Bacteriology of deep carious lesions underneath amalgam restorations with different pulp-capping materials--an in vivo analysis

Microorganisms remaining in dentin following cavity preparation may induce pulp damage, requiring the use of pulp-capping agents with antimicrobial activity underneath permanent restorations.

Objective

The aims of this study were to analyze the bacteriological status of carious dentin and to assess the efficacy of different base underneath silver amalgam restorations.

Material and Methods

This study was conducted on 50 patients aged 13 to 30 years. Sterile swabs were used to take samples after cavity preparation, which was assessed by microbiological culture to identify the microorganisms present. Following this, cavities were restored with silver amalgam, using one of the materials being investigated, as the base: calcium hydroxide (Group II), polyantibiotic paste (Group III), a novel light-cured fluoride-releasing hydroxyapatite-based liner (Group IV) and mineral trioxide aggregate - MTA (Group V). In Group I, the cavities were restored with silver amalgam, without any base. After 3 months, the amalgam was removed and samples taken again and analyzed for the microbial flora.

Results

Lactobacilli were the most commonly isolated microorganisms in the samples of carious dentin. Groups IV and V showed negative culture in the 3-month samples. There was no statistically significant difference between Groups I, II and III. There was no significant difference between Groups IV and V (p>0.05). Both Groups IV and V showed significantly better results when compared to Groups I, II and III (p<0.05).

Conclusions

The hydroxyapatite-based liner and MTA performed significantly better in terms of antibacterial activity than the other materials.     

Influence of different restorative techniques on marginal seal of class II composite restorations

Objective

To evaluate the gingival marginal seal in class II composite restorations using different restorative techniques.

Material and Methods

Class II box cavities were prepared in both proximal faces of 32 sound human third molars with gingival margins located in either enamel or dentin/cementum. Restorations were performed as follows: G1 (control): composite, conventional light curing technique; G2: composite, soft-start technique; G3: amalgam/composite association (amalcomp); and G4: resin-modified glass ionomer cement/ composite, open sandwich technique. The restored specimens were thermocycled. Epoxy resin replicas were made and coated for scanning electron microscopy examination. For microleakage evaluation, teeth were coated with nail polish and immersed in dye solution. Teeth were cut in 3 slices and dye penetration was recorded (mm), digitized and analyzed with Image Tool software. Microleakage data were analyzed statistically by non-parametric Kruskal-Wallis and Mann-Whitney tests.

Results

Leakage in enamel was lower than in dentin (p<0.001). G2 exhibited the lowest leakage values (p<0.05) in enamel margins, with no differences between the other groups. In dentin margins, groups G1 and G2 had similar behavior and both showed less leakage (p<0.05) than groups G3 and G4. SEM micrographs revealed different marginal adaptation patterns for the different techniques and for the different substrates.

Conclusion

The soft-start technique showed no leakage in enamel margins and produced similar values to those of the conventional (control) technique for dentin margins.     

EFFECT OF BETAMETHASONE ON THE PULP AFTER TOPICAL APPLICATION TO THE DENTIN OF RAT TEETH: VASCULAR ASPECTS OF THE INFLAMMATION

Objective:

This study investigated the pulpal effect of topically applied betamethasone to the dentin of rat molars in the vascular phase of inflammation.

Material and Methods:

Deep cavities were prepared on the occlusal face of the maxillary right and left 1st molars with non-refrigerated inverted-cone steel burs at low speed. Three groups were formed: Group I was composed of right 1st molars; Group II was composed of left 1st molars that received the application of a drop of betamethasone on dentin surface for 5 min; and Group III (control) was composed of right 2nd molars that received no cavity preparation or betamethasone application. Changes in the vascular characteristics of the pulp tissue were checked by calculating the pulp vascular area in relation to its total area and the number of blood vessels per unit area. Data were subjected to ANOVA and Tukey''s test (α=0.05).

Results:

Group I presented a significantly larger number of vessels (p<0.05) than Group II. Regarding the vascular/total area ratio (%), Group I presented statistically significantly higher values (p=0.01) than Groups II and III.

Conclusion:

Betamethasone applied on the dentin of rat teeth proved to reduce the vascular phase of pulp inflammation regarding vessel diameter and number of blood vessels.     

