Recovery of silver residues from dental amalgam

Dental amalgam residues are probably the most important chemical residues generated from clinical dental practice because of the presence of heavy metals among its constituents, mainly mercury and silver.

OBJECTIVE

The purpose of this study was to develop an alternative method for the recovery of silver residues from dental amalgam.

MATERIAL AND METHODS

The residue generated after vacuum distillation of dental amalgam for the separation of mercury was initially diluted with 32.5% HNO3, followed by precipitation with 20% NaCl. Sequentially, under constant heating and agitation with NaOH and sucrose, the sample was reduced to metallic silver. However, the processing time was too long, which turned this procedure not viable. In another sequence of experiments, the dilution was accomplished with concentrated HNO3 at 90 degrees C, followed by precipitation with 20% NaCl. After washing, the pellet was diluted with concentrated NH4OH, water and more NaCl in order to facilitate the reaction with the reducer.

RESULTS

Ascorbic acid was efficiently used as reducer, allowing a fast reduction, thus making the procedure viable.

CONCLUSIONS

The proposed methodology is of easy application and does not require sophisticated equipment or expensive reagents.

Bond strength of luting cements to core foundation materials

PURPOSE

The purpose was to compare the shear bond strength of luting cements to foundation materials and to determine the effect of storage in lactate buffer solution.

MATERIALS AND METHODS

Disks that were 8 mm in diameter and 2-mm thick were fabricated from foundation substrates: amalgam, composite resin, resin-modified glass ionomer, and glass ionomer (n = 20). Cylinders that were 2 mm in diameter and 4 mm in length of resin luting cement, resin-modified glass ionomer luting cement, and a glass ionomer luting cement were bonded to the foundation substrate materials. Shear bond strength of each foundation substrate material/cement pair was determined with a universal testing machine after 24 hours. A second set of specimens was tested after storage in a 0.01M lactate buffer solution for 24 hours. A three-way analysis of variance followed by pair-wise comparisons was performed to compare bond strengths (P < .05).

RESULTS

The resin cement provided the highest (P < .05) bond strengths to amalgam, composite resin, and resin-modified glass ionomer foundation materials while the glass ionomer cement showed the lowest bond strength (P < .05) to composite resin and glass ionomer foundation restoration materials. After immersion in a 0.01M lactate buffer solution, the shear bond strength of all the material combinations was significantly lower (P < .05) than nonimmersed specimens, except the bonds between composite resin foundation and resin luting cement, which significantly increased (P < .05) in strength.

CONCLUSION

The resin cement had the highest bond strength to most foundation substrates investigated. The highest bond was observed between the composite resin foundation and resin cement. This bond was also the most durable on immersion in lactic acid.

Resistance of composite and amalgam core foundations retained with and without pins and bonding agents

To compare the resistance of different amalgam and composite core foundations retained by pins, bonding agents, or both, 100 molars were mounted in acrylic resin and their occlusal surfaces were reduced to expose dentin. Pins were inserted at the four line angles of the teeth and matrices were placed. Bonding agents were applied according to the manufacturers' instructions. Amalgam was handcondensed and composite was incrementally added and photocured. Restorations were adjusted to produce specimens (n = 10) 5 mm in height with a 1 mm bevel at the axial-occlusal surface. After immersion in deionized water for 24 hours, specimens were loaded at a 45 degree angle on their beveled surfaces in a Universal Testing Machine at a crosshead speed of 0.02 in./minute. ANOVA and Tukey's tests indicated that FluoroCore 2 (with or without pins) was statistically stronger than all other combinations (p < 0.05).

The effect of thermocycling on the determination of microleakage in Permite amalgam restorations

INTRODUCTION

Microleakage is an important clinical performance parameter of restorative materials. A literature review of the effect of thermocycling on microleakage revealed an incongruity of results.

AIMS AND OBJECTIVES

The aim of this study was to describe the effect of thermocycling on microleakage in Class V Permite amalgam restorations.

