New method of measuring subjective well-being: prospective validation study of the 'Daily Experience Sampling Questionnaire' (DESQ) in patients with psoriasis and healthy subjects in Germany.

OBJECTIVES: To validate the newly developed Daily Experience Sampling Questionnaire (DESQ) that measures affective subjective well-being (SWB). The DESQ is an end-of-day diary in which respondents retrospectively rate their SWB at six different, randomly determined moments; it is completed over 1 week. The DESQ shall provide an alternative or complementary approach to existing methods of near-time SWB measurement (experience sampling, Day Reconstruction Method). The primary research objective was to determine criterion validity of the DESQ. DESIGN: Prospective, non-interventional study. SETTING: Participants were recruited in Hamburg, Germany, at a specialised outpatient clinic (patients) and via different channels (healthy participants). PARTICIPANTS: 101 adults with diagnosed and stable psoriasis (46 women, 55 men); 105 adults without psoriasis (49 women, 56 men). PRIMARY AND SECONDARY OUTCOME MEASURES: Participants completed the DESQ for 3 weeks. In weeks 2 and 3, they also performed experience sampling. Criterion validity was determined by weekwise intraclass correlations (ICC) between both methods. Sensitivity to change was determined by the correlation between changes in both methods from weeks 2 to 3. For convergent validity, related concepts such as life satisfaction were measured. Retest reliability was determined using DESQ values of weeks 2 and 3. RESULTS: Criterion validity was excellent (ICC: patients=0.86, 95% CI 0.81 to 0.91; healthy participants=0.86, 95% CI 0.79 to 0.91). Sensitivity to change was r=0.57 and r=0.56, respectively. Correlations with convergent criteria were mostly significant and higher in constructs more proximal to SWB. The ICC indicating retest reliability was 0.77 in patients (95% CI 0.68 to 0.84) and 0.81 in healthy participants (95% CI 0.73 to 0.86). CONCLUSIONS: The DESQ is a valid, reliable and feasible instrument for SWB measurement in people with psoriasis and healthy people. Its approach of end-of-day evaluations of single moments may also lend itself to the measurement of other highly time-variant constructs such as pain, fatigue or depression.

Air polishing with erythritol powder - In vitro effects on dentin loss.

CONTEXT: Low-abrasive polishing powders such as glycine (GLY) or erythritol (ERY) are used for subgingival air polishing. GLY was reported to possibly affect the dentin surface, while this is unclear for ERY. AIMS: This in vitro study aimed to evaluate the substance loss from the dentin surface by air polishing with ERY at different settings for pressure (PR), distance (DI), and angulation of the spray jet to the surface (AJ). MATERIALS AND METHODS: The in vitro testing was performed on smooth human root dentin surfaces. In 18 groups with 10 specimens each, ERY was applied with constant water supply for 5 s without moving the handpiece at the following settings: PR minimum (min), medium (med), and maximum (max); DI at 1, 3, and 5 mm; and 45° or 90° AJ. The substance loss was measured as defect depth (DD) using three-dimensional (3D)-laser profilometry. ANOVA with Bonferroni correction and α = 0.05 were used for statistical analysis. RESULTS: The DD was statistically significantly higher at a DI of 1 mm compared to a DI of 5 mm for the respective groups of the same PR and AJ (P < 0.05). For DI 1 mm, max PR, and AJ 90°, the maximum loss of substance amounted DD of 117 ± 43 µm. The minimal loss of substance occurred at minimal PR, 45° AJ, and a DI of 5 mm (15 µm × 20 µm). DD related directly with the parameters PR and AJ and inversely with DI. The highest influence on DD was proven for DI. CONCLUSIONS: Slight loss of dentin might occur during air polishing with ERY depending on DI, PR and AJ. The setting influences the amount of dentin loss.

Cleaning effectiveness of implant prophylaxis instruments.

