Evaluation of potential apex locator induced electrophoresis.

INTRODUCTION: In 1890, Breuer applied an electrical field concept to root canals in an attempt at sterilization. Recently, Balson and Dovgan have renewed interest in the use of electricity to aid in canal disinfection. The purpose of this investigation is to determine if the use of the apex locator or apex locator in conjunction with low speed handpiece causes a previously unreported electrophoretic effect. MATERIALS: Forty low-fat, dried sirloin steak cubes separated into four groups of 10 and immersed in 5.25% sodium hypochlorite for two minutes while connected to 1) an apex locator with no batteries, 2) one with batteries, or an apex locator and low speed handpiece set at either 3) zero or 4) 800 rotations per minute. Samples were dried and percentage of weight loss was calculated. ANOVA and Tukey Multicomparison tests were performed for statistical significance of α ≤ 0.05. RESULTS: ANOVA test and Tukey Multicomparison tests showed that there was a significant difference (α ≤ 0.05) between the groups. They revealed statistically significant differences between 800 rotations per minute and all other groups. This study showed that there were no significant differences between an apex locator with no batteries, one used with batteries and one used in conjunction with the low speed handpiece at zero rotations per minute. However, it was shown that there was significantly more tissue dissolution with an apex locator with low speed handpiece at 800 rotations per minute compared to the first three groups. CONCLUSION: These results did not support the original hypothesis that the apex locator with or without the low speed handpiece has an electrophoretic effect. However, the results do support the use of sodium hypochlorite agitation for increased tissue dissolution.

Effect of mica reinforcement on the flexural strength and microhardness of polymethyl methacrylate denture resin.

PURPOSE: Conventional denture base polymethyl methacrylate (PMMA) is low in strength, soft, and brittle on impact. Improvements in the mechanical properties of denture base materials have been sought by adding different reinforcing phases to the PMMA matrix. The purpose of this work was to study the effects of mica reinforcement on the mechanical properties, flexural strength, and microhardness of PMMA denture base resin. MATERIALS AND METHODS: Wet ground muscovite mica and Lucitone 199 original shade denture base resin were used. Two micas were tested: W200 and P66 with average particle sizes (d50) of 131 µm and 30 µm, respectively. The mica was silane treated in a solution of 3-methacryloxypropyl trimethoxysilane, ethanol, and water, and then dried. The specimens were fabricated using the denture base resin manufacturer's instructions with a powder : liquid ratio of 21 g/10 ml and a mixing time of 30 seconds. Five treatment groups were produced with differing amounts of mica added to the PMMA denture base resin: (A) control group with 0 vol% mica, (B) 10 vol% W200 mica, (C) 20 vol% W200 mica, (D) 10 vol% P66 mica, (E) 20 vol% P66 mica. The mica replaced equal volumes of the PMMA powder component to minimize changes in viscosity. The three-point bending flexural strength specimens were 70 × 11 × 3 mm(3) . Seven specimens were prepared for each treatment group. The hardness specimens were prepared from the ends of the three-point bend specimens after they were broken (N = 7). After deflasking, the specimens were polished with 600 grit silicon carbide paper to achieve smooth surfaces. A standard three-point bending jig with a span length of 50 mm was attached to an Instron universal testing machine. The specimens were placed on the jig, and loading was carried out using a 1 mm/min crosshead speed until failure. Microhardness was measured using a Clark microhardness tester with a Knoop indenter. The load was set to 200 g and the dwell time to 15 seconds. ANOVA and Tukey tests were used for statistical analyses (Alpha = 0.05). RESULTS: The flexural strength of the control group was between 77% and 94% higher than all the mica-containing groups (p≤ 0.05). No significant differences were found within the four mica groups. Microhardnesses of the 20% mica groups (both fine and coarse) were 33% and 26% higher than the control (p≤ 0.05). The 10% mica groups had higher hardness than the control group, but the increase was not statistically significant (p > 0.05). CONCLUSION: Mica additions to denture PMMA reduced flexural strength; however, with the specimens containing highest mica concentrations (20%), microhardness significantly increased.

