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Item Beam profile characterization of light-emitting-diode curing units and its effect on polymerization of a resin-matrix composite(2017) AlZain, Afnan Omar; Platt, Jeffrey A.; Chu, Tien-Min G.; Bottino, Marco C.; Hara, Anderson T.; Goodpaster, John V.; Roulet, Jean-FrancoisThe general aim of this study was to investigate the influence of the localized irradiance beam profiles from multiple light-emitting-diode (LED) light-curing units (LCUs) on the polymerization pattern within a resin-matrix composite (RMC). Irradiance beam profiles were generated from one quartz-tungsten-halogen and various single and multiple emission peak LED LCUs using a camera-based beam profiler system combined with LCU power measurements obtained using an integrating sphere/spectrometer assembly. The influence of distance on irradiance, radiant exposure (RE) and degree of conversion (DC) on the top and bottom surfaces of a RMC increment, using various LCUs, at two clinically relevant distances was investigated. Molar absorptivity of the photoinitiators present in the nano-hybrid RMC (Tetric EvoCeram bleaching shade-XL) assessed was using UV-spectrophotometry. The correlation among irradiance, RE and DC was explored. A mapping approach was used to investigate DC, microhardness and cross-link density (CLD) within 5×5×2 mm specimens at various depths; top, 0.5, 0.7, 0.9, 1.1, 1.3,1.5 mm and bottom. The localized irradiance correlation with its corresponding DC, microhardness and CLD was explored, and localized DC correlation with microhardness was assessed. The DC was measured using micro-Raman spectroscopy, and CLD was assessed by an ethanol-softening method (%KHN reduction) using an automated microhardness tester. Molar absorptivity of diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide was 20-fold higher than camphorquinone. Non-uniform LCU beam profiles caused localized polymerization discrepancies that were significant at specific depths and points within the specimens with respect to DC, microhardness and CLD, which did not follow a specific pattern regardless of the LCU or curing distance assessed. A moderate correlation was displayed among irradiance, RE and DC. The localized irradiance from the LCUs was weakly correlated with the corresponding DC, microhardness and CLD on the top surface of a RMC at both curing distances. The localized microhardness was moderately correlated with DC. In conclusion, polymerization within the RMC investigated was non-uniform and did not reflect the LCU irradiance pattern at the area assessed. Also, a mapping approach within the specimens provided a detailed polymerization pattern assessment occurring within a RMC increment. Therefore, the LCUs explored may potentially increase the risk of RMC fracture.Item Comparison of Tensile Bond Strengths of Glass Ionomer Cements Using Hydroxyapatite Coated and Uncoated Orthodontic Brackets(1993) Ng, Richard I. Cheng Hin; Hohlt, William F.; Moore, B. Keith; Oshida, Yoshiki; Garetto, Lawrence P.; Roberts, W. Eugene; Shanks, James C.The use of glass ionomer cements (GIC) in orthodontics as a bonding agent has been receiving considerable attention due to its favorable properties, ie., physico-chemical adhesion to enamel, fluoride leaching capabilities and less traumatic bonding procedure to tooth structure. GIC ability to bond to the hydroxyapatite (HA) in the tooth enamel was tested utilizing an HA coated bracket developed by American Orthodontics. This study compared in vitro tensile bond strengths of four dental adhesives: Ketac-cem™ (KC), Vitrebond™ (VB), Transbond™ (TB) or Unite™ (UN), when used to bond to HA coated brackets and non-HA coated brackets. Bovine incisors were divided into eight groups of 20 specimens each. Each group included either an HA coated or non-HA coated bracket and one of the four adhesives. The brackets are manufactured with a Tricalcium Phosphate (TPC) coating, which is converted to an HA coating by the addition of -OH during autoclaving. The coated and non-coated brackets were bonded to the bovine teeth, which were embedded in epoxy resin blocks to fabricate the testing specimen. All of the specimens were stored in distilled water at room temperature for two weeks. This was followed by thermocycling after