不同邻面抛光方法对牙釉质表面粗糙度及表面形貌的影响

目的：评价4种邻面抛光方法对邻面釉质表面粗糙度及显微形貌的影响,为邻面抛光方法的选择提供依据。方法：选择21颗离体牙前磨牙,沿颊舌面中线纵剖后获得邻面釉质试件42枚,再用自凝塑料包埋,暴露邻面釉质,用浮石粉抛光,并超声清洗。将42个试样均分为6组,分别作如下处理：A组空白对照,不做处理;B组：阴性对照,采用标准金刚砂车针切磨触点及其周围釉质,切磨后不抛光;其余4组为实验组,经标准金刚砂车针切磨后分别采用以下方法抛光：C组：极细粒度金刚砂车针抛光;D组：裂钻抛光;E组：矽粒子抛光;F组：彩虹抛光条抛光。之后用粗糙度仪测定釉面粗糙度,并进行扫描电镜观察。结果：标准金刚砂车针切磨后粗糙度大幅度增加（P〈0.05）,釉质表面发生明显条形凹陷性缺损;经4种方法抛光后,釉质表面粗糙度均有显著下降（P〈0.05）,显微形貌均较阴性组光滑,其中矽粒子抛光组可达到较空白对照组更为光滑的表面。结论：实验涉及的4种不同邻面抛光方法均有助于降低釉质切磨区域的表面粗糙度,但抛光效果存在差异;采用矽粒子抛光可完全抵消牙体预备时旋转器械对邻牙邻面的切磨作用,获得最为光滑的釉质表面。     

Effect of various grit burs on marginal integrity of resin composite restorations

The purpose of this study was to evaluate the generation of enamel cracks and gaps at the cavosurface margin of resin composite restorations using various burs. Saucer-shaped cavities with a bevel were prepared on mid-coronal buccal or lingual surfaces of extracted human molars using a regular-grit round diamond bur, a fine-grit diamond bur, a superfine-grit diamond bur or a six-bladed tungsten carbide bur with an air turbine handpiece. The enamel margin of the cavity in each group was observed by a light microscope. Cavities were restored with a self-etching adhesive and a light-cured composite resin. After thermocycling, enamel cracks and gaps at the cavosurface margins were observed and scored. Specimens were sectioned longitudinally in two halves, and the resin-cavity interface was observed by means of a light microscope. In cavity preparation, the regular-grid diamond bur and the tungsten carbide bur caused more cracks in the marginal enamel than other groups. From the surface and sectioned surface observation of restored teeth, the superfine-grit diamond bur generated fewer cracks and gaps than the other burs.     

Iatrogenic tooth abrasion comparisons among composite materials and finishing techniques

STATEMENT OF PROBLEM: Many different rotary instruments are available for shaping composite restorations. Whether use of these instruments causes undesirable iatrogenic abrasion of either the tooth surface or the composite restorative material is unknown. Assuming that damage occurs, which technique is least damaging is unknown. PURPOSE: This in vitro study quantified the loss of surface enamel and dentin surrounding Class V preparations during composite shaping and finishing procedures. The susceptibility of 2 types of composites to tooth abrasion was also examined. MATERIALS AND METHODS: Standardized Class V cavities were prepared at the amelodentinal junction of 36 human molar teeth. The teeth were randomly assigned to 6 groups of 6 teeth each. They were restored with either a low- or high-viscosity composite (Revolution or Prodigy Condensable, respectively) and finished with aluminum oxide disks, tungsten carbide burs, or ultrafine finishing diamond burs. The preparations were profiled before and after restoration. After each finishing procedure, morphological measurements of surface changes in the dentin and enamel were made and reported as volume (in cubic millimeters); maximum depth, mean maximum depth, and mean depth (in micrometers); and surface area (in square millimeters). The results were subjected to a 2-way analysis of variance for restorative material and finishing technique (P<.05). RESULTS: Aluminum oxide disks removed significantly less enamel than tungsten carbide burs or ultrafine finishing diamond burs, as measured by volume, maximum depth, mean maximum depth, mean depth, and surface area (P<.05). Conversely, aluminum oxide disks removed significantly greater dentin than either tungsten carbide burs or ultrafine finishing burs as measured by loss of volume, mean depth, and surface area (P<.05). There was no significant difference in the loss of surrounding tooth substance based on resin type (low or high viscosity). CONCLUSION: Within the limitations of this study, the 3 finishing systems tested resulted in varying degrees of iatrogenic abrasion of enamel and dentin. The composite material used had no significant effect on abrasion of the surrounding enamel or dentin.     