Two-year clinical evaluation of three adhesive systems in non-carious cervical lesions

Objectives

Adhesive systems are continuously being introduced to Dentistry, unfortunately often without sufficient clinical validation. The aim of this study was to evaluate the clinical performance of cervical restorations done with three different adhesive systems.

Material and methods

158 non-carious cervical lesions of 23 patients were restored with a nanofilled composite resin (Filtek Supreme, 3M/ESPE) combined with Single Bond (3M/ESPE, group SI), Clearfil SE (Kuraray Medical Inc., group CL) and Xeno III (De Trey Dentsply, group XE). In groups SI-B, CL-B and XE-B, the outer surface of the sclerotic dentin was removed by roughening with a diamond bur before application of the respective adhesive systems. In groups CL-BP and XE-BP, after removal of the outer surface of the sclerotic dentin with the bur, the remaining dentin was etched with 37% phosphoric acid and the self-etch adhesive systems Clearfil SE and Xeno III were applied, respectively. Lesions were evaluated at baseline, and restorations after 3 months, 1 year and 2 years using modified USPHS criteria.

Results

After 2 years, no significant difference was found between the retention rates of the groups (p >0.05). Although groups CL and SI showed significantly better marginal adaptation than group XE (p<0.05) at 2 years, no significant difference was found between the marginal adaptation of the groups SI-B, CL-B and XE-B (p>0.05). After 2 years no significant difference was observed among the marginal staining results of all groups (p>0.05).

Conclusion

Although all adhesive systems showed similar retention rates, Clearfil SE and Single Bond showed better marginal adaptation than Xeno III after 2 years of follow-up.     

Effect of chemical degradation followed by toothbrushing on the surface roughness of restorative composites

Objectives

The aim of the present study was to assess the effect of the exposure to food-simulating liquids prior to brushing simulation on the surface roughness of five composite materials (Quixfil, Filtek Supreme, Esthet-X, Filtek Z250, Tetric Ceram).

Material and methods

Twenty cylinders (5 mm diameter and 4 mm height) of each composite were randomly allocated to 4 groups (n=5), according to the food-simulating liquid in which they were immersed for 7 days at 37ºC: artificial saliva, heptane, citric acid, and ethanol. After this period, the top surface of composite cylinders was submitted to 7,500 brushing cycles (200 g load). Measurements of the surface roughness (Ra, µm) were carried out before and after the exposure to the chemicals/brushing simulation. Changes on the morphology of composite surfaces were observed through scanning electron microscopy (SEM).

Results

The statistical analysis (ANOVA with cofactor / Tukey''s test, α=5%) detected a significant interaction between solutions and composite resins. Esthet-X, Filtek Z250 and Tetric Ceram were not affected by the food-simulating liquids/toothbrushing. Citric acid and ethanol increased the surface roughness of Quixfil and Filtek Supreme, respectively. SEM images corroborate the surface roughness findings, demonstrating the negative effect from chemical solutions and mechanical abrasion.

Conclusions

The surface roughness of composite resin materials are differently affected by the food-simulating solutions, depending on the immersion media.     

Effect of resin-modified glass-ionomer cement lining and composite layering technique on the adhesive interface of lateral wall

Interface integrity can be maintained by setting the composite in a layering technique and using liners.

Objective

The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations.

Material and Methods

Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) – no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37^oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher’s test.

Results

There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups.

Conclusions

RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations.     

56-month clinical performance of Class I and II resin composite restorations

Objective

This study evaluated the 56-month clinical performance of Class I and II resin composite restorations. Filtek P60 was compared with Filtek Z250, which are both indicated for posterior restorations but differ in terms of handling characteristics. The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth.

Material and Methods

Thirty-three patients were treated by the same operator, who prepared 48 Class I and 42 Class II cavities, which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems. Restorations were evaluated by two independent examiners at baseline and after 56 months, using the modified USPHS criteria. Data were analyzed statistically using Chi-square and Fisher''s Exact tests (a=0.05).

