GPDM- and 10-MDP-based Self-etch Adhesives Bonded to Bur-cut and Uncut Enamel - "Immediate" and "Aged" µTBS.

PURPOSE: To determine the microtensile bond strength (µTBS) of two 2-step self-etch adhesives (SEAs) to bur-cut and uncut enamel. MATERIALS AND METHODS: The buccal and lingual enamel surfaces of 15 teeth were ground flat ("bur-cut" enamel), while the enamel surface of another set of 15 teeth was solely prophylactically cleaned ("uncut" enamel). Resin composite was bonded to the surfaces using the GPDM-based SEA OptiBond XTR (Kerr), the 10-MDP-based SEA Clearfil SE Bond (Kuraray Noritake), or the 3-step etch-and-rinse adhesive (E&RA) OptiBond FL (Kerr) that served as the gold-standard control. After 1-week water storage at 37°C, specimens were serially cut into 1-mm2 stick-shaped microspecimens, of which half per tooth were further subjected to 20,000 thermocycles (TC) prior to µTBS testing. Data were statistically analyzed using ANOVA and the post-hoc Tukey test. The interfacial ultrastructure of the GPDM-based SEA OptiBond XTR with uncut and bur-cut enamel was additionally characterized with transmission electron microscopy (TEM). RESULTS: After 1-week water storage and upon TC aging, both SEAs bonded significantly (p < 0.05) less effectively to both bur-cut and uncut enamel than did the control OptiBond FL, except when OptiBond XTR was bonded to bur-cut enamel; then a similarly high µTBS was recorded (p > 0.05). TEM interfacial characterization revealed a tight interaction of Optibond XTR with both bur-cut and uncut enamel. CONCLUSION: The best bonding efficacy to enamel is still achieved by etching with phosphoric acid, following an E&R approach, while the higher etching efficacy of the GPDM-based SEA may result in equally effective bonding, provided that the enamel is bur-roughened first.

Influence of hydrophilic pre-treatment on resin bonding to zirconia ceramics.

Atmospheric plasma or ultraviolet (UV) treatment alters the surface characteristics of tetragonal zirconia polycrystal (TZP), increasing its hydrophilicity by reducing the contact angle against water to zero. This suggests that such treatment would increase the wettability of bonding resin. The purpose of this study was to determine how increasing the hydrophilicity of TZP through plasma irradiation, UV treatment, or application of ceramic primer affected initial bonding with resin composites. Here, the effect of each pre-treatment on the hydrophilicity of TZP surfaces was determined by evaluating change in shear bond strength. Plasma irradiation, UV, or ceramic primer pre-treatment showed no significant effect on bonding strength between TZP surfaces and resin composites. In addition, alumina blasting yielded no significant increase in bond strength. Plasma irradiation, UV treatment, or ceramic primer pre-treatment did not lead to significant increase in bond strength between TZP and resin composites.

Personality traits in patients with oral malodor.

Many patients presenting at oral malodor clinics have psychological halitosis, which is characterized as being obsessive about having oral malodor or being distressed from a keen awareness of oral odor. We used the Tokyo University Egogram (TEG) to evaluate personality traits in patients presenting at the oral malodor clinic of this institute. The incidence of each TEG personality type was compared between a total of 600 patients presenting at the clinic and a cohort of healthy individuals. Differences were found between the malodor patient and healthy groups. Nurturing Parent (NP)-dominant, Adult (A)-dominant, inverse N (NP low, Free Child high), showed a significant decrease of 6.7, 11.3, and 3.6%, respectively; whereas N (A low) and N (NP high, Free Child low) showed a significant increase of 3.3 and 6.4%, respectively (p < 0.01).

Influence of different rubber dam application on intraoral temperature and relative humidity.

