Browsing by Author "Levon, John A."
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Item The ability of dual whitening anti-caries mouthrinses to remove extrinsic staining and enhance caries lesion remineralization – An in vitro study(Elsevier, 2020) Al-Shahrani, Ahid A.; Levon, John A.; Hara, Anderson T.; Tang, Qing; Lippert, Frank; Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjectives This laboratory study investigated the ability of dual whitening anti-caries mouthrinses to remove extrinsic staining from artificially stained caries lesions and to enhance their remineralization and fluoridation. Materials and Methods Early caries lesions were created in bovine enamel specimens. The lesions were artificially stained and pH cycled for 10 days with the daily cycling regimen consisting of twice daily 60s-treatments with one of 11 mouthrinses, a 4-h demineralization period and artificial saliva treatments in between. Mouthrinses were eight commercially available products, all containing 100 ppm fluoride but utilizing hydrogen peroxide, pyro-, tri- or hexametaphosphate salts and/or sodium bicarbonate. The three control mouthrinses were 100 ppm fluoride, 30 % hydrogen peroxide and deionized water. Enamel color changes (ΔE) were determined spectrophotometrically. Vickers surface microhardness (VHN) was used to determine lesion remineralization. Enamel fluoride content (EFC) was determined using the microbiopsy technique. Data were analyzed using ANOVA. Results ΔE was significantly different among groups (p = 0.0045). Thirty percent hydrogen peroxide was superior to all other mouthrinses, while there were no differences between commercial mouthrinses and deionized water. There were small, directional but non-significant differences between commercial mouthrinses with those containing hydrogen peroxide providing better whitening. There were no significant differences between mouthrinses in their ability to remineralize caries lesions (p = 0.2898). EFC differed among groups (p < 0.0001), with the two mouthrinses containing pyrophosphate salts having lower EFC than all but the deionized water group. Conclusions Artificially stained caries lesions show reduced susceptibility to fluoride remineralization and whitening effects of commercial whitening and anti-caries mouthrinses. Clinical Relevance Artificially stained caries lesions appear to require stronger than over-the-counter interventions to successfully whiten and remineralizing them.Item Accuracy of digital duplication scanning methods for complete dentures(Wiley, 2023) Alehaideb, Abdullah; Lin, Wei-Shao; Levon, John A.; Chu, Tien-Min G.; Yang, Chao-Chieh; Prosthodontics, School of DentistryPurpose To compare the accuracy of four digital scanning methods in duplicating a complete denture. Material and Methods Four scanning methods were used: cone beam computed tomography (CBCT), Straumann desktop scanner (DS), Trios intraoral scanner (TIO), and Virtuo Vivo intraoral scanner (VVIO). Each method was used to duplicate all the surfaces of a printed complete denture. The denture was scanned 10 times in each group. The trueness (in root mean square, RMS) and precision (in standard deviation, SD) were calculated by comparing the combined dentition, denture extension, and intaglio surfaces with the reference file. One-way analysis of variance and F-tests were used to test statistical differences (α = 0.05). Results For the scanning accuracy of the whole denture, CBCT showed the highest RMS (0.249 ± 0.020 mm) and lowest trueness than DS (0.124 ± 0.014 mm p < 0.001), TIO (0.131 ± 0.006 mm p < 0.001), and VVIO (0.227 ± 0.020 mm p = 0.017), while DS and TIO showed smaller RMS than VVIO (p < 0.001). For the trueness of dentition, denture extension, and intaglio surfaces, CBCT also showed the highest mean RMS and lowest trueness among all groups (p < 0.001). DS and TIO had smaller mean RMS and higher trueness among all groups in all surfaces (p < 0.001, except VVIO in intaglio surface, p > 0.05). TIO had significantly lower within-group variability of RMS and highest precision compared to DS (p = 0.013), CBCT (p = 0.001), and VVIO (p < 0.001) in the combined surface. For dentition and denture extension surfaces, TIO showed similar within-group variability of RMS with the DS group (p > 0.05) and lower than CBCT and VVIO (p < 0.001). Conclusion The 7 