Influence of Etching Mode on Enamel Bond Durability of Universal Adhesive Systems.

The purpose of this study was to determine the enamel bond durability of three universal adhesives in different etching modes through fatigue testing. The three universal adhesives used were Scotchbond Universal, Prime&Bond Elect universal dental adhesive, and All-Bond Universal light-cured dental adhesive. A single-step self-etch adhesive, Clearfil S3 Bond Plus was used as a control. The shear bond strength (SBS) and shear fatigue strength (SFS) to human enamel were evaluated in total-etch mode and self-etch mode. A stainless steel metal ring with an internal diameter of 2.4 mm was used to bond the resin composite to the flat-ground (4000-grit) tooth surfaces for determination of both SBS and SFS. For each enamel surface treatment, 15 specimens were prepared for SBS and 30 specimens for SFS. The staircase method for fatigue testing was then used to determine the SFS of the resin composite bonded to the enamel using 10-Hz frequencies for 50,000 cycles or until failure occurred. Scanning electron microscopy was used to observe representative debonded specimen surfaces and the resin-enamel interfaces. A two-way analysis of variance and the Tukey post hoc test were used for analysis of the SBS data, whereas a modified t-test with Bonferroni correction was used for the SFS data. All adhesives in total-etch mode showed significantly higher SBS and SFS values than those in self-etch mode. Although All-Bond Universal in self-etch mode showed a significantly lower SBS value than the other adhesives, there was no significant difference in SFS values among the adhesives in this mode. All adhesives showed higher SFS:SBS ratios in total-etch mode than in self-etch mode. With regard to the adhesive systems used in this study, universal adhesives showed higher enamel bond strengths in total-etch mode. Although the influence of different etching modes on the enamel-bonding performance of universal adhesives was found to be dependent on the adhesive material, total-etch mode effectively increased the enamel bond strength and durability, as measured by fatigue testing.

Effect of Phosphoric Acid Pre-etching on Fatigue Limits of Self-etching Adhesives.

The purpose of this study was to use shear bond strength (SBS) and shear fatigue limit (SFL) testing to determine the effect of phosphoric acid pre-etching of enamel and dentin prior to application of self-etch adhesives for bonding resin composite to these substrates. Three self-etch adhesives--1) G- ænial Bond (GC Corporation, Tokyo, Japan); 2) OptiBond XTR (Kerr Corp, Orange, CA, USA); and 3) Scotchbond Universal (3M ESPE Dental Products, St Paul, MN, USA)--were used to bond Z100 Restorative resin composite to enamel and dentin surfaces. A stainless-steel metal ring with an inner diameter of 2.4 mm was used to bond the resin composite to flat-ground (4000 grit) tooth surfaces for determination of both SBS and SFL. Fifteen specimens each were used to determine initial SBS to human enamel/dentin, with and without pre-etching with a 35% phosphoric acid (Ultra-Etch, Ultradent Products Inc, South Jordan, UT, USA) for 15 seconds prior to the application of the adhesives. A staircase method of fatigue testing (25 specimens for each test) was then used to determine the SFL of resin composite bonded to enamel/dentin using a frequency of 10 Hz for 50,000 cycles or until failure occurred. A two-way analysis of variance and Tukey post hoc test were used for analysis of SBS data, and a modified t-test with Bonferroni correction was used for the SFL data. Scanning electron microscopy was used to examine the area of the bonded restorative/tooth interface. For all three adhesive systems, phosphoric acid pre-etching of enamel demonstrated significantly higher (p<0.05) SBS and SFL with pre-etching than it did without pre-etching. The SBS and SFL of dentin bonds decreased with phosphoric acid pre-etching. The SBS and SFL of bonds using phosphoric acid prior to application of self-etching adhesives clearly demonstrated different tendencies between enamel and dentin. The effect of using phosphoric acid, prior to the application of the self-etching adhesives, on SBS and SFL was dependent on the adhesive material and tooth substrate and should be carefully considered in clinical situations.

Localized and generalized simulated wear of resin composites.