Results

After 56 months, 25 patients (31 Class I and 36 Class II) were analyzed. A 3% failure rate occurred due to secondary caries and excessive loss of anatomic form for P60. For both restorative systems, there were no significant differences in secondary caries and postoperative sensitivity. However, significant changes were observed with respect to anatomic form, marginal discoloration, and marginal adaptation. Significant decreases in surface texture were observed exclusively for the Z250 restorations.

Conclusions

Both restorative systems can be used for posterior restorations and can be expected to perform well in the oral environment.     

Cariostatic effect of fluoride-containing restorative materials associated with fluoride gels on root dentin

Secondary caries is still the main cause of restoration replacement, especially on the root surface

Objective

This in vitro study evaluated the cariostatic effects of fluoride-containing restorative materials associated with fluoride gels, on root dentin.

Materials and Methods

A randomized complete block design was used to test the effects of the restorative systems, fluoride regimes and the interactions among them at different distances from restoration margins. Standardized cavities were prepared on 240 bovine root specimens and randomly assigned to 15 groups of treatments (n=16). Cavities were filled with the following restorative materials: Ketac-Fil (3M-ESPE); Vitremer (3M-ESPE); Dyract/Prime & Bond NT (Dentsply); Charisma/Gluma One Bond (Heraeus Kulzer) and the control, Z250/Single Bond (3M-ESPE). The specimens were subjected to a pH-cycling model designed to simulate highcaries activity. During the cycles, 1.23% acidulated phosphate fluoride, 2.0% neutral sodium fluoride or deionized/distilled water (control) was applied to the specimens for 4 min. The surface Knoop microhardness test was performed before (KHN_i) and after (KHN_f) the pH cycles at 100, 200 and 300 mm from the margins. Dentin microhardness loss was represented by the difference in initial and final values (KHN_i - KHN_f). Data were analyzed by Friedman''s and Wilcoxon''s tests, ANOVA and Tukey''s test (α=5%).

Results

The interaction of restorative systems and topical treatments was not significant (p=0.102). Dentin microhardness loss was lowest closer to the restoration. Ketac-fil presented the highest cariostatic effect. Vitremer presented a moderate effect, while Dyract and Charisma did not differ from the control, Z250. The effects of neutral and acidulated fluoride gels were similar to each other and higher than the control.

Conclusion

Conventional and resin-modified glass ionomer cements as well as neutral and acidulated fluoride gels inhibit the progression of artificial caries adjacent to restorations. The associated effect of fluoride-containing restorative materials and gels could not be demonstrated.     

Comparison of marginal microleakage of flowable composite restorations in primary molars prepared by high-speed carbide bur, Er:YAG laser, and air abrasion

PURPOSE: The purpose of this study was to assess in vitro the influence of 3 cavity preparation devices (carbide bur, Er:YAG laser, and air abrasion) on the microleakage of flowable composite restorations in primary teeth. METHODS: Fifteen primary second molars were selected, and Class V cavities were prepared on the buccal/lingual surfaces, being assigned to 3 groups (n= 10). Group 1 (control) was prepared using a high-speed handpiece and was acid etched. Group 2 was prepared and treated with a Er:YAG laser (400mJ/4Hz and 80mJ/4Hz, respectively) and was acid etched. Group 3 was prepared and treated with an air abrasion system and was acid etched. Cavities were restored and stored for 7 days. Restorations were polished, thermocycled, immersed in 0.2% rhodamine B, sectioned, and analyzed for leakage. RESULTS: Er:YAG laser-prepared cavities showed the highest degree of infiltration. The performance of the air abrasion device was comparable to that of the high-speed handpiece. CONCLUSION: It may be concluded that the method of cavity preparation affected the microleakage of Class V cavities restored with flowable composite in primary teeth.     

Ion release from a composite resin after exposure to different 10% carbamide peroxide bleaching agents

Objective

This in vitro study evaluated the influence of two 10% carbamide peroxide bleaching agents - a commercial product (Opalescence PF; Ultradent Products, Inc.) and a bleaching agent prepared in a compounding pharmacy - on the chemical degradation of a light-activated composite resin by determining its release of ions before and after exposure to the agents.

