Trueness of vat-photopolymerization printing technology of interim fixed partial denture with different building orientation: A Microcomputed tomography study

Background

The aim was to assess the consequence of different printing orientation on the marginal misfit and internal gap of 3-unit interim fixed partial denture manufactured by two different additive manufacturing technologies compared to milling technique.

Material and Methods

Three-unit interim fixed partial denture (FPD) was designed by using exocad software (Dental CAD 3.0 Galway) in the format of standard tessellation language (STL) , which was transferred to a nesting software (PreForm) and printed by A Next Dent C&B resin liquid (NextDent; Soesterberg, Neitherland) by using two printing technologies; stereolithography (SLA, n=30) and digital light processing (DLP, n=30) with 3 different orientations (occlusal direction [0°] ,buccal direction [90°] & lingual direction [270°]) for each technology (n=10). Additionally, a control group was milled (CAD/Milling, n=10) from DC PMMA A1 Disc (White peaks dental solutions; Gmbh& co., Germany). A Microcomputed tomography was used to measure the marginal misfit and internal gap for each specimen in 12 different points. The average value of the marginal and internal gaps measurements was calculated, and one-way ANOVA was used for the comparison between groups.

Results

SLA printing technology showed a similar result to CAD/Milling with all different printing orientations tested. DLP printing technology showed the highest gap values within all the printing orientations with significant difference (p< 0.001) with the CAD/Milling and SLA.

Conclusions

Regarding the trueness of the interim FPDs, SLA was a promising technology for its superior adaptation. Marginal misfit and Internal gap for DLP printing technology limiting the use of that technology as it exceeded the acceptable clinical range. Key words:3D Printing, Microcomputed topography, Marginal Gap, Internal Misfit.

Effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia fixed partial dentures: An in vitro study

STATEMENT OF PROBLEM

Strength-gradient zirconia combining 3 zirconia formulations with different flexural strengths has been reported to have outstanding mechanical properties. However, data concerning the effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia fixed partial dentures (FPDs) are sparse.

PURPOSE

The purpose of this in vitro study was to test the effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia FPDs.

MATERIAL AND METHODS

Two custom-made stainless-steel master dies were designed to replicate a mandibular right second premolar and second molar prepared to receive a 3-unit monolithic zirconia FPD. Thirty monolithic zirconia FPDs were milled from gradient zirconia blanks and allocated to 3 groups (n=10) according to the sintering protocols: high-speed sintering, speed sintering, and conventional sintering. The FPDs were cemented onto the corresponding dies with traditional glass ionomer cement. All FPDs were cyclic loaded (600 000 cycles/49 N/1.7 Hz) in a mastication simulator. Fracture load measurements for each FPD were determined by using a universal testing machine. Scanning electron microscopy (SEM) at ×80 magnification was used to examine a fractured FPD from each group. A representative specimen from each group was examined with SEM at ×30 000 magnification to determine the grain size. One-way ANOVA, pair-wise Tukey honestly significant difference (HSD), and Pearson correlation tests were used for statistical analysis of the data (α=.05).

RESULTS

The high-speed sintered FPDs recorded the highest statistically significant fracture load mean ±standard deviation value (2526 ±300 N), followed by the speed sintered FPDs (2136 ±127 N), while the lowest statistically significant fracture load mean value was recorded with the conventionally sintered FPDs (1361 ±181 N) (P<.001). In addition, the mean ±standard deviation grain size values were 488 ±272 nm for the high-speed sintered specimen, 578 ±409 nm for the speed sintered specimen, and 832 ±551 nm for the conventionally sintered specimen (P<.001). A significant negative correlation was found between fracture strength and grain size among the 3 groups.

CONCLUSIONS

The fracture strength of 3-unit monolithic gradient zirconia FPDs sintered by using a high-speed protocol was significantly higher than that of speed and conventionally sintered FPDs (P<.001). The high-speed sintering protocol reduced the mean grain size of gradient zirconia FPDs compared with that of both speed and conventional sintering protocols.

