Strategies to Avoid Underdiagnosing Pit-and-Fissure Caries.

Traditionally, testing for whether pit-and-fissure caries should be restored involved probing with a sharp explorer and evaluating resistance to withdrawal (ie, "stick"). Alternative visual methods of evaluation and classification have been proposed, validated, and accepted formally in the core curriculum on caries management in both Europe and North America. This article examines the resistance to occlusal breakdown of fluoridehardened enamel despite progression of underlying dentin caries with accompanying difficulty in diagnosis.

Caries Management with the International Caries Detection and Assessment System II: Established Pit and Fissure Lesions.

Introduction: Operative dentistry addresses the surgical management of caries, a significant portion of dental practice. Dental students, who typically develop their skill sets in this important discipline by creating idealized preparations in plastic teeth, are often confused by the wide variety of tooth anatomy and caries presentation they see when they subsequently treat patients. To address this significant clinical transition issue, we developed this resource on preparing the moderate carious lesion using a stepwise, structured technique.

Dental Anatomy and Occlusion: Mandibular Incisors-Flipped Classroom Learning Module.

Introduction: This dental anatomy module is the second in a series that develops skills in analyzing the morphology, function, anomalies, and development of human teeth. Learning the visual details associated with teeth has often proven difficult using the lecture format; thus, we have utilized computer-assisted flipped learning, which has been shown to be just as effective as lectures and frees up class time for active learning.

Methods: In a flipped classroom approach, students learn basic knowledge with a self-paced, interactive tutorial prior to class.

Uninfiltrated Collagen in Hybrid Layers produced after Reduced Acid-etching Time on Primary and Permanent Dentin.

Aim: This study evaluated the influence of acid-etching time on collagen exposure in adhesive interfaces established on primary and permanent dentin.

Materials And Methods: Flat dentin surfaces were produced on sound primary molars and premolars (n = 8). The surfaces were divided into mesial and distal halves, and each half was etched with phosphoric acid for 5 or 15 seconds.

Effect of Sodium Fluoride on the endogenous MMP Activity of Dentin Matrices.

Objectives: This study evaluated the effect of incorporating increasing concentrations of sodium fluoride in incubation media, on the loss of dry mass and solubilization of collagen from demineralized dentin beams incubated for up to 7 days. The effect of fluoride on the inhibition of matrix-bound metalloproteinases (MMPs) was also measured.

Methods: Dentin beams were completely demineralized in 10% phosphoric acid.

Water distribution in dentin matrices: bound vs. unbound water.

Objective: This work measured the amount of bound versus unbound water in completely-demineralized dentin.

Methods: Dentin beams prepared from extracted human teeth were completely demineralized, rinsed and dried to constant mass. They were rehydrated in 41% relative humidity (RH), while gravimetrically measuring their mass increase until the first plateau was reached at 0.

Cytotoxicity of endodontic sealers after one year of aging in vitro.

The in vitro cytotoxic response to endodontic sealers was assessed for one year. AH-Plus (AHP), Epiphany (EPH), EndoRez (ER), Guttaflow (GF), InnoEndo (IN), and Pulp Canal Sealer (PCS) were exposed to mouse osteoblasts and human monocytes after curing, 52 weeks of aging, and after resurfacing post-aging; cellular response was estimated by succinate dehydrogenase (SDH) activity. The effect of materials on TNFα secretion from activated (LPS) and inactivated monocytes also was measured.

Quaternary ammonium silane-functionalized, methacrylate resin composition with antimicrobial activities and self-repair potential.

The design of antimicrobial polymers to address healthcare issues and minimize environmental problems is an important endeavor with both fundamental and practical implications. Quaternary ammonium silane-functionalized methacrylate (QAMS) represents an example of antimicrobial macromonomers synthesized by a sol-gel chemical route; these compounds possess flexible Si-O-Si bonds. In present work, a partially hydrolyzed QAMS co-polymerized with 2,2-[4(2-hydroxy 3-methacryloxypropoxy)-phenyl]propane is introduced.

