The effect of different types of composite resin fillings on marginal gingiva

Earlier studies of plaque accumulation on and gingival response around conventional composite resin fillings have produced conflicting results. No studies have been found in which the gingival reaction around newer types of resin fillings had been recorded. The aim of this study was to measure plaque retention and gingival conditions around in vivo, aged, subgingivally located, composite fillings of conventional, hybrid and microfiller types. This study was performed in 2 groups of patients. In the 1st group, there were 108 1-year-old class-III restorations of the 3 composite types and in the 2nd group, 228 3- or 4-year-old class-III or class-IV fillings. Plaque and gingival index scores and the amount of crevicular fluid were recorded. In the group with 1-year-old fillings, the composite resins did not adversely affect the health of the gingival tissues. The amount of plaque on and the degree of gingivitis around the composite fillings were not significantly higher than those for the enamel surfaces. Significant differences in the amount of crevicular fluid were found between both the conventional and hybrid composites and the enamel. In the groups with 3-4 year-old fillings, the indices for each material were significantly higher than those for the enamel surfaces and the fillings showed greater amounts of plaque and a higher degree of gingivitis than the 1-year-old fillings. Differences among the 3 types of composite resins were minimal in both groups and not statistically significant.     

Development of gingivitis around different types of composite resin

Earlier studies have demonstrated signs of gingivitis around conventional composite resin restorations. Newly developed resin types differ considerably in composition and surface characteristics. The purpose of this study was to compare the initiation of gingival inflammation around aged restorations of 3 types of composite resins and around enamel, during a 7-day period of experimental gingivitis. Plaque index, gingival index and crevicular exudate were registered at days 0 and 7. There was significantly less exudate around the intact enamel surfaces than around the composite fillings at both registration times. The plaque and gingival indices showed no significant differences among the composite resins and enamel. The results indicate that differences among the resins with regard to surface roughness and composition did not result in clinically measurable differences in the development of plaque and gingivitis.     

Development of gingivitis around aged restorations of resin-modified glass ionomer cement, polyacid-modified resin composite (compomer) and resin composite

Resin-modified glass ionomer cements (RMGIC) and polyacid-modified resin composites (PMC, compomers) are two recently introduced material groups supposed to replace traditional cements in operative dentistry. The new restoratives release initially fluoride in different relatively high concentrations, which decrease gradually during the first weeks in vivo. Earlier studies showed a stronger subclinical inflammatory reaction around different conventional tooth colored restorative materials than around intact enamel. The aim of this study was to compare intra-individually the initiation of gingival inflammation around, aged RMGIC, PMC and resin composite restorations. Subgingivally located Class III restorations were placed in 17 patients. Each patient received one of each of the experimental materials. All patients were placed on an oral hygiene regime 1-year after finishing of the restorations. Gingivitis was induced during a one-week period without oral hygiene. The gingival condition was assessed by sampling of gingival crevicular fluid (GCF), registration of the amount of bacterial plaque and by registration of bleeding after gentle probing of the entrance of the gingival sulcus (SBI) on the experimental filling- and control-enamel surfaces at days 0 and 7. No differences were seen in plaque and gingival index scores between the materials at both days. The GCF increased significantly for all surfaces during the experimental gingivitis period. At day 7 significantly lower GCF was sampled around the enamel surfaces. In conclusion, the differences between the materials did not result in measurable differences concerning clinical or subclinical signs of gingivitis. Received: 19 September 1998 / Accepted: 26 November 1998     

Effect of a novel ceramic filling material on plaque formation and marginal gingiva