METHODS

Class V cavities were prepared at the mesial and distal cemento-enamel junctions of 20 extracted, sound, human molar teeth. Cavities were treated with Polyvar cavity varnish and restored with Permite amalgam as per manufacturer's directions. Teeth were randomly divided into two groups of 10 teeth each. After one day only one group was thermocycled for 500 hundred cycles (5 - 55 degrees C; dwell time of 30 seconds: transfer time of 10 seconds). Teeth were subsequently submersed in 0.5% Basic Fuchsin solution (24 hours: room temperature), then cleaned and embedded in polyester potting resin. Teeth were sectioned longitudinally along the long axis of the tooth into three slices using the Isomet low speed saw. Microleakage was scored under a light microscope at 10 times magnification.

RESULTS

While microleakage at cementum margins was significantly and negatively influenced by thermocycling, enamel margins appeared to be significantly unaffected.

CONCLUSION

The effect of thermocycling on the determination of microleakage was only significant at the cementum margins of Permite restorations.

Neuropsychological function in school-age children with low mercury exposures

The EPA reference dose for methylmercury (MeHg) was established using data from populations with greater exposures than those typical of the US. Few data are available on potential adverse health effects at lower levels. We examined relationships between hair mercury (Hg) levels and neuropsychological outcomes in a population of US children. This study included data from 355 children ages 6-10 enrolled in the New England Children's Amalgam Trial. Data on total hair Hg levels, sociodemographic information and neuropsychological function were collected. We evaluated associations between hair Hg and neuropsychological test scores with linear regression methods and used generalized additive models to determine the shape of associations that departed from linearity. Models controlled for relevant covariates, including the potential beneficial effects of consuming fish. In adjusted models, we observed no significant linear relationships between hair Hg level and any test score. Significant departures from linearity were identified for WIAT Math Reasoning and WRAMVA Visual-Motor Composite scores. The association was positive for hair Hg levels below 0.5 microg/g and negative for levels between 0.5 and 1.0 microg/g. Overall, test scores of children with hair Hg levels 1.0 microg/g appeared to be lower than those of children with levels < 1.0 microg/g, but few children had levels in this upper range and these differences did not reach statistical significance. Hair Hg levels below 1.0 microg/g in US school-age children were not adversely related to neuropsychological function.

Traditional operative treatment options

Operative intervention should be avoided, whenever possible, by adopting a preventive approach. Timely management of early caries can lead to arrest and possibly remineralization of the lesion rendering operative intervention unnecessary. The dentist must judge when the tooth tissue has become sufficiently demineralized to allow bacterial ingress leading to irreversible changes in the tissue. Once a decision has been made to restore a tooth, the clinician must decide, from a series of traditional operative treatment options, what materials should be used in the restoration and what preparation will achieve good retention and best preservation of tooth structure. With the development of new adhesive materials and a more conservative approach, a new era of minimally invasive dentistry has dawned. Improvements in the properties of composite materials have made them the choice for coronal aesthetic restorations: for posterior restorations involving load-bearing occlusal surfaces, amalgam is still the most commonly used material in UK dental practice; glass ionomer materials also have a place in minimally invasive dentistry--patterns of use differing in different counties. The numbers of studies investigating minimal caries removal are relatively limited; there are still scope and need for research in this field.

[Specific bonding technics]

Bonding is a major component of our therapeutic arsenal. We routinely bond attachments to enamel as well as to other surfaces including dentin, ceramic, acrylic, steel, amalgam, and gold, especially for adult patients. This procedure poses certain technical problems for which adapted and specific technical protocols can provide solutions.

Absence of carious lesions at margins of glass-ionomer and amalgam restorations: a meta- analysis

AIM

To report on the absence of carious lesions at margins of glass ionomer cement (GIC) and amalgam restorations.

METHODS

Six Anglophone and 1 Lusophone databases were searched for articles up to 5 January 2008. Inclusion criteria for articles were: (i) titles/abstracts relevant to topic; (ii) published in English, Portuguese or Spanish language; (iii) reporting on a randomised control trial. Exclusion criteria were: (i) insufficient random allocation of study subjects (ii) operator and subject not blinded, where appropriate; (iii) not all entered subjects accounted for at trial conclusion; (iv) subjects of both groups not followed up the same way. Articles were accepted only if they complied with all the criteria. Ten articles complied with the inclusion criteria and were selected for review. From these 4 were rejected and 6 articles reporting on 8 separate studies accepted. Due to aspects of heterogeneity, studies were sub-grouped before meta- analysis.

