Effect of Piper betle extract on anti-candidal activity, gelation time, and surface hardness of a short-term soft lining material.

The purpose of this study was to evaluate anti-candidal activity, gelation time, and surface hardness of a short-term soft lining material incorporated with varying concentrations of Piper betle extract (0.25 to 20% w/w). Agar-diffusion assay was conducted to evaluate an inhibitory effect against Candida albicans. The gelation time was assessed and surface hardness was measured at 2 h and 7 days by Shore AO durometer. A soft liner containing at least 5% w/w of P. betle extract was observed the inhibitory effect against C. albicans. An increasing of P. betle concentrations provided larger inhibition zone. Incorporating 5% w/w of P. betle extract into the soft liner did not significantly alter its gelation time and surface hardness (ANOVA; p>0.05). The optimum composition at 5% w/w of P. betle extract can be used as an additive in the soft liner to provide the anti-candidal activity without significantly affect these two main properties.

Effect of mouth-motion fatigue and thermal cycling on the marginal accuracy of partial coverage restorations made of various dental materials.

OBJECTIVES: To investigate the influence of mouth-motion fatigue on marginal-accuracy of partial-coverage-restorations-(PCRs) of various dental materials. METHODS: Eighty molars were prepared equally and divided into five groups (n=16). PCRs were fabricated of following dental materials: Group-GO=Gold-Pontor-MPF(double dagger), Group-TA=Targis*, Group-EX=IPS-e.max-Press*, Group-EM=IPS-Empress*, Group-PC=ProCAD*/Cerec 3(dagger) ((double dagger)Metalor/*Ivoclar-Vivadent/(dagger)Sirona-Dental-System). Gold-PCRs were cemented conventionally. Residual 64 PCRs were adhesively luted and subjected to masticatory loading (1.2million-cycles, 1.6Hz, 49N) and thermal cycling (5 degrees C/55 degrees C, 60s, dwell-time, 5500cycles). Discrepancies in marginal-accuracy were examined on epoxy replicas (200 x magnification). Statistical analysis was performed by unpaired and paired t-tests (alpha=0.05). RESULTS: After cementing, marginal-accuracy (geometrical mean)[95% confidence limits] was recorded: GO-47[43-51]microm, TA-42[38-45]microm, EX-60[52-67]microm, EM-52[45-60]microm and PC-75[59-94]microm. No significant differences were found between groups GO, TA and EM. Values of Group-EX were significantly higher compared to Group-TA (p=0.04). Group-PC demonstrated significantly decreased marginal-accuracy towards groups GO (p=0.03) and TA (p=0.02). Except for Group-GO (p=0.01), no significant changes in marginal-accuracy were observed after mouth-motion fatigue and thermal cycling (GO-42[38-45]microm, TA-42[38-47]microm, EX-56[49-65]microm, EM-54[46-64]microm and PC-71[59-84]microm). However, Group-GO and Group-EM showed significant deviations in marginal-accuracy after aging (p=0.04). Marginal discrepancies of groups EX and EM were similar (p=1.0). Values of Group-PC were significantly higher when compared to groups GO (p=0.01) and TA (p=0.02). Buccal-lingual marginal discrepancies were significantly higher than mesial-distal in all groups and stages. SIGNIFICANCE: Cast-gold-PCRs demonstrated superior marginal-accuracy, followed by indirect ceromer PCRs. All-ceramic PCRs showed in vitro clinical acceptable marginal widths, even though CAD/CAM fabrication slightly compromised marginal-accuracy. Since preparation margins were not exposed to occlusal loading directly, increased marginal discrepancies due to marginal chipping during mouth-motion fatigue were not experienced.

All-ceramic partial coverage restorations on natural molars. Masticatory fatigue loading and fracture resistance.

