Fracture behavior of structurally compromised non-vital maxillary premolars restored using experimental fiber reinforced composite crowns

PURPOSE: To study the fracture behavior of direct resin composite crowns with or without experimental fiber reinforcement. METHODS: Clinical crowns of single-rooted maxillary premolars were cut off at the cemento-enamel junction. Canals were prepared with Gates Glidden drills up to size 4. No additional post-space preparations were made. Roots were embedded in acrylic and canal entrances were standardized (depth 2 mm, diameter 1.75 mm). Three groups of 14 samples were treated as follows: (1) custom-made glass FRC post (EverStick Post); fibers 5 mm deep in the canal, (2) similar post-system as (1) with incorporation of a new type of glass fiber fabric, (3) no fiber reinforcement (control). Posts were cemented with resin cement (Panavia F). Resin composite crowns (Filtek Z250) were made using an anatomically formed mold. Static load until fracture was applied using a universal loading device with a cylindrical bar (diameter 2 mm) with a crosshead speed of 5 mm/minute (loading angle: 30 degrees to the tooth long-axis). Failure modes were categorized as favorable and unfavorable failures. RESULTS: There was no significant difference in mean failure loads among the four groups (P > 0.05). Favorable failures occurred significantly more often in Group 2 than in the other groups (P < 0.05). The results suggest that an incorporated glass fiber fabric does not affect the load-bearing capacity of resin composite complete crowns on structurally compromised and non-vital premolars. Incorporation of a glass fiber fabric, however, has a beneficial effect on the failure mode.     

What do patients expect from complete dentures?

OBJECTIVES: An investigation was undertaken with the aim of determining whether patients wearing complete dentures in dental hospital (DH) and dental practice (DP) had different expectations from their dentures, together with their requirements for information about denture construction and oral and denture care. METHODS: A total of 214 edentulous patients, with a mean age of 69 years, from DP (125) and DH (89) participated in the questionnaire-based study. A valid questionnaire (P-DEQ) was constructed which demonstrated good test-retest reliability (Cronbach's alpha 0.86). The P-DEQ sought to determine how patients responded to a series of questions related to what dentists are urged to achieve with complete dentures. The questions covered not only what might be termed "normative" expectations but also patients' perceived needs for further information about the stages of prosthodontic treatment and oral or denture care. RESULTS: Significant differences (p< or =0.001) emerged between the two groups; 82% of the DH group thought it essential that their dentures caused no pain compared with 59% of the DP group; for "absence of slackness" (DH 87%; DP 65%), and "good bite" (DH 82%; DP 55%). No significant differences emerged for the other parameters investigated, but both groups had high expectations for ease of chewing, speech, and good appearance. Differences (p<0.05) between the groups also emerged with respect to the demand for more information regarding the stages involved in denture construction (DH 57%, DP 76%) and how to care for dentures (DH 75%, DP 89%). Large proportions of patients from both groups would prefer to have more information about the selection of teeth (71% DH, 72% DP), and how to care for their mouths (84% DH, 86% DP), but there were no differences between the groups in these parameters. CONCLUSIONS: Most patient expectations appear to equate with the normative view expressed in standard prosthodontic texts. However, expectations may differ not only between individuals but also between patient groups managed in teaching hospital and DP settings. Edentulous patients also need information regarding the stages involved in denture construction and how to care for their mouths and dentures. This may have implications for the management of edentulous patients in DP and dental hospital.     

Effect of bur type on microtensile bond strengths of self-etching systems to human dentin

PURPOSE: To compare the microtensile bond strength (microTBS) of five adhesives to human dentin prepared with 600-grit SiC abrasive paper (SiC), a diamond rotary instrument, or a carbide bur. The null hypothesis was that different cavity preparation instruments do not affect adhesion of resin adhesives. MATERIALS AND METHODS: Human molars (n = 45) were randomly divided into three groups according to surface treatment. Each group was bonded using a total-etch adhesive (Single Bond, 3M ESPE), one of three self-etching primer systems (Clearfil SE Bond or ABF, Kuraray; Imperva Fluorobond, Shofu), or a self-etching adhesive (One-Up Bond F, Tokuyama). A 4-mm composite crown was built over the bonded surface. Specimens were stored in water for 24 h at 37 degrees C. They were sectioned into 0.7-mm-thick slabs, trimmed to a cross-sectional area of 1 mm2, and loaded to failure at a crosshead speed of 1 mm/min using a tabletop tester (EZ-Test, Shimadzu). Microtensile bond strength data were analyzed using analysis of variance and Fisher's PLSD test. RESULTS: Surface preparation using a carbide bur generally yielded higher bond strengths than preparation using either a diamond rotary instrument or SiC abrasive paper. SE Bond had the highest mean microTBS of the five adhesives tested. CONCLUSION: Resin-dentin bond strengths can be affected by the type of instrument used to prepare the tooth. Specifically, higher bond strengths might be achieved by using carbide burs rather than diamond cutting instruments.     

