Research Article
Wear of an ion-releasing powder/liquid polymer resin
in relation to that of glass-ionomer and conventional resin composites
Siegward Dietmar Heintze, dmd, phd, Gabriele Zellweger & Arnd Peschke, dmd
Abstract: Purpose: To evaluate the wear in vitro of a new ion-releasing
powder/liquid polymer resin in relation to that of glass-ionomer derivatives
and conventional composites. Methods: Flat specimens (eight per material) of the ion-releasing powder/liquid polymer
resin Cention N, five resin-modified glass-ionomer
cements [ChemFil Rock, Equia Fil (with and without coating), Fuji II, Photac Fil, Riva], six
conventional glass-ionomer cements (Fuji IX, Fuji IX GP, Ionofil Molar, Ketac Fil Plus, Ketac Molar, Ketac Universal),
and two popular conventional resin composites (CeramX, Filtek Z350 XT) were processed and luted to aluminum holders. After storage in water at 37°C
for 24 hours, the specimens were polished to 2,500 grit and subjected to the Ivoclar wear method, which
mainly simulates attrition wear using a commercially available chewing
simulator. A standardized stylus made of pressable ceramic (IPS Empress) hits flat specimens 120,000 times with a 5 kg weight and
a lateral movement of 0.7 mm under constant exchange of water at different
temperatures (5°C/55°C). The vertical loss was measured on plaster replicas
with a laser scanner and 3D software. The Ivoclar wear method moderately correlates with clinical wear. Results: The mean vertical wear of the resin-modified glass-ionomer
cements was statistically significantly higher, between 616±44 µm (Ionofil Molar) and 946±101 µm (Fuji IX GP) than that of the
ion-releasing polymer resin Cention N (327±63 µm)
(ANOVA post-hoc Tukey B, P< 0.01), which was in
the same statistical group of the conventional resin CeramX (323±31 µm). Filtek Z350 XT showed significantly
lower wear (221±19 µm) (ANOVA post-hoc Tukey B, P<
0.05). The materials ChemFil Rock (39±13 µm), Photac Fil (41±9 µm), and Fuji II
(42±8 µm) had the lowest antagonist wear, while Ketac Fil Universal (143±37 µm) and CeramX (135±13 µm) had the highest antagonist wear. Antagonist wear for Cention N was somewhere in between (90±21 µm). (Am J Dent 2020;33:171-177).
Clinical significance: For the restoration of posterior
Class II and large Class I restorations, resin-based materials should be chosen
over resin-modified or conventional glass-ionomer cements.
Mail: Dr. Siegward
D. Heintze, Ivoclar Vivadent AG, Bendererstrasse 2, FL-9494 Schaan, Liechtenstein.
E-mail: siegward.heintze@ivoclarvivadent.com
Research Article
Resin cement removal from titanium dental implant
surface using a novel side-firing laser fiber and Er,Cr:YSGG irradiation
Christopher J. Walinski, dds & Keng-Liang Ou,
ms, phd
Abstract: Purpose: To evaluate the influence of an erbium, chromium:
yttrium, scandium, gallium, garnet (Er,Cr:YSGG)
laser using multiple tip types, on the removal of retained cement on a titanium
implant surface. Methods: Nine
titanium dental implants were coated with a non-eugenol resin composite implant cement. An Er,Cr:YSGG device at a wavelength of 2,780 nm was fitted
sequentially with three laser fiber tips: (1) 6 mm long, 600 µm diameter
end-firing, quartz; (2) 9 mm long, Radial-Firing Perio Tip, 500 µm diameter, quartz; and (3) 18 mm long Side-Firing Tip, 800 µm × 300
µm, sapphire. Irradiation on the implant surfaces was performed in short pulse
mode (140 µsec pulse duration) with output power of 1.5 W, 50% water, 40% air,
and either: (1) 15 Hz, 100 mJ/pulse; (2) 30 Hz, 50 mJ/pulse; or (3) 40 Hz, 37.5 mJ/pulse.