A laboratory study was conducted to examine the wear of resin composite materials using both a localized and generalized wear simulation model. Twenty specimens each of seven resin composites (Esthet•X HD [HD], Filtek Supreme Ultra [SU], Herculite Ultra [HU], SonicFill [SF], Tetric EvoCeram Bulk Fill [TB], Venus Diamond [VD], and Z100 Restorative [Z]) were subjected to a wear challenge of 400,000 cycles for both localized and generalized wear in a Leinfelder-Suzuki wear simulator (Alabama machine). The materials were placed in custom cylinder-shaped stainless steel fixtures. A stainless steel ball bearing (r=2.387 mm) was used as the antagonist for localized wear, and a stainless steel, cylindrical antagonist with a flat tip was used for generalized wear. A water slurry of polymethylmethacrylate (PMMA) beads was used as the abrasive media. A noncontact profilometer (Proscan 2100) with Proscan software was used to digitize the surface contours of the pretest and posttest specimens. AnSur 3D software was used for wear assessment. For localized testing, maximum facet depth (µm) and volume loss (mm(3)) were used to compare the materials. The mean depth of the facet surface (µm) and volume loss (mm(3)) were used for comparison of the generalized wear specimens. A one-way analysis of variance (ANOVA) and Tukey post hoc test were used for data analysis of volume loss for both localized and generalized wear, maximum facet depth for localized wear, and mean depth of the facet for generalized wear. The results for localized wear simulation were as follows [mean (standard deviation)]: maximum facet depth (µm)--Z, 59.5 (14.7); HU, 99.3 (16.3); SU, 102.8 (13.8); HD, 110.2 (13.3); VD, 114.0 (10.3); TB, 125.5 (12.1); SF, 195.9 (16.9); volume loss (mm(3))--Z, 0.013 (0.002); SU, 0.026 (0.006); HU, 0.043 (0.008); VD, 0.057 (0.009); HD, 0.058 (0.014); TB, 0.061 (0.010); SF, 0.135 (0.024). Generalized wear simulation results were as follows: mean depth of facet (µm)--Z, 9.3 (3.4); SU, 12.8 (3.1); HU, 15.6 (3.2); TB, 19.2 (4.8); HD, 26.8 (6.5); VD, 29.1 (5.5); SF, 35.6 (8.4); volume loss (mm(3))--Z, 0.132 (0.049); SU, 0.0179 (0.042); HU, 0.224 (0.044); TB, 0.274 (0.065); HD, 0.386 (0.101); VD, 0.417 (0.076); SF, 0.505 (0.105). The ANOVA showed a significant difference among materials (p<0.001) for facet depth and volume loss for both localized and generalized wear. The post hoc test revealed differences (p<0.05) in localized and generalized wear values among the seven resin composites examined in this study. The findings provide valuable information regarding the relative wear characteristics of the materials in this study.

Mechanical Properties and Simulated Wear of Provisional Resin Materials.

