Bonding Effectiveness of Saliva-Contaminated Monolithic Zirconia Ceramics Using Different Decontamination Protocols

Objective

This research study investigated the effect of new decontamination protocols on the bonding capacity of saliva-contaminated monolithic zirconia (MZ) ceramics cemented with two different monomer-containing self-adhesive resin cements.

Materials and Methods

Standardized tooth preparations (4 mm. axial height) were performed for eighty human maxillary premolars under constant water cooling system. Eighty monolithic zirconia crowns (Whitepeaks Supreme Monolith) (n = 8/10 groups) were manufactured by CAD-CAM. Specimens were kept in the artificial saliva at pH = 7.3 for 1 minute at 37°C except control groups. The specimens have not been prealumina blasted and grouped according to cleaning methods and resin cements: control groups (C) (no saliva contamination + GPDM + 4-META (N) (CN) and 10-MDP (M) containing resin cement (CM), alumina blasted (AL) + GPDM + 4-META (ALN) and 10-MDP containing resin cement (ALM), zirconium oxide containing universal cleaning agent (IC) applied + GPDM + 4-META (N) (ICN) and 10-MDP containing resin cement (ICM), pumice (P) applied + GPDM + 4-META (PN) and 10-MDP containing resin cement (PM), and air-water spray (AW) applied + GPDM + 4-META (AWN) and 10-MDP containing resin cement (AWM)). Monobond Plus was applied to all surfaces for 40 seconds before cementation. The thermal cycle was applied at 5,000 cycles after cementation. The crowns were tested in tensile mode at a speed of 1 mm/min. The mode of failure was recorded. SEM examinations were carried out at different magnifications. Data were analyzed using rank-based Kruskal-Wallis and Mann-Whitney tests.

Results

No significant differences were found between the surface treatments and between the two types of resin cements. Interaction effects between surface treatments and resin cements were found to be significant by two-way ANOVA analysis. ICM group resulted in significantly better bond strength results compared with CN. ICM was found to result in better bond strength results compared with PM. The combination of universal cleaning agent and 10-MDP containing resin cement had significantly the highest cementation bond strength values. The increasing order of mean tensile bond strength values of decontamination protocols was C < AW < P < AL < IC. The mean tensile bond strength of 10-MDP containing resin cement was slightly higher than GPDM + 4-META containing resin cement.

Conclusions

Universal cleaning agents can be preferred as an efficient cleaning method with 10-MDP-containing cement after saliva contamination for better adhesive bond strength of 4 mm crown preparation height of monolithic zirconia ceramics.

The Use of Zirconium and Feldspathic Porcelain in the Management of the Severely Worn Dentition: A Case Report

The management of the interim phase of a complete oral rehabilitation in patients with severely worn dentition is often challenging due to the loss of occlusal vertical dimension, loss of tooth structure, uneven wear of teeth creating an uneven plane of occlusion, and para-functional habits. This case report describes the management of excessive tooth tissue loss in a 45 year old woman with a history of bruxism, esthetical complaints in anterior teeth, and impaired dental function due to reduced tooth height. The patient used occlusal splint for a month and than resection of the alveolar bone was performed on the vestibular sides of the maxillary anterior teeth, except the interdental alveolar crest. Maxillary anterior teeth were restored with zirconia porcelain. Feldspathic porcelain was chosen to restore remaining teeth in both jaws; the patient also was given an occlusion guard to protect the restoration against future bruxism. Regardless of the cause of occlusal instability, it is important that the restorative dentist should be able to recognize its signs such as tooth hypermobility, tooth wear, periodontal breakdown, occlusal dimpling, stress fractures, exostosis, muscle enlargement, and loss of posterior disclusion. When restoring the worn dentition, the clinician should bear in mind the five P’s: proper planning prevents poor performance. (Eur J Dent 2009;3:75-80)

Comparison of time-dependent two-dimensional and three-dimensional stability with micro-computerized tomography and wettability of three impression materials

