The Influence of Cavity Shape on the Stresses in Composite Dental Restorations: A Finite Element Study

Dental restoration adhering to the cavity exhibits fundamentally different load transfer mechanisms from non-adhering restorations. It is therefore questionable that traditional cavity designs are optimal from a purely mechanical point of view when working with composite materials. Drawing from general engineering experience, it can be hypothesised that smooth, well rounded designs with bevelled margins are superior. A finite element model is used in the present investigation to determine the stress field in four different cavity designs as it develops during the curing of the restoration. The results show that a significant reduction of the stress along the adhesive interface between the tooth and the restoration can be achieved through the use of a rounded cavity shape. They also show that the adoption of bevelled margins leads to a reduction of the stress concentration at this location. These results are confirmed by a set of experimental results published in the literature. It is concluded that adhering restorations will perform better from a mechanical point of view if an appropriate cavity shape is selected.     

Salivary levels of mutans streptococci associated with restorations: a case-control study

Our aim was to estimate whether restorative therapy with amalgam and composite resin could decrease salivary mutans streptococcal level, thus also decreasing the risk for other caries development. We selected a case group of 93 children with detectable salivary mutans levels (i.e., at least 1x10(4) cfu/ml), and a control group (n=93 subjects) with undetectable levels. Children had the same age (12 years), no extracted teeth, crowns, temporary fillings, and restorations other than amalgam and composite resin, and the two groups had similar gender distribution. We clinically examined children and recorded active caries, restorations and oral hygiene level by means of gingival bleeding on probing; we also investigated sucrose intake at breakfast. The case group had statistically significant higher prevalence of restorations (36.6% vs. 18.3%), active caries (44.1% vs. 12.9%), and bad oral hygiene (84.9% vs. 68.8%) than the control group. However, the logistic regression analysis showed that presence of active caries was the only significant variable associated with mutans streptococci (OR=4.0; p=0.0002), while the effects of sucrose intake and of restorations were marginally significant. This apparent contrast between statistical analyses was due to the concomitant presence, in children with detectable mutans streptococci level, of restorations and decayed teeth at the same time, and, on the basis of the multivariate analysis, presence of mutans streptococci in these children was explained by the presence of active caries, more than restorations.     

The influence of cavity shape on the stresses in composite dental restorations: a finite element study

Dental restoration adhering to the cavity exhibits fundamentally different load transfer mechanisms from non-adhering restorations. It is therefore questionable that traditional cavity designs are optimal from a purely mechanical point of view when working with composite materials. Drawing from general engineering experience, it can be hypothesised that smooth, well rounded designs with bevelled margins are superior. A finite element model is used in the present investigation to determine the stress field in four different cavity designs as it develops during the curing of the restoration. The results show that a significant reduction of the stress along the adhesive interface between the tooth and the restoration can be achieved through the use of a rounded cavity shape. They also show that the adoption of bevelled margins leads to a reduction of the stress concentration at this location. These results are confirmed by a set of experimental results published in the literature. It is concluded that adhering restorations will perform better from a mechanical point of view if an appropriate cavity shape is selected.     

Microleakage in composite resin restorations.

The aim of the present study was to evaluate the marginal microleakage of the newest generation of composite resin restorative materials. Class V restorations were prepared in human extracted teeth. Different combinations of restorative materials were used. All the materials tested showed marginal microleakage along the dentinal walls, suggesting that the adhesion value is not sufficient to counteract the composite shrinkage and to reduce the marginal space.     

Finite element analysis of a new customized composite post system for endodontically treated teeth

This paper investigated the mechanical behavior of a new customized post system built up with a composite framework presently utilized for crowns, bridges, veneers and inlay/onlay dental restorations. The material has been shaped so to follow perfectly the profile of the root canal in order to take advantage of the better mechanical properties of composites with respect to metallic alloys commonly used for cast posts.

The analysis has been carried out with 3D finite element models previously validated on the basis of experimental work. The new post system has been compared to a variety of restorations using either prefabricated or cast posts. The structural efficiency of the new restoration has been evaluated for an upper incisor under different loading conditions (mastication, bruxism, impact).

