Filiz Aykent

Effect of different finishing techniques for restorative materials on surface roughness and bacterial adhesion

STATEMENT OF PROBLEM The formation of biofilm and bacterial accumulation on dental materials may lead to the development of gingival inflammation and secondary caries. PURPOSE The purpose of this study was to examine the effect of different surface finishing and polishing methods on surface roughness and the adhesion of S. mutans bacteria to 2 new-generation indirect composite resins, 1 direct composite resin, and 1 ceramic material. MATERIAL AND METHODS Forty specimens (10 x 10 x 2 mm) of each material, indirect composite resins (SR Adoro, Estenia), direct composite resin (Tetric), and a ceramic material (VITABLOCS Mark II), were fabricated. Specimens were divided into 4 groups (n=10) that were treated with 1 of the following 4 surface finishing techniques: diamond rotary cutting instrument, sandpaper discs (Sof-Lex), silicone-carbide rubber points (Shofu), or a felt wheel with diamond paste. Surface roughness was measured with a profilometer. Test specimens were covered with artificial saliva and mucin to produce pellicle. Bacterial suspension (10(9) CFU/ml) was then added to the pellicle-coated specimens, and bacterial adhesion was determined using a confocal laser microscope and image analyzing program. Data were analyzed with 2-way ANOVA, followed by Tukey HSD test, Pearson correlation, and regression analysis (alpha=.05). RESULTS The highest surface roughness values were recorded in SR Adoro and diamond rotary cutting instrument groups. The lowest vital S. mutans adhesion was seen in the ceramic group and in SR Adoro indirect composite resin (P<.05). CONCLUSIONS Bacterial adhesion to indirect composite resin materials differed from that to ceramic material after surface treatments. A positive correlation was observed between surface roughness and the vital S. mutans adhesion.

Bond strengths of porcelain laminate veneers to tooth surfaces prepared with acid and Er,Cr:YSGG laser etching

STATEMENT OF PROBLEM The erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) hydrokinetic laser system has been successful in the ablation of dental tissues. It has been reported that this system is also useful for preparing tooth surfaces for adhesion, but results to date have been controversial. PURPOSE This in vitro study evaluated the bond strengths of porcelain laminate veneers to tooth surfaces after etching with acid and Er,Cr:YSGG laser conditioning. Material and method Forty extracted caries- and restoration-free human maxillary central incisors were used. The teeth were sectioned 2 mm below the cementoenamel junction. The crowns were embedded in autopolymerizing acrylic resin with the labial surfaces facing up. The labial surfaces were prepared with.05 mm reduction to receive porcelain veneers. The teeth were divided into 4 groups of 10 specimens. Thirty specimens received 1 of the following surface treatments before the bonding of IPS Empress 2 laminate veneers: (1) laser radiation from an Er,Cr:YSGG laser unit; (2) 37% orthophosphoric acid; and (3) 10% maleic acid. Ten specimens received no surface treatment and served as the control group. The veneers were bonded with dual-polymerizing resin, Variolink II. One microtensile specimen from each of the cervical and incisal thirds measuring 1.2 x 1.2 mm was prepared with a slow-speed diamond saw sectioning machine with a diamond-rim blade. These specimens were attached to opposing arms of the microtensile testing device with cyanoacrylate adhesive and fractured under tension at a crosshead speed of 1 mm/min, and the maximum load at fracture (Kg) was recorded. The data were analyzed with a 2-way analysis of variance and Tukey HSD tests (alpha=.05). RESULTS No statistically significant differences were found among the bond strengths of veneers bonded to tooth surfaces etched with Er,Cr:YSGG laser (12.1 +/- 4.4 MPa), 37% orthophosphoric acid (13 +/- 6.5 MPa), and 10% maleic acid (10.6 +/- 5.6 MPa). The control group demonstrated the lowest bond strength values in all test groups. Statistically significant differences were found between the bond strengths of cervical and incisal sections (P<.001). CONCLUSION In vitro microtensile bond strengths of porcelain laminate veneers bonded to tooth surfaces that were laser-etched showed results similar to orthophosphoric acid or maleic acid etched tooth surfaces.