The aim of this clinical investigation was to evaluate a novel ceramic (CF) filling material (DoxaDent) compared to resin composite (RC) and enamel in regard to plaque formation and gingival inflammation. The CF material is inorganic, non-metallic, and contains calcium aluminate, silicate, and water. To make intra-individual comparisons possible, each participant had at least one set of three test surfaces: two Class V restorations with subgingival cervical margins (one of the novel CF material and one of a hybrid RC) and one non-filled enamel surface (E). The amounts of plaque, gingival crevicular fluid, and clinical signs of gingival inflammation were intra-individually compared in 20 sets of the three test surfaces. In a cross-sectional study (CSS), the effect of oral hygiene on plaque formation and gingivitis around the surfaces was evaluated. In a following 10-day experimental gingivitis study (EGS), plaque formation and the induction of gingivitis during refrain from oral hygiene was compared. In the CSS, no significant differences were found between the surfaces in terms of amount of plaque and degree of gingival inflammation. At the end of the EGS the restorative materials showed a significantly higher amount of plaque (CF versus E, P = 0.014; RC versus E, P = 0.034), but no significant differences were found in degree of gingival inflammation. In condusion, the ceramic filling material was comparable to RC regarding plaque formation and gingival inflammation with customary oral hygiene. With neglected oral hygiene, significantly less plaque growth and a non-significant tendency toward lower amounts of gingival crevicular fluid were observed on enamel surfaces.     

Dental biofilm, gingivitis and interleukin-1 adjacent to approximal sites of a bonded ceramic

AIM: The aim of this study was to investigate in vivo the influence of aged, resin-bonded, ceramic restorations on approximal dental biofilm formation and gingival inflammatory response, associated with and without customary oral hygiene. MATERIAL AND METHODS: In a cross-sectional and in a 10-day experimental gingivitis study, Quigley-Hein plaque index, gingival index (GI), crevicular fluid and its levels of interleukin (IL)-1alpha, -1beta and receptor antagonist were measured at appoximal surfaces of leucite-reinforced bonded ceramic coverages, resin composite restorations and enamel and compared intra-individually in 17 participants. RESULTS: No differences were found between the ceramic, composite and enamel regarding plaque index, GI, levels of IL-1alpha, -1beta and the receptor antagonist. Throughout, higher crevicular fluid amounts were observed at ceramic sites compared with the enamel (p<0.05). In the experimental gingivitis, plaque index, GI, crevicular fluid and its IL-1alpha levels increased significantly. CONCLUSION: The need for optimal oral hygiene and professional preventive oral health care does not seem to be reduced with regard to approximal surfaces of aged, resin-bonded, leucite-reinforced ceramic restorations in comparison with those of a hybrid, resin composite and enamel.     

Effect of a novel ceramic filling material on plaque formation and marginal gingiva

The aim of this clinical investigation was to evaluate a novel ceramic (CF) filling material (DoxaDent) compared to resin composite (RC) and enamel in regard to plaque formation and gingival inflammation. The CF material is inorganic, non-metallic, and contains calcium aluminate, silicate, and water. To make intra-individual comparisons possible, each participant had at least one set of three test surfaces: two Class V restorations with subgingival cervical margins (one of the novel CF material and one of a hybrid RC) and one non-filled enamel surface (E). The amounts of plaque, gingival crevicular fluid, and clinical signs of gingival inflammation were intra-individually compared in 20 sets of the three test surfaces. In a cross-sectional study (CSS), the effect of oral hygiene on plaque formation and gingivitis around the surfaces was evaluated. In a following 10-day experimental gingivitis study (EGS), plaque formation and the induction of gingivitis during refrain from oral hygiene was compared. In the CSS, no significant differences were found between the surfaces in terms of amount of plaque and degree of gingival inflammation. At the end of the EGS the restorative materials showed a significantly higher amount of plaque (CF versus E, P = 0.014; RC versus E, P = 0.034), but no significant differences were found in degree of gingival inflammation. In conclusion, the ceramic filling material was comparable to RC regarding plaque formation and gingival inflammation with customary oral hygiene. With neglected oral hygiene, significantly less plaque growth and a non-significant tendency toward lower amounts of gingival crevicular fluid were observed on enamel surfaces.     

Presence of Streptococcus mutans and lactobacilli in saliva and on enamel, glass ionomer cement, and composite resin surfaces

The quantity of S. mutans, total streptococci, and lactobacilli on sound enamel surfaces and 1-yr-old glass ionomer cement and composite resin fillings with the cervical margins placed subgingivally was compared intra-individually. The amount of bacteria was compared to their number in saliva. The evaluation was done in a cross sectional study, where the patients continued to use their customary oral hygiene procedures and during a 14-day period of experimental plaque formation. The number of lactobacilli and S. mutans recovered from the test surfaces indicated that the critical salivary concentrations necessary for the isolation of S. mutans and lactobacilli from glass ionomer cement and composite resin surfaces are the same as for the enamel surfaces. The fluoride levels in plaque adjacent to glass ionomer cement will not become high enough to inhibit the accumulation of the investigated bacteria.     

