How some ridge shapes affect the fit of denture bases.

Polymerization shrinkage can result in poor denture fit. The aim of this study was to determine the accuracy of heat-polymerized acrylic bases on simulated edentulous metal ridges having simplified and standardized geometric configurations. Analysis of variance was used to explore the relationship between fit and ridge-slope/ridge-convergences. The outcome of that analysis revealed that the discrepancies between the base plates decreased significantly (p < 0.05) as both the ridge slope decreased and the anterior-sagital convergence increased. These geometric correlations can help clinicians to anticipate potential areas of sore spots on residual ridges when delivering complete dentures.

Influence of light-curing procedures and photo-initiator/co-initiator composition on the degree of conversion of light-curing resins.

OBJECTIVE: The hypothesis that the degree and rate of conversion can be modified favourably by using different light-curing procedures and different photo initiator/co-initiator combinations was tested. METHOD: A photo-initiator (0.02 mM/g resin); either camphorquinone (CQ) or 1-phenyl-1,2-propanedione (PPD), was mixed with bisGMA:TEGDMA (50:50 by weight). In addition, a co-initiator (0.04 mM/g resin); either N,N-dimethyl-p-aminobenzoic acid ethylester (DABE), N,N-cyanoethylmethylaniline (CEMA), or 2-dimethylaminoethyl methacrylate (DMAEMA), was added. These six combinations were subjected to three curing conditions (standard curing, soft-start curing or LED curing). The conversion levels (DC) were determined with differential scanning calorimetry (DSC). The DSC results were analysed using a general linear model (GLM) and Duncan's multiple range test and regular t-test. RESULTS: The fastest conversion initially was obtained by standard curing, followed by LED curing and soft-start curing. After 40 s of curing, conventional curing and soft-start curing produced a higher DC than LED curing. However, strong interactions occurred between the different variables (curing method, initiator and co-initiator). Initially, CQ was more efficient than PPD, but after 40 s, this difference was insignificant. CONCLUSION: By using soft-start curing and an appropriate photo initiator/co-initiator combination it is possible to achieve slow curing and a high DC at within a curing time of 40 s.

Clinical wear performance of eight experimental dental composites over three years determined by two measuring methods.

The effect of matrix selection, filler composition, filler silanization, operator variations, and test site (dental clinic) on the wear rate of eight composites were evaluated. The wear was measured on replicas using both a microscopic and a laser scanning measuring method. The average wear rate on contact-free surfaces was 9.2 +/- 4.2 microm/month with the microscopic measurement and 8.5 +/- 3.7 microm/ month with the laser scanner over the 36-month period. The urethane-based composites performed significantly better than those which were bisGMA-based. Restorations placed at one dental clinic showed significantly lower initial wear. There was also a significant difference between the operators that was most pronounced during the first 6 months. The other variable (filler composition and silane treatment) did not affect the wear rate significantly.

Comparison of shear and flexural bond strength tests versus failure modes of dentin bonding systems.

PURPOSE: To (1) measure the shear and flexural bond strengths of three different bonding agents that use different application techniques, (2) determine whether the shear and flexural bond tests rank the three materials similarly, and (3) determine whether the fractured surface produced with the flexural test, facilitates studies of failures within the adhesive interphase region. MATERIALS AND METHODS: Scotchbond MP (SBMP), Single Bond (SNGB) and Clearfil SE (CLSE) were evaluated. For each material, 16 samples were bonded. Eight of these samples were bonded for shear testing and the other 8 samples for flexural bond strength testing. After the bonding was completed, all samples were stored in water at 37 degrees C for 30 days. Shear bond strength was measured using an orthodontic edge wire loop and flexural strength was measured using a 4-point bending device. The samples used for the flexural test consisted of 3 mm x 3 mm x 20 mm beams in which center a 1 mm thick dentin wafer had been bonded perpendicularly to the length of the beam. An indentation with a microhardness tester was placed at one of the dentin-composite interfaces to serve as an induced flaw. This flaw was placed on the surface in tension during flexural testing. The data were analyzed using ANOVA. Scanning electron microscopy was used to examine each specimen and assign its failure mode. Percent occurrence of failure mode was determined for each material and overall for both test methods. When there was uncertainty regarding failure location, electron dispersive spectroscopy x-ray analysis was used to identify elements present on the fractured surface. RESULTS: No significant difference (P > 0.05) in bond strength was observed within each test group, while significant differences (P < 0.05) existed between the two test methods (shear: SBMP = 21.2 +/- 4.0 MPa, SNGB= 24.3 +/- 4.7 MPa, CLSE= 24.6 +/- 4.4 MPa; flexural strength: SBMP= 34.6 +/- 9.3 MPa, SNGB = 31.9 +/- 6.9 MPa, CLSE= 34.3 +/- 4.7 MPa). Shear bond test specimens failed mostly within dentin (54.2%), followed by failures within the adhesive interphase (41.6%), and failures in composite (4.2%). Flexural strength specimens failed mostly within the adhesive interphase (83.3%), followed by failure in composite (16.7%). Bond strengths were similar for all three adhesive systems within each test method group. Failure mode analysis revealed significant differences (P < 0.0001) among the two test methods.

