Ayman Ellakwa

Effect of Aluminum Oxide Addition on the Flexural Strength and Thermal Diffusivity of Heat‐Polymerized Acrylic Resin

PURPOSE This work was undertaken to investigate the effect of adding from 5% to 20% by weight aluminum oxide powder on the flexural strength and thermal diffusivity of heat-polymerized acrylic resin. MATERIALS AND METHODS Seventy-five specimens of heat-polymerized acrylic resin were fabricated. The specimens were divided into five groups (n = 15) coded A to E. Group A was the control group (i.e., unmodified acrylic resin specimens). The specimens of the remaining four groups were reinforced with aluminum oxide (Al2O3) powder to achieve loadings of 5%, 10%, 15%, and 20% by weight. Specimens were stored in distilled water at 37 degrees C for 1 week before flexural strength testing to failure (5 mm/min crosshead speed) in a universal testing machine. Results were analyzed by one-way analysis of variance and post hoc Tukey paired group comparison tests (p < 0.05). Weibull analysis was used to calculate the Weibull modulus, characteristic strength, and the required stress for 1% and 5% probabilities of failure. Cylindrical test specimens (5 specimens/group) containing an embedded thermocouple were used to determine thermal diffusivity over a physiologic temperature range (0 to 70 degrees C). RESULTS The mean flexural strength values of the heat-polymerized acrylic resin were (in MPa) 99.45, 119.92, 121.19, 130.08, and 127.60 for groups A, B, C, D, and E, respectively. The flexural strength increased significantly after incorporation of 10% Al2O3. The mean thermal diffusivity values of the heat-polymerized acrylic resin (in m(2)/sec) were 6.8, 7.2, 8.0, 8.5, and 9.3 for groups A, B, C, D, and E, respectively. Thermal diffusivities of the composites were found to be significantly higher than the unmodified acrylic resin. Thermal diffusivity was found to increase in proportion to the weight percentage of alumina filler, which suggested that the proper distribution of alumina powders through the insulating polymer matrix might form a pathway for heat conduction. CONCLUSION Al2O3 fillers have potential as added components in denture bases to provide increased flexural strength and thermal diffusivity. Increasing the flexural strength and heat transfer characteristics of the acrylic resin base material could lead to more patient satisfaction.

Fluoride Release, Recharge and Mechanical Property Stability of Various Fluoride-containing Resin Composites

AIM To determine the fluoride release and recharge of three fluoride-containing resin composites when aged in deionized water (pH 6.5) and lactic acid (pH 4.0) and to assess mechanical properties of these composites following aging. METHODS Three fluoride-containing resin composites were analyzed in this study; a new giomer material named Beautifil II, Gradia Direct X, and Tetric EvoCeram. A glass ionomer cement, Fuji IX Extra, was also analyzed for comparison. Specimens were fabricated for two test groups: group 1 included 10 disc specimens initially aged 43 days in deionized water (five specimens) and lactic acid (five specimens). The fluoride release from these specimens was measured using a fluoride-specific electrode on nine specific test days during the aging period. Following 49 days of aging, each specimen was recharged in 5000 ppm neutral sodium fluoride solution for 5 minutes. Specimen recharge was then repeated on a weekly basis for 3 weeks. The subsequent fluoride rerelease was measured at 1, 3, and 7 days after each recharge episode. Group 2 included six disc specimens aged for 3 months in deionized water (three specimens) and lactic acid (three specimens). The hardness and elastic modulus of each specimen was measured using nano-indentation at intervals of 24 hours, 1 month, and 3 months after fabrication. Two-way factorial analysis of variance (ANOVA) and post-hoc (Tukey) testing was used to assess the influence of storage media (two levels) and composite type (three levels) on the fluoride release, fluoride rerelease, hardness, and elastic modulus of the assessed materials. The level of significance was set at p=0.05. RESULTS All three composites demonstrated fluoride release and recharge when aged in both deionized water and lactic acid. The cumulative fluoride released from Beautifil II into both media was substantially greater than the fluoride released from Gradia Direct X and Tetric EvoCeram after 43 days aging and was significantly (p<0.05, ANOVA, Tukey test) greater during several analysis periods. Beautifil II demonstrated the greatest recharge ability of the three composites over the 3-week recharge period in both media. Fuji IX Extra demonstrated a significantly (p<0.05) greater fluoride release and recharge compared with the three resin composites. The elastic modulus and hardness of the three composites did not decrease significantly (p<0.05) with fluoride release or fluid uptake over the 3-month aging period, in either media. CONCLUSION The three composites in the present study demonstrated fluoride release (Beautiful II > Gradia Direct X > Tetric EvoCeram) and fluoride recharge (Beautiful II > Gradia Direct X > Tetric EvoCeram). This capability raises the possibility of fluoride-containing composites exhibiting a lower incidence of recurrent caries than non fluoride–containing composites. The mechanical properties of each composite did not diminish with aging and fluoride release over the testing period.

