepregs is utilized still most commonly in fabrication of dental FRC devices but CAD-CAM systems are to be come for use in certain production steps of dental constructions and medical FRC implants. Although metals, ceramics and particulate filler resin composites have successfully been used as dental and medical biomaterials for decades, devices made out of these materials do not meet all clinical requirements. Only little attention has been paid to FRCs as dental materials and majority of the research in dental field has been focusing on particulate filler resin composites and in medical biomaterial research to biodegradable polymers. This is paradoxical because FRCs can potentially resolve many of the problems related to traditional isotropic dental and medical materials. This overview reviews the rationale and status of using biostable glass FRC in applications from restorative and prosthetic dentistry to cranial surgery. The overview highlights also the critical material based factors and clinical requirement for the succesfull use of FRCs in dental reconstructions.

Urinary levels of nickel and chromium associated with dental restoration by nickel–chromium based alloys

PubMed Central

Chen, Bo; Xia, Gang; Cao, Xin-Ming; Wang, Jue; Xu, Bi-Yao; Huang, Pu; Chen, Yue; Jiang, Qing-Wu

2013-01-01

This paper aims to investigate if the dental restoration of nickel–chromium based alloy (Ni–Cr) leads to the enhanced excretions of Ni and Cr in urine. Seven hundred and ninety-five patients in a dental hospital had single or multiple Ni–Cr alloy restoration recently and 198 controls were recruited to collect information on dental restoration by questionnaire and clinical examination. Urinary concentrations of Ni and Cr from each subject were measure by graphite furnace atomic absorption spectrometry. Compared to the control group, the urinary level of Ni was significantly higher in the patient group of <1 month of the restoration duration, among which higher Ni excretions were found in those with either a higher number of teeth replaced by dental alloys or a higher index of metal crown not covered with the porcelain. Urinary levels of Cr were significantly higher in the three patient groups of <1, 1 to <3 and 3 to <6 months, especially in those with a higher metal crown exposure index. Linear curve estimations showed better relationships between urinary Ni and Cr in patients within 6-month groups. Our data suggested significant increased excretions of urinary Ni and Cr after dental restoration. Potential short- and long-term effects of Ni–Cr alloy restoration need to be investigated. PMID:23579466

Evaluation of microleakage of class II dental composite resin restorations cured with LED or QTH dental curing light; Blind, Cluster Randomized, In vitro cross sectional study

PubMed Central

2014-01-01

Background The aim of this study is to compare the microleakage of Class II dental composite resin restorations which have been cured by three different LED (light emitting diode) light curing modes compared to control samples cured by QTH (quartz tungsten halogen) light curing units (LCUs), to determine the most effective light curing unit and mode of curing. Results In this experimental study, class II cavities were prepared on 100 sound human premolars which have been extracted for orthodontic treatment. The teeth were randomly divided into four groups; three experimental and one control group of 25 teeth each. Experimental groups were cured by either conventional, pulse-delay, or ramped curing modes of LED. The control group was cured for 20 seconds by QTH. The restorations were thermocycled (1000 times, between 5 and 55°C, for 5 seconds dwell time), dyed, sectioned mesio-distally and viewed under stereo-microscope (40×) magnification. Teeth were then scored on a 0 to 4 scale based on the amount of microleakage. The data were analyzed by Chi-square test. No significant difference was demonstrated between the different LCUs (light curing units), or modes of curing, at the enamel side (p > 0.05). At the dentin side, all modes of LED curing could significantly reduce microleakage (p < 0.05). The results suggest that slow start curing improves marginal integrity and seal. High intense curing endangers those aims. Conclusions Comparison between the three LED mode cured composite resin restorations and QTH curing showed LED curing in all modes is more effective than QTH for reducing microleakage. Both LED and QTH almost completely eliminate the microleakage on the enamel side, however none of them absolutely eliminated microleakage on the dentin side. PMID:24990296

Understanding the management and teaching of dental restoration repair: Systematic review and meta-analysis of surveys.

PubMed

Kanzow, Philipp; Wiegand, Annette; Göstemeyer, Gerd; Schwendicke, Falk

2018-02-01

Repair instead of complete replacement is recommended to manage partially defective restorations. It is unclear if and why such treatment is taught at dental schools or practiced by dentists. We aimed to identify barriers and facilitators for repairs using a systematic review and meta- and qualitative analysis. Electronic databases (PubMed, CENTRAL, Embase, PsycINFO) were searched. Quantitative studies reporting on the proportion of (1) dentists stating to perform repairs, (2) dental schools teaching repairs, (3) failed restorations having been repaired were included. We also included qualitative studies on barriers/facilitators for repairs. Random-effects meta-analyses, meta-regression and a thematic analysis using the theoretical domains framework were conducted. 401 articles were assessed and 29, mainly quantitative, studies included. 7228 dentists and 276 dental schools had been surveyed, and treatment data of 30,172 restorations evaluated. The mean (95% CI) proportion of dentists stating to perform repairs was 71.5% (49.7-86.4%). 83.3% (73.6-90.0%) of dental schools taught repairs. 31.3% (26.3-36.7%) of failed restorations had been repaired. More recent studies reported significantly more dentists to repair restorations (p=0.004). Employment in public health practices and being the dentist who placed the original restoration were facilitators for repairs. Amalgam restorations were repaired less often, and financial aspects and regulations came as barriers. While most dentists state to perform repairs and the vast majority of dental schools teach repairs, the proportion of truly repaired restorations was low. A number of interventions to implement repair in dental practice can be deduced from our findings. Partially defective restorations are common in dental practice. While repairs are taught and dentists are aware of the recommendation towards repairs, the actually performed proportion of repairs seems low. Copyright © 2017 Elsevier Ltd. All rights reserved.

Shrinkage of Dental Composite in Simulated Cavity Measured with Digital Image Correlation

PubMed Central

Li, Jianying; Thakur, Preetanjali; Fok, Alex S. L.

2014-01-01

Polymerization shrinkage of dental resin composites can lead to restoration debonding or cracked tooth tissues in composite-restored teeth. In order to understand where and how shrinkage strain and stress develop in such restored teeth, Digital Image Correlation (DIC) was used to provide a comprehensive view of the displacement and strain distributions within model restorations that had undergone polymerization shrinkage. Specimens with model cavities were made of cylindrical glass rods with both diameter and length being 10 mm. The dimensions of the mesial-occlusal-distal (MOD) cavity prepared in each specimen measured 3 mm and 2 mm in width and depth, respectively. After filling the cavity with resin composite, the surface under observation was sprayed with first a thin layer of white paint and then fine black charcoal powder to create high-contrast speckles. Pictures of that surface were then taken before curing and 5 min after. Finally, the two pictures were correlated using DIC software to calculate the displacement and strain distributions. The resin composite shrunk vertically towards the bottom of the cavity, with the top center portion of the restoration having the largest downward displacement. At the same time, it shrunk horizontally towards its vertical midline. Shrinkage of the composite stretched the material in the vicinity of the “tooth-restoration” interface, resulting in cuspal deflections and high tensile strains around the restoration. Material close to the cavity walls or floor had direct strains mostly in the directions perpendicular to the interfaces. Summation of the two direct strain components showed a relatively uniform distribution around the restoration and its magnitude equaled approximately to the volumetric shrinkage strain of the material. PMID:25079865

New nano-sized Al2O3-BN coating 3Y-TZP ceramic composites for CAD/CAM-produced all-ceramic dental restorations. Part I. Fabrication of powders.

PubMed

Yang, Se Fei; Yang, Li Qiang; Jin, Zhi Hao; Guo, Tian Wen; Wang, Lei; Liu, Hong Chen

2009-06-01

Partially sintered 3 mol % yttria-stabilized tetragonal zirconium dioxide (ZrO(2), zirconia) polycrystal (3Y-TZP) ceramics are used in dental posterior restorations with computer-aided design-computer-aided manufacturing (CAD/CAM) techniques. High strength is acquired after sintering, but shape distortion of preshaped compacts during their sintering is inevitable. The aim of this study is to fabricate new machinable ceramic composites with strong mechanical properties that are fit for all-ceramic dental restorations. Aluminum oxide (Al(2)O(3))-coated 3Y-TZP powders were first prepared by the heterogeneous precipitation method starting with 3Y-TZP, Al(NO(3))(3) . 9H(2)O, and ammonia, then amorphous boron nitride (BN) was produced and the as-received composite powders were coated via in situ reaction with boric acid and urea. Transmission electron microscopy (TEM) and X-ray diffraction (XRD) were used to analyze the status of Al(2)O(3)-BN on the surface of the 3Y-TZP particles. TEM micrographs show an abundance of Al(2)O(3) particles and amorphous BN appearing uniformly on the surface of the 3Y-TZP particles after the coating process. The size of the Al(2)O(3) particles is about 20 nm. The XRD pattern shows clearly the peak of amorphous BN among the peaks of ZrO(2).

New layer-based imaging and rapid prototyping techniques for computer-aided design and manufacture of custom dental restoration.

PubMed

Lee, M-Y; Chang, C-C; Ku, Y C

2008-01-01

Fixed dental restoration by conventional methods greatly relies on the skill and experience of the dental technician. The quality and accuracy of the final product depends mostly on the technician's subjective judgment. In addition, the traditional manual operation involves many complex procedures, and is a time-consuming and labour-intensive job. Most importantly, no quantitative design and manufacturing information is preserved for future retrieval. In this paper, a new device for scanning the dental profile and reconstructing 3D digital information of a dental model based on a layer-based imaging technique, called abrasive computer tomography (ACT) was designed in-house and proposed for the design of custom dental restoration. The fixed partial dental restoration was then produced by rapid prototyping (RP) and computer numerical control (CNC) machining methods based on the ACT scanned digital information. A force feedback sculptor (FreeForm system, Sensible Technologies, Inc., Cambridge MA, USA), which comprises 3D Touch technology, was applied to modify the morphology and design of the fixed dental restoration. In addition, a comparison of conventional manual operation and digital manufacture using both RP and CNC machining technologies for fixed dental restoration production is presented. Finally, a digital custom fixed restoration manufacturing protocol integrating proposed layer-based dental profile scanning, computer-aided design, 3D force feedback feature modification and advanced fixed restoration manufacturing techniques is illustrated. The proposed method provides solid evidence that computer-aided design and manufacturing technologies may become a new avenue for custom-made fixed restoration design, analysis, and production in the 21st century.

Mechanical properties and three-body wear of dental restoratives and their comparative flowable materials.

PubMed

Schultz, Sabine; Rosentritt, Martin; Behr, Michael; Handel, Gerhard

2010-01-01

To compare wear performance and resistance to crack propagation (K1C) of commercial restorative materials and their flowable variations. A potential correlation between three-body wear and fracture toughness, modulus of elasticity, fracture work, Vickers hardness, and filler content was investigated. Seven restoratives (five composites, one ormocer, and one compomer) and their corresponding flowable materials were used to determine and compare the three-body wear with a bolus of millet-seed shells and rice food (Willytec). The wear characteristics were measured by profilometry after 50,000, 100,000, 150,000, and 200,000 loading cycles. The fracture toughness value, K1C (MPam1/2), for each single-edged notched specimen was measured in a three-point bending test (universal testing machine 1446, Zwick). Fracture work and modulus of elasticity were calculated from the load curves. Vickers hardness was measured (HV hardness tester, Zwick) according to DIN 50133. The veneering composite Sinfony (3M ESPE) was used as a reference material. Heavily filled composites experienced less wear than their flowable variations. The nanofiller composites revealed better wear results than hybrid composites, compomers, and ormocers. After 200,000 load cycles, the lowest wear rates were detected for Grandio (14 microm; Voco), and the highest mean values were found for Dyract AP (104 microm; Dentsply DeTrey). The values for fracture toughness (K1C) ranged from 0.82 to 3.64 MPam1/2. Highest K1C data was exhibited by the nanocomposite Nanopaq (Schutz Dental). All tested restorative materials exhibited higher fracture toughness than their low-viscosity variations. The wear resistance of the newer generation composites with incorporated nanofiller or microfiller particles increased to a high extent. Flowables show less resistance against wear and crack propagation because of their lower filler content. The reduced mechanical properties limit their use as a restorative to small noncontact

Understanding dental CAD/CAM for restorations - dental milling machines from a mechanical engineering viewpoint. Part A: chairside milling machines.

PubMed

Lebon, Nicolas; Tapie, Laurent; Duret, Francois; Attal, Jean-Pierre

2016-01-01

The dental milling machine is an important device in the dental CAD/CAM chain. Nowadays, dental numerical controlled (NC) milling machines are available for dental surgeries (chairside solution). This article provides a mechanical engineering approach to NC milling machines to help dentists understand the involvement of technology in digital dentistry practice. First, some technical concepts and definitions associated with NC milling machines are described from a mechanical engineering viewpoint. The technical and economic criteria of four chairside dental NC milling machines that are available on the market are then described. The technical criteria are focused on the capacities of the embedded technologies of these milling machines to mill both prosthetic materials and types of shape restorations. The economic criteria are focused on investment costs and interoperability with third-party software. The clinical relevance of the technology is assessed in terms of the accuracy and integrity of the restoration.

Repair vs replacement of direct composite restorations: a survey of teaching and operative techniques in Oceania.

PubMed

Brunton, Paul A; Ghazali, Amna; Tarif, Zahidah H; Loch, Carolina; Lynch, Christopher; Wilson, Nairn; Blum, Igor R

2017-04-01

To evaluate the teaching and operative techniques for the repair and/or replacement of direct resin-based composite restorations (DCRs) in dental schools in Oceania. A 14-item questionnaire was mailed to the heads of operative dentistry in 16 dental schools in Oceania (Australia, New Zealand, Fiji and Papua New Guinea). The survey asked whether the repair of DCRs was taught within the curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability, expected longevity and recall systems. All 16 schools participated in the study. Thirteen (81%) reported the teaching of composite repairs as an alternative to replacement. Most schools taught the theoretical and practical aspects of repair at a clinical level only. All 13 schools (100%) agreed on tooth substance preservation being the main reason for teaching repair. The main indications for repair were marginal defects (100%), followed by secondary caries (69%). All 13 schools that performed repairs reported high patient acceptability, and considered it a definitive measure. Only three schools (23%) claimed to have a recall system in place following repair of DCRs. Most respondents either did not know or did not answer when asked about the longevity of DCRs. Repair of DCRs seems to be a viable alternative to replacement, which is actively taught within Oceania. Advantages include it being minimally invasive, preserving tooth structure, and time and money saving. However, standardised guidelines need to be developed and further clinical long-term studies need to be carried out. The decision between replacing or repairing a defective composite restoration tends to be based on what clinicians have been taught, tempered by experience and judgement. This study investigated the current status of teaching and operative techniques of repair of direct composite restorations in dental schools in Oceania. Copyright © 2017 Elsevier Ltd

Use of near-IR to monitor the influence of external heating on dental composite photopolymerization.

PubMed

Trujillo, Marianela; Newman, Sheldon M; Stansbury, Jeffrey W

2004-10-01

This study was conducted to determine the effect of modest external heating on the photopolymerization kinetics and conversion of commercial dental composite restorative materials. A transmission-mode, real-time near-infrared spectroscopic technique was used to monitor the photopolymerization process in the composite materials at various temperatures between 23 and 70 degrees C. Several light curing units, differing in spectral output and power densities were compared at the different cure temperatures. Several significantly different commercial composites were compared for their response. Regardless of the curing light or composite material used, photopolymerization at a moderate curing temperature of 54.5 degrees C resulted in significantly higher immediate and final conversion values compared with room temperature photocuring. Contrary to the room temperature cured materials, at the elevated cure temperature the extent of post-cure was minor and different curing lights produced very uniform conversion values within a given material. The time required to reach a given level of conversion, established as full conversion with the room temperature cure, was reduced typically by 80-90% using the elevated curing conditions. Complementary kinetic studies confirmed the effect of cure temperature on increasing the polymerization rate in dental composites as significant. Increasing the temperature of composite resin within potentially biologically compatible limits can significantly influences resin polymerization. These increased rates and conversion could lead to improved properties of composite restorative materials.

High performance dental resin composites with hydrolytically stable monomers.

PubMed

Wang, Xiaohong; Huyang, George; Palagummi, Sri Vikram; Liu, Xiaohui; Skrtic, Drago; Beauchamp, Carlos; Bowen, Rafael; Sun, Jirun

2018-02-01

the experimental series (0.458GPa) were still above the clinically required threshold of approx. 0.4GPa. Hydrolytic stability, composition-controlled polymerization and the overall enhancement in clinically-relevant properties of the new resin composites make them viable candidates to replace traditional resin composites as a new generation of strong and durable dental restoratives. Copyright © 2017 The Academy of Dental Materials. All rights reserved.

A conservative approach for restoring anterior guidance: a case report.

PubMed

Pontons-Melo, Juan Carlos; Pizzatto, Eduardo; Furuse, Adilson Yoshio; Mondelli, José

2012-06-01

One of the most common dental problems in today's clinics is tooth wear, specifically when related to bruxism. In such cases, the esthetics of anterior teeth may be compromised when excessive wear to the incisal surfaces occurs. Anterior tooth wear resulting from parafunctional bruxism can be conservatively treated with the use of direct resin composite restorations. This restorative approach has the advantages of presenting good predictability, load resistance, acceptable longevity, preservation of healthy dental tissues, and lower cost when compared with indirect restorations. The use of resin composites to solve esthetic problems, however, requires skill and practice. Thus, the present article demonstrates a conservative approach for restoring the esthetics and function of worn anterior teeth with the aid of direct resin composite restorations and selective occlusal adjustment. A conservative approach to restore anterior teeth with excessive wear is possible with direct resin composites. © 2011 Wiley Periodicals, Inc.

Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function.

PubMed

Oilo, Marit; Hardang, Anne D; Ulsund, Amanda H; Gjerdet, Nils R

2014-06-01

Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation. © 2014 Eur J Oral Sci.

Modelling the Longevity of Dental Restorations by means of a CBR System

PubMed Central

Aliaga, Ignacio J.; Vera, Vicente; García, Alvaro E.

2015-01-01

The lifespan of dental restorations is limited. Longevity depends on the material used and the different characteristics of the dental piece. However, it is not always the case that the best and longest lasting material is used since patients may prefer different treatments according to how noticeable the material is. Over the last 100 years, the most commonly used material has been silver amalgam, which, while very durable, is somewhat aesthetically displeasing. Our study is based on the collection of data from the charts, notes, and radiographic information of restorative treatments performed by Dr. Vera in 1993, the analysis of the information by computer artificial intelligence to determine the most appropriate restoration, and the monitoring of the evolution of the dental restoration. The data will be treated confidentially according to the Organic Law 15/1999 on 13 December on the Protection of Personal Data. This paper also presents a clustering technique capable of identifying the most significant cases with which to instantiate the case-base. In order to classify the cases, a mixture of experts is used which incorporates a Bayesian network and a multilayer perceptron; the combination of both classifiers is performed with a neural network. PMID:25866792

Impact of Atraumatic Restorative Treatment (ART) on the treatment profile in pilot government dental clinics in Tanzania.

PubMed

Kikwilu, Emil Namakuka; Frencken, Jo; Mulder, Jan

2009-06-08

The predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems. Atraumatic Restorative Treatment (ART) was perceived as a suitable alternative. A 3.5-year study was designed to document the changes in the treatment profiles ascribed to the systematic introduction of ART in pilot government dental clinics. Dental practitioners who were working in 13 government dental clinics underwent a 7-day ART training. Treatment record data on teeth extracted and teeth restored by the conventional and ART approaches were collected from these clinics for the three study periods. The mean percentage of ART restorations to total treatment, ART restorations to total restorations, and total restorations to total treatments rendered were computed. Differences between variables were determined by ANOVA, t-test and Chi-square. The mean percentage of ART restorations to total treatment rendered was 0.4 (SE = 0.5) and 11.9 (SE = 1.1) during the baseline and second follow-up period respectively (ANOVA mixed model; P < 0.0001). The mean percentage of ART restorations to total restorations rendered at baseline and 2nd follow-up period was 8.4% and 88.9% respectively (ANOVA mixed model; P < 0.0001). The mean percentage of restorations to total treatment rendered at baseline and 2nd follow-up was 3.9% and 13.0%, respectively (ANOVA mixed model; P < 0.0001). Ninety-nine percent of patients were satisfied with ART restorations, 96.6% willing to receive ART restoration again in future, and 94.9% willing to recommend ART treatment to their close relatives. ART introduction in pilot government dental clinics raised the number of teeth saved by restorative care. Countrywide introduction of the ART approach in Tanzania is recommended.

Rugometric and microtopographic non-invasive inspection in dental-resin composites and zirconia ceramics

NASA Astrophysics Data System (ADS)

Fernández-Oliveras, Alicia; Costa, Manuel F. M.; Pecho, Oscar E.; Rubiño, Manuel; Pérez, María. M.

2013-11-01

Surface properties are essential for a complete characterization of biomaterials. In restorative dentistry, the study of the surface properties of materials meant to replace dental tissues in an irreversibly diseased tooth is important to avoid harmful changes in future treatments. We have experimentally analyzed the surface characterization parameters of two different types of dental-resin composites and pre-sintered and sintered zirconia ceramics. We studied two shades of both composite types and two sintered zirconia ceramics: colored and uncolored. Moreover, a surface treatment was applied to one specimen of each dental-resin. All the samples were submitted to rugometric and microtopographic non-invasive inspection with the MICROTOP.06.MFC laser microtopographer in order to gather meaningful statistical parameters such as the average roughness (Ra), the root-mean-square deviation (Rq), the skewness (Rsk), and the kurtosis of the surface height distribution (Rku). For a comparison of the different biomaterials, the uncertainties associated to the surface parameters were also determined. With respect to Ra and Rq, significant differences between the composite shades were found. Among the dental resins, the nanocomposite presented the highest values and, for the zirconia ceramics, the pre-sintered sample registered the lowest ones. The composite performance may have been due to cluster-formation variations. Except for the composites with the surface treatment, the sample surfaces had approximately a normal distribution of heights. The surface treatment applied to the composites increased the average roughness and moved the height distribution farther away from the normal distribution. The zirconia-sintering process resulted in higher average roughness without affecting the height distribution.

Candida albicans adherence to resin-composite restorative dental material: influence of whole human saliva.

PubMed

Maza, José Luis; Elguezabal, Natalia; Prado, Carlota; Ellacuría, Joseba; Soler, Iñaki; Pontón, José

2002-11-01

Attachment of Candida albicans to oral surfaces is believed to be a critical event in the colonization of the oral cavity and in the development of oral diseases such as Candida-associated denture stomatitis. Although there is considerable information about the adhesion of C albicans to buccal epithelial cells and prosthetic materials, there is very little information about the adhesion of C albicans to composite restorative materials. The purpose of this study was to investigate the degree of adhesion of C albicans to a resin-composite restorative material (Herculite). The adhesion of 2 strains of C albicans, a germinative and a germ tube-deficient mutant, was studied by a visual method after incubating the fungus and the resin with and without human whole saliva. In absence of saliva, the adhesion of the C albicans germinative isolate to the resin showed an increase in parallel with the germination, reaching a maximum at the end of the experiment (120 minutes). However, no significant differences were observed in the adhesion of the agerminative mutant during the period of time studied. In the presence of saliva, the adhesion of both isolates to the resin was significantly lowered. Germination and the presence of human whole saliva are important factors in the adhesion of C albicans to the resin-composite restorative material Herculite.

Fractography and Mechanical Properties of Urethane Dimethacrylate Dental Composites Reinforced with Glass Nanoparticles.

PubMed

M, Monfared; Me, Bahrololoom

2016-12-01

Dental resin composites are becoming prevalent in restorative dentistry and have almost replaced amalgam nowadays. Consequently, their mechanical properties and durability are critical. The aim of this study was to produce Pyrex glass nano-particles by wet milling process and use them as reinforcement in dental resins for anterior restorations and then examination of fractographic properties of these composites. The glass nano-particles were achieved via wet milling. The surface of the particles was modified with 3-(Trimethoxysilyl) propyl methacrylate (γ-MPTMS) silane in order to improve their surface. Fourier transform infra-red (FTIR) analysis showed that the silane groups provided double bonds to the surface of the particles and prevented agglomeration. Then, the composite resins were made with different weight percentages of Pyrex glass. The mechanical properties of samples flexural test were evaluated. The required energy for fracture of the specimens was achieved via this test. The fracture surfaces of the samples were analyzed using a scanning electron microscope (SEM) in order to explain the mechanisms of fracture. The results and analysis showed that increasing the glass nano-particles mass fraction had a great effect on mechanical properties of the composites due to the mechanisms of crack propagation and crack deflection as well as preventing void formation. The effective energy dissipation mechanisms such as crack pinning and deflection, was observed in SEM micrographs. Void formation in the low filler content composite is one of the mechanisms to decrease the energy required for fracture of these composites and eventually weaken them.

Fractography and Mechanical Properties of Urethane Dimethacrylate Dental Composites Reinforced with Glass Nanoparticles

PubMed Central

M*, Monfared; ME, Bahrololoom

2016-01-01

Statement of Problem: Dental resin composites are becoming prevalent in restorative dentistry and have almost replaced amalgam nowadays. Consequently, their mechanical properties and durability are critical. Objectives: The aim of this study was to produce Pyrex glass nano-particles by wet milling process and use them as reinforcement in dental resins for anterior restorations and then examination of fractographic properties of these composites. Materials and Methods: The glass nano-particles were achieved via wet milling. The surface of the particles was modified with 3-(Trimethoxysilyl) propyl methacrylate (γ-MPTMS) silane in order to improve their surface. Fourier transform infra-red (FTIR) analysis showed that the silane groups provided double bonds to the surface of the particles and prevented agglomeration. Then, the composite resins were made with different weight percentages of Pyrex glass. The mechanical properties of samples flexural test were evaluated. The required energy for fracture of the specimens was achieved via this test. The fracture surfaces of the samples were analyzed using a scanning electron microscope (SEM) in order to explain the mechanisms of fracture. Results: The results and analysis showed that increasing the glass nano-particles mass fraction had a great effect on mechanical properties of the composites due to the mechanisms of crack propagation and crack deflection as well as preventing void formation. The effective energy dissipation mechanisms such as crack pinning and deflection, was observed in SEM micrographs. Conclusions: Void formation in the low filler content composite is one of the mechanisms to decrease the energy required for fracture of these composites and eventually weaken them. PMID:28959761

Shear bond strength of brackets on restorative materials: Comparison on various dental restorative materials using the universal primer Monobond® Plus.

PubMed

Ebert, Thomas; Elsner, Laura; Hirschfelder, Ursula; Hanke, Sebastian

2016-03-01

The purpose of this work was to analyze surfaces consisting of different restorative materials for shear bond strength (SBS) and failure patterns of metal and ceramic brackets. Bonding involved the use of a universal primer (Monobond® Plus, Ivoclar Vivadent). Six restorative materials were tested, including one composite resin (Clearfil Majesty™ Posterior, Kuraray Noritake Dental), one glass-ceramic material (IPS Empress® Esthetic, Ivoclar Vivadent), one oxide-ceramic material (CORiTEC Zr transpa Disc, imes-icore), two base-metal alloys (remanium® star, Dentaurum; Colado® CC, Ivoclar Vivadent), and one palladium-based alloy (Callisto® 75 Pd, Ivoclar Vivadent). Bovine incisors served as controls. Both metal and ceramic brackets (discovery®/discovery® pearl; Dentaurum) were bonded to the restorative surfaces after sandblasting and pretreatment with Monobond® Plus. A setup modified from DIN 13990-2 was used for SBS testing and adhesive remnant index (ARI)-based analysis of failure patterns. The metal brackets showed the highest mean SBS values on the glass-ceramic material (68.61 N/mm(2)) and the composite resin (67.58 N/mm(2)) and the lowest mean SBS on one of the base-metal alloys (Colado® CC; 14.01 N/mm(2)). The ceramic brackets showed the highest mean SBS on the glass-ceramic material (63.36 N/mm(2)) and the lowest mean SBS on the palladium-based alloy (38.48 N/mm(2)). Significant differences between the metal and ceramic brackets were observed in terms of both SBS values and ARI scores (p < 0.05). Under both bracket types, fractures of the composite-resin and the glass-ceramic samples were observed upon debonding. Opaque restorative materials under metal brackets were found to involve undercuring of the adhesive. Monobond® Plus succeeded in generating high bond strengths of both bracket types on all restorative surfaces. Given our observations of cohesive fracture (including cases of surface avulsion) of the composite-resin and the glass

Shrinkage strain-rates of dental resin-monomer and composite systems.

PubMed

Atai, Mohammad; Watts, David C; Atai, Zahra

2005-08-01

The purpose of this study was to investigate the shrinkage strain rate of different monomers, which are commonly used in dental composites and the effect of monomer functionality and molecular mass on the rate. Bis-GMA, TEGDMA, UDMA, MMA, HEMA, HPMA and different ratios of Bis-GMA/TEGDMA were mixed with Camphorquinone and Dimethyl aminoethyle methacrylate as initiator system. The shrinkage strain of the samples photopolymerised at Ca. 550 mW/cm2 and 23 degrees C was measured using the bonded-disk technique of Watts and Cash (Meas. Sci. Technol. 2 (1991) 788-794), and initial shrinkage-strain rates were obtained by numerical differentiation. Shrinkage-strain rates rose rapidly to a maximum, and then fell rapidly upon vitrification. Strain and initial strain rate were dependent upon monomer functionality, molecular mass and viscosity. Strain rates were correlated with Bis-GMA in Bis-GMA/TEGDMA mixtures up to 75-80 w/w%, due to the higher molecular mass of Bis-GMA affecting termination reactions, and then decreased due to its higher viscosity affecting propagation reactions. Monofunctional monomers exhibited lower rates. UDMA, a difunctional monomer of medium viscosity, showed the highest shrinkage strain rate (P < 0.05). Shrinkage strain rate, related to polymerization rate, is an important factor affecting the biomechanics and marginal integrity of composites cured in dental cavities. This study shows how this is related to monomer molecular structure and viscosity. The results are significant for the production, optimization and clinical application of dental composite restoratives.

The Effect of Preventive Agents (Mouthwashes/Gels) on the Color Stability of Dental Resin-Based Composite Materials

PubMed Central

Al-Samadani, Khalid H.

2017-01-01

The color of dental restorative material should be maintained throughout its functional lifetime in an oral environment. However, the frequent use of mouthwash may affect the color stability of these composite restorations. The aim of this study is to assess the effects of using various mouthwashes on the color stability of various dental restorative composite materials. For this purpose, four mouthwashes/gels (Flocare gel (0.4% stannous fluoride), Pascal gel (topical APF fluoride), Pro-Relief mouthwash (sodium fluoride), and Plax Soin mouthwash (sodium fluoride)), and distilled water as a control, were selected. These were divided into five groups: Group 1: Flocare gel; Group 2: Pascal gel; Group 3: Pro-Relief mouthwash; Group 4: Plax Soin mouthwash; and Group 5: distilled water (control). Prepared restorative materials samples were immersed in the groups of mouthwashes/gels and the distilled water (control) for 24, 48, and 72 h. The discoloration that all materials exhibited with all immersion groups was significantly different at each of the three time periods for all groups (p < 0.05). Results from immersion in Flocare gel, Pascal gel, Pro-Relief mouthwash, and Plax Soin mouthwash were statistically significant (p < 0.05). The color change chroma was not significant for Pro-Relief and Plax Soin mouthwash (p > 0.05). Mouthwashes/gels affect color shifting for all composite resin materials, and changes are exaggerated over time. However, discoloration effects are not perceptible to the human eye. PMID:29563424

Mechanical properties of polymer-infiltrated-ceramic (sodium aluminum silicate) composites for dental restoration.

PubMed

Cui, Bencang; Li, Jing; Wang, Huining; Lin, Yuanhua; Shen, Yang; Li, Ming; Deng, Xuliang; Nan, Cewen

2017-07-01

To fabricate indirect restorative composites for CAD/CAM applications and evaluate the mechanical properties. Polymer-infiltrated-ceramic composites were prepared through infiltrating polymer into partially sintered sodium aluminum silicate ceramic blocks and curing. The corresponding samples were fabricated according to standard ISO-4049 using for mechanical properties measurement. The flexural strength and fracture toughness were measured using a mechanical property testing machine. The Vickers hardness and elastic modulus were calculated from the results of nano-indentation. The microstructures were investigated using secondary electron detector. The density of the porous ceramic blocks was obtained through TG-DTA. The conversion degrees were calculated from the results of mid-infrared spectroscopy. The obtained polymer infiltrated composites have a maximum flexural strength value of 214±6.5MPa, Vickers hardness of 1.76-2.30GPa, elastic modulus of 22.63-27.31GPa, fracture toughness of 1.76-2.35MPam 1/2 and brittleness index of 0.75-1.32μm -1/2 . These results were compared with those of commercial CAD/CAM blocks. Our results suggest that these materials with good mechanical properties are comparable to two commercial CAD/CAM blocks. The sintering temperature could dramatically influence the mechanical properties. Restorative composites with superior mechanical properties were produced. These materials mimic the properties of natural dentin and could be a promising candidate for CAD/CAM applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of Different Composite Restorations on the Cuspal Deflection of Premolars Restored with Different Insertion Techniques- An In vitro Study.

PubMed

Singhal, Sakshi; Gurtu, Anuraag; Singhal, Anurag; Bansal, Rashmi; Mohan, Sumit

2017-08-01

This study was conducted to assess the effect of different composite materials on the cuspal deflection of premolars restored with bulk placement of resin composite in comparison to horizontal incremental placement and modified tangential incremental placement. The aim of this study was to evaluate the cuspal deflection caused by different composite materials when different insertion techniques were used. Two different composite materials were used that is Tetric N Ceram (Ivoclar Vivadent marketing, India) and SonicFill TM (Kerr Sybron Dental). Forty standardized Mesio-Occluso-Distal (MOD) preparations were prepared on maxillary first premolars. Each group was divided according to composite insertion technique (n=10), as follows: Group I - bulk insertion using Tetric N Ceram, Group II - Horizontal incremental insertion technique using Tetric N Ceram, Group III- Modified tangential incremental technique using Tetric N Ceram, and Group IV- bulk insertion using SonicFill TM . Preparations were acid-etched, and bonded with adhesive resin to provide micro mechanical attachment before restoration using a uniform etching and bonding protocol in all the groups. All groups received the same total photo-polymerization time. Cuspal deflection was measured during the restorative procedure using customized digital micrometer assembly. One-way ANOVA test was applied for the analysis of significant difference between the groups, p-value less than 0.05 was considered statistically significant. The average cuspal deflections for the different groups were as follows: Group I 0.045±0.018, Group II 0.029±0.009, Group III 0.018±0.005 and Group IV 0.017±0.004. The intergroup comparison revealed statistically significant difference. A measurable amount of cuspal deflection was present in all the four studied groups. In general, bulkfill restoration technique with conventional composite showed significantly highest cusp deflection. There were no significant differences in cuspal

In vitro investigation of the performance of different restorative materials under cast circumferential clasps for removable dental prostheses.

