Indirect Resin Composite Restorations Research Articles

Influence of the indirect restoration design on the fracture resistance: a finite element study.

Objectives To establish a three-dimensional (3D) finite element (FE) model of a maxillary first premolar and to evaluate the stress generated on the tooth (dentine) and on the indirect composite resin restorations by occlusal forces.Methods An embedded intact maxillary first premolar tooth was sliced serially and scanned digitally parallel to the occlusal surface. The 64 images were assembled in a 3D FE mesh and exported to generate a 3D solid tooth model. Simulated, adhesively cemented indirect mesial-occlusal-distal (MOD) inlays of 2 mm (I1), 3 mm (I2) and 4 mm (I3) in width, and MOD onlays with occlusal cusp coverage of 2 mm (O1) and 3 mm (O2) in depth were created. The peak von Mises stress values in the five tooth models resulting from static vertical and oblique occlusal forces (300 N) were evaluated using Patran FE software.ResultsThe peak stress values generated by vertical occlusal force generated in dentine of I1, I2, I3, O1 and O2 restoration were 67, 32, 29, 38 and 27 MPa, respectively, and those generated by oblique occlusal force were 52, 114, 168, 54 and 55 MPa, respectively. The peak von Mises stress values in I1, I2, I3, O1 and O2 restoration subjected to oblique occlusal loading were 79, 120, 1740, 1400 and 1170 MPa, respectively.ConclusionA 3D FE model of a maxillary first premolar was established. Simulated cemented composite resin onlay markedly reduces occlusal stress in the underlying dentine of large MOD preparation. Oblique occlusal force imparts substantially higher stress to large composite resin inlay than to the adjacent dentine.

Evaluation of Surface Roughness of Ceramic and Resin Composite Material Used for Conservative Indirect Restorations, after Repolishing by Intraoral Means.

To evaluate and compare the mean surface roughness (Ra) of one ceramic and one resin composite material used for indirect restorations, after grinding and repolishing by intraoral means. The materials used were the lithium disilicate glass ceramic IPS e.max Press (EMP) and the indirect resin composite restoration system Gradia (GR). Twelve specimen disks were prepared from each material according to the manufacturer of each material. Five initial measurements of the Ra (Ra1 ) were made on each specimen as a referral basis, and the specimens were ground with a fine (red) diamond bur. The specimens were repolished using (a) Komet Dialite Polishing Kit for EMP and (b) Enhance Finishing and Polishing System and Prisma Gloss Polishing Paste for GR. Five final Ra (Ra2 ) measurements were performed on each specimen. All measurements were made using a laser profilometer. Scanning electron microscopy (SEM) was also used to visualize the initial surface morphology and the morphological changes on the specimens' surface after repolishing. A highly significant difference was found between Ra1EMP and Ra2EMP (p < 0.001), between Ra1GR and Ra2GR (p < 0.001), as well as between Ra2EMP and Ra2GR (p < 0.001), when compared in pairs. A highly significant difference (p < 0.001) was also found between ΔRaEMP and ΔRaGR , with ΔRaGR being higher than ΔRaEMP . The RaGR values were higher than the RaEMP values at all times. SEM revealed that both EMP and GR repolished surfaces presented with irregularities; however, in GR specimens major voids and craters were present. EMP was found to perform better when polished by intraoral means compared with GR. Both materials exhibited Ra2 above the critical threshold for increased plaque accumulation and periodontal inflammation. If enamel-to-enamel roughness found in occlusal contact areas is considered as baseline, both materials were clinically acceptable after repolishing.

Fracture Resistance and Failure Mode of Endodontically Treated Premolars Restored with Different Adhesive Restorations

