Degree of conversion of dual-cured composite luting agents: The effect of transition metal-based touch-cure activators.

PURPOSE: The aim of the study was (a) to assess the effect of universal adhesives and tooth primers with novel touch-cure activators on the conversion of dual-cured resin composite luting agents (RLAs) polymerized under the self-curing mode, and (b) to investigate the source of the catalytic effect exerted by the activators. MATERIALS AND METHODS: The materials selected were the adhesive RLAs Panavia V5/Tooth Primer (PV5/TP5), Variolink Esthetic DC/Adhese Universal DC (VLE/ADC), and the self-adhesive RLAs GCem ONE/AE Primer (GCO/AEP), RelyX Universal/Scotchbond Universal Plus (RXU/SUP) and Panavia SA Universal/Clearfil Universal Bond Quick (PSU/CUQ), the later serving as a control with an aryl-sulfinate activator. Coronal dentin specimens were prepared (n = 5/material), treated with the corresponding primers/adhesives (non-irradiated) and covered with a 100 µm-thick RLA layer (SC+A group). Three specimen series were additionally prepared (n = 3 × 5/material): A self-cured without the primers/adhesives (SC group), a dual-cured (20 s irradiation) with the corresponding primers/adhesives (DC+A group) and a dual-cured without primers/adhesives (DC group). All specimens were stored for 15 min (37 °C/dark/60 %RH). After demolding the degree of C = C conversion (DC%, top RLA surfaces) was measured by ATR-FTIR spectroscopy. The primer/adhesive liquids were further analyzed by ICP-MS and the microbrush tips of ADC by SEM-EDS. RESULTS: The touch-cure activators increased the DC% in all self-cured RLAs but failed to reach the values of the corresponding dual-cured RLAs. The effect of the activators in dual-cured specimens was negligible. The ICP-MS analysis showed the presence of V (AEP, TP5, ADC) and Cu (SUP) transitional metals in the activators, with V been located at the free ends of ADC tip bristles. The V activators demonstrated the highest DC% improvement in self-cured specimens. CONCLUSION: The new touch-cure activators significantly increased the conversion of the self-cured RLAs. Therefore, this step should be considered as universally applicable and not selective, as currently proposed for the self-adhesive luting agents by the manufacturers.

Effect of curing mode on the conversion and IIT-derived mechanical properties of core build-up resin composites.

The aim of the study was to evaluate the degree of conversion and the mechanical properties of five composite core build-up materials polymerized in dual-curing and self-curing modes. The materials tested were: Clearfil DC Core Plus (CF), Gradia Core (GC), Luxacore-Z Dual Smartmix (LX), Multicore Flow (MC) and Paracore (PC). Disk-shaped specimens were prepared from each material; half the specimens were light-cured, whereas the rest were only self-cured. After a 3-week storage period (dark/dry/37 °C) the Martens Hardness, Indentation Modulus, and Elastic Index were determined by instrumented indentation testing (IIT), while the degree of conversion was assessed by ATR-FTIR spectroscopy. Statistical analysis was performed by 2-way ANOVA and post-hoc testing (α = 0.05). The dual-curing mode resulted in statistically higher Martens Hardness and Elastic Index than the self-curing mode in most materials but showed insignificant differences in Indentation Modulus. MC and PC demonstrated significantly higher degree of conversion in both curing modes. Overall, the self-curing mode was inferior to the dual-curing in conversion and mechanical properties for most products, despite their differences in monomer composition and filler loading.

Comparative analysis of the mechanical properties of fiber and stainless steel multistranded wires used for lingual fixed retention.