Presence of Streptococcus mutans and lactobacilli in saliva and on enamel, glass ionomer cement, and composite resin surfaces

Abstract— The quantity of S. mutans , total streptococci, and lactobacilli on sound enamel surfaces and 1-yr-old glass ionomer cement and composite resin fillings with the cervical margins placed subgingivally was compared intraindividually. The amount of bacteria was compared to their number in saliva. The evaluation was done in a cross sectional study, where the patients continued to use their customary oral hygiene procedures and during a 14-day period of experimental plaque formation. The number of lactobacilli and S. mutans recovered from the test surfaces indicated that the critical salivary concentrations necessary for the isolation of S. mutans and lactobacilli from glass ionomer cement and composite resin surfaces are the same as for the enamel surfaces. The fluoride levels in plaque adjacent to glass ionomer cement will not become high enough to inhibit the accumulation of the investigated bacteria.     

牙体充填材料充填前后菌斑内细菌组成比较

目的 探讨充填材料对菌斑内细菌组成的影响。方法 比较复合树指、银汞合金、玻璃离子粘固粉充填前后一月内邻近菌斑细菌组成的变化情况及不同材料充填后菌斑细菌组成的差异。结果 复合树脂与银汞合金充填前后，总菌落数及变链菌、粘放菌的组成均无明显改变（Ｐ〉０．０５）。材料组间比较发现：玻璃离子粘固粉充填后的粘放菌、变链菌组成显著低于复合树指及银汞合金充填后（Ｐ〈０．０５）。结论 不同材料充填影响邻近菌斑内的细     

Interleukin-1 levels in gingival crevicular fluid adjacent to restorations of calcium aluminate cement and resin composite

OBJECTIVES: The aim of this clinical study was to intra-individually compare Class V restorations of a calcium aluminate cement (CAC), resin composite and enamel with respect to the adjacent levels of interleukin (IL)-1alpha, IL-1beta and IL-1 receptor antagonist (IL-1ra) in gingival crevicular fluid (GCF). The hypothesis was that there are higher IL-1 levels adjacent to resin composite, compared with CAC and enamel. MATERIALS AND METHODS: In 15 subjects, at least one set of two Class V restorations with subgingival margins, one CAC and one universal hybrid resin composite, and one control surface of enamel were included. In a cross-sectional study and on days 0, 3 and 7 of an experimental gingivitis study, GCFs were collected with Periopaper for 30 s. The GCF concentrations of IL-1alpha, IL-1beta and IL-1ra were quantified with enzyme linked immunosorbent assays. RESULTS: Neither the cross-sectional study nor the experimental gingivitis study showed any significant differences in the levels of IL-1alpha, IL-1beta and IL-1ra between CAC, resin composite and enamel sites (p>0.05). In the cross-sectional study, low IL-1 concentrations were observed. The IL-1 levels increased significantly during the experimental gingivitis. CONCLUSION: Regardless of CAC or resin composite, the restorations per se did not affect the GCF levels of IL-1 and IL-1ra, neither at healthy gingiva, nor at initiation of plaque-related gingival inflammation.     

Longevity of new hybrid restorative materials in class III cavities

The aim of this study was to evaluate the durability of two new tooth-colored restorative materials, a polyacid-modified resin composite (compomer) and a resin-modified glass ionomer cement. In an intra-individual comparison with a resin composite, the materials were studied during a 5-yr period. In 50 patients, 154 large class III restorations were placed. Most patients received one of each of the three materials. The restorations were evaluated by modified United States Public Health Service (USPHS) criteria. Of the 144 restorations evaluated, 15 were found unacceptable. No significant differences were seen between the materials concerning recurrent caries incidence. The resin composite showed a significantly better color match. No difference was found between resin composite fillings in enamel- or total-etched cavities. Significantly higher surface roughness was found in the aged resin-modified glass ionomer cement restorations. Fracture of the incisal enamel corner was observed adjacent to 10 restorations. None of the three total-etch techniques resulted in postoperative sensitivity or loss of vitality. All the restorative techniques showed a low failure rate during the 5-yr follow-up.     

