Influence of light intensity from different curing units upon composite temperature rise.

The unavoidable consequence of composite resin photopolymerization is temperature rise in tooth tissue. The temperature rise depends not only on the illumination time, but also on light intensity, distance of light guide tip from composite resin surface, composition and shade of composite resin and composite thickness. The most commonly used units for polymerization today are halogen curing units, which emit a large spectrum of wavelengths. A proportion of the spectrum has no influence on degree of conversion and therefore causes unnecessary temperature rise. Units based on light source - blue light emitting diodes (LED), as an alternative for halogen curing units, have been introduced in clinical practice. The aim of this study was to show the influence of the light intensity of curing units Elipar Trilight, Astralis 7 and Lux-o-Max unit on temperature rise in composite resin sample of Tetric Ceram. The temperature was measurement with Metex M-3850 D multimeter with the tip of temperature probe put into unpolymerized composite resin sample 1 mm depth. The highest temperature rise was recorded with standard curing mode for Elipar Trilight halogen curing unit (13.3 +/- 1.21 degrees C after 40 s illumination), while the lowest temperature rise was recorded for the Lux-o-Max unit based on LED technology (5.2 +/- 1.92 degrees C after 40 s illumination).

Photopolymerization of composite resins with plasma light.

Everyday improvements in components and characteristics of composite materials have induced faster development of curing units. Besides standard halogen curing units and soft-start photopolymerization light sources, some experiments with argon and pulsed laser light and low intensity blue superbright light emitting diodes have been made. On the other hand, rapid polymerization with strong plasma light is also clinically applicable. The aim of this study was to measure the degree of conversion and temperature rise for three restorative composite materials: Tetric Ceram (Vivadent, Schaan, Liechtenstein), Pertac II (ESPE, Seefeld, Germany) and Z100 (3M Dental Products, St Paul, MN, USA) during polymerization with plasma light Apollo 95E (DMDS, Dental/Medical Diagnostic Systems, Fleury d'Aude, France) and compare it with the results of polymerization with a halogen curing unit, Elipar Trilight (ESPE, Seefeld, Germany). The results revealed the degree of conversion values in the case of polymerization with plasma light to be almost equal to those obtained by curing with the halogen curing unit, whereas the temperature rise was almost negligible.

Composite conversion and temperature rise using a conventional, plasma arc, and an experimental blue LED curing unit.

The objective of this study was to evaluate the degree of conversion and temperature rise in three different composite materials when illuminated by an experimental light source [blue superbright light emitting diodes (LEDs)] and compared with plasma light and traditional photopolymerization unit. The degree of conversion and temperature rise were measured using Fourier transform infrared (FTIR) spectroscopy and digital multimeter, respectively. The results revealed significantly higher degree of conversion values in case of conventional curing than with other two light sources whereas temperature rise was significantly lower when blue LEDs and plasma light were used. There were great differences in light intensities between blue LEDs of only 9 mW cm-2 compared with plasma light of 1370 mW cm-2 and Elipar II of 560 mW cm-2. Better match of LED spectral distribution peak to camphorquinone absorption distribution peak probably explains much lower intensities used for similar photopolymerization effect like in the case of rapid plasma lamp curing.

Influence of diet on dental caries in diabetics.

Two groups of population consisting of 84 patients suffering from diabetes (60 type I, 24 type II) and 69 nondiabetics of the same age have been examined on: oral hygiene index (OHI), frequency of daily tooth brushing, dietary habits and incidence of dental caries by registration of the decayed, missed and filled dental surfaces (DMFS-index). OHI in type I and type II diabetes was found to bee slightly worse than in nondiabetics, but not significantly (p > 0.05). In the number of daily tooth brushing there is not significant difference between diabetics and nondiabetics. All diabetics have considerably lower daily intake of total as well as simple carbohydrates than nondiabetics. The diabetics have a significantly higher daily intake of dietary fibers, calcium and phosphorus as well as the number of meals with simple carbohydrates and also DMFS-index than the nondiabetics. A significantly higher incidence (p < 0.01) of caries location was found on the buccal and labial cervical areas among patients suffering from diabetes. Explanation for this could be more frequent daily intake of low molecular carbohydrates with an improper calcium phosphorus ratio.

