Browsing by Author "Cook, Norman B."

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    Effects of etching duration on the surface roughness, surface loss, flexural strength, and shear bond strength to a resin cement of e.max cad glass ceramic
    (2017) Al-Johani, Hanan; Chu, Tien-Min Gabriel; Platt, Jeffrey A.; Cook, Norman B.; Bottino, Marco C.
    Background: Long-term retention of ceramic restorations is dependent on the bond strength of the luting resin to both the tooth and porcelain substrates. In order to achieve successful bonding, the surface of the porcelain substrate must be modified to increase the surface roughness, and this can be achieved chemically by hydrofluoric (HF) acid etching. However, prolonged HF acid etching has shown to have a weakening effect on the evaluated lithium disilicate glass-ceramics. Therefore, it is essential to quantify the required etching duration of HF acid to minimize the possible deleterious effects on ceramic strength while maximizing the bond strength to tooth structure. Objectives: To evaluate the effects of HF acid etching duration on the surface roughness, surface loss, flexural strength, and shear bond strength of IPS e.max CAD (Ivoclar Vivadent) lithium disilicate-based glass ceramic to a resin cement. Hypothesis: The differences in HF acid etching durations will not have a significant effect on the surface roughness, surface loss, flexural strength, or shear bond strength of IPS e.max CAD to a resin cement. Methods: 168 specimens were prepared from IPS e.max CAD blocks. All specimens were polished and sonically cleaned in distilled water. Specimens were fired in the vacuum pump furnace according to the manufacturer’s instructions. Specimens were then divided into 4 groups, according to etching durations, then further divided into 3 subgroups, according to the properties tested. Group A was not etched (control), Groups B, C and D were etched with 5-percent HF acid (IPS Ceramic Etching gel, Ivoclar Vivadent) for 20 s, 60 s and 90 s respectively. The morphologies of both etched and non-etched surfaces in specimens of subgroup 1 of each etching group (n = 16/group) were observed under scanning electron microscopy (SEM). In addition, non-contact surface profilometry (Proscan 2000) was used to calculate the surface loss and to examine the surface roughness of the etched ceramic surfaces and roughness values (Ra, Rq) were documented for each group. Furthermore, etched specimens of subgroup 2 (n = 16/group) were silanated (Monobond Plus, Ivoclar Vivadent) and cemented with a resin cement (Multilink Automix, Ivoclar Vivadent). The shear bond strength (SBS) was measured using a universal mechanical testing machine. For each etching group, subgroup 3 specimens (n = 10/group) were loaded to failure in a three-point bending test to measure their flexural strength values using a universal mechanical testing machine. Data for surface roughness, surface loss, and flexural strength were analyzed using one-way analysis of variance (ANOVA), to identify the significant effects of different HF acid etching durations. Data for shear bond strength test were analyzed using two-way ANOVA to test the effects of etching duration, storage for 24 hours/thermocycling, and their interaction. All pair-wise comparisons from ANOVA analysis were made using Fisher’s Protected Least Significant Differences to control the overall significance level at 5 percent. Results: Difference in HF etching durations did not have a significant effect on surface roughness values Ra or Rq (p = 0.3408; p = 0.3245) respectively, but had a significant effect on surface loss (p = 0.0006). SBS values were not significantly different between experimental groups (p = 0.4650); however, SBS values after 24-h storage were significantly higher than that found after thermocycling (p = 0.0166) among different etching durations. Finally, different HF etching durations did not have a significant effect on flexural strength values (p = 0.1260). Conclusion: Within the limitations of this study, different HF etching durations did not have a significant effect on surface roughness, flexural strength, or shear bond strength of IPS e.max CAD. However, the different etching durations significantly affected the surface loss of the lithium disilicate glass ceramics.
