Showing papers in "Journal of Oral Rehabilitation in 2005"

Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations

Abstract: summary: Evaluation of the marginal and internal fit of all-ceramic molar crown-copings hypothesizing that Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) fabrication shows the same accuracy of fit as conventional techniques. A set of six individual crown preparations was duplicated 12 times yielding 72 plaster dies. Slip-cast (In-Ceram Zirconia®), heat-pressing (Empress II®) and CAD/CAM crown-copings (Cerec inLab®, DCS®, Decim® and Procera®) were seated on 12 dies each. Marginal and internal gap width was measured in the SEM at 120× magnification. Marginal gap of slip-cast (25 ± 18 μm) was significantly (P 0·05) from slip-cast (25 ± 18 μm) but were smaller (P 0·05) from any of the others. The internal mid-orobuccal gap width of Procera® (136 ± 68 μm) was larger (P 0·05) from Decim®, Procera® and slip-cast. Internal mesiodistal gap width was similar. The fit of conventional and CAD/CAM all-ceramic molar crown-copings covered the same range of gap width confirming the assumed hypothesis.

All-ceramic fixed partial dentures designed according to the DC-Zirkon technique. A 2-year clinical study.

Abstract: The aim of the study was to investigate whether the properties of a pre-sintered, hot iso-static post-compacted ( HIP) ZrO2 are adequate for use in three-five-unit fixed partial dentures (FPDs) and to evaluate the clinical results. Twenty three five-unit FPDs were fabricated for 18 patients on a total of 56 abutments. They were all made on abutments cut with a shoulder preparation and cemented with a zinc phosphate cement. They were clinically followed for 24 months. After 24 months all FPDs were still in use without any fractures or clinical wear but in three cases (15%) minor chip-of fractures were observed. Marginal integrity was rated excellent at 45 abutments and acceptable at 11. Within the limitations of this 2-year clinical follow-up study, FPDs made of pre-sintered HIP ZrO2 core material veneered with a compatible ceramic is an acceptable alternative in the fabrication of FPDs with the extensions investigated in this study. Special attention, however, must be paid to designing the core for an occlusal shape that provides sufficient support for the veneer. (Less)

Clinical marginal and internal gaps of Procera AllCeram crowns.

Abstract: summary This study evaluated the marginal and internal gaps of Procera AllCeram crowns in vivo using silicone materials. Ninety Procera AllCeram crowns were evaluated before final cementation. White and black silicone materials were used to record the marginal and internal fit; then the crowns were sectioned bucco-lingually and mesio-distally to measure the thickness of the silicone layer using a microscope. Sixteen reference points were measured on each specimen. Mean marginal gaps among anterior, premolar and molar teeth, and mean gaps at the reference points within the groups were compared by analysis of variance and Dunnett T3 test. The mean values at the margins were the smallest in all tooth groups, whereas those at the rounded slope of the chamfer were the largest. There were significant differences (P < 0·001) in the mean gaps at the four reference points (margin, rounded slope of the chamfer, axial wall and occlusal surface) in each group, except for the molar teeth. The mean marginal gaps of the Procera AllCeram crowns were within the range of clinical acceptance.

Some flexural properties of a nylon denture base polymer

Abstract: Nylon denture base material could be a useful alternative to poly (methyl methacrylate) (PMMA) in special circumstances such as patient allergy to the monomer. The aim of this study was to evaluate the flexural properties of a nylon denture base material (Lucitone FRS), a conventional compression-moulded heat-polymerized (Meliodent), a compression-moulded microwave-polymerized (Acron MC) and an injection-moulded microwave-polymerized (Lucitone 199) PMMA polymers. The effect of aldehyde-free, oxygen releasing disinfectant solution (Perform((R))) on these properties was also investigated. The flexural modulus and the flexural strength were assessed with a three-point bending test. Specimens were stored in water at a temperature of 37 degreesC for 30 days. For each material, half of the prepared specimens were randomly selected and immersed in the disinfectant 24 h prior to testing. Results were compared statistically at a confidence level of 95. The result showed that in both the control and disinfected groups, the flexural modulus of nylon was significantly lower than the three PMMA polymers. The flexural strength of nylon was significantly lower than those of Meliodent and Acron MC but was comparable with Lucitone 199. A 24-h immersion in the disinfecting solution increased the rigidity of nylon denture base material.

Low intensity laser therapy in the treatment of temporomandibular disorders: a double-blind study.