PURPOSE: The aim of this study was to evaluate the cleaning effectiveness of implant prophylaxis instruments on polished and acid-etched implant surfaces. MATERIALS AND METHODS: Biofilm layers of Streptococcus mutans were grown on a total of 80 titanium disks; 40 disks were polished and 40 were acid-etched. Five disks of each surface were cleaned using each of seven implant prophylaxis instruments: (1) manual plastic curette, (2) manual carbon fiber-reinforced plastic (CFRP) curette, (3) sonic-driven prophylaxis brush, (4) rotating rubber cup with prophylaxis paste, (5) sonic-driven polyether ether ketone (PEEK) plastic tip, (6) ultrasonic-driven PEEK plastic tip, and (7) air polishing with amino acid (glycine) powder. Ten disks (five of each surface type) served as controls. After cleaning, the surfaces with remaining bacteria were assessed by light microscopy. Statistical analyses of the results were performed with one-way and two-way analyses of variance with Bonferroni-Dunn multiple comparisons post hoc analysis (α = .05). RESULTS: The cleaning effectiveness of the plastic curette was significantly lower than those of all machine-driven instruments on the polished surface. Significantly lower cleaning effectiveness occurred with the CFRP curette compared to the prophylaxis brush and to both oscillating PEEK plastic tips on the polished surface. The rubber cup provided less cleaning effectiveness compared to the ultrasonic PEEK plastic tip and air polishing on the acid-etched surface. Superior results, with less than 4% of the biofilm remaining, were obtained for both oscillating PEEK plastic tips and air polishing on both implant surfaces. The cleaning ability of the prophylaxis brush, rubber cup, and ultrasonic PEEK plastic tip differed significantly between both surface structures. CONCLUSIONS: Cleaning effectiveness, ie, less than 4% of the biofilm remaining, was not observed with all tested implant prophylaxis instruments. The cleaning ability of the devices depended on the implant surface structure.

Preparation time and surface roughness of core foundation resins and dentin.

STATEMENT OF PROBLEM: It is unclear if the preparation of core foundation resins is similar to that of dentin. PURPOSE: The purpose of this in vitro study was to compare the preparation time and resulting roughness of 5 core foundation resins and dentin. MATERIAL AND METHODS: Standardized preparations (10 mm length, 5 mm height) were made of 5 specimens of 5 core materials with a device-mounted dental handpiece (150 000 rpm, water-cooling) with weight-controlled contact pressure (50 g). To assess the cutting time of 100 µm grit cylindrical diamond rotary cutting instruments, 2 mm and 4 mm depths were cut 3 times (n=15). Afterwards surface roughness Ra and Rz were measured. Blocks of dentin were used as a control. Both preparation time and surface roughness data were statistically analyzed (1-way ANOVA, Scheffé correction, α=.05). RESULTS: The average preparation times for dentin were 7 seconds for a 2 mm preparation depth and 22 seconds for a 4 mm depth with an average Ra of 5.4 µm or Rz of 30 µm. For a 4 mm depth, preparation times for Build-It, Rebilda LC, and Ti-Core ranged from 24 to 27 seconds. The preparation times of these 3 core foundation materials did not differ significantly from dentin for a 4 mm depth. The results of Core Paste and Luxacore were significantly lower (10 and 11 seconds, P<.001). For a 2 mm cutting depth, Core Paste and Luxacore showed similar preparation times compared to dentin (7 seconds, P>.05). Build-It (12 seconds) and Rebilda LC (10 seconds) showed greater preparation times compared to dentin, whereas Ti-Core preparation (5 seconds) was less. ANOVA revealed significantly lower Ra (5.0 µm) and Rz values (23-26 µm) after preparation of Core Paste, Luxacore, and Ti-Core than those of dentin (P<.05). CONCLUSIONS: The preparation times of only some core foundation materials were comparable to dentin. Regarding the cutting depths, different materials provided a dentin-like preparation ability. The surface roughness values of core resins were comparable with or significantly lower than those of dentin.

Effects of 10 cleaning instruments on four different implant surfaces.

PURPOSE: The aim of this study was to evaluate the effects of a variety of implant cleaning instruments on different implant surfaces, specifically surface roughness and cleaning efficacy. MATERIALS AND METHODS: Biofilm layers of Streptococcus mutans were cultivated on titanium disks with four different surface structures (polished, grit-blasted, acid-etched, and acid-etched/grit-blasted). Five disks each were cleaned using nine mechanical implant cleaning instruments or an erbium:yttrium-aluminum-garnet laser. Surface roughness (average, Ra; maximum, Rz) and waviness (Lr) were evaluated by two-dimensional laser profilometry. Surface structure damage and cleaning scores were assessed by scanning electron microscopy. Statistical analyses of the results were performed with one- and two-way analyses of variance and Bonferroni-Dunn multiple-comparison post hoc analysis (α = .05). RESULTS: Ra and Rz values for the acid-etched surfaces and Ra, Rz, and Lr values for the polished and the grit-blasted surfaces showed no significant differences between the different cleaning methods or cleaning instruments compared to the control (not cultured, not cleaned) groups. Significantly lower Ra and Rz values on grit-blasted/acid-etched implant surfaces were found following use of the Sonic-Flex clean with prophylaxis brush and the plastic curette compared to Satelec ProphyMax with Periosoft curette. Ra and Rz values of the different implant structure surfaces before cleaning were significantly different between all implant surfaces except for the polished compared to the acid-etched surfaces. CONCLUSIONS: Cleaning effect and alterations of the implant surfaces were strongly dependent on the implant cleaning method used.