Introduction: The restoration of endodontically treated teeth is a topic that has been studied extensively but it is still a challenge for dental practitioners. The aim of this study was to evaluate fracture resistance, fracture patterns and fracture location of endodontically treated human maxillary premolars restored with direct and indirect composite resin and ceramic restoration. Methods: Eighty non-carious maxillary premolars were selected and divided into four groups (n=20). Endodontic treatment and mesio-occluso-distal preparations were carried out in all the groups except for the control group (group I). Subsequently, the prepared teeth were restored as follows: group II: indirect composite restoration; group III: ceramic restoration; group IV: direct composite restoration. The specimens were subjected to compressive axial loading until fracture occurred. The mode of failure was also recorded. Results: Group I had higher fracture resistance (1196.82±241.74) than the other groups (P<0.05) and group IV exhibited significantly higher values (962.10±165.52) compared to groups II (731.21±85.89) and III (758.18±108.10) (P<0.05). The fracture patterns were significantly different between the composite resin groups and the ceramic group (P<0.05). The most prevalent fracture pattern in the groups II and IV was mixed fracture and in the group III, restoration cohesive fracture was the predominant pattern. With regard to fracture location, the direct composite restorations exhibited more fractures below the CEJ compared to the indirect restorations (P<0.05). Conclusions: Use of direct composite restorations resulted in higher resistance against fracture, but their failure modes may be unfavorable

Indirect composite restorations luted with two different procedures: A ten years follow up clinical trial.

Objectives: The aim of this clinical trial was to evaluate posterior indirect composite resin restoration ten years after placement luted with two different procedures. Study Design: In 23 patients 22 inlays/onlays (Group A) were luted using a dual-cured resin composite cement and 26 inlays/onlays (Group B) were luted using a light cured resin composite for a total of 48 Class I and Class II indirect composite resin inlays and onlays. The restorations were evaluated at 2 time points: 1) one week after placement (baseline evaluation) and 2) ten years after placement using the modified USPHS criteria. The Mann-Whitney and the Wilcoxon tests were used to examine the difference between the results of the baseline and 10 years evaluation for each criteria. Results: Numerical but not statistically significant differences were noted on any of the recorded clinical parameters (p>0.05) between the inlay/onlays of Group A and Group B. 91% and 94 % of Group A and B respectively were rated as clinically acceptable in all the evaluated criteria ten years after clinical function. Conclusions: Within the limits of the study the results showed after ten years of function a comparable clinical performance of indirect composite resin inlays/onlays placed with a light cure or dual cure luting procedures. Key words:Light curing composite, dual curing composite, indirect composite restoration, inlays/onlays, clinical trial.

Laser Phototherapy (660 nm) Can Be Beneficial for Reducing Gingival Inflammation in Prosthodontics.

Among the new technologies developed, low power lasers have enabled new approaches to provide conservative treatment. Low power lasers act at cellular level, resulting in reduced pain, modulating inflammation, and improved tissue healing. Clinical application of the low power laser requires specific knowledge concerning laser interaction with biological tissue so that the correct irradiation protocol can be established. The present case report describes the clinical steps involved in an indirect composite resin restoration performed in a 31-year-old patient, in whom low power laser was used for soft tissue biomodulation. Laser therapy was applied with a semiconductor laser 660 nm, spot size of 0.028 cm2, energy density of 35.7 J/cm2, mean power of 100 mW, and energy per point as 1 J, in contact mode, on a total of 2 points (mesial and distal), totaling 2 J of energy. The therapy with low power laser can contribute positively to the success of an indirect restorative treatment.

Bond strength and monomer conversion of indirect composite resin restorations, Part 1: Light vs heat polymerization.

To assess the resin microtensile bond strength (MTBS) and the monomer conversion (MC) of indirect composite resin restorations made of three different materials. Two light-polymerized direct materials (Filtek Z100 and Premise) and one light- and heat-polymerized indirect material (Premise Indirect) were used. For MTBS testing, 42 cylindrical samples were fabricated (7 pairs per material). Surface conditioning included airborne-particle abrasion, cleaning, and application of a silane. Cylinders were bonded to each other using adhesive resin (Optibond FL). Specimens were stored in water for 24 h. Another 15 cylinders (5 per material) were fabricated for MC measurements (FT-IR) immediately and at 24 h. The MTBS data were submitted to one-way ANOVA and the MC to two-way ANOVA (material and storage time) (α=0.05), followed by post-hoc comparisons with the Tukey test. The MTBS to Z100 was 72.2 MPa, significantly higher than that to Premise (48.4 MPa) and Premise Indirect (52.7 MPa). The immediate MC was similar for all materials (range 51% to 56%) and significantly increased at 24 h (range 57% to 66%), except for Z100. Premise Indirect showed the highest MC (66% at 24 h). Z100 showed better "bondability" than Premise and Premise Indirect. Premise Indirect, with its heat initiator, did not present a higher MC.

