Research progress on fluoride-releasing restorative materials for caries control / 口腔疾病防治

@#Restorative materials such as conventional glass ionomer cement (CGIC), resin-modified glass ionomer cement (RMGIC), polyacid-modified composite resin (compomer), and giomer have the properties of fluoride release and refill, which may prevent or slow down the progression of caries. The caries resistance of these materials was evaluated according to the following criteria: fluorine-releasing ability, antibacterial activity, mechanical properties and anti-aging properties. The anti-caries effect of these materials mainly depends on the effect of fluoride ions on mineralization. However, materials with strong fluorine release ability, such as CGIC, are mainly used in pediatric dentistry and temporary restoration due to their poor mechanical properties. It is difficult to achieve both fluoride ion release potential and mechanical strength, and there are few materials that can provide ideal mechanical strength while maintaining a high standard of fluoride release. The fluoride releasing and recharging capacity of CGIC, RMGIC, compomer and giomer decrease successively. The trend of material modification, to a certain extent, tends to sacrifice the fluoride release capacity of materials to maintain the ideal mechanical strength. In recent years, scholars have tried to add a variety of fillers to further enhance the anti-cracking ability of materials and add antibacterial agents to compensate for the anti-caries effect to reduce the loss of fluoride release.

Study on the long-term effect of three bone graft materials after periodontal regeneration / 国际生物医学工程杂志

Objective:To evaluate the medium and long term clinical effect of three bone graft materials on periodontitis after periodontal regeneration.Methods:Initially, 16 patients with periodontitis after periodontal regeneration in Tianjin Stomatological Hospital from July 2017 to November 2018 were divided into three groups: Bio-Oss ( n=6), Bio-Gene ( n=5) and Bone 3(n=5) according to the differences in bone materials. Clinical and radiological results were evaluated at pre-surgery, post-6 months, and post-4 years. Results:The 6-month and 4-year clinical follow-up showed that, the depth of exploration (PD) and clinical attachment loss (CAL) of patients in the three groups were lower than those before operation (all P<0.05), and the changes of PD (ΔPD) and CAL (ΔCAL) were not statistically significant (all P>0.05). There was no statistically significant difference in gingival recession (GR) between the three groups (all P>0.05), and there was no statistically significant difference in the change of GR (ΔGR) between the groups (all P>0.05). From 6 months to 4 years after operation, there was no significant difference among ΔGR, ΔPD and ΔCAL groups (all P>0.05). At 6 months and 4 years after operation, the residual alveolar bone height (RBH%) of the three groups was significantly higher than that before operation (all P<0.05), and there was no significant difference between the two groups (all P>0.05); From 6 months to 4 years after operation, there was no significant difference in RBH% between the groups (all P>0.05). Conclusions:Three kinds of bone graft materials have significant clinical effects on periodontitis after periodontal regeneration, which can provide a reference for the selection of clinical regeneration materials.

Comparação in vitro da sorção e da solubilidade de quatro materiais restauradores provisórios em endodontia / In vitro comparison of the sorption and solubility properties of temporary restorative materials used in endodontics

Objetivo: Este estudo comparou as propriedades de sorção e solubilidade de materiais restauradores provisórios utilizados em endodontia. Material e método: Foram confeccionados 60 corpos de prova, divididos em quatro grupos: G1-IRM® (Dentsply), G2- Coltosol® (Coltene), G3- Riva Light Cure® (SDI), G4 Clip F® (Voco) e pesados após 24h em balança analítica de precisão. Após, foram imersas em água destilada por 12 dias e pesados novamente. Retornaram à estufa a 37 °C por 24h. Resultados: Apresentaram diferenças estatisticamente significativas entre os grupos para sorção e solubilidade. O grupo G4 apresentou menor grau de sorção com diferença estatística dos demais grupos (0,0000087). Os níveis de sorção, encontrados nos grupos G3 (0,0000313) e G1 (0,0000493), apresentam- -se estatisticamente semelhantes entre si e o G2 (0,0000573) foi estatisticamente semelhante ao G1(0,0000493). Quanto à solubilidade, G1 (0,0000107) apresentou o menor nível com diferença estatística em relação aos demais grupos. Os valores de solubilidade, em ordem crescente, foram verificados respectivamente nos grupos G4 (-0,0000213), G3 (-0,000064) e G2 (-0,0002693). Conclusões: 1. Materiais provisórios fotoativados apresentaram os menores resultados quanto à sorção de água; 2. Compostos à base de óxido de zinco e eugenol apresentaram o menor nível de solubilidade comparado com todos os outros materiais provisórios e 3 - compostos livres de eugenol de uso imediato obtiveram os maiores valores tanto de sorção quanto de solubilidade.