The purpose of this study was to investigate the effect of type of rubber dam and application method on the moisture exclusion effect. The intraoral temperature and relative humidity were compared among various moisture exclusion appliances. Various dry field techniques were applied to 5 subjects and intraoral temperature and relative humidity measured 5 min after placing a digital hygro-thermometer in the mouth. The relative humidity was 100% in all subjects when moisture was excluded by means of cotton rolls alone. When only tooth 36 was exposed, relative humidity was significantly lower with latex, urethane, or 3-dimensional sheets than with cotton rolls alone, and was similar to the level of humidity in the room. When a local rubber dam was used, the relative humidity was significantly higher than the indoor humidity (p<0.05). No significant differences were noted in the intraoral temperature or relative humidity between exposure of 4 teeth and 1 tooth, but variation in the relative humidity was more marked in 4- than in 1-tooth exposure. The creation of an air vent did not influence the moisture exclusion effect. These results suggest that the rubber dam isolation technique excludes moisture to a level equivalent to the humidity in the room when only a single tooth is exposed, but the moisture exclusion effect may be inconsistent when several teeth are exposed.

Career paths and aspirations among postgraduate dental trainees on completion of clinical residency program at Tokyo Dental College.

Career paths and aspirations were investigated among postgraduate dental trainees on completion of clinical training at Tokyo Dental College between 2006, when clinical residency became mandatory, and 2011. Overall, those finding employment with independent general dental practitioners accounted for the majority (34%), followed by those entering postgraduate courses at the Chiba Hospital (20%), those embarking on a postgraduate clinical specialty course at the Chiba Hospital (16%), and those going on to other universities (7%). At the Chiba Hospital, the number selecting postgraduate courses, residency training (including further residency training or a postgraduate clinical specialty course), or employment with a general dental practitioner was almost the same; however, the number selecting postgraduate courses at the Suidobashi Hospital was low, showing a strong tendency toward becoming a general or clinical practitioner. At the Ichikawa General Hospital, most of the trainees decided to remain at the same school or hospital as postgraduate students or residents, showing an aspiration toward further specialization. The results of the Fisher's exact test showed a significant difference in career paths between the Chiba, Suidobashi, and Ichikawa General Hospitals. Trends among postgraduate dental trainees from this and other schools completing the clinical residency program here and subsequently entering postgraduate courses, further residency training, or a postgraduate clinical specialty course at this school were investigated. No major difference was observed in the percentage of trainees remaining at the same school or entering postgraduate courses between those from this and those from other schools; however, more trainees from other schools selected further residency training, while fewer selected a postgraduate clinical specialty course.

Effect of emitted wavelength and light guide type on irradiance discrepancies in hand-held dental curing radiometers.

The purpose of this study was to determine any discrepancies in the outputs of five commercial dental radiometers and also to evaluate the accuracy of these devices using a laboratory-grade spectroradiometer. The power densities of 12 different curing light sources were repeatedly measured for a total of five times using each radiometer in a random order. The emission spectra of all of the curing light sources were also measured using the spectroradiometer, and the integral value of each spectrum was calculated to determine the genuine power densities, which were then compared to the displayed power densities measured by the dental radiometers. The displayed values of power density were various and were dependent on the brand of radiometer, and this may be because each radiometer has a different wavelength sensitivity. These results cast doubt upon the accuracy of commercially available dental radiometers.

Analysis of dental treatment performed by dental residents at General Dentistry Department of Tokyo Dental College Chiba Hospital over 6 years following introduction of mandatory dental clinical training system.

Six years have passed since the introduction of legislation mandating at least 1 year of clinical training for those who have passed the national dentist examination. To determine whether clinical training has been appropriately implemented at the General Dentistry Department of Tokyo Dental College Chiba Hospital, a managed-type clinical training facility, the number of patients treated and types of dental and dental technical work performed by dental residents trained by the department were summarized and analyzed. The number of patients treated per dental resident increased from 11 in 2006 to 15 in 2011. By treatment type, periodontic treatment was the most frequently performed throughout the study period, followed by endodontic treatment. Conservation treatment, prosthodontic treatment with crowns/bridges, and prosthodontic treatment with dentures were performed at a similar moderate frequency, while oral surgical treatment was performed least frequently throughout the study period. The frequency of periodontic treatment increased slightly, whereas that of endodontic treatment decreased slightly or remained almost unchanged after introduction of the mandatory clinical training system. When the distribution of dental treatment performed at our department was compared with that of dental treatment performed by general dentists across Japan in 2011, our department showed a slightly lower frequency of periodontic treatment and higher frequency of endodontic treatment than the national total, whereas the frequency of other types of treatment was similar between the two populations. These results demonstrated that appropriate clinical training has been provided by our department to meet the purpose of offering dentists the opportunity to acquire the basic diagnostic and treatment abilities that would enable them to provide appropriate treatment for injuries and diseases frequently encountered in daily practice. The study also revealed some problems, such as a decreasing number of residents engaging in dental technical work each year. For additional improvement in the quality of dental clinical training, more analyses are needed to further identify and address potential problems in the system.