RESULTS

Significantly less carious lesions were observed on single-surface GIC restorations in permanent teeth after 6 years as compared to restorations with amalgam (OR 2.64 - CI 95% 1.39 - 5.03, p= 0.003). No studies investigating multiple-surface restorations on permanent teeth were identified. Studies investigating carious lesions at margins of restorations in primary teeth showed no difference between both materials after 3 and 8 years.

CONCLUSIONS

Carious lesions at margins of single-surface GIC restorations are less common than with amalgam fillings after 6 years in permanent teeth. No difference was observed in primary teeth. More trials are needed in order to confirm these results.

Marginal adaptation of root-end filling materials: an in vitro study with teeth and replicas

AIM

The purpose of this investigation was to evaluate the marginal adaptation of five root-end filling materials.

METHODS AND MATERIALS

Fifty human single-rooted teeth were resected 3 mm from the apex. Root-end cavities were then prepared using an ultrasonic tip and filled with one of the following materials: silver amalgam without zinc, white MTA-Angelus, white Portland cement (PC), Vitremer, and GC Fuji Ortho LC. The apical portion of the roots was then sectioned to obtain two 1 mm thick transversal sections. Epoxy resin replicas of these apical sections were fabricated for an analysis of marginal adaptation. Scanning electron microscopy (SEM) was used to determine gaps in the adaptation of the root-end filling materials at the interface between them and the dentin. The Kruskal-Wallis test and a multiple comparison test were used for statistical data analysis. The Spearman correlation coefficient was used to determine the correlation between the results found for teeth and replicas.

RESULTS

Materials containing calcium oxide (MTA and PC) showed similar results. Resin modified glass ionomer cements (GICs) presented similar variations in marginal adaptation, but Vitremer showed significantly greater marginal adaptation when compared to GC Fuji Ortho LC.

CONCLUSION

A positive and significant correlation was observed between marginal adaptation values found in the teeth and their replicas.

CLINICAL SIGNIFICANCE

The use of ionomers as root-end filling materials may improve clinical outcomes in periradicular surgery.

Effect of a desensitizing paste containing 8% arginine and calcium carbonate on the surface roughness of dental materials and human dental enamel

PURPOSE

To evaluate the effect of an 8% arginine-calcium carbonate fluoride-free desensitizing paste on the surface roughness of resin composite, porcelain, amalgam, gold, and human dental enamel both prior to and following simulated toothbrushing.

METHODS

A resin composite (Filtek Supreme), a commercial porcelain (IPS Empress), an amalgam (Dispersalloy), gold (JIF-PF) and human dental enamel were used, as well as commercial finishing and polishing instruments. Eight two-sided samples were fabricated for each group. The composite and amalgam samples were stored at 100% relative humidity and 37 degrees C for 48 hours prior to measuring the surface roughness and completing the subsequent finishing and polishing procedures. Enamel blocks were cut from human lesion-free teeth and embedded in acrylic. The blocks were then polished flat with high polishing pastes. For gold and porcelain, the same size was used and the materials processed by a professional dental laboratory. Following storage, each surface was polished using the Super-Snap (Shofu) system. The amalgam was polished with conventional polishing techniques. Roughness (Ra and Ry) was evaluated with both a 3D non-contact profilometer and a stylus profilometer. With the two-sided samples only one side was polished with the desensitizing paste and the other side was left unpolished without paste. The 8% arginine-calcium carbonate desensitizing paste was applied to a surface for 15 seconds using a single disposable prophy cup. Each polished surface was measured by the profilometers and three roughness values per surface were recorded as the "initial prophy" surface. Following initial surface analysis, each side of every sample was treated with a simulated toothbrushing technique using a toothbrushing device (V-8). A 50:50 (w/w) slurry of toothpaste (Colgate Cavity Protection) and deionized water was used. Each surface was brushed 10,000 times. Then, the samples were rinsed with tap water and stored in 100% humidity until roughness values were obtained using the profilometers as previously described ("toothbrush surface"). After analyzing the brushed surfaces, the samples were returned to their original treatment group ("desensitizing paste"). Each surface was re-polished with the desensitizing paste as previously stated. Those surfaces (referred to as "recall paste") were measured as previously described for final surface roughness. Data was analyzed using repeated measures two-factor ANOVA with Tukey HSD pairwise comparison as appropriate (alpha=0.05). Two additional samples were made of each material in order to measure step-heights. Tape was placed on the surface of each sample to separate the treatment side and the non-treated side. The tape was removed before each profilometry reading.

