1
|
Kielbassa AM, Summer S, Frank W, Lynch E, Batzer JS. Equivalence study of the resin-dentine interface of internal tunnel restorations when using an enamel infiltrant resin with ethanol-wet dentine bonding. Sci Rep 2024; 14:12444. [PMID: 38816512 PMCID: PMC11139992 DOI: 10.1038/s41598-024-63289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024] Open
Abstract
This preregistered ex vivo investigation examined the dentinal hybrid layer formation of a resinous infiltrant (Icon), with reference to both thickness (HLT) and homogeneity when combined with modified tunnel preparation (occlusal cavity only) and internal/external caries infiltration. The adhesives Syntac and Scotchbond MP were used as controls (Groups 1 and 3) or in combination with Icon (Groups 2 and 4). A split-tooth design using healthy third molars from 20 donors resulted in 20 prepared dentine cavities per experimental group. The cavity surfaces (n = 80) were etched (37% H3PO4), rinsed, and air-dried. Rewetting with ethanol was followed by application of the respective primers. After labeling with fluorescent dyes, either Syntac Adhesive/Heliobond or Scotchbond MP Adhesive was used alone or supplemented with Icon. HLT, as evaluated by scanning electron microscopy, did not significantly differ (P > 0.05), and confocal laser scanning microscopy revealed homogeneously mixed/polymerized resin-dentine interdiffusion zones in all groups. Icon can be successfully integrated into an ethanol-wet dentine bonding strategy, and will result in compact and homogeneous hybrid layers of comparable thickness considered equivalent to the non-Icon controls, thus allowing for preservation of the tooth's marginal ridge and interdental space in the case of internal/external infiltration of proximal caries.
Collapse
Affiliation(s)
- Andrej M Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems an der Donau, Austria.
| | - Sabrina Summer
- Department for Biomedical Research, Centre of Experimental Medicine, University for Continuing Education Krems, Krems an der Donau, Austria
| | - Wilhelm Frank
- Centre for Health Sciences, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University (DPU), Krems an der Donau, Austria
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Leicester, UK
| | - Julia-Susanne Batzer
- Centre for Operative Dentistry, Periodontology, and Endodontology, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems an der Donau, Austria
| |
Collapse
|
2
|
Preusse PJ, Winter J, Amend S, Roggendorf MJ, Dudek MC, Krämer N, Frankenberger R. Class II resin composite restorations-tunnel vs. box-only in vitro and in vivo. Clin Oral Investig 2020; 25:737-744. [PMID: 33169273 PMCID: PMC8364904 DOI: 10.1007/s00784-020-03649-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
Purpose In a combined in vitro/in vivo approach, tunnel vs. box-only resin composite restorations should be evaluated using thermomechanical loading (TML) in vitro and a restrospective clinical trial in vivo. Materials and methods For the in vitro part, box-only and tunnel cavities were prepared in 32 extracted human third molars under simulated intraoral conditions in a phantom head. Specimens were randomly assigned to four groups (n = 8; 16 box-only/16 tunnel) and received bonded resin composite restorations with Amelogen Plus (box A/tunnel A) or lining with Ultraseal and Amelogen plus (box B/tunnel B) both bonded using PQ1 (all Ultradent). Specimens were subjected to a standardized aging protocol, 1-year water storage (WS) followed by TML (100,000 × 50 N; 2500 × + 5/+ 55 °C). Initially and after aging, marginal qualities were evaluated using replicas at × 200 magnification (SEM). For the corresponding in vivo observational study, 229 patients received 673 proximal resin composite restorations. From 371 tunnel restorations, 205 cavities were filled without flowable lining (tunnel A), and 166 tunnels were restored using UltraSeal as lining (tunnel B). A total of 302 teeth received conventional box-only fillings. Restorations were examined according to modified USPHS criteria during routine recalls up to 5 years of clinical service. Results In vitro, all initial results showed 100% gap-free margins when a flowable lining was used. Tunnels without lining exhibited some proximal shortcomings already before TML and even more pronounced after TML (p < 0.05). After TML, percentages of gap-free margins dropped to 87–90% in enamel with lining and 70–79% without lining (p < 0.05). In vivo, annual failure rates for box-only were 2.2%, for tunnel A 6.1%, and for tunnel B 1.8%, respectively (p < 0.05). Tunnels had significantly more sufficient proximal contact points than box-only restorations (p < 0.05). Flowable lining was highly beneficial for clinical outcome of tunnel-restorations (p < 0.05). Conclusions With a flowable lining, tunnel restorations proved to be a good alternative to box-only resin composite restorations. Clinical relevance Class II tunnel restorations showed to be a viable alternative for box-only restorations, however, only when flowable resin composite was used as adaptation promotor for areas being difficult to access.