Micro-CT analysis of marginal and internal fit of milled and pressed polyetheretherketone single crowns

STATEMENT OF PROBLEM

Polyetheretherketone (PEEK) has been increasingly used as a framework material in prosthetic dentistry. However, data on the marginal and internal fit of PEEK restorations fabricated by using either the computer-aided design and computer-aided manufacturing (CAD-CAM) or heat-pressing technique are sparse.

PURPOSE

The aim of this in vitro study was to assess the marginal and internal fit of milled and pressed PEEK single crowns by using microcomputed tomography (μCT).

MATERIAL AND METHODS

A custom-made, single stainless-steel die was designed to replicate a maxillary first premolar prepared for a ceramic crown. PEEK copings (N=30) were fabricated and allocated to 3 groups (n=10) according to the fabrication technique: milled from a prefabricated PEEK blank, heat pressed from PEEK pellets, and heat pressed from PEEK granules. All copings were veneered with a composite resin material. The marginal fit was recorded at 4 predetermined points and the internal fit at 8 predetermined points on each crown by using μCT. Two-way ANOVA, pair-wise Tukey honestly significant difference (HSD), and simple main effect tests were used for statistical analysis of the data (α=.05).

RESULTS

Concerning marginal fit, the milled crowns demonstrated the best marginal fit overall (44 ±3 μm), followed by those pressed from pellets (92 ±3 μm), and finally by those pressed from granules (137 ±7 μm) (P<.001). The interaction between the effects of the fabrication technique and the measurement point on the marginal fit was not statistically significant (P=.142). The milled crowns demonstrated the lowest mean gap values overall, followed by those pressed from pellets and those pressed from granules (P<.001). The interaction between the effects of the fabrication technique and the measurement point on the internal fit was statistically significant (P<.001). Except for the distal occlusal gap and mesial occlusal gap, all tested groups showed a statistically significant difference (P<.001). In addition, statistically significant differences were observed among all measurement points in different fabrication techniques (P<.001).

CONCLUSIONS

The marginal and internal fit of milled PEEK crowns was significantly better than pressed crowns. However, both CAD-CAM and heat-pressing techniques produced PEEK crowns with a clinically acceptable marginal and internal fit. The mean marginal gap of the PEEK crowns pressed from granules was above the range of clinically acceptable value.

Reaction Sintering of Biocompatible Al2O3-hBN Ceramics

Biocompatible Al₂O₃-hBN ceramic was sintered from AlN and B₂O₃ precursors by reaction hot pressing at 1750 °C and 30 MPa for 8 min. The ceramic was compared to nonreactive (NR) one sintered from Al₂O₃ and BN under the same sintering conditions. The NR ceramic possesses 9% porosity as opposed to only 2% porosity for the reaction sintered Al₂O₃-hBN. The reaction sintered ceramic has crack resistance in the region of 5.0 ± 0.1 MPa·m^1/2, which is approximately 20% higher than previously reported pure Al₂O₃ or Al₂O₃-hBN sintered without reaction support. The higher amount of hBN in the developed Al₂O₃-hBN material (27 vol %) facilitates hardness lowering to the region of 6 GPa, which is closer to the bone hardness and makes the ceramic machinable. Reaction sintering of the Al₂O₃-hBN composite opens a new area of creation and formation of load-bearing Al₂O₃-hBN ceramic bioimplants.