Abstract: This study aimed to evaluate the effectiveness of low intensity laser therapy (LILT) in 30 patients presenting temporomandibular joint (TMJ) pain and mandibular dysfunction in a random and double-blind research design. The sample, divided into experimental group (1) and placebo group (2), was submitted to the treatment with infrared laser (780 nm, 30 mW, 10 s, 6.3 J/cm(2)) at three TMJ points. The treatment was evaluated throughout six sessions and 15, 30 and 60 days after the end of the therapy, through visual analogue scale (VAS), range of mandibular movements and TMJ pressure pain threshold. The results showed a reduction in VAS (p < 0.001) and through the ANOVA with repeated measures it was observed that the groups did not present statistically significant differences (P = 0.2060), as the averages of the evaluation times (P = 0.3955) and the interaction groups evaluation times (P = 0.3024), considering the MVO. The same occurred for RLE (P = 0.2988, P = 0.1762 and P = 0.7970), LLE (P = 0.3265, P = 0.4143 and P = 0.0696), PPTD (P = 0.1558, P = 0.4695 and P = 0.0737) and PPTE (P = 0.2376, P = 0.3203 and P = 0.0624). For PE, there were not statistically significant differences for groups (P = 0.7017) and the interaction groups evaluation times (P = 0.6678), even so in both groups the PE varied with time (P = 0.0069).

Influence of light intensity from different curing units upon composite temperature rise

Abstract: The unavoidable consequence of composite resin photopolymerization is temperature rise in tooth tissue. The temperature rise depends not only on the illumination time, but also on light intensity, distance of light guide tip from composite resin surface, composition and shade of composite resin and composite thickness. The most commonly used units for polymerization today are halogen curing units, which emit a large spectrum of wavelengths. A proportion of the spectrum has no influence on degree of conversion and therefore causes unnecessary temperature rise. Units based on light source - blue light emitting diodes (LED), as an alternative for halogen curing units, have been introduced in clinical practice. The aim of this study was to show the influence of the light intensity of curing units Elipar Trilight, Astralis 7 and Lux-o-Max unit on temperature rise in composite resin sample of Tetric Ceram. The temperature was measurement with Metex M-3850 D multimeter with the tip of temperature probe put into unpolymerized composite resin sample 1 mm depth. The highest temperature rise was recorded with standard curing mode for Elipar Trilight halogen curing unit (13.3 +/- 1.21 degrees C after 40 s illumination), while the lowest temperature rise was recorded for the Lux-o-Max unit based on LED technology (5.2 +/- 1.92 degrees C after 40 s illumination).

Home-exercise regimes for the management of non-specific temporomandibular disorders.

Abstract: There is a consensus on treatment strategies for temporomandibular disorders (TMDs) being reversible. Among reversible therapies, physiotherapy is often chosen for the treatment of TMD pain and dysfunction because it is simple and non-invasive, it has a low cost as compared with other treatments, it allows an easy self-management approach, it allows a good doctor-patient communication, and it can be managed by the general practitioner. Home-exercises regime protocols are reviewed in this article in the context of the biopsychosocial approach. The actual evidence for the efficacy of home physical exercises is weak because of the very limited number of randomized clinical trials (RCTs) available in literature. Therefore, there is a need for further well-designed studies and RCTs to investigate the therapeutic efficacy. Recent reports and clinical experience, however, suggest that this approach can be promising, particularly if it is tailored towards the individual patient. The favourable cost benefit ratio over other treatment modalities seems to indicate that physiotherapy can be regarded as a first choice approach in selected TMD patients.

Survival rate, fracture strength and failure mode of ceramic implant abutments after chewing simulation.

Abstract: The aim of this study was to compare titanium-reinforced ZrO(2) and pure Al(2)O(3) abutments regarding their outcome after chewing simulation and static loading. Forty-eight standard diameter implants with an external hexagon were divided into three groups of 16 implants each and restored with three different types of abutments (group A: ZrO(2) abutments with titanium inserts; group B: Al(2)O(3) abutments; group C: titanium abutments). All abutments were fixated on the implants with gold-alloy screws at 32 Ncm torque, and metal crowns were adhesively cemented onto the abutments. The specimens were exposed to 1.2 million cycles in a chewing simulator. Surviving specimens were subsequently loaded until fracture in a static testing device. Fracture loads (N) and fracture modes were recorded. A Wilcoxon Rank test to compare fracture loads among the three groups and a Fisher exact test to detect group differences in fracture modes were used for statistical evaluation (P < 0.05). All specimens but one of group B survived chewing simulation. No screw loosening occurred. The median fracture loads (+/-s.d.) were as follows: group A, 294 N (+/-53); group B, 239 N (+/-83), and group C, 324 N (+/-85). The smaller fracture loads in group B were statistically significant. The use of pure Al(2)O(3) abutments resulted in significantly more abutment fractures. It is proposed that titanium-reinforced ZrO(2) abutments perform similar to metal abutments, and can therefore be recommended as an aesthetic alternative for the restoration of single implants in the anterior region. All-ceramic abutments made of Al(2)O(3) possess less favourable properties.

