Longevity of Crown Margin Repairs Using Glass Ionomer Cement: A Retrospective Study.

OBJECTIVE: The objective of this study was to determine the survival time of crown margin repairs (CMRs) with glass ionomer and resin-modified glass ionomer cements on permanent teeth using electronic dental record (EDR) data. METHODS: We queried a database of EDR (axiUm; Exan Group, Coquitlam, BC, Canada) in the Indiana University School of Dentistry (IUSD), Indianapolis, IN, USA, for records of patients who underwent CMRs of permanent teeth at the Graduate Operative Dentistry Clinic. Two examiners developed guidelines for reviewing the records and manually reviewed the clinical notes of patient records to confirm for CMRs. Only records that were confirmed with the presence of CMRs were retained in the final dataset for survival analysis. Survival time was calculated by Kaplan-Meier statistics, and a Cox proportional hazards model was performed to assess the influence of age, gender, and tooth type on survival time (a<0.05). RESULTS: A total of 214 teeth (115 patients) with CMR were evaluated. Patient average age was 69.4 ± 11.7 years old. Posterior teeth accounted for 78.5% (n=168) of teeth treated. CMRs using glass ionomer cements had a 5-year survival rate of 62.9% and an annual failure rate (AFR) of 8.9%. Cox proportional-hazards model revealed that none of the factors examined (age, gender, tooth type) affected time to failure. CONCLUSION: The results indicate the potential of CMRs for extending the functional life of crowns with defective margins, thus reducing provider and patient burden of replacing an indirect restoration. We recommend future studies with a larger population who received CMR to extend the generalizability of our findings and to determine the influence of factors such as caries risk and severity of defects on survival time.

Comparison of Internal Adaptation of Bulk-fill and Increment-fill Resin Composite Materials.

OBJECTIVES:: To evaluate 1) the internal adaptation of a light-activated incremental-fill and bulk-fill resin-based composite (RBC) materials by measuring the gap between the restorative material and the tooth structure and 2) the aging effect on internal adaptation. METHODS AND MATERIALS:: Seventy teeth with class I cavity preparations were randomly distributed into five groups; four groups were restored with bulk-fill RBCs: Tetric EvoCeram Bulk Fill (TEC), SonicFill (SF), QuiXX Posterior Restorative (QX), and X-tra fil (XF); the fifth group was restored with incremental-fill Filtek Supreme Ultra Universal Restorative (FSU). One-half of the specimens of each group were thermocycled. Each tooth was sectioned, digital images were recorded, and the dimensions of any existing gaps were measured. Data were analyzed using analysis of variance (α=0.05). RESULTS:: FSU had the smallest gap measurement values compared with the bulk-fill materials except QX and TEC ( p≤0.008). FSU had the smallest sum of all gap category values compared with the bulk-fill materials, except QX ( p≤0.021). The highest gap incidence and size values were found at the composite/adhesive interface. All aged groups had greater gap values in regard to the gap measurement and the sum of all gap categories compared with non-aged groups. SIGNIFICANCE:: The incrementally placed material FSU had the highest internal adaptation to the cavity surface, while the four bulk-fill materials showed varied results. Thermocycling influenced the existing gap area magnitudes. The findings suggest that the incremental-fill technique produces better internal adaptation than the bulk-fill technique.

A Direct Refractory Die Technique for Cast Gold Restorations.

Fabricating accurate cast gold restorations can be challenging for both clinicians and laboratory technicians. Removing the wax pattern from the master die often distorts the pattern, which, in turn, compromises the overall fit and marginal adaptation of the casting. This article demonstrates a laboratory technique in which the final restoration is cast directly on the refractory die without removing the wax pattern. Thus, distortion of the wax pattern is avoided, enabling the production of superbly fitting gold castings for both intracoronal and extracoronal restorations.

The influence of a packable resin composite, conventional resin composite and amalgam on molar cuspal stiffness.