Shear strength of dentin and dentin bonded composites.

PURPOSE: The objective of this study was to compare the shear strength of dentin with the shear strength of dentin bonded composites, and to determine how variables such as composite strength and blade width used during shear testing influence shear strength values. MATERIALS AND METHODS: Dentin test samples (n = 36) were made by milling the anatomical molar crowns to a shape similar to a composite rod bonded to a flat dentin surface. Dentin bonding was accomplished by bonding composites to flat dentin surfaces (n = 72) using Scotchbond MP and Z100 (n = 36) or Silux Plus (n = 36) composites. Shear testing was conducted using a guillotine-like device with a flat blade embracing half the dentin or composite cylinders. The blade thickness was either 0.25, 0.5, 0.75, 1.0, 1.25, or 1.50 mm. Six samples per material and blade thickness were tested. In addition to the above study, the bond strength of Z100 (n = 6) and Silux (n = 6) bonded with Scotchbond MP and tested with an orthodontic edgewire loop were also tested and compared with the bond strength of the Z100 and Silux samples tested with the 0.5 thick blade. All shear testing was done at a load rate of 0.5 mm/min. The results were analyzed using ANOVA and Duncan's multiple range test. RESULTS: The shear strength values when tested with the blades were: dentin = 39.7 +/- 13.0 MPa, Z100 = 29.3 +/- 7.2 MPa, and Silux = 21.1 +/- 4.9 MPa; each group had significantly different values (p < 0.05). The blade thickness had no significant effect on strength (p = 0.471). Comparing the 0.5-mm-wide blade with the edge wire (width = 0.45 mm) revealed a significant difference (p = 0.0014) favoring the blade. Z100 performed better than Silux (p = 0.0014). CONCLUSION: The shear strength of the tested bonding agent is significantly lower than the shear strength of dentin. The shear strength depends on testing method (blade vs loop) and composite material.

Calcium leaching from dentin and shear bond strength after etching with phosphoric acid of different concentrations.

Based on the H2O-P2O5-CaO phase diagram, we hypothesize that a phosphoric acid concentration around 27 wt% leaches most calcium from dentin. We also hypothesize that bond strength is affected by resin infiltration, and that resin infiltration becomes incomplete when calcium leakage exceeds a certain value. Dentin disks were cut from human molars. Eight phosphoric acid concentrations were prepared (15.7-51.2 wt%). For each acid group, there were four etch time subgroups (15, 30, 60 and 120 s). The dentin disks were etched in acid and rinsed in water for times corresponding to 15 s, 30 s, 60 s and 120 s. The calcium concentrations were analyzed using atomic absorption spectroscopy. Composite cylinders were bonded to the remaining parts of the teeth using the same etching protocol, and shear bond strength was determined. The 29.2 wt% group demonstrated the highest and the 15.7 wt% group the lowest calcium leaching value. Even though there were trends towards lower bond strength for longer etch times, a statistically significant difference was only found between 30 and 120 s. There was no significant correlation between calcium leaching and bond strength. The results support the tested hypothesis that the highest leaching value would be around 27 wt% phosphoric acid.

Filler particle leachability of experimental dental composites.

We studied the effect of matrix selection, filler composition, and filler silanization on filler leachability after storage in distilled water or artificial saliva. We evaluated 2 matrix systems, 2 filler systems and 2 silane treatment procedures, combined into 8 different dental composite materials. A total of 128 batches were made, and 2 specimens per batch were prepared. Of these 2 specimens per batch, one was stored in distilled water and the other in artificial saliva, both at 37 degrees C. We transferred the specimens each 30th day during a 3-yr period to new vials containing either freshly distilled water or newly mixed artificial saliva and analyzed the solutions the specimens had been stored in regarding Si, Ba and Al concentrations. The analyses revealed that storage solution, filler composition, and total time in the storage solution had strong effects on leachability. The average monthly leakage of the three elements was linear with time and higher in the artificial saliva. The Ba-containing filler leached Si faster in artificial saliva than in distilled water, and roughly twice as much as the quartz filler. The storage effect approached an order of magnitude, while the filler effect was roughly a factor of two. Filler leaching was linear over time.

