Prevention of caries progress in xerostomic patients by topical fluoride applications: a studyin vivo andin vitro

Fluoride uptake by the surface enamel of teeth was studiedin vivo andin vitro in xerostomic patients and in extracted human teeth respectively, following various topical fluoride applications (Duraphat varnish, 2·26 per cent F; APF gel, 1·23 per cent F; Elmex gélee, 0·4 per cent F). Fluoride increments known to be effective for inhibition of caries in xerostomic patients were achievedin vivo andin vitro from all preparations. Arrest of caries was observed only in patients who were cooperative in the preventive fluoride programme. It was concluded, on the basis that the fluoride incorporation found in the experimentsin vitro was not stable, that topical fluoride applications in xerostomic patients had to be used frequently to ensure a prophylactic success.     

美观充填材料氟离子释放的体外研究

目的：分析3种传统玻璃离子水门汀、4种玻璃离子树脂复合体和1种树 脂的释氟能力。方法：在体外测量每一个材料应用含氟凝胶前后各6周的氟离子释放量。结果：部分材料在测量初2d释氟水平高，之后迅速下降，在3－5周内维持于稳定水平。用含氟凝胶进行氟再吸收后。所有材料均有短暂而显著的释氟增加。结论：新型的复保体同玻璃离子水门汀一样，起氟储存库的作用。     

In vitro fluoride release from aesthetic restorative materials following recharging with APF gel

In this in vitro study, the fluoride ion release from three more-viscous conventional glass ionomer cements (GICs)--ChemFlex, Fuji IX GP, Ionofil Molar--four polyacid-modified resin composites (compomers)--Dyract AP, Compoglass F, Freedom, F2000--and a hybrid resin composite--Ariston pHc--were compared. The amounts of fluoride release from 3 x 2.7 mm specimens were measured over six weeks using a fluoride ion-selective electrode. After six weeks, the specimens were recharged with 2 ml of 1.23 per cent acidulated phosphate fluoride (APF) gel for four minutes. The recharged specimens were then assessed for the amounts of fluoride release over another six weeks. Statistical analyses were performed using one-way and repeated measures ANOVA. The GICs and Compoglass F showed significantly higher initial fluoride release rates during the first two days (p < 0.05). After the first two days, fluoride release rates from all materials dropped quickly and became essentially stabilized within three-five weeks, in an exponential mode. The recharging of the specimens with APF gel caused a brief, but significant, increase in fluoride release for all materials (p < 0.05), before decreasing to previous comparable rates. Compoglass F released relatively more fluoride, and Ariston pHc relatively less, after APF gel application than before. The lowest total amounts over the study were released by Dyract AP and Freedom. The newer compomers, as well as the newer more-viscous GICs, appear to act as fluoride reservoirs to varying extents.     

Efficiency of desensitizing materials in xerostomic patients with head and neck cancer: a comparative clinical study

To assess the clinical effectiveness of four desensitizing materials in patients who are xerostomic due to radiotherapy for head and neck cancer (HNC) in c     

Professionally applied topical fluoride and restorative care in insured children

OBJECTIVES: This study evaluates the association between use of professionally applied topical fluoride and use of interproximal restorations in primary and permanent teeth of children. METHODS: Insurance claims from 15,190 children, for treatment provided by 1,556 different dentists, were analyzed to look for associations between frequency of use of professionally applied topical fluoride and use of interproximal restorations. The average follow-up period for the children included in the analysis was 5.3 years, with the range from 3.0 to 7.9 years. RESULTS: Both tabular and regression results failed to demonstrate an association between frequency of use of professionally applied topical fluoride and use of interproximal restorations in either the primary or permanent dentition. The most powerful predictor of restorative care for these children was the overall propensity of the dentist to place restorations in children. CONCLUSIONS: In this group of insured children, we were unable to find an association between the frequency of use of professionally applied topical fluoride and restorative care. Further, despite numerous recommendations that professionally applied topical fluorides should be used only in moderate- and high-caries children, approximately two-thirds of these children received topical fluoride at every recall visit, nearly two times per year.     

Release and recharge of fluoride by restorative materials

This study investigated the release and recharge of fluoride by restorative materials. Resin-modified glass ionomers (RGIs), polyacid-modified composite resins (PMCRs) and resin composite containing fluoride were used for comparison of fluoride release. Non-fluoride-releasing resin composite was used as a control. The amounts of fluoride release from RGIs and PMCRs remarkably increased in the citrate-phosphate acid buffer compared with distilled water. The amounts of fluoride recharged in RGIs increased with the concentration of NaF solution, but those of PMCRs exposed to all concentrations of NaF solutions were less than 1.5 ppm. Neither resin composite containing fluoride and non-fluoride-releasing resin composite gave any evidence of recharge. RGIs and PMCRs affected by acid buffer solution could not recharge much fluoride even if they were immersed in the 1000 ppmF NaF solution. The results suggested that the matrix of RGIs and PMCRs functioned as a reservoir of fluoride, but the functions were lost by acid attack.     