Series desktop scanner and Trios 4 intraoral scanner can duplicate dentures in higher trueness than CBCT and the Virtuo Vivo intraoral scanner. The Trios 4 intraoral scanner was more precise in the combined surfaces than other scanning methods, while the 7 Series desktop scanner and Trios 4 intraoral scanner were more precise in the denture extension surface.Item Bone regeneration in novel porous titanium implants(2010) Khouja, Naseeba, 1981-; Chu, Tien-Min Gabriel; Brown, David T.; Platt, Jeffery A., 1958-; Blanchard, Steven B.; Levon, John A.The objective of this study was to evaluate the in vivo performance of the novel press-fit dental implant fabricated via electron beam melting (EBM, Southern Methodist Univ.) and compare it to a commercially-available porous-coated press-fit dental implant (Endopore, Innova Corp.). Twelve cylindrical shaped implants 3 mm in diameter x 5 mm long were made by EBM (Southern Methodist Univ.) using Ti6Al4V ELI alloy. Twelve commercial implants (Endopore, Innova Corp.) of the same geometry were used as controls. Samples were implanted in rabbit tibia and retrieved six weeks postoperatively. Six specimens from each implant type were embedded undecalcified, sectioned, and stained with toluidine blue (Sigma) for histomorphometry analysis. Bone-to-implant contact (BIC) was measured. On the six remaining samples from each implant type, the mechanical properties were evaluated by pushout test on a material testing machine. The samples were loaded at a loading rate of 1 mm/min. The pushout strength was measured and the apparent shear stiffness was calculated. The results were analyzed with a paired-t test. The histology shows osteointegration of surrounding bone with both implant types. Bone was found to grow into the porous space between the beads. Both the Endopore (Innova Corp.) and the EBM (Southern Methodist Univ.) showed similar BIC. The mean BIC for the Endopore (Innova Corp.) and EBM (Southern Methodist Univ.) implant were 35 ± 6% and 32 ± 9%, respectively. It failed to reach statistical significance (p > 0.05). The peak pushout force for Endopore (Innova Corp.) and EBM (Southern Methodist Univ.) implants were 198.80 ± 61.29 N and 243.21 ± 69.75 N, respectively. The apparent shear stiffness between bone and implant for the Endopore (Innova Corp.) and EBM (Southern Methodist Univ.) implants were 577.36 ± 129.99 N/mm; and 584.48 ± 146.63 N/mm, respectively. Neither the peak pushout force nor the apparent shear stiffness of the implants was statistically different between the two groups (p > 0.05). The results suggest that the implants manufactured by EBM (Southern Methodist Univ.) perform equally well as the commercial implant Endopore (Innova Corp.) in this current animal model.Item Caries lesion remineralization with fluoride toothpastes and chlorhexidine - effects of application timing and toothpaste surfactant(SciELO, 2018-06-11) Almohefer, Sami A.; Levon, John A.; Gregory, Richard L.; Eckert, George J.; Lippert, Frank; Restorative Dentistry, School of DentistryINTRODUCTION: Habitual toothbrushing with fluoridated toothpaste followed by rinsing with antibacterial mouthwashes is a method to maintain good oral hygiene and to diminish the occurrence and severity of dental caries and periodontal disease. However, our understanding of how antimicrobial agents in mouthwashes affect fluoride-mediated caries lesion remineralization is still poor. OBJECTIVE: The objectives of this in vitro study were a) to determine the effects of the waiting period of chlorhexidine (CHX) rinsing after fluoride toothpaste use and b) to further determine the effect of the type of toothpaste surfactant [sodium dodecyl sulfate (SDS) or cocamidopropyl betaine (CAPB)] on caries lesion remineralization associated with CHX rinsing. MATERIAL AND METHODS: Caries lesions were formed in bovine enamel specimens and assigned to 10 treatment groups (n=18) based on Vickers surface microhardness (VHN). Lesions were then pH-cycled for 10 days with daily regimen comprised of twice daily toothpaste slurry treatments (1150 ppm fluoride, with SDS or CAPB), followed by CHX solution treatments [0, 15, 30 or 60 minutes following slurry treatment or no CHX treatment (negative control)]. VHN was measured again and the extent of lesion remineralization calculated (∆VHN). RESULTS: ∆VHN with SDS-toothpaste was