Recent trends among dental residents at Tokyo Dental College.

Trends among dental residents at Tokyo Dental College between 2006, at which time clinical residency became mandatory, and 2011 were analyzed and the following results obtained. Almost all the eligible students from our school participated in the orientation seminar on dental residency programs. Although the number varied slightly by year, approximately 70 to 150 students from other schools also participated in these orientation seminars. Almost all the students from our school and 60 to 80% of those from other schools participating in the orientation seminar each year applied to sit the dental residency entrance examination. The number of candidates was highest in 2006 (318) and lowest in 2010 (205) (average: 248), and the applicant-to-seat ratio for residency was 1.59. The examination pass rate was 59.02%. Approximately 10% of the students from other schools were admitted as dental residents.

Changes in Gloss Alteration, Surface Roughness, and Color of Direct Dental Restorative Materials after Professional Dental Prophylaxis.

In the context of optimizing dental care for patients who are elderly, the purpose of this in vitro study was to evaluate the surface gloss (with a micro-area gloss meter) of, surface roughness (with a compact surface roughness measuring instrument) of, and color change (with a dental colorimeter) in two commercially available injectable resin-based composites (Estelite Universal Flow (EUF) and Beautifil Flow Plus F00 (BFP)) as well as two glass-ionomer cements (GC Fuji II LC CAPSULE (FLC) and GC Fuji IX GP EXTRA CAPSULE (FGP)), before and after dental prophylaxis. After 24 h, the surfaces of each specimen were polished at 2500 rpm with a prophy brush (Mersage Brush, Shofu) and one-step prophylaxis paste (Prophy Paste Pro, Directa): under 100 or 300 gf load, and for 10 or 30 s, 4× cycles of cleaning. After mechanical cleaning, conditions were found for a significant reduction in the gloss level (EUF, BFP, or FLC; p < 0.05) and a significant increase in surface roughness (BFP; 300 gf load, 10 s × four cycles of cleaning). Overall, the longer time or higher prophylaxis load tended to decrease the surface gloss. However, the observed change in surface roughness varied between the restorative materials. There was no color change post-prophylaxis.

Combined use of baking soda and electric toothbrushing for removal of artificial extrinsic stain on enamel surface: An in vitro study.

BACKGROUND: This study aimed to investigate the combined effect of baking soda and electric toothbrushing on the removal of artificial extrinsic stain in vitro. MATERIAL AND METHODS: Flat enamel surfaces of 15 bovine incisors were artificially stained with 10% citric acid / 3% ferric chloride solution followed by 1% tannic acid solution. These specimens were randomly divided into three groups (n = 5) - Group S+B: brushing with an electric toothbrush and baking soda, Group S+C: brushing with an electric toothbrush and fluoride dentifrice, Group S: brushing only with an electric toothbrush. Color values (L*, a*, and b*) and surface roughness were measured before and after brushing (after 1, 2, 3, and 5 min). The data were statistically analyzed using two-way analysis of variance and Tukey's honest significant difference test as a post hoc test (p< 0.05). RESULTS: The L* value of Group S+B increased over time, and was significantly different between before brushing and at 5 min (p< 0.05). A significant difference in the ΔE* value of Group S+B was found at 5 min (p< 0.05). However, no significant difference was found in the ΔE* values of Group S+C and Group S. No significant differences in Ra were found in any of the groups. CONCLUSIONS: The results of this study suggest that the combined use of baking soda and electric toothbrushing has an excellent stain-removing effect compared with electric toothbrushing with a fluoride dentifrice. Additionally, the changes in surface roughness were similar to the changes caused by the use of general dentifrices. Key words:Baking soda, dentifrice, extrinsic stain removal, color change, surface roughness.