Double tooth.

The form of primary and permanent teeth can differ morphologically from that which is considered normal, completely or in some parts. The changes in tooth form can be hereditary or caused by some disease or trauma. Fusion is a union of one or more teeth during development. Gemination means that two separate morphological units were created by division of the tooth germ. The intention of this study was to state the prevalence of double teeth (fusion and gemination) among the persons tested, as to gender, distribution in the maxilla or mandible, and whether the anomaly occurred bilaterally or unilaterally. The results of this investigation have shown that in a total of examined 3,517 plaster models, a prevalence of double teeth was 0.2%. 57.2% of them were fusioned and 42.9% geminated.

PTCH gene altered in dentigerous cysts.

Motivated by the evidence that odontogenic keratocysts are associated with genetic alterations, we examined the possibility that development of other odontogenic cysts can be attributed to gene malfunctioning, in particular to the PTCH gene. Cyst epithelium was examined for polymorphism on chromosome 9q22.3, the region that contains the PTCH gene. Loss of heterozygosity (LOH) for the D9S287 marker and/or D9S180 marker was observed in about 50% of dentigerous cysts, whereas radicular cysts gave no indication of lesions in the PTCH region. As a more direct argument for PTCH involvement in cystic growth, we report evidence of PTCH expression in dentigerous cyst lining, which indicates malfunctioning of the relevant signaling pathway. While we found no reason to believe that PTCH should be associated with radicular cysts, other genes may be implicated in their development. We performed immunohistochemical comparisons of keratocysts, dentigerous and radicular cysts for the nonmetastatic marker Nm23. A graded response placed radicular cysts in between the other two types, suggesting a similar neoplastic character for their epithelial proliferation.

Degree of conversion and temperature rise during polymerization of composite resin samples with blue diodes.

To ensure an adequate clinical composite filling light source for photopolymerization is of great importance. In everyday clinical conditions commonly used unit for polymerization of composite material is halogen curing unit. The development of new blue superbright light emitting diodes (LED) of 470 nm wavelengths comes as an alternative to standard halogen curing unit of 450-470 nm wavelengths. The purpose of this study was to compare the degree of conversion (DC) and temperature rise of four hybrid composite materials: Tetric Ceram, Pertac II, Valux Plus and Degufill Mineral during 40 s illumination with standard halogen curing unit Heliolux GTE of 600 mW cm(-2) intensity, Elipar Highlight soft-start curing unit of 100 mW cm(-2) (10 s) and 700 mW cm(-2) (30 s) intensity and 16 blue superbright LED of minimal intensity of 12 mW cm(-2) on the surface and 1 mm depth. The results revealed only a little bit higher DC values in case of polymerization with even 66 times stronger halogen curing units which showed twice higher temperature than blue diodes. Temperature and DC obtained are higher on the surface than on 1 mm depth regardless on the light source used.

The efficiency of dentine adhesives in treating non-caries cervical lesions.

The aim of this study was to prove the hypothesis that dentine adhesives can be used as therapeutic material in treating dentine hypersensitivity, regardless of aetiology. The research was conducted on 492 students of Zagreb University School of Dental Medicine (154 male, 338 female), 20-25-years-old. The defects of the tooth neck were found in 38 patients, on 133 teeth (38 of male patients, 95 of female) and dentine hypersensitivity was recorded according to the subjective sensations of patients. Therapeutic characteristics of three adhesive materials were examined simultaneously: All Bond 2, fourth generation adhesive, Syntac Single Component and One Step, fifth generation adhesives. Teeth treated with dentine lacquer Cervitec were used as a control group. Tooth necks were treated with selected materials according to instructions of a manufacturer. A completed statistical survey of the results has clearly shown that dentine adhesives can be used in symptomatic therapy of dentine hypersensitivity of the non-caries cervical lesions (NCCL). The survey has also shown that dentine adhesives of the fifth generation (Syntac Single Component and One Step) have much higher efficiency rate than dentine adhesives of the fourth generation (All Bond 2) and dentine lacquer (Cervitec). According to data complied through this study the conclusion can be brought forward that dentine adhesives are not a final solution to the problem of dentine hypersensitivity, because their efficiency decreases with time.

