New direct restorative materials. FDI Commission Project

Comparative Assessment of Marginal Micro Leakage of Different Esthetic Restorative Materials Used on Primary Teeth: An In-vitro Study

AIM

The aim of the current investigation was to evaluate the marginal microleakage of various esthetic restorative materials applied to primary teeth.

MATERIALS AND METHODS

A total of 75 noncarious primary molars that were removed for orthodontic intervention and teeth nearing exfoliation were chosen. One millimeter (mm) above the cementoenamel junction, on the buccal surface of the teeth, Class V cavities were prepared. William's graded periodontal probe was used to standardize cavity preparation on all teeth. 3 mm was the cavity's length, 2 mm in width, and 2 mm in depth. The teeth were then divided into three groups (25 samples in each group) according to the type of esthetic restorative material used. Group I: Resin-modified glass ionomer cement, Group II: Ormocer, Group III: Giomer. The samples underwent 500 cycles of thermocycling, with an immersion time of 60 seconds and a well time of 15 seconds, between 5 and 55°C. The samples were submerged in methylene blue dye for 24 hours at room temperature and dried. The samples were then divided into sections and examined with a stereomicroscope. Data was recorded and statistically analyzed.

RESULTS

The least marginal microleakage was found in the ormocer group (1.22 ± 0.01) followed by resin-modified glass ionomer cement group (1.31 ± 0.07) and the giomer group (1.78 ± 0.03). There was a highly statistically significant difference found between resin-modified glass ionomer cement group and the ormocer group, resin-modified glass ionomer cement group and giomer group. And no significant difference was found between the ormocer group and the giomer group.

CONCLUSION

The present study concluded that there was some amount of microleakage in primary teeth in all restorative materials examined in this in-vitro investigation. However, the marginal sealing ability of ormocer was found highest compared to resin-modified glass ionomer cement and Giomer materials.

CLINICAL SIGNIFICANCE

The primary reason dental restorations fail, particularly in Class V cavities, is microleakage since the margins of these restorations are typically found in the dentin or cementum. Assessing microleakage is a crucial step in determining the marginal integrity of restorative materials. Developing methods and resources that reduce the adverse effects caused by the restorative marginal seal failing would benefit from this. How to cite this article: Al Ghwainem A, Alqarni AS. Comparative Assessment of Marginal Micro Leakage of Different Esthetic Restorative Materials Used on Primary Teeth: An In-vitro Study. J Contemp Dent Pract 2024;25(1):58-61.

Morphological Interface Between Restorative and Pulp-Capping Materials: A Systematic Review

Background

Bioceramic materials (BCMs) are widely used in vital pulp therapy (VPT) for their biocompatibility and bioactivity; however, their mechanical properties are equally important in the clinical outcome of the pulp-capped teeth.

Objective

To carry out an analysis of the research produced on the morphology of the interface between BM and restorative materials (RM) through a systematic review.

Methodology

An electronic search was performed in Scopus, PubMed, and Web of Science until December 9, 2022. The keywords used in combination with truncation and Boolean operators were: (morphology OR filtration OR porosity) AND (silicate OR composite) AND (cement) AND ("pulp capping" OR "vital pulp therapy" OR "vital pulp treatment").

Results

Of the 387 articles initially retrieved from the electronic search databases, 5 articles met the criteria for qualitative data collection. MTA and Biodentine were the most studied BCMs. All the articles used a scanning electron microscope as a method of evaluating the samples. Sample sizes and setting times of RM and BCMs differed between studies. Three out of 5 studies used similar conditions of recorded temperature and humidity of 37°C and 100%, respectively.

Conclusion

The different biomaterials used, the application of adhesive systems, humidity and restoration time affect the bonding performance and the ultrastructural interface between BCMs and RMs. The scarcity of research on this point makes it necessary to delve into it and study new materials to obtain more scientific evidence.

Evaluating the Mechanical Properties of Restorative Glass Ionomers Cements

OBJECTIVE

The aim of this research was to assess the efficiency of 4 restorative glass ionomer cements (GICs): Fuji IX (GC), ChemFil Rock (DENSPLY), Riva Self-Cure (SDI), and Ketac Nano (3M ESPE).

MATERIALS AND METHODS

The 4 restorative glass ionomers' diametral tensile and compressive strengths were evaluated at room temperature for 24 hours and then stored in distilled water. The universal testing machine (INSTRON 5566A) was used to record the maximum load necessary to fracture specimens. Surface wear, diametral tensile strength, and compressive strength against dental ceramic were compared using analysis of variance followed by the Bonferroni method at a significance level of 0.05.

RESULTS

Ketac Nano and ChemFil Rock were found to have better diametral tensile strength than Riva Self-Cure and Fuji IX. The significant difference between ChemFil Rock and Fuji IX (P ≤ .005) and ChemFil Rock with Riva Self-Cure (P ≤ .005) was shown by post hoc analysis. Ketac Nano had better tensile strength than Riva Self-Cure and Fuji IX. Fuji IX showed the lowest material loss of the GICs as revealed by wear against VITABLOCS Mark II (VITA Zahnfabrik).

CONCLUSIONS

This study indicated a significant difference in the compressive strengths of ChemFil Rock and Riva Self-Cure. ChemFil Rock had the highest tensile strength. The diameter tensile strength of all 4 materials was statistically insignificant. Finally, Fuji IX had the least amount of material loss. ChemFil Rock was proven to be more effective than Fuji IX.

