Factors influencing the progression of noncarious cervical lesions: A 5-year prospective clinical evaluation.

STATEMENT OF PROBLEM: The etiology (chemical, friction, abfraction) of noncarious cervical lesion (NCCL) progression is poorly understood. PURPOSE: The purpose of this 5-year prospective clinical trial was to measure the relationship between NCCLs and various etiologic factors. MATERIAL AND METHODS: After review board approval, 29 participants with NCCLs were enrolled. Polyvinyl siloxane impressions were made of each NCCL, and casts were poured at baseline, 1, 2, and 5 years. The casts were scanned with a noncontact profilometer, and 1-, 2-, and 5-year scans were superimposed over baseline scans to measure volumetric change in NCCLs. T-scan and Fujifilm Prescale films were used to record relative and absolute occlusal forces on teeth with NCCLs at the 5-year recall. Participant diet, medical condition, toothbrushing, and adverse oral habit questionnaires were given at the 5-year recall. Occlusal analysis was completed on mounted casts to determine the presence of wear facets and group function. Volumetric lesion progression from 1 to 5 years was correlated to absolute and relative occlusal force using mixed model analysis. The Kruskall-Wallis and Mann-Whitney analyses compared lesion progression with diet, medical condition, toothbrushing, adverse oral habits, wear facets, and group function. RESULTS: The NCCL progression rate over 5 years was 1.50 ±0.92 mm(3)/yr. The rate of progression of NCCLs was related to mean occlusal stress (P=.011) and relative occlusal force (P=.032) in maximum intercuspation position. No difference was seen in NCCL progression between participants with any other factors. CONCLUSION: Heavy occlusal forces play a significant role in the progression of NCCLs.

The Effect of Contamination of Implant Screws on Reverse Torque.

PURPOSE: To determine if contamination of abutment screws with titanium nanoparticles affects the preload by measuring the reverse torque after multiple cycles of screw closing-opening. MATERIALS AND METHODS: The study included 30 internal hex implants, titanium abutments, and titanium abutment screws. Fifteen abutment screws were contaminated with 60- to 80-nm titanium nanoparticles (contamination group), and the remaining 15 screws did not receive titanium nanoparticle contamination (noncontamination group). Each abutment screw was initially tightened to 25 Ncm with a digital torque gauge to stabilize the abutment to the implant. The second torque, 25 Ncm, was applied 10 minutes after the initial torque. After an additional 5 minutes, the screw was loosened to measure the reverse torque. Ten cycles of screw insertion and removal were conducted, and reverse torque values were measured in each cycle. Repeated measures analysis of variance and the Student t test were used for statistical analysis. The level of significance was set at α = .05. After 10 cycles of closure-opening, abutment screw threads were observed under ×40 magnification. RESULTS: Abutment screws at every cycle generally showed preload values less than the initial applied torque. The mean reverse torque values in both groups had a tendency to decline as the test cycle progressed, except at the 6th, 9th, and 10th cycle in the contamination group. The noncontamination group always had higher mean reverse torques than the contamination group at the same test cycle with significant differences at the 1st, 2nd, 4th, 5th, 7th, and 8th cycles. The preload loss in percentages were 7.83% and 12.57% after the 1st cycle, 14.48% and 19.77% after 5 cycles, and 18.83% and 19.83% after 10 cycles in the noncontamination and contamination group, respectively. Abutment screws in both groups showed various degrees of wear and metal debris on screw surfaces. CONCLUSION: Contamination of abutment screws with titanium nanoparticles decreased screw reverse torque values because of a settling effect, though this effect seemed minimal after five cycles. A future clinical study is indicated to validate if cleaning of contaminated screws before the delivery of the prosthesis will increase preloads.

Contact angle of unset elastomeric impression materials.

