| Abstracts
of the October 2007 Issue
Mineral trioxide aggregate as pulp
dressing agent in pulpotomy treatment of primary molars:
42-month clinical study
Myriam Maroto,
dmd, phd,
Elena Barbería,
md, dmd, phd,
dds,
Vicente Vera,
md, phd,
lds &
Franklin García-Godoy,
dds, ms
Abstract:
Purpose: To evaluate the long-term clinical and
radiographical results of using gray mineral trioxide aggregate
(MTA) in pulpotomy treatments in primary molars. Methods:
A total of 69 primary molars were treated with pulpotomy
procedures using MTA and follow-up every 6 months up to 42
months. Results: Clinical success was 100% as none of the
molars showed clinical pathologic signs; radiographical success
was 98.5% as one case of internal resorption was recorded.
Reparative dentin deposition was found as stenosis of the pulp
canals in 84% of the cases 42 months after treatment and as
dentin bridge formation in 83% of the cases 42 months after
treatment. Moreover, 11 permanent successors erupted at their
normal exfoliation time without pathology after pulpotomy
treatment with gray MTA of the primary molars. (Am J Dent
2006;19:283-286).
Clinical
significance: Gray MTA could be considered a reasonable
alternative to the use of formocresol in pulpotomy treatments of
primary molars.
Address: Dr. Myriam Maroto, Department of Prevention,
Pediatric Dentistry and Orthodontics, Faculty of Dentistry,
Complutense University of Madrid, Avda. Complutense sn, Ciudad
Universitaria, 28040 Madrid, Spain. E-:
myriammaroto@yahoo.com
Long-term retrospective study of the
clinical performance of fiber posts
Marco Ferrari,
md, dds, phd,
Maria Crysanti Cagidiaco
md, dds, phd,
Cecilia Goracci,
md, msc, phd,
Alessandro Vichi,
dds, msc, phd,
Pier Nicola Mason,
md, dds,
Ivana Radovic,
dds, msc
& Franklin Tay,
bdsc (hons), phd
Abstract: Purpose: To
retrospectively evaluate the long-term clinical performance of
three types of fiber posts after a service period of 7-11 years.
Methods: 985 posts were included in the study: 615
Composiposts, 160 Æstethic Posts and 210 Æsthetic Plus Posts
were placed into endodontically treated teeth. Four combinations
of dentin adhesives/luting materials were used. Endodontic and
prosthodontic results were recorded. Results: A 7-11%
failure rate was recorded for the three types of posts. A total
of 79 failures were recorded: 39 due to endodontic reasons, one
root fracture, one fiber post fracture, 17 crown dislodgements
and 21 due to post debonding. The mechanical failures were
always related to the lack of coronal tooth structure. The
results indicated that fiber posts in combination with bonding/luting
materials may be used routinely for restoring endodontically
treated teeth. Mechanical failure of restored teeth with fiber
posts can be related to the amount of residual coronal
structure. (Am J Dent 2007;20:287-291).
Clinical significance: The use of
fiber posts in combination with adhesive restorative materials
can provide a long term clinical success in endodontically
treated teeth.
Address: Prof. Marco Ferrari, Department of Restorative
Dentistry and Dental Materials, University of Siena, Policlinico
Le Scotte, Viale Bracci, 53100 Siena, Italy.
E-:
md3972@mclink.it
The use of a flowable ormocer for
bonding brackets
Ascensión Vicente,
dds, phd
& Luis A.
Bravo, md,
dds, ms, phd
Abstract:
Purpose: To evaluate the effectiveness of the
ormocer Admira Flow for bonding brackets. Methods: 45
extracted human premolars were used. They were divided into two
groups: (1) Brackets cemented with the traditional resin
orthodontic bonding system Transbond XT, and (2) Brackets bonded
with Admira Flow. Shear bond strength was measured with a
universal testing machine with a cross-head speed of 1
mm/minute. The adhesive remnant on the tooth after debonding was
quantified using image analysis equipment. Results: No
significant differences were observed in bond strength for
Transbond XT and that of Admira Flow, nor were there significant
differences in the quantity of adhesive remnant left on the
teeth after debonding (P< 0.05). (Am J Dent
2007;20:292-294).