Synthetic wavelength to increase the snapshot optical sensor's elevated vertical measurement ranges

Screening manufactured products that are conducted faster to enhance the contemporary manufacture processes and quality is possible by implementing enhanced quality control. Such quality control of manufactured products has increased the market for process-focused precision metrology that can execute evaluations faster while providing significant feedback for the manufacturing system. This investigation examines spatial dispersive interferometry's potential for producing accurate surface profile measurements by emphasizing vertical range measurements and identifying a system that can enable them to increase incrementally while maintaining the results' quality. Thus, this investigation selected Fourier transform profilometry (FTP) to assess surface profile measurements, as it provides the most reliable and fastest outcome data regarding this sensor. Exploring new surface scanning methods is important, as crucial weaknesses hinder several common approaches. As optical metrology sensors are bulky, difficult to establish, and expensive, the investigation will prove that FTP can resolve these restrictions. The investigation uses the synthetic wavelength approach for addressing vertical measurement limitation concerning optical systems for extending surface step height's vertical measurement range. Though it was observed that the FTP technique surmounts the vertical height limitations, certain limitations were also noted, with all outcomes considering key variables, including the scanning objective lens, system resolution, the spectrometer resolution, and diffraction grating. Future examinations must examine a wider vertical range to expand the snapshot spatial dispersive interferometry process's scope. Further, the step-height repeatability is enhanced, showing a good outcome range from 22 to 20 nm.

UScale: a digital device for automatic urine volume measurement and frequency volume charting

Background

Health issues relating to the lower urinary tract are an increasing burden on the health economy. Measurement of urination frequency/volume using diaries to evaluate symptoms and assess severity is established in the management of these health problems. In current practice, these frequency volume diaries are completed by voiding into a measuring jug and the completion of paper or digital charts. Despite being shown useful to diagnosis, this can be a cumbersome method of data collection, leading to issues with patient compliance. In this paper we describe the established benefits of providing clinicians accurate micturition data followed by an analysis of the problems with the current data collection method.

Methods

We introduce our prototype electronic device and accompanying method, which is designed to improve data accuracy and patient compliance, while reducing patient training requirements and clinician workload.

Results

The device hardware calibration and testing procedure is described, and two sets of initial data from assumed healthy volunteers are presented, allowing us to demonstrate the advantages of digital data in the fast calculation of diary summary statistics and their potential use to clinicians.

Conclusions

We discuss the design improvements to the UScale device, collection bag, and electronic medical records integration undertaken while validating our described method.

The effect of primer cap material on ballistic toolmark evidence

There has recently been an increase in the research and implementation of advanced measurement techniques to ballistic toolmark identification. This has led to a shift from greyscale imaging to the acquisition of dense areal datasets. With the addition of mathematical correlation algorithms, these advanced techniques will be advantageous in criminal investigation. However, with the use of areal topography comes the addition of height point data which may differ in primer caps of varying material composition. This study discusses the differences in the overall topography of firing pin impressions in different primer cap materials, and the effect it has on the successful correlation of ballistic toolmark evidence.

Comparative study of material loss at the taper interface in retrieved metal-on-polyethylene and metal-on-metal femoral components from a single manufacturer

There have been a number of reports on the occurrence of taper corrosion and/or fretting and some have speculated on a link to the occurrence of adverse local tissue reaction specifically in relation to total hip replacement which have a metal-on-metal bearing. As such a study was carried out to compare the magnitude of material loss at the taper in a series of retrieved femoral heads used in metal-on-polyethylene bearings with that in a series of retrieved heads used in metal-on-metal bearings. A total of 36 metal-on-polyethylene and 21 metal-on-metal femoral components were included in the study all of which were received from a customer complaint database. Furthermore, a total of nine as-manufactured femoral components were included to provide a baseline for characterisation. All taper surfaces were assessed using an established corrosion scoring method and measurements were taken of the female taper surface using a contact profilometry. In the case of metal-on-metal components, the bearing wear was also assessed using coordinate metrology to determine whether or not there was a relationship between bearing and taper material loss in these cases. The study found that in this cohort the median value of metal-on-polyethylene taper loss was 1.25 mm³ with the consequent median value for metal-on-metal taper loss being 1.75 mm³. This study also suggests that manufacturing form can result in an apparent loss of material from the taper surface determined to have a median value of 0.59 mm³. Therefore, it is clear that form variability is a significant confounding factor in the measurement of material loss from the tapers of femoral heads retrieved following revision surgery.