OBJECTIVE: To evaluate the effect of different resins used for the co-polymerization of EverStick fiber-reinforced fixed orthodontic retainer on its mechanical properties and to compare the mechanical properties of these configurations to commonly used multistrand wires. MATERIALS AND METHODS: Ten 0.0175-in. WildCat (WC175), ten 0.0215-in. WildCat (WC215) three-strand twisted wires and thirty EverStick fibers were tested in this study. The EverStcik fibers were equally shared in three groups (n=10). The samples of first group (ESRE) were polymerized employing Stickresin (Light cure enamel adhesives), the second one (ESFT) employing Flow Tain (Light cured composite), whilst the specimens for the third group (ES) were not combined with resin. All samples were loaded in tensile up to fracture in a universal tensile testing machine and the modulus of elasticity, tensile strength and strain after fracture were recorded. The same groups were also tested employing Instrumented Indentation Testing (IIT) and Martens Hardness (HM), Indentation Modulus (EIT) and elastic index (ηIT) were determined. The results of tensile testing and IIT were statistically analyzed employing one way Anova and the Student Newman Keuls test (SNK) at a=0.05 level of significance. RESULTS: WC175 and WC215 showed higher modulus of elasticity and tensile strength but lower strain after fracture compared to Everstic groups. IIT illustrated significantly higher values for HM, EIT, and ηIT for WC groups compared to ESRE, ESFT and ES. ESFT showed higher HM and elastic index compared to ESRE and ES, a finding which is attributed to the fact the FlowTain is a filler-reinforce composite with higher hardness compared to unfilled resins. SIGNIFICANCE: Multistrand wires demonstrated higher values in mechanical properties compared to EverStick ones. The co-polymerization with difference resins does not affect the tensile properties of Everstic, however the use of a light cured composite has a beneficial effect on hardness.

Setting characteristics of a resin infiltration system for incipient caries treatment.

OBJECTIVES: This study investigated the curing efficiency, the extent of atmospheric oxygen inhibition to the polymerization reaction and the mechanical properties of a new resin-infiltration system for caries treatment. METHODS: The curing efficiency was estimated by measuring the percentage degree of cure (%DC) of thin resin films (h: 150µm, Ø: 5mm, n=3), 10min after 40s exposure to a quartz halogen bulb (750mW/cm2) light curing unit (Optilux 501, Demetron/Kerr, USA), in the absence of O2, by micro ATR-FTIR spectroscopy. The extent of O2 inhibition on resin film setting (width in µm) was assessed by transmission optical microscopy on thin films (h: 150µm, Ø: ∼7mm, n=5) placed between two transparent cover slips and exposed to air from lateral sites. For each sample the extent of inhibition was measured at 5 different locations. The mechanical properties were tested employing Instrumented Indentation Testing according to ISO 14577:2002. Resin specimens (h: 2mm, Ø: 10mm, n=5) were prepared employing cylindrical teflon moulds enclosed in transparent matrix strips and glass slides as before. The measurements were performed employing a Vickers indenter attached to a universal hardness testing machine (ZHU2.5/Z2.5 plus test Xpert software, Zwick/Roell, Ulm, Germany). The parameters tested were Martens Hardness (MH), Vickers Hardness (VHN), Indentation Elastic Modulus (EIT) and elastic to total ratio of indentation work (ηIT). For all these tests, specimens of a conventional light-curing bonding resin (HB-Heliobond, Ivoclar-Vivadent, FL) prepared as above were used as control. Student t-test was used to identify statistically significant differences between the two materials in the parameters tested (a: 0.05). RESULTS: The results of the materials tested were: (a) [% DC]; IC: 57.4±1.5, HB: 59.8±2.4, (b) [Width of O2 inhibition/µm]; IC: 33.1±6.5, HB: 23.6±4.4, (c) [MH/N/mm(2)] IC; 116±16, HB: 261±35, (d) [VHN]; IC; 15.4±2.5, HB: 22.1±1.8, (e) [EIT/(GPa)]; IC; 2.3±0.4, HB: 7.5±0.5, and (g) [ηIT (%)] IC; 50.3±3.4, HB: 35.1±1.9. The IC presented no significant difference in terms of % DC, higher thickness of the inhibited layer, lower MH, VHN, EIT and greater ηIT values than HB. CONCLUSIONS AND CLINICAL SIGNIFICANT: The resin-infiltrating system for incipient caries treatment demonstrated the same curing efficiency with a conventional unfilled bonding resin, but exhibited higher extent of oxygen inhibition, lower hardness, lower elastic modulus and higher plastic to elastic indentation energy.

