Howard W. Roberts

Resin-modified Glass-ionomer Setting Reaction Competition

Resin-modified glass ionomers (RMGI) set by at least 2 mechanisms dependent upon reactant diffusion prior to gelation. Each reaction’s kinetics and setting mechanism may rely on and/or compete with the other. In this study, we investigated RMGI setting reaction interactions using differential scanning calorimetry (DSC) by varying light-cure initiation times. A RMGI was analyzed with isothermal and dynamic temperature scan DSC with light-curing occurring immediately, or at 5 or 10 minutes after mixing as well as without light-activation. Results show that as time allowed for the acid-base reaction increased, the light-activation polymerization exotherm decreased. Conversely, analysis of DSC data suggests that earlier light-activation may limit the acid-base reaction and result in a different structured material. During early RMGI development, acid-base and light-polymerization reactions compete with and inhibit one another.

Microstructural evolution and physical behavior of a lithium disilicate glass–ceramic

BACKGROUND Elucidating the microstructural responses of the lithium disilicate system like the popular IPS e.max® CAD (LS2), made specifically for computer-aided design and computer-aided manufacturing (CAD-CAM), as a temperature-dependent system unravels new ways to enhance material properties and performance. OBJECTIVE To study the effect of various thermal processing on the crystallization kinetics, crystallite microstructure, and strength of LS2. METHODS The control group of the LS2 samples was heated using the standard manufacturer heating-schedule. Two experimental groups were tested: (1) an extended temperature range (750-840°C vs. 820-840°C) at the segment of 30°C/min heating rate, and (2) a protracted holding time (14min vs. 7min) at the isothermal temperature of 840°C. Five other groups of different heating schedules with lower-targeted temperatures were evaluated to investigate the microstructural changes. For each group, the crystalline phases and morphologies were measured by X-ray diffraction (XRD) and scanning electron microscope (SEM), respectively. Differential scanning calorimeter (DSC) was used to determine the activation energy of LS2 under non-isothermal conditions. A universal testing machine was used to measure 3-point flexural strength and fracture toughness, and elastic modulus and hardness were measured by a nanoindenter. A one-way ANOVA/Tukey was performed per property (alpha=0.05). RESULTS DSC, XRD, and SEM revealed three distinct microstructures during LS2 crystallization. Significant differences were found between the control group, the two aforementioned experimental groups, and the five lower-targeted-temperature groups per property (p<0.05). The activation energy for lithium disilicate growth was 667 (±29.0)kJ/mol. CONCLUSIONS Groups with the extended temperature range (750-840°C) and protracted holding time (820-840°C H14) produced significantly higher elastic-modulus and hardness properties than the control group but showed similar flexural-strength and fracture-toughness properties with the control group. In general, rapid growth of lithium disilicates occurred only when maximum formation of lithium metasilicates had ended.

Phase transformation changes in thermocycled nickel–titanium orthodontic wires

OBJECTIVE In the oral environment, orthodontic wires will be subject to thermal fluctuations. The purpose of this study was to investigate the effect of thermocycling on nickel-titanium (NiTi) wire phase transformations. METHODS Straight segments from single 27 and 35 degrees C copper NiTi (Ormco), Sentalloy (GAC), and Nitinol Heat Activated (3M Unitek) archwires were sectioned into 5mm segments (n=20). A control group consisted of five randomly selected non-thermocycled segments. The remaining segments were thermocycled between 5 and 55 degrees C with five randomly selected segments analyzed with differential scanning calorimetry (DSC; -100<-->150 degrees C at 10 degrees C/min) after 1000, 5000, and 10,000 cycles. Thermal peaks were evaluated with results analyzed via ANOVA (alpha=0.05). RESULTS Nitinol HA and Sentalloy did not demonstrate qualitative or quantitative phase transformation behavior differences. Significant differences were observed in some of the copper NiTi transformation temperatures, as well as the heating enthalpy with the 27 degrees C copper NiTi wires (p<0.05). Qualitatively, with increased thermocycling the extent of R-phase in the heating peaks decreased in the 35 degrees C copper NiTi, and an austenite to martensite peak shoulder developed during cooling in the 27 degrees C copper NiTi. SIGNIFICANCE Repeated temperature fluctuations may contribute to qualitative and quantitative phase transformation changes in some NiTi wires.