Anxiety symptoms in clinically diagnosed bruxers.

Abstract: The present work was an attempt to investigate for the existence of an association between anxiety psychopathology and bruxism. The presence of bruxism was investigated according to validated clinical criteria in 98 subjects, who also filled out a self-report questionnaire (PAS-SR) for the assessment of panic-agoraphobic spectrum. 34.7% (n = 34) of participants were diagnosed as bruxers. The prevalence of anxiety psychopathology was similar between bruxers and non-bruxers, but Mann-Whitney U-test revealed significant differences in total PAS-SR (P = 0.026) score, indicating that subclinical symptoms of the anxiety spectrum might differentiate bruxers from controls. In particular, significant differences emerged in scores of domains evaluating panic (P = 0.039), stress sensitivity (P = 0.006) and reassurance sensitivity symptoms (P = 0.005) of panic-agoraphobic spectrum. Support to the existence of an association between bruxism and certain psychopathological symptoms has been provided.

The prevalence of signs and symptoms of temporomandibular disorders in very old subjects.

Abstract: Previous studies on the prevalence of signs of temporomandibular disorders (TMD) in elderly people have used non-standardized and invalidated examination protocols. The prevalence of the different signs of TMD in this group is therefore still unclear. The aim of this study was to evaluate the prevalence of signs of TMD in subjects of advanced aged, using a standardized and validated examination protocol. Additionally, young subjects were examined as a control group. Fifty-eight old peoples' home inhabitants and 44 young subjects were examined using a standardized and validated examination protocol. Differences between the groups were assessed using Mann-Whitney U-test or t-test. Geriatric subjects more often exhibited objective symptoms of TMD (38% exhibited joint sounds on opening), but rarely suffered from pain (pain at rest: 0%, joint pain: 0%, muscle pain: 12%). In contrast, young subjects rarely exhibited objective symptoms (joint sounds: 7%), but suffered more frequently from pain (facial: 7%, joint pain: 16%, muscle pain: 25%). The mandibular range of motion was higher in young subjects. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (joint sounds) of TMD, they rarely suffered from pain. In contrast, younger subjects rarely exhibited objective TMD signs but more frequently suffered from subjective signs (muscular pain on palpation) and facial pain.

Masticatory function in patients with an extremely resorbed mandible restored with mandibular implant‐retained overdentures: comparison of three types of treatment protocols

Abstract: The objective of the present study was to analyse the effects of implant supported overdentures on masticatory function in patients with an extremely resorbed mandible, and to compare the masticatory function in these patients using three differing types of implant treatment protocols. The mandibular overdentures were retained by a transmandibular implant, by four endosseous implants following augmentation of the mandible, and by four short endosseous implants, respectively. Sixty patients (50 women, 10 men, mean age 59.4 years) were randomly allocated to one of the three treatment groups. Masticatory function was assessed before and after treatment using a questionnaire, a masticatory performance test, and a structured interview. The patient-based masticatory function improved significantly. Concerning these parameters there were no significant differences between the three groups before and after treatment. A significant difference existed between the three groups for the laboratory-assessed masticatory function before treatment, but after treatment this difference was no longer significant. From this study it can be concluded that patients with an extremely resorbed mandible and functional complaints of their lower denture report significant improvement in masticatory function after implant-overdenture treatment. Differences in masticatory function between the three studied modalities were not significant after treatment.

Antibacterial activity of glass-ionomer cements, compomers and resin composites: relationship between acidity and material setting phase.

Abstract: Agar diffusion testing was used with four different media to evaluate the antibacterial activity of six products (one conventional glass-ionomer cement (GIC), two light-activated glass-ionomers, two polyacid-modified resin composites and one resin composite) on Streptoccoccus mutans. Their respective antibacterial activities were also compared during and after setting. The relationship between product acidity and antibacterial activity was evaluated. All the GICs demonstrated antibacterial properties in contrast to the polyacid-modified resin composites and resin composite which did not shown any antibacterial effects. Vitrebond GIC exhibited higher antibacterial action, probably because of a cytotoxic photo-initiator diphenyliodoniumchloride. A direct relationship between material acidity and growth inhibition of S. mutans was observed.