Coronas estéticas de nano-resina híbrida en dientes temporales. Reporte de caso

Within the field of dentistry, loss of primary teeth due to caries, pulp conditions and crown fractures has been recognized as one of the most severe etiological factors of dental problems in the pediatric dentistry field. One of the greatest headways in dentistry in the last years encompasses the adhesion to enamel of primary teeth, this has led to the development of many techniques to restore the tooth. Obstacles that might be encountered are the presence of an aprismatic layer on the surface of primary teeth. This layer might reach 25μ as well as the reduced amount of enamel present. Nevertheless, dentists might overcome these factors and manufacture esthetically-pleasing restorations. Crowns manufactured with composite resins and used in indirect techniques in the laboratory optimize physical and chemical characteristics and in general, polymerize with the use of physical means (light, heat, pressure, etc.). Therefore, they present smooth, pore-free surfaces, which allow for suitable esthetics, greater resistance to abrasion and proper adaptation. The aim of the present work was to present a clinical case of rehabilitation with indirect composite resin restoration (Signum-ceramis-Heraeus) and to show a technique for the rehabilitation of primary, upper anterior teeth which did not entail placement of provisional teeth. Rehabilitation of primary temporary teeth with nano-resin-hybrid crowns prefabricated in the lab represents a suitable option in the field of pediatric dentistry.

Effect of dentinal surface preparation on the bonding of self-adhesive luting cements

The purpose of the present study was to evaluate the bond strength and the interaction morphology of self-adhesive resin luting cements (SLCs) to dentin prepared with different methods. Four SLCs were used: RelyX U100®, RelyX U200®, Clearfil SA Luting®, and SmartCem2®. A flat dentin surface of 40 human molars was exposed and each tooth was sectioned in four tooth-quarters, which were distributed into four groups according to the SLC used to cement indirect resin composite restorations. The tooth-quarters of each group were then distributed in four subgroups according to the method used for dentin preparation: flat-ended cylindrical fine-grit diamond, flat-ended cylindrical median-grit diamond, flat-ended cylindrical plain-cut tungsten carbide, or abraded with #600-grit SiC paper (control). The restored tooth-quarters were sectioned to obtain beams (0.8 mm2) and submitted to the microtensile bond strength test (n = 10). The results were analyzed using two-way ANOVA/Tukey (α = 0.05). Forty-four additional teeth were used for micromorphological investigation of the SLC/dentin interface and of the topographic aspect of the dentin surfaces after application of the SLCs. Only the bond strength of RelyX U200 was significantly influenced by the surface preparation. No interference was identified on the micromorphological aspect of the bonding interfaces. The topographic investigation of the dentinal surfaces showed that the SLCs were not able to effectively remove the smear layer and etch the underlying dentin, irrespective of the preparation method. So, the interference of the dentin preparation on the bond strength of SLCs is material dependent, but don’t influence the micromorphologic aspect of the interaction zone.

Randomized Control Trial of Composite Cuspal Restorations

The objective of this randomized control trial was to compare the five-year clinical performance of direct and indirect resin composite restorations replacing cusps. In 157 patients, 176 restorations were made to restore maxillary premolars with Class II cavities and one missing cusp. Ninety-two direct and 84 indirect resin composite restorations were placed by two operators, following a strict protocol. Treatment technique and operator were assigned randomly. Follow-up period was at least 4.5 yrs. Survival rates were determined with time to reparable failure and complete failure as endpoints. Kaplan-Meier five-year survival rates were 86.6% (SE 0.27%) for reparable failure and 87.2% (SE 0.27%) for complete failure. Differences between survival rates of direct and indirect restorations [89.9% (SE 0.34%) vs. 83.2% (SE 0.42%) for reparable failure and 91.2% (SE 0.32%) vs. 83.2% (SE 0.42%) for complete failure] were not statistically significant (p = .23 for reparable failure; p = .15 for complete failure). Mode of failure was predominantly adhesive. The results suggest that direct and indirect techniques provide comparable results over the long term (trial registration number: ISRCTN29200848).