Resistance against pull-out force of prefabricated coated FRC posts.

PURPOSE: To investigate the effect of a prefabricated tribochemical coating of FRC (fiber-reinforced composite) posts with and without aging on the pull-out forces compared to posts without conditioning. MATERIALS AND METHODS: Post space preparations were performed on 108 extracted anterior teeth. Thirty-six uncoated FRC posts (DentinPost) and 72 prefabricated tribochemically coated FRC posts (DentinPost Coated) were used at a length of 12 mm. Thirty-six of the coated posts were thermally aged. FRC posts (n = 9) were placed using DentinBuild or MultiCore Flow foundation composite resins or Panavia F2.0 or RelyX Unicem resin cements. Following water storage (37°, 24 h) and thermocycling (5000 cycles, 5° to 55°C, 30 s), pull-out force testing was performed. Fracture modes were assessed using a light microscope. Data were analyzed statistically (1-way and 3-way ANOVA, Bonferroni-Dunn correction, α = 0.05). RESULTS: Significantly higher pull-out forces of posts luted with Panavia F2.0 were observed for the coated and coated/aged FRC posts compared to the unconditioned posts (control group, p < 0.001). The pull-out forces of tribochemically coated FRC posts luted with MultiCore Flow were significantly lower than of coated posts luted with Panavia F2.0 (p < 0.001). Coated/aged FRC posts exhibited similar pull-out forces for the tested luting composite resins (p > 0.05). Except for DentinBuild (coated posts), more mixed or cohesive fractures were assessed for coated and coated/aged FRC posts than for unconditioned FRC posts. CONCLUSION: Prefabricated tribochemical coating of FRC posts provided a stable interface between coating and post and remained stable over time.

Fracture resistance and analysis of stress distribution of implant-supported single zirconium ceramic coping combination with abutments made of different materials.

The purpose of this study was to compare the fracture resistance and fracture mode of single implant-zirconium coping combinations using zirconium and titanium abutments and to analyze the stress distribution pattern using three-dimensional finite elements analysis. Twenty implants with titanium and zirconium abutments were randomly divided into two groups (n = 10) and into resin blocks. Zirconium copings were cemented onto the abutments. The specimens were loaded with 135° angles to the long axis and the load values at the moment of failure were recorded using a universal test machine. Stress levels were calculated according to the maximum Von Mises criteria. The fracture resistances for titanium and zirconium abutment groups were 525.65 N and 514.05 N, respectively. No significant differences were observed between two groups regarding the fracture resistance levels. The maximum Von Mises equivalent stress concentrated on zirconium copings in both of the groups. Implant-abutment-ZrO2 coping combination has the potential to withstand physiological occlusal forces in the anterior region. Three-dimensional finite elements analysis results of the implant-abutment-ZrO2 coping combination is compatible with the results of fracture resistance.

Effect of noble metal alloy post and core material on the fracture resistance of endodontically treated teeth.

The aim of this study was to investigate the effect of one particular brand of post and core system (ER Post) consisted of different post and core materials on the fracture resistance of endodontically treated teeth. Fifty caries-free maxillary central incisors were randomly assigned to five groups (n=10). All teeth were sectioned at the cemento-enamel junction except for the teeth in the control group. Four experimental groups consisted of cast gold post-and-core group (GG), Heraplat post/cast gold core group (HG), titanium post/composite core (TC), and titanium post/cast gold core (TG). The control group (ETT) consisted of endodontically treated teeth without posts. All posts were cemented in the roots with zinc phosphate cement. Following thermal cycling (5000 cycles between 5 degrees C and 55 degrees C with a dwell time of 30 seconds) a static load was applied to 2 mm below the incisal edge on the palatal surface of each specimen until they were fractured. Fracture data obtained and statistically analyzed with one-way ANOVA and a Tukey's test (p<0.05). Means of the fracture resistance during static loading were: 423.76 N (GG), 529.46 N (HG), 389.08 N (TC), 408.7 N (TG), 404.4 N (ETT, control). Heraplat post with cast gold core exhibited the highest fracture load than the other groups (p<0.05). Specimens in groups HG and ETT (control) showed the most repairable failure. Heraplat post with cast gold core had the highest fracture resistance of endodontically treated teeth.