An in vitro study of the bond strength of a glass ionomer cement in the direct bonding of orthodontic brackets

The shear/peel bond strength of a 'no-mix' composite orthodontic bonding resin was compared in vitro with that of a glass ionomer cement. The effect of pre-treatment of the enamel, with either phosphoric acid or polyacrylic acid, prior to using the glass ionomer cement was also assessed. The composite resin had a significantly higher bond strength than the glass ionomer cement. Simple prophylaxis and drying of the enamel achieved the best results when using the glass ionomer cement, whilst etching the tooth surface with phosphoric acid produced a significantly poorer bond to the enamel. Investigation of the site of failure showed the composite resin bonded very well to the tooth and less well to the bracket, whilst the glass ionomer adhered significantly better to the bracket base than to the tooth surface.     

Demineralization around orthodontic brackets bonded with resin-modified glass ionomer cement and fluoride-releasing resin composite.

PURPOSE: Enamel demineralization adjacent to orthodontic brackets is one of the risks associated with orthodontic treatment. Glass ionomer cements have been shown to decrease enamel demineralization adjacent to brackets and bands but do not exhibit bond strengths comparable to resin composites. The purpose of this in vitro study was to compare a fluoride-releasing resin composite versus a resin-modified glass ionomer cement for inhibition of enamel demineralization surrounding orthodontic brackets. METHODS: Forty-five teeth were randomly assigned to 3 groups of 15 teeth. Fifteen were bonded with Concise (3M), a non-fluoride-releasing resin composite (control); 15 teeth were bonded with Light Bond (Reliance), a fluoride-releasing resin composite; and 15 teeth were bonded with Fuji Ortho LC (GC Corporation), a resin-modified glass ionomer cement. The teeth were placed in an artificial caries solution to create lesions. Following sectioning of the teeth in a buccolingual direction, polarized light microscopy was utilized to evaluate enamel demineralization adjacent to the orthodontic bracket. The area of the lesion was measured 100 microns from the orthodontic bracket and bonding agent. RESULTS: MANOVA (P < .0001) and Duncan's test (P < .05) indicated the resin-modified glass ionomer cement (Fuji Ortho LC) and the fluoride-releasing resin composite (Light Bond) had significantly less adjacent enamel demineralization than the non-fluoride-releasing resin composite control. However, there was no significant difference between the resin-modified glass ionomer cement and the fluoride-releasing resin composite. CONCLUSIONS: Based on the results of this in vitro study, it can be concluded that Fuji Ortho LC and Light Bond exhibit significant inhibition of adjacent demineralization compared to the non-fluoride-releasing control.     

The sealing ability of materials used as retrograde root fillings in endodontic surgery

The sealing ability of retrograde root fillings of amalgam plus cavity varnish, EBA cement, glass ionomer cement, light-cured composite resin, dentine bonding agent, and light-cured composite resin plus dentine bonding agent were compared with laterally condensed conventional root fillings. A dye penetration technique was used to assess microleakage and it was concluded that none of the materials produced a perfect seal but that glass ionomer cement, light-cured composite resin, light-cured composite resin plus dentine bonding agent and dentine bonding agent alone produced better seals than conventional laterally condensed gutta-percha, amalgam plus cavity varnish and EBA cement.     

Microleakage of glass ionomer/composite resin restorations: A laboratory study. 1. The influence of glass ionomer cement

Acid-etching of enamel margins, often combined with bevelling and use of a low viscosity resin, has resulted in improved sealing of composite restorations. When enamel is absent and margins involve dentine or cementum, microleakage is more often observed. The use of glass ionomer cement, as both a restorative material and as a base combined with a veneer of composite resin, has been advocated as a means of minimizing microleakage where margins are placed in dentine or cementum. Four restorative techniques incorporating glass ionomer cement were used, in vitro, to restore cervical cavities. After thermal cycling, dye penetration was scored along occlusal and gingival margins. In all instances the gingival margin exhibited a less reliable seal than the occlusal margin. The sandwich restorations produced a superior seal at both occlusal and gingival margins when compared with glass ionomer restorative cement.     

