For an Organisation for Caries Research/European Federation of Conservative Dentistry consensus, this systematic review is aimed to assess the question of how to manage the caries process in the case of early childhood caries (ECC). Medline via PubMed was searched systematically regarding management of ECC. First priority was existing systematic reviews or randomized clinical trials otherwise cohort studies dealing with management of ECC, primarily with carious anterior teeth. After data extraction, the potential risk of bias was estimated depending on the study types, and the level of evidence was evaluated. Regarding management of ECC, results are presented for silver diamine fluoride (SDF, n = 5), nonoperative caries management (NOCM, n = 10), and restorative approaches (RA, n = 8) separately, as different kinds of studies with different levels of evidence were found for the different aspects in the management of ECC. The 5 systematic reviews on SDF showed a high potential for arrest of ECC on a high level of evidence. In NOCM, a low level of evidence for a moderate effect of fluoride varnish in arresting or remineralizing, especially non-cavitated lesions, was assessed. For RA in carious anterior upper primary teeth, a low level of evidence was found for higher failure rates of glass ionomer cement and composite fillings than composite strip crowns even if placed under general anaesthesia and especially compared to other crowns (stainless steel and zirconia). In conclusions, ECC may be managed successfully with nonoperative (SDF, regular fluoride application) and moderately well with operative approaches, but the decision is affected by many other variables such as pulpal involvement, the child's cooperation, or a general anaesthesia setting.
Background: The aim of this study was to assess the influence of externally applied 'command set' methods on the microleakage of several glass ionomer cements (GICs). Methods: Four different restorative GICs were cured using three different methods: standard curing (SC), ultrasonic excitation (UC) and by an external heat source (HC). Different conditioning agents (10% polyacrylic and 10% citric acid) were used. The sample comprised 180 teeth with 360 Class V restorations placed on the lingual and vestibular tooth surface. After thermocycling, the teeth were immersed in a dye solution for 24 hours, embedded in acrylic resin, sectioned and evaluated. Oberholtzer criteria were used for margin evaluation. Data were analysed using three-way ANOVA. Results: The heat cured GIC showed statistically significant better marginal adaptation compared to the other tested groups (SC, UC) (p < 0.001). GICs in groups with HC and conditioned cavities had lower microleakage scores. The highly viscous material Fuji IX GP Fast in the HC and conditioned cavities group demonstrated the best marginal adaptation. The other three products reacted similarly to heating treatment. Leakage at the enamel margins was significantly lower than the cementum ⁄ dentine margins (p < 0.001). Conclusions: Heating the GIC during setting decreased microleakage, improved marginal adaptation of the GIC restoration and is suitable for clinical practice.
Under clinical conditions, conventional glass-ionomer dental cements can be cured by application of heat from dental cure lamps, which causes acceleration in the setting. In order for this to be successful, such heat must be able to spread sufficiently through the cement to enhance cure, but not transmit heat so effectively that the underlying dental pulp of the tooth is damaged. The current study was aimed at measuring heat transfer properties of modern restorative glass-ionomers to determine the extent to which they meet these twin requirements. Three commercial glass ionomer cements (Ionofil Molar, Ketac Molar and Equia™ Fill) were used in association with three different light emitting diode cure lamps designed for clinical use. In addition, for each cement, one set of specimens was allowed to cure without application of a lamp. Temperature changes were measured at three different depths (2, 3 and 4 mm) after cure times of 20, 40 and 60 s. The difference among the tested groups was evaluated by ANOVA (P < 0.05) and post hoc Newman-Keuls test. All brands of glass-ionomer showed a small inherent setting exotherm in the absence of heat irradiation, but much greater temperature increases when exposed to the cure lamp. However, temperature rises did not exceed 12.9 °C. Application of the cure lamp led to the establishment of a temperature gradient throughout each specimen. Differences were typically significant (P < 0.05) and did not reflect the nominal power of the lamps, because those lamps have variable cooling systems, and are designed to optimize light output, not heating effect. Because the thermal conductivity of glass-ionomers is low, temperature rises at 4 mm depths were much lower than at 2 mm. At no time did the temperature rise sufficiently to cause concern about potential damage to the pulp.