Results prove that maximum stress values in restored teeth are rather insensitive to post types and materials. However, the new customized composite restoration allows to reduce significantly the stresses inside the dentinal regions where conservative clinical interventions are not possible.     

Beyond Streptococcus mutans: Dental Caries Onset Linked to Multiple Species by 16S rRNA Community Analysis

Dental caries in very young children may be severe, result in serious infection, and require general anesthesia for treatment. Dental caries results from a shift within the biofilm community specific to the tooth surface, and acidogenic species are responsible for caries. Streptococcus mutans, the most common acid producer in caries, is not always present and occurs as part of a complex microbial community. Understanding the degree to which multiple acidogenic species provide functional redundancy and resilience to caries-associated communities will be important for developing biologic interventions. In addition, microbial community interactions in health and caries pathogenesis are not well understood. The purpose of this study was to investigate bacterial community profiles associated with the onset of caries in the primary dentition. In a combination cross-sectional and longitudinal design, bacterial community profiles at progressive stages of caries and over time were examined and compared to those of health. 16S rRNA gene sequencing was used for bacterial community analysis. Streptococcus mutans was the dominant species in many, but not all, subjects with caries. Elevated levels of S. salivarius, S. sobrinus, and S. parasanguinis were also associated with caries, especially in subjects with no or low levels of S. mutans, suggesting these species are alternative pathogens, and that multiple species may need to be targeted for interventions. Veillonella, which metabolizes lactate, was associated with caries and was highly correlated with total acid producing species. Among children without previous history of caries, Veillonella, but not S. mutans or other acid-producing species, predicted future caries. Bacterial community diversity was reduced in caries as compared to health, as many species appeared to occur at lower levels or be lost as caries advanced, including the Streptococcus mitis group, Neisseria, and Streptococcus sanguinis. This may have implications for bacterial community resilience and the restoration of oral health.     

Development of Amelogenin-chitosan Hydrogel for In Vitro Enamel Regrowth with a Dense Interface

Biomimetic enamel reconstruction is a significant topic in material science and dentistry as a novel approach for the treatment of dental caries or erosion. Amelogenin has been proven to be a critical protein for controlling the organized growth of apatite crystals. In this paper, we present a detailed protocol for superficial enamel reconstruction by using a novel amelogenin-chitosan hydrogel. Compared to other conventional treatments, such as topical fluoride and mouthwash, this method not only has the potential to prevent the development of dental caries but also promotes significant and durable enamel restoration. The organized enamel-like microstructure regulated by amelogenin assemblies can significantly improve the mechanical properties of etched enamel, while the dense enamel-restoration interface formed by an in situ regrowth of apatite crystals can improve the effectiveness and durability of restorations. Furthermore, chitosan hydrogel is easy to use and can suppress bacterial infection, which is the major risk factor for the occurrence of dental caries. Therefore, this biocompatible and biodegradable amelogenin-chitosan hydrogel shows promise as a biomaterial for the prevention, restoration, and treatment of defective enamel.     

不同修复方式对儿童乳牙牙体缺损的疗效和安全性比较

目的:探讨不同修复方式对儿童乳牙牙体缺损修复的治疗效果和安全性。方法:选择2011年1月至2015年1月在我院因牙体缺损严重无法填充修复的乳牙牙体缺损患儿67例。将所有患者随机分为三组,记为A组(22例)、B组(22例)和C组(23例)。A组患儿进行金属预成冠修复,B组患儿进行铸瓷嵌体修复,C组患儿进行银汞合金充填修复。随访18个月,比较3组患儿的治疗效果和不良反应的发生情况。结果:C组患儿随访期间发生牙痛6例,食物嵌塞、修复体和牙体之间出现裂缝的患儿各5例,牙龈充血3例,继发龋2例;B组患儿发生牙痛3例,食物嵌塞、牙龈充血、修复体和牙体之间出现裂缝以及继发龋等各1例;A组患儿发生疼痛和食物嵌塞各2例,牙龈充血1例。A组和B组患儿以上不良事件的发生率明显低于C组(P0.05),A组发生不良事件的发生率低于B组,但是差异无统计学意义(P0.05)。结论:应用金属预成冠修复和铸瓷嵌体修复儿童乳牙牙体缺损较银汞合金充填修复具有更好的临床效果,且安全性更高。     