Collapse
Affiliation(s)
- Peter J Preusse
- , Marburg, Germany
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - Julia Winter
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - Stefanie Amend
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Matthias J Roggendorf
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - Marie-Christine Dudek
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - Norbert Krämer
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
| |
Collapse
|
3
|
Yu OY, Zaeneldin AM, Hamama HHH, Mei ML, Patel N, Chu CH. Conservative Composite Resin Restoration for Proximal Caries - Two Case Reports. Clin Cosmet Investig Dent 2020; 12:415-422. [PMID: 33116910 PMCID: PMC7549752 DOI: 10.2147/ccide.s270453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/05/2020] [Indexed: 11/23/2022] Open
Abstract
The paradigms of contemporary caries management have shifted to minimal intervention dentistry. Conservative restorative procedures are recommended to replace the complete removal of all carious tissues in the management of dental caries. This article reports two clinical cases of conservative restorations of proximal caries. Different conservative cavity designs and restorative techniques were performed in the two cases. Proximal caries in posterior teeth were prepared using the box-only preparation technique or the proximal tunnel preparation technique. The cavities were restored directly with resin composites. The advantages of using the box-only preparation with fissure sealant included the maximum conservation of tooth hard tissues and the prevention of unnecessary tissue removal in the occlusal surface. The tunnel preparation preserved the marginal ridge and protected the restored tooth from fracture. The filling of composites into the tunnel demonstrated a better marginal adaptation than other restorative materials. These two techniques allowed for the preservation of more healthy dental hard tissue compared with traditional techniques. Potential problems in the restoration included the high incidence of the inappropriate removal of dental hard tissue, damage of the vital pulp and the microleakage due to the polymerization shrinkage. The solutions to minimize the risk of these problems in the operative procedures were discussed.
Collapse
Affiliation(s)
- Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Ahmed Mohamed Zaeneldin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | | | - May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, Otago, New Zealand
| | - Neil Patel
- Division of Dentistry, University of Manchester, Manchester, UK
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| |
Collapse
|
4
|
Kielbassa AM, Leimer MR, Hartmann J, Harm S, Pasztorek M, Ulrich IB. Ex vivo investigation on internal tunnel approach/internal resin infiltration and external nanosilver-modified resin infiltration of proximal caries exceeding into dentin. PLoS One 2020; 15:e0228249. [PMID: 31990942 PMCID: PMC6986723 DOI: 10.1371/journal.pone.0228249] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/11/2020] [Indexed: 02/08/2023] Open
Abstract
This ex vivo proof-of-concept study aimed to investigate the effect of nanosilver particles (AgNP) added to a conventional infiltrant resin (Icon) on external penetration into natural proximal enamel caries exceeding into dentin after internal tunnel preparation and internal infiltration. Carious lesions (ICDAS codes 2/3) of extracted human (pre-)molars revealing proximal caries radiographically exceeding into dentin (E2/D1 lesions) were preselected. Then, 48 of those specimens showing demineralized areas transcending the enamel-dentin border as assessed by means of near-infrared light transillumination (DIAGNOcam) were deproteinized (NaOCl, 5%). Using an internal tunnel approach, occlusal cavities central to the marginal ridge were prepared. Excavation of carious dentin, total etch procedure (H3PO4, 40%), and internal resin infiltration (FITC-labeled) followed, along with final restorations (flowable composite resin). Outer lesion surfaces were etched (HCl, 15%) prior to external infiltration (RITC-labeled). Group 1 (control; n = 24) used non-modified infiltrant, while an infiltrant/AgNP mixture (20 nm; 5.5 wt%) was used with experimental Group 2 (n = 24). Non-infiltrated pores of cut lesions were stained (Berberine), and specimens were analyzed using confocal laser scanning microscopy. Compared to the non-filled infiltrant, incorporation of AgNP had no effect on the resin's external penetration. Between the groups, no significant differences regarding internal or external infiltration could be detected, and non-infiltrated lesion areas did not differ significantly (p>0.109; t-test). The internal tunnel preparation in combination with both an internal resin infiltration and an additional external infiltration approach using a nanosilver-modified infiltrant resin leads to increased infiltrated lesion areas, thus occluding and adhesively stabilizing the porous volume of the demineralized enamel. While exerting antimicrobial effects by the nanosilver particles, this approach should have the potential as a viable treatment alternative for proximal lesions extending into dentin, thus avoiding the sacrifice of sound enamel, postponing the frequently inevitable restoration/re-restoration cycle of conventional proximal caries treatment, and improving dental health.