Metallurgical and interfacial characterization of PFM Co-Cr dental alloys fabricated via casting, milling or selective laser melting.

OBJECTIVES: Bulk and interfacial characterization of porcelain fused to metal (PFM) Co-Cr dental alloys fabricated via conventional casting, milling and selective laser melting. METHODS: Three groups of metallic specimens made of PFM Co-Cr dental alloys were prepared using casting (CST), milling (MIL) and selective laser sintering (SLM). The porosity of the groups was evaluated using X-ray scans. The microstructures of the specimens were evaluated via SEM examination, EDX and XRD analysis. Vickers hardness testing was utilized to measure the hardness of the specimens. Interfacial characterization was conducted on the porcelain-covered specimens from each group to test the elemental distribution with and without the application of INmetalbond. The elemental distribution of the probed elements was assessed using EDX line profile analysis. Hardness results were statistically analyzed using one-way ANOVA and Holm-Sidak's method (α=0.05). RESULTS: X-ray radiography revealed the presence of porosity only in the CST group. Different microstructures were identified among the groups. Together with the γ phase matrix, a second phase, believed to be the Co3Mo phase, was also observed by SEM and subsequent XRD analysis. Cr7C3 and Cr23C6 carbides were also identified via XRD analysis in the CST and MIL groups. The hardness values were 320±12 HV, 297±5 HV and 371±10 HV, and statistically significant differences were evident among the groups. SIGNIFICANCE: The microstructure and hardness of PFM Co-Cr dental alloys are dependent on the manufacturing technique employed. Given the differences in microstructural and hardness properties among the tested groups, further differences in their clinical behavior are anticipated.

Effect of root canal curvature on the failure incidence of ProFile rotary Ni-Ti endodontic instruments.

AIM: To investigate the effect of root canal curvature on the failure incidence and fracture mechanism of ProFile rotary Ni-Ti endodontic instruments. METHODOLOGY: Three hundred mesial root canals of mandibular molars were instrumented using the ProFile system in a crown-down technique up to size 25 0.06 taper. Root canals were classified according to the angle and radius of curvature to: straight (group A: 0 + 10°, radius 0 mm), moderately curved (group B: 30 ± 10°, radius 2 ± 1 mm) and severely curved (group C: 60 ± 10°, radius 2 ± 1 mm). After each use, instruments were cleaned ultrasonically and autoclaved. Instruments that prepared 20 root canals, fractured or were plastically deformed without fracture were retrieved and substituted. Kaplan-Meier estimator was used for survival analysis and post hoc test for determination of significant differences (a=0.05). All fractured instruments were subjected to fractographic analysis under SEM, and all used instruments were viewed under the metallographic microscope. RESULTS: Regardless of the size of instrument, fracture and overall failure were significantly more frequent (P<0.05) in group C. SEM examination of the fracture surfaces revealed mainly the characteristic pattern of ductile failure, whereas examination under the metallographic microscope revealed no sign of cracks. CONCLUSIONS: The abruptness of root canal curvature negatively affected the failure rate of ProFile rotary Ni-Ti instruments. The fractographic results confirmed that failure of Ni-Ti files was caused by a single overload during chemomechanical preparation.

A metallurgical characterization of ten endodontic Ni-Ti instruments: assessing the clinical relevance of shape memory and superelastic properties of Ni-Ti endodontic instruments.

