Static and cyclic loading of fiber-reinforced dental resin.

OBJECTIVE: The aim of this study was to evaluate the flexure strength of unidirectional fiber-reinforced resins under static and cyclic loading with and without thermal cycling. METHODS: The fiber-reinforced resin materials chosen for this project were commercially available endodontic posts and commercially procured bar samples. For all materials, controls for flexure strength were tested in air and in water using three-point loading. Specimens were thermal cycled between 7 and 63 degrees C for 6000 cycles. A staircase approach was used to determine the flexure fatigue limit and scanning microscopy was used to examine the microstructure. RESULTS: The carbon/graphite fiber-reinforced resin posts and the glass FiberKor posts were significantly stronger than the ceramic (zirconia) and the other glass-reinforced resin materials. Thermal cycling caused a significant lowering (11-24%) of the flexure strength for each resin based post system. The ceramic post system decreased only by 2%. Further, for standard size glass fiber-reinforced resin bars, no significant differences between testing in air and water was observed, but a significant difference between static and cyclic loading was noted. SIGNIFICANCE: The decreases in the strength property due to thermal cycling and the cyclic loading of these materials indicates that their utilization in the oral environment enhances their degradation, and potentially shortens their clinical life.     

In vitro antimicrobial activity of various medication preparations on E. faecalis in root canal dentin

The purpose of this study was to evaluate the antimicrobial activity of several medication preparations in root canal dentin infected with Enterococcus faecalis. Roots of extracted bovine incisors were prepared to standardized cylindrical test specimens, 5 mm in height. The smear layer was removed and the samples were autoclaved and then incubated at 37 degrees C/5% CO2 for 24 h in brain-heart infusion (BHI) broth containing 7.0 x 10(4) colony forming units per ml of E. faecalis. The samples were washed in phosphate buffered saline and mounted to individual culture wells with sticky wax. Test medications were applied to fill the canal lumina; medication groups were: (a) sterile H2O (positive control); (b) a 10% mixture of 1.0 g Ca(OH)2 USP in 10 ml sterile H2O; (c) 10% Ca(OH)2 in 0.12% chlorhexidine gluconate (Peridex); (d) Peridex; and (e) uninoculated BHI (negative control). The samples were incubated at 37 degrees C/5% CO2 for 24 h. Dentin samples for quantitative microbiology were then obtained with consecutive sterile burs (ISO 029, 035, 042). All three experimental groups demonstrated significantly greater antimicrobial activity than the positive control (p < 0.001). Group 2 demonstrated significantly greater antimicrobial activity than Group 3 or Group 4 at all dentin depths (p < 0.05). These results suggest that 10% Ca(OH)2 may be more effective than Peridex or 10% Ca(OH)2 in Peridex for the elimination of E. faecalis from dentin tubules.     

Evaluation and management of TMDs, Part 1. History, epidemiology, classification, anatomy, and patient evaluation

The study of temporomandibular disorders has undergone many changes throughout its history. Focus on the structure and function of the TMJ continues to improve our understanding of these complex disorders. A more standardized classification system allows practitioners and researchers to discuss findings in a common language. With improved patient evaluation techniques, the clinician can establish a proper working differential diagnosis and begin focusing attention on treatment planning.     

Antibiotic prophylaxis in intraoral orthognathic surgery

A prospective randomized double-blind study was conducted to evaluate two prophylactic antibiotic regimens in a population of 40 patients undergoing intraoral orthognathic surgery. All patients received one intramuscular dose of 600,000 units procaine penicillin G and 400,000 units aqueous penicillin G preoperatively. Two million units aqueous penicillin G were administered intravenously every three hours intraoperatively and postoperatively three hours after the last intraoperative dose. One group of 20 patients then received 2 million units aqueous penicillin G intravenously every four hours for a total of 12 doses (two days) postoperatively. The second group of 20 patients received a placebo intravenously every four hours for a total of 12 doses (two days) postoperatively. Three infections occurred in the group of patients receiving the placebo postoperatively and none in the group of patients receiving the antibiotics postoperatively.     

Capacity for training in clinical research: status and opportunities

The ability to base patient care on scientific evidence depends in part on the results of translational and applied research. The shortage of trained clinical researchers identified by several sources limits the availability of clinical research studies upon which to base evidence-based therapeutics. This premise suggests that the dental profession needs to train more clinical researchers and faculty to conduct clinical research and to teach its applications to practice. Increasing opportunities for clinical research training in a variety of settings should eventually increase the numbers of clinical researchers, raise faculty involvement in clinical research, and promote science transfer. This paper reports on the current status of clinical research in dental schools, specifies the diverse groups involved in the clinical research enterprise, and identifies underutilized opportunities and partnerships for clinical research training. Data on federal and nonfederal funding of clinical research and training programs are presented. Existing and novel mechanisms for expanding clinical research training throughout and across traditional as well as unconventional environments are explored.     