PubMed

Pospiech, Peter; Nagel, Florian; Gebhart, Florian; Nothdurft, Frank P; Mitov, Gergo

2012-12-01

The objective of this in vitro study was to investigate the behavior of different composite restorative materials under the load of cast circumferential clasps for removable dental prostheses (RDPs). In 60 human molars, standardized mesial-occlusal-distal cavities were prepared. The cavities were restored with the following materials: Definite, Tetric Ceram, SureFil, Heliomolar RO, Ariston pHc, and Oralloy, and provided with a rest seat. The rest seats were subjected to 5,000 cycles of thermal cycling and 1,200,000 masticatory cycles in a mastication simulator via cobalt-chromium circumferential clasps cast to standardized frameworks in a laboratory model designed to simulate the biomechanics of a free-end denture base. Fracture analysis of the restorations was performed by light microscopy. Before and after loading, material wear was measured with a 3D-laser scanner, and an analysis of the marginal quality was performed in an SEM at ×200 applying the replica technique. No significant differences in the fracture behavior among the composite materials were found; the amalgam control group showed a significantly higher fracture resistance. Regarding the wear of the materials, the composites Definite and SureFil exhibited a behavior similar to that of amalgam. The other composites demonstrated higher wear rates. The initial marginal quality was significantly worse for Ariston pHc. The marginal adaptation decreased significantly after thermal and mechanical loading for Definite and Ariston pHc. In terms of the investigated aspects of mechanical performance, the tested composites seemed to be inferior to amalgam. Further clinical studies are needed to evaluate the ability of composite restorations to provide support for RDP clasps. The use of composites as direct restoration materials should be avoided in teeth, which serve as abutments for clasp-retained RDPs.

A comparison of knowledge of local analgesia, pulp therapy and restoration of primary molar teeth amongst dental students, dentists and dental therapists within a dental hospital setting.

PubMed

Foley, J

2007-06-01

To gain an overview of knowledge of local analgesia, pulpal therapy and restorative procedures in the primary dentition amongst dental undergraduate students (DS), dental therapy students (DTS), recently-qualified dentists (QD) and dental therapists (DT), working within a Dental Hospital setting. A survey undertaken at Dundee Dental Hospital and School, NHS Tayside, United Kingdom to determine current knowledge regarding the use of local analgesia, pulp anatomy and pulp therapy techniques in addition to restoration of primary teeth. Data were available for 24 individuals (DS: 5; QD: 6; DTS: 8; DT: 5). Deficiencies in knowledge regarding the maximum safe dose for local analgesia, pulp canal anatomy, pulp therapy medicaments and the preparation required prior to placement of a pre-formed metal crown were noted in both student and staff groups. The knowledge of basic dental procedures for children amongst a group of dental students, student dental therapists and recently qualified dentists and dental therapists, was found to be imperfect. These findings indicate that more research is needed on the educational procedures used in the transfer of such knowledge and skills. Deficiencies in knowledge were identified in all areas assessed. Courses should be designed at both the pre- and postgraduate level to address and avoid such gaps in knowledge.

Fracture behavior of single-structure fiber-reinforced composite restorations

PubMed Central

Nagata, Kohji; Garoushi, Sufyan K.; Vallittu, Pekka K.; Wakabayashi, Noriyuki; Takahashi, Hidekazu; Lassila, Lippo V. J.

2016-01-01

Abstract Objective: The applications of single-structure fiber-reinforced composite (FRC) in restorative dentistry have not been well reported. This study aimed to clarify the static mechanical properties of anterior crown restorations prepared using two types of single-structure FRC. Materials and methods : An experimental crown restoration was designed for an upper anterior incisor. The restorations were made from IPS Empress CAD for CEREC (Emp), IPS e.max® CAD (eMx), experimental single-structure all-FRC (a-FRC), Filtek™ Supreme XTE (XTE), and commercially available single-structure short-FRC (everX Posterior™) (n = 8 for each material) (s-FRC). The a-FRC restorations were prepared from an experimental FRC blank using a computer-aided design and manufacturing (CAD/CAM) device. A fracture test was performed to assess the fracture load, toughness, and failure mode. The fracture loads were vertically applied on the restorations. The surface micromorphology of the FRC restorations was observed by scanning electron microscopy (SEM). The data were analyzed by analysis of variance (p = .05) followed by Tukey's test. Results : s-FRC showed the highest mean fracture load (1145.0 ± 89.6 N) and toughness (26.2 ± 5.8 Ncm) among all the groups tested. With regard to the micromorphology of the prosthetic surface, local crushing of the fiberglass was observed in s-FRC, whereas chopped fiberglass was observed in a-FRC. Conclusions : The restorations made of short-FRC showed a higher load-bearing capacity than those made of the experimental all-FRC blanks for CAD/CAM. The brittle-like fractures were exhibited in the recent dental esthetic materials, while local crushing fractures were shown for single-structure FRC restorations. PMID:28642921

Analytical methods for the measurement of polymerization kinetics and stresses of dental resin-based composites: A review

PubMed Central

Ghavami-Lahiji, Mehrsima; Hooshmand, Tabassom

2017-01-01

Resin-based composites are commonly used restorative materials in dentistry. Such tooth-colored restorations can adhere to the dental tissues. One drawback is that the polymerization shrinkage and induced stresses during the curing procedure is an inherent property of resin composite materials that might impair their performance. This review focuses on the significant developments of laboratory tools in the measurement of polymerization shrinkage and stresses of dental resin-based materials during polymerization. An electronic search of publications from January 1977 to July 2016 was made using ScienceDirect, PubMed, Medline, and Google Scholar databases. The search included only English-language articles. Only studies that performed laboratory methods to evaluate the amount of the polymerization shrinkage and/or stresses of dental resin-based materials during polymerization were selected. The results indicated that various techniques have been introduced with different mechanical/physical bases. Besides, there are factors that may contribute the differences between the various methods in measuring the amount of shrinkages and stresses of resin composites. The search for an ideal and standard apparatus for measuring shrinkage stress and volumetric polymerization shrinkage of resin-based materials in dentistry is still required. Researchers and clinicians must be aware of differences between analytical methods to make proper interpretation and indications of each technique relevant to a clinical situation. PMID:28928776

Advances in dental materials.

PubMed

Vaderhobli, Ram M

2011-07-01

The use of materials to rehabilitate tooth structures is constantly changing. Over the past decade, newer material processing techniques and technologies have significantly improved the dependability and predictability of dental material for clinicians. The greatest obstacle, however, is in choosing the right combination for continued success. Finding predictable approaches for successful restorative procedures has been the goal of clinical and material scientists. This article provides a broad perspective on the advances made in various classes of dental restorative materials in terms of their functionality with respect to pit and fissure sealants, glass ionomers, and dental composites. Copyright © 2011 Elsevier Inc. All rights reserved.

Understanding dental CAD/CAM for restorations--the digital workflow from a mechanical engineering viewpoint.

PubMed

Tapie, L; Lebon, N; Mawussi, B; Fron Chabouis, H; Duret, F; Attal, J-P

2015-01-01

As digital technology infiltrates every area of daily life, including the field of medicine, so it is increasingly being introduced into dental practice. Apart from chairside practice, computer-aided design/computer-aided manufacturing (CAD/CAM) solutions are available for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental solutions can be considered a chain of digital devices and software for the almost automatic design and creation of dental restorations. However, dentists who want to use the technology often do not have the time or knowledge to understand it. A basic knowledge of the CAD/CAM digital workflow for dental restorations can help dentists to grasp the technology and purchase a CAM/CAM system that meets the needs of their office. This article provides a computer-science and mechanical-engineering approach to the CAD/CAM digital workflow to help dentists understand the technology.

Reducing composite restoration polymerization shrinkage stress through resin modified glass-ionomer based adhesives.

PubMed

Naoum, S J; Mutzelburg, P R; Shumack, T G; Thode, Djg; Martin, F E; Ellakwa, A E

2015-12-01

The aim of this study was to determine whether employing resin modified glass-ionomer based adhesives can reduce polymerization contraction stress generated at the interface of restorative composite adhesive systems. Five resin based adhesives (G Bond, Optibond-All-in-One, Optibond-Solo, Optibond-XTR and Scotchbond-Universal) and two resin modified glass-ionomer based adhesives (Riva Bond-LC, Fuji Bond-LC) were analysed. Each adhesive was applied to bond restorative composite Filtek-Z250 to opposing acrylic rods secured within a universal testing machine. Stress developed at the interface of each adhesive-restorative composite system (n = 5) was calculated at 5-minute intervals over 6 hours. The resin based adhesive-restorative composite systems (RBA-RCS) demonstrated similar interface stress profiles over 6 hours; initial rapid contraction stress development (0-300 seconds) followed by continued contraction stress development ≤0.02MPa/s (300 seconds - 6 hours). The interface stress profile of the resin modified glass-ionomer based adhesive-restorative composite systems (RMGIBA-RCS) differed substantially to the RBA-RCS in several ways. Firstly, during 0-300 seconds the rate of contraction stress development at the interface of the RMGIBA-RCS was significantly (p < 0.05) lower than at the interface of the RBA-RCS. Secondly, at 300 seconds and 6 hours the interface contraction stress magnitude of the RMGIBA-RCS was significantly (p < 0.05) lower than the stress of all assessed RBA-RCS. Thirdly, from 300 seconds to 6 hours both the magnitude and rate of interface stress of the RMGIBA-RCS continued to decline over the 6 hours from the 300 seconds peak. The use of resin modified glass-ionomer based adhesives can significantly reduce the magnitude and rate of polymerization contraction stress developed at the interface of adhesive-restorative composite systems. © 2015 Australian Dental Association.

Quality in restorative dentistry: a report of an advanced postgraduate dental symposium.

PubMed

Wilson, N H

1996-08-01

A joint Royal College of Surgeons of Edinburgh--Royal College of Physicians and Surgeons of Glasgow Advanced Postgraduate Dental Symposium addressed the issue of quality in restorative dentistry. The overall view was that quality in clinical care, including all aspects of restorative dentistry, is the consistent achievement of successful outcome. Ongoing developments and effective audit processes were recognized to provide important opportunities for continuous quality improvement in restorative dentistry.

First Permanent Molar Restoration Differences between Those with or without Dental Sealants.

ERIC Educational Resources Information Center

Kuthy, Raymond A.; And Others

1990-01-01

The study examined differences in the number of restorations in permanent, posterior teeth for those children receiving dental sealants with cost sharing when compared to children who do not receive sealants. Results indicated a 51 percent reduction in restoration rates for each quadrant sealed. Findings have implications for cost savings and…

Physico-mechanical and thermal characteristics of commercially available and newly developed dental flowable composites

NASA Astrophysics Data System (ADS)

Kamalak, Hakan; Canbay, C. Aksu; Yiğit, Oktay; Altin, Serdar

2018-03-01

In this study, we investigated the structural stability, thermal conductivity, thermal analysis, materials' homogeneity of newly developed flowable composites. 6 different dental flowable composite resins; Grandio Flow (GF), Charisma Flow (CF), Tetric N Flow (TNF), Clearfil Majesty Flow (CMF),3M Filtek Ultimate Flow (3MFU), Voco Amaris Flow (VFA) were used. Restorations were made in standard teflon molds and the materials were light-cured for 20s in a 6 mm × 2 mm teflon mould. After polymerization, samples were kept in distilled water at 37 °C/24 h .It was found that the composites have multiphase component such as metallic dopant and organic binder. The XRD investigation showed that there was a broad halo in the pattern which indicates the organic section in the composites. The FTIR results indicate the bond structure of the composites. The temperature dependence of the thermal conductivity of the composites were found below to 5 mW/K value depending on the type of the composites, which are low enough for dental application. The micro-hardness of the samples was analyzed and the result was compared.

Effect of a Simulation Exercise on Restorative Identification Skills of First Year Dental Hygiene Students.

PubMed

Lemaster, Margaret; Flores, Joyce M; Blacketer, Margaret S

2016-02-01

This study explored the effectiveness of simulated mouth models to improve identification and recording of dental restorations when compared to using traditional didactic instruction combined with 2-dimensional images. Simulation has been adopted into medical and dental education curriculum to improve both student learning and patient safety outcomes. A 2-sample, independent t-test analysis of data was conducted to compare graded dental recordings of dental hygiene students using simulated mouth models and dental hygiene students using 2-dimensional photographs. Evaluations from graded dental charts were analyzed and compared between groups of students using the simulated mouth models containing random placement of custom preventive and restorative materials and traditional 2-dimensional representations of didactically described conditions. Results demonstrated a statistically significant (p≤0.0001) difference: for experimental group, students using the simulated mouth models to identify and record dental conditions had a mean of 86.73 and variance of 33.84. The control group students using traditional 2-dimensional images mean graded dental chart scores were 74.43 and variance was 14.25. Using modified simulation technology for dental charting identification may increase level of dental charting skill competency in first year dental hygiene students. Copyright © 2016 The American Dental Hygienists’ Association.

Automated ablation of dental composite using an IR pulsed laser coupled to a plume emission spectral feedback system.

PubMed

Jang, Andrew T; Chan, Kenneth H; Fried, Daniel

2017-01-28

Dental composites are used as restorative materials for filling cavities, shaping, and covering teeth for esthetic purposes, and as adhesives. Dentists spend more time replacing existing restorations that fail than they do placing new restorations. Tooth colored restorations are difficult to differentiate from the surrounding tooth structure making them challenging to remove without damaging healthy tooth structure. Previous studies have demonstrated that CO 2 lasers in conjunction with spectral feedback can be used to selectively remove composite from tooth surfaces. The purpose of this study is to assemble a system that is feasible for clinical use incorporating a spectral feedback system, a scanning system, articulating arm and a clinical handpiece and then evaluate the performance of that system on extracted teeth. In addition, the selectivity of composite removal was analyzed using a high-speed optical coherence tomography system that is suitable for clinical use. The system was capable of rapidly removing composite from small preparations on tooth occlusal surfaces with a mean loss of enamel of less than 20-μm.

Automated ablation of dental composite using an IR pulsed laser coupled to a plume emission spectral feedback system

NASA Astrophysics Data System (ADS)

Jang, Andrew T.; Chan, Kenneth H.; Fried, Daniel

2017-02-01

Dental composites are used as restorative materials for filling cavities, shaping, and covering teeth for esthetic purposes, and as adhesives. Dentists spend more time replacing existing restorations that fail than they do placing new restorations. Tooth colored restorations are difficult to differentiate from the surrounding tooth structure making them challenging to remove without damaging healthy tooth structure. Previous studies have demonstrated that CO2 lasers in conjunction with spectral feedback can be used to selectively remove composite from tooth surfaces. The purpose of this study is to assemble a system that is feasible for clinical use incorporating a spectral feedback system, a scanning system, articulating arm and a clinical handpiece and then evaluate the performance of that system on extracted teeth. In addition, the selectivity of composite removal was analyzed using a high-speed optical coherence tomography system that is suitable for clinical use. The system was capable of rapidly removing composite from small preparations on tooth occlusal surfaces with a mean loss of enamel of less than 20-μm.

The influence of body mass index, age, implants, and dental restorations on image quality of cone beam computed tomography.

PubMed

Ritter, Lutz; Mischkowski, Robert A; Neugebauer, Jörg; Dreiseidler, Timo; Scheer, Martin; Keeve, Erwin; Zöller, Joachim E

2009-09-01

The aim was to determine the influence of patient age, gender, body mass index (BMI), amount of dental restorations, and implants on image quality of cone-beam computerized tomography (CBCT). Fifty CBCT scans of a preretail version of Galileos (Sirona, Germany) were investigated retrospectively by 4 observers regarding image quality of 6 anatomic structures, pathologic findings detection, subjective exposure quality, and artifacts. Patient age, BMI, gender, amount of dental restorations, and implants were recorded and statistically tested for correlations to image quality. A negative effect on image quality was found statistically significantly correlated with age and the amount of dental restorations. None of the investigated image features were garbled by any of the investigated influence factors. Age and the amount of dental restorations appear to have a negative impact on CBCT image quality, whereas gender and BMI do not. Image quality of mental foramen, mandibular canal, and nasal floor are affected negatively by age but not by the amount of dental restorations. Further studies are required to elucidate influence factors on CBCT image quality.

Influence of dental restorations and mastication loadings on dentine fatigue behaviour: Image-based modelling approach.

PubMed

Vukicevic, Arso M; Zelic, Ksenija; Jovicic, Gordana; Djuric, Marija; Filipovic, Nenad

2015-05-01

The aim of this study was to use Finite Element Analysis (FEA) to estimate the influence of various mastication loads and different tooth treatments (composite restoration and endodontic treatment) on dentine fatigue. The analysis of fatigue behaviour of human dentine in intact and composite restored teeth with root-canal-treatment using FEA and fatigue theory was performed. Dentine fatigue behaviour was analysed in three virtual models: intact, composite-restored and endodontically-treated tooth. Volumetric change during the polymerization of composite was modelled by thermal expansion in a heat transfer analysis. Low and high shrinkage stresses were obtained by varying the linear shrinkage of composite. Mastication forces were applied occlusally with the load of 100, 150 and 200N. Assuming one million cycles, Fatigue Failure Index (FFI) was determined using Goodman's criterion while residual fatigue lifetime assessment was performed using Paris-power law. The analysis of the Goodman diagram gave both maximal allowed crack size and maximal number of cycles for the given stress ratio. The size of cracks was measured on virtual models. For the given conditions, fatigue-failure is not likely to happen neither in the intact tooth nor in treated teeth with low shrinkage stress. In the cases of high shrinkage stress, crack length was much larger than the maximal allowed crack and failure occurred with 150 and 200N loads. The maximal allowed crack size was slightly lower in the tooth with root canal treatment which induced somewhat higher FFI than in the case of tooth with only composite restoration. Main factors that lead to dentine fatigue are levels of occlusal load and polymerization stress. However, root canal treatment has small influence on dentine fatigue. The methodology proposed in this study provides a new insight into the fatigue behaviour of teeth after dental treatments. Furthermore, it estimates maximal allowed crack size and maximal number of cycles for a

Survival of occlusal ART restorations in primary molars placed in school environment and hospital dental setup-one year follow-up study.

PubMed

Roshan, Noor-Mohammed; Sakeenabi, Basha

2011-11-01

The objectives of this clinical study were to: evaluate the survival of occlusal atraumatic restorative treatment (ART) restorations, on a longitudinal basis, in the primary molars of children; and compare the success rate of ART restorations placed in school environment and in hospital dental setup. One dentist placed 120 ART restorations in 60 five- to seven year-olds who had bilateral matched pairs of carious primary molars. A split-mouth design was used to place restorations in school and in hospital dental setup, which were assigned randomly to contralateral sides. Restorations were evaluated after 6 and 12 months using the ART criteria. The survival rate of ART restorations placed in school environment was 82.2% at the 6-month assessment and 77.77% at the 12-month assessment. The success rates of ART restorations placed in hospital dental setup in the 2 assessments were 87.7% and 81.48%, respectively. There was no statistically significant difference between the ART restorations placed in school environment and hospital dental setup in both assessments (P > O.05). The main cause of failure was the loss of restoration. The one year success rate of occlusal ART restorations in primary molars was moderately successful. The ART technique's done in hospital dental setup was not proven to be better than restorations placed in school environment.

Nordic dentists' opinions on the safety of amalgam and other dental restorative materials.

PubMed

Widström, E; Haugejorden, O; Sundberg, H; Birn, H

1993-08-01

The safety of amalgam and other restorative materials has caused concern among dental patients in recent years. The aim of this study was to obtain information on dentists' perceived competence in handling different filling materials and their opinions on the safety of these. A random sample of practising dentists in Denmark, Finland, Norway, and Sweden received a mail questionnaire in spring 1990. Answers were received from 1732 dentists (65%). The study showed that the respondents believed that their theoretic knowledge and clinical skills were generally at a high level regarding restorative materials. The risks of the side-effects of gold, ceramic materials, and glass ionomer were considered to be low by about 90% of the respondents. Amalgam was considered to be significantly more hazardous by the Swedish respondents than the others. Interestingly, composite was considered to be associated with a high risk of side-effects by about half of the dentists in all Nordic countries. The dentists' opinions were not found to be greatly influenced by their sex, age, or place of residence but rather by their country and service sector. Against the background of the present lack of scientific evidence on the hazardousness of amalgam or other restorative materials for patients' general health, these findings indicate that dentists are influenced by discussions in the mass media about dental treatment and materials and, of course, by the guidelines given by the health authorities in their own countries. Few dentists were shown to be concerned about occupational risks associated with the use of amalgam, and they had not had their own amalgam fillings replaced.(ABSTRACT TRUNCATED AT 250 WORDS)

Modeling the Residual Stresses in Reactive Resins-Based Materials: a Case Study of Photo-Sensitive Composites for Dental Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grassia, Luigi; D'Amore, Alberto

Residual stresses in reactive resins-based composites are associated to the net volumetric contraction (shrinkage) arising during the cross-linking reactions. Depending on the restoration geometry (the ratio of the free surface area to the volume of the cavity) the frozen-in stresses can be as high as the strength of the dental composites. This is the main reason why the effectiveness and then the durability of restorations with composites remains quite lower than those realized with metal alloys based materials. In this paper we first explore the possibility to circumvent the mathematical complexity arising from the determination of residual stresses in reactivemore » systems three-dimensionally constrained. Then, the results of our modeling approach are applied to a series of commercially available composites showing that almost all samples develop residual stresses such that the restoration undergoes failure as soon as it is realized.« less

Quantification of Staphylococcus aureus adhesion forces on various dental restorative materials using atomic force microscopy

NASA Astrophysics Data System (ADS)

Merghni, Abderrahmen; Kammoun, Dorra; Hentati, Hajer; Janel, Sébastien; Popoff, Michka; Lafont, Frank; Aouni, Mahjoub; Mastouri, Maha

2016-08-01

In the oral cavity dental restorative biomaterials can act as a reservoir for infection with opportunistic Staphylococcus aureus pathogen, which can lead to the occurrence of secondary caries and treatment failures. Our aim was to evaluate the adhesion forces by S. aureus on four dental restorative biomaterials and to correlate this finding to differences in specific surface characteristics. Additionally, the influence of salivary conditioning films in exerted adhesion forces was investigated. The substrate hydrophobicity was measured by goniometer and the surface free energy was calculated using the equilibrium advancing contact angle values of water, formamide, and diiodomethane on the tested surfaces. The surface roughness was determined using atomic force microscope (AFM). Additionally, cell force spectroscopy was achieved to quantify the forces that drive cell-substrate interactions. S. aureus bacterium exerted a considerable adhesion forces on various dental restorative materials, which decreased in the presence of saliva conditioning film. The influence of the surface roughness and free energy in initial adhesion appears to be more important than the effect of hydrophobicity, either in presence or absence of saliva coating. Hence, control of surface properties of dental restorative biomaterials is of crucial importance in preventing the attachment and subsequent the biofilm formation.

DH and ESPI laser interferometry applied to the restoration shrinkage assessment

NASA Astrophysics Data System (ADS)

Campos, L. M. P.; Parra, D. F.; Vasconcelos, M. R.; Vaz, M.; Monteiro, J.

2014-01-01

In dental restoration postoperative marginal leakage is commonly associated to polymerization shrinkage effects. In consequence the longevity and quality of restorative treatment depends on the shrinkage mechanisms of the composite filling during the polymerization. In this work the development of new techniques for evaluation of those effects under light-induced polymerization of dental nano composite fillings is reported. The composite resins activated by visible light, initiate the polymerization process by absorbing light in wavelengths at about 470 nm. The techniques employed in the contraction assessment were digital holography (DH) and Electronic Speckle Pattern Interferometry (ESPI) based on laser interferometry. A satisfactory resolution was achieved in the non-contact displacement field measurements on small objects concerning the experimental dental samples. According to a specific clinical protocol, natural teeth were used (human mandibular premolars). A class I cavity was drilled and restored with nano composite material, according to Black principles. The polymerization was monitored by DH and ESPI in real time during the cure reaction of the restoration. The total displacement reported for the material in relation of the tooth wall was 3.7 μm (natural tooth). The technique showed the entire tooth surface (wall) deforming during polymerization shrinkage.

A Comparison of US and Japanese Dental Restorative Care Present on Service Members Recovered from the WWII Era.

PubMed

Shiroma, Calvin Y

2017-11-01

The documentation of dental materials used in the USA during the WWII era is readily available, while references for the Japanese are minimal. It was therefore important to build a photographic database of Japanese restorative care which could be utilized as a comparison tool for the deployed odontologist. The dental restorative care of approximately 400 US and 100 Japanese sets of remains was evaluated. Both countries share many similar restorative techniques to include collared crowns, full-coverage restorations, cantilever bridge/pontics to close spaces; restorative materials such as amalgam, gold, and zinc phosphate (temporary) restorations; and removable prostheses. The dental restorative materials most commonly used by US dentists include the amalgam and silicate cement, while the full-coverage crown was the type of restoration most frequently seen on the Japanese remains. Silicates, porcelain and replaceable crowns, and partial-coverage prepared crowns were not observed on the recovered Japanese remains. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

High elastic modulus nanopowder reinforced resin composites for dental applications

NASA Astrophysics Data System (ADS)

Wang, Yijun

2007-12-01

Dental restorations account for more than $3 billion dollars a year on the market. Among them, all-ceramic dental crowns draw more and more attention and their popularity has risen because of their superior aesthetics and biocompatibility. However, their relatively high failure rate and labor-intensive fabrication procedure still limit their application. In this thesis, a new family of high elastic modulus nanopowder reinforced resin composites and their mechanical properties are studied. Materials with higher elastic modulus, such as alumina and diamond, are used to replace the routine filler material, silica, in dental resin composites to achieve the desired properties. This class of composites is developed to serve (1) as a high stiffness support to all-ceramic crowns and (2) as a means of joining independently fabricated crown core and veneer layers. Most of the work focuses on nano-sized Al2O3 (average particle size 47 nm) reinforcement in a polymeric matrix with 50:50 Bisphenol A glycidyl methacrylate (Bis-GMA): triethylene glycol dimethacrylate (TEGDMA) monomers. Surfactants, silanizing agents and primers are examined to obtain higher filler levels and enhance the bonding between filler and matrix. Silane agents work best. The elastic modulus of a 57.5 vol% alumina/resin composite is 31.5 GPa compared to current commercial resin composites with elastic modulus <15 GPa. Chemical additives can also effectively raise the hardness to as much as 1.34 GPa. Besides>alumina, diamond/resin composites are studied. An elastic modulus of about 45 GPa is obtained for a 57 vol% diamond/resin composite. Our results indicate that with a generally monodispersed nano-sized high modulus filler, relatively high elastic modulus resin-based composite cements are possible. Time-dependent behavior of our resin composites is also investigated. This is valuable for understanding the behavior of our material and possible fatigue testing in the future. Our results indicate that with

In vitro fatigue behavior of restorative composites and glass ionomers.

PubMed

Braem, M J; Lambrechts, P; Gladys, S; Vanherle, G

1995-03-01

This in vitro study was conducted to investigate the fatigue behavior of several dental restoratives, including composites, glass ionomers and a resin-reinforced glass ionomer. Fatigue was imposed under a reverse stress-controlled regimen, following a staircase approach. Samples were stored and tested under both dry and wet conditions. The following parameters were measured and analyzed: Young's modulus, restrained fracture strength, and flexural fatigue limit. As a general trend, all products showed a decrease in Young's modulus following water sorption. For all products except the resin-reinforced glass ionomer, the same trend was seen in the restrained fracture strength. This is, however, no longer valid for the flexural fatigue limit: the trend is steady-state for the glass ionomers, status quo for the resin-reinforced glass ionomer, and all composites tested show a decrease. The diversity in structure of both composites and glass ionomers does not allow findings for one product to be extrapolated to other similar products.

Modification of the restoration protocol for resin-based composite (RBC) restoratives (conventional and bulk fill) on cuspal movement and microleakage score in molar teeth.

PubMed

Politi, I; McHugh, L E J; Al-Fodeh, R S; Fleming, G J P

2018-05-29

To modify the resin-based composite (RBC) restoration protocol for standardised Class II cavities in third molar teeth restored using conventional RBCs or their bulk fill restorative counterparts. Employing cuspal deflection using a twin channel deflection measuring gauge (during) and microleakage to determine marginal integrity (following) RBC restoration, the modified restoration protocol results were compared with traditional (oblique) restoration of Class II cavities. Thirty-two sound third molar teeth, standardised by size and morphology, were subjected to standardised Class II cavity preparations and randomly allocated to four groups. Restorations were placed in conjunction with a universal bonding system and resin restorative materials were irradiated with a light-emitting-diode light-curing-unit. The cumulative buccal and palatal cuspal movements from a twin channel deflection measuring gauge were summed, the restored teeth fatigued thermally prior to immersion in 0.2% basic fuchsin dye for 24h, before sectioning and examination for microleakage. Teeth restored using conventional RBC materials had significantly higher mean total cuspal movement values compared with bulk fill resin restorative restoration (all p<0.0001). Teeth restored with Admira Fusion and Admira Fusion x-tra had significantly the lowest microleakage scores (all p<0.001) compared with Tetric EvoCeram and Tetric EvoCeram Bulk Fill restored teeth. The microleakage scores for the range of RBC materials tested were significantly reduced (all p<0.001) when the modified RBC restoration protocol was employed compared with the traditional Class II restoration technique. Modification of the RBC restoration protocol of some conventional RBCs and bulk fill resin restoratives significantly improve bond integrity and could be translated as a validation of the limited clinical studies available on bulk fill materials in the dental literature where Class II cavities perform less well than Class I

Curing mode affects bond strength of adhesively luted composite CAD/CAM restorations to dentin.

PubMed

Lührs, Anne-Katrin; Pongprueksa, Pong; De Munck, Jan; Geurtsen, Werner; Van Meerbeek, Bart

2014-03-01

To determine the effect of curing mode and restoration-surface pre-treatment on the micro-tensile bond strength (μTBS) to dentin. Sandblasted CAD/CAM composite blocks (LAVA Ultimate, 3M ESPE) were cemented to bur-cut dentin using either the etch & rinse composite cement Nexus 3 ('NX3', Kerr) with Optibond XTR ('XTR', Kerr), or the self-etch composite cement RelyX Ultimate ('RXU', 3M ESPE) with Scotchbond Universal ('SBU', 3M ESPE). All experimental groups included different 'curing modes' (light-curing of adhesive and cement ('LL'), light-curing of adhesive and auto-cure of cement ('LA'), co-cure of adhesive through light-curing of cement ('AL'), or complete auto-cure ('AA')) and different 'restoration-surface pre-treatments' of the composite block (NX3: either a silane primer (Kerr), or the XTR adhesive; RXU: either silane primer (RelyX Ceramic Primer, 3M ESPE) and SBU, or solely SBU). After water-storage (7 days, 37°C), the μTBS was measured. Additionally, the degree of conversion (DC) of both cements was measured after 10min and after 1 week, either auto-cured (21°C/37°C) or light-cured (directly/through 3-mm CAD/CAM composite). The linear mixed-effects model (α=0.05) revealed a significant influence of the factors 'curing mode' and 'composite cement', and a less significant effect of the factor 'restoration-surface pre-treatment'. Light-curing 'LL' revealed the highest μTBS, which decreased significantly for all other curing modes. For curing modes 'AA' and 'AL', the lowest μTBS and a high percentage of pre-testing failures were reported. Overall, DC increased with light-curing and incubation time. The curing mode is decisive for the bonding effectiveness of adhesively luted composite CAD/CAM restorations to dentin. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Three-dimensional analysis of cavity wall deformation after composite restoration of masticatory teeth.

PubMed

Manchorova-Veleva, Neshka A

2011-01-01

The aim of the present work was to study the size of cavity wall deformation in eight class I and II defects after composite restoration. 1. Creating a geometric model - data on the size of the left maxillary second premolar were obtained from a routine craniofacial scanning of a 20-year-old patient with a 2,5 Dental CT scanner (General Electric), with high resolution and 0.625mm-thin slices. The contour of each of the 33 cross-sections of tooth 25 was delineated using graphics software (CorelDraw 7.0) and transferred to a specialized product for engineering design (SolidWorks Office Premium 2010, SolidWorks Corp. USA). The pulp cavity and periodontal ligament were created in the same manner and were integrated in the premolar body; 2. Generation of a finite element method - the geometric model was exported to specialized software for analysis by the finite element method - COSMOSWorks 2010, which automatically builds a 3D finite elements mesh. Based on the generated model, eight additional models of class I and II cavities with different geometries, adhesive layer and nanofilled composite restorations were constructed. The polymerization shrinkage was modelled by thermal deformation, with a negative temperature difference (cooling), corresponding to the actual volume shrinkage of the composite materials by 2.1%. In models A and B, the maximum cavity wall displacement was small - 0.014 mm and 0.015 mm, respectively. In models Al, B1, C1 and C, the displacement was at the expense of large deformation of the dental tissues. The maximum cavity wall displacements were 0.020 mm, 0.026 mm, 0.020 mm, 0.035 mm, respectively. The least cavity wall displacement was in models A2 and B2 with 0.008 mm and 0.017 mm, respectively. The least displacement resulting from cavity wall deformation is found in patient-friendly class I and II preparations. Preservation of the dental tissues reduces the risk of mechanical pressure on the dentinal lymph and the likelihood of post

Priorities for future innovation, research, and advocacy in dental restorative materials.

