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Occlusal caries detection on 3D models obtained with an intraoral scanner. A validation study. J Dent 2023; 131:104457. [PMID: 36858167 DOI: 10.1016/j.jdent.2023.104457] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES To evaluate the diagnostic performance of visual caries assessment on 3D dental models obtained using an intraoral scanner and to compare it with the performance of the clinical visual inspection. METHODS Fifty-three permanent posterior teeth scheduled for extraction were randomly selected and included in this study. One to three independent examination sites on the occlusal surface of each tooth were clinically inspected using International Caries Detection and Assessment System (ICDAS) criteria. Afterwards, the examined teeth were scanned intraorally with a 3D intraoral scanner (TRIOS 4, 3Shape TRIOS A/S, Copenhagen, Denmark) using white and blue-violet light (415 nm wavelength) to capture the colour and fluorescence signal from the tissues. Six months after the clinical examination, the same examiner conducted the on-screen assessment of the obtained 3D digital dental models at the selected examination sites using modified ICDAS criteria. Both tooth colour and fluorescence texture with high resolution were assessed. Lastly, an independent examiner conducted the histological examination of all teeth after extraction. Using histology as the reference test, Sensitivity (SE), Specificity (SP), Accuracy (ACC), area under the Receiver Operating Characteristic (ROC) curve, and Spearman's correlation coefficient were calculated for the clinical and on-screen ICDAS assessments. RESULTS The ACC values of the evaluated methods varied between 0.59-0.79 for initial caries lesions and 0.77-0.99 for moderate-extensive caries lesions. Apart from SE values corresponding to caries in the inner half of enamel, no significant difference was observed between clinical visual inspection and on-screen assessment. In addition, no difference was found in the assessment of 3D models with tooth colour alone or supplemented with fluorescence for all the evaluated diagnostic measures. CONCLUSIONS On-screen visual assessment of 3D digital dental models with tooth colour or fluorescence showed a similar diagnostic performance to the clinical visual inspection when detecting and classifying occlusal caries lesions on permanent teeth. CLINICAL SIGNIFICANCE 3D intraoral scanning can aid the detection and classification of occlusal caries as part of patient screening and can potentially be used in remote caries assessment for clinical and research purposes.
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Development of a Fluorescence-Based Caries Scoring System for an Intraoral Scanner: An in vitro Study. Caries Res 2020; 54:324-335. [PMID: 33053552 DOI: 10.1159/000509925] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/04/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To develop an automated fluorescence-based caries scoring system for an intraoral scanner and totest the performance of the system compared to state-of-the-art methods. METHODS Seventy-three permanent posterior teeth were scanned with a three-dimensional (3D) intraoral scanner prototype which emitted light at 415 nm. An overlay representing the fluorescence signal from the tissue was mapped onto 3D models of the teeth. Multiple examination sites (n = 139) on the occlusal surfaces were chosen, and their red and green fluorescence signal components were extracted. These components were used to calculate 4 mathematical functions upon which a caries scoring system for the scanner prototype could be based. Visual-tactile (International Caries Detection and Assessment System, ICDAS), radiographic (ICDAS), and histological assessments were conducted on the same examination sites. RESULTS Most index tests showed significant correlation with histology. The strongest correlation was observed for the visual-tactile examination (rs = 0.80) followed by the scanner supported by the caries classification function that quantifies the overall fluorescence compared to sound surfaces (rs = 0.78). Additionally, this function resulted in the highest intra-examiner reliability (κ = 0.964), and the highest sum of sensitivity (SE) and specificity (SP) (sum SE-SP: 1.60-1.84) at the 2 histological levels where the comparison with visual-tactile assessment was possible (κ = 0.886, sum SE-SP = 1.57-1.81) and at the 3 out of 4 histological levels where the comparison with radiographic assessment was possible (κ = 0.911, sum SE-SP = 1.37-1.78); the only exception was for the lesions in the outer third of dentin, where the radiographic assessment showed the highest sum SE-SP (1.78). CONCLUSION A fluorescence-based caries scoring system was developed for the intraoral scanner showing promising performance compared to state-of-the-art caries detection methods. The intraoral scanner accompanied by an automated caries scoring system may improve objective caries detection and increase the efficiency and effectiveness of oral examinations. Furthermore, this device has the potential to support reliable monitoring of early caries lesions.