Effect of Aging on Surface Roughness and Color Stability of a Novel Alkasite in Comparison with Current Direct Restorative Materials

AIM

To compare the surface roughness and color stability of a novel alkasite with current direct restorative materials with and without an aging step.

METHODS AND MATERIALS

Twenty-six specimens of each of the following materials were prepared: alkasite, ormocer, giomer, high-viscosity glass ionomer, glass carbomer, and nanohybrid composite (control). Half of the specimens in each group were stained, the other half of the specimens were aged and then stained. Color and surface roughness evaluations were conducted at baseline, after aging and after staining, using a dental spectrophotometer, and a three-dimentional (3D) noncontact optical profilometer, respectively. Statistical analyses were completed using one-way analysis of variance, post hoc Tukey test, and paired samples t-test.

RESULTS

At baseline and after aging, the surface of alkasite was found to be rougher than nanohybrid composite and ormocer surfaces (p<0.05). However, in terms of roughness increase caused by aging, ormocer, nanohybrid composite, and alkasite were affected in a similar way (p>0.05). In terms of color stability, alkasite was more colored than nanohybrid composite and ormocer (p<0.05), and performed similar to giomer (p>0.05).

CONCLUSIONS

The surface roughness and color stability characteristics of alkasite material was between composite resins and glass ionomer-based materials after aging.

Influence of a new polishing system on changes in gloss and surface roughness of resin composites after polishing and brushing

This study aimed to compare the change of surface roughness (Ra) and gloss units (GU) of five dental composites (Filtek Z250, Filtek Z350XT, Metafil CX, Ceram X one, and Venus Diamond) polished with three systems (Sof-Lex XT, Enhance/Pogo, and Sof-Lex Diamond) before/after simulated brushings and to determine the amount of time required to achieve maximum gloss. Ninety rectangular specimens (n=18 per composite) were prepared. Six specimens of each composite were assigned to one of the polishing systems. The Ra and GU of each specimen were measured after each polishing step. Five polished specimens per composite were brushed with a toothbrush machine, and the Ra and GU values were determined. Filtek Z350XT exhibited the most stable and lowest Ra during the brushing cycles regardless of polishing system. When using the Sof-Lex Diamond and Enhance/Pogo systems, the highest gloss and the smoothest surfaces were achieved after polishing and brushing.

One-year clinical evaluation of two high-viscosity glass-ionomer cements in class II restorations of primary molars

BACKGROUND

Little information exists on the clinical performance of restorative materials on primary teeth of preschool children. This study aimed to evaluate clinical performance of compomer, glass-hybrid-added high-viscosity glass-ionomer cement and zinc-added high-viscosity glass-ionomer cement materials in class ΙΙ restorations of primary molars.

METHODS

The study included 251 teeth of 57 patients aged 4-7 years with proximal caries in primary molars. The teeth were divided into three groups, and each restorative material was randomly distributed. Dyract XP, Equia Forte and ChemFil Rock materials were placed after cavity preparation and clinically evaluated at 3, 6, 9 and 12 months using modified United States Public Health Service criteria. Statistical analyses were performed using chi-square and z tests.

RESULTS

At the end of 12 months, a total of three restorations in Dyract XP group, 22 in Equia Forte group and 11 in ChemFil Rock group failed in retention criteria. No statistically significant difference existed between retention, colour match and surface texture criteria of all groups at 3 and 6 months, but a statistically significant difference was found at 12 months (P < 0.05).

CONCLUSION

For class ΙΙ restorations of primary molars, the success of compomer material was superior to high-viscosity glass-ionomer materials.

Direct technique premolar coronal restorations: From metallic material to "complete adhesive restoration"

Introduction:

The choice of restorative materials has for a long time been determined by the tooth position. Thus, premolar restoration depended on the practitioner's clinical assessment and practical experience in regard to the material to be handled.

Aim:

The objective of this study was to assess, in the students' practice, the change in the choice of materials used for premolars restoration.

Materials and Methods:

This was a retrospective study based on the available care records in the department of conservative dentistry and endodontics of a dental school. Variables analyzed included the year of restoration, the type of material, the premolar position in the arch, and the coronal restoration site (occlusal, proximal, and cervical). Data collected were processed with the SPSS software version 22 (SPSS Inc., Chicago, IL, USA; 2013). The statistical significance threshold was set at 5% for Pearson's Chi-square test.

Results:

Between 1994 and 2017, 1738 restored premolars were identified. Over the years, amalgam restorations declined from 99.2% in 1994 to 1.3% in 2017, contrary to composite whose frequency increased from 0.6% to 88.6%. Maxillary premolars were exclusively restored with composite in 2017 when amalgam was still, somewhat, used for mandibular premolars.

Conclusion:

The reversal in the choice of materials in favor of composites reflects the global trend. This seems to be related to the current awareness of the prohibition, among others, of medical devices containing mercury.

In vitro wear of dual-cured bulkfill composites and flowable bulkfill composites

OBJECTIVES

The objective of this study is to test the wear of dual-cured bulkfill and flowable bulkfill composites.