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    The Impact of Mouthrinses on the Efficacy of Fluoride Dentifrices in Preventing Enamel and Dentin Erosion/ Abrasion
    (2018) Albeshir, Ebtehal; Lippert, Frank; Cook, Norman B.; Hara, Anderson
    Objective: Toothbrushing with fluoride toothpaste followed by rinsing with mouthwash is a routine procedure to maintain good oral hygiene. It is unknown to what extent these rinses can modulate the effect of fluoride in its ability to prevent erosion/abrasion.The aim of this in-vitro study was to investigate and compare the impact of chlorhexidine (CHX), essential oils (EO) and cetylpyridinium chloride (CPC) mouthrinses on erosive tooth wear protection afforded by conventional fluoride toothpastes. Materials and Methods: The following experimental factors were considered: five rinses: CHX, EO, CPC, a fluoride rinse, and deionized water, two fluoride toothpastes: stannous fluoride (SnF2) or sodium fluoride (NaF) and two models: (erosion/ erosion+abrasion). Slabs of bovine enamel and dentin were prepared and embedded in resin blocks and generated 10 enamel and dentin testing groups (n = 8). UPVC tapes were placed on the sides of each slab leaving 1mm area exposed in the center. The blocks were subjected to a five-day cycling model. Then, the blocks were placed in a brushing machine and exposed to fluoride toothpaste slurry (one side was brushed and the other wasn’t). The blocks were then exposed to rinse treatments. Artificial saliva was used to remineralize the specimens after erosions and treatment challenges, and as storage media. After the fifth day of cycling, surface loss (in micrometers) was determined by profilometer. Data were analyzed using ANOVA (α = 0.05). Results: There was no interaction among the three factors (type of toothpaste, mouthrinse and abrasion or not (dentin p = 0.0520, enamel p = 0.4720). There were no significant two-way interactions as SL was only affected by toothpaste and mouthrinse. NaF caused less SL than SnF2 (4.60 vs. 5.83 μm; p < 0.0001) in dentin, whereas the opposite was found in enamel (5.20 vs. 3.56 μm; p < 0.0001). Toothbrushing abrasion caused comparatively more SL in enamel (6.53 vs. 2.23 μm; p < 0.0001) than in dentin (6.06 vs. 4.38 μm; p < 0.0001). None of the tested mouthrinses affected SL. Conclusion: Commonly used mouthrinses containing antimicrobial agents or additional fluoride, do not impair the erosion/abrasion protection afforded by fluoride toothpastes. Tested SnF2 dentifrice offered greater protection against enamel surface loss and NaF dentifrices showed more protection for the dentin surface. Clinical relevance: The understanding of the interaction between commonly used rinses and fluoride dentifrices will help dentists provide better recommendations to patients with erosive lesions.
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    Influence of curing-light beam profile non-uniformity on degree of conversion and micro-flexural strength of resin-matrix composite
    (2016-10-05) Eshmawi, Yousef Tariq; Platt, Jeffrey A.; Hara, Anderson T.; Diefenderfer, Kim E.; Cook, Norman B.
    Background. Beam profile non-uniformity of light-curing units (LCUs) may result in suboptimal properties of resin-matrix composite (RMC) restorations. Objectives: The objective of this study was to evaluate the effect of curing-light beam profile of multiple light curing units (LCUs) on the degree of conversion (DC) and micro-flexural strength (μ-flexural strength) of RMC. Methods: Forty-five nano-filled hybrid RMC (Tetric EvoCeram, Ivoclar Vivadent, Amherst, NY) specimens were fabricated. Quartz tungsten halogen (QTH) (Optilux 401) (O), multiple emission peak (VALO Cordless) (V) and single emission peak (Demi Ultra) (DU) light-emitting-diode (LED) LCUs were investigated at different light-curing locations (LCLs): 1) the center of the LCU tip; 2) 1.5 mm to the left of the center of the LCU tip; and 3) 1.5 mm to the right of the center of the LCU tip. Specimens were stored wet in deionized water at 37C for 24 hours. The DC was measured on top and bottom surfaces using Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy. Micro-flexural strength testing was performed using a universal mechanical testing machine at crosshead speed of 1 mm/min. Multi-factorial ANOVAs were used to analyze the data (α = 0.05). Results: All LCUs exhibited significant differences in DC between top and bottom surfaces at the different LCLs. Micro-flexural strength varied with LCL for DU. Conclusions: The non-uniform curing-light beam profile could have a significant effect on μ-flexural strength and DC on top and bottom surfaces of RMC specimens cured at different LCLs.
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    Shear Bond Strengths Of A Two-Step Self-Etch Adhesive And A Three-Step Etch-And-Rinse Adhesive In Artificial Dentin Caries Lesions Of Various Depths: An In Vitro Study
    (2024-07) Buechele, Ryan W.; Cook, Norman B.; Diefenderfer, Kim E.; Capin, Orian R; Sochacki, Sabrina F.; Strother , James M.