Objective: This study compared the sorption and solubility properties of temporary restorative materials used in endodontics. Material and method: 60 specimens were divided into four groups: G1-IRM® (Dentsply), G2-Coltosol® (Coltene), G3-Riva Light Cure® (SDI), G4 Clip F® ) and weighed after 24 hours in precision analytical balance scale. Afterwards, they were immersed in distilled water for 12 days and weighed again. They returned to the stove at 37 ° C for 24 hours. Results: There were statistically significant differences between the groups for sorption and solubility. The G4 group presented lower degree of sorption with statistical difference of the other groups (0.0000087). The sorption levels, found in groups G3 (0.0000313) and G1 (0.0000493), were statistically similar to each other and G2 (0.0000573) was statistically similar to G1 (0.0000493). Regarding solubility, G1 (0.0000107) presented the lowest level with statistical difference in relation to the other groups. The solubility values, in ascending order, were respectively verified in groups G4 (-0.0000213), G3 (-0.000064) and G2 (-0.0002693). Conclusion: 1. Temporary photoactivated materials presented the lowest results regarding sorption of water; 2. Compounds based on zinc oxide and eugenol showed the lowest level of solubility compared to all other provisional materials and 3. eugenolfree compounds of immediate use obtained the highest values of both sorption and solubility.

Stress distribution in premolars restored with inlays or onlays: 3D finite element analysis

PURPOSE: To analyze stress distribution in premolars restored with inlays or onlays using various materials. MATERIALS AND METHODS: Three-dimensional maxillary premolar models of abutments were designed to include the following: 1) inlay with O cavity (O group), 2) inlay with MO cavity (MO group), 3) inlay with MOD cavity (MOD group), and 4) onlay (ONLAY group). A restoration of each inlay or onlay cavity was simulated using gold alloy, e.max ceramic, or composite resin for restoration. To simulate masticatory forces, a total of 140 N static axial force was applied onto the tooth at the occlusal contact areas. A finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading. RESULTS: Maximum von Mises stress values generated in the abutment teeth of the ONLAY group were ranged from 26.1 to 26.8 MPa, which were significantly lower than those of inlay groups (O group: 260.3–260.7 MPa; MO group: 252.1–262.4 MPa; MOD group: 281.4–298.8 MPa). Maximum von Mises stresses generated with ceramic, gold, and composite restorations were 280.1, 269.9, and 286.6 MPa, respectively, in the MOD group. They were 252.2, 248.0, 255.1 MPa, respectively, in the ONLAY group. CONCLUSION: The onlay design (ONLAY group) protected tooth structures more effectively than inlay designs (O, MO, and MOD groups). However, stress magnitudes in restorations with various dental materials exhibited no significant difference among groups (O, MO, MOD, ONLAY).

Wear matching performance of dental restoration materials oppositing to dentine / 实用口腔医学杂志

Objective:To compare the wear resistance between dentin and dental restoration material in vitro.Methods:The friction and wear behaviors of natural tooth dentin respectively against highly polished polymer ceramic,glass ceramic and zirconia were investigated in an artificial saliva test environment by UMT-2 friction and wear testing machine.Worn surface morphology was observed by scanning electron microscopy(SEM),roughness was measured by roughness instrument,the rigidity value was weighed by electronic balance.Results:The roughness of the 3 materials was similar to that of dentin(P ＞ 0.05),the rigidity of dentin was less than that of the 3 materials (P ＜ 0.05).After friction and wear test,the abrasion quantity of dentin respectively against the 3 materials was less than that of the materials (P ＜ 0.05).There was positive correlation between the wear loss and the hardness of the 3 materials and dentin(r =0.846).The mass loss of the dentin against Poly Ceramic after grinding abrasion was the closest among the 3 materials.Conclusion:Different materials have varying degrees abrasion against dentine.The Polymer Ceramic has closer abrasion performancez with dentin than the other 2 materials.