MATERIALS AND METHODS

Six dual-cured bulkfill composites, Cention, Cention-Exp, Activa, Fill-up, Hyperfil Injectafill, and two flowable bulkfill composites Tetric Evoflow BulkFill and G-aenial Universal Flo were tested in this study (n = 8). Each composite was applied into an aluminum sample holder and cured with a Valo Grand (1230 mW/cm² ) or self-cured according to manufacturer's recommendations, and stored in water for 3 weeks. The samples were subjected to 120 000 load cycles of 49 N (CS-4) against spherical steatite antagonists and simultaneously subjected to 4440 thermocycles (5°C-55°C). At intervals between load cycles, polyvinyl siloxane impressions were taken and scanned with a True Definition Laser Scanner. The volumetric wear was calculated using image software (Geomagic). Microscopic images of selected wear facets and their corresponding worn antagonists were obtained using SEM. All data were analyzed using analysis of variance (ANOVA) and Tukey post hoc test for multiple comparison (α = .05; β = .2).

RESULTS

The load cycles volumetric wear-increase was linear. Two-way ANOVA showed significant main effects (material and light-cured) and significant interactions. Self-cured materials (mean = 0.38 mm³ ) showed more wear than light-cured materials (mean = 0.35mm³ ).

CONCLUSIONS

The bioactive materials except Activa light-cured showed significantly more wear than the flowable composites.

CLINICAL SIGNIFICANCE

This study demonstrated that most of the dual-cured composites, if light-cured, showed the same wear as the flowable composites used as control. Therefore, to obtain adequate wear resistance the dual-cured composites should be routinely light-cured.

Color stability of Lucirin-photo-activated resin composite after immersion in different staining solutions: a spectrophotometric study

INTRODUCTION

Exceptional optical properties characterize teeth. As such, an esthetic restorative material should enable the dental professional to imitate the optical properties of natural teeth accurately. IPS Empress Direct was introduced to the market with the claim that it can mimic optically dental tissues with superior clinical performance.

AIM

To evaluate the ability of IPS Empress Direct to mimic tooth appearance and color and resist staining.

MATERIALS AND METHODS

Three disc specimens were prepared for each shade of enamel and dentin of Lucirin-based composite, IPS Empress Direct (Ivoclar Vivadent) (A1, A2, A3, B1, and B2) (total of 60). The specimens were submitted to colorimetric evaluation in comparison after immersion in 10 different solutions (coffee, coffee with sugar, coffee with milk, red tea, red tea with sugar, red tea with milk, tomato juice, pomegranate juice, coke, and distilled water as a control group) for 4 weeks using spectrophotometric analysis.

RESULTS

After plotting the data and conducting linear regression analyses, IPS Empress showed high potential in mimicking the optical properties of natural tooth color according to the CIE color space. Three solutions showed a change in color higher than 3, coffee, coffee with sugar, and red tea. All other solution showed changes in color that are acceptable clinically.

CONCLUSION

IPS Empress Direct can satisfactory mimic teeth appearance and color while manifesting high stability of color resisting staining upon clinical aging.

Influences of Different Air-Inhibition Coatings on Monomer Release, Microhardness, and Color Stability of Two Composite Materials

The aim of this study was to evaluate the effect of light-curing protocols on two modern resin composites using different air-inhibition coating strategies. This was accomplished by assessing the amount of monomer elution, surface microhardness, and composite discoloration in different storage conditions. A total of 120 specimens were prepared using Filtek Supreme XTE (3M ESPE, Seefeld, Germany) and CeramX Universal (Dentsply DeTrey, Konstanz, Germany). Specimens were light-cured in air as per manufacturer's instructions or in the absence of oxygen. This latter condition was achieved using three different approaches: (i) transparent polyester strip; (ii) glycerin; (iii) argon gas. Specimens were assessed for release of monomers, Vickers hardness, and discoloration after storage in different solutions. The results were analyzed with ANOVA one-way test followed by Student-Newman-Keuls test. Moreover, multiple comparisons of means were performed using the Student t-test (p<0.05). The amount of monomers released from the tested specimens was very low in all conditions. The presence of oxygen induced some decrease in microhardness. The highest discoloration values, for both materials, were obtained after ageing in red wine. In case finish and polish procedures are awkward to achieve in posteriors composite restoration, light-curing in the absence of oxygen should be considered, especially when performing composite restoration in esthetic areas.

Antioxidants as a novel dental resin-composite component: Effect on elution and degree of conversion

OBJECTIVE

Ascorbic acid (Asc) and N-acetylcysteine (NAC) were reported to reduce genotoxicity induced by dental (co)monomers and their epoxy metabolites. The aim of the present study was to investigate Asc or NAC as novel components in light-curable methacrylate based dental composites regarding their effects on degree of conversion (DC) and elution of composite components. Additionally, the release of Asc or NAC was determined.

METHODS

Asc or NAC (1, 0.1, 0.01 or 0 wt%) was experimentally incorporated into the composites Venus^®, Grandio^® and Filtek^TM Supreme XTE and polymerized according to the instruction of manufacturers. The samples were elussted in methanol and water. For each composite-antioxidant mixture and elution medium four samples (n = 4) were prepared. The eluates were analyzed by gas chromatography/mass spectrometry (GC/MS), high-performance liquid chromatography/ultraviolett/diode array detection (HPLC/UV/DAD) and high-performance liquid chromatography/fluorescence detection (HPLC/FLD). DC of composite-antioxidant mixtures was measured in real-time with Fourier transform infrared spectroscopy (FTIR).