Flexure strength evaluation of a laboratory-processed fiber-reinforced composite resin

STATEMENT OF PROBLEM: A fiber-reinforced composite resin system has been introduced for posterior restorations; however, little information is known regarding possible degradation of its flexure strength with respect to aging and cyclic loading. PURPOSE: The aim of this in vitro study was to determine whether the fiber reinforcement improved the flexure strength of an indirect composite resin aged in air and water for 3 months and then subjected to static and cyclic loading. MATERIAL AND METHODS: The materials tested in this study, non-fiber-reinforced composite resin (n=160) (Tescera Dentin) and fiber-reinforced composite resin (n=160) (Tescera U-beam and Rod), were fabricated as bars, 25.0 x 4.5 x 4.5 mm, and polished with 120- to 320-grit silicon carbide grinding paper. The static (n=15) and cyclical (n=25) flexure strengths (MPa) of specimens were tested initially and after 3 months' aging in air and water. The specimens were tested in 3-point loading in their respective aging media at a loading rate of 2 mm/min. Cyclic testing followed the staircase approach of either 1000 cycles or until specimen fracture. Statistical analysis for the static-loaded specimens consisted of a 3-way analysis of variance (media, aging, and fiber-reinforced versus unreinforced) (alpha=.05), whereas the cyclic-loaded specimens used confidence levels of .95 for the respective variables (media, aging, and fiber-reinforced versus unreinforced) and to compare static versus cyclic loading. RESULTS: The statistical analysis of the static specimens showed no significant difference between control (unaged) groups and aged groups and aging media, but a significant difference (P<.001) between reinforced versus unreinforced specimens. For the cyclic-loaded specimens, the confidence levels at .95 showed no difference between control (unaged) groups and aged groups and aging media (air or water), but a difference between reinforced versus unreinforced specimens, and static-loaded versus cyclic-loaded specimens. During testing, the specimens separated into several pieces when the fiber reinforcement was on the compressive side, whereas the specimen remained intact when the fiber reinforcement was on the tensile side. CONCLUSIONS: When compared to indirect composite resin without fiber reinforcement, the addition of fibers is an effective method to improve the flexure strength of indirect composite resin for the materials tested.     

Deformational posterior plagiocephaly: diagnosis and treatment.

OBJECTIVE: This study was designed to evaluate the effectiveness of helmet therapy (DOC band) in the correction of patients with moderate to severe posterior deformational plagiocephaly. DESIGN: In this prospective study, the infants were evaluated using 18 anthropometric measurements. PATIENTS: The charts of 248 patients seen between August 1, 1995, and July 31, 1999, were reviewed, and 125 met the criteria for inclusion in the study. All the patients had posterior deformational plagiocephaly with no other craniofacial deformities or medical conditions. Treatment was instituted prior to 1 year of age, and all patients were compliant with DOC band usage and had complete anthropometric measurements. RESULTS: The study recorded a 41.56% (p < .001) reduction in cranial vault asymmetry and a 40.23% (p <.001) reduction in cranial base asymmetry. Orbitotragial asymmetry was improved 18.72% (p = .0738). The age at which treatment was begun was not a significant factor in predicting treatment outcomes.     

Gingival fibroblast response to cyclosporin A and transforming growth factor β1

This study investigates a potential role for TGFβ₁ in the pathogenesis of cyclosporin A-induced gingival overgrowth (CsA-OG). TGFβ₁ was localized immunohistochemically in the connective tissue of both normal gingiva and CsA-OG. Intense staining for TGFβ₁ was detected at the tips of the dermal papillae of the overgrown gingiva. In addition, fibroblasts derived from healthy gingiva and fibroblasts derived from CsA-OG were cultured both as monolayers or embedded in a 3D-collagen gel. Fibroblast activity was monitored in terms of protein and collagen production in the presence of (i) 1 ng/ml TGFβ₁ (ii) 500 ng/ml CsA, or (iii) 500 ng/ml CsA and 1 ng/ml TGFβ₁. In monolayer culture TGFβ₁ significantly increased protein and collagen production in all cell strains (p<0.05); however, there was no difference in response between fibroblasts from overgrown and healthy tissue. The production of both protein and collagen was significantly lower in the presence of the combination of CsA and TGFβ₁ when compared with the maximal stimulation produced by TGFβ₁ alone. In gel, TGFβ₁ significantly elevated matrix production by all overgrown cell strains (p<0.05) but had little or no effect on the normal cell strains. The combination of CsA and TGFβ₁ in gel cultures reduced protein and collagen production by overgrown cell strains compared with TGFβ¹ alone. It is concluded that the cellular activity of gingival fibroblasts is dependant on culture conditions and that fibroblasts derived from overgrown gingival tissue are more responsive to TGFβ₁ than normal gingival fibroblasts when cultured in type I collagen gel.