Clinical evaluation of a flowable resin composite in non-carious Class V lesions: two-year results

This in vivo study evaluated the clinical performance and appearance of a flowable resin composite and a hybrid resin composite over two years. Twenty-eight (28) pairs of restorations of a flowable resin composite and a conventional hybrid resin composite were placed in non-carious, asymptomatic facial Class V lesions. The restorations were evaluated at baseline, six, twelve, eighteen and twenty-four (6, 12, 18 and 24) months, using modified Ryge/USPHS criteria. No significant difference (p < 0.05) was observed in the performance or appearance of both materials.

Accessing and restoring root caries: a case report

Adequate access to root caries can be problematic. The inability to view, isolate, and access the entire lesion may result in residual caries, poor adaptation of the restoration, and defective margins. Minor periodontal procedures, ranging from a mini-flap involving only one tooth, to conventional flap surgery can provide increased visibility and access to these troublesome areas. Through utilization of this technique, excellent preparations and restorations can be achieved. Restorative materials with a high potential for fluoride release as well as uptake should be highly considered in cases of root caries. The selection of a conventional or resin-modified glass ionomer provides several advantages. Most notably are the ability of these restoratives to chemically bond to tooth structure, and to provide significant fluoride release and uptake. These properties are not present in amalgam, composites, or compomers. Additionally, the material itself is relatively easy to use and provides an effective zone of caries inhibition around the margins of the restoration. Glass ionomers are not as sensitive to moisture as conventional resin composites or compomers, and, as a result, may provide a better bond to tooth structure and margination in areas where moisture control is troublesome. Finally, the polymerization shrinkage of these materials is not as great as resin composites, which should also improve marginal integrity. Clinical studies have demonstrated longevity of ten years or greater as well as success in xerostomic patients. Management of xerostomic patients should be directed toward finding satisfactory methods to relieve dryness. Some prescription medications are available, but should only be recommended after consultation with the primary care physician. Oral moisturizers are also available as are saliva substitutes. Caution should be used when recommending saliva substitutes due to the fact that some commercial products have been demonstrated to have a pH below the demineralization point of enamel. Products of this nature should be avoided. In the last few decades, the age of the patient population has increased and individuals have a greater tendency to maintain their natural dentition throughout their entire life. Gingival recession and subsequent root exposure has become more prevalent in the adult population. Additionally, the use of prescription medications that impact the flow and consistency of saliva is widespread. As a result of these phenomena, it has been predicted that root caries will become more prevalent. When preventive measures prove to be ineffective and restorations must be placed, access, visibility, and appropriate material selection are paramount. A combined minor periodontal surgery and restorative procedure is relatively simple, and when done properly, can provide excellent and affordable dentistry in these problematic areas.

Comparison of the Use of a Toothpick Holder to Dental Floss in Improvement of Gingival Health in Humans

BACKGROUND

Although advances have been made in modulation of host inflammatory response in periodontal therapy, it is important to control the bacterial challenge to the host immune system through conventional therapy and improvement of personal oral hygiene. Although toothbrushing is generally performed, interdental cleaning is not as common. This study compared the use of dental floss to a toothpick holder in the improvement of gingival health.

METHODS

Participants were examined and those with clinical gingivitis or slight chronic periodontitis were included in the study. O'Leary plaque, interproximal plaque index (IPI), and Eastman interdental bleeding index scores (EIBI) were recorded at baseline and following appointments. Forty-two females and 13 males ranging from 18 to 50 years in age were randomly divided into either a dental flossing group or toothpick holder using group. Each was given instructions in the use of the oral hygiene device and examined 2, 6, and 12 weeks following baseline. At 12 weeks, 27 floss users and 20 toothpick-holder users completed the study.

RESULTS

Plaque scores were reduced in both groups as the study progressed. Mean O'Leary plaque scores decreased significantly for both methods from baseline to week 12 (P < 0.05). The EIBI and IPI scores decreased in mean scores over time for each method (P < 0.05). A correlation was found between the O'Leary plaque index and the IPI scores (P < 0.05).

CONCLUSION

The results of this study found that the use of dental floss or toothpick holder resulted in no significantly different effect in the improvement of gingival health.