Clinical
significance: Although in vivo studies are necessary,
the results of this study show that Admira Flow could be an
alternative to traditional bracket bonding.
Address: Dr. Ascensión Vicente,
Orthodontic Teaching Unit, Dental Clinic, The University of
Murcia, Hospital Morales Meseguer, 2ª planta, C/Marqués de los
Vélez, s/n. 30008 Murcia, Spain. E-:
ascenvi@um.es
The apical sealing ability of a new
root canal filling material
Emre Bodrumlu,
dds, phd
& Umut Tunga,
dds, phd
Abstract: Purpose: To assess
the apical sealing property of a new root canal filling
material, Epiphany. Methods: Seventy extracted maxillary
and mandibular single-rooted teeth were used. They were randomly
divided into three groups and obturated by lateral condensation
with gutta-percha and AH 26/AH Plus sealers and Resilon core
material and Epiphany sealer. Apical leakage was measured by the
fluid-transport method. Results: The differences in
leakage among gutta-percha with AH 26, gutta-percha with AH
Plus, and Resilon with Epiphany were statistically significant
(P< 0.05). The teeth filled with gutta-percha/AH 26 displayed
the most apical leakage. There were no differences between the
Resilon/Epiphany and gutta-percha/AH Plus groups (P> 0.05). (Am
J Dent 2007;20:295-298).
Clinical significance: Resilon core
material and Epiphany sealer and AH Plus groups were found to be
superior to the gutta-percha and AH 26 in terms of apical
leakage. However, Resilon core material and Epiphany sealer
group was the most likely to give successful results similar to
gutta-percha/AH Plus.
Address: Dr. Emre Bodrumlu, Department of Operative
Dentistry and Endodontics, Ondokuz Mayis University, Faculty of
Dentistry, Kurupelit-Samsun, 55139 Turkey. E-:
bodrumlu@omu.edu.tr
Influence of coffee on reflectance and
chemistry of resin composite protected by surface sealant
Luís Eduardo Silva Soares,
dds, ms, phd,
Ilene Cristine Rosia Cesar,
dds, msc,
Carla Gabriela Couto Santos,
dds,
Ana Luiza Merigo de Oliveira Cardoso,
dds,
Priscila Christiane Suzy Liporoni,
dds, ms, phd,
Egberto Munin,
phys, phd
& Airton Abrahão Martin,
phys, phd
Abstract: Purpose: To assess
the influence of the light-curing unit type and whether or not
it was worth using surface sealant protection on resin composite
restorative materials stained by coffee. Another objective was
to propose the monitoring of coffee staining by FT-Raman
spectroscopy using carbon-hydrogen (C-H) bonds as reference to
the composite matrix degradation. Methods: Sixty
cylindrical specimens of resin composite were prepared and
divided into six groups: HC (control) - cured with a halogen
light; LC (control) cured with a LED; HF - cured with a halogen
light + Fortify Plus; LF - cured with a LED + Fortify Plus; HP -
cured with a halogen light + PermaSeal; LP - cured with a LED +
PermaSeal. After storage for 24 hours at 37% and 100% of
relative humidity, the top surface was protected, and the other
surfaces isolated. Polishing with paper discs was performed
after 24 hours of curing and prior to FT-Raman spectroscopy and
reflectance measurements. All specimens were submitted to coffee
staining for 14 days and evaluated by both systems. Results were
statistically analyzed by ANOVA and Tukey tests. Results:
FT-Raman spectrum only showed significant changes in groups LC
and LP (P< 0.05). Reflectance demonstrated that staining was
present in all specimens protected by sealants. Sealant staining
was larger in the HF (P< 0.001) group. (Am J Dent
2007;20:299-304)
Clinical significance: Significant
chemical changes were observed in the resin matrix cured with
the LED light-curing unit, which produced a larger composite
staining than the halogen light. The Fortify Plus sealant
stained more than the PermaSeal sealant. There are no advantages
to using surface sealants to prevent composite staining, as the
sealants also stained.