Three trials each were completed for each of three different fiber tip types
for a total of 27 trials (three trials for each of the nine groups). Results: All samples in Groups 1-6
demonstrated complete removal of cement from the implant surface. SEM inspection
revealed a high degree of melting of the resin composite cement on the implant
surface in all samples treated with 100 mJ/pulse
(Groups 1, 2, 3). At 50 mJ/pulse
(30 Hz), the results of the end-firing and side-firing tips improved
remarkably, with clean implant surfaces and comparatively little melting. The
side-firing fiber at 50 mJ/pulse and 30 Hz provided
the best overall combination of cement removal and least amount of residual
melted material on the implant surface. Based on the limitations of this study,
the most appropriate method of removing residual cement from a TiUnite coated titanium implant surface is by using an Er,Cr:YSGG laser device fitted
with a side-firing laser tip. Laser parameters of 50 mJ/pulse
and 30 Hz (1.5W average power), with at least 50% water and 40% air in the
aerosolized water spray are ideal. (Am J
Dent 2020;33:178-182).
Clinical significance: As the presence of peri-implantitis continues to increase in numbers and
severity, it is imperative to have a predictable treatment protocol to address
the large number of ailing and failing implant cases. This study offers one
solution to the problem of peri-implantitis,
especially if caused by retained cement. Optimal laser settings are proposed
for surface decontamination and treatment.
Mail: Dr.
Christopher J. Walinski, Touro College of Dental
Medicine, New York Medical College, 19 Skyline Drive, Hawthorne, NY 10532, USA.
E-mail: christopher.walinski@touro.edu
Research Article
Effects of toothpaste containing surface
pre-reacted glass-ionomer (S-PRG)
Toshiyuki Suge, dds, phd & Takashi Matsuo, dds, phd
Abstract: Purpose: To examine
the acid resistance of experimental toothpaste containing different wt% of
surface pre-reacted glass-ionomer (S-PRG) filler. Methods: Hydroxyapatite (HAP) pellets
were treated with toothpaste containing 0, 1, 5, 10, 20, or 30 wt% S-PRG filler
for 5 minutes. A demineralization and remineralization cycle were repeated for 7 days. The demineralized depths of the pellets were measured using a surface roughness analyzer. The crystallinity of both HAP and dicalcium phosphate dehydrate (DCPD) after the S-PRG treatment was measured by a powder
X-ray diffraction (XRD) analysis. Fluoride gel (9,000 ppmF)
was used for comparison. Results: The demineralizd depth decreased with increases in
the S-PRG filler concentration. The demineralized depth with the 30 wt% S-PRG treatment (4.6 µm ± 2.0) was slightly greater than
that with the fluoride gel (3.3 µm ± 0.5), but not significantly different
(P< 0.05). However, significant differences were observed in demineralized depths between the fluoride gel and the other
wt% of S-PRG tested (P< 0.05). In the XRD analysis, no crystallinity changes were noted in HAP or DCPD after the S-PRG or fluoride gel treatments.
The formation of calcium fluoride was not detected in any treatment group. (Am J Dent 2020;33:183-186).
Clinical
significance: The
results demonstrated the effectiveness of the toothpaste containing 30 wt%
S-PRG filler for inhibiting the demineralization of HAP pellets. However, the toothpaste
containing S-PRG filler prevented demineralization less effectively than the fluoride
gel.
