The Effect of Resin-modified Glass-ionomer Cement Base and Bulk-fill Resin Composite on Cuspal Deformation

Objectives: This study investigated cuspal deformation in teeth restored with different types of adhesive materials with and without a base.

Methods: Mesio-occluso-distal slot cavities of moderately large dimension were prepared on extracted maxillary premolars (n=24). Teeth were assigned to one of four groups and restored with either a sonic-activated bulk-fill resin composite (RC) (SonicFill), or a conventional nanohybrid RC (Herculite Ultra). The base materials used were a flowable nanofilled RC (Premise Flowable) and a high-viscosity resin-modified glass-ionomer cement (RMGIC) (Riva Light-Cure HV). Cuspal deflection was measured with two direct current differential transformers, each contacting a buccal and palatal cusp. Cuspal movements were recorded during and after restoration placement. Data for the buccal and palatal cusp deflections were combined to give the net cuspal deflection.

Results: Data varied widely. All teeth experienced net inward cuspal movement. No statistically significant differences in cuspal deflection were found among the four test groups.

Conclusions: The use of a flowable RC or an RMGIC in closed-laminate restorations produced the same degree of cuspal movement as restorations filled with only a conventional nanohybrid or bulk-fill RC.

Effect of Tooth Surface Preparation on the Bonding of Self-Etching Primer Adhesives

The effectiveness of some self-etching primer adhesive systems is not significantly affected by the mode of rotary instrumentation used in dentin preparation.

Odontoblast dysfunction in osteogenesis imperfecta: an LM, SEM, and ultrastructural study

The inherited dentin defect dentinogenesis imperfecta (DI), while clinically obvious in osteogenesis imperfecta (OI) Types IB and IC, II, III, and IVB, is now thought to be present in all children with OI, in a continuum from minimal to severe dentin pathology. This collaborative study further clarifies the structural and ultrastructural dentin changes in the teeth of OI children with clinically obvious DI, and attempts to explain these in terms of odontoblast dysfunction. Collaborative studies were carried out in Melbourne, Australia, and Strasbourg, France, using light and polarized-light microscopy, scanning and transmission electron microscopy (SEM, TEM), selected-area diffraction (SAD), and x-ray spectroscopy (EDX). These showed structurally normal enamel (but containing long and broad lamellae) and a normally scalloped dentino-enamel junction (DEJ), but severe pathologic changes in the dentin. An initial narrow band of normal-appearing dentin tubules (including the mantle layer) ceased abruptly and was replaced by a wavelike laminar zone parallel to the DEJ with occluded tubules. Multiple parallel channels of 5-10 microns diameter were present at right angles to the DEJ indenting this zone, some terminating in retro-curved "processes." The abnormal dentin containing these channels almost completely occluded the pulp chamber. The structural and ultrastructural changes seen can be explained on the basis of the collagen defect in OI resulting in odontoblast dysfunction, which produces a distinct phenotype and one that is different from that in bone.

Comparison of electrode position in the human cochlea using various perimodiolar electrode arrays

OBJECTIVE

This study was conducted to evaluate the insertion properties and intracochlear trajectories of three perimodiolar electrode array designs and to compare these designs with the standard Cochlear/Melbourne array.

BACKGROUND

Advantages to be expected of a perimodiolar electrode array include both a reduction in stimulus thresholds and an increase in dynamic range, resulting in a more localized stimulation pattern of the spiral ganglion cells, reduced power consumption, and, therefore, longer speech processor battery life.

METHODS

The test arrays were implanted into human temporal bones. Image analysis was performed on a radiograph taken after the insertion. The cochleas were then histologically processed with the electrode array in situ, and the resulting sections were subsequently assessed for position of the electrode array as well as insertion-related intracochlear damage.

RESULTS

All perimodiolar electrode arrays were inserted deeper and showed trajectories that were generally closer to the modiolus compared with the standard electrode array. However, although the precurved array designs did not show significant insertion trauma, the method of insertion needed improvement. After insertion of the straight electrode array with positioner, signs of severe insertion trauma in the majority of implanted cochleas were found.

CONCLUSIONS

Although it was possible to position the electrode arrays close to the modiolus, none of the three perimodiolar designs investigated fulfilled satisfactorily all three criteria of being easy, safe, and atraumatic to implant.

