Immediate versus water-storage performance of Class V flowable composite restoratives

Objectives The aims of this investigation were to clarify the effects of 24 h water-storage and finishing time on mechanical properties and marginal adaptation to a Class V cavity of eight modern flowable resin-composites. Methods Eight flowable composites, plus two controls (one microfilled and one hybrid composite), were investigated with specimen sub-groups (n = 10) for each property measured. The principal series of experiments was conducted in model Class V cavities with interfacial polishing either immediately (3 min) after setting or after 24 h water-storage. After the finishing procedure, each tooth was sectioned in a buccolingual direction through the center of the restoration, and the presence or absence of marginal-gaps was measured (and then summed for each cavity) at 14 points (each 0.5 mm apart) along the cavity restoration interface (n = 10 per group; total points measured = 140). The shear bond-strengths to enamel and to dentin, and flexural strengths and moduli data were also measured at 3 min and after 24 h water-storage. Results For all flowable composites, polished immediately after setting, 14–30 summed gaps were observed (controls: 64 and 42). For specimens polished after 24 h, a significantly (p &#60; 0.05) reduced number of 8–17 summed gaps occurred for only 3 flowable composites; whereas for 5 flowable composites there were non-significantly-different (p &#62; 0.05) numbers (11–17) of summed gaps (controls: 28 and 22). After 24 h storage, shear bond-strengths to enamel and to dentin, flexural strengths and moduli increased highly significantly (p &#60; 0.001) for all materials, except Silux Plus. Significance A post-cure interval of 24 h resulted in enhanced mechanical and adhesive properties of flowable dental composites. In a minority of cases there was also a reduced incidence of marginal-gap formation. However the latter effect may be partly attributed to 24 h delayed polishing, even though such a delay is not usual clinical practice.</p

Marginal and flexural integrity of three classes of luting cement, with early finishing and water storage

Objectives. The aims of this investigation were to clarify the effects of finishing-time and 24 h water-storage on mechanical properties and marginal adaptation to dentin of seven modern luting cements, representing three chemical types. Methods. Bistite II, Chemiace II, Compolute, XenoCem, PermaCem, Fuji Cem and Fuji Plus were investigated with specimen sub-groups (N=10) for each property measured. The principal series of experiments was conducted in dentin cavities with interfacial polishing either immediately (3 min) after setting or after 24 h water-storage. After the finishing procedure, the maximum marginal gap width and the opposing width (if any) per cavity were measured microscopically, and summed. Then the overall sum of gap-widths (per group; N=10) was calculated. Marginal gaps were similarly measured in Teflon cavities, together with shear-bond-strengths to dentin and early flexural strengths, moduli and swelling data. Results. For specimen-sets polished immediately after setting, summed marginal gaps of 23–121 &#956;m were observed, for all luting cements except Compolute. A significantly different (p&#60;0.05) result of either no gap or 6–28 &#956;m summed gap-widths occurred in specimens polished after 24 h. For all materials, their shear-bond-strengths, flexural strength and moduli significantly increased after 24 h storage. Significance. The marginal behavior can be interpreted in terms of the contributions of bonding, shrinkage, swelling and compliance of components, along with compositional features of the cements. With these types of cement it is generally inadvisable to polish the interfacial luting surface immediately after cementing. The polishing procedures should be carried out not less than 24 h later. One resin-cement was able to withstand immediate finishing.</p

Flexural Property of a Composite Biomaterial in Three Applications

Resin composite is widely used in the dental field in clinics as a biomaterial. For example, it has been used as a composite material, a type of biomaterial, to repair caries and restore masticatory function, and as a luting agent to adhere the restoration to the tooth substrate. In order to demonstrate its function, we have measured the mechanical strength. From such basic research, we explain the potential of a dental material through the measurement of flexural strength and modulus of elasticity. In this research, we introduce commercial products that are actually used as composite materials suitable for tooth substrate and provide readers with their properties based on flexural strength and modulus of elasticity. In clinical performance, it might be advisable to delay polishing when a composite material is used for a luting material, a filling material and a core build-up material, as the flexural strength and the flexural modulus of elasticity were improved after 1 day of storage, and flexural strength and characteristics are considered as important mechanical properties of oral biomaterials.</p

Root-surface gap-formation with RMGIC restorations minimized by reduced P/L ratio of the first increment and delayed polishing