Criteria for clinical translucency evaluation of direct esthetic restorative materials

The purpose of this review was to suggest practical criteria for the clinical translucency evaluation of direct esthetic restorative materials, and to review the translucency with these criteria. For the evaluation of reported translucency values, measuring instrument and method, specimen thickness, background color, and illumination should be scrutinized. Translucency parameter (TP) of 15 to 19 could be regarded as the translucency of 1 mm thick human enamel. Visual perceptibility threshold for translucency difference in contrast ratio (ΔCR) of 0.07 could be transformed into ΔTP value of 2. Translucency differences between direct and indirect resin composites were perceivable (ΔTP > 2). Universal and corresponding flowable resin composites did not show perceivable translucency differences in most products. Translucency differed significantly by the product within each shade group, and by the shade group within each product. Translucency of human enamel and perceptibility threshold for translucency difference may be used as criteria for the clinical evaluation of translucency of esthetic restorative materials.

Shear bond strength of dental CAD-CAM hybrid restorative materials repaired with composite resin / 대한치과보철학회지

PURPOSE: This study was performed in order to assess the effect of the surface treatment methods and the use of bonding agent on the shear bond strength (SBS) between the aged CAD-CAM (computer aided design-computer aided manufacturing) hybrid materials and added composite resin. MATERIALS AND METHODS: LAVA Ultimate (LU) and VITA ENAMIC (VE) specimens were age treated by submerging in a 37℃ water bath filled with artificial saliva (Xerova solution) for 30 days. The surface was ground with #220 SiC paper then the specimens were divided into 9 groups according to the combination of the surface treatment (no treatment, grinding, air abrasion with aluminum oxide, HF acid) and bonding agents (no bonding, Adper Single Bond 2, Single Bond Universal). Each group had 10 specimens. Specimens were repaired (added) using composite resin (Filtek Z250), then all the specimens were stored for 7 days in room temperature distilled water. SBS was measured and the fractured surfaces were observed with a scanning electron microscope (SEM). One-way ANOVA and Scheffe test were used for statistical analysis (α=.05). RESULTS: Mostly groups with bonding agent treatment showed higher SBS than groups without bonding agent. Among the groups without bonding agent the groups with aluminum oxide treatment showed higher SBS. However there was no significant difference between groups except two subgroups within LU group, which revealed a significant increase of SBS when Single Bond Universal was used on the ground LU specimen. CONCLUSION: The use of bonding agent when repairing an aged LAVA Ultimate restoration is recommended.

Translucency changes of direct esthetic restorative materials after curing, aging and treatment

The purpose of this article was to review the changes in translucency of direct esthetic restorative materials after curing, aging and treatment. As a criterion for the evaluation of clinical translucency changes, visual perceptibility threshold in translucency parameter difference (ΔTP) of 2 was used. Translucency changes after curing were perceivable depending on experimental methods and products (largest ΔTP in resin composites = 15.9). Translucency changes after aging were reported as either relatively stable or showed perceivable changes by aging protocols (largest ΔTP in resin composites = -3.8). Translucency changes after curing, aging and treatment were perceivable in several products and experimental methods. Therefore, shade matching of direct esthetic materials should be performed considering these instabilities of translucency in direct esthetic materials.

Comparison of physical & chemical properties of Angelus MTA and new endodontic restorative material.

In current study the Iranian New Endodontic Restorative Material (NERM) with Angelus MTA, has been compared in term of physical and chemical properties such as; PH, Compressive Strength, release of calcium ions, and final phase of each product and setting time. Five samples of each dental material were prepared based on ISO standards to survey the physical and chemical properties of NERM and Angelus MTA. Structural survey for both dental material revealed a similar crystal structure and no significant differences were observed in the microstructure of the NERM and Angelus MTA. Setting time in NERM and Angelus MTA samples was 25 and 17 minutes, respectively (P<0.05). Both materials tested were alkaline and released calcium, the results revealed a higher pH for MTA Angelus than for NERM. The compressive strength values of NERM were greater than the angelus MTA at 14 days. Thus, it can be concluded that NERM has better chemical and physical properties than the Angelus MTA, but Angelus MTA is preferred in terms of setting time. With more studies and considering the physical and chemical properties of NREM, it could be recommended for clinical application because of its accessibility and lower prices.

Citotoxicidad de los adhesivos dentinarios / Citotoxicity of dental adhesives

Los adhesivos son materiales de amplio uso en procedimientos de odontología restauradora que han tenido gran evolución en los últimos años, su función principal es unir la estructura dentaria previamente grabada al material restaurativo con el fin de crear una unión micromecánica y químicafuerte y duradera, su composición y las complejas reacciones químicas que originan el fenómenoadhesivo tienen influencia en su comportamiento biológico.