which the specimens were returned to water storage for an additional two weeks. The specimens were tested in tension on an lnstron Testing Machine until bond failure occurred. Mode of bond failure was determined visually by light microscope. The mean tensile bond strengths for KC and VB were each significantly less (p< 0.05) than the other three materials, while UN and TB were not significantly different. KC was the weakest at 0.68± 0.31 MPa, while UN was the strongest, 4.38±0.84 MPa. When comparing the GIG alone, there was a significant difference (p<0.0001) between the VB and the KC. The resins were not significantly different from each other. Differences between coated and non-coated were significant at p<0.05 with the noncoated brackets having the higher strength. Adhesive failure at the bracket interface for the two bracket types showed no difference for KC. TB and UN showed this type of failure significantly more with the coated brackets (p<0.05), and VB showed the opposite and more failure with non-coated brackets (p<0.01). The tensile bond strength of GIG continues to be significantly less than those of existing resins. The bond failure also revealed a high degree of within group variability. Trends relating failure mode to tensile bond strength could not be established. Greater bond strengths with the coated brackets and the GIG were not shown; however in the case of VB, the tendency for the coated brackets to fail less frequently at the bracket adhesive interface shows some promise. Further studies of these coated brackets are still warranted.Item Cuspal Deflection in Premolar Teeth Restored with Bulk-Fill Resin-Based Composite Materials(2015) Elsharkasi, Marwa M.O.; Platt, Jeffrey A.; Cook, Norman Blaine; Hara, Anderson T.; Matis, Bruce A.; Bottino, MarcoObjectives: To investigate the effect of bulk-fill resin based composite materials on cuspal deflection in large slot mesio-occlusal-distal cavities (MOD) in premolar teeth. Methodology: Thirty-two sound maxillary premolar teeth with large slot MOD cavities were distributed to four groups (n=8). Three groups were restored with bulk-fill resin composite materials (Tetric EvoCeram, x-tra fil, and Sonic Fill, respectively) in a single increment. The conventional composite group, Filtek Z100, was used to restore the cavities in 2mm increments. Cusp deflection was recorded post irradiation using a Nikon measurescope UM-2 (Nikon, Tokyo, Japan), by measuring the changes in the bucco-palatal width of the premolar teeth at 5 minutes, 24 hours, and 48 hours after completion of the restoration. The cuspal deflection was obtained by recording the difference between the baseline measurements and the other measurements for each tooth. Results: Cuspal deflection was significantly higher in Conventional Composite than in Tetric EvoCeram Bulk Fill (p=0.0031), x-tra Fil Bulk (p=0.0029), and SonicFill Bulk (p=0.0002). There was no significant difference in cuspal deflection for Tetric EvoCeram Bulk, X-tra Fil Bulk, and SonicFill Bulk Composites. Conclusions: All the investigated bulk-fill resin composites exhibited cuspal deflection lower than conventional resin composite. One of the aims of research and studies on the resin composite materials is improving their clinical longevity, and simplifying their use. For that purpose bulk-fill materials are considered promising materials and further clinical studies should be conducted.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 Effect of post-irradiation polymerization on selected mechanical properties of six direct resins(J-STAGE, 2022) Sochacki, Sabrina; Karczewski, Ashley; Platt, Jeffrey; Roberts, Howard W.; Biomedical Sciences and Comprehensive Care, School of DentistryThis study evaluated the post-irradiation mechanical property development of six resin composite-based restorative materials from the same manufacturer starting at 1 h post irradiation, followed by 24 h, 1 week, and 1 month after fabrication. Samples were stored in 0.2M phosphate buffered saline until testing. Flexural strength, flexural modulus, flexural toughness, modulus of resiliency, fracture toughness, and surface microhardness were performed at each time interval. Mean data was analyzed by Kruskal Wallis and Dunn's post hoc testing at a 95% level of confidence (α=0.05). Results