Lewis Adduct-Dissociating Hydrolysis of Boratrane for Water-Triggered Dehydration of Copolymers with a Hydrophobic Moiety.

As a new example of intrinsically water-triggered phenomena, we report underwater dehydration of the statistical copolymers synthesized from triethanolamine borate (TEAB) methacrylate and styrene (St) induced by the hydrolysis of the pendant TEAB group. TEAB possesses high polarity owing to its internal Lewis adduct structure, which is lost by hydrolysis to triethanolamine (TEA) with a lower dipole moment. Therefore, the hydration of the copolymers became unfavorable through the hydrolysis of the pendant TEAB to TEA, despite polyol formation, and through a hydrophobic interaction based on St moieties becoming alternatively dominant. The dehydration behavior of the copolymers, along with the hydrolysis of the pendant TEAB group, was systematically investigated. The water solubility of the copolymers was found to be dependent on the gradient of the hydrolysis equilibrium of TEAB on the side chains and was the lowest for the TEA state. These findings offer a novel concept toward designing water-responsive materials.

Light-curing of dental resins with GaN violet laser diode: the effect of photoinitiator on mechanical strength.

The purpose of this study was to evaluate whether a Gallium Nitride (GaN) -based violet laser diode (VLM500) could be used as a light source for light-cured dental resins. Three experimental unfilled resins containing different photoinitiators (camphorquinone, CQ; phenyl propanedione, PPD; or mono acylphosphineoxide, MAPO) were evaluated. These resins were light-cured with a VLM500 laser diode, and their ultimate micro-tensile strengths (µTS) were compared to those cured with three different LED light sources (Curenos, G-Light Prima-normal mode and G-Light Prima-PL mode). The VLM500 produced high µTS values in all three resins, and we concluded that this violet laser diode can be used as a light source for light-cured dental resin materials.

Character traits of malodor patients.

Many patients visit oral malodor clinics because of malodors which are brought to their attention by friends and family, or because they note the behavior of people around them, they suspect a problem and develop a fear of having an oral malodor. However, only around 30% of such patients actually have levels of malodor high enough to bother other people. Many patients exhibit halitophobia symptoms, which present as self-perception of malodor, and thus have a strong obsession about their smell which results in distress. Here, we carried out a study on 300 outpatients who visited the Tokyo Dental College Chiba Hospital Odor Clinic. We used the Tokyo University Egogram (TEG) to elucidate character traits of affected outpatients and compared the occurrence of TEG types in these patients with those of normal individuals. We discovered that 10.4% of patients were A-dominant type, which was 10.6% lower than the 21.0% of normal individuals. On the other hand, 18.4% of patients were N-type (NP high, FC low), which was 9.9% higher than the 8.5% of normal individuals. Results revealed that very few of the malodor outpatients exhibited the trait that shows intelligence, calm judgment, and self-affirmation, and as a result enjoy their life. Instead, many of these patients tended to show high levels of kindness and appeared to be holding themselves back and exercising patience.

Matching system within clinical training facilities group of clinical dental training in Tokyo Dental College Chiba Hospital.

Since clinical dental training became mandatory in April 2006, Tokyo Dental College Chiba Hospital has been offering the following two types of training system: 1. a single system, and 2. a clinical training facilities group system. The clinical training facilities group system consists of program B, in which residents are trained in a cooperation-type clinical training facility for 3-4 months, and program C, in which residents are trained in two cooperation-type clinical training facilities for 7-8 months. A matching system within the clinical training facilities group is applied to select and decide on the cooperation-type clinical training facility for residents. In this system, the ranking of resident candidates that a cooperation-type clinical training facility would like to accept, and the ranking of training facilities that candidates choose are matched. The present study investigated the matching system within the clinical training facilities group in 2006, 2007, and 2008. The rate of matching to their third choice was more than 90% in program B and about 80% in program C in each year, suggesting a high matching rate. The percentage of cooperation-type clinical training facilities accepting dental residents dropped due to a decrease in the number of such residents. The distribution of accepted cooperation-type clinical training facilities is concentrated in Chiba Prefecture where our hospital, the management-type clinical training facility, is located, and the neighboring prefectures.