Objectives This in vitro study evaluated the effect on interfacial gap-formation around resin-modified glass–ionomer (RMGIC) root surface restorations with (a) variations in powder/liquid ratio (P/L) of the first increment of an incremental procedure, compared with a bulk restoration technique, and (b) delayed versus immediate polishing, to permit maturation. Methods Cavity preparations were placed in premolar teeth on upper facial root surfaces. Two RMGICs were studied (Fuji II LC and Vitremer), with their associated conditioner or primer, applied with an incremental technique. The P/L ratio of the first increment was reduced to fractional (normalized) values between 0.2 and 1.0 of the manufacturers' recommended P/L, and the manufacturers' P/L was used for the second increment. Control groups were bulk filled. After polishing, either: (i) immediately after light-activation or (ii) after 24 h storage, the restored teeth were sectioned in a buccolingual direction through the center of the restoration and the presence or absence of marginal gaps was measured at ×1000 magnification at 14 points (each 0.5-mm apart) along the cavity restoration interface; (n=10; total points measured per group=140). Results For both RMGICs, significant differences (p Significance To minimize gap formation, more fluid mixes could be used especially with Fuji II LC to give improved adaptation to the dentin. Secondly, whenever possible, polishing should be delayed on the final increment to permit maturation and minimize mechanical disruption of both increments.</p

Flexural Strength of Resin Core Build-Up Materials: Correlation to Root Dentin Shear Bond Strength and Pull-Out Force

The aims of this study were to investigate the effects of root dentin shear bond strength and pull-out force of resin core build-up materials on flexural strength immediately after setting, after one-day water storage, and after 20,000 thermocycles. Eight core build-up and three luting materials were investigated, using 10 specimens (n = 10) per subgroup. At three time periods-immediately after setting, after one-day water storage, and after 20,000 thermocycles, shear bond strengths to root dentin and pull-out forces were measured. Flexural strengths were measured using a 3-point bending test. For all core build-up and luting materials, the mean data of flexural strength, shear bond strength and pull-out force were the lowest immediately after setting. After one-day storage, almost all the materials yielded their highest results. A weak, but statistically significant, correlation was found between flexural strength and shear bond strength (r = 0.508, p = 0.0026, n = 33). As the pull-out force increased, the flexural strength of core build-up materials also increased (r = 0.398, p = 0.0218, n = 33). Multiple linear regression analyses were conducted using these three independent factors of flexural strength, pull-out force and root dentin shear bond strength, which showed this relationship: Flexural strength = 3.264 x Shear bond strength + 1.533 x Pull out force + 10.870, p = 0.002). For all the 11 core build-up and luting materials investigated immediately after setting, after one-day storage and after 20,000 thermocycles, their shear bond strengths to root dentin and pull-out forces were correlated to the flexural strength in core build-up materials. It was concluded that the flexural strength results of the core build-up material be used in research and quality control for the predictor of the shear bond strength to the root dentin and the retentive force of the post

Flexural properties, bond ability, and crystallographic phase of highly translucent multi-layered zirconia

This study investigated the mechanical properties, bond ability, and crystallographic forms of different sites in a highly translucent, multi-layered zirconia disk. Flexural properties, bond ability to resin cement, and phase composition were investigated at three sites of a highly translucent, multi-layered zirconia disk: incisal, middle, and cervical. Flexural strength (FS) and flexural modulus (FM) were measured with static three-point flexural test. Shear bond strength (SB) to resin cement was measured after 24 h storage (37°C). Phase composition under mechanical stress was analyzed using X-ray diffraction. Without air abrasion, FS at the incisal site yielded the lowest value and was significantly lower than the middle and cervical sites. Air abrasion lowered the FS of each site. FM at the incisal site without air abrasion showed the significantly lowest value, and air abrasion increased its FM value. At the middle and cervical sites, their FM values were higher than the incisal site but were not significantly affected by air abrasion. SB value did not show significant differences among the sites. After sintering, cubic zirconia was detected at each site. Rhombohedral phase transformation occurred after mirror polishing. In highly translucent, multi-layered zirconia which was mainly composed of cubic zirconia, rhombohedral phase transformation occurred under mechanical stress and resulted in weakened mechanical properties