Effect of Sandblasting on Shear Bond Strength Composite Resin Veneer

Attachment between restoration and enamel surface in indirect resin composite veneer restoration (IRCV) is obtained using multi-step (MS) resin cement. Recently, a one step self-adhesive dual-cured resin cement (SADRC) was introduced. Objective: To determine the effect of sandblasting on shear bond strength (SBS) of IRCV to enamel using MS resin cement and SADRC. Methods: Forty specimens of buccal surface of enamel human were light-cured in Solidilite chamber and were divided into two groups: IRCV without sandblasting (n=20) and with sandblasting for 10 seconds (n=20) and then bonded to enamel using MS (n=10) and SADRC (n=10), respectively. After 24h SBS of specimens were tested using a Universal Testing Machine. Data were analyzed statistically by one-way ANOVA. Results: The average SBS value of IRCV without SB and bonded with MS was 18.95+7.80MPa and MS with SB was 19.30+ SB (4.85+2.12MPa) and SADRC with SB (9.57+3.45MPa)( p <0.05). Conclusion: increased SBS VIRK to enamel using MS resin cement than SADRC.

A Five-Year Clinical Evaluation of Direct Nanofilled and Indirect Composite Resin Restorations in Posterior Teeth

To assess the clinical efficacy of posterior composite resin restorations placed directly and indirectly in posterior teeth after five years. A total of 108 cavities in 54 patients were restored with three direct composite resins (Filtek SupremeXT [FSXT], Tetric Evo Ceram [TEC], AELITE Aesthetic [AA]) and two indirect composite resins (Estenia [E] and Tescera ATL [TATL]). All restorations were evaluated by two examiners using the United States Public Health Service criteria at baseline and five years after placement. Statistical analysis was completed with Fisher exact and McNemar χ(2) tests. At baseline, 4% (five) of the restored teeth presented postoperative sensitivity; however, only one of them (a member of the E group) required canal treatment and replacement after two years. At the five-year evaluation, all restorations were retained, with Alpha ratings at 100%. Only one tooth (in the TEC group) required replacement after three years due to secondary caries. Color match, surface texture, and marginal integrity were predominantly scored as Alpha after five years for all groups. After that time, marginal discoloration was scored as Alpha in 64% of AE restorations, 70% of TATL restorations, 73% of E restorations, and 87% of FSXT restorations. There were no Charlie scores recorded for any of the restorative systems. Under controlled clinical conditions, indirect composite resin inlays and direct composite resin restorations exhibited an annual failure rate of 2.5% and 1.6%, respectively, after five years. Therefore, the investigated materials showed acceptable clinical performance, and no significant differences were found among them.

1-Year clinical study of indirect resin composite restorations luted with a self-adhesive resin cement: effect of enamel etching

In vitro studies have recommended enamel-etching before luting indirect restorations with self-adhesive resin cement. However, there is no scientific proof that this procedure has any clinical relevance. Thus, the aim of this study was to evaluate the effect of enamel-etching on the marginal quality of indirect composite resin restorations (inlay/onlay) using the self-adhesive cement RelyX Unicem clicker. Forty-two posterior teeth were selected from 25 patients that presented one or two teeth with large restorations in need of replacement. All teeth were prepared by the same operator and impressed with polyvinylsiloxane material. The composite resin restorations were built over plaster casts using the incremental technique with a LED device for light-curing the increments. The inlays/onlays were cemented according to one of the following protocols: 1. Etched group (ETR) - selective enamel phosphoric-acid etching + RelyX Unicem clicker; 2. Non-etched group (NER) - RelyX Unicem clicker alone. Each surface was light-cured for 60 s. Recalls occurred after 1 week (baseline), 6 and 12 months when the teeth were evaluated according to previously established scores (modified USPHS criteria). The clinical analysis showed little or no visible changes in the marginal quality after 1 year, even though a probe could detect all the restorations margins. Statistical analysis (Fisher's exact test, p<0.05) detected no differences between the groups after 12 months. No restorations failed and no secondary caries were found. Enamel acid etching had no clinical relevance on the marginal quality of indirect composite resin restorations luted with RelyX Unicem clicker after 1 year of follow up.