The Clinical Profiles of Individuals With and Without Root Surface Caries1

As part of a collaborative multidisciplinary investigation of root surface caries (RSC), 273 subjects (median age = 57) were clinically evaluated for coronal caries, debris, calculus, gingivitis, periodontal pocketing, recession, abrasion, as well as RSC. The entire study group was divided into three subgroups: (1) subjects whose exposed root surface were without lesions or restorations (non-diseased individuals, n= 43); (2) subjects whose exposed root surfaces had one or more lesions and may or may not have had restorations (diseased individuals, n= 110); (3) subjects with one or more restorations but no lesions, since it was not known whether these restorations were preceded by RSC or abrasion the disease status of these individuals was unclear (n= 120). A comparison of Subgroup 1 (unequivocally non-diseased) and Subgroup 2 (unequivocally diseased) revealed that subjects without RSC had more teeth, less coronal caries, less recession, less debris, less calculus, less gingivitis, and more abrasion. We infer that the common factor underlying most if not all of the subgroup differences is oral hygiene which must therefore be a major disease determinant.     

The Copenhagen Oral Health Senior Cohort: design, population and dental health

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2010.00383.x The Copenhagen Oral Health Senior Cohort: design, population and dental health Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe the design, measurement procedures, and baseline values for COHS including spatial distribution of restorations and dental caries as well as reasons for non‐participation. Materials and methods: Seven hundred and eighty‐three individuals aged 65 years or older, from a total of 1918 invited elderly people, underwent an interview regarding oral health‐related behaviour and a clinical oral examination including measurement of unstimulated whole saliva flow rate. Results: Twelve percent of the COHS was edentulous. The number of dental restorations was higher for women compared to men; however, men had more caries than women. Coronal caries was most frequent on mesial and distal surfaces and on the maxillary incisors and canines; root caries was most frequent on labial surfaces and evenly distributed within the dentition. Only 41% of all invited elderly people accepted the invitation, with old age and poor health being the primary reasons for non‐participation. Conclusion: The baseline values for COHS show that a substantial proportion of the participants had retained a natural dentition and that dental caries was prevalent with the anterior maxillary teeth being most affected.     

Hereditary and environmental dental findings in identification of human remains

The paper presents the results on hereditary and environmental dental findings in identification of human remains exhumed from mass graves in the Republic of Croatia. The total of 17,880 teeth from all the categories (incisors, canines, premolars and molars) was examined. Hereditary findings of the teeth such as shape, size, position, as well as age were used in all of the cases confirming and completing the identification. In only 15% of the cases they were the starting points for the identification that would be later confirmed with another 3-5 traditional identification procedures. Disturbances in tooth eruption were recorded in 22% of the cases, impaction of teeth in 10%, and retarded eruption of teeth in 12%. Disturbances of tooth position were recorded in 65% of the cases. Tooth rotation in 26% and diastema mediana in maxilla or mandible in 39%. Disorders of tooth number in the form of unilateral and bilateral missing of lateral maxillary incisors were recorded only in 2% of the monitored cases. Abnormalities of the tooth shape were found in 11% of the cases. The majority of them were found on the tooth crowns 6%, and less on the tooth roots 5%. Environmental dental findings that were the most significant for the identifications were prosthetic appliances in 30% of cases. Prostheses were helpful in the identification of 3% of the cases, while crowns and bridges were helpful in 27% of the cases. Ante mortem teeth extractions were helpful in 25% of the cases. Teeth restorations were recorded in 20% of the identified cases, amalgams in 19% and aesthetic filings in 1%. Dental caries was helpful in only 10% of the cases, superficial caries in 3% and caries of dentin in 7% of cases.     