Packable resin composites may offer improved properties and clinical performance over conventional resin composites or dental amalgam. This in vitro study examined the cuspal stiffness of molars restored with a packable resin composite, a conventional posterior microfilled resin composite and amalgam. Forty-eight intact caries-free human third molars were distributed into four treatment groups (n=12) so that the mean cross-sectional areas of all groups were equal. Standardized MOD cavity preparations were made and specimens restored using one of four restorative materials: (1) a spherical particle amalgam (Tytin); (2) Tytin amalgam with a dentin adhesive liner (OptiBond Solo); (3) a conventional microfilled posterior resin composite (Heliomolar); (4) a packable posterior resin composite (Prodigy Posterior). Cuspal stiffness was measured using a Bionix 200 biomaterials testing machine (MTS). Specimens were loaded vertically to 300 N at a crosshead speed of 1.0 mm/minute. Stiffness was measured at 10 intervals: (1) prior to cavity preparation (intact); (2) following cavity preparation, but before restoration; (3) seven days after restoration; then (4) 1, 2, 3, 4, 5, 6 and 12 months after restoration. All specimens were stored at 37 degrees C in deionized water throughout the study and thermocycled (5 degrees/55 degrees C; 2000 cycles) monthly for 12 months. Repeated Measures ANOVA revealed significant differences among treatment groups over time (p<0.0001). Cavity preparation reduced cuspal stiffness by more than 60%. At 12 months, the cuspal stiffness of restored teeth was, on average, 58% that of intact specimens. Neither the packable nor the conventional resin composite increased cuspal stiffness over that of amalgam.

Shear bond strengths of 10 adhesive resin/amalgam combinations.

This study compared the shear bond strengths of amalgam to dentin using two amalgam alloys and five adhesive resin systems. One hundred extracted human third molars were flattened occlusally to expose dentin. Dentin surfaces were treated with one of five adhesive resins: All-Bond 2, Amalgambond Plus, Amalgambond Plus with HPA Powder, OptiBond, and Resinomer. Tytin (spherical) or Dispersalloy (admixed) amalgam was condensed onto the treated dentin surface through a Teflon split mold. The samples were stored 7-10 days and thermocycled before shear testing using a Zwick Materials Testing Machine. Two-way ANOVA revealed significant differences among the 10 groups (P < 0.05). The combination of Tytin/OptiBond produced the highest bond strength to dentin (14.17 MPa), while Dispersalloy/Amalgambond Plus produced the lowest (3.89 MPa). In general, the filled resin systems (Amalgambond Plus with HPA Powder, OptiBond, Resinomer) produced higher bond strengths than the unfilled systems (All-Bond 2, Amalgambond Plus). Additionally, for four of the five resins, bond strengths were higher with Tytin than with Dispersalloy, although differences were statistically significant in only two groups.

Surface treatment effects on amalgam repair strength.

PURPOSE: To determine whether the use of microetching and bonding agents could improve the shear bond strength between aged and freshly added dental amalgam, simulating an amalgam repair. MATERIALS AND METHODS: Aged amalgam surfaces were treated with either a carbide bur or carbide bur + microetcher (Al2O3 abrasive). Five commercially-available adhesive systems were tested. Fresh amalgam was condensed through a split mold onto each prepared amalgam surface. Two control groups were included: a positive control consisting of non-repaired amalgam, and a negative control consisting of aged specimens which received neither carbide bur nor microetching preparation prior to the addition of fresh amalgam. In addition, one group received only carbide bur and another received only carbide bur and microetching treatments, without any adhesive. Following storage and thermocycling, each specimen was tested for shear bond strength. RESULTS: The mean shear bond strength of the repaired samples treated with carbide bur alone (25.8 MPa) was not exceeded by any of the other treatments. Neither microetching nor use of an adhesive agent significantly improved amalgam-to-amalgam shear bond strength. In some cases, use of an adhesive agent significantly decreased the shear bond strength of repaired amalgam samples.