Bond Strength and Interfacial Micromorphology of Etch‐and‐Rinse and Self‐Adhesive Resin Cements to Dentin

To evaluate the microtensile bond strength and interfacial micromorphology of indirect composite restorations to dentin using three commercial resin cements after 24 hours and 30 days of water storage. The medium dentin of third human molars was exposed (N = 30, n = 10 per group). Three commercial resin cements were used to cement indirect resin composite restorations to dentin: the auto-cured C&B Cement/All Bond 2, the dual-cured RelyX ARC/Adper Single Bond 2, and the self-adhesive dual-cured RelyX Unicem. Teeth were sectioned after water storage at 37°C (24 hours and 30 days) to obtain beams with a bonded area of 0.8 mm(2) . The specimens were tested in a universal testing machine at a 0.5 mm/min crosshead speed. Scanning electron microscopic fractographic and interfacial micromorphology analyses were performed. Data were analyzed using two-way ANOVA and Tukey's test (α= 0.05). Mean bond strength (MPa) after 24 hours: C&B Cement 19.5 ± 3.8, RelyX ARC 40.8 ± 9.4, RelyX Unicem 31.3 ± 7.4; after 30 days: C&B Cement 24.5 ± 5.1, RelyX ARC 44.2 ± 8.5, RelyX Unicem 28.3 ± 7.1. The mean bond strengths of both dual-cure cements were significantly higher than that obtained with C&B Cement after 24 hours. A significant increase in the bond strength of C&B Cement was verified after 30 days, reaching values statistically equivalent to those produced by RelyX Unicem and RelyX ARC. The self-adhesive cement preserved the same level of bond strength after 30 days. Fractographic analysis revealed a prevalence of cohesive fractures in the hybrid layer for C&B Cement, mixed (cohesive in the cement, hybrid layer, and adhesive) for RelyX ARC, and cohesive in the cement for RelyX Unicem. No distinguishable hybrid layer or resin tags were observed in the interaction of RelyX Unicem with dentin. The particular interaction of each cement with dentin results in specific bond strength and failure patterns that varied among groups in both evaluation times. Even though the self-adhesive cement tested exhibited no authentic hybrid layer, it was able to promote reliable adhesion with the underlying dentin.

Aesthetic resin onlay restorations: ‘rationale and methods’

Resin composite restorations have gained increasing popularity over the past two decades. This has been largely driven by a patient-orientated demand for the use of aesthetic restorative materials. It has occurred concomitantly with an improvement in the mechanical properties of available materials, and advances in our knowledge of resin bonding. Onlay restorations are advocated for a plethora of clinical applications. This paper considers the role of adhesive onlay restorations fabricated in resin composite in contemporary restorative practice, including the presentation of two case reports. This case report describes a minimally invasive, aesthetic solution to provide cuspal coverage by means of either a direct or indirect resin composite onlay restoration, respectively.

COMMENTARY. early hardness of self‐adhesive resin cements cured under indirect resin composite restorations

Journal of Esthetic and Restorative DentistryVolume 23, Issue 2 p. 125-125 COMMENTARY. early hardness of self-adhesive resin cements cured under indirect resin composite restorations Sharukh S. Khajotia BDS, MS, PHD, Sharukh S. Khajotia BDS, MS, PHD President's Associates Presidential Professor, Chair, Department of Dental Materials, University of Oklahoma College of Dentistry, Full Member, OUHSC Graduate College, Associate Professor of Chemical, Biological and Materials Engineering, University of Oklahoma, College of Engineering, Oklahoma City, OK 73190 USASearch for more papers by this author Sharukh S. Khajotia BDS, MS, PHD, Sharukh S. Khajotia BDS, MS, PHD President's Associates Presidential Professor, Chair, Department of Dental Materials, University of Oklahoma College of Dentistry, Full Member, OUHSC Graduate College, Associate Professor of Chemical, Biological and Materials Engineering, University of Oklahoma, College of Engineering, Oklahoma City, OK 73190 USASearch for more papers by this author First published: 07 April 2011 https://doi.org/10.1111/j.1708-8240.2011.00409.xCitations: 1 This commentary is accompanied by article, “Early Hardness of Self-Adhesive Resin Cements Cured under Indirect Resin Composite Restorations,” Isabel Giráldez, DDS, Laura Ceballos, DDS, PhD, Miguel A. Garrido, PhD, Jesús Rodríguez, PhD, DOI 10.1111/j.1708-8240.2011.00408.x Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume23, Issue2April 2011Pages 125-125 RelatedInformation

