Roeland De Moor

Fluoride release profiles of restorative glass ionomer formulations

OBJECTIVES The amounts of fluoride released by different glass ionomer formulations were compared on the basis of individual fluoride release profiles in order to derive the effect of the physical and chemical formulation on the fluoride release process. METHODS The fluoride release profiles of each of five specimens of ten glass ionomer cements setting by an acid-base reaction were investigated. The profiles were obtained by determining the amount of fluoride released [F] after equilibrating the samples at 37 degrees C in distilled water for 140 d. The [[F],t]-profiles were compared with a Multivariate Data Analysis on the basis of a Principal Component Analysis. RESULTS The Multivariate Data Analysis reveals that eight of the ten glass ionomers can be classified into four distinct groups. When the cumulative amount of fluoride released by each sample, [F]c, is calculated and fitted as a function of time, a regression analysis (r > 0.99) reveals that [F]c for all samples is most adequately represented by [F]c = ([F]l x t)/(t + t1/2) + beta x square root of t, indicating that two kinetic processes are responsible for the fluoride release profiles. SIGNIFICANCE A comparison of the parameters of this equation shows that the physicochemical rationale for the classification of the glass ionomers conforms to differences in the kinetics of these processes which are determined by the qualitative and quantitative chemical composition as well as by the presentation (hand-mixed vs. capsules) of the glass ionomer. From the classification, it becomes apparent that different formulations can result in the same fluoride release profiles.

Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs.

INTRODUCTION The study assessed the efficacy of laser activated irrigation (LAI) with Erbium: Yttrium Aluminum Garnet (Er:YAG) and Erbium Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) wavelengths as compared with passive ultrasonic irrigation (PUI). Previously proposed irrigation times were used for LAI (4x 5 seconds) and the intermittent flush technique (3x 20 seconds). METHODS We used a split root model with an artificial root canal wall groove. Roots were prepared to an apical size # 40 with ProFiles 0.06 (Dentsply Maillefer, Baillaigues, Switzerland). Five groups of 20 straight canine roots were evaluated as follows: Group 1: hand irrigation for 20 s with 2.5% NaOCl (CI); Group 2: PUI performed once for 20 s with the #20 Irrisafe (Satelec Acteon group, Merignac, France) (PUI 1); Group 3: PUI for 3x 20 s with the Irrisafe (PUI 2); Group 4: LAI with the Er,Cr:YSGG laser and Z2 (200 microm) Endolase tip (Biolase, San Clemente, USA) at 75 mJ for 4x 5 s (LAI 1); Group 5: LAI with the Er:YAG laser (HoYa Versawave, Cortaboeuf, France) and a 200 mum endodontic fiber at 75 mJ for 4x 5 s (LAI 2). Images from the groove were taken before and after irrigation. The quantity of dentin debris in the groove after the experimental protocols was evaluated. RESULTS Statistically significant differences (p < 0.05) were found between CI and all other groups and between PUI 1 and the other groups. CONCLUSION LAI techniques using erbium lasers (Er:YAG or Er,Cr:YSGG) for 20 seconds (4x 5 seconds) are as efficient as PUI with the intermittent flush technique (3x 20 seconds).

Laser induced explosive vapor and cavitation resulting in effective irrigation of the root canal. Part 2: Evaluation of the efficacy

Limited information exists regarding the efficacy of laser activated irrigation (LAI) on removal of root canal debris. This study compares the efficacy of LAI for removal of debris in root canals as compared to conventional irrigation (CI) and passive ultrasonic irrigation (PUI).

Fluoride release process of (resin-modified) glass-ionomer cements versus (polyacid-modified) composite resins

The fluoride release of conventional and resin-modified glass-ionomers is reviewed and compared to that of fluoride-releasing (polyacid-modified) composite resins. Each formulation displays a typical fluoride release profile. The cumulative amount of fluoride released is described by [F]c = [F](I)t/(t + t1/2) + beta square root t for glass ionomers whether resin-modified or not, whereas for composite resins this quantity is given by [F]c = [F](I)t/(t + t1/2) + alpha t. Both equations indicate that two kinetic processes are responsible for the fluoride release profiles. The kinetic parameters [F](I), t1/2, beta and alpha depend on the formulation. On the basis of the exchange characteristics for fluoride, an attempt is made to explain the mechanisms responsible for these fluoride release processes.

Laser Induced Explosive Vapor and Cavitation Resulting in Effective Irrigation of the Root Canal. Part 1 : A Visualization Study

Limited information exists regarding the induction of explosive vapor and cavitation bubbles in an endodontic rinsing solution. It is also not clear whether a fiber has to be moved in the irrigation solution or can be kept stationary. No information is available on safe power settings for the use of cavitation in the root canal. This study investigates the fluid movements and the mechanism of action caused by an Er,Cr:YSGG laser in a transparent root model.

Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities

In root canal therapy, irrigating solutions are essential to assist in debridement and disinfection, but their spread and action is often restricted by canal anatomy. Hence, activation of irrigants is suggested to improve their distribution in the canal system, increasing irrigation effectiveness. Activation can be done with lasers, termed laser-activated irrigation (LAI). The purpose of this in vitro study was to compare the efficacy of different irrigant activation methods in removing debris from simulated root canal irregularities. Twenty-five straight human canine roots were embedded in resin, split, and their canals prepared to a standardized shape. A groove was cut in the wall of each canal and filled with dentin debris. Canals were filled with sodium hypochlorite and six irrigant activation procedures were tested: conventional needle irrigation (CI), manual-dynamic irrigation with a tapered gutta percha cone (manual-dynamic irrigation (MDI)), passive ultrasonic irrigation, LAI with 2,940-nm erbium-doped yttrium aluminum garnet (Er:YAG) laser with a plain fiber tip inside the canal (Er-flat), LAI with Er:YAG laser with a conical tip held at the canal entrance (Er-PIPS), and LAI with a 980-nm diode laser moving the fiber inside the canal (diode). The amount of remaining debris in the groove was scored and compared among the groups using non-parametric tests. Conventional irrigation removed significantly less debris than all other groups. The Er:YAG with plain fiber tip was more efficient than MDI, CI, diode, and Er:YAG laser with PIPS tip in removing debris from simulated root canal irregularities.

