Effect of polyaramid fiber reinforcement on the strength of 3 denture base polymethyl methacrylate resins.

PURPOSE: The interactive effects of synthetic polyaramid reinforcement fibers on the transverse strength of intact and repaired heat-polymerized denture base acrylic resins were investigated. MATERIALS AND METHODS: Three polymethylmethacrylate (PMMA) polymers were tested: Acron MC (GC International Corp, Scottsdale, AZ), Lucitone 199 (Dentsply International Inc, York, PA), and Microlon (The Hygienic Corp, Akron, OH). With each polymer, there were 2 controls and 4 experimental groups (n = 9 per group). The treatment groups were intact heat-polymerized PMMA control, PMMA with unreinforced repair, PMMA with polyaramid reinforced repair, intact polyaramid reinforced heat-polymerized PMMA control, polyaramid reinforced PMMA with unreinforced repair, and polyaramid reinforced PMMA with polyaramid reinforced repair. The transverse fracture strengths of the samples were measured with a 3-point bending test on a Zwick Universal Testing Machine (Zwick of America, Inc, East Windsor, CT). RESULTS: The highest mean strength at fracture was recorded with intact polyaramid reinforced heat-polymerized PMMA controls for all resins. Analysis of variance showed significant differences in transverse strength (p < .05) by experimental group, by material, and by interaction of group and material. Tukey HSD (honestly significant difference) Multiple Comparisons Test (alpha = 0.05) showed that intact polyaramid reinforced heat-polymerized PMMA controls were significantly stronger than intact heat-polymerized PMMA controls and all the other treatment groups. Use of polyaramid reinforcement in repair of unreinforced PMMA or polyaramid reinforced PMMA did not result in significantly increased transverse strength. CONCLUSIONS: Polyaramid reinforcement significantly increased the transverse strength of intact heat-polymerized PMMA. Polyaramid fibers did not significantly increase strength to reinforce PMMA repairs.

In vitro microleakage of luting cements and crown foundation material.

STATEMENT OF PROBLEM: Microleakage is a concern for the long-term prognosis of a cemented crown and foundation. PURPOSE: The aims of this investigation were, first, to evaluate microleakage of zinc phosphate cement and resin-reinforced glass ionomer cement under ideal (dry) versus contaminated (wet) conditions, and second, to compare 3 foundations under both ideal and contaminated conditions. MATERIAL AND METHODS: One hundred forty extracted molar teeth were cleaned and mounted. Tooth preparations for complete veneer cast crowns were completed with a chamfer finish line. A mesial surface class II cavity preparation 4 mm wide buccolingually and 2 mm deep was made in each tooth. Seven restorative groups were formed: amalgam/cavity varnish, amalgam/dentinal bonding agent, and composite/dentinal bonding agent, each with dry and contaminated groups, and a seventh group of class II cavity preparations without foundations. Finish lines for crown margins were refined 1.5 mm gingival to the restoration. Artificial crowns were cast in type III gold. Treatment groups were divided into 4 cement groups: dry and contaminated zinc phosphate cement and dry and contaminated resin-reinforced glass ionomer cement. The specimens were thermocycled and immersed in erythrosine B solution for 24 hours. Subsequently, they were rinsed, and their coronal portions were embedded in clear resin. Teeth were sectioned mesiodistally, and standard photomicrographs were made. The microleakage of each restoration and crown was measured. RESULTS: The least foundation microleakage was recorded for amalgam/dentinal bonding agents (ideal group) and composite/dentinal bonding agents (ideal group). The most microleakage was observed within the group without a foundation. In cement groups, the control and experiment sides were evaluated separately but displayed the same order of finding. The least leakage was recorded with resin-reinforced glass ionomer cement (ideal group); the most microleakage was noted with zinc phosphate cement (ideal group). An interaction was demonstrated on the experimental side between cements and the foundations (P=.0001). CONCLUSION: Within the experimental conditions of this study, less microleakage was recorded with resin-reinforced glass ionomer cement (ideal or contaminated) than with zinc phosphate cement (ideal or contaminated). There also was less microleakage evident with a foundation of silver amalgam or composite when a dentinal bonding agent was used under ideal conditions.