significantly lower than with CAPB-toothpaste, indicating more remineralization for the CAPB-toothpaste. ∆VHN with 0-minute waiting time was significantly lower than with 30-minute waiting time and with negative control. CONCLUSIONS: The absence of CHX as an adjunct to fluoride toothpastes led to greater remineralization of enamel lesions compared with the immediate use of CHX treatment for both SDS- and CAPB-toothpastes. CAPB-toothpastes indicated significantly greater remineralization than SDS-toothpastes, and can be suggested for patients at high risk of caries. A 30-minute waiting time for CHX treatment is recommended after brushing.Item Color stability of light-activated bleach shade composites(2010) Al-Yakoubi, Yaser; Levon, John A.; Platt, Jeffrey A., 1958-; Kim, Seok-jin, 1967-; Brown, David T.; Andres, Carl J., 1942-This study evaluated the color stability of bleach shade composites when activated by a high-intensity quartz tungsten-halogen (QTH) light source after 1 day, 7 days, and 30 days of exposure to different conditions. The color stability of bleach shade composites depends on various factors, namely, the resin material, the shade of the resin material, the storage method, and the storage time.Item Comparison of surface characteristics of denture base resin materials with two surface treatment protocols and simulated brushing(Wiley, 2023) Alouthah, Hesham; Lippert, Frank; Yang, Chao-Chieh; Levon, John A.; Lin, Wei-Shao; Prosthodontics, School of DentistryPurpose To investigate the effects of 4 denture base materials, 2 surface treatment protocols, and simulated brushing (SB) on the surface hardness, surface roughness, surface gloss, and the surface loss of denture base materials. Materials and Methods Four denture base resin material groups (compression-molded, injection-molded, 3D-printed, and milled) with two different surface treatment protocols (polished and glazed) were utilized in this study. A total of 80 samples (n = 10) were evaluated for surface hardness (Vickers) before SB. SB was performed for each sample (custom-built V8 cross brushing machine, 50,000 reciprocal strokes). Surface roughness (Ra) was measured before and after SB with a non-contact optical profilometer. Surface gloss was performed using a glossmeter to determine changes in surface reflectivity of the specimens before and after SB. Surface loss (wear resistance) was measured after SB using optical profilometry. The effects of material, surface treatment, and SB on all surface characteristics were examined with two-way and three-way analysis of variance models (ANOVA) (α = 0.05). Results The polished compression-molded group had significantly higher surface hardness than all other groups. The protective glaze coating significantly increased the surface hardness for all groups (P < 0.001). SB increased the surface roughness of all groups regardless of surface treatments (P < 0.001). The increase in surface roughness after SB was significantly higher with polished surface treatment than with a glazed surface treatment in all groups (P < 0.001). Surface gloss was significantly higher with the glazed surface treatment than with the polished surface treatment for all denture base materials (P < 0.001). After SB, milled denture base material showed the highest, and 3D-printed material showed the second highest surface gloss compared to the other groups (P < 0.001), regardless of surface treatment. In all materials tested, surface glaze significantly decreased surface loss (P < 0.001). With the glaze surface treatment, compression-molded denture base material had significantly less surface loss (more surface gain) than other materials, while with the polished surface treatment, 3D-printed denture base material had the least surface loss when compared with other groups. Conclusions A single layer of nano-filled, light-polymerizing protective glaze coating has displayed potential for enhancing the longevity of denture base materials, as evidenced by increased hardness and wear resistance. Following simulated brushing, the milled denture material exhibited the highest surface gloss and lowest surface roughness among all groups, regardless of the surface treatment protocol. This indicates that milled denture base material possesses favorable surface properties and may serve as a viable alternative to traditional