Mineral Trioxide Aggregate Repair of a Perforating Internal Resorption in a Mandibular Molar

Internal resorption is a rare condition in permanent teeth that poses difficulties for treatment. The challenge is complicated further if the resorption extends beyond the confines of the root. This article describes treatment of a perforating internal resorption in the mesial root of a second lower molar, with adjacent destruction of the alveolar bone. After cleaning the root canal space and the resorption lacuna by mechanical instrumentation, irrigation, and interim calcium hydroxide dressing, the defect was filled with mineral trioxide aggregate, and the canals were obturated conventionally with gutta percha and epoxy resin sealer. At a 2-year follow-up examination, no clinical abnormalities were found, and complete resolution of the alveolar bone lesion and establishment of a new periodontal ligament were observed.

Towards a better understanding of the adhesion mechanism of resin-modified glass-ionomers by bonding to differently prepared dentin

OBJECTIVES The purpose of this study was to evaluate the bonding effectiveness of a resin-modified glass-ionomer (RMGI) to differently prepared dentin and how this restorative material interacts with these distinct substrates. Also the potential adhesion-promoting role of a polyalkenoic-acid conditioner was assessed. METHODS Forty-eight dentin surfaces were prepared from sound human molars and randomly distributed among 6 experimental groups. Fuji II LC (GC) was applied on bur-cut (100 μm diamond), fractured and Er:YAG laser-irradiated (200mJ, 10Hz, 31.4J/cm(2)) dentin with or without the beforehand application of the aqueous polyalkenoic-acid conditioner, Cavity Conditioner (GC). After 7 days of storage in water at 37 °C, specimens were prepared for microtensile bond strength testing (μTBS), as well as for TEM characterization of the resultant RMGI-dentin interface. Statistical analysis of the μTBS results was performed using ANOVA and Tukeys test (p<0.05). RESULTS The use of conditioner resulted in a significantly higher bond strength only when dentin was prepared by diamond bur (p<0.05). Laser irradiation induced micro-cracks on the dentin surface and led to the lowest bond strength, irrespective of the use of conditioner (p<0.05). Fuji II LC was able to partially demineralise (up to 2.0μm) and infiltrate bur-cut and fractured dentin, but no evident interaction was observed at the interface between the RMGI and laser-irradiated dentin. CONCLUSIONS Laser-induced surface modifications impaired the interaction of the RMGI with dentin, thereby negatively influencing its bonding effectiveness. The use of a polyalkenoic-acid conditioner remains crucial for the RMGI to bond effectively to bur-cut dentin.

Changes in surface hardness of conventional restorative glass ionomer cements

The effect of a contact with an aqueous solution on the surface hardness of glass ionomers has been investigated in a few studies and for a limited number of formulations. As there is no information on the long-term changes of the surface hardness in this respect, the aim of this study was to determine these long-term changes in 10 conventionally setting glass ionomer formulations after storage in water as compared to maturation in a humid atmosphere (85% RH). After setting for 15 min different series of glass ionomer specimens were stored at 37 degrees C in both experimental media for 1, 7, 28 and 140 days. At the end of the specific maturation times, the mean surface hardness was determined on the basis of Knoop Hardness (KHN). Data were analyzed using ANOVA. In a humid atmosphere the surface hardness generally increases rapidly initially, followed after 1 day by a more gradual increase. In contact with water, the hardness also increases up to one day but not to the same extent. The surface hardness then remains constant or slightly decreases. Evidence of a detrimental softening of the surface ascribed previously to the loss of matrix forming ions was not found. A surface erosion is not likely to occur.

Effect of acetic acid on the fluoride release profiles of restorative glass ionomer cements

OBJECTIVES This study investigates the fluoride release of glass ionomers in an acetic acid solution in order to substantiate a model according to which the short-term release results from an elution of loosely bound fluoride and the long-term release from an erosive leaching of the glass particles in the bulk of the cement. METHODS Individual fluoride release profiles of five specimens of 10 acid-base setting restorative glass ionomers were obtained by determining the amounts of fluoride released by each sample at 37 degrees C in consecutive elutions for up to 140 days with 25 ml of a 0.01 mol/l acetic acid solution with pH = 4. Differences in the fluoride release profiles were determined with a Multivariate Data Analysis on the basis of a Principal Component Analysis. RESULTS The fluoride release profiles of the 10 glass ionomers can be classified into five distinct groups which are characterized by a cumulative fluoride release described by the equation [F]c = [F]l t/(t + t1/2) + beta square root of t. The parameters ([F]l, t1/2) and beta are characteristic for the materials in the groups, and refer to the short-term and long-term fluoride release, respectively. The acidic solution enhances both processes compared to an elution in water, the effect being more pronounced for the long-term release. SIGNIFICANCE The fluoride release mechanism is intrinsically the same as determined for elutions in water. The increased amount of fluoride released under acidic conditions, especially in the long term, corroborates that an erosive leaching of the glass particles in the bulk of the cement accounts for the long-term fluoride release.