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Adhesion and marginal adaptation of a claimed bioactive, restorative material. Biomater Investig Dent 2019; 6:90-98. [PMID: 31998876 PMCID: PMC6964780 DOI: 10.1080/26415275.2019.1696202] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/13/2019] [Indexed: 02/07/2023] Open
Abstract
Objectives: Adhesion and marginal adaptation of a claimed bioactive restorative material (ACTIVA BioACTIVE Restorative) to human teeth were compared with those of a resin-modified glass ionomer cement (Fuji II LC) and a control resin composite (Ceram X Mono). Material and Methods: Shear bond strength and marginal adaptation to enamel and dentine were assessed after no pretreatment of the hard tissues or after etching with phosphoric acid (ACTIVA BioACTIVE Restorative and Ceram X Mono) or polyacrylic acid (Fuji II LC). For ACTIVA BioACTIVE Restorative, the effect of applying a self-etch adhesive (Xeno Select, Dentsply Sirona) was also investigated. Data were analyzed using non-parametric tests (α = 0.05). Results: Bond strength and marginal adaptation in enamel and dentine were significantly different among the investigated materials (p<.05). Due to loss of restorations, it was not possible to measure bond strength of ACTIVA BioACTIVE Restorative if no pretreatment was performed or if dentine was etched; however, use of the self-etch adhesive resulted in similar bond strength as Ceram X Mono. Etching improved adhesion of Fuji II LC to enamel and dentine. Regarding marginal adaptation, ACTIVA BioACTIVE Restorative showed the highest wall-to-wall contraction to enamel in all pretreatment groups and the overall highest wall-to-wall contraction to dentine after etching. Due to loss of restorations, no marginal assessment was possible on cavities with margins in dentine when no pretreatment was used. The use of a self-etch adhesive with ACTIVA BioACTIVE Restorative resulted in similar adaptation to dentine compared to the other materials. Conclusion: The self-adhesive property of ACTIVA BioACTIVE Restorative is nonexistent.
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Do in vitro solubility studies on endodontic sealers demonstrate a high level of evidence? A systematic review. Acta Odontol Scand 2019; 77:253-263. [PMID: 30849267 DOI: 10.1080/00016357.2018.1538535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To systematically review the quality of evidence of available in vitro solubility studies on endodontic sealers according to prespecified evidence criteria. MATERIAL AND METHODS This systematic review was based on the PRISMA guidelines and the AMSTAR measurement tool. A systematic duplicate search of the literature on endodontic sealer solubility studies was conducted in PubMed and Embase databases (until 18 October 2017). Mapping terms to subject headings and free text terms were used and combined with hand searching before exclusion of duplicates. Studies specifically dealing with endodontic sealer solubility were selected. The evidence level was graded (low, medium or high) independently by two investigators following systematic data extraction in pilot forms, which was based on prespecified evidence criteria and the modified CONSORT checklist for in vitro studies on dental materials. RESULTS The search retrieved 1053 articles, from which 88 were assessed in full. From the 63 articles retained in the final analysis, 11 were classified as having moderate and 52 as low quality of evidence (0 high). The studies graded as low had low sample size (n < 10) and/or insufficient details to allow replicability. Most of the studies did not conform to the modified CONSORT checklist and did not include parameters considered relevant in the prespecified criteria. CONCLUSIONS Existing in vitro studies on the solubility of endodontic sealers do not demonstrate a high quality of evidence. Most of these studies do not present systematic reporting nor employ relevant parameters prespecified in our evidence criteria.
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Challenges in luting fibre posts: Adhesion to the post and to the dentine. Dent Mater 2018; 34:1054-1062. [DOI: 10.1016/j.dental.2018.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
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Retention of Root Canal Posts: Effect of Cement Film Thickness, Luting Cement, and Post Pretreatment. Oper Dent 2015; 40:E149-57. [PMID: 25764045 DOI: 10.2341/14-159-l] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc] and a self-etch adhesive resin cement [Panavia F2.0]) were used. After removal of the crowns of 360 extracted premolars, canines, or incisors, the root canals were prepared with a parallel-sided drill system to three different final diameters. Half the posts did not receive any pretreatment. The other half received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement, pretreatment with tribochemical silicate coating significantly increased retention of the posts. Increased cement film thickness resulted in decreased retention of untreated posts and of pretreated posts luted with zinc phosphate cement. Increased cement film thickness had no influence on retention of pretreated posts luted with resin cement. Thus, retention of the posts was influenced by the type of luting cement, by the cement film thickness, and by the post pretreatment.