BIS-GMA--based resins in dentistry: are they safe?

BACKGROUND: The authors critically surveyed research dealing with the release of resin components from dental composites and the potential of these agents to mimic or disrupt estrogenic cell responses. TYPES OF STUDIES REVIEWED: The studies reviewed included those on synthetic methods used to make bisphenol A glycidyl methacrylate, or BIS-GMA, and the biological effects of this resin in cell culture and animals. The estrogenic effect of bisphenol A was targeted because bisphenol A is present as an impurity in some resins (BIS-GMA) and as a degradation product from other resins (bisphenol A dimethacrylate, or BIS-DMA). RESULTS: The outcomes of this review revealed that short-term administration of BIS-GMA and/or bisphenol A in animals or cell cultures can induce changes in estrogen-sensitive organs or cells. However, considering the dosages and routes of administration and the modest response of estrogen-sensitive target organs, the authors conclude that the short-term risk of estrogenic effects from treatments using bisphenol A-based resins is insignificant. Long-term effects need to be investigated further. CLINICAL IMPLICATIONS: Commonly used dental resins should not be of concern to the general public; however, pharmacological evaluation of dental materials is needed to ensure biologically safe and therapeutically effective substances.

Determinants of quality in operative dentistry.

The definition of quality in operative dentistry has often, at least in part, been related to how well a cut preparation compares with an ideal preparation. The ideal preparation follows well-defined design principles. These design principles have their roots in empirical dentistry and scientific evaluations, the latter often being conducted in vitro. Because of the complexity of following these design principles practically, a large portion of dental education consists of perfecting cavity preparations. By focusing on how to cut these cavity preparations as closely as possible to the ideal preparation, dentists with high psycho-motor skills have been able to provide the public with restorative procedures of high standards over the years. However, because of the tendency of relating quality in operative dentistry to the ideal preparation, we found it justifiable to review the literature dealing with the cavity design principles of the Class II amalgam preparation. What triggered this review was a request from the International Dental Federation (FDI) to start a process leading to a scientifically based quality definition of dental restorations, a definition that determines how different factors, including cavity design principles, affect the longevity of both tooth and restoration. From our review, we conclude that patient response and restoration performance over time, rather than how closely a cavity preparation compares with the ideal preparation, will be of more significance in determining the longevity of a Class II amalgam restoration.

Enamel and dentine shear bond strength of two resin modified glass ionomers and two resin based adhesives.

OBJECTIVES: The purpose of this in vitro study was to compare the shear bond strength to enamel and dentine of two resin modified glass ionomers (Fuji Bond L.C. and Vitrebond) and two resin based adhesives (Prime&Bond 2.1 and Scotchbond Multi-Purpose). METHODS: A total of 120 bond sites were prepared on either enamel (n = 60) or dentine (n = 60) on human molars by grinding the teeth flat with a 600 grit sandpaper. Each tooth substrate group was divided into four groups (n = 15) to match each material. Each of the four material systems was applied, according to the manufacturers instructions, to the bond sites. On top of the placed material, a microfilled composite was placed in a 2.5 mm diameter matrix and light-cured for 40 s. All specimens were thermocycled 500 times (5-55 degrees C). Shear bond strength values were determined 120 h after bonding using a Zwick testing machine. One-way ANOVA was used to determine whether significant differences (p < 0.05) existed among the material groups on enamel and dentine. Pairwise comparisons were used to determine significant differences (p < 0.05) among the four products. RESULTS: The ANOVA revealed strong significant differences on enamel (p = 0.0001) and dentine (p = 0.0172). The enamel bond strength values of the two resin based adhesives were significantly higher than one of the resin modified glass ionomers (Vitrebond), while the other resin modified glass ionomers did not differ from Scotchbond Multi-Purpose. On dentine, however, Vitrebond performed significantly better than the two resin based adhesives. CONCLUSIONS: The investigated resin modified glass ionomers bonded better to dentine surfaces than to enamel surfaces, while the investigated resin based adhesive systems bonded better to enamel than to dentine.

Wear resistance of composites: a solved problem?

During the past few years, the use of posterior composites has increased, due to an increased demand from patients to have their metallic restorations replaced with tooth colored restorations. However, until recently, posterior composites were not considered suitable alternatives to metallic restorations mainly because of their tendency to contract during polymerization and wear more than traditional metallic materials. Improvements in bonding agents and composite materials have now made it possible to produce posterior composites that may not produce excessive long-term wear. Despite these improvements, clinicians may find that some composites wear more than expected in certain patients. By developing a good understanding of the different wear mechanisms, the clinician can become familiar with clinical wear variations and select clinical cases where composites may work well without excessive wear.

