Temperature transmission of high-output light-curing units through dentin

Light-curing units used for polymerizing restorative resins produce heat during operation. Newer curing units with concentrating light guides or different light sources may require shorter curing times, however, the effect of such modifications on temperature transfer to the pulp is unknown. This study examined the effect of high output light-curing units on temperature transfer through resin composite and dentin. Temperature rise was measured for 40 seconds for one curing light (Optilux 401 Curing Light) with either a standard 8 mm light guide tip or a light-concentrating tip (Turbo Light Guide), and for three seconds with a plasma arc lamp (Apollo 95E Curing Light). Temperatures were directly recorded at the tip of the light guide and through a sandwich composed of a 1 mm thick pre-cured cylinder of resin composite and dentin (dentin thickness either 0.58 mm or 1.45 mm). The mean temperature rise ranged from 1.8degrees C, measured through the sandwich of 1 mm of composite and 1.45 mm of dentin with the plasma are unit, to 26.4degrees C measured directly on the Turbo light guide. For each light guide, the temperature increase was greatest when measured directly on the curing tip and least when measured through the composite and 1.45 mm dentin specimens. When measured through the composite/dentin sandwich, the plasma arc unit produced the lowest temperature increase (0.58 mm thick dentin specimen = 5.1 degrees C; 1.45 mm thick dentin specimen = 1.8 degrees C). For a given thickness of resin, the differences in temperature change for all comparisons among the three curing unit/light guides were significant at the 95% level of confidence. Also, for a given light, the differences in temperature for all comparisons among the dentin thicknesses were significant at the 95% level of confidence. However, there were three comparisons of light unit and dentin thickness interaction that were not significant at the 95% leyel of confidence. For all other comparisons of interaction, significant differences were found at the 95% level of confidence. The temperature increased by 42% to 56% when the Turbo Light Guide was used compared to the standard light guide for thick and thin dentin specimens, respectively.

Interchangeability of two semiadjustable articulators

PURPOSE

Interchangeability between articulators allows mounted casts to be transferred accurately from one articulator to another. The purpose of this study was to evaluate the interchangeability of 109 new, unused interchangeable articulators in the centric position.

MATERIALS AND METHODS

The interchangeability of 38 unused Whip Mix model #2240 and 71 unused model #3040 semiadjustable articulators was evaluated using the Whip Mix #2245 check system as the standard. Vertical discrepancies between the check system cylinders were also measured.

RESULTS

Within the standard for interchangeability established by the Whip Mix #2245 check system (< 94 microns horizontal discrepancy), 101 (93%) of 109 articulators were interchangeable (34 were model #2240 and 67 were model #3040). Overall, the amount of vertical space between the check system cylinders was < or = 52 microns in 99.4% of the model #2240 articulators and 99.7% of the #3040 articulators.

CONCLUSION

New, unused Whip Mix model #2240 and #3040 articulators are potentially interchangeable in the centric position.

Effect of Distance on the Power Density from Two Light Guides

PURPOSE

This study determined the effect of distance on the power density from standard and Turbo light guides (Demetron/Kerr, Danbury, Connecticut).

MATERIALS AND METHODS

Power density was measured from 0 to 10 mm away from the tip of standard 8-mm curved light guides and 13/8-mm Turbo curved light guides. To determine the effect of distance on power density, a polynomial regression line was fitted. The Kolmogorov-Smirnov (K-S) statistic and the Wilcoxon rank sum (WR) tests were used to determine if there was a difference in the rate at which the power density decreased for the standard and Turbo light guides as the distance from the tip increased. Photographs of the light dispersion from each tip were also taken.

RESULTS

At 0 mm, the mean (+/- SD) power density from the two standard light guides was 743 +/- 6.1 mW/cm2 and from the four Turbo light guides was 1128 +/- 22.1 mW/cm2. As the distance from the tip of the light-guide tip increased, the power density decreased, but the rate of decrease was greater from the Turbo light guides than from the standard light guides. At 6 mm the power density from the standard light guides fell to 372 mW/cm2 (50% of the original value) and the power density from the Turbo light guides fell to 263 mW/cm2 (23% of the original value). Both the K-S statistic and the WR sum test indicated that the distribution of light intensities was significantly different from the two light guides (WR p-value = .0246, K-S p-value < .0001). The two estimated polynomials intersected at 3.66 mm, and the 95% prediction intervals intersected at about 2.8 and 4.8 mm. Therefore, beyond 5 mm away from the tip of the light guide, the standard light guides gave higher power density readings than the Turbo light guides. Photographs showed that the light dispersed at a wider angle from the Turbo light guides than from the standard light guide.