Adhesives are materials widely used in restorative dentistry procedures that have evolved greatly in recent years; their main function is to attach the previously etched dental structure to the restorative material in order to create a strong and lasting micromechanical union; their composition and the complex chemical reactions that cause the bonding phenomenon influence their biological behavior.

Avaliação da microinfltração coronária de três materiais utilizados na restauração provisória da cavidade endodôntica: estudo in vitro. / Coronal leakage of three materials used for temporary restoration of endodontic access cavities: an in vitro study

O objetivo deste trabalho foi avaliar a capacidade seladora de um material restaurador provisório, Villevie, e de uma resina composta, Tetric Ceram, associada a dois tipos de sistema adesivos, XENO III e Single Bond. Quarenta incisivos inferiores unirradiculares foram distribuídos em três grupos de dez dentes cada e cinco dentes para cada grupo controle, positivo e negativo. Os espécimes, após a cirurgia de acesso, foram preparados por meio de sistema de instrumentação rotatória e irrigados com água destilada e deionizada. A porção externa dos dentes foi impermeabilizada até 2 mm aquém da margem externa da cirurgia de acesso. Colocou-se no interior do canal radicular um cone de papel seguido de uma pensa de algodão impregnados com solução alcoólica de dimetilglioxima 1%. A cavidade endodôntica foi selada de acordo com os seguintes grupos: GA- sistema adesivo autocondicionante XENO III + resina composta; GB- sistema adesivo Single Bond + resina composta; e GC- selador provisório. Os espécimes foram imersos em recipientes contendo solução de sulfato de níquel 5% e submetidos à ciclagem térmica por 72h. Os testes de Kruskal-Wallis e Dunn foram utilizados para análise dos resultados com nível de 5% de signifcância. O menor nível de microinfltração foi observado no grupo do restaurador provisório (GC), com diferença estatística signifcante em relação aos demais grupos (P<0,001). Os grupos A e B mostraram-se semelhantes ao controle positivo (P>0,05), com os maiores índices de microinfltração. Concluiu-se que nenhum dos materiais avaliados foi capaz de impedir a microinfltração coronária.

The purpose of this study was to evaluate the sealing capacity of a temporary restorative material (Villevie) and a composite resin, Tetric Ceram, associated with two adhesive systems (XENO III and Single Bond). Forty single-rooted mandibular incisors were distributed into three experimental groups of 10 teeth each, and two control groups (positive and negative) of 5 teeth each. After preparation of the access cavities, the canals were instrumented with a rotary system and irrigated with distilled deionized water. The external surfaces of the teeth were rendered water-proof up to 2 mm from the external margins of the access cavities. A paper point and a coton mesh impregnated with an alcoholic 1% dimethylglyoxime were placed inside the root canals, and the endodontic access cavities were sealed according to the following groups: GA- XENO III self-etch adhesive system + composite resin; GB- Single Bond etch-and-rinse adhesive system + composite resin; and GC- temporary restorative material. The specimens were immersed in receptacles containing a 5% nickel sulfate solution and subjected to a thermal cycling regimen during 72 h. The Kruskal-Wallis and Dunn's tests were used for statistical analysis of the results at 5% signifcance level. The group restored with the temporary restorative material (GC) presented statistically signifcant less coronal leakage than the other groups (p<0.001). GA and GB were statistically similar to the positive control (p>0.05), showing the highest levels of coronal leakage. None of the tested materials was able to prevent the occurrence of coronal leakage.

Amalgam tattoo: a cause of sinusitis?

Little attention has been paid to the toxicity of silver amalgam fillings, which have been used over the centuries in Dentistry. Amalgam particles may accidentally and/or traumatically be embedded into the submucosal tissue during placement of a restoration and perpetuate in such area. This article presents a case of amalgam tattoo and investigates whether it is related to the patient's repeated episodes of sinusitis. The patient was a 46-year-old woman with a 2 mm diameter radiopaque lesion in the right oral mucosa detected on a panoramic radiograph and presented as a black macula clinically. A complete surgical resection was carried out. The histopathological examination revealed deposits of dark-brownish pigments lining the submucosal tissue with adjacent lymphocytic inflammatory infiltrate and multinucleated giant cells phagocyting pigments. There was a negative staining for both iron and melanin. One year after lesion removal, the patient reported that the sinusitis crises had ceased after repeated episodes for years. It may be speculated that the inflammatory process related to amalgam tattoo seems to lead to a local immune response that causes sinusitis because it enhances the human leukocyte antigen DR (HLA-DR) tissue expression.