The purpose of this study was to determine flexural properties and erosive wear behavior of provisional resin materials. Three bis-acryl base provisional resins-1) Protemp Plus (PP), 2) Integrity (IG), 3) Luxatemp Automix Plus (LX)-and a conventional poly(methylmethacrylate) (PMMA) resin, UniFast III (UF), were evaluated. A resin composite, Z100 Restorative (Z1), was included as a benchmark material. Six specimens for each of the four materials were used to determine flexural strength and elastic modulus according to ISO Standard 4049. Twelve specimens for each material were used to examine wear using a generalized wear simulation model. The test materials were each subjected to wear challenges of 25,000, 50,000, 100,000, and 200,000 cycles in a Leinfelder-Suzuki (Alabama) wear simulator. The materials were placed in custom cylinder-shaped stainless-steel fixtures, and wear was generated using a cylindrical-shaped flat-ended stainless-steel antagonist in a slurry of nonplasticized PMMA beads. Wear (mean facet depth [µm] and volume loss [mm(3)]) was determined using a noncontact profilometer (Proscan 2100) with Proscan and AnSur 3D software. The laboratory data were evaluated using two-way analysis of variance (ANOVA; factors: 1) material and 2) cycles) followed by Tukey HSD post hoc test (α=0.05). The flexural strength ranged from 68.2 to 150.6 MPa, and the elastic modulus ranged from 2.0 to 15.9 GPa. All of the bis-acryl provisional resins (PP, IG, and LX) demonstrated significantly higher values than the PMMA resin (UF) in flexural strength and elastic modulus (p<0.05). However, there was no significant difference (p>0.05) in flexural properties among three bis-acryl base provisional resins (PP, IG, and LX). Z1 demonstrated significantly (p<0.05) higher flexural strength and elastic modulus than the other materials tested. The results for mean facet wear depth (µm) and standard deviations (SD) for 200,000 cycles were as follows: PP, 22.4 (5.0); IG, 51.0 (6.5); LX, 63.7 (4.5); UF, 70.5 (8.0); and Z1, 7.6 (1.2). Volume loss (mm(3)) and SDs for 200,000 cycles were as follows: PP, 0.311 (0.049); IG, 0.737 (0.074); LX, 0.919 (0.053); UF, 1.046 (0.127); and Z1, 0.111 (0.017). The two-way ANOVA showed a significant difference among materials (p<0.001) and number of cycles for both facet depth and volume loss. The post hoc test revealed differences (p<0.05) in wear values among the tested materials examined in this study. The findings provide valuable information regarding the flexural properties and the relative wear behavior of the provisional resins examined in this study.

Childhood infections, orchitis and testicular germ cell tumours: a report from the STEED study and a meta-analysis of existing data.

BACKGROUND: Similarities between the age-specific incidence pattern of testicular germ cell tumours (TGCTs) and the age-specific incidence pattern of cancers of viral origin prompted us to evaluate the relationship between common infections occurring during childhood or young adult life and TGCT using existing data from the US Servicemen's Testicular Tumor Environmental and Endocrine Determinants (STEED) case-control study. METHODS: TGCT cases diagnosed between 2002 and 2005 (n=767) were matched on age, race and serum draw date to at least one control (n=929). RESULTS: None of the infections evaluated were associated with TGCT risk. Further, a meta-analysis of mumps and mumps orchitis or orchitis infection did not support an association with TGCT (mumps pooled odds ratio (OR): 1.03, 95% confidence interval (CI): 0.89-1.20; mumps orchitis or orchitis pooled OR: 1.80, 95% CI: 0.74-4.42). CONCLUSION: Based on our evaluation of childhood and early life infections and meta-analyses of mumps and mumps orchitis and/or orchitis, TGCT does not appear to be associated with common childhood infections.

Effect modification of endocrine disruptors and testicular germ cell tumour risk by hormone-metabolizing genes.

It has been hypothesized that the increased prevalence of testicular germ cell tumours (TGCT) may be attributable to endocrine disrupting chemicals, such as persistent organic pollutants (POPs); these may be modulated by hormone-metabolizing enzymes. Using data from 568 cases and 698 controls enrolled in the US Servicemen's Testicular Tumor Environmental and Endocrine Determinants Study, we examined associations between TGCT and POPs, including p,p'-dichlorodiphenyldichloroethylene, chlordane-related compounds and polychlorinated biphenyls (PCBs), modified by polymorphisms in five hormone-metabolizing genes (CYP17A1, CYP1A1, HSD17B1, HSD17B4 and AR). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models that stratified associations of POP exposure and TGCT risk by genotype. Two polymorphisms in CYP1A1, rs1456432 and rs7495708, modified the association between trans-nonachlor and total chlordanes and TGCT risk. Among men with a minor allele for rs1456432, those with the highest quartiles had an increased risk of TGCT (OR = 1.90, 95% CI, 1.01-3.56) compared with those with the lowest; there was no increased risk among men with the homozygous major allele genotype (p-interactions = 0.024). Similar results were seen for rs7495708. HSD17B4 rs384346 modified the associations between TGCT risk and PCB-118 and PCB-138 concentrations: the 45-55% reductions in TGCT risk for men with the highest quartiles compared with the lowest quartiles were only present in those who had a major homozygous allele genotype (p-interactions < 0.04). Thus, there are suggestions that certain CYP1A1 and HSD17B4 polymorphisms may modify the associations between POPs and TGCT risk. With false discovery rate values >0.2, however, caution is advisable when interpreting the findings of this study.

