Influence of powder/liquid mixing ratio on porosity and translucency of dental porcelains

STATEMENT OF PROBLEM: Dental technicians use a variety of techniques when condensing dental porcelains. It is unclear whether these techniques affect the total porosity and translucency of dental porcelains. PURPOSE: The objective of this study was to determine whether varying the powder/liquid ratio during condensation affects porosity and translucency of porcelains.Material and methods Duceram LFC dentin, Duceram LFC incisal, IPS Eris dentin, and IPS Eris incisal porcelains were studied. For each specimen, 1.0 g of porcelain powder was mixed with 1 of 3 different volumes of deionized water to form a slurry with a thin, medium, or thick consistency. The slurries were condensed in a plastic syringe mold, fired, and polished to a 3-microm finish to form 12 groups of 4 specimens each (14-mm diameter, 1.10-mm thickness). The apparent density (g/mL) of each specimen was measured using Archimedes method, and the porosity (%) calculated. Each specimen was coupled to standard ceramic tiles using an immersion liquid, and the color shade was measured in CIE Yxy coordinates using a tristimulus colorimeter. Translucency was assessed by calculating the contrast ratio of shade value (Y) in front of black versus white backgrounds. Two-way analysis of variance and Tukey's multiple comparison tests (alpha = .05) were used to test for significant effects of factors. RESULTS: Porcelain type and powder/liquid ratio had a significant interactive effect on the apparent density (P < .001) and on total porosity (P = .003); however, there was no consistent trend. The powder/liquid ratio did not significantly affect translucency (P = .28), but porcelain type had a significant effect on translucency (P < .001). CONCLUSION: In this in vitro study, total porosity of specimens prepared using 4 porcelains was found to be sensitive to powder/liquid ratio; whereas translucency was found to be insensitive to powder/liquid ratio.     

Serum mepivacaine concentrations after intraoral injection in young children

The authors measured plasma concentrations of mepivacaine in 36 children from the ages of 2 to 5 years who received dental care under light general anesthesia. The subjects were randomly assigned to receive either 2 percent mepivacaine hydrochloride with 1:20,000 levonordefrin or 3 percent mepivacaine hydrochloride without vasoconstrictor. The volume of anesthetic injected depended on the planned procedures for each patient. Blood samples (3 mL) were drawn from an intravenous line before and 5, 10, 20, 30, 45, and 60 minutes after mepivacaine injection. The serum was collected and analyzed by gas-liquid chromatography. Mean serum concentrations, normalized to a dose of 1 mg/kg body weight, reached a peak of 0.67 +/- 0.42 microgram/mL (mean +/- SD) after 3 percent mepivacaine and 0.63 +/- 0.21 microgram/mL after 2 percent mepivacaine with levonordefrin. Levonordefrin had no significant effect on the plasma concentrations. However, because of the higher concentration of mepivacaine in the 3 percent formulation, it was potentially 1.5 times as toxic (P < 0.002) on a volume basis. Statistical analysis also suggested that the maximum recommended dose of 3 mg/lb could result in potentially toxic blood concentrations in a small percentage of pediatric patients. The authors conclude that 3 percent mepivacaine should not be used when relatively large volumes of local anesthetic must be administered to small children and recommend that the maximum dose of mepivacaine not exceed 5 mg/kg.     

Magnetic Field Interactions of Orthodontic Wires during Magnetic Resonance Imaging (MRI) at 1.5 Tesla

AbstractBackground: Orthodontic appliances pose a potential risk during magnetic resonance imaging (MRI) due to forces on metallic objects within the static magnetic field of MRI systems. The aim of the present investigation was to measure forces on orthodontic wires caused by the static magnetic field of a 1.5-Tesla MRI system, and to assess the safety hazards associated with these forces.Materials and Methods: Thirty-two different orthodontic wires (21 arch wires, eight ligature wires and three retainer wires) were investigated in a 1.5-Tesla MRI system (Magnetom Symphony, Siemens Medical Solutions, Erlangen, Germany). The translational forces were measured using the deflection angle test (ASTM F2052-02); rotational forces were assessed on a 5-point qualitative scale.Results and Conclusion: All retainer wires and the steel arch wires (the Noninium^® arch wire being the exception) were subjected to considerable rotational and translational forces within the MRI system’s magnetic field. Translational forces were from 9.1- to 27.6-times as high as gravitational forces on these objects. Steel ligature wires and arch wires made of cobalt chromium, titanium molybdenum, nickel-titanium, and brass alloys showed no or negligible forces within the magnetic field. The translational and rotational forces within the MRI magnetic field should pose no risk to carefully-ligated arch wires. Steel retainer wire bonds should be checked to ensure secure attachment prior to an MRI investigation.* both authors share first authorship     

A long-term follow up of spontaneously healed root fractures later subjected to orthodontic forces – two case reports

Abstract –  There is evidence that many dental injuries which result in root fractures may not require active treatment in cases where the coronal fragment is minimally displaced and does not exhibit clinical signs or symptoms. This paper discusses two individual cases where spontaneous root fracture healing was observed and this healing was apparently not compromised by later orthodontic tooth movement. The observation periods for the two cases were 13 and 18 years since the original root fractures occurred.     