Fracture resistance of endodontically treated teeth: effect of tooth coloured post material and surface conditioning.

This in vitro study evaluated the effects of the different endodontic posts and surface conditioning on the fracture resistance and fracture modes of endodontically treated teeth. The experimental groups consisted of zirconia ceramic post with a glasss-ceramic core [A], zirconia ceramic post with a composite core [B], glass fiber composite post (FRC) with a composite core [C], and titanium post with a composite core [D]. All posts in these groups were cemented with self-adhesive resin cement (Rely X Unicem Aplicap) combination with tribochemical silica coating (TSC). Groups E, F, G and H comprised the same post-and-core materials as the first 4 groups but cemented with the same resin cement without TSC. Specimens were subjected to thermal cycling between 5 degrees C and 55 degrees C for a total of 5000 cycles with 30s per cycle. Static load was applied to the palatal surface of each specimen until they were fractured. Statistical analysis was conducted using analysis of variance (ANOVA) followed by post-hoc comparisons (Tukey). The fracture resistance was significantly affected by the post material (P < 0.001) and surface conditioning (P < 0.001; two-way ANOVA). The application of TSC to post surface decreased the fracture resistance of zirconia ceramic post with composite core (p=0.002; Tukey) and glass FRC post with composite core (p=0.029; Tukey). No catastrophic failure was observed for groups B, C, D, E, F and G. Under the testing conditions used, the titanium post/composite core that had been silicoated exhibited the highest fracture resistance.

Effect of surface conditioning on the retentive bond strengths of fiberreinforced composite posts.

STATEMENT OF PROBLEM: Debonding is a common cause of failure encountered with fiber-reinforced composite (FRC) posts, and usually occurs along the post space-dentin adhesive interface. Surface conditioning of posts is expected to increase the chemical and mechanical bond between the luting composite resin and the post, but the best method has not been definitively determined. PURPOSE: The purpose of this in vitro study was to compare the effects of 3 surface-conditioning methods on the retentive bond strengths of FRC posts using 5 composite resin materials, and compare results to those of unconditioned FRC posts as well. MATERIAL AND METHODS: Post space preparations (DentinPost ER root post system, length of 12 mm) were performed on 200 human anterior teeth. Groups of 50 FRC posts (ISO size 90) each were treated using 1 of the following conditioning methods: silanization, etching with 5% hydrofluoric acid, tribochemical coating (CoJet system), or were left untreated (control group). FRC posts (n=10) in each group were placed using 1 of 5 composite resin materials (Calibra or RelyX Unicem resin cements or Build-It, MultiCore Flow, or Rebilda DC foundation composite resins). Following water storage (37 degrees C, 24 hours) and thermal cycling (5000 cycles, 5 degrees -55 degrees C, 30-second dwell time), tensile strength testing was performed. Fracture modes were assessed using a light microscope. Data were analyzed statistically (1-way and 2-way ANOVA, Bonferroni-Dunn correction, alpha=.05). RESULTS: Retentive bond strengths of FRC posts luted with MultiCore Flow in combination with the CoJet system, and of posts inserted with Rebilda DC in combination with hydrofluoric acid (HF) etching as well as with the CoJet system, were significantly higher than those of the corresponding unconditioned FRC posts (P<.001). No significant differences were noted between the bond strength values of RelyX Unicem with CoJet, MultiCore Flow with CoJet, and Rebilda DC with either CoJet or HF etching (P>.05). Retentive bond strengths were significantly lower for HF etching (Calibra, RelyX Unicem, Build-It), and for the treatment with the CoJet system in combination with Build-It compared to the corresponding control groups (P<.001). Fracture modes were primarily adhesive at the post surface or cohesive within the composite resin layer or within the FRC post. CONCLUSIONS: The retentive bond strengths differed significantly with respect to the tested combinations of conditioning method and luting composite resin.

Stability of loaded and unloaded implants with different surfaces.