Address: Dr. Luís Eduardo Silva Soares, Biomedical
Vibrational Spectroscopy Laboratory, Research and Development
Institute, University of Vale do Paraíba – UNIVAP, Av.
Shishima Hifumi, 2911, Urbanova, 12,244-000,
São José dos Campos, SP, Brazil. E-:
lesoares@univap.br
Morphological characterization of the
interface between self-etching
adhesives and vital dentin
Ali I. Abdalla,
dds, phd
& Albert J. Feilzer,
dds, phd
Abstract:
Purpose: To evaluate the in vivo interface between
one total-etch and two self-etching adhesives to dentin.
Methods: Two self-etching primers, SE Bond and Hybrid Bond
and one total-etch adhesive, Admira Bond, were applied in
vivo to flat dentin surfaces on human teeth scheduled for
extraction. After adhesive application and curing, a thin layer
of resin composite was applied and cured. The teeth were
extracted immediately after adhesive application. All samples
were split fractured along their long axes. Half of the samples
were decalcified and deproteinized to permit visualization of
the hybrid layer. The other halves were completely dissolved to
observe the morphology of resin tags. Results: The
total-etch system Admira Bond showed a thick hybrid layer and
long resin tags, while SE Bond showed very thin hybrid layer
with short resin tags. The findings of Hybrid Bond were similar
to that of Admira Bond. (Am J Dent 2007;20:305-308).
Clinical
significance: The interaction between total-etch adhesives
and vital dentin is characterized by the formation of hybrid
layer and long resin tags. For the self-etching primer, the
interaction was mainly superficial. For the single-bottle,
self-etching adhesive, the thick hybrid layer dissolved when
challenged by acid/base treatment.
Address:
Dr. A.I. Abdalla, Faculty of Dentistry, University of Tanta,
Tanta, Egypt. E-:
aliebraheem01@yahoo.com
Tooth whitening through the removal
of extrinsic stain with two sodium
hexametaphosphate-containing whitening dentifrices
Geza T.
Terézhalmy,
dds, ma,
Aaron R. Biesbrock,
dmd, phd,
ms,
Svetlana Farrell,
dds, phd,
Matthew L.
Barker,
phd
& Robert D. Bartizek,
ms
Abstract:
Purpose: To evaluate the tooth whitening benefit through
stain removal delivered by a marketed whitening dentifrice
(Crest Vivid White) used twice a day or a combination regimen of
two marketed dentifrices (Crest Vivid White Night used at night
and Crest Cavity Protection used in the morning) relative to a
positive control over a 2-week period. Methods: Both
studies were randomized, two treatment, parallel group,
examiner-blind, 2-week clinical trials involving 22 and 30
healthy adults with longstanding visible extrinsic stain on the
facial surfaces of at least six anterior teeth. In each study,
subjects were randomized to one of two treatments: a sodium
fluoride/sodium hexametaphosphate whitening dentifrice used
alone (Study 1) or in combination with a cavity protection
dentifrice (Study 2) with an ADA reference manual toothbrush
versus a control power toothbrush with a cavity protection
dentifrice (both studies). Results: In both studies, all
treatment groups statistically significantly (P< 0.001) reduced
baseline stain scores following 1 and 2 weeks of brushing. After
2 weeks, the whitening dentifrice used twice daily had a median
percent stain removal of 90% and the night-time whitening
dentifrice (used once a day) in combination with the cavity
protection dentifrice had a median percent stain removal of 85%
while powered toothbrush groups showed median percent stain
removal of 88-89% in both studies. Stain removal scores after 1
and 2 weeks of brushing did not differ significantly between the
two treatment groups in either study. (Am J Dent
2007;20:309-314).
Clinical
significance: These clinical studies showed that a sodium
hexametaphosphate whitening dentifrice used twice daily and a
regimen of sodium hexametaphosphate whitening dentifrice used at
night with a cavity protection dentifrice used in the morning
whiten teeth through extrinsic stain removal.