Mail:
Dr. Toshiyuki Suge, Department of Conservative Dentistry, Institute of
Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8504, Japan. E-mail: suge@tokushima-u.ac.jp
Research Article
Effect of a continuous mechanical polishing protocol and toothbrushing on the surface roughness of acrylic resin teeth
Giovanna Guerreiro Guimarães, dds, Marina Fiuza Sarte, dds, Joel Oliveira Barreto, dds, msc,
Karina Matthes de Freitas-Pontes, dds, msc, phd & Romulo Rocha Regis, dds, msc, phd
Abstract: Purpose: To evaluate in vitro the effect of a continuous mechanical polishing protocol, performed in different periods, on the surface roughness of acrylic resin teeth subjected to toothbrushing (Br). Methods: Artificial acrylic teeth (n=30) were randomly divided into three groups according to the polishing protocol and toothbrushing (Br): Br; Br+Pol15 (Br associated with a biweekly polishing); Br+Pol30 (monthly polishing). Br group was subjected to a total of 89,000 brushing cycles. Polishing was performed by applying aluminum oxide paste to the specimens with a felt wheel coupled to an electric motor (5 seconds, 3,000 rpm) after each 741 and 1482 brushing cycles for Br+Pol15 and Br+Pol30 groups, respectively. A contact profilometer and an analytical balance were used to measure surface roughness and mass changes before (T0) and after 1, 2, 3, and 5 years (T4) of simulated toothbrushing. Scanning electron microscopy (SEM) images were obtained. Differences among groups were tested by means of two-way ANOVA/Bonferroni tests (P= 0.05). Results: Toothbrushing gradually increased surface roughness [T0 – 0.16 (0.01); T4 - 0.30 (0.10); P< 0.001]. The tested polishing promoted a significant roughness reduction (P< 0.001) for both biweekly [T4 - 0.09 (0.01)] and monthly [T4 - 0.13 (0.02)] regimes, and it did not influence the mass alterations caused by toothbrushing. SEM showed a smoother aspect of the material surface subjected to biweekly polishing with less defects caused by brushing abrasiveness. (Am J Dent 2020;33:187-190).
Clinical significance: In order to reduce the effects of various deleterious factors on the properties of acrylic resin for removable prostheses during their period of use, a frequent mechanical polishing protocol could increase clinical performance and extend the lifespan of these appliances. Furthermore, a polishing protocol by means of a simple technique could be employed by patients in a home environment.
Mail: Dr. Romulo Rocha Regis, Department of Restorative Dentistry, Federal University of Ceará, Alexandre Baraúna St. 949, Rodolfo Teófilo, Fortaleza, CE, 60430-160, Brazil. E-mail: romuloregis@hotmail.com
Research
Article
Effect of saliva and beverages on the surface
roughness and hardness of acrylic resin modified with nanomaterial
Mirian Maiumi Muraishi Kamimura, dds, Denise Tornavoi de Castro, phd, Mariana
Lima da Costa Valente, phd & Andréa Cândido dos Reis, phd
Abstract: Purpose: To evaluate
the surface roughness and hardness of thermopolymerized acrylic resin incorporated with nanostructured silver vanadate (AgVO3) subjected to saliva and
beverages. Methods: The 128
specimens (5×5×2 mm) were prepared in thermopolymerized acrylic resin, according to the AgVO3 concentrations (n=32): 0%,
2.5%, 5% and 10%. The roughness and hardness were analyzed before and after
immersion in saliva, Coca-Cola, orange juice and red wine, for 12 and 24 days.
2-way ANOVA and Bonferroni test (α= 0.05) were
performed. Results: After 12 days,
Coca-Cola caused the highest roughness increase in the 2.5% group). The 10%
group with saliva presented a higher roughness increase (P= 0.009). The control
presented a decrease in roughness when in beverages (P< 0.05). After 24
days, orange juice and Coca-Cola produced a higher decrease in roughness in the
control group (P< 0.05). After 12 days, saliva and wine produced a higher
decrease in hardness of the 2.5% group (P< 0.05). Coca-Cola produced a
decrease in hardness and wine an increase in hardness
in the group with 10% AgVO3 concentration (P< 0.05). After 24
days, the group with 2.5% presented the highest decrease in hardness (P<
0.05). The immersions produced decreased hardness in the acrylic resin.
Initially, there was an increase in roughness, however, over time, it
decreased. (Am J Dent 2020;33:191-195).
Clinical significance: The control of oral biofilm is
fundamental for the maintenance of the patient’s oral health; however the
incorporation of antimicrobial nanomaterial into
prosthetic materials frequently exposed to saliva and beverages in the oral
cavity interfered with the physical-mechanical properties of the products
tested.
