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Journal of Functional Biomaterials Feb 2024The aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the... (Review)
Review
The aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the literature was conducted in three databases (MedLine/PubMed, Web of Science, and Scopus). The inclusion criteria were: (1) to be a systematic review of clinical trials that (2) evaluated the clinical longevity of GICs as a restorative material in primary and/or permanent teeth; the exclusion criteria were: (1) not being a systematic review of clinical trials; (2) not evaluating longevity/clinical performance of GICs as a restorative material; and (3) studies of dental restorative materials in teeth with enamel alterations, root caries, and non-carious cervical lesions. Twenty-four eligible articles were identified, and 13 were included. The follow-up periods ranged from 6 months to 6 years. Different types of GICs were evaluated in the included studies: resin-modified glass ionomer cement (RMGIC), compomers, and low- and high-viscosity glass ionomer cement. Some studies compared amalgam and composite resins to GICs regarding longevity/clinical performance. Analyzing the AMSTAR-2 results, none of the articles had positive criteria in all the evaluated requisites, and none of the articles had an a priori design. The criteria considered for the analysis of the risk of bias of the included studies were evaluated through the ROBIS tool, and the results of this analysis showed that seven studies had a low risk of bias; three studies had positive results in all criteria except for one criterion of unclear risk; and two studies showed a high risk of bias. GRADE tool was used to determine the quality of evidence; for the degree of recommendations, all studies were classified as Class II, meaning there was still conflicting evidence on the clinical performance/longevity of GICs and their recommendations compared to other materials. The level of evidence was classified as Level B, meaning that the data were obtained from less robust meta-analyses and single randomized clinical trials. To the best of our knowledge, this is the first umbrella review approaching GIC in permanent teeth. GICs are a good choice in both dentitions, but primary dentition presents more evidence, especially regarding the atraumatic restorative treatment (ART) technique. Within the limitation of this study, it is still questionable if GIC is a good restorative material in the medium/long term for permanent and primary dentition. Many of the included studies presented a high risk of bias and low quality. The techniques, type of GIC, type of cavity, and operator experience highly influence clinical performance. Thus, clinical decision-making should be based on the dental practitioner's ability, each case analysis, and the patient's wishes. More evidence is needed to determine which is the best material for definitive restorations in permanent and primary dentition.
PubMed: 38391901
DOI: 10.3390/jfb15020048 -
Magnetic Resonance in Medicine Feb 2024Dental amalgam contains mercury and is commonly used in dental restorations. The impact of MRI on mercury excretion from dental amalgam is not well understood across...
PURPOSE
Dental amalgam contains mercury and is commonly used in dental restorations. The impact of MRI on mercury excretion from dental amalgam is not well understood across clinical field strengths, especially 7T. We investigated the effects of MRI exposure on mercury excretion using fresh, lab-created dental amalgam restorations and in extracted teeth with old, pre-existing restorations.
METHODS
Donated, unfilled human teeth (n = 120) were restored with amalgam before being stored in saline, artificial saliva, or a dry box prior to MRI scanning. The teeth were placed in individual tubes of fresh artificial saliva and scanned at 1.5T, 3T, or 7T or left unscanned as controls. Mercury concentrations were measured 24-30 h later. Donated teeth with pre-existing restorations (n = 40) were stored in artificial saliva, scanned at 7T or left unscanned as controls, and mercury concentration tested.
RESULTS
For teeth extracted and restored in a laboratory, no significant difference was found (F = 2.42, P = 0.072) between mean mercury concentrations of unscanned teeth (13.72 μg/L) and teeth scanned at 1.5T (10.88 μg/L), 3T (12.65 μg/L), or 7T (8.88 μg/L). For teeth extracted with previously placed restorations, no significant difference (P = 0.288) was found between unscanned controls (4.28 μg/L) and teeth scanned at 7T (6.63 μg/L).
CONCLUSION
MRI of dental amalgam does not significantly increase mercury excretion at 1.5T, 3T, or 7T compared to unscanned teeth. This holds true for controlled laboratory restorations as well as for those placed and lived with prior to extraction and scanning, demonstrating no added risk to the clinical patient or research subject.
Topics: Humans; Mercury; Saliva, Artificial; Dental Amalgam; Magnetic Resonance Imaging; Hymecromone
PubMed: 37755142
DOI: 10.1002/mrm.29872 -
Cureus Jul 2023To assess the influence of windowing, and to evaluate, and compare the effect of the metal artifact reduction (MAR) and non-metal artifact reduction (non-MAR) algorithms...
Influence of Windowing and Evaluation of Metal Artifact Reduction Algorithm on Five Different Restorative Materials by Using Different Cone Beam Computed Tomography (CBCT) Scanners: A CBCT Study.