AIM: To evaluate the elemental composition, microstructure and hardness of Ni-Ti endodontic instruments and to assess the relevance of shape memory and superelastic properties. METHODOLOGY: Ten brands of Ni-Ti endodontic instrument were evaluated (EndoSequence, Ergoflex K, FlexMaster, Hero 642, Hyflex X-File, K3 Endo, Liberator, NRT, Profile and ProTaper). After embedding in resin and metallographic preparation the elemental composition, structure and hardness were evaluated employing SEM/energy-dispersive X-ray spectrometer (EDX), X-ray diffraction (XRD) and microhardness measurements. The results of elemental composition and hardness were analysed statistically by one-way anova followed by SNK test (alpha : 0.05). The correlation between Ni content and microhardness was examined by the Pearson test. RESULTS: The instruments comprised of Ni (52.1-56.2%wt) and Ti (43.8 to 47.9%wt) and were classified in four different Ni content groups: ProTaper, Liberator, ProFile and K3 demonstrated higher Ni content than Hylfex X-File but lower than Hero 642, NRT and Ergoflex. EndoSequence and FlexMaster had the highest Ni content. XRD analysis revealed the presence of the austenitic structure in all instruments. Vickers hardness values ranged from 312 (K3) to 376 VHN (Endosequence). No correlation (r(2) = 0.026) was found between Ni content and hardness among the instruments tested. Microstructural and hardness data confirm that the Ni-Ti instruments were manufactured by cold worked Ni-Ti and do not posses shape memory or superelastic properties. CONCLUSIONS: The endodontic instruments tested were manufactured from cold worked Ni-Ti wires and thus have neither shape memory nor superelastic properties.

Bond strength and interfacial characterization of eight low fusing porcelains to cp Ti.

OBJECTIVES: The aim of this study was the interfacial characterization and the determination of bond strength of commercially available low fusing dental porcelain for Ti. METHODS: Eight materials were included in this study: Duceratin, Duceratin Plus, Initial Ti, Ti-22, TiKrom, TitanKeramik, Triceram (powder) and Triceram (paste). Eight ISO 9693 bond characterization specimens from each porcelain were prepared according to manufacturers' instructions. One specimen from each group was embedded in acrylic resin and after metallographic preparation was studied under an SEM. Interfacial characterization was carried out with Backscattered Electron Imaging and X-ray EDS analysis operating in line scan mode. Metal-ceramic specimens were tested in three point bending at a crosshead speed of 1.5mm/min according to ISO 9693 requirements. Additionally the fracture mode (adhesive-cohesive) of all specimens was evaluated employing SEM/EDS analysis. The results of bond strength and adhesive percentage were statistically analysed with one-way ANOVA and SNK multiple comparison test (a=0.05). Additionally the possible correlation between the bond strength and fracture mode was also tested using Pearson test. RESULTS: Interfacial characterization showed the mutual diffusion of Ti, Si, O and La along the Ti-ceramic interface. Only in Tricerap (paste) Zr showed an increased concentration at the interface. The results of bond strength classified the materials in the following decreasing order: TiKrom>Duceratin>InitialTi>Duceratin Plus>Ti-22>Triceram(paste)>Triceram(powder)>TitanKeramik. No correlation (r=0.132) between the fracture mode and bond strength of the selected material denoting that the fracture mode is irrelevant with the bond strength of Ti-ceramic joint and thus the former should not be applied for comparison among different materials. SIGNIFICANCE: According to the results of this study the materials tested provided great difference in interfacial analysis and bond strength with metallic Ti.

Surface characterization of zirconia dental implants.

OBJECTIVES: The aim of the study was to characterize the chemical composition, microstructure and roughness of two commercially available zirconia dental implants (WhiteSky and Zit-Z). METHODS: The chemical composition of the cervical collar and threaded root parts of the implants (n=2) were studied by XPS and HV-EDX. LV-SEM was used for morphological assessment, Raman microanalysis for microstructural characterization and optical profilometry for surface roughness measurements. XRD, HV-EDX and Raman microanalysis of bulk regions (longitudinal sections) were used as reference. RESULTS: XPS showed the presence of C, O, Zr and Y (collar) plus Al (root) at implant surfaces. More C (10-26at%) and a lower Al/Zr ratio were found in WhiteSky (1.05 vs 1.26 in Zit-Z). Zr, Y and Al were detected in single, fully oxidized states. The same elements, plus Hf, were identified by HV-EDX at bulk and surface regions, with a Al/Zr ratio higher in WhiteSky (0.17 vs 0.09 in Zit-Z). Na, K and Cl contaminants were traced at implant root parts by both methods. XRD analysis of cross-sectioned specimens revealed the presence of monoclinic and tetragonal zirconia along with cubic yttria phases. Raman microanalysis showed that the monoclinic zirconia volume fraction was higher at root surfaces than the collar. No monoclinic phase was found at bulk regions. Significantly higher Sa and Sq values were recorded in WhiteSky than Zit-Z, whereas Zit-Z showed higher Rt value. SIGNIFICANCE: The differences found between the implants in the extent of carbon contamination, residual alumina content, tetragonal to monoclinic ZrO(2) phase transformation and 3D-roughness parameters may contribute to a substantial differentiation in the cellular and tissue response.