Marginal Leakage of Endodontic Temporary Restorative Materials around Access Cavities Prepared with Pre-Endodontic Composite Build-Up: An In Vitro Study.

This study aimed to examine the marginal seal between various commercial temporary restorative materials and exposed dentin/built-up composite. Sixty bovine incisors were cut above the cemento-enamel junction, and half of the dentin was removed to form a step, which was built up using flowable resin composite. The root canals were irrigated, filled with calcium hydroxide, and sealed using one of six temporary sealing materials (hydraulic temporary restorative material, temporary stopping material, zinc oxide eugenol cement, glass-ionomer cement, auto-cured resin-based temporary restorative material, and light-cured resin-based temporary restorative material) (n = 10 for each material). The samples were thermocycled 500 times and immersed in an aqueous solution of methylene blue. After 2 days, they were cut along the long axis of the tooth and the depth of dye penetration was measured at the dentin side and the built-up composite side. For the margins of the pre-endodontic resin composite build-up, the two resin-based temporary restorative materials showed excellent sealing. Hydraulic temporary restorative material had a moderate sealing effect, but the sealing effect of both zinc oxide eugenol cement and glass-ionomer cement was poorer.

Microtensile bond strength of indirect resin composite to resin-coated dentin: interaction between diamond bur roughness and coating material.

This aim of this study was to determine the effect of type of bur and resin-coating material on microtensile bond strength (microTBS) of indirect composite to dentin. Dentin surfaces were first ground with two types of diamond bur and resin-coated using UniFil Bond (UB) or Adper Single Bond (SB), and then bonded to a resin composite disc for indirect restoration with adhesive resin cement. After storage for 24 hr in distilled water at 37 degrees C, microTBS was measured (crosshead speed 1 mm/min). When UB was applied to dentin prepared using the regular-grit diamond bur, microTBS was significantly lower than that in dentin prepared using the superfine-grit bur. In contrast, no significant difference was found between regular-grit and superfine-grit bur with SB. However, more than half of the superfine-grit specimens failed before microTBS testing. These results indicate that selection of bur type is important in improving the bond strength of adhesive resin cement between indirect resin composite and resin-coated dentin.

Clinical usefulness of "Isolite Plus" for oral environment of Japanese people.

The recent demand for dental devices which are easier to handle and offer higher levels of reliability and safety has led to the development in the US of Isolite Plus, a new oral support device. When placed in the oral cavity, Isolite Plus enables marking of the surgical field, secures the treatment space, ensures a vacuum, protects the cheek and tongue, assists in opening the mouth, prevents accidental ingestion/aspiration, ensures treatment without contamination and enhances comfort and safety during dental treatment. The present study was carried out to verify whether Isolite Plus can fit well in the mouth of Japanese people and to determine whether it performs adequately. Thirty resident dentists were required to wear Isolite Plus in their mouth and perform mutual simulation training using an air turbine handpiece. After the training, both subjects playing the role of surgeon and those playing the role of patient were asked to complete questionnaires. On the basis of the results, we discuss the clinical usefulness of Isolite Plus in Japanese people. In the present investigation, Isolite Plus was rated slightly better by surgeons than by patients. The supportive functions of the device were judged inadequate due to the poor fit of the mouthpiece portion of the device to subjects' mouth. For the distribution of Isolite Plus in the Japanese market, the mouthpiece portion of the device should be improved so that it can fit the mouth of Japanese people.

Influence of free-hand vs uniform irradiation on tensile bond strength in Er:YAG-lased dentin.

