Polymerization shrinkage of densely-filled resin composites.

A new group of restorative materials called "packable" composites has recently been introduced. These products are essentially highly-filled or densely-filled hybrid resin composites. One of the many claims made about these materials is that they undergo less polymerization shrinkage than their conventional counterparts. This in vitro investigation compared the amount of linear shrinkage that occurs within a variety of densely filled resin composites (DFC) and conventional hybrid resin composites when cured with a visible halogen light. Six DFC resins (Alert, Ariston, P60, Prodigy, Solitaire and Surefil) and two hybrids (TPH-Spectrum, Z100) were used in this study. Dimensional change was measured in a linear direction using a calibrated light microscope. Eighty samples of resin composite were tested, resulting in eight groups of 10 samples (N=10) each. The one-way ANOVA with Student-Newman-Keuls post-hoc test was used to compare the shrinkage between groups, and Pearson's Correlation was used to test the relationship between filler characteristics and shrinkage. Alert and P-60 had significantly less shrinkage than Solitaire, Ariston, Prodigy, Z-100 and TPH-S. Thus, the shrinkage values of some DFC resins were significantly less and others were no different from conventional hybrid resins. There is a moderate association between filler volume and shrinkage. Filler size and resin chemistry are other factors that may also effect shrinkage.

Evaluation of fiber-composite laminate in the restoration of immature, nonvital maxillary central incisors.

The purpose of this study was to evaluate the use of fiber-composite laminate, a reinforcement ribbon embedded throughout a composite restoration, to reinforce immature maxillary central incisors. Twenty-six mature maxillary central incisors were prepared a minimum of 3 mm below the facial cementoenamel junction to simulate immature nonvital teeth. They were separated into 3 groups: group 1 was unfilled and served as a control; group 2 was filled to the depth of the preparation with composite; and group 3 was filled with composite and Connect Reinforcement Ribbon. The specimens were subjected to class I loading in an Instron Testing Machine until catastrophic failure occurred. The results indicate a highly significant difference between the groups (p < or = 0.003). Group 1 fractured at an average load of 31.08 kg, group 2 at 51.00 kg, and group 3 at 37.93 kg. These findings suggest that composite alone increases fracture resistance of the immature tooth model more than composite with Reinforcement Ribbon.

Accuracy of electronic implant torque controllers following time in clinical service.

Tightening of the screws in implant-supported restorations has been reported to be problematic, in that if the applied torque is too low, screw loosening occurs. If the torque is too high, then screw fracture can take place. Thus, accuracy of the torque driver is of the utmost importance. This study evaluated 4 new electronic torque drivers (controls) and 10 test electronic torque drivers, which had been in clinical service for a minimum of 5 years. Torque values of the test drivers were measured and were compared with the control values using a 1-way analysis of variance. Torque delivery accuracy was measured using a technique that simulated the clinical situation. In vivo, the torque driver turns the screw until the selected tightening torque is reached. In this laboratory experiment, an implant, along with an attached abutment and abutment gold screw, was held firmly in a Tohnichi torque gauge. Calibration accuracy for the Tohnichi is +/- 3% of the scale value. During torque measurement, the gold screw turned a minimum of 180 degrees before contact was made between the screw and abutment. Three torque values (10, 20, and 32 N-cm) were evaluated, at both high- and low-speed settings. The recorded torque measurements indicated that the 10 test electronic torque drivers maintained a torque delivery accuracy equivalent to the 4 new (unused) units. Judging from the torque output values obtained from the 10 test units, the clinical use of the electronic torque driver suggests that accuracy did not change significantly over the 5-year period of clinical service.

Implant-abutment screw joint preload of 7 hex-top abutment systems.

This study measured the screw joint preload of the implant-abutment interface for 7 common hex-top abutment systems. Increasingly, prosthetic designs are utilizing a direct prosthetic connection to the implant, placing the implant-abutment screw joint under direct functional loads and moments. Sufficiently high screw joint preloads are required to maintain screw joint integrity and confer clinical longevity to implant prosthetic components to prevent such complications as abutment screw loosening and screw fracture. Strain-gauged abutment load cells were calibrated to measure screw joint pre-load at the implant-abutment interface. Torque delivery by electronic torque controller was varied at low- and high-speed settings. At manufacturer's recommended torques, the overall mean preload measured was 181.6 +/- 60.0 N for the Nobel Biocare Standard abutment, 291.3 +/- 41.2 N for the Nobel Biocare EsthetiCone abutment, 456.5 +/- 44.0 N for the Nobel Biocare MirusCone abutment, 369.7 +/- 32.9 N for the 3i Titanium Abutment post, 643.4 +/- 143.1 N for the Nobel Biocare CeraOne abutment, 536.3 +/- 68.6 N for the Nobel Biocare "Gold Cylinder to Fixture" abutment, and 556.9 +/- 145.6 N for the Nobel Biocare TiAdapt abutment. Analysis of variance revealed significant differences between abutment systems (P < .001) and between torque driver speed settings (P < .001). Implant-abutment screw joint preload of external-hex implants is dependent on abutment design, screw diameter, material, tightening torque, and torque controller speed.

