Amelogenesis Imperfecta: Case Study.

Amelogenesis imperfecta (AI) refers to a group of rare genetic disorders that involve tooth development and that are passed down through families as a dominant trait. This condition is characterized by abnormal enamel formation caused by gene mutations that alter the quality and/or quantity of enamel. This dental problem can impact both primary and permanent dentition, varies among affected individuals, and results in esthetic and functional problems. This condition caused the patient in the current case report to have a lack of confidence when speaking. The treatment for amelogenesis imperfecta depends on the severity of the problem and age of the patient. It is crucial to plan a proper remedy, which requires collaboration among dental specialties to execute comprehensive dental treatment in order to provide a long-term solution with adequate esthetics. The current clinical study presents a patient affected by AI that was diagnosed when the patient was a child. The interdisciplinary treatment continued throughout his childhood and into adult life. The initial treatment consisted of resin composite veneers and stainless-steel crowns to restore the defective tooth structure. The malocclusion of the patient was corrected using a fixed orthodontic appliance that was placed when he had an entire permanent dentition. The treatment plan was eventually intended to include all ceramic crowns and veneers.

Battery Charge Affects the Stability of Light Intensity from Light-emitting Diode Light-curing Units.

This study investigated the influence of battery charge levels on the stability of light-emitting diode (LED) curing-light intensity by measuring the intensity from fully charged through fully discharged batteries. The microhardness of resin composites polymerized by the light-curing units at various battery charge levels was measured. The light intensities of seven fully charged battery LED light-curing units-1) LY-A180, 2) Bluephase, 3) Woodpecker, 4) Demi Plus, 5) Saab II, 6) Elipar S10, and 7) MiniLED-were measured with a radiometer (Kerr) after every 10 uses (20 seconds per use) until the battery was discharged. Ten 2-mm-thick cylindrical specimens of A3 shade nanofilled resin composite (PREMISE, Kerr) were prepared per LED light-curing unit group. Each specimen was irradiated by the fully charged light-curing unit for 20 seconds. The LED light-curing units were then used until the battery charge fell to 50%. Specimens were prepared again as described above. This was repeated again when the light-curing units' battery charge fell to 25% and when the light intensity had decreased to 400 mW/cm2. The top/bottom surface Knoop hardness ratios of the specimens were determined. The microhardness data were analyzed by one-way analysis of variance with Tukey test at a significance level of 0.05. The Pearson correlation coefficient was used to determine significant correlations between surface hardness and light intensity. We found that the light intensities of the Bluephase, Demi Plus, and Elipar S10 units were stable. The intensity of the MiniLED unit decreased slightly; however, it remained above 400 mW/cm2. In contrast, the intensities of the LY-A180, Woodpecker, and Saab II units decreased below 400 mW/cm2. There was also a significant decrease in the surface microhardnesses of the resin composite specimens treated with MiniLED, LY-A180, Woodpecker, and Saab II. In conclusion, the light intensity of several LED light-curing units decreased as the battery was discharged, with a coincident reduction in the units' ability to polymerize resin composite. Therefore, the intensity of an LED light-curing unit should be evaluated during the life of its battery charge to ensure that sufficient light intensity is being generated.

Shear bond strength of dual-cured and self-cured resin composites to dentin using different bonding agents and techniques.

This study determined the effects of bonding agents on the shear bond strength of dual- and self-cured resin composites to dentin. Two light-cured dentin bonding agents (Excite and One-Step) and a dual-cured bonding agent (Excite DSC) were compared. Light activation of the bonding agents prior to placement of the resin composites was also evaluated. This in vitro study was performed on 120 extracted non-carious human third molars. The occlusal part of the crowns was removed to expose a flat dentin surface. The teeth were then randomly divided into three major groups for Excite, One-Step and Excite DSC as bonding agents. The specimens in each adhesive group were divided into four subgroups: with and without light activation of the bonding agent and with dual-cured (Luxacore Dualcure, DMG, Hamburg, Germany) or light-cured resin (Luxacore, DMG, Hamburg, Germany) composites. After placing the restorations, the specimens were kept in water at 37 degrees C for 24 hours before being tested for shear bond strength on an Instron universal testing machine at a crosshead speed of 0.5 mm/minute. The results showed that the shear bond strength of dual-cured resin composite to dentin was significantly higher than that of self-cured resin composite (p = 0.017). Light activation of the bonding agents prior to applying the resin composites led to a significantly higher shear bond strength of the resin composites to dentin, compared to no light activation (p < 0.05).