Occlusal geometrical considerations in all-ceramic pre-molar crown failure testing

OBJECTIVES To evaluate the influence of occlusal geometry of all-ceramic pre-molars, namely cusp angle and associated notch radius, on the scatter of load to failure tests. METHODS Forty-five all-ceramic upper pre-molar crowns with three zirconia core thicknesses (0.4, 0.6 and 0.8 mm) were broken on dental implant abutments oriented in three angulations (0°, 15°, and 30°). The crowns were loaded using a 4 mm diameter steel cylindrical bar placed along the midline fissure at a crosshead speed of 1 mm min(-1). The scatter of the failure load was evaluated using Weibull analysis. The cusp angle of each crown was critically evaluated to determine the cusp angle and effective radius of the fissure notch root. The relationship between failure load and cusp angle was compared with that between failure load and effective radius as well as notch induced stress concentration by considering R(2) values of fitted trend lines with these relationships. RESULTS The fracture load differences either between abutment angulations or zirconia thicknesses were not clearly revealed in this study. Except for the group of 30° abutment angulation, the crowns present high scatter of failure loads with low Weibull modulus. However, a simple dependence between fracture load and effective cusp angle was observed. SIGNIFICANCE Occlusal geometry is an important issue that affects the degree of stress concentration and should be understood by both technician and clinician for appropriate design and material selection of all-ceramic crowns.

Influence of Immediate Dentin Sealing on the Shear Bond Strength of Pressed Ceramic Luted to Dentin with Self-Etch Resin Cement

Objectives. To examine the effect of immediate dentin sealing (IDS), with dentin bonding agents (DBAs) applied to freshly cut dentin, on the shear bond strength of etched pressed ceramic luted to dentin with RelyX Unicem (RXU) cement. Method. Eighty extracted noncarious third molars were ground flat to expose the occlusal dentin surfaces. The teeth were randomly allocated to five groups (A to E) of sixteen teeth each. Groups A to D were allocated a dentin bonding agent (Optibond FL, One Coat Bond, Single Bond, or Go!) that was applied to the dentin surface to mimic the clinical procedure of IDS. These specimen groups then had etched glass ceramic discs (Authentic) luted to the sealed dentin surface using RXU. Group E (control) had etched glass ceramic discs luted to the dentin surface (without a dentin bonding agent) using RXU following the manufacturers instructions. All specimens were stored for one week in distilled water at room temperature and then shear stressed at a constant cross-head speed of 1 mm per minute until failure. Statistical analysis was performed by ANOVA followed by post hoc Tukey HSD method (P < 0.05) applied for multiple paired comparisons. Results. The shear bond strength results for group A to E ranged from 6.94 ± 1.53 to 10.03 ± 3.50 MPa. One-way ANOVA demonstrated a difference (P < 0.05) between the groups tested and the Tukey HSD demonstrated a significant (P < 0.05) difference between the shear bond strength (SBS) of Optibond FL (Group A) and Go! (Group D). There was no statistical difference (P > 0.05) in the SBS between the test groups (A–D) or the control (group E). Conclusion. IDS using the dentin bonding agents tested does not statistically (P > 0.05) affect the shear bond strength of etched pressed ceramic luted to dentin with RXU when compared to the control.