Objectives

The objective of this study is to explore time-dependent dimensional stability of three different elastomeric impression materials - vinyl polyether silicone (VPES), vinyl polysiloxane (VPS), and polyether (PE) - through micro-computerized tomography (μ-CT) imaging, allows three-dimensional (3D) imaging and measurement without sample preparation or chemical fixation. Materials and Methods: Thirty specimens were created using 3 mm high, 30 mm wide Teflon molds (n = 10). Specimens were scanned with μ-CT on the 1^st (T1) h and 1^st (T2), 7^th (T3), and 14^th (T4) days. 3D models were created at the above-mentioned times, volumetric measurements were conducted and dimensional changes were calculated. Diameters and heights of each impression material were measured with 2D analyses. Furthermore, contact angle measurements of these elastomeric impression materials were collected using the sessile drop method during and after polymerization at 0, 2, 5, 20, 60, 120, and 240 s These measurements were made on specimens (n = 10) prepared in standard sizes using a 50 μm deep stainless steel die with dimensions of 62 mm × 20 mm × 3 mm.

Results

Evaluation of the dimensional volume changes of the VPES, VPS, and PE measurements showed there to be no statistically significant differences between the T1, T2, T3, and T4 (P > 0.05). Only the decreases in the volume averages of T3 and T4 in the VPES were statistically significant (P < 0.05). As a result of binary comparisons, the evaluation of contact angle measurements of VPES, VPS, and PE materials during and after polymerization were compared. The average contact angle measurements of the VPS group were statistically significantly lower than the averages of the VPES and PE groups (P < 0.01).

Conclusions

VPS was found to be the most stable impression material concerning dimensional change and wettability.

Evaluation of the marginal fit of full ceramic crowns by the microcomputed tomography (micro-CT) technique

Objective:

To evaluate the marginal gap (MG) and absolute marginal discrepancy (MD) of full ceramic crowns with two finish line designs, shoulder and chamfer, using microcomputed tomography (micro-CT) before and after cementation.

Materials and Methods:

Sixty extracted human maxillary premolar teeth were divided into two groups based on the finish line design: Group I: 90° shoulder and Group II: 135° chamfer. The specimens were further grouped based on the type of full ceramic crown they received: Group A: Feldspathic Cerec inLab ceramic system, Group B: Cerec inLab aluminum oxide ceramic system and Group C: Lithium disilicate press ceramic system. Before cementation, five crowns from each group were scanned using micro-CT in two sections, sagittal and coronal, to determine the MG and MD values for four regions of the crown (sagittal buccal, sagittal lingual, coronal mesial and coronal distal). After cementation and thermal cycling, the scanning was repeated. Measurements were obtained from 10 points for each region, 80 points totally, to evaluate the MG and MD values. Files were processed using NRecon and CTAn software. Results were statistically analyzed using one- and two-way ANOVA and Tukey HSD tests (P = 0.05).

Results:

Full ceramic systems showed clinically acceptable marginal adaptation values. The Feldspathic Cerec inLab ceramic system generally presented the lowest variance, except in the MG values of the coronal mesial region. The MG and MD values of all ceramics increased significantly after cementation, except in the shoulder preparation design (sagittal buccal region) for MG and in the chamfer preparation design (sagittal lingual region) for MD values.

Conclusions:

Full-ceramic crowns showed clinically acceptable marginal adaptation values. The Feldspathic Cerec inLab ceramic system (Vitablocs Mark II) generally presented the lowest variance when compared with the other ceramics, except for the MG values on the mesial surface of the coronal section.

Intranasal midazolam may prevent gagging reflex: a case report

Background

Gagging can become a conditioned response that makes dental treatment difficult or impossible for both the individual and the dentist. The aim of this study is to report a 50 year old female and two children (15 and 11 years old) with exaggerated gag reflex referred to Faculty of Dentistry of Selçuk University.