Risk of testicular germ-cell tumours in relation to childhood physical activity.

The US Servicemen's Testicular Tumor Environmental and Endocrine Determinants (STEED) case-control study of testicular germ-cell tumours (TGCTs) enrolled participants and their mothers in 2002-2005. Hours of sports or vigorous childhood physical activity per week were ascertained for three time periods; 1st-5th grades, 6th-8th grades and 9th-12th grades. Son- and mother-reports were analysed separately and included 539 control son-mother pairs and 499 case son-mother pairs. Odds ratios and 95% confidence intervals were produced. The analysis of the sons' responses found no relationship between childhood physical activity and TGCT, while the mothers' analysis found an inverse association, which was solely due to nonseminoma. Future studies should seek to validate responses further using recorded information sources such as school records.

A clinical comparison of glass ionomer, resin-modified glass ionomer and resin composite restorations in the treatment of cervical caries in xerostomic head and neck radiation patients.

Controversy exists as to whether there is less secondary caries at the margins of glass ionomer restorations compared with other materials that do not release fluoride. This study examined the incidence of secondary caries for three types of restorative materials in Class V restorations in xerostomic patients. The study group consisted of 45 high caries-risk adult patients who had undergone head and neck irradiation for the treatment of cancer. All were substantially xerostomic and in need of at least three restorations in the same arch. Every patient received a restoration with each of the test materials, a conventional glass ionomer (GI), a resin modified glass ionomer (RMGI) and a resin composite (C). Patients were instructed in the daily use of a neutral pH sodium fluoride gel in custom trays. Recall appointments were made at 6, 12, 18 and 24 months, and the restorations were examined for material loss, marginal integrity and recurrent caries at the restoration margin. Fluoride compliance was determined at each recall period and recorded as the percentage of recommended use during that interval. Patients were categorized at the end of the study as fluoride non-users if their average compliance was 50% or less. Those with greater than 50% compliance were categorized as fluoride users. In the latter group, no recurrent caries was found for any of the restorations, whereas a material-dependent incidence of recurrent caries was found in the fluoride non-user group. None of the GI, one RMGI and eight C restorations failed due to recurrent caries. For the fluoride non-user patients, Fishers exact test (p=0.05) showed no statistical difference between GI and RMGI but statistical differences were found among those materials and resin composite at each recall period. Recurrent caries reductions for GI and RMGI relative to C were greater than 80% in xerostomic patients not using topical fluoride supplementation.

Effect of enamel pretreatments on bond strength of compomer.

OBJECTIVES: The objective of this study was to evaluate the effect of various enamel surface treatments on the bond strength of a compomer to enamel. METHODS: Ground bovine enamel specimens were divided into four groups. A compomer (F2000, 3M) was bonded to the specimens using different enamel surface treatments. Two groups examined the effect of application of the F2000 self-etching primer/adhesive (3M) with respect to static or dynamic priming. A third examined use of the primer/adhesive after phosphoric acid etching, and the fourth (control) group provided bond strength of the compomer to phosphoric acid etched enamel with a resin bonding system (Single Bond, 3M). Shear bond strengths for the specimens were measured after 24h storage in water at 37 degrees C. Effects of the various surface treatments on enamel were examined by SEM. RESULTS: Significant differences in bond strength of compomer to enamel were found that were related to the various surface pretreatments. Dynamic priming resulted in higher enamel bond strengths than static priming, and the best bond strengths were obtained when the enamel was etched with phosphoric acid. SEM analysis showed that depth of etch and resin penetration was also directly related to the bond strengths measured. SIGNIFICANCE: Bond strength of compomer to enamel is significantly affected by the method of pretreatment of the enamel.

p300 coactivates the adipogenic transcription factor CCAAT/enhancer-binding protein alpha.