Surface EMG of jaw elevator muscles: effect of electrode location and inter‐electrode distance

Abstract: This study addresses methodological issues on surface electromyographic (EMG) signal recording from jaw elevator muscles. The aims were (i) to investigate the sensitivity to electrode displacements of amplitude and spectral surface EMG variables, (ii) to analyse if this sensitivity is affected by the inter-electrode distance of the bipolar recording, and (iii) to investigate the effect of inter-electrode distance on the estimated amplitude and spectral EMG variables. The superficial masseter and anterior temporalis muscles of 13 subjects were investigated by means of a linear electrode array. The percentage difference in EMG variable estimates from signals detected at different locations over the muscle was larger than 100% of the estimated value. Increasing the inter-electrode distance resulted in a significant reduction of the estimation variability because of electrode displacement. A criterion for electrode placement selection is suggested, with which the sensitivity of EMG variables to small electrode displacements was of the order of 2% for spectral and 6% for amplitude variables. Finally, spectral and, in particular, amplitude EMG variables were very sensitive to inter-electrode distance, which thus should be fixed when subjects or muscles are compared in the same or different experimental conditions.

The evaluation of vertical heights of maxillary and mandibular bones and the location of anatomic landmarks in panoramic radiographs of edentulous patients for implant dentistry

Abstract: The purpose of this study was to determine variations in the vertical height measurements in the edentulous maxilla and mandible, and to assess positions of the maxillary sinus, mandibular foramen, and the mandibular canal, which are important for implant length selection and planning using panoramic radiographs. The study sample included 346 edentulous alveolar ridges of 90 men and 83 women. Sixty-three dentate patients' panoramic radiographs were used for location of the first premolar and molar area. Panoramic radiographs were made with a Siemens Orthophos panoramic machine which had been standardized previously. All radiographs were made using a standardized manner by the same technician. Fourteen sites were measured on every panoramic radiograph whenever possible, eight sites in the maxilla and six sites in the mandible. Correlation analyses were performed between age groups and all measurements to determine if age is significant as a covariate. In order to examine the effect of gender the statistical analysis of differences between men and women was performed with Student t-test. The 5% significance level was used for statistical significancy. The height of the maxilla and the mandible in the anterior, first premolar, and first molar regions were significantly greater in men than in women. A majority of the most inferior border of the maxillary sinuses was located anterior to the first molar area (premolar regions) both in men (48.9%) and women (55.4%). Although, there was no statistically significant difference between edentulous men and women for the vertical distances from the mental foramen to the alveolar crest, and horizontal distances from mental foramen to midline, there were statistically significant differences between edentulous men and edentulous women for the vertical distances from the upper border of the mandibular canal to the alveolar crest in the first molar area. Mental foramens were located at the crest of the ridge in 7.2% of the edentulous women, and 6.7% of the edentulous men. The results of this study may guide clinicians to make primer decision of implant insertion area for implant supported prosthesis in edentulous patients.

Evaluation of apical sealing ability and adaptation to dentine of two resin-based sealers.

Abstract: The purpose of this study was to evaluate the apical sealing ability and adaptation to dentine of two resin-based root canal sealers. The root canals of 55 human maxillary anterior teeth were prepared using a step-back technique and the smear layer removed with 17% ethylenediaminetetraacetic acid. The teeth were divided into two groups of 25 teeth and the remaining five teeth served as control. Then the teeth were prepared and obturated with gutta-percha by a lateral condensation and either AH plus and EndoRez used as a sealer. Twenty teeth from each group were used for the apical leakage test and the remaining five teeth from each group were used for examination under the scanning electron microscope (SEM). For apical leakage test, teeth were covered with nail varnish and sticky wax to within 1 mm of the apical foramen and placed in 2% methylene blue for 7 days. After this period, the teeth were sectioned longitudinally and apical leakage measurements made. The mean value of dye penetration for AH plus was 2.87 +/- 0.43 mm, while that of EndoRez was 4.54 +/- 0.36 mm. The difference between mean of dye penetration was statistically significant (P < 0.01). The SEM examination showed both sealers had better adaptation and penetration in coronal and middle thirds than apical third of root canal. In apical third, AH plus was adapted better adpated to dentine than EndoRez. In conclusion, AH plus sealer has better apical sealing ability and adaptation to dentine than EndoRez sealer.