Early Hardness of Self‐Adhesive Resin Cements Cured under Indirect Resin Composite Restorations

To determine the influence of curing mode on the surface hardness of seven resin cements used to lute indirect composite restorations. Seven commercial dual-curing resin cements were tested: two were total-etch (RelyX ARC [3M ESPE, St. Paul, MN, USA] and Variolink II [Ivoclar Vivadent, Schaan, Liechtenstein]); one was self-etch (Multilink Automix [Ivoclar Vivadent]), and four were self-adhesive (RelyX Unicem [3M ESPE], Maxcem Elite [Kerr Corp., Orange, CA, USA], SmartCem2 [Dentsply, Detrey, GmbH, Konstanz, Germany], and G-Cem [GC CORPORATION, Itabashi-Ku, Tokyo, Japan]). Three specimens (0.5 × 6.5mm) of each material were prepared for each of three experimental groups: Group 1 (cements allowed to self cure); Group 2 (cements light-cured for 40 seconds); and Group 3 (cements light-cured for 80 seconds). All specimens were cured through a 4-mm-thick composite cylinder (Filtek Z250-A3). Surface microhardness numbers were determined at 20 min after preparation. Results were analyzed by two-way analysis of variance and Student-Newman-Keuls tests (p<0.05). Superficial hardness was significantly influenced by the resin cement tested (p<0.0001), the curing mode (p<0.0001), and their interaction (p<0.0001). RelyX ARC exhibited the highest mean microhardness values regardless of the curing mode. Light-curing significantly increased the microhardness of all resin cements studied, and these values increased even further with a doubling of irradiation time. Self-adhesive cements exhibited different behavior according to the curing mode. RelyX Unicem was highly sensitive to light irradiation, showing the lowest mean values in the self-curing mode. After light irradiation for 40 or 80 seconds, Maxcem Elite exhibited the lowest mean hardness values of all the resin cements tested. The microhardness of resin cements is highly dependent on the brand. Dual-curing resin cements should always be light irradiated for longer periods than that recommended by manufacturers. Dual-curing resin cements should always be light-cured for longer irradiation times, as light irradiation for 80 seconds yields the highest microhardness values in comparison with self-curing or light irradiation for 40 seconds. However, some self-adhesive resin cements exhibit low microhardness values when used to cement 4-mm-thick indirect composite restorations regardless of the curing mode applied.

Assessment of marginal sealing in indirect resin composite restorations

The aim of this study was to evaluate the sealing of indirect resin restorations cemented with three different luting agents. Thirty bovine teeth were used. Box type cavities preparations were made in the middle third of the buccal face. The cavities were restored with inlay restorations by the direct/indirect technique using resin composite Resilab (Wilcos, Petrópolis, RJ, Brazil). The teeth were randomly divided into three groups: Group 1: etched with 37% phosphoric acid for 30 seconds, adhesive system Prime Bond 2.1 and Enforce resin cement (Dentsply, Petrópolis, RJ, Brazil); Group 2: etched with 37% phosphoric acid for 30 seconds, adhesive system Single Bond and RelyX ARC resin cement (3M ESPE, St Paul, MN, USA); and Group 3: resin-modified glass ionomer cement RelyX Unicem Aplicap (Dentsply, Petrópolis, RJ, Brazil). The indirect restorations were cemented with the respective cements and thermal cycled for 800 cycles. The specimens were stored in 50% silver nitrate dye for 24 hours, after this procedure the teeth were sectioned in the bucco-lingual direction into 3 slices of 1 mm thick, fixed on a glass slide and then analyzed by a stereomicroscope were was coupled a digital camera to register the images. From these pictures, the marginal leakage areas were measured by the software Image Tool 3.0. The data obtained were submitted to the ANOVA and Tukey tests. ANOVA showed that there was no significant difference (p=0.73) among groups (mean values(±SD): Group 1=0.96(±0.71); Group 2: 1.10(±0.63) and Group 3: 0.99(±0.35) . It was concluded that the 3 luting agents presented no significance regarding marginal microleakage, demonstrating similar performance in the proposed research situation.