Despite the knowledge that CCAAT/enhancer-binding protein alpha (C/EBPalpha) plays an important role in preadipocyte differentiation, our understanding of how C/EBPalpha interacts with nuclear proteins to regulate transcription is limited. Based on the hypothesis that evolutionarily conserved regions are functionally important and likely to interact with coactivators, we compared the amino acid sequence of C/EBPalpha from different species (frog to human) and identified four highly conserved regions (CR1-CR4) within the transactivation domain. A series of amino-terminal truncations and internal deletion constructs were made creating forms of C/EBPalpha which lack single or multiple conserved regions. To determine which regions of the C/EBPalpha transactivation domain are important in its ability to induce spontaneous differentiation of 3T3-L1 preadipocytes, we infected preadipocytes with expression vectors encoding the C/EBPalpha conserved region mutants and observed their ability to induce differentiation. We found that CR2 fused to the DNA binding domain is able to induce spontaneous differentiation independent of the other conserved regions. However, CR2 was not necessary for the adipogenic action of C/EBPalpha because a combination of CR1 and CR3 can also induce adipogenesis. Because the transcriptional coactivator p300 participates in the signaling of many transcription factors to the basal transcriptional apparatus, we examined whether functional interaction exists between C/EBPalpha and p300. Cotransfection of p300 with p42C/EBPalpha results in a synergistic increase in leptin promoter activity, indicating that p300 acts as a transcriptional coactivator of C/EBPalpha. Analyses using C/EBPalpha conserved region mutants suggest that multiple regions (CR2 and CR3) of the C/EBPalpha transactivation domain functionally interact with p300.

A fluoride-releasing composite for dental applications.

OBJECTIVES: The aim of this work was to attempt formulation of a dental composite, for investigational purposes, which will release fluoride at a rate comparable to glass ionomer materials, while retaining physical properties adequate for potential use in a number of dental applications. METHODS: An organic fluoride material, tetrabutylammonium tetrafluoroborate (TBATFB), was incorporated into a hydrophilic monomer system made of 2,2-bis[4-(2-hydroxy-3-methacroyloxypropoxy)phenyl]-propane (BisGMA) and 2-hydroxyethyl methacrylate (HEMA). This fluoride-containing monomer system was filled with silane treated quartz to 81 wt%. The resultant material was tested for fluoride release, physical strength properties and bond strength to enamel, each in comparison to control materials. RESULTS: Cumulative fluoride release from the experimental composite was approximately linear over time and comparable to glass ionomer materials. The long term rate of release exceeded several of the glass ionomer materials tested. Diametral tensile strength was comparable to resin-modified glass ionomer (RMGI) materials. Bond strength to etched enamel was statistically equivalent to a commercially available hybrid composite control. SIGNIFICANCE: The experimental resin-based composite material could potentially be used as an alternative to glass ionomer materials in non-stress bearing restorative applications and for orthodontic bracket bonding, where high fluoride release is desirable.

Demineralization of enamel in relation to the fluoride release of materials.

PURPOSE: To examine the reduction in enamel demineralization provided by fluoride release from a conventional glass-ionomer, a resin-modified glass-ionomer and an experimental fluoride-releasing resin-based composite compared to a conventional resin-based composite control, and to correlate the level of fluoride release with demineralization. MATERIALS AND METHODS: Enamel surfaces of extracted human incisors had a 0.4 mm thick layer of the specified test material carefully placed in a band across the mid-facial enamel to simulate a cement layer beneath an orthodontic bracket. The top surface of the test material was covered with nail varnish, leaving only the edges of the material exposed to release fluoride. The teeth were additionally covered with nail varnish to within 1 mm of the test material. Each group of teeth was placed into separate volumes of unstirred demineralizing solution at a pH of 4.7 for 4 days. The specimens were sectioned and examined by polarized light microscopy. Lesion areas were measured at distances from 100-800 microm away from the test material. Fluoride release for the test materials was measured for periods up to 5 months. RESULTS: All of the fluoride-releasing materials demonstrated a statistically significant (P< 0.05) degree of protection of enamel from demineralization compared to the non-fluoride control material. The degree of protection was greatest near the material, but lesion areas increased with distance in an inverse relationship to the amount of fluoride release. Lesions were displaced from the region near the materials and the mean displacement was directly related to amount of fluoride release. The mean lesion areas for each distance decreased with the logarithm of the cumulative fluoride release.