郑州孙庄遗址仰韶文化人群的龋病

孙庄遗址位于河南省郑州市中原区孙庄村,是分布在黄河中游的一处仰韶文化晚期遗址,该遗址出土的54例仰韶时期的人骨保存状况良好,为我们了解仰韶文化人群的龋患情况提供了珍贵的资料。本文以肉眼观察为主并结合超景深显微镜对遗址出土的846枚牙齿进行鉴定、统计与分析,得出以下结论：孙庄遗址古代人群的龋病患病率70.37%,龋齿率22.93%,龋均3.59;壮年组患龋率最高,为88.89%,不同年龄组之间的龋齿率差异性显著;龋齿率女性为30.55%,男性为16.16%,女性龋齿率显著高于男性,P(0.000)<0.05,两性之间的龋齿率有显著差异;浅龋率为6.70%,中龋率为21.65%,深龋率为27.32%,深龋已穿髓率为19.07%,残冠残根率为25.26%,随着年龄的增长,龋病的病变程度呈加重趋势;龋损范围小于1/2牙冠累龋最常见,占总患龋齿数的42.27%;上颌龋齿率为26.91%,下颌龋齿率为19.70%,上下颌龋齿率差异显著（P<0.05）。龋病在不同牙位上的发生率依次为M3>M2>P2>M1>P1>C>I1>I2;邻面和 面是主要的龋患分布处,分别占患龋牙齿数的46.40%和39.18%。孙庄人群门齿较高的患龋率表明该遗址人群患龋情况已经非常严重,患龋率与龋齿率明显高于其他古代组,较高的龋病罹患率可能与孙庄人群复杂的农业经济模式有关。     

Growth and Arbuscular Mycorrhizal Fungal Colonization of Two Prairie Grasses Grown in Soil from Restorations of Three Ages

I compared growth and arbuscular mycorrhizal fungal (AMF) colonization of two prairie grasses (Wild rye [Elymus canadensis] and Little bluestem [Schizachyrium scoparium]), an early‐ and a late‐dominating species in prairie restorations, respectively, grown in soil from restored prairies of differing age, soil characteristics, and site history. There were no consistent patterns between restoration age and soil inorganic nutrients or organic matter. The oldest restoration site had higher soil mycorrhizal inoculum potential (MIP) than 2‐ and 12‐year‐old restorations. However, MIP did not translate into actual colonization for two species grown in soils from the three restorations, nor did MIP relate to phosphorus availability. There were significant differences in root mass and colonization among Wild rye plants but not among Little bluestem plants grown in soils from the three restorations. Wild rye grown in 2‐year‐old restoration soil had significantly higher AMF colonization than when it was grown in soils from the 12‐ and 17‐year‐old restorations. Wild rye grown in 2‐year‐old restoration soil also had higher colonization than Little bluestem grown in 2‐ and 12‐year‐old restoration soils. Little bluestem had no significant correlations between shoot biomass, root biomass or colonization, and concentrations of soil P, total N, or N:P. However, for Wild rye, total soil N was positively correlated with root mass and negatively correlated with colonization, suggesting that in this species, mycorrhizae may affect N availability. Collectively, these results suggest that soil properties unrelated to restoration age were important in determining differences in growth and AMF colonization of two species of prairie grasses.     

山东广饶县中南世纪城墓地出土明代人骨的初步研究

本文对广饶县中南世纪城墓地出土的明代人骨进行了多方面的生物考古学研究,包括性别、年龄的分布,身高的复原以及古病理的观察。牙病方面,对龋病、牙釉质发育不全和错牙合畸形进行了观察记录,从性别、年龄、龋患程度及好发牙位等方面对该人群的龋患情况进行统计分析。研究结果表明,该人群牙齿患龋率不具备明显的性别差异,与年龄变化也无显著相关性,好发牙位多为臼齿。此外,还观察到多孔性骨肥厚、骨关节疾病等病理现象以及一处愈合较好的骨折创伤。     

