Jelena Juloski

Influence of phosphoric acid etching on microleakage of a self-etch adhesive and a self-adhering composite.

BACKGROUND The aim of this study was to evaluate the influence of preliminary phosphoric acid etching on the microleakage of a self-adhering flowable composite and a self-etch adhesive used in combination with the proprietary flowable composite. METHODS Standard Class V cavities were prepared on the buccal side of 20 extracted sound human molars. Specimens were randomly divided into five groups: (1) Gel Etchant/Optibond FL/Premise Flowable; (2) Vertise Flow; (3) Optibond XTR/Premise Flowable; (4) Gel Etchant/Vertise Flow; and (5) Gel Etchant/Optibond XTR/Premise Flowable (Kerr). The interfacial sealing ability of the materials was evaluated by scoring the depth of silver nitrate penetration and through scanning electron microscopy observations. Differences in leakage at either the enamel or the dentine interface were evaluated for statistical significance (Kruskal-Wallis ANOVA, Mann-Whitney U test, p < 0.05). RESULTS At the enamel interface, no significant differences were found among the materials. On dentine, Gel Etchant/Vertise Flow had the highest leakage scores and the difference was statistically significant (p < 0.05). CONCLUSIONS The early sealing ability of the self-adhering flowable composite and the self-etch adhesive in Class V restorations did not significantly benefit from selective enamel etching. Preliminary phosphoric acid etching of dentine negatively affected the quality of the seal when using the adhesive-free flowable composite.

Micro-computerized tomographic analysis of premolars restored with oval and circular posts

ObjectivesThe purpose of the study was to evaluate by micro-computerized tomography (microCT) areas and volumes of post, cement, and voids/bubbles in the post space of oval-shaped premolars restored either with oval or circular posts.Materials and methodsTwelve extracted premolars were divided into two groups according to the drill-fiber post system used: (1) GC Fiber Post Drill + circular post GC Fiber Post; (2) Ellipson tipTM + oval post Ellipson postTM. Each tooth was scanned using microCT, and areas and volumes of canal, post space, post, cement, and voids at coronal, medium, and apical level were calculated by using a three-dimensional visualization software. Two-way analyses of variance and Tukey tests were used for statistical analysis (p < 0.05).ResultsThe area of voids was significantly greater at apical level of oval posts, but no difference was found between the levels among the groups. Regardless of post shape, the volume of voids and of cement was significantly higher at the coronal level. With oval posts, the total volume of cement was twice as much as with circular posts, and the difference was statistically significant.ConclusionsOur results indicate that the volume of voids does not depend on post shape. Moreover, the microCT analysis demonstrated that the volume of cement was greater with oval posts compared to circular posts.Clinical relevanceThe microCT analysis provided interesting information on voids distribution and on the ratio between post shape and cement thickness. These results might address the clinician in the reconstruction of teeth with fiber posts.

Post-Retained Single Crowns versus Fixed Dental Prostheses: A 7-Year Prospective Clinical Study:

Biomechanical integrity of endodontically treated teeth (ETT) is often compromised. Degree of hard tissue loss and type of final prosthetic restoration should be carefully considered when making a treatment plan. The objective of this prospective clinical trial was to assess the influence of the type of prosthetic restoration as well as the degree of hard tissue loss on 7-y clinical performance of ETT restored with fiber posts. Two groups (n = 60) were defined depending on the type of prosthetic restoration needed: 1) single unit porcelain-fused-to-metal (PFM) crowns (SCs) and 2) 3- to 4-unit PFM fixed dental prostheses (FDPs), with 1 healthy and 1 endodontically treated and fiber post-restored abutment. Within each group, samples were divided into 2 subgroups (n = 30) according to the amount of residual coronal tissues after abutment buildup and final preparation: A) >50% of coronal residual structure or B) equal to or <50% of coronal residual structure. The clinical outcome was assessed based on clinical and intraoral radiographic examinations at the recalls after 6, 12, 24, 36, 48, and 84 mo. Data were analyzed by Kaplan-Meier log-rank test and Cox regression analysis (P < 0.05). The overall 7-y survival rate of ETT restored with fiber post and either SCs or FDPs was 69.2%. The highest 84-mo survival rate was recorded in group 1A (90%), whereas teeth in group 2B exhibited the lowest performance (56.7% survival rate). The log-rank test detected statistically significant differences in survival rates among the groups (P = 0.048). Cox regression analysis revealed that the amount of residual coronal structure (P = 0.041; hazard ratio [HR], 2.026; 95% confidence interval [CI] for HR, 1.031–3.982) and the interaction between the type of prosthetic restoration and the amount of residual coronal structure (P = 0.024; HR, 1.372; 95% CI for HR, 1.042–1.806) were statistically significant factors for survival (ClinicalTrials.gov NCT01532947).