The effect of preoperative ibuprofen on tooth sensitivity caused by in-office bleaching.

This study determined the effect of Ibuprofen on tooth sensitivity from in-office bleaching with 38% hydrogen peroxide. A double-blind, randomized-controlled clinical trial was performed on healthy non-smoker patients who retain all anterior teeth (N=31). Patients with anterior restorations, calculus or heavy stain, and those who were taking medications or desensitizer products were excluded. After signing the informed consent, the patients were randomly divided into a Placebo group (n=16) that received a placebo (tinted oil in clear capsule) (Health Dimensions Inc, Compound Pharmacy, Farmington Hills, MI, U.S.A.) or an Ibuprofen group (n=15) that received a 600 mg, PO single dose of Ibuprofen (Advil Liquid Gel, Wyeth, Madison, NJ, USA). The patients were watched while taking the capsules 30 minutes prior to treatment. A single operator applied the 38% hydrogen peroxide (Opalescence Xtra Boost, Ultradent Products Inc) for 20 minutes on 12 anterior teeth. The hydrogen peroxide solution was then rinsed, the teeth were gently dried and the cycle was repeated, for a total application time of 40 minutes. A Visual Analog Scale (VAS) was used to evaluate the level of sensitivity 30 minutes before treatment, immediately after treatment, then 1 hour and 24 hours post-bleaching. The patients graded their maximum sensitivity levels during each period on a scale from 0 to 100 (0=no sensitivity, 100=unbearable sensitivity). The VAS scores were statistically analyzed to compare the groups' scores at different times and to compare the scores within each group at various times (Wilcoxon rank sum tests). The mean score and standard deviation of the Ibuprofen group immediately after bleaching was 5.0 +/- 9.9, at 1 hour--31.5 +/- 32.1 and at 24 hours--25.8 +/- 30.8; the placebo group at the time of treatment was 26.6 +/- 31.0, at 1 hour--30.9 +/- 30.5 and at 24 hours--31.1 +/- 32.6. When comparing the two groups at different times, the Ibuprofen group showed statistically significantly lower sensitivity scores immediately post-bleaching than the placebo group (p = 0.0216) but not at 1 hour (p = 0.84) or 24 hours post-bleaching (p = 0.54). When comparing times within the Ibuprofen group, the mean VAS score immediately after bleaching was significantly lower than 1 hour post-bleaching (p = 0.0024) and 24-hours post-bleaching (p = 0.0110), but the mean VAS score at 1 hour post-bleaching and 24-hours post-bleaching were not significantly different (p = 0.64). For the placebo group, the intragroup time effect was not significant. Within the limitations of the current study, the authors concluded that the use of an analgesic may help to reduce tooth sensitivity during in-office bleaching. In the current study, Ibuprofen (600 mg, PO single dose) reduced tooth sensitivity during but not after the treatment period.

Effect of pre-heating resin composite on restoration microleakage.

Improving the adaptation of resin composites during placement is necessary to increase durability and reduce microleakage. Flowable resin liners have been introduced to improve adaptation in composite restorations. In addition, a device that lowers the viscosity of regular dental composites has been introduced (Calset, AdDent Inc, Danbury, CT, USA). This device lowers the viscosity of composites by preheating them to 54.4 degrees C, which should lead to improved adaptation. This study compared microleakage in Class II composite restorations prepared using: 1) preheated resin composite, 2) unheated composite and 3) a flowable liner followed by unheated composite. Class II cavities were prepared on the mesial and distal surfaces of extracted third molars. Ten preparations were restored with resin composite (Esthet-X, Dentsply, York, PA, USA) for each of the following four techniques: Control (Esthet-X with Prime & Bond NT, Dentsply), Flowable (f) (as Control but used Esthet-X Flow liner), Preheated (p) (as Control but with preheating composite to 54.4 degrees C) and Delay (d) (as Preheated but followed by a 15-second delay before curing). The teeth were restored, finished, stored in distilled water for 24 hours, then thermocycled between water bath temperatures of 5 degrees C and 55 degrees C with a one-minute dwell time for 1000 cycles. Tooth apices were sealed with epoxy and varnish was applied to within 1 mm of the restoration margins. The teeth were placed in 0.5% basic fuschin dye for 24 hours, rinsed, then embedded in self-curing resin. The embedded teeth were sectioned mesiodistally with a slow-speed diamond saw, providing multiple sections per restoration. Microleakage was rated by two evaluators using a 0-4 ordinal scale at the occlusal and cervical margins of each restoration and light microscopy (40x). The data were analyzed with Kruskal-Wallis ANOVA and pairwise testing with the Sign test (alpha=0.05). No statistical differences were observed among materials at the occlusal margin. However, at the cervical margin, the preheated samples P showed statistically lower microleakage than the controls and all other treatments. The D samples showed higher microleakage than the P and F samples. Ranked sum scores for the cervical were D (4516), C (3974), F (2756) and P (1958). There was a statistically greater amount of leakage at the cervical margins compared to the occlusal p<0.05. Preheating the composite resulted in significantly less microleakage at the cervical margins compared to the flowable liner and control. Delaying light curing of the preheated composite for 15 seconds (D) was counterproductive and led to increased microleakage.