Inhibition of adipogenesis by Wnt signaling.

Wnts are secreted signaling proteins that regulate developmental processes. Here we show that Wnt signaling, likely mediated by Wnt-10b, is a molecular switch that governs adipogenesis. Wnt signaling maintains preadipocytes in an undifferentiated state through inhibition of the adipogenic transcription factors CCAAT/enhancer binding protein alpha (C/EBPalpha) and peroxisome proliferator- activated receptor gamma (PPARgamma). When Wnt signaling in preadipocytes is prevented by overexpression of Axin or dominant-negative TCF4, these cells differentiate into adipocytes. Disruption of Wnt signaling also causes transdifferentiation of myoblasts into adipocytes in vitro, highlighting the importance of this pathway not only in adipocyte differentiation but also in mesodermal cell fate determination.

Induction of the peroxisomal glycerolipid-synthesizing enzymes during differentiation of 3T3-L1 adipocytes. Role in triacylglycerol synthesis.

The glycerophosphate backbone for triglyceride synthesis is commonly believed to be created through the conversion of dihydroxyacetone phosphate (DHAP) by glycerophosphate dehydrogenase (GPD) to sn-glycerol 3-phosphate (GP), which is then converted by glycerophosphate acyltransferase (GPAT) to 1-acyl-GP. Consistent with this, GPD and GPAT are highly induced during differentiation of mouse 3T3-L1 preadipocytes. While the acyl dihydroxyacetone phosphate (acyl-DHAP) pathway for glycerolipid synthesis is commonly believed to be involved only in glycerol ether lipid synthesis, we report here that during conversion of 3T3-L1 preadipocytes to adipocytes, the specific activity of peroxisomal DHAP acyltransferase (DHAPAT) is increased by 9-fold in 6 days, while acyl-DHAP:NADPH reductase is induced by 5-fold. A parallel increase in the catalase (the peroxisomal marker enzyme) activity is also seen. In contrast, the specific activity of alkyl-DHAP synthase, the enzyme catalyzing the synthesis of the ether bond, is decreased by 60% during the same period. Unlike microsomal GPAT, the induced DHAPAT is found to have high activity at pH 5.5 and is resistant to inhibition by sulfhydryl agents, heat, and proteolysis. On subcellular fractionation, DHAPAT is found to be associated with microperoxisomes whereas GPAT activity is mainly present in microsomes. Northern blot analyses reveal that induction of DHAPAT can be largely explained through increases in DHAPAT mRNA. A comparison of microsomal and peroxisomal glycerolipid synthetic pathways, using D-[3-(3)H, U-(14)C]glucose as the precursor of the lipid glycerol backbone shows that about 40-50% of triglyceride is synthesized via the acyl-DHAP pathway. These results indicate that the acyl-DHAP pathway is important not only for the synthesis of ether lipids, but also for the synthesis of triacylglycerol and other non-ether glycerolipids.

Glycogen synthase kinase 3 is an insulin-regulated C/EBPalpha kinase.

CCAAT/enhancer binding protein alpha (C/EBPalpha) is a transcription factor involved in creating and maintaining the adipocyte phenotype. We have shown previously that insulin stimulates dephosphorylation of C/EBPalpha in 3T3-L1 adipocytes. Studies to identify the insulin-sensitive sites of phosphorylation reveal that a C/EBPalpha peptide (amino acids H215 to K250) is phosphorylated on T222, T226, and S230 in vivo. The context of these phosphoamino acids implicates glycogen synthase kinase 3 (GSK3), whose activity is known to be repressed in response to insulin, as a potential kinase for phosphorylation of T222 and T226. Accordingly, GSK3 phosphorylates the predicted region of C/EBPalpha on threonine in vitro, and GSK3 uses C/EBPalpha as a substrate in vivo. In addition, the effect of pharmacological agents on GSK3 activity correlates with regulation of C/EBPalpha phosphorylation. Treatment of 3T3-L1 adipocytes with the phosphatidylinositol 3-kinase inhibitor wortmannin results in phosphorylation of C/EBPalpha, whereas treatment with the GSK3 inhibitor lithium results in dephosphorylation of C/EBPalpha. Collectively, these data indicate that insulin stimulates dephosphorylation of C/EBPalpha on T222 and T226 through inactivation of GSK3. Since dephosphorylation of C/EBPalpha in response to lithium is blocked by okadaic acid, strong candidates for the T222 and T226 phosphatase are protein phosphatases 1 and 2a. Treatment of adipocytes with insulin alters the protease accessibility of widespread sites within the N terminus of C/EBPalpha, consistent with phosphorylation causing profound conformational changes. Finally, phosphorylation of C/EBPalpha and other substrates by GSK3 may be required for adipogenesis, since treatment of differentiating preadipocytes with lithium inhibits their conversion to adipocytes.