Development and application of a new abrasion testing device.

STATEMENT OF PROBLEM: Wear of gypsum materials is a significant problem in the fabrication of accurately fitting cast prosthetic devices. Unfortunately, there is little agreement on how to measure it. PURPOSE: This study was designed to evaluate the efficacy of a newly designed abrasion device and to develop a test methodology that provides a clinically relevant measure of material loss from gypsum material. MATERIAL AND METHODS: In this study, a unique benchtop microabrasion/microimpact device was created. The device consists of a vertical arm with a variably loaded stylus and a reciprocating table that moves the specimen under the stylus. Type IV gypsum samples (Silky Rock, Whip Mix Corp, Louisville, Ky.) were made with 1 mm vertical, 45-degree angled ridges used to represent crown margins. Samples (n = 30) were separated 1 hour after pouring and allowed to bench set for 24 hours or 7 days. Three loads (15, 50, and 75 g) were used, and the resulting defect was evaluated after 5, 10, 15, or 20 cycles of loading. Changes in mass and volume were recorded. RESULTS: At both 24 hours and 7 days, there was an increase in both mass and material volume loss with increasing load on the stylus (P<0.0001). There was no significant change in mass after 5 cycles of loading (P<0.05), but an increase in the volume loss occurred because of compaction of the walls of the defect (P<0.0001). CONCLUSION: Under these conditions, the increasing load had a greater effect than the number of load cycles on gypsum brittle fracture.

Patient management and decision making in complete denture fabrication using a duplicate denture procedure: a clinical report.

A patient may have difficulty adapting to a new prosthesis for either physical or psychological reasons. This article describes a procedure for duplicating an existing denture and gives the practitioner an alternative to the traditional denture fabrication techniques. The duplicated denture fabrication technique minimizes the changes to the new denture, making it easier for the patient to adapt to new dentures. However, in-depth communication with the patient is necessary for successful denture therapy.

Evaluation of the accuracy of solid implant casts.

PURPOSE: Materials used to fabricate the most dimensionally accurate implant casts have not been identified experimentally. The purpose of this investigation was to examine the dimensional accuracy of implant casts fabricated with different materials. Measurements of linear horizontal dimensional change and strain produced on a master framework were evaluated and correlated. MATERIALS AND METHODS: A master framework was fabricated to fit an aluminum five-implant model. Forty polyether implant impressions of the aluminium model were randomly grouped and poured in either Vel-mix, Die Keen, Resin Rock, or Low Fusing Alloy. A digital veneer caliper was used to measure linear distance between the most distal abutments on each of the experimental implant casts and the master model. In addition, strain values were recorded from strain gauges bonded in the mesiodistal axis of the framework, which was secured by prosthetic retaining screws torqued to 10 Ncm. RESULTS: A one-way ANOVA showed a significant difference among the four die materials in dimensional change of the experimental casts (p = .0001). A post-hoc Duncan's multiple-range test (p < .05) showed that casts fabricated with Low Fusing Alloy had the least linear dimensional change from the master cast, but the material exhibited the greatest dimensional variability. A MANOVA (Wilks' Lambda) showed significant differences in strain on the framework based upon die material (p = .015). A post-hoc Duncan's multiple-range test (p < .05) showed that Resin Rock casts induced significantly less strain on the framework than the other materials. Negligible correlation was found between the linear horizontal dimensional change and the total absolute strain on the framework. CONCLUSION: Experimental implant casts made of Resin Rock minimized strain on the master framework and decreased the amount of framework distortion on casts of this material. Low Fusing Alloy yielded accurate casts, but highly variable linear dimensional changes in the horizontal dimension may preclude its clinical benefit.