Stress distributions in maxillary bone surrounding overdenture implants with different overdenture attachments

Abstract: In this study, effects of different overdenture attachments on the stress distributions in the maxillary bone surrounding the overdenture implants are studied. Four different types of attachment are considered. They are rigid Dalbo Stud, movable Dalbo Stress Broken, movable Dalro, and movable O-ring attachments. Three-dimensional finite element analysis was conducted with commercial package to obtain the stress distributions in the maxillary bone. Varying the attachment types and angle of inclination of load, the stress distributions in the portions of compact bone and trabecular bone were monitored separately. The analysis was conducted by assuming two different boundary conditions at the interface between cap and overdenture abutment in order to evaluate influence of interface boundary condition on stress distribution in the maxillary bone. They were perfect bonding condition and contact with friction at the interfaces. However, it is preferable to assume perfect bond condition at the interface for rigid type attachment systems and contact with friction at the interface for movable type attachment systems. From the numerical results, it was found that the load transfer mechanism of the implant system is altered significantly by the types of the overdenture attachment and also special care must be taken to assign proper boundary conditions at the interface for the analysis. The movable type Dalro attachment generated the highest maximum effective stress in the maxillary bone among the models under the same inclined loading condition for contact with friction. The rigid type Dalbo Stud attachment generated the smallest maximum effective stress in the maxillary bone among the models under the same inclined loading condition for perfect bonding condition.

Infantile reflexes and their effects on dental caries and oral hygiene in cerebral palsy individuals.

Abstract: The aim of this study was to evaluate the presence of pathological primitive reflexes and their effects on dental caries and oral hygiene in cerebral-palsied individuals. A group of 124 non-institutionalized patients (57 males) attending Lar Escola Sao Francisco Rehabilitation Center, who had a medical diagnosis of spastic CP (age range 3-17 years, mean+/-s.d.=8.6+/-4.3) were selected for dental clinical evaluation according to WHO (Oral health surveys: basic methods, WHO, Geneva, 1997) and oral hygiene using the oral hygiene index proposed by Greene and Vermillion (J Am Dent Assoc, 1964, 68, 7). The presence/absence of the pathological primitive oral reflexes of rooting, suckle-swallow, biting and gagging was evaluated by observing patients' reaction after a stimulus. Results were statistically analysed by Fisher's exact, Chi-square and Kruskal-Wallis tests. A significantly higher percentage of the biting reflex in patients with quadriplegia was observed, and also the absence of this reflex in patients with hemiplegia (P=0.006). Patients with hemiplegia presented significantly lower DMF index values. Kruskal-Wallis test showed no statistical difference (P=0.335; 0.677; 0.202) for OHI-S among the quadriplegia, diplegia and hemiplegia for all dentitions. Our data suggest that the more severe the neurological damage is, the more frequent is the presence of the biting reflex and consequently, the higher is the risk of oral diseases in this population due to the difficulty to perform an adequate oral hygiene.

Influence of marginal bone resorption on stress around an implant--a three-dimensional finite element analysis.

Abstract: Average marginal bone resorption of about 1 mm after the first year of functional loading, which is followed by an annual loss of approximately 0.1 mm, has been reported in stable implants. However, finite element analyses on bone stress around implants have been limited to analysing the bone stress in the absence of any bone resorption. Thus, a three-dimensional finite element analysis was performed to compare the bone stresses in a non-resorption model with those in four models with bone resorption of two depths (1.3 and 2.6 mm) and types (horizontal resorption and angular defects). Axial and bucco-lingual forces were separately applied to the center of the superstructure and the maximum equivalent stress was calculated. The main tendencies of bone stress (highest stress concentration around implant neck, higher stresses under bucco-lingual than axial load, as well as in the cortical than cancellous bone) were the same in the non-resorption and resorption models. Bone stress distributions were similar in the non-resorption and horizontal resorption models, but differed from those in the angular defect models. Moreover, the changes of the bone stress values with resorption depth differed for the two resorption types. Thus, in FEA, accurate simulation of the marginal bone shape in the implant neck region is advisable.

The measurement of tooth whiteness by image analysis and spectrophotometry: a comparison

Abstract: Digital image capturing and analysis techniques have been used to measure the colour of teeth and to compare with spectrophotometric results and visual observations. A non-linear image analysis approach was developed and, for the colour range of human teeth, allows device-dependant digital camera colour data to be quantitatively transformed to Commission Internationale de l'Eclairage (CIE) colorimetric values. With reference to a CIE standard illuminant, two different lighting arrays have been used. For flat and non-translucent white and yellow surfaces, spectrophotometric results showed that this transformation achieves required accuracy. It was found, in all of the present studies, which included measurements on the VITA Lumin Vacuum shade guide and extracted teeth, that spectrophotometry invariably underestimated values of the CIE whiteness index. However, the results from these two types of measurement correlated well. There was also a reasonably good correlation between earlier data obtained by visual assessment and the present data by the two instrumental methods. For extracted teeth, both instrumental methods used in this work did not confirm a whitening effect for 2-min brushing with toothpaste, but did show significant whitening results for bleaching with 15% hydrogen peroxide.