Mail: Dr. Andréa Cândido dos Reis, Av. do Café,
s/nº - Ribeirao Preto - SP 14040-904, Brazil. E-mail: andreare73@yahoo.com.br
Research Article
The effect
of silver diamine fluoride and cleaning methods on
bond strength
of glass-ionomer cements to caries-affected dentin
Paulo Vitor Fernandes Braz, dds, ms, Andressa Fabro Luciano dos Santos, dds, ms, phd, Soraya Coelho Leal, dds,
ms, phd, Patrícia Nóbrega Rodrigues Pereira, dds, phd & Ana Paula Dias Ribeiro, dds, ms, phd
Abstract:
Purpose: To evaluate the effect
of silver diamine fluoride (SDF) application on the microshear bond strength (MBS) of glass-ionomer cements
(GIC) to caries-affected dentin (Part 1) and dentin cleaning methods to reduce
SDF’s potential effect on MBS (Part 2). Methods: For Part 1, 56 extracted human teeth were randomly divided into eight groups
with GIC, 38% SDF application and dentin substrate. Samples of artificial
caries-affected human dentin were treated or not with 38% SDF and restored with
conventional or resin-modified GIC. The same procedures were performed in sound
dentin tested for MBS test after 24 hours. In Part 2, different dentin cleaning
agents (water, aluminum oxide, and pumice slurry) were tested after SDF
application. The procedure was performed on the group that presented the worst
values for MBS in Part 1. Fracture mode was evaluated under scanning electron
microscope. Data were statistically analyzed by ANOVA. Results: MBS was affected by the presence of caries and the type of
material, with the conventional GIC the most affected (P< 0.05). Pumice
slurry was superior in comparison to the other agents in cleaning SDF-treated
dentin. Fracture evaluation showed more mixed failures in all the groups. (Am J Dent 2020;33:196-200).
Clinical significance: Clinicians should have caution when selecting the glass-ionomer cement (GIC) for restorations in silver diamine fluoride (SDF)-treated dentin. The mechanical properties of conventional GIC restorations were more affected than resin-modified GICs. Pumice slurry was the most effective cleaning method to minimize the negative effect of SDF on dentin.
Mail: Dr. Ana Paula Dias Ribeiro, Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL 32610, USA. E-mail: aribeiro@dental.ufl.edu
Research Article
Effect of biofilm exposure on marginal integrity of
composite restorations
Amanda Mahammad Mushashe, dds, msc, Sarah
Aquino de Almeida, dds, msc, Jack Libório Ferracane, msc, phd,
Abstract: Purpose: To evaluate the effect of
bacterial exposure on the marginal integrity of dentin-resin interfaces for
composites with and without bioactive glass (BAG). Methods: Cavity preparations of 5 mm width and 1.5 mm depth were
machined into dentin disks by means of a computer controlled milling system.
After applying the bonding agent, cavity preparations (n=3-5) were restored by
incremental technique with experimental resin composites (50:50 BisGMA/TEGDMA: 72wt% filler) with different filler
compositions: control – 67 wt% silanated strontium
glass and 5wt% aerosol-silica filler and BAG – 57 wt% silanated strontium glass and 15 wt% BAG-65 wt% silica. Samples were then stored in
sterile Todd-Hewitt media or co-incubated with Streptococcus mutans (UA 159), at 37°C,
5% CO2 for 1-2 weeks. For samples co-incubated with a living
biofilm, a luciferase assay was performed in order to
assess its viability. Surfaces were impressed before and after
each storage condition and replicas examined in a scanning electron
microscope. Using image analysis software (Image J), the discontinuous margins
percentage (%DM) was quantitatively assessed. Data were analyzed using two-way
ANOVA followed by Tukey’s test (α= 0.05). Results: Gap size ranged between 7-23
µm. The bacterial exposure significantly increased the %DM in both groups
predominantly due to the formation of new gap regions. There was no difference
between control and BAG composites regarding %DM and the biofilm viability.
Bacterial exposure promoted degradation of composite restoration marginal
integrity, with no difference between composites with and without BAG. (Am J Dent 2020;33:201-205).