Material and Methods

Thirty composite resin (Filtek Z250; 3M/ESPE) samples were divided into three groups: group I (exposed to Opalescence PF commercial bleaching agent), group II (exposed to a compounded bleaching agent) and group III (control - Milli-Q water). After 14 days of exposure, with a protocol of 8 h of daily exposure to the bleaching agents and 16 h of immersion in Milli-Q water, the analysis of ion release was carried out using a HP 8453 spectrophotometer. The values were analyzed statistically by ANOVA, Tukey''s test and the paired t-tests. The significance level was set at 5%.

Results

After 14 days of the experiment, statistically significant difference was found between group II and groups I and III, with greater ion release from the composite resin in group II.

Conclusions

The compounded bleaching agent had a more aggressive effect on the composite resin after 14 days of exposure than the commercial product and the control (no bleaching).     

A randomized double-blind clinical trial of posterior composite restorations with or without bevel: 1-year follow-up

Objective

This randomized double-blind clinical trial compared the performance of posterior composite restorations with or without bevel, after 1-year follow-up.

Material and Methods

Thirteen volunteers requiring at least two posterior composite restorations were selected. Twenty-nine cavities were performed, comprising 14 without bevel (butt joint) and 15 with bevel preparation of the enamel cavosurface angle. All cavities were restored with simplified adhesive system (Adper Single Bond) and composite resin (Filtek P60). A halogen light curing unit was used through the study. Restorations were polished immediately. Analysis was carried out at baseline, after 6 months and after 1 year by a calibrated evaluator (Kappa), according to the FDI criteria. Data were statistically analyzed by Mann-Whitney test (p<0.05).

Results

Beveled and non-beveled cavities performed similarly after 1 year follow-up, regarding to fractures and retention, marginal adaptation, postoperative hypersensitivity, recurrence of caries, surface luster and anatomic form. However, for surface and marginal staining, beveled cavities showed significantly better performance (p<0.05) than butt joint restorations.

Conclusions

It was concluded that the restorations were acceptable after 1 year, but restorations placed in cavities with marginal beveling showed less marginal staining than those placed in non-beveled cavities.     

Luting glass ceramic restorations using a selfadhesive resin cement under different dentin conditions

Objectives

The aim of this study was to investigate the bond strength of ceramic restorations luted using a self-adhesive resin cement (RelyX Unicem, 3M ESPE) under different dentin conditions.

Material and Methods

In the experimental groups, ceramic restorations were luted to bovine incisors with RelyX Unicem under the following conditions: [Dry dentin]: surface was dried using air stream for 15 s; [Moist dentin]: excess dentin moisture was removed with absorbent paper; [Bonding agent]: Clearfil SE Bond (Kuraray) self-etching adhesive system was previously applied to dentin. In the Control group, cementation was done using an etch-and-rinse adhesive (Excite DSC) and Variolink II resin cement (Ivoclar Vivadent). Photoactivation of the resin cements was performed with UltraLume LED 5 unit (Ultradent). The restorations (n=5 per group) were sectioned into beams and microtensile testing was carried out. Data were subjected to ANOVA and Tukey''s test (p<0.05). Failure modes were classified under Scanning Electron Microscopic (SEM) (×120 magnification).

Results

The bond strength was dependent on the moisture status of the dentin. Bond strength in the "dry dentin group" was significantly lower than that of all other groups, which showed similar results. A predominance of mixed failures was detected for the control group, while a predominance of adhesive failures was observed for the "bonding agent" and "dry dentin" groups. The "moist dentin" group presented predominantly cohesive failures within the luting material. The previous application of a self-etching adhesive showed no significant effect.

Conclusions

Only excess dentin moisture should be removed for the cementation of ceramic restorations with self-adhesive resin cements.     

Marginal integrity of restorations produced with a model composite based on polyhedral oligomeric silsesquioxane (POSS)

Marginal integrity is one of the most crucial aspects involved in the clinical longevity of resin composite restorations.

Objective

To analyze the marginal integrity of restorations produced with a model composite based on polyhedral oligomeric silsesquioxane (POSS).

Material and Methods

A base composite (B) was produced with an organic matrix with UDMA/TEGDMA and 70 wt.% of barium borosilicate glass particles. To produce the model composite, 25 wt.% of UDMA were replaced by POSS (P25). The composites P90 and TPH3 (TP3) were used as positive and negative controls, respectively. Marginal integrity (%MI) was analyzed in bonded class I cavities. The volumetric polymerization shrinkage (%VS) and the polymerization shrinkage stress (Pss - MPa) were also evaluated.

