The influence of the veneering porcelain and different surface treatments on the biaxial flexural strength of a heat-pressed ceramic

STATEMENT OF PROBLEM: The strength of all-ceramic restorations can be adversely affected by surface defects, leading to restoration failures. Additionally, when a 2-layer all-ceramic restoration is required for esthetic purposes, part of the stronger ceramic core material is replaced by veneering porcelain. PURPOSE: This study evaluated the effect of different surface treatments on the strength of a ceramic core material and veneering porcelain, as well as the influence of veneering porcelain on the strength of a 2-layer ceramic structure. MATERIAL AND METHODS: Fifty heat-pressed ceramic cores and 30 veneering porcelain discs (17 mm diameter x 2 mm) were made. From the ceramic core group, 20 discs were selected and reduced to a thickness of 1 mm and veneered with 1 mm of porcelain. These specimens were divided into 2 groups of 10 each. The remaining 30 ceramic core and the 30 veneering porcelain discs were divided into 2 sets of 3 equal sized groups (n=10). Ceramic core groups were prepared for testing having the following surfaces: airborne-particle abrasion, ground, and overglazed. Veneering porcelain groups were tested: as fired (no additional treatment), ground, and overglazed. Biaxial flexural strength was measured using the ball-on-ring test method. All specimens were loaded to fracture. One and 2-way analysis of variance were used to analyze the data (alpha=.05). RESULTS: The ceramic core discs were significantly (P=.001) stronger than the veneering porcelain discs for the airborne-particle abrasion, as-fired, and ground surface treatments (82 +/- 11 MPa vs 51 +/- 8 MPa and 93 +/- 14 MPa vs 60 +/- 6 MPa, respectively). For the overglazed treatment, there was not a significant difference between the core (115 +/- 1 4 MPa) and the veneer materials (107 +/- 14 MPa). The ground 1-layer core was significantly (P=.015) stronger (93 +/- 14 MPa) than the 2-layer with the core tested in tension (72 +/- 19 MPa). There was no significant difference between 1-layer veneer overglazed (107 +/- 14 MPa) and 2-layer discs when tested with the veneer in tension (105 +/- 16 MPa). CONCLUSION: The overglazed surface treatment significantly improved the strength of the materials tested, as well as the strength of 2-layer discs with the veneer in tension. The veneering porcelain influenced the strength of 2-layer specimens only when tested with the ground ceramic core surface in tension.     

Behçet's syndrome

A dentist referred a 35-year-old woman to the department of oral and maxillofacial surgery because of recurrent aphtous-like changes of the oral mucosa and persisting pain. She also experienced similar complaints about her eyes and genitals. This combination of symptoms was suspect for Beh?et's disease.     

Effect of four different opalescence tooth-whitening products on enamel microhardness

OBJECTIVES: The purpose was to evaluate the effect of various Opalescence tooth-whitening products on enamel. METHODS AND MATERIALS: Enamel blocks were exposed to Opalescence PF 10% Carbamide Peroxide (n = 10), Opalescence PF 20% Carbamide Peroxide (n = 10), Opalescence Trèswhite Supreme 10% Hydrogen Peroxide (n = 10) and Opalescence Quick PF 45% Carbamide Peroxide (n = 10) according to the manufacturer's instructions. The control group was enamel blocks (n = 10) kept in artificial saliva. The values were obtained before exposure and after the 14-days treatment period. Enamel blocks were kept in saliva between treatments. Indent marks on enamel blocks were examined using the scanning electron microscope for treatment effects. RESULTS: All four different Opalescence products damaged enamel. The most damage was done when treated for a long period (112 hours). SEM images also showed damage to enamel by all 4 products. Opalescence with 10% and with 20% Carbamide Peroxide showed the highest damage, which also differed significantly (p < 0.05) from the saliva control group (p < 0.05; Tukey-Kramer Multiple comparison test). CONCLUSION: All 4 Opalescence products damaged enamel. Higher damage was done by the 10% carbamide peroxide and 20% carbamide peroxide products because of the much longer exposure period (112 hours in comparison to 7 hours).     

