Howard E. Strassler

Nanocomposite containing CaF2 nanoparticles: Thermal cycling, wear and long-term water-aging

OBJECTIVES Fluoride (F) releasing dental restoratives are promising to promote remineralization and combat caries. The objectives of this study were to develop nanocomposite containing calcium fluoride nanoparticles (nCaF(2)), and to investigate the long-term mechanical durability including wear, thermal-cycling and long-term water-aging behavior. METHODS Two types of fillers were used: nCaF(2) with a diameter of 53 nm, and glass particles of 1.4 μm. Four composites were fabricated with fillers of: (1) 0% nCaF(2)+65% glass; (2) 10% nCaF(2)+55% glass; (3) 20% nCaF(2)+45% glass; (4) 30% nCaF(2)+35% glass. Three commercial materials were also tested. Specimens were subjected to thermal-cycling between 5°C and 60°C for 10(5) cycles, three-body wear for 4×10(5) cycles, and water-aging for 2 years. RESULTS After thermal-cycling, the nCaF(2) nanocomposites had flexural strengths in the range of 100-150 MPa, five times higher than the 20-30 MPa for resin-modified glass ionomer (RMGI). The wear scar depth showed an increasing trend with increasing nCaF(2) filler level. Wear of nCaF(2) nanocomposites was within the range of wear for commercial controls. Water-aging decreased the strength of all materials. At 2 years, flexural strength was 94 MPa for nanocomposite with 10% nCaF(2), 60 MPa with 20% nCaF(2), and 48 MPa with 30% nCaF(2). They are 3-6 fold higher than the 15 MPa for RMGI (p<0.05). SEM revealed air bubbles and cracks in a RMGI, while composite control and nCaF(2) nanocomposites appeared dense and solid. SIGNIFICANCE Combining nCaF(2) with glass particles yielded nanocomposites with long-term mechanical properties that were comparable to those of a commercial composite with little F release, and much better than those of RMGI controls. These strong long-term properties, together with their F release being comparable to RMGI as previously reported, indicate that the nCaF(2) nanocomposites are promising for load-bearing and caries-inhibiting restorations.

Canal-Centering Ability of Two Rotary File Systems

The ability of two nickel-titanium rotary file systems to maintain the original path of the canal were compared by using a new split-mold design (the Endodontic Cube). The mesial roots of 10 mandibular first- and second-molar teeth with separate canals from orifice to foramen were divided into two groups based on canal curvature and morphology. Working lengths for each canal were determined 1.0 mm short of where the file tip was visible on the external surface of the root. The teeth were embedded in composite resin by using the Endodontic Cube as a mold and sectioned into five pieces. ProFile Ni-Ti.06 taper Series 29 and ProFile GT rotary instrumentation techniques were randomly assigned to one of the canals and used in a crown-down fashion to a 0.217 ProFile and a 0.06 GT master apical file, respectively. Digital photographs were made of the middle three sections and software features of Adobe Photoshop were used to measure the movement of the canal centers by superimposing the images of the instrumented and uninstrumented canals. Data were analyzed using ANOVA. Both systems remained centered within the canal with minimal deviation from the original canal path. The largest mean movement was less than 0.15 mm. The Endodontic Cube was an effective tool for studying and comparing instrumentation techniques.

Effects of water-aging on self-healing dental composite containing microcapsules

OBJECTIVES The objectives of this study were to develop a self-healing dental composite containing poly(urea-formaldehyde) (PUF) shells with triethylene glycol dimethacrylate (TEGDMA) and N,N-dihydroxyethyl-p-toluidine (DHEPT) as healing liquid, and to investigate the mechanical properties of the composite and its self-healing efficacy after water-aging for 6 months. METHODS PUF microspheres were synthesized encapsulating a TEGDMA-DHEPT healing liquid. Composite containing 30% of a resin matrix and 70% of glass fillers by mass was incorporated with 0%, 2.5%, 5%, 7.5% and 10% of microcapsules. A flexural test was used to measure flexural strength and elastic modulus. A single edge V-notched beam method was used to measure fracture toughness (KIC) and self-healing efficacy. Specimens were water-aged at 37 °C for 1 day to 6 months and then tested for self-healing. Fractured specimens were healed while being immersed in water to examine self-healing efficacy, in comparison with that in air. RESULTS Incorporation of up to 7.5% of microcapsules into the resin composite achieved effective self-healing, without adverse effects on the virgin mechanical properties of the composite (p>0.1). An excellent self-healing efficacy of 64-77% recovery was obtained (mean±sd; n=6). Six months of water-aging did not decrease the self-healing efficacy compared to 1 day (p>0.1). Exposure to water did not decrease the healing efficacy, compared to that healed in air (p>0.1). CONCLUSIONS A composite was developed with excellent self-healing efficacy even while being immersed in water. The self-healing efficacy did not decrease with increasing water-aging time for 6 months. CLINICAL SIGNIFICANCE The novel self-healing composite may be promising for dental applications to heal cracks, resist fracture, and increase the durability and longevity.