Results

The values for %MI were as follows: P90 (100%) = TP3 (98.3%) = B (96.9%) > P25 (93.2%), (p<0.05). The %VS ranged from 1.4% (P90) to 4.9% (P25), while Pss ranged from 2.3 MPa (P90) to 3.9 MPa (B). For both properties, the composite P25 presented the worst results (4.9% and 3.6 MPa). Linear regression analysis showed a strong positive correlation between %VS and Pss (r=0.97), whereas the correlation between Pss and %MI was found to be moderate (r=0.76).

Conclusions

The addition of 25 wt.% of POSS in methacrylate organic matrix did not improve the marginal integrity of class I restorations. Filtek P90 showed lower polymerization shrinkage and shrinkage stress when compared to the experimental and commercial methacrylate composite.     

Effect of light-curing units in shear bond strength of metallic brackets: an in vitro study

Objective

To determine the influence of the light curing units on the shear bond strength of orthodontic brackets.

Material and Methods

Seventy-two premolars were divided into six groups (n=12): Group I: brackets bonded with Transbond and polymerization with halogen light; Group II: Transbond and LED; Group III: Fuji Ortho and halogen light; Group IV: Fuji Ortho and LED; Group V: Fuji Ortho, without acid and halogen light; Group VI: Fuji Ortho, without acid and LED. The groups were tested to shear strength in a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by ANOVA and Tukey’s test.

Results

The composite resin presented higher shear bond strength than the resin-modified glass ionomer cement (p<0.05). The halogen light and LED sources produced similar shear bond strength (p>0.05).

Conclusion

The shear bond strength was influenced by the material but not by the light-curing unit. The use of LED reduced the experimental time by approximately 60%, with the same curing efficiency.     

Marginal adaptation of class V composite restorations submitted to thermal and mechanical cycling

Objective:

This study evaluated the effect of the margin location and an adhesive system on the marginal adaptation of composite restorations.

Material and Methods:

Class V cavities were prepared in bovine teeth with the gingival margin on the dentin and the incisal margin on the enamel. The cavities were restored with a micro-hybrid composite resin using an etch-and-rinse [Single Bond 2 (SB)] or a self-etching adhesive [Clearfil SE Bond (CL)]. After finishing and polishing the restorations, epoxy replicas were prepared. The marginal adaptation was analyzed using scanning electronic microscopy (SEM, 500 x magnification). The higher gap width in each margin was recorded (T0). After the first evaluation, the samples were submitted to thermal cycling (2,000 cycles of 5ºC±2ºC followed by 55ºC±2ºC - T1) and mechanical cycling (100,000 cycles of 50 kN and 2 Hz - T2). Replicas of samples were rebuilt after each cycling and analyzed under SEM. The data were submitted to Mann-Whitney, Wilcoxon and Friedman testing (a=0.05).

Results:

The SB presented higher gaps in the dentin than the enamel, while there was no difference between the substrate for the CL. In the dentin, the CL showed better marginal sealing than the SB. The opposite occurred in the enamel. There were no significant differences between the baseline, thermal and mechanical cycling for any experimental condition.

Conclusions:

The outcomes of the present study showed that the adhesive system and margin location have an important effect on the marginal adaptation of composite restorations.     

Kinetic cavity preparation effects on secondary caries formation around resin restorations: a polarized light microscopic in vitro evaluation