Microleakage of posterior packable resin composites with and without flowable liners.

The use of flowable composites as liners in Class II packable composites has been suggested by some manufacturers. However, the contributions of this technique are unproven. This study evaluated marginal microleakage in Class II packable composite restorations with and without the use of a flowable composite liner. A conventional microhybrid composite was used as a control. Microleakage at occlusal and gingival margins of Class II cavities was evaluated using 45Ca and autoradiographs. Fifty non-carious, restoration-free human molar teeth were used. Separate mesio-occlusal and disto-occlusal Class II cavity preparations were made in each tooth. Gingival margins of all cavities were placed 1 mm apical to the cementoenamel junction (CEJ). Four Packable composites (Alert, Surefil, Pyramid and Solitaire) and one conventional microhybrid composite (Renew) with their respective manufacturer's bonding agents were used to restore the cavities. One side of each tooth was restored with composite alone, while the other side was restored with the composite lined with that manufacturer's flowable liner. The restored teeth were thermally stressed and 45Ca was used to evaluate microleakage. Two independent evaluators scored leakage based on the autoradiographs. The results showed flowable composites helped reduce microleakage at gingival margins of Class II restorations (p < 0.05). Gingival margins had higher microleakage than occlusal margins (p < 0.05). Without flowable liners, three packable composites (Alert, Pyramid and Surefil) showed higher leakage (p < 0.05) than the microhybrid control. Only Solitaire packable composite without liner showed no significant difference in microleakage to the control (p > 0.05). Although the flowable liners help reduce microleakage, Alert and Pyramid packable composites with liners still showed higher leakage than the control (p < 0.05). Surefil and Solitaire packable composites with flowable liners showed no significant difference in microleakage (p > 0.05) to the control.

In vitro study of fracture incidence and compressive fracture load of all-ceramic crowns cemented with resin-modified glass ionomer and other luting agents.

STATEMENT OF PROBLEM: Anecdotal reports based on clinical observation have recently linked resin-modified glass ionomer luting agents with postcementation fracture of all-ceramic crowns. PURPOSE: This study evaluated the fracture incidence of In-Ceram and VitaDur Alpha porcelain jacket all-ceramic crowns cemented with 5 luting agents (Fuji I, Fuji Plus, Vitremer, Advance, and Panavia 21) during 2 months storage in 0.8% NaCl solution. MATERIAL AND METHODS: Fifty human maxillary premolar teeth were prepared for each ceramic system and divided into 5 subgroups of 10 teeth to be cemented with 5 luting cements. Specimens were observed for fracture lines and crack initiation at storage times up to 2 months. Incidence of fracture was analyzed with Fisher's Exact test. Specimens that did not fracture during storage were loaded in compression to failure. Failure loads were analyzed by analysis of variance and multiple pairwise comparisons. RESULTS: Only all-ceramic crowns cemented with Advance cement fractured during the 2-month observation period, and porcelain jacket crowns were found to fracture earlier and more frequently than In-Ceram crowns. Cracks initiated at the crown margin, and multiple crack lines were found as the time of storage increased. In-Ceram crowns were significantly stronger (140 +/- 21.5 kg) than porcelain jacket crowns (98.6 +/- 17.8 kg) at P <.05. For In-Ceram crowns, cement type did not influence failure load while for porcelain jacket crowns, Fuji I (110.5 kg) was significantly higher than Vitremer (86.6 kg) at P <.05. CONCLUSIONS: For the cements studied, only crowns cemented with Advance cement demonstrated fracture during 2-month storage. Results for the true resin-modified glass ionomer cements do not support anecdotal reports of fracture of all-ceramic crowns cemented with these materials.