PubMed

Watson, T; Fox, C H; Rekow, E D

2013-11-01

Innovations in materials science, both within and outside of dentistry, open opportunities for the development of exciting direct restorative materials. From rich dialog among experts from dental and non-dental academic institutions and industry, as well as those from policy, research funding, and professional organizations, we learned that capitalizing on these opportunities is multifactorial and far from straightforward. Beginning from the point when a restoration is needed, what materials, delivery systems, and skills are needed to best serve the most people throughout the world's widely varied economic and infrastructure systems? New research is a critical element in progress. Effective advocacy can influence funding and drives change in practice and policy. Here we articulate both research and advocacy priorities, with the intention of focusing the energy and expertise of our best scientists on making a difference, bringing new innovations to improve oral health.

Optical approach in characterizing dental biomaterials

NASA Astrophysics Data System (ADS)

Demoli, Nazif; Vučić, Zlatko; Milat, Ognjen; Gladić, Jadranko; Lovrić, Davorin; Pandurić, Vlatko; Marović, Danijela; Moguš-Milanković, Andrea; Ristić, Mira; Čalogović, Marina; Tarle, Zrinka

2013-04-01

The purpose of this paper is to present the current activities of a research collaborative program between three institutions from Zagreb (School of Dental Medicine, Institute of Physics, and Institute Ruđer Bo\\vsković). Within the scope of this program, it is planned to investigate and find guidelines for the refinement of the properties of dental biomaterials (DBs) and of procedures in restorative dental medicine. It is also planned to identify and model the dominant mechanisms which control polymerization of DBs. The materials to be investigated include methacrylate based composite resins, new composite materials with amorphous calcium phosphate, silorane based composite resins, glass-ionomer cements, and giomer.

Mesoporous silica fillers and resin composition effect on dental composites cytocompatibility.

PubMed

Attik, Nina; Hallay, Franck; Bois, Laurence; Brioude, Arnaud; Grosgogeat, Brigitte; Colon, Pierre

2017-02-01

Many new dental composites containing mesoporous silica fillers have been developed to improve rheological properties and enhance the resin-filler interface. To investigate the correlation between the cytocompatibility of several dental composites and their composition; two aspects have been considered: presence of bisphenol A (BPA)-glycidyl methacrylate (Bis-GMA) or triethyleneglycol-dimethacrylate (TEGDMA) among the resin monomers and presence of porous particles among the filler blends. Five commercial composites with different resin matrices and mineral fillers were compared to four experimental composites designed without any BPA-based monomers or TEGDMA. Porous fillers, with or without silanation, were added in some of the experimental composites. Two reference resin matrices were also selected. Cytocompatibility with cultured primary human gingival fibroblasts was assessed by confocal laser scanning microscopy with time-lapse imaging. Fourier transform infrared spectroscopy was used to control monomer conversion rate. Conversion rates of the experimental composites ranged from 57% to 71%, a comparable ratio for dental composites. Experimental samples were better tolerated than tested commercial samples not containing TEGDMA and significantly better than those containing TEGDMA. Experimental composites with porous fillers exhibited good cytocompatibility, especially when surfaces were silanated. Cytotoxicity was associated with resin amount and especially resin nature. Composites containing porous fillers might behave as if the resin trapped into pores has no effect on toxicity. The cytotoxicity of composites with and without BPA derivatives was mainly attributed to the release of residual TEGDMA rather than the BPA derivatives. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Dental preparation with sonic vs high-speed finishing: analysis of microleakage in bonded veneer restorations.

PubMed

Faus-Matoses, Ignacio; Solá-Ruiz, Fernanda

2014-02-01

To compare marginal microleakage in porcelain veneer restorations following dental finishing using two types of instruments to test the hypothesis that microleakage will be less when teeth are prepared with sonic oscillating burs than when prepared with high-speed rotating burs. Fifty-six extracted human maxillary central incisors were selected and divided randomly into two groups. Group 1 samples underwent dental finishing using high-speed rotating diamond burs, while group 2 used sonic oscillating diamond burs. Buccal chamfer preparation was carried out for both groups. Forty eight of the samples (24 per group) were restored using IPS Empress ceramic veneers. 2% methylene blue was used to evaluate microleakage at the tooth/composite veneer interface. Teeth were sectioned lengthwise into three parts and microleakage was measured at two points - cervical and incisal - on each section. Before bonding, four teeth per group underwent SEM examination. Evaluation of microleakage at the cervical dentin margin showed a value of 10.5% in group 1 and 6.6% in group 2, which was statistically significantly different (p < 0.05). Incisal microleakage was 1.3% for group 1 and 1.2% for group 2, which was not significantly different. SEM revealed different patterns of surface texture in both areas according to the instrument used. Group 1 exhibited parallel horizontal abrasion grooves with a milled effect and thick smear layers; group 2 showed abrasive erosion, discontinuous perpendicular depressions, and thin smear layers. Tooth preparations finished with sonic burs produced significantly less microleakage in the cervical dentin area of bonded veneer restorations. No differences were found in the incisal enamel area.

Simplified treatment of severe dental erosion with ultrathin CAD-CAM composite occlusal veneers and anterior bilaminar veneers.

PubMed

Schlichting, Luís Henrique; Resende, Tayane Holz; Reis, Kátia Rodrigues; Magne, Pascal

2016-10-01

Restorative treatment for patients with dental erosion requires an analysis of the degree of structural damage. Patients affected by moderate to severe dental erosion are particularly challenging because complex occlusal reconstruction will be needed. Ultrathin bonded occlusal veneers represent a conservative alternative to traditional onlays and complete coverage crowns for the treatment of severe erosion. This article describes a complete mouth rehabilitation with ultrathin computer-aided design and computer-aided manufacturing (CAD-CAM) composite resin occlusal veneers in a patient with a severely eroded dentition. In the maxillary anterior teeth, the bilaminar approach was chosen with lingual composite resin veneers and labial porcelain veneers. The main benefit of this approach is the possibility of using additive adhesive techniques, allowing only strategic reduction of sound dental structure or no preparation. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Influence of the operatory field isolation technique on tooth-colored direct dental restorations.

PubMed

Cajazeira, Marlus Roberto Rodrigues; De Sabóia, Ticiana Medeiros; Maia, Lucianne Cople

2014-06-01

To evaluate, through a systematic review, the influence of the operatory field isolation technique on the longevity of dental restorations performed with tooth-colored materials. An electronic search of the scientific databases (MEDLINE, SCIRUS, VHL and SIGLE) and reference lists of the selected articles was conducted to identify randomized controlled clinical trials with a follow-up period of at least 12 months. The selected articles evaluated the effects of the operatory field isolation techniques (rubber dam or cotton rolls/saliva ejector) on the longevity of direct restorations performed with tooth-colored materials (e.g. resin composites, compomers and glass-ionomer cements) in primary or permanent posterior teeth. The selected studies were analyzed and categorized using a checklist proposed by the National Institute for Health and Clinical Excellence of the United Kingdom. 484 studies were identified on the scientific databases. After applying the exclusion criteria and removal of duplicates, a total of nine studies were considered as potentially eligible. From these, five studies were included in the final analysis by two evaluators. In four studies analyzed, the use of rubber dam did not influence the longevity of restorations in comparison to cotton rolls/saliva ejector. Only two studies were considered as low risk of bias.

Paediatric dentistry education of atraumatic restorative treatment (ART) in Brazilian dental schools.

PubMed

Camargo, L B; Fell, C; Bonini, G C; Marquezan, M; Imparato, J C P; Mendes, F M; Raggio, D P

2011-12-01

To evaluate the degree of knowledge, use and teaching of atraumatic restorative treatment (ART) of paediatric dentistry lecturers in dental schools throughout Brazil. A structured questionnaire was applied, containing questions regarding the use of ART, socio-demographic characteristics and academic degree background. Descriptive analysis and Poisson's regression were conducted in order to verify the association between exploratory variables and ART teaching (α=5%). Of the 721 questionnaires sent to dental schools, approximately 40% were returned (n=285). Some 98.2% of the participants teach ART. Concerning dental lecturers who teach ART, in multiple regression model, considering ART indication (emergency versus restorative treatment) the lecturers residents of the Mid-West (PR=1.66; CI:1.13-2.45) and Northeast region (PR=1.33; CI:1.02-1.72) and lecturers who use ART regularly (PR=3.73; CI:2.11-5.59) teach ART as restorative treatment. When the question was about reason for using ART (conservative technique versus other techniques failures/fast treatment), lecturers with a longer period of TG (time elapsed since graduation) (PR=1.30; CI:1.08- 1.56) and also lecturers who use ART regularly (PR=2.87; CI:1.95-4.22), teach it as being a conservative technique. Regarding the patients' age covered by ART (versus without limitation), women (PR=1.26; CI:1.06-1.50) and lecturers who use ART regularly (PR=1.28; CI:1.06-1.54), teach that there is no age restriction. ART has been widely taught in Brazilian dental schools, is regularly used in lecturer's clinical practices and has positively influenced the appropriate teaching of this technique.

Novel dental composites reinforced with zirconia-silica ceramic nanofibers.

PubMed

Guo, Guangqing; Fan, Yuwei; Zhang, Jian-Feng; Hagan, Joseph L; Xu, Xiaoming

2012-04-01

To fabricate and characterize dental composites reinforced with various amounts of zirconia-silica (ZS) or zirconia-yttria-silica (ZYS) ceramic nanofibers. Control composites (70 wt% glass particle filler, no nanofibers) and experimental composites (2.5, 5.0, and 7.5 wt% ZS or ZYS nanofibers replacing glass particle filler) were prepared by blending 29 wt% dental resin monomers, 70 wt% filler, and 1.0 wt% initiator, and polymerized by either heat or dental curing light. Flexural strength (FS), flexural modulus (FM), energy at break (EAB), and fracture toughness (FT) were tested after the specimens were stored in 37°C deionized water for 24h, 3 months, or 6 months. Degree of conversion (DC) of monomers in composites was measured using Fourier transformed near-infrared (FT-NIR) spectroscopy. Fractured surfaces were observed by field-emission scanning electron microscope (FE-SEM). The data were analyzed using ANOVA with Tukey's Honestly Significant Differences test used for post hoc analysis. Reinforcement of dental composites with ZS or ZYS nanofibers (2.5% or 5.0%) can significantly increase the FS, FM and EAB of dental composites over the control. Further increase the content of ZS nanofiber (7.5%), however, decreases these properties (although they are still higher than those of the control). Addition of nanofibers did not decrease the long-term mechanical properties of these composites. All ZS reinforced composites (containing 2.5%, 5.0% and 7.5% ZS nanofibers) exhibit significantly higher fracture toughness than the control. The DC of the composites decreases with ZS nanofiber content. Incorporation of ceramic nanofibers in dental composites can significantly improve their mechanical properties and fracture toughness and thus may extend their service life. Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

A dynamic Monte Carlo model for predicting radiant exposure distribution in dental composites: model development and verifications

NASA Astrophysics Data System (ADS)

Chen, Yin-Chu; Ferracane, Jack L.; Prahl, Scott A.

2005-03-01

Photo-cured dental composites are widely used in dental practices to restore teeth due to the esthetic appearance of the composites and the ability to cure in situ. However, their complex optical characteristics make it difficult to understand the light transport within the composites and to predict the depth of cure. Our previous work showed that the absorption and scattering coefficients of the composite changed after the composite was cured. The static Monte Carlo simulation showed that the penetration of radiant exposures differed significantly for cured and uncured optical properties. This means that a dynamic model is required for accurate prediction of radiant exposure in the composites. The purpose of this study was to develop and verify a dynamic Monte Carlo (DMC) model simulating light propagation in dental composites that have dynamic optical properties while photons are absorbed. The composite was divided into many small cubes, each of which had its own scattering and absorption coefficients. As light passed through the composite, the light was scattered and absorbed. The amount of light absorbed in each cube was calculated using Beer's Law and was used to determine the next optical properties in that cube. Finally, the predicted total reflectance and transmittance as well as the optical property during curing were verified numerically and experimentally. Our results showed that the model predicted values agreed with the theoretical values within 1% difference. The DMC model results are comparable with experimental results within 5% differences.

Predictable repair of provisional restorations.

PubMed

Hammond, Barry D; Cooper, Jeril R; Lazarchik, David A

2009-01-01

The importance of provisional restorations is often downplayed, as they are thought of by some as only "temporaries." As a result, a less-than-ideal provisional is sometimes fabricated, in part because of the additional chair time required to make provisional modifications when using traditional techniques. Additionally, in many dental practices, these provisional restorations are often fabricated by auxillary personnel who may not be as well trained in the fabrication process. Because provisionals play an important role in achieving the desired final functional and esthetic result, a high-quality provisional restoration is essential to fabricating a successful definitive restoration. This article describes a method for efficiently and predictably repairing both methacrylate and bis-acryl provisional restorations using flowable composite resin. By use of this relatively simple technique, provisional restorations can now be modified or repaired in a timely and productive manner to yield an exceptional result. Successful execution of esthetic and restorative dentistry requires attention to detail in every aspect of the case. Fabrication of high-quality provisional restorations can, at times, be challenging and time consuming. The techniques for optimizing resin provisional restorations as described in this paper are pragmatic and will enhance the delivery of dental treatment.

Assessing patterns of restorative and preventive care among children enrolled in Medicaid, by type of dental care provider.

PubMed

Taichman, L Susan; Sohn, Woosung; Lim, Sungwoo; Eklund, Stephen; Ismail, Amid

2009-07-01

The authors investigate the relationship of preventive dental treatment to subsequent receipt of comprehensive treatment among Medicaid-enrolled children. The authors analyzed Medicaid dental claims data for 50,485 children residing in Wayne County, Mich. The study sample included children aged 5 through 12 years in 2002 who had been enrolled in Medicaid for at least one month and had had at least one dental visit each year from 2002 through 2005. The authors assessed dental care utilization and treatment patterns cross-sectionally for each year and longitudinally. Among the Medicaid-enrolled children in 2002, 42 percent had had one or more dental visits during the year. At least 20 percent of the children with a dental visit in 2002 were treated by providers who billed Medicaid exclusively for diagnostic and preventive (DP) services. Children treated by DP care providers were less likely to receive restorative and/or surgical services than were children who were treated by dentists who provided a comprehensive mix of dental services. The logistic model showed that children who visited a DP-care provider were about 2.5 times less likely to receive restorative or surgical treatments than were children who visited comprehensive-care providers. Older children and African-American children were less likely to receive restorative and surgical treatments from both types of providers. The study results show that the type of provider is a significant determinant of whether children received comprehensive restorative and surgical services. The results suggest that current policies that support preventive care-only programs may achieve increased access to preventive care for Medicaid-enrolled children in Wayne County, but they do not provide access to adequate comprehensive dental care.

Nanoparticle concentrations and composition in a dental office and dental laboratory: A pilot study on the influence of working procedures.

PubMed

Lang, Andreja; Ovsenik, Maja; Verdenik, Ivan; Remškar, Maja; Oblak, Čedomir

2018-05-01

During material treatment in dentistry particles of different size are released in the air. To examine the degree of particle exposure, air scanning to dental employees was performed by the Scanning Mobility Particle Sizer. The size, shape and chemical composition of particles collected with a low-pressure impactor were determined by scanning electronic microscopy and X-ray dispersive analysis. The average concentrations of nanoparticles during working periods in a clean dental laboratory (45,000-56,000 particles/cm 3 ), in an unclean dental laboratory (28,000-74,000 particles/cm 3 ), and in a dental office (21,000-50,000 particles/cm 3 ), were significantly higher compared to average concentrations during nonworking periods in the clean dental laboratory (11,000-24,000 particles/cm 3 ), unclean laboratory (14,000-40,000 particles/cm 3 ), and dental office (13,000-26,000 particles/cm 3 ). Peak concentration of nanoparticles in work-intensive periods were found significantly higher (up to 773,000 particles/cm 3 ), compared to the non-working periods (147,000 particles/cm 3 ) and work-less intensive periods (365,000 particles/cm 3 ). The highest mass concentration value ranged from 0.055-0.166 mg/m 3 . X-ray dispersive analysis confirmed the presence of carbon, potassium, oxygen, iron, aluminum, zinc, silicon, and phosphorus as integral elements of dental restorative materials in form of nanoparticle clusters, all smaller than 100 nm. We concluded that dental employees are exposed to nanoparticles in their working environment and are therefore potentially at risk for certain respiratory and systematic diseases.

Mechanical and fracture behavior of veneer-framework composites for all-ceramic dental bridges.

PubMed

Studart, André R; Filser, Frank; Kocher, Peter; Lüthy, Heinz; Gauckler, Ludwig J

2007-01-01

High-strength ceramics are required in dental posterior restorations in order to withstand the excessive tensile stresses that occur during mastication. The aim of this study was to investigate the fracture behavior and the fast-fracture mechanical strength of three veneer-framework composites (Empress 2/IPS Eris, TZP/Cercon S and Inceram-Zirconia/Vita VM7) for all-ceramic dental bridges. The load bearing capacity of the veneer-framework composites were evaluated using a bending mechanical apparatus. The stress distribution through the rectangular-shaped layered samples was assessed using simple beam calculations and used to estimate the fracture strength of the veneer layer. Optical microscopy of fractured specimens was employed to determine the origin of cracks and the fracture mode. Under fast fracture conditions, cracks were observed to initiate on, or close to, the veneer outer surface and propagate towards the inner framework material. Crack deflection occurred at the veneer-framework interface of composites containing a tough framework material (TZP/Cercon S and Inceram-Zirconia/Vita VM7), as opposed to the straight propagation observed in the case of weaker frameworks (Empress 2/IPS Eris). The mechanical strength of dental composites containing a weak framework (K(IC)<3 MPam(1/2)) is ultimately determined by the low fracture strength of the veneer layer, since no crack arresting occurs at the veneer-framework interface. Therefore, high-toughness ceramics (K(IC)>5 MPam(1/2)) should be used as framework materials of posterior all-ceramic bridges, so that cracks propagating from the veneer layer do not lead to a premature failure of the prosthesis.

Association and comparison between visual inspection and bitewing radiography for the detection of recurrent dental caries under restorations.

PubMed

Lino, José R; Ramos-Jorge, Joana; Coelho, Valéria Silveira; Ramos-Jorge, Maria L; Moysés, Marcos R; Ribeiro, José C R

2015-08-01

The aim of the present study was to investigate, in posterior teeth, the association between the characteristics of the margins of a restoration visually inspected and the presence, under restorations, of recurrent or residual dental caries detected by radiographic examination. Furthermore, the agreement between visual inspection and radiographs to detect dental caries was assessed. Eighty-five permanent molars and premolars with resin restorations on the interproximal and/or occlusal faces, from 18 patients, were submitted for visual inspection and radiographic examination. The visual inspection involved the criteria of the International Caries Detection and Assessment System (ICDAS). Bitewing radiographs were used for the radiographic examination. Logistic regression was used to analyse the association between the characteristics of the margins of a restoration assessed by visual inspection (absence of dental caries, or early, established, inactive and active lesions) and the presence of recurrent caries detected by radiographs. Kappa coefficients were calculated for determining agreement between the two methods. The Kappa coefficient for agreement between visual inspection and radiographic examination was 0.19. Established lesions [odds ratio (OR) = 9.89; 95% confidence interval (95% CI): 2.94-33.25; P < 0.05] and lesion activity (OR = 2.57; 95% CI: 0.91-7.27; P < 0.05) detected by visual inspection, were associated with recurrent or residual dental caries detected by radiographs. Restorations with established and active lesions at the margins had a greater chance of exhibiting recurrent or residual lesions in the radiographic examination. The present findings demonstrate that restorations with established and active lesions at the margins when visually inspected often require removal and retreatment. © 2015 FDI World Dental Federation.

Dental erosion: understanding this pervasive condition.

PubMed

Almeida e Silva, Júnio S; Baratieri, Luiz Narciso; Araujo, Edson; Widmer, Nicolas

2011-08-01

Dental erosion is a contemporary disease, mostly because of the change of the eating patterns that currently exist in society. It is a "silent" and multifactorial disease, and is highly influenced by habits and lifestyles. The prevalence of dental erosion has considerably increased, with this condition currently standing as a great challenge for the clinician, regarding the diagnosis, identification of the etiological factors, prevention, and execution of an adequate treatment. This article presents a dental erosion review and a case report of a restorative treatment of dental erosion lesions using a combination of bonded ceramic overlays to reestablish vertical dimension and composite resin to restore the worn palatal and incisal surfaces of the anterior upper teeth. Adequate function and esthetics can be achieved with this approach. © 2011 Wiley Periodicals, Inc.

Backscattering from dental restorations and splint materials during therapeutic radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farman, A.G.; Sharma, S.; George, D.I.

1985-08-01

Models were constructed to simulate as closely as possible the human oral cavity. Radiation absorbed doses were determined for controls and various test situations involving the presence of dental restorative and splint materials during cobalt-60 irradiation of the models. Adjacent gold full crowns and adjacent solid dental silver amalgam cores both increased the dose to the interproximal gingivae by 20%. Use of orthodontic full bands for splinting the jaws increased the dose to the buccal tissues by an average of 10%. Augmentation of dose through backscatter radiation was determined to be only slight for intracoronal amalgam fillings and stainless steelmore » or plastic bracket splints.« less

Synthesis and characterization of antibacterial dental monomers and composites

PubMed Central

Xu, Xiaoming; Wang, Yapin; Liao, Sumei; Wen, Zezhang T.; Fan, Yuwei

2012-01-01

The objective of this study is to synthesize antibacterial methacrylate and methacrylamide monomers and formulate antibacterial fluoride-releasing dental composites. Three antibacterial methacrylate or methacrylamide monomers containing long-chain quaternary ammonium fluoride, 1,2-methacrylamido-N,N,N-trimethyldodecan-1-aminium fluoride (monomer I), N-benzyl-11-(methacryloyloxy)-N,N-dimethylundecan-1-aminium fluoride (monomer II), and methacryloxyldecylpyridinium fluoride (monomer III) have been synthesized and analyzed by nuclear magnetic resonance (NMR) and mass spectrometry (MS). The cytotoxicity test and bactericidal test against Streptococcus mutans indicate that antibacterial monomer II is superior to monomers I and III. A series of dental composites containing 0–6% of antibacterial monomer II have been formulated and tested for degree of conversion (DC), flexure strength, water sorption, solubility, and inhibition of S. mutans biofilms. An antibacterial fluoride-releasing dental composite has also been formulated and tested for flexure strength and fluoride release. The dental composite containing 3% of monomer II has a significant effect against S. mutans biofilm formation without major adverse effects on its physical and mechanical properties. The new antibacterial monomers can be used together with the fluoride-releasing monomers containing a ternary zirconiun- fluoride chelate to formulate a new antibacterial fluoride- releasing dental composite. Such a new dental composite is expected to have higher anticaries efficacy and longer service life. PMID:22447582

Class II composite resin restorations: faster, easier, predictable.

PubMed

Jackson, R D

2016-11-18

Composite resin continues to displace amalgam as the preferred direct restorative material in developed countries. Even though composite materials have evolved to include nanoparticles with high physical properties and low shrinkage stress, dentists have been challenged to efficiently create quality, long lasting, predictable restorations. Unlike amalgam, composite resin cannot be condensed making the establishment of a predictable, proper contact more difficult. In addition, composite requires an understanding of adhesives and an appreciation for their exacting application. These facts combined with the precise adaptation and light-curing of multiple layers makes placement of quality Class II composite restorations tedious and time-consuming. For private practicing dentists, it can also have an effect on economic productivity. Clinicians have always wanted an easier, efficient placement technique for posterior composite restorations that rivals that for amalgam. It appears that advances in instrumentation, materials and technology have finally delivered it.

Fatigue resistance and crack propensity of large MOD composite resin restorations: direct versus CAD/CAM inlays.

PubMed

Batalha-Silva, Silvana; de Andrada, Mauro Amaral Caldeira; Maia, Hamilton Pires; Magne, Pascal

2013-03-01

To assess the influence of material/technique selection (direct vs. CAD/CAM inlays) for large MOD composite adhesive restorations and its effect on the crack propensity and in vitro accelerated fatigue resistance. A standardized MOD slot-type tooth preparation was applied to 32 extracted maxillary molars (5mm depth and 5mm bucco-palatal width) including immediately sealed dentin for the inlay group. Fifteen teeth were restored with direct composite resin restoration (Miris2) and 17 teeth received milled inlays using Paradigm MZ100 block in the CEREC machine. All inlays were adhesively luted with a light curing composite resin (Filtek Z100). Enamel shrinkage-induced cracks were tracked with photography and transillumination. Cyclic isometric chewing (5 Hz) was simulated, starting with a load of 200 N (5000 cycles), followed by stages of 400, 600, 800, 1000, 1200 and 1400 N at a maximum of 30,000 cycles each. Samples were loaded until fracture or to a maximum of 185,000 cycles. Teeth restored with the direct technique fractured at an average load of 1213 N and two of them withstood all loading cycles (survival=13%); with inlays, the survival rate was 100%. Most failures with Miris2 occurred above the CEJ and were re-restorable (67%), but generated more shrinkage-induced cracks (47% of the specimen vs. 7% for inlays). CAD/CAM MZ100 inlays increased the accelerated fatigue resistance and decreased the crack propensity of large MOD restorations when compared to direct restorations. While both restorative techniques yielded excellent fatigue results at physiological masticatory loads, CAD/CAM inlays seem more indicated for high-load patients. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Factors relating to usage patterns of amalgam and resin composite for posterior restorations--a prospective analysis.

PubMed

Khalaf, Mai E; Alomari, Qasem D; Omar, Ridwaan

2014-07-01

This study prospectively analyzed the use of amalgam and resin composite posterior restorations placed by general dentists in relation to dentist, patient and cavity factors. One thousand posterior restorations placed by a representative sample of general dentists working in the Ministry of Health (MOH), Kuwait, during routine clinical practice were included. Information about the restorations was recorded using a survey questionnaire. Descriptive statistics and multivariate logistic regression analysis were used to determine the factors associated with the use of amalgam versus tooth coloured restoratives. Dentists chose amalgam for 30.8% of the 1000 restorations. Dentists with longer work experience (>15 years) were more likely to choose amalgam (OR=2.61, 95% CI=1.06, 6.40). Younger dentists (≤30 years) were less likely to choose amalgam (OR=0. 45, 95% CI=0.26, 0.77). Amalgam was more likely to be chosen for patients with poor oral hygiene (OR=1.58, 95% CI=1.08, 2.32) and a higher number (≥4) of restorations (OR=1.44, 95% CI=1.07, 1.94) with large cavity sizes (OR=6.33, 95% CI=3.88, 10.32). Tooth-coloured restorations were more likely to be chosen for cavities of smaller sizes. The use of resin composite materials as the dominant choice among dentists in Kuwait reflects the trend worldwide. Nevertheless, clinicians still find a use for amalgam in posterior load-bearing teeth and in the high-caries risk population. The findings give insight into factors influencing material usage under different clinical conditions and provides information about the perceived deficiencies or shortcomings of resin composite materials in a general dental practice setting. This information can be useful for identifying perceived barriers to the usage of newer restorative materials and finding ways to overcome them. Copyright © 2014 Elsevier Ltd. All rights reserved.

Composition of Mineral Produced by Dental Mesenchymal Stem Cells.

PubMed

Volponi, A A; Gentleman, E; Fatscher, R; Pang, Y W Y; Gentleman, M M; Sharpe, P T

2015-11-01

Mesenchymal stem cells isolated from different dental tissues have been described to have osteogenic/odontogenic-like differentiation capacity, but little attention has been paid to the biochemical composition of the material that each produces. Here, we used Raman spectroscopy to analyze the mineralized materials produced in vitro by different dental cell populations, and we compared them with the biochemical composition of native dental tissues. We show that different dental stem cell populations produce materials that differ in their mineral and matrix composition and that these differ from those of native dental tissues. In vitro, BCMP (bone chip mass population), SCAP (stem cells from apical papilla), and SHED (stem cells from human-exfoliated deciduous teeth) cells produce a more highly mineralized matrix when compared with that produced by PDL (periodontal ligament), DPA (dental pulp adult), and GF (gingival fibroblast) cells. Principal component analyses of Raman spectra further demonstrated that the crystallinity and carbonate substitution environments in the material produced by each cell type varied, with DPA cells, for example, producing a more carbonate-substituted mineral and with SCAP, SHED, and GF cells creating a less crystalline material when compared with other dental stem cells and native tissues. These variations in mineral composition reveal intrinsic differences in the various cell populations, which may in turn affect their specific clinical applications. © International & American Associations for Dental Research 2015.

An investigation into sealant restoration usage in general dental practice in England.

PubMed

Hassall, D C; Mellor, A C

2001-10-13

A study was undertaken to investigate attitudes to sealant restorations and their usage in general dental practice in England. Seventy three dentists in three areas (Doncaster, Hereford/Worcester and Wycombe) provided retrospective details of treatment provided over a one year period for 4,250 6-12 and 13-15 year old subjects. Fifty nine of these dentists then completed a telephone questionnaire relating to their treatment patterns and attitudes to sealant restorations. The treatment data indicated that only 59 of the 4,250 children received a sealant restoration during the study period. Of the 44 dentists who claimed in the questionnaire to be using sealant restorations, only 28 had placed them in their selected patients. Positive attitudes to sealant restorations were expressed but also concerns that may be prejudicing usage.

The future of dental amalgam: a review of the literature. Part 3: Mercury exposure from amalgam restorations in dental patients.

PubMed

Eley, B M

1997-05-10

This is the third article in a series of seven on the future of dental amalgam and covers mercury exposure from functioning dental amalgam restorations in patients. It firstly discusses the evidence for mercury release from amalgam fillings by considering the mechanisms of mercury release and its measurement in the expired air and the intra-oral air. In this connection it also discusses the various factors involved in the accurate measurement and calculation of mercury levels in these situations. It finally describes the various attempts to calculate the daily mercury dose from dental amalgam fillings and considers the likely accuracy of these calculations.

78 FR 24761 - National Institute of Dental & Craniofacial Research; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of Dental and Craniofacial Research Special Emphasis Panel; Design and Development of Novel Dental Composite Restorative...

Influence of immediate loading on provisional restoration in dental implant stability

NASA Astrophysics Data System (ADS)

Ikbal, M.; Odang, R. W.; Indrasari, M.; Dewi, R. S.

2017-08-01

The success of dental implant treatment is determined by the primary stability at placement. One factor that could influence this stability is occlusal loading through provisional restoration. Two types of loading protocols are usually used: immediate and delayed loading. However, some controversies remain about the influence of occlusal loading on implant stability. Therefore, the influence of immediate loading on implant stability must be studied. An animal study was conducted by placing nine dental implants in the mandibular jaw of three Macaca fascicularis. Provisional restorations with various occlusal contacts (no, light, and normal contact) were placed on the implant. The implant stability was measured using the Ostell ISQ three times: immediately (baseline) and at the first and second months after implant placement. The implant stability between implants with no and normal occlusal contact as well as light and normal occlusal contact showed significant differences (p < 0.05) at the first and second months after implant placement. However, no significant increase (p > 0.05) in implant stability was seen at the baseline and the first and second months after implant placement for all occlusal contact groups. Immediate loading influenced the implant stability, and provisional restoration of implant without occlusal contact showed the highest implant stability.

Novel Dental Composites Reinforced with Zirconia-Silica Ceramic Nanofibers

PubMed Central

Guo, Guangqing; Fan, Yuwei; Zhang, Jian-Feng; Hagan, Joseph; Xu, Xiaoming

2011-01-01

Objective To fabricate and characterize dental composites reinforced with various amounts of zirconia-silica (ZS) or zirconia-yttria-silica (ZYS) ceramic nanofibers. Methods Control composites (70 wt% glass particle filler, no nanofibers) and experimental composites (2.5, 5.0, and 7.5 wt% ZS or ZYS nanofibers replacing glass particle filler) were prepared by blending 29 wt% dental resin monomers, 70 wt% filler, and 1.0 wt% initiator, and polymerized by either heat or dental curing light. Flexural strength (FS), flexural modulus (FM), energy at break (EAB), and fracture toughness (FT) were tested after the specimens were stored in 37 °C deionized water for 24 h, 3 months, or 6 months. Degree of conversion (DC) of monomers in composites was measured using Fourier transformed near-infrared (FT-NIR) spectroscopy. Fractured surfaces were observed by field-emission scanning electron microscope (FE-SEM). The data were analyzed using ANOVA with Tukey’s Honestly Significant Differences test used for post hoc analysis. Results Reinforcement of dental composites with ZS or ZYS nanofibers (2.5% or 5.0%) can significantly increase the FS, FM and EAB of dental composites over the control. Further increase the content of ZS nanofiber (7.5%), however, decreases these properties (although they are still higher than those of the control). Addition of nanofibers did not decrease the long-term mechanical properties of these composites. All ZS reinforced composites (containing 2.5%, 5.0% and 7.5% ZS nanofibers) exhibit significantly higher fracture toughness than the control. The DC of the composites decreases with ZS nanofiber content. Significance Incorporation of ceramic nanofibers in dental composites can significantly improve their mechanical properties and fracture toughness and thus may extend their service life. PMID:22153326

Does atraumatic restorative treatment reduce dental anxiety in children? A systematic review and meta-analysis

PubMed Central

Simon, Arun K.; Bhumika, T. V.; Nair, N. Sreekumaran

2015-01-01

Dental anxiety is one of the major problems affecting children, which impairs the rendering of dental care, leading to impaired quality of life. It often leads to occupational stress in dental personnel and conflict between parents/caregivers. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials done in children, to synthesize evidence of the effectiveness of atraumatic restorative treatment (ART) in reducing dental anxiety in children compared to conventional restorative treatments. The databases searched included PubMed, Google Scholar and The Cochrane Oral Health Group's Trials Register. Eligible studies reporting dental anxiety by a variety of psychometric scales were tabulated. The review was conducted and reported in accordance with the guidelines provided by the Cochrane Collaboration. Among 416 studies retrieved through literature search, six studies matched the inclusion criteria. Due to lack of data, only three studies were included for meta-analysis using RevMan software (Review Manager, Version 5.3;The Cochrane Collaboration, Copenhagen, 2014). The pooled meta-analysis data, (standardized mean difference − 2.12 [95% confidence interval: −4.52, 0.27]) failed to show any difference between ART group and the conventional treatment group. In conclusion, ART was not more beneficial in reducing dental anxiety among pediatric dental patients. The findings are relevant in the field of clinical practice in dentistry in the management of the anxious pediatric dental patient. PMID:26038668

The opinion of children and their parents about four different types of dental restorations in a public health service in Brazil.