The purpose of this in vitro study was to compare the effect of conventional handpiece and kinetic cavity preparation (KCP, air abrasion) techniques of cavity preparation on caries-like enamel lesion formation. After a fluoride-free prophylaxis, twelve human molars were examined macroscopically to ensure that buccal and lingual surfaces were caries-free. Unfilled cavities were prepared in mesiobuccal (conventional [CU]) and mesiolingual (air abrasion [AU]) enamel surfaces. Cavities were prepared in distobuccal (conventional [CF]) and distolingual (air abrasion [AF]) enamel surfaces and restored with composite resin following placement of a bonding agent. Acid-etching of cavity walls was performed only with the conventionally prepared cavities restored with resin. Air abrasion (KCP) prepared cavities were restored without acid-etching of the cavity walls. Teeth were thermocycled (500 cycles, 5 degrees to 50 degrees C, 500 cycles) and exposed to an artificial caries medium for caries initiation and progression. After caries formation, two longitudinal sections were taken from unfilled and filled cavity preparations and examined by polarized light microscopy for wall lesion presence and mean surface lesion depth. Surface lesion depths were similar among groups after the caries initiation period (CU = 225 microns; AU = 237 microns; CF = 241 microns; AF = 251 [p > .05, ANOVA, DMR]), and progression (CU = 437 microns; AU = 415 microns; CF = 405 microns; AF = 429 um [p > 0.05, ANOVA, DMR]). Extensive wall lesions were present in all CU and AU; while small wedge-shaped wall lesions were significantly (p < .05, ANOVA, DMR) fewer in CF (19 percent & 21 percent) and AF (17 percent & 21 percent) following caries initiation and progression compared with unfilled controls. Resin restorations placed in cavities prepared by air abrasion (KCP) and conventional handpiece techniques provided similar degrees of protection against a secondary caries-like challenge.     

Effect of alginate chemical disinfection on bacterial count over gypsum cast

PURPOSE

To evaluate the efficacy of sodium hypochlorite (1 : 10) and iodophor disinfectants on alginate impressions along with their effect on the survived bacterium count on the gypsum cast.

MATERIALS AND METHODS

Four alginate impression on each dentate patients were made, of which Group I were not washed or disinfected, Group II impressions were merely washed with water, Group III were disinfected by spraying with sodium hypochlorite (1 : 10), Group IV were disinfected with iodophor (1 : 213). Gypsum cast (type III) were made from all the impression. Impressions and gypsum cast were swabbed in mid palatal region for bacterial culture. Bacterial colony counting done after 3 days of incubation at 37℃ in blood agar media. The data obtained was analyzed by one way ANOVA test at a significant difference level of 0.05.

RESULTS

Group I and Group II showed significantly more bacteria compared to Group III and Group IV. Bacterial colonies on the alginate impression and gypsum cast in group disinfected with Sodium hypochlorite (1 : 10) were 0.18, 0.82 respectively compared to group treated with iodophor (1 : 213). There was an increase in bacterial count on dental cast compared to source alginate impressions.

CONCLUSION

Sodium hypochlorite (1 : 10) was found to be better disinfectant for alginate impression. There was an indication of increase in number of bacteria from alginate impression to making of dental cast. Additional gypsum cast disinfectant procedures need to be encouraged to completely eliminate cross infection to dental laboratory.     

Evaluation of bond strength of silorane and methacrylate based restorative systems to dentin using different cavity models

Objective

The aim of this in vitro study was to evaluate the microtensile bond strength (µTBS) to dentin of two different restorative systems: silorane-based (P90), and methacrylate-based (P60), using two cavity models.

Material and Methods

Occlusal enamel of 40 human third molars was removed to expose flat dentin surface. Class I cavities with 4 mm mesial-distal width, 3 mm buccal-lingual width and 3 mm depth (C-factor=4.5) were prepared in 20 teeth, which were divided into two groups (n=10) restored with P60 and P90, bulk-filled after dentin treatment according to manufacturer''s instructions. Flat buccal dentin surfaces were prepared in the 20 remaining teeth (C-factor=0.2) and restored with resin blocks measuring 4x3x3 mm using the two restorative systems (n=10). The teeth were sectioned into samples with area between 0.85 and 1.25 mm² that were submitted to µTBS testing, using a universal testing machine (EMIC) at speed of 0.5 mm/min. Fractured specimens were analyzed under stereomicroscope and categorized according to fracture pattern. Data were analyzed using ANOVA and Tukey Kramer tests.

Results

For flat surfaces, P60 obtained higher bond strength values compared with P90. However, for Class I cavities, P60 showed significant reduction in bond strength (p<0.05). No statistical difference between restorative systems was shown for Class I cavity model (p>0.05), or between Class I Cavity and Flat Surface group, considering P90 restorative system (p>0.05). Regarding fracture pattern, there was no statistical difference among groups (p=0.0713) and 56.3% of the fractures were adhesive.

