Development and characterisation of dental composites containing anisotropic fluorapatite bundles and rods.

OBJECTIVES: To develop dental composites incorporating fluorapatite (FA) crystals as a secondary filler and to characterise degree of conversion, key mechanical properties and fluoride release. METHODS: FA rod-like crystals and bundles were hydrothermally synthesised and characterised by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS), X-ray diffraction (XRD) and 19F MAS-NMR. Composites were formulated containing BisGMA/TEGDMA/BisEMA and barium-aluminium-silicate glass (0FA). FA crystals were incorporated at 10 (10FA), 20 (20FA), 30 (30FA) and 40wt% (40FA) maintaining a filler content of 80wt% (63-67vol%). Degree of conversion (DC), flexural strength (FS), flexural modulus (FM), fracture toughness (K1C), Vickers hardness (HV) and 2-body wear were measured. Fluoride release was measured in neutral and acidic buffers. RESULTS: XRD and 19F MAS-NMR confirmed that only FA was formed, whilst SEM revealed the presence of single rods and bundles of nano-rods. DC ranged between 56-60% (p>0.05). FA composites showed lower FM and lower FS (p<0.05), but comparable wear resistance and HV (p>0.05) to 0FA. 30FA and 40FA showed similar K1C to 0FA (p>0.05), with SEM showing evidence of toughening mechanisms, whereas 10FA and 20FA showed lower K1C (p<0.05). FA containing composites released fluoride that was proportional to the amount of FA incorporated (p<0.05) but only under acidic conditions. SIGNIFICANCE: The addition of FA to the experimental composites reduced strength and stiffness but not the DC, hardness or wear rate. 30FA and 40FA had a higher K1C compared to other FA groups. Fluoride release occurred under an accelerated acidic regime, suggesting potential as a bioactive 'smart' composite.

An approach to understanding tribological behaviour of dental composites through volumetric wear loss and wear mechanism determination; beyond material ranking.

OBJECTIVE: To investigate the fundamental wear mechanisms of six resin-based composite (RBC) formulations during short-term in vitro wear testing. MATERIALS: RBC materials were condensed into rectangular bar-shaped specimens and light irradiated using the ISO 4049 specimen manufacture and irradiation protocol. Wear testing (n=10 specimens for each RBC) was performed on a modified pin-on-plate wear test apparatus and wear facets were analysed for wear volume loss using a white light profilometer. The wear tested RBC specimens and their corresponding antagonists were analysed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS), respectively to determine the wear mechanism. RESULTS: Data generated using the profilometer showed variations in the mean total wear volume (mm3) between the RBCs tested (p<0.05). Abrasive wear was evident in all RBCs investigated with varying degrees of damage. Material transfer/deposition of the filler particles on the corresponding antagonists was evident in two RBC materials (Filtek Supreme and Kalore) indicative of a further adhesive wear mechanism. CONCLUSION: It is proposed that the approach employed to use a combination of measurement and analytical techniques to quantify the wear facet volume (profilometry), wear trough (SEM) and material transfer (EDS) provides more useful information on the wear mechanism and the tribology of the system rather than relying on a simple wear ranking for the RBC materials as is routinely the case in dental research studies.

In vitro enamel thickness measurements with ultrasound.

In the work described here, agreement between ultrasound and histologic measurements of enamel thickness in vitro was investigated. Fifteen extracted human premolars were sectioned coronally to produce 30 sections. The enamel thickness of each specimen was measured with a 15-MHz hand-held ultrasound probe and verified with histology. The speed of sound in enamel was established. Bland-Altman analysis, intra-class correlation coefficient and Wilcoxon sign rank test were used to assess agreement. The mean speed of sound in enamel was 6191 ± 199 m s(-1). Bland-Altman limits of agreement were -0.16 to 0.18 mm when the speed of sound for each specimen was used, and -0.17 to 0.21 mm when the mean speed of sound was used. Intra-class correlation coefficient agreement was 0.97, and the Wilcoxon sign rank test yielded a p-value of 0.55. Using the speed of sound for each specimen results in more accurate measurement of enamel thickness. Ultrasound measurements were in good agreement with histology, which highlights its potential for monitoring the progressive loss of enamel thickness in erosive tooth surface loss.