Clinical significance: The samples incubated with
living biofilm had a higher gap percentage in the margins, confirming the
negative effect of cariogenic bacteria on margin
degradation. The parameters defined for such synergy can help to understand the
multi-factorial aspect of marginal discontinuity and therefore, predict the
behavior of composite restorations subjected to the challenging oral
environment.
Mail: Dr. Gisele Maria Correr,
School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo. Rua Professor Pedro Viriato
Parigot de Souza 5300, Campo Comprido, Curitiba – PR 81280-330 Brazil. E-mail: gmcnolasco@gmail.com
Research Article
Dentin
moisture does not influence postoperative sensitivity in posterior
restorations: A
double-blind randomized clinical trial
Andrea
dos Santos de Castro, dds, msc, Bianca
Medeiros Maran, dds, msc, phd, Mario Felipe Gutiérrez, dds, msc, phd, Eveline Claudia
Martini, dds, msc, Fabiana Dias Simas Dreweck, dds, msc, Luján Mendez-Bauer, dds, msc, phd, Alessandra
Reis, dds, phd & Alessandro Dourado Loguercio, dds, msc, phd
Abstract: Purpose: This double-blind, randomized clinical trial evaluated the influence of dentin moisture on postoperative sensitivity (POS) in posterior restorations using a simplified etch-and-rinse adhesive, until 12 months of clinical service. Methods: 90 restorations were inserted in 45 patients to treat carious lesions or to replace existing posterior restorations with a depth ≥ 3 mm. After cavity preparation, the simplified etch-and-rinse adhesive (Adper Single Bond 2) was applied on dry or wet dentin followed by a bulk-fill resin composite (Filtek Bulk Fill) under rubber dam isolation. The patient’s spontaneous and stimulated POS was evaluated at baseline and after 7 days, 6 months, and 12 months of clinical evaluation. The secondary parameters (marginal discoloration, marginal adaptation, fracture and recurrence of caries) were evaluated by World Dental Federation (FDI) criteria after 7 days, 6 and 12 months of clinical evaluation. Results: No significant spontaneous and stimulated POS was observed when dry and wet dentin were compared (P> 0.05). A significant and higher risk of spontaneous POS (18.6%; 95% CI 9.7 to 32.6) occurred up to 48 hours after restoration placement for both groups when compared to all evaluation times (P< 0.03). However, the intensity of POS was mild at up to 48 hours with a difference between the dry and wet dentin groups (P> 0.79). When secondary parameters were evaluated, no significant difference between the groups were observed (P> 0.05). (Am J Dent 2020;33:206-212).
Clinical significance: The moisture level of the dentin substrate in posterior restorations does not influence POS in bulk-fill resin composite posterior restorations when associated with an etch-and-rinse ethanol-based adhesive system.
Mail: Prof. Dr. Alessandro D. Loguercio, Rua Carlos Cavalcanti, 4748 Bloco M, Sala 64-A, Uvaranas, Ponta Grossa, Paraná 84030-900, Brazil. E-*: aloguercio@hotmail.com
Research Article
Clinical and radiographic evaluation of high
viscosity bulk-fill resin composite restorations
Luiza Salles Alves Berti, dds, ms, Cecilia Pedroso Turssi, dds, ms, phd, Flávia
Lucisano Botelho do Amaral, dds, ms, phd, Roberta
Tarkany Basting, dds, ms, phd, José Luiz Cintra Junqueira, dds, ms, phd, Francine
Kuhl Panzarella, dds, ms, phd, André Figueiredo Reis, dds, ms, phd & Fabiana Mantovani Gomes França, dds,
ms, phd
Abstract: Purpose: To perform a clinical and
radiographic evaluation comparing Filtek Bulk Fill
high viscosity bulk-fill resins with Filtek Z350 XT nanoparticulate for 1 year. Methods: 58 restorations were performed for each material (bulk-fill
and nanoparticulate), for a total of 116 restorations.