Address:
Robert D. Bartizek, The Procter & Gamble Company, 8700
Mason-Montgomery Rd., Mason, OH 45040-9462, USA. E-:
bartizek.rd@pg.com
A randomized controlled trial of home
tooth-whitening products
Edward C.M. Lo,
bds, phd,
Anthony H.H. Wong,
bds, mds
& Colman McGrath,
b dent
sc, phd
Abstract:
Purpose: To evaluate the effectiveness of two marketed home
tooth-whitening products. Methods: A randomized
controlled clinical trial involving 87 adults who were randomly
allocated into one of three groups: (1) 6% hydrogen peroxide
whitening strips, (2) 18% carbamide peroxide whitening gel, and
(3) a placebo (fluoride toothpaste) control group. Subjects were
instructed individually and then used the given product daily
for 2 consecutive weeks. Color was determined in brightness
(L*), yellowness (b*) and redness (a*) [color space] at baseline
and 8 weeks after dispensing the product by employing a high
resolution digital camera (Fuji HC1000 CCD) to image the
subject’s anterior maxillary teeth under standard polarized
lighting conditions. The subjects also completed a questionnaire
on self-satisfaction with the treatment outcome. Results:
One-way ANOVA (Bonferroni test) demonstrated significant
differences in color between the three groups with changes in
brightness (L*, P< 0.001), yellowness (b*, P< 0.001) and redness
(a*, P< 0.001). Changes in L* a* b* was greatest among those who
used the 6% hydrogen peroxide whitening strips. Subjects in the
whitening strip group also rated that product significantly (P<
0.01) more favorably than other groups with respect to the
amount of whiteness improvement, as well as whitening
satisfaction and overall impression while there is no
significant difference between the whitening gel and the placebo
groups. (Am J Dent 2007;20:315-318).
Clinical
significance: This study found that Crest Whitestrips (6.5%
hydrogen peroxide) and Colgate Simply White (18% carbamide
peroxide) are both effective in tooth whitening with the former
being more effective.
Address: Prof. Edward C. M. Lo, Faculty of Dentistry, The
University of Hong Kong, 34 Hospital Road, Hong Kong.
E-:
edward-lo@hku.hk
Shear bond strength of resin composite
to enamel and dentin submitted to a carbamide peroxide
dentifrice
Bruna Maria Covre Garcia da Silva,
dds,
Flávia Martão Flório,
dds, ms, scd
& Roberta Tarkany Basting,
dds, ms, scd, phd
Abstract:
Purpose: To assess the shear bond strength of resin
composite to human enamel and dentin after using a whitening
dentifrice containing carbamide peroxide for 21 days.
Methods: Thirty enamel and 30 dentin slabs were embedded,
flattened and randomly divided into three groups (n=10) that
received different treatments: carbamide peroxide containing
dentifrice (Rembrandt Plus), fluoride containing dentifrice
(Close Up with fluoride), and immersion in artificial saliva as
the control group. Applications were made for a 15-minute period
daily, immersing the slabs in a suspension with distilled water
and dentifrice in the ratio of 3:1 (weight) for 21 days. For the
rest of the time, the slabs were kept in an artificial saliva
solution. After the last application, an adhesive system (Single
Bond) was used to bond resin-based composite cylinders (Z100) to
the enamel and dentin surfaces for the shear bond strength
tests. These tests were carried out in a universal testing
machine at a speed of 0.5 mm/minute. Results: ANOVA and
the Tukey test for enamel and Kruskal-Wallis and the Dunn Method
for dentin, showed significant differences between slabs treated
with Rembrandt Plus (REM) and the artificial saliva control
group, with higher values for REM (P< 0.05). There were no
differences in mean bond strengths of enamel and dentin treated
with Close Up with fluoride (CLO) and REM, nor were any
differences shown between CLO and the artificial saliva control
group. A whitening dentifrice containing carbamide peroxide
increased the bond strength of restorative systems. (Am J
Dent 2007;20:319-323).
Clinical
significance: Enamel and dentin slabs treated with a
whitening dentifrice containing carbamide peroxide produced
greater mean shear bond strength values. Dentifrices containing
carbamide peroxide changed the shear bond strength of
restorative systems to enamel and dentin, but may be
insignificant in a clinical situation.
