Comparison of the abrasive wear resistance between amalgams, hybrid composite material and different dental cements

Oral lichenoid lesions - a review and update

Background:

Oral lichenoid lesions or reactions (OLLs/OLRs) are clinical and histological contemporaries of the classical oral lichen planus (OLP) that have generated a lot of debate in literature. In contrast to the idiopathic nature of OLP, OLLs are often associated with a known identifiable inciting factor. A superficial examination of these lesions clinically and histologically often reveals many similarities with OLP, but recent data indicate that distinguishable features do exist and form the basis of most classifications.

Aims and Objectives:

This paper attempts to collate available data in English literature on OLLs, highlight distinguishing features clinically and histologically and reflect on the malignant transformation potential and treatment modalities of the condition.

Materials and Methods:

A comprehensive search of medical and dental databases including PubMed, Ovid, Cochrane, Pubget, Researchgate, and non-medical search engines were utilized for the review. The search words included “oral lichen planus”, “oral lichenoid lesions”, “oral drug reactions”, “lichenoid dysplasia”, and “adverse effects of dental materials”.

Review Results:

OLLs seem to grossly underrated and most cases were clubbed as OLP. Definite clinical and histological features were uncovered to establish the identity of this lesion. Associations with dental restorative materials, drugs, and medications have been conclusively proven in the etiology of this condition. Specific markers are being utilized to diagnose the condition and monitor its progress.

Conclusion:

Substantial differentiating features were uncovered to delineate OLLs as a separate entity with definite etiology, pathogenesis, and a high malignant transformation rate compared with OLP.

Composite veneering of complex amalgam restorations

In large posterior cavities, indirect restorations could provide improved performance when compared to direct restorations, but with higher cost and removal of sound tooth structure. Improved mechanical properties have resulted in good clinical performance for amalgam in large cavities but without an esthetic appearance. Resin composites have become popular for posterior restorations, mainly because of good esthetic results. A restorative technique is presented that combines the esthetic properties of directly bonded resin composite and the wide range of indications for amalgam in stress-bearing areas.

Healing of oral lichenoid lesions after replacing amalgam restorations: a systematic review

OBJECTIVE

We sought to systematically review the literature related to oral lichenoid lesions (OLLs) and amalgam restorations.

STUDY DESIGN

Cohort and case-controlled studies (no randomized controlled trials or controlled clinical trials available) were reviewed with respect to inclusion criteria and data on patients with OLLs, treatment interventions, and the measurement of outcomes.

RESULTS

Fourteen cohort and 5 case-controlled trials met the criteria. The study population consisted of 1158 patients (27% male and 73% female; age range, 23-79 years). From 16% to 91% of patients had positive patch test results for at least 1 mercury compound. Of 1158 patients, 636 had to have their restorations replaced. The follow-up period ranged from 2 months to 9 1/2 years. Complete healing ranged from 37.5% to 100%. The greatest improvements were seen in lesions in close contact with amalgam.

CONCLUSIONS

Protocols must be standardized to obtain valid results. The replacement of amalgam restorations can result in the resolution or improvement of OLLs. Patch testing seems to be of limited value. The topographic relationship between an OLL and an amalgam restoration is a useful--but not conclusive--marker.

Wear Resistance of Packable Resin Composites after Simulated Toothbrushing Test

PURPOSE

The purpose of this study was to determine the wear resistance of five different packable composites versus two different composite controls using a laboratory toothbrushing simulation test.

MATERIALS AND METHODS

Twelve samples measuring 5 mm in diameter and 3 mm thick were prepared from the following resin composites: Packable resin composites SureFil (Dentsply Ind. Com. Ltda, Petrópolis, Rio de Janeiro, Brazil), Alert (Jeneric Pentron Incorporated, Wallingford, CT, USA), Filtek P60 (3M ESPE Dental Products, St. Paul, MN, USA), Prodigy Condensable (sds Kerr, Orange CA, USA), Solitaire (Heraeus Kulzer GmbH, Wehrheim, Germany), and control resin composites Z100 Restorative (3M ESPE) and Silux Plus (3M ESPE). Finishing and polishing were conducted with Sof-Lex disks (3M ESPE), and baseline weight (grams) and surface roughness (measured with Hommel Tester T 1000, Hommelwerke, GmbH, Alte Tuttinger Strebe 20. D-7730 VS-Schwenningen, Germany) were recorded. Specimens were aged for 2 weeks until they reached a weight that remained constant for 5 consecutive days, and then were subjected to 100,000 cycles of brushing (representative of 4.2 yr) using a toothbrushing testing machine. Toothbrush heads with soft bristle tips (Colgate Classic, Colgate-Palmolive Co., Osasco, São Paulo, Brazil) with dentifrice suspension (Colgate MFP, Colgate-Palmolive Co.) in deionized water were used under a 200 g load. Changes in weight and surface roughness were determined after toothbrushing cycles.