Effect of dentinal surface preparation on bond strength of self-etching adhesives

PURPOSE: This study examined the effects of cutting dentin with different burs at various speeds on the microtensile bond strength (muTBS) of two self-etching adhesive systems. MATERIALS AND METHODS: Flat deep dentin surfaces from 50 extracted human third molars were divided into 5 groups (n = 10) according to bur type and speed of rotation: (I) high-speed diamond bur, (II) low-speed diamond bur, (III) high-speed tungsten carbide bur, (IV) low-speed tungsten carbide bur. Controls were abraded with 600-grit SiC paper. A two-step self-etching adhesive, Clearfil SE Bond (SE, Kuraray) and a one-step self-etching adhesive, Clearfil S3 Bond (S3, Kuraray) were applied to dentin surfaces and light cured. Composite buildups were performed using Filtek Z250 (3M ESPE). For lTBS evaluation, composite-dentin beams of 0.8 mm2 were stressed to failure at a crosshead speed of 1 mm/min. The muTBS data were analyzed using two-way ANOVA and Tukey's multiple comparison tests. Representative fractured beams from each group were prepared for fractographic analysis under SEM. RESULTS: Two-way ANOVA showed that the effects of dentin surface preparations, adhesive systems, and their interaction were statistically significant (p < 0.001). The muTBS was the highest when bonding SE to dentin surface prepared with 600-grit SiC abrasive paper (47.3 +/- 7.4 MPa), followed by high-speed tungsten carbide burs (40.8 +/- 6.1 MPa), and the lowest when bonding S3 to dentin surfaces prepared with a high-speed diamond bur (15.2 +/- 6.2 MPa). SEM observation of the fractured surfaces revealed mixed and adhesive failures for SE groups, while in the S3 groups, adhesive failures predominated with numerous inclusion droplets. CONCLUSION: Higher bond strengths are achieved with SE bond when applied on dentin surfaces prepared with tungsten carbide burs. Proper bur and adhesive selection are essential to optimize dentin adhesion of self-etching adhesives.     

Effectiveness of diamond-impregnated felt wheels for polishing a hybrid composite

The effectiveness of diamond-impregnated felt wheels for polishing the surfaces of a fine-particle hybrid composite was studied in relation to different finishing methods. Standardised composite specimens were finished with one or a series of two or three finishing diamonds (particle size 30, 15 and 8 μm), one or two tungsten carbide finishing burs (12- and 30-fluted) or with a finishing diamond followed by a tungsten carbide bur. The final polishing of all specimens was done with the diamond-impregnated felt wheel Diafix α. Treatment with Sof-Lex discs after the use of a finishing diamond served as a polishing standard for comparison. Evaluation of the final surfaces was done with profilometry and by scanning electron microscopy. The profilometric results showed that the type of pretreatment was decisive for the quality of the final polishing. Nearly all surfaces polished by the diamond-impregnated felt wheels were smoother than those treated by the flexible discs (P<0.01). The lowest roughness data were recorded following a pretreatment with a finishing diamond and a tungsten carbide finishing bur. After appropriate pretreatment, the hybrid composite surface was sufficiently polished with the diamond-impregnated felt wheels.     