RESULTS

The desensitizing paste containing 8% arginine and calcium carbonate did not have a significant effect on the surface roughness of the substrates tested. Although the 3D non-contact profilometry images showed slight roughness after toothbrushing followed by the use of the desensitizing paste, these changes were not statistically significant (P>0.05).

Urinary porphyrin excretion in children with mercury amalgam treatment: findings from the Casa Pia Children's Dental Amalgam Trial

Increases in the urinary concentrations of pentacarboxyl- and coproporphyrins and the appearance of the atypical precoproporphyrin have been defined in relation to mercury (Hg) body burden in animal studies, and this change in the porphyrin excretion pattern has been described as a biomarker of occupational Hg exposure and toxicity in adult human subjects. In the present studies, urinary porphyrins were determined in relation to Hg exposure in children and adolescents, 8-18 yr of age, over the 7-yr course of a clinical trial designed to evaluate the neurobehavioral and renal effects of dental amalgam in children. Subjects were randomized to either dental amalgam or composite resin treatments. Urinary porphyrins and creatinine concentrations were measured at baseline and annually in all subjects. Results were evaluated using linear regression analysis. No significant differences between treatment groups (amalgam versus composite) were found when comparing all subjects for any of the porphyrins of interest. However, incipent amalgam treatment-specific increases were observed in the mean concentrations of penta-, precopro- and coproporphyrins especially when the analyses were restricted to younger subjects (8 to 9 yr old at baseline), and these increases were most apparent during yr 2 through 3 of follow-up, the period of highest mercury exposure from amalgam treatment. Based on the mean number of amalgam fillings received by children in this group (17.8), the renal Hg concentration associated with incipient increases in urinary porphyrins was estimated to be approximately 2.7 microg/g renal cortex. This value corresponds to an observed mean urinary Hg concentration of 3.2 microg/g creatinine, which is approximately fivefold less than that at which renal damage from Hg exposure is estimated to occur in children. These findings are consistent with growing evidence supporting the sensitivity of urinary porphyrins as a biological indicator of subclinical Hg exposure in children.

Mercury, copper, and zinc concentrations in extracted human teeth

Amalgam has been used as a filling material for over 150 years. Mercury, copper, and zinc are present in restoration. The aim of this study was to compare mercury, copper, and zinc concentrations in extracted human teeth with amalgam restorations and teeth without restorations. Thirty-two teeth, 15 restored with dental amalgam and 17 without restorations, were chemically analyzed in an Optima 3300 DV (Perkin Elmer) plasma emission spectrometer. Mercury, copper, and zinc were found in human teeth regardless of the presence of amalgam restorations. The highest mercury concentrations were found in the coronary portions of the teeth with amalgam restorations. Copper concentrations were very high. Zinc concentrations in the teeth without restoration were lower than those seen in the coronary portion of the teeth with restorations.

Multi-species biofilm formation on dental materials and an adhesive patch

PURPOSE

This laboratory study assessed the influence of surface roughness and contact time on the formation of a multi-species biofilm on dental materials (adhesive patch, composite, amalgam and enamel).

MATERIALS AND METHODS

Rough and smooth specimens of each material were prepared and the mean surface roughness was assessed profilometrically. The biofilms were then allowed to grow either for 15 min or 15 h respectively on saliva-preconditioned specimens of each material, and colony-forming units on blood agar were counted (N = 9/group) Surface morphology was assessed using a scanning electron microscope.