Polymerization shrinkage of composite resins using plasma-arc photocuring.

When composite resins are photocured, they undergo a certain degree of polymerization shrinkage. A new method utilizes plasma-arc photocuring instead of conventional visible light. The purpose of this in vitro investigation was to compare the amount of linear shrinkage that occurs when a hybrid composite resin is cured using three different plasma-arc light (PAL) sources. There was no significant difference between the three groups and a halogen light control in the amount of shrinkage of the hybrid composite resin. In terms of resin shrinkage values, using a PAL is no different than using a conventional halogen curing light. However, even though the curing intensity is increased, the shorter curing times may result in a reduced depth of cure.

Fracture load and mode of failure of ceramic veneers with different preparations.

STATEMENT OF PROBLEM: Fracture is a clinical failure modality for ceramic veneers. Whether design of tooth preparation can affect the strength of ceramic veneers remains controversial. PURPOSE: This in vitro study evaluated fracture load and mode of failure of ceramic veneers, with 4 tooth preparation designs, that were bonded on extracted human maxillary central incisors. Identical parameters were also measured on unrestored intact teeth for comparison. MATERIAL AND METHODS: Fifty maxillary central incisors were randomly divided into 5 equal groups. Each group was assigned a different tooth preparation design: (1) no incisal reduction, (2) 2 mm incisal reduction without palatal chamfer (butt joint), (3) 1 mm incisal reduction and 1 mm height palatal chamfer, (4) 4 mm incisal reduction and 1 mm height palatal chamfer, and (5) unrestored (control). Forty teeth were prepared to accommodate ceramic veneers of equal thickness and incisocervical length. Stone dies were fabricated and veneers made from IPS Empress ceramic. Ceramic veneers were bonded and all teeth mounted in phenolic rings with epoxy resin. Fracture loads were recorded with a mechanical testing machine. RESULTS: Mean fracture loads (SD) in kgf were as follows: group 1, 23.7 (6.11); group 2, 27.4 (9.63); group 3, 16.4 (3.44); group 4, 19.2 (6.18); and group 5, 31.0 (10.38). Modes of failure were also analyzed for both ceramic veneers and teeth. One-way ANOVA with multiple comparisons revealed 3 significant subsets: groups 1-2-5, groups 4-1, and groups 3-4 (P <.05). Groups 1 and 2 had no ceramic veneer fractures; group 3 had 3 ceramic veneer fractures, and group 4 had 6 ceramic veneer fractures. CONCLUSION: Groups 1 and 2 recorded the greatest fracture loads that were comparable to an unrestored control.

A comparison of instrumentation using Naviflex and Profile nickel-titanium engine-driven rotary instruments.

This study was designed to compare the changes in canal configuration resulting from instrumentation by either Profile or Naviflex instruments. Forty mesial canals in extracted human molar teeth were embedded and sectioned at two root levels. Reassembled teeth were instrumented with a modified crown-down technique as described in the Profile training video for Profile files and in a similar manner for Naviflex instruments. Superimposed pre- and postinstrumented cross-sectional root images were projected, traced, and scanned into a computer for analysis. Canal movement, in relation to the furca, and canal area change were recorded. The results showed no significant difference in canal center movement or canal area change between the Profile or Naviflex groups. The degree of canal curvature had no effect on canal center movement or canal area change.

Evaluation of friction during sliding tooth movement in various bracket-arch wire combinations.

Frictional forces during simulated sliding tooth movement were measured with a model that was representative of the clinical condition. The model allowed tipping of the tooth until contact was established between the arch wire and diagonally opposite corners of the bracket wings; it also allowed rotation until the wire contacted opposite corners of the ligature tie, or the buccal shield with self-ligating brackets, and the base of the slot. Conventional and self-ligating stainless steel brackets as well as conventional ceramic brackets, and ceramic brackets with a stainless steel slot, all with 0.022 inch bracket slot, were tested with 0.019 x 0.025 inch arch wires of stainless steel, nickel titanium, and beta titanium. Each of the 12 bracket-arch wire combinations was tested 10 times. No significant interaction was detected between brackets and arch wires (P = .89), but the bracket and arch wire effects were significant (P < .001). The pairwise differences between conventional and self-ligating stainless steel brackets and ceramic brackets with stainless steel slot were not significant. However, the conventional ceramic brackets generated significantly higher friction than the other brackets tested. Beta titanium arch wires produced higher frictional forces than nickel titanium arch wires, but no significant differences were found between each of the two and stainless steel arch wires. Attempts to identify differences in surface scratches of the arch wires produced by the different brackets were unsuccessful.