Dental Burs—What Bur for Which Application? A Survey of Dental Schools

PURPOSE: The purpose of this study was to survey North American dental schools regarding recommendations for rotary instrumentation for fixed prosthodontic and operative procedures at the predoctoral and postgraduate level. MATERIALS AND METHODS: A 25-question survey was sent to 64 North American dental schools, of which 15 questions specifically related to rotary instrument recommendations. One questionnaire was addressed to the individual at each school having administrative responsibility for teaching tooth preparation techniques. A high response rate was assured by follow-up telephone calls and faxes. The distributions of bur recommendations for both predoctoral and advanced prosthodontic programs were analyzed by chi-squared tests at an a priori alpha = 0.05. RESULTS: Completed surveys were received from 58 of 64 dental schools, a response rate > 90%. Medium grit burs predominate in predoctoral education for gross tooth reduction for fixed prosthodontics, whereas coarse grit burs predominate at the graduate level (p < .05). The use of the diamond bur alone predominates for axial wall refinement, whereas the use of carbide burs or carbide burs in combination with diamond burs prevails for marginal refinement (p < .05). In predoctoral operative dentistry, recommendations for cavity outline form were similar at all dental schools (p > .05) and were principally tungsten carbide (WC) burs. Carbide burs are the instrument of choice for internal walls, but the WC bur alone or in combination with diamond burs is preferred for refining composite margins (p < .05). CONCLUSIONS: There is a broad consensus within North American dental schools on rotary instrumentation used by dental students. There is a greater use of coarser grit burs for gross tooth reduction in fixed prosthodontics at the postgraduate than predoctoral level.     

Effect of bur type and conditioning on the surface and interface of dentine

The purpose of this in vitro study was to evaluate the surface and resin-dentine interface characteristics of permanent tooth dentine cut with diamond or carbide burs and treated with phosphoric acid (PA) or an acidic conditioner. Labial surfaces of permanent incisors were prepared into dentine with high-speed carbide or diamond burs and divided into two halves. Phosphoric acid 36% was applied on one half and non-rinse conditioner (NRC) was applied on the other half. Ten randomly selected scanning electron microscopy (SEM) fields from each specimen (n = 15) were evaluated. Occlusal surfaces of third molars were divided in two halves for evaluation of the resin-dentine interface. The halves were randomly assigned to one of each conditioner and restored with Prime & Bond NT/Spectrum. Ten specimens were analysed by SEM to evaluate hybrid layer formation and interfacial seal. We observed that surfaces prepared with carbide bur presented less residual smear plugs (P < 0.05) than surfaces prepared with diamond burs. Surfaces conditioned with NRC, which is a smear layer modifier, presented more residual smear plugs than surfaces conditioned with PA (P < 0.05). Treatment with PA resulted in more sealed interfaces than specimens treated with NRC. Within the limitations of this study the results showed that carbide burs leave a surface that is more conducive to bonding than diamond burs.     

New finishing instruments for composite resins

The trimming of composite resin restorations encompasses gross finishing, contouring, fine finishing, and polishing. A series of aluminum oxide-coated flexible disks have been marketed and are suitable for that purpose. However, their use is confined to directly accessible convex surfaces. For precise finishing of small delineated areas, and for concave and occlusal surfaces, rigid rotary instruments are necessary. The currently used stones and tungsten carbide burs are ineffective with microfilled composite systems. Thus, a series of finishing burs coated with 40- and 15-microns diamond chips were evaluated because of the superior grinding effectiveness as compared with existing instruments. Surface roughness measurements, and qualitative and quantitative SEM evaluations, indicate that these fine and superfine diamond finishing burs produce surfaces on composite resins as smooth as tungsten carbide burs and stones. At the same time, they cause less surface and subsurface damage or marginal fractures on composite resin restorations. The three-year clinical experience is generally favorable. Further quantitative clinical studies are warranted.     

不同旋转器械对基牙牙本质表面粗糙度及显微形貌的影响

目的评价不同旋转器械对基牙牙本质表面粗糙度及显微形貌的影响,为临床牙体预备过程中旋转器械的选择使用提供参考。方法选择54颗离体牙,均分为3组,使用不同的预备方式对唇面进行预备。A组：标准金刚砂车针预备;B组：标准金刚砂车针预备,极细粒度金刚砂车针修整;C组：标准金刚砂车针预备,钨钢车针修整。之后用粗糙度仪测定牙本质表面粗糙度（Ra、Rq和Rz）,并进行扫描电镜观察,对其结果进行统计学处理。结果 3种预备方式后的牙本质表面粗糙度Ra存在显著差异（P〈0.05）;粗糙度由大到小依次为：A组〉B组〉C组。结论不同旋转器械切磨牙本质所得表面粗糙度不同,使用极细粒度金刚砂车针和钨钢车针修整可获得较为光滑的牙体预备体表面。     

Surface roughness and bond strength of enamel to composite.