RESULTS

No difference was found in the biofilm formation rate among all the materials that were tested. After a short incubation period, a statistical significant difference between smooth and rough samples could be detected on amalgam and on the resin composite material (P < or = 0.001).

CONCLUSIONS

Surface roughness may influence the initial biofilm adherence, but differences vanish following growth and maturation. The multi-species biofilm offers a reliable laboratory model for studying plaque formation.

Catechol O-methyltransferase (COMT) VAL158MET functional polymorphism, dental mercury exposure, and self-reported symptoms and mood

Associations were evaluated between a functional single nucleotide polymorphism (Val158Met) in the gene encoding the catecholamine catabolic enzyme catechol O-methyltransferase (COMT), dental mercury exposure, and self-reported symptoms and mood among 183 male dentists and 213 female dental assistants. Self-reported symptoms, mood, and detailed work histories were obtained by computerized questionnaire. Spot urine samples were collected and analyzed for mercury concentrations to evaluate recent exposures, whereas a chronic mercury exposure index for all subjects was created from the work histories. COMT polymorphism status was determined using a polymerase chain reaction (PCR)-based assay. Scores for current, recent, and chronic self-reported symptom groups and six self-reported mood factors were evaluated with respect to recent and chronic mercury exposure and COMT polymorphism status. Multiple regression analysis controlled for age, socioeconomic status, tobacco and alcohol use, self-reported health problems, and medications. Separate evaluations were conducted for dentists and dental assistants. No consistent patterns of association between either urinary mercury concentration or the chronic index of mercury exposure and any category of symptoms were observed. However, consistent and significant associations were found between increased symptoms and the COMT polymorphism involving the double allelic substitution (full mutation) compared to subjects with no substitutions. Associations with mood were limited to polymorphism status among female dental assistants, and were observed for four of six mood factors and overall mood score. These findings extend evidence of genetic factors potentially affecting human susceptibility to the toxic effects of mercury and other environmental chemicals.

Comparison of chlorine and chloramine in the release of mercury from dental amalgam

The purpose of this project was to compare the ability of chlorine (HOCl/OCl(-)) and monochloramine (NH(2)Cl) to mobilize mercury from dental amalgam. Two types of amalgam were used in this investigation: laboratory-prepared amalgam and samples obtained from dental-unit wastewater. For disinfectant exposure simulations, 0.5 g of either the laboratory-generated or clinically obtained amalgam waste was added to 250 mL amber bottles. The amalgam samples were agitated by end-over-end rotation at 30 rpm in the presence of 1 mg/L chlorine, 10 mg/L chlorine, 1 mg/L monochloramine, 10 mg/L monochloramine, or deionized water for intervals of 0 h, 2 h, 4 h, 8 h, and 24 h for the clinically obtained amalgam waste samples and 4 h and 24 h for the laboratory-prepared samples. Chlorine and monochloramine concentrations were measured with a spectrophotometer. Samples were filtered through a 0.45 microm membrane filter and analyzed for mercury with USEPA standard method 245.7. When the two sample types were combined, the mean mercury level in the 1 mg/L chlorine group was 0.020 mg/L (n=25, SD=0.008). The 10 mg/L chlorine group had a mean mercury concentration of 0.59 mg/L (n=25, SD=1.06). The 1 mg/L chloramine group had a mean mercury level of 0.023 mg/L (n=25, SD=0.010). The 10 mg/L chloramine group had a mean mercury level of 0.024 mg/L (n=25, SD=0.011). Independent samples t-tests showed that there was a significant difference between the natural log mercury measurements of 10 mg/L chlorine compared to those of 1 mg/L and 10 mg/L chloramine. Changing from chlorine to chloramine disinfection at water treatment plants would not be expected to produce substantial increases in dissolved mercury levels in dental-unit wastewater.