Address: Prof. Dr. Roberta
Tarkany Basting, Faculty of Dentistry and Dental Research Center
São Leopoldo Mandic, Department of Restorative Dentistry -
Operative, Rua José Rocha Junqueira, 13 Bairro Swift, Campinas,
SP, CEP: 13045-755, Brazil. E-:
rbasting@yahoo.com
Enamel microhardness and shear bond
strength after treatment
with an 18% carbamide peroxide bleaching varnish
Robson Tetsuo Sasaki, Cinthia Maria Barbosa,
dds,
Flávia Martão Flório,
dds, ms scd
& Roberta Tarkany Basting,
dds, ms scd, phd
Abstract: Purpose: To
evaluate the microhardness and shear bond strength of human
enamel treated with an 18% carbamide peroxide bleaching varnish.
Methods: 40 dental enamel slabs were embedded and ground
flat, dividing them into four groups (n=10) which received the
varnish application for 14 consecutive days: (G1) one daily
varnish application; (G2) two daily varnish applications with an
interval of 15 minutes; (G3) two daily varnish applications with
an interval of 5 hours. After varnish application, the slabs
were immersed in artificial saliva changed daily. The control
group (G4) consisted of slabs (n=10) that did not receive any
varnish treatment and were maintained in artificial saliva for
14 days. Microhardness tests were performed with Knoop
indentation with a load of 25 grams for 5 seconds at the
beginning of the treatment (baseline values) and after 7 and 14
days. Cylinders were made with microhybrid resin composite and
one-bottle adhesive system for shear bond strength tests. Using
a universal testing machine with a speed of 0.5 mm/minute to
obtain the values in MPa. Results: The Kruskal-Wallis
test showed no changes in microhardness values among groups
after 7-day varnish application, although there was a decrease
in microhardness values when using an 18% carbamide peroxide
varnish twice a day with a time-interval of 5 hours between
applications (P< 0.05). For enamel shear bond strength, ANOVA
test (P> 0.05) did not show significant differences among the
groups (G1=15.8; G2=15.2; G3=19.0; G4=15.1). (Am J Dent
2007;20:324-328).
Clinical significance: A bleaching
varnish containing 18% carbamide peroxide did not affect enamel
mineral content if used for a 7-day treatment, independent of
the protocol chosen. However, changes in enamel mineral content
were observed if used twice a day with a 5-hour time interval
after 14 days treatment, although restorative procedures are
recommended after 7 days post bleaching treatment.
Address: Prof. Dr. Roberta Tarkany Basting, Faculty of
Dentistry and Dental Research Center São Leopoldo Mandic,
Department of Restorative Dentistry - Operative, Rua José Rocha
Junqueira, 13 Bairro Swift, Campinas, SP, CEP: 13045-755,
Brazil. E-:
rbasting@yahoo.com
Comparison of the effect of storage
media on hardness and shear punch strength of tooth-colored
restorative materials
Rafat Bagheri,
phd,
Martin J. Tyas,
bds, phd
ddsc & Michael F. Burrow,
mds, phd,med
Abstract:
Purpose: To measure the surface hardness and shear punch
strength of six tooth-colored restorative materials before and
after immersion in acidic and alkaline solutions. Methods:
Specimens were prepared from three resin composites; Ceram
X, Filtek Supreme, Point 4, two polyacid-modified resin
composites; Dyract, F2000, and one resin-modified glass-ionomer
cement; Fuji II LC, immersed in distilled water for 24 hours at
60°C, polished with silicon carbide papers up to 2000-grit and
subjected to baseline measurement for Vickers hardness or shear
punch strength. Further specimens were transferred to one of
four aqueous media at 60°C for a further 2 weeks; distilled
water, 0.01 mol/L lactic acid, 0.1 N NaOH or coffee 15g /500mL,
washed, dried and tested for final hardness or shear punch
strength. Results: Data analysis using ANOVA and Tukey’s
test showed that the hardness and shear punch strength values
were material and solution dependent. Regardless of the
solutions; the hardness of F2000 was the highest and Fuji II LC
the lowest; Point 4 and Filtek Supreme had the highest shear
punch strength; Fuji II LC and F2000 had lowest. NaOH
significantly reduced the hardness of all materials and
completely dissolved the structure of Fuji II LC. Lactic acid
and coffee significantly increased shear punch strength compared
to baseline. (Am J Dent 2007;20:329-334).