The Effect of Bleaching Agents on the Color Stability of Ceromer and Porcelain Restorative Materials In Vitro

PURPOSE The aim of this in vitro study was to determine the color changes of five different restorative materials after exposing these materials to two different home bleaching agents. METHODS This study applied bleaching agents to an ultralow-fusing porcelain, a low-fusing porcelain, two types of heat-pressed glass ceramics, and a ceromer. A total of 24 disc-shaped specimens were fabricated (with a diameter of 10 mm and a thickness of 2 mm) from each material (n=12). The initial color measurements were taken with a spectrophotometer. The first set of specimens were bleached with 10% hydrogen peroxide (HP) for one hour daily for 10 days. The other set of specimens were bleached with 10% carbamide peroxide (CP) bleaching gel for eight hours daily for 14 days. Data were analyzed with the one-way analysis of variance and Kruskal-Wallis statistical test. The difference in the prebleaching and postbleaching color of each material was considered to be statistically significant at p < 0.05. RESULTS The study found a statistically significant difference among the color changes of the test groups after exposing them to both bleaching agents (p<0.05). Appreciable color change was observed in the Estenia (ΔE=3.99) specimens that were bleached with the HP, and noticeable color changes were observed in the Estenia (ΔE=1.89) and IPS Empress 2 (ΔE=1.66) groups when they were treated with the CP. CONCLUSIONS Restorations (especially polymer-containing restorative materials) should be protected before any bleaching procedure due to the high risk of color change.

Effect of Nd:YAG laser bleaching and antioxidizing agents on the shear bond strength of brackets.

OBJECTIVE The aims of this study were to evaluate the effect of hydrogen peroxide bleaching agents, both nonactivated and activated by a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, and of antioxidant treatment on the shear bond strength (SBS) of orthodontic brackets. BACKGROUND DATA Nd:YAG laser activation is expected to accelerate the bleaching therapy without decrease shear bond strength. MATERIALS AND METHODS Ninety extracted maxillary central incisors were divided into two experimental groups and a control group. Group I was the control group, Group II was bleached with 35% hydrogen peroxide and had no photoactivation, and Group III was bleached with 35% hydrogen peroxide with activation by a Nd:YAG laser (4.0 W, 60 Hz frequency, 1 mm distance, 20 sec). Each group was divided into two subgroups: Subgroup A was immersed in artificial saliva for 2 weeks, and then bonded using the total etch system, whereas subgroup B was treated with an antioxidant agent (10% sodium ascorbate) and then bonded using the same system. The samples were stored in water for 24 h at 37°C, and thermocycled. The SBS in megapascals (MPa) was determined by a shear test with 1 mm/min crosshead speed, and failure types were classified with modified adhesive remnant index scores. The data were analyzed with two way analyses of variance, Tukey, and χ(2) tests at the α = 0.05 level. RESULTS In both Groups II and III, the SBSs of brackets bonded after bleaching (Group II 15.16, Group III 17.50 MPa) were significantly lower than those of brackets in the bonded unbleached group (Group I 22.13 MPa); however, sodium ascorbate treatment significantly increased the SBSs of brackets in the bleached groups (Group II 21.52, Group III 22.43 MPa), but had an insignificant effect on the SBS of the control group (Group I 23.66MPa). CONCLUSIONS Hydrogen peroxide bleaching agents reduce the SBSs both with and without Nd:YAG laser activation; however, treatment of the bleached enamel surface with 10% sodium ascorbate prior to bonding negates the effect.

Implant-supported overdenture therapy: a 3- to 8-year prospective study.

Inflammatory changes in periimplant soft tissues and loss of alveolar bone can develop as in periodontal diseases. This clinical phenomena has been described as periimplantitis. Microorganisms such as Gram-negative anaerobic rods, spirochetes, and bacteroides that are seen in subgingival flora in periodontitis have also been found in sulcular microflora in periimplantitis. The purpose of this study was to evaluate periimplant tissue changes in totally edentulous patients who had implant-supported overdentures for 3 to 8 years (5-5.5 years) clinically from both a subjective and an objective point of view. The clinical parameters used in this study can be helpful in the evaluation of periimplant tissue health.

Complex Midfacial Reconstruction With an Implant-supported Framework

This clinical report describes the treatment of a patient with osseointegrated extraoral implants supporting a framework retainer and acrylic resin mesostructures and a large silicone midfacial prosthesis. A metal framework was used to splint the implants together and provided satisfactory retention for the facial prosthesis. A 2-piece prosthesis that composed of an obturator and facial prosthesis was fabricated. Cosmetic improvements as well as the ability to speak, swallow, and, to a lesser degree, chew, were achieved for this patient.