Influence of the temperature, volume and type of solution in the mercury vaporization of dental amalgam residue

One of the qualitative methods for the identification of mercury vapor is what it occurs as a way of chemical reaction between palladium chloride and metallic mercury. Palladium chloride ribbons with yellowish coloration put in contact with the vaporized mercury of dental amalgam residue, liberates palladium and forms mercury chloride in your surface, and starts to have black coloration; this form identify the presence of the mercury vapor in the system. This work studies the influence of temperature, volume and type of barrier-solution in the vaporization of mercury during the period of storage of dental amalgam residues, aiming to establish the best conditions for storage of these residues. It was found that for all tested solutions, the longest storage times without any occurrence of mercury vaporization were obtained in the lowest temperatures tested and the largest solution volumes of barrier-solution. The radiographic effluent presented bigger efficacy in the reduction of the volatilization, increasing the period when the residue was stored, however the analysis of this solution after the vaporization test showed the presence of organic mercury. These results show that water is the most efficient barrier against the vaporization of mercury, since it did not result in organic mercury formation in the effluent solution from the storage process.

Bonding of adhesive resin luting agents to metal and amalgam

The shear bond strength of three adhesives, Panavia 21, Superbond, All Bond C&B Cement, and a dual cure resin (Variolink), to Ni-Cr-Be (Rexillium III), Midigold (Type III gold) and Amalgam (Sybraloy) were determined. Fifteen samples were prepared using 800 grit abrasive papers for Ni-Cr and Midi-Gold, and 100 grit papers for amalgam. Ni-Cr-Be and Midi-Gold samples were sandblasted for 30 s and steam cleaned for 10 s. The adhesives were bonded to the samples using gelatine capsules and were matured for 24 h in water at 37 degrees C. The samples were debonded in shear using an Instron at a cross-head speed of 1 mm/min. The data was analysed using ANOVA and a Tukey test. The bond strength of Superbond to both metal alloys was significantly higher (P<0.05) than any of the materials tested, with the exception Panavia 21 to gold. The bond strength of All Bond C&B cement had shown to be not significant difference from those of Panavia 21 and Variolink, when bonded to Rexillium and Midi-Gold, respectively. The bond strength of All Bond C&B Cement to amalgam was significantly greater (P<0.05) than those of the other materials tested. The shear bond strength to gold showed lower bonding for all adhesives when compared with Rexillium (P<.001). The ranking of bond strength to both alloys was as follows: Superbond>Panavia 21>All Bond C&B>Variolink. The nature of substrate to be used for bonding and the adhesive material itself are important factors in bonding which can be achieved between cast metals and prepared teeth with amalgam filling. Superbond should be successful as an adhesive for the attachment of all substrates tested, with the possible exception of amalgam, for which All Bond C&B Cement gives the best result.

Biomarkers of kidney integrity in children and adolescents with dental amalgam mercury exposure: findings from the Casa Pia children's amalgam trial

Mercury is toxic to the kidney, and dental amalgam is a source of mercury exposure. Few studies have evaluated the effects of dental amalgam on kidney function in a longitudinal context in children. Here, we evaluated urinary concentrations of glutathione S-transferases (GSTs) alpha and pi as biomarkers of renal proximal and distal tubular integrity, respectively, and albumin as a biomarker of glomerular integrity in children and adolescents 8-18 years of age over a 7-year course of dental amalgam treatment. Five hundred seven children, 8-12 years of age at baseline, participated in a clinical trial to evaluate the neurobehavioral and renal effects of dental amalgam in children. Subjects were randomized to either dental amalgam or resin composite treatments. Urinary GSTs alpha and pi, albumin, and creatinine concentrations were measured at baseline and annually in all subjects. Results were evaluated using linear regression analysis. GST-alpha concentrations were similar between treatment groups and in each sex and race (white vs. non-white) group in each follow-up year. GST-pi levels tended upward over the course of follow-up by four- to six-fold. This increase was seen in all groups irrespective of the treatment, race, or gender. Females had GST-pi levels approximately twice those of males at all ages. Albumin concentrations were constant throughout the follow-up period and did not differ by treatment, although females had 39% higher albumin levels than males. Additionally, we found no significant effects of amalgam treatment on the proportion of children with microalbuminuria (>30 mg/g creatinine). These findings are relevant within the context of children's health risk assessment as relates to the safety of mercury exposure from dental amalgam on kidney function. These data also provide normative values for sensitive indices of renal functional integrity that may serve in the evaluation of children and adolescents with renal disorders.