Long-Term Fluoride Exchanges at Restoration Surfaces and Effects on Surface Mechanical Properties

Aim. The aim of the study was to determine whether three fluoride containing resin composites could maintain fluoride release, fluoride recharge, and mechanical stability over long-term (18-month) aging. Materials and Methods. Fluoride containing composites Beautifil II, Gradia Direct X, Tetric EvoCeram, and glass ionomer Fuji IX Extra were analyzed. Specimens of each material were fabricated for two test groups: Group 1: bimonthly fluoride release/recharge analysis (n = 5); Group 2: hardness and elastic modulus analysis (n = 6). Nanoindentation was employed at 24 hours and at 1, 3, 6, 12, and 18 months. After 18 months, each specimen was immersed (recharged) in 5000 ppm NaF gel, and fluoride rerelease, hardness, and elastic modulus were measured. Results. Beautifil II and Gradia Direct X maintained fluoride release and recharge capability throughout 18-month aging (Beautifil II > Gradia Direct X > Tetric EvoCeram). The fluoride rerelease from Beautifil II following a 10-minute NaF recharge (at 18 months) was comparable to the long-term fluoride release from Fuji IX Extra. Elastic modulus and hardness did not change significantly (P > 0.05) with fluoride release, recharge, and water aging over 18 months for all three analyzed composites. Conclusions. The long-term fluoride release, fluoride recharge, and mechanical property stability of Beautifil II and Gradia Direct X render these composites suitable for load bearing restorations in high caries risk patients. Clinical Relevance. The ability for Beautifil II and Gradia Direct X to maintain fluoride release and fluoride recharge capability, despite long-term aging, raises the potential for unrestored tooth surfaces in contact with Beautifil II or Gradia Direct X restorations to demonstrate a reduced rate of caries incidence compared to unrestored surfaces adjacent to conventional nonfluoride containing composites.

The effect of repeated fluoride recharge and storage media on bond durability of fluoride rechargeable Giomer bonding agent.

BACKGROUND For a restorative material or adhesive to exhibit caries inhibitive potential through fluoride release, it must be capable of fluoride recharge. The aim of this study was to evaluate the effect of repeated fluoride recharge and different storage media on dentine bond strength durability. METHODS Two self-etch adhesive systems (two-step) were evaluated: fluoride-rechargeable Giomer FL-Bond II and non-fluoride-containing UniFil Bond. For each adhesive 32 human dentine specimens were prepared for shear bond strength testing. The specimens were randomly allocated to one of four storage groups: Group 1 - 24-hour water ageing; Group 2 - four-month water ageing; Group 3 - four-month water ageing with weekly fluoride recharge (5000 ppm for 10 minutes); and Group 4 - four-month acid ageing with weekly fluoride recharge. RESULTS Weekly fluoride recharge over four months ageing did not significantly (p > 0.05) reduce the dentine shear bond strength of FL-Bond II or UniFil Bond. Storage media did not significantly (p > 0.05) affect bond durability. CONCLUSIONS The adhesion between fluoride rechargeable FL-Bond II and dentine maintained durability despite regular fluoride recharge over the four months ageing. Clinicians prescribing the fluoride recharge regime used in the present study to reduce recurrent caries incidence associated with Giomer FL-Bond II restorations can do so without compromising dentine bond strengths.

Influence of implant abutment angulations on the fracture resistance of overlaying CAM-milled zirconia single crowns.

BACKGROUND An in vitro study was performed to assess the effect of three implant abutment angulations and three core thicknesses on the fracture resistance of overlaying computer-aided manufacturing (CAM) milled zirconia (Cercon(®) system) single crowns. METHODS Three groups, coded A to C, with different implant abutment angulations (group A/0°, group B/15° and group C/30° angulation) were used to construct 15 crowns for each angulation. Forty-five overlay restorations were milled using the Cercon(®) system with zirconium core thicknesses of 0.4, 0.6 and 0.8 mm using five crowns for each angulation. The final restorations were prepared and stored in distilled water at mouth temperature (37°C) for 24 hours prior to testing. The restorations were cemented using Temp Bond(®) . The load required to break each crown and the mode of failure were recorded. All the results obtained were statistically analysed by the ANOVA test (level of significance p < 0.05). Tested crowns were examined using a stereomicroscope at 40X and selected crowns (five randomly selected from each group were further examined by scanning electron microscopy) to reveal the zirconia-ceramic interface and to determine the fracture origin. RESULTS Implant abutment angulations significantly (p < 0.05) reduced the fracture resistance of overlaying CAM-milled zirconia single crowns. The fracture loads of Cercon(®) crowns cemented onto abutment preparations with a 30° angulation were the lowest of the groups tested. The core thickness (0.4 to 0.8 mm) did not significantly (p > 0.05) affect the fracture resistance of the CAM-milled zirconia single crowns. SEM showed that the origin of the fracture appeared to be located at the occlusal surfaces of the crowns and the crack propagation tended to radiate from the occlusal surface towards the gingival margin. CONCLUSIONS The implant angulation of 30° significantly (p < 0.05) reduced the fracture resistance of overlaying CAM-milled zirconia single crowns. Reducing the core thickness from 0.8 mm to 0.4 mm did not affect (p > 0.05) the fracture resistance of overlaying CAM-milled zirconia single crowns.