Clinical Marginal and Internal Gaps of In-Ceram Crowns Fabricated Using the GN-I System

Abstract: The marginal and internal gaps of ceramic crowns with alumina copings fabricated using a computer-aided design, computer-aided manufacturing system, were evaluated in vivo using silicone materials. Black and white silicone materials were used to record the marginal and internal gaps of 82 In-Ceram crowns before final cementation. The silicone materials were sectioned bucco-lingually and mesio-distally and viewed under a microscope to measure the thickness of the white silicone layer. Sixteen reference points were measured on each specimen. The mean marginal gaps were compared among the anterior, premolar and molar teeth, and the mean gaps at the reference points within the groups were compared by analysis of variance and the Dunnett T3 test. The mean marginal gap was 66.8 mum. There were no differences in marginal gaps among the three groups. In all the groups, the marginal gaps were the smallest, whereas the occlusal gaps were the largest. The mean marginal gaps of the In-Ceram crowns with the alumina copings fabricated using the GN-I system were within the range of clinically acceptable values.

Human enamel erosion in constant composition citric acid solutions as a function of degree of saturation with respect to hydroxyapatite

Abstract: summary The objective of this study was to investigate human enamel erosion under constant composition conditions, as a function of solution degree of saturation (DS) with respect to hydroxyapatite. The experimental conditions were relevant to the initial stages of enamel erosion by soft drinks. Nanoindentation was used to compare enamel surface softening caused by a control mineral water and two citric acid solutions with DS = 0·000 and DS = 0·032, both having pH 3·30. Enamel hardness and reduced elastic modulus were measured after 0, 30, 60, 120, 300 and 600 s exposure. A statistically significant change in enamel hardness was detected after 30 s exposure to both citric acid solutions, indicating that nanoindentation is extremely sensitive to the initial stages of erosion. There was a statistically significant difference between the mechanical properties of enamel exposed to the two citric acid solutions after 30, 60 and 120 s. At these times, the solution with DS = 0·000 caused twice as much enamel softening as that with DS = 0·032. This demonstrates that it may be possible to design a soft drink with a low erosive potential and a good taste by a small change in DS, at a typical drink pH.

Adhesive bonding of a lithium disilicate ceramic material with resin-based luting agents

Abstract: This study evaluates the bonding characteristics of a lithium disilicate-based ceramic material (IPS Empress 2). Two sizes of disk specimens of the material were made, and three groups of disk pairs were separately surface-prepared using three techniques; etching with phosphoric acid, etching with hydrofluoric acid, and air-abrasion with alumina. Each group was further divided into four sub-groups; group (i) was bonded with the Variolink II composite, (ii) was treated with the Monobond-S silane primer and bonded with the Variolink II composite, (iii) was bonded with the Super-Bond acrylic adhesive and (iv) was treated with the Porcelain Liner M silane primer and bonded with the Super-Bond acrylic adhesive. Shear bond strengths were determined before and after 100 000 thermocycles. Bond strength varied from 10.6 to 71.5 MPa before thermocycling, whereas post-thermocycling bond strength ranged from 0 to 61.2 MPa. Among the three surface preparations, hydrofluoric acid etching (HF) was most effective in enhancing bond strength of both luting materials, especially for unsilanized specimens. Application of the silane primer elevated bond strength of both luting agents regardless of surface preparation method. It can be concluded, for both luting agents, that durable bond to the Empress 2 ceramic material can be achieved through the combined application of HF and the proprietary silane primer.

How light source and product shade influence cure depth for a contemporary composite.

Abstract: Directly placed light activated resin based composite restorations are becoming increasingly popular for restoring cavities in posterior teeth. Marketing and patient as factors well as operator preference are behind this trend. Achieving adequate depth of cure is critical to the success of these restorations. Recently a number of second generation light emitting diode (LED) light activation units have been marketed and the manufacturer of one of these claims that it is capable of curing in half the time of its predecessor. This study tested that claim using a companion composite from the same manufacturer. The relationship between cure depth, shade changes on curing and opacity were also assessed. Under the limitations of the current investigation the results indicated that the second generation LED unit in question met the manufacturer's claim for halving cure time. Depths of cure approached those of a control halogen unit in half the 40 s radiation time of the latter. For the product tested depth of cure is strongly linked to material opacity.

A 5-year prospective study on small diameter screw-shaped oral implants.