Material loss at the taper junction of retrieved large head metal-on-metal total hip replacements

It has been speculated that material loss, either as corrosion or wear, at the head-stem taper junction is implicated in the high revision rates reported for metal-on-metal total hip replacements. We measured the volume of material loss from the taper and bearing surfaces of retrieved devices, and investigated the associations with blood metal ion levels and the diagnosis of a cystic or solid pseudotumor. The median volumes of material lost from the female and male taper surfaces were 2.0 and 0.29 mm(3) , respectively, while the median volumes of wear from the cup and head bearing surfaces were 1.94 and 3.44 mm(3) , respectively. Material loss from the female taper was similar to that from the acetabular bearing surface (p = 0.55), but significantly less than that from the femoral bearing surface (p < 0.001). Material loss from the male taper was less than that from both bearing surfaces (p < 0.001). Multivariable analysis demonstrated no significant correlations between the volume of material lost from the taper surfaces and either blood cobalt or chromium ions, or the presence of pseudotumor. While a substantial volume of material is lost at the taper junction, the clinical significance of this debris remains unclear.

Investigation of relative micromotion at the stem—cement interface in total hip replacement

Cemented total hip replacement has become a standard surgical technique to treat patients with osteoarthritis and osteonecrosis. The stem—cement interface experiences fretting wear in vivo due to low-amplitude oscillatory micromotion under physiological loading, and this wear is currently becoming important as a potential mechanism for the overall wear of cemented total hip replacements. However, the relative micromotion at the stem—cement interface has not been widely reported. In the present study, a new micromotion sensor is developed that is based on the deformation of a strain gauge, and this sensor is used to probe the migration of a polished Exeter stem within a Simplex P cement mantle through an in vitro wear simulation. It is demonstrated that the stem migration value generally increases with an increase in the number of loading cycles, with a gradual decrease of migration rate. Additionally, fretting wear is successfully replicated on the stem surface, and the micropores in the cement surface are considered to contribute to initiation and propagation of the fretting damage on the stem. This is confirmed by the observation that no evidence of fretting wear is detected on the stem where the surface is in contact with the pore-free areas on the cement. This study allows a deep insight into the micromotion at the stem—cement interface, and provides evidence highlighting the significance of the micropores in the cement surface in the generation of fretting wear on a polished femoral stem.

Femoral stem wear in cemented total hip replacement

The great success of cemented total hip replacement to treat patients with end-stage osteoarthritis and osteonecrosis has been well documented. However, its long-term survivorship has been compromised by progressive development of aseptic loosening, and few hip prostheses could survive beyond 25 years. Aseptic loosening is mainly attributed to bone resorption which is activated by an in-vivo macrophage response to particulate debris generated by wear of the hip prosthesis. Theoretically, wear can occur not only at the articulating head—cup interface but also at other load-bearing surfaces, such as the stem—cement interface. Recently, great progress has been made in reducing wear at the head—cup interface through the introduction of new materials and improved manufacture; consequently femoral stem wear is considered to be playing an increasingly significant role in the overall wear of cemented total hip replacement. In this review article, the clinical incidences of femoral stem wear are comprehensively introduced, and its significance is highlighted as a source of generation of wear debris and corrosion products. Additionally, the relationship between femoral stem surface finish and femoral stem wear is discussed and the primary attempts to reproduce femoral stem wear through in-vitro wear testing are summarized. Furthermore, the initiation and propagation processes of femoral stem wear are also proposed and a better understanding of the issue is considered to be essential to reduce femoral stem wear and to improve the functionality of cemented total hip replacement.