Effect of surface roughness of cavity preparations on the microleakage of Class V resin composite restorations

This study determined whether surface roughness of the internal walls of a Class V resin composite preparation, using a carbide bur, a medium-grit diamond bur and a fine-grit diamond bur, affected the degree of microleakage of the restoration. The facial and lingual surfaces of 45 non-carious extracted human molars provided 90 samples for evaluation. The specimen surfaces were assigned randomly in equal numbers to one of three groups (n = 30). Conservative Class V composite preparations were made using one of three different burs: a 330-carbide bur, a 330 fine-grit diamond bur or a 330 medium-grit diamond bur (Brasseler USA). After acid etching, PQ1 (Ultradent Products Inc) primer/bonding resin and Vitalescence (Ultradent Products Inc) were applied and cured following the manufacturers' instructions. After minor finishing, the apices of all root surfaces were sealed with Vitrebond (3M), and the unprepared external surfaces were sealed with nail polish to within 1 mm of the restoration margins. The specimens were stored in distilled water at room temperature for 24 hours, then subjected to 1,200 thermocycles at 5 degrees C and 55 degrees C with a 30-second dwell time. After cycling, the teeth were immersed in a 5% solution of methylene blue dye for 12 hours. The molars were invested in clear acrylic casting resin, labeled, then sectioned once vertically approximately midway through the facial and lingual surfaces using a diamond coated saw blade. Microleakage was evaluated using a 10x microscope for the enamel and cementum surfaces and blindly scored by two independent examiners. In all cases, regardless of the examiner, at both the enamel and the dentin margins, the analysis revealed no statistically significant differences in microleakage across bur types. Further results show that dentin margins leaked significantly more than enamel margins for all bur types.

Microleakage of dentin/amalgam alloy bonding agents: results after 1 year

The purpose of this study was to evaluate the 1-year results of the dentin bond (DBS)/viscous resin liner combinations Amalgambond Plus, Tenure/Panavia, Syntac/Dual Cem, and All-Bond 2/Liner F in reducing microleakage in class 5 cavity preparations restored with an admixed or a spherical amalgam alloy and to compare these results to the previously reported short-term (4-day) data from this same study. Class 5 cavity preparations with occlusal margins in enamel and gingival margins in cementum were prepared on extracted human molar teeth. Prepared teeth were distributed randomly into 12 treatment groups (n = 10) consisting of the various DBS/ liners, Copalite, and no liner for each alloy. Samples were stored in saline for 12 months, thermocycled, and stained with dye. Restorations were sectioned and microleakage scored. The DBS/liner combinations, with the exception of Syntac/Dual Cem, had significantly less microleakage with both alloys than Copalite or no liner. Comparing short-term to long-term results within the DBS/liners, only Tenure/ Panavia with Tytin had a significant increase in microleakage scores. These data indicate DBS/ liner combinations can provide significant protection against microleakage under high-copper amalgam alloys for up to 1 year.

Microleakage of dentin-amalgam bonding agents

PURPOSE

To evaluate in vitro the microleakage of various dentin bond/resin liner systems when used with both a spherical and an admixture alloy.

MATERIALS AND METHODS

Class V cavity preparations were prepared on 60 noncarious extracted human molar teeth with one margin in enamel and another in dentin and restored with either Dispersalloy or Tytin alloy. Treatment groups utilizing either no liner, Copalite varnish, Amalgambond Plus/HPA, Tenure with Panavia EX Dental Adhesive, Syntac with Dual Cem, and All-Bond 2 with Liner F were tested. Samples were thermocycled, stained, and sectioned to evaluate microleakage.

RESULTS

A significant reduction in microleakage at the enamel and dentin margins was found in all dentin bond system/resin liner groups when compared to unlined and Copalite-lined alloys. There were no significant differences in total microleakage scores between the alloy types. Statistically significant differences in microleakage were detected between some systems. The Tenure with Panavia EX treatment group exhibited a significantly lower total microleakage when used with Tytin. The Syntac/Dual Cem treatment groups exhibited a significantly higher total microleakage when used with Dispersalloy.