Among these, 42 Class I and 16 Class II restorations were performed for each
group, in molars and premolars. Clinical evaluation was performed 7 days
(baseline), 6 months and 1 year after restorations, using the World Dental
Federation (FDI) criteria. Radiographs were obtained at 7 days and 1 year after
the restoration was placed and the radiopacity was
measured using Image J software at the same time interval. Results: Of the 70 restorations available for evaluation at 1 year,
the Mann-Whitney and Friedman tests showed no statistically significant
difference for the FDI criteria analyzed. Greater radiopacity was observed for bulk-fill resin compared to nanoparticulate (two-way ANOVA, P= 0.022). This same test showed no difference in radiopacity between the groups in the two evaluation
periods (P= 0.062). The high viscosity bulk-fill resin composite presented
similar clinical performance to nanoparticulate resin
in this evaluation period and higher radiopacity was
observed for this material when compared to nanoparticulate resin, in both time periods. (Am J Dent 2020;33:213-217).
Clinical significance: The high
viscosity bulk-fill resin composite showed similar performance to the nanoparticulateresin
during the evaluation period of 1 year. Radiopacity showed high values for the bulk-fill resin when compared to nanoparticulate resin. The bulk-fill resin has potential to be used in posterior teeth.
Mail: Profa.
Dra. Fabiana Mantovani Gomes França, Faculty São Leopoldo Mandic, Research
Institute São Leopoldo Mandic, Rua José Rocha Junqueira, 13 Swift, Campinas -
SP CEP 13045-755, Brazil. E-mail: biagomes@yahoo.com
Research Article
The relative clinical efficacy of three
0.454% stannous fluoride dentifrices for the treatment of gingivitis over 3
months
Tao He, dds, phd, Sushma Nachnani, phd, Steve Lee, dds, Yuanshu Zou, phd, Julie Grender, phd, Svetlana
Farrell, dds, phd, Paul
Sagel, bsche & Aaron
R. Biesbrock, dmd, phd, ms
Abstract: Purpose: To assess the safety and efficacy of three stannous
fluoride (SnF2) dentifrices in the reduction of gingivitis versus a
negative control dentifrice. Methods: This was a randomized, controlled, double-blind, four-treatment parallel group
study. 120 healthy adult volunteers with established gingivitis were enrolled
and randomly assigned to one of four dentifrice treatment groups (30/group):
0.454% SnF2 + citrate dentifrice A; 0.454% SnF2 + sodium hexameta-phosphate dentifrice B; 0.454% SnF2 +
pyrophosphate dentifrice C; or 0.76% sodium monofluorophosphate negative control group. Subjects brushed with their assigned dentifrice and an
assigned regular manual toothbrush (Oral-B Indicator) for 1 minute twice daily
for 12 weeks. Number of gingival bleeding sites and Löe-Silness Gingival Index (LSGI) scores were assessed at baseline and at Weeks 2, 4 and
12. Results: 120 subjects were
enrolled and 112 completed the trial. Subjects had an average age (SD) of 39.31
(14.5) years; 67% of subjects were female. Overall baseline means (SD) were
81.2 (25.6) for number of bleeding sites and 1.51 (0.197) for mean LSGI score.
Baseline disease levels were balanced across all treatment groups. At Week 2, SnF2 dentifrices A and B demonstrated a significant reduction in gingival bleeding
sites versus the negative control; however, SnF2 dentifrice C was
not significantly different from the negative control (P= 0.15). At Weeks 4 and
12, all SnF2 dentifrices demonstrated a significant gingival
bleeding site reduction versus the negative control (P< 0.001). At Weeks 2,
4 and 12, the SnF2 dentifrices were rank ordered dentifrice A >
dentifrice B > dentifrice C for reduction in gingival bleeding sites (P<
0.001). The same trends were seen for LSGI scores. (Am J Dent 2020;33:218-224).
Clinical
significance: In
this 12-week clinical study, all 0.454% SnF2 dentifrices delivered
statistically significant reductions in the number of gingival bleeding sites
relative to the negative control. Importantly, statistically significant
efficacy differences were observed among the three 0.454% SnF2 dentifrices, demonstrating the important role that differences in formulation
have on clinical efficacy.
Mail: Dr.
Tao He, The Procter & Gamble Company, Mason
Business Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA. E-mail:: he.t@pg.com