A fluoride-containing composite resin--an in vitro study of a new material for orthodontic bonding

The shear/peel bond strength of a new material, a 'hybrid' of a composite resin and a glass ionomer cement, was compared in vitro with the bond strengths of a composite resin and of a glass ionomer cement. The new material had a significantly greater bond strength than the other materials tested and its properties were very similar to the composite resin. Unlike the glass ionomer cement, etching of the enamel before applying the adhesive is required. The clinical indications for using this new cement are discussed.     

3种充填材料治疗老年人后牙根面龋临床比较

目的　选择老年人后牙根面龋充填治疗的理想材料。方法　 2 79颗患牙随机分成 3组 ,分别用银粉加强型玻璃离子、DyractAP及光固化复合树脂充填治疗 ,随访 18～ 2 4个月。结果　银粉加强型玻璃离子组的成功率为 96 .4 % ,高于光固化复合树脂组 (6 7.12 % ) ,P <0 .0 5 ,与DyractAP组 (92 .4 7% )差异无显著性 (P >0 .0 5 )。结论　银粉加强型玻璃离子治疗老年人后牙根面龋优于光固化树脂     

两种材料修复楔状缺损的黏接性能对比研究

目的　比较玻璃离子和光固化复合树脂对牙体的黏接性能。方法　分别采用玻璃离子和光固化复合树脂对 180例75 0个楔状缺损患牙进行修复治疗 ,并于 6个月后复查 ,观察修复材料脱落程度 ,对比两者黏接效果。结果　玻璃离子组修复楔状缺损的总有效率为 92 .0 9% ,光固化复合树脂组为 81.0 1% ,两组相比差异有显著性 (χ2 =33.5 2 5 ,P <0 .0 5 )。结论　玻璃离子对牙体的黏接性能优于光固化复合树脂     

Evaluating the effects of fluoride-releasing dental materials on adjacent interproximal caries.

BACKGROUND: The authors examined several restorative materials to evaluate their ability to inhibit demineralization and enhance remineralization of incipient carious lesions on the interproximal enamel of teeth adjacent to those restored with the materials. METHODS: Twenty-one subjects in need of a crown on a mandibular molar and a Class II inlay on an adjacent tooth took part in this six-phase study. Artificial enamel lesions were created and positioned within the interproximal portion of a crown. Lesions were photographed with polarized light microscopy and characterized before and after 30-day intraoral exposures. Each phase included the placement of a new section in the crown model and a new Class II inlay restorative material in the adjacent tooth. RESULTS: Results demonstrated that nonfluoridated resin composite, fluoridated resin composite and resin-modified glass ionomer restorative materials, when placed in subjects who brushed with a fluoridated dentifrice, demonstrated significantly (P < .05) less enamel demineralization than the nonfluoridated resin composite control placed in subjects who brushed with a nonfluoridated dentifrice. The resin-modified glass ionomer cement, however, even when brushed with a nonfluoridated dentifrice, exhibited significantly (P < .05) less demineralization than the nonfluoridated resin composite control brushed with a nonfluoridated dentifrice. CONCLUSIONS: Resin-modified glass ionomer cement appears to significantly inhibit demineralization of interproximal enamel of teeth adjacent to those restored with the material. CLINICAL IMPLICATIONS: Resin-modified glass ionomer cement restorations can enhance prevention of enamel demineralization on adjacent teeth.     

Marginal leakage in class V composite resin restorations with glass ionomer liners in vitro

This in vitro study evaluated the use of a glass ionomer lining cement in conjunction with composite resin in class V preparations in terms of marginal sealing ability. Two preparations, the occlusal walls in enamel (etched) and the gingival walls in dentin, were place in each tooth. One contained the etched glass ionomer liner, a dentin bonding agent, and a microfill composite resin. The second contained the dentin bonding agent and the microfill composite resin. The teeth were thermocycled, stained with methylene blue dye, sectioned, and evaluated for leakage at the occlusal and gingival margins on a scale of 0 to 3. No significant leakage was recorded at the occlusal margin for either restoration. Leakage at the gingival margin was significantly reduced for the lined restorations, and in no instance did the dye penetrate beyond the liner, which suggests that the lining cement may significantly decrease leakage at the gingival aspect of composite resins in class V restorations.