Sandblasting may damage the surface of composite CAD-CAM blocks

　OBJECTIVE:　 CAD-CAM blocks to fabricate semi-direct and indirect restorations are available in different sorts of ceramics as well as composite. In order to bond restorations prepared out of composite blocks into tooth cavities, it is recommended to gently sandblast the surface prior to the application of a primer/adhesive. Today, the effect of sandblasting composite block surfaces has not thoroughly been investigated. In this study, the ultra-structure of composite CAD-CAM blocks was investigated with special attention to the effect of sandblasting on the surface topography and of silanization on the bonding performance. 　METHODS:　 Five different composite CAD-CAM blocks were involved. We correlatively investigated their structural and chemical composition using X-ray diffraction (XRD), energy dispersion spectroscopy (EDS), scanning electron microscopy (SEM) and (scanning) transmission electron microscopy ((S)TEM). The effect of sandblasting was also imaged in cross-section and at the interface with composite cement. Finally, we measured the shear bond strength to the sandblasted block surface with and without silanization. 　RESULTS:　 All composite blocks revealed a different ultra-structure. Sandblasting increased surface roughness and resulted in an irregular surface with some filler exposure. Sandblasting also damaged the surface. When the sandblasted composite blocks were silanized, superior bonding receptiveness in terms of higher bond strength was achieved except for Shofu Block HC. 　SIGNIFICANCE:　 Sandblasting followed by silanization improved the bond strength to composite CAD-CAM blocks. However, sandblasting may also damage the composite CAD-CAM block surface. For the composite CAD-CAM block Shofu Block HC, the damage was so severe that silanization did not improve bond strength

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

Published online: 25 March 2014ArticleJOURNAL OF GASTROENTEROLOGY. 49(5):765-784 (2014)journal articl

Prevention of hypoglycemia by intermittent-scanning continuous glucose monitoring device combined with structured education in patients with type 1 diabetes mellitus : A randomized, crossover trial

Aims: We conducted a randomized, crossover trial to compare intermittent-scanning continuous glucose monitoring (isCGM) device with structured education (Intervention) to self-monitoring of blood glucose (SMBG) (Control) in the reduction of time below range. Methods: This crossover trial involved 104 adults with type 1 diabetes mellitus (T1DM) using multiple daily injections. Participants were randomly allocated to either sequence Intervention/Control or sequence Control/Intervention. During the Intervention period which lasted 84 days, participants used the first-generation FreeStyle Libre (Abbott Diabetes Care, Alameda, CA, USA) and received structured education on how to prevent hypoglycemia based on the trend arrow and by frequent sensor scanning (≥10 times a day). Confirmatory SMBG was conducted before dosing insulin. The Control period lasted 84 days. The primary endpoint was the decrease in the time below range (TBR; <70 mg/dL). Results: The time below range was significantly reduced in the Intervention arm compared to the Control arm (2.42 ± 1.68 h/day [10.1 %±7.0 %] vs 3.10 ± 2.28 h/day [12.9 %±9.5 %], P = 0.012). The ratio of high-risk participants with low blood glucose index >5 was significantly reduced (8.6 % vs 23.7 %, P < 0.001). Conclusions: The use of isCGM combined with structured education significantly reduced the time below range in patients with T1DM

Flexural Strength of Resin Core Build-Up Materials: Correlation to Root Dentin Shear Bond Strength and Pull-Out Force

The aims of this study were to investigate the effects of root dentin shear bond strength and pull-out force of resin core build-up materials on flexural strength immediately after setting, after one-day water storage, and after 20,000 thermocycles. Eight core build-up and three luting materials were investigated, using 10 specimens (n = 10) per subgroup. At three time periods&mdash;immediately after setting, after one-day water storage, and after 20,000 thermocycles, shear bond strengths to root dentin and pull-out forces were measured. Flexural strengths were measured using a 3-point bending test. For all core build-up and luting materials, the mean data of flexural strength, shear bond strength and pull-out force were the lowest immediately after setting. After one-day storage, almost all the materials yielded their highest results. A weak, but statistically significant, correlation was found between flexural strength and shear bond strength (r = 0.508, p = 0.0026, n = 33). As the pull-out force increased, the flexural strength of core build-up materials also increased (r = 0.398, p = 0.0218, n = 33). Multiple linear regression analyses were conducted using these three independent factors of flexural strength, pull-out force and root dentin shear bond strength, which showed this relationship: Flexural strength = 3.264 &times; Shear bond strength + 1.533 &times; Pull out force + 10.870, p = 0.002). For all the 11 core build-up and luting materials investigated immediately after setting, after one-day storage and after 20,000 thermocycles, their shear bond strengths to root dentin and pull-out forces were correlated to the flexural strength in core build-up materials. It was concluded that the flexural strength results of the core build-up material be used in research and quality control for the predictor of the shear bond strength to the root dentin and the retentive force of the post