OBJECTIVES: The aim of the study was to assess the influence of pretreating enamel by different rotary instruments on shear-bond strength of composite to enamel after the acid etch technique. METHODS: Ninety human enamel specimens with transversely and longitudinally sectioned prisms were ground flat, and half of the enamel area of each specimen was prepared with one of the eight different rotary instruments: a 120 microns diamond bur, three finishing diamonds (30, 15 and 8 microns), two tungsten carbide finishing instruments (8- and 30-fluted) and two stones (Dura green and Dura white). The other half of the enamel area was left untreated. Enamel roughness was measured by laser-stylus profilometry. Two cylinders filled with the hybrid composite Pertac were adhesively fixed on each enamel surface, one on the prepared side and the other on the untreated side. After seven days of water storage, shear-bond strength was measured with a Universal testing machine. RESULTS: Rz values of the treated enamel surfaces were between 4.14 and 17.75 microns. The shear-bond strength data varied between 16.8 and 29.4 MPa and were similar for transversely and longitudinally orientated prisms. The different roughness data had no significant influence on shear-bond strength of composite to enamel. Additional SEM investigation showed that the surface geometry caused by the rotary instruments largely persisted after acid etching. SIGNIFICANCE: With regard to shear-bond strength, there was no advantage in using a special bur for finishing enamel surfaces prior to the acid etch technique. Burs causing extreme roughness should not be used for this purpose.     

A New Carbide Finishing Bur for Bracket Debonding

BACKGROUND: The removal of residual bonding resin with rotary instruments after bracket debonding may damage the enamel surface. Conventional carbide burs may scratch the enamel due to the shape and sharpness of their blades. CARBIDE FINISHING BUR: A new carbide finishing bur with a slightly tapered shape, rounded tip and eight twisted blades has been developed. As a special feature the wedge angle of the blades has been enlarged to ca. 130-135 degrees by means of an oblique ground chamfer (relief angle ca. 0-5 degrees). The transition from head to shaft has been smoothed off with a safety chamfer. Overall, the cutting capacity has been reduced in the enamel, while the bur has remained sufficiently sharp within the adhesive resin. PROTOTYPE TESTING: For prototype testing, incisor brackets were bonded in vitro to 70 human incisors according to the standard clinical technique and removed after 7 days. Residual bonding resin was removed with conventional carbide burs and with gradually modified prototypes of the new finishing instrument respectively. The resulting enamel surfaces were evaluated by scanning electron microscopy. The specimens were then treated with a polishing paste and evaluated again. RESULTS: Conventional carbide burs remove not only residual bonding resin but also some enamel; scoring may occur. The newly developed finishing bur has been proven by morphological evaluation to be less aggressive in removing residual bonding resin after bracket debonding.     

Effect of high- and low-speed burs used for partial pulpotomy in monkey teeth

Abstract. This study investigated the immediate effect of partial pulpotomy in monkey teeth using different rotary instruments. The rotary instruments used were a diamond bur at 300,000 rpm, a tungsten carbide bur at 300,000 rpm and a steel round bur at 6,000 rpm. The pulps were examined half-an-hour after the operative procedure. Both high speed techniques were shown to cause minimal damage to the pulp. The results also suggested that steel round burs produced a satisfactory alternative where the bur could be supported on dentine.     