OBJECTIVES
To assess the influence of windowing, and to evaluate, and compare the effect of the metal artifact reduction (MAR) and non-metal artifact reduction (non-MAR) algorithms on different high-density restorative dental materials using different cone beam computed tomography (CBCT) devices.
MATERIAL AND METHOD
Height and diameter of all cylindrical shape metals including amalgam, cobalt-chromium, composite, gutta-percha, and titanium were measured using a digital caliper device. Polymethylmethacrylate block and arch phantom with a cylindrical-shaped perforation containing five different metals were submitted to tomographic acquisition with six different cone beam computed tomographic devices in small fields of view with their MAR enabled and disabled. Windowing was done using ITK-SNAP software (3.8.2) which was used as a contrast medial tool for window level and window width. The data was analyzed for probability distribution using the Kolmogorov-Smirnov test, where a p-value of <0.05 indicated that the data were not normally distributed. The comparison of length and width was done using the Wilcoxon sign rank test. Comparison of categorical variables was done using the Chi-square test where a p-value of <0.05 was considered statistically significant.
RESULTS
Length and width of all these metals measured using MAR and non-MAR CBCT were found to be statistically non-significant (p-value of >0.05). MAR algorithm significantly reduces metals artifact produced by high-density restorative materials (p-value of <0.05).
CONCLUSION
Amalgam and cobalt-chromium produced more artifacts while composite and gutta-percha did not produce enough artifacts to be reduced by the MAR algorithm. Large window width and high window level would be beneficial to reduce the metal artifact.
PubMed: 37575712
DOI: 10.7759/cureus.41742 -
Frontiers in Dentistry 2024Teeth bleaching is an accepted and modern treatment in cosmetic dentistry. Bleaching agents may affect amalgam restorations and increase mercury release; therefore,...
Teeth bleaching is an accepted and modern treatment in cosmetic dentistry. Bleaching agents may affect amalgam restorations and increase mercury release; therefore, patients are at increased risk of mercury exposure in the body. The aim of this study was to investigate the effect of polishing and universal bonding application on mercury release from aged amalgams exposed to bleaching. In this in-vitro experimental study, 64 dental amalgam specimens with dimensions of 3×5×10 were prepared and divided into two experimental and control groups. Each group was further divided into 4 subgroups and received one of the following treatments: no intervention, surface bonding, polishing, or polishing and surface bonding. Subsequently, the samples were immersed in bleaching agent containing 7% hydrogen peroxide and the amount of mercury released after 96h was measured. The results were analyzed by two-way ANOVA and Tukey post hoc tests (α≤0.05). The results showed that the type of solution (P<0.05) and surface treatment (P<0.001) significantly affected the level of mercury release. However, there was no significant interaction between surface treatment methods in the bleaching group and those in the phosphate buffer group (P=0.621). Bleaching agents were found to enhance mercury release from dental amalgam. The application of polishing and universal bonding on amalgam surfaces exhibited significant effects on the reduction of the mercury release
PubMed: 38919769
DOI: 10.18502/fid.v21i14.15392 -
Nederlands Tijdschrift Voor... May 2024A 56-year-old woman presented with persistent unilateral gnathological complaints after replacing an amalgam restoration. The patient reported tension and pain in the...
A 56-year-old woman presented with persistent unilateral gnathological complaints after replacing an amalgam restoration. The patient reported tension and pain in the right side of her jaw, along with crackling sounds in the temporomandibular joint. Physical examination revealed tenderness in the right masseter muscle and temporomandibular joint, as well as anterior disc replacement with reduction on both sides. The initial treatment focused on providing rest to the temporomandibular joint, the Yoda exercise, and later, wet-needling. Despite initially limited improvement, the symptoms persisted. This case underscores the complexity and various treatment options for temporomandibular joint issues following dental procedures.
Topics: Humans; Female; Middle Aged; Temporomandibular Joint Disorders; Dental Amalgam; Treatment Outcome; Dental Restoration, Permanent
PubMed: 38715536
DOI: 10.5177/ntvt.2024.05.23106 -
Journal of the American Dental... Jul 2023Despite increasing evidence, dentists have not widely adopted repairs. The authors aimed to develop and test potential interventions targeting dentists' behavior.
BACKGROUND
Despite increasing evidence, dentists have not widely adopted repairs. The authors aimed to develop and test potential interventions targeting dentists' behavior.
METHODS
Problem-centered interviews were performed. Emerging themes were linked to the Behavior Change Wheel to develop potential interventions. The efficacy of 2 interventions was then tested in a postally delivered behavioral change simulation trial among German dentists (n = 1,472 per intervention). Dentists' stated repair behavior regarding 2 case vignettes was assessed. Statistical analysis was performed using McNemar test, Fisher exact test, and a generalized estimating equation model (P < .05).