denture base materials.Item The effect of a novel photoinitiator system (RAP) on dental resin composites' flexural strength, polymerization stress, and degree of conversion(2009) Schaub, Kellie; Platt, Jeffrey A., 1958-; Andres, Carl J., 1942-; Levon, John A.; Brown, David; Hovijitra, Suteena, 1944-Objectives: A new technology has been introduced into the field of dental resin composites that professes to enhance light-curing efficiency. Rapid amplified photopolymerization (RAP) initiator technology has not yet been fully compared with resin composites with conventional initiators such as camphorquinone (CQ). The purpose of this study was to compare and contrast the effects of this novel technology (RAP) on properties of two light-cured resin composites. Flowable (EFQ) and microfilled (ESQ) experimental composites were fabricated and supplied from Tokuyama Dental with (w/RAP) and without RAP (w/o RAP). The flexural strength (MPa) and flexural modulus (MPa) were obtained using a three-point bending apparatus (Sintech Renew 1123, Instron Engineering Corp., Canton, MA). Polymerization stress curves were created using a tensometer (American Dental Association Health Foundation, NIST, Gaithersburg, MD) which were then used to calculate the maximum stress rate. Finally, the degree of conversion was measured using infrared spectroscopy (Jassco FT-IR spectrometer, Model: 4100, Jasco Corporation, Tokyo, Japan). When evaluating the flexural strength, the peak stress for EFQ w/RAP was significantly higher than EFQ w/o RAP (p = 0.0001). This was statistically not significant for the ESQ group, even though ESQ w/RAP did have a higher peak stress then ESQ w/o RAP (p = 0.28). The interaction between resin type and RAP was not significant when evaluating the flexural modulus (p = 0.21). Formulations with RAP had a significantly higher flexural modulus then w/o RAP (p = 0.0001). Experimental resins with RAP had significantly higher maximum stress rates than those w/o RAP when evaluating polymerization stress (p = 0.0001). Finally, groups w/ RAP appeared to have a higher degree of conversion than groups without (p = 0.0057). This study showed that the experimental composites with RAP had greater mechanical properties than those without. Unfortunately, the increase in polymerization stress causes concern clinically due to the chance of leakage at the restoration/tooth interface. One of the main potential disadvantages of this new RAP technology is an increase in the polymerization stress. Deciding if this amount of polymerization stress is clinically acceptable is yet to be accomplished.Item Effect of Hydrofluoric Acid Etching Followed by Unfilled Resin Application on the Biaxial Flexural Strength of a Glass-based Ceramic(2012) Posritong, Sumana, 1974-; Bottino, Marco C.; Brown, David T.; Hovijitra, Suteera, 1944-; Chu, Tien-Min Gabriel; Levon, John A.Background: Numerous studies have reported the use of hydrofluoric (HF) acid as one of the most effective methods for the achievement of a durable bond between glass-based ceramics and resin cements. Nevertheless, there is little information available regarding the potential deleterious effect on the ceramic mechanical strength. Objectives: (1) to investigate the effect of HF acid etching regimens on the biaxial flexural strength of a low-fusing nanofluorapatite glass-ceramic (IPS e.max ZirPress, Ivoclar Vivadent), (2) to study the ability of an unfilled resin (UR) to restore the initial (i.e., before etching) mechanical strength, and (3) to evaluate the effect of HF acid etching on the ceramic surface morphology before and after UR treatment via scanning electron microscopy (SEM). Methods: One hundred and forty-four disc-shaped (15 ± 1 mm in diameter and 0.8 ± 0.1 mm in thickness) IPS e.max ZirPress specimens were allocated into 12 groups, as follows: G1-control (no etching), G2-30 s, G3-60 s, G4-90 s, G5-120 s, G6- 60 + 60 s. Meanwhile, groups (G7- G12) were treated in the same fashion as G1-G6, but followed by silane and UR applications. Surface morphology evaluation of non-etched and etched IPS e.max ZirPress (G1-G12) was carried out by scanning electron microscopy (SEM). The flexural strength was determined by biaxial testing as described in ISO 6872. Statistics were performed using two-way ANOVA and the Sidak multiple comparisons (α = 0.05). In addition, the