PURPOSE: To compare the torsional strengths and the effects of functional loading on five different implant surface structures. MATERIALS AND METHODS: This in vivo longitudinal study of 9 months' duration examined osseointegration in 180 stepped cylindric implants placed into the mandibles of 18 healthy sheepdogs. Implants with five different surface structures were placed (n = 36 in each group): (1) smooth surface; (2) deep profile structure (DPS); (3) titanium plasma sprayed (TPS); (4) hydroxyapatite coated; and (5) sol-gel hydroxyapatite coated (SGHA). All implants were investigated under standardized conditions. At uncovering (3 months), half the implants were loaded with prefabricated crowns for 6 months, and the other half remained unloaded. Removal torque values were evaluated at 3, 6, and 9 months after implant placement. The data were analyzed using analysis of variance and Scheffé correction (alpha < .05). RESULTS: All smooth-surface and SGHA implants failed in succession during the fourth and ninth months of the study. After 3 months the removal torque resistance of DPS, TPS, and hydroxyapatite-coated implants was significantly higher (P < .001) than that seen in the other two groups. Initially, the removal torque resistance of unloaded hydroxyapatite-coated implants was superior, and the decrease during the observation period was not significant. The increase in removal torque resistance under functional loading was not significant for the DPS implants. A significant increase was found in removal torque resistance for the loaded TPS implants (P < .05). The unloaded DPS and TPS implants showed no change in removal torque levels after the closed healing period of 3 months. CONCLUSIONS: Successful osseointegration was achieved with DPS, TPS, and hydroxyapatite-coated implants, and smooth-surface and SGHA implants failed. Removal torque resistance was enhanced with controlled functional loading.

Yield strength of fiber-reinforced composite posts with coronal retention.

STATEMENT OF PROBLEM: Currently, glass fiber-reinforced composite (FRC) posts with shank heads are only recommended for moderate coronal defects. Restoring endodontically treated teeth with large coronal defects remains a challenge, requiring posts with coronal retention and high bending resistance. PURPOSE: The purpose of this in vitro study was to investigate the yield strengths of FRC posts and titanium posts (TI) with coronal retention for core foundations compared to FRC and TI posts without coronal retention. MATERIAL AND METHODS: Tapered posts (ER root post system) of 4 diameters (ISO 50, 70, 90, 110), 2 lengths (tapered part: 9 and 12 mm) of identical shape, 2 materials (FRC, titanium), and 2 head designs (shank without retention (SH) and post head with horizontal retention (RET)) were evaluated (n=9). Titanium posts (TI-SH, TI-RET) served as the control. The 0.2% yield strengths (R(0.2)) of all specimens were tested in a universal testing machine. Three-way and 1-way ANOVAs with Bonferroni-Dunn's multiple comparison tests were performed (alpha=.05). RESULTS: The yield strengths of the control groups TI-RET were significantly higher for ISO 110 with a 9-mm length and for ISO 70 and 110 with a 12-mm length, compared to the respective FRC-RET posts (P<.001), whereas in all other groups, TI-RET and FRC-RET showed no significant differences. FRC-SH groups did not differ from FRC-RET groups. TI-SH showed significantly lower yield strength for ISO 70 compared to TI-RET, but significantly higher values for ISO 90 and 110 (P<.001). CONCLUSIONS: Head design of the tested FRC posts does not improve the yield strength, compared to FRC posts with a shank design. The diameter of the posts had a significant effect on the yield strengths of RET as well as SH groups.

Wear and hardness of different core build-up materials.

Before crown preparation, teeth with extensive coronal destructions are built up with core materials. Sometimes, these build ups are exposed to the oral environment without the protection of crowns. Therefore, this in vitro investigation was aimed at evaluating the wear, surface roughness, Vickers hardness, and surface structure of 10 core composites, two glass ionomer cements (GICs), and four posterior restoration composites. The three-body wear was tested after water storage and 2,00,000 cycles. We measured both surface roughness and Vickers hardness (DIN 50133) and evaluated the surface structures by scanning electron microscopy. Results were statistically analyzed by use of the Mann-Whitney U test (alpha = 0.05). Lowest wear was found for the restorative composites (20 microm Grandio; others about 40 microm). A comparison of the composites Build-It, Chroma Core, Rebilda LC, and Rebilda DC to Quixfil showed similar wear values for each material (43-50 microm). Wear values of GICs and all others core composites ranged between 58 and 75 microm. Only Ti-Core showed significantly higher wear than all other materials (p < 0.05). All core materials except Ti-Core (35 HV) showed Vickers hardness values between 42 and 61 HV. Most core composites, particularly Build-It, Multicore Flow, Rebilda LC, Ecusit, and Tetric Evo Ceram, showed more homogenous surface structures compared to GICs and restorative composites. Therefore, wear values of core build-up materials not only differed widely but were higher than those of conventional restorative materials; yet, core build-up materials showed advantageous surface structures.