were material specific but overall, all resin composite material mechanical properties were found to be immature at 1 h after polymerization as compared to that observed at 24 h. It may be prudent that clinicians advise patients, especially those receiving complex posterior composite restorations, to guard against overly stressing these restorations during the first 24 h.Item Evaluation of Second Generation Indirect Composite Resins(2008) Jain, Vishal V.; Platt, Jeffrey A., 1958-; Moore, B. Keith; Xie, Dong; Taskonak, BurakIndirect composites were introduced so that the composites can be cured extraorally to improve the degree of conversion and other material properties. These materials are indicated as long term full coverage dental restorative materials. However the mechanical and physical properties of new Second Generation Indirect Composites for this particular application have not been fully evaluated. The purpose of the study was to compare the appropriateness of the four commercially available laboratory composite resins for application as long term full coverage restorative materials. Water solubility and sorption levels, staining resistance, gloss, surface roughness, wear due to tooth brush abrasion, two-body and three-body wear, fracture toughness and radiopacity of four indirect composite restorative materials; Radica (Dentsply), Sculpture Plus (Pentron), Belleglass-NG (Kerr) and Gradia Indirect (GC America) were determined. The results showed that the four composites differed significantly from each other. Bell eglass-NG and Gradia Indirect showed negative water solubility. All the four groups demonstrated less color stability when exposed to coffee slurry for 3 weeks. Significant decrease in gloss and volume occurred when the omposites were exposed to simulated tooth-brush abrasion. Sculpture Plus v demonstrated lowest abrasion and attrition wear resistance among the four indirect composites. Radica had the highest fracture toughness and radiopacity of all the composites with values close to or less then dentin. In conclusion, different indirect composite systems possessed different mechanical and physical advantages when compared to each other. In general, Belleglass-NG demonstrated superior advantages due to its higher abrasion and attrition wear resistance and stain resistance. This was followed by Radica,Gradia Indirect and Sculpture Plus.Item An Evaluation of the Bond Strength and Failure Site of Composite Resin and Glass Ionomer in Identical Orthodontic Direct Bonding Systems(1989) Fryar, Brian C.; Garner, LaForrest D.; Moore, B. Keith; Newton, Carl W.; Shanks, James C.; Koerber, Leonard G.Glass ionomers offer several advantages for orthodontic cementation of brackets including no etching of enamel, fluoride release, and ease of debonding. This study compared in vitro bond strengths of glass ionomers with a composite resin. Two luting glass ionomers, (Ketaccem and Fuji I), two restorative ionomers, (Ketac-fil and Fuji II), and an orthobonding resin, (System 1 +), were used. Extracted human maxillary premolars were selected for a sample of 22 per cement. The teeth were pumiced prior to bonding. Ormco minimesh bicuspid brackets were bonded following manufacturer's directions. Only the teeth bonded with resin cement were etched. After bonding the teeth were stored in water at 37 C for 7 days and thermocycled 2500 times through a 40° c differential. Tensile bond strengths were measured at a crosshead speed of 0.5mm/min. Debonded specimens were examined to record failure modes. System 1+ had a bond strength of 103 +/- 21 kg/cm2 with 80% cohesive failure in the cement. Ketac-fil, Ketaccem and Fuji II were not significantly different and had strengths of 32.6 +/- 6.4, 31.9 +/- 7.1 and 33.7 +/- 8.5 respectively. Failure was 93% cohesive in the cements. Fuji I had a strength of 26. 6 +/- 4. 