Repair of fractured framework: scanning electron microscopy and energy dispersive X-ray spectroscopy.

Fractured metal prostheses can be analyzed for possible causes of failure using scanning electron microscopy (SEM). In this study, fractography is used to determine the cause of the failure and whether repair is practical. Energy-dispersive x-ray spectroscopy (EDS) is used to determine composition of the fractured prosthesis so that a repair process can be recommended. The technique is presented for the repair of a titanium framework for an implant-supported overdenture based on the analysis data.

Evaluation of surface finish and polish of eight provisional restorative materials using acrylic bur and abrasive disk with and without pumice.

This study evaluated the effects of two finishing techniques and pumice polishing on the surface roughness of eight different provisional materials. Provisional materials included polymethylmethacrylate-based Alike, Snap, Trim and Jetand composite-based provisional materials Temphase, Protemp 3 Garant, Luxatemp and Integrity. Baseline surface roughness was measured by a profilometer, then the provisional materials were finished using extra fine acrylic burs or medium abrasive disks. The surface roughness of each sample was measured following finishing using a profilometer as previously stated. Each surface was then polished with pumice and the surface roughness was measured again. The data were analyzed using repeated measures of ANOVA and Bonferroni pairwise comparisons (alpha = 0.05). The results indicated that with composite provisional materials, the unfinished surfaces are smoother than with bur or abrasive-disk finished surfaces. Pumice application did not smooth the surface finish for all materials. The different types of provisional materials required different finishing techniques to produce the smoothest finishes.

The effect of prophylactic polishing pastes and toothbrushing on the surface roughness of resin composite materials in vitro.

Polishing composite restorations at recall prophylaxis may affect their surface roughness. This investigation evaluated the effect of prophy paste on the surface roughness of a microfilled (Filtek A110) and a microhybrid (Filtek Z250) resin composite before and after simulated toothbrushing. Twenty, two-sided samples of both materials were fabricated in acrylic molds against a Mylar strip (baseline). Three roughness readings were recorded for each surface using a Surfanalyzer 5400 to determine the mean roughness. The samples were finished and polished with the Sof-Lex disk system and the surface roughness (Ra) was re-measured. Samples were randomly assigned and five surfaces for each material were polished with Nupro coarse, medium, fine or Clinpro prophy paste and the surface roughness measured again. All surfaces were brushed 60,000 times at 1.5Hz using a 2N brush-head force (Manly V-8 cross-brushing machine) in a 50:50 (w/w) slurry of toothpaste and water. The surface roughness was measured followed by the application of prophy paste as previously described and this final roughness recorded. Data were analyzed using repeated measures two-factor ANOVA with TUKEY HSD pairwise comparison as appropriate (alpha = 0.05). No significant difference in surface roughness was determined between the microfilled and microhybrid materials at baseline or disk treatment, yet significant differences were observed following brushing and/or prophy paste application. In conclusion, although baseline and disk treated surfaces were not significantly different in microfilled versus microhybrid composites, subsequent prophy paste application and/or simulated toothbrushing caused significant differences.