Surface characterization and force relaxation of retrieved silk sutures.

AIM: To investigate the relaxation of as-received and retrieved silk sutures and characterize the compositional and structural changes occurred during service. MATERIALS AND METHODS: Silk sutures were tested in three conditions: (a) as-received, (b) retrieved from the oral cavity of patients, and (c) retrieved from extraoral sites of patients following 4 days. Specimens of the first group were fabricated by tying a knot on a plastic cable of 5 mm diameter. Specimens (n = 6) of groups (b) and (c) were placed in the appropriate surgical site and retrieved. Specimens were subjected to Fourier transform infrared spectroscopy for the characterization of molecular composition; low vacuum scanning electron microscopy (LV-SEM) to investigate the morphological variation; and energy dispersive X-ray microanalysis to assess the elemental composition of integuments formed onto the materials. To investigate the stress relaxation of elastics, a portable test assembly was developed to monitor the force exerted by a stretched suture for a period of 4 days. RESULTS: Retrieved specimens demonstrated absorption of proteinaceous matter comprising of amide I and II and alcohol, as well as precipitation of Mg, Si, Cl, and Ca for the extraorally aged specimens and additional K and P for the intraorally exposed sutures. Aged specimens showed swelling and disorganization and rupture of suture bundles. Stress relaxation data were indicative of no difference between the three groups, which relaxed at 30% of the initial value, whereas the curves showed similar slopes. SIGNIFICANCE: Significant relaxation was found for silk sutures, which seems to be independent of surgical site.

Characterization and in vitro estrogenicity of orthodontic adhesive particulates produced by simulated debonding.

OBJECTIVE: To investigate the structure and composition of ground orthodontic adhesive particulates produced under simulated clinical conditions and assess their estrogenic action in vitro. MATERIALS AND METHODS: A chemically cured and a light-cured adhesive were included in the study. Specimens were prepared by simulating bonding procedures, covering the bracket base surface with cellulose films to detach the full set material. The adhesives prepared under this method were grounded in glass chambers with an 8-fluted tungsten carbide on a high-speed handpiece; a new bur and different chamber was used for each adhesive sample and grindings were performed on different days to avoid contamination of the room. The adhesive particulates produced were subjected to FT-IR spectroscopy for the molecular characterization of particles; scanning electron microscopy for the morphologic condition and structure; and X-ray microanalysis for the elemental composition of the particles. Amounts of the ground adhesives were immersed in saline for 1 month at 37 degrees C. Eluents from solution of the two adhesives were added to media of an estrogen-responsive cell line derived from human breast adenocarcinoma (MCF-7), to assess the estrogenicity. Positive (estradiol and bisphenol-A) and negative (saline) controls were used; all assays were repeated four times and the results were averaged. Estrogenicity data were analyzed with one-way ANOVA and the Tukey test at the .05 level of significance. RESULTS: The study of the composition of particles revealed compounds related to monomers with no major differences noted. Significant structural alterations were observed between the materials studied, with the chemically cured adhesive having larger particles. The ground samples contained Si, Na and Al apparently deriving from fillers, whereas large Ba fillers were identified only in the chemically cured group, whereas no distinct molecular variation was noted between the set material and its corresponding particulate form. Both chemically cured and light-cured adhesives exhibited an estrogenic action through induction of the proliferation rate of MCF-7 cells (160% and 128%, respectively, compared to control). SIGNIFICANCE: Apart from the potentially hazardous action of adhesive particulate aerosol produced by grinding, composite resin particulates may act as endocrinological disruptors.

In-depth hardness profiles of stainless steel and Ni-Ti endodontic instrument cross-sections by nano-indentation.