CLINICAL SIGNIFICANCE

The design of the light guide of a light curing unit affects light dispersion, power density, and ultimately the dentist's ability to properly cure composite. For these reasons, manufacturers should report the power density at the tip of the light guide and 6 mm from the tip of the light guide, since significant differences exist between light guide designs.

Interchangeability of semiadjustable articulators after 2 to 7 years of use

PURPOSE

The purpose of this study was to test the interchangeability of articulators that had been in use from 2 to 7 years and compare these results with the interchangeability of the same articulators 1 year earlier.

MATERIALS AND METHODS

Forty-six Whip Mix model #2240 articulators (Whip Mix Corporation, Louisville, KY) that were in clinical use from 2 to 7 years were checked for interchangeability using the Whip Mix #2245 check system. The horizontal tolerance of the check system was 94 microm. Articulators were also evaluated in the vertical dimension at 4 predetermined locations around the check system cylinders using 26-microm-thick shimstock. Vertical discrepancies between the cylinders were recorded as the thickness of 0, 1, 2, or more than 2 pieces of shimstock. Interchangeability results were compared with those determined 1 year previously using the same evaluation methods using the Exact McNemar's Test of Agreement (alpha = 0.05).

RESULTS

Using the Whip Mix 2245 check system, 35 (76%) articulators were interchangeable after 2 to 7 years of use. This compares to 38 (83%) that were interchangeable upon evaluation 1 year earlier. The decrease in interchangeability was not significant (p =.4531). Forty-three (94%) of the articulators had vertical discrepancies of 52 microm or less at the initial evaluation. One year later, 45 (98%) of the articulators had vertical discrepancies of 52 microm or less. After 1 year, there were significant differences in the amount of vertical space between the cylinders only at the right side (p =.014).

CONCLUSION

The Whip Mix model #2240 articulator can remain interchangeable during clinical use for 7 years, but should be routinely checked for calibration.

The effect of polishing on surface roughness of tissue conditioners

PURPOSE

Surface roughness can affect microbial colonization of long-term denture liners, alloys, and denture acrylic. The purpose of the present study was to examine the effect of finishing and polishing procedures on surface roughness of 4 temporary resilient denture liners (tissue conditioners).

MATERIALS AND METHODS

Mean surface roughness was measured for 4 materials (Lynal, Visco-gel, Coe-Soft, and Functional Impression Tissue Toner [FITT]) finished in 4 ways: unfinished (control); polished; reduced, unpolished; and reduced, polished. Samples were allowed to polymerize at 37 degrees C for 24 hours, and the surface roughness was measured using a Mitutoyo Surftest 212.

RESULTS

Mean surface roughness ranged from 1.8 +/- 0.8 microns for polished Lynal to 7.8 +/- 1.1 microns for reduced, unpolished FITT. All polished samples were smoother than unpolished samples (including controls), whether or not the samples were reduced with a bur.

CONCLUSION

Polished samples of tissue conditioning material had lower mean surface roughness measurements than control or reduced, unpolished samples at the 95% level of confidence. There was no difference in mean surface roughness measurements of control samples and unpolished samples reduced with a bur at the 95% level of confidence. Mean surface roughness differed significantly between the materials tested.

Marginal discrepancy of ceramic crowns with redesigned implant components

A previous study indicated a mean marginal discrepancy of 169 microns (SD = 23) for cemented CeraOne ceramic crowns. Since then, the components have been redesigned by the manufacturer. This study assessed the marginal discrepancy of the new components by use of a video camera and stereomicroscope connected to a computer. Fifteen samples each of (a) ceramic caps (control), (b) ceramic caps fired once in a porcelain oven (c) ceramic crowns, and (d) cemented (zinc phosphate) ceramic crowns were examined. The results indicated that the mean marginal discrepancies were: caps 20.4 microns (SD = 10.8), fired caps 18.3 microns (SD = 9.3), crowns 28.1 microns (SD = 9.7), and cemented crowns 65.9 microns (SD = 15.8). Statistical analysis (ANOVA) revealed significant differences between these mean marginal discrepancies (p < 0.0001). A Scheffe F-test revealed no statistically significant difference between the means for caps, fired caps, and crowns, whereas cemented crowns had significantly greater mean marginal discrepancies compared with all uncemented retainers (p < 0.0001). The mean marginal discrepancy of the redesigned CeraOne ceramic system (cemented crowns) was reduced by more than 100 microns compared with the original design.