The effect of the photopolymerization method on the quality of composite resin samples.

An optimal degree of conversion and minimal polymerization shrinkage are generally antagonistic goals, as increased monomer conversion invariably leads to elevated polymerization shrinkage values. However, both parameters are indispensable for an optimal resin composite restoration. A number of approaches have been used to reduce the stress on the restoration cavity wall interface, such as dentine bonding agents to counteract polymerization shrinkage, stress-absorbing lining materials and low-intensity curing lights to control the flow capacity of the material during polymerization. However, the configuration of the cavity and cohesive fractures of the material and surrounding tooth tissues are still a problem in day-to-day clinical practice. A new photopolymerization light source, pulsed laser, ensures a higher degree of conversion and lower polymerization shrinkage, and differentiates this technique from standard polymerization methods and continuous-wave argon laser polymerization. The coherence and monochromacity of pulsed laser light set at 468 nm and the far greater intensity of laser nanopulses produce a saturation effect in the depths of the composite, thus resulting in higher monomer conversion. The total amount of energy illuminating the sample surface, which is only one-fifth of that of conventional methods, and the cooling and relaxation of the material between nanopulses may be responsible for the reduced net polymerization shrinkage.

"C"-shaped canal configuration of mandibular second permanent molar.

Roots of the second mandibular molar often fuse so the purpose of this investigation was to examine the appearance of "C"-shaped root canals and to classify different root canal types. A hundred and twelve randomly chosen second lower permanent molars-after extraction due to periodontal disease-were prepared and then analysed. Contrast liquid (methylene blue) was injected into prepared teeth. Each tooth was cut into slices to view the root canal morphology. Results of the analysis revealed fusion, either total or partial in 14 cases (12.5%). As a conclusion various appearances were classified into 5 types according to the fused canal shapes and the frequency of different types varied from 0.89%-6.25%.

Pulsed blue laser curing of hybrid composite resins.

Clinical performance of light-curing composite restorations is greatly influenced by the quality of the curing-light. Currently used photopolymerization units have some important drawbacks, such as decreasing light output with time and distance, which results in a relatively low degree of conversion and shallow depth of cure, particularly of darker shades. Experiments with continuous argon laser polymerization showed overheating of the composite sample, as well as increased shrinkage of the material. In this study a pulsed laser, set at 468 nm (the maximum of the camphorquinone absorption coefficient), with 20-ns pulse duration, repetition rate of 10 Hz and energy of 10 mJ per pulse, was used as a light source. The aim of the study was to evaluate the effect of polymerization of light and dark shades of three different hybrid composites cured by pulsed laser at the surface and at 3.0 mm depth. The degree of conversion was measured by Fourier transform infrared spectroscopy (FTIR). Applying pulsed blue laser, significantly better results were obtained for both shades compared to standard polymerization values. Very weak dependence of the degree of conversion, between the surface measurements and those at 3.0 mm, were observed in the case of pulsed laser polymerization due to the piercing nanopulses and the monochromatic light at 468 nm.

Polymerization of composites using pulsed laser.