AIM: To evaluate the in-depth hardness profiles of Stainless Steel (SS) and nickel titanium (Ni-Ti) endodontic instrument cross-sections using a nano-indentation technique. METHODOLOGY: Three SS (Reamer, K and Hedström) and three Ni-Ti (ProFile, NRT and Liberator) instruments were studied. After embedding and metallographic preparation the in-depth hardness profiles of instrument cross-sections were measured starting from the cutting surface towards the centre to a depth of 2000 nm using an MTS XP nanoindenter with a Berkovich diamond indenter. The results of hardness measurements of outer (near to cutting edge) and inner locations were statistically analyzed by two-way anova followed by SNK test (alpha = 0.05). RESULTS: For all instrument cross-sections the maximum hardness was obtained at the outer surface followed by hardness attenuation towards the centre of the cross section. The statistical analysis of hardness classified the instruments, for both outer and innermost locations, to the following decreasing order: Reamer > K > Hedström > Profile > NRT shank (without thermal treatment) > NRT tip (with thermal treatment) > Liberator. The maximal hardness, at the outer surface of endodontic instruments, can be attributed to the residual stresses developed due to cutting and thermal effects during the manufacturing process. The increased outer layer hardness may have a beneficial effect on the cutting ability and wear resistance of endodontic instruments. CONCLUSIONS: All endodontic instruments had a decrease in hardness towards their centre. This implies that the surface hardness of contemporary endodontic instruments is significantly enhanced by the consequences of manufacturing processes.

Failure mechanism of ProTaper Ni-Ti rotary instruments during clinical use: fractographic analysis.

AIM: To evaluate the failure mechanism of ProTaper Ni-Ti rotary instruments fractured under clinical conditions. METHODOLOGY: A total of 46 ProTaper instruments that failed (fractured and/or plastically deformed) during the clinical use were collected from various dental clinics, whereas a new set of ProTaper instruments served as control. After inspection under stereomicroscopy the instruments were classified into three categories: (i) plastically deformed but not fractured, (ii) fractured with plastic deformation and (iii) fractured without plastic deformation. Three instruments from each group were analysed with computerized X-ray microtomography (micro-XCT) to detect surface and internal defects, whilst all the fracture surfaces were investigated under SEM. RESULTS: Stereomicroscopic inspection showed that 17.4% of the discarded instruments were only plastically deformed, 8.7% were fractured with plastic deformation and 73.9% were fractured without plastic deformation. Micro-XCT revealed instruments without any surface or bulk defects along with a few files with crack development below the fracture surface. No defects were identified in the unused instruments. SEM examination of fractured surfaces demonstrated the presence of dimples and cones, a typical pattern of dimple rupture developed because of ductile failure. CONCLUSIONS: The results suggest that a single overloading event causing ductile fracture of ProTaper instruments is the most common fracture mechanism encountered under the clinical conditions.

Susceptibility to localized corrosion of stainless steel and NiTi endodontic instruments in irrigating solutions.

AIM: To evaluate the pitting and crevice corrosion characteristics of stainless steel (SS) and NiTi endodontic files in R-EDTA and NaOCl irrigating solutions. METHODOLOGY: The corrosion behaviour of two H-files produced from different SS alloys (Mani, AISI 303 SS, Dentsply Maillefer, AISI 304 SS) and one file produced from NiTi alloy (Maillefer) was determined in R-EDTA and NaOCl irrigating solutions by the cyclic potentiodynamic polarization method. The cutting flutes of 12 files of each material were embedded in an epoxy resin, polished, exposed to the irrigating solutions and used as an electrode. An Ag/AgCl electrode was used as a reference, a platinum plate was used as a counter electrode and polarization curves were obtained for all files in R-EDTA and NaOCl irrigating solutions in 37 degrees C with a potential scan rate of 5 mV min(-1). Corrosion potential (Ecorr), Corrosion current density (Icorr) and Pitting potential (Epit) were calculated from each curve. The results were statistically analysed with two-way anova and Student-Newman-Keuls (SNK) multiple comparison test with materials and irrigating solutions serving as discriminating variables (a = 0.05). RESULTS: Cyclic polarization curves presented negative hysteresis implying that pitting or crevice corrosion are not likely to occur for all the materials examined in both irrigating solutions. In NaOCl all materials showed significantly higher Ecorr (P = 0.011) as well as lower Icorr compared with R-EDTA reagent. Moreover, all materials demonstrated equal Epit in NaOCl, which was to be found significantly lower (P = 0.009) than the value of Epit in R-EDTA. CONCLUSIONS: None of the tested materials is susceptible to pitting or crevice corrosion in R-EDTA and NaOCl solutions and from this standpoint are appropriate for the production of endodontic files.