Dysregulation of monocytic cytokine secretion by endodontic sealers.

Recent studies have reported that sealers may alter the secretion of specific cytokines from THP1 monocytic cells in vitro. In this study, a cytokine array was used to determine if endodontic sealers changed secretion of 42 cytokines. White mineral trioxide aggregate (WMTA), MTA preparation (CS), AH-Plus (AHP), and Pulp Canal Sealer (PCS) were mixed, allowed to set for 72 h, then "aged" in buffered-saline for 12 weeks.

Cytotoxic response of three cell lines exposed in vitro to dental endodontic sealers.

The in vitro cytotoxicity of five endodontic sealers was measured >8-12 weeks using L929 mouse fibroblasts, osteoblastic cells (ROS) 17/2.8 rat osteoblasts, and MC3T3-E1 mouse osteoblasts. Discs (n = 6) of AH-plus Jet (AHP), two versions of Endo Rez (ER, ERx), Epiphany (EPH), and Pulp Canal Sealer (PCS) were prepared.

In vitro osteogenic potential of an experimental calcium silicate-based root canal sealer.

Objective: This in vitro study compared the cytotoxicity and osteogenic potential of an experimental calcium silicate-based sealer with an epoxy resin-based sealer (AH Plus; Dentsply Caulk, Milford, DE) and a zinc oxide-eugenol-based sealer (Pulp Canal Sealer; SybronEndo, Orange, CA).

Methods: Disks prepared from the respective sealer and from Teflon (negative control) were placed in direct contact with a MC3T3-E1 osteogenic cell line at 6 weekly intervals after immersion in a culture medium. Succinic dehydrogenase activities were evaluated using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay.

Two-year clinical performance of Clearfil SE and Clearfil S3 in restoration of unabraded non-carious class V lesions.

This study was undertaken to evaluate the two-year clinical performance of a self-etching primer and a self-etching adhesive, both of which employ the same acidic monomer. Forty pairs of restorations of AP-X hybrid resin composite (Kuraray Co, Ltd, Osaka, Japan) were placed in caries-free cervical erosion/abfraction lesions. Based on insensitivity to air, the dentin in 62% of these lesions was considered to be sclerotic.

Inflammatory suppression by endodontic sealers after aging 12 weeks In vitro.

Dental endodontic sealers are in intimate contact with tissues around the root apex (periapical area) for extended periods. New endodontic sealers have been developed in the past decade, but the biological responses to many new products are not well documented. In this study, we assessed in vitro monocytic cytotoxic and inflammatory responses to several contemporary endodontic sealers.

Minimally retentive gold onlays: a six-year case report.

Partial veneer gold restorations, such as gold onlays, have changed little in preparation design over the past 40 years, as evidenced by textbooks that have long been in print. Such designs must have been based on the assumption that restorations would be luted with zinc phosphate cement but have not altered, despite the introduction of stronger luting cement classes, such as resin composite and resin-modified glass ionomer cements. It is well-established that both porcelain and base metal materials, which have been etched on the intaglio surface, can be combined with resin composite luting cements to produce restorations retained largely through adhesion.

A comparison of human raters and an intra-oral spectrophotometer.

Consistently choosing an accurate shade match is far more difficult than it appears. Recently, several electronic shade-matching devices have been marketed. One device is an intraoral spectrophotometer, Easyshade.

Color differences: polymerized composite and corresponding Vitapan Classical shade tab.

Objectives: This study compared newer composite resin restorative materials to the Vitapan Classical tabs they purported to represent.

Methods: Five Vitapan Classical tabs were studied: A3.5, B2, C1, C3, and D2 (n=3).

In vitro cytotoxicity evaluation of a self-adhesive, methacrylate resin-based root canal sealer.

