Ulf Örtengren

Influence of pH and storage time on the sorption and solubility behaviour of three composite resin materials

OBJECTIVES The aim of this study was to determine whether pH and time has any influence on the sorption and solubility behaviour of composite resin materials stored in a buffer solution. METHODS Three hybrid composite restorative resin materials (Spectrum, Z-100 and ArtGlass) with different matrix structure and filler composition were studied. One hundred and twenty specimens of each material were produced according to ISO 4049. The materials were stored in McIlvains buffer solution at different pH (4, 6 and 8) at 1, 7, 60 and 180 days. pH measurements were carried out before and after completed storage. RESULTS Time had a significant influence on the sorption and solubility behaviour of the composite resin materials tested. One of the materials Z-100 showed a significant mass increase and/or decrease depending on the pH of the solution. The material Spectrum was significantly influenced by pH, resulting in different sorption depending on the pH of the solution. CONCLUSIONS Time of storage was important for the sorption and solubility behaviour of the composite resin materials tested. Comparison of solubility for one of the materials showed twice as high values in the present study as previously reported when distilled water was used as storage medium. pH in the solution seems to have an influence on the sorption and solubility behaviour of composite resin materials. The sensitivity of the sorption and solubility behaviour to time and pH of the materials tested seems to be related to the hydrophilicity of the matrix and the chemical composition of the filler.

Contact allergy and hand eczema in Swedish dentists

Hand eczema and contact allergy in Swedish dentists were studied in a multidisciplinary project. The aims of the study were to establish diagnoses, to investigate the occurrence of contact allergy, in particular to (meth)acrylates, and to evaluate certain consequences of hand eczema. A postal questionnaire on skin symptoms, atopy and occupational experience was mailed to 3500 dentists aged <65 years, and licensed 1965–1995. The response rate was 88%. Among dentists living in 3 major cities, 14.9% (n=191) reported hand eczema during the previous year. They were invited to a clinical examination, including patch testing with a standard and a dental series. 158/191 (83%) dentists attended, and hand eczema diagnosis was confirmed in 149/158 (94%). Irritant contact dermatitis was diagnosed in 67% and allergic contact dermatitis in 28%. On patch testing, 50% presented at least 1 positive reaction. The most frequent allergens were nickel sulfate, fragrance mix, gold sodium thiosulfate and thiuram mix. 7 (5%) had positive reactions to (meth)acrylates, all to 2‐hydroxyethyl methacrylate and 6 also to ethyleneglycol dimethacrylate. 38% had consulted a physician, 4% had been on sick‐leave and 1% had changed occupational tasks due to hand eczema. No dentist with allergy to acrylates had been on sick‐leave or changed occupation. It is concluded that dentistry is a high‐risk occupation for hand eczema, and that irritant contact dermatitis is most common. The prevalence of contact allergy to acrylates was below 1% in the population of responding dentists, and in most cases did not have serious medical, social or occupational consequences.

Fracture resistance of monolithic zirconia molar crowns with reduced thickness

Abstract Objectives. The purpose of the present study was to analyze the relationship between fracture load of monolithic zirconia crowns and axial/occlusal thickness and to evaluate the fracture resistance of monolithic zirconia crowns with reduced thickness in comparison with that of monolithic lithium disilicate crowns with regular thickness. Materials and methods. Monolithic zirconia crowns (Lava Plus Zirconia, 3M/ESPE) with specified axial/occlusal thicknesses and lithium disilicate crowns (IPS e.max press, Ivoclar/Vivadent) with regular thickness were fabricated using a dental CAD/CAM system and a press technique, respectively. The crowns cemented onto dies were loaded until fracture. Based on measurements of the crown thickness made by micro-CT and the fracture load, multiple regression analysis was performed. Results. It was revealed that the occlusal thickness significantly affected the fracture load (p < 0.01), but the axial thickness did not (p = 0.2828). Although the reduction of the occlusal thickness decreased the fracture resistance of the monolithic zirconia crowns, the fracture load of the zirconia crowns with the occlusal thickness of 0.5 mm (5558 ± 522 N) was significantly higher than that of lithium disilicate crowns with an occlusal thickness of 1.5 mm (3147 ± 409 N). Conclusion. Within the limitations of the present study, it is suggested that monolithic zirconia crown with chamfer width of 0.5 mm and occlusal thickness of 0.5 mm can be used in the molar region in terms of fracture resistance.