STATEMENT OF PROBLEM: Some elastomeric impression materials are hydrophobic, and it is often necessary to take definitive impressions of teeth coated with some saliva. New hydrophilic materials have been developed. PURPOSE: The purpose of this in vitro study was to compare contact angles of water and saliva on 7 unset elastomeric impression materials at 5 time points from the start of mixing. MATERIAL AND METHODS: Two traditional polyvinyl siloxane (PVS) (Aquasil, Take 1), 2 modified PVS (Imprint 4, Panasil), a polyether (Impregum), and 2 hybrid (Identium, EXA'lence) materials were compared. Each material was flattened to 2 mm and a 5 µL drop of distilled water or saliva was dropped on the surface at 25 seconds (t0) after the start of mix. Contact angle measurements were made with a digital microscope at initial contact (t0), t1=2 seconds, t2=5 seconds, t3=50% working time, and t4=95% working time. Data were analyzed with a generalized linear mixed model analysis, and individual 1-way ANOVA and Tukey HSD post hoc tests (α=.05). RESULTS: For water, materials grouped into 3 categories at all time-points: the modified PVS and one hybrid material (Identium) produced the lowest contact angles, the polyether material was intermediate, and the traditional PVS materials and the other hybrid (EXA'lence) produced the highest contact angles. For saliva, Identium, Impregum, and Imprint 4 were in the group with the lowest contact angle at most time points. CONCLUSION: Modified PVS materials and one of the hybrid materials are more hydrophilic than traditional PVS materials when measured with water. Saliva behaves differently than water in contact angle measurement on unset impression material and produces a lower contact angle on polyether based materials.

Influence of implant angulation on the fracture resistance of zirconia abutments.

PURPOSE: To investigate the effects of abutment design to correct for implant angulation and aging on the fracture resistance of zirconia abutments. Greater understanding of the fracture strength of the zirconia abutments under various clinical conditions may lead to improvement of clinical protocols and possibly limit potential failures of implant prosthetics. MATERIALS AND METHODS: Test specimens consisted of an implant-zirconia abutment-zirconia crown assembly with implant apex positioned at 0°, 20° to the facial (20F), and 20° to the lingual (20L) with respect to a constant crown contour. To keep the abutment design as the only variable, CAD/CAM technology was used to generate monolithic zirconia crowns identical both in external and internal dimensions and marginal contours to precisely fit all the abutments in an identical fashion. The monolithic zirconia abutments were designed to fit the constant crown contours and the internal connection of the implant at the three angulations. The customized abutments for the three implant angulations varied in emergence profile, screw hole location, and material thickness around the screw hole. Half the specimens from each group were subjected to steam autoclaving and thermocycling to simulate aging of the restorations in vivo. To mimic the off-axis loading of the central incisor, the specimens were loaded at the recommended cephalometric interincisal relationship of 135° between the long axis of the crown supported by the implant and the Instron force applicator simulating the mandibular incisor. The force applicator was positioned 2 mm from the incisal edge and loaded at a 1 mm/min crosshead speed. Data were evaluated by 2-way ANOVA (α = 0.05) and Tukey's HSD. RESULTS: The 20F group had the highest fracture values followed by the 0° group, and the 20L group had the lowest fracture values. Aging did not yield any significant difference in fracture force magnitudes. CONCLUSION: Within the limitations of this study, tilting the implant apex to the lingual significantly reduced the fracture strength of angle-corrected zirconia abutments. Accordingly, while the angle between the occlusal force application and the long axis of the implant decreases, the resistance (force) to fracture decreases.

Effect of Luting Agents on Retention of Dental Implant-Supported Prostheses.

To evaluate the retentive strength of 7 different luting agents in cement-retained implant abutment/analog assemblies. Fifty-six externally hexed dental implant abutment/analog assemblies and cast superstructures were divided randomly into 7 groups for cementation with each of the 7 luting agents. Five definitive cements tested were zinc phosphate cement, All-Bond 2, Maxcem, RelyX Luting cement, HY-Bond, and two provisional cements, ImProv and Premier. Cast superstructures were cemented onto the implant abutments and exposed to 1000 thermal cycles (0°C-55°C) and 100 000 cycles on a chewing simulator (75 N load). A universal testing machine was used to measure cement failure load of the assembled specimens. Cement failure load was evaluated with 1-way ANOVA and Duncan's multiple range analysis. Significant differences in cement failure loads were measured (P < .0001). Post hoc testing with Duncan's multiple range indicated 4 separate groupings. Maxcem and All-Bond 2 were comparable, having the greatest load failure. RelyX and zinc phosphate cement were analogous, and higher than HY-Bond. Improv and Premier constituted a pair, which demonstrated the lowest retentive values. Within the limitations of this in vitro study, Maxcem and All-Bond 2 are good candidates for cement-retained implant prostheses while concerning retention.