RESULTS

The highest concentrations of eluted Asc were 313.98 μM (Venus^®-1 wt% Asc; 1 day; methanol) and 245.34 μM (Filtek^TM Supreme XTE-1 wt% Asc; 5 min; water). The highest concentrations of eluted NAC were 42.99 μM (1 day; Filtek^™ Supreme XTE-1 wt% NAC; 1 day; methanol) and 108.11 μM (Filtek^™ Supreme XTE-1 wt% NAC; 7 day; water). Triethylene glycol dimethacrylate (TEGDMA) elution was significantly increased in Venus^®-1 wt% Asc and Grandio^®-1 wt% Asc (1 day and 7 day methanol/water), compared to control. No significant difference was found for TEGDMA elution in Filtek^™ Supreme XTE-1 wt% Asc/NAC. DC was significantly decreased compared to control (= composite without antioxidant) in Grandio^® and Filtek^™ Supreme XTE after 1, 0.1 and 0.01 wt% Asc incorporation and in Venus^® after 1 and 0.1 wt% Asc incorporation. For composite-NAC mixtures, only DC of Grandio^®-1 wt% NAC was significantly reduced.

SIGNIFICANCE

Incorporation of NAC (1 wt%), as a novel composite component, into Filtek^™ Supreme XTE, had no effect on DC and composite component elution, and supplies sufficient amount of antioxidant which may reduce toxicity. Therefore, it represents a beneficial mixture.

In Vitro Evaluation of Onlay Restorations on Primary Teeth

Purpose

Many novel materials have been developed such as composite resin, ceramic, zircon or metal-supported ceramic for use in aesthetic restoration of primary teeth and permanent teeth with extensive crown damage. The aim of the present study was to compare microtensile bond strengths on materials using the microtensile bond strength test.

Materials and methods

The microtensile bond strength on the primary tooth dentin was measured on extracted primary teeth using an indirect method and fracture patterns were evaluated.

Results

The analysis of bond strengths using the Mann-Whitney U-test did not show significant difference between the rank averages of the compomer and composite resin (p = 0.741). The dentin sections, from which test samples were obtained, contributed to the bond strength; dentin samples obtained just above the pulp had lower bond strength, and the difference was statistically significant (p = 0.005). The adhesive type fracture was the most prevalent fracture type for both materials.

Conclusions

When the chemical, physiological, and micromorphological differences between primary and permanent teeth are taken into consideration, the success of the materials used for restorations can be different between primary and permanent teeth. Therefore, materials used in the dentistry must be evaluated separately for primary teeth.

Evaluation of fracture resistance and mode of failure of premolars restored with nanohybrid composite, ORMOCER and ceramic inlays

Objectives

To evaluate the fracture resistance and mode of failure of maxillary premolars restorations restored with nanohybrid Composite, ORMOCER and Ceramic Inlays.

Materials and method

100 extracted first maxillary premolar were collected. Samples were divided into five groups. Group I - Intact premolars, Group II -MOD cavities without restorations, Group III - MOD cavities restored with composite restoration, GROUP IV - MOD cavities restored with ORMOCER restoration and GROUP V - MOD cavities restored with ceramic inlays. All the samples were sent for the axial compression test under the universal testing machine. Fracture resistance and fracture modes were recorded.

Result

Highest fracture resistance was achieved in Group V (1324.74 ± 336.78) almost comparable to that of natural tooth (1381.07 ± 259.36) (p < 0.05), followed by Group IV (MOD cavities with ORMOCER restorations) (1082.27 ± 351.27) (p < 0.01) and least fracture resistance in Group III (MOD cavities with composite restorations) (778.35 ± 100.25) (p < 0.0001). Mode of fracture in Group IV and Group V are almost similar and In Group III 65% of the cases showed non-restorable fractures.

Conclusion

ORMOCER fracture resistance along with other groups of clinically restorable fracture stand better than Nanohybrid composite.

Clinical Relevance

Based on the present study, the dentist can utilize the ORMOCER material as a restoration material for the cavities of posterior teeth which is better in terms of fracture resistance and durability of the restoration when compare to nanohybrid composite.

Can onlay's be an alternative restoration for severely damaged primary teeth

Objective:

The aim of this study was to evaluate indirect compomer and composite resin onlay restorations of severely damaged primary molars in vivo.

Materials and Methods:

At the study, 48 restorations, in seven girls and ten boys totally 17 patients aged 4–8, was evaluated clinically with using USPHS criteria for 15 months.

Results:

The study results revealed that the clinical success rate of compomer and composite onlay restorations was 79% and 96%, respectively. No significant differences were found statistically between the materials.

Conclusions:

In the children severely damaged primary molars, onlays are usually worked with an indirect technique in clinics. One of the advantages of indirect technique is being most similar to its original form morphologically.

Clinical Acceptability of the Internal Gap of CAD/CAM PD-AG Crowns Using Intraoral Digital Impressions

The purpose of this study was to compare the internal gap between CAD/CAM palladium-silver crowns and cast gold crowns generated from intraoral digital versus conventional impressions and to determine the clinical acceptability. Nickel-chrome master dies were made from the prepared resin tooth with the conventional impression method (n = 40). For ICC (Intraoral, CAD/CAM) group, 10 intraoral digital impressions were made, and 10 CAD/CAM crowns of a PD-AG (palladium-silver) machinable alloy were generated. For IC (Intraoral, Cast) group, 10 gold crowns were cast from ten intraoral digital impressions. For CCC (Conventional, CAD/CAM) group, 10 CAD/CAM PD-AG crowns were made using the conventional impression method. For CC (Conventional, Cast) group, 10 gold crowns were fabricated from 10 conventional impressions. One hundred magnifications of the internal gaps of each crown were measured at 50 points with an optical microscope and these values were statistically analyzed using a two-way analysis of variance (α = 0.05). The internal gap of the intraoral digital impression group was significantly larger than in the conventional impression group (P < 0.05). No significant difference was observed between the CAD/CAM group and the cast group (P > 0.05). Within the limitations of this in vitro study, crowns from intraoral digital impressions showed larger internal gap values than crowns from conventional impressions.