Biocompatibility of dental materials

With the long history of use of many materials in dental surgery, biocompatibility concerns are not as great a concern as other issues, such as long-term degradation, mechanical strength problems, and prevention of secondary caries. It is important, however, not to forget that the potential exists for adverse tissue responses to synthetic materials used in repair, augmentation, and repair of natural tissue structures. As new materials and repair techniques become available and the sophistication of cell-level and subcellular response evaluations increases, the concerns to be addressed and the methods to be used may change. The advent of tissue-engineered medical products may mean that new questions must be addressed.

Posterior amalgam restorations--usage, regulation, and longevity

The use of dental amalgam has declined, but in most of the world, amalgam is the most widely used and widely taught direct restorative material for load-bearing posterior restorations. There are few national regulations on the use of amalgam; however, there are several nations where few amalgam restorations are placed. Long-term studies have shown that under optimum conditions, posterior restorations of amalgam and resin composite last longer than reported previously and that amalgam restorations outlast composite restorations. In general practice settings, posterior amalgam and composite restorations both have lower longevities.

Magnetic susceptibility and electrical conductivity of metallic dental materials and their impact on MR imaging artifacts

OBJECTIVES

The aim of this study was to test the hypothesis that dental materials vary significantly in MR-relevant material parameters-magnetic susceptibility and electrical conductivity, and that knowledge of these parameters may be used to estimate the quality of MR imaging in the presence of devices made of such materials.

METHODS

Magnetic susceptibility, electrical conductivity and artifacts were evaluated for 45 standardized cylindrical samples of dental alloys and amalgams. Magnetic susceptibility was determined by fitting the phase of gradient-echo MR images to numerically modeled data. Electrical conductivity was determined by standard electrotechnical measurements. Artifact sizes were measured in spin-echo (SE) and gradient-echo (GE) images at 1.5T according to the standards of the American Society for Testing and Materials.

RESULTS

It has been confirmed that dental materials differ considerably in their magnetic susceptibility, electrical conductivity and artifacts. For typical dental devices, magnetic susceptibility differences were found of little clinical importance for diagnostic SE/GE imaging of the neck and brain, but significant for orofacial imaging. Short-TE GE imaging has been found possible even in very close distances from dental devices made of amalgams, precious alloys and titanium alloys. Nickel-chromium and cobalt-chromium artifacts were found still acceptable, but large restorations of aluminum bronzes may preclude imaging of the orofacial region. The influence of electrical conductivity on the artifact size was found negligible.

SIGNIFICANCE

MR imaging is possible even close to dental devices if they are made of dental materials with low magnetic susceptibility. Not all materials in current use meet this requirement.

Marginal adaptation and microleakage of five root-end filling materials: an in vitro study

AIM

Endodontic surgery consists of several procedures which involve the endodontic space or the root canal and is performed as an alternative to unsuccessful outcomes or complications following endodontic treatments. The aim of the study was to evaluate the sealing ability of five root-end filling materials.

METHODS

Fifty human single rooted teeth were treated endodontically; roots were resected at 3 mm from the apex, and root end cavities were prepared with ultrasonic tips. Root ends were filled with one of the following materials: silver amalgam (control group); mineral trioxide aggregate; white Portland cement; Vitremer; and Fuji Ortho. Apical sealing was evaluated by evaluating microleakage of 50% silver nitrate solution. The apical portion of the roots was sectioned to obtain 1-mm thick transversal slices, and epoxy resin replicas of these apical slices were produced. A scanning electron microscope (SEM) was used for analyses. The Kruskal-Wallis test and a multiple comparisons test were used for statistical data analysis.

RESULTS

Results showed microleakage and variable adaptation gaps on the interface between dentin and root-end filling material in all specimens.

CONCLUSION

All the studied materials exhibited some degree of apical microleakage and marginal gaps. No correlation was found between data obtained from analyses of apical sealing and marginal adaptation.