Penetration of moxifloxacin into rat mandibular bone and soft tissue.

OBJECTIVE: Based on its in vitro activity and spectrum of activity, the new 8-methoxyquinolone antibiotic moxifloxacin (MXF) seems suited for the antibiotic therapy of odontogenic infections. Penetration into the relevant tissue is another prerequisite for clinical efficacy. For this reason, the levels of MXF in plasma, soft tissue, and mandibular bone were determined in an animal model with Wistar rats. MATERIAL AND METHODS: Samples of 49 rats were analyzed. Tissue samples were homogenized and proteins were precipitated. The pharmacokinetic evaluation was conducted based on non-compartmental analysis. RESULTS: The concentration-time courses of tissues show a more plateau-shaped curve compared to plasma. Calculated AUC (area under the curve) ratios tissue:plasma were M. masseter:plasma = 2.64 and mandibles:plasma = 1.13. CONCLUSIONS: Administration of antibiotics is considered an important part of therapy during and/or after surgical procedures in the maxillofacial area. Because of the good penetration into bone and muscle tissues demonstrated in Wistar rats, MXF might be an option for clinical application in this indication.

Influence of oversized dowel space preparation on the bond strengths of FRC posts.

This study compared the bond strengths of fiber-reinforced composite (FRC) posts luted into oversized dowel spaces with FRC posts luted into precisely fitting dowel spaces using five different resin cements or build-up composites. The hypotheses examined were that bond strength does not present vast variations according to the width of the gap between the root canal and post and that bond strength increases for FRC posts luted with build-up composites compared with FRC posts luted with resin cements. Dowel space preparations (ER post-restoring system, 12 mm in length) were performed on 100 human anterior teeth up to ISO 90 and ISO 110 of 50 roots each. FRC posts, all ISO size 90, were inserted into the precisely fitting as well as into the oversized dowel spaces (n = 10) using five composite materials (Calibra, Multicore Flow, Rely X Unicem; resin cements and Build-It, Rebilda DC; build-up composites). The manufacturers' instructions of the composite materials were strictly followed except for Rebilda DC, which was used with Adhese for dentin bonding. Following water storage (37 degrees C, 24 hours) and thermocycling (5000 cycles, 5 degrees C-55 degrees C, 30 seconds) tensile strength testing was performed and fracture modes were assessed using SEM. Data were analyzed statistically (one-way and two-way ANOVA, Bonferroni/Dunn correction, alpha < 0.05). The retentive bond strengths of FRC posts in oversized dowel spaces decreased significantly for all luting composites except for Rebilda DC, compared with the respective groups with precise fitting (p < 0.011). Yet, the bond strengths of RelyX Unicem (454 N +/- 64 N), Build-It (422 N +/- 43 N) and Calibra (408 N +/- 50 N) showed significantly higher values for the precisely fitting posts than Rebilda DC (267 N +/- 54 N). RelyX Unicem revealed significantly higher values than Multicore Flow (296 N +/- 73 N). The bond strengths of FRC posts in oversized dowel spaces varied from 301 N +/- 78 N for Build-It to 152 N +/- 37 N for Calibra. The values of Build-It were significantly higher compared with Calibra, Multicore Flow (180 N +/- 47 N) and Rebilda DC (186 N +/- 52 N), as well as those of RelyX Unicem (256 N +/- 115 N) were significantly higher than Calibra. Fracture modes were shown to be mainly adhesive at the post surface or cohesive for precisely fitting posts and to occur between post and composite except for RelyX Unicem with cohesive fractures for the oversized dowel spaces. The build-up composite Build-It showed superior bond strengths in oversized canals, which were still not as high as those of posts in precisely fitting dowel spaces using common resin cements.

Influence of luting agent on the microleakage of all-ceramic crowns.