Effects of Tooth Preparation Burs and Luting Cement Types on the Marginal Fit of Extracoronal Restorations

Purpose: Although surface roughness of axial walls could contribute to precision of a cast restoration, it is unclear how the roughness of tooth preparation affects marginal fit of the restoration in clinical practice. The purpose of this study was to describe the morphologic features of dentin surfaces prepared by common rotary instruments of similar shapes and to determine their effects on the marginal fit for complete cast crowns. Materials and Methods: Ninety crowns were cast for standardized complete crown tooth preparations. Diamond, tungsten carbide finishing, and crosscut carbide burs of similar shape were used (N = 30). The crowns in each group were subdivided into three groups (n = 10) for use with different luting cements: zinc phosphate cement (Fleck's), glass ionomer cement (Ketac‐Cem), and adhesive resin cement (Panavia 21). Marginal fit was measured with a light microscope in a plane parallel to the tooth surface before and after cementation between four pairs of index indentations placed at equal distances around the circumference of each specimen. Difference among groups was tested for statistical significance with analysis of variance (ANOVA) followed by Ryan‐Einot‐Gabriel‐Welsch Multiple Range Test (α= 0.05). Results: Analysis of measurements disclosed a statistically significant difference for burs used to finish tooth preparations (p < 0.001); however, luting cement measurements were not significantly different (p= 0.152). Also, the interaction effect was not significantly different (p= 0.685). For zinc phosphate cement, the highest marginal discrepancy value (100 ± 106 μm) was for tooth preparations refined with carbide burs, and the lowest discrepancy value (36 ± 30 μm) was for tooth preparations refined with finishing burs. For glass ionomer cement, the highest marginal discrepancy value (61 ± 47 μm) was for tooth preparations refined with carbide burs, and the lowest discrepancy value (33 ± 40 μm) was for tooth preparations refined with finishing burs. For adhesive resin cement, the highest marginal discrepancy value (88 ± 81 μm) was for tooth preparations refined with carbide burs, and the lowest discrepancy value (19 ± 17 μm) was for tooth preparations refined with finishing burs. Conclusions: Marginal fit of complete cast crowns is influenced by tooth preparation surface characteristics, regardless of the type of luting agent used for cementation. Tooth preparations refined with finishing burs may favor the placement of restorations with the smallest marginal discrepancies, regardless of the type of cement used.     

Effects of different orthodontic adhesives and resin removal techniques on enamel color alteration

Objective: To investigate the color alterations in enamel following the use of different orthodontic bonding resins and adhesive residue–removal burs.Materials and Methods:Metal brackets were bonded to extracted human premolars (n  =  175) by using an etch-and-rinse adhesive system, a self-etch adhesive system (SEP), or a resin-modified glass ionomer cement (RMGIC). After 24 hours of photoaging, the brackets were removed and the adhesive residue on the tooth surfaces was cleaned with either a tungsten carbide bur or a Stainbuster bur. Tooth colors were measured with a spectrophotometer at baseline, after adhesive removal, and after additional photoaging. Color evaluation was made, and color differences induced by photoaging were calculated. Statistical evaluation was made using the Kruskal-Wallis test and the Mann-Whitney U-test, with Bonferroni correction.Results:All specimens showed discoloration at varying levels. The highest color change was observed in the etch-and-rinse adhesive/tungsten carbide bur group. When the etch-and-rinse and self-etch adhesives were used, adhesive-remnant removal with Stainbuster burs resulted in significantly lower discoloration. The type of bur did not affect the extent of enamel discoloration in the RMGIC group.Conclusions:Orthodontic treatment alters the original color of enamel, and both the adhesive system and the resin-removal methods are responsible for this change. When brackets are bonded with the etch-and-rinse system or the SEP, cleaning the adhesive residuals with Stainbuster burs is recommended for minimal change. RMGIC can be safely cleaned with tungsten carbide burs.     

An evaluation of polymer rotary instruments' ability to remove healthy, non-carious dentine

The aim of this study was to confirm that Smartprep burs do not cut non-carious, healthy dentine. Twenty non-carious extracted molars were trimmed with a diamond bur to remove enamel and to create a flat dentine surface. A new Smartprep bur (RA # 4) was applied to each tooth for 30 seconds. As a control, a new number three round stainless steel bur was applied to each tooth. The mean dentine loss was 4.25 mg (range 1.4 - 9 mg) for Smartprep burs and 12.21 mg (range 7.6 - 16.5 mg) for stainless steel burs. The Smartprep burs remove significantly less dentine than stainless steel burs.     