Comparison of pulp stump wounds created by profile rotary root canal instruments and small-diameter fine diamond burs.

INTRODUCTION: The aim of this investigation was to evaluate and compare the pulp stump wounds created by the following root canal instruments: ProFile rotary files and small-diameter fine diamond burs. METHODS: Extracted mandibular premolars from adult patients with vital pulps and fully formed root canals were collected and stored in formalin. Within 48 hours of extraction, the periapical tissue was fixated to the root with a double coating of ethyl cyanoacrylate, and the pulp chambers were accessed with a #4 round carbide bur and high-speed handpiece in a traditional fashion. The pulp tissue of 10 specimens per group was extirpated at a level approximately 5 mm from the apex by using standard endodontic techniques. The specimens were then examined at ×100 magnification under a digital microscope. Grading criteria were developed, and the wounds were scored. RESULTS: Wounds created by diamond burs were significantly smoother that those created by ProFile rotary files; the mean wound score for diamond burs was 1.4 versus a mean wound score of 3 for ProFiles. After the author's scoring of the wounds, 2 endodontist graders were shown photos of each specimen in a double-blind fashion and instructed to score each specimen as being smooth or rough. To validate the developed scoring system and remove potential observer bias of the author, the data from the double-blind observations were used to complete a cross-tabulation for a Cohen kappa test. CONCLUSIONS: Kappa values demonstrated substantial inter-rater agreement for both groups.

Influence of surface treatment of yttrium-stabilized tetragonal zirconium oxides and cement type on crown retention after artificial aging.

STATEMENT OF PROBLEM: Information about the influence of zirconia crown surface treatment and cement type on the retention of zirconia crowns is limited. It is unclear whether zirconia crowns require surface treatment to enhance their retention. PURPOSE: The purpose of this in vitro study was to evaluate the effect of surface treatment on the retention of zirconia crowns cemented with 3 different adhesive resin cements after artificial aging. MATERIAL AND METHODS: Ninety extracted human molars were prepared for ceramic crowns (approximately 20-degree taper, approximately 4-mm axial length) and were divided into 3 groups (n=30). Computer-aided design and computer-aided manufacturing zirconia copings were fabricated. Three surface treatments were applied to the intaglio surface of the copings. The control group received no treatment, the second group was airborne-particle abraded with 50 µm Al2O3, and the third group was treated with 30 µm silica-modified Al2O3, The copings were luted with a self-etch (RelyX Unicem 2), a total-etch (Duo-Link), or a self-etch primer (Panavia F 2.0) adhesive cement. They were stored for 24 hours at 37°C before being artificially aged with 5000 (5°C-55°C) thermal cycles and 100,000 cycles of 70 N dynamic loading. Retention was measured on a universal testing machine under tension, with a crosshead speed of 0.5 mm/min. Statistical analysis was performed with 1-way and 2-way ANOVA. RESULTS: Mean retention values ranged from 0.72 to 3.7 MPa. Surface treatment increased crown retention, but the difference was not statistically significant (P>.05), except for the Duo-Link cement group (P<.05). Analysis of the adhesives revealed that the Duo-Link cement resulted in significantly lower crown retention (P<.05) than the other 2 cements. CONCLUSION: For zirconia crowns, retention seems to be dependent on cement type rather than surface treatment.

The wear of polished and glazed zirconia against enamel.