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Bulk-Fill Resin Composites: Polymerization Contraction, Depth of Cure, and Gap Formation. Oper Dent 2015; 40:190-200. [DOI: 10.2341/13-324-l] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The bulk-filling of deep, wide dental cavities is faster and easier than traditional incremental restoration. However, the extent of cure at the bottom of the restoration should be carefully examined in combination with the polymerization contraction and gap formation that occur during the restorative procedure. The aim of this study, therefore, was to compare the depth of cure, polymerization contraction, and gap formation in bulk-fill resin composites with those of a conventional resin composite. To achieve this, the depth of cure was assessed in accordance with the International Organization for Standardization 4049 standard, and the polymerization contraction was determined using the bonded-disc method. The gap formation was measured at the dentin margin of Class II cavities. Five bulk-fill resin composites were investigated: two high-viscosity (Tetric EvoCeram Bulk Fill, SonicFill) and three low-viscosity (x-tra base, Venus Bulk Fill, SDR) materials. Compared with the conventional resin composite, the high-viscosity bulk-fill materials exhibited only a small increase (but significant for Tetric EvoCeram Bulk Fill) in depth of cure and polymerization contraction, whereas the low-viscosity bulk-fill materials produced a significantly larger depth of cure and polymerization contraction. Although most of the bulk-fill materials exhibited a gap formation similar to that of the conventional resin composite, two of the low-viscosity bulk-fill resin composites, x-tra base and Venus Bulk Fill, produced larger gaps.
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Susceptibility to Coffee Staining during Enamel Remineralization Following the In-Office Bleaching Technique: An In Situ Assessment. J ESTHET RESTOR DENT 2015; 28 Suppl 1:S23-31. [DOI: 10.1111/jerd.12134] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Colour stability, staining and roughness of silorane after prolonged chemical challenges. J Dent 2013; 41:1229-35. [DOI: 10.1016/j.jdent.2013.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 08/16/2013] [Accepted: 10/01/2013] [Indexed: 11/15/2022] Open
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A comparison of microhardness of indirect composite restorative materials. J Appl Oral Sci 2012; 11:157-61. [PMID: 21409330 DOI: 10.1590/s1678-77572003000200013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2003] [Accepted: 05/20/2003] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to compare the microhardness of four indirect composite resins. Forty cylindrical samples were prepared according to the manufacturers recommendations using a Teflon mold. Ten specimens were produced from each tested material, constituting four groups (n=10) as follows: G1 - Artglass; G2 - Sinfony; G3 - Solidex; G4 - Targis. Microhardness was determined by the Vickers indentation technique with a load of 300g for 10 seconds. Four indentations were made on each sample, determining the mean microhardness values for each specimen. Descriptive statistics data for the experimental conditions were: G1 - Artglass (mean ±standard deviation: 55.26 ± 1.15HVN; median: 52.6); G2 - Sinfony (31.22 ± 0.65HVN; 31.30); G3 - Solidex (52.25 ± 1.55HVN; 52.60); G4 - Targis (72.14 ± 2.82HVN; 73.30). An exploratory data analysis was performed to determine the most appropriate statistical test through: (I) Levene's for homogeneity of variances; (II) ANOVA on ranks (Kruskal-Wallis); (III) Dunn's multiple comparison test (0.05). Targis presented the highest microhardness values while Sinfony presented the lowest. Artglass and Solidex were found as intermediate materials. These results indicate that distinct mechanical properties may be observed at specific materials. The composition of each material as well as variations on polymerization methods are possibly responsibles for the difference found in microhardness. Therefore, indirect composite resin materials that guarantee both good esthetics and adequate mechanical properties may be considered as substitutes of natural teeth.