PURPOSE: In this in-vitro study, microleakage of all-ceramic crowns was evaluated at enamel and dentin margins. MATERIALS AND METHODS: Forty maxillary central incisors were randomly divided into 4 groups (n = 10). While buccal and palatal margins were placed on enamel, mesial and distal margins were placed below the cementoenamel junction. In groups 1 to 3, IPS Empress 2 crowns were luted with Variolink 2/Syntac Classic (group 1), Bifix DC/Solobond Plus (group 2) and Calibra/Prime & Bond NT combinations (group 3), respectively. In the control group (group 4), porcelain-fused-to-metal crowns were luted with a zinc-phosphate cement. All specimens were subjected to 5000 thermocycles (at 5 degrees C to 55 degrees C; 30-s dwell time). After immersion in India ink for 48 h at 37 degrees C, the specimens were sectioned both buccolingually and mesiodistally. Each section was evaluated for microleakage under a stereomicroscope at 24X magnification. RESULTS: According to the Krukal-Wallis test, in all groups, there were significant differences in microleakage at the enamel margins (p = 0.001). Nevertheless, the margins finished in dentin showed no significant differences (p = 0.163). According to the Mann-Whitney U-test, statistically significant differences were observed in microleakage between groups 1 and 3 (p = 0.049), groups 1 and 4 (p = 0.001), groups 2 and 4 (p = 0.002), and between groups 3 and 4 (p = 0.045) at the enamel margin. In group 1, significantly greater microleakage was observed at the dentin margin compared to the enamel margin (p = 0.007). CONCLUSION: The adhesive luting technique demonstrated an excellent ability to minimize microleakage of all-ceramic crowns at the enamel margins. Water-based dentin bonding systems showed less microleakage than the water-free acetone-based dentin bonding system at the enamel margin.

Analysis of dentinal stress distribution of maxillary central incisors subjected to various post-and-core applications.

This study evaluated the stress distribution on an endodontically treated maxillary central incisor restored with different post-and-core systems by using a three-dimensional finite element analysis model. Seven three-dimensional finite element models were created. Each model contained cortical bone, cancelous bone, periodontal ligament, 3 mm apical root canal filling, post-and-core and all-ceramic crowns. Two different pre-fabricated zirconia ceramic post systems, a glass fiber-reinforced post system and a titanium post system were modeled. As a control, an all-ceramic crown on an endodontically treated maxillary central incisor without a post-and-core was modeled. Each model received a 45 degrees oblique occlusal load at a constant intensity of 100 N. In each model, the ratio of Von Mises stress distribution was compared. The greatest stresses were observed in the coronal third of the roots on facial surfaces. The ratio of Von Mises stress distribution in dentin for the zirconia ceramic post (CosmoPost) and ceramic core (Cosmo Ingot), zirconia ceramic post (CosmoPost) and composite core (Tetric Ceram), glass fiber-reinforced post (FRC Postec) and composite core (Tetric Ceram), titanium post (Er post) and composite core (Tetric Ceram), zirconia ceramic post (Cerapost) and ceramic core (Cosmo Ingot), zirconia ceramic post (Cerapost) and composite core (Tetric Ceram) and the control group were 0.886, 0.889, 0.988, 0.924, 0.889, 0.893 and 1, respectively. The stress concentrations in dentin created by two different zirconia ceramic post systems were nearly the same. The zirconia ceramic post systems created slightly less stress concentration in dentin than the glass fiber-reinforced and titanium posts.

Effect of surface treatment of titanium posts on the tensile bond strength.

OBJECTIVES: Retention of composite resins to metal can be improved when metal surfaces are conditioned. The purpose of this investigation was to investigate the effect of two conditioning treatments on the tensile bond strength of four resin-based luting cements and zinc phosphate cement to titanium posts. METHODS: The effect on tensile bond strength of (1) air-particle abrasion (50 microm Al2O3) and (2) silica coating (30 microm SiO(x)) and silanization of tapered titanium posts prior to luting with any of the four resin composite luting cements (Compolute) Aplicap, Flexi-Flow cemTM, Panavia 21 EX, Twinlook) were evaluated. The posts luted with zinc phosphate cement (Tenet) were considered as the control group. Following endodontic preparation of 100 intact anterior human teeth with hand instruments, the post spaces were prepared using the opening drills of the corresponding size of the posts. All posts were cemented into the roots according to the manufacturer's instructions of each cement. The specimens were first stored in water at 37 degrees C for 24 h and then subjected to thermocycling (5000 cycles, 5-55 degrees C, 30 s). The tensile strength values were measured on a universal testing machine at a cross-head speed of 0.5 mm/min. Data were analyzed statistically using ANOVA and corrected with Scheffé-test due to the significance levels (P<0.05). RESULTS AND SIGNIFICANCE: The composite resin luting cements did not show significant differences (P<0.05) showing values between (352+/-76N-475+/-104N) when the posts were air-abraded. After silica coating and silanization, significantly higher (P<0.05) tensile strengths were obtained for Compolute Aplicap (600+/-123N) than those of the other luting cements (Flexi-Flow cemTM: 191+/-62N; Panavia 21 EX: 375+/-77; Twinlook: 430+/-78N). No significant differences (P>0.05) were found between the tensile strength of the posts luted with zinc phosphate (414+/-102N) and the resin composite cements. Silica coating and silanization revealed the highest tensile bond strength in posts luted with Compolute Aplicap but it was not effective for the other experimental groups. Zinc phosphate cement exhibited tensile bond strength as good as resin composite cements.