Impression materials: a comparative review of impression materials most commonly used in restorative dentistry

Impression materials are used to record intraoral structures for the fabrication of definitive restorations. Accurate impressions are necessary for construction of any dental prosthesis. The relationship between static and mobile oral structures must be reproduced accurately for an optimum cast. The more common types of impressions are used for fabricating diagnostic and master casts. Accurate impressions depend on identifying the applications that do or do not fit each material's characteristics. Materials used without adequate knowledge of their characteristics can impair a successful outcome. Often, the choice of impression materials depends on the subjective choice of the operator based on personal preferences and past experience with particular materials.     

Subjective and clinical evaluation of oral lubricants in xerostomic patients

The purpose of this investigation was to evaluate and compare four oral lubricants in relation to oral mucosal status, perceived relief of dry mouth symptoms, and patient acceptance. Three commercial oral lubricants—two sprays and one gel—and a home remedy of margarine were evaluated. Twenty-five xerostomic/salivary gland dysfunctional patients demonstrating < 0.20 mL/min of unstimulated whole saliva participated in the randomized, four-phase, cross-over study. Each phase included a ten-day use of oral lubricants, followed by a four-day washout period. On the first and tenth days of use, lip and buccal mucosa dryness and perceived oral dryness were evaluated. Patient acceptance of the oral lubricant was evaluated at the end of each ten-day period. The Wilcoxon matched-pairs signed-rank test was used to analyze data over time and between-group differences. The gel group reported a statistically significant improvement in perceived oral dryness from Day 1 to Day 10. No other significant with-in-group differences were found. Subjects rated the gel significantly better than margarine for convenience, perceived value, minutes of relief, and in the "overall" rating. No other significant between-group differences were noted.     

Fluoride retention following topical fluoride foam and gel application

The purpose of this study was to compare the oral fluoride (F) retention following acidulated phosphate fluoride (APF) foam and gel applications in children. Fifty-nine children were divided into two groups, 6-9 years old and 10-13 years old. They each received a randomly assigned sequence of topical F foam and gel applications in two consecutive visits, using either sponge-lined or unlined trays. Approximately 0.6-0.8 g of APF foam, or 3-4 g of APF gel was used in each of the 4-min F applications. The amounts of F applied, recovered from the mouth, and retained were calculated for each treatment. The retention of an average of 1.26 mg F after an APF foam application was significantly less than 2.53 mg F for the APF gel. The sponge-lined trays also reduced significantly the F retention, compared with unlined trays. However, there was no significant difference in the amount of F retained between the two different age groups. The amount of F retained was reduced significantly from 3.65 mg F in the first appointment, to 1.24 mg F in the second appointment when unlined trays were used.     

Professionally applied topical fluoride: evidence-based clinical recommendations

BackgroundWith the dramatic increase in the amount of scientific information available about oral health, an evidence-based approach to oral health care and the practice of dentistry is necessary. There is a need to summarize, critique and disseminate scientific evidence and to translate the evidence into a practical format that is used easily by dentists The evidence-based clinical recommendations in this report were developed by an expert panel established by the American Dental Association Council on Scientific Affairs that evaluated the collective body of scientific evidence on the effectiveness of professionally applied topical fluoride for caries prevention. The recommendations are intended to assist dentists in clinical decision making.Types of Studies ReviewedMEDLINE and the Cochrane Library were searched for systematic reviews and clinical studies of professionally applied topical fluoride—including gel, foam and varnish—through October 2005.ResultsPanelists were selected on the basis of their expertise in the relevant subject matter. The recommendations are stratified by age groups and caries risk and indicate that periodic fluoride treatments should be considered for both children and adults who are at moderate or high risk of developing caries. Included in the clinical recommendations is a summary table that can be used as a chairside resource.Clinical ImplicationsThe dentist, knowing the patient's health history and vulnerability to oral disease, is in the best position to make treatment decisions in the interest of each patient. These clinical recommendations must be balanced with the practitioner's professional expertise and the individual patient's preferences.     

Professionally applied topical fluoride: evidence-based clinical recommendations

With the dramatic increase in the amount of scientific information available about oral health, an evidence-based approach to oral health care and the practice of dentistry is necessary. There is a need to summarize, critique, and disseminate scientific evidence and to translate the evidence into a practical format that is used easily by dentists. The evidence-based clinical recommendations in this report were developed by an expert panel established by the American Dental Association Council on Scientific Affairs that evaluated the collective body of scientific evidence on the effectiveness of professionally applied topical fluoride for caries prevention. The recommendations are intended to assist dentists in clinical decision making. MEDLINE and the Cochrane Library were searched for systematic reviews and clinical studies of professionally applied topical fluoride-including gel, foam, and varnish-through October 2005. Panelists were selected on the basis of their expertise in the relevant subject matter. The recommendations are stratified by age groups and caries risk and indicate that periodic fluoride treatments should be considered for both children and adults who are at moderate or high risk of developing caries. Included in the clinical recommendations is a summary table that can be used as a chairside resource. The dentist, knowing the patient's health history and vulnerability to oral disease, is in the best position to make treatment decisions in the interest of each patient. These clinical recommendations must be balanced with the practitioner's professional expertise and the individual patient's preferences.     