Clinical
significance: Within the parameters of this study, the
mechanical properties of the restorative materials were affected
by immersion in various solutions. Regardless of the storage
medium, for the shear punch strength, resin composites were
significantly stronger than the PAMRCs, which in turn were
significantly stronger than the RM-GIC.
Address:
Dr. Martin J. Tyas, School of Dental Science, 720 Swanston
Street, Melbourne 3010, Australia. E-:
m.tyas@unimelb.edu.au
Shade distribution of commercial resin
composites and color difference with shade guide tabs
Seung-Kook Park,
dds
& Yong-Keun Lee,
dds, phd
Abstract: Purpose: To determine the shade distribution of
varied shades of contemporary resin composites, and to measure
the color difference (∆E*ab)
between individual shades of resin composites and the nearest
shade tabs, which showed the smallest color difference with each
shade of resin composite, in the VITA shade guide. Methods:
Eight light-curing resin composites, with a total of 41 shades,
were studied. Color of specimens was measured on a reflection
spectrophotometer over a white background. Ranges and
distributions of CIE L*, C*ab,
a* and b* values of each brand of resin composites
were determined. Color difference between each shade of resin
composites and each shade of the shade guide tabs were
calculated, and the nearest shade guide tab was selected.
Results: The range of CIE L* value for eight brands
of resin composites was 3.2-9.0, that of C*ab
was 2.5-11.6, that of CIE a* value was 1.1-5.8, and that
of CIE b* value was 5.9-11.5. Color differences (∆E*ab)
between each shade of resin composites and the nearest shade tab
of the shade guide was 0.9-12.8. (Am J Dent
2007;20:335-339).
Clinical
significance: Color distribution ranges for each brand of
resin composite varied depending on the brand of resin
composite, and the color differences between each shade of the
resin composite and the nearest shade tab of a shade guide was
rated unacceptable in 34 of 41 shades of resin composites. This
study supports the clinical practice of curing a small sample of
resin composite on the tooth to select the desired shade before
initiating restorative procedures.
Address: Dr. Yong-Keun Lee, Department of Dental
Biomaterials Science and Dental Research Institute, School of
Dentistry, Seoul National University, 28 Yeongeon-dong,
Jongro-gu, Seoul, Korea. E-:
ykleedm@snu.ac.kr
Oral piercing: Complications and side
effects
Liran Levin,
dmd
& Yehuda Zadik,
dmd
Abstract:
Purpose: To review current relative literature on oral
piercing regarding its prevalence, complications and possible
side effects An increasing number of patients present to their
treating dental professionals wearing jewelry inserted into the
peri-oral and intra-oral tissues. Since the literature is mainly
confined to individual cases or a small series of patients, it
is difficult to assess the magnitude of risks that face
individuals with oral piercing. Methods: The current
study was based on scientific literature published in English
regarding oral piercing. A Medline search, using the PubMed
Bibliographic Index to identify clinical articles published
between January 1992 and August 2007, found 11 articles on the
prevalence of oral piercing, and/or on the prevalence of
complications and side effects. Results: Three studies
reported the prevalence of oral piercing (ranging from 3.4% to
20.3%). Immediate post-operative complications reported were
swelling and/or infections (24%-98%), pain or tenderness
(14%-71%), and bleeding or hematoma. Jewelry-related
complications mainly consisted of tooth fractures and wear
(14%-41%) and gingival recessions (19%-68%). (Am J Dent
2007;20:340-344).
Clinical
significance: Dental professionals should be aware of the
increasing number of patients with pierced oral sites and should
be able to provide appropriate guidance to patients
contemplating body piercing of oral sites.
Address: Dr. Liran Levin, Department of Oral Rehabilitation,
The Maurice and Gabriela Goldschleger School of Dental Medicine,
Tel Aviv University, Tel Aviv, Israel. E-:
liranl@post.tau.ac.il
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