PubMed

Maciel, R; Salvador, D; Azoubel, K; Redivivo, R; Maciel, C; da Franca, C; Amerongen, E; Colares, V

2017-02-01

To investigate the opinion of children and their parents of four different types of restoration placed in primary molars. A mixed method study in which both children and their parents were involved. In the quantitative study, children and parents gave their opinion using a face scale about four different types of restoration immediately after placement, evaluating how satisfied they were. In the qualitative part, children and their parents were interviewed to report their preference among the four types of restoration using dental models and photos. In the quantitative study, 1045 restorations were placed, being conventional restorations (198 with amalgam and 205 with composite resin) and atraumatic interventions [408 with glass ionomer: ART, atraumatic restorative treatment, and 234 with preformed metal crowns (PMCs): Hall technique]. Almost all participants (children and parents) gave a positive opinion (from 94.9 to 100%) on the four types of restoration placed in the children's teeth. There was no statistical significant difference in opinion in terms of acceptance of the four types of restoration placed (Chi square test, p value > 0.05). In the qualitative approach, 18 children and 11 parents were interviewed. If they could choose, children (16/18) preferred the PMCs, while parents (10/11) preferred aesthetic materials such as composite resin and glass ionomer cement. A high degree of satisfaction was observed with children and their parents in the four types of restoration after placement. However, if it could be chosen in advance, children prefer the PMCs and parents a tooth-coloured material.

Assessment of exposures and potential risks to the US adult population from the leaching of elements from gold and ceramic dental restorations.

PubMed

Richardson, G Mark; James, Kyle Jordan; Peters, Rachel Elizabeth; Clemow, Scott Richard; Siciliano, Steven Douglas

2016-01-01

Using data from the 2001 to 2004 US National Health and Nutrition Examination Survey (NHANES) on the number and placement of tooth restorations in adults, we quantified daily doses due to leaching of elements from gold (Au) alloy and ceramic restorative materials. The elements with the greatest leaching rates from these materials are often the elements of lowest proportional composition. As a result, exposure due to wear will predominate for those elements of relatively high proportional composition, while exposure due leaching may predominate for elements of relatively low proportional composition. The exposure due to leaching of silver (Ag) and palladium (Pd) from Au alloys exceeded published reference exposure levels (RELs) for these elements when multiple full surface crowns were present. Six or more molar crowns would result in exceeding the REL for Ag, whereas three or more crowns would be necessary to exceed the REL for Pd. For platinum (Pt), the majority of tooth surfaces, beyond just molar crowns, would be necessary to exceed the REL for Pd. Exposures due to leaching of elements from ceramic dental materials were less than published RELs for all components examined here, including having all restorations composed of ceramic.

Mechanical properties of dental resin/composite containing urchin-like hydroxyapatite.

PubMed

Liu, Fengwei; Sun, Bin; Jiang, Xiaoze; Aldeyab, Sultan S; Zhang, Qinghong; Zhu, Meifang

2014-12-01

To investigate the reinforcing effect of urchin-like hydroxyapatite (UHA) in bisphenol A glycidyl methacrylate (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) dental resin (without silica nanoparticles) and dental composites (with silica nanoparticles), and explore the effect of HA filler morphologies and loadings on the mechanical properties. UHA was synthesized by a facile method of microwave irradiation and studied by X-ray diffraction (XRD), scanning electron microscope (SEM), and thermogravimetric analysis (TGA). Mechanical properties of the dental resin composites containing silanized UHA were tested by a universal mechanical testing machine. Analysis of variance was used for the statistical analysis of the acquired data. The fracture morphologies of tested composites were observed by SEM. Composites with silanized irregular particulate hydroxyapatite (IPHA) and hydroxyapatite whisker (HW) were prepared for comparative studies. Impregnation of lower loadings (5 wt% and 10 wt%) of silanized UHA into dental resin (without silica nanoparticles) substantially improved the mechanical properties; higher UHA loadings (20 wt% and 30 wt%) of impregnation continuously improved the flexural modulus and microhardness, while the strength would no longer be increased. Compared with silanized IPHA and HW, silanized UHA consisting of rods extending radially from center were embedded into the matrix closely and well dispersed in the composite, increasing filler-matrix interfacial contact area and combination. At higher filler loadings, UHA interlaced together tightly without affecting the mobility of monomer inside, which might bear higher loads during fracture of the composite, leading to higher strengths than those of dental resins with IPHA and HW. Besides, impregnation of silanized UHA into dental composites (with silica nanoparticles) significantly improved the strength and modulus. UHA could serve as novel reinforcing HA filler to improve the mechanical properties

Dental ceramics: a review of new materials and processing methods.

PubMed

Silva, Lucas Hian da; Lima, Erick de; Miranda, Ranulfo Benedito de Paula; Favero, Stéphanie Soares; Lohbauer, Ulrich; Cesar, Paulo Francisco

2017-08-28

The evolution of computerized systems for the production of dental restorations associated to the development of novel microstructures for ceramic materials has caused an important change in the clinical workflow for dentists and technicians, as well as in the treatment options offered to patients. New microstructures have also been developed by the industry in order to offer ceramic and composite materials with optimized properties, i.e., good mechanical properties, appropriate wear behavior and acceptable aesthetic characteristics. The objective of this literature review is to discuss the main advantages and disadvantages of the new ceramic systems and processing methods. The manuscript is divided in five parts: I) monolithic zirconia restorations; II) multilayered dental prostheses; III) new glass-ceramics; IV) polymer infiltrated ceramics; and V) novel processing technologies. Dental ceramics and processing technologies have evolved significantly in the past ten years, with most of the evolution being related to new microstructures and CAD-CAM methods. In addition, a trend towards the use of monolithic restorations has changed the way clinicians produce all-ceramic dental prostheses, since the more aesthetic multilayered restorations unfortunately are more prone to chipping or delamination. Composite materials processed via CAD-CAM have become an interesting option, as they have intermediate properties between ceramics and polymers and are more easily milled and polished.

A model for shrinkage strain in photo polymerization of dental composites.

PubMed

Petrovic, Ljubomir M; Atanackovic, Teodor M

2008-04-01

We formulate a new model for the shrinkage strain developed during photo polymerization in dental composites. The model is based on the diffusion type fractional order equation, since it has been proved that polymerization reaction is diffusion controlled (Atai M, Watts DC. A new kinetic model for the photo polymerization shrinkage-strain of dental composites and resin-monomers. Dent Mater 2006;22:785-91). Our model strongly confirms the observation by Atai and Watts (see reference details above) and their experimental results. The shrinkage strain is modeled by a nonlinear differential equation in (see reference details above) and that equation must be solved numerically. In our approach, we use the linear fractional order differential equation to describe the strain rate due to photo polymerization. This equation is solved exactly. As shrinkage is a consequence of the polymerization reaction and polymerization reaction is diffusion controlled, we postulate that shrinkage strain rate is described by a diffusion type equation. We find explicit form of solution to this equation and determine the strain in the resin monomers. Also by using equations of linear viscoelasticity, we determine stresses in the polymer due to the shrinkage. The time evolution of stresses implies that the maximal stresses are developed at the very beginning of the polymerization process. The stress in a dental composite that is light treated has the largest value short time after the treatment starts. The strain settles at the constant value in the time of about 100s (for the cases treated in Atai and Watts). From the model developed here, the shrinkage strain of dental composites and resin monomers is analytically determined. The maximal value of stresses is important, since this value must be smaller than the adhesive bond strength at cavo-restoration interface. The maximum stress determined here depends on the diffusivity coefficient. Since diffusivity coefficient increases as

Composition of Mineral Produced by Dental Mesenchymal Stem Cells

PubMed Central

Volponi, A.A.; Gentleman, E.; Fatscher, R.; Pang, Y.W.Y.; Gentleman, M.M.; Sharpe, P.T.

2015-01-01

Mesenchymal stem cells isolated from different dental tissues have been described to have osteogenic/odontogenic-like differentiation capacity, but little attention has been paid to the biochemical composition of the material that each produces. Here, we used Raman spectroscopy to analyze the mineralized materials produced in vitro by different dental cell populations, and we compared them with the biochemical composition of native dental tissues. We show that different dental stem cell populations produce materials that differ in their mineral and matrix composition and that these differ from those of native dental tissues. In vitro, BCMP (bone chip mass population), SCAP (stem cells from apical papilla), and SHED (stem cells from human-exfoliated deciduous teeth) cells produce a more highly mineralized matrix when compared with that produced by PDL (periodontal ligament), DPA (dental pulp adult), and GF (gingival fibroblast) cells. Principal component analyses of Raman spectra further demonstrated that the crystallinity and carbonate substitution environments in the material produced by each cell type varied, with DPA cells, for example, producing a more carbonate-substituted mineral and with SCAP, SHED, and GF cells creating a less crystalline material when compared with other dental stem cells and native tissues. These variations in mineral composition reveal intrinsic differences in the various cell populations, which may in turn affect their specific clinical applications. PMID:26253190

The future of dental amalgam: a review of the literature. Part 1: Dental amalgam structure and corrosion.

PubMed

Eley, B M

1997-04-12

This is the first article in a series of seven on the future of dental amalgam. Dental amalgam is still the most useful restorative material for posterior teeth and has been used successfully for over 100 years. The history of dental amalgam since its introduction in 1819 and the controversies about its use between 1834 and today are described. The composition of the various dental amalgams in clinical use today are then reported. It finally covers the corrosion of amalgams since this is the means by which metals, including mercury, can be released.

Two year clinical evaluation of a low-shrink resin composite material in UK general dental practices.

PubMed

Burke, F J Trevor; Crisp, Russell J; James, A; Mackenzie, L; Pal, A; Sands, P; Thompson, O; Palin, W M

2011-07-01

A novel resin composite system, Filtek Silorane (3M ESPE) with reduced polymerization shrinkage has recently been introduced. The resin contains an oxygen-containing ring molecule ('oxirane') and cures via a cationic ring-opening reaction rather than a linear chain reaction associated with conventional methacrylates and results in a volumetric shrinkage of ∼1%. The purpose of this study was to review the literature on a recently introduced resin composite material, Filtek Silorane, and evaluate the clinical outcome of restorations formed in this material. Filtek Silorane restorations were placed where indicated in loadbearing situations in the posterior teeth of patients attending five UK dental practices. These were evaluated, after two years, using modified USPHS criteria. A total of 100 restorations, of mean age 25.7 months, in 64 patients, were examined, comprised of 30 Class I and 70 Class II. All restorations were found to be present and intact, there was no secondary caries. Ninety-seven per cent of the restorations were rated optimal for anatomic form, 84% were rated optimal for marginal integrity, 77% were rated optimal for marginal discoloration, 99% were rated optimal for color match, and 93%% of the restorations were rated optimal for surface quality. No restoration was awarded a "fail" grade. No staining of the restoration surfaces was recorded and no patients complained of post-operative sensitivity. It is concluded that, within the limitations of the study, the two year assessment of 100 restorations placed in Filtek Silorane has indicated satisfactory clinical performance. Copyright © 2011. Published by Elsevier Ltd.

Optimizing tooth form with direct posterior composite restorations.

PubMed

Raghu, Ramya; Srinivasan, Raghu

2011-10-01

Advances in material sciences and technology have provided today's clinicians the strategies to transform the mechanistic approach of operative dentistry into a biologic philosophy. In the last three decades, composite resins have gone from being just an esthetically pleasing way of restoring Class III and Class IV cavities to become the universal material for both anterior and posterior situations as they closely mimic the natural esthetics while restoring the form of the human dentition. In order to enhance their success, clinicians have to rethink their protocol instead of applying the same restorative concepts and principles practiced with metallic restorations. Paralleling the evolution of posterior composite resin materials, cavity designs, restorative techniques and armamentarium have also developed rapidly to successfully employ composite resins in Class II situations. Most of the earlier problems with posterior composites such as poor wear resistance, polymerization shrinkage, postoperative sensitivity, predictable bonding to dentin, etc., have been overcome to a major extent. However, the clinically relevant aspect of achieving tight contacts in Class II situations has challenged clinicians the most. This paper reviews the evolution of techniques and recent developments in achieving predictable contacts with posterior composites. A Medline search was performed for articles on "direct posterior composite contacts." The keywords used were "contacts and contours of posterior composites." The reference list of each article was manually checked for additional articles of relevance.

Differentiation of dental restorative materials combining energy-dispersive X-ray fluorescence spectroscopy and post-mortem CT.

PubMed

Merriam, Tim; Kaufmann, Rolf; Ebert, Lars; Figi, Renato; Erni, Rolf; Pauer, Robin; Sieberth, Till

2018-06-01

Today, post-mortem computed tomography (CT) is routinely used for forensic identification. Mobile energy-dispersive X-ray fluorescence (EDXRF) spectroscopy of a dentition is a method of identification that has the potential to be easier and cheaper than CT, although it cannot be used with every dentition. In challenging cases, combining both techniques could facilitate the process of identification and prove to be advantageous over chemical analyses. Nine dental restorative material brands were analyzed using EDXRF spectroscopy. Their differentiability was assessed by comparing each material's x-ray fluorescence spectrum and then comparing the spectra to previous research investigating differentiability in CT. To verify EDXRF's precision and accuracy, select dental specimens underwent comparative electron beam excited x-ray spectroscopy (EDS) scans, while the impact of the restorative surface area was studied by scanning a row of dental specimens with varying restorative surface areas (n = 10). EDXRF was able to differentiate all 36 possible pairs of dental filling materials; however, dual-energy CT was only able to differentiate 33 out of 36. The EDS scans showed correlating x-ray fluorescence peaks on the x-ray spectra compared to our EDXRF. In addition, the surface area showed no influence on the differentiability of the dental filling materials. EDXRF has the potential to facilitate corpse identification by differentiating and comparing restorative materials, providing more information compared to post-mortem CT alone. Despite not being able to explicitly identify a brand without a control sample or database, its fast and mobile use could accelerate daily routines or mass victim identification processes. To achieve this goal, further development of EDXRF scanners for this application and further studies evaluating the method within a specific routine need to be performed.

[Influence of the fluoride releasing dental materials on the bacterial flora of dental plaque].

PubMed

Płuciennik, Małgorzata; Sakowska, Danuta; Krzemiński, Zbigniew; Piatowska, Danuta

2008-01-01

The assessment of influence of silver-free, fluor releasing dental materials on dental plaque bacteria quantity. 17 patients were included into the study. 51 restorations were placed following manufacturers recommendations. Following materials were used: conventional glassionomer Ketac-Molar ESPE, resin modified glassionomer Fuji II LC GC and fluor containing composite Charisma Heraeus Kulzer Class V restorations were placed in following teeth of upper and lower jaw: canines, first bicuspids, second bicuspids. Sound enamel was a control. After 10 weeks the 72 hours old dental plaque was collected from surface of restorations and control using sterile probe. Total amount of 68 dental plaques were investigated. Each plaque was placed on scaled and sterile aluminum foil. The moist weight of dental plaque was scaled. Dental plaque was moved into 7 ml 0.85% NaCl solution reduced by cystein chlorine hydrogen and disintegrated by ultrasounds (power:100 Watt, wave amplitude: 5 micorm). The suspension of dental plaque was serially diluted from 10(-4) to 10(-5) in sterile 0,85% NaCl solution, and seeded with amount of 0.1 ml on appropriate base. In dental plaque trials the amount of cariogenic bacteria was calculated--Streptococcus mutans, Streptococcus, Lactobacillus, Veillonella and Neisseria, and also total amount of aerobic and anaerobic bacteria was measured. Microbiologic studies were performed in Institute of Microbiology, Medical University, Łódź. Statistical analysis of collected data was accomplished. In 72 hours old dental plaques collected from the surfaces of Ketac -Molar, Fuji II LC, Charisma after 10 weeks since being placed into the class V cavity, results show no statistically significant differences in the amount of Streptococcus mutans, Streptococcus spp., Lactobacillus spp., Veillonella spp., Neisseria spp, in total amount of aerobic and anaerobic bacteria and in the quantity proportion of Streptococcus mutans versus Streptococcus spp. in comparison

Failure Rate of Direct High-Viscosity Glass-Ionomer Versus Hybrid Resin Composite Restorations in Posterior Permanent Teeth - a Systematic Review

PubMed Central

Mickenautsch, Steffen; Yengopal, Veerasamy

2015-01-01

Purpose Traditionally, resin composite restorations are claimed by reviews of the dental literature as being superior to glass-ionomer fillings in terms of restoration failures in posterior permanent teeth. The aim of this systematic review is to answer the clinical question, whether conventional high-viscosity glass-ionomer restorations, in patients with single and/or multi-surface cavities in posterior permanent teeth, have indeed a higher failure rate than direct hybrid resin composite restorations. Methods Eight databases were searched until December 02, 2013. Trials were assessed for bias risks, in-between datasets heterogeneity and statistical sample size power. Effects sizes were computed and statistically compared. A total of 55 citations were identified through systematic literature search. From these, 46 were excluded. No trials related to high-viscosity glass-ionomers versus resin composite restorations for direct head-to-head comparison were found. Three trials related to high-viscosity glass-ionomers versus amalgam and three trials related to resin composite versus amalgam restorations could be included for adjusted indirect comparison, only. Results The available evidence suggests no difference in the failure rates between both types of restoration beyond the play of chance, is limited by lack of head-to-head comparisons and an insufficient number of trials, as well as by high bias and in-between-dataset heterogeneity risk. The current clinical evidence needs to be regarded as too poor in order to justify superiority claims regarding the failure rates of both restoration types. Sufficiently large-sized, parallel-group, randomised control trials with high internal validity are needed, in order to justify any clinically meaningful judgment to this topic. PMID:26962372

Near-infrared Imaging of Secondary Caries Lesions around Composite Restorations at Wavelengths from 1300–1700-nm

PubMed Central

Simon, Jacob C.; Lucas, Seth; Lee, Robert; Darling, Cynthia L.; Staninec, Michal; Vanderhobli, Ram; Pelzner, Roger; Fried, Daniel

2016-01-01

Background and Objectives Current clinical methods for diagnosing secondary caries are unreliable for identifying the early stages of decay around restorative materials. The objective of this study was to access the integrity of restoration margins in natural teeth using near-infrared (NIR) reflectance and transillumination images at wavelengths between 1300–1700-nm and to determine the optimal NIR wavelengths for discriminating composite materials from dental hard tissues. Materials and Methods Twelve composite margins (n=12) consisting of class I, II & V restorations were chosen from ten extracted teeth. The samples were imaged in vitro using NIR transillumination and reflectance, polarization sensitive optical coherence tomography (PS-OCT) and a high-magnification digital microscope. Samples were serially sectioned into 200–μm slices for histological analysis using polarized light microscopy (PLM) and transverse microradiography (TMR). Two independent examiners evaluated the presence of demineralization at the sample margin using visible detection with 10× magnification and NIR images presented digitally. Composite restorations were placed in sixteen sound teeth (n=16) and imaged at multiple NIR wavelengths ranging from λ=1300–1700-nm using NIR transillumination. The image contrast was calculated between the composite and sound tooth structure. Results Intensity changes in NIR images at wavelengths ranging from 1300–1700-nm correlate with increased mineral loss measured using TMR. NIR reflectance and transillumination at wavelengths coincident with increased water absorption yielded significantly higher (P<0.001) contrast between sound enamel and adjacent demineralized enamel. In addition, NIR reflectance exhibited significantly higher (P<0.01) contrast between sound enamel and adjacent composite restorations than visible reflectance. Significance This study shows that NIR imaging is well suited for the rapid screening of secondary caries lesions

Repair bond strength of resin composite to bilayer dental ceramics

PubMed Central

2018-01-01

PURPOSE The purpose of this study was to investigate the effect of various surface treatments (ST) on the shear bond strength of resin composite to three bilayer dental ceramics made by CAD/CAM and two veneering ceramics. MATERIALS AND METHODS Three different bilayer dental ceramics and two different veneering ceramics were used (Group A: IPS e.max CAD+IPS e.max Ceram; Group B: IPS e.max ZirCAD+IPS e.max Ceram, Group C: Vita Suprinity+Vita VM11; Group D: IPS e.max Ceram; Group E: Vita VM11). All groups were divided into eight subgroups according to the ST. Then, all test specimens were repaired with a nano hybrid resin composite. Half of the test specimens were subjected to thermocycling procedure and the other half was stored in distilled water at 37℃. Shear bond strength tests for all test specimens were carried out with a universal testing machine. RESULTS There were statistically significant differences among the tested surface treatments within the all tested fracture types (P<.005). HF etching showed higher bond strength values in Groups A, C, D, and E than the other tested ST. However, bonding durability of all the surface-treated groups were similar after thermocycling (P>.00125). CONCLUSION This study revealed that HF etching for glass ceramics and sandblasting for zirconia ceramics were adequate for repair of all ceramic restorations. The effect of ceramic type exposed on the fracture area was not significant on the repair bond strength of resin composites to different ceramic types. PMID:29713430

Microtensile bond strength of bulk-fill restorative composites to dentin.

PubMed

Mandava, Jyothi; Vegesna, Divya-Prasanna; Ravi, Ravichandra; Boddeda, Mohan-Rao; Uppalapati, Lakshman-Varma; Ghazanfaruddin, M D

2017-08-01

To facilitate the easier placement of direct resin composite in deeper cavities, bulk fill composites have been introduced. The Mechanical stability of fillings in stress bearing areas restored with bulk-fill resin composites is still open to question, since long term clinical studies are not available so far. Thus, the objective of the study was to evaluate and compare the microtensile bond strength of three bulk-fill restorative composites with a nanohybrid composite. Class I cavities were prepared on sixty extracted mandibular molars. Teeth were divided into 4 groups (n= 15 each) and in group I, the prepared cavities were restored with nanohybrid (Filtek Z250 XT) restorative composite in an incremental manner. In group II, III and IV, the bulk-fill composites (Filtek, Tetric EvoCeram, X-tra fil bulk-fill restoratives) were placed as a 4 mm single increment and light cured. The restored teeth were subjected to thermocycling and bond strength testing was done using instron testing machine. The mode of failure was assessed by scanning electron microscope (SEM). The bond strength values obtained in megapascals (MPa) were subjected to statistical analysis, using SPSS/PC version 20 software.One-way ANOVA was used for groupwise comparison of the bond strength. Tukey's Post Hoc test was used for pairwise comparisons among the groups. The highest mean bond strength was achieved with Filtek bulk-fill restorative showing statistically significant difference with Tetric EvoCeram bulk-fill ( p < 0.003) and X-tra fil bulk-fill ( p <0.001) composites. Adhesive failures are mostly observed with X-tra fil bulk fill composites, whereas mixed failures are more common with other bulk fill composites. Bulk-fill composites exhibited adequate bond strength to dentin and can be considered as restorative material of choice in posterior stress bearing areas. Key words: Bond strength, Bulk-fill restoratives, Configuration factor, Polymerization shrinkage.

Ablation by-products of dental materials from the Er:YAG laser and the dental handpiece

NASA Astrophysics Data System (ADS)

Wigdor, Harvey A.; Visuri, Steven R.; Walsh, Joseph T., Jr.

1995-05-01

Recently there has been much interest in lasers and their potential use to replace the dental drill. The research has been directed towards vital dental tissues. It must be understood that any laser to be used in dentistry which will replace the dental drill must also ablate and remove existing dental materials. Some concern exists about the ablation products when the Er:YAG laser is used to ablate dental materials. It is incumbent on the professionals using these lasers to understand the materials being produced by these lasers and protect themselves and their patients from possible toxic products. It is the intent of this paper to evaluate the products produced by the ablation of both dental amalgam and composite dental restorative materials and compare them with those produced by the traditional dental handpiece (drill).

Effect of professional dental prophylaxis on the surface gloss and roughness of CAD/CAM restorative materials.

PubMed

Sugiyama, Toshiko; Kameyama, Atsushi; Enokuchi, Tomoka; Haruyama, Akiko; Chiba, Aoi; Sugiyama, Setsuko; Hosaka, Makoto; Takahashi, Toshiyuki

2017-06-01

This study aimed to evaluate the effect of dental prophylaxis on the surface gloss and roughness of different indirect restorative materials for computer-aided design/computer-aided manufacturing (CAD/CAM): two types of CAD/CAM composite resin blocks (Shofu Block HC and Estelite Block) and two types of CAD/CAM ceramic blocks (IPS Empress CAD and Celtra DUO). After polishing the CAD/CAM blocks and applying prophylaxis pastes, professional dental prophylaxis was performed using four different experimental protocols (n = 5 each): mechanical cleaning with Merssage Regular for 10 s four times (Group 1); four cycles of mechanical cleaning with Merssage Regular for 10 s and Merssage Fine for 10 s (Group 2); four cycles of mechanical cleaning with Merssage Regular for 10 s and Merssage Fine for 30 s (Group 3); and mechanical cleaning with Merssage Fine for 10 s four times (Group 4). A glossmeter was used to measure surface gloss before and after mechanical cleaning, and a contact stylus profilometer was used to measure surface roughness (Ra). Polishing with prophylactic paste led to a significant reduction in surface gloss and increase in surface roughness among resin composite blocks, whereas the polishing-related change in surface gloss or roughness was smaller in Celtra DUO, a zirconia-reinforced lithium silicate block. Changes in surface gloss and roughness due to polishing with a prophylactic paste containing large particles were not improved by subsequent polishing with a prophylactic paste containing fine particles. Key words: CAD/CAM, professional dental prophylaxis, prophylactic paste, surface gloss, surface roughness.

Effect of professional dental prophylaxis on the surface gloss and roughness of CAD/CAM restorative materials

PubMed Central

Sugiyama, Toshiko; Enokuchi, Tomoka; Haruyama, Akiko; Chiba, Aoi; Sugiyama, Setsuko; Hosaka, Makoto; Takahashi, Toshiyuki

2017-01-01

Background This study aimed to evaluate the effect of dental prophylaxis on the surface gloss and roughness of different indirect restorative materials for computer-aided design/computer-aided manufacturing (CAD/CAM): two types of CAD/CAM composite resin blocks (Shofu Block HC and Estelite Block) and two types of CAD/CAM ceramic blocks (IPS Empress CAD and Celtra DUO). Material and Methods After polishing the CAD/CAM blocks and applying prophylaxis pastes, professional dental prophylaxis was performed using four different experimental protocols (n = 5 each): mechanical cleaning with Merssage Regular for 10 s four times (Group 1); four cycles of mechanical cleaning with Merssage Regular for 10 s and Merssage Fine for 10 s (Group 2); four cycles of mechanical cleaning with Merssage Regular for 10 s and Merssage Fine for 30 s (Group 3); and mechanical cleaning with Merssage Fine for 10 s four times (Group 4). A glossmeter was used to measure surface gloss before and after mechanical cleaning, and a contact stylus profilometer was used to measure surface roughness (Ra). Results Polishing with prophylactic paste led to a significant reduction in surface gloss and increase in surface roughness among resin composite blocks, whereas the polishing-related change in surface gloss or roughness was smaller in Celtra DUO, a zirconia-reinforced lithium silicate block. Conclusions Changes in surface gloss and roughness due to polishing with a prophylactic paste containing large particles were not improved by subsequent polishing with a prophylactic paste containing fine particles. Key words:CAD/CAM, professional dental prophylaxis, prophylactic paste, surface gloss, surface roughness. PMID:28638554

Polymerization stresses in low-shrinkage dental resin composites measured by crack analysis.

PubMed

Yamamoto, Takatsugu; Kubota, Yu; Momoi, Yasuko; Ferracane, Jack L

2012-09-01

The objective of this study was to compare several dental restoratives currently advertised as low-shrinkage composites (Clearfil Majesty Posterior, Kalore, Reflexions XLS Dentin and Venus Diamond) with a microfill composite (Heliomolar) in terms of polymerization stress, polymerization shrinkage and elastic modulus. Cracks were made at several distances from the edge of a precision cavity in a soda-lime glass disk. The composites were placed into the cavity and lengths of the cracks were measured before and after light curing. Polymerization stresses generated in the glass at 2 and 10 min after the irradiation were calculated from the crack lengths and K(c) of the glass. Polymerization shrinkage and elastic modulus of the composites also were measured at 2 and 10 min after irradiation using a video-imaging device and a nanoindenter, respectively. The data were statistically analyzed by ANOVAs and Tukey's test (p<0.05). The stress was significantly affected by composite brand, distance and time. The stress was directly proportional to time and inversely proportional to distance from the edge of the cavity. Clearfil Majesty Posterior demonstrated the highest stress and it resulted in the fracture of the glass at 2 min. Venus Diamond and Heliomolar exhibited the greatest shrinkage at both times. The elastic moduli of Clearfil Majesty Posterior and Reflexions XLS Dentin were greatest at 2 and 10 min, respectively. Among the four low-shrinkage composites, two demonstrated significantly reduced polymerization stress compared to Heliomolar, which has previously been shown in in vitro tests to generate low curing stress. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Trends in restorative composites research: what is in the future?

PubMed

Maas, Mariel Soeiro; Alania, Yvette; Natale, Livia Camargo; Rodrigues, Marcela Charantola; Watts, David Christopher; Braga, Roberto Ruggiero

2017-08-28

Clinical trials have identified secondary caries and bulk fracture as the main causes for composite restoration failure. As a measure to avoid frequent reinterventions for restoration replacement, composites with some sort of defense mechanism against biofilm formation and demineralization, as well as materials with lower susceptibility to crack propagation are necessary. Also, the restorative procedure with composites are very time-consuming and technically demanding, particularly concerning the application of the adhesive system. Therefore, together with bulk-fill composites, self-adhesive restorative composites could reduce operator error and chairside time. This literature review describes the current stage of development of remineralizing, antibacterial and self-healing composites. Also, an overview of the research on fiber-reinforced composites and self-adhesive composites, both introduced for clinical use in recent years, is presented.

Cytotoxic evaluation of hydroxyapatite-filled and silica/hydroxyapatite-filled acrylate-based restorative composite resins: An in vitro study.

PubMed

Chadda, Harshita; Naveen, Sangeetha Vasudevaraj; Mohan, Saktiswaren; Satapathy, Bhabani K; Ray, Alok R; Kamarul, Tunku

2016-07-01

Although the physical and mechanical properties of hydroxyapatite-filled dental restorative composite resins have been examined, the biocompatibility of these materials has not been studied in detail. The purpose of this in vitro study was to analyze the toxicity of acrylate-based restorative composite resins filled with hydroxyapatite and a silica/hydroxyapatite combination. Five different restorative materials based on bisphenol A-glycidyl methacrylate (bis-GMA) and tri-ethylene glycol dimethacrylate (TEGDMA) were developed: unfilled (H0), hydroxyapatite-filled (H30, H50), and silica/hydroxyapatite-filled (SH30, SH50) composite resins. These were tested for in vitro cytotoxicity by using human bone marrow mesenchymal stromal cells. Surface morphology, elemental composition, and functional groups were determined by scanning electron microscopy (SEM), energy-dispersive x-ray spectroscopy (EDX), and Fourier-transformed infrared spectroscopy (FTIR). The spectra normalization, baseline corrections, and peak integration were carried out by OPUS v4.0 software. Both in vitro cytotoxicity results and SEM analysis indicated that the composite resins developed were nontoxic and supported cell adherence. Elemental analysis with EDX revealed the presence of carbon, oxygen, calcium, silicon, and gold, while the presence of methacrylate, hydroxyl, and methylene functional groups was confirmed through FTIR analysis. The characterization and compatibility studies showed that these hydroxyapatite-filled and silica/hydroxyapatite-filled bis-GMA/TEGDMA-based restorative composite resins are nontoxic to human bone marrow mesenchymal stromal cells and show a favorable biologic response, making them potential biomaterials. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Recommendations for conducting controlled clinical studies of dental restorative materials.

PubMed

Hickel, R; Roulet, J-F; Bayne, S; Heintze, S D; Mjör, I A; Peters, M; Rousson, V; Randall, R; Schmalz, G; Tyas, M; Vanherle, G

2007-03-01

About 35 years ago, Ryge provided a practical approach to evaluation of clinical performance of restorative materials. This systematic approach was soon universally accepted. While that methodology has served us well, a large number of scientific methodologies and more detailed questions have arisen that require more rigor. Current restorative materials have vastly improved clinical performance and any changes over time are not easily detected by the limited sensitivity of the Ryge criteria in short term clinical investigations. However, the clinical evaluation of restorations not only involves the restorative material per se but also different operative techniques. For instance, a composite resin may show good longevity data when applied in conventional cavities but not in modified operative approaches. Insensitivity, combined with the continually evolving and non-standard investigator modifications of the categories, scales, and reporting methods, has created a body of literature that is extremely difficult to meaningfully interpret. In many cases, the insensitivity of the original Ryge methods is misinterpreted as good clinical performance. While there are many good features of the original system, it is now time to move to a more contemporary one. The current review approaches this challenge in two ways: (1) a proposal for a modern clinical testing protocol for controlled clinical trials, and (2) an in-depth discussion of relevant clinical evaluation parameters, providing 84 references that are primarily related to issues or problems for clinical research trials. Together, these two parts offer a standard for the clinical testing of restorative materials/procedures and provide significant guidance for research teams in the design and conduct of contemporary clinical trials. Part 1 of the review considers the recruitment of subjects, restorations per subject, clinical events, validity versus bias, legal and regulatory aspects, rationales for clinical trial

Intraoral Digital Impressioning for Dental Implant Restorations Versus Traditional Implant Impression Techniques.

PubMed

Wilk, Brian L

2015-01-01

Over the course of the past two to three decades, intraoral digital impression systems have gained acceptance due to high accuracy and ease of use as they have been incorporated into the fabrication of dental implant restorations. The use of intraoral digital impressions enables the clinician to produce accurate restorations without the unpleasant aspects of traditional impression materials and techniques. This article discusses the various types of digital impression systems and their accuracy compared to traditional impression techniques. The cost, time, and patient satisfaction components of both techniques will also be reviewed.

Influence of the shape of the layers in photo-cured dental restorations on the shrinkage stress peaks-FEM study.