Growth of oral and skin fibroblasts from patients with oral submucous fibrosis

The purpose of the investigation was to evaluate and compare the proliferation (growth) of mouth fibroblasts and skin fibroblasts from patients with oral submucous fibrosis (OSF). Material comprised fibroblasts from fibrous bands situated in the buccal mucosa and from the inner aspect of the forearm of 8 patients with classic features of OSF as well as fibroblasts from 6 buccal mucosa and 8 skin biopsy specimens from healthy non-areca nut chewing individuals. Cells were cultured for 8 days according to standard techniques. Their growth was monitored daily, under optimal conditions as well as exposure to concentrations of arecoline. The data were analyzed using regression analysis, analysis of variance and the Kruskal-Wallis test. We found no statistically significant differences between the proliferation patterns of oral and skin fibroblasts from patients or between those from patients and controls. The reaction of the cells exposed to concentrations of arecoline was similar; at low concentrations (0.1–10 μg/ml) normal growth was maintained, while 100 μg/ml inhibited growth. It is concluded that fibroblasts from mouths affected by OSF have proliferation patterns which fall within normal parameters, that the excessive collagen formation in established OSF is not due to increased fibroblast proliferation and that arecoline does not stimulate fibroblast proliferation.     

Syndromes 14. Rendu-Osler-Weber disease

The Rendu-Osler-Weber disease is due to an autosomal dominant disease with multiple telangiectasia in skin and mucosa. Recurrent bleeding of the nose is due to telangiectasia of the nasal mucosa. Haemorrhage of the oral mucosa also occurs. Extensive arteriovenous malformations can be present in lungs, liver and brain. Treatment of bleedings in the oral mucosa is easily possible by means of coagulation. Patients with pulmonary arteriovenous malformations should receive prophylactic antibiotic treatment before extractions, removal of third molars and subgingival curettage.     

Caries in children and quality of life

Caries is the most prevalent oral disease in children. The majority of caries in toddlers remains untreated, with toothaches as a consequence. Although toothache is an important determinant of the quality of life, prevalence data on toothaches hardly exist. Research results indicate that children's quality of life improves after caries treatment. The question remains which type of treatment is preferable. To address this question, evidence from randomized controlled clinical trials on various treatment methods is needed.     

Probe penetration in relation to the connective tissue attachment level: influence of tine shape and probing force

Abstract. Previous research has shown that probing force and probe tine shape influence the clinically assessed probing depth. The purpose of the present study was to investigate the effect of tine shape and probing force on probe penetration, in relation to the microscopically assessed attachment level in untreated periodontal disease. In 22 patients, scheduled for partial or full mouth tooth extraction and no history of periodontal treatment, 135 teeth were selected. At mesial and distal sites of the teeth reference marks were cut. Three probe tines, mounted in a modified Florida Probe® handpiece, were tested: a tapered, a parallel and a bail-ended; tip-diameter 0.5 mm. The three tines were distributed at random over the sites. At each site increasing probing forces of 0.10 N, 0.15 N, 0.20 N, 0.25 N were used. After extraction, the teeth were cleaned and stained for connective tissue fiber attachment. The distance between the reference mark and the attachment level was determined using a stereomicroscope. The results showed that the parallel and ball-ended tine measured significantly beyond the microscopically assessed attachment level at all force levels; with increasing forces, the parallel tine measured 0.96 to 1.38 mm and the ball-ended tine 0.73 to 1.06 mm deeper. The tapered tine did not deviate significantly from the microscopic values at the forces of 0.15. 0.20 and 0.25 N. It can be concluded that for the optimal assessment of the attachment level in inflamed periodontal conditions, a tapered probe with a tip diameter of 0.5 mm and exerting a probing force of 0.25 N may be most suitable.     

A global perspective on changes in the burden of caries and periodontitis: implications for dentistry

The structure and contents of most oral health care systems and the contents of dental curricula reflect a deep-rooted tradition for attempting to cure oral diseases by refined technological means. However, better oral health conditions for the world's populations necessitate the application of up-to-date scientific knowledge to control the major oral diseases. This review points out that not only should the structure and contents of oral health care delivery systems be based on state-of-the-art knowledge about the biology of the oral diseases; they must also take into account the trends for change in caries and periodontal diseases within and between populations, and acknowledge the impact of changes in treatment philosophies for these trends. The oral disease profiles for populations in low- and high-income countries are briefly described, and it is concluded that the rapidly changing disease profiles observed in high-income countries necessitate re-thinking of the future role and organization of dentistry in such countries. The priorities for low- and middle-income countries must be to avoid repeating the mistakes made in the high-income countries. Instead, these societies might take advantage of setting priorities based on a population-based common risk factor approach. If such an approach is adopted, the training of personnel with oral health care competence must be rethought. The authors suggest three different cadres of dental care providers to be considered for an approach that allows health care planners in different populations around the world to prioritize appropriate oral health care with due respect for the socio-economic conditions prevailing.