This study compared the cytotoxicity of MetaSEAL (Parkell Inc, Farmington, NY), a methacrylate resin-based sealer with an epoxy resin-based (AH Plus Jet; Dentsply Caulk, Milford, DE) and a zinc oxide-eugenol-based sealer (Pulp Canal Sealer; SybronEndo, Orange, CA). Five-millimeter diameter disks prepared from the respective sealer and disks prepared from Teflon (negative control) and polymethyl methacrylate (positive control) were placed in direct contact with a rat osteosarcoma (ROS) 17/2.8 rat osteoblast-like cell line at six intervals after setting completely at 72 hours and for 5 succeeding weeks after the disks were immersed in simulated body fluid.

Comparison of traditional and low sensitivity whiteners.

This placebo-controlled, double-blind randomized clinical trial compared five 10% carbamide peroxide tooth whitening formulations. Three products contained varying concentrations of potassium nitrate as desensitizers. One contained no desensitizers and one was a placebo.

Comparison of two low sensitivity whiteners.

Purpose: To evaluate two commercially available doctor-supplied, patient-applied, bleaching systems for their ability to whiten the maxillary anterior teeth while at the same time not causing sensitivity.

Methods: 46 participants were randomly assigned to one of two groups: One group received Rembrandt Xtra-Comfort and the other group Nite White Excel 2Z. Bleaching stents were fabricated and the bleaching systems were used following manufacturers' instructions.

The effect of light curing source on the residual yellowing of resin composites.

Purpose: This study evaluated the amount of residual yellow in cured resin composites when polymerizing with either a quartz-tungsten-halogen (QTH) or blue light-emitting diode (LED).

Material And Methods: Twelve shades (bleaching to conventional shades) of microfill, hybrid and microhybrid resin composite specimens (n = 10) were polymerized with both light types. All the materials contained only camphorquinone as the photoinitiator.

In vitro cytotoxic response to lithium disilicate dental ceramics.

Objectives: The use of lithium disilicate dental ceramics is increasing in dentistry and previous reports have suggested that they may have greater biological risks than previously thought. We tested a hypothesis that composition and processing influence the biological properties of these ceramics.

Methods: The cytotoxicity of two machined and three pressed lithium disilicate materials (n=6) were tested in vitro using mouse fibroblasts in direct contact with the materials for 72h.

Effect of restoration size on the clinical performance of posterior "packable" resin composites over 18 months.

Fifty predominantly moderate or large Class II or multiple-surface Class I resin composite restorations were placed in molars under rubber dam isolation. The restorative systems used were: Alert Condensable (Jeneric/Pentron) and SureFil (Dentsply/Caulk). The restorations were classified according to size, with 7 small, 25 moderate and 18 large, of which 8 were cusp replacement restorations.

The effect of chlorhexidine on dentin hybrid layers in vivo.

This in vivo study evaluated by TEM the degradation of dentin hybrid layers in deep occlusal resin composite restorations. Caries-free premolars scheduled for extraction as part of orthodontic treatment were prepared, restored and evaluated after two and six months. The adhesive used was a single-bottle etch-and-rinse product (Single Bond Plus, 3M ESPE).

Comparison of seal after obturation techniques using a polydimethylsiloxane-based root canal sealer.

A polydimethylsiloxane-based sealer (GuttaFlow) was used for filling single-rooted teeth with four obturation techniques. Prefitted gutta-percha master-cones were employed in groups 1 to 3 with backfilling of the sealer. Apical third of the roots were first filled with GuttaFlow, and sealer-coated master cones were seated with up-and-down motion (group 1) or rotated to place (group 2).

Initial in vitro biological response to contemporary endodontic sealers.

The objective of this study was to evaluate the cytotoxicity of three endodontic sealers (AH Plus/Maillefer-Dentsply, Epiphany/Pentron, GuttaFlow, Coltene-Whaledent). Materials were mixed according to the manufacturer instructions and packed into Teflon molds (10 x 1 mm). For cytotoxicity testing (MTT method), the specimens were placed in contact with cultured cells, then evaluated at two subsequent time points (24 or 72 h).