Effects of resistance training on bone parameters in young and mature rats

1. Osteoporosis is a major public health problem that is predicted to worsen over the next decade and preventative strategies that increase bone strength have become the focus of substantial research. 2. Although mechanical load is a primary factor in the acquisition and maintenance of skeletal tissue, the type of exercise used and when in life it is most effectively prescribed remain inconclusive. 3. The present study compared 10 weeks of resistance training in both young and mature female Sprague-Dawley rats and measured bone density and body composition by dual energy X-ray absorptiometry and biomechanical properties by three point bending tests of the tibia and femur. 4. No significant differences were observed for any of the bone parameters when comparing exercise and control groups at either age. This was despite using a comparable training protocol to that in humans and using loads of approximately 150% bodyweight. 5. The present study concludes that more intensive work programmes of resistance training or different outcome measures are required when using animal models for skeletal research.

Amelogenesis imperfecta and nephrocalcinosis syndrome. Case studies of clinical features and ultrastructure of tooth enamel in two siblings

This article describes the enamel ultrastructure and clinical features in two siblings with the little known syndrome of Amelogenesis imperfecta and nephrocalcinosis. Nephrocalcinosis was diagnosed by x-ray examination of the abdomen, intravenous pyelography, ultrasonography, and computed tomography scan. Amelogenesis imperfecta was diagnosed from clinical and histologic examinations. The affected enamel was hypoplastic (approximately 0.2 mm thick), positively birefringent, generally aprismatic, porous, and consisted of loosely packed, randomly orientated, thin (approximately 10 nm wide), ribbonlike crystals. The enamel surface was rough, extensively cracked, and covered with ovoid or globular protrusions. Observations showed that in this case hypoplasia, hypocalcification, or hypomaturation defects were present in the same tooth, indicating that both secretory and maturation phases may have been affected. The study suggested the possibility of an abnormality in interstitial matrix, which could lead to dystrophic calcification in the kidney and abnormal tooth enamel formation. It also suggested the possibility of involvement of two separate but closely linked genes.

Ultrastructural study of tooth enamel with amelogenesis imperfecta in AI-nephrocalcinosis syndrome

This paper describes the ultrastructure of the affected enamel and the clinical features in two siblings with the syndrome of nephrocalcinosis and amelogenesis imperfecta. Nephrocalcinosis was diagnosed by intravenous pyelography, and confirmed by ultrasonography and CT scan. Amelogenesis imperfecta AI was diagnosed clinically and histologically. Light microscopy showed that the affected enamel surfaces were rough and the enamel was hypoplastic and mainly positively birefringent. Scanning electron microscopy revealed a rough and extensively cracked enamel surface covered with oval shaped blister-like protrusions. TEM showed porous enamel consisting of loosely packed and randomly oriented thin ribbon-like crystals with little or no prismatic structure. Observations showed that hypoplasia together with hypocalcification and/or hypomaturation defects were present in the same tooth, indicating the possibility of an abnormality in interstitial matrix, leading to dystrophic calcification in the kidney and abnormal tooth enamel formation, or alternatively an involvement of two separate but closely linked genes.

The effect on the ultrastructure of dental enamel of excimer-dye, argon-ion and CO2 lasers

This study aimed to investigate the ultrastructural changes that occur in dental enamel irradiated with pulsed excimer-dye, continuous-wave (CW) argon-ion and CW CO2 lasers. The pulsed excimer-dye laser produced deep craters, rough damaged surfaces with underlying porosity and amorphous vitrified material. The vitrification of the enamel indicated that the temperature in these areas must have been at least in the range 1280 to 1600 degrees C. The CW argon-ion laser irradiation produced a changed non-cratered surface with inter-crystalline porosity and a mixture of small and some large irregularly packed recrystallized enamel crystals. The CW CO2 laser produced shallow craters, surface crazing and lifting off the removal of the surface layer to expose the underlying roughened enamel. The ultrastructure revealed inter- and intra-crystalline porosity, a mixture of small but variable size irregularly packed recrystallized enamel crystals and also well packed large crystals which indicated further grain growth. The porosity in lased enamel was overall very similar to that seen in enamel heated in an electric furnace to a temperature of 600 degrees C. The presence of recrystallized enamel crystals indicated a temperature rise of approximately 1000 degrees C and the grain growth indicated that a temperature > or = 1000 degrees C existed for some time after the laser irradiation. In general the excimer-dye laser produced most surface destruction because of its higher power density and shorter interaction time and the argon-ion laser produced least damage. These results indicated that the lasers used in this study require much more refinement before they can find therapeutic application to dental enamel, and this may well be the case for other lasers being investigated for clinical dental practise.