The in vivo effects of bisGMA on murine uterine weight, nucleic acids and collagen.

The aim of this investigation was to evaluate the ability of commercial bisGMA to stimulate growth in an estrogen-sensitive target tissue. Adult, female, Swiss-Webster mice were ovariectomized and received either oil, estradiol (100 microg/kg), or one of two bisGMA doses (25 microg/kg or 100 microg/kg). Starting on the day of surgery, the hormone, drug or oil was injected subcutaneously 3 times a week. After 3 wk of treatment, the animals were sacrificed, the uteri removed, weighed and stored at -80 degrees C for biochemical analysis. The uteri from ovariectomized mice receiving high dose (100 microg/kg) bisGMA or estradiol showed a significant increase in normalized wet weight that was 29% and 786%, respectively, greater than the ovariectomized control uterine normalized weights. In the low bisGMA dose (25 microg/kg) group, normalized uterine wet weights were not statistically significant from ovariectomized controls. Biochemical analyses of uterine tissues revealed that estradiol resulted in maintaining DNA content, RNA content, RNA/DNA ratios and collagen content significantly above the ovariectomized control. Neither the low nor high doses of bisGMA stimulated RNA content, DNA content or RNA/DNA ratios above ovariectomized controls. However, the high dose (100 microg/kg) of bisGMA caused a significant increase above ovariectomized controls in uterine collagen content.

Effect of primer solvent, primer agitation, and dentin dryness on shear bond strength to dentin.

PURPOSE: To evaluate the shear bond strength of acetone- or water-based primers applied with or without agitation to either wet or dry dentin. MATERIALS AND METHODS: Forty-eight caries-free extracted human premolars were embedded in gypsum and flat dentin surfaces were prepared. The teeth were randomly divided in eight groups with six specimens each. After acid etching and rinsing, either a HEMA and acetone (Ac) or a HEMA and water (Wa) primer were applied to dry (D) or wet (W) dentin. The primer was placed with (Y) or without (N) agitation according to the following combinations: Group 1: D-Ac-Y; Group 2: D-Ac-N; Group 3: D-Wa-Y; Group 4: D-Wa-N; Group 5: W-Ac-Y; Group 6: W-Ac-N; Group 7: W-Wa-Y; Group 8: W-Wa-N. The primed surface was dried, covered with a bonding resin and light-cured, whereupon a composite cylinder was bonded to the dentin surface. The shear bond strength was determined after 30 days in water. RESULTS: The mean and standard deviations, expressed in MPa, were: Group 1: 13.1 +/- 3.42; Group 2: 15.9 +/- 4.84; Group 3: 19.8 +/- 6.64; Group 4: 18.6 +/- 5.18; Group 5: 16.5 +/- 5.25; Group 6: 25.5 +/- 4.79; Group 7: 21.9 +/- 4.94; Group 8: 17.4 +/- 4.50. The results were analyzed using ANOVA and Waller-Duncans K-ratio t-test. The acetone-based primer gave the highest bond strength to wet dentin without agitation. When the acetone-based primer was used on dry dentin a significant decrease in bond strength occurred (P < 0.05). No significant difference (P > 0.05) was found for the water-based primer on wet or dry dentin. Agitation improved the bond strength for the water-based primer, but decreased the bond strength for the acetone-based primer.

The effect of comonomer composition, silane heating, and filler type on aqueous TEGDMA leachability in model resin composites.

Experimental composites using either bisGMA/TEGDMA or UEDMA/ TEGDMA matrices, quartz or barium glass fillers, and 2 different filler silanization methods were evaluated regarding monomer leachability in distilled water. The leached amount was detected and quantified using gas chromatography. The results showed that twice as much TEGDMA is leached from a bisGMA/TEGDMA based composite than from an UEDMA/ TEGDMA based composite, when both contain 50 wt% TEGDMA. The hypothesis suggested that the higher degree of cure of UEDMA/TEGDMA based composites would be reflected in a lower monomer leaching value, and this hypothesis was supported by the findings. Whether such a correlation exists within groups of UEDMA/TEGDMA based matrices having different degrees of cure was not determined and needs to be investigated in future studies. Variables such as filler composition and silane treatment did not affect the leaching values of TEGDMA in water. That finding suggests that future studies should target differences in matrices, and that the need for considering effects of filler composition and silane treatment methods should not receive the same priority.

