Marginal adaptation and micro-porosity of class II restorations of a high copper amalgam and a palladium-free gallium-based alloy.

The aim of the current investigation was to compare the marginal adaptation and internal porosity of a gallium (Ga)-based alloy (Galloy) with a high copper amalgam (Permite C DP) when used in moderately sized conventional class II cavities. Ten dentists placed two restorations of each material in standardized class II cavities in typodont teeth set in a phantom head. The proximal surfaces of the restored teeth were subsequently examined using an optical microscope and colour photographs were taken. The teeth were then serially sectioned before being re-examined microscopically and re-photographed. Three dentists rated the photographs of the restorations on two occasions, 2 weeks apart, for marginal adaptation and internal porosity using a six and five point scoring criteria, respectively. Inter- and intra-examiner agreements were assessed with weighted kappa statistics. The Ga-based alloy exhibited inferior marginal adaptation and a significantly higher level of porosity and internal defects compared with the dental amalgam. Marginal defects were mainly concentrated at the gingival third of the proximal boxes for both alloys. The poor marginal adaptation and extensive internal porosity detected for the Ga-based alloy was attributed to the difficulty in the alloy condensation related mainly to the 'stickiness' of the alloy to the condensers and to the rapid change in the plasticity of the alloy during condensation. This could possibly be a factor in the post-operative complications reported with the clinical use of this alloy.

Formation of brushite, monetite and whitlockite during equilibration of human enamel with acid solutions at 37 degrees C.

The residues of 5 samples of powdered human enamel, each subjected to 5 sequential equilibrations at 37 degrees C with either 17 or 4 mmol/l phosphoric acid, were examined microscopically. With 17 mmol/l acid, both brushite and monetite were found after 1 equilibration but, after further equilibrations, brushite was no longer present and the abundance of monetite crystals increased. Formation of monetite probably contributed to the lower metastability of this system compared to similar low-pH systems at 25 degrees C, where monetite does not form. Neither brushite nor monetite were present after equilibration with 4 mmol/l acid. Whitlockite was identified by transmission electron microscopy and electron diffraction in all residues. In the 4 mmol/l systems, the ionic activity product (IMWH) for magnesium whitlockite, Ca9Mg(HPO4)(PO4)6, became constant after 1-3 equilibrations, at a mean value of 3.6 (+/-0.51 SE).10(-105), which may reflect saturation with respect to this solid. For the 17 mmol/l systems, higher values of IMWH, and supersaturation with respect to monetite, were interpreted as evidence for persistent metastability due to slow crystal growth of whitlockite and monetite. It is concluded that neither brushite nor monetite are likely to form within carious lesions, but the results are consistent with the known association of whitlockite with caries.

Effects of low fluoride concentrations on formation of caries-like lesions in human enamel in a sequential-transfer bacterial system.

Human enamel surfaces were exposed to sequential batch cultures of Streptococcus mutans NCTC 10832 in a sucrose-rich medium containing 0-5 mg/l added fluoride (F). In 10-day experiments, subsurface lesion formation was partly inhibited by 1 mg/l F and completely by 2 and 5 mg/l F, but small lesions formed in 2 mg/l F in 21-day experiments. Analysis of the spent media, together with analogous, bacteria-free experiments, suggested that lesion inhibition involved two main effects. First, inhibition of bacterial acid production reduced the pH fall, resulting in reduced undersaturation with respect to hydroxyapatite and consequently reduced rate of demineralization. Secondly, interaction of F with enamel mineral resulted in a small increase in reprecipitation during periods of supersaturation and a much larger reduction in demineralization during periods of undersaturation. It is concluded that, at low F concentrations, inhibition of bacterial acid production is a major factor in lesion inhibition, which may contribute significantly to caries prevention in vivo where plaque fluid F levels are raised by frequent topical applications.

The hydroxyapatite ion activity product in acid solutions equilibrated with human enamel at 37 degrees C.

Five samples of powered enamel were each sequentially equilibrated 5 times at 37 degrees C with either 4 or 17 mmol/l H3PO4, in contact with air, and the ionic activity product for hydroxyapatite (IHA) estimated. There was evidence for preferential release of Mg and Na, especially in the first equilibrations. In two experiments, raised values of IHA were observed in the first equilibration but otherwise IHA was reasonable constant within experimental error and was much closer to the solubility product of hydroxyapatite than many previous estimates, mainly at 25 degrees C, suggest. The mean value of IHA for the majority fraction, averaged over all samples, was 1.7 (+/- 0.7) x 10(-58). Non-apatitic solids formed in all systems but solubility appeared nevertheless to be controlled by an apatitic phase: either the enamel mineral itself or apatite reprecipitated during the course of equilibration. High values of IHA reported previously may be due to use of conditions favouring dissolution only of more soluble factions or to metastability artifacts associated with control of solubility by non-apatitic phases.