STATEMENT OF PROBLEM: The wear of tooth structure opposing anatomically contoured zirconia crowns requires further investigation. PURPOSE: The purpose of this in vitro study was to measure the roughness and wear of polished, glazed, and polished then reglazed zirconia against human enamel antagonists and compare the measurements to those of veneering porcelain and natural enamel. MATERIAL AND METHODS: Zirconia specimens were divided into polished, glazed, and polished then reglazed groups (n=8). A veneering porcelain (Ceramco3) and enamel were used as controls. The surface roughness of all pretest specimens was measured. Wear testing was performed in the newly designed Alabama wear testing device. The mesiobuccal cusps of extracted molars were standardized and used as antagonists. Three-dimensional (3D) scans of the specimens and antagonists were obtained at baseline and after 200 000 and 400 000 cycles with a profilometer. The baseline scans were superimposed on the posttesting scans to determine volumetric wear. Data were analyzed with a 1-way ANOVA and Tukey Honestly Significant Difference (HSD) post hoc tests (α=.05) RESULTS: Surface roughness ranked in order of least rough to roughest was: polished zirconia, glazed zirconia, polished then reglazed zirconia, veneering porcelain, and enamel. For ceramic, there was no measureable loss on polished zirconia, moderate loss on the surface of enamel, and significant loss on glazed and polished then reglazed zirconia. The highest ceramic wear was exhibited by the veneering ceramic. For enamel antagonists, polished zirconia caused the least wear, and enamel caused moderate wear. Glazed and polished then reglazed zirconia showed significant opposing enamel wear, and veneering porcelain demonstrated the most. CONCLUSIONS: Within the limitations of the study, polished zirconia is wear-friendly to the opposing tooth. Glazed zirconia causes more material and antagonist wear than polished zirconia. The surface roughness of the zirconia aided in predicting the wear of the opposing dentition.

Fracture resistance and marginal discrepancy of porcelain laminate veneers influenced by preparation design and restorative material in vitro.

OBJECTIVES: The purpose of this investigation is to evaluate marginal discrepancy and fracture resistance of two veneering materials using two preparation designs. METHODS: Two veneer preparation designs (full and traditional) were restored with leucite-reinforced ceramic (ProCAD, Ivoclar Vivadent, Amherst, NY) milled by CAD/CAM (Cerec 3D milling system, Serona Dental Systems), and conventional sintered feldspathic porcelain (Noritake Super Porcelain EX3, Noritake Dental Supply Co). Forty-eight specimens were analysed with a sample size of n=12 per group. The thickness of each veneer was measured on four specific surfaces. Marginal discrepancy was evaluated with a replica technique and cross-sectional view using a digital microscope. The fracture resistance of veneers cemented on standardised composite resin dies was evaluated using a universal testing machine. Results were analysed with ANOVA, Tukey-Kramer post hoc testing, and linear regression. RESULTS: The results of this investigation revealed no correlation between the thickness and marginal discrepancy of the veneers. The full preparation design with ProCAD and the traditional preparation design with feldspathic porcelain manifested smaller gap. Fracture resistance was decreased for the full preparation design with feldspathic porcelain. CONCLUSIONS: In terms of marginal discrepancy and fracture resistance, the most favourable combination was a traditional veneer preparation design with conventional sintered feldspathic porcelain. For the full veneer preparation, a stronger ceramic material such as ProCAD is suggested.

Flow profile of regular and fast-setting elastomeric impression materials using a shark fin testing device.

STATEMENT OF THE PROBLEM: Light-bodied impression materials with high flow over time are needed to capture preparation margins, particularly with impressions of multiple preparations. PURPOSE: The flow of five different impression materials (three vinyl polysiloxane, one polyether, and one hybrid) of two setting times (fast and regular) was compared over 30-second intervals. MATERIALS AND METHODS: Flow was measured using a shark fin testing apparatus (3M ESPE, Seefeld, Germany). A weighted metal caste was suspended above a cup of impression material. The caste was dropped into the impression material, which displaced the material and caused it to flow into a triangular notch within the caste, creating a "shark fin." The test was repeated for each specimen at 30-second increments. These shark fin molds were kept in an incubator to allow setting of the impression materials. After complete setting, the height of the "shark fin" was measured. The data were analyzed using separate two-way analysis of variance and Tukey's HSD post hoc analyses to determine significant intergroup differences (p = 0.05). RESULTS: Shark fin values differed significantly among materials and at each time interval (p = 0.05). Polyether impression materials produced the greatest flow when compared with the vinyl polysiloxane and hybrid materials. CONCLUSION: Based on the limitations of this study and the materials used, polyether impression material had a better flow profile compared with the vinyl polysiloxane and hybrid materials. CLINICAL SIGNIFICANCE: An impression material must be selected based on the consistency and flow properties of the material, its setting time, anatomic aspects of the preparation, and speed of the operator. Impressions with deep subgingival margins and/or multiple preparations may be better captured with a polyether impression material.