Ultrastructure of spindles and tufts in human dental enamel

A transmission electron microscope (TEM) study was made of spindles and tufts as identified in the light microscope, from samples prepared by selected-area argon-ion-beam thinning. Spindles in human dental enamel were found to be continuous with dentinal tubules across the dentin-enamel junction (DEJ) and usually appeared at the DEJ as electron-lucent, empty channels nearly circular in cross-section. The spindles were found to cross prism boundaries, branched rarely, and some were occasionally found to be occluded or partially occluded with small needle-like crystals (approximately 5 nm width and approximately 70 nm length), granular material (approximately 1.5 nm diameter) and/or amorphous material. Near the DEJ, the majority of spindles had a diameter less than 2 microns, while in the prismatic enamel away from the DEJ, spindles with a diameter greater than 2 microns were generally found. Spindle varicosity was characterized by an enlargement of their diameter. Tufts started at the DEJ and were not associated with dentinal tubules. Two types of ultrastructure were observed in the TEM: (i) disrupted regions of enamel incorporating large voids (up to approximately 0.1 microns in diameter), or, more commonly, (ii) channels within the enamel occluded or partially occluded, with small needle-like crystals and granular and/or amorphous material similar to that found in the enamel spindles. It was concluded that spindles and tufts represent areas of hypomineralization with increased void volume and partial remineralization.

The polarized light microscopy and ultrastructure of Polynesian pigmented tooth enamel

Transmitted and polarized light microscopy of unerupted and erupted teeth affected by a pigmented anomaly found in two geographically isolated Polynesian populations, the New Zealand Maori and the French Polynesian Marquesas Islander, showed similar histological characteristics. Mounted in water, the pigmented areas were positively birefringent and covered with a thin negatively birefringent surface layer 200-250 microns thick. Cervical areas were negatively birefringent. Transmission electron microscopy of argon-ion-beam thinned specimens of affected enamel revealed large voids, disruption in the packing of crystals and spacing at prism boundaries. In the surface layer of enamel from erupted and unerupted teeth, the intra- and interprismatic spaces were occluded by fine crystals or amorphous material. A well-defined prism structure and close crystal packing were found in cervical enamel. The ultrastructure of these pigmented enamels was similar to and consistent with a hypomaturation type of amelogenesis imperfecta.

Effects of continuous-wave CO2 laser on the ultrastructure of human dental enamel

Laser-induced changes in plano-parallel sections were examined by light microscopy (LM) and scanning electron microscopy (SEM), and correlated with ultrastructural changes as observed by transmission electron microscopy (TEM). LM and SEM revealed two different changes--extensive crazing, and crazing and cratering. Rough exposed enamel was commonly found, resulting from lifting off and removal of the top layer of crazed, or crazed and cratered, enamel. The type of induced change was mainly dependent on the energy density used (range approximately 0.8 to approximately 200 J cm-2) and on enamel prism orientation. Lased enamel was also softer than unlased enamel. TEM of both crazed enamel and rough exposed enamel revealed that most crystals generally resembled those of unlased enamel in size and shape, but that inter- and intra-crystalline voids were present in some areas. The crazed and cratered enamel had significant ultrastructural changes: new homogeneous and inhomogeneous crystals of apatite with a different shape and larger size than those of the original, and a loss of prismatic structure. The lack of uniformity of the laser effect on crazed and cratered enamel was shown by variation in crystal packing (from good to poor), variations in crystal size from area to area, and the presence of pockets of poorly packed homogeneous crystals alongside pockets of well-packed inhomogeneous crystals. The crazing, crazing and cratering, rough exposed enamel and the greater number of voids, as well as the relative softness of lased enamel do not indicate an overall ultrastructural improvement. However, the larger apatite crystal size and loss of prismatic structure in crazed and cratered areas may partly explain previous observations of reduced rates of subsurface demineralization in lased enamel.

The ultrastructure of human dental enamel heat-treated in the temperature range 200 degrees C to 600 degrees C

Heating enamel in the temperature range 200 degrees C to 600 degrees C resulted in poor crystal packing due to void formation, permanent change in the sign of its birefringence (from negative to positive) in some areas, and an altered crystal morphology. Transmission electron microscopy of enamel heated in the temperature range 200 degrees C to 400 degrees C revealed that the distinction between the positively birefringent regions and the negatively birefringent regions (which were present up to 350 degrees C and occasionally up to 400 degrees C) at the tooth's surface was due to the greater volume of intra- and inter-crystalline voids within the positively birefringent regions. There was a significant increase in void volume at 400 degrees C, and above this all of the enamel was positively birefringent and opaque. Large remineralized crystals of beta-tricalcium phosphate (beta-TCP) phase (whitlockite) were initially formed at 400 degrees C, and their size and number increased at 500 degrees C and above. Both the greater solubility of beta-TCP crystals and the increased surface area due to the presence of voids would increase the rate of demineralization of heat-treated enamel.