The influence of low-temperature degradation and cyclic loading on the fracture resistance of monolithic zirconia molar crowns

The present study analyzed the kinetics of low-temperature degradation (LTD) in zirconia, and evaluated the influence of LTD and cyclic loading on the fracture resistance of monolithic zirconia molar crowns. Bar-shaped zirconia specimens were divided into nine groups and autoclaved at 134°C for 0-200h to induce LTD. The surface fraction and penetration depth of the monoclinic phase were examined using X-ray diffraction and scanning electron microscopy. Monolithic zirconia molar crowns were prepared for crown fracture testing. The crowns were autoclaved for 0-100h (n=6) and cemented to dies. Six crown-die samples that were not autoclaved and six samples that were autoclaved for 100h were subjected to cyclic loading with a load of 300N for 240,000 cycles. All samples were tested in a load-to-failure test. The monoclinic fraction on the surface increased with autoclaving time and reached a plateau after 50h. The depth of the monoclinic phase increased without reaching a plateau. The fracture load of the crowns significantly decreased from 5683N (SD: 342) to 3975N (SD: 194) after 100h of autoclaving. Cyclic loading did not significantly affect the fracture resistance of the crowns in all cases. Kinetic analysis showed no linear correlation between the surface fraction and depth of the monoclinic phase after 50h of autoclaving. Even though LTD increased the monoclinic phase, resulting in lower strength, the fracture resistance of the monolithic zirconia crowns was still sufficient to withstand the loading conditions in the molar regions.

Protective gloves in Swedish dentistry: use and side‐effects

Background During the 1980s routine wearing of gloves in dentistry was recommended by health authorities in several countries. However, prolonged glove use is associated with side‐effects of irritant and allergic origin.

Fracture resistance of computer-aided design/computer-aided manufacturing-generated composite resin-based molar crowns.

The aim of this study was to investigate whether different fabrication processes, such as the computer-aided design/computer-aided manufacturing (CAD/CAM) system or the manual build-up technique, affect the fracture resistance of composite resin-based crowns. Lava Ultimate (LU), Estenia C&B (EC&B), and lithium disilicate glass-ceramic IPS e.max press (EMP) were used. Four types of molar crowns were fabricated: CAD/CAM-generated composite resin-based crowns (LU crowns); manually built-up monolayer composite resin-based crowns (EC&B-monolayer crowns); manually built-up layered composite resin-based crowns (EC&B-layered crowns); and EMP crowns. Each type of crown was cemented to dies and the fracture resistance was tested. EC&B-layered crowns showed significantly lower fracture resistance compared with LU and EMP crowns, although there was no significant difference in flexural strength or fracture toughness between LU and EC&B materials. Micro-computed tomography and fractographic analysis showed that decreased strength probably resulted from internal voids in the EC&B-layered crowns introduced by the layering process. There was no significant difference in fracture resistance among LU, EC&B-monolayer, and EMP crowns. Both types of composite resin-based crowns showed fracture loads of >2000 N, which is higher than the molar bite force. Therefore, CAD/CAM-generated crowns, without internal defects, may be applied to molar regions with sufficient fracture resistance.

Influence of grain size and veneer firing process on the flexural strength of zirconia ceramics

The aim of the present investigation was to study the influence of grain size on the strength of yttria-stabilized zirconia upon exposure to an additional heat treatment, mimicking the veneering process. The green bodies of zirconia discs prepared by cold isostatic pressing were sintered at 1,425, 1,500, or 1,575°C to customize the grain size. The disc-shaped specimens were highly polished and then processed with or without additional heat treatments (five times at 850-930°C). Ten specimens from each treatment group were subjected to a biaxial flexural strength test according to the ISO 6872 standard. The grain size of the specimens was analyzed by the mean linear intercept technique using scanning electron microscopy. It was demonstrated that the mechanical strength of zirconia ceramics was not reduced by the veneer firing processes when polished specimens were used, but the strength was found to decrease with increasing grain size. The raw materials and the sintering process used should be selected appropriately to avoid grain coarsening because it was found that the strength was influenced by large grains.