In vivo reproducibility study of ultrasound for monitoring enamel thickness.

OBJECTIVE: This work assesses ultrasound's reproducibility for monitoring enamel thickness in vivo. STUDY DESIGN: This clinical reproducibility study recruited 30 healthy consenting volunteers. The enamel thickness on an intact maxillary central incisor was evaluated at 3 sites on 3 separate visits, 1 week apart. Bland-Altman statistical test and intraclass coefficients (ICC) were used to assess reproducibility. RESULTS: Reproducibility results were highest for the cervical site (bias [mm] = -0.01; 95% limits of agreement = -0.05, 0.04), followed by midbuccal (bias = 0.01; 95% limits of agreement = -0.04, 0.06) and incisal site (bias = 0; 95% limits of agreement = -0.25, 0.25). ICC was highest for the cervical site (0.96) followed by midbuccal (0.71). CONCLUSIONS: Ultrasound is a sufficiently reproducible and reliable technique for monitoring change in enamel thickness, as in erosive tooth surface loss (TSL). The preferred sites for ultrasonographic measurements are cervical and midbuccal.

Wear resistance of four types of vacuum-formed retainer materials: a laboratory study.

OBJECTIVE: To investigate the resistance to wear of four different vacuum-formed retainer (VFR) materials: Essix C+, Essix ACE, Duran, and Tru-Tain. Essix C+ is a polypropylene polymer; the other materials are polyethylene co-polymers. MATERIALS AND METHODS: The study was undertaken at the Leeds Dental Institute, Leeds, UK, with 26 samples in each group. The specimens were vacuum-formed according to the manufacturers' guidelines, and a custom-made wear-simulation machine was used to conduct the test. Each specimen was subjected to 1000 cycles of the wear simulation, with steatite balls as the antagonist material. The resistance to wear of the VFR materials was evaluated by measuring the maximum wear depth using noncontact, three-dimensional surface profilometry. The wear depth was given in micrometers. RESULTS: The median wear depth was 63.20 µm for the Essix C+ group, 7.88 µm for the Essix ACE group, 9.75 µm for the Duran group, and 12.08 µm for the Tru-Tain group. The Kruskal-Wallis test to compare the four VFR materials detected a statistically significant difference between the groups (P < .001). Comparisons of the groups using the Mann-Whitney U-test demonstrated that the Essix C+ group had significantly greater wear than the other three groups (P < .001). There was no statistically significant difference in median wear depth between the two groups with the least amount of wear-the Essix ACE and Duran groups. CONCLUSIONS: Under the standardized conditions of this laboratory study, the three polyethylene co-polymer materials-Essix ACE, Duran, and Tru-Tain-exhibited significantly less wear than the polypropylene material, Essix C+.

Diagnostic ultrasound tooth imaging using fractional Fourier transform.

An ultrasound contact imaging method is proposed to measure the enamel thickness in the human tooth. A delay-line transducer with a working frequency of 15 MHz is chosen to achieve a minimum resolvable distance of 400 µm in human enamel. To confirm the contact between the tooth and the transducer, a verification technique based on the phase shift upon reflection is used. Because of the high attenuation in human teeth, linear frequency-modulated chirp excitation and pulse compression are exploited to increase the penetration depth and improve the SNR. Preliminary measurements show that the enamel-dentin boundary creates numerous internal reflections, which cause the applied chirp signals to interfere arbitrarily. In this work, the fractional Fourier transform (FrFT) is employed for the first time in dental imaging to separate chirp signals overlapping in both time and frequency domains. The overlapped chirps are compressed using the FrFT and matched filter techniques. Micro-computed tomography is used for validation of the ultrasound measurements for both techniques. For a human molar, the thickness of the enamel layer is measured with an average error of 5.5% after compressing with the FrFT and 13.4% after compressing with the matched filter based on the average speed of sound in human teeth.