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Accuracy of Single-Step versus 2-Step Double-Mix Impression Technique. ISRN DENTISTRY 2011; 2011:341546. [PMID: 21991468 PMCID: PMC3169190 DOI: 10.5402/2011/341546] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 06/19/2011] [Indexed: 11/23/2022]
Abstract
Objective. To investigate the accuracy of dies obtained from single-step and 2-step double-mix impressions. Material and Methods. Impressions (n = 10) of a stainless steel die simulating a complete crown preparation were performed using a polyether (Impregum Soft Heavy and Light body) and a vinyl polysiloxane (Perfectim Blue Velvet and Flexi-Velvet) in two consistencies, in one or two (without relief) steps. Accuracy of the stone dies was accessed at a measuring microscope, using a metallic crown with perfect fit to the reference crown preparation. Data were submitted to 2-way ANOVA and Tukey test (α = 0.05). Results. The single-step technique resulted in slightly larger dies, while the 2-step technique without relief produced significantly smaller dies, when compared to the original stainless steel die. Stone dies obtained from 2-step polyether impressions were significantly smaller when compared to dies obtained from 2-step vinyl polysiloxane impressions (Impregum 2-step: -290.94 ± 71.64 μm; Perfectim 2-step: -201.86 ± 28.58 μm). No significant differences were observed in dies obtained from either polyether or vinyl polysiloxane with the single-step technique (Impregum single-step: 63.52 ± 16.60 μm; Perfectim single-step: 79.40 ± 14.11 μm). Conclusion. Higher discrepancies were detected for the 2-step impression technique without relief for the investigated materials.
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Influence of curing rate on softening in ethanol, degree of conversion, and wear of resin composite. AMERICAN JOURNAL OF DENTISTRY 2011; 24:115-118. [PMID: 21698992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To investigate the effect of curing rate on softening in ethanol, degree of conversion, and wear of resin composites. METHOD With a given energy density and for each of two different light-curing units (QTH or LED), the curing rate was reduced by modulating the curing mode. Thus, the irradiation of resin composite specimens (Filtek Z250, Tetric Ceram, Esthet-X) was performed in a continuous curing mode and in a pulse-delay curing mode. Wallace hardness was used to determine the softening of resin composite after storage in ethanol. Degree of conversion was determined by infrared spectroscopy (FTIR). Wear was assessed by a three-body test. Data were submitted to Levene's test, one and three-way ANOVA, and Tukey HSD test (alpha = 0.05). RESULTS Immersion in ethanol, curing mode, and material all had significant effects on Wallace hardness. After ethanol storage, resin composites exposed to the pulse-delay curing mode were softer than resin composites exposed to continuous cure (P< 0.0001). Tetric Ceram was the softest material followed by Esthet-X and Filtek Z250 (P< 0.001). Only the restorative material had a significant effect on degree of conversion (P< 0.001): Esthet-X had the lowest degree of conversion followed by Filtek Z250 and Tetric Ceram. Curing mode (P= 0.007) and material (P< 0.001) had significant effect on wear. Higher wear resulted from the pulse-delay curing mode when compared to continuous curing, and Filtek Z250 showed the lowest wear followed by Esthet-X and Tetric Ceram.
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Effect of storage period on the accuracy of elastomeric impressions. J Appl Oral Sci 2009; 15:195-8. [PMID: 19089129 PMCID: PMC4327466 DOI: 10.1590/s1678-77572007000300008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Accepted: 04/18/2007] [Indexed: 11/26/2022] Open
Abstract
Aims: To investigate the effect of the storage period on the accuracy of recently developed elastomeric materials. Methods: Simultaneous impressions of a steel die were taken using a polyether (I: Impregum Soft Heavy and Light body, 3M ESPE) and vinyl polysiloxane (P: Perfectim Blue Velvet and Flexi-Velvet, J.Morita). The trays were loaded with the heavy-bodied impression materials while the light-bodied impression materials were simultaneously spread on the steel die. The impressions were poured after 2 hours, 24 hours, and 7 days. Impressions were stored at approximately 55% relative humidity and room temperature. Ten replicas were produced for each experimental condition (n=60). Accuracy of the stone dies was assessed with a depth-measuring microscope. The difference in height between the surface of the stone die and a standard metallic ring was recorded in micrometers at four demarcated points, by two independent examiners. Dxata were submitted to two-way ANOVA and Tukey test (α = 0.05). Results: Significant differences were found among the groups. Smaller discrepancies were observed when pouring was performed up to 24 hours (I-2h= 65.0 ± 15.68 μm; I-24h= 81.6 ± 11.13 μm) for the polyether, and up to 7 days for the vinyl polysiloxane (P-2h= 79.1 ± 13.82 μm; P-24h= 96.8 ± 6.02 μm; P-7d= 81.4 ± 4.3 μm). Significant dimensional discrepancies, however, were observed when polyether was stored for 7 days (I-7d= 295.3 ± 17.4 μm). Conclusion: Storage may significantly affect the dimensional accuracy of impressions and, thus, a maximum period and storage condition should be specified for the recently developed materials.