Effect of surface roughness of cavity preparations on the microleakage of Class V resin composite restorations

This study determined whether surface roughness of the internal walls of a Class V resin composite preparation, using a carbide bur, a medium-grit diamond bur and a fine-grit diamond bur, affected the degree of microleakage of the restoration. The facial and lingual surfaces of 45 non-carious extracted human molars provided 90 samples for evaluation. The specimen surfaces were assigned randomly in equal numbers to one of three groups (n = 30). Conservative Class V composite preparations were made using one of three different burs: a 330-carbide bur, a 330 fine-grit diamond bur or a 330 medium-grit diamond bur (Brasseler USA). After acid etching, PQ1 (Ultradent Products Inc) primer/bonding resin and Vitalescence (Ultradent Products Inc) were applied and cured following the manufacturers' instructions. After minor finishing, the apices of all root surfaces were sealed with Vitrebond (3M), and the unprepared external surfaces were sealed with nail polish to within 1 mm of the restoration margins. The specimens were stored in distilled water at room temperature for 24 hours, then subjected to 1,200 thermocycles at 5 degrees C and 55 degrees C with a 30-second dwell time. After cycling, the teeth were immersed in a 5% solution of methylene blue dye for 12 hours. The molars were invested in clear acrylic casting resin, labeled, then sectioned once vertically approximately midway through the facial and lingual surfaces using a diamond coated saw blade. Microleakage was evaluated using a 10x microscope for the enamel and cementum surfaces and blindly scored by two independent examiners. In all cases, regardless of the examiner, at both the enamel and the dentin margins, the analysis revealed no statistically significant differences in microleakage across bur types. Further results show that dentin margins leaked significantly more than enamel margins for all bur types.     

Enamel surface roughness after debonding: Comparison of two different burs

Objective:To test the hypotheses that (1) there is no significant difference between the effects of two burs on the surface roughness of enamel after orthodontic debonding, and (2) there is no difference between resin removal times of the two burs.Materials and Methods:The crowns of 20 premolars were embedded in acrylic blocks, and the buccal surfaces were subjected to atomic force microscopy (AFM), with measurement of initial roughness values. The brackets were bonded with a light-cured adhesive and were debonded with a debonding plier. In half of samples, adhesive remnants were removed with a tungsten carbide bur, whereas a fiber-reinforced composite bur was used in the other half. The second AFM measurements were made after resin removal. Duration of removal procedures was also recorded. Results of roughness and duration measurements were analyzed with the use of repeated measurements analysis of variance and independent t-tests, respectively.Results:The two resin removal instruments had significantly different effects on enamel roughness; higher average roughness (Sa) (P < .001), root mean square roughness (Sq) (P  =  .046), and maximum roughness depth (Smax) (P < .001) values were obtained with use of the tungsten carbide bur. Time required for resin removal with the composite bur was significantly greater than time required with the carbide bur (P < .001).Conclusion:The hypothesis is rejected. The composite bur used for resin removal creates smoother surfaces after orthodontic bonding; however, the process takes longer than it does when the tungsten carbide bur is used.     

