Graham J. Mount

The effect of varnishes and other surface treatments on water movement across the glass ionomer cement surface. II

The aesthetic restorative glass ionomer cements undergo a rather prolonged setting reaction during which time they are susceptible to water uptake and water loss. If they can be maintained in isolation long enough in the oral cavity then the clinical result will be superior. A further series of surface treatments has been tested and it has been shown that immediate covering of the immature glass ionomer cement surface with light-activated bonding resin is the most effective method of limiting water movement across the surface. This restriction of water movement is not effective for all light-activated bonding resins suggesting that there may be a physico-chemical interaction occurring on the glass ionomer cement surface with certain of the resins.

Therapeutic effect of glass‐ionomers: an overview of evidence

The requirements for an ideal restorative material include adhesion to tooth structure (enamel and dentine) and an ability to withstand the traumas of occlusion. However, some level of an anticaries effect is also desirable. After a long history of glass-ionomer cement (GIC) development, an evidence base in support of the therapeutic effect of GIC, particularly with regard to its anticaries effect, is emerging. This evidence is increasingly presented through systematic reviews of clinical GIC application and, to a certain extent, relates to a caries-preventive effect of the material itself. However, the strength of evidence supporting other aspects of GIC, such as a higher remineralizing effect, fluoride uptake in hard tooth tissue and fluoride release of GIC, is limited. Nevertheless, the results of these in situ and laboratory trials provide valuable insights into factors that facilitate understanding of the clinical efficacy of GIC.

The influence of resin coating on the shear punch strength of a high strength auto-cure glass ionomer

OBJECTIVES The aim of this study is to examine the influence of early water contact on the shear punch strength of a modern, high strength, auto-cure glass ionomer (Fuji IX GP). METHODS Specimens, 8.0mm in diameter and approximately 1.25mm thick, were prepared in metal washers, and allowed to remain covered by polyester strips for 7min, to ensure completion of the initial set. A minimum of 32 specimens was prepared for each set of experiments and they were divided into two equal groups. Following removal of the strips, the surfaces of the specimens in Group 1 were immediately coated on both sides with Fuji Coat LC and light cured for 10s. In Group 2 the specimens were left uncoated. All specimens were then placed in distilled water at 37 degrees C, and stored for periods of 24h, 1, 2, 5, or 8 weeks. The strength of the specimens was measured at each time interval in the shear mode by a punch test in a universal testing machine. RESULTS The mean strength of the coated specimens in Group 1, which had been protected against exposure to water, increased significantly on ageing from 67.1 (24h) to 78.0MPa (1 week), with no further significant change in strength. The mean strength of the specimens in Group 2 increased significantly from 75.7 (24h) to 83.3 (1 week) and 91.9MPa (2 weeks), with no further significant change in strength. Uncoated specimens were stronger at all points of time. The difference was statistically significant at 24h, 2, 5, and 8 weeks (P<0.05), but not at 1 week (P=0.061). Significance. The results suggest that, contrary to the usual instructions for placement of glass ionomer, early access to water will positively influence the shear punch strength of Fuji IX GP.

An in vitro model for the study of chemical exchange between glass ionomer restorations and partially demineralized dentin using a minimally invasive restorative technique

OBJECTIVES This study was designed to validate an in vitro model of the Atraumatic Restorative Technique (ART). This model allowed in depth analyses of the migration of apatite forming Sr and F, from a glass-ionomer, Fuji IXGP (GC Corporation, Tokyo, Japan), into partly demineralized dentine. The second objective was to study the effects of the levels of mineral loss on such ionic exchange. METHODS Artificial lesions were created in thirty third molars, which were divided into three groups based on time of exposure to the demineralizing solution (7, 14 and 21 days). These were restored with Fuji IXGP and left for 21 days. The method of analysis was electron probe microanalysis (EPMA) with wavelength dispersive spectrometry (WDS). This combination can yield both qualitative identification of elements as well as quantitative compositional information, with a minimum detection limit of 0.01%. RESULTS The results indicated that there was no significant difference in the levels of Ca and P from the control and test sides for all three groups of demineralized dentine. The differences in the depth of penetration and the amount of Sr and F between control and test were significant. CONCLUSIONS The validity of the in vitro model was confirmed. There was migration of both strontium and fluorine to the artificially demineralized dentine in a pattern consistent with remineralization and similar to what was observed in a previous in vivo study.

Idiopathic internal resorption. A report on fifteen cases.

Abstract Many reports have been published on “idiopathic internal resorption,” but little is known about its origin or cause. Most cases reported concern anterior teeth, but the condition is probably not rare in posterior teeth. This article reviews the literature and reports on fifteen posterior teeth in which internal resorption has been diagnosed over a period of 4 years in one private practice. It is often difficult to decide whether the lesion began internally or externally; the majority probably began externally, but in three of the teeth in this series the lesions certainly began internally. If these teeth are to be saved, early diagnosis is essential. This requires careful examination of routine roentgenograms, especially in patients who demonstrate a susceptibility.

A new paradigm for operative dentistry.

It is over 100 years since G V black gathered together most of the knowledge then current on the caries process and set clear parameters for the discipline of operative dentistry. His four-volume treatise set standards that were relevant for the times and, in fact, were so well described that they remained dominant in this discipline until quite recently. However, over the last 50 years there has been great progress in scientific method and in knowledge of the common diseases of the oral environment, including the caries process, so maybe it is time for change. The term “paradigm” describes a philosophy of science, a generally accepted model of how ideas relate to one another, forming a conceptual framework within which scientific research is carried out. Black defined the paradigm within which further research was to be conducted during the following years and the profession accepted his lead. However, it is not expected that the parameters of a profession should remain unchanged over a substantial period so it is suggested that the dental profession should, at this time, recognize a new paradigm. Improvements in scientific method have led to a better understanding of the oral environment, resulting in extensive changes for this profession. It is suggested that the standards set by Black should be now consigned to history and an entirely new paradigm adopted. First, the profession must recognize that dental caries is a bacterial disease and its primary efforts should be directed towards identification and elimination of the disease prior to initiating repair of the damage that it has caused. Preservation of natural tooth structure is then the next responsibility. There should be maximum use made of preventive strategies, including remineralization, followed by minimal intervention cavity designs and the use of bioactive restorative materials to restore the lesions. The profession should be prepared to move on.