PubMed

Kowalczyk, Piotr

2009-12-01

The aim of the paper is to analyse an influence of the shape of the layers in photo-cured dental restorations of Class I on distribution of shrinkage stresses along the tooth-restoration interface. The study is a continuation of the previous considerations (Kowalczyk and Gambin (2008) [1]), where techniques, which reduce stress concentration at the top of the tooth-restoration interface, were considered. The analysis leads to proposition of new layer forming techniques, which diminish the stress peaks at the interface and prevent the crack propagation process. To find the stress distributions in the dental restoration layers and the tooth tissues the finite element method implemented in the ABAQUS (Simulia, Providence, USA) software is used. For Class I restoration of the premolar tooth, the axisymmetrical model is assumed. The restoration is made of four layers of a photo-cured composite. Between the tooth tissues and the restoration, a layer of bonding agent 0.01mm thick is placed and modeled by FEM with help of the cohesive elements. The assumed model takes into account an influence of changes of elastic properties and viscous effects. For each case of the restoration layers system, the Huber-Mises stresses are analysed. The investigations show that the stresses near the restoration-tooth tissue interface are reduced due to viscous flow of the cured material and due to existence of a thin layer of the bonding agent. However, the stress distribution both, in the restoration and in the tooth tissues, is strongly dependent on a shape of the filling layers. Numerical simulations disclose that stress peaks are located at the top corners of each layer. The top corners of the last layer are the places where microleakage may occur. Stress concentrations at the corners of the preceding layers may lead to a growth of uprising crack. It will be shown that the flat layers in the restoration create relatively high values of the stress peaks. The rounded layers, with shapes

Implications of resin-based composite (RBC) restoration on cuspal deflection and microleakage score in molar teeth: Placement protocol and restorative material.

PubMed

McHugh, Lauren E J; Politi, Ioanna; Al-Fodeh, Rami S; Fleming, Garry J P

2017-09-01

To assess the cuspal deflection of standardised large mesio-occluso-distal (MOD) cavities in third molar teeth restored using conventional resin-based composite (RBC) or their bulk fill restorative counterparts compared with the unbound condition using a twin channel deflection measuring gauge. Following thermocycling, the cervical microleakage of the restored teeth was assessed to determine marginal integrity. Standardised MOD cavities were prepared in forty-eight sound third molar teeth and randomly allocated to six groups. Restorations were placed in conjunction with (and without) a universal bonding system and resin restorative materials were irradiated with a light-emitting-diode light-curing-unit. The dependent variable was the restoration protocol, eight oblique increments for conventional RBCs or two horizontal increments for the bulk fill resin restoratives. The cumulative buccal and palatal cuspal deflections from a twin channel deflection measuring gauge were summed, the restored teeth thermally fatigued, immersed in 0.2% basic fuchsin dye for 24h, sectioned and examined for cervical microleakage score. The one-way analysis of variance (ANOVA) identified third molar teeth restored using conventional RBC materials had significantly higher mean total cuspal deflection values compared with bulk fill resin restorative restoration (all p<0.0001). For the conventional RBCs, Admira Fusion (bonded) third molar teeth had significantly the lowest microleakage scores (all p<0.001) while the Admira Fusion x-tra (bonded) bulk fill resin restored teeth had significantly the lowest microleakage scores compared with Tetric EvoCeram Bulk Fill (bonded and non-bonded) teeth (all p<0.001). Not all conventional RBCs or bulk fill resin restoratives behave in a similar manner when used to restore standardised MOD cavities in third molar teeth. It would appear that light irradiation of individual conventional RBCs or bulk fill resin restoratives may be problematic such that

Dentists' restorative decision-making and implications for an 'amalgamless' profession. Part 4: clinical factor.

PubMed

Alexander, G; Hopcraft, M S; Tyas, M J; Wong, Rhk

2017-09-01

The Minamata Convention embodies a worldwide reduction in the production and use of mercury and mercury-containing products and processes, including a phase-down of dental amalgam. This will change the approach to the use of direct restorative materials in the near future. There is little research as to the influence of clinical factors on dentists' decision-making which may be of use when determining the impact of any change. An online survey relating to aspects of and attitudes to the use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association and/or members or fellows of the Royal Australasian College of Dental Surgeons. Data were statistically analysed. There were 408 respondents to the survey. Eighty-seven per cent of respondents (strongly) disagreed that amalgam was a technically more difficult material to place compared with resin composite, 82% (strongly) disagreed that placement time for amalgam was longer than that for resin composite and 69% (strongly) disagreed that amalgam was more difficult to finish than resin composite. Eighty-three per cent of respondents stated they were confident in their ability to place amalgam restorations. Where physical properties were of importance, indirect restorations were preferred (e.g. parafunction) 54%. The factors considered most important when choosing a direct restorative material included moisture control and aesthetics; least important factors were cost and time to place. There is consensus that amalgam is not more technically difficult to use, place or finish than resin composite and vice versa. There is recognition that both amalgam and resin composite have limitations in terms of physical properties. When choosing a direct restorative material, clinical factors considered to be of greatest importance are moisture control, aesthetics and the need to apply minimally invasive approaches. There is little difference in the opinions of users and non

Processing and properties of ceramic matrix-polymer composites for dental applications

NASA Astrophysics Data System (ADS)

Huang, Hsuan Yao

The basic composite structure of natural hard tissue was used to guide the design and processing of dental restorative materials. The design incorporates the methodology of using inorganic minerals as the main structural phase reinforced with a more ductile but tougher organic phase. Ceramic-polymer composites were prepared by slip casting a porous ceramic structure, heating and chemical treating the porous preform, infiltrating with monomer and then curing. The three factors that determined the mechanical properties of alumina-polymer composites were the type of polymer used, the method of silane treatments, and the type of bond between particles in the porous preforms. Without the use of silane coupling agents, the composites were measured to have a lower strength. The composite with a more "flexible" porous alumina network had a greater ability to plastically dissipate the energy of propagating cracks. However, the aggressive nature of the alumina particles on opposing enamel requires that these alumina-polymer composites have a wear compatible coating for practical application. A route to dense bioactive apatite wollastonite glass ceramics (AWGC)-polymer composites was developed. The problems associated with glass dissolution into the aqueous medium for slip casting were overcome with the use of silane. The role of heating rate and development of ceramic compact microstructure on composite properties was explored. In general, if isothermal heating was not applied, decreasing heating rate increased glass crystallinity and particle-particle fusion, but decreased pore volume. Also composite strength and fracture toughness decreased while modulus and hardness increased with decreasing heating rate. If isothermal heating was applied, glass crystallinity, pore content, and composite mechanical properties showed relatively little change regardless of the initial heating rate. The potential of AWGC-polymer composites for dental and implant applications was explored

Novel Translucent and Strong Submicron Alumina Ceramics for Dental Restorations.

PubMed

Zhao, M; Sun, Y; Zhang, J; Zhang, Y

2018-03-01

An ideal ceramic restorative material should possess excellent aesthetic and mechanical properties. We hypothesize that the high translucency and strength of polycrystalline ceramics can be achieved through microstructural tailoring. The aim of this study is to demonstrate the superior optical and mechanical properties of a new class of submicron grain-sized alumina ceramics relative to the current state-of-the-art dental ceramic materials. The translucency, the in-line transmission ( T IT ) in particular, of these submicron alumina ceramics has been examined with the Rayleigh-Gans-Debye light-scattering model. The theoretical predictions related very well with the measured T IT values. The translucency parameter ( TP) and contrast ratio ( CR) of the newly developed aluminas were measured with a reflectance spectrophotometer on a black-and-white background. For comparison, the T IT , TP, and CR values for a variety of dental ceramics, mostly measured in-house but also cited from the literature, were included. The flexural strength of the aluminas was determined with the 4-point bending test. Our findings have shown that for polycrystalline alumina ceramics, an average grain size <1 µm coupled with a porosity level <0.7% could yield translucency values ( T IT , TP, CR) similar to those of the commercial high-translucency porcelains. These values are far superior to the high-translucency lithium disilicate glass-ceramic and zirconias, including the most translucent cubic-containing zirconias. The strength of these submicron grain-sized aluminas was significantly higher than that of the cubic-containing zirconia (e.g., Zpex Smile) and lithia-based glass-ceramics (e.g., IPS e.max CAD HT). A coarse-grained alumina could also reach a translucency level comparable to that of dental porcelain. However, the relatively low strength of this material has limited its clinical indications to structurally less demanding applications, such as orthodontic brackets. With a combined

Effect of hybrid layer on stress distribution in a premolar tooth restored with composite or ceramic inlay: an FEM study.

PubMed

Belli, Sema; Eskitaşcioglu, Gürcan; Eraslan, Oguz; Senawongse, Pisol; Tagami, Junji

2005-08-01

The aim of this finite elemental stress analysis study was to evaluate the effect of hybrid layer on distribution and amount of stress formed under occlusal loading in a premolar tooth restored with composite or ceramic inlay. The mandibular premolar tooth was selected as the model based on the anatomical measurements suggested by Wheeler. The analysis is performed by using a Pentium II IBM compatible computer with the SAP 2000 structural analysis program. Four different mathematical models including the following structures were evaluated: 1) composite inlay, adhesive resin, and tooth structure; 2) composite inlay, adhesive resin, hybrid layer, and tooth structure; 3) ceramic inlay, adhesive resin, and tooth structure; 4) ceramic inlay, adhesive resin, hybrid layer, and tooth structure. Loading was applied from the occlusal surface of the restoration, and shear stresses under loading were evaluated. The findings were drawn by the Saplot program, and the results were analyzed by graphical comparison method. The output indicated that the hybrid layer acts as a stress absorber in models 2 and 4. The hybrid layer has also changed mathematical values of stress on cavity floors in both restoration types. Ceramic inlay collected the stress inside the body of the material, but the composite inlay directly transferred the stress through dental tissues. As a result, it was concluded that the hybrid layer has an effect on stress distribution under loading in a premolar tooth model restored with composite or ceramic inlay. Copyright 2005 Wiley Periodicals, Inc.

Inaccurate Dental Charting in an Audit of 1128 General Dental Practice Records.

PubMed

Brown, Nathan L; Jephcote, Victoria E L

2017-03-01

Fourteen dentists at different practices in the UK assessed the dental charts of 1128 patients who were new to the dentist but not new to the practice; 44% of the dental charts were found to be inaccurate. Inaccuracy of the individual practice-based charts ranged between 16% for the best performing practices to 83% for the worst: 5% of dental charts had too many teeth charted and 5% had too few teeth charted; 13% of charts had missed amalgam restorations and 18% had missed tooth-coloured restorations; 5% of charts had amalgam restorations recorded but with the surfaces incorrect (eg an MO restoration charted but a DO restoration actually present); 9% of charts had tooth-coloured restoration surfaces incorrectly recorded. For 7.5% of charts, amalgams were charted but not actually present. Other inaccuracies were also noted. The authors reinforce the requirements of the GDC, the advice of defence organizations, and the forensic importance of accurate dental charts. Clinical relevance: Dental charting forms part of the patient’s dental records, and the GDC requires dentists to maintain complete and accurate dental records.

Fatigue of restorative materials.

PubMed

Baran, G; Boberick, K; McCool, J

2001-01-01

Failure due to fatigue manifests itself in dental prostheses and restorations as wear, fractured margins, delaminated coatings, and bulk fracture. Mechanisms responsible for fatigue-induced failure depend on material ductility: Brittle materials are susceptible to catastrophic failure, while ductile materials utilize their plasticity to reduce stress concentrations at the crack tip. Because of the expense associated with the replacement of failed restorations, there is a strong desire on the part of basic scientists and clinicians to evaluate the resistance of materials to fatigue in laboratory tests. Test variables include fatigue-loading mode and test environment, such as soaking in water. The outcome variable is typically fracture strength, and these data typically fit the Weibull distribution. Analysis of fatigue data permits predictive inferences to be made concerning the survival of structures fabricated from restorative materials under specified loading conditions. Although many dental-restorative materials are routinely evaluated, only limited use has been made of fatigue data collected in vitro: Wear of materials and the survival of porcelain restorations has been modeled by both fracture mechanics and probabilistic approaches. A need still exists for a clinical failure database and for the development of valid test methods for the evaluation of composite materials.

Properties of Experimental Dental Composites Containing Antibacterial Silver-Releasing Filler.

PubMed

Stencel, Robert; Kasperski, Jacek; Pakieła, Wojciech; Mertas, Anna; Bobela, Elżbieta; Barszczewska-Rybarek, Izabela; Chladek, Grzegorz

2018-06-18

Secondary caries is one of the important issues related to using dental composite restorations. Effective prevention of cariogenic bacteria survival may reduce this problem. The aim of this study was to evaluate the antibacterial activity and physical properties of composite materials with silver sodium hydrogen zirconium phosphate (SSHZP). The antibacterial filler was introduced at concentrations of 1%, 4%, 7%, 10%, 13%, and 16% ( w / w ) into model composite material consisting of methacrylate monomers and silanized glass and silica fillers. The in vitro reduction in the number of viable cariogenic bacteria Streptococcus mutans ATCC 33535 colonies, Vickers microhardness, compressive strength, diametral tensile strength, flexural strength, flexural modulus, sorption, solubility, degree of conversion, and color stability were investigated. An increase in antimicrobial filler concentration resulted in a statistically significant reduction in bacteria. There were no statistically significant differences caused by the introduction of the filler in compressive strength, diametral tensile strength, flexural modulus, and solubility. Statistically significant changes in degree of conversion, flexural strength, hardness (decrease), solubility (increase), and in color were registered. A favorable combination of antibacterial properties and other properties was achieved at SSHZP concentrations from 4% to 13%. These composites exhibited properties similar to the control material and enhanced in vitro antimicrobial efficiency.

Imaging in vivo secondary caries and ex vivo dental biofilms using cross-polarization optical coherence tomography

PubMed Central

Lenton, Pat; Rudney, Joel; Chen, Ruoqiong; Fok, Alex; Aparicio, Conrado; Jones, Robert S.

2012-01-01

Objectives Conventional diagnostic methods frequently detect only late stage enamel demineralization under composite resin restorations. The objective of this study is to examine the subsurface tooth-composite interface and to assess for the presence of secondary caries in pediatric patients using a novel Optical Coherence Tomography System with an intraoral probe. Methods A newly designed intraoral cross polarization swept source optical coherence tomography (CP-OCT) imaging system was used to examine the integrity of the enamel-composite interfaces in vivo. Twenty two pediatric subjects were recruited with either recently placed or long standing composite restorations in their primary teeth. To better understand how bacterial biofilms cause demineralization at the interface, we also used the intraoral CP-OCT system to assess ex vivo bacterial biofilm growth on dental composites. Results As a positive control, cavitated secondary carious interfaces showed a 18.2 dB increase (p<0.001), or over 1-2 orders of magnitude higher, scattering than interfaces associated with recently placed composite restorations. Several long standing composite restorations, which appeared clinically sound, had a marked increase in scattering than recently placed restorations. This suggests the ability of CP-OCT to assess interfacial degradation such as early secondary caries prior to cavitation. CP-OCT was also able to image ex vivo biofilms on dental composites and assess their thickness. Significance This paper shows that CP-OCT imaging using a beam splitter based design can examine the subsurface interface of dental composites in human subjects. Furthermore, the probe dimensions and acquisition speed of the CP-OCT system allowed for analysis of caries development in children. PMID:22578989

Repair of bis-acryl provisional restorations using flowable composite resin.

PubMed

Bohnenkamp, David M; Garcia, Lily T

2004-11-01

Provisional restorations provide interim coverage for prepared teeth while fixed definitive restorations are fabricated. Several types of autopolymerizing acrylic resins have been used for many years to fabricate provisional restorations. In recent years, bis-acryl resin composite material has gained popularity among clinicians for the direct fabrication of provisional fixed restorations. Occasionally, deficiencies may occur while fabricating a direct provisional restoration and require chairside repair. This article describes an effective procedure for the use of light-polymerized flowable composite resin for the intraoral repair of bis-acryl provisional restorations.

Ultrashort pulse laser processing of hard tissue, dental restoration materials, and biocompatibles

NASA Astrophysics Data System (ADS)

Yousif, A.; Strassl, M.; Beer, F.; Verhagen, L.; Wittschier, M.; Wintner, E.

2007-07-01

During the last few years, ultra-short laser pulses have proven their potential for application in medical tissue treatment in many ways. In hard tissue ablation, their aptitude for material ablation with negligible collateral damage provides many advantages. Especially teeth representing an anatomically and physiologically very special region with less blood circulation and lower healing rates than other tissues require most careful treatment. Hence, overheating of the pulp and induction of microcracks are some of the most problematic issues in dental preparation. Up till now it was shown by many authors that the application of picosecond or femtosecond pulses allows to perform ablation with very low damaging potential also fitting to the physiological requirements indicated. Beside the short interaction time with the irradiated matter, scanning of the ultra-short pulse trains turned out to be crucial for ablating cavities of the required quality. One main reason for this can be seen in the fact that during scanning the time period between two subsequent pulses incident on the same spot is so much extended that no heat accumulation effects occur and each pulse can be treated as a first one with respect to its local impact. Extension of this advantageous technique to biocompatible materials, i.e. in this case dental restoration materials and titanium plasma-sprayed implants, is just a matter of consequence. Recently published results on composites fit well with earlier data on dental hard tissue. In case of plaque which has to be removed from implants, it turns out that removal of at least the calcified version is harder than tissue removal. Therefore, besides ultra-short lasers, also Diode and Neodymium lasers, in cw and pulsed modes, have been studied with respect to plaque removal and sterilization. The temperature increase during laser exposure has been experimentally evaluated in parallel.

The evidence base for 'own label' resin-based dental restoratives.

PubMed

Burke, F J Trevor

2013-01-01

There is anecdotal evidence that sales of 'own-label' (OL) or 'private label' dental products is increasing, as dentists become more cost conscious in times of economic downturn. However, the purchase of such (less expensive) products could be a false economy if their performance falls below accepted standards. So, while the examination of a resin-based product under research conditions alone may not guarantee success, it could be considered that a material which has been subjected to testing under research conditions will demonstrate its effectiveness under laboratory conditions or reveal its shortcomings; either of these being better than the material not being examined in any way. It was therefore considered appropriate to determine the materials on which research was carried out, with particular reference to OL brands. To determine whether there is a research base behind OL resin-based restorative dental materials.

Anxiety in children during occlusal ART restorations in primary molars placed in school environment and hospital dental setup.

PubMed

Roshan, N M; Sakeenabi, B

2012-01-01

To evaluate the anxiety in children during occlusal atraumatic restorative treatment (ART) in the primary molars of children; and compare the anxiety for ART procedure performed in school environment and in hospital dental setup. A randomized controlled trial where one dentist placed 120 ART restorations in 60 five- to seven year-olds who had bilateral matched pairs of occlusal carious primary molars. A split-mouth design was used to place restorations in school and in hospital dental setup, which were assigned randomly to contralateral sides. Anxiety was evaluated by Modified Venhem score and the heart rate of the children at five fixed moments during dental treatment. At the entrance of the children into the treatment room, statistically significant difference between treatment in school environment and treatment in hospital dental setup for venham score and heart rate could be found (P = 0.023 and P = 0.037 respectively). At the start of the treatment procedure higher venham score and heart rate was observed in children treated in hospital dental setup in comparison with the children treated in school environment, finding was statistically significant (P = 0.011 and P = 0.029 respectively). During all other three points of treatment, the Venham scores of the children treated in school were lower than those of the children treated in hospital dental setup but statistically not significant (P > 0.05). Positive co-relation between Venham scores and Heart rate was established. No statistically significant relation could be established between boys and girls. Overall anxiety in children for ART treatment was found to be less and the procedure was well accepted irrespective of environment where treatment was performed Hospital dental setup by itself made children anxious during entrance and starting of the treatment when compared to children treated in school environment.

Proteins, pathogens, and failure at the composite-tooth interface.

PubMed

Spencer, P; Ye, Q; Misra, A; Goncalves, S E P; Laurence, J S

2014-12-01

In the United States, composites accounted for nearly 70% of the 173.2 million composite and amalgam restorations placed in 2006 (Kingman et al., 2012), and it is likely that the use of composite will continue to increase as dentists phase out dental amalgam. This trend is not, however, without consequences. The failure rate of composite restorations is double that of amalgam (Ferracane, 2013). Composite restorations accumulate more biofilm, experience more secondary decay, and require more frequent replacement. In vivo biodegradation of the adhesive bond at the composite-tooth interface is a major contributor to the cascade of events leading to restoration failure. Binding by proteins, particularly gp340, from the salivary pellicle leads to biofilm attachment, which accelerates degradation of the interfacial bond and demineralization of the tooth by recruiting the pioneer bacterium Streptococcus mutans to the surface. Bacterial production of lactic acid lowers the pH of the oral microenvironment, erodes hydroxyapatite in enamel and dentin, and promotes hydrolysis of the adhesive. Secreted esterases further hydrolyze the adhesive polymer, exposing the soft underlying collagenous dentinal matrix and allowing further infiltration by the pathogenic biofilm. Manifold approaches are being pursued to increase the longevity of composite dental restorations based on the major contributing factors responsible for degradation. The key material and biological components and the interactions involved in the destructive processes, including recent advances in understanding the structural and molecular basis of biofilm recruitment, are described in this review. Innovative strategies to mitigate these pathogenic effects and slow deterioration are discussed. © International & American Associations for Dental Research.

ClinicAl Evaluation of Dental Restorative Materials

DTIC Science & Technology

1989-01-01

use of an Atuarial Life Table Survival Analysis procedure. The median survival time for anterior composites was 13.5 years, as compared to 12.1 years...dental materials. For the first time in clinical biomaterials research, we used a statistical approach of Survival Analysis which utilized the... analysis has been established to assure uniformity in usage. This scale is now in use by clinical investigators throughout the country. Its use at the

Dentin surface treatment using a non-thermal argon plasma brush for interfacial bonding improvement in composite restoration

PubMed Central

Ritts, Andy Charles; Li, Hao; Yu, Qingsong; Xu, Changqi; Yao, Xiaomei; Hong, Liang; Wang, Yong

2010-01-01

The objective of this study is to investigate the treatment effects of non-thermal atmospheric gas plasmas on dentin surfaces for composite restoration. Extracted unerupted human third molars were used by removing the crowns and etching the exposed dentin surfaces with 35% phosphoric acid gel. The dentin surfaces were treated by using a non-thermal atmospheric argon plasma brush for various durations. The molecular changes of the dentin surfaces were analyzed using FTIR/ATR and an increase in carbonyl groups on dentin surfaces was detected with plasma treated dentin. Adper Single Bond Plus adhesive and Filtek Z250 dental composite were applied as directed. To evaluate the dentin/composite interfacial bonding, the teeth thus prepared were sectioned into micro-bars as the specimens for tensile test. Student Newman Keuls tests showed that the bonding strength of the composite restoration to peripheral dentin was significantly increased (by 64%) after 30 s plasma treatment. However, the bonding strength to plasma treated inner dentin did not show any improvement. It was found that plasma treatment of peripheral dentin surface up to 100 s gave an increase in interfacial bonding strength, while a prolong plasma treatment of dentin surfaces, e.g., 5 min treatments, showed a decrease in interfacial bonding strength. PMID:20831586

Material properties and fractography of an indirect dental resin composite.

PubMed

Quinn, Janet B; Quinn, George D

2010-06-01

Determination of material and fractographic properties of a dental indirect resin composite material. A resin composite (Paradigm, 3M-ESPE, MN) was characterized by strength, static elastic modulus, Knoop hardness, fracture toughness and edge toughness. Fractographic analyses of the broken bar surfaces was accomplished with a combination of optical and SEM techniques, and included determination of the type and size of the failure origins, and fracture mirror and branching constants. The flexure test mean strength+/-standard deviation was 145+/-17 MPa, and edge toughness, T(e), was 172+/-12N/mm. Knoop hardness was load dependent, with a plateau at 0.99+/-0.02 GPa. Mirrors in the bar specimens were measured with difficulty, resulting in a mirror constant of approximately 2.6 MPa m(1/2). Fracture in the bar specimens initiated at equiaxed material flaws that had different filler concentrations that sometimes were accompanied by partial microcracks. Using the measured flaw sizes, which ranged from 35 to 100 microm in size, and using estimates of the stress intensity shape factors, fracture toughness was estimated to be 1.1+/-0.2 MPa m(1/2). Coupling the flexure tests with fractographic examination enabled identification of the intrinsic strength limiting flaws. The same techniques could be useful in determining if clinical restorations of similar materials fail from the same causes. The existence of a strong load-dependence of the Knoop hardness of the resin composite is not generally mentioned in the literature, and is important for material comparisons and wear evaluation studies. Finally, the edge toughness test was found promising as a quantitative measure of resistance to edge chipping, an important failure mode in this class of materials. Copyright (c) 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Validation of assessment of intraoral digital photography for evaluation of dental restorations in clinical research.

PubMed

Signori, Cácia; Collares, Kauê; Cumerlato, Catarina B F; Correa, Marcos B; Opdam, Niek J M; Cenci, Maximiliano S

2018-04-01

The aim of this study was to investigate the validity of assessment of intraoral digital photography in the evaluation of dental restorations. Intraoral photographs of anterior and posterior restorations were classified based on FDI criteria according to the need for intervention: no intervention, repair and replacement. Evaluations were performed by an experienced expert in restorative dentistry (gold standard evaluator) and 3 trained dentists (consensus). The clinical inspection was the reference standard method. The prevalence of failures was explored. Cohen's kappa statistic was used. Validity was accessed by sensitivity, specificity, likelihood ratio and predictives values. Higher prevalence of failed restorations intervention was identified by the intraoral photography (17.7%) in comparison to the clinical evaluation (14.1%). Moderate agreement in the diagnosis of total failures was shown between the methods for the gold standard evaluator (kappa = 0.51) and consensus of evaluators (kappa = 0.53). Gold standard evaluator and consensus showed substantial and moderate agreement for posterior restorations (kappa = 0.61; 0.59), and fair and moderate agreement for anterior restorations (kappa = 0.36; 0.43), respectively. The accuracy was 84.8% in the assessment by intraoral photographs. Sensitivity and specificity values of 87.5% and 89.3% were found. Under the limits of this study, the assessment of digital photography performed by intraoral camera is an indirect diagnostic method valid for the evaluation of dental restorations, mainly in posterior teeth. This method should be employed taking into account the higher detection of defects provided by the images, which are not always clinically relevant. Copyright © 2018 Elsevier Ltd. All rights reserved.

Surface Hardness of Dental Composite Resin Restorations in Response to Preventive Agents.

PubMed

Al-Samadani, Khalid H

2016-12-01

To assess the impact of using preventive mouthwash agents on the surface hardness of various resins composites. Hundred specimens were prepared from five types of composite resin material in a Teflon mold. Five specimens from each type of restorative materials (Herculite XRV Ultra, Estelite Σ Quick, Z Hermack, Versa Comp Sultan, and Empress Direct IPS) were evaluated posttreatment with immersion in four types of preventive mouthwashes gels and rinses - group 1: Flocare gel (0.4% stannous fluoride), group 2: Pascal gel (topical APF fluoride), group 3: Pro-relief mouthwash (Na fluoride), and group 4: Plax Soin mouthwash (Na fluoride) - at 37°C in a dark glass container at 24, 48, and 72 hours. Surface hardness measurement was made for each tested material. Statistically, we analyzed the mean values with one-way analysis of variance (ANOVA) and Tukey's test, with significance level of p < 0.05. All composite resin materials showed decrease in their surface hardness with the time elapsed (24, 48, and 72 hours) postimmersion in the preventive mouthwashes and gels except the Herculite XRV Ultra and Versa Comp Sultan materials. Flocare gel group showed increase in the surface hardness after 48 hours of immersion than the other periods and in Estelite Σ Quick after 72 hours. There was significant differences in all materials tested with the immersion in the preventive mouthwashes and gels, such as Flocare gel (0.4% stannous fluoride), Pro-relief mouthwash (Na fluoride), and Plax Soin mouthwash (Na fluoride) except Pascal gel (topical APF fluoride) (p > 0.05), at time intervals mentioned earlier (p < 0.05). The effect of preventive mouthwashes and gels on resin composite materials was decreased surface hardness with the time elapse of immersion for all materials except the Flocare gel group, which contains 0.4% stannous fluoride as a preventive ingredient increases the surface hardness after 48 h for Herculite XRV Ultra and Versa Comp Sultan and Estelite Σ Quick after

Measurement of J-integral in CAD/CAM dental ceramics and composite resin by digital image correlation.

PubMed

Jiang, Yanxia; Akkus, Anna; Roperto, Renato; Akkus, Ozan; Li, Bo; Lang, Lisa; Teich, Sorin

2016-09-01

Ceramic and composite resin blocks for CAD/CAM machining of dental restorations are becoming more common. The sample sizes affordable by these blocks are smaller than ideal for stress intensity factor (SIF) based tests. The J-integral measurement calls for full field strain measurement, making it challenging to conduct. Accordingly, the J-integral values of dental restoration materials used in CAD/CAM restorations have not been reported to date. Digital image correlation (DIC) provides full field strain maps, making it possible to calculate the J-integral value. The aim of this study was to measure the J-integral value for CAD/CAM restorative materials. Four types of materials (sintered IPS E-MAX CAD, non-sintered IPS E-MAX CAD, Vita Mark II and Paradigm MZ100) were used to prepare beam samples for three-point bending tests. J-integrals were calculated for different integral path size and locations with respect to the crack tip. J-integral at path 1 for each material was 1.26±0.31×10(-4)MPam for MZ 100, 0.59±0.28×10(-4)MPam for sintered E-MAX, 0.19±0.07×10(-4)MPam for VM II, and 0.21±0.05×10(-4)MPam for non-sintered E-MAX. There were no significant differences between different integral path size, except for the non-sintered E-MAX group. J-integral paths of non-sintered E-MAX located within 42% of the height of the sample provided consistent values whereas outside this range resulted in lower J-integral values. Moreover, no significant difference was found among different integral path locations. The critical SIF was calculated from J-integral (KJ) along with geometry derived SIF values (KI). KI values were comparable with KJ and geometry based SIF values obtained from literature. Therefore, DIC derived J-integral is a reliable way to assess the fracture toughness of small sized specimens for dental CAD/CAM restorative materials; however, with caution applied to the selection of J-integral path. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of dual-cure composite resin as restorative material on marginal adaptation of class 2 restorations.

PubMed

Bortolotto, Tissiana; Melian, Karla; Krejci, Ivo

2013-10-01

The present study attempted to find a simple direct adhesive restorative technique for the restoration of Class 2 cavities. A self-etch adhesive system with a dual-cured core buildup composite resin (paste 1 + paste 2) was evaluated in its ability to restore proximo-occlusal cavities with margins located on enamel and dentin. The groups were: A, cavity filling (cf) with paste 1 (light-curing component) by using a layering technique; B, cf by mixing both pastes, bulk insertion, and dual curing; and C, cf by mixing both pastes, bulk insertion, and chemical curing. Two control groups (D, negative, bulk; and E, positive, layering technique) were included by restoring cavities with a classic three-step etch-and-rinse adhesive and a universal restorative composite resin. SEM margin analysis was performed before and after thermomechanical loading in a chewing simulator. Percentages (mean ± SD) of "continuous margins" were improved by applying the material in bulk and letting it self cure (54 ± 6) or dual cure (59 ± 9), and no significant differences were observed between these two groups and the positive control (44 ± 19). The present study showed that the dual-cured composite resin tested has the potential to be used as bulk filling material for Class 2 restorations. When used as filling materials, dual-cure composite resins placed in bulk can provide marginal adaptation similar to light-cured composites applied with a complex stratification technique.

Influence of different restorative techniques on marginal seal of class II composite restorations

PubMed Central

RODRIGUES JUNIOR, Sinval Adalberto; PIN, Lúcio Fernando da Silva; MACHADO, Giovanna; DELLA BONA, Álvaro; DEMARCO, Flávio Fernando

2010-01-01

Objective To evaluate the gingival marginal seal in class II composite restorations using different restorative techniques. Material and Methods Class II box cavities were prepared in both proximal faces of 32 sound human third molars with gingival margins located in either enamel or dentin/cementum. Restorations were performed as follows: G1 (control): composite, conventional light curing technique; G2: composite, soft-start technique; G3: amalgam/composite association (amalcomp); and G4: resin-modified glass ionomer cement/ composite, open sandwich technique. The restored specimens were thermocycled. Epoxy resin replicas were made and coated for scanning electron microscopy examination. For microleakage evaluation, teeth were coated with nail polish and immersed in dye solution. Teeth were cut in 3 slices and dye penetration was recorded (mm), digitized and analyzed with Image Tool software. Microleakage data were analyzed statistically by non-parametric Kruskal-Wallis and Mann-Whitney tests. Results Leakage in enamel was lower than in dentin (p<0.001). G2 exhibited the lowest leakage values (p<0.05) in enamel margins, with no differences between the other groups. In dentin margins, groups G1 and G2 had similar behavior and both showed less leakage (p<0.05) than groups G3 and G4. SEM micrographs revealed different marginal adaptation patterns for the different techniques and for the different substrates. Conclusion The soft-start technique showed no leakage in enamel margins and produced similar values to those of the conventional (control) technique for dentin margins. PMID:20379680

Allied restorative functions training in Minnesota: a case study.

PubMed

Cooper, Brigette R; Monson, Angela L

2007-03-01

In 2003, the Minnesota Dental Practice Act was modified to allow dental hygienists and assistants to place amalgam, composite, glass ionomer, and stainless steel crowns. The concept of utilizing allied professionals to perform expanded functions has been suggested as a way to increase access to care and productivity. A continuing education course was offered to provide required certification for interested dental practitioners (N=12). The objectives of this study were to examine confidence levels and effectiveness of the continuing education program. Pre- and post-course restorative content knowledge, along with confidence levels in knowledge, technical skills, and the ability to implement skills were measured. A matched pairs t-test found a significant increase in participants' restorative content knowledge (p<.001). Wilcoxen signed rank tests revealed an increase in confidence in all content knowledge (p<.01) and technical skill (p<.05) categories. Participants did not significantly increase in confidence to implement restorative functions skills into practice (p<.7). Interview data revealed that participants remain unclear about ways to incorporate restorative functions into the schedule. Findings in this case study suggest that content knowledge and confidence levels increase following completion of a restorative functions course. To improve education and training, research is needed to identify why participants' confidence in implementation did not increase.