Influence of Light-curing Parameters on Biofilm Development and Flexural Strength of a Silorane-based Composite

Objectives: The aim of this study was to evaluate the differences in biological and mechanical performances of a silorane-based and a methacrylate-based composite. Another aim was to assess the influence of light-curing time and light-curing intensity on in vitro biofilm formation and flexural strength of the two tested composites.

Methods: Experiment 1: 432 specimens obtained from a silorane-based composite and from a standard methacrylate-based composite were divided into six groups and light-cured for 10, 20, 30, 40, 60, or 80 seconds, using one of two light-curing intensities, 400 mW/cm2 or 800 mW/cm2. At 24 hours, a monospecific Streptococcus mutans biofilm adherent to the surfaces of the samples was obtained. Then, a colorimetric technique (MTT assay) was used to evaluate the adherent viable biomass. Two samples per group were observed using confocal laser scanning microscopy. Analysis of variance (ANOVA) and Tukey tests were used to analyze the results (p&lt;0.05). Experiment 2: 192 bar-shaped specimens were obtained and light-cured as in the previous experiment. A three-point bend test using a universal testing machine was performed to obtain flexural strength values. ANOVA and Tukey tests were used to analyze the results (p&lt;0.05).

Results: In experiment 1, a highly significant difference (p&lt;0.0001) in biofilm development was shown between silorane-based and methacrylate-based composites. In fact, the silorane-based composite exhibited better biological performance. Significant differences were also found between the two light-curing intensities (p&lt;0.018) and for curing times (p&lt;0.0001): silorane-based composite light-cured for 80 seconds at 800 mW/cm2 light-curing intensity showed the lowest biofilm development. In experiment 2, a significant difference in flexural strength (p&lt;0.0318) was only found between the different composites. Nevertheless, both resin composites showed flexural strength values in accordance with International Organization for Standardization guidelines even after 10 seconds of light-curing time.

Conclusions: Silorane-based composite was less prone to biofilm development compared with a methacrylate-based composite. Acceptable flexural strength values for both composites were obtained after 10 seconds of light-curing time.

Toxicity test of a dental commercial composite

BACKGROUND

International rules must be followed for testing biosecurity in dental materials. A new brand of restorative material appeared in the market and regulations indicated that it should be tested for toxicity.

OBJECTIVES

The aim of this study was to determine the 90-day sub chronic toxicity of one triethylene glycol dimethacrylate containing composite (MEDENTAL Light-Cure Composite™) orally administered to rats according to Organization for Economic Co-Operation and Development no. 48 guidelines and the requirements specified in the ISO 10993-11.

MATERIAL AND METHODS

Wistar rats ate the polymerized composite during 90 days and were observed to determine changes in their behavior, eye and skin signs and other attitudes such as aggressiveness, posture, walking and response to handling. After 90 days were sacrificed to ascertain blood alterations, we did special hematological tests and assessed microscopic slides from 33 different organs.

RESULTS

We recorded no significant changes in clinical behavior of the animals. Microscopic review of the H&E stained slides obtained from the analyzed organs showed no abnormal inflammatory or cytological changes and all hematological special tests were within normal limits.

CONCLUSIONS

Results of this study show that under our experimental conditions the MEDENTAL Light-Cure Composite™ does not produce inflammatory or cytological changes suggestive of toxicity. Key words:Dental materials, composite resin, toxicity, inflammation, TEGDMA.

Bonding Ability of Paste-Paste Glass Ionomer Systems to Tooth Structure: In Vitro Studies

This study investigated the effect of nonrinse conditioners (ie, Ketac Nano Primer [KNP] and GC Self Conditioner [SC]) used as substrate pretreatment and their respective paste-paste resin-modified glass-ionomer cement (RMGIC) (ie, Ketac Nano [KN] and Fuji Filling LC [FF]) on microtensile bond strength to dentin and marginal sealing when compared with traditional RMGIC (ie, Photac Fil [PF] and Fuji II LC [FII]) used in association with polyacrylic acid (ie, Ketac Cavity Conditioner [KC] and GC Cavity Conditioner [CC]). A total of 192 extracted human molars were allocated into eight groups: KNP-KN, KC-KN, KNP-PF, KC-PF, SC-FF, CC-FF, SC-FII, and CC-FII. For microtensile bond strength, the teeth were sectioned to expose occlusal dentin and restored according to the group. After 24 hours the teeth were cut to yield nine beams per tooth (±0.8 mm2). Testing was done using a universal testing machine followed by failure mode classification. For microleakage testing, standardized cavity preparations were made on the buccal cementoenamel junction and restored according to the group. The teeth were thermocycled (500 cycles, 8°C to 48°C), sealed, immersed in methylene blue for 24 hours, and then assessed for microleakage using a stereomicroscope. Microtensile bond strengths in megapascals (mean±SE) were KNP-KN: 14.9 ± 1.6, KC-KN: 17.2 ± 1.5, KNP-PF: 31.2 ± 1.6, KC-PF: 26.2 ± 1.2, SC-FF: 23.6 ± 1.5, SC-FII: 31.2 ± 1.5, and CC-FII: 21.9 ± 1.5. Cervical margins showed more microleakage compared with occlusal margins. Overall, the use of nonrinse conditioners in association with traditional RMGICs demonstrated superior microtensile bond strengths to dentin when compared with the paste-paste RMGICs. Meanwhile, the association between polyacrylic acid (CC) and a traditional RMGIC (FII) led to the least microleakage for cervical locations when compared with all other groups.