Effectiveness of computer-aided removable partial denture design.

PURPOSE: Computer programs have been developed for removable partial denture (RPD) design, but their educational impact has never been investigated. This study measured the effectiveness of computer-based RPD design simulations in a traditional RPD design course for second-year dental students. MATERIALS AND METHODS: Thirty-six students were randomly assigned to four groups, two simulation and two control groups, at the beginning of the RPD design module. A cross-over design compared the two strategies during laboratory exercises. First, the simulation group worked with the simulation, while the control group met in small-group seminars with faculty. Post-test 1 was given, and then students switched teaching methods and post-test 2 was given. Each post-test had two parts. Part 1 involved designing an RPD based on specific patient criteria. Part 2 involved choosing the more correct of the two designs. RESULTS: Results showed a significant difference (p = .0072) in two of four test groups. Although it was an initial evaluation, the computer simulation was shown to be equivalent to faculty-led small-group seminars. Students also responded positively to a questionnaire on their perceived effectiveness of the simulations. CONCLUSIONS: The results suggest that RPD design can be taught as effectively with computer-based simulations as with faculty-led seminars.

Denture duplication technique with alternative materials.

This denture duplication technique uses addition silicone impression material. It is an easy, time-efficient method that allows the fabrication of the duplicate denture at a convenient time.

Twelve-month results of a clinical wear study of three artificial tooth materials.

This study compared in vivo wear of a new artificial tooth material with that of existing artificial tooth materials. Artificial tooth wear was determined by measuring height changes of selected points on contacting tooth surfaces in patients with complete dentures during a 12-month period. These results are part of an ongoing 3-year clinical study. A total of 67 patients were randomized to one of three treatment groups in this double-blind study. Group 1 received dentures with existing artificial tooth materials. Group 2 received dentures that contained teeth with the new experimental material. Group 3 received dentures with Bioform IPN resin teeth (Dentsply International Inc., York, Pa). A computerized coordinate measuring machine and computer-controlled X-Y positioning stages were used for this study. Tooth wear was determined by measuring vertical heights of contacting points from baseline points at each of two time intervals. The calculation of wear was made by comparing the differences in height at the beginning of the experiment with those measured at each time interval. A repeated measures analysis of variance (ANOVA) was used to test the difference in mean wear among the three groups from baseline to 6 months and from 6 to 12 months. Group differences in total wear at 12 months were also tested. The ANOVA results revealed no statistically significant differences in the wear among the three types of denture teeth at the 6- or 12-month time intervals or at 12 months (p > 0.05). The average total wear value at 12 months was 90 microns. Group 1 averaged 102 microns of wear, group 2 averaged 88 microns of wear, and group 3 averaged 76 microns of wear.

Constructing episodes of care from encounter and claims data: some methodological issues.

There is growing agreement that episodes of care methodology provides the most effective means of analyzing health care delivery because it organizes health care services around the condition or illness for which they were prescribed. This paper presents a computerized approach for developing episodes of care from encounter and claims data and discusses some methodological issues. We found that we could group into five generic types of episodes of care the 31 illnesses that incur the majority of expenses for a health maintenance organization. This article describes the process for developing these types and summarizes the specific criteria defining the episodes of care for the 31 illnesses.

Linear dimensional variability and tensile strengths of three solder index materials.

This study compared the linear dimensional change and tensile strengths of three indexing materials used for aligning joints to be soldered. Sixty rods 6 mm in diameter and 18 mm in length were made from base metal. The rods were divided into three groups of 10 pairs each, and a simulated solder gap was created between the rods in each pair. Ten simulated gaps were indexed with Duralay resin, 10 were indexed with Relate resin, and 10 were indexed with ZAPIT cyanoacrylate material. Measurements were made of each pair, before and after indexing, and the tensile strength of each indexed pair was measured and recorded. Linear measurements showed no significant difference between any of the groups. However, significant differences in tensile strength were found among all the materials tested.