The dental curing light: A potential health risk

ABSTRACT Powerful blue-light emitting dental curing lights are used in dental offices to photocure resins in the mouth. In addition, many dental personnel use magnification loupes. This study measured the effect of magnification loupes on the “blue light hazard” when the light from a dental curing light was reflected off a human tooth. Loupes with 3.5x magnification (Design for Vision, Carl Zeiss, and Quality Aspirator) and 2.5x magnification (Design for Vision and Quality Aspirator) were placed at the entrance of an integrating sphere connected to a spectrometer (USB 4000, Ocean Optics). A model with human teeth was placed 40 cm away and in line with this sphere. The light guide tip of a broad-spectrum Sapphire Plus (Den-Mat) curing light was positioned at a 45° angle from the facial surface of the central incisor. The spectral radiant power reflected from the teeth was recorded five times with the loupes over the entrance into the sphere. The maximum permissible cumulative exposure times in an 8-hr day were calculated using guidelines set by the ACGIH. It was concluded that at a 40 cm distance, the maximum permissible cumulative daily exposure time to light reflected from the tooth was approximately 11 min without loupes. The weighted blue irradiance values were significantly different for each brand of loupe (Fishers PLSD p < 0.05) and were up to eight times greater at the pupil than when loupes were not used. However, since the linear dimensions of the resulting images would be 2.5 to 3.5x larger on the retina, the image area was increased by the square of the magnification and the effective blue light hazard was reduced compared to without the loupes. Thus, although using magnification loupes increased the irradiance received at the pupil, the maximum cumulative daily exposure time to reflected light was increased up to 28 min. Further studies are required to determine the ocular hazards of a focused stare when using magnification loupes and the effects of other curing lights used in the dental office.

Adolescent dentistry programs: A survey of United States dental schools

The dental care needs of the adolescent have not been recognized as a distinct area of education and treatment. A survey was sent to United States dental schools to determine the number of schools with adolescent dentistry programs and how these programs are organized. The results suggest that dental schools are beginning to incorporate adolescent dentistry as a separate entity. Greater attention is required for teaching of this topic in the future.

COMMENTARY. Incisal translucency of vital natural unrestored teeth: a clinical study.

A significant restorative challenge is the restoration of an anterior tooth in the esthetic zone that reproduces the appearance of adjacent anterior teeth to the tooth restored. Although there is artistry in creating an “invisible” restoration, one that only the patient and clinician know was placed, there is also having an understanding of the challenge in communicating and replicating the tooth appearance from the cervical enamel extending to the incisal edge.The authors/researchers of this article provide insight and understanding, a checklist of sorts, in developing a highly esthetic restoration that mimics the adjacent teeth. Teeth restored in the esthetic zone must provide a range of appearances when light is reflected and refracted that include not only the surface form and color, but also the translucency, opacity, iridescence, surface luster, and fluorescence. By investigating the distribution of incisal translucency of unrestored vital maxillary anterior teeth, the authors provide the clinician with insight and a classification system to better describe how the translucent layers of the incisal edge appear.This classification system is extremely valuable when creating an esthetic road map for both directly placed anterior esthetic restorations and for communicating with the dental laboratory when anterior esthetic restorations are fabricated.

A retainerless matrix for amalgam restorations.

Summary The Automatrix is an alternative method for the restoration of mutilated posterior teeth. It provides improved access, visibility, convenience, and economy of time for amalgam procedures.