Oral streptococci growth on aging and non-aging esthetic restorations after radiotherapy

The aim of this study was to examine Streptococcus mutans biofilm growth on both aged and non-aged restorative dental resins, which were submitted to therapeutic irradiation. Sixty-four disks of an esthetic restorative material (Filtek Supreme) were divided into 2 groups: aged group (AG) and a non-aged group (NAG). Each group was subdivided into 4 subgroups: non-irradiated and irradiated with 10Gy, 35Gy, and 70Gy. The biofilms were produced by Streptococcus mutans UA159 growing on both AG and NAG surfaces. The colony-forming units per mL (CFU/mL) were evaluated by the ANOVA and the Tukey LSD tests (α=0.05). AG presented smaller amounts of CFU/mL than the NAG before irradiation and after 10Gy of irradiation (p<0.05). AG irradiated with 35 and 70Gy showed increased amount of bacterial biofilm when compared to non-irradiated and 10Gy-irradiated disks (p<0.05). The exposure to ionizing radiation at therapeutic doses promoted changes in bacterial adherence of aged dental restorative material.

O objetivo deste estudo foi avaliar a formação do biofilme de Streptococcus mutans crescido em resina restauradora envelhecida e não-envelhecida, submetidas à radiação terapêutica. Sessenta e quatro discos do material restaurador Filtek Supreme foram divididos em 2 grupos: grupo envelhecido (AG) e grupo não-envelhecido (NAG) e cada grupo foi dividido em 4 sub-grupos: não-irradiado e irradiado com 10Gy, 35Gy e 70Gy. O biofilme de S. mutans UA159 foi produzido na superfície de ambos os discos AG e NAG. As unidades formadoras de colônia/mL (UFC/mL) foram avaliadas por ANOVA e teste de Tukey (α=0,05). O grupo AG demonstrou menores quantidades de UFC/mL que o grupo NAG antes da radiação e após a radiação de 10Gy (p<0,05). Os sub-grupos AG irradiados com 35 e 70Gy demonstraram aumento na quantidade de biofilme quando comparado aos não irradiados e irradiados com 10Gy (p<0,05). A exposição à radiação ionizante nas doses terapêuticas promoveu mudanças na aderência bacteriana no material restaurador.

Effect of restoration type on the stress distribution of endodontically treated maxillary premolars; Three-dimensional finite element study / 대한치과보존학회지

The purpose of this study was to investigate the effects of four restorative materials under various occlusal loading conditions on the stress distribution at the CEJ of buccal, palatal surface and central groove of occlusal surface of endodontically treated maxillary second premolar, using a 3D finte element analysis. A 3D finite element model of human maxillary second premolar was endodontically treated. After endodontic treatment, access cavity was filled with Amalgam, resin, ceramic or gold of different mechanical properties. A static 500N forces were applied at the buccal (Load-1) and palatal cusp (Load-2) and a static 170N forces were applied at the mesial marginal ridge and palatal cusp simultaneously as centric occlusion (Load-3). Under 3-type Loading condition, the value of tensile stress was analyzed after 4-type restoration at the CEJ of buccal and palatal surface and central groove of occlusal surface. Excessive high tensile stresses were observed along the palatal CEJ in Load-1 case and buccal CEJ in Load-2 in all of the restorations. There was no difference in magnitude of stress in relation to the type of restorations. Heavy tensile stress concentrations were observed around the loading point and along the central groove of occlusal surface in all of the restorations. There was slight difference in magnitude of stress between different types of restorations. High tensile stress concentrations around the loading points were observed and there was no difference in magnitude of stress between different types of restorations in Load-3.

Microleakage of endodontic temporary restorative materials under dynamic loading / 대한치과보존학회지

The purpose of this study was to compare the sealing abilities of four endodontic temporary restorative materials using a methylene blue dye penetration test under dynamic loading. Standardized access cavities were prepared in forty-four intact human permanent molar teeth, and the cavities were restored with Caviton, MD-Temp, IRM, or ZOE. After thermocycling, an intermittent load of 98 N at 1 Hz was applied for 1,000 cycles to the long axis of the functional cusp of each of the teeth, which were immersed in a 1% methylene blue solution. The teeth were split in half, and the linear depth of dye penetration was evaluated according to the criteria. The results were analyzed using one-way ANOVA (p = 0.05) and Duncan's multiple range test. The results demonstrated that Caviton and MD-Temp showed significantly lower microleakage than IRM and ZOE. It was concluded that Caviton and MD-Temp exhibited better sealing ability than IRM and ZOE under dynamic loading.