Shear Bond Strength to Enamel and Flexural Strength of Different Fiber-reinforced Composites

PURPOSE To assess the shear bond strength to unground human enamel (ESBS) and flexural strength (FS) of different reinforcing fibers used in combination with a flowable composite resin. MATERIALS AND METHODS For ESBS testing, 90 human molars were selected and randomly divided into 9 groups (n = 10) according to the reinforcing fiber to be tested: 1. RTD Quartz Splint additionally impregnated at chairside with Quartz Splint Resin (RTD); 2. RTD Quartz Splint without additional impregnation; 3. Ribbond-THM (Ribbond) impregnated with OptiBond FL Adhesive; 4: Ribbond Triaxial (Ribbond) impregnated with OptiBond FL Adhesive; 5. Connect (Kerr) impregnated with OptiBond FL Adhesive; 6. Construct (Kerr) impregnated with Opti- Bond FL Adhesive; 7. everStick PERIO (Stick Tech); 8. everStick C&B (Stick Tech); 9. nonreinforced composite Premise flowable (Kerr). Cylinders of flowable composite reinforced with the fibers were bonded to the intact buccal surface of the teeth. After 24 h of storage, shear loading was performed until failure occurred. FS was assessed performing three-point bending test according to ISO Standard 4049/2000. ESBS and FS data were analyzed using one-way ANOVA, followed by Tukeys HSD test for post-hoc comparisons (p < 0.05). RESULTS For each group, the ESBS and FS, respectively, in MPa were: 1. 17.07 ± 4.52 and 472.69 ± 30.49; 2. 14.98 ± 3.92 and 441.77 ± 61.43; 3. 18.59 ± 5.67 and 186.89 ± 43.89; 4. 16.74 ± 6.27 and 314.41 ± 148.52; 5. 14.38 ± 4.14 and 223.80 ± 77.35; 6. 16.00 ± 5.55 and 287.62 ± 85.91; 7. 16.42 ± 3.67 and 285.35 ± 39.68; 8. 23.24 ± 5.81 and 370.46 ± 29.26; 9. 12.58 ± 4.76 and 87.75 ± 22.87. For most fibers, no significant difference in ESBS was found compared to the control group, except for everStick C&B, which yielded higher ESBS. Nonreinforced composite exhibited the lowest FS, while all fibers positively affected the FS. CONCLUSIONS Fiber reinforcement of flowable composite does not affect its ESBS. The flexural strength of FRCs is significantly influenced by fiber composition and pattern.

Prosthetics in Paediatric Dentistry

Summary Premature loss of teeth in children may lead to both functional and esthetic problems. Missing teeth in both anterior and posterior regions may cause malfunctions in mastication and proper pronunciation. If the missing teeth are not replaced, further complications may occur, including adjacent tooth migration, loss of alveolar bone, and irregular occlusion. Considering the sensitive nature of children, loss of teeth may cause the development of insecurities and low self esteem problems. Due to dynamic nature of growth in children and adolescents, prosthetic appliances must not hinder development of orofacial system, and must meet adequate esthetic and functional standards. Dental prosthetic appliances in paediatrics must be planned with respect to the special conditions that led to tooth loss or damage. Multi-disciplinary approach is needed, under constant supervision of paediatric dentist and orthodontist, as well as regular checkups with clinical and radiographical examinations.