Radiation-induced dental caries, prevention and treatment - A systematic review

PubMed Central

Gupta, Nishtha; Pal, Manoj; Rawat, Sheh; Grewal, Mandeep S.; Garg, Himani; Chauhan, Deepika; Ahlawat, Parveen; Tandon, Sarthak; Khurana, Ruparna; Pahuja, Anjali K.; Mayank, Mayur; Devnani, Bharti

2015-01-01

Treatment of head and neck cancers (HNCs) involves radiotherapy. Patients undergoing radiotherapy for HNCs are prone to dental complications. Radiotherapy to the head and neck region causes xerostomia and salivary gland dysfunction which dramatically increases the risk of dental caries and its sequelae. Radiation therapy (RT) also affects the dental hard tissues increasing their susceptibility to demineralization following RT. Postradiation caries is a rapidly progressing and highly destructive type of dental caries. Radiation-related caries and other dental hard tissue changes can appear within the first 3 months following RT. Hence, every effort should be focused on prevention to manage patients with severe caries. This can be accomplished through good preoperative dental treatment, frequent dental evaluation and treatment after RT (with the exception of extractions), and consistent home care that includes self-applied fluoride. Restorative management of radiation caries can be challenging. The restorative dentist must consider the altered dental substrate and a hostile oral environment when selecting restorative materials. Radiation-induced changes in enamel and dentine may compromise bonding of adhesive materials. Consequently, glass ionomer cements have proved to be a better alternative to composite resins in irradiated patients. Counseling of patients before and after radiotherapy can be done to make them aware of the complications of radiotherapy and thus can help in preventing them. PMID:27390489

Radiation-induced dental caries, prevention and treatment - A systematic review.

PubMed

Gupta, Nishtha; Pal, Manoj; Rawat, Sheh; Grewal, Mandeep S; Garg, Himani; Chauhan, Deepika; Ahlawat, Parveen; Tandon, Sarthak; Khurana, Ruparna; Pahuja, Anjali K; Mayank, Mayur; Devnani, Bharti

2015-01-01

Treatment of head and neck cancers (HNCs) involves radiotherapy. Patients undergoing radiotherapy for HNCs are prone to dental complications. Radiotherapy to the head and neck region causes xerostomia and salivary gland dysfunction which dramatically increases the risk of dental caries and its sequelae. Radiation therapy (RT) also affects the dental hard tissues increasing their susceptibility to demineralization following RT. Postradiation caries is a rapidly progressing and highly destructive type of dental caries. Radiation-related caries and other dental hard tissue changes can appear within the first 3 months following RT. Hence, every effort should be focused on prevention to manage patients with severe caries. This can be accomplished through good preoperative dental treatment, frequent dental evaluation and treatment after RT (with the exception of extractions), and consistent home care that includes self-applied fluoride. Restorative management of radiation caries can be challenging. The restorative dentist must consider the altered dental substrate and a hostile oral environment when selecting restorative materials. Radiation-induced changes in enamel and dentine may compromise bonding of adhesive materials. Consequently, glass ionomer cements have proved to be a better alternative to composite resins in irradiated patients. Counseling of patients before and after radiotherapy can be done to make them aware of the complications of radiotherapy and thus can help in preventing them.

Numerical fatigue 3D-FE modeling of indirect composite-restored posterior teeth.

PubMed

Ausiello, Pietro; Franciosa, Pasquale; Martorelli, Massimo; Watts, David C

2011-05-01

In restored teeth, stresses at the tooth-restoration interface during masticatory processes may fracture the teeth or the restoration and cracks may grow and propagate. The aim was to apply numerical methodologies to simulate the behavior of a restored tooth and to evaluate fatigue lifetimes before crack failure. Using a CAD-FEM procedure and fatigue mechanic laws, the fatigue damage of a restored molar was numerically estimated. Tessellated surfaces of enamel and dentin were extracted by applying segmentation and classification algorithms, to sets of 2D image data. A user-friendly GUI, which enables selection and visualization of 3D tessellated surfaces, was developed in a MatLab(®) environment. The tooth-boundary surfaces of enamel and dentin were then created by sweeping operations through cross-sections. A class II MOD cavity preparation was then added into the 3D model and tetrahedral mesh elements were generated. Fatigue simulation was performed by combining a preliminary static FEA simulation with classical fatigue mechanical laws. Regions with the shortest fatigue-life were located around the fillets of the class II MOD cavity, where the static stress was highest. The described method can be successfully adopted to generate detailed 3D-FE models of molar teeth, with different cavities and restorative materials. This method could be quickly implemented for other dental or biomechanical applications. Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Characterization and human gingival fibroblasts biocompatibility of hydroxyapatite/PMMA nanocomposites for provisional dental implant restoration

NASA Astrophysics Data System (ADS)

Zhang, Jingchao; Liao, Juan; Mo, Anchun; Li, Yubao; Li, Jidong; Wang, Xuejiang

2008-11-01

The aim of this study was to determine nHA/PMMA composites (H/P) in an optimal ratio with improved cytocompatibility as well as valid physical properties for provisional dental implant restoration. 20 wt.%, 30 wt.%, 40 wt.% and 50 wt.% H/P were developed and characterized using XPS, bending strength test and SEM. Human gingival fibroblasts cultured in extracts or directly on sample discs were investigated by fluorescent staining and MTT assay. Chemical integration in nHA/PMMA interface was indicated by XPS. Typical fusiform cells with adhesion spots were detected on H/P discs. MTT results also indicated higher cell viability in 30 wt.% and 40 wt.% H/P discs ( P < 0.05). We conclude that nHA addition to PMMA enhances cytocompatibility and the optimal nHA/PMMA ratio for provisional fixed crowns (PFC) is 0.4:1.

Effects of elevated temperatures on different restorative materials: An aid to forensic identification processes

PubMed Central

Pol, Chetan A.; Ghige, Suvarna K.; Gosavi, Suchitra R.; Hazarey, Vinay K.

2015-01-01

Background: Heat-induced alterations to dental and restorative materials can be of great interest to forensic dentistry. Knowing the specific optical behavior of dental materials can be of high importance as recognition of changes induced by high temperatures can lead to the determination of material which was used in a dental restoration, facilitating identification of burned human remains. Aim: To observe the effects of predetermined temperatures (200°C–400°C–600°C–800°C–1000°C) on unrestored teeth and different restorative materials macroscopically and then examine them under a stereomicroscope for the purpose of identification. Materials and Methods: The study was conducted on 375 extracted teeth which were divided into five groups of 75 teeth each as follows: group 1- unrestored teeth, group 2- teeth restored with all-ceramic crowns, Group 3- with class I silver amalgam filling, group 4- with class I composite restoration, and group 5- with class I glass ionomer cement restoration. Results: Unrestored and restored teeth display a series of specific macroscopic & stereomicroscopic structural changes for each range of temperature. Conclusion: Dental tissues and restorative materials undergo a series of changes which correlate well with the various temperatures to which they were exposed. These changes are a consequence of the nature of the materials and their physicochemical characteristics. PMID:26005305

Effects of chemical composition on the corrosion of dental alloys.

PubMed

Galo, Rodrigo; Ribeiro, Ricardo Faria; Rodrigues, Renata Cristina Silveira; Rocha, Luís Augusto; de Mattos, Maria da Glória Chiarello

2012-01-01

The aim of this study was to determine the effect of the oral environment on the corrosion of dental alloys with different compositions, using electrochemical methods. The corrosion rates were obtained from the current-potential curves and electrochemical impedance spectroscopy (EIS). The effect of artificial saliva on the corrosion of dental alloys was dependent on alloy composition. Dissolution of the ions occurred in all tested dental alloys and the results were strongly dependent on the general alloy composition. Regarding the alloys containing nickel, the Ni-Cr and Ni-Cr-Ti alloys released 0.62 mg/L of Ni on average, while the Co-Cr dental alloy released ions between 0.01 and 0.03 mg/L of Co and Cr, respectively.The open-circuit potential stabilized at a higher level with lower deviation (standard deviation: Ni-Cr-6Ti = 32 mV/SCE and Co-Cr = 54 mV/SCE). The potenciodynamic curves of the dental alloys showed that the Ni-based dental alloy with >70 wt% of Ni had a similar curve and the Co-Cr dental alloy showed a low current density and hence a high resistance to corrosion compared with the Ni-based dental alloys. Some changes in microstructure were observed and this fact influenced the corrosion behavior for the alloys. The lower corrosion resistance also led to greater release of nickel ions to the medium. The quantity of Co ions released from the Co-Cr-Mo alloy was relatively small in the solutions. In addition, the quantity of Cr ions released into the artificial saliva from the Co-Cr alloy was lower than Cr release from the Ni-based dental alloys.

Satisfaction with Dental Appearance and Attitude toward improving Dental Esthetics among Patients attending a Dental Teaching Center.

PubMed

Maghaireh, Ghada A; Alzraikat, Hanan; Taha, Nessrin A

2016-01-01

The aim of this study was to evaluate the factors influencing the satisfaction of dental appearance and attitude toward treatments to improve dental esthetics among patients attending a dental teaching center. A questionnaire was used to collect data of four background variables among 450 patients attended a dental teaching center in the city of Irbid in Jordan. The questionnaire enclosed self-reported questions about the appearance of anterior teeth, received esthetic treatment and desired treatment for improving esthetics. Descriptive, multiple logistic regression and Chi-square tests were used for data analysis (p ≤ 0.05). The 450 participants consisted of (66.2%) male and (33.8%) female. Of these, 69.3% were satisfied with their dental appearance and 58.0% with the color of their teeth. Esthetic restorations were the most received treatment (39.8%) and whitening of teeth was the most desired treatment (55.3%). The patients' satisfaction with dental appearance was influenced by teeth color, crowding and receiving whitening (p < 0.05. r = 0.561, r(2) = 0.315). The most desired esthetic treatments influenced by the satisfaction with dental appearance were esthetic restorations and orthodontics (p < 0.05. r = 0.223, r(2) = 0.05). Significantly more female reported having esthetic restorations and orthodontics (p = 0.008, 0.000) and desired to have orthodontic, crowns or veneers and esthetic restorations (p = 0.000, 0.015, 0.028). Satisfaction with dental appearance was affected by teeth color, feeling teeth are crowded, desire for esthetic restorations and orthodontic treatment. A high percentage of patients were not satisfied with the color of their teeth. Recognizing the factors that affect patients' satisfaction with their present dental appearance and attitude toward treatments to improve dental esthetic can guide clinicians to strategies to improve esthetics.

Load-bearing capacity of human incisor restored with various fiber-reinforced composite posts.

PubMed

Le Bell-Rönnlöf, Anna-Maria; Lassila, Lippo V J; Kangasniemi, Ilkka; Vallittu, Pekka K

2011-06-01

The aim of this study was to evaluate the load-bearing capacity and microstrain of incisors restored with posts of various kinds. Both prefabricated titanium posts and different fiber-reinforced composite posts were tested. The crowns of human incisors were cut and post preparation was carried out. The roots were divided into groups: (1) prefabricated serrated titanium posts, (2) prefabricated carbon fiber-reinforced composite posts, (3) individually formed glass fiber-reinforced composite posts with the canal full of fibers, and (4) individually formed "split" glass fiber-reinforced composite posts. The posts were cemented and composite crowns were made. Intact human incisors were used as reference. All roots were embedded in acrylic resin cylinders and stored at room temperature in water. Static load was applied under a loading angle of 45° using a universal testing machine. On half of the specimens microstrain was measured with strain gages and an acoustic emission analysis was carried out. Failure mode assessment was also made. The group with titanium posts showed highest number of unfavorable failures compared to the groups with fiber-reinforced composite posts. With fiber-reinforced composite posts the failures may more often be favorable compared to titanium posts, which clinically means repairable failures. Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Versatile composite resins simplifying the practice of restorative dentistry.

PubMed

Margeas, Robert

2014-01-01

After decades of technical development and refinement, composite resins continue to simplify the practice of restorative dentistry, offering clinicians versatility, predictability, and enhanced physical properties. With a wide range of products available today, composite resins are a reliable, conservative, multi-functional restorative material option. As manufacturers strive to improve such properties as compression strength, flexural strength, elastic modulus, coefficient of thermal expansion, water sorption, and wear resistance, several classification systems of composite resins have been developed.

Calculation of optical properties of dental composites as a basis for determining color impression and penetration depth of laser light

NASA Astrophysics Data System (ADS)

Weniger, Kirsten K.; Muller, Gerhard J.

2005-03-01

In order to achieve esthetic dental restorations, there should be no visible difference between restorative material and treated teeth. This requires a match of the optical properties of both restorative material and natural teeth. These optical properties are determined by absorption and scattering of light emerging not only on the surface but also inside the material. Investigating different dental composites in several shades, a method has been developed to calculate the optical parameters absorption coefficient μa, scattering coefficient μs, anisotropy factor g and reduced scattering coefficient μs'. The method includes sample preparation and measurements of transmittance and reflectance in an integrating sphere spectrometer, followed by inverse Monte Carlo simulations. Determination of optical properties is more precise and comprehensive than with the previously used Kubelka Munk theory because scattering can be looked at separated into pure scattering with the scattering coefficient μs and its direction with the anisotropy factor g. Moreover the use of the inverse Monte Carlo simulation not only minimizes systematic errors and considers the scattering phase function, but also takes into account the measuring geometry. The compilation of a data pool of optical parameters now enables the application of further calculation models as a basis for optimization of the composition of new materials. For example, a prediction of the general color impression for multiple layers can be carried out as well as the calculation of the wavelength dependent penetration depths of light with regard to photo polymerization. Further applications are possible in the area of laser ablation.

X-ray diffraction analysis of residual stress in zirconia dental composites

NASA Astrophysics Data System (ADS)

Allahkarami, Masoud

Dental restoration ceramic is a complex system to be characterized. Beside its essential biocompatibility, and pleasant appearance, it requires being mechanically strong in a catastrophic loading environment. Any design is restricted with geometry boundary and material property limits. Inspired by natural teeth, a multilayer ceramic is a smart way of achieving an enhanced restoration. Bi-layers of zirconia core covered by porcelain are known as one of the best multilayer restorations. Residual stresses may be introduced into a bi-layer dental ceramic restoration during its entire manufacturing process due to thermal expansion and elastic property mismatch. It is impossible to achieve a free of residual stresses bi-layer zirconia-porcelain restoration. The idea is to take the advantage of residual stress in design in such a way to prevent the crack initiation and progression. The hypothesis is a compressive residual stress at external contact surface would be enabling the restoration to endure a greater tensile stress. Optimizing the layers thickness, manufacturing process, and validating 3D simulations require development of new techniques of thickness, residual stresses and phase transformation measurement. In the present work, a combined mirco-tomography and finite element based method were adapted for thickness measurement. Two new 2D X-ray diffraction based techniques were adapted for phase transformation area mapping and combined phase transformation and residual stress measurement. Concerning the complex geometry of crown, an efficient method for X-ray diffraction data collection mapping on a given curved surface was developed. Finally a novel method for 3D dimensional x-ray diffraction data collection and visualization were introduced.

Perception of dental esthetics: influence of restoration type, symmetry, and color in four different countries.

PubMed

Mehl, Christian; Harder, Sönke; Lin, Jun; Vollrath, Oliver; Kern, Matthias

2015-01-01

In this study, the influence of restoration type, symmetry, and color on the perception of dental appearance was evaluated. An esthetic questionnaire was completed by 29 patients before and after esthetic rehabilitation. In addition, 94 dentists from four countries (Germany, the United Kingdom [UK], China, and Switzerland) evaluated the influence of the above factors using before-and-after rehabilitation pictures. The most invasive treatment was recommended by Chinese dentists, while German, Swiss, and UK dentists recommended comparable treatment options. As for restorative symmetry, restoration type, and color, significant differences could be found among and within the dentists of the four countries (P ± .05).

Restoring proximal caries lesions conservatively with tunnel restorations

PubMed Central

Chu, Chun-Hung; Mei, May L; Cheung, Chloe; Nalliah, Romesh P

2013-01-01

The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive and can be particularly challenging for inexperienced restorative dentists. Recent advances in technology, such as the contemporary design of dental handpieces with advanced light-emitting diode (LED) and handheld comfort, offer operative dentists better vision, illumination, and maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new generation of restorative materials has improved mechanical properties. Tunnel restoration can be an option to restore proximal caries if the dentist performs proper case selection and pays attention to the details of the restorative procedures. This paper describes the clinical technique of tunnel restoration and reviews the studies of tunnel restorations. PMID:24019754

Restoring proximal caries lesions conservatively with tunnel restorations.

PubMed

Chu, Chun-Hung; Mei, May L; Cheung, Chloe; Nalliah, Romesh P

2013-07-30

The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive and can be particularly challenging for inexperienced restorative dentists. Recent advances in technology, such as the contemporary design of dental handpieces with advanced light-emitting diode (LED) and handheld comfort, offer operative dentists better vision, illumination, and maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new generation of restorative materials has improved mechanical properties. Tunnel restoration can be an option to restore proximal caries if the dentist performs proper case selection and pays attention to the details of the restorative procedures. This paper describes the clinical technique of tunnel restoration and reviews the studies of tunnel restorations.

Digital data acquisition for a CAD/CAM-fabricated titanium framework and zirconium oxide restorations for an implant-supported fixed complete dental prosthesis.

PubMed

Lin, Wei-Shao; Metz, Michael J; Pollini, Adrien; Ntounis, Athanasios; Morton, Dean

2014-12-01

This dental technique report describes a digital workflow with digital data acquisition at the implant level, computer-aided design and computer-aided manufacturing fabricated, tissue-colored, anodized titanium framework, individually luted zirconium oxide restorations, and autopolymerizing injection-molded acrylic resin to fabricate an implant-supported, metal-ceramic-resin fixed complete dental prosthesis in an edentulous mandible. The 1-step computer-aided design and computer-aided manufacturing fabrication of titanium framework and zirconium oxide restorations can provide a cost-effective alternative to the conventional metal-resin fixed complete dental prosthesis. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluating tooth restorations: micro-computed tomography in practical training for students in dentistry

NASA Astrophysics Data System (ADS)

Deyhle, Hans; Schmidli, Fredy; Krastl, Gabriel; Müller, Bert

2010-09-01

Direct composite fillings belong to widespread tooth restoration techniques in dental medicine. The procedure consists of successive steps, which include etching of the prepared tooth surface, bonding and placement of composite in incrementally built up layers. Durability and lifespan of the composite inlays strongly depend on the accurate completion of the individual steps to be also realized by students in dental medicine. Improper handling or nonconformity in the bonding procedure often lead to air enclosures (bubbles) as well as to significant gaps between the composite layers or at the margins of the restoration. Traditionally one analyzes the quality of the restoration cutting the tooth in an arbitrarily selected plane and inspecting this plane by conventional optical microscopy. Although the precision of this established method is satisfactory, it is restricted to the selected two-dimensional plane. Rather simple micro computed tomography (μCT) systems, such as SkyScan 1174™, allows for the non-destructive three-dimensional imaging of restored teeth ex vivo and virtually cutting the tomographic data in any desired direction, offering a powerful tool for inspection of the restored tooth with micrometer resolution before cutting and thus also to select a two-dimensional plane with potential defects. In order to study the influence of the individual steps on the resulted tooth restoration, direct composite fillings were placed in mod cavities of extracted teeth. After etching, an adhesive was applied in half of the specimens. From the tomographic datasets, it becomes clear that gaps occur more frequently when bonding is omitted. The visualization of air enclosures offers to determine the probability to find a micrometer-sized defect using an arbitrarily selected cutting plane for inspection.

Dental glass-reinforced composite for caries inhibition: Calcium phosphate ion release and mechanical properties

PubMed Central

Xu, Hockin H. K.; Moreau, Jennifer L.

2010-01-01

The two main challenges facing dental composite restorations are secondary caries and bulk fracture. Previous studies developed whisker-reinforced Ca-PO4 composites that were relatively opaque. The objective of this study was to develop an esthetic glass particle-reinforced, photo-cured calcium phosphate composite. Tetracalcium phosphate (TTCP) particles were incorporated into a resin for Ca and PO4 release, while glass particles provided reinforcement. Ion release and mechanical properties were measured after immersion in solutions with pH of 7, 5.5, and 4. For the composite containing 40% mass fraction of TTCP, incorporating glass fillers increased the strength (p < 0.05). Flexural strength (mean ± sd; n = 6) at 30% glass was (99 ± 18) MPa, higher than (54 ± 20) MPa at 0% glass (p < 0.05). Elastic modulus was 11 GPa at 30% glass, compared to 2 GPa without glass. At 28 d, the released Ca ion concentration was (4.61 ± 0.18) mmol/L at pH of 4, much higher than (1.14 ± 0.07) at pH of 5.5, and (0.27 ± 0.01) at pH of 7 (p < 0.05). PO4 release was also dramatically increased at cariogenic, acidic pH. The TTCP-glass composite had strength 2-3 fold that of a resin-modified glass ionomer control. In conclusion, the photo-cured TTCP-glass composite was “smart” and substantially increased the Ca and PO4 release when the pH was reduced from neutral to a cariogenic pH of 4, when these ions are most needed to inhibit tooth caries. Its mechanical properties were significantly higher than previous Ca, PO4 and fluoride releasing restoratives. Hence, the photo-cured TTCP-glass composite may have potential to provide the necessary combination of load-bearing and caries-inhibiting capabilities. PMID:19810118

[Post-academic dental specialties. 11. Discomfort during atraumatic restorative treatment (ART) versus conventional restorative treatment].

PubMed

van Gemert-Schriks, M C M

2007-05-01

Although Atraumatic Restorative Treatment (ART) claims to be a patient-friendly method of treatment, little scientific proof of this is available. The aim of this study, therefore, was to acquire a reliable measurement of the degree of discomfort which children experience during dental treatment performed according to the ART approach and during the conventional method. A number of 403 Indonesian schoolchildren were randomly divided into 2 groups. In each child, one class II restoration was carried out on a deciduous molar either by means of ART or the use of rotary instruments (750 rpm). Discomfort scores were determined both by physiological measurements (heart rate) and behavioral observations (Venham scale). Venham scores showed a marked difference between the 2 groups, whereas heart rate scores only differed significantly during deep excavation. A correlation was found between Venham scores and heart rate measurements. Sex, initial anxiety and performing dentist were shown to be confounding variables. In conclusion it can be said that children treated according to the ART approach experience less discomfort than those treated with rotary instruments.

Factors influencing the appropriateness of restorative dental treatment: an epidemiologic perspective.

PubMed

Grembowski, D; Fiset, L; Milgrom, P; Forrester, K; Spadafora, A

1997-01-01

An epidemiology analysis was performed to identify patient and dentist factors influencing over- and undertreatment of restorative services in a sample of insured adults. At baseline, 681 Washington State employees and their spouses, aged 20 to 34 years and residing in the Olympia or Pullman areas, were interviewed by telephone. Oral assessments were conducted to measure personal characteristics, oral disease, and restoration quality. Adults were followed for two years to measure use of restorative services from dental insurance claims. Each adult's baseline and claims data were linked with provider and practice variables collected from the dentist who provided treatment. For overtreatment, 39 percent of adults received one or more replacement restorations in nondecayed teeth with satisfactory fillings at baseline, while 18 percent of adults had one or more restorations placed in teeth with no decay and fillings. An adult's probability of overtreatment was higher if the adult had more fillings at baseline, or if an adult's dentist was younger, had a busy practice, advertised, charged higher fees, had less continuing education, or had a solo practice. For undertreatment, about 16 percent of adults either received no replacement restorations in teeth with unsatisfactory fillings at baseline, or had decayed teeth at baseline that were not filled or crowned. An adult's probability of undertreatment was higher if an adult had less decayed or more missing surfaces at baseline, or if an adult's dentist believed in sharing information with patients, had a busy practice, or reported not placing fillings when radiographic evidence of new caries was present. A minority of adults aged 20 to 34 experienced potential over- or undertreatment of restorative services, which are influenced by both patient and dentist factors.

Cuspal Deflection of Premolars Restored with Bulk-Fill Composite Resins.

PubMed

Behery, Haytham; El-Mowafy, Omar; El-Badrawy, Wafa; Saleh, Belal; Nabih, Sameh

2016-01-01

This in vitro study compared cuspal deflection of premolars restored with three bulk-fill composite resins to that of incrementally-restored ones with a low-shrinkage silorane-based restorative material. Forty freshly-extracted intact human upper premolars were used. Reference points at buccal and palatal cusp tips were acid-etched and composite rods were horizontally bonded to them (TPH-Spectra-HV, Dentsply). Two acrylic resin guiding paths were made for each premolar to guide beaks of a digital micrometer used for cuspal deflection measurements. Standardized MOD cavities, 3 mm wide bucco-lingually and 3.5 mm deep, were prepared on each premolar. Prepared teeth were then equally divided into four groups (n = 10) and each group was assigned to one of four composite resin (QuiXX, Dentsply; X-tra fil, Voco; Tetric EvoCeram Bulk Fill, Ivoclar Vivadent; low-shrinkage Filtek LS, 3M/ESPE). Adper Single Bond-Plus, 3M/ESPE was used with all bulk-fill restoratives. LS-System Adhesive, 3M/ESPE was used with Filtek LS. For each prepared premolar, cuspal deflection was measured in microns as the difference between two readings between reference points before and after restoration completion. Means and SDs were calculated and data statistically-analyzed using One-way ANOVA and Tukey's test. Filtek LS showed the lowest mean cuspal deflection value 6.4(0.84)μm followed by Tetric EvoCeram Bulk Fill 10.1(1.2) μm and X-tra fil 12.4(1.35)μm, while QuiXX showed the highest mean 13(1.05)μm. ANOVA indicated significant difference among mean values of groups (p < 0.001). Tukey's test indicated no significant difference in mean values between QuiXX and X-tra fil (p = 0.637). Tetric EvoCeram Bulk Fill had significantly lower mean cuspal deflection compared with the two other bulk-fill composite resins tested. Filtek LS had the lowest significant mean cuspal deflection in comparison to all tested bulk-fill restoratives. The use of Tetric EvoCeram Bulk fill composite resin

Effects of audiovisual distraction in children with special healthcare needs during dental restorations: a randomized crossover clinical trial.

PubMed

Bagattoni, Simone; D'Alessandro, Giovanni; Sadotti, Agnese; Alkhamis, Nadia; Piana, Gabriela

2018-01-01

Audiovisual distraction using video eyeglasses is useful in managing distress and reducing fear and anxiety in healthy children during dental treatments. To evaluate the effect of audiovisual distraction on behavior and self-reported pain of children with special healthcare needs (SHCN) without intellectual disability during dental restorations and its influence on the operator stress and the time of the appointment. This randomized controlled crossover trial comprised 48 children with SHCN requiring at least two dental restorations. One restoration was done wearing the video eyeglasses and one wearing conventional behavior management techniques. Subjective and objective pain was evaluated using the Faces Pain Scale - Revised (FPS-R) and the revised Face, Leg, Activity, Cry, and Consolability scale (r-FLACC). The operator stress using a VAS, the time of the appointment, and the child satisfaction were recorded. The use of video eyeglasses significantly reduced the operator stress. The bivariate analysis showed that the mean FPS-R score and the mean r-FLACC score were significantly lower using the video eyeglasses only during the second clinical session. Audiovisual distraction could be useful in managing distress in SHCN children without intellectual disability but cannot replace the conventional behavior management techniques. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Family composition and children's dental health behavior: evidence from Germany.

PubMed

Listl, Stefan

2011-01-01

To assess whether children's dental health behavior differs between family compositions of either natural parents or birth mothers together with stepfathers. We use data from the German Health Interview and Examination Survey Children and Adolescents (KiGGS) public use file. This is the first nationally r ep resentative sample on child health in Germany and particularly contains variables for dental attendance, tooth care, and eating behavior of 13,904 children below 14 years of age. A series of zero-inflated Poisson, ordinary least squares, binary, and ordered logistic regression models was set up in order to identify whether family composition is a significant explanatory variable for children's dental health behavior. Family composition turned out as a significant parameter for some aspects of children's dental health behavior. Specifically, children who grow up in families with a birth mother and a stepfather have only half the probability to access dental services but, once seeking treatment, the number of visits is significantly higher in comparison with children raised by their natural parents. Moreover, children growing up in such a patchwork family setting consume a higher amount of sugary foods and drinks. This appears mainly attributable to differential consumption habits for juices, cookies, and chocolate. Children who grow up in settings other than the nuclear family may develop different dental health behaviors than children who grow up with both natural parents, albeit more research is needed to identify the extent to which such behavioral changes lead to variations in caries occurrence.

The Direct-Indirect Technique for Composite Restorations Revisited.

PubMed

Ritter, André V; Fahl, Newton; Vargas, Marcos; Maia, Rodrigo R

2017-06-01

In the direct-indirect composite technique, composite is applied to a nonretentive tooth preparation (eg, a noncarious cervical lesion or a veneer/inlay/onlay preparation) without any bonding agent, sculpted to a primary anatomic form, and light-cured. The partially polymerized restoration is then removed from the preparation and finished and tempered extraorally chairside. The finished inlay is bonded to the preparation using a resin-based luting agent. Advantages of this technique include enhanced physical and mechanical properties afforded by the extraoral chairside tempering process because of increased monomer conversion, and greater operator control over the final marginal adaptation, surface finishing and polishing, and anatomy of the restoration, given that these elements are defined outside of the patient's mouth. The direct-indirect approach also affords enhanced gingival health and patient comfort. This article presents a clinical case in which the direct-indirect composite technique was used to restore three noncarious cervical lesions on the same quadrant on an adult patient. Clinical steps and tips for success are offered. The authors also present scanning electron microscope and atomic force microscope images showing the excellent marginal fit obtained with the direct-indirect composite technique.

Fabrication and evaluation of Bis-GMA/TEGDMA dental resins/composites containing halloysite nanotubes.

PubMed

Chen, Qi; Zhao, Yong; Wu, Weidong; Xu, Tao; Fong, Hao

2012-10-01

To investigate the reinforcement of Bis-GMA/TEGDMA dental resins (without conventional glass filler) and the corresponding composites (with conventional glass filler) containing varied mass fractions of halloysite nanotubes (HNTs). Three dispersion methods were studied to separate the silanized halloysite as individual HNTs and to uniformly distribute them into dental matrices. Photopolymerization induced volumetric shrinkage was measured by using a mercury dilatometer. Real time near infrared spectroscopy was adopted to study the degree of vinyl double bond conversion and the photopolymerization rate. Mechanical properties of the composites were tested by a universal mechanical testing machine. Analysis of variance (ANOVA) was used for the statistical analysis of the acquired data. Morphologies of halloysite/HNTs and representative fracture surfaces of the reinforced dental resins/composites were examined by SEM and TEM. Impregnation of small mass fractions (e.g., 1% and 2.5%) of the silanized HNTs in Bis-GMA/TEGDMA dental resins/composites improved mechanical properties significantly; however; large mass fractions (e.g., 5%) of impregnation did not further improve the mechanical properties. The impregnation of HNTs into dental resins/composites could result in two opposite effects: the reinforcing effect due to the highly separated and uniformly distributed HNTs, and the weakening effect due to the formation of HNT agglomerates/particles. Uniform distribution of a small amount of well-separated silanized HNTs into Bis-GMA/TEGDMA dental resins/composites could result in substantial improvements on mechanical properties. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

The importance of the biomimetic composites components for recreating the optical properties and molecular composition of intact dental tissues.

NASA Astrophysics Data System (ADS)

Seredin, P. V.; Goloshchapov, D. L.; Gushchin, M. S.; Ippolitov, Y. A.; Prutskij, T.

2017-11-01

The objective of this paper was to investigate whether it is possible to obtain biomimetic materials recreating the luminescent properties and molecular composition of intact dental tissues. Biomimetic materials were produced and their properties compared with native dental tissues. In addition, the overall contribution of the organic and non-organic components in the photoluminescence band was investigated. The results showed that it is possible to develop biomimetic materials with similar molecular composition and optical properties to native dental tissues for the early identification of dental caries.

Psychology of dental esthetics: dental creation and the harmony of the whole.

PubMed

Talarico, Giorgio; Morgante, Ezio

2006-01-01

Esthetic dentistry is characterized primarily by the smile. The goal in the creation of esthetic dental restorations is to simulate, or improve upon, the appearance of the natural dentition. However, it is important to note that the smile is just one element of the face, which serves as the primary means of emotional expression. Therefore, successful esthetic restorations must integrate harmoniously with the whole of the face, not just with the surrounding teeth. This requires a full understanding of each patient's unique personality-the psychology of dental esthetics. This article will discuss esthetic psychology and the process by which our creative thought and understanding of a patient takes concrete, physical form in the creation of dental restorations. The integration of dental restorations with the face using both shape and color will be addressed; specifically, the intricate movement of the facial muscles will be explored, as will the ways in which color is perceived in the brain, both of which are key considerations for proper esthetic restorations.

[Evaluation method with radiographic image quality indicator for internal defects of dental casting metallic restoration].

PubMed

Li, Y; Zheng, G; Lin, H

2014-12-18

To develop a new kind of dental radiographic image quality indicator (IQI) for internal quality of casting metallic restoration to influence on its usage life. Radiographic image quality indicator method was used to evaluate the depth of the defects region and internal quality of 127 casting metallic restoration and the accuracy was compared with that of conventional callipers method. In the 127 cases of casting metallic restoration, 9 were found the thickness less than 0.7 mm and the thinnest thickness only 0.2 mm in 26 casting metallic crowns or bridges' occlusal defects region. The data measured by image quality indicator were consistent with those measured by conventional gauging. Two metal inner crowns were found the thickness less than 0.3 mm in 56 porcelain crowns or bridges. The thickness of casting removable partial denture was more than 1.0 mm, but thinner regions were not found. It was found that in a titanium partial denture, the X-ray image of clasp was not uniform and there were internal porosity defects in the clasp. Special dental image quality indicator can solve the visual error problems caused by different observing backgrounds and estimate the depth of the defects region in the casting.

Ceramics in Restorative and Prosthetic DENTISTRY1

NASA Astrophysics Data System (ADS)

Kelly, J. Robert

1997-08-01

This review is intended to provide the ceramic engineer with information about the history and current use of ceramics in dentistry, contemporary research topics, and potential research agenda. Background material includes intra-oral design considerations, descriptions of ceramic dental components, and the origin, composition, and microstructure of current dental ceramics. Attention is paid to efforts involving net-shape processing, machining as a forming method, and the analysis of clinical failure. A rationale is presented for the further development of all-ceramic restorative systems. Current research topics receiving attention include microstructure/processing/property relationships, clinical failure mechanisms and in vitro testing, wear damage and wear testing, surface treatments, and microstructural modifications. The status of the field is critically reviewed with an eye toward future work. Significant improvements seem possible in the clinical use of ceramics based on engineering solutions derived from the study of clinically failed restorations, on the incorporation of higher levels of "biomimicry" in new systems, and on the synergistic developments in dental cements and adhesive dentin bonding.