Static shear strength between polished stem and seven commercial acrylic bone cements

The stem-cement interface is one of the most significant sites in cemented total hip replacement and has long been implicated in failure of the whole joint system. However, shear strength at this interface has rarely been compared across a range of commercially available bone cements. The present study seeks to address this issue by carrying out a comparative study. The results indicated that the static shear strength was more dependent on cement type than cement viscosity and volume. However, both cement type and viscosity were contributory factors on porosity and micropore size in the cement surface. There was no significant difference between Simplex P and Simplex P with Tobramycin. Although the bone cements were all hand mixed in this study, the static shear strength was significantly larger than the values recorded by other researchers, and the porosity and micropore size showed much lower values. Bone cement transfer films were detected on the stem surface, typically about 4-10 mum thick. They were considered to be an important factor contributing to high friction at the stem-cement interface after initial debonding.

Reproduction of fretting wear at the stem—cement interface in total hip replacement

The stem-cement interface experiences fretting wear in vivo due to low-amplitude oscillatory micromotion under physiological loading, as a consequence it is considered to play an important part in the overall wear of cemented total hip replacement. Despite its potential significance, in-vitro simulation to reproduce fretting wear has seldom been attempted and even then with only limited success. In the present study, fretting wear was successfully reproduced at the stem-cement interface through an in-vitro wear simulation, which was performed in part with reference to ISO 7206-4: 2002. The wear locations compared well with the results of retrieval studies. There was no evidence of bone cement transfer films on the stem surface and no fatigue cracks in the cement mantle. The cement surface was severely damaged in those areas in contact with the fretting zones on the stem surface, with retention of cement debris in the micropores. Furthermore, it was suggested that these micropores contributed to initiation and propagation of fretting wear. This study gave scope for further comparative study of the influence of stem geometry, stem surface finish, and bone cement brand on generation of fretting wear.

Paradigm shifts in surface metrology. Part I. Historical philosophy

Surface texture and its measurement are becoming the most critical factors and important functionality indicators in the performance of high precision and nanoscale devices and components. Surface metrology as a discipline is currently undergoing a huge paradigm shift: from profile to areal characterization, from stochastic to structured surfaces, and from simple geometries to complex free-form geometries, all spanning the millimetre to sub-nanometre scales.

This paper builds a complete philosophical framework for surface metrology through a review of the paradigm shifts that have occurred in the discipline of surface metrology, tracing the development of fundamental philosophies and techniques. The paper starts with a brief overview of the historical paradigm shifts and builds an up-to-date foundational philosophy, capable of rapid and effective development. The growth in interest in surface metrology stems mainly from the need to control the manufacture of armaments during the Second World War and the production of domestic goods and appliances since that time. The surfaces produced by manufacture seemed to offer the possibility of being useful for process control. Unfortunately, only a few tentative investigations had been carried out to establish usable relationships between the processes, the machine tools and the available surface parameters (with their limitations). Even fewer investigations had been carried out to relate surface geometry to the performance of manufactured products. The result was that the metrology was unprepared and, consequently, the progress was sporadic.

This overall review is given in two parts. Part I focuses on the historical philosophy of surface metrology and Part II discusses the progress within the current paradigm shift.

Paradigm shifts in surface metrology. Part II. The current shift

This is the second part of the paper ‘Paradigm shifts in surface metrology’. In part I, the three historical paradigm shifts in surface metrology were brought together, and the subsequent evolution resulting from the shifts discussed. The historical philosophy highlighted the fact that the paradigm shifts must be robust and flexible, meaning that surface metrology must allow for full control of surface manufacture and provide an understanding of the surface functional performance. Part II presents the current paradigm shift as a ‘stepping stone’, building on the above historical context. Aspects of surface geometry will also have to cater for surfaces derived from disruptive application, i.e. structured and freeform surfaces are identified candidates. The current shift is presented in three aspects: from profile to areal characterization; from stochastic to structured surfaces; and from simple geometries to complex freeform geometries, all spanning the millimetre to sub-nanometre scales. In this paradigm shift, the scale of surface texture is beginning to approach some of the geometrical features in micro/nano electro-mechanical systems devices and is becoming one of the most important functionality indicators. Part II will contextualize the current shifts in the discipline of surface metrology, and cement surface metrology in place in the ultra precision and nanotechnology age.