7 with 89% cohesive failure and was significantly weaker than the others. Although the strengths of the glass ionomers studied were substantially lower than the resin, they failed consistently in cohesive fracture through the cement with relatively small deviations. Since the minimum bond strength required for clinical success is not known, only a controlled clinical study can determine the ultimate effectiveness of glass ionomers as orthodontic bonding adhesives.Item In vitro evaluation of polymerization energy for bulk fill composites(2016-05) AlRasheed, Rawan S.; Platt, Jeffery A.; Wallace, Joseph; Matis, Bruce A.; Cook, Norman Blaine; Chu, Tien-Min GabrielRecently, the concept of “bulk-fill” resin-based composites (RBCs) has been re-emphasized, with claimed improvements in depth of cure (DOC) with similar mechanical properties and comparable adaptation to walls and margins relative to conventional composite. More research is needed to carefully examine the properties of these new materials. The objective of this study was to measure the light energy, microhardness (VHN), and elastic modulus across the depth of one conventional and three bulk-fill RBCs. Materials and Methods: Three commercially available bulk-fill RBCs (Tetric EvoCeram Bulk Fill [TE], SonicFill [SF], X-tra fill[XF]) and one conventional RBC (Premise [PR]) were evaluated (n = 10). DOC (using Vickers’s microhardness), elastic modulus (using atomic force microscopy), and the mean irradiance and total light energy transmitted through different thicknesses of RBC were measured by a spectrometer. The effects of group, location, and curing depth on VHN were analyzed using mixed-model ANOVA. Elastic modulus and light energy comparisons were made using two-way ANOVA, with a significance level of 5 percent. Results: There was a significant difference in the depths for the mean irradiance and total energy between different depths in all materials. All materials achieved the manufacturers’ claimed DOC. XF had the highest DOC with 7 mm and a light energy of 0.56± 0.02 J/cm2 at 7 mm. PR had the lowest DOC with 3 mm and a light energy of 0.84 ±0.12 J/cm2 at 3 mm. The elastic modulus showed significant variation in depth profiles that were different than the DOC. Significance: The manufacturers’ claims for bulk-fill DOC were achieved using a microhardness method. However, this method failed to detect the quality of the polymerization. Assessment of the elastic modulus using AFM is a promising method for greater understanding of the polymerization.Item 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.Item Longevity of Crown Margin Repairs Using Glass Ionomer: A Retrospective Study(2020) Watson, Justin I.; Cook, N. Blaine; Thyvalikakath, Thankam; Diefenderfer, Kim E.; Capin, OrianaObjectives: Repair of crown margins may extend the functional life of existing crowns. However, the longevity of such treatment is unknown. This study determined the survival time of crown margin repairs (CMR) with glass-ionomer (GI) and resin-modified glass-ionomer cements. Methods: We queried axiUm (Exan Group, Coquitlam, BC, Canada) database for permanent teeth that underwent CMR in the Graduate Operative Dentistry Clinic, Indiana University School of Dentistry (IUSD), Indianapolis, Ind., USA, from January 1, 2006 through January 1, 2018. Since there is no CDT code for the CMR procedure, CDT codes for resin-composite and GI restorations (D23XX) were queried; these patients also had treatment notes that indicated CMR. The final data set included patient ID, birth date, gender, dates of treatments, CDT codes, tooth type, tooth surface and existing findings. Two examiners developed guidelines for record review and manually reviewed the clinical notes of patient records to confirm CMR. Only records that were confirmed with the presence of CMR were retained in the final dataset for survival analysis. Survival time was calculated by Kaplan-Meier statistics and a Cox Proportional Hazards model was performed to assess the influence of selected variables (p < 0.05). Results: 214 teeth (115 patients) with CMR were evaluated. Patient average age was 69.4 11.7 years old. Posterior teeth accounted for 78.5 percent (n = 168) of teeth treated. CMRs using GI had a projected 5-year survival rate of 62.9 percent (K-M Analysis) and an 8.9 percent annual failure rate. Cox Proportional Hazards Regression analysis revealed that none of the factors examined (age, gender, tooth type) affected time to failure. Conclusion: CMRs may extend the longevity of crowns with defective margins. Larger EHR studies or case control studies are needed to investigate other variables, such as the caries risk status or the severity of defects that may affect the survival rate of CMRs.