Anthony H.L. Tjan

Measurement of Adhesion of Endodontic Sealers to Dentin

The bond strength of root canal sealers to dentin seems to be an important property for maintaining the integrity of the seal of root-canal fillings. In the few studies published, various assessment methods were used so quantitative comparison is not possible. The purpose of this study was to develop an effective and easily reproducible model and to test it with nine contemporary, commercially available endodontic sealers. After slicing off the coronal 2 mm of extracted third molars, the exposed dentin served as test surfaces. The teeth were fixed with plaster in 1-inch phenolic rings. Five-mm long sections of polyethylene tubing, filled with freshly mixed sealer, were placed on the dentin and tested for shearing bond strength after setting. A custom-made holder allowed the rings to be attached to an Instron machine, activated at a cross-arm speed of 0.5 mm/min. The mean bond strength, ranged from 0 to 4.9 MPa. The sealers were ranked and those that did not differ statistically in their bond strength were grouped together. This model provides a simple and reproducible means for measuring the in vitro bond strength of endodontic sealers.

Effect of various incremental techniques on the marginal adaptation of class II composite resin restorations

The effects of various placement techniques on the formation of microgaps were compared at the gingival margins of class II composite resin restorations. Three incremental techniques (occlusogingival layering, oblique layering, and faciolingual layering) and two one-bulk techniques of placing composite resin were studied. In the first one-bulk placement technique the composite resin was photocured occlusally; in the second one-bulk technique the composite resin was irradiated from three directions; facial, lingual, and occlusal. None of the incremental placement techniques improved the adaptation at the gingival margin compared with a one-bulk technique irradiated occlusally. However, the one-bulk placement technique that was irradiated from three directions created a substantial marginal discrepancy.

Fracture load and mode of failure of ceramic veneers with different preparations.

STATEMENT OF PROBLEM Fracture is a clinical failure modality for ceramic veneers. Whether design of tooth preparation can affect the strength of ceramic veneers remains controversial. PURPOSE This in vitro study evaluated fracture load and mode of failure of ceramic veneers, with 4 tooth preparation designs, that were bonded on extracted human maxillary central incisors. Identical parameters were also measured on unrestored intact teeth for comparison. MATERIAL AND METHODS Fifty maxillary central incisors were randomly divided into 5 equal groups. Each group was assigned a different tooth preparation design: (1) no incisal reduction, (2) 2 mm incisal reduction without palatal chamfer (butt joint), (3) 1 mm incisal reduction and 1 mm height palatal chamfer, (4) 4 mm incisal reduction and 1 mm height palatal chamfer, and (5) unrestored (control). Forty teeth were prepared to accommodate ceramic veneers of equal thickness and incisocervical length. Stone dies were fabricated and veneers made from IPS Empress ceramic. Ceramic veneers were bonded and all teeth mounted in phenolic rings with epoxy resin. Fracture loads were recorded with a mechanical testing machine. RESULTS Mean fracture loads (SD) in kgf were as follows: group 1, 23.7 (6.11); group 2, 27.4 (9.63); group 3, 16.4 (3.44); group 4, 19.2 (6.18); and group 5, 31.0 (10.38). Modes of failure were also analyzed for both ceramic veneers and teeth. One-way ANOVA with multiple comparisons revealed 3 significant subsets: groups 1-2-5, groups 4-1, and groups 3-4 (P <.05). Groups 1 and 2 had no ceramic veneer fractures; group 3 had 3 ceramic veneer fractures, and group 4 had 6 ceramic veneer fractures. CONCLUSION Groups 1 and 2 recorded the greatest fracture loads that were comparable to an unrestored control.

Comparison of the marginal fit of various ceramic crown systems

This study evaluated the marginal fit of four ceramic crown systems, (1) metal ceramic crowns with a metal margin, (2) metal ceramic crowns with a porcelain facial margin, (3) Cerestore crowns, and (4) Dicor crowns. Measurements of the marginal adaptation were recorded from the facial and lingual margins by using a video-enhanced microscope with digital micrometer and image intensification in a high resolution television screen. Results indicate that all four crown systems yielded comparable and acceptable marginal fit.