Methods

During obtaining records, taking impression procedure was elicited the patients’ hypersensitive gagging reflex. Therefore, it was decided to administer intranasal midazolam to facilitate the taking of accurate dental impressions. After given verbal information about the procedure, 2.5 mg intranasal midazolam (Demizolam, Dem Medikal, Istanbul) were applied incrementally in both nostrils.

Results

Five minutes later; patients had no gagging reflex and allowed the clinician to take satisfying impressions. No serious adverse effects were observed and the patients remained cooperative during the entire procedure which was completed to the full satisfaction of all involved. The short absorption time and the fast relief process of anaesthetics transferred to the systemic circulatory system are important advantages of nasal application.

Conclusions

Intranasal midazolam may be very useful for the treatment of gag reflex probably effecting on the depression of upper airway reflex sensitivity.

The effect of repeated porcelain firings on corrosion resistance of different dental alloys

PURPOSE

The aim of this study was to evaluate the effects of repeated porcelain firing process on the corrosion rates of the dental alloys.

MATERIALS AND METHODS

Cr-Co, Cr-Ni and Pd-Ag alloys were used for this study. Each metal supported porcelain consisted of 30 specimens of 10 for 7, 9 and 11 firing each. Disc-shaped specimens 10 mm diameter and 3 mm thickness were formed by melting alloys with a propane-oxygen flame and casted with a centrifuge casting machine and then with the porcelain veneer fired onto the metal alloys. Corrosion tests were performed in quintuplicate for each alloy (after repeated porcelain firing) in Fusayama artificial saliva solution (pH = 5) in a low thermal-expansion borosilicate glass cell. Tamhane and Sheffe test was used to compare corrosion differences in the results after repeated firings and among 7, 9 and 11 firing for each alloy. The probability level for statistical significance was set at α=0.05.

RESULTS

The corrosion resistance was higher (30 mV), in case of 7 times firing (Commercial). On the other hand, it was lower in case of 11 times firing (5 mV) (P<.05).

CONCLUSION

Repeated firings decreased corrosion resistance of Pd-Ag, Cr-Co and Cr-Ni alloys. The Pd-Ag alloy exhibited little corrosion in in vitro tests. The Cr-Ni alloy exhibited higher corrosion resistance than Cr-Co alloys in in vitro tests.

Effect of various laser irradiations on the mineral content of dentin

OBJECTIVE

THE AIM OF THIS STUDY WAS TO EVALUATE THE MINERAL CONTENT OF DENTIN IRRADIATION WITH ERBIUM: yttrium-aliminum-garnet (Er:YAG), Neodmiyum:yttrium-aliminum garnet (Nd:YAG) and potassium titanium phosphate (KTP) laser used for in the treatment of dentin hypersensitivity.

METHODS

Six extracted wisdom, unerupted molar teeth were used in this study. The enamel of the teeth was removed with a conventional bur under water cooling to expose the dentin surface. The teeth were mounted in a slow-speed, diamond-saw, sectioning machine. Two dentin slabs were obtained from each tooth and each slab was sectioned so that 4 slabs were made from each teeth. Then dentin slabs were randomly divided into four groups. Group A: Control Group, Group B: Er:YAG laser, Group C: Nd:YAG laser, Group D: KTP laser. The levels of Ca, K, Mg, Na,P and Ca/P mineral ratio in each dentin slab were measured by inductively coupled plasma-atomic emission spectrometry (ICP-AES). Data were analysed by one way analysis of variance (ANOVA) and Tukey HSD tests. One sample from each group was prepared for scanning electron microscopy (SEM).

RESULTS

There were no significant differences between the groups for Ca, K, Mg, Na,P and Ca/P mineral ratio (P>.05). SEM photographs indicated that there were melted areas around the exposed dentin tubules in groups treated with Er:YAG and KTP lasers.

CONCLUSION

This study demonstrated that laser etching with the Er:YAG, Nd:YAG, KTP laser systems did not affect the compositional structure of the dentin surfaces.