Transverse molar movements during growth

The purpose of this study was to evaluate changes in molar crown torque and intermolar arch width from the time of permanent first molar eruption to early adulthood. Molar crown torque and intermolar arch width were measured in 36 untreated subjects with Class I occlusion from the Iowa Facial Growth Study at approximate ages 7.5, 10.3, 12.9, 16.5, and 26.4 years. On average, the mandibular first and second molars uprighted buccally by 5.0 degrees and 7.5 degrees, respectively. Mandibular first and second molar intermolar width increased by 2.2 and 0.78 mm, respectively. On average, maxillary first and second molars uprighted lingually by 3.3 degrees and 5.9 degrees, respectively. Maxillary first and second intermolar width increased by 2.8 and 2.0 mm, respectively. Results of statistical analysis by the Wilcoxon signed rank test indicate that (1) maxillary molars erupt with buccal crown torque and upright with age, whereas mandibular molars erupt with lingual crown torque and upright with age (P <.01), and (2) molar crown torque changes are accompanied by concurrent increases in maxillary and mandibular intermolar width (P <.01).     

Severe proliferative congenital temporomandibular joint ankylosis: a proposed treatment protocol utilizing distraction osteogenesis

The classical treatment for temporomandibular joint (TMJ) ankylosis in children: 1) joint release; 2) arthroplasty; 3) reconstruction; and 4) postoperative physical therapy (PT), is often unsuccessful. Postoperative physical therapy is difficult in the young patient due to poor cooperation. Moreover, there is a subgroup of patients who have a refractory congenital proliferative bony process that is the cause of their disease. In these patients, a role for distraction osteogenesis (DO) has been defined. We present a series of young patients with congenital proliferative TMJ ankylosis. Some have failed classic treatment. In such cases, DO is used to expand the mandibular size and soft tissue matrix. This creates a static open bite, facilitates mid-facial growth, and avoids compromise of the airway, speech, nutrition, and oral hygiene. To maintain these objectives, mandibular DO may be repeated as the child matures. Once skeletal maturity is reached, DO is used to normalize occlusion and further expand the soft tissue envelope prior to definitive reconstruction and aggressive post-op PT. In seven patients, this protocol has been used. Five patients are currently in the active phase of growth and undergoing interim treatment with mandibular DO. Two patients have reached skeletal maturity and have completed the protocol of DO with definitive arthroplasty and reconstruction. DO is a valuable aid in the treatment of the problematic child with congenital proliferative TMJ ankylosis. Interim DO, prior to definitive arthroplasty and reconstruction, can provide a static open bite that prevents progressive deformity and its associated functional disturbances.     

Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents

This longitudinal study monitored periodontal status in 20 adults and 20 adolescents undergoing fixed orthodontic treatment. Ten adults had generalized periodontitis and received periodontal treatment, including periodontal surgery, before orthodontic treatment. They also received periodontal maintenance at 3-month intervals during orthodontic treatment. The other 10 adults had normal periodontal tissues. Neither these latter adults nor the adolescents received periodontal maintenance during orthodontic treatment. Periodontal status was determined (1) at six standard sites before fixed appliances were placed (baseline), (2) at 1, 3, 6, 9, 12, and 18 months after appliances had been placed, and (3) 1, 3, 6, and 12 months after appliances had been removed. At each of these visits, these sites were assessed for plaque index, gingival index, bleeding tendency, and pocket depth. Loss of attachment between baseline and 3 months after appliances were removed and tooth loss were also determined. Complete data were obtained for 15 adolescents and 14 adults. During orthodontic treatment the adolescent group showed significantly more (p less than 0.05) periodontal inflammation and supragingival plaque than the adults; after appliances were removed, this pattern was no longer statistically significant. For loss of attachment, there were no significant differences among adolescents, adults with normal periodontal tissues, or adults with reduced but healthy periodontal tissues who had undergone treatment for periodontal disease. For tooth loss, three nonstudy site teeth with pockets deeper than 6 mm and/or furcation involvements were lost because of periodontal abscesses in the adult group treated for periodontal disease.     

Dispensing and weighing apparatus for alginate impression material

Constant proportions in mixing of alginate impression material are difficult to achieve, especially in a teaching department, owing to variability in powder measurement with the conventional scoop method. Apparatus to facilitate powder measurement by weighing is described, and its accuracy assessed.     

Can poly(acrylic) acid molecular weight mixtures improve the compressive fracture strength and elastic modulus of a glass-ionomer restorative?

Objectives

To optimize the compressive fracture strength (σ) and elastic modulus (E) of a glass-ionomer (GI) restorative using poly(acrylic) acid (PAA) weight average molecular weight (M_w) mixtures.

Methods

174 PAA solutions were prepared (four control PAA M_ws at three PAA concentrations (25, 35 and 45%) (n = 12) and six M_w mixtures (Groups A-F at nine blend ratios and three PAA concentrations (n = 162))). The viscosity (η) of each PAA solution was determined using a digital viscometer. The PAA solutions were hand-mixed with a commercial GI restorative powder (Ionofil Molar; Voco, Cuxhaven, Germany) and σ and E were determined using cylindrical (6 mm height, 4 mm diameter) specimens (n = 20) at 24 h. Data were analyzed using analyses of variance (ANOVA) (three-, two- and one-way) and regression analyses at p < 0.05.

Results

The three- and two-way ANOVAs highlighted significant effects of M_w mixture, blend ratio and PAA concentration (all p < 0.0001) on the η, σ and E data. Regression analyses showed significant increases in η, σ and E (p < 0.0001) with increasing M_w from Groups A to F. There was no significant effect of blend ratio on the σ data for Groups A (p = 0.178), D (p = 0.747) and F (p = 0.107) and on the E data (p > 0.083).

Significance

The current approach to improving the mechanical properties of GI restoratives using PAA M_w mixtures is encouraging, however, further manipulation of the GI restorative system by optimizing PAA M_w mixtures, blend ratios and PAA concentrations is required to elicit further improvements in σ and E without impacting upon the η of the PAA solution.