Journal of Dental Medicine

Background and Aims: Reliable bonding between tooth substrate and zirconia-based ceramic restorations is always of great importance. The laser might be useful for treatment of ceramic surfaces. The aim of the present study was to investigate the effect of laser irradiation on the shear bond strength of zirconia ceramic surface to dentin.

Materials and Methods: In this experimental in vitro study, 40 Cercon zirconia ceramic blocks were fabricated. The surface treatment was performed using sandblasting with 50-micrometer Al2O3, CO₂ laser, or Nd:YAG laser in each test groups. After that, the specimens were cemented to human dentin with resin cement. The shear bond strength of ceramics to dentin was determined and failure mode of each specimen was analyzed by stereo-microscope and SEM investigations. The data were statistically analyzed by one-way analysis of variance and Tukey multiple comparisons. The surface morphology of one specimen from each group was investigated under SEM.

Results: The mean shear bond strength of zirconia ceramic to dentin was 7.79±3.03, 9.85±4.69, 14.92±4.48 MPa for CO₂ irradiated, Nd:YAG irradiated, and sandblasted specimens, respectively. Significant differences were noted between CO₂ (P=0.001) and Nd:YAG laser (P=0.017) irradiated specimens with sandblasted specimens. No significant differences were observed between two laser methods (P=0.47). The mode of bond failure was predominantly adhesive in test groups (CO₂ irradiated specimens: 75%, Nd:YAG irradiated: 66.7%, and sandblasting: 41.7%).

Conclusion: Under the limitations of the present study, surface treatment of zirconia ceramics using CO₂ and Nd:YAG lasers was not able to produce adequate bond strength with dentin surfaces in comparison to sandblasting technique. Therefore, the use of lasers with the mentioned parameters may not be recommended for the surface treatment of Cercon ceramics.

Background and Aims: Failure of bonding between artificial teeth and denture base material is a considerable problem for patients who wear dentures. According to the different impact of artificial teeth and different information about resistance force of mastication and also with deficiency in researchs, this study was designed to compare the bond strength of composite and acrylic artificial teeth to auto-polymerized denture base resins with and without cyclic loading.

Materials and Methods: In this experimental and in vitro study, an acrylic resin auto-polymerized (Rapid Repair, Dentsply) and four artificial teeth (Acrylic Marjan new, Composite Glamour teeth and Ivoclar acrylic and composite teeth) were used. Therefore, 8 groups of 10 specimens each were evaluated. All specimens were thermocycled for 5000 cycles, in water baths between 5 and 55 ^◦ C. Half the specimens in each group were treated with cyclic loading at 50N for 14, 400 cycles at 1.2 Hz. The shear bond strengths were measured using a Universal Testing Machine. Data were analyzed using Two-way ANOVA test.

Results: Statistical analysis demonstrated no significant effect of cyclic loading on the shear bond strength, but the type of artificial tooth affected the shear bond strength (P=0.006). Also, the interaction between Cyclic loading and the type of artificial tooth showed no significant difference (P=0.98). Tukey test showed that acrylic teeth (Ivoclar) had statistically higher bond strength values than that of other teeth (P_Glamour=0.02), (P_{Composite ivoclar}=0.01) and (P_{Marjan new}=0.02).

Conclusion: Within the limitation of this study, the predominant type of fracture in all groups was cohesive, therefore the bond strength was adequate in all teeth and the type of artificial tooth may influence the bond strength of denture teeth to denture base resin. Cyclic loading had no significant effect on the bond strength of denture teeth to the auto-polymerized acrylic resin.

  Background and Aims : The aim of this study was to evaluate the effect of chlorhexidin 2%, sodium hypochlorite 2.5% and hydrogen peroxide 3% as three effective and regular disinfectants on the microleakage of 7th generation bonding agents in vitro.

  Materials and Methods: 45 extracted molar teeth without carries were collected and disinfected. On buccal and lingual aspects of these teeth conventional class V cavity preparation were done (90 cavities), then randomly divided to 4 groups, three of them had 10 teeth (20 cavities) and one of them had 5 teeth (10 cavities) as control group. Cavities in each experimental group prepared with one of the disinfectants and then 7th generation bonding (Optibond all in one, kerr) was used as noted by manufacturer, then cavities filled with composite and polished. Bonding agent was used without our previous disinfectants manipulation in control group. Specimens were thermocycled with 1000 thermal cycles between 5 and 55 ⁰ C each for 30 seconds and then immersed in the methylene blue 5%, then sectioned mesiodistally and investigated for microleakage under stereomicroscope (Olympus, Japan). Data were analyzed using Kruskal-Wallis and Wilcoxon mean rank tests.

  Results: Despite the lower mean rank values for the untreated group at both occlusal and gingival aspects, the Kruskal-Wallis procedure (α=0.05) showed that the treatment factor did not significantly affect the mean rank values neither in occlusal (P=0.12) nor in gingival (P=0.39) part of cavities.

  Conclusion: According to the results of this study, antimicrobial agents such as chlorhexidine 2%, sodium hypochloride 2.5% and hydrogen peroxide 3% can be used perior to 7th generation dentin bonding agent
(Optibond all in one, kerr) without much concern.