Laser welding of a cobalt-chromium removable partial denture alloy.

STATEMENT OF PROBLEM: The electric alloy brazed joints of removable partial denture alloys have failed frequently after routine usage. PURPOSE: A technique providing higher joint strengths was investigated. This investigation compared the tensile strengths of electric-brazed and laser-welded joints for a cobalt-chromium removable partial denture alloy. MATERIAL AND METHODS: Twenty-four cobalt-chromium standard tensile testing rods were prepared and divided into three groups of eight. All specimens in the control group (group 1) were left in the as-cast condition. Groups 2 and 3 were the test specimens, which were sectioned at the center of the rod. Eight specimens were joined by using electric brazing, and the remaining specimens were joined by using laser welding. After joining, each joint was ground to a uniform diameter, then tested to tensile failure on an Instron universal testing machine. Failure loads were recorded and fracture stress calculated. Statistical analysis was applied. RESULTS: The student-Newman-Keuls test showed a highly significant difference between the joint strengths of the as-cast control specimens, the electric-brazed and laser-welded joints. CONCLUSIONS: The tensile strengths of the as-cast joints were higher than those for the laser-welded joints, and both were higher than the electric-brazed joint strengths.

Leakage associated with load fatigue-induced preliminary failure of full crowns placed over three different post and core systems.

Thirty-six maxillary central incisors were endodontically treated and restored with a post and core and cast crown. Three different post and core systems were evaluated. Restored teeth were fatigue-loaded until preliminary failure of the casting occurred as detected by a strain gauge bonded across the lingual margin of the cast crown. After preliminary failure, fatigue loading was continued for 100,000 load cycles with the crown margin exposed to basic fuschin dye. Teeth were then immersed in dye for 24 h, sectioned, and evaluated for leakage. There was no significant difference in the number of load cycles required to cause preliminary failure among the three post and core systems. Leakage occurred in all three groups, with no significant difference between groups. The occurrence of preliminary failure is clinically undetectable, yet it allows leakage between the restoration and tooth that may extend down the prepared post space.

Load fatigue of compromised teeth: a comparison of 3 luting cements.

PURPOSE: This study compared the number of cycles to failure of central incisors restored with full cast crowns and then cemented with 3 different luting cements. MATERIALS AND METHODS: Fifteen human maxillary central incisors received cast post-and-core restorations. These were cemented with zinc phosphate. The teeth were then divided into 3 groups of 5 samples each. Each tooth had a ferrule length of 1.0 mm and was prepared for a full crown. A waxing jig was used to standardize the load application point on all waxed crowns. Complete cast crowns were cemented to the compromised teeth using 3 different luting cements: a zinc phosphate cement (control group), a resin-modified glass-ionomer cement, and a resin cement with a dentin bonding agent. A fatigue load of 1.5 kg was applied at a rate of 72 cycles per minute until failure of the cement layer occurred between the crown and the tooth (preliminary failure). The independent variable was the number of load cycles required to create preliminary failure. An electrical resistance strain gauge was used to provide evidence of preliminary failure. RESULTS AND CONCLUSION: The resin cement samples had a significantly higher number of load cycles to preliminary failure than both the zinc phosphate and the resin-modified glass ionomer (P < or = 0.05). There was no significant difference between the zinc phosphate and the resin-modified glass-ionomer cements.

A comparison of curved canal transportation with balanced force versus lightspeed.

The Flex-R file was compared with the Lightspeed nickel-titanium file in respect to canal center movement and final canal area after instrumentation. Thirty-eight root canals in extracted human molars were divided into two equal groups of 19, in all of which the angle of curvature ranged from 20 to 35 degrees. After mounting in a mold, each root was sectioned at two locations, providing an apical and coronal section. Pre- and postinstrumentation 35 mm photographic slides of each section were projected, traced, and then scanned into a computer. From these computerized pre- and postinstrumentation images, the movement of the canal center and the area of each canal were computed at both the apical and coronal sections. Results showed significant difference in the apical canal center movement and postinstrumentation area with the Lightspeed yielding smaller values in both cases. Coronally, the Flex-R Lightspeed instruments demonstrated no significant difference in canal movement or postinstrumentation area. No significant correlation was found between the angle of root curvature and canal movement or the angle of root curvature and postinstrumentation canal area.

Tolerance measurements of various implant components.

Machining tolerance, an intrinsic characteristic that exists between machined implant components, identifies the amount of horizontal shift possible between paired components. Machining tolerances between implant components (abutment, gold, cylinder, impression coping, and brass abutment replicas) were measured with a coordinate measuring machine. The measured tolerances ranged from 22 to 100 microns. Machining tolerances between implant components should be included in future studies of accuracy, because it is an inherent characteristic of the component itself.