RESULTS
Two interventions (guideline, treatment fee item) were developed on the basis of identified barriers. A total of 504 dentists participated in the trial (17.1% response rate). Both interventions significantly changed dentists' behavior toward repairs of composite and amalgam restorations, respectively (guideline: difference [Δ] = +7.8% and Δ = +17.6%, treatment fee item: Δ = +6.4% and Δ = +31.5%; adjusted P < .001). Dentists were more likely to consider repairs if they already performed repairs frequently (odds ratio [OR], 1.23; 95% CI, 1.14 to 1.34) or sometimes (OR, 1.08; 95% CI, 1.01 to 1.16), if they regarded repairs as highly successful (OR, 1.24; 95% CI, 1.04 to 1.48), if their patients preferred repairs over total replacements (OR, 1.12; 95% CI, 1.03 to 1.23), for partially defective composite restorations (OR, 1.46; 95% CI, 1.39 to 1.53), and after receiving 1 of the 2 behavioral interventions (OR, 1.15; 95% CI, 1.13 to 1.19).
CONCLUSIONS
Systematically developed interventions targeting dentists' repair behaviors are likely efficacious to promote repairs.
PRACTICAL IMPLICATIONS
Most partially defective restorations are replaced completely. Effective implementation strategies are required to change dentists' behavior. This trial was registered at https://www.
CLINICALTRIALS
gov. The registration number is NCT03279874 for the qualitative phase and NCT05335616 for the quantitative phase.
Topics: Humans; Dental Restoration, Permanent; Dental Restoration Failure; Practice Patterns, Dentists'; Data Collection; Dental Care; Dentists
PubMed: 37212760
DOI: 10.1016/j.adaj.2023.04.007 -
Brazilian Oral Research 2024The aim of this study was to analyze the expression of mast cell markers toluidine blue, c-kit, and tryptase and presence of mononuclear inflammatory cells in oral...
The aim of this study was to analyze the expression of mast cell markers toluidine blue, c-kit, and tryptase and presence of mononuclear inflammatory cells in oral lichen planus (OLP) and oral lichenoid lesions related to dental amalgam. Nineteen specimens of OLP, OLLC, and healthy oral mucosa were selected. Mononuclear inflammatory cells were analyzed. Histochemical and immunohistochemical analyses were performed using toluidine blue, anti-c-kit and anti-tryptase reagents, and the results were quantified in areas A and B of connective tissue. Mast cells of all OLP and OLLC samples were positive for toluidine blue, c-kit, and tryptase. The density of toluidine blue+, c-kit+ and tryptase+ mast cells was higher in tissue with OLP and OLLC compared with healthy controls (p < 0.05). No difference was noted in mast cells density between OLP and OLLC (p > 0.05). The density of tryptase+ mast cells was higher in the subepithelial region (area A) than the region below it (Area B) in OLLC (p = 0.047). The mononuclear inflammatory cell density was higher in OLLC compared to OLP, but without statistical significance (p > 0.05). A positive statistical correlation was found between mononuclear immune cells and density of c-kit+ and tryptase+ mast cells in OLP (r = 0.943 and r = 0.886, respectively). Our data demonstrate that the etiopathogenesis process of OLP and OLLC modulates the expansion and degranulation of mast cells; mast cells density, however, was similar between OLP and OLLC. The distribution of mast cells appears to vary along the lamina propria.
Topics: Humans; Mast Cells; Lichen Planus, Oral; Dental Amalgam; Tolonium Chloride; Tryptases
PubMed: 38198305
DOI: 10.1590/1807-3107bor-2024.vol38.0005 -
Journal of Ayub Medical College,... 2023There are several materials available in the market for the core buildup of endodontically treated teeth. The purpose of our study is to evaluate the fracture resistance...
BACKGROUND
There are several materials available in the market for the core buildup of endodontically treated teeth. The purpose of our study is to evaluate the fracture resistance of endodontically treated teeth restored with composite resin, amalgam and glass ionomer cement as core buildup materials.
METHODS
Forty-eight sound-extracted mandibular premolar teeth were randomly divided into 4 groups of 12 teeth each. The first group served as a control and consisted of intact sound teeth. In all of the remaining teeth, root canal treatment was performed first. In Group II composite resin was used as the core build-up material Group III amalgam and Group IV GIC. Teeth were then subjected to fracture using a universal testing machine.
RESULTS
One Way ANOVA test was performed to study the differences in the data of the four groups. The mean forces required for fracture were 1050 N for control teeth, 738 N for composite, 872 N for amalgam and 567 N for GIC. The variation is of statistical significance as depicted by a p-value of 0.003.