  Background and Aims: Indirect composites are designed to overcome the shortcomings of direct composites such as polymerization shrinkage and low degree of conversion. But, good adhesion of resin cements to indirect composites is still difficult. This research was designed to assess the effect of different powers of ErYAG laser compared with sandblasting. On the micro tensil bond strength of resin cement to indirect composites.

  Materials and Methods: Specimens were prepred using dental resin composite (Gradia GC) and metallic mold (15×5×5 mm) and were cured according to the manufacturer’s instructions. 24 blocks were prepared and randomly divided into 12 groups. G1:no treatment (as control), G 2-6: Er YAG laser irradiation (2, 3, 4, 5, 6 Watt), G7: sandblast. Two composite blocks were bonded to each other with Panavia F.2. resin cement. The cylindrical sections with dimensions of 1 mm were tested in a microtensile bond strength tester device using 0.5 mm/min speed until fracture points. Data were analyzed using 2-way ANOVA and T-test.

  Results: Interaction between lasers irradiation and sandblast treatments were significant (P<0.05). Thus, T-test was used for comparing laser groups. T-test showed that when using laser with energies less than 150 mJ, there was no significant difference (P>0.05) whether samples were sandblasted or not. Samples which received 300 mJ of laser showed lower bond strength compared with no laser treatment. Other groups showed no significant difference (P>0.05).

  Conclusion: It seems that application of sandblast with proper variables, is a good way to improve bond strength.
Laser application had no influence in improving the bond strength between the indirect composite and resin cement.

  Background and Aims: Debonding of denture teeth from the denture base can be frustrating for both clinician as well as patient. The aim of this study was to determine the effect of different tooth preparations on the tensile bond strength of composite denture teeth to acrylic denture base material.

  Materials and Methods : In this experimental study, 108 anterior Glamour teeth were selected and divided into 9 groups, based on their preparation (physical: no physical change, glaze removal, creating two slots with 1.5 mm depth, creating a hole with 2.5mm depth, chemical: (without chemical materials, monomer, silane). Specimens were prepared and tested according to the methods of the International standards organization (ISO 20795-1). After attachment of teeth to acryl, the tensile bond stregth test was performed in a Universal Testing Machine (UTM) with a crosshead speed of 1mm/min and specimens were subjected to tensile force until failure. Data were analyzed with one-way ANOVA, Tukey HSD and Two-way ANOVA.

  Results: There were significant differences between the bond strength of tested groups (P=0.012). Based on Tukey test, there was a significant difference between monomer/without physical change group and without/without (P<0.001) and control group. No significant differences were found between the bond strengths of the other groups (P=0.17) . All specimens were debonded as cohesive failure.

  Conclusion: Application of monomer on the ridge lap surface led to improve the tensile bond strength between glamour composite denture teeth and Iranian acrylic resin, however physical changes were not effective. According to the cohesive failure of all the specimens, it can be concluded that the bond strength between this type of teeth and acrylic resin was stronger than the strength of teeth.

  Background and Aims: Diagnosis of vertical root fractures often poses a clinical dilemma. Diagnosis of VRF in intraoral radiographs, except in cases where the beam is perpendicular to the direction of fracture is difficult. Misdiagnosis often leads to wrong decisions about the design of teeth future treatment plan. The aim of this study was to determine the diagnostic accuracy of reverse contrast enhancement options in digital radiography, and to compare it with the original images to find a suitable method to detect vertical root fracture.

  Materials and Methods: In this experimental study, digital radiography with phosphor plate detector was taken from 40 extracted single root teeth. From each intact and fractured tooth, the original and reverse contrast images captured and stored. Two expert observers viewed the images twice with an interval of two weeks. Diagnostic criteria (Accuracy, PPV, NPV, Specificity and Sensitivity) in form of absolute and complete for each observer and each images was calculated. Inter and intra observer reliability was obtained using Mc-Nemar test.

  Results: No significant differences in inter-observer reliability between the initial appearance and reverse contrast was observed (P>0.05), but in view of the intra-observer reliability in two cases, the difference was significant (P<0.05). No significant difference in the accuracy, sensitivity, specificity and PPV was observe between the two used images (P>0.05), whereas significant difference between the two images was found in NPV index (P<0.05).

  Conclusion: The use of reverse contrast enhancement option for detection of vertical root fracture did not show significant difference from initial view.

Background and Aims: One of the major challenges in dental practice is dental complaints that majority of complaints resulted in criminal prosecution and the legal practitioners. The aim of this study was to investigate the patients’ complaints on the diagnosis and treatment plan, dentist’s behavior, treatment charge, and management unlike the behavior of medical affairs, lack of enforcement in Tehran Medical Council between 2005-2011.

Materials and Methods: We referred to the Medical Council in order to obtain permission for evaluating complaints of dentists in Tehran. All files in units of prosecutors, magistrates and judicial committee were evaluated. Data were analyzed using spss version16 software.

Results: The results showed that the highest percentage of complaints was related to the how treatment was managed (41.7%) and the lowest percentage of complaints were about the dentist's diagnosis and treatment plan (2.9%).

Conclusion: Based on the results of this study, with dentists’ awareness of the existing rules and strict supervision, occurrence of complaints on the dental treatment can be prevented.