Laminated zones in carious human dental enamel

Laminated zones within the body of carious lesions were studied by polarized light microscopy and transmission electron microscopy. Areas from within and surrounding the laminated zones, precisely selected using light microscopy, were argon-ion-beam thinned and examined by transmission electron microscopy. Laminated zones were present in approximately 7% of the samples studied. Polarized light microscopy showed variation in mineralization from zone to zone and the enamel surrounding the zones in the body of the lesion. Laminated zones whose central region showed approximately 1% of space when examined in air and whose boundaries showed approximately 2-4% of space when imbibed in quinoline were selected for ultrastructural studies. Electron microscopy showed the laminated zone to be less demineralized than the surrounding enamel in the body of the lesion. The ultrastructure of their central regions was similar to healthy enamel but their boundaries showed demineralization which increased into the body of the lesion. Within the central region of lamination there was greater evidence of resistance to demineralization rather than the presence of remineralization.

Ultrastructure of the intact surface zone of white spot and brown spot carious lesions in human enamel

Electron microscopy of the intact surface zone of white spot and brown spot carious lesions showed that in general their ultrastructure was similar. Their outermost crystalline surface consisted of small crystals similar to those in healthy enamel, crystals with central core dissolution, and rounded crystals. Below this, surface demineralization of enamel was observed as the enlargement of micropores, the central core dissolution of crystals, the formation of channels and the enlargement of spaces at prism boundaries. Remineralization of enamel was observed as the partial occlusion of voids, the rounding and enlargement of crystals, and some new needle-shaped crystals. Some other features indicated combined demineralization and remineralization. The occlusion of spaces at prism boundaries was a more common feature in brown spot lesions, whereas the pockets of rounded crystals were more common in white spot lesions. A relatively uniform distribution of needle-shaped crystals throughout the intact surface zone was a feature of some brown spot lesions only.

On the nature of the opaque and translucent enamel regions of some macropodinae (Macropus giganteus, Wallabia bicolor and Peradorcas concinna)

Teeth of three macropod species, M. giganteus, W. bicolor and P. concinna, have been studied using the techniques of light microscopy, scanning- and transmission-electron microscopy and hardness measurement. Light microscope observations showed that the teeth of these species had a translucent enamel region close to the dentine and an outer opaque enamel region at the tooth's surface. These regions were not related to the presence or absence of tubules which are a characteristic feature of marsupial enamel. Hardness tests showed that the opaque enamel was softer than the translucent enamel. Scanning electron microscope observations revealed that there was no correlation between any particular prism packing or orientation and the opaque and translucent enamel regions. Transmission electron microscope observations showed that the translucent enamel region consisted of well defined prisms and well packed, lath-like crystals, whereas the opaque enamel was disrupted by voids (which ranged in size from enlarged micropores to about 2 microns in diameter in extreme cases) between crystals and some randomly oriented, loosely packed crystals. This disruption within the opaque enamel region was more common at prism boundaries but pockets of disrupted enamel were also found within prisms and interprismatic regions. The opacity of the enamel was caused by scattering of light from the voids. The ultrastructure of the opaque enamel region indicated that this region was hypomineralized; hardness tests and polarized light microscope observations were consistent with these results.

Electron-microscope study of the dentine-enamel junction of kangaroo (Macropus giganteus) teeth using selected-area argon-ion-beam thinning

Transmission electron microscopy of selected-area argon-ion-beam thinned kangaroo (Macropus giganteus) enamel revealed a complex ultrastructure in the region of the dentine-enamel junction (DEJ). Characteristic features were multiple branching of dentinal tubules, rejoining of enamel tubules, elongated defects, extended protrusions of dentine into enamel, two types (A and B) of hypomineralized enamel and a continuity between dentinal and enamel tubules. In the intertubular regions of the DEJ a complex intermingling of finer enamel and dentine crystals, similar to that found in human enamel, was observed. The varicosities observed in the light microscope were a combined optical effect caused by the hypomineralized (type A) enamel and the branching and rejoining of the enamel tubules.