Effect of short glass fibers on the polymerization shrinkage stress of dental composite

This study examines contraction stresses of seven short fiber reinforced composites (sFRC) exhibiting different volume loads and aspect ratios (AR)* of fibres. The shift towards a greater utilization of posterior resin composites in dentistry has seen increased interest in the use of randomly oriented short glass fibers in these restorative materials. While the effect of these fibers on modulus, strength, and toughness has been studied, very little information exists on their effect on polymerization shrinkage and even less on shrinkage stress. S2-glass fibers with an average AR of 68 were used to form three experimental groups with 5%, 10%, and 20% volume loads. Commercial sFRC with ARs of 20 and 100 were also tested. A tensilometer set up was used with moderate compliance, 5.4 J/cm2 irradiance, and a C-factor of 2.75. Data was statistically analyzed using ANOVA followed by post hoc Tukeys test. The addition of 5% of the experimental fiber did not significantly increase stress while the 10% and 20% groups resulted in 36.3% and 39.1% higher stress values, respectively, compared to the non-fiber control group (p < 0.05). Of all the sFRC groups, the very low AR material exhibited the lowest stress [0.682 MPa (p = 0.001)] while another commercial material with higher AR fibers exhibited the highest overall value [1.822 MPa (p < 0.001)] when compared to the control group. The results indicate that both short fiber volume and AR are important variables to consider with regards to setting stresses of sFRC.

Surface characteristics and microbial adherence ability of modified polymethylmethacrylate by fluoridated glass fillers

BACKGROUND The current study objectives were to evaluate the influence of fluoridated glass fillers loading on the surface roughness, wettability, and adherence of candida and bacteria with and without saliva presence to a polymethylmethacrylate (PMMA) denture base material surface. METHODS Four concentrations of fluoridated glass fillers were added to PMMA: 1%, 2.5%, 5% and 10% by weight pre-polymerization and 0% was the control. Discs of each concentration were fabricated (n = 5 for each variable). Surface roughness (Ra ) was measured using atomic force microscopy (AFM). Wettability was assessed by measuring the contact angle of a sessile drop of water. Specimens were incubated with Candida albicans, or Streptococcus mutans with and without saliva coating. Adherence was presented as a percentage of the colonized surface area, counted using an optical microscope at x100 magnification. RESULTS The 10% group showed significantly greater roughness than the control and 1% groups; however, no significant differences in contact angle values were detected. The microbial adhesion was inversely proportional to the fluoridated glass fillers concentration where 10% concentration significantly decreased candidal and bacterial adhesion compared to others. Saliva coating significantly decreased microbial adhesion. CONCLUSIONS It was concluded that fluoridated glass fillers could decrease microbial adhesion to acrylic denture base without adversely affecting surface properties.

Influence of implant abutment angulations and two types of fibers on the fracture resistance of ceramage single crowns.