Abstract: summary Alveloar ridges of limited dimensions could preclude the placement of dental implants of the regular dimension. Smaller diameter implants – narrow platform (NP) implants were commercially available to address this issue. The aim of the study was to determine the 5-year clinical performance of 3·3 mm diameter NP implants. Twenty-three machined screw-shaped NP implants were placed in nine patients (six males; three females) between 18 and 70 years of age. Clinical and radiographic examinations were performed annually for 5 years. Recognized implant success criteria was used. The criteria were based on the mean marginal alveolar bone loss, the placement of prosthesis of satisfactory appearance, and the absence of implant mobility, peri-implant radiolucency, pain, discomfort or infection. One implant failed at abutment connection. The remaining 22 implants were restored and functioned successfully according to the criteria. The mean marginal alveolar bone loss during the first year was 0·41 ± 0·17 mm. The mean marginal alveolar bone loss between the second and fifth year was 0·03 ± 0·06 mm. The success rate of NP implants according to a well-established set of criteria was 96%.

Precision of fit and clinical evaluation of all‐ceramic full restorations followed between 0·5 and 5 years

Abstract: Currently CAD-CAM systems are rapidly gaining importance in dental practice as some of their products aim to combine aesthetics with strength and are free of metals. This study reports on the crown adaptation, marginal fit and clinical behaviour of 300 all-ceramic full coverage restorations (Procera, Gothenburg, Sweden) placed in one clinical centre and followed up to 5 years. The marginal fit and coping adaptation before and after luting was determined by direct measurement as well as after sectioning in a laboratory study. Three hundred all-ceram restorations were installed in 165 patients between 1994 and 1998. Before the end of 2000, patients were recalled to assess their restorations, using the California Dental Association quality evaluation index, their own appreciation, as well as the reaction towards the periodontium. The in vitro data revealed a mean marginal adaptation of 30 microm, before and after luting of the Al(2)0(3)-coping onto the tooth. However, at the deepest part of the chamfer, the distance increased to 135 microm. In the clinical study only one restoration fractured, while in 6% small porcelain infractions occurred. After polishing the latter, no persistent patient complaints remained. At the last recall visit 1.8% of the margins were rated unacceptable. Dentists rated 72 and 78% of the restorations excellent for surface, colour and anatomic form respectively. Eighty-seven per cent of the patients rated their restorations more than 7/10 on an ordered analogue scale for aesthetics as well as for function.

Effect of LED and halogen light curing on polymerization of resin-based composites

Abstract: summary The clinical performance of light polymerized resin-based composites (RBCs) is greatly influenced by the quality of the light curing unit (LCU). A commonly used unit for polymerization of RBC material is the halogen LCUs. However, they have some drawbacks. Development of new blue superbright light emitting diodes (LED LCU) of 470 nm wavelengths with high light irradiance offers an alternative to standard halogen LCU. The aim of this study is compared the effectiveness of LED LCU and halogen LCU on the degree of conversion (DC) of different resin composites [two hybrid (Esthet-X, Filtek Z 250), four packable (Filtek P60, Prodigy Condensable, Surefil, Solitaire), one ormocer-based resin composite (Admira)]. The DC values of RBCs polymerized by LED LCU and halogen LCU ranged approximately from 61·1 ± 0·4 to 50·6 ± 0·6% and from 55·6 ± 0·7 to 47·4 ± 0·5%, respectively. Significantly higher DC of RBCs except Surefil and Filtek Z 250 was obtained for LED LCU compared with halogen LCU (P 0·05). As a result, it was observed that the performance of LED LCU used in the study was satisfactory clinically and had sufficient irradiance to polymerize RBCs (hybrid, packable and ormocer based) at 2 mm depth with a curing time of 40 s.

Association between diet, social resources and oral health related quality of life in edentulous patients.

Abstract: To assess whether there was an association between diet, oral health related quality of life and social resources in a population of older edentulous adults, and, to assess the impact of provision of new complete replacement dentures. This study was carried out at Cork University Dental Hospital in Ireland. In this prospective clinical study, 35 edentulous adults who requested new complete dentures completed pre-treatment questionnaires which included validated oral health status, social resources and nutritional assessment questionnaires. New dentures were provided and the impact of treatment on oral health related quality of life, diet and ability to chew food was assessed. Satisfaction with dentures and oral health related quality of life improved following provision of new dentures. However, food choice remained similar to pre-treatment choice, and subjects were rated as medium risk for poor nutritional status on the Mini Nutritional Assessment (MNA) score. Oral health related quality of life and diet were not correlated. Three quarters of the sample felt they had no nutritional problems. However, approximately 70% reported that they had changed their food choices because of dental problems and that financial cost was a barrier to dental treatment. Food selection among the group studied was not ideal, and not improved by the provision of new dentures. There was no association between diet and oral health related quality of life. Further research is needed to improve our understanding of the relationship between oral health and diet.