The fit of tapered posts in root canals luted with zinc phosphate cement: a histological study.

OBJECTIVES: Stress transmission to the root through passive fitting dental posts is partly influenced by the thickness of the cement layer between the post and the prepared root canal surface as well as the fit of the post in the root canal. The objective of this study was to compare the cement gap between the post surfaces and the root canals using five prefabricated, tapered, unthreaded titanium posts of different manufacturers, without and with cement. METHODS: Following the endodontic treatment with hand instruments of 100 intact anterior teeth, post spaces were prepared using opening drills of the corresponding size of post. Fifty posts were cemented with zinc phosphate cement into the roots for each system while another 50 posts were inserted into the canal without using the cement. After histological sectioning, the cement gap was measured at six sites for three times at the coronal, middle and apical regions between the root canal wall and the post surface under a light microscope before and after cementation. RESULTS: Before cementation, the highest overall cement gap was observed with the Dr Mooser post system (46 microm) and the lowest with the Velva post system and Cylindro-Conical system (30 microm). Significantly less (P<0.05) mean cement gap was observed with respect to the Erlangen post system (41 microm), the Dr Mooser post system (48 microm), the MP Pirec post system (34 microm) and Velva post system (33 microm) when compared with the Cylindro-Conical system (62 microm). The Cylindro-Conical system (79, 61 microm) and MP Pirec post system (25, 24 microm) demonstrated no significant difference (P>0.001) compared with Velva-Post (38, 20 microm) at the coronal and middle part, respectively (Mann-Whitney U-test, Boneferroni correction). Significant differences (P<0.001) were observed between the cement gap at the coronal and apical part for the Cylindro-Conical system (79, 46 microm), Dr Mooser post system (45, 56 microm) and MP Pirec post system (25, 52 microm). After cementation, the highest cement gap at the coronal part was obtained with the Cylindro-Conical system (79+/-21 microm) and the lowest with the MP Pirec post system (25+/-9 microm). However, at the apical end, the MP Pirec post system (52+/-89 microm) and Dr Mooser post system (56+/-16 microm) revealed the highest gap. SIGNIFICANCE: Form-congruence between the preparation drill and the post systems exhibited differences. The most consistent cement gap either at the coronal, middle or apical parts of the root canals was obtained with the Erlangen post system.

Bending resistance of prefabricated titanium posts following molten cast core attachment.

Posts and cores are used to restore endodontically treated teeth that have substantial loss of the coronal tooth structure. This in vitro study was designed to determine the mechanical properties of prefabricated titanium posts following attachment of their metal cores by molten casting (caston). Prefabricated tapered titanium posts (ER post-restoring system, Komet, Lemgo, Germany) in three diameter sizes (ISO 50, 90, 110) (n=9) were cast over with the metal cores of three different alloys (Au-Ag-Pt, Au-Pt-Pd, Co-Cr-Mo). Also, posts of each size were precision fit into the central core channels of the different cast metal cores to serve as control specimens. The 0.2% yield strengths (R0.2) of all specimens were tested on a universal testing machine. Statistical analyses of the results were carried out with an analysis of variance (ANOVA, one-way, two-way) and Bonferroni-Dunn's multiple comparisons post-hoc analysis for test groups (alpha=0.05). There was a significant decrease in yield strength (p<0.05) as a result of casting the various metals over the different post sizes, considered to be due to the detrimental thickening and porosity formation of the titanium surface oxide layer. Twenty-one percent, 51% and 33% reduction in yield strength, respectively, was obtained for the ISO 50, ISO 90 and ISO 110 cast-on groups relative to controls (p<0.05). Statistically significant differences in various core alloys were found only for the Au-Ag-Pt alloy compared to the Co-Cr-Mo alloy (post size ISO 50) and the Au-Pt-Pd alloy compared to the Co-Cr-Mo alloy (post size ISO 110) (p>0.05). Prefabricated titanium posts with metal cores cast over them showed inferior mechanical properties compared to precision-fit posts. These results indicate greater strength of the titanium posts when their cast cores were attached mechanically rather than by the molten casting method.