Bonding amalgam to dentin by different methods.

The shear bond strengths of amalgam to dentin by use of (1) All-Bond-2 adhesive, (2) Amalgambond Plus adhesive and (3) TMS Minim pins were compared in this study. Forty-five sound human molars were mounted in acrylic resin and randomly assigned to one of the three groups. The occlusal surfaces were ground to expose the dentin, which was then wet-polished with 600-grit sand paper. All materials were applied according to manufacturer's instructions. A split die with a 5 mm opening was placed and amalgam was condensed, which created an amalgam cylinder bonded/retained to the dentin surface. A shear bond force was applied to the base of the amalgam cylinder. The data were analyzed with analysis of variance and Scheffé's test at the 95% level. All systems were found to promote adhesion/retention of amalgam to dentin. The All-Bond 2 group showed significantly higher bond strength (11.106 +/- 3.585 MPa) than Amalgambond Plus (6.343 +/- 3.564 MPa) and TMS pin (6.868 +/- 0.794 MPa) (p < 0.05).

The effect of dentin primer on the shear bond strength between composite resin and enamel.

The purpose of this study was to determine the effect of accidental dentin primer contact with etched enamel on shear bond strength of composite resin to enamel. Four dentin bonding systems were included in this study: GLUMA Dentin Bond, Scotchbond, and Prisma Universal Bond 2 and 3. Eighty extracted human permanent anterior teeth were used and divided in eight test groups. The vestibular surfaces were ground and acid etched. For each dentin bonding system 10 samples were treated with dentin primer prior to placement of resin. Shear bond testing showed that enamel contact with dentin primer in the above two systems decreased the shear bond strength between composite and enamel by 31 to 44%.

Effect of different adhesive systems on microleakage at the amalgam/composite resin interface.

The objective of this study was to evaluate the effect of different bonding systems on teh microleakage at the amalgam/composite interface. The microleakage at the amalgam/composite resin interface was evaluated with a quantitative dye penetration method. Amalgam cylinders were made and a 2 mm composite base was added after the application of five different bonding systems to the roughened interface of the amalgam cylinders. The cylinders were filled with an exact volume of 0.05% fuchsin solution, and the total weight of the sample was measured. The cylinders were placed on a filter paper with the composite base down and evaluated for leakage after 1, 3, 6, and 24 hours. Weight loss and coloring of the filter paper represented microleakage. The results indicated that the application of Prisma Universal Bond 2 adhesive, Cover Up II, or Amalgambond (groups E, F, and G) reduced the amount of microleakage significantly as compared to the groups in which no adhesive system, 3M Porcelain Repair Kit (with and without acid etching of the amalgam surface), or Prisma Universal Bond 2 primer and adhesive (groups A, B, C or D) was applied.

Tensile bond strength of repaired amalgam.

This study evaluated the tensile strength of repaired high-copper amalgams and analyzed the different treatments of the amalgam interface prior to repair. One hundred specimens were divided into 10 groups: group 1 was left intact and was considered as the control group. In groups 2 through 8, the specimens were sectioned into halves after 10 days and were reconstructed with new amalgam. Groups 9 and 10 were condensed with time intervals of 15 minutes and all specimens were subjected to tensile loads in a Universal Testing Machine. The tensile strengths at the junction between old and new amalgam ranged between 50% to 79% of those of the control group and verified that the same type of amalgam and uncontaminated interfaces had higher strengths. The results also suggested that if an amalgam repair is anticipated, additional retention is critical to the longevity of the restoration.

The influence of an adhesive system on shear bond strength of repaired high-copper amalgams.

The shear bond strengths of intact high-copper spherical and admixed amalgams were compared with repaired high-copper spherical and admixed amalgam specimens with and without the use of an adhesive system (Amalgambond). In the spherical group the shear bond strength of the repaired specimens was found to be 55 and 53.2% of the intact specimens without and with the use of the adhesive system. After thermocycling those percentages were 48.5 and 43. In the admixed groups those percentages were 39, 36.5, 34.5, and 35.2 respectively. It was found that the application of Amalgambond did not significantly increase the strength of the repaired amalgam. Thermocycling only had a significantly adverse effect on the repair strength in the admixed group repaired without an adhesive system.

Major vascular complications of orthognathic surgery: false aneurysms and arteriovenous fistulas following orthognathic surgery.

False aneurysms and arteriovenous fistulas are rare complications of orthognathic surgery. The vessel most commonly involved with false aneurysms following mandibular surgery is the internal maxillary artery, and this vessel, especially the sphenopalatine branch, may also be involved following maxillary surgery. An unusual factor in the presentation of false aneurysms following Le Fort I osteotomies is an initial episode of epistaxis occurring greater than 2 weeks postoperatively. Arteriovenous fistulas following orthognathic surgery are more apt to involve large vessels, especially the internal carotid artery. Embolization procedures are the treatment of choice for false aneurysms and arteriovenous fistulas in the maxillofacial region following orthognathic surgery.

Shear bond strength of composite resin to amalgam: an experiment in vitro using different bonding systems.

The shear bond strength between amalgam and composite resin with and without the use of adhesive systems was evaluated. It was found that the application of Cover-Up II or Prisma Universal Bond prior to placement of composite resin enhanced the shear bond strength between amalgam and composite resin more than five times; and a shear strength of 4.34 and 4.30 MPa was measured respectively. Acid-etching of the roughened amalgam surface prior to application of Prisma Universal Bond decreased the bond strength by nearly 45%.

Assessing microleakage at the junction between amalgam and composite resin: a new method in vitro.

A new dye-diffusion test method was utilized to evaluate the microleakage between amalgam and composite resin. An amalgam cylinder was made to which a base of composite was added. The effects of several factors upon the microleakage were investigated. The test results indicated less microleakage when bonding agent was applied directly to the roughened amalgam prior to placement of composite resin. The most microleakage was found when roughened amalgam surface was acid-etched before placement of bonding agent and composite resin.

Major vascular complications of orthognathic surgery: hemorrhage associated with Le Fort I osteotomies.

Major intraoperative or postoperative bleeding associated with Le Fort I osteotomies can be venous and/or arterial in nature. Arterial hemorrhage generally involves the maxillary artery and its terminal branches. Arterial hemorrhage tends to be more persistent and can be recurrent, which makes it more difficult to manage. Postoperative bleeding following Le Fort I osteotomies generally presents as epistaxis and usually occurs initially within the first 2 weeks following surgery. Treatment modalities that have been used to successfully arrest postoperative hemorrhage include anterior and/or posterior nasal packing; packing of the maxillary antrum; reoperating with clipping or electrocoagulation of bleeding vessels, or the use of topical hemostatic agents in the pterygomaxillary region; external carotid artery ligation; and selective embolization of the maxillary artery and its terminal branches.

Aseptic necrosis following maxillary osteotomies: report of 36 cases.

The sequelae of insufficient vascularity following maxillary orthognathic surgery can vary from loss of tooth vitality, to periodontal defects, to tooth loss, to loss of major maxillary dentoalveolar segments. The results of a questionnaire mailed to oral and maxillofacial surgeons found this complication was most likely to occur with Le Fort I osteotomies done in multiple segments in conjunction with superior repositioning and transverse expansion. Significant palatal perforations definitely seem to compromise the already tenuous blood supply to the anterior maxilla. Suggestions are given regarding the prevention and treatment of this complication.