PURPOSE To assess the effect of three implant abutment angulations and two types of fibers on the fracture resistance of overlaying Ceramage single crowns. MATERIALS AND METHODS Three groups, coded A to C, with different implant abutment angulations (group A/0°, group B/15°, and group C/30° angulation) were restored with 45 overlay composite restorations; 15 Ceramage crowns for each angulation. Groups A, B, and C were further subdivided into three subgroups (n = 5) coded: 1, crowns without fiber reinforcement; 2, crowns with Connect polyethylene reinforcement; and 3, crowns with Interlig glass reinforcement. All crowns were constructed by one technician using the Ceramage System. The definitive restorations (before cementation) were stored in distilled water at mouth temperature (37°C) for 24 hours prior to testing. Before testing, the crowns were cemented using Temp Bond. The compressive load required to break each crown and the mode of failure were recorded. The speed of testing was 1 mm/min. The results were statistically analyzed by two-way ANOVA (p < 0.05). The tested crowns were examined using a stereomicroscope at 40×, and selected crowns (five randomly selected from each group) were further examined by scanning electron microscopy (SEM) to reveal the composite-fiber interface. RESULTS Fracture resistance of single crowns was not affected (p > 0.05) by the different abutment angulations chosen (0°, 15°, 30°) or fiber reinforcement (Connect and Interlig fibers). Crowns in group A exhibited average loads to fracture (N) of A1 = 843.57 ± 168.20, A2 = 1389.20 ± 193.40, and A3 = 968.00 ± 387.53, which were not significantly different (p > 0.05) from those of groups B (B1 = 993.20 ± 327.19, B2 = 1471.00 ± 311.68, B3 = 1408.40 ± 295.07), or group C (C1 = 1326.80 ± 785.30, C2 = 1322.20 ± 285.33, C3 = 1348.40 ± 527.21). SEM images of the fractured crowns showed that the origin of the fracture appeared to be located at the occlusal surfaces of the crowns, and the crack propagation tended to extend from the occlusal surface towards the gingival margin. CONCLUSIONS Implant abutment angulations of 0°, 15°, and 30° did not significantly (p > 0.05) influence the fracture resistance of overlaying Ceramage single crowns constructed with or without reinforcing fibers. The two types of fibers used for reinforcement (Connect and Interlig) had no effect (p > 0.05) on the fracture resistance of overlaying Ceramage single crowns.Purpose: To assess the effect of three implant abutment angulations and two types of fibers on the fracture resistance of overlaying Ceramage single crowns. Materials and Methods: Three groups, coded A to C, with different implant abutment angulations (group A/0°, group B/15°, and group C/30° angulation) were restored with 45 overlay composite restorations; 15 Ceramage crowns for each angulation. Groups A, B, and C were further subdivided into three subgroups (n = 5) coded: 1, crowns without fiber reinforcement; 2, crowns with Connect polyethylene reinforcement; and 3, crowns with Interlig glass reinforcement. All crowns were constructed by one technician using the Ceramage System. The definitive restorations (before cementation) were stored in distilled water at mouth temperature (37°C) for 24 hours prior to testing. Before testing, the crowns were cemented using Temp Bond. The compressive load required to break each crown and the mode of failure were recorded. The speed of testing was 1 mm/min. The results were statistically analyzed by two-way ANOVA (p < 0.05). The tested crowns were examined using a stereomicroscope at 40×, and selected crowns (five randomly selected from each group) were further examined by scanning electron microscopy (SEM) to reveal the composite–fiber interface. Results: Fracture resistance of single crowns was not affected (p > 0.05) by the different abutment angulations chosen (0°, 15°, 30°) or fiber reinforcement (Connect and Interlig fibers). Crowns in group A exhibited average loads to fracture (N) of A1 = 843.57 ± 168.20, A2 = 1389.20 ± 193.40, and A3 = 968.00 ± 387.53, which were not significantly different (p > 0.05) from those of groups B (B1 = 993.20 ± 327.19, B2 = 1471.00 ± 311.68, B3 = 1408.40 ± 295.07), or group C (C1 = 1326.80 ± 785.30, C2 = 1322.20 ± 285.33, C3 = 1348.40 ± 527.21). SEM images of the fractured crowns showed that the origin of the fracture appeared to be located at the occlusal surfaces of the crowns, and the crack propagation tended to extend from the occlusal surface towards the gingival margin. Conclusions: Implant abutment angulations of 0°, 15°, and 30° did not significantly (p > 0.05) influence the fracture resistance of overlaying Ceramage single crowns constructed with or without reinforcing fibers. The two types of fibers used for reinforcement (Connect and Interlig) had no effect (p > 0.05) on the fracture resistance of overlaying Ceramage single crowns.