    Background: Minimally invasive caries management philosophy advocates leaving carious dentin as a substrate for adhesive bonding. However, the performance of current resin adhesives in incompletely excavated caries lesions is unknown. Understanding the limitations of bonding to carious dentin is critical for the restoring clinician. Objective: To compare the shear bond strengths of a two-step self-etch adhesive and a three-step etch-and-rinse adhesive to moderate and severe artificial dentin caries. Methods: 96 bovine incisors were prepared and assigned to experimental groups of moderate or severe artificial dentin caries lesions or control groups (sound dentin). Specimens were randomly assigned to a two-step self-etch (Clearfil SE Bond 2) or three-step etch-and-rinse (OptiBond FL) adhesive for bonding to a nanohybrid composite resin. TMR analysis determined lesion depth. Specimens were stored for 30 days in Millipore water (5oC), shear bond strengths were measured, and failure modes observed. Two-way ANOVA with interactions evaluated the effects of adhesive type and demineralization severity on shear bond strength. Failure modes were compared using ordinal logistic regression. A two-sided 5% significance level was used for all tests. Results: Clearfil SE performed significantly better than Optibond FL in both moderate and severe lesions. Both adhesives performed adequately on sound dentin, but poorly in severe lesions. For OptiBond FL, bond strengths were lowest in moderate lesions; failures were predominantly mixed or cohesive within composite resin in both moderate and severe lesions, as well as in sound dentin specimens. For Clearfil SE, bond strengths were lowest in severe lesions; failures were predominantly adhesive in moderate lesions, cohesive within composite resin in severe lesions, and mixed adhesive/cohesive in sound dentin specimens. Discussion: Bonding to demineralized dentin was highly variable for both adhesives. Bonding to sound dentin yielded higher bond strengths. Conclusions: A three-step etch-and-rinse adhesive did not perform better than a two-step self-etch adhesive in this study. A self-etch adhesive may be the better choice when bonding to demineralized dentin. Either adhesive may be acceptable when bonding to sound dentin.
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    The impact of mouth rinses on the efficacy of fluoride dentifrices in preventing enamel and dentin erosion/abrasion
    (Discovery Scientific Society, 2023-11) Albeshir, Ebtehal G.; Albluwi, Reem A.; Almubarak, Ibtisam K.; Alrabea, Abdulmohsen; Cook, Norman B.; Eckert, George J.; Hara, Anderson T.; Lippert, Frank; Biomedical and Applied Sciences, School of Dentistry
    Purpose: Toothbrushing followed by is a method to maintain good oral hygiene. It is unknown to what extent mouth rinses can modulate the effect of fluoride in its ability to prevent erosion/abrasion. The aim of this in vitro study was to investigate the impact of chlorhexidine (CHX), essential oils (EO), and cetylpyridinium chloride (CPC) mouth rinses on erosive tooth wear protection afforded by conventional fluoride toothpaste. Methodology: The following experimental factors were considered: Five rinses: CHX, EO, CPC, a fluoride rinse, and water, two fluoride toothpaste: stannous fluoride (SnF2), sodium fluoride (NaF), and two models: erosion only and erosion + abrasion. Bovine enamel and dentin slabs were embedded in resin blocks (n=8). Specimens were subjected to a five-day cycling regimen consisting of twicedaily treatments, with or without abrasion, with fluoride toothpaste, followed by mouth rinse exposure. Erosion (0.3% citric acid) was performed 5×/d. Specimens were exposed to artificial saliva during remineralization periods. Surface loss (SL) was determined using non-contact profilometry. Data were analyzed using ANOVA (=0.05). Results: There was no interaction among the three factors (type of toothpaste, mouth rinse, and abrasion or not). There were no significant two-way interactions, as SL was only affected by toothpaste and mouth rinse. NaF caused less SL than SnF2 (p<0.0001) in dentin, whereas the opposite was found in enamel (p<0.0001). Erosion + abrasion caused more SL than erosion only (p<0.0001). None of the tested mouth rinses affected SL. Conclusion: Commonly used mouth rinses do not impair the erosion/abrasion protection fluoride toothpaste provides.