Gloss and surface roughness produced by polishing kits on resin composites.

PURPOSE: To compare in vitro the surface roughness (Ra) and gloss (G) produced by three conventional and one experimental polishing kits on four resin composites. METHODS: 24 discs were prepared (d = 12 mm, t = 4 mm) for each resin composite: Filtek Supreme Plus Body/A2 (FSB), Yellow Translucent (FST), Heliomolar/A2 (HM), and EsthetX/A2 (EX) following the manufacturers' instructions. They were finished with 320 grit silicon carbide paper for 80 seconds each. Polishing systems: Sof-Lex, Enhance-Pogo, Astropol and Experimental Discs/EXL-695, were applied following manufacturers' instructions. Each specimen was ultrasonically cleaned with distilled water and dried. Gloss and Ra were measured with a small area glossmeter (Novo-curve) and non-contact profilometer (Proscan 2000) following ISO 4288, respectively. The results were evaluated by two-way ANOVA followed by separate one-way ANOVA and Tukey/Kramer test (P = 0.05). RESULTS: There was a significant interaction of surface roughness and gloss between the composites and polishing systems (P < 0.05). The lowest surface roughness was recorded for FST polished with the Experimental kit. The highest gloss was obtained for FSB composite polished with the Experimental kit. The experimental polishing system produced smoothest surfaces (P < 0.05). The Enhance-Pogo and the experimental polishing kit produced highest gloss (P < 0.05).

Acid-etch interval and shear bond strength of Er,Cr:YSGG laser-prepared enamel and dentin.

The formation of a superficial layer of tiny flakes has been observed on teeth prepared by Erbium lasers. It has been suggested that removing this layer (mechanically or chemically) may increase the bond strength of the resin composite. The purpose of this study is to evaluate the effect of various etching times on bond strength of resin composite to enamel and dentin prepared by Er,Cr:YSGG laser. Sixty previously flattened human molars were irradiated for 10 s by an Er,Cr:YSGG laser. Enamel (E) specimens were etched with 37% H(3)PO(4) for 20, 40 or 60 s and dentin (D) specimens were etched for 15 or 30 s. All specimens were prepared for a standard shear bond strength (SBS) test (1 mm/min). Data were analyzed [ANOVA, Tukey post-hoc, a < 0.05)] and the failure mode was studied under SEM. Mean SBS+/-sd (MPa) for each group was 16.97 +/- 7.77 (E20s), 21.34 +/- 3.55 (E40s), 14.08 +/- 4.77 (E60s), 13.62 +/- 7.28 (D15s) and 13.15 +/- 6.25 (D30s). SBS for E40s was significantly higher than E60s (p = 0.023). No difference was noted between the dentin groups. SEM evaluation showed predominantly cohesive failure. Within the limits of this study, etching time significantly influenced the SBS of composite resin to laser-prepared enamel. SEM showed subsurface cracks, fissures, and deformities leading to predominantly cohesive failure in both enamel and dentin.

A preliminary survey of impression trays used in the fabrication of fixed indirect restorations.

PURPOSE: A variety of impression trays are used in the fabrication of fixed indirect restorations. Impressions used in the construction of fixed indirect restorations were examined for tray type, manner of use, and overall impression quality. MATERIALS AND METHODS: A commercial dental laboratory provided 1403 impressions used to fabricate fixed indirect restorations during a 3-month period. Impressions were examined for tray type, quantity and type of recorded abutments, the impression of intact teeth adjacent to and opposing the abutment, the presence of the canine in the impression, and an assessment of the quality of the impression. RESULTS: A majority of trays examined were plastic (864, or 61.6%). Dual-arch trays comprised 73.1% of the total. Most of these were metal posterior (n = 499) or plastic posterior (n = 280). Among partial dual-arch impressions, 561 (55.7%) were for the single abutment restoration, bounded by intact teeth anterior and posterior, and with an intact opposing tooth. Eleven percent of plastic dual-arch impressions failed to register the canine. Regarding restoration type, there were 955 impressions for the single-tooth crown, 46 for implant-supported restorations, and 11 for veneers. Twenty impressions were for posts, inlays, or onlays. Impressions for multiple single-tooth crowns and fixed partial dentures comprised the remainder. In terms of overall quality, 85.3% of impressions were excellent or good. The lowest performance in terms of excellent quality was in the anterior plastic single-arch impression (44.8%), whereas the best rate of excellent quality noted was for the posterior dual-arch impression (82.4%). CONCLUSIONS: Within the limitations of this study, dual-arch trays were the most commonly used tray. Recommendations for the use of the dual-arch tray were not followed in a substantial number of impressions examined.