Color Stability of CAD/CAM Fabricated Inlays after Accelerated Artificial Aging

PURPOSE To investigate the influence of accelerated artificial aging on the color stability of three different inlay restorations produced with a CAD/CAM system. MATERIALS AND METHODS Thirty non-carious human mandibular molar teeth were used. The teeth were embedded in autopolymerizing acrylic resin blocks. Standard Class I inlay cavities were prepared, and the teeth were randomly divided into three groups (n = 10) to fabricate inlay restorations: (1) a feldspathic-ceramic group, (2) a resin nano-ceramic group, and (3) a leucite glass-ceramic group. Optical impressions were made with CEREC software, and the restorations were designed and then milled. The inlays were adhesively cemented with a dual-polymerizing resin cement and left in distilled water at room temperature for 1 week. Color measurements were performed with a spectrophotometer before and after accelerated aging in a weathering machine with a total energy of 150 kJ/m(2) . Changes in color (∆E, ∆L, ∆a, ∆b, ∆C) were determined using the CIE L*a*b* system. The results were assessed using a one-way ANOVA and Tukeys HSD test (p = 0.05). RESULTS The color changes of the materials ranged from 2.1 to 9.29. The highest color change was seen in the resin nano-ceramic material. This change was not clinically acceptable (∆E > 5.5). No significant differences were found in the ∆L and ∆a values of the test groups. CONCLUSIONS Color changes were observed in each evaluated material after accelerated aging. All CAD/CAM inlays became darker in appearance, more saturated, a little reddish, and more yellow.

Temperature rises during tooth bleaching with different light-curing units

The aim of this study was to evaluate the influence of three different light-curing units on the temperature rise induced in the pulpal cavity, when bleached with 35% hydrogen peroxide (HP). Forty extracted maxillary central incisors were randomly divided into four groups according to photoactivation procedure (n = 10). Whiteness HP (WHP) bleaching agent which contains 35% HP bleach was placed on the facial tooth surface and no photoactivation device was used (control); an blue light-emitting diode (LED, 40 s), a diode laser (4 W, Continous mode, 20 s), and Nd:YAG laser (4 W, 60 Hz frequency, 20 s). Temperature rise in the pulpal chamber was measured with a J-type thermocouple wire that was connected to a data logger before and immediately after each 20–40 s application. One tooth of each group was selected for scanning electron microscope analysis. Data were analyzed using one-way ANOVA followed by the Games Howell post hoc test at a preset α of 0.05. One-way ANOVA revealed that there was a significant difference among the light-curing units (p < 0.05) and between control group and light-curing units (p < 0.05). The Nd:YAG induced significantly, which resulted in higher temperature increase than other light-curing units (10.7 °C). The LED unit produced the lowest temperature changes (3.2 °C) among the light-curing units. The presence of the bleaching gel did not cause a temperature increase in control group (0 °C). The results suggested that using light-curing units caused temperature changes in the intrapulpal cavity during tooth bleaching. The use of LED will be more safer for pulpal health when assisted with WHP bleaching gel.

Amelogenesis Imperfecta and Generalized Gingival Overgrowth Resembling Hereditary Gingival Fibromatosis in Siblings: A Case Report

Amelogenesis imperfecta (AI) is a group of hereditary disorders primarily characterized by developmental abnormalities in the quantity and/or quality of enamel. There are some reports suggesting an association between AI and generalized gingival enlargement. This paper describes the clinical findings and oral management of two siblings presenting both AI and hereditary gingival fibromatosis (HGF) like generalized gingival enlargements. The treatment of gingival enlargements by periodontal flap surgery was successful in the management of the physiologic gingival form for both patients in the 3-year follow-up period. Prosthetic treatment was also satisfactory for the older patient both aesthetically and functionally.

Hipohidrotik ektodermal displazili bir hastanın protetik tedavisi: Bir olgu sunumu

Ust cenesinde oligodonti ve alt cenesinde anodonti gorulen hipohidrotik ektodermal displazili (HED) 13 yasindaki erkek hastanin konvensiyonel protetik yaklasimi rapor edilmistir.Fonksiyonel, psikolojik, ekonomik ve estetik faktorler tedavi planlamasinda dikkate alinmistir. Ust cenede kanal tedavili surekli santral kesicilerden ve surekli 2. molar dislerin kroselerinden destek alinarak hareketli bolumlu protez alt cenede de hareketli tam protez klinik olarak planlanmistir. 5 sene sonraki takibinde, hasta cenesini kapatirken protruzyona alismis ve on bolgede retansiyon kaybi yasamis fakat protezlerinden memnun oldugunu ve konusmasinin duzeldigini soylemistir.Bu vaka HED gorulen buyumekte olan hastalarda konvansiyonel protetik tedavi yaklasimini rapor etmektedir. Implant destekli protez yaptiramayan ya da uygun olmayan cocuk hastalarda bu tedavinin faydali psikolojik etkileri vardir ve bu tedavi stomagnatik fonksiyon, estetik ve fonasyonu arttirmaktadir.