Weibull statistics were estimated. Results: A significant effect of etching time (p=0.0290) on biaxial flexural strength was observed. Indeed, G4 led to a significantly (p=0.0392) higher flexural strength than G1. Correspondingly, G10 revealed a considerably higher flexural strength than G7 (p=0.0392). Furthermore, biaxial flexural strength was significantly higher for G7 – G12 than for G1 – G6 (p<0.0001). For G1 – G6, G4 showed the highest Weibull characteristic strength while the lowest Weibull characteristic strength was seen in G6. In G7 – G12, the highest Weibull characteristic strength was presented in G10 whereas G7 had the lowest. Finally, the SEM data revealed that the HF acid etching affected the surface of IPS e.max ZirPress by generating pores and irregularities and more importantly that the UR was able to penetrate into the ceramic microstructure. Conclusion: Within the limitations of this study, HF acid etching time did not show a damaging effect on the biaxial flexural strength of the IPS e.max ZirPress ceramic. Moreover, the ceramic biaxial flexural strength could be enhanced after UR treatment.Item Effect of interim fixed prosthodontics materials and flowable composite resins on polymerization of polyvinyl siloxane impressions(2017) Alsayed, Hussain D.; Platt, Jeffrey A.; Levon, John A.; Haug, Steven P.; Brown, David T.Item The effect of polymerization methods and fiber types on the mechanical behavior of fiber-reinforced composite resin(2015) Huang, Nan-Chieh; Chu, Tien-Min Gabriel; Hara, Anderson T.; Brown, David T.; Bottino, Marco C.; Levon, John A.Background: Interim restoration for a lost anterior tooth is often needed for temporary esthetic and functional purposes. Materials for interim restorations usually have less strength than ceramic or gold and can suffer from fracture. Several approaches have been proposed to reinforce interim restorations, among which fiber reinforcement has been regarded as one of the most effective methods. However, some studies have found that the limitation of this method is the poor polymerization between the fibers and the composite resin, which can cause debonding and failure. 64 Purpose: The purpose of this study was to investigate the effects of different polymerization methods as well as fiber types on the mechanical behavior of fiberreinforced composite resin. Material and Methods: A 0.2-mm thick fiber layer from strip fibers or mesh fibers embedded in uncured monomers w as fabricated with polymerization (two-step method) or without polymerization (one-step method), on top of which a 1.8-mm composite layer was added to make a bar-shape sample, followed by a final polymerization. Seventy-five specimens were fabricated and divided into one control group and four experimental groups (n=15), according to the type of glass fiber (strip or mesh) and polymerization methods (one-step or two-step). Specimens were tested for flexural strength, flexural modulus, and microhardness. The failure modes of specimens were observed by scanning electron microscopy (SEM). Results: The fiber types showed significant effect on the flexural strength of test specimens (F = 469.48; p < 0.05), but the polymerization methods had no significant effect (F = 0.05; p = 0.82). The interaction between these two variables was not significant (F = 1.73; p = 0.19). In addition, both fiber types and polymerization steps affected the flexural modulus of test specimens (F = 9.71; p < 0.05 for fiber type, and F = 12.17; p < 0.05 for polymerization method). However, the interaction between these two variables was not significant (F = 0.40; p = 0.53). Both fiber types and polymerization steps affected the Knoop hardness number of test specimens (F = 5.73; p < 0.05 for polymerization method. and F = 349.99; p < 0.05 for fiber type) and the interaction between these two variables was also significant (F = 5.73; p < 0.05). SEM images revealed the failure mode tended to become repairable while fiber reinforcement was 65 existed. However, different polymerization methods did not change the failure mode. Conclusion: The strip fibers showed better mechanical behavior than mesh fibers and were suggested for use in composite resin reinforcement. However, different polymerization methods did not have significant effect on the strength and the failure mode of fiber-reinforced composite