Poly(propylene glycol) and urethane dimethacrylates improve conversion of dental composites and reveal complexity of cytocompatibility testing.

PubMed

Walters, Nick J; Xia, Wendy; Salih, Vehid; Ashley, Paul F; Young, Anne M

2016-02-01

To determine the effects of various monomers on conversion and cytocompatibility of dental composites and to improve these properties without detrimentally affecting mechanical properties, depth of cure and shrinkage. Composites containing urethane dimethacrylate (UDMA) or bisphenol A glycidyl methacrylate (Bis-GMA) with poly(propylene glycol) dimethacrylate (PPGDMA) or triethylene glycol dimethacrylate (TEGDMA) were characterized using the following techniques: conversion (FTIR at 1 and 4mm depths), depth of cure (BS EN ISO 4049:2009 and FTIR), shrinkage (BS EN ISO 17304:2013 and FTIR), strength and modulus (biaxial flexural test) and water sorption. Cytocompatibility of composites and their liquid phase components was assessed using three assays (resazurin, WST-8 and MTS). UDMA significantly improved conversion, BFS and depth of cure compared to Bis-GMA, without increasing shrinkage. UDMA was cytotoxic at lower concentrations than Bis-GMA, but extracts of Bis-GMA-containing composites were less cytocompatible than of those containing UDMA. PPGDMA improved conversion and depth of cure compared to TEGDMA, without detrimentally affecting shrinkage. TEGDMA was shown by all assays to be highly toxic. Resazurin, but not WST-8 and MTS, suggested that PPGDMA exhibited improved cytocompatibility compared to TEGDMA. The use of UDMA and PPGDMA results in composites with excellent conversion, depth of cure and mechanical properties, without increasing shrinkage. Composites containing UDMA appear to be slightly more cytocompatible than those containing Bis-GMA. These monomers may therefore improve the material properties of dental restorations, particularly bulk fill materials. The effect of diluent monomer on cytocompatibility requires further investigation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparative physico-mechanical characterization of new hybrid restorative materials with conventional glass-ionomer and resin composite restorative materials.

PubMed

Gladys, S; Van Meerbeek, B; Braem, M; Lambrechts, P; Vanherle, G

1997-04-01

The recently developed hybrid restorative materials contain the essential components of conventional glass ionomers and light-cured resins. The objective of this study was to determine several physical and mechanical properties of eight such materials in comparison with two conventional glass ionomers, one micro-filled, and one ultrafine compact-filled resin composite. The two resin composites and two of the three polyacid-modified resin composites could be polished to a higher gloss than the conventional as well as the resin-modified glass ionomers. After abrasion, surface roughness increased for all materials, but not at the same extent, being the least for the conventional resin composites and one polyacid-modified resin composite, Dyract. In contrast to the later resin composites, of which the surface roughness is principally determined by the presence of protruding filler particles above the resin matrix, roughness of conventional and resin-modified glass ionomers results from both protruding filler particles and intruding porosities. The mean particle size of the hybrid restorative materials fell between the smaller mean particle size of the resin composites and the larger one of the conventional glass ionomers. The micro-hardness and Young's modulus values varied substantially among all eight hybrid restorative materials. For all the resin-modified glass-ionomer restorative materials, the Young's modulus reached a maximum value one month after mixing and remained relatively stable thereafter. The Young's modulus of the conventional and the polyacid-modified resin composites decreased slightly after one month. The conventional glass-ionomer materials undoubtedly set the slowest, since their Young's modulus took six months to reach its maximum. The flexural fatigue limit of the hybrid restorative materials is comparable with that of the micro-filled composite. From this investigation, it can be concluded that the physico-mechanical properties vary widely among

Effect of water on dental material ablation of the Er:YAG laser

NASA Astrophysics Data System (ADS)

Wigdor, Harvey A.; Visuri, Steven R.; Walsh, Joseph T., Jr.

1994-09-01

It is understood that if a laser is to replace the dental high speed handpiece it must be able to ablate dental materials which are present in teeth being treated with the laser. It is the intent of this paper to evaluate the effects of the Er:YAG laser on dental composite restorative material concentrating on the etch rate with and without waterspray. Composite dental material is used to form plugs of known thickness and the etch rate of the Er:YAG laser on this material is determined. The results are compared with those obtained from studies of the Er:YAG on dentin and enamel. In these studies the water reduced the efficiency of the Er:YAG laser 15 - 20% on these tissues.

Repair Strength in Simulated Restorations of Methacrylate- or Silorane-Based Composite Resins.

PubMed

Consani, Rafael Leonardo Xediek; Marinho, Tatiane; Bacchi, Atais; Caldas, Ricardo Armini; Feitosa, Victor Pinheiro; Pfeifer, Carmem Silvia

2016-01-01

The study verified the bond strength in simulated dental restorations of silorane- or methacrylate-based composites repaired with methacrylate-based composite. Methacrylate- (P60) or silorane-based (P90) composites were used associated with adhesive (Adper Single Bond 2). Twenty-four hemi-hourglass-shaped samples were repaired with each composite (n=12). Samples were divided according to groups: G1= P60 + Adper Single Bond 2+ P60; G2= P60 + Adper Single Bond 2 + P60 + thermocycling; G3= P90 + Adper Single Bond 2 + P60; and G4= P90 + Adper Single Bond 2 + P60 + thermocycling. G1 and G3 were submitted to tensile test 24 h after repair procedure, and G2 and G4 after submitted to 5,000 thermocycles at 5 and 55 ?#61616;C for 30 s in each bath. Tensile bond strength test was accomplished in an universal testing machine at crosshead speed of 0.5 mm/min. Data (MPa) were analyzed by two-way ANOVA and Tukey's test (5%). Sample failure pattern (adhesive, cohesive in resin or mixed) was evaluated by stereomicroscope at 30?#61655; and images were obtained in SEM. Bond strength values of methacrylate-based composite samples repaired with methacrylate-based composite (G1 and G2) were greater than for silorane-based samples (G3 and G4). Thermocycling decreased the bond strength values for both composites. All groups showed predominance of adhesive failures and no cohesive failure in composite resin was observed. In conclusion, higher bond strength values were observed in methacrylate-based resin samples and greater percentage of adhesive failures in silorane-based resin samples, both composites repaired with methacrylate-based resin.

Fabrication and evaluation of Bis-GMA/TEGDMA dental resins/composites containing halloysite nanotubes

PubMed Central

Chen, Qi; Zhao, Yong; Wu, Weidong; Xu, Tao; Fong, Hao

2012-01-01

Objective To investigate the reinforcement of Bis-GMA/TEGDMA dental resins (without conventional glass filler) and the corresponding composites (with conventional glass filler)containing vari ed mass fractions of halloysite nanotubes (HNTs). Methods Three dispersion methods were studied to separate the silanized halloysite as individual HNTs and to uniformly distribute them into dental matrices. Photopolymerization induced volumetric shrinkage was measured by using a mercury dilatometer. Real time near infrared spectroscopy was adopted to study the degree of vinyl double bond conversion and the photopolymerization rate. Mechanical properties of the composites were tested by a universal mechanical testing machine. Analysis of Variance (ANOVA) was used for the statistical analysis of the acquired data. Morphologies of halloysite/HNTs and representative fracture surfaces of the reinforced dental resins/composites were examined by SEM and TEM. Results Impregnation of small mass fractions (e.g., 1% and 2.5%) of the silanized HNTs in Bis-GMA/TEGDMA dental resins/composites improved mechanical properties significantly; however; large mass fractions (e.g., 5%) of impregnation did not further improve the mechanical properties. The impregnation of HNTs into dental resins/composites could result in two opposite effects: the reinforcing effect due to the highly separated and uniformly distributed HNTs, and the weakening effect due to the formation of HNT agglomerates/particles. Significance Uniform distribution of a small amount of well-separated silanized HNTs into Bis-GMA/TEGDMA dental resins/composites could result in substantial improvements on mechanical properties. PMID:22796038

Implementation of revolutionary legislation for informed consent for dental patients receiving amalgam restorations.

PubMed

Edlich, Richard F; Cross, Catherine L; Dahlstrom, Jill J; Long, William B; Newkirk, Anthony T

2008-01-01

Mercury is one of the most dangerous environmental toxins. Realizing the environmental dangers of mercury, the Norwegian Minister of the Environment and International Development, Erik Solheim, has therefore prohibited the use of mercury in products in Norway. This ban will include dental filling materials (amalgam) and measuring instruments, as well as other products. This ban is valid from January 1, 2008. Sweden announced a similar ban, and dentists in Denmark will no longer be able to use mercury in fillings after April 1, 2008. It is indeed unfortunate that the United States has not taken a leadership role in enacting Informed Consent Legislations for patients receiving dental amalgam restorations. Informed Consent Legislations have been enacted by Maine, California, Connecticut, and Vermont.

Dental amalgam and mercury vapor release.

PubMed

Osborne, J W

1992-09-01

Dental diseases are among the most common ailments, and dentists in the United States spend over 50% of their time in dental practice rebuilding carious, malformed, and traumatically injured teeth. It is logical, therefore, that the majority of the dental school curriculum is devoted to the diagnosis, prevention, and treatment of teeth with anomalies. Dentists have several choices of materials they can use to accomplish the task of rebuilding teeth. Besides amalgam, they have ceramic materials, resin composites, base-metal and noble casting alloys, and glass-ionomer cements to use to restore the posterior dentition. Each of these restorative materials has advantages and disadvantages, and the clinical judgment as to when a particular material should be used is given a high priority in dental education. Amalgam is the most widely used of these restorative materials, with 92% of dentists listing it as the material of choice in the posterior of the mouth (Clinical Research Associates, 1990). Dentists have been placing amalgams for over 150 years in the US. They placed 150 million last year, which represents over 75 tons of amalgam alloy. The reasons that dentists use this restorative material so frequently are its durability, ease of manipulation, and low cost. Numerous clinical studies have been conducted on the serviceability of amalgam. Most of these have been on the old, low-copper alloys, and results indicate that they last from 8 to 15 years (Bailit et al., 1979; Osborne et al., 1980; Qvist et al., 1986). In the past 20 years, vast improvements have been made in amalgams with the development of the high-copper systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of the physical properties of dental resin composites using optical fiber sensing technology.

PubMed

Rajan, Ginu; Shouha, Paul; Ellakwa, Ayman; Bhowmik, Kishore; Xi, Jiangtao; Prusty, Gangadhara

2016-09-01

The characterization of the physical properties of dental resin composites is fraught with difficulties relating to significant intra and inter test parameter variabilities and is relatively time consuming and expensive. The main aim of this study was to evaluate whether optical fiber Bragg grating (FBG) sensing system may become a viable tool to study dental material characteristics. Of particular focus was the potential for the system to demonstrate a multi parameter all-in-one feature. A miniature FBG was embedded in six different dental resin composites and employed as a sensor to evaluate linear polymerization shrinkage, thermal expansion and water sorption. Six commercially available dental composites with different filler types and volume are evaluated. The tests are repeated with three sets of samples. The curing characteristics and residual strain gradient exhibited by the cured dental composites were also observed and commented. Among the studied samples, SDR shows lowest polymerization shrinkage, while Beautifil FO3 shows the highest. The results also show clear distinction between particle filler type and fiber reinforcement based composites in their polymerization shrinkage properties. The agreement of the results with existing literatures show that FBG based system provides accurate results. Polymerization shrinkage rate of the samples are also obtained. Thermal expansion of the composites are measured using the FBG sensing method for the first time and is correlated with resin type, volume, filler type and glass transition temperature. The water sorption characteristics of the dental composite are also successfully measured using the FBG sensing method. The high level of repeatability and the low standard deviations shown in the results indicate good reliability with the use of FBG sensors. This study demonstrates how optical fiber technology can provide simple and reliable methods of measuring the critical physical properties of dental composites

Dental responsibility loadings and the relative value of dental services.

PubMed

Teusner, D N; Ju, X; Brennan, D S

2017-09-01

To estimate responsibility loadings for a comprehensive list of dental services, providing a standardized unit of clinical work effort. Dentists (n = 2500) randomly sampled from the Australian Dental Association membership (2011) were randomly assigned to one of 25 panels. Panels were surveyed by questionnaires eliciting responsibility loadings for eight common dental services (core items) and approximately 12 other items unique to that questionnaire. In total, loadings were elicited for 299 items listed in the Australian Dental Schedule 9th Edition. Data were weighted to reflect the age and sex distribution of the workforce. To assess reliability, regression models assessed differences in core item loadings by panel assignment. Estimated loadings were described by reporting the median and mean. Response rate was 37%. Panel composition did not vary by practitioner characteristics. Core item loadings did not vary by panel assignment. Oral surgery and endodontic service areas had the highest proportion (91%) of services with median loadings ≥1.5, followed by prosthodontics (78%), periodontics (76%), orthodontics (63%), restorative (62%) and diagnostic services (31%). Preventive services had median loadings ≤1.25. Dental responsibility loadings estimated by this study can be applied in the development of relative value scales. © 2017 Australian Dental Association.

Mechanical behavior of bulk direct composite versus block composite and lithium disilicate indirect Class II restorations by CAD-FEM modeling.

PubMed

Ausiello, Pietro; Ciaramella, Stefano; Fabianelli, Andrea; Gloria, Antonio; Martorelli, Massimo; Lanzotti, Antonio; Watts, David C

2017-06-01

materials. Model B mastication behavior (with E=20GPa) was similar to the sound tooth stress relief pattern. Model B internally showed differences from the sound tooth model but reduced maximum stresses than model A and partially than model C. Model C (with E=70GPa) behaved similarly to model B with well redistributed stresses at the occlusal margins and the lateral sides with higher stress concentrations in the proximal boxes. Models B and C showed a more favorable performance than model A with elastic biomechanics similar to the sound tooth model. Bulk filling resin composite with 1% linear polymerization shrinkage negatively affected the mechanical behavior of class II MOD restored teeth. Class II MOD direct resin composite showed greater potential for damage because of higher internal and marginal stress evolution during resin polymerization shrinkage. With a large class II MOD cavity an indirect composite or a lithium disilicate inlay restoration may provide a mechanical response close to that of a sound tooth. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Site specific mineral composition and microstructure of human supra-gingival dental calculus.

PubMed

Hayashizaki, Junko; Ban, Seiji; Nakagaki, Haruo; Okumura, Akihiko; Yoshii, Saori; Robinson, Colin

2008-02-01

Dental calculus has been implicated in the aetiology of several periodontal conditions. Its prevention and removal are therefore desirable clinical goals. While it is known that calculus is very variable in chemical composition, crystallinity and crystallite size little is known about site specific variability within a dentition and between individuals. With this in mind, a study was undertaken to investigate the comparative site specific nature and composition of human dental supra-gingival dental calculus obtained from 66 male patients visiting for their dental check-up using fluorescent X-ray spectroscopy, X-ray diffractometry and Fourier transform infrared spectroscopy. The supra-gingival dental calculus formed on the lingual surfaces of lower anterior teeth and the buccal surfaces of upper molar teeth were classified into four types based on calcium phosphate phases present. There was significant difference in composition of the crystal phase types between lower and upper teeth (p<0.01). There was no significant difference in crystal size between dental calculus on anterior or molar teeth of all samples. The degree of crystallinity of dental calculus formed on the upper molar teeth was higher than that formed on the lower anterior teeth (p<0.01). The CO(3)(2-) contents in dental calculus formed on the lower anterior teeth were higher than on upper molar teeth (p<0.05) which might explain the difference in crystallinity. Magnesium and Si contents and Ca:P ratio on the other hand showed no significant difference between lower and upper teeth. It was concluded that the crystal phases, crystallinity and CO(3)(2-) contents of human dental supra-gingival dental calculus is related to its location in the mouth.

Class II glass ionomer cermet tunnel, resin sandwich and amalgam restorations over 2 years.

PubMed

Wilkie, R; Lidums, A; Smales, R

1993-08-01

This study compared the clinical behavior of a glass ionomer (polyalkenoate) silver cermet, a posterior resin composite used with the "tunnel" technique, a posterior resin composite used with the "closed sandwich" technique, and a high-copper amalgam for restoring small, proximal surface carious lesions. Two dentists placed 86 restorations in the posterior permanent teeth of 26 adults treated at a dental hospital. Restorations were assessed at 6-month intervals over 2 years for gingivitis adjacent to them, the tightness of proximal contacts, occlusal wear, surface voids, roughness and cracking, surface and marginal staining, and marginal fracture. Small filling defects, surface voids and occlusal wear were obvious with the cermet material, with surface crazing and cracking present in 48% of the tunnel restorations. Two of the posterior resin composites, but none of the amalgam restorations, also failed. The cermet cannot be recommended as a long-term permanent restorative material in situations where it is likely to be subjected to heavy occlusal stresses and abrasive wear.

Advancements in all-ceramics for dental restorations and their effect on the wear of opposing dentition

PubMed Central

Rashid, Haroon; Sheikh, Zeeshan; Misbahuddin, Syed; Kazmi, Murtaza Raza; Qureshi, Sameer; Uddin, Muhammad Zuhaib

2016-01-01

Tooth wear is a process that is usually a result of tooth to tooth and/or tooth and restoration contact. The process of wear essentially becomes accelerated by the introduction of restorations inside the oral cavity, especially in case of opposing ceramic restorations. The newest materials have vastly contributed toward the interest in esthetic dental restorations and have been extensively studied in laboratories. However, despite the recent technological advancements, there has not been a valid in vivo method of evaluation involving clinical wear caused due to ceramics upon restored teeth and natural dentition. The aim of this paper is to review the latest advancements in all-ceramic materials, and their effect on the wear of opposing dentition. The descriptive review has been written after a thorough MEDLINE/PubMed search by the authors. It is imperative that clinicians are aware of recent advancements and that they should always consider the type of ceramic restorative materials used to maintain a stable occlusal relation. The ceramic restorations should be adequately finished and polished after the chair-side adjustment process of occlusal surfaces. PMID:28042280

Marginal and internal fit of nano-composite CAD/CAM restorations.

PubMed

Park, So-Hyun; Yoo, Yeon-Jee; Shin, Yoo-Jin; Cho, Byeong-Hoon; Baek, Seung-Ho

2016-02-01

The purpose of this study was to compare the marginal and internal fit of nano-composite CAD-CAM restorations. A full veneer crown and an mesio-occluso-distal (MOD) inlay cavity, which were prepared on extracted human molars, were used as templates of epoxy resin replicas. The prepared teeth were scanned and CAD-CAM restorations were milled using Lava Ultimate (LU) and experimental nano-composite CAD/CAM blocks (EB) under the same milling parameters. To assess the marginal and internal fit, the restorations were cemented to replicas and were embedded in an acrylic mold for sectioning at 0.5 mm intervals. The measured gap data were pooled according to the block types and measuring points for statistical analysis. Both the block type and measuring point significantly affected gap values, and their interaction was significant (p = 0.000). In crowns and inlays made from the two blocks, gap values were significantly larger in the occlusal area than in the axial area, while gap values in the marginal area were smallest (p < 0.001). Among the blocks, the restorations milled from EB had a significantly larger gap at all measuring points than those milled from LU (p = 0.000). The marginal and internal gaps of the two nano-composite CAD/CAM blocks differed according to the measuring points. Among the internal area of the two nano-composite CAD/CAM restorations, occlusal gap data were significantly larger than axial gap data. The EB crowns and inlays had significantly larger gaps than LU restorations.

Marginal and internal fit of nano-composite CAD/CAM restorations

PubMed Central

Park, So-Hyun; Shin, Yoo-Jin

2016-01-01

Objectives The purpose of this study was to compare the marginal and internal fit of nano-composite CAD-CAM restorations. Materials and Methods A full veneer crown and an mesio-occluso-distal (MOD) inlay cavity, which were prepared on extracted human molars, were used as templates of epoxy resin replicas. The prepared teeth were scanned and CAD-CAM restorations were milled using Lava Ultimate (LU) and experimental nano-composite CAD/CAM blocks (EB) under the same milling parameters. To assess the marginal and internal fit, the restorations were cemented to replicas and were embedded in an acrylic mold for sectioning at 0.5 mm intervals. The measured gap data were pooled according to the block types and measuring points for statistical analysis. Results Both the block type and measuring point significantly affected gap values, and their interaction was significant (p = 0.000). In crowns and inlays made from the two blocks, gap values were significantly larger in the occlusal area than in the axial area, while gap values in the marginal area were smallest (p < 0.001). Among the blocks, the restorations milled from EB had a significantly larger gap at all measuring points than those milled from LU (p = 0.000). Conclusions The marginal and internal gaps of the two nano-composite CAD/CAM blocks differed according to the measuring points. Among the internal area of the two nano-composite CAD/CAM restorations, occlusal gap data were significantly larger than axial gap data. The EB crowns and inlays had significantly larger gaps than LU restorations. PMID:26877989

The decision to repair or replace a defective restoration is affected by who placed the original restoration: findings from the National Dental PBRN

PubMed Central

Gordan, Valeria V; Riley, Joseph; Geraldeli, Saulo; Williams, O. Dale; Spoto, Joseph C; Gilbert, Gregg H

2014-01-01

Objectives To evaluate how restoration characteristics are associated with the decision to repair or replace an existing restoration. The following hypotheses were studied: Dentists who placed the original restoration are more likely to repair instead of replace restorations (H1) that are in molar teeth; (H2) that are in the upper arch; (H3) that have amalgam restorative material; (H4) if a fracture is not the primary reason for the defect; and (H5) when the restoration comprises more than one surface. Methods This cross-sectional study used a consecutive patient/restoration recruitment design. 194 dentists members of a dental practice-based research network recorded data on restorations in permanent teeth that needed repair or replacement. Results For 6,623 of the 8,770 defective restorations in 6,643 patients, the treatment was provided by the dentist who had not placed the original restoration (75%). The 2-way interaction revealed that dentists who had placed the original restoration often chose to repair when the defective restoration was in a molar, relative to premolar or anterior teeth (OR = 2.2, p < .001); and chose to replace when the restoration had amalgam (OR = 0.5, p < .001), and when it was a fracture compared to another reason (OR = 0.8, p = 001). Conclusion Most dentists are not conservative when they revisit a restoration that they originally placed regardless of type of failure, number of surfaces or material used. However, dentists who had placed the original restoration were significantly more likely to repair it when the defective restoration was in a molar tooth. PMID:25223822

Success of Dental Treatments under Behavior Management, Sedation and General Anesthesia.

PubMed

Blumer, Sigalit; Costa, Liora; Peretz, Benjamin

To present comparative study aims to assist the practitioner to choose between behavior modification (BM) techniques, pharmacologic sedation (N 2 O-O 2 alone or combined with midazolam 0.5 mg/ kg) or routine general anesthesia (GA) for the most successful approach in enabling pediatric dental care. Dental records of 56 children treated in a university dental clinic between 2006-2016 were reviewed, and data on age, gender, required treatment (amalgam restorations, composite restorations, pulpotomy, and stainless steel crowns [SSC]), treatment approaches and therapeutic success at final follow-up were retrieved. Treatment under GA had the best success rates compared to both BM and pharmacologic sedation. N 2 O-O 2 alone had a 6.1-fold greater risk of failure compared to N 2 O-O 2 +midazolam (p- <0.008). Amalgam restorations had a 2.61-fold greater risk of failure than SSC (p- <0.008). The GA mode yielded significantly greater success than the N 2 O-O 2 mode alone. There were no significant differences in success rates between GA and combined midazolam 0.5 mg/kg+N 2 O-O 2 . When choosing restoration material, it is important to remember the high success rate of SSC compared to amalgam restoration.

Wicked problems: policy contradictions in publicly financed dental care.

PubMed

Quiñonez, Carlos

2012-01-01

To review two policy issues that define publicly financed dental care as a "wicked policy problem." Historical review. By demonstrating how governments have shifted their funding focus from direct delivery care, to public third-party financing arrangements in private dental offices, and by their willingness to fund composite restorations in public fee schedules, it is clear that the logic and sustainability of public programming needs reconsideration. The current contradictions in public dental care programs speak to the need for policy makers to reassess their goals, and ask whether decisions are based more on political necessity than on a logical evidence-informed approach to the delivery of publicly financed dental care. © 2012 American Association of Public Health Dentistry.

An experimental bioactive dental ceramic for metal-ceramic restorations: Textural characteristics and investigation of the mechanical properties.

PubMed

Goudouri, Ourania-Menti; Kontonasaki, Eleana; Papadopoulou, Lambrini; Manda, Marianthi; Kavouras, Panagiotis; Triantafyllidis, Konstantinos S; Stefanidou, Maria; Koidis, Petros; Paraskevopoulos, Konstantinos M

2017-02-01

The aim of this study was the evaluation of the textural characteristics of an experimental sol-gel derived feldspathic dental ceramic, which has already been proven bioactive and the investigation of its flexural strength through Weibull Statistical Analysis. The null hypothesis was that the flexural strength of the experimental and the commercial dental ceramic would be of the same order, resulting in a dental ceramic with apatite forming ability and adequate mechanical integrity. Although the flexural strength of the experimental ceramics was not statistically significant different compared to the commercial one, the amount of blind pores due to processing was greater. The textural characteristics of the experimental ceramic were in accordance with the standard low porosity levels reported for dental ceramics used for fixed prosthetic restorations. Feldspathic dental ceramics with typical textural characteristics and advanced mechanical properties as well as enhanced apatite forming ability can be synthesized through the sol-gel method. Copyright © 2016 Elsevier Ltd. All rights reserved.

Physical properties of a new sonically placed composite resin restorative material.

PubMed

Ibarra, Emily T; Lien, Wen; Casey, Jeffery; Dixon, Sara A; Vandewalle, Kraig S

2015-01-01

A new nanohybrid composite activated by sonic energy has been recently introduced as a single-step, bulk-fill restorative material. The purpose of this study was to compare the physical properties of this new composite to various other composite restorative materials marketed for posterior or bulk-fill placement. The following physical properties were examined: depth of cure, volumetric shrinkage, flexural strength, flexural modulus, fracture toughness, and percent porosity. A mean and standard deviation were determined per group. One-way ANOVA and Tukey's post hoc tests were performed per property (α = 0.05). Percent porosity was evaluated with a Kruskal-Wallis/Mann-Whitney test (α = 0.005). Significant differences were found between groups (P < 0.001) per test type. Compared to the other composite restorative materials, the new nanohybrid composite showed low shrinkage and percent porosity, moderate fracture toughness and flexural modulus, and high flexural strength. However, it also demonstrated a relatively reduced depth of cure compared to the other composites.

Microleakage of class V resin composite restorations after bur, air-abrasion or Er:YAG laser preparation.

PubMed

Corona, S A; Borsatto, M; Dibb, R G; Ramos, R P; Brugnera, A; Pécora, J D

2001-01-01

This in vitro study compared the microleakage of Class V resin composite restorations placed in cavities prepared with a high-speed dental bur, air-abrasion or Er:YAG laser. Twenty sound extracted human third molars were selected and randomly assigned to four equal Groups (n=10): Group I, cavities were cut by dental drill at high-speed; Group II, aluminum oxide air-abrasion was used for cavity preparation, and in Groups III and IV, cavities were prepared by Er:YAG laser. Following cavity preparation, Groups I and II were acid-etched, Group III was treated only by Er:YAG laser and Group IV was conditioned by Er:YAG laser followed by acid-etching. Cavities were restored (Single Bond + Z-100) and the teeth stored for seven days in distilled water. Then, the restorations were polished and the specimens thermocycled, immersed in a 0.2% Rhodamine solution, sectioned and analyzed for leakage at the occlusal (enamel) and cervical (dentin/cementum) interfaces using an optical microscope connected to a video camera. The images were digitized and software was utilized for microleakage assessment. Upon analyzing the results, statistically significant differences (p<0.01) between the occlusal and cervical regions for all groups was observed, and, as a rule, there was better marginal sealing at the enamel margins. The highest degree of infiltration was observed for cavities prepared and treated exclusively by Er:YAG (Group III). The other experimental groups showed statistical similarities in the amount of marginal leakage at the enamel margins. However, at the cervical margins, there was a significant difference (p<0.05) between Group I and the remaining groups. None of the techniques completely eliminated marginal microleakage at the dentin/ cementum margins.

Rehabilitation of a patient with amelogenesis imperfecta using porcelain veneers and CAD/CAM polymer restorations: A clinical report.

PubMed

Saeidi Pour, Reza; Edelhoff, Daniel; Prandtner, Otto; Liebermann, Anja

2015-01-01

The complete dental rehabilitation of patients with a vertical dimension loss (VDL) caused by structural enamel deficits associated with amelogenesis imperfecta (AI) represents a difficult challenge for restorative teams. Accurate analysis and treatment planning that includes esthetic and functional evaluations and adequate material selection are important prerequisites for successful results. Long-term provisional restorations play an important role in exploring and elucidating the patients' esthetic demands and functional needs. Restorative treatment options can vary from requiring only oral hygiene instructions to extensive dental restorations that include composite fillings, ceramic veneers, metal-ceramic, or all-ceramic crowns. This case report describes a full-mouth rehabilitation of a patient with amelogenesis imperfecta including the case planning, bite replacement, preparation, and restoration setting steps with an experimental CAD/CAM polymer and porcelain veneers.

Fabrication and Evaluation of Bis-GMA/TEGDMA Dental Resins/Composites Containing Nano Fibrillar Silicate

PubMed Central

Tian, Ming; Gao, Yi; Liu, Yi; Liao, Yiliang; Hedin, Nyle E.; Fong, Hao

2008-01-01

Objective To investigate the reinforcement of Bis-GMA/TEGDMA dental resins (without conventional glass filler) and composites (with conventional glass filler) with various mass fractions of nano fibrillar silicate (FS). Methods Three dispersion methods were studied to separate the silanized FS as nano-scaled single crystals and uniformly distribute them into dental matrices. The photo-curing behaviors of the Bis-GMA/TEGDMA/FS resins were monitored in situ by RT-NIR to study the photopolymerization rate and the vinyl double bond conversion. Mechanical properties (flexural strength, elastic modulus and work of fracture) of the nano FS reinforced resins/composites were tested, and Analysis of Variance (ANOVA) was used for the statistical analysis of the acquired data. The morphology of nano FS and the representative fracture surfaces of its reinforced resins/composites were examined by SEM/TEM. Results Impregnation of small mass fractions (1 % and 2.5 %) of nano FS into Bis-GMA/TEGDMA (50/50 mass ratio) dental resins/composites improved the mechanical properties substantially. Larger mass fraction of impregnation (7.5 %), however, did not further improve the mechanical properties (one way ANOVA, P > 0.05) and may even reduce the mechanical properties. The high degree of separation and uniform distribution of nano FS into dental resins/composites was a challenge. Impregnation of nano FS into dental resins/composites could result in two opposite effects: a reinforcing effect due to the highly separated and uniformly distributed nano FS single crystals, or a weakening effect due to the formation of FS agglomerates/particles. Significance Uniform distribution of highly separated nano FS single crystals into dental resins/composites could significantly improve the mechanical properties of the resins/composites. PMID:17572485

Fabrication and evaluation of Bis-GMA/TEGDMA dental resins/composites containing nano fibrillar silicate.

PubMed

Tian, Ming; Gao, Yi; Liu, Yi; Liao, Yiliang; Hedin, Nyle E; Fong, Hao

2008-02-01

To investigate the reinforcement of Bis-GMA/TEGDMA dental resins (without conventional glass filler) and composites (with conventional glass filler) with various mass fractions of nano fibrillar silicate (FS). Three dispersion methods were studied to separate the silanized FS as nano-scaled single crystals and uniformly distribute them into dental matrices. The photo-curing behaviors of the Bis-GMA/TEGDMA/FS resins were monitored in situ by RT-NIR to study the photopolymerization rate and the vinyl double bond conversion. Mechanical properties (flexural strength, elastic modulus and work-of-fracture) of the nano FS reinforced resins/composites were tested, and analysis of variance (ANOVA) was used for the statistical analysis of the acquired data. The morphology of nano FS and the representative fracture surfaces of its reinforced resins/composites were examined by SEM/TEM. Impregnation of small mass fractions (1% and 2.5%) of nano FS into Bis-GMA/TEGDMA (50/50 mass ratio) dental resins/composites improved the mechanical properties substantially. Larger mass fraction of impregnation (7.5%), however, did not further improve the mechanical properties (one way ANOVA, P>0.05) and may even reduce the mechanical properties. The high degree of separation and uniform distribution of nano FS into dental resins/composites was a challenge. Impregnation of nano FS into dental resins/composites could result in two opposite effects: a reinforcing effect due to the highly separated and uniformly distributed nano FS single crystals, or a weakening effect due to the formation of FS agglomerates/particles. Uniform distribution of highly separated nano FS single crystals into dental resins/composites could significantly improve the mechanical properties of the resins/composites.

Atraumatic restorative treatment and minimal intervention dentistry.

PubMed

Frencken, J E

2017-08-11

Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and fill' treatments and embrace the holistic oral healthcare approach that is minimal intervention dentistry (MID) and includes within it minimally invasive operative skills. Dental caries is, after all, a preventable disease. The atraumatic restorative treatment (ART) concept is an example of MID. ART consists of a preventive (ART sealant) and a restorative (ART restoration) component. ART sealants using high-viscosity glass-ionomer (HVGIC) have a very high dentine carious lesion preventive effect. The survival rate of these sealants is not significantly different from that of sealants produced with resin. The survival rate of ART/HVGIC restorations matches those of amalgam and resin composite in single- and multiple-surface cavities in primary teeth and in single-surface cavities in permanent teeth. The principles of carious tissue removal within a cavity recommended by the International Caries Consensus Collaboration are in line with those of treating a cavity using ART. Owing to its good performance and the low levels of discomfort/pain and dental anxiety associated with it, ART and/or other evidence-based atraumatic care procedures should be the first treatment for a primary dentine carious lesion. Only if the use of ART is not indicated should other more invasive and less-atraumatic care procedures be used in both primary and permanent dentitions.

A resin composite material containing an eugenol derivative for intracanal post cementation and core build-up restoration.