Micromechanical versus chemical bonding between CoCr alloys and methacrylate resins

INTRODUCTION

As adhesive systems for bonding to metals have developed in dentistry, considerable importance is attached to the preparation of the metal alloy for both mechanical and chemical bonding. Different grit sizes when sandblasting Cobalt Chromium (CoCr) will provide a different three-dimensional surface for bonding. Previous reports have shown that 4-Methacryloyloxyethyl trimellitic anhydride (4-Meta) resins offer high bond strengths to CoCr alloy, with various surface preparations providing varying bond strengths. The relevance of this to bond strength was assessed.

OBJECTIVES

The aim of the study was to evaluate the importance of grit size of alumina in the preparation of CoCr alloy and to determine the effect on the tensile bond strength of four different acrylic resins to the CoCr alloy.

METHODS

Ten specimens were prepared within each group of four resins. Four grit sizes were assessed, 50, 110, 250 microm, and a range from 180 to 330 microm. The specimens were tested both within one day of production after storing at 37 degrees C in phosphate-buffered saline for seven days and after thermocycling.

RESULTS

Grit size resulted in a change in average contact surface area available for bonding. A significant difference (p < 0.01) existed in bond strengths between each of the materials, but no significant difference (p = 0.0673) was determined when different grit sizes were included.

SIGNIFICANCE

It was concluded that grit size determined the available contact surface area of CoCr alloy for bonding but did not determine the bond strength that could be achieved between acrylic resins and CoCr alloy as a result of the poor adaptation of the resin to the complex surface topography.

An in vitro investigation into the cutting action of ultrasonic radicular access preparation instruments

The aim of this study was to investigate the dentine cutting action of a CT4 and SJ4 radicular preparation inserts (Excellence in Endodontics/Analytic Technology, Orange, CA, USA) used in a Piezon Master 400 ultrasonic handpiece (Electro Medical Systems SA, Nyon, Switzerland). Calibration of the ultrasonic inserts was carried out at minimum, medium and maximum power settings using light microscopic measurement of the tip displacement amplitudes (x120 mag). Polished dentine samples were instrumented, at monitored loads, at the three chosen power settings, to produce uniform dentine cuts. The resultant dentine debris was collected for SEM analysis, and comparison with that produced by rotary instruments. The depth of dentine cut was measured at x30 magnification. Fracture of the SJ4 insert was noted at medium power setting. Results revealed a significant increase in both displacement amplitude and depth of dentine cut with power setting (ANOVA P < 0.001). Dentine chip size increased with power, and differed in structure and appearance from those produced by rotary instruments. In conclusion, ultrasonic cutting is influenced significantly by power setting, and dentine chip formation is fundamentally different to rotary instrumentation.

Three dimensional measurement of the surface topography of ceramic and metallic orthopaedic joint prostheses

The comprehensive study of surface topography of the orthopaedic joint prostheses has become very important for analysis of the wear mechanism and the performance life of the joint replacement systems. The aim of the study to investigate "best" methods for the three-dimensional (3D) surface metrology of orthopaedic joint prostheses. Characterization techniques for the identification and evaluation of the functional features of the bearing surface topographies has been provided in previous work. This paper concentrates on addressing issues of measurement and application techniques for assessment of the 3D surface topography of the joint replacement systems by using contacting stylus instruments, atomic force microscopes (AFM), and non-contacting measurement supported by focus detection instruments and phase-shifting interferometers. The techniques are discussed according to different analysis requirements of the orthopaedic joint prostheses. This work also discusses the performances of the instruments in terms of the measurement of femoral heads. Finally, recommendations for acceptable measurement techniques and application for analyzing surface topography of orthopaedic joint prostheses are summarized.