Statistical estimation of resin composite polymerization sufficiency using microhardness

With respect to determining sub-surface resin polymerization sufficiency, this study compared a traditional method of applying linear regression to bottom- to top-surface Knoop hardness ratios to an alternative method based on nonlinear regression. Inverse linear regression on ratios was used to estimate the exposure duration required for 80% bottom-surface hardness with respect to the top, in six light-by-material groups. Alternatively, a one-phase, two-parameter, exponential association of the form Y=Y(max)(1-e(-kt)) (where Y(max) is maximum hardness, k is a rate constant, and t is exposure duration), was used to model hardness. Inverse nonlinear regression estimated, for each condition, the exposure duration required for the bottom surface to achieve 80% of corresponding condition (light and material) top-surface Y(max). Mathematically, analysis of ratios was demonstrated to yield potentially less precise and biased estimates. Nonlinear regression yielded better statistical fit and provided easily accessible tests for differences in k across light-system groups. Another recently proposed nonlinear model for polymerization, Y=Y(max)kt(n)/(1+kt(n)), was also considered. While this new model has substantially greater phenomenological and mechanistic justification, we found that the model-fitting process was more sensitive to initial parameter values and sometimes yielded untenable results when applied to our data. However, we believe that these problems would not occur if sample points are well distributed across a wide range of exposure durations, and that the model, Y=Y(max)kt(n)/(1+kt(n)), should be considered for such data sets.

Effect of Endocrown Pulp Chamber Extension Depth on Molar Fracture Resistance

PURPOSE The purpose of this study was to evaluate the effect of endocrown pulp chamber extension on mandibular molar fracture resistance. METHODS AND MATERIALS A total of 36 recently extracted mandibular third molars of approximate equal size were sectioned at the facial lingual height of contour followed by endodontic access into the pulp chamber. The specimens were then randomly divided into three groups (n=12) and pulpal and root canal contents removed. Pulp chamber floors were established at 2, 3, and 4 mm from the occlusal table using a three-step etch-and-rinse adhesive and a flowable resin composite. The prepared specimens were then embedded in auto-polymerizing denture base resin with surface area available for adhesive bonding determined using a digital recording microscope. Specimens were restored using a standardized template with a chairside computer-aided design/computer-aided manufacturing unit with the endocrown milled from a lithium disilicate glass-ceramic material. Restoration parameters of occlusal table anatomy and thickness were standardized with the only parameter difference being the pulp chamber extension depth. The endocrown restorations were luted with a self-adhesive resin luting agent and tested to failure after 24 hours on a universal testing machine, with force applied to the facial cusps at a 45° angle to the long axis of the tooth. The failure load was converted into stress for each specimen using the available surface area for bonding. Mean failure load and stress among the three groups was first subjected to the Shapiro-Wilk and Bartlett tests and then analyzed with an analysis of variance with the Tukey post hoc test at a 95% confidence level (p=0.05). RESULTS The 2- and 4-mm chamber extension groups demonstrated the highest fracture resistance stress, with the 3-mm group similar to the 2-mm group. The 3- and 4-mm chamber extension group specimens demonstrated nearly universal catastrophic tooth fracture, whereas half the 2-mm chamber extension group displayed nonrestorable root fractures. CONCLUSIONS Under the conditions of this study, mandibular molars restored with the endocrown technique with 2- and 4-mm pulp chamber extensions displayed greater tooth fracture resistance force as well as stress. All groups demonstrated a high number of catastrophic fractures, but these results may not be clinically significant because the fracture force results are higher than normal reported values of masticatory function.

Microtomographic porosity determination in alginate mixed with various methods.

PURPOSE Mechanical spatulation of alginate impression materials reportedly produces fewer voids and superior casts than hand mixing. Two current methods of alginate mechanical preparation are a vacuum mixer Vac-U-Vestor, (Whip Mix Corp, Louisville, KY) and a semiautomated method that involves hand spatulation in a rotating bowl Alginator II (Cadco, Oxnard, CA). A new alginate-mixing machine has been introduced, TurboMax (Dentsply Raintree Essex, Sarasota, FL), with a centrifugal-spinning action that reportedly incorporates the alginate powder into the water more efficiently. The purpose of this study was to determine the number, percent, and volume distribution of porosities in alginate mixed with three mechanical-mixing methods using a nondestructive, microtomographic analysis method. MATERIALS AND METHODS Alginate was mixed by each of the three mechanical methods per respective manufacturers guidelines, with the set alginate analyzed using a microtomography unit and proprietary software. A mean and standard deviation was determined per group and analyzed with Kruskal-Wallis ANOVA/Mann-Whitney tests. RESULTS Significant differences (p < 0.001) were found between groups per each of the three testing parameters (number, percent, volume distribution of porosities). The vacuum mixer produced significantly less percent porosity and number of porosities than the centrifugal mixer and semiautomated hand mixer. Both the vacuum mixer and centrifugal mixer produced porosities of significantly smaller volume than the semiautomated hand mixer. CONCLUSION Of the three mechanical mixing methods, the vacuum mixer had the best performance overall in reducing the number, percent, and volume of porosities in the mixed alginate.