Conclusion

It was concluded that methacrylate-based composite µTBS was influenced by cavity models, and the use of silorane-based composite led to similar bond strength values compared to the methacrylate-based composite in cavities with high C-factor.     

Annealing of Co-Cr dental alloy: effects on nanostructure and Rockwell hardness

PURPOSE

The aim of the study was to evaluate the effect of annealing on the nanostructure and hardness of Co-Cr metal ceramic samples that were fabricated with a direct metal laser sintering (DMLS) technique.

MATERIALS AND METHODS

Five groups of Co-Cr dental alloy samples were manufactured in a rectangular form measuring 4 × 2 × 2 mm. Samples fabricated by a conventional casting technique (Group I) and prefabricated milling blanks (Group II) were examined as conventional technique groups. The DMLS samples were randomly divided into three groups as not annealed (Group III), annealed in argon atmosphere (Group IV), or annealed in oxygen atmosphere (Group V). The nanostructure was examined with the small-angle X-ray scattering method. The Rockwell hardness test was used to measure the hardness changes in each group, and the means and standard deviations were statistically analyzed by one-way ANOVA for comparison of continuous variables and Tukey''s HSD test was used for post hoc analysis. P values of <.05 were accepted as statistically significant.

RESULTS

The general nanostructures of the samples were composed of small spherical entities stacked atop one another in dendritic form. All groups also displayed different hardness values depending on the manufacturing technique. The annealing procedure and environment directly affected both the nanostructure and hardness of the Co-Cr alloy. Group III exhibited a non-homogeneous structure and increased hardness (48.16 ± 3.02 HRC) because the annealing process was incomplete and the inner stress was not relieved. Annealing in argon atmosphere of Group IV not only relieved the inner stresses but also decreased the hardness (27.40 ± 3.98 HRC). The results of fitting function presented that Group IV was the most homogeneous product as the minimum bilayer thickness was measured (7.11 Å).

CONCLUSION

After the manufacturing with DMLS technique, annealing in argon atmosphere is an essential process for Co-Cr metal ceramic substructures. The dentists should be familiar with the materials that are used in clinic for prosthodontics treatments.     

Characterization of aqueous silver nitrate solutions for leakage tests

Objectives

To determine the pH over a period of 168 h and the ionic silver content in various concentrations and post-preparation times of aqueous silver nitrate solutions. Also, the possible effects of these factors on microleakage test in adhesive/resin restorations in primary and permanent teeth were evaluated.

Material and Methods

A digital pHmeter was used for measuring the pH of the solutions prepared with three types of water (purified, deionized or distilled) and three brands of silver nitrate salt (Merck, Synth or Cennabras) at 0, 1, 2, 24, 48, 72, 96 and 168 h after preparation, and storage in transparent or dark bottles. Ionic silver was assayed according to the post-preparation times (2, 24, 48, 72, 96, 168 h) and concentrations (1, 5, 25, 50%) of solutions by atomic emission spectrometry. For each sample of each condition, three readings were obtained for calculating the mean value. Class V cavities were prepared with enamel margins on primary and permanent teeth and restored with the adhesive systems OptiBond FL or OptiBond SOLO Plus SE and the composite resin Filtek Z-250. After nail polish coverage, the permanent teeth were immersed in 25% or 50% AgNO₃ solution and the primary teeth in 5% or 50% AgNO₃ solutions for microleakage evaluation. ANOVA and the Tukey''s test were used for data analyses (α=5%).

Results

The mean pH of the solutions ranged from neutral to alkaline (7.9±2.2 to 11.8±0.9). Mean ionic silver content differed depending on the concentration of the solution (4.75±0.5 to 293±15.3 ppm). In the microleakage test, significant difference was only observed for the adhesive system factor (p=0.000).

Conclusions

Under the tested experimental conditions and based on the obtained results, it may be concluded that the aqueous AgNO₃ solutions: have neutral/alkaline pH and service life of up to 168 h; the level of ionic silver is proportional to the concentration of the solution; even at 5% concentration, the solutions were capable of indicating loss of marginal seal in the composite restorations; the 3-step conventional adhesive system had better performance regarding microleakage in enamel on primary and permanent teeth.