Effect of low-temperature degradation on the mechanical and microstructural properties of tooth-colored 3Y-TZP ceramics

The aim of the present study was to evaluate the effects of low-temperature degradation (LTD) induced by autoclaving on the mechanical and microstructural properties of tooth-colored 3 mol% yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP). In total, 162 disc-shaped 3Y-TZP specimens were prepared. Two-thirds of the specimens were shaded by either the infiltration or powder mixing methods while the remaining specimens were used without coloring. The specimens were autoclaved at 134 °C for 0, 10, and 100 h to induce LTD (n=18 for each group). Chemical compositions were analyzed with X-ray fluorescence spectroscopy. Biaxial flexural strength was measured using a piston-on-three-ball test. The surface fraction and penetration depth of the monoclinic phase were examined using X-ray diffraction and scanning electron microscopy, respectively. The tooth-colored 3Y-TZP specimens contained Fe2O3 and Er2O3 (infiltration technique), and Fe2O3 (powder mixing method) at concentrations of<0.5 wt%. The tooth-colored 3Y-TZP had higher strength than the non-colored material after 100 h of autoclaving. In terms of surface fraction and penetration depth, the generation of monoclinic phase was significantly lower in the tooth-colored 3Y-TZP than in the non-colored material. The tooth-colored 3Y-TZP possessed equivalent biaxial flexural strength to that of the non-colored material and higher resistance to LTD regardless of the coloring technique (infiltration technique or powder mixing method) when the coloring pigments were contained at concentrations used in the present study.

The influence of bis-EMA vs bis GMA on the degree of conversion and water susceptibility of experimental composite materials

Abstract Objective. The aim of this work was to assess the influence of the bis-EMA content on the degree of conversion (DC) and its effect on the water sorption and solubility. Materials and methods. In a polytetrafluorethylene (PTFE) mould, 30 samples (Ø = 5 mm, height = 2 mm) of four experimental dental composite resins were cured for 10 s, 20 s and 40 s. The DC was analysed by Fourier Transform (FT)-Raman spectroscopy. To analyse sorption and solubility, six samples (Ø = 15 mm and thickness = 1 mm) of each composite (n = 72) were stored in water at 37°C for different storage periods: 24 h, 7 days and 30 days. Results. When cured for 20 or 40 s the DC increased with the increasing content of bis-EMA. However, the presence of 15 wt% of bis-GMA did not affect the DC, except when cured with 10 s irradiation time. This study also found a correlation between the content of bis-EMA and the reduced values for sorption and solubility, for all storage times used, when the materials were cured with 20 s. Conclusions. The DC of mixtures with higher content of bis-EMA is affected by the presence of bis-GMA at lower energy density delivered from the curing device, suggesting that the restrictions caused by the presence of hydrogen bonds is dependent of the irradiation time used.

Fatigue analysis of computer-aided design/computer-aided manufacturing resin-based composite vs. lithium disilicate glass-ceramic.

Resin-based composite molar crowns made by computer-aided design/computer-aided manufacturing (CAD/CAM) systems have been proposed as an inexpensive alternative to metal-ceramic or all-ceramic crowns. However, there is a lack of scientific information regarding fatigue resistance. This study aimed to analyze the fatigue behavior of CAD/CAM resin-based composite compared with lithium disilicate glass-ceramic. One-hundred and sixty bar-shaped specimens were fabricated using resin-based composite blocks [Lava Ultimate (LU); 3M/ESPE] and lithium disilicate glass-ceramic [IPS e.max press (EMP); Ivoclar/Vivadent]. The specimens were divided into four groups: no treatment (NT); thermal cycling (TC); mechanical cycling (MC); and thermal cycling followed by mechanical cycling (TCMC). Thermal cycling was performed by alternate immersion in water baths of 5°C and 55°C for 5 × 10(4) cycles. Mechanical cycling was performed in a three-point bending test, with a maximum load of 40 N, for 1.2 × 10(6) cycles. In addition, LU and EMP molar crowns were fabricated and subjected to fatigue treatments followed by load-to-failure testing. The flexural strength of LU was not severely reduced by the fatigue treatments. The fatigue treatments did not significantly affect the fracture resistance of LU molar crowns. The results demonstrate the potential of clinical application of CAD/CAM-generated resin-based composite molar crowns in terms of fatigue resistance.