Marginal fracture of posterior composite resins

This study assesses the early cavomarginal breakdown of the newer posterior composite resin restorations compared with that of amalgam restorations. A total of 432 posterior composite restorations and 73 amalgam restorations were examined: 121 composite restorations (28%) and 44 amalgam restorations (60%) clinically showed a marginal crevice at some point on the cavosurface margin of the restoration at 6-month, 1-year, and 2-year recalls. The largest single reason for poor marginal adaptation was marginal fracture. Up to 2 years, the marginal integrity of the studied posterior composites was superior to that of an amalgam alloy. It was determined that smaller cavities, greater bulk of resin at the margin (especially at functional cusp areas), and well-finished margins without overfiling seem to reduce the occurrence of marginal fracture on composite resin restorations.     

Ultrastructural examination of human periodontal pockets following the use of an oral irrigation device in vivo

To date, there are no ultrastructural studies that have examined untreated chronic periodontal pockets immediately following dental debridement with an oral irrigation device. This study used both scanning electron microscopic and transmission electron microscopic methodology to examine previously untreated human periodontal pockets after their exposure to a pulsating oral irrigation with saline solution. A comparison of 16 untreated controls with 16 test specimens revealed qualitative differences in microbial morphotypes at various pocket depths. Control specimens at all pocket depths examined (0-6 mm), exhibited a mixed microbial flora consisting of cocci, short rods, and filamentous organisms. Specifically at 3- to 4-mm and 5- to 6-mm levels in control specimens, spirochetes, fusiforms, and branching organisms were obvious. In contrast, test specimens exhibited a few cocci and short rods at 0- to 2-mm and 3- to 4-mm levels and a mixed flora at the 5- to 6-mm level. There was no observable difference between control and test specimens concerning epithelial topography, cavitations, microulcerations, spatial relationships, and individual cell appearance. Both control and test specimens exhibited a mild spirochete invasion of the epithelial strata. Collectively these observations suggest that pulsating oral irrigation effects a qualitative change on subgingival plaque and is not injurious to the soft tissues.     

Experimentally induced resorption cavities in rat molars

The incidence and ultrastructure of resorption cavities were studied in albino rat molars. The transseptal fiber system between the 1st and 2nd maxillary molars in 30 albino rats aged 50 days was transected by buccopalatal incision. Fifty approximal surfaces represented the experimental material. Unaffected interproximal areas and approximal surfaces of adjacent teeth as well as of 10 teeth from five healthy, unoperated rats served as controls. The rats scheduled for operation were assigned to experimental groups each comprising three or four animals. Following injury, the incisional wounds were allowed to heal for 1, 2, 4, 5, 6, 8, 10, 14 and 21 days. The animals were sacrificed by an overdose of pentothal sodium and specimens prepared for light and electron microscopy. Normal, healthy teeth showed no resorption cavities on tooth surfaces facing the interproximal area, in contrast to the observation that minor resorption cavities with cemental repair were regularly present on root surfaces facing periodontal ligament. Following surgical injury, extensive resorption cavities in dentin and cementum developed on experimental surfaces adjacent to the area of wound healing. Arrest of active resorption in some of the experimentally induced cavities had occurred in 14-day specimens. Repair of resorption cavities appeared to start by attachment of connective tissue fibers to exposed dentinal and cemental collagen. The ultrastructural observations indicate that initial fibril attachment to exposed collagen is mediated by a granular, coating material resembling minute deposits of afibrillar cementum.     

Occupational exposure to mercury in dentistry and pregnancy outcome

A questionnaire was mailed to dentists and dental assistants requesting information about work, health, and reproductive history. Statistical analysis of the data indicated that there were no increased rates of spontaneous abortions or congenital abnormalities in the children of men and women who were exposed to low versus high levels of mercury in a dental environment.     

ELISA and conventional techniques for identification of black-pigmented Bacteroides isolated from Periodontal pockets

Conventional biochemical characterization and an ELISA technique were compared for their ability to identify reference cultures and fresh isolates from suppurating and non-suppurating periodontal pockets, as well as healthy gingival sulci in the same individual. Antisera to Bacteroides gingivalis strain 381, Bacteroides intermedius strains 581 and VP1 8944, and Bacteroides melaninogenicus ss. melaninogenicus strain 287 were prepared by immunizing rabbits. The antisera were conjugated with peroxidase and appropriate dilutions were chosen to minimize cross-reactions in the ELISA technique. Conventional characterization of the isolates included cellular and colonial morphology, biochemical characterization, and gas liquid chromatography of acid end products. The antisera appeared to be specific for each black-pigmented species, since cross-reactions were not observed to reference strains of heterologous species. There was a 94% agreement between the ELISA and conventional identifications of over 300 fresh isolates from periodontal sites.
The predominant black-pigmented Bacteroides species isolated from suppurating sites was Bacteroides intermedius using either identification technique. The median value of proportions of this species was significantly increased in the suppurating periodontal pockets (16.5%) when compared to non-suppurating deep periodontal pockets (3%) and healthy gingival sulci (0%). Significant differences in proportions were not observed for the other species of black-pigmented Bacteroides .