Filler leachability of composites stored in distilled water or artificial saliva.

Though dental composite materials leach filler elements when stored in distilled water, it is not known whether similar leaching occurs in saliva. The hypothesis to be tested was that due to ion exchange occurring at the filler surfaces, more filler elements leach from composites stored in a salt solution simulating saliva than from composites stored in distilled water. Another aim was to determine how matrix selection, filler composition, and filler silanization affect filler leachability of composites after storage in the simulated saliva and water media. We made 128 batches of experimental composites. Half of these used a bis-GMA/TEGDMA matrix and the other a UEDMA/TEGDMA matrix. Either silica or barium glass filler particles were incorporated into these matrices. Filler silanization was followed by a filler drying at 60 degrees C for 24 h. Half of the silanized particles received an additional heat treatment for 1 h at 110 degrees C in vacuum. One specimen per batch was stored in distilled water and the other in artificial saliva at 37 degrees C. After each 30-day interval for one year, the specimens were transferred to either freshly distilled water or newly mixed artificial saliva. The "old" solutions were analyzed by ICP for determination of the Si, Ba, and Al concentrations. Analysis of variance revealed that storage solution, filler composition, and total time in the storage solution had strong effects on the leachability (p < 0.0001 in all cases). The average monthly leakage of Si for quartz-filled composites was 0.22 +/- 0.20 microgram/mL (distilled water) and 2.80 +/- 1.20 microgram/mL (artificial saliva). For barium-glass-filled composites, the corresponding Si leaching values were 0.73 +/- 0.48 microgram/mL and 5.00 +/- 2.20 microgram/mL. The monthly means of the barium leaching values were 2.00 +/- 1.00 microgram/mL (distilled water) and 3.10 +/- 1.80 microgram/mL (artificial saliva). The large difference between leaching in artificial saliva and in distilled water, as well as the interaction between storage medium and filler, cast doubt on the clinical relevance of in vitro studies using distilled water.

Does resin based dentine bonding work?

Since Buonocore, in the mid 1950s, introduced enamel etching to be used to bond resinous restorations to enamel, different resin based bonding procedures have continuously found their way into dental practise. Today, dentists bond materials not only to enamel, but also to dentine. Up until recently, the clinical success with dentine bonding agents had been unreliable at best, and many clinicians had become sceptical as to whether it would ever be possible to bond to dentine. In this paper, some of the important break-throughs in the field of dentinal adhesives are reviewed in an attempt to throw some light on the question, does resin based dentine bonding work? The technical procedure used to optimise dentine bonding is reviewed, emphasising the significance of etching dentine, placing the primer on a slightly moist dentine surface, avoiding oxygen inhibition of the bonding resin, and maximising the degree of cure. In addition, emphasis is also placed on the significance of variations in dentine structure, and how sclerotic dentine may make dentine bonding less efficient. The conclusion of the entire review is that although significant improvements have been made in the field of dentine bonding during the last few years, it is still too early to conclude that dentine bonding will survive several years of clinical service.

Some effects of water on dentin bonding.

OBJECTIVES: The goals of this study were to determine how: 1) the bond strengths of hydroxyethylmethacrylate (HEMA)-based dentin primers are affected by different solvents (water or acetone), 2) the application time of these primers affect the bond strength, and 3) the conversion of water contaminated bonding resins. METHODS: HEMA (35%), mixed with water or acetone, was placed on moist dentin for 30 or 120 s, dried, covered with a bonding resin, and light-cured. Composite cylinders were bonded to these surfaces, and the shear bond strength was determined after 30 d of water storage at 37 degrees C. The conversion of bonding resins containing 0.05, 0.1, 0.2, 0.4 and 0.8 mL water per mL of bonding resin was determined with FTIR. RESULTS: The two acetone groups gave significantly (p<0.5) higher bond strength values (sigma 30s=22.2 +/- 2.1 MPa and sigma 120s=21.5 +/- 3.2 MPa) than the two water groups (sigma 30s=7.0 +/- 3.3 MPa and sigma 120s=16.2 +/- 4.8 MPa). In contrast to the acetone-based primer, the water-based primer improved its bond strength with increased priming time without reaching that of the two acetone groups. The conversion of the bonding resin was 53.5%, which decreased to approximately 25% when 0.2 mL or more water was added per mL resin. SIGNIFICANCE: Compared to acetone, water is inferior as a solvent for HEMA-based dentin primers and gives both lower bond strength and requires longer priming time than acetone. A possible explanation of these results is the ability of water to interfere with the polymerization of the resin systems.