Failure analysis of two Ti-alloy total hip arthroplasty femoral stems fractured in vivo.

Failure of total hip arthroplasty femoral stems is a serious clinical complication. Even modern metal alloys and designs sometimes suffer such incidents. The reported study aimed at the investigation of the reasons leading the in vivo fracture of two Ti6Al4V femoral stems. Stems were retrieved during revision surgery approximately 2 years postoperatively. Examination and analysis included XRF spectrometry for identification of chemical composition, macroscopic examination and topographical measurements, SEM study of fracture surfaces, study of alloy microstructure by optical microscopy, and finally measurement of mechanical properties by means of tensile testing conducted on alloy samples machined from the stems themselves. Macroscopic examination and measurements showed close topographical similarity between the two fractures. XRF spectrometry, tensile testing, and microstructure analysis identified the alloy as a typical Ti6Al4V surgical titanium alloy. During SEM analysis the fracture surfaces exhibited characteristic fatigue striations tidally running on the cross sections, which were considered as the weakest ones regarding toward geometry and stress concentration. Fracture in both stems occurred due to fatigue along these cross sections.

In vitro characterization of two laboratory-processed resin composites.

PURPOSE: To compare various characteristics of two new-generation laboratory-processed resin composites (BelleGlass HP/SDS-Kerr and Sinfony/3M-ESPE). The properties evaluated were degree of C=C conversion, microhardness, roughness, biaxial flexural strength and polymerization shrinkage-strain. MATERIALS AND METHODS: All specimens were subjected to a first and a second polymerization cycle according to the manufacturers' instructions. The degree of C=C conversion (DC) was recorded on rectangular (3 x 2 x 0.5mm(3)) specimens (n=3) by FT-IR micromultiple internal reflectance spectroscopy immediately after each of the two polymerization cycles. Twenty cylindrical specimens (10 x 2mm(2)) of each material were prepared for surface microhardness (n=10, VHN, 200 g load, 20s) and surface roughness (n=10, Ra) measurements. The biaxial flexural strength and stiffness were determined on disk-shaped (n=8, 15 x 0.7 mm(2)) specimens loaded to fracture at 1 mm/min crosshead speed. The polymerization shrinkage-strain was calculated with the bonded-disk method. All values were statistically analyzed by Student's unpaired t-test (p<0.05). RESULTS: The second polymerization cycle significantly increased the degree of C=C conversion for both materials (p<0.05). BelleGlass HP exhibited significantly higher degree of C=C conversion, surface microhardness, surface roughness, biaxial flexural strength and stiffness values compared to Sinfony (p<0.05). SIGNIFICANCE: Several differences exist between the materials although both products are recommended for the same clinical applications.

Analysis of a retrieved Isola spinal system fractured in service.

A 1/4-in.diameter two-column Isola spinal system implanted in a 13-year-old girl suffering from cerebral palsy and a severe neuromuscular scoliosis of 120 degrees, was replaced 22 months after primary implantation. The system was removed due to fracture of the lower left (concave) bar, between its two cross connectors (i.e., the distal bypass connector and a transverse cross link), as a result of a postoperative infection and a subsequently developed pseudarthrosis. The retrieved implants were analyzed with the use of a multitechnique characterization procedure involving macroscopic and microscopic examination, micro-multiple internal reflectance FTIR spectroscopy, X-ray fluorescence (XRF) spectrometry, roughness measurement, and mechanical testing of the constituent material and components. Findings suggest that the spinal system failed due to in vivo loosening of a two-set screw tandem connector and subsequent overloading of the contralateral bar.