Adhesion to root canal dentine using one and two-step adhesives with dual-cure composite core materials.

Abstract: The regional tensile bond strengths of two dual-cure composite resin core materials to root canal dentine using either a one or two-step self-etching adhesive were evaluated. Extracted premolar teeth were decoronated and their root canals prepared to a depth of 8 mm and a width of 1.4 mm. In one group, a one-step self-etching adhesive (Unifil Self-etching Bond) was applied to the walls of the post-space and light-cured for 10 s. After which, the post-spaces were filled with the a dual-cure composite resin (Unifil Core) and then half the specimens were light-cured for 60 s and the other half placed in darkness for 30 min. In the second group, a self-etching primer (ED Primer II) was applied for 30 s, followed by an adhesive resin (Clearfil Photo Bond), which was light-cured for 10 s. The post-spaces were filled with a dual-cure composite resin (DC Core) and then half the specimens were light-cured for 60 s and the other half placed in darkness for 30 min. Chemical-cure composite resin was placed on the outer surfaces of all the roots, which were then stored in water for 24 h. They were serially sliced perpendicular to the bonded interface into 8, 0.6 mm-thick slabs, and then transversely sectioned into beams, approximately 8 x 0.6 x 0.6 mm, for the microtensile bond strength test (muTBS). Data were divided into two (coronal/apical half of post-space) and analysed using three-way anova and Scheffe's test (P 0.05). In addition, both dual-cure composite resins exhibited no significant differences in muTBS irrespective of whether polymerization was chemically or photoinitiated (P > 0.05). Both dual-cure composite resins exhibited good bonding to root canal dentin, which was not dependent upon region or mode of polymerization.

The comparison between pains, difficulties in function, and associating factors of patients in subtypes of temporomandibular disorders.

Abstract: The aim of this study was to compare the multidimensional properties among subtypes of painful temporomandibular disorders (TMD): myofascial pain (group I), disc displacement (group II), arthralgia (group IIIa) and osteoarthritis (group IIIb). A total of 511 patients answered a battery of questionnaires, which included questions relating to intensity and duration of pain, the Japanese version of the McGill Pain Questionnaire, limitation of daily functions, the Hospital Anxiety and Depression Scale, the Eysenck Personality Questionnaire short-form and 34 items of behavioural contributing factors. Group IIIb showed significantly the highest age in all subtypes. Those in group I had higher depression scores than those in group II (P = 0.005). Group IIIa had a lower women's ratio than in group II (P = 0.001) and the patients showed a shorter pain duration than those in groups I (P = 0.000) and II (P = 0.001). Group IIIa patients also showed lower visual analogue scale (VAS) ratings for pain descriptors 'heavy' (P = 0.002) and 'tiring' (P = 0.004) than those of group I, and 'dull' (P = 0.005), 'heavy' (P = 0.001) and 'tiring' (P = 0.005) than those of group II. Group IIIa showed lower ratios of contributing factors of 'an awareness of grinding/clenching during sleep' (P = 0.000) and 'an awareness of clenching sensation when waking up at night' (P = 0.002) than those of group I, and also showed a higher ratio of 'a liking for a hard food' (P = 0.000) and lower ratio of 'talking for a long time on the telephone' (P = 0.001) than those of group II. In conclusion, although several properties were different between subtypes, the majority of them were similar in the four subtypes of TMD.

Preliminary rapport on head posture and muscle activity in subjects with class I and II.

Abstract: Forward head posture may cause alterations in the stomatognathic system, including changes in the muscle activity of the masticatory muscles and dental occlusion alterations. Considering the need for further understanding of the relationship between the stomatognathic system and the cervical region, the purpose of this study was to analyse the head posture and the electromyographic (EMG) activity of the anterior portion of temporal and masseter muscles bilaterally among bruxist's subjects with different dental occlusion classifications using the Angle method. The study consisted of 20 female volunteers, between the ages of 17 and 27 years. They were separated into two groups (class I and class II occlusions) according to a dentist-performed evaluation. An assessment of forward head posture was conducted using a photographic technique (angular calculus) combined with a clinical analysis. In the EMG analyses, active differential surface electrodes (Ag) were utilized and were placed bilaterally on the belly of masseter and temporal muscles, perpendicular to the muscles fibres. The EMG signal recorded during bilateral isotonic mastication, was presented using the Root Mean Square and was processed by Matlab software. The results indicated that the EMG responses of temporal and masseter muscles tend to be modified by occlusion alteration class II. Subjects with class II occlusion tended to present more occurrence of forward head posture with alterations in the muscle activity pattern between masseter and temporal muscles.