The use of confocal microscopy to assess surface roughness of two milled CAD-CAM ceramics following two polishing techniques.

OBJECTIVE: To assess the effects of two polishing techniques on the surface roughness of a commercial and experimental dental ceramic for use in a chairside CAD-CAM system. METHODS: A standard onlay was reproduced fifteen times in each of the two materials. Each stub was retained and examined using confocal microscopy in reflection mode. Five random samples of each were polished with Sof-Lex aluminium oxide discs, five polished with diamond impregnated polishing wheels and five left in the as-machined state. Surface roughness parameters were measured for each material group in each condition and statistical analyses carried out to determine the efficacy of the polishing techniques for each material. RESULTS: The as-machined surfaces of both materials had a statistically similar surface finish. Polishing with Sof-Lex discs was effective at reducing surface roughness of both materials. Whilst the polishing wheels were effective in reducing surface roughness for the commercial material, there was no statistically significant difference in the surface roughness of the experimental material in the as-machined or wheel polished states. SIGNIFICANCE: Although Sof-Lex discs were effective in reducing surface roughness of the two materials examined in this study, wheel polishing should not be used to reduce surface roughness of the experimental material. This will need to be taken into consideration in any future clinical studies of this material.

Thermal conductivity through various restorative lining materials.

OBJECTIVES: Traditional teaching has advocated the placement of insulating materials under restorations to protect against 'thermal shock'. Often this involves placement of a thick zinc-oxide eugenol cement lining. The purpose of this in vitro study was to assess the heat transfer through four lining materials and dentine and to relate these findings to the temperature exposures that may be experienced in the oral environment. METHODS: Two 'traditional' linings, zinc oxide eugenol cement (ZNOE) and calcium hydroxide paste (CAOH), and two more contemporary materials, a resin modified glass polyalkenoate (RMGP) and dentine bonding system (DBS) were studied in addition to dentine itself. Seven samples of each material were tested by utilising a Lees' Disc apparatus. Incorporation of thermocouples allowed heat transfer through the sample to be recorded. Thermal conductivity (J/m/s/ degrees C) was calculated for individual samples and a mean value obtained for each material. One way ANOVA and post hoc Tukey's tests were applied to the data obtained. RESULTS: In ascending order of thermal conductivity, DBS

Reinforcement of poly(methyl methacrylate) denture base with glass flake.

OBJECTIVES: Since the introduction of poly(methyl methacrylate) as a denture base material, it has suffered from having relatively poor mechanical properties. Many methods of improving its strength and toughness have been investigated. Most of these have not been adopted due to: increased cost, the need for specialist processing equipment or increased laboratory time due to more complicated procedures. Glass flake has been used as a reinforcing agent in many industrial polymers, but is as yet untested with denture base acrylic materials. The aim of this study is to evaluate the effect of adding glass flake to denture base acrylic powder on the fracture toughness of the set material. METHODS: Glass flake was added in 5, 10 or 20% w/w to Trevalon denture base powder. The material was mixed, flasked, packed and processed in a manner typical for a denture base material. Fracture toughness was determined using a double torsion test technique. RESULTS: The addition of glass flake gave up to a 69% increase in fracture toughness compared to plain Trevalon material. The addition of 5% glass flake lead to an improvement in fracture toughness that was statistically significant compared to both plain Trevalon and the 10 and 20% groups. SIGNIFICANCE: The significant improvement in fracture toughness of a denture base acrylic material using glass flake is an extremely promising result. Other mechanical properties will require testing before glass flake can be recommended as a reinforcing agent for denture base acrylic materials.