Collapse
Affiliation(s)
- Andrej M. Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
- * E-mail:
| | - Marlene R. Leimer
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
| | - Jens Hartmann
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Stephan Harm
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Markus Pasztorek
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Ina B. Ulrich
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
| |
Collapse
|
5
|
Mei ML, Chen YM, Li H, Chu CH. Influence of the indirect restoration design on the fracture resistance: a finite element study. Biomed Eng Online 2016; 15:3. [PMID: 26758615 PMCID: PMC5002181 DOI: 10.1186/s12938-015-0115-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/11/2015] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To establish a three-dimensional (3D) finite element (FE) model of a maxillary first premolar and to evaluate the stress generated on the tooth (dentine) and on the indirect composite resin restorations by occlusal forces. METHODS An embedded intact maxillary first premolar tooth was sliced serially and scanned digitally parallel to the occlusal surface. The 64 images were assembled in a 3D FE mesh and exported to generate a 3D solid tooth model. Simulated, adhesively cemented indirect mesial-occlusal-distal (MOD) inlays of 2 mm (I1), 3 mm (I2) and 4 mm (I3) in width, and MOD onlays with occlusal cusp coverage of 2 mm (O1) and 3 mm (O2) in depth were created. The peak von Mises stress values in the five tooth models resulting from static vertical and oblique occlusal forces (300 N) were evaluated using Patran FE software. RESULTS The peak stress values generated by vertical occlusal force generated in dentine of I1, I2, I3, O1 and O2 restoration were 67, 32, 29, 38 and 27 MPa, respectively, and those generated by oblique occlusal force were 52, 114, 168, 54 and 55 MPa, respectively. The peak von Mises stress values in I1, I2, I3, O1 and O2 restoration subjected to oblique occlusal loading were 79, 120, 1740, 1400 and 1170 MPa, respectively. CONCLUSION A 3D FE model of a maxillary first premolar was established. Simulated cemented composite resin onlay markedly reduces occlusal stress in the underlying dentine of large MOD preparation. Oblique occlusal force imparts substantially higher stress to large composite resin inlay than to the adjacent dentine.
Collapse
Affiliation(s)
- May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China.
| | - Ya Ming Chen
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.
| | - Hao Li
- School of Civil and Hydraulic Engineering, Hefei University of Technology, Hefei, China.
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China.
| |
Collapse
|
6
|
Chu CH, Mei ML, Nalliah RP. A survey of practices of tunnel preparation among dentists who attended the 100th FDI Annual World Dental Congress. ACTA ACUST UNITED AC 2014; 6:63-8. [PMID: 24415714 DOI: 10.1111/jicd.12081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 09/29/2013] [Indexed: 11/30/2022]
Abstract
AIM To study the practice of tunnel restoration (TR) among dentists who attended the 100th World Dental Federation (FDI) Annual World Dental Congress (AWDC). METHODS An anonymous questionnaire was administered to a sample of 150 dentists who attended the 100th FDI AWDC in 2012. The participants were asked about TR and their practice of TR. They were also asked to provide their years of dental practice and the countries in which they received their dental training. RESULTS Fifteen respondents were not performing restoration, and they were excluded from analysis. Most respondents (123/135) practiced general dentistry. Their basic dental training was from 46 countries and regions. Most of them (n = 117, 87%) knew about TR, and 53% (n = 71) practiced it. There were 12 dentists (9%) who had performed more than 10 TRs in the previous 12 months. Practice of TR among dentists who graduated more than 10 years previously was more common (odds ratio 5.87-5.98) than those who graduated <3 years previously. CONCLUSIONS The current study found that about half of the surveyed dentists practiced TR, although most of them knew about it. Tunnel restoration was performed more frequently among dentists who had more than 10 years of clinical experience.
Collapse
Affiliation(s)
- Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | | |
Collapse
|