The effect of etching technique on the retention of adhesively cemented prefabricated dowels.

PURPOSE: To determine if etching technique influences the bond strength of resin cement to root canal dentin. MATERIALS AND METHODS: Fifty-five extracted teeth were endodontically treated, dowel space prepared, and divided into five groups. Each group was treated with different etchant consistencies: acid gel, semi-gel, low-viscosity gel, liquid, and a self-etching primer. After dowel cementation, four sections were removed from each root and a push-out test was performed. RESULTS: Significant effects were found for etching procedure and for location within the root canal. The apical segment produced the lowest bond strength. Self-etching primer showed the highest bond strength. CONCLUSIONS: The consistency of etchant material influenced the bond strength of a prefabricated dowel in the canal.

Biomechanical response of implant systems placed in the maxillary posterior region under various conditions of angulation, bone density, and loading.

PURPOSE: The aim of this study was to determine the relative contribution of changes in implant system, position, bone type, and loading condition on the biomechanical response of a single-unit implant-supported restoration using nonlinear 3-dimensional finite element analysis (3D FEA). MATERIALS AND METHODS: FEA models of a single-unit (crown) restoration supported by the Frialit-2 implant and MH-6 abutment or the Straumann standard implant with the Straumann solid abutment were used. Each system was analyzed by FEA with both straight and 20-degree angled abutments. Simulated implant placement was performed in the maxillary premolar area with 3 variations in implant orientation relative to the residual ridge. Analysis of each orientation was conducted for each of 4 bone quality types described by Lekholm and Zarb, with lateral and axial loading conditions imposed. The effect of each variable was expressed as a percentage of the total sum of squares as computed using analysis of variance. RESULTS: Larger strain values were noted in cortical bone with lateral force and the Frialit-2 system. Bone strain increased with decreasing bone density and was affected primarily by bone quality. Implant stress was influenced mainly by implant position. CONCLUSIONS: Better stress/strain distribution is possible when implants are placed along the axis of loading with multiple areas of cortical contact. The Straumann solid abutment performed better as a force-transmission mechanism.

Patient responses to dental implant-retained mandibular overdenture therapy: a 6-year clinical study.

BACKGROUND: The purpose of this study was to record subjective patient experiences with respect to the surgical placement of dental implants and the functioning of mandibular implant-retained overdentures versus conventional dentures. METHODS: Completely edentulous patients (n = 56) unable to wear a conventional mandibular complete denture were each treated with 4 one-stage titanium plasma sprayed or Sandblasted Large-grit Acid-etched (SLA) screw implants and overdentures retained by a cast bar with extracoronal attachments. Fifty-six patients were subsequently clinically evaluated over a period of up to 6 years. Fifty-three patients responded to questions on their experiences prior to and after treatment with implant retained overdentures. RESULTS: No implants or restorations failed during the observation period. Most of the patients (96%) felt satisfied with their new overdentures, and reported their new dentures fit comfortably. CONCLUSIONS: The use of implants to retain and support the denture improved comfort, giving the patients more self-confidence and improved social interaction, in addition to oral rehabilitation. This study demonstrates rehabilitation of the mandibluar arch with an implant-retained overdenture is a predictable treat-

Comparison of 7 luting protocols and their effect on the retention and marginal leakage of a cement-retained dental implant restoration.