Marginal discrepancy of all-ceramic crowns cemented on implant abutments

PURPOSE

The purpose of this investigation was to determine the mean marginal discrepancy of all-ceramic crowns cemented on implant abutments.

MATERIALS AND METHODS

Five Brånemark CeraOne abutments were connected to implant fixtures embedded in acrylic resin blocks. The marginal discrepancy was measured using a video camera connected to a digitizing board at four locations on each abutment for five samples in each of the following groups: all-ceramic caps (caps), all-ceramic crowns (crowns), and all-ceramic crowns cemented with zinc phosphate cement (cemented crowns).

RESULTS

The mean marginal discrepancies were as follows: caps, 99.0 micrometers (SD, 16); crowns, 117.8 micrometers (SD, 20); and cemented crowns, 168.8 micrometers (SD, 23). Statistically significant differences were found between all three groups at the 99% level of confidence. In addition there were two significant differences between abutments.

CONCLUSIONS

Subgingival marginal discrepancies of the magnitude measured in this study have been shown to cause periodontal problems. It is probable that the marginal discrepancy of CeraOne restorations, as tested, can be improved. Efforts should be made to enhance the marginal accuracy of these restorations.

The effect of load angulation on fracture resistance of teeth restored with cast post and cores and crowns

The purpose of this study was to determine if loading post-restored teeth at different angles would affect their fracture resistance. Thirty maxillary central incisors were treated endodontically to within 5.0 mm of the apex. Standardized cast post and cores were fabricated using plastic #4 Parapost patterns. Post and cores were cemented using zinc phosphate cement, followed by crowns of average dimensions. Ten teeth each were loaded at 110, 130, and 150 degrees to the long axis of the tooth. Mean failure loads were: 110 degrees = 372.4 N +/- 140.8 (SD); 130 degrees = 597.6 N +/- 138.5 (SD); 150 degrees = 1274.3 N +/- 429.9 (SD). There were significant differences in fracture resistance between teeth tested at the following angles: 110 degrees versus 150 degrees (P < .0001), and 130 degrees versus 150 degrees (P < .0001), but not for 110 degrees versus 130 degrees (P = .2016). Mean failure loads increased as load angle approached parallelism to the long axis of the teeth. Significant differences in fracture resistance of post-restored teeth can occur as a result of load angle.

Marginal accuracy of indirect provisional restorations fabricated on poly(vinyl siloxane) models

Indirect interim restorations have been traditionally fabricated on stone casts. Recently, flexible models fabricated from poly(vinyl siloxane) impression material have been suggested in place of stone casts. This study compared the marginal accuracy of indirect single-unit provisional restorations fabricated on stone casts with units made on poly(vinyl siloxane) impression material models. The mean marginal discrepancy of provisional restorations was compared for restorations fabricated from stone, low-viscosity poly(vinyl siloxane), and medium-viscosity poly(vinyl siloxane). Ten restorations were also fabricated directly on a master metal model (control). The mean marginal discrepancies were: control = 0.161 mm; stone model = 0.180 mm; low-viscosity poly(vinyl siloxane) = 0.245 mm; and medium-viscosity poly(vinyl siloxane) = 0.157 mm. The mean marginal discrepancy for the low-viscosity poly(vinyl siloxane) models was significantly higher than the other three groups. No significant difference was found between the control, stone cast, and medium-viscosity poly(vinyl siloxane) model groups.

Marginal accuracy of provisional restorations fabricated by different techniques

Provisional restorations were fabricated on a cast metal model and the resulting marginal discrepancies were measured. In the control group, the restorations were fabricated directly on the die and no coolant was applied. Five other methods of fabricating provisional restorations were evaluated. The mean marginal discrepancies were as follows: Control = 0.228 mm, In Situ (control plus coolant) = 0.196 mm, Removal (removed from die to polymerize) = 0.403 mm, On/Off (repeated removal/replacement) = 0.601 mm, Reline = 0.074 mm, and Indirect = 0.161 mm. The mean marginal discrepancy for the On/Off technique was significantly greater than that for all other techniques. The mean marginal discrepancy with the Removal technique was significantly greater than that with the Control, In Situ, Reline, and Indirect techniques. No significant differences were found between the Control, In Situ, Reline, and Indirect techniques.