Three-dimensional surface characterization for orthopaedic joint prostheses

This study attempts to investigate a range of 'better' methods for the characterization of the three-dimensional (3D) surface topography of orthopaedic joint prostheses. In this paper, a new characterization tool for the comprehensive identification and evaluation of functional features of these surface topographies is presented. For identification, the surface topography is investigated in a space-scale space, by employing wavelet analysis. The roughness, waviness and form involved in surface topography are consequently separated and recovered respectively. The multiscalar topographical features are identified and captured. The errors caused as a consequence of three-dimensional measurement methods can be reduced. After identification, the three-dimensional surface assessment techniques previously reported by Stout and co-workers are used for the quantitative evaluation of various surface roughness features of the orthopaedic joint prostheses. Moreover, the functional properties, such as bearing area, material volume and void volume which are significantly effected by large peaks, pits and scratches are studied and the location of isolated peaks, pits and scratches in the different scales is also clearly characterized. In this work, measurement of the femoral heads and acetabular cups is carried out to demonstrate the applicability of the characterization technique for the three-dimensional surface topography of orthopaedic joint prostheses.

Surface integrity of composite inlays following ultrasonic vibration

PURPOSE

To assess the effect of ultrasonic vibration on the surface integrity of a resin composite inlay.

MATERIALS AND METHODS

Ultrasonic vibration in the form of a scaling tip oriented either parallel or perpendicular to the surface was applied to 2 mm thick, 10 mm wide composite discs and the experiment was repeated with the probe oriented perpendicular using composite or rubber shields. The indentations produced were measured using a form Talysurf profilometer. The surfaces of the discs were also observed using scanning electron microscopy. Five discs were used for each experiment.

RESULTS

Both parallel and perpendicular orientations produced an indentation with a scattering of composite debris. A significant increase in the depth of indentation occurred if the vibrations of the ultrasonic scaler were oriented parallel to the composite surface (Two sample t- test, P < 0.01). The presence of a composite shield significantly reduced (Mann-Whitney, P < 0.05) the depth of indentation but produced roughening of the surface with impaction of material from the shield onto the surface. The rubber shield, however, polished the surface significantly smoother than the control specimens (Mann-Whitney, P < 0.05). Microscope slide separation was used to measure the thickness of composite luting agent following vibration with an ultrasonic scaling tip with and without a protective sleeve. There was a significantly thinner film of luting agent when an unsleeved scaler was used (ANOVA, P < 0.001). Although an unguarded tip oriented perpendicular to the surface appears to result in the best energy transfer for a thin layer of composite luting agent, it does, however, create minimal surface damage.

Measurement of tooth wear in patients with palatal erosion

AIM

To develop a reproducible method for the assessment of tooth wear in vivo using a laser profilometer.

DESIGN

A controlled study to measure tooth wear.

SUBJECTS AND METHODS

Wear was measured over a 6-month period in 13 patients with unexplained palatal dental erosion and compared with a group of 7 controls without any evidence of abnormal wear.

MAIN OUTCOME MEASURES

Metal disks were cemented to the tooth surface and impressions taken at 6-month intervals. Wear was estimated by scanning the impressions with a contacting laser profilometer and measuring a change in depth around the disk over a 6-month period using fixed reference points on the metal disks.

RESULTS

A statistically significant difference was observed between patients with palatal erosion and the controls. Patients with erosion had a median of 36.5 microns of wear over 6 months (range 17.6-108.2) and the controls had a median of 3.7 microns (range 0.5-15.8).

CONCLUSIONS

This paper presents a novel method for measuring erosion using fixed reference points cemented to the palatal surfaces of upper incisor teeth.