The quality of visible-light-cured composites depends on the capability of the light source to properly polymerize the material within a specified exposure time. In this study, the degree of conversion of different composite materials (hybrid and microfilled) of light and dark shades was compared after illumination by a standard curing unit and pulsed laser (lambda=468) respectively. The degree of conversion was measured by Fourier transform infrared spectroscopy. Results obtained by the analysis of the pulsed laser-induced polymerization were significantly higher for all the materials and shades observed. All values of the degree of conversion were lower for dark shades of all types of composites, regardless of the photopolymerization technique used. Besides the surface, better polymerization was recorded also at depths of 1.0, 2.0 and 3.0 mm, respectively. These values varied from 59.7%+/-2.14 to 84.5%+/-0.33 for pulsed laser (including all depths) caused by the saturation effect induced by high power laser pulses and from 42.7%+/-1.48 to 74.7%+/-0.99 for standard polymerization.

A computerized method for the evaluation of root canal morphology.

The objective of this research was to develop a technique that would allow three-dimensional imaging of root canals utilizing computer image processing. Ten single-rooted permanent human teeth with mature apices were analysed. The teeth were decoronated and fixed on boards with the long axis of the root perpendicular to the board. The cross-sectioning started at the root apex and continued in the coronal direction, roughly perpendicular to the long axis of the ++root. The samples were divided into two groups. The first five samples were sectioned 15 times, each section being 0.5-mm thick, in order to obtain the three-dimensional reconstruction of the root and the root canal. The root apex of each sample was cross-sectioned 19 times and each section was 0.2-mm thick. After each section, the root canal contour was defined utilizing the calibrated net with coordinate system in the ocular of the stereomicroscope. The coordinates of the root canal cross-section contour thus determined, together with the value of the thickness of each cut, were relevant input data for the reconstruction of the root canal cross-sections, longitudinal sections and for the final three-dimensional rebuild of the root and the root canal model. this technique appears to be highly accurate in determining the anatomy of the root canal system and may also be applied in other fields of dental research.

Asymmetry of the root canal foramen.

Deviation of the major apical foramen from the anatomical root apex is a recognized phenomenon. To determine the frequency, position and mean distance of the major apical foramen from the anatomical root apex, 230 roots of permanent teeth were examined stereomicroscopically and radiographically. Radiographic analysis was used to establish how accurate the conventional radiograph was in displaying such a deviation. The frequency of deviation of the major foramen, determined stereomicroscopically, was 76%, and depended on the type of teeth examined. Radiographic analysis of the same sample revealed 57% of root canals had asymmetry of the root canal foramen. Agreement of stereomicroscopic and radiographic findings was found to be 61%. The most frequent deviation of the major foramen was on the distal root surface (29%), but this was not statistically significant. The mean distance between the deviation of the major foramen and the anatomical root apex was 0.99 mm. The study indicates that the clinician should consider deviation of the foramen during root canal treatment, as the deviation could not easily be detected radiographically.

[Composite materials in aesthetic dentistry]. / Kompozitni materijali u estetskoj stomatologiji.

Composite resins are, undoubtedly the most important discovery in dental science in the last three decades. Today, esthetics and restorative dentistry are unthinkable without composite resins. These dental materials deserve attention of the dental scientists and the dental practitioners who are interested to reach the good results which are the imperative of modern dentistry. Until now the three generations of composite resins have been developed. The first of them, composite materials with macrofiller are not in operative use today due to their shortages. Composite materials with microfiller and composite complexes with microfiller are good for frontal teeth while the hybrid composite resins are good for bicuspids and molars. Moreover, three generations of dentin adhesion materials for better adhesion of composite resins on dentin surfaces have been developed.

[Quantitative evaluation of the immunoglobulin G, A and M in the human dental pulp]. / Kvantitativna evaluacija imunoglobulina G, A i M humane zubne pulpe.

The presence of immunoglobulins G, A and M was studied in human dental pulps using a quantitative method of radial immunodiffusion. Valid data on the amounts of IgG, IgA and IgM were obtained on the basis of measured concentrations of immunoglobulins in each pulp sample and their correlation with total protein concentrations. The results indicated IgG to be present in 100%, IgA in 15% and IgM in 8% of 13 pulp samples affected by chronic inflammation. The mean values of IgG, IgA and IgM thus determined were 84.3, 4.4 and 1.4 mg/g protein, respectively. In intact pulp tissue, however, no presence of immunoglobulins G, A and M could be detected using the same method as above. The results obtained suggested the possibility of local synthesis of immunoglobulins in chronically inflamed pulp tissue, indicated that nonspecific inflammatory reaction may have occurred concurrently with some specific immunologic reactions. The predominance of IgG pointed to immunologic reactions of early types II and III hypersensitivity.