PURPOSE: To determine the cement bond strength and marginal leakage of castings cemented to implant abutments. MATERIALS AND METHODS: Fifty-six titanium abutments and castings were divided into 7 groups (n=8), 1 for each cement. Castings were cemented to abutments using 1 of 3 resin-based cements (RES, RES-B, and RES-B-P), a resin-modified glass ionomer (GI), a polycarboxylate cement (PCB), an acrylic urethane cement (UDM), or a zinc phosphate cement (ZP). Specimens were placed in 100% humidity at 37 degrees C for 24 hours. Specimens were subjected to compressive load cycling followed by thermal cycling; they were then immersed for 24 hours in 0.5% basic fuchsin. Castings were removed with an Instron universal testing machine with a crosshead speed of 0.125 cm/min. Leakage was visually graded from 0 (no leakage) to 2 (leakage extended beyond the lower half of the internal surface of the casting). Failure load (FL) was analyzed with analysis of variance and Scheffe's test (alpha = .05). Chi-square was used to analyze leakage (alpha = .05). RESULTS: Cements were categorized by FL into 4 statistically unique groups: (1) RES-B-P (351 N) and GI (337 N); (2) ZP (245 N) and RES-B (241 N); (3) PCB (107 N); and (4) RES (63 N) and UDM (55 N). Leakage was greater for the PCB group than for the other groups (7 of 8 specimens demonstrated leakage; P < .01). Three ZP specimens demonstrated leakage. UDM and RES each had 1 specimen with leakage. RES-B-P, RES-B, and GI showed no leakage. CONCLUSIONS: Luting agents designated by the manufacturer as provisional cements demonstrated lower resistance to removal, regardless of material type. Luting agents described by manufacturers as "permanent" differed in resistance, with resin cements being most resistant, followed by zinc phosphate and polycarboxylate cements. Provisional cements demonstrated leakage comparable to higher-strength materials.

Hardness and wear resistance of two resin composites cured with equivalent radiant exposure from a low irradiance LED and QTH light-curing units.

PURPOSE: To measure and compare three-body wear and Vickers hardness at depths of 0 mm and 2 mm in two composite resin materials cured with either a low irradiance light emitting diode (LED) or a quartz tungsten halogen (QTH) light-curing unit (LCU) in which exposure duration with the LED was increased to deliver equivalent radiant exposure in the 450-490 nm wavelength range. METHODS: The VIP QTH and Freelight LED LCU's were obtained and the emission spectrum of each was determined using a Spectra Pro 750 spectrograph. Irradiance in the 450-490 nm range for each LCU was determined by calculating the area under the spectral curve. Curing of two composite resins (Z100 and Esthet-X) with equivalent radiant exposure within this prescribed wavelength range was achieved by increasing the irradiation time of the LED 33% from 30-40 seconds to compensate for its lower irradiance (Table 1). The resulting radiant exposure of 8.40 J/cm2 was roughly equivalent to the radiant exposure produced in 30 seconds by the QTH LCU (8.67 J/cm2). The cured specimens were polished with progressively fine wet silicon carbide papers to 600 grit and stored in distilled water at 37 degrees C for 24 hours prior to evaluating hardness and wear. Indentations for Vickers hardness testing were produced by applying a 0.5 kg load with a 15-second dwell time. Equivalent degree of cure was established indirectly through Vickers hardness numbers for the top and bottom surface of 2 mm thick disks of each material cured with each light (N = 3/group). Hardness ratios were computed by dividing mean bottom hardness by mean top hardness within each group. Three-body wear testing (N = 10/group) was performed on similarly fabricated specimens with a mechanical wear device using 44 microm unpolymerized PMMA beads as a simulated food bolus. The composite resin samples opposed spherical, stainless steel styli. A 75 N contact force was applied at 1.2 Hz for 100,000 cycles. Profilometry was used to quantify localized wear of the resin. Multivariate ANOVA and the Tukey-Kramer post hoc test (alpha = 0.05) were used to assess differences in hardness and wear of the materials. RESULTS: With respect to hardness, no difference was noted between top and bottom specimen sides based on material or curing method. Specimens cured using the LED exhibited hardness ratios approaching unity. No significant difference in hardness was found for the main effect of light used, but the main effect of material was highly significant. This was primarily because Z100 cured with the LED demonstrated statistically higher hardness than the other three groups, which were statistically similar. No significant difference in wear was found based on the light used, with the lowest mean wear seen in Z100 cured with the LED. Overall, Z100 exhibited significantly greater surface hardness (P < 0.001) and significantly less wear (P < 0.01) compared to Esthet-X