In vitro evaluation of the effect of two finishing and polishing systems on four esthetic restorative materials

Aim:

To determine the surface roughness of esthetic restorative materials after finishing and polishing.

Materials and Methods:

All 60 specimens were divided into four groups. Group I: Nanocomposite, Z 350 XT (3M ESPE, USA); Group II: Microhybrid composite, Z 250 (3M ESPE, USA); Group III: Compomer, Dyract XP (LD Caulk/Dentsply, USA); and Group IV: Resin modified glass ionomer cement (GIC), Fuji II LC (GC, Japan). Each group was again divided into three subgroups. Subgroup A: Sof-Lex (3M ESPE); Subgroup B: Super-Snap Rainbow finishing and polishing kit (Shofu INC, Japan); and Subgroup C: Control Mylar strip. Surface roughness was determined by Perthen Perthometer S6P profilometer.

Result:

Filtek Z350 XT showed minimum surface roughness followed by Filtek Z250, Dyract XT and Fuji II LC. Super-Snap exhibited less surface roughness than Sof-Lex polishing systems.

Statistical Analysis:

One-way analysis of variance (ANOVA) followed by multiple post hoc comparisons using least square difference method and unpaired t-test was used.

Conclusion:

Filtek Z350 XT with Mylar strip exhibited least surface roughness.

Effect of water storage on fluoride release and mechanical properties of a polyacid-modified composite resin (compomer)

We evaluated the effect of water storage on fluoride release and mechanical properties of compomer restorative material. Fluoride release was recorded using a specific fluoride electrode. Flexural properties and fracture toughness were measured using a universal testing machine. Vickers hardness was measured using a micro-hardness tester. There was initial burst of fluoride release up to 1 w, which was diminished to a low level in 1 mon and remained relatively constant over 6 mon. Flexural strength and hardness were increased up to 1 mon followed by a gradual decrease up to 6 mon. Flexural modulus was decreased gradually up to 6 mon. Fracture toughness was increased during the first week and gradually decreased over the storage period. We concluded that flexural properties, fracture toughness, Vickers hardness and fluoride release of compomer were sensitive to water as well as storage time. There was a significant effect of fluoride release on the studied mechanical properties.

Comparative evaluation of residual monomer content and polymerization shrinkage of a packable composite and an ormocer

Aim:

The aim of this study is to evaluate the residual monomer content and polymerization shrinkage of a packable composite (Surefil) and an ormocer (Admira).

Materials and Methods:

The study was conducted in two parts. In Part I, 10 samples of each material were prepared in a standardized split brass mould, using incremental curing technique. The residual monomer content was measured by observing change in weight before and after Soxhlet Extraction procedure. In part II, the volumetric polymerization shrinkage was calculated by measuring the difference in specific gravities of 10 uncured and 10 cured samples of each material using a modified version of ASTM D-792 method. The data obtained was put to statistical analysis using student's ‘t’ test.

Results:

Part I - The percentage change in weight for Surefil was 0.525% while that for Admira was 0.374%, which was found to be statistically significant. Part II - The volumetric percentage shrinkage for Surefil ranged between 1.04-3.42% and that for Admira between 1.01-2.31%, which was not found to be significant statistically.

Conclusion:

Admira may be considered more biocompatible than Surefil due to the lower residual monomer content in the former; however, both are comparable with regards to their polymerization shrinkage.

Ormocer: An aesthetic direct restorative material; An in vitro study comparing the marginal sealing ability of organically modified ceramics and a hybrid composite using an ormocer-based bonding agent and a conventional fifth-generation bonding agent

AIMS AND OBJECTIVES

To compare the marginal sealing ability of ormocer with a hybrid composite using an ormocer based bonding agent and a conventional fifth generation bonding agent.

MATERIALS AND METHODS

Fifty four human premolars were randomly distributed into four test groups of 12 teeth each and two control groups of 3 teeth each. Class I occlusal preparation of 1.5 mm depth were made in each tooth. These were restored using the adhesive and restorative material according to the group. The restorations were finished using a standard composite finishing and polishing kit. Thermocycling between 5° C and 55°C was carried out. Having blocked the root apex and the entire tooth surface except 1 mm around the restoration margin, the teeth were immersed in 2% methylene blue for 48 hours, after which the dye penetration through the margins of each sample was studied under a stereomicroscope.

RESULTS AND DISCUSSION

Group IV (Admira with Admira Bond) showed the minimum marginal leakage with a mean of 0.200 mm. Four samples in this group showed no microleakage at all and a maximum of 0.400 mm was seen in one sample. Group II (Spectrum TPH with Admira Bond) showed the maximum leakage with a mean of 0.433 mm. One sample showed as much as 1.00 mm of microleakage. Admira when used with Admira Bond showed lesser microleakage than Spectrum TPH used with Prime & Bond NT, the difference being statistically insignificant.