PURPOSE: To determine the reliability and fracture resistance of adhesively luted all-ceramic partial coverage restorations (PCR) on natural upper molars after masticatory fatigue loading. METHODS: 64 maxillary molars were divided into four groups of 16 specimens each. Control Group NP remained unprepared. Teeth in Groups EM, EX and PC were prepared equally according to standardized guidelines and restored with the following PCR: Group EM = IPS Empress; Group EX = IPS e.max Press; Group PC = ProCAD/Cerec 3. The 48 PCR were all bonded adhesively with dual polymerizing composite (Variolink II). All specimens were subjected to cyclic mechanical loading (1.2 million cycles, 1.6 Hz, invariable occlusal load 49 N) with thermal cycling (5 degrees C/55 degrees C, dwell time 60 seconds, 5500 cycles) in a mastication simulator. Failure was defined by bulk fracture of a specimen. Subcritical crack patterns were observed. Surviving specimens were loaded until fracture in a universal testing machine. The load to fracture values (N) (1.5 mm/minute crosshead speed) were automatically recorded by controlling software. Statistical analysis of the data was performed by Kruskal Wallis test (ANOVA) (alpha = 0.05) and pair-wise Wilcoxon rank sum test (alpha = 0.05). RESULTS: All specimens survived mastication simulation. The following median fracture resistance values (N) (IQR = x.25-x.75) were recorded: Group-NP 1960 (1481-2228), Group-EM 1400 (1043-1722), Group-EX 1489 (1114-1751), Group-PC 2134 (2052-2391). The load-to-fracture values of Groups NP and PC in particular were significantly higher (P < 0.05) than those of Groups EM and EX. ProCAD restorations demonstrated the best predictability of failure (SD <). Within the limitations of this study, maxillary molars restored with ProCAD PCR showed a similar fracture resistance when compared to natural teeth. Since the majority of IPS e.max Press and ProCad restorations survived loads within the range of physiological mastication forces, both materials appeared to be suitable for the predictable use of posterior partial crowns.

Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study.

STATEMENT OF PROBLEM: Teeth are weakened after endodontic treatment and should, ideally, be crowned, especially posterior teeth. However, this is not always possible. Information about the longevity of endodontically treated teeth without crown coverage may assist in selecting appropriate treatment modalities. PURPOSE: The aims of this cohort study were to evaluate the survival rate for endodontically treated molars without crown coverage and to identify possible related factors. MATERIAL AND METHODS: A total of 220 endodontically treated permanent molar teeth in 203 subjects on a waiting list for fixed prosthodontic treatment at the Faculty of Dentistry-Mahidol University, Thailand, were included. Follow-up data were derived from a clinical examination and review of the dental record and radiographs. Subjects were not included in the study if teeth had provisional crowns, definitive restorations with cuspal coverage, or with dowel and core and/or crown restorations. The outcome evaluated was defined as a failure if there were negative findings in the condition of a tooth that required a restoration, tooth repair, or extraction. Tooth loss due to endodontic and periodontal reasons was excluded. The independent variables assessed were patient age, gender, location (maxilla or mandible), the existence of an opposing dentition and adjacent teeth, remaining tooth structure, and types of restorative material. Kaplan-Meier analysis with a 95% confidence level was used to calculate the survival probability, and a log-rank test was used to determine whether significant differences existed. RESULTS: Overall survival rates of endodontically treated molars without crowns at 1, 2, and 5 years were 96%, 88%, and 36%, respectively. With greater amounts of coronal tooth structure remaining, the survival probability increased. Molar teeth with maximum tooth structure remaining after endodontic treatment had a survival rate of 78% at 5 years. Restorations with direct composite had a better survival rate than conventional amalgam and reinforced zinc oxide and eugenol with polymethacrylate restorations. CONCLUSION: Within the limitations of this study, the amount of remaining tooth structure and types of restorative material have significant association with the longevity of endodontically treated molars without crown coverage.

Fracture strength of all-ceramic lithium disilicate and porcelain-fused-to-metal bridges for molar replacement after dynamic loading.

The replacement of missing posterior teeth using all-ceramic bridges remains a challenge. This study compares the fracture resistance of all-ceramic 3-unit bridges for the replacement of first molars to conventional porcelain-fused-to-metal bridges. Human premolars and molars were used to create two test groups and one control group of 16 specimens each. To simulate clinical parameters, the specimens were exposed to cyclic fatigue loading in an artificial mouth with simultaneous thermocycling. All samples were thereafter exposed to fracture strength testing. Porcelain-fused-to-metal bridges showed significantly higher fracture strengths than all-ceramic bridges. However, the fracture strength of the all-ceramic bridges was higher than peak physiological chewing forces.