In vivo fracture of a new rubber-dam clamp.

AIM: This study was carried out to investigate the reasons for fracture of a new rubber-dam clamp used for the first time. SUMMARY: The fractured surfaces of the broken clamp were studied with optical microscopy. Characteristic surface patterns of tensile fracture were identified. Cracks originated from the groove of letter D mechanically engraved on the inner surface of the clamp bow, and developed with high velocity (unstable crack growth rate) leading to catastrophic fracture. This behaviour was attributed to the residual stresses introduced by the labelling technique due to local thermal alterations. KEY LEARNING POINTS: The labelling technique used to number clamps may be implicated with catastrophic failure. Dentists should be aware that even new clamps can fracture. It is important that clamps are secured to prevent inhalation of metal fragments, should catastrophic failure occur.

Clinical relevance of standardization of endodontic files dimensions according to the ISO 3630-1 specification.

The aim of this study was to examine the current status of standardization of endodontic instruments. Measurements of instrument dimensions were conducted on stainless steel H- and K-files (sizes 08-40), as well as on rotary-driven nickel titanium (NiTi) files (sizes 15-40), to determine the incidence and degree of deviation from ISO 3630-1, 1992 specification. In addition, the dimensions of sets of H- and K-files (sizes 08-25) were measured to identify discrepancies in dimensions among instruments within the same size per manufacturer. The percentage of difference in width were used to determine the graduation from each size to the next. None of the files tested complied with the ISO nominal size. All files were within the ISO tolerance limits. However, under such tolerance limits, there is a high possibility of either sizes overlapping or of great differences between two sequential sizes. These results may explain the clinical difficulty found in negotiating narrow and curved canals and may establish the need for a more comprehensive approach on the evaluation methods used in root-canal instrument dimension specifications.

Effect of pressure of helium, argon, krypton, and xenon on the porosity, microstructure, and mechanical properties of commercially pure titanium castings.

STATEMENT OF PROBLEM: Porosity is a frequently observed casting defect in dental titanium alloys. PURPOSE: This study evaluated the effect of pressure of helium, argon, krypton, and xenon on the porosity, microstructure, and mechanical properties of commercially pure titanium (cp Ti) castings. MATERIAL AND METHODS: Eight groups (A-H) of 16 rectangular wax patterns each (30 mm in length, 3 mm in width, and 1 mm in depth) were prepared. The wax patterns were invested with a magnesia-based material and cast with cp Ti (grade II). Groups A, C, E, and G were cast under a pressure of 1 atm, and groups B, D, F, and H were cast under a pressure of 0.5 atm of He, Ar, Kr, and Xe, respectively. The extent of the porosity of the cast specimens was determined radiographically and quantified by image analysis. Three specimens of each group and 3 cylinders of the as-received cp Ti used as a reference were embedded in resin and studied metallographically after grinding, polishing, and chemical etching. These surfaces were used for determination of the Vickers hardness (VHN) as well. Eight specimens from each group were fractured in the tensile mode, and the 0.2% yield strength, fracture stress, and percentage elongation were calculated. Porosity was analyzed with 2-way ANOVA and the Newman-Keuls multiple range test. VHN measurements and tensile properties for specimen groups were compared with 1-way ANOVA and the Newman-Keuls multiple range test (95% significance level). RESULTS: The porosity levels per group were (%): A = 5.50 +/- 4.34, B = 0.77 +/- 1.27, C = 2.44 +/- 3.68, D = 0.06 +/- 0.12, E-H = 0. Two-way ANOVA showed that there was no detectable interaction (P<.05) between gas type and applied pressure. Metallographic examination revealed no differences in microstructure among the groups studied. A finer grain size was observed in all cast groups compared with the original cp Ti. The VHN of the as-received cp Ti was significantly greater than all the cast groups tested. Groups cast under He showed the highest VHN, yield strength, and fracture stress. No significant differences were found in percentage elongation values among the groups. CONCLUSION: Porosity and mechanical properties of cp Ti castings are dependent on the gas type and pressure, whereas the microstructure remains unaffected.