Considering the results of our research it is essential to emphasize the need for better health education of parents.
Glass Ionomer Cements (GIC) have been widely used in clinical practice since they have a wide range of positive characteristics: chemical bonding to the tooth surface, fluoride release, a heat-expansion coefficient similar to the tooth, do not require an absolutely dry working area, less volumetric contraction, good color stability. Physical properties can be improved by using external energy such as ultrasound and radiant heat (thermo-curing), which also accelerates chemical curing. Objectives: The aim of this study was to determine the most effective polishing technique and to compare the surface roughness of two Glass Ionomer Cements after treatment with heat (thermo-curing), and without heat treatment during the setting process. Materials and methods: Two polishing systems (Tungsten carbide burs and Sof-Lex discs) were used on two types of GIC (Equia Fil and Ketac Molar Universal). Bluephase 16i LED (Vivadent, Schaan Liechtenstein) light was used for the specimens treated with heat (thermo-curing). Samples without heat treatment are left for 10 minutes to chemically cure. Surface profilometar was used for measuring the mean surface roughness value (Ra). Results: Group with Mylar strip (control group) of each material showed the lowest (Ra) value. The Equia Fil material samples treated with heat (thermo-curing) achieved lower surface roughness values (Ra), and showed lower surface roughness values (Ra) after polishing with a Sof-Lex discs (p<0.05). The results for Ketac Molar Universal samples showed no statistically significant difference (p>0.05) between polishing with Sof-Lex discs and Tungsten carbide burs. Conclusion: Based on the obtained results, it can be concluded that the smoothest surface roughness is achieved by the Mylar strip. Some types of Glass Ionomer Cements can obtain better surface polishing with heat treatment (thermo-curing).
Cilj ovog in vitro istraživanja bio je utvrditi učinak fluoridnih gelova i lakova u odnosu na CPP-ACP kompleks na sprječavanje demineralizacije cakline. Materijali i Metode: Caklinski blokovi su ispolirani, podijeljeni u osam grupa i izloženi dnevnom cikličkom režimu. Tri skupine su tretirane 10 minuta s fluoridnim gelovima: Fluorogal, Fluor Protector Gel and Cervitec Gel, jedna je tretirana samo s GC Tooth Mousse i jedna je tretirana s GC Tooth Mousse (Recaldent CPP-ACP 10.0%).. Preostale tri grupe su tretirane fluoridnim lakovima: Fluoridin Gel N5, Bifluorid 12 i Fluor Protector. Oni su premazivani jedanput na tjedan prije demineralizacijskog razdoblja. Svi uzorci su čuvani u umjetnoj slini između i nakon ciklusa. Površinska mikrotvrdoća (SMH) uzoraka je mjerena na početku i nakon 12 dana koristeći HMV-2000 (Shimadzu, Japan). Postotak promjene SMH (% SMH) je izračunat nakon cikličkog režima. Podaci su analizirani t-testom za individualne usporedbe (p<0,05). Rezultati: Statistička analiza t-testom pokazala je značajnu razliku između SMH prije i nakon tretmana fluoridima u svim skupinama. Sve skupine tretirane fluoridnim gelovima, lakovima i GC Tooth Mousseom pokazale su povećanje SMH. Nije bilo statistički značajne razlike između postotaka promjene SMH cakline između skupina. Nije bilo statistički značajne razlike između fluoridnih gelova, lakova i GC Tooth Moussea. Zaključak: Rezultati dobiveni u ovom istraživanju pokazali su da fluoridni lakovi, gelovi i Tooth Mousse učinkovito sprječavaju demineralizaciju u eksperimentalnim uvjetima. Ključne riječi fluoridacija, površinska; zubna caklina; tvrdoća; zub, demineralizacija
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