Stabilized record bases for implant-retained overdentures

A procedure is described that uses elastomeric impression material to retain and stabilize overdenture record bases without the use of costly overdenture components. The retentive record base simplifies the registration of jaw relations and the analysis of esthetics and phonetics at the wax try-in stage by minimizing potential record base movement.

Finishing and polishing of a poly (fluoroalkoxyphosphazene) resilient denture liner

A raised ridge of Novus resilient denture liner was removed from samples using one of three burs, three stones, or a coarse sandpaper disc. Samples were polished using pumice alone, tin oxide alone, or both agents. A flat, unfinished sample served as a control. Average surface roughness of control samples was 0.96 microns. Average surface roughness measurements for reduced samples ranged from 7.21 microns (sandpaper disc) to 3.34 microns (Prolastic wheel). Without polishing, sandpaper discs and serrated burs produced rougher surfaces than stones or the nonserrated bur. The sandpaper disc reduced the liner the quickest. There were no significant differences between treatments or controls after the use of pumice alone or after the use of a combination of pumice and tin oxide. An acceptable finishing protocol for this poly(fluoroalkoxyphosphazene) resilient liner appears to differ from that previously established for a silicone resilient denture liner.

The effect of finishing and polishing on surface roughness of a processed resilient denture liner

A raised ridge on a Molloplast-B sample was removed using one of three burs, four stones, or a coarse sandpaper disc. Samples were polished using pumice alone, tin oxide alone, or both agents. A flat, unfinished sample served as a control. The average surface roughness was measured after reductions and subsequent polishings. The length of time required for initial reduction was recorded. Average surface roughness measurements ranged from 16.0 to 1.4 microns, with the control measuring 0.66 micron. Without polishing, burs produced rougher surfaces than stones and required longer times for reduction. Bur samples also remained rougher than stone samples after pumicing. No significant differences were found between treatments or controls after the use of either a combination of pumice and tin oxide or tin oxide alone.

The effect of cooling techniques on intrapulpal temperature during direct fabrication of provisional restorations

In vitro measurements were made of the heat transferred to the pulp chamber during the direct fabrication of extracoronal provisional restorations. The temperature was monitored for the following four groups: (1) control--the provisional restoration was left on the tooth with no coolant used; (2) removal--the provisional restoration was removed upon initial resin polymerization; (3) in situ--the provisional restoration was left in place and cooled with an air/water spray; and (4) on/off--the provisional restoration was repeatedly removed and replaced upon initial polymerization while using an air/water spray. The intrapulpal temperature rises were as follows: control 7.08 degrees C, removal 2.39 degrees C, in situ 2.36 degrees C, and on/off 3.12 degrees C. The temperature rise for all cooling techniques was significantly lower than that of the control. No significant differences were found between the three cooling techniques.

Three-dimensional photoelastic stress analysis of the ferrule effect in cast post and cores

The effect of a metal collar on stress distribution with cast post and cores was studied by using three-dimensional photoelastic models of maxillary canine teeth of average dimensions. Standardized parallel post and cores were cemented into the models, with half of the samples incorporating a 1.5 mm metal collar. A 400 gm load was applied to the cingulum of the cores and stresses were frozen in the models. The posts were removed, the teeth were sectioned, and stresses were measured with a circular polariscope. In both groups the greatest stress concentration was found at the lingual apex of the post. On a point by point basis, stresses were higher in the collared specimens. Variation in stress magnitude among five preselected points was greater within the noncollared group.

A boxing technique for irreversible hydrocolloid impressions

A technique is described for boxing irreversible hydrocolloid impressions by using the paper sheets that separate boxing wax strips.

Velopharyngeal dysfunction: recommendations for use of nomenclature

A review of literature relating to velopharyngeal dysfunction reveals that there is no consensus regarding the precise definition of the terms "velopharyngeal incompetence," "velopharyngeal inadequacy," or "velopharyngeal insufficiency." Since this represents an obstacle to communication among members of multidisciplinary teams concerned with rehabilitation of velopharyngeal problems, current usage of these terms is reviewed and recommendations for clarification of the nomenclature are provided.