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Bond strength of resin-resin interfaces contaminated with saliva and submitted to different surface treatments. J Appl Oral Sci 2009; 15:501-5. [PMID: 19089188 PMCID: PMC4327499 DOI: 10.1590/s1678-77572007000600009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2007] [Accepted: 09/19/2007] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to investigate the effect of different surface treatments on shear bond strength of saliva-contaminated resin-resin interfaces. Flat resin surfaces were fabricated. In the control group, no contamination or surface treatment was performed. The resin surfaces of the experimental groups were contaminated with saliva and air-dried, and then submitted to: (G1) rinsing with water and drying; (G2) application of an adhesive system; (G3) rinsing and drying, abrasion with finishing disks, etching and application of adhesive system; (G4) rinsing and drying, etching, application of silane and adhesive system. Resin cylinders were placed over the treated surfaces. The specimens were stored in water or ethanol. Shear bond strength tests were performed and the mode of failure was evaluated. Data were submitted to two-way ANOVA and Dunnett T3 test. Contamination of resin-resin interfaces with saliva significantly reduced shear strength, especially after prolonged storage (p<0.05). Similar values to the original bond strength were obtained after abrasion and application of adhesive (G3) or etching and application of silane and adhesive (G4). If contamination occurs, a surface treatment is required to guarantee an adequate interaction between the resin increments.
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Tooth structure and fracture strength of cavities. Braz Dent J 2009; 18:134-8. [PMID: 17982553 DOI: 10.1590/s0103-64402007000200009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Accepted: 05/15/2007] [Indexed: 11/22/2022] Open
Abstract
This study evaluated, in vitro, the loss of tooth substance after cavity preparation for direct and indirect restorations and its relationship with fracture strength of the prepared teeth. Sixty sound human maxillary first premolars were assigned to 6 groups (n=10). MOD direct composite cavities (Groups I, II and III) and indirect inlay cavities (Groups IV, V and VI) were prepared maintaining standardized dimensions: 2-mm deep pulpal floors, 1.5-mm wide gingival walls and 2-mm high axial walls. Buccolingual width of the occlusal box was established at 1/4 (Groups I and IV), 1/3 (Groups II and V) or 1/2 (Groups III and VI) of the intercuspal distance. Teeth were weighed (digital balance accurate to 0.001 g) before and after preparation to record tooth substance mass lost during cavity preparation. The prepared teeth were submitted to occlusal loading to determine their fracture strength using a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed by two-way ANOVA and Tukey test (alpha= 0.05). 1/4-inlay cavities had higher percent mean mass loss (9.71%) than composite resin cavities with the same width (7.07%). 1/3-inlay preparations also produced higher percent mean mass loss (13.91%) than composite resin preparations with the same width (10.02%). 1/2-inlay cavities had 21.34% of mass loss versus 16.19% for the 1/2-composite resin cavities. Fracture strength means (in kgf) were: GI = 187.65; GII = 143.62; GIII = 74.10; GIV = 164.22; GV = 101.92; GVI = 50.35. Statistically significant difference (p<0.05) were observed between Groups I and IV, II and V, III and VI. Higher tooth structure loss and lower fracture strength were recorded after preparation of inlay cavities, regardless of the width of the occlusal box, compared to the direct composite resin cavities.
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Multidisciplinary management of anterior diastemata: clinical procedures. PRACTICAL PROCEDURES & AESTHETIC DENTISTRY : PPAD 2007; 19:185-91; quiz 192. [PMID: 17511124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance the aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology and treatment planning.
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Abstract
Clinical Relevance
When deciding on a specific curing protocol, dental professionals should be aware of the advantages and limitations of each curing mode.