Microhardness and fluoride release of restorative materials in different storage media

This study evaluated the surface microhardness and fluoride release of 5 restorative materials - Ketac-Fil Plus, Vitremer, Fuji II LC, Freedom and Fluorofil - in two storage media: distilled/deionized water and a pH-cycling (pH 4.6). Twelve specimens of each material, were fabricated and the initial surface microhardness (ISM) was determined in a Shimadzu HMV-2000 microhardness tester (static load Knoop). The specimens were submitted to 6- or 18-h cycles in the tested media. The solutions were refreshed at the end of each cycle. All solutions were stored for further analysis. After 15-day storage, the final surface microhardness (FSM) and fluoride release were measured. Fluoride dose was measured with a fluoride-specific electrode (Orion 9609-BN) and digital ion analyzer (Orion 720 A). The variables ISM, FSM and fluoride release were analyzed statistically by analysis of variance and Tukey's test (p<0.05). There was significant difference in FSM between the storage media for Vitremer (pH 4.6 = 40.2 +/- 1.5; water = 42.6 +/- 1.4), Ketac-Fil Plus (pH 4.6 = 73.4 +/- 2.7; water = 58.2 +/- 1.3) and Fluorofil (pH 4.6 = 44.3 +/- 1.8; water = 38.4 +/- 1.0). Ketac-Fil Plus (9.9 +/- 18.0) and Fluorofil (4.4 +/- 1.3) presented higher fluoride release in water, whereas Vitremer (7.4 +/- 7.1), Fuji II LC (5.7 +/- 4.7) and Freedom (2.1 +/- 1.7) had higher fluoride release at pH 4.6. Microhardness and fluoride release of the tested restorative materials varied according to the storage medium.     

Utilization of multiple restorative materials in full-mouth rehabilitation: a clinical report

Many different restorative materials are currently available for use in modern dentistry. Clinicians and dental technicians should be able to choose the most suitable materials for each patient based on research, anecdotal evidence, clinical experience, as well as patient's expectations and desires. The purpose of this article is to share the challenges presented in full-mouth rehabilitation and to describe the considerations in selecting three different restorative materials to achieve a successful restoration in terms of biomechanics, function, and esthetics.

CLINICAL SIGNIFICANCE

Interdisciplinary treatment planning, knowledge of available restorative materials, sequencing treatment modalities, and adequate communication between all parties involved are key to a successful treatment outcome when pursuing full-mouth restorative rehabilitation.     

Fluoride release and uptake by four new fluoride releasing restorative materials

The present study compared the initial fluoride release and release following refluoridation of a conventional glass-ionomer Ketac-Molar (ESPE), a resin-modified glass-ionomer, Vitremer (3M), and two compomers F-2000 (3M) and Hytac (ESPE). Fifteen test specimens were prepared for each brand and immersed in deionized water. The fluoride released was measured every 2 days for 22 days. Refluoridation of the test specimens was done with solutions of 0.02, 0.04 and 0.2% NaF for 5 min on days 22, 30, 38 and 46. The fluoride released from recharged specimens was measured every 2 days until day 54. The fluoride release was highest during the first days after preparation, after which it decreased sharply and then more slowly. The four materials became 'recharged' with fluoride following repeated fluoride exposure in solution, the 0.2% solution being the most effective. From a clinical point of view, the results from this study imply that all the restorative materials tested may act as intra-oral devices for the controlled slow release of fluoride at sites at risk of recurrent caries. Fluoride release and uptake by four new fluoride releasing restorative materials.     

Differential wear of teeth and restorative materials: clinical implications

PURPOSE: This study reviewed the wear of commonly used dental restorative materials and their effects on the opposing dentition. MATERIALS AND METHODS: Key words were used with PubMed to retrieve pertinent references to publications on tooth and restoration wear. RESULTS: The wear resistance of newer esthetic restorative materials has generally improved, and the damage caused by several materials to the opposing dentition has been reduced. However, the different structures and physical properties of tooth substance and restorative materials will eventually lead to varying degrees of differential wear. The extent and rate of wear are influenced by many intraoral factors. CONCLUSION: Selection of restorative materials must be based on knowledge of their wear behavior and the individual needs of each patient. The lowest wear rates for restorations and the opposing dentition occur with metal alloys, machined ceramics, and microfilled and microfine hybrid resin composites.