Analysis of the surface cut by sonic files

The purpose of this investigation was to compare 3D profilometry and SEM analysis of a polished surface of bovine bone instrumented by sonic files. Two situations where investigated, i) no operator assisted movement, ii) operator assisted movement. Heliosonic, Rispisonic and Shaper files were investigated at full power setting and an interfacial load of 100 grams. The specimens were subjected to analysis using a 3D Form Talysurf prior to being sputter coated with gold and viewed under an SEM. The 3D surface analysis was found to be complimentary to SEM evaluation in that each provided additional information to the other. 3D analysis proved to be excellent for showing the topographical nature of the cut surface and gave a better indication of depth than the SEM. Debris was however more apparent on SEM evaluation. Each file showed distinctive characteristics in the shape that was cut. The cutting appeared to be as a result of abrasion with no operator assisted movement and was as a result of the longitudinal file action. However when movement was superimposed on this action continuous chip formation was apparent especially for the Rispisonic and Shaper files.

Factors affecting the cutting ability of sonic files

The aim of this study was to investigate the cutting ability of sonic files. A model system was developed and the following variables evaluated: file type. Heliosonic or Shaper; file length, 21 or 29 mm; power, air inlet ring opening of half or fully open; stroke length, 2 or 4 mm; stroke rate, one or two cycles per second; and load 50 or 100 g. A 2(6) full-factorial analysis with two replications into the effect of the above variables on the cutting ability of the MM1500 sonic instrument was performed. A new size 25 file was used for each cut, together with water irrigation, and the substrate used was 1-mm thick sections of bovine bone. The differences between the variables were significant (ANOVA, P < 0.001). However, examination of the F-values showed that the most significant variable to affect cutting was load, followed by power, file type, stroke length and stroke rate, with the least significant variable being file length. The most significant interaction was between rate and length of stroke. An increase in stroke rate from one to two cycles per second at a stroke length of 2 mm produced an increase in cutting for both the Heliosonic and Shaper files. However, at the longer stroke length of 4 mm, the same increase in rate resulted in a decrease in cutting for the Shaper files. Therefore, it is suggested that operators should press the file against the canal wall and move it slowly to maximise cutting.

Cutting characteristics of a sonic root-end preparation instrument

The aim of this study was to investigate the cutting ability of retro tips powered by a sonic handpiece (MM 1500, Micro Mega, Prodonta, Geneva, Switzerland). Two levels of the following variables were evaluated in this study: a) power setting with the an inlet ring half or fully open, b) orientation of tip perpendicular or parallel to the long axis of the handpiece, c) length of tip 2 or 3 min, d) loading of 25 or 50 grams, e) tip size 35 or 55. The substrate used was 1 mm thick sections of bovine bone and load was controlled by using a load cell interfaced with a transducer meter. Instrumentation time was fixed at 10 seconds with water irrigation. A 2(5) full factorial analysis was performed with two replications making a total of 64 experimental units. The resultant depth of cut was measured using a stereo microscope at x50 magnification. Analysis of the data indicated that all variables had a significant effect on cutting (ANOVA p < 0.05). The most significant factor was power, followed by tip length tip orientation, width and load. An increase in loading resulted in tip constraint and a reduction of cutting at the lower power setting. In conclusion sonically activated retro tips were found to cut satisfactorily with instrument air inlet ring opening/power having the main effect.

Cutting ability of an ultrasonic retrograde cavity preparation instrument

The aim of this study was to investigate the cutting ability of a working ultrasonic instrument designed for surgical endodontic use (Neosonic, Amadent Corp, Cherry Hill, NJ, USA). Three designs of tip, designated CT 1 to CT 3 were calibrated by measuring their displacement amplitudes in air using light microscopy over a range of power settings. Extracted teeth were sectioned longitudinally and polished to produce a smooth dentine surface onto which the tips were applied for 1 minute over the above range of power settings at a load of approximately 20 g. The depth of cut in the dentine surface was measured using a two dimensional surface profilometry technique. Results showed that a raising of the power setting produced an increase in displacement amplitude and cutting ability for all tip designs. This increase was linear, with minimal cutting occurring at lower power settings. In conclusion the ultrasonic tips could be successfully used to remove dentine, and medium to high power settings optimised their efficiency.