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5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions. Oper Dent 2006; 31:403-8. [PMID: 16924979 DOI: 10.2341/05-87] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions. METHOD AND MATERIALS One operator placed 70 restorations (35 resin modified glass ionomer restorations and 35 resin composite restorations) in 30 patients under rubber dam isolation without mechanical preparation. The restorations were directly assessed by 2 independent examiners, using modified USPHS criteria at baseline and 6, 12, 24 and 60 months. RESULTS Twenty-two patients were available for recall after 5 years (73.3% recall rate) and 55 out of 70 restorations were evaluated. Excellent agreement was registered for all criteria between examiners (kappa > or = 0.85). Sixteen composite restorations were dislodged (51.5% retention) and 1 ionomer restoration was lost (96.4% retention). The McNemar test detected significant differences in resin composite restorations between baseline and 5-year recall for marginal integrity (p<0.001) and retention (p=0.004). For resin modified glass ionomer restorations, no significant differences were identified for all criteria (p>0.05). When comparing both materials, the Fisher exact test pointed out significant differences in retention (p=0.002) after 5 years of clinical service. CONCLUSIONS After 5 years of evaluation, the clinical performance of resin modified glass ionomer restorations was superior to resin composite restorations.
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Evaluation of the bleached human enamel by Scanning Electron Microscopy. J Appl Oral Sci 2005; 13:204-11. [PMID: 20924550 DOI: 10.1590/s1678-77572005000200021] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2004] [Accepted: 09/28/2004] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Since bleaching has become a popular procedure, the effect of peroxides on dental hard tissues is of great interest in research. PURPOSE The aim of this in vitro study was to perform a qualitative analysis of the human enamel after the application of in-office bleaching agents, using Scanning Electron Microscopy (SEM). MATERIALS AND METHODS Twenty intact human third molars extracted for orthodontic reasons were randomly divided into four groups (n=5) treated as follows: G1- storage in artificial saliva (control group); G2- four 30-minute applications of 35% carbamide peroxide (total exposure: 2h); G3- four 2-hour exposures to 35% carbamide peroxide (total exposure: 8h); G4- two applications of 35% hydrogen peroxide, which was light-activated with halogen lamp at 700mW/cm² during 7min and remained in contact with enamel for 20min (total exposure: 40min). All bleaching treatments adopted in this study followed the application protocols advised by manufacturers. Evaluation of groups submitted to 35% carbamide peroxide was carried out after two time intervals (30 minutes and 2 hours per session), following the extreme situations recommended by the manufacturer. Specimens were prepared for SEM analysis performing gold sputter coating under vacuum and were examined using 15kV at 500x and 2000x magnification. RESULTS Morphological alterations on the enamel surface were similarly detected after bleaching with either 35% carbamide peroxide or 35% hydrogen peroxide. Surface porosities were characteristic of an erosive process that took place on human enamel. Depression areas, including the formation of craters, and exposure of enamel rods could also be detected. CONCLUSION Bleaching effects on enamel morphology were randomly distributed throughout enamel surface and various degrees of enamel damage could be noticed. CLINICAL SIGNIFICANCE In-office bleaching materials may adversely affect enamel morphology and therefore should be used with caution.
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Abstract
AIM To investigate pulp chamber penetration of bleaching agents in teeth following restorative procedures. METHODOLOGY Bovine lateral incisors were sectioned 3 mm apical to the cemento-enamel junction and the coronal pulpal tissue was removed. Teeth were divided into six groups (n = 10): G1, G2 and G3 were not submitted to any restorative procedure, while G4, G5 and G6 were submitted to Class V preparations and restored with composite resin. Acetate buffer was placed in the pulp chamber and treatment agents were applied for 60 min at 37 degrees C as follows: G1 and G4, immersion into distilled water; G2 and G5, 10% carbamide peroxide (CP) exposure; G3 and G6, 35% CP bleaching. The buffer solution was removed and transferred to a glass tube where leuco crystal violet and horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined spectrophotometrically at 596 nm. A standard curve made with known amounts of hydrogen peroxide was used to convert the optical density values of the coloured samples into microgram equivalents of hydrogen peroxide. Data were submitted to anova and Tukey's test (5%). RESULTS Amounts of hydrogen peroxide found in the pulp chamber of G2 and G5 specimens (0.1833 +/- 0.2003 micro g) were significantly lower (P = 0.001) when compared to G3 and G6 specimens (0.4604 +/- 0.3981 micro g). Restored teeth held significantly higher (P = 0.001) hydrogen peroxide concentrations in the pulp chamber than intact teeth. CONCLUSION Higher concentrations of the bleaching agent produced higher levels of hydrogen peroxide in the pulp chamber, especially in restored teeth.
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