[Dentin hypersensitivity: etiology and methods of treatment]. / Dentinska preosjetljivost: etiologija i metode lijecenja.

This work presents review on etiology of dentinal hypersensitivity and mechanisms of dentin desensitization. The main theories on dentin sensitivity are discussed in details. Particularly are stressed hydrodynamic and transducer theories. Two main approaches to the dentin desensitization by tubule occlusion and blocking pulpal nerve activity by altering the sensory nerves excitability are presented. The aim of dentin desensitization is to apply various agents that occlude dentinal tubules and so decrease dentin sensitivity or to apply agents that reduce nerve excitability. Between many different agents in use the most wide use and best results in decreasing dentin sensitivity have topical application of oxalate salts and application of unfilled resins. Different toothpaste with strontium chloride or potassium nitrate as active ingredients have been commonly used as very effective desensitizing agents.

Indium light source for curing composite resins.

There is an existing problem of cumulative hazardous effect of violet and near ultra-violet light which is produced by standard polymerisation units. Another restrict is shallow depth of cure, particularly of darker composite shades in premolar and molar region. Searching for better light source we used indium resonance lines from several indium high pressure lamps and tested curing effect on three different composite resins. The overall results are better with the lamp in which two strong resonance lines of indium are present, rather than with a lamp with just one strong resonance line. The improvements in lamp design are necessary to overcome conventional polymerisation lamps.

[Saliva as a risk factor for caries in diabetic patients]. / Slina kao cinilac karijes rizika u bolesnika od seérne bolesti.

Saliva is an important factor upon which general health of the oral cavity is dependent and which influences the occurrence of caries. In diabetic patients, xerostomia may occur due to pronounced polyuria in non-regulated and inadequately regulated cases. The aim of this study was to determine the amount of stimulated saliva and salivary pH in diabetic patients and in normal subjects, and to study the possible difference in the occurrence of caries. Results pointed to a significant decrease in the amount of stimulated saliva in insulin dependent diabetics (1.22 ml/min vs. 1.43 ml/min in normal subjects; p less than 0.01). The lowest amount of stimulated saliva was found in non-regulated diabetics (1.00 ml/min). In all diabetic patients, a significantly lower salivary pH was recorded as compared to normal subjects (p less than 0.01). The DMFS index was significantly higher in both insulin dependent and non-insulin dependent diabetics as compared to normal subjects (p less than 0.01). Concerning the state of diabetes control, significant differences at the level of p less than 0.01 in the DMFS index were observed among all groups of subjects (normal subjects, and regulated, inadequately regulated and non-regulated diabetics). A decreased salivary flow and pH may represent one from a series of caries risk factors in diabetics, especially in inadequately regulated and non-regulated cases of the disease.

The association between palatal grooves in upper incisors and periodontal complications.

Palatal groove is a rare morphological defect of upper incisors, frequently associated with localized destruction of periodontal tissue with endodontic complications. In this study, a sample of 1,081 male, young adult subjects, aged 20 to 22, palatal grooving was recorded in 11 (1.01%) subjects, affecting 15 incisors. Among 634 adult subjects, aged 35 to 50, with periodontal disease, palatal groove was found in 5 (0.79%) incisors. Second incisors were more frequently (75%) associated with this anomaly. In the young adults, the mean probing pocket depth in the groove region and around other teeth of the intercanine area was 3.8 mm and 1.2 mm, respectively. In the group of periodontal patients, the mean probing pocket depth was significantly greater at the site of palatal groove (8.8 mm vs. 4.0 mm).