Restoring Stream Ecosystems: Lessons from a Midwestern State

Reach‐scale stream restorations are becoming a common approach to repair degraded streams, but the effectiveness of these projects is rarely evaluated or reported. We surveyed governmental, private, and nonprofit organizations in the state of Indiana to determine the frequency and nature of reach‐scale stream restorations in this midwestern U.S. state. For 10 attempted restorations in Indiana, questionnaires and on‐site assessments were used to better evaluate current designs for restoring stream ecosystems. At each restoration site, habitat and water quality were evaluated in restored and unrestored reaches. Our surveys identified commonalities across all restorations, including the type of restoration, project goals, structures installed, and level of monitoring conducted. In general, most restorations were described as stream‐relocation projects that combined riparian and in‐stream enhancements. Fewer than half of the restorations conducted pre‐ or post‐restoration monitoring, and most monitoring involved evaluations of riparian vegetation rather than aquatic variables. On‐site assessments revealed that restored reaches had significantly lower stream widths and greater depths than did upstream unrestored reaches, but riparian canopy cover often was lower in restored than in unrestored reaches. This study provides basic information on midwestern restoration strategies, which is needed to identify strengths and weaknesses in current practices and to better inform future stream restorations.     

Three-dimensional finite element analysis of the composite and compomer onlays in primary molars

Resin onlay restoration is an esthetic alternative technique used for restoring extensively damaged primary molars. Understanding the behavior of materials under repeated functional stress and how the stress is transmitted to the remaining tooth structure is important. The aim of this study was to compare stresses in primary molars restored with indirect composite and compomer onlay. 3D frame models of the right mandibular and maxillary primary molars and the alveolar bone were created using computerized tomography images of a six-year-old girl. The enamel and dentine layers above the cement layer were unified to generate onlay restoration, and composite and compomer were used as restorative materials. The vertical occlusal load (100?N) was applied to the teeth in the occlusal contact areas. The von Mises stress distributions and normal stress distributions of the y-axis (parallel to the long axis of tooth) were evaluated. The occlusal stress is transmitted to the cervical part of healthy teeth by spreading it through the enamel layer. The composite and compomer restorative materials exhibited similar stress distribution patterns. An indirect technique creates a structure similar to the original morphological form, and it allows restorations to distribute high occlusal stresses and to minimize possible breakages.     

Analysis of the compressive strain below the removable and fixed prosthesis in the posterior mandible using a digital image correlation method

It was the purpose of this study to determine and analyse strains in the bone of posterior mandible below the removable and fixed partial dentures using Digital Image Correlation Method. Dried mandible with shortened dental arch (Kennedy Class 1) was used in the experiment. The mandible model was prepared for accepting two types of restorations for bilaterally missing molars conventional therapy, and removable and fixed partial dentures were manufactured following standard prosthetic protocol. The models with prosthetic restorations placed in situ were subjected to loading of 50-300 N, and photographed using two digital cameras as part of the digital image correlation method equipment. Afterwards, the obtained data for strains within restored mandible during loading ciclus were analysed in the software Aramis and graphically presented. Percentage size of the mandible strains within the line section are from 0.14 to 0.19% for the removable partial denture experimental model and 0-0.14% for the fixed partial denture experimental model. The study has demonstrated that Digital Image Correlation method can be used to measure strain on the mandible surface and replacements during loading and that from biomechanical perspective both therapeutic modalities can be equally useful for the restoration of the mandible with bilaterally distal edentulous spaces.     