Different methods of finishing and polishing enamel

STATEMENT OF PROBLEM: Highly polished enamel surfaces are recommended for axial tooth surfaces that will serve as guiding planes and be contacted by component parts of a removable partial denture. There is little evidence to support the assumption that this tooth modification will provide accurate adaptation of the framework and prevent build-up of plaque. PURPOSE: The aim of this investigation was to evaluate the surface roughness of the tooth enamel, prepared to serve as guiding planes, with different polishing systems. MATERIAL AND METHODS: Four different methods (designated A, B, C, and D) for finishing and polishing the prepared enamel surfaces of 20 freshly extracted third molar teeth were studied. Each method involved 3, 4, or 5 different steps. The roughness of each specimen was measured at the start of each method before recontouring, after recontouring, and after each step of the 4 finishing and polishing procedures. The 4 experimental finishing methods were applied after recontouring the axial surfaces (buccal, lingual, and proximal) of each tooth. Thus the 20 teeth (60 surfaces) were finished and polished by use of 1 of the experimental methods. Surface roughness was measured with a profilometer (microm); the readings of the unpolished enamel surfaces were recorded as control measurements. Results were statistically analyzed with one-way analysis of variance followed by Tukey's test at the 95% level of confidence. RESULTS: The highest roughness mean values (14.41 microm to 16.44 microm) were found when the diamond bur was used at a high speed for tooth preparation. A significant decrease in roughness values was observed with the diamond bur at a low speed (P<.05). Analysis of the roughness values revealed that all polishing methods produced surface roughness similar to that of the corresponding control teeth. CONCLUSION: Within the limitations of this study, all finishing procedures tested effectively promoted an enamel surface similar to the original unpolished enamel.     

High and low torque handpieces: cutting dynamics, enamel cracking and tooth temperature

OBJECTIVE: The aim of these experiments was to compare the cutting dynamics of high-speed high-torque (speed-increasing) and high-speed low-torque (air-turbine) handpieces and evaluate the effect of handpiece torque and bur type on sub-surface enamel cracking. Temperature changes were also recorded in teeth during cavity preparation with high and low torque handpieces with diamond and tungsten carbide (TC) burs. The null hypothesis of this study was that high torque handpieces cause more damage to tooth structure during cutting and lead to a rise in temperature within the pulp-chamber. MATERIALS AND METHODS: Images of the dynamic interactions between burs and enamel were recorded at video rate using a confocal microscope. Central incisors were mounted on a specially made servomotor driven stage for cutting with a type 57 TC bur. The two handpiece types were used with simultaneous recording of cutting load and rate. Sub-surface enamel cracking caused by the use of diamond and TC burs with high and low torque was also examined. Lower third molars were sectioned horizontally to remove the cusp tips and then the two remaining crowns cemented together with cyanoacrylate adhesive, by their flat surfaces. Axial surfaces of the crowns were then prepared with the burs and handpieces. The teeth were then separated and the original sectioned surface examined for any cracks using a confocal microscope. Heat generation was measured using thermocouples placed into the pulp chambers of extracted premolars, with diamond and TC burs/high-low torque handpiece variables, when cutting occlusal and cervical cavities. RESULTS: When lightly loaded the two handpiece types performed similarly. However, marked differences in cutting mechanisms were noted when increased forces were applied to the handpieces with, generally, an increase in cutting rate. The air turbine could not cope with steady heavy loads, tending to stall. 'Rippling' was seen in the interface as this stall developed, coinciding with the bur 'clearing' itself. No differences were noted between different handpieces and burs, in terms of sub-surface enamel cracking. Similarly, no differences were recorded for temperature rise during cavity preparation. CONCLUSIONS: Differences in cutting mechanisms were seen between handpieces with high and low torque, especially when the loads and cutting rates were increased. The speed increasing handpiece was better able to cope with increased loading. Nevertheless, there was no evidence of increased tooth cracking or heating with this type handpiece, indicating that these do not have any deleterious effects on the tooth.     

Durability of tungsten carbide burs for the fabrication of titanium crowns using dental CAD/CAM

The purpose of this study was to evaluate the durability of tungsten carbide burs for the fabrication of titanium crowns using two dental CAD/CAM systems (DECSY, Digital Process, Japan and Cadim, Advance, Japan). A tungsten carbide bur in each system was examined and used without fracture to fabricate 51 titanium crowns. For both systems tiny chips were found on the bur blade at the 11th machining. These chips gradually enlarged as the number of machining times increased. At the first machining no significant difference in the average surface roughness was found on the crown between the two systems (1.6 microm for DECSY and 1.2 microm for Cadim). The cutting grooves became dull and the average surface roughness increased as the number of machining times increased. It is concluded that the tungsten carbide burs for both systems can be used to fabricate up to 51 titanium crowns.