PURPOSE: To compare effects of free-hand and mechanically applied uniform irradiation on tensile bond strength of 4-META/MMA-TBB resin to Er:YAG laser-irradiated dentin using an X-Y moving stage. MATERIALS AND METHODS: Three different laser conditions were evaluated: 1.0 W, 100 mJ/pulse, 10 pps; 1.0 W, 50 mJ/pulse, 20 pps; 1.0 W, 33 mJ/pulse, 30 pps. Samples of bovine dentin were set on a moving stage and mechanically irradiated with an Er:YAG laser at a scanning speed of 1.0 mm/s or subjected to free-hand irradiation. The lased dentin surfaces were acid conditioned with 10% citric acid/3% ferric chloride for 15 s, rinsed, and dried. The surfaces were bonded to PMMA rods with 4-META/MMA-TBB resin, and mini-dumbbell-shaped bonded specimens were prepared. Tensile bond strength was measured and compared with the results for free-hand irradiated samples obtained under the same conditions in an earlier study. SEM observations of fractured surfaces after tensile bond testing were also performed. RESULTS: A significant difference was found in tensile bond strength among the 3 laser settings in both free-hand and mechanically uniform irradiations. A comparison of free-hand laser irradiation and mechanically performed uniform laser irradiation revealed no significant difference under either laser condition (p > 0.05). SEM observation of the fractured surfaces showed no difference between the two irradiation methods under all laser conditions. CONCLUSION: No significant difference was found in tensile bond strength between free-hand and mechanically irradiated dentin. Significant differences were found, however, with changes in laser setting in both groups.

Nano-hardness of adhesive interface between Er:YAG laser-irradiated dentin and 4-META/MMA-TBB resin.

OBJECTIVE: The purpose of this study was to evaluate the hardness of the adhesive interface between resin and Er:YAG laser-irradiated bovine dentin by nano-indentation. BACKGROUND DATA: It has been reported that laser output energy and pulse repetition rate affect the tensile bond strength in Er:YAG laser-irradiated dentin. MATERIALS AND METHODS: Three laser settings were evaluated at the same total energy level (approximately 1.0 W): 100 mJ/pulse-10 pps (100-10), 50 mJ/pulse-20 pps (50-20), and 33 mJ/pulse-30 pps (33-30). Laser-irradiated dentin in each group was conditioned with 10% citric acid solution containing 3% ferric chloride for 15 sec, rinsed with distilled water for 30 sec, and bonded to PMMA rods with 4-META/MMA-TBB resin. The bonded specimens were sectioned vertically, embedded in epoxy resin, and their nano-hardness measured. A non-irradiated control group was also investigated. RESULTS: The adhesive resin interface in the controls showed the lowest level of hardness, which gradually increased from the top of the hybrid layer (0 microm) through the bottom of the hybrid layer (5 microm) and into the underlying dentin ( approximately 10 microm). Significant differences in hardness were observed between the 5 microm point in the controls, the 10 microm and 15 microm points in the 100-10 group, and the 10 microm point in the 50-20 and 33-30 groups. CONCLUSION: The results suggest that laser settings affect hybrid layer thickness, even when the total energy level is constant.

Tensile bond strength of one-step self-etch adhesives to Er:YAG laser-irradiated and non-irradiated enamel.

This study determined the bond strengths to Er:YAG laser-irradiated and non-irradiated bovine enamel of three one-step self-etch adhesives (AQ Bond Plus (AQP), G-Bond (GB), and Clearfil Tri-S Bond (TS)) and one two-step self-etch adhesive (Clearfil Megabond (MB)). Eighty SiC paper-ground bovine enamel surfaces were used, of which half were laser-irradiated. The enamel surfaces were bonded to a resin composite with each adhesive, and tensile bond strengths were determined after 24 hours. For non-irradiated enamel groups, MB achieved greater bond strength to enamel than GB and TS (p < 0.05), but no significant difference was found between MB and AQP (p > 0.05). For laser-irradiated enamel groups, no significant differences were found among the four adhesives (p > 0.05). Additionally, for each adhesive, no significant differences were found between laser-irradiated and non-irradiated enamel. It was thus concluded that Er: YAG laser irradiation of enamel did not affect the tensile bond strength of one-step and two-step self-etch adhesives.