Prevalence of removable partial dentures users treated at the Aracatuba Dental School-UNESP

doi: 10.1111/j.1741‐2358.2012.00653.x
Prevalence of removable partial dentures users treated at the Aracatuba Dental School – UNESP Objectives: The aim of this study was to evaluate the frequency of removable partial dentures (RPD) at the Aracatuba Dental School. Methods: The study was conducted by analysing 412 clinical history of patients attended at the RPD clinics in the period from 2000 to 2007. Results: 412 charts were analysed: 148 (35.9%) men and 264 (64.1%) women. The mean age was 53.8 years (men) and 52.4 years (women). A total of 556 dentures were made; of these, 233 (41.90%) were maxillary and 323 (58.09%) were mandibular dentures. The most frequent Kennedy classification found was Class III (maxilla) and Class I (mandible). In the maxilla, 55% (126) of the major connectors were of the anterior–posterior palatal bar, while in the mandible, 64% (202) were the lingual bar. As regards the claps, 401 were circumferential and 318 were bar claps. Conclusion: The mean age of the patients was 52.9 years with higher prevalence of female patients; the most frequent Kennedy’s classification was Class I in mandible and Class III in maxilla; the most common major connector was anterior–posterior palatal bar for maxilla and lingual bar for mandible; the circumferential clasps were the most common retainer used in both jaws.     

Relationship between high CRP and cytokines in Saudi old people with dental caries in alkharj Region,Saudi Arabia

ObjectiveDental caries is one of the most common problems of the oral cavity which is frequently observed in older people. The aim of this study is to evaluate serum C-reactive proteins (CRP) levels and to identify the correlation between dental caries and CRP levels.MethodologyThe study included 12 aged patients with an average age of 65-years; the patients were diagnosed with dental caries and did not have clinical history of heart diseases, rheumatoid arthritis or any other infection. The control group consisted of 10 healthy donors with an average age of 60-years. The CRP level of positive samples was measured by using CRP Enzyme-linked immunosorbent assay-ELISA Kit.ResultsThe currents study showed that only 5 out of 12 patients were CRP positive.ConclusionsBecause of study limitations, it is early to conclude of close relationship between serum CRP and dental caries from the findings of this study; however, this study will give a clearer picture to understand the relationship between serum CRP, inflammatory cytokines and dental caries.     

Influence of the fluoride releasing dental materials on the bacterial flora of dental plaque

The assessment of influence of silver-free, fluor releasing dental materials on dental plaque bacteria quantity. 17 patients were included into the study. 51 restorations were placed following manufacturers recommendations. Following materials were used: conventional glassionomer Ketac-Molar ESPE, resin modified glassionomer Fuji II LC GC and fluor containing composite Charisma Heraeus Kulzer Class V restorations were placed in following teeth of upper and lower jaw: canines, first bicuspids, second bicuspids. Sound enamel was a control. After 10 weeks the 72 hours old dental plaque was collected from surface of restorations and control using sterile probe. Total amount of 68 dental plaques were investigated. Each plaque was placed on scaled and sterile aluminum foil. The moist weight of dental plaque was scaled. Dental plaque was moved into 7 ml 0.85% NaCl solution reduced by cystein chlorine hydrogen and disintegrated by ultrasounds (power:100 Watt, wave amplitude: 5 micorm). The suspension of dental plaque was serially diluted from 10(-4) to 10(-5) in sterile 0,85% NaCl solution, and seeded with amount of 0.1 ml on appropriate base. In dental plaque trials the amount of cariogenic bacteria was calculated--Streptococcus mutans, Streptococcus, Lactobacillus, Veillonella and Neisseria, and also total amount of aerobic and anaerobic bacteria was measured. Microbiologic studies were performed in Institute of Microbiology, Medical University, ?ód?. Statistical analysis of collected data was accomplished. In 72 hours old dental plaques collected from the surfaces of Ketac -Molar, Fuji II LC, Charisma after 10 weeks since being placed into the class V cavity, results show no statistically significant differences in the amount of Streptococcus mutans, Streptococcus spp., Lactobacillus spp., Veillonella spp., Neisseria spp, in total amount of aerobic and anaerobic bacteria and in the quantity proportion of Streptococcus mutans versus Streptococcus spp. in comparison with control trail. Results show no statistically significant differences in the amount of listed above bacteria and in the proportion of Streptococcus mutans versus Streptococcus spp. in 72 hours old dental plaques collected from surfaces of investigated restorative materials.