A Comparative Evaluation of Marginal Leakage of Different Restorative Materials in Deciduous Molars: An in vitro Study

Context: Microleakage around dental restorative materials is a major problem in clinical dentistry. Inspite of many new restorative materials available in the market very few actually bond to the tooth surface.

Aims: The aims of this study were: (1) To evaluate and compare the marginal leakage of newer restorative materials viz colored compomer, ormocer, giomer and RMGIC in class I restoration of deciduous molars. (2) To compare the microleakage scores between the groups of: Colored compomer and ormocer, giomer and RMGIC, ormocer with giomer and RMGIC, giomer with RMGIC.

Materials and methods: A total of 40 primary molars were randomly divided into four groups of 10 each. Class I cavities were prepared and the cavities were restored with colored compomer (Group A), Ormocer (Group B), Giomer (Group C) and RMGIC (Group D). The teeth were thermocycled and subjected to 0.5% basic fuchsin dye penetration followed by sectioning. The cut sections were evaluated under a stereomicroscope and the data was subjected to statistical analysis.

Statistical analysis used: Mann-Whitney U test and Student t-test.

Results: No significant difference was observed when colored compomer was compared to ormocer, giomer and RMGIC. Ormocer showed significantly lower microleakage when compared to giomer. However, no significant difference was observed when ormocer was compared to RMGIC. No significant difference between giomer and RMGIC was found.

Conclusion: Ormocer has proven to be an excellent restorative material as it showed least microleakage followed by colored compomer, giomer and RMGIC in increasing order.

How to cite this article: Yadav G, Rehani U, Rana V. A Comparative Evaluation of Marginal Leakage of Different Restorative Materials in Deciduous Molars: An in vitro Study . Int J Clin Pediatr Dent 2012;5(2):101-107.

The effect of thermocycling on the bonding of different restorative materials to access opening through porcelain fused to metal restorations

PURPOSE

Porcelain fused to metal (PFM) crowns provide the best treatment option for teeth that have a large or defective restoration. More than 20% of teeth with PFM crowns or bridges require non-surgical root canal treatment (NSRCT). This may be due to the effect of restorative procedures and the possible leakage of bacteria and or their by-products, which leads to the demise of the tooth pulp. Thus, this study was planned to compare the ability of the restorative materials to seal perforated PFM specimens.

MATERIALS AND METHODS

The study evaluates the ability of amalgam, composite or compomer restorative materials to close perforated PFM specimen's in-vitro. Ninety PFM specimens were constructed using Ni-Cr alloys and feldspathic porcelain, and then they were divided into 3 groups: amalgam (A), composite + Exite adhesive bond (B) and compomer + Syntac adhesive bond (C). All the PFM samples were embedded in an acrylic block to provide complete sealing of the hole from the bottom side. After the aging period, each group was further divided into 3 equal subgroups according to the thermocycling period (one week for 70 cycles, one month for 300 cycles and three months for 900 cycles). Each subgroup was put into containers containing dye (Pelikan INK), one maintained at 5℃ and the other at 55℃, each cycle for 30 sec time. The data obtained was analyzed by SPSS, 2006 using one way ANOVA test and student t-test and significant difference level at (P<.01).

RESULTS

The depth of dye penetration was measured at the interfaces of PFM and filling materials using Co-ordinate Vernier Microscope. The lowest levels of the dye penetration for the three groups, as well as subgroups were during the first week. The values of dye leakage had significantly increased by time intervals in subgroups A and C.

CONCLUSION

It was seen that amalgam showed higher leakage than composite while compomer showed the lowest level of leakage.

Streptococcus mitis/human gingival fibroblasts co-culture: the best natural association in answer to the 2-hydroxyethyl methacrylate release

One of the major components of dental polymerized resin-based restorative materials is 2-hydroxyethyl methacrylate (HEMA) and its release in monomeric form interferes with the oral cavity environment. This study aimed to evaluate HEMA monomeric effects on the co-culture of Streptococcus mitis and human gingival fibroblasts (HGFs). Streptococcus mitis DS12 and S. mitis ATCC 6249 were co-cultivated with HGF in the presence of HEMA (3 mM), for 48 and 72 h; the amount of sessile and planktonic cells, as well as the prokaryotic and eukaryotic cell viability were analyzed in treated and untreated samples. The treatment of S. mitis/HGFs with HEMA did not produce significant effects on the bacterial adhesion and induced an increase in planktonic S. mitis ATCC 6249 population after 48 and 72 h. HEMA increased significantly the planktonic S. mitis ATCC 6249 viability when co-cultured with HGFs, while a cytotoxic effect on HGFs, without bacteria, was recorded. An increase of bacterial aggregation on HGFs was also detected with HEMA. Data obtained in this study suggest that HEMA exhibits a toxic effect mainly on eukaryotic cells and this effect can be modulated by co-cultivation with the S. mitis cells which, in the presence of the monomer, enhance their aggregation rate on HGFs.