CONCLUSIONS
The highest strength was shown by intact sound teeth. Teeth restored with composite resin and amalgam had similar strengths and those with GIC had significantly lower resistance to fracture.
Topics: Humans; Flexural Strength; Tooth, Nonvital; Materials Testing; Dental Pulp Cavity; Tooth Fractures; Composite Resins
PubMed: 38406942
DOI: 10.55519/JAMC-04-11949 -
Operative Dentistry Jan 2024The aim was to compare intrapulp temperature (IPT) changes when flat-fissure diamond burs and pear-shaped tungsten carbide burs were used to cut tooth structure,...
OBJECTIVE
The aim was to compare intrapulp temperature (IPT) changes when flat-fissure diamond burs and pear-shaped tungsten carbide burs were used to cut tooth structure, amalgam, and composite resin with and without water coolant.
METHODS
Thermocouples were inserted into the pulp chamber of extracted intact mandibular molars. The thermocouples were connected to an electronic thermometer that detects temperature every second to an accuracy of 0.1°C. IPT changes were recorded while using a high-speed handpiece during MOD cavity preparations (n=40), composite resin removal (n=40), and amalgam removal (n=40). A two-way ANOVA was used for each procedure to test for the effect of bur (pear-shaped tungsten carbide vs flat-fissured diamond) and water coolant (on vs off), with significant main effects (α=0.05) further analyzed using Tukey's multiple comparison test.
RESULTS
During MOD cavity preparation, water coolant reduced changes in IPT (0.03±0.27°C) compared to no water coolant (1.27±0.29°C) when tungsten carbide burs were used (p<0.05) but not when diamond burs were used. During composite resin removal, tungsten carbide burs had less changes in IPT (0.55±0.18°C) compared to diamond burs (1.66±0.50°C) with no water coolant (p<0.05). Water coolant also reduced changes in IPT (0.09±0.14°C) compared to no water coolant (1.66±0.50°C) when diamond burs were used (p<0.01). Water coolant did not significantly affect IPT when tungsten carbide burs were used. During amalgam removal, tungsten carbide burs had lower changes in IPT (0.56±0.15°C) compared to diamond burs (1.88±0.43°C) with no water coolant (p<0.05). Water coolant also significantly reduced changes in IPT (0.71±0.2°C) compared to no water coolant (1.88±0.43°C) when diamond burs were used (p<0.05) but not when tungsten carbide burs were used.
CONCLUSIONS
Water coolant reduced IPT changes when drilling tooth structure with tungsten carbide burs, but not when removing amalgam or composite. Conversely, water coolant reduced IPT changes when drilling with flat fissure diamond burs to remove amalgam and composite, but not when removing tooth structure. When amalgam and composite were removed without water coolant, the tungsten carbide burs resulted in lower IPT changes than when flat fissure diamond burs were used in the same way.
Topics: Temperature; Water; Dental High-Speed Equipment; Composite Resins; Tungsten Compounds; Diamond; Surface Properties
PubMed: 38057997
DOI: 10.2341/23-033-L -
Physics and Imaging in Radiation... Jan 2024High-density dental fillings pose a non-negligible impact on head and neck cancer treatment. For proton therapy, stopping power ratio (SPR) prediction will be...
BACKGROUND AND PURPOSE
High-density dental fillings pose a non-negligible impact on head and neck cancer treatment. For proton therapy, stopping power ratio (SPR) prediction will be significantly impaired by the associated image artifacts. Dose perturbation is also inevitable, compromising the treatment plan quality. While plenty of work has been done on metal or amalgam fillings, none has touched on composite resin (CR) and glass ionomer cement (GIC) which have seen an increasing usage. Hence, this work aims to provide a detailed characterisation of SPR and dose perturbation in proton therapy caused by CR and GIC.
MATERIALS AND METHODS
Four types of fillings were used: CR, Fuji Bulk (FB), Fuji II (FII) and Fuji IX (FIX). The latter three belong to GIC category. Measured SPR were compared with SPR predicted using single-energy computed tomography (SECT) and dual-energy computed tomography (DECT). Dose perturbation of proton beams with lower- and higher-energy levels was also quantified using Gafchromic films.
RESULTS
The measured SPR for CR, FB, FII and FIX were 1.68, 1.77, 1.77 and 1.76, respectively. Overall, DECT could predict SPR better than SECT. The lowest percentage error achieved by DECT was 19.7 %, demonstrating the challenge in estimating SPR, even for fillings with relatively lower densities. For both proton beam energies and all four fillings of about 4.5 mm thickness, the maximum dose perturbation was 3 %.
CONCLUSION
This study showed that dose perturbation by CR and GIC was comparatively small. We have measured and recommended the SPR values for overriding the fillings in TPS.
PubMed: 38405428
DOI: 10.1016/j.phro.2024.100552