Marginal leakage of cast gold crowns luted with an adhesive resin cement.

The microleakage of cast gold complete crowns cemented with Panavia EX cement was evaluated and compared with those luted with a standard zinc phosphate cement. The effect of water immersion of specimens for 30 and 90 days was also investigated. The finding of this study indicated that crowns cemented with Panavia EX cement exhibited substantially less marginal leakage than those cemented with zinc phosphate cement. No significant difference in marginal leakage was observed between 30-day and 90-day water immersion of crowns cemented with Panavia EX cement.

Seating and retention of complete crowns with a new adhesive resin cement

The retentive property of cast gold complete crowns cemented with an adhesive resin cement (Panavia Ex) was compared with retention of crowns cemented with zinc phosphate cement (Flecks) and the conventional resin cement (Comspan). The effect of these agents on seating of crowns also was evaluated. Panavia cement exhibited the highest retentive strength, with values almost twice those obtained with zinc phosphate cement. However, the difference in mean retention values of crowns cemented with Comspan cement or with zinc phosphate cement was not statistically significant. Both resin cements used in this study provided better seating of crowns than did zinc phosphate cement.

Temperature rise in the pulp chamber during fabrication of provisional crowns

This study measured and compared thermal changes in the pulp chamber during the fabrication of provisional crowns by direct method using various brands of autopolymerizing resin systems. The effect of curing the crowns in condensation and addition-reaction silicone putty matrices was also evaluated. The results suggested that the amount of heat transferred in the pulp chamber during the curing of resins may be damaging to the dental pulp and odontoblasts. Curing provisional resin crowns in either condensation or addition silicone putty impressions significantly reduced the temperature rise in the pulp chamber.

Marginal accuracy of complete crowns made from alternative casting alloys

The marginal accuracy of complete cast crowns made from five alternative casting alloys was measured and compared with that of crowns made from the traditional type III high-gold alloy. The alternative alloys studied were low-gold-palladium, high palladium, silver-palladium, nickel-chrome-molybdenum, and copper-aluminum. The findings indicated that Ag-Pd alloy crowns exhibited the best marginal accuracy among the alternative alloys tested. However, their marginal discrepancy value was still slightly higher than that of crowns made of type III high-gold alloy. Conversely, Ni-Cr-Mo alloy crowns exhibited the poorest marginal accuracy.

Microleakage of composite resin cores treated with various dentin bonding systems

Composite resin post and cores have gained widespread acceptance as an alternative for cast-gold post and core systems. A prefabricated metal post is generally used. Substantial microleakage at the interface between the composite resin core and the dentin substrate may occur. A tight and impervious bond between the dentin and the restorative material is critical for the longevity of core restorations. This study compared the microleakage of composite resin cores treated with various dentin bonding agents, including the recently developed Gluma, Tenure, and Scotchbond 2. The results indicated that Tenure and Scotchbond 2 bonding agents were most effective in reducing microleakage, followed by Gluma and conventional Scotchbond (Dual Cure) bonding agents. Although all proprietary dentin bonding systems used in this study significantly reduced microleakage, no system was capable of preventing microleakage completely.

Microleakage of core materials for complete cast gold crowns

This study evaluated the microleakage patterns of complete cast-gold crowns cemented onto teeth rebuilt with pin-retained cores made from cast gold, amalgam, composite resin, and silver-reinforced glass ionomer by using three different cements (zinc phosphate, glass ionomer, and resin cement). Crowns cemented onto unrebuilt tooth preparations with zinc phosphate cement served as controls. The cemented specimens were thermocycled between 4 degrees and 50 degrees C in waterbaths. They were then embedded in epoxy resin and sectioned. The extent of marginal microleakage was evaluated with a stereomicroscope and scored. The findings indicated that the type of luting agent used appeared to affect microleakage more than the core material. No significant differences in the degree of microleakage were found under crowns cemented onto teeth rebuilt with the four core materials when cemented with the same luting cement.