Resin composite restorative materials

This paper surveys the most important developments in resin-based dental composites and focuses on the deficits (e.g. polymerization shrinkage) and strengths of the materials and their clinical implications. Moreover, differences between composite categories, such as hybrid, nanohybrid, microfilled, packable, ormocer-based, silorane-based, polyacid-modified composites (compomers) and flowable composites are highlighted, especially in view of their mechanical behaviour. In addition to the classical dimethacrylate-based composites, special attention is given to alternative monomers, such as siloranes, ormocers or high-molecular-weight dimethacrylate monomers (e.g. dimer acid-based dimethacrylates and tricyclodecane (TCD)-urethane), analysing their advantages, behaviour and abilities. Finally, the paper attempts to establish the needs and wishes of clinicians for further development of resin-based composites.

Evaluation of Light Intensity Output of QTH and LED Curing Devices in Various Governmental Health Institutions

Evaluating the intensity of a light curing unit regularly prior to the application of tooth-colored restorative materials is essential to assure the quality of restorative procedures.

Dental amalgam: An update

Dental amalgam has served as an excellent and versatile restorative material for many years, despite periods of controversy. The authors review its history, summarize the evidence with regard to its performance and offer predictions for the future of this material. The PubMed database was used initially; the reference list for dental amalgam featured 8641 articles and 13 publications dealing with recent advances in dental amalgam. A forward search was undertaken on selected articles and using some author names. For the present, amalgam should remain the material of choice for economic direct restoration of posterior teeth. When esthetic concerns are paramount, tooth-colored materials, placed meticulously, can provide an acceptable alternative. All alternative restorative materials and procedures, however, have certain limitations.

Dental Glass Ionomer Cements as Permanent Filling Materials? – Properties, Limitations and Future Trends

Glass ionomer cements (GICs) are clinically attractive dental materials that have certain unique properties that make them useful as restorative and luting materials. This includes adhesion to moist tooth structures and base metals, anticariogenic properties due to release of fluoride, thermal compatibility with tooth enamel, biocompatibility and low toxicity. The use of GICs in a mechanically loaded situation, however, has been hampered by their low mechanical performance. Poor mechanical properties, such as low fracture strength, toughness and wear, limit their extensive use in dentistry as a filling material in stress-bearing applications. In the posterior dental region, glass ionomer cements are mostly used as a temporary filling material. The requirement to strengthen those cements has lead to an ever increasing research effort into reinforcement or strengthening concepts.

Fluoride release of six restorative materials in water and pH-cycling solutions

The fluoride release of restorative materials in deionized water has been the subject of many studies, but the behavior of these materials under conditions of acid challenge that simulates the oral cavity, needs to be further explored. Therefore, the aim of this study was to evaluate the fluoride release of restorative materials in two storage protocols: deionized water and pH-cycling system (demineralizing solution-pH 4.3 and remineralizing solution-pH 7.0) for 15 days. Eight disks of each material (Vitremer-positive control, Dyract AP, Ariston pHc, Definite, TetricCeram and Z100-negative control) were prepared (11.0 mm x 1.5 mm) and suspended individually in 4.0 mL of each solution, which were daily changed. Daily fluoride release was analyzed with an ion specific electrode (Orion 9609) by the direct method or after HMDS-facilitated diffusion, following 1, 7 and 15 days. The values obtained were converted into microgF/mm(2) and the data analyzed by ANOVA and Tukey's test (p< 0.05). The results showed that all materials released more fluoride in the pH-cycling system, except for Ariston pHc which maintained a constant release during the experiment. The highest fluoride release was presented by the positive control, Vitremer in pH-cycling and by Ariston pHc, in deionized water. The negative control Z100 and the resins Definite and TetricCeram did not present statistically significant differences.

Evaluation of the mechanical properties of dental adhesives and glass-ionomer cements

Adhesives and lining/base materials should relieve the stresses concentrated at the tooth/restoration interface. The study aimed at comparing the mechanical properties of eight adhesives and six glass-ionomer cements (GICs). The adhesives were applied on dentin disks, whereas 2 mm x 3 mm x 2 mm GICs specimens were prepared in a teflon mold. Vicker's hardness (VH), elastic modulus (E), creep (Cr) and elastic work (We/Wtot) were measured with a micro hardness indenter. One-way ANOVA and Tukey's test were used to compare the mechanical properties within each materials' type and among the materials' classes. Enamel and dentin were used as references. Significant differences were detected within each materials' type and among the materials' classes and enamel and dentin. GICs were superior to adhesives in VH and E and showed a VH similar to dentin. GICs presented mechanical properties more similar to enamel and dentin than adhesives.

Cytotoxic effects of halogen- and light-emitting diode-cured compomers on human pulp fibroblasts

OBJECTIVE

The aim of this study was to determine the cytotoxic effects of three different compomers (Dyract AP, Compoglass, and Hytac) cured using a halogen light-curing unit (LCU) and a light-emitting diode (LED) LCU on human pulp fibroblasts.

METHODS

Specimens of three compomers were added to human pulp fibroblast cultures. Cytotoxicity was evaluated over 96 h using the agar overlay method.

RESULTS

All three compomers tested were found to be moderately cytotoxic to human pulp fibroblasts, regardless of whether they were cured using halogen or LED LCUs. The decolorization zone of Hytac was significantly larger than those of the other compomers tested (P < 0.05). Dyract AP and Compoglass specimens showed greater decolorization when cured with LED than with halogen LCUs (P < 0.05).

CONCLUSION

Compomers are potentially toxic to human pulp fibroblasts, and the type of curing unit may affect compomer toxicity.