PubMed

Almaroof, A; Rojo, L; Mannocci, F; Deb, S

2016-02-01

To formulate and evaluate new dual cured resin composite based on the inclusion of eugenyl methacrylate monomer (EgMA) with Bis-GMA/TEGDMA resin systems for intracanal post cementation and core build-up restoration of endodontically treated teeth. EgMA was synthesized and incorporated at 5% (BTEg5) or 10% (BTEg10) into dual-cure formulations. Curing properties, viscosity, Tg, radiopacity, static and dynamic mechanical properties of the composites were determined and compared with Clearfil™DC Core-Plus, a commercial dual-cure, two-component composite. Statistical analysis of the data was performed with ANOVA and the Tukey's post-hoc test. The experimental composites were successfully prepared, which exhibited excellent curing depths of 4.9, 4.7 and 4.2 mm for BTEg0, BTEg5 and BTEg10 respectively, which were significantly higher than Clearfil™DC. However, the inclusion of EgMA initially led to a lower degree of cure, which increased when measured at 24 h with values comparable to formulations without EgMA, indicating post-curing. The inclusion of EgMA also lowered the polymerization exotherm thereby reducing the potential of thermal damage to host tissue. Both thermal and viscoelastic analyses confirmed the ability of the monomer to reduce the stiffness of the composites by forming a branched network. The compressive strength of BTEg5 was significantly higher than the control whilst flexural strength increased significantly from 95.9 to 114.8 MPa (BTEg5) and 121.9 MPa (BTEg10). Radiopacity of the composites was equivalent to ∼3 mm Al allowing efficient diagnosis. The incorporation of EgMA within polymerizable formulations provides a novel approach to prepare reinforced resin composite material for intracanal post cementation and core build-up and the potential to impart antibacterial properties of eugenol to endodontic restorations. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Dental plaque microcosm biofilm behavior on calcium phosphate nanocomposite with quaternary ammonium.

PubMed

Cheng, Lei; Weir, Michael D; Zhang, Ke; Wu, Eric J; Xu, Sarah M; Zhou, Xuedong; Xu, Hockin H K

2012-08-01

Half of dental restorations fail in 10 years, with secondary caries as the main reason. Calcium phosphate composites could remineralize tooth lesions. The objectives of this study were to: (1) impart antibacterial activity to a composite with nanoparticles of amorphous calcium phosphate (NACP); and (2) investigate the effect of quaternary ammonium dimethacrylate (QADM) on mechanical and dental plaque microcosm biofilm properties for the first time. The NACP and glass particles were filled into a dental resin that contained bis(2-methacryloyloxy-ethyl) dimethyl-ammonium bromide, the QADM. NACP nanocomposites containing 0%, 7%, 14%, and 17.5% of QADM by mass, respectively, were photo-cured. A commercial composite with no antibacterial activity was used as control. Mechanical properties were measured in three-point flexure. A human saliva microcosm model was used to grow biofilms on composites. Live/dead assay, metabolic activity, colony-forming unit (CFU) counts, and lactic acid production of biofilms on the composites were measured. Increasing QADM mass fraction monotonically reduced the biofilm viability, CFU and lactic acid. Biofilms on NACP nanocomposite with 17.5% QADM had metabolic activity that was 30% that on a commercial composite control (p<0.05). Total microorganisms, total streptococci, and mutans streptococci CFU counts (mean ± sd; n = 6) on composite control was 6-fold those on NACP +17.5% QADM nanocomposite. Composite control had long strings of bacterial cells with normal short-rod shapes, while some cells on NACP-QADM nanocomposites disintegrated into pieces. Adding QADM to NACP did not decrease the composite strength and elastic modulus, which matched (p>0.1) those of a commercial composite without Ca-PO(4) or antibacterial activity. A dental plaque microcosm model was used to evaluate the novel NACP-QADM nanocomposite. The nanocomposite greatly reduced the biofilm viability, metabolic activity and lactic acid, while its mechanical properties

Two-year clinical comparison of a flowable-type nano-hybrid composite and a paste-type composite in posterior restoration.

PubMed

Hirata-Tsuchiya, Shizu; Yoshii, Shinji; Ichimaru-Suematsu, Miki; Washio, Ayako; Saito, Noriko; Urata, Mariko; Hanada, Kaori; Morotomi, Takahiko; Kitamura, Chiaki

2017-08-01

The purpose of the present study was to compare the clinical efficacy between a flowable-type nano-hybrid composite and a paste-type composite for posterior restoration. Of 62 posterior teeth in 33 patients (mean age: 34.1 years), 31 were filled with a paste-type composite (Heliomolar [HM] group), and another 31 with a flowable nano-hybrid composite (MI FIL [MI] group). Clinical efficacy was evaluated at 2 years after the restoration. There were no differences for retention, surface texture deterioration, anatomical form change, deterioration of marginal adaptation, and secondary caries, while a statistical difference was found for marginal discoloration, which was significantly greater in the HM group (P < 0.05). Furthermore, color matching in the MI group was superior to that in the HM group immediately after the restoration throughout the study period. The present 2-year clinical evaluation of different composites showed that the flowable nano-hybrid composite could be an effective esthetic material for posterior restoration. © 2016 John Wiley & Sons Australia, Ltd.

The effect of short fiber composite base on microleakage and load-bearing capacity of posterior restorations

PubMed Central

Garoushi, Sufyan K.; Hatem, Marwa; Lassila, Lippo V. J.; Vallittu, Pekka K.

2015-01-01

Abstract Objectives: To determine the marginal microleakage of Class II restorations made with different composite base materials and the static load-bearing capacity of direct composite onlay restorations. Methods: Class II cavities were prepared in 40 extracted molars. They were divided into five groups (n = 8/group) depending on composite base material used (everX Posterior, SDR, Tetric EvoFlow). After Class II restorations were completed, specimens were sectioned mid-sagitally. For each group, sectioned restorations were immersed in dye. Specimens were viewed under a stereo-microscope and the percentage of cavity leakage was calculated. Ten groups of onlay restorations were fabricated (n = 8/group); groups were made with composite base materials (everX Posterior, SDR, Tetric EvoFlow, Gradia Direct LoFlo) and covered by 1 mm layer of conventional (Tetric N-Ceram) or bulk fill (Tetric EvoCeram Bulk Fill) composites. Groups made only from conventional, bulk fill and short fiber composites were used as control. Specimens were statically loaded until fracture. Data were analyzed using ANOVA (p = 0.05). Results: Microleakage of restorations made of plain conventional composite or short fiber composite base material showed statistically (p < 0.05) lower values compared to other groups. ANOVA revealed that onlay restorations made from short fiber-reinforced composite (FRC) as base or plain restoration had statistically significant higher load-bearing capacity (1593 N) (p < 0.05) than other restorations. Conclusion: Restorations combining base of short FRC and surface layer of conventional composite displayed promising performance related to microleakage and load-bearing capacity. PMID:28642894

Esthetic restorative materials and opposing enamel wear.

PubMed

Olivera, Anna Belsuzarri; Marques, Márcia Martins

2008-01-01

This in vitro study compared the effects of a gold alloy (Degulor M), four dental ceramics (IPS Empress, IPS Empress 2, Duceram Plus, Duceram LFC) and a laboratory-processed composite (Targis) on the wear of human enamel. The amount of wear of the enamel (dental cusps) and restorative materials (disks) were tested in water at 37 degrees C under standard load (20 N), with a chewing rate of 1.3 Hz and was determined after 150,000 and 300,000 cycles. Before the test, the average surface roughness of the restorative materials was analyzed using the Ra parameter. The results of this study indicate that Targis caused enamel wear similar to Degulor M and resulted in significantly less wear than all the ceramics tested. IPS Empress provoked the greatest amount of enamel wear and Degulor M caused less vertical dimension loss. Targis could be an appropriate alternative material to ceramic, because it is esthetic and produces opposing enamel wear comparable to gold alloy.

Failure analysis of various monolithic posterior aesthetic dental crowns using finite element method

NASA Astrophysics Data System (ADS)

Porojan, Liliana; Topală, Florin

2017-08-01

The aim of the study was to assess the effect of material stiffness and load on the biomechanical performance of the monolithic full-coverage posterior aesthetic dental crowns using finite element analysis. Three restorative materials for monolithic dental crowns were selected for the study: zirconia; lithium disilicate glass-ceramic, and resin-based composite. Stresses were calculated in the crowns for all materials and in the teeth structures, under different load values. The experiments show that dental crowns made from all this new aesthetic materials processed by CAD/CAM technologies would be indicated as monolithic dental crowns for posterior areas.

Dental plaque microcosm biofilm behavior on calcium phosphate nanocomposite with quaternary ammonium

PubMed Central

Cheng, Lei; Weir, Michael D.; Zhang, Ke; Wu, Eric; Xu, Sarah M.; Zhou, Xuedong; Xu, Hockin H. K.

2012-01-01

Objectives Half of dental restorations fail in 10 years, with secondary caries as the main reason. Calcium phosphate composites could remineralize tooth lesions. The objectives of this study were to: (1) Impart antibacterial activity to a composite with nanoparticles of amorphous calcium phosphate (NACP); and (2) investigate the effect of quaternary ammonium dimethacrylate (QADM) on mechanical and dental plaque microcosm biofilm properties for the first time. Methods The NACP and glass particles were filled into a dental resin that contained bis(2-methacryloyloxy-ethyl) dimethyl-ammonium bromide, the QADM. NACP nanocomposites containing 0%, 7%, 14%, and 17.5% of QADM by mass, respectively, were photo-cured. A commercial composite with no antibacterial activity was used as control. Mechanical properties were measured in three-point flexure. A human saliva microcosm model was used to grow biofilms on composites. Live/dead assay, metabolic activity, colony-forming unit (CFU) counts, and lactic acid production of biofilms on the composites were measured. Results Increasing QADM mass fraction monotonically reduced the biofilm viability, CFU and lactic acid. Biofilms on NACP nanocomposite with 17.5% QADM had metabolic activity that was 30% that on a commercial composite control (p<0.05). Total microorganisms, total streptococci, and mutans streptococci CFU counts (mean±sd; n=6) on composite control was 6-fold those on NACP+17.5% QADM nanocomposite. Composite control had long strings of cells with normal short-rod shapes, while some cells on NACP-QADM nanocomposites disintegrated into pieces. Adding QADM to NACP did not decrease the strength and elastic modulus, which matched (p>0.1) those of a commercial composite without Ca-PO4 or antibacterial activity. Significance A dental plaque microcosm model was used to evaluate the novel NACP-QADM nanocomposite. The nanocomposite greatly reduced the biofilm viability, metabolic activity and lactic acid, while its mechanical

Fluoride-releasing restorative materials and secondary caries.

PubMed

Hicks, John; Garcia-Godoy, Franklin; Donly, Kevin; Flaitz, Catherine

2003-03-01

Secondary caries is responsible for 60 percent of all replacement restorations in the typical dental practice. Risk factors for secondary caries are similar to those for primary caries development. Unfortunately, it is not possible to accurately predict which patients are at risk for restoration failure. During the past several decades, fluoride-releasing dental materials have become a part of the dentist's armamentarium. Considerable fluoride is released during the setting reaction and for periods up to eight years following restoration placement. This released fluoride is readily taken up by the cavosurface tooth structure, as well as the enamel and root surfaces adjacent to the restoration. Resistance against caries along the cavosurface and the adjacent smooth surface has been shown in both in vitro and in vivo studies. Fluoride-releasing dental materials provide for improved resistance against primary and secondary caries in coronal and root surfaces. Plaque and salivary fluoride levels are elevated to a level that facilitates remineralization. In addition, the fluoride released to dental plaque adversely affects the growth of lactobacilli and mutans streptococci by interference with bacterial enzyme systems. Fluoride recharging of these dental materials is readily achieved with fluoridated toothpastes, fluoride mouthrinses, and other sources of topical fluoride. This allows fluoride-releasing dental materials to act as intraoral fluoride reservoirs. The improvement in the properties of dental materials with the ability to release fluoride has improved dramatically in the past decade, and it is anticipated that in the near future the vast majority of restorative procedures will employ fluoride-releasing dental materials as bonding agents, cavity liners, luting agents, adhesives for orthodontic brackets, and definitive restoratives.

Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review.

PubMed

Azeem, Rubeena Abdul; Sureshbabu, Nivedhitha Malli

2018-01-01

Composite resin, serves as esthetic alternative to amalgam and cast restorations. Posterior teeth can be restored using direct or indirect composite restorations. The selection between direct and indirect technique is a clinically challenging decision-making process. Most important influencing factor is the amount of remaining tooth substance. The aim of this systematic review was to compare the clinical performance of direct versus indirect composite restorations in posterior teeth. The databases searched included PubMed CENTRAL (until July 2015), Medline, and Cochrane Database of Systematic Reviews. The bibliographies of clinical studies and reviews identified in the electronic search were analyzed to identify studies which were published outside the electronically searched journals. The primary outcome measure was evaluation of the survival of direct and indirect composite restorations in posterior teeth. This review included thirteen studies in which clinical performance of various types of direct and indirect composite restorations in posterior teeth were compared. Out of the thirteen studies which were included seven studies had a high risk of bias and five studies had a moderate risk of bias. One study having a low risk of bias, concluded that there was no significant difference between direct and indirect technique. However, the available evidence revealed inconclusive results. Further research should focus on randomized controlled trials with long term follow-up to give concrete evidence on the clinical performce of direct and indirect composite restorations.

Evaluating the Marginal Integrity of Bulk Fill Fibre Reinforced Composites in Bio-mimetically Restored Tooth.

PubMed

Patnana, Arun Kumar; Vanga, V Narsimha Rao; Chandrabhatla, Srinivas Kumar

2017-06-01

Over the past years, composites in aesthetic dentistry are showing a considerable progress, but mechanical strength and polymerization shrinkage are the two main drawbacks, which limit their use in high stress bearing areas. To evaluate the marginal integrity of short glass fibre reinforced composite restorations, fibre reinforced composites with composite superficial layer, and fibre reinforced composites with underlying flowable composite layer. This study was done on twenty eight sound premolar teeth with standardized class V cavities restored under four groups as Group I: Particulate filler composite (Filtek Z 250 XT, 3M ESPE); Group II: Short glass fibre reinforced composite (everX Posterior, GC); Group III: Short glass fibre reinforced composite with an overlying layer of particulate filler composite; Group IV: Short glass fibre reinforced composite with an underlying layer of flowable composite (Filtek Z 250 XT, 3M ESPE). Test samples were immersed in a 2% methylene blue dye for 24 hours at 37°C and each tooth was sectioned bucco-lingually. Staining along the tooth restoration interface was recorded and results were analysed statistically using Independent sample t-test and Tukey's post-hoc one-way ANOVA. The results showed significant difference in the dye penetration between the restorative materials in the occlusal and gingival margins (p=0.02). Short fibre reinforced composites showed a statistically significant difference in the microleakage scores when compared with the particulate filler composites (p=0.01). Short glass fibre reinforced composite restorations showed an improved marginal integrity when compared to the traditional particulate filler composite restorations.

New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations

PubMed Central

Romero, Luis; Jiménez, Mariano; Espinosa, María del Mar; Domínguez, Manuel

2015-01-01

Aim This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system. Method From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data. Results Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants. PMID:26696528

New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations.

PubMed

Romero, Luis; Jiménez, Mariano; Espinosa, María Del Mar; Domínguez, Manuel

2015-01-01

This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system. From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data. Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants.

Towards long lasting zirconia-based composites for dental implants: Transformation induced plasticity and its consequence on ceramic reliability.

PubMed

Reveron, Helen; Fornabaio, Marta; Palmero, Paola; Fürderer, Tobias; Adolfsson, Erik; Lughi, Vanni; Bonifacio, Alois; Sergo, Valter; Montanaro, Laura; Chevalier, Jérôme

2017-01-15

Zirconia-based composites were developed through an innovative processing route able to tune compositional and microstructural features very precisely. Fully-dense ceria-stabilized zirconia ceramics (84vol% Ce-TZP) containing equiaxed alumina (8vol%Al 2 O 3 ) and elongated strontium hexa-aluminate (8vol% SrAl 12 O 19 ) second phases were obtained by conventional sintering. This work deals with the effect of the zirconia stabilization degree (CeO 2 in the range 10.0-11.5mol%) on the transformability and mechanical properties of Ce-TZP-Al 2 O 3 -SrAl 12 O 19 materials. Vickers hardness, biaxial flexural strength and Single-edge V-notched beam tests revealed a strong influence of ceria content on the mechanical properties. Composites with 11.0mol% CeO 2 or above exhibited the classical behaviour of brittle ceramics, with no apparent plasticity and very low strain to failure. On the contrary, composites with 10.5mol% CeO 2 or less showed large transformation-induced plasticity and almost no dispersion in strength data. Materials with 10.5mol% of ceria showed the highest values in terms of biaxial bending strength (up to 1.1GPa) and fracture toughness (>10MPa√m). In these ceramics, as zirconia transformation precedes failure, the Weibull modulus was exceptionally high and reached a value of 60, which is in the range typically reported for metals. The results achieved demonstrate the high potential of using these new strong, tough and stable zirconia-based composites in structural biomedical applications. Yttria-stabilized (Y-TZP) zirconia ceramics are increasingly used for developing metal-free restorations and dental implants. Despite their success related to their excellent mechanical resistance, Y-TZP can undergo Low Temperature Degradation which could be responsible for restoration damage or even worst the failure of the implant. Current research is focusing on strategies to improve the LTD resistance of Y-TZP or to develop alternative composites with better

Methicillin-resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes.

PubMed

Hall, David L

2003-01-01

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in nursing home residents now averages 20-35%. This includes both numerous asymptomatic mostly unidentified carriers, and the occasional patient with an active infection. Among the most common sites for positive MRSA colonization are the nares and mouth (saliva). Ohio State University (OSU) dental students perform routine restorative dental care onsite in local nursing homes using portable equipment including handpieces that can generate aerosols. Using a series of cultured test swabs and plates, this pilot study suggests that protection for both dental health care personnel and patients are provided by the following: 1. universal barrier precautions (for example, gloves, gowns, masks, hats, facial shields, glasses), 2. surface disinfectants, 3. pre-op 0.12% chlorhexidene mouth rinses, 4. high volume evacuation, 5. perioral skin scrubs. Additional infection control methods, techniques and equipment were evaluated and compared including rubber dam isolation, hand excavation and bond technique, high-speed air turbine and electric "high" speed handpiece. There was no indication of a special tendency or heightened ability of MRSA to aerosolize.

Macroinvertebrate Taxonomic and Functional Trait Compositions within Lotic Habitats Affected By River Restoration Practices

NASA Astrophysics Data System (ADS)

White, J. C.; Hill, M. J.; Bickerton, M. A.; Wood, P. J.

2017-09-01

The widespread degradation of lotic ecosystems has prompted extensive river restoration efforts globally, but many studies have reported modest ecological responses to rehabilitation practices. The functional properties of biotic communities are rarely examined within post-project appraisals, which would provide more ecological information underpinning ecosystem responses to restoration practices and potentially pinpoint project limitations. This study examines macroinvertebrate community responses to three projects which aimed to physically restore channel morphologies. Taxonomic and functional trait compositions supported by widely occurring lotic habitats (biotopes) were examined across paired restored and non-restored (control) reaches. The multivariate location (average community composition) of taxonomic and functional trait compositions differed marginally between control and restored reaches. However, changes in the amount of multivariate dispersion were more robust and indicated greater ecological heterogeneity within restored reaches, particularly when considering functional trait compositions. Organic biotopes (macrophyte stands and macroalgae) occurred widely across all study sites and supported a high alpha (within-habitat) taxonomic diversity compared to mineralogical biotopes (sand and gravel patches), which were characteristic of restored reaches. However, mineralogical biotopes possessed a higher beta (between-habitat) functional diversity, although this was less pronounced for taxonomic compositions. This study demonstrates that examining the functional and structural properties of taxa across distinct biotopes can provide a greater understanding of biotic responses to river restoration works. Such information could be used to better understand the ecological implications of rehabilitation practices and guide more effective management strategies.

Influence of light polymerization modes on degree of conversion and crosslink density of dental composites.

PubMed

da Silva, Eduardo Moreira; Poskus, Laiza Tatiana; Guimarães, José Guilherme Antunes; de Araújo Lima Barcellos, Alexandre; Fellows, Carlos Eduardo

2008-03-01

This study analyzed the influence of light polymerization modes on crosslink density (CD) and the degree of conversion (DC) of dental composites. A minifilled hybrid and a nanofilled dental composite were photoactivated with two light polymerization modes: Conventional-850 mW/cm2 for 20 s and Gradual-50 up to 1,000 mW/cm2 for 10 s+1,000 mW/cm2 for 10 s. DC was determined by the use of FT-Raman-spectrometer. A softening test, using Knoop diamond indentation, was carried out at the top and bottom of 2 mm thick dental composite disks, before and after storage in 100% ethanol for 24 h, in order to represent the amount of crosslink density. Data were analyzed by ANOVA and Student-Newman-Keuls' multiple range test (alpha=0.05). The DC was influenced by light polymerization modes, with Gradual mode presenting lower DC. On bottom surfaces, the nanofilled dental composite was more susceptible to softening by ethanol than minifilled hybrid, and gradual light polymerization of nanofilled dental composite resulted in more softening than when conventional light polymerization was used. The results suggest that nanofilled composites are capable undergoing more plasticization if applied in thick increments.

Antimicrobial properties of conventional restorative filling materials and advances in antimicrobial properties of composite resins and glass ionomer cements-A literature review.

PubMed

Farrugia, Cher; Camilleri, Josette

2015-04-01

It has been reported that complete caries removal from cavities during restoration of teeth is difficult. Furthermore with the tissue saving approach it is expected that more of the saved affected tissue will possibly harbor more residual bacteria. Antimicrobial restorative filling materials would be ideal to prevent the spread of caries after completion of tooth restoration, thus preventing recurrent decay and eventually restoration failure. This paper reviews the literature on the antimicrobial properties of dental restorative filling materials. Pubmed searches on the antibacterial properties of restorative materials were carried out. Keywords were chosen to assess antibacterial properties of conventional filling materials. Methods of introducing antimicrobial agents in restorative materials were also reviewed together with the methodology used to assess antimicrobial activity. 174 articles from 1983 till 2014 were included. Adhesive materials have decreased antimicrobial activity when compared to amalgams and zinc oxides. Several techniques have been employed in order to increase the antimicrobial activity of restorative materials. Although antimicrobial activity of restorative materials is important, the introduction of antimicrobial agents/techniques should not be at the expense of other material properties. Environmental changes within a material may affect the bacterial response to the antimicrobial. Bacterial adhesion to the restorative materials should be assessed. Long term assessment of antimicrobial activity is important and is clinically relevant. The use of antimicrobial dental materials is important unless such characteristics are gained to the detriment of other material properties. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Mechanical properties of experimental composites with different calcium phosphates fillers.

PubMed

Okulus, Zuzanna; Voelkel, Adam

2017-09-01

Calcium phosphates (CaPs)-containing composites have already shown good properties from the point of view of dental restorative materials. The purpose of this study was to examine the crucial mechanical properties of twelve hydroxyapatite- or tricalcium phosphate-filled composites. The raw and surface-treated forms of both CaP fillers were applied. As a reference materials two experimental glass-containing composites and one commercial dental restorative composite were applied. Nano-hardness, elastic modulus, compressive, flexural and diametral tensile strength of all studied materials were determined. Application of statistical methods (one-way analysis of variance and cluster agglomerative analysis) allowed for assessing the similarities between examined materials according to the values of studied parameters. The obtained results show that in almost all cases the mechanical properties of experimental CaPs-composites are comparable or even better than mechanical properties of examined reference materials. Copyright © 2017 Elsevier B.V. All rights reserved.

Minimally invasive restoration of a maxillary central incisor with a partial veneer.

PubMed

Horvath, Sebastian; Schulz, Claus-Peter

2012-01-01

Minimally invasive treatment modalities allow for the preservation of sound tooth substance. However, by limiting the preparation to the extent of a defect, the transition between restoration and natural tooth may be moved to more visible areas. The materials available for the restoration of a limited defect in the anterior area are either resin composite materials or porcelain. A patient was presented who asked for the replacement of a discolored filling on the maxillary right central incisor. Tooth preparation was limited to the extent of the old filling, and a porcelain partial veneer restoration was fabricated. Despite the horizontal finish line in the middle of the clinical crown, a result could be achieved that was regarded as a success by the patient. This type of restoration proves to be a suitable alternative to direct composite restorations in the anterior area for the reconstruction of a limited defect, eg, due to a dental trauma.

[Clinical observation of using composite resin to fill dental attrition on occlusal surface].

PubMed

Guo, Li-juan; Xu, Yan; Chen, Guang-quan

2005-10-01

The purpose of this study was to evaluate the clinical effect of using composite resin to fill dental attrition on occlusal surface. Whether the dental attrition had enough space to the material was determined first. Sometimes grinding the sharp and steep cusps or ridges of the opposite teeth was needed. Then the dental attrition was cleaned thoroughly, and finally filled with CLEARFIL bond and composite resin without preparing cavity. The follow-up period was 1 year. Out of 70 teeth from 25 patients, 52 were successful, 16 were curative, and 2 were failed. The curative rate was 97.14%. The method avoids endangering the dental pulp. It was easily accepted by the patients and operated by dentists, and can be widely applied in clinical cases.

Conservative reconstruction of the smile by orthodontic, bleaching, and restorative procedures

PubMed Central

Sundfeld, Renato Herman; Machado, Lucas Silveira; de Oliveira, Fernanda Garcia; Santos, Eduardo Almada; Lugato, Isabel Cristina Prado Torres; Sundfeld Neto, Daniel

2012-01-01

The following is a clinical case report of a patient whose chief complaint was the presence of generalized spacing in the maxillary anterior segment following orthodontic treatment. After meticulous clinical analyses and discussions of the clinical procedures to be adopted, dental bleaching was performed in both arches with 10% hydrogen peroxide (Opalescence Trèswhite Supreme 10% Hydrogen Peroxide - Ultradent Products, Inc., South Jordan, USA) after the conclusion and stabilization of orthodontic treatment. Then, the orthodontic appliance was removed and the diastemas in the maxillary anterior teeth were closed with Amelogen Plus (Ultradent Products, Inc., South Jordan, USA) resin composite. It was observed that the association of orthodontic, bleaching, and restorative procedures was capable of restoring dental shape, function, and esthetics, allowing the patient to smile without hesitation. PMID:22229015

Severe tetracycline dental discoloration: Restoration with conventional feldspathic ceramic veneers. A clinical report.

PubMed

Faus-Matoses, Vicente; Faus-Matoses, Ignacio; Ruiz-Bell, Esther; Faus-Llácer, Vicente J

2017-11-01

The treatment of severe tetracycline discoloration is a challenge for the dentist. There are several treatment options and one of the most effective is the use of feldspathic veneers. The aim of this clinical case was to carry out the replacement with conventional feldspathic ceramic veneers on a patient with highly stained teeth (grade IV tetracycline) by a minimally invasive approach. Clinical examination revealed gingival retraction, color change of the veneers, ceramic cracked of 1.1 and 1.3 and incisal wear in lower anterior teeth. The decision was to retreat with feldspathic ceramic veneers from 1.6 to 2.6. Premolars and first molars were included because its dark color intensifies the width buccal corridors. Also, the restoration with veneers from 3.3 to 4.3 was considered. Firstly, the veneers were removed and the color was selected by the Vitapan 3D Master guide (Vita Zahnfabrick, Bad Säckingen, Germany). Mock-up was made to evaluate aesthetic, phonetic and functional parameters. Then, teeth were prepared through the mock-up in order to reduce the minimal amount of dental tissue possible. Opaque dentine mass of microhybrid composite (Esthet-X A2O, Dentsply Sirona, Konstanz, Germany) was placed to mask the most intense stains. The definitive impressions were taken with silicone (Aquasil Ultra XLV, Dentsply Sirona, Konstanz, Germany) were taken to fabricate conventional feldsphatic ceramic veneers (Noritake kisai Co, Ltd. Japan) by the parallel stratification masking technique. For cementing, an opaque cement was selected from the try-in tests (Calibra, Dentsply Sirona, Konstanz, Germany) and the composite was silicatized with an air-abrasion device. A favorable and minimally invasive result was achieved to treat grade IV tetracycline stains, surpassing the patient's aesthetic expectations and functional needs. Key words: Porcelain veneer, tetracycline teeth, minimally invasive, masking, opaque composite.

An approach to biomimetics: the natural CAD/CAM restoration: a clinical report.

PubMed

Schlichting, Luís Henrique; Schlichting, Kathryn Klemz; Stanley, Kyle; Magne, Michel; Magne, Pascal

2014-02-01

Those in the dental field have always pursued the perfect dental material for the treatment of compromised teeth. Gold, amalgam, composite resin, glass ionomer, and porcelain have been used. Tooth-like restorative materials (composite resin and porcelain) combined with an effective hard tissue bond have met the growing demand for esthetic or metal-free restorations in the past 15 to 20 years. However, none of those materials can fully mimic the unique properties of dentin (compliance and crack-stopping behavior) and enamel (wear resistance, function). The aim of this article is to report the restoration of an extensively damaged tooth with a natural restoration obtained by milling an extracted third molar tooth with a computer-aided design and computer-aided manufacturing (CAD/CAM) system. The main benefit of this novel technique is the replacement of lost tissues by actual enamel and dentin, with the potential to recover mechanical, esthetic, and biologic properties. The indication for extracting third molars and premolars because of impaction or for orthodontic reasons makes these posterior teeth readily available. The innovation of the method presented here is the optimal use of the extracted tooth substrate thanks to its positioning technique in the CAD/CAM milling chamber. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Factors affecting marginal integrity of class II bulk-fill composite resin restorations

PubMed Central

Savadi Oskoee, Siavash; Bahari, Mahmoud; Jafari Navimipour, Elmira; Ajami, Amir Ahmad; Ghiasvand, Negar; Savadi Oskoee, Ayda

2017-01-01

Background. Bulk-fill composite resins are a new type of resin-based composite resins, claimed to have the capacity to be placed in thick layers, up to 4 mm. This study was carried out to evaluate factors affecting gap formation in Cl II cavities restored using the bulk-fill technique. Methods. A total of 60 third molars were used in this study. Two Cl II cavities were prepared in each tooth, one on the mesial aspect 1 mm coronal to the CEJ and one on the distal aspect 1 mm apical to the CEJ. The teeth were divided into 4 groups: A: The cavities were restored using the bulk-fill technique with Filtek P90 composite resin and its adhesive system and light-cured with quartz tungsten halogen (QTH) light-curing unit. B: The cavities were restored similar to that in group A but light-cured with an LED light-curing unit. C: The cavities were restored using the bulk-fill technique with X-tra Fil composite resin and Clearfil SE Bond adhesive system and light-cured with a QTH curing unit. D: The cavities were restored similar to that in group C but light-cured with an LED light-curing unit. The gaps were examined under a stereomicroscope at ×60. Data were analyzed with General Linear Model test. In cases of statistical significance (P<0.05), post hoc Bonferroni test was used for further analyses. Results. The light-curing unit type had no effect on gap formation. However, the results were significant in relation to the composite resin type and margin location (P<0.001). The cumulative effects of light-curing unit*gingival margin and light-curing unit*composite resin type were not significant; however, the cumulative effect of composite rein type*gingival margin was significant (P=0.04) Conclusion. X-tra Fil composite exhibited smaller gaps compared with Filtek P90 composite with both light-curing units. Both composite resins exhibited smaller gaps at enamel margins. PMID:28748051

Considerations Regarding the Optical Properties of the Composite Resin Restorative Materials

PubMed Central

Manolea, H.; Râcă, R.; Coleş, Evantia; Preotu, Gabriela; Mărăşescu, P.

2011-01-01

The purpose of this study has been to investigate the effects of certain substances frequently used in alimentation on the color stability of the composite resin restorative materials. The research hypothesis was that color stability of the composite resin is affected by the type of composite material used and by the polishing procedure. 14 samples of 5X15X2mm have been prepared from seven universal light curing restorative composite resins. The materials have manipulated and cured using LA 500 Blue Light lamp. A first color determination was done before the introduction of the samples in the dyeing agent with the help of an Easy Shade device. The samples have been splited into two lots each with seven samples. The samples from the first lot have been sectioned into three equal segments. The samples from the second lot have also been sectioned into three equal segments, and in addition to the previous group, their exterior surfaces were processed with a diamond burr. For each type of composite we have introduced a sample in one of the three chosen dyes: red alimentary colorant, coffee and red wine. The color of the samples has been determined again using the Vita Easy Shade device. From clinical point of view the results of this study shows that there are three important factors that matter when we talk about durable aesthetic results: the type of composite resin used for the restoration, the finishing and polishing procedures and the pacients’ alimentation habits. The composite resins with a good representation of the anorganic structure are easier to be polished, therefore they have only slight color modifications. Using plastic matrixes for shaping the exterior surface of the restoration is the best solution for obtaining a very smooth surface. The most significant color modifications have been done by the red wine. Coffee and to a smaller extent the red alimentary colorant have modified the color of the restoration material in a smaller degree. PMID:24778835

Dental caries experience and use of dental services among Brazilian prisoners.

PubMed

Cavalcanti, Alessandro Leite; Rodrigues, Iris Sant Anna Araujo; de Melo Silveira, Ingrid Thays; de Oliveira, Thaliny Batista Sarmento; de Almeida Pinto, Magaly Suenya; Xavier, Alidianne Fabia Cabral; de Castro, Ricardo Dias; Padilha, Wilton Wilney Nascimento

2014-11-25

This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, and oral health impacts were investigated. The mean DMFT index value was 19.72. Of the components, the decayed component showed the highest mean value (11.06 ± 5.37). Statistically significant association was found between DMFTs with values from 22 to 32 and oral health satisfaction (p = 0.002), difficulty speaking (p = 0.024), shame of talking (p = 0.004) and smiling (p < 0.001). Regarding the use of dental services, 80% had their last dental appointment less than one year ago, with most visits occurring in prison (80%), with restorative treatment (32%), followed by dental pain (26.4%), being the main reasons for such appointments. Most prisoners used dental services provided by the prison. Although restorative treatment has been the main reason for the use of dental services, "decayed" and "missing" components contributed to the high mean DMFT index.

Dental Caries Experience and Use of Dental Services among Brazilian Prisoners

PubMed Central

Leite Cavalcanti, Alessandro; Araujo Rodrigues, Iris Sant´Anna; de Melo Silveira, Ingrid Thays; Sarmento de Oliveira, Thaliny Batista; de Almeida Pinto, Magaly Suenya; Cabral Xavier, Alidianne Fabia; Dias de Castro, Ricardo; Nascimento Padilha, Wilton Wilney

2014-01-01