Clinical performance and caries inhibition of resin-modified glass ionomer cement and amalgam restorations.

BACKGROUND: The authors clinically examined two restorative materials to evaluate their effectiveness in Class II restorations in primary molars and their ability to inhibit recurrent caries. METHODS: Forty subjects, each in need of two Class II restorations in primary molars, took part in this study. Each patient received one Class II restoration of resin-modified glass ionomer cement and one of amalgam. The authors evaluated the restorations at six-month, one-year, two-year and three-year recall appointments. On exfoliation, teeth with experimental restorations were retrieved and microscopically examined for inhibition of demineralization at restoration margins. RESULTS: The results of the clinical evaluation demonstrated no significant differences between the resin-modified glass ionomer cement restorations and the amalgam restorations (P < .05). Polarized light microscopic examination of the returned teeth that were restored as a part of this study indicated that the resin-modified glass ionomer cement had significantly less enamel demineralization at restoration margins than did amalgam (P < .0001). CONCLUSIONS: The resin-modified glass ionomer cement functioned clinically as well as amalgam for Class II restorations in primary molars. However, the resin-modified glass ionomer exhibited significantly less enamel demineralization at restoration margins than did amalgam. CLINICAL IMPLICATIONS: Resin-modified glass ionomer cement restorative material functions well for Class II restorations in primary molars and exhibits less recurrent caries at restoration margins than does amalgam.

New light curing options for composite resin restorations.

The concerned practitioner needs to understand the chemistry of the materials, the dynamics of polymerization, the stress factors created, and the specific light energy requirements needed to attain maximum results. If a practitioner chooses to use one of the nontraditional curing systems, he or she needs to consult with the manufacturer to determine the spectral output of the system, and contact the manufacturer of the composite to ensure that the material used will cure properly with the chosen light source. The manufacturers have customer service representatives who are usually very knowledgeable about their products. Current claims about new technological developments based on laboratory experiments and anecdotal information are promising. However, multicenter prospective clinical studies are still needed to validate safety and efficacy. Then clinicians can make informed decisions that will enable them to provide the highest quality dentistry for their patients. We will revisit this topic as more information becomes available.

Protective effects of resin impregnation on demineralization of enamel.

PURPOSE: To determine if resin penetrated into the enamel etch pattern, in the absence of a polymerized outer surface film, could reduce the degree of demineralization of enamel subjected to a simulated caries challenge, and to evaluate whether the addition of fluoride to the resin would enhance reductions in demineralization. MATERIALS AND METHODS: Enamel surfaces of extracted human incisors were acid-etched. One-half of the etched area was treated with an unfilled bonding resin, while the other one-half was left untreated as a control. In another group, this same procedure was followed except the unfilled bonding resin contained fluoride. The applied resin was aggressively air thinned to ensure oxygen inhibition throughout the external surface film thickness. The thinned film was visible light-cured and the area was wiped with an ethanol swab to remove the inhibited layer. The specimens were exposed to a buffer solution of pH = 4.7 for 4 days, and were sectioned and examined by polarized light microscopy and microradiography. RESULTS: In each of the two test groups, the demineralization of the resin-treated side was significantly lower than the control side (P < 0.015). Under the conditions of this study, the experimental fluoride resin did not produce statistically significant reductions in demineralization compared with the non-fluoride resin.