Fracture resistance of amalgam/glass-polyalkenoate open sandwich Class II restorations : An in vitro study

OBJECTIVE To investigate the effect of two glass-polyalkenoate restorative materials used as root-dentin replacements on the fracture strength of Class II amalgam restorations. MATERIALS AND METHODS Class II slot preparations extending 2mm apical to the cemento-enamel junction were made in 30 teeth and randomly assigned to three groups. Group 1 (Control): restored entirely with amalgam (Tytin, Sybron Kerr, Orange, CA, USA). Group 2: The root-dentin area was restored with a viscous conventional glass-polyalkenoate restorative material (Fuji IX GP, GC America, Alsip, IL, USA), and the remainder of the preparation restored with amalgam. Group 3: The root-dentin area was restored with a resin-modified glass-polyalkenoate restorative material (Fuji II LC, GC America) and the remainder restored with amalgam. The amalgam restorations were loaded in compression to failure and the data analyzed using one-way ANOVA (alpha=0.05). RESULTS No significant differences in fracture strength were found. CONCLUSION Root-dentin replacement with the tested glass-polyalkenoate materials did not affect the fracture strength of Class II amalgam restorations.

Effect of light-cure initiation time on polymerization efficiency and orthodontic bond strength with a resin-modified glass-ionomer

OBJECTIVES The polymerization and acid-base reactions in resin-modified glass-ionomers (RMGI) are thought to compete with and inhibit one another. To examine the effect of visible light-cure (VLC) delay on the polymerization efficiency and orthodontic bond strength of a dual-cured RMGI. SETTING AND SAMPLE POPULATION The Orthodontics Graduate Program at Marquette University. An in vitro study utilizing 72 freshly extracted human bicuspid teeth. MATERIALS AND METHODS A RMGI light-cured immediately, 2.5, 5, or 10 min after mixing comprised the experimental groups. Isothermal and dynamic temperature scan differential scanning calorimetry (DSC) analysis of the RMGI was performed to determine extents of VLC polymerization and acid-base reaction exotherms. Human premolars (n = 18/group) were bonded with the RMGI. Shear bond strength and adhesive remnant index (ARI) scores were determined. RESULTS Differential scanning calorimetry results showed the 10-min-delay RMGI group experienced significantly (p < 0.05) lower VLC polymerization compared with the other groups. Acid-base reaction exotherms were undetected in all groups except the 10-min delay group. No significant differences (p > 0.05) were noted among the groups for mean shear bond strength. A chi-square test showed no significant difference (p = 0.428) in ARI scores between groups. CONCLUSIONS Delay in light-curing may reduce polymerization efficiency and alter the structure of the RMGI, but orthodontic shear bond strength does not appear to be compromised.

Effect of surface treatments on the mechanical properties and antimicrobial activity of desiccated glass ionomers

OBJECTIVES The purpose of this study was to evaluate the effect of various surface treatments on the mechanical properties and antibacterial activity of desiccated glass-ionomer (GI) and resin-modified glass-ionomer (RMGI) materials. METHODS One hundred GI and RMGI specimens were fabricated in a mold, stored in 100% humidity for 24h, placed in air to desiccate for 24h, and then stored for one week in one of the five media [casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), chlorhexidine (CHX), sodium fluoride (NaF), cetylpyridinium chloride (CPC), or 100% humidity (control)]. Fifty GI and RMGI specimens were tested in flexure to determine flexural strength and modulus, with the fragments used for Knoop hardness testing. The remaining 50 GI and RMGI specimens were covered with a suspension of Streptococcus mutans and incubated for 24h. The bacterial suspension was removed and the specimens were washed. Sterile saline was added, vortex mixed, serially diluted, and plated. CFU/mLs were calculated after 3days of incubation. RESULTS Compared to the 100% humidity control group, surface treatment of the desiccated GI and RMGI materials had a variable effect on the mechanical properties. In general, NaF provided the greatest improvement in flexural strength and modulus. Surface treatment of the desiccated GI or RMGI specimens with CHX or CPC resulted in no growth of the S. mutans. NaF resulted in significantly lower CFU/mL than CPP-ACP, which was significantly lower than the control group. SIGNIFICANCE Surface treatment with 5% NaF provides improved antimicrobial and strength properties of desiccated GI or RMGI materials.

Evaluation of Field Dental Equipment in a Deployment Environment

Dental officers and technicians must have reliable, durable, well-performing field dental equipment to enable them to provide dental care to deployed troops in operational environments. Unfortunately, no organized program exists to test such equipment before its purchase and use in the field. This article presents the results of a project conducted by the Naval Institute for Dental and Biomedical Research and the Air Force Dental Evaluation and Consultation Service to evaluate commercially available field dental equipment through laboratory testing and clinical-user evaluations in theater. The purpose of this 2-year project was to identify the best-performing and most cost-effective field dental equipment for possible future procurement. Initial laboratory testing was performed at the Naval Institute for Dental and Biomedical Research, and the equipment was then shipped to Kuwait for in-theater environmental and clinical-user testing. A seven-member scientific team of military dental officers and technicians was deployed for 1 month to perform in-theater testing under regional environmental conditions and to coordinate clinical-user evaluations. The testing provided beneficial results by identifying equipment that performed properly and equipment that exhibited shortcomings serious enough to render it inadequate for operational use. It is recommended that the project serve as a model for future testing and evaluation of medical/dental equipment by all of the military services.