RESULTS

Significant differences of weight loss and surface roughness were found (paired t-test, p < .05). Weight loss percentage (mean [SD]) ranged from 0.38 to 1.69% (analysis of variance and Tukey's least significant difference, p < .05); the weight loss of the materials ranked from least to most as follows: SureFil (0.38 [0.56]), Alert (0.52 [0.18]), Z100 (1.16 [0.27]), Filtek P60 (1.31 [0.17]), Solitaire (1.51 [0.45]), Prodigy Condensable (1.55 [0.471), and Silux Plus (1.69 [0.66]). Regarding surface roughness, Prodigy Condensable (0.19 [0.08]), Solitaire (0.28 [0.06]), and Z100 (0.30 [0.07]) became less rough after toothbrushing, whereas all the others were rendered rougher: Alert (0.49 [0.29]), Filtek P60 (0.28 [0.08]), Silux Plus (0.39 [0.091), and SureFil (0.81 [0.32]).

CONCLUSION

SureFil and Alert were statistically more resistant to wear (less weight loss) than were the other materials. SureFil became significantly rougher than did all the others.

CLINICAL SIGNIFICANCE

Overal, packable resin composites are unlikely to show superior wear resistance with regard to weight loss and surface roughness compared with current resin composites also indicated for posterior restorations.

Evaluation of the roughness and mass loss of the flowable composites after simulated toothbrushing abrasion

The purpose of this study was to measure mass loss and surface roughness changes of different brands of flowable resin composites after a simulated toothbrushing test. The null hypotheses were that there would be no differences in mass loss and no significant changes in surface roughness after this test and that there would be no correlation between the two variables. The tested materials were Aeliteflo (Bisco), Flow-It (Pentron), Flow-It LF (Pentron), Natural Flow (DFL) and Wave (SDI). Z100 (3M/ESPE) microhybrid and Silux Plus (3M/ESPE) microfilled resin composites were used as control materials. Twelve specimens (5 mm in diameter, 3 mm thick) of each material were prepared according to manufacturers' instructions. Toothbrushing abrasion was performed on all specimens from each of the materials using a simulator. The percentage mass loss and surface roughness were assessed before and after 100,000 brushstrokes, using a Sartorius analytical balance of 0.0001 g accuracy and a Hommel Tester T1000, respectively. The measurements of both properties were statistically compared by paired t-test and Tukey's test (p < 0.05). All materials presented a statistically significant mass loss comparing initial and final values, with the exception of Flow-It LF. However, no difference was revealed when comparing the mass loss of the different tested materials. All materials became rougher and Wave presented statistically higher roughness compared to the other resin composites. Flowable resin composites did not seem to be superior to the control groups, and they can be expected to wear by mass loss and to have an increased roughness of surface after toothbrushing action. The anticipated null hypotheses were partially accepted.

Selected characteristics of an Ormocer and a conventional hybrid resin composite

OBJECTIVES

The objective of this in vitro study was to evaluate surface roughness, hardness and wear resistance of an Ormocer (Admira), polymerized by a plasma arc system. A secondary objective was to investigate two placement technique bulk or incremental layers.

METHODS

Blocks from Admira and Amelogen (a microhybrid composite) were prepared in cylinders, 3 mm in diameter, and 2 and 5 mm in thickness (bulk or incrementally placed) and polymerized by a plasma arc and a conventional light system. Surface roughness measurements were taken by a Surface Profilometer on the top of the specimens. Vickers hardness measurements, with a load of 600mN were taken on the top and bottom of 2 mm and top, intermediate and bottom of 5 mm thick specimens. For the wear test, specimes (8 mm in diameter and 2 mm in thickness) of Admira, Amelogen and amalgam were tested in a ball-on design, by circular movements of the antagonist (alumina ball; diameter 10 mm) under 10 N load. For the statistical evaluation of the results of surface roughness, microhardness and wear test; a paired samples t-test and Kruskal-Wallis analysis of variance test, were performed.

RESULTS

Admira showed highest hardness values in all polymerization types at the top surface and this was statistically significant (p < 0.05). These highest hardness values were obtained with conventional polymerization (81.84 +/- 1.167 VHN). Meanwhile, the wear resistance of Admira was found to be higher than Amelogen (Wd(admira) = 0.024 +/- 0.00149 mm3; Wd(amelogen) = 0.032 +/- 0.00075 mm3). However, Admira demonstrated the highest surface roughness value compared to Amelogen, with plasma arc 5 s (0.65 +/- 0.023 microm). Amelogen was found to have the lowest surface roughness value with conventional 40 s (0.45 +/- 0.012 microm).

SIGNIFICANCE

The results indicated that Ormocer, which was developed by Ormocer technology, demonstrated higher microhardness and wear resistance when compared to a hybrid composite; however, the polishability of Ormocer needs further investigation. Also the selection of visible light activated composite resins exhibited higher surface microhardness values when polymerized with conventional rather than with plasma arc.