Light curing procedures - performance, knowledge level and safety awareness among dentists.

OBJECTIVES: This study aimed to investigate dentists' exposure to curing light and to obtain information about the dentists' knowledge on practical use and technical features of their curing lights as well as their safety awareness. METHODS: A pre-coded questionnaire was sent electronically to all dentists (n=1313) in the Public Dental Service (PDS) in Norway in 2015. RESULTS: The Response rate was 55.8%. The dentists spent on average 57.5% of their working days placing restorations, ranging from 1 to 30 (mean 7.7, SD 3.6) restorations per day. The average length of light curing one normal layer of composite was 27s. The longest individual mean curing time per day was about 100 times higher than that of the lowest. The mean curing time for lamps of the lower reported irradiances was similar to the time representing exceedance of international guidelines for limit values for blue light to the eyes. Almost one-third of the dentists used inadequate eye protection against blue light. The odds of using adequate eye protection were significantly higher among young dentists (p<0.01). The majority of the respondents (78.3%) were unaware of the irradiance value of their curing lights, thus rendering the curing time uncertain. More dentists in this group did not perform regular maintenance of their curing lights compared with all respondents (17.1% vs. 3.3%, p<0.01). CONCLUSIONS: This study revealed considerable variations among Norwegian dentists in the Public Dental Service with respect to performance of light curing of restorations, safety awareness and technical knowledge of the curing light. CLINICAL SIGNIFICANCE: The questionnaire study identifies specific knowledge gaps among Norwegian dentists with regard to curing lights and use of personal protection. Today's dependence on technology in dentistry necessitates that the operator possesses knowledge of essential technical specifications and safe use of devices and instruments routinely used in dental treatment.

Surface modification of fiber reinforced polymer composites and their attachment to bone simulating material.

The purpose of this study was to investigate the effect of fiber orientation of a fiber-reinforced composite (FRC) made of poly-methyl-methacrylate (PMMA) and E-glass to the surface fabrication process by solvent dissolution. Intention of the dissolution process was to expose the fibers and create a macroporous surface onto the FRC to enhance bone bonding of the material. The effect of dissolution and fiber direction to the bone bonding capability of the FRC material was also tested. Three groups of FRC specimens (n = 18/group) were made of PMMA and E-glass fiber reinforcement: (a) group with continuous fibers parallel to the surface of the specimen, (b) continuous fibers oriented perpendicularly to the surface, (c) randomly oriented short (discontinuous) fibers. Fourth specimen group (n = 18) made of plain PMMA served as controls. The specimens were subjected to a solvent treatment by tetrahydrofuran (THF) of either 5, 15 or 30 min of time (n = 6/time point), and the advancement of the dissolution (front) was measured. The solvent treatment also exposed the fibers and created a surface roughness on to the specimens. The solvent treated specimens were embedded into plaster of Paris to simulate bone bonding by mechanical locking and a pull-out test was undertaken to determine the strength of the attachment. All the FRC specimens dissolved as function of time, as the control group showed no marked dissolution during the study period. The specimens with fibers along the direction of long axis of specimen began to dissolve significantly faster than specimens in other groups, but the test specimens with randomly oriented short fibers showed the greatest depth of dissolution after 30 min. The pull-out test showed that the PMMA specimens with fibers were retained better by the plaster of Paris than specimens without fibers. However, direction of the fibers considerably influenced the force of attachment. The fiber reinforcement increases significantly the dissolution speed, and the orientation of the glass fibers has great effect on the dissolving depth of the polymer matrix of the composite, and thus on the exposure of fibers. The glass fibers exposed by the solvent treatment enhanced effectively the attachment of the specimen to the bone modeling material.

Role of thiol-complex formation in 2-hydroxyethyl- methacrylate-induced toxicity in vitro.

Methacrylate monomers that are found to leach from cured resin-based dental materials induce biological effects in vitro. The underlying mechanisms have not been fully elucidated although involvement of increased cellular reactive oxygen species (ROS) and DNA-damage has been suggested. In this in vitro study we have elucidated the impact of a commonly used methacrylate monomer, HEMA, on the level and oxidation state of cellular glutathione, intracellular ROS level, as well as the formation of complex between HEMA and glutathione. HEMA exposure rapidly led to increased level of ROS and reduced level of GSH (reduced form of glutathione). Antioxidants effectively counteracted the ROS increase, but had no effect on the GSH depletion. No change in glutathione-disulphide (GSSG; oxidized form of glutathione) concentration was detected in the HEMA treated cells, showing that oxidation of glutathione was not responsible for the reduced GSH concentration. Further we demonstrated spontaneous formation of a complex between HEMA and GSH. In conclusion, we showed that exposure to HEMA led to drop in cellular glutathione level probably caused by complex formation with HEMA. A similar covalent binding of HEMA to macromolecules combined with increased level of cellular ROS due to lower levels of GSH is suggested to be important factors triggering the toxic response.