Molar-Incisor-Hypomineralisation: A literature review

Molar-Incisor-Hypomineralisation (MIH) is a qualitative defect of 1-4 first permanent molars with or without the maxillary and mandibular permanent incisors. It seems to have been recognised first in the 1970s and prevalence varies between 2.8% and 25%, dependent upon the study. The dental literature was searched using a number of key terms entered into MEDLINE, the reference list of each paper as located was examined for further papers that had been missed in the initial search. The review of the literature showed that teeth that are affected indicate a systemic cause at around the time of birth; investigators have put forward a number of possible causes; asthma, pneumonia, upper respiratory tract infections, otitis media, antibiotics, dioxins in mother's milk, tonsillitis and tonsillectomy and exanthamatous fevers of childhood. However, at the present time the aetiology remains unclear. Treatment of the affected permanent first molars can include restorations using adhesive intra-coronal restorations to extra-coronal restorations (e.g. preformed metal crowns). There is little evidence to support one option over another. In severe cases extraction at the optimum time may be the best option; allowing the permanent second molars to come forwards. There is little improvement in affected anterior teeth with microabrasion and direct or indirect composite resin restorations may be appropriate in some children. Ultrastructural and biochemical make up of MIH affected teeth seem to have been investigated less than other areas. It is important that children with MIH are diagnosed as early as possible and managed appropriately; this will involve multidisciplinary input.

Influence of method and period of storage on the microtensile bond strength of indirect composite resin restorations to dentine

This study evaluated the influence of the method and period of storage on the adhesive bond strength of indirect composite resin to bovine dentin. Ninety bovine incisors were stored in three different solutions: 0.2% thymol, 10% formalin, and 0.2% sodium azide, during 3 periods of storage: 7 days, 30 days and 6 months, resulting in 9 groups (n = 10). The roots were cut off and the buccal surface was ground with #600-grit silicon carbide paper. The surface was conditioned with 37% phosphoric acid for 15 s and a composite resin restoration (TPH Spectrum) was fixed using a one-bottle adhesive system (Adper Single Bond) and a dual-cured resinous cement (Rely X ARC) under a load of 500 g for 5 minutes. The samples were serially cut perpendicular to the bonded interface to obtain slices of 1.2 mm in thickness. Each slab was trimmed with a cylindrical diamond bur resulting in an hourglass shape with a cross-sectional area of approximately 1 mm(2). The microtensile bond strength (microTBS) testing was performed in a testing machine (EMIC 2000 DL) at a 0.5 mm/minute crosshead-speed until failure. After fracture, the specimens were examined under SEM to analyze the mode of fracture. muTBS Means were expressed in MPa and the data were analyzed by two-way ANOVA (3X3) and the Tukey test (alpha = 0.05). The storage times of 7 and 30 days produced no significant difference irrespective of the solution type. The formalin and thymol solutions, however, did have a negative influence on bond strength when the teeth were stored for 6 months.

Influence of different light curing units on the bond strength of indirect resin composite restorations

The aim of this study was to evaluate the influence of different light sources on the bond strength of indirect resin composite restorations cemented with a dual-cure resin cement. The superficial dentin of human third molars was exposed and acid-etched and an adhesive system was applied (Single Bond 2). Four-mm-thick indirect resin composite restorations (Gradia) were fabricated and cemented using a dual-cure resin cement (Rely X). Four light sources were used to polymerize the cement: QTH - Optilux 401; LED1 - L.E.Demetron 1; LED2 - Optilight CL; and LED3--Ultralume 5. The teeth were stored for 24 h and then sectioned, yielding stick-shaped specimens for each group with a bonded area of 1.0 mm(2). The specimens were then tested in a universal testing machine, at a crosshead speed of 1 mm/min. Data were analyzed using ANOVA. Bond strength mean values were: QTH: 22.5 (+/- 8.4); LED1: 22.7 (+/- 9.4); LED2: 21.4 (+/- 10.2); and LED3: 27.3 (+/- 13.8). No statistically significant difference was observed among the experimental groups. The bond strength values when the cement was polymerized using different LED lights were equivalent to the values when the QTH